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Clinical Characteristics of Arthrogryposis, Renal Tubular Dysfunction, Cholestasis(ARC) Syndrome in Korea (ARC(Arthrogryposis, Renal Tubular Dysfunction, Cholestasis) 증후군의 발병양상에 관한 연구)

  • Lee Soon Min;Kim Ji Hong;Lee Jae Seung;Han Suk Joo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.222-230
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    • 2005
  • Purpose : ARC syndrome refers to an association of arthrogryposis, renal tubular dysfunction, and cholestasis. The VPS33B gene was recently identified as the causative gene. So far, 41 cases of ARC syndrome have been reported worldwide, and it has rarely been reported in Korea. This study was conducted to report the clinical findings of seven ARC syndrome cases in Korean children, focusing especially on renal tubular dysfunction. Methods : The hospital records of 7 cases diagnosed as ARC syndrome at Severance Hospital between Mar. 1995 and Aug. 2005 were reviewed and analyzed. Results : Of the 7 cases, 4 were boys and 3 were girls. Six patients(85$\%$) were born with normal birth weight at term, and one was born at preterm. All cases presented with cholestasis and severe jaundice. According to the type of arthrogryposis described by Brown et al, type 3 and 4 were found in 2 patients and type,6, 7, and the undistributed type in one patient respectively. Other associated clinical findings were as follows : failure to thrive in 6(85$\%$), lax skin in 5(71$\%$), and gray platelet syndrome in 4(57$\%$). Urine analysis revealed 6 cases(85$\%$) with proteinuria, 3(43$\%$) with hematuria, 5(71$\%$) with glycosuria, 2(29$\%$) with phosphaturia and 2(29$\%$) with calciuria. Serum electrolytes showed 4 cases(57$\%$) with hyponatremia, 3(43$\%$) with hypokalemia, and 1(14$\%$) with creatinine elevation. Renal tubular dysfunctions were diagnosed as renal tubular acidosis in 6 cases(85$\%$), nephrogenic diabetes insipidus in 2(29$\%$), and Fanconi syndrome in 2(29$\%$). During the follow-up period, 2(29$\%$) had no treatment, 5(85$\%$) had continuous supplementation to correct the electrolyte imbalance and acidosis, and 1(14$\%$) had dialysis. Only one patient had a family history of ARE syndrome in a sibling. Four cases(57$\%$) were diagnosed at the mean age of 8.2 months, and one case was lost during follow-up. Ages of the survived 2 cases were 13 and 25 months, respectively. Conclusion : The rare disease of ARC syndrome Is associated with severe renal dysfunction. However, this study revealed that the renal manifestation of ARC syndrome in Korean children is relatively mild and survival rate is higher than that of previous studies. Contrary to previous reports, this study showed that familial cases are rare and sporadic occurence is possible in Korea. Thus, the diagnosis of this syndrome requires a careful evaluation of the venal function in cases of congenital arthrogryposis, and a mandatory genetic counseling of affected family for prevention of familial occurance. (J Korean Soc Pediatr Nephrol 2005;9:222-230)

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Comparison of the Operative Results of Performing Endoscopic Robot Assisted Minimally Invasive Surgery Versus Conventional Cardiac Surgery (수술용 내시경 로봇(AESOP)을 이용한 최소 침습적 개심술과 동 기간에 시행된 전통적인 개심술의 결과에 대한 비교)

  • Lee, Young-Ook;Cho, Joon-Yong;Lee, Jong-Tae;Kim, Gun-Jik
    • Journal of Chest Surgery
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    • v.41 no.5
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    • pp.598-604
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    • 2008
  • Background: The improvements in endoscopic equipment and surgical robots has encouraged the performance of minimally invasive cardiac operations. Yet only a few Korean studies have compared this procedure with the sternotomy approach. Material and Method: Between December 2005 and July 2007, 48 patients (group A) underwent minimally invasive cardiac surgery with AESOP through a small right thoracotomy. During the same period, 50 patients (group B) underwent conventional surgery. We compared the operative time, the operative results, the post-operative pain and the recovery of both groups. Result: There was no hospital mortality and there were no significant differences in the incidence of operative complications between the two groups. The operative $(292.7{\pm}61.7\;and\;264.0{\pm}47.9min$, respectively; p=0.01) and CPB times ($128.4{\pm}37.6\;and\;101.7{\pm}32.5min$, respectively; <0.01) were longer for group A, whereas there was no difference between the aortic cross clamp times ($82.1{\pm}35.0\;and\;87.8{\pm}113.5min$, respectively; p=0.74) and ventilator times ($18.0{\pm}18.4\;and\;19.7{\pm}9.7$ hr, respectively; p=0.57) between the groups. The stay on the ICU $(53.2{\pm}40.2\;and\;72.8{\pm}42.1hr$, respectively; p=0.02) and the hospitalization time ($9.7{\pm}7.2\;and\;14.8{\pm}11.9days$, respectively; p=0.01) were shorter for group A. The Patients in group B had more transfusions, but the difference was not significant. For the overall operative intervals, which ranged from one to four weeks, the pair score was significantly lower for the patients of group A than for the patients of group B. In terms of the postoperative activities, which were measured by the Duke Activity Scale questionnaire, the functional status score was clearly higher for group A compared to group B. The analysis showed no difference in the severity of either post-repair of mitral ($0.7{\pm}1.0\;and\;0.9{\pm}0.9$, respectively; p=0.60) and tricuspid regurgitation ($1.0{\pm}0.9\;and\;1.1{\pm}1.0$, respectively; p=0.89). In both groups, there were no valve related complications, except for one patient with paravalvular leakage in each group. Conclusion: These results show that compared with the median sternotomy patients, the patients who underwent minimally invasive surgery enjoyed significant postoperative advantages such as less pain, a more rapid return to full activity, improved cosmetics and a reduced hospital stay. The minimally invasive surgery can be done with similar clinical safety compared to the conventional surgery that's done through a median sternotomy.

Hepatitis Complicated with Mycoplasma pneumoniae Infection in Children (소아의 Mycoplasma pneumoniae 폐렴에 합병된 간염)

  • Lee, Seung Min;Lee, Sung Moon;Tchah, Hann;Jeon, In Sang;Ryoo, Eell;Cho, Kang Ho;Seon, Yong Han;Son, Dong Woo;Hong, Hee Joo
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.832-838
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    • 2005
  • Purpose : Mycoplasma pneumoniae infection is relatively common in childhood. Its extrapulmonary manifestations have been reported so much, but hepatitis associated with it has been reported rarely in Korea. Methods : A clinical study was performed on 556 patients of M. pneumoniae pneumonia diagnosed serologically at Gil hospital from January 2001 to December 2004. We reviewed 65 cases among these patients, who had elevated level of serum AST and ALT greater than 50 IU/L respectively without evidence of hepatitis A, B, C, Cytomegalovirus and Ebstein-Barr virus infections. Results : Hepatitis occurred in 11.7% of Mycoplasma pneumoniae pneumonia, especially in fall and winter times. Male to female ratio was 1.2 : 1 and the mean age was 4 years and 3 months. Besides hepatitis, cough(95.4%), sputum(52.3%) and dyspnea(12.3%) were common as pulmonary manifestations. And among gastrointestinal manifestations, nausea/vomiting(26.2%) was the most common symptom, followed by poor oral intake(12.3%), diarrhea(12.3%) and abdominal pain(6.2%). In addition to hepatomegaly(4.6%) and splenomegaly(4.6%), coarse breathing sound was the most common physical manifestation, followed by rale(63.1%), pharyngeal injection(26.2%), and rash(10.8%). Anemia was noted in 20.0%, neutrophilia in 10.8%, eosinphilia in 38.5% and thrombocytosis in 6.2%, respectively. Mean level of ESR and CRP was 32.02 mm/hr and 6.69 mg/dL, respectively. Mean level of AST and ALT was 293.80 IU/L and 181.48 IU/L, respectively. Hyperbilirubinemia was noted in 7.7% and hypoalbuminemia was noted in 58.5%. Lobar or lobular pneumonia(78.5%) was the most common finding in chest X-ray and left lower lobe(39.2%) was most commonly affected. Pleural effusion was noted in 26.2%. Mean duration of hospitalization was 9.91 days. Serum AST/ALT level was normalized within 9.94 days and pulmonary consolidation resolved within 14.29 days. Conclusion : The prognosis of M. pneumoniae hepatitis is good. However, liver function should be considerately checked in M. pneumoniae infection because its incidence is not so low.

Developmental Plans and Research on Private Security in Korea (한국 민간경비 실태 및 발전방안)

  • Kim, Tea-Hwan;Park, Ok-Cheol
    • Korean Security Journal
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    • no.9
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    • pp.69-98
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    • 2005
  • The security industry for civilians (Private Security), was first introduced to Korea via the US army's security system in the early 1960's. Shortly after then, official police laws were enforced in 1973, and private security finally started to develop with the passing of the 'service security industry' law in 1976. Korea's Private Security industry grew rapidly in the 1980's with the support of foreign funds and products, and now there are thought to be approximately 2000 private security enterprises currently running in Korea. However, nowadays the majority of these enterprises are experiencing difficulties such as lack of funds, insufficient management, and lack of control over employees, as a result, it seems difficult for some enterprises to avoid the low production output and bankruptcy. As a result of this these enterprises often settle these matters illegally, such as excessive dumping or avoiding problems by hiring inappropriate employees who don't have the right skills or qualifications for the jobs. The main problem with the establishment of this kind of security service is that it is so easy to make inroads into this private service market. All these hindering factors inhibit the market growth and impede qualitative development. Based on these main reasons, I researched this area, and will analyze and criticize the present condition of Korea's private security. I will present a possible development plan for the private security of Korea by referring to cases from the US and Japan. My method of researching was to investigate any related documentary records and articles and to interview people for necessary evidence. The theoretical study, involves investigation books and dissertations which are published from inside and outside of the country, and studying the complete collection of laws and regulations, internet data, various study reports, and the documentary records and the statistical data of many institutions such as the National Police Office, judicial training institute, and the enterprises of private security. Also, in addition, the contents of professionals who are in charge of practical affairs on the spot in order to overcomes the critical points of documentary records when investigating dissertation. I tried to get a firm grasp of the problems and difficulties which people in these work enterprises experience, this I thought would be most effective by interviewing the workers, for example: how they feel in the work places and what are the elements which inpede development? And I also interviewed policemen who are in charge of supervising the private escort enterprises, in an effort to figure out the problems and differences in opinion between domestic private security service and the police. From this investigation and research I will try to pin point the major problems of the private security and present a developmental plan. Firstly-Companies should unify the private police law and private security service law. Secondly-It is essential to introduce the 'specialty certificate' system for the quality improvement of private security service. Thirdly-must open up a new private security market by improving old system. Fourth-must build up the competitive power of the security service enterprises which is based on an efficient management. Fifth-needs special marketing strategy to hold customers Sixth-needs positive research based on theoretical studies. Seventh-needs the consistent and even training according to effective market demand. Eighth-Must maintain interrelationship with the police department. Ninth-must reinforce the system of Korean private security service association. Tenth-must establish private security laboratory. Based on these suggestions there should be improvement of private security service.

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Mid-Term Results of 292 cases of Coronary Artery Bypass Grafting (관상동맥 우회술 292례의 중기 성적)

  • 김태윤;김응중;이원용;지현근;신윤철;김건일
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.643-652
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    • 2002
  • As the prevalence of coronay artery disease is increasing, the surgical treatment has been universalized and operative outcome has been improved. We analyzed the short and mid-term results of 292 CABGs performed in Kangdong Sacred Heart Hospital. Material and Method: From June 1994 to December 2001, 292 patients underwent coronary artery bypass grafting. There were 173 men and 119 women and their ages ranged from 39 to 84 years with a mean of $61.8{\pm}9.1$ years. We analyzed the preoperative risk factors, operative procedures and operative outcome. In addition, we analyzed the recurrence of symptoms, long-term mortality and complications via out-patient follow-up for discharged patients. Result: Preoperative clinical diagnoses were unstable angina in 137(46.9%), stable angina in 34(11.6%), acute myocardial infarction in 40(13.7%), non-Q myocardial infarction in 25(8.6%), postinfarction angina in 22(7.5%), cardiogenic shock in 30(10.3%) and PTCA failure in 4(1.4%) patients. Preoperative angiographic diagnoses were three-vessel disease in 157(53.8%), two-vessel disease in 35 (12.0%), one-vessel disease in 11(3.8%) and left main disease in 89(30.5%) patients. We used saphenous veins in 630, internal thoracic arteries in 257, radial arteries in 50, and right gastoepiploic arteries in 2 distal anastomoses. The mean number of distal anastomoses per patient was $3.2{\pm}1.0$ There were 18 concomitant procedures ; valve replacement in 8(2.7%), left main coronary artery angioplasty in 6(2.1%), patch closure of postinfarction ventricular septal defect(PMI-VSD) in 2(0.7%), replacement of ascending aorta in 1(0.3%) and coronary endarterectomy in 1(0.3%) patient. The mean ACC time was $96.6{\pm}35.3 $ minutes and the mean CPB time was $179.2{\pm}94.6$ minutes. Total early mortality was 8.6%, but it was 3.1% in elective operations. The most common cause of early mortality was low cardiac output syndrome in 6(2.1%) patients. The stastistically significant risk factors for early mortality were hypertension, old age($\geq$ 70 years), poor LV function(EF<40%), congestive heart failure, preoperative intraaortic balloon pump, emergency operation and chronic renal failure. The most common complication was arrhythmia in 52(17.8%) patients. The mean follow-up period was $39.0{\pm}27.0$ months. Most patients were free of symptoms during follow-up. Fourteen patients(5.8 %) had recurrent symptoms and 7 patients(2.9%) died during follow-up period. Follow-up coronary angiography was performed in 13 patients with recurrent symptoms and they were managed by surgical and medical treatment according to the coronary angiographic result. Conclusion: The operative and late results of CABG in our hospital, was acceptable. However, There should be more refinement in operative technique and postoperative management to improve the results.

Bioacoustics and Habitat Environment Analysis of Cicadas in Taebaeksan National Park (태백산국립공원에 서식하는 매미류의 생물음향 및 서식환경 분석)

  • Kim, Yoon-Jae;Jung, Tae-Jun;Ki, Kyong-Seok
    • Korean Journal of Environment and Ecology
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    • v.33 no.6
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    • pp.664-676
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    • 2019
  • This study aimed to analyze the bioacoustics and habitat environment of the cicadas inhabiting Taebaeksan National Park, an sub-alpine region in Korea. The mating calls of the cicadas were recorded for approximately 3 months, between July and September of 2018. The recording devices were installed in Daedeoksan valley and Baekcheon valley, inside Taebaeksan National Park, and the sounds were recorded 24 hours a day. In order to obtain the habitat distribution data of the cicadas, the sounds were recorded from 111 spots located in the Taebaeksan National Park trail in August 2018. The daily weather data was obtained from the Taebaek city weather center. The results of the study demonstrated that 5 species of cicadas inhabit Taebaeksan National Park, namely, Leptosemia takanonis, Lyristes intermedius, Kosemia yezoensis, Hyalessa fuscata, and Meimuna opalifera. The time of appearance for L. takanonis was early July to mid-July, and that for L. intermedius, K. yezoensis, H. fuscata, and M. opalifera was mid-July to early September. Analysis of the circadian rhythm revealed that L. intermedius, K. yezoensis, and H. fuscata started producing mating calls between 6:00 and 7:00, which ended at around 19:00 for all the three species. The peak time for producing mating calls was 11:00 for L. intermedius, 12:00 for H. fuscata, and around 13:00 to 14:00 for K. yezoensis. The environmental factors influencing the mating calls of the cicadas inhabiting Taebaeksan National Park were analyzed by logistic regression. The results showed that the probability of producing mating calls increased by 1.192 and 1.279 times in L. intermedius and K. yezoensis, respectively, when the average temperature increased by one degree. When the duration of sunlight increased by one hour, the probability of producing mating calls increased by 4.366 and 2.624 times in L. intermedius and H. fuscata, respectively. Analysis of the interspecific effects revealed that when H. fuscata produced a single mating call, the probability of producing mating calls increased by 14.620 and 2.784 times in L. intermedius and K. yezoensis, respectively. When K. yezoensis and L. intermedius produced mating calls, the probability of producing mating calls in H. fuscata increased by 11.301 and 2.474 times, respectively. L. intermedius and K. yezoensis did not have any effects on each other with respect to the production of mating calls. Analysis of the habitat environment of each species revealed that their habitats were located at altitudes of 1,046 m (780~1,315 m) for L. intermedius, 1,072 m (762~1,361 m) for K. yezoensis, and 976 m (686~1,245 m) for H. fuscata. Unlike H. fuscata, which was found at a low altitude, K. yezoensis and L. intermedius were not found at altitudes lower than 700 m. Analysis of the average aspect of the habitats of each of the cicada species revealed that L. intermedius was found at 166° (125~207°), K. yezoensis was found at 100° (72~128°), and H. fuscata was found at 173° (118~228°). Examination of the distribution of each of the cicada species revealed that they were predominantly distributed in the ridges and slopes located in the southeastern region of Munsubong in Taebaeksan. In summary, L. intermedius and K. yezoensis was found to inhabit higher altitudes in Taebacksan National Park than H. fuscata, which was found throughout the Korean peninsula. Additionally, the main aspect of the cicada habitat was found to be the southeastern region (100~173°), which has good access to daylight.

Changes of Physical Characteristics of Cooked Rice by Pressure Cooking (가압취반시(加壓炊飯時) 미반(米飯)의 물성변화(物性變化)에 관(關)한 연구(硏究))

  • Kim, Dong Woo;Chang, Kyu Seob
    • Korean Journal of Agricultural Science
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    • v.8 no.1
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    • pp.97-107
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    • 1981
  • This study was carried out in order to provide the basic data necessary to develop the effective and desirable cooking method on large scale for investigating the physical characteristics of cooked rices and studying optimum cooking conditions by pressure in kettle cooking rices. Milyang-15, local Japonica type and Milyang-23, high yielding Indica type major varieties cultivated in Korea were used as cooking sample after polishing 70% and 90% respectively, and the results obtained are summarized as follows. 1. The average moisture content of cooked rice by open kettle and pressure kettle method in typical households were 65.17% and 64.52%, respectively. 2. In water absorption capacity of rice grain Milyang-23 was 4.5% higher than Milyang-15, and maximum water content after absorption in Milyang-23 was 29.14%. 3. The expansion volume of cooked rice was changed proportionally by water absorption, heating temperature and time, and maximum expansion volume of cooked rice was 3.2 times greater than rice grain. 4. The gelatinization degree of cooked rice intensively concerning in hardness of rice grain was increased as water-to-rice ratio, heating temperature and time increased, and it was 0.44 in Milyang-23 and 0.64 in Milyang-15 under the optimum cooking conditions as 160% water-to-rice ratio, $0.2kg/cm^2$ cooking pressure and 25 minutes cooking time. 5. The hardness of cooked rice was decreased as water-to-rice ratio, heating temperature and time increased, and it showed 2.35kg/wt in 90% polished Milyang-23 and 2.0kg/wt in 90 polished Milyang-15 under optimum cooking conditions. For maintaining the same level of hardness of cooking rice Milyang-23 required 25% much more water than Milyang-15. 6. The elasticity of cooked rice was changed proportionally by water-to-rice ratio, heating temperature and time, and it appeared 19.2mm and 15.7mm in 90% polished Milyang-15 and Milyang-23 respectively. 7. The gumminess of cooked rice was decreased as water-to-rice ratio, heating temperature and time increased, and it showed 60 and 73 in 90% polished Milyang-23 and Milyang-15, respectively. 8. The optimum cooking time on differerent pressure in kettle took 25 minutes at $0.2kg/cm^2$, 20 minutes at $0.4kg/cm^2$, 15 minutes at $0.6kg/cm^2$, and 10 minutes at $0.8kg/cm^2$.

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Customer Behavior Prediction of Binary Classification Model Using Unstructured Information and Convolution Neural Network: The Case of Online Storefront (비정형 정보와 CNN 기법을 활용한 이진 분류 모델의 고객 행태 예측: 전자상거래 사례를 중심으로)

  • Kim, Seungsoo;Kim, Jongwoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.221-241
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    • 2018
  • Deep learning is getting attention recently. The deep learning technique which had been applied in competitions of the International Conference on Image Recognition Technology(ILSVR) and AlphaGo is Convolution Neural Network(CNN). CNN is characterized in that the input image is divided into small sections to recognize the partial features and combine them to recognize as a whole. Deep learning technologies are expected to bring a lot of changes in our lives, but until now, its applications have been limited to image recognition and natural language processing. The use of deep learning techniques for business problems is still an early research stage. If their performance is proved, they can be applied to traditional business problems such as future marketing response prediction, fraud transaction detection, bankruptcy prediction, and so on. So, it is a very meaningful experiment to diagnose the possibility of solving business problems using deep learning technologies based on the case of online shopping companies which have big data, are relatively easy to identify customer behavior and has high utilization values. Especially, in online shopping companies, the competition environment is rapidly changing and becoming more intense. Therefore, analysis of customer behavior for maximizing profit is becoming more and more important for online shopping companies. In this study, we propose 'CNN model of Heterogeneous Information Integration' using CNN as a way to improve the predictive power of customer behavior in online shopping enterprises. In order to propose a model that optimizes the performance, which is a model that learns from the convolution neural network of the multi-layer perceptron structure by combining structured and unstructured information, this model uses 'heterogeneous information integration', 'unstructured information vector conversion', 'multi-layer perceptron design', and evaluate the performance of each architecture, and confirm the proposed model based on the results. In addition, the target variables for predicting customer behavior are defined as six binary classification problems: re-purchaser, churn, frequent shopper, frequent refund shopper, high amount shopper, high discount shopper. In order to verify the usefulness of the proposed model, we conducted experiments using actual data of domestic specific online shopping company. This experiment uses actual transactions, customers, and VOC data of specific online shopping company in Korea. Data extraction criteria are defined for 47,947 customers who registered at least one VOC in January 2011 (1 month). The customer profiles of these customers, as well as a total of 19 months of trading data from September 2010 to March 2012, and VOCs posted for a month are used. The experiment of this study is divided into two stages. In the first step, we evaluate three architectures that affect the performance of the proposed model and select optimal parameters. We evaluate the performance with the proposed model. Experimental results show that the proposed model, which combines both structured and unstructured information, is superior compared to NBC(Naïve Bayes classification), SVM(Support vector machine), and ANN(Artificial neural network). Therefore, it is significant that the use of unstructured information contributes to predict customer behavior, and that CNN can be applied to solve business problems as well as image recognition and natural language processing problems. It can be confirmed through experiments that CNN is more effective in understanding and interpreting the meaning of context in text VOC data. And it is significant that the empirical research based on the actual data of the e-commerce company can extract very meaningful information from the VOC data written in the text format directly by the customer in the prediction of the customer behavior. Finally, through various experiments, it is possible to say that the proposed model provides useful information for the future research related to the parameter selection and its performance.

Comparison of Health Status and Activities for the Pain and No-pain Groups in the Elderly (노인의 만성동통 유무에 따른 건강상태 및 일상활동장애 비교)

  • Kim, Hyo-Jung;Kim, Myung-Ae;Park, Kyung-Min
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.79-89
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    • 1999
  • The purpose of this study is to compare health status and activities for the pain and no-pain groups in the elderly. The study subjects included 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes through interview using a closed-ended questionnaire from Nov. 6th. to Nov. 16th. 1997. The instrument used in the study was selected after carefully reviewing pain-related articles and records well described the characteristics of the elderly. The data were analysed by using descriptive statistics and chi-square tests. The findings were as follows : Of the 189 subjects, 83.6% reported experiencing the pain for the last year. By the age, there were significant differences between the pain and no-pain group(${\chi}^2$=9.572, p=.023). The percentage of the pain complainers was the highest in 80 years and older(100.0%), followed by 70~74(89.1%), 75~79(81.3%), 65~69(76.8%) which presented crude increase according to age. By sex, men had lower pain prevalence(69.5%) than that of women(90.0%). The number of pain complainers was higher in women than men(${\chi}^2$=12.448, p=.023). There were significant differences between the pain and no-pain groups by spouse distribution(${\chi}^2$=10.736, p=.001), educational state(${\chi}^2$=13.020, p=.000), occupation(${\chi}^2$=18.807, p=.000). Pain prevalence in the subjects having no spouse(59.3%) was higher than those having spouse(40.7%), Illiteracy rate was higher in pain group(49.0%) than no-pain group(13.3%). The number of the subjects having occupation(full time or part time) was fewer in pain group than no-pain group. By health status, there were significant differences between two groups(${\chi}^2$=40.055, p=.000). : the pain group showed poor(61.4%), followed by moderate(22.1%), good(16.5%) while no-pain group showed good(64.5%), moderate(29.0%), poor(6.5%). By activities, there were significant differences between the pain and no-pain groups. The pain group was disturbed more severely than the no-pain group in movement(${\chi}^2$=57.829, p=.000), sleep(${\chi}^2$=12.785, p=.000), usual activities(${\chi}^2$=39.196, p=.000), receiving guests(${\chi}^2$=13.163, p=.000), and hobbies and recreation(${\chi}^2$=28.177, p=.000).

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COMPLIANCE STUDY OF METHYLPHENIDATE IR IN THE TREATMENT OF ADHD (주의력결핍과잉행동장애 치료 약물 Methylphenidate IR의 순응도 연구)

  • Hwang, Jun-Wan;Cho, Soo-Churl;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.160-167
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    • 2004
  • Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

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