• Korean Journal of Psychosomatic Medicine
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• v.16 no.2
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• pp.69-74
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• 2008

Delirium is an organic psychiatric syndrome characterized by an acute onset, prominent disturbance of consciousness and cognitive impairment with fluctuating course. Although there is not a clear consensus concerning the optimal classification system for delirium subtypes, Lipowski(1983) firstly classified delirium by psychomotor activity, namely hyperactive, hypoactive, and mixed. According results of several following studies, prevalence of hypoactive delirium were not less than that of hyperactive delirium. But a diagnosis of hypoactive delirium often missed, which is most frequently misdiagnosed as depression and dementia. Hyperactive delirium can be caused by alcohol or benzodiazepine withdrawal, would be related with excessive dopamine and cholinergic deficiency, and is more responsive to high-potency antipsychotics therapy. Hypoactive delirium would be caused by metabolic encephalopathy, and tends to present a less responsiveness to antipsychotics and poorer overall prognosis with a prolonged duration of admission than hyperactive delirium. Delirium is not a homogenous syndrome. Because of different subtypes, it may have dissimilar underlying pathogenetic pathways. So different treatment strategies between various subtypes may be needed.

• Korean Journal of Psychosomatic Medicine
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• v.23 no.2
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• pp.79-85
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• 2015

Objectives : To investigate clinical and symptomatic differences among motoric subtypes of delirium. Methods : A total of 256 patients referred to psychiatric consultation services for delirium due to general medical condition were assessed retrospectively. Motoric subtypes were determined according to Lipowski's criteria for hyperactive, hypoactive and mixed subtypes. All patients were evaluated according to Delirium Rating Scale-Revised-98(DRS-98-R) by trained psychiatrists to obtain symptomatic profiles of delirium. Results : Hyperactive subtype were 50.8%(n=130), mixed 46.1%(n=118) and hypoactive 3.1%(n=8). Hyperactive patients were younger than mixed subtype($69.62{\pm}13.976$ vs. $73.97{\pm}11.569$, p=0.022) and received antipsychotics to manage symptoms of delirium more frequently(83.8% vs. 57.6%, p<0.001). Hyperactive patients had higher DRS-R-98 scores on both noncognitive($7.14{\pm}3.543$ for hyperactive, $5.62{\pm}3.279$ for mixed subtype) and cognitive subscales($10.00{\pm}3.574$ for hyperactive, $6.38{\pm}2.875$ for hypoactive, $7.43{\pm}3.771$ for mixed subtype, p<0.001). Conclusions : We demonstrated that clinical and symptomatic profiles were different across motoric subtypes in delirium. Diagnostic and therapeutic approach should be made differently according to motoric subtypes of delirium and special attention is needed not to underestimate or delay treatment in specific motoric subtype of delirium.

• Korean Journal of Poultry Science
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• v.46 no.3
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• pp.173-183
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• 2019

Based on their virulence, the avian influenza viruses (AIVs) are classified into two pathotypes: low pathogenic avian influenza (LPAI) virus and highly pathogenic avian influenza (HPAI) virus. Among the 16 HA subtypes of AIV, only the H5 and H7 subtypes are classified as HPAI. Some AIVs, including H5 and H7 viruses, can infect humans directly. Six H7 subtype isolates from wild birds of the H7N7 (n=4) and H7N1 (n=2) subtypes were characterized in this study. Phylogenetic analysis showed that eight viral genes (HA, NA, PB2, PB1, PA, NP, M, and NS) of the H7 isolates clustered in the Eurasian lineage, the genetic diversity of which is indicated by its division into several sublineages. The Korean H7 isolates had two motifs, PEIPKGR and PELPKGR, at the HA cleavage site, which have been associated with LPAI viruses. Six H7 isolates encoded glutamine (Q) and glycine (G) at positions 226 (H3 numbering) and 228 of HA, suggesting avian-type receptor-binding specificity. None of the Korean H7 isolates had the amino acid substitutions E627K in PB2 and I368V in PB1, which are critical for efficient replication in human cells. The Korean H7 isolates showed no deletions in the NA stalk region and in NS. These results suggest that the Korean H7 isolates from wild birds are different from the H7N9 influenza viruses isolated in China in 2013, which are capable of infecting humans.

• Korean Journal of Biological Psychiatry
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• v.8 no.1
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• pp.20-36
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• 2001

The debate about whether depressive disorders should be divided into categories or arrayed along a continuum has gone for decade, without resolution. In our review, there is more evidence consistent with the spectrum concept than there is with the idea that depressive disorders constitute discrete clusters marked by relatively discontinuous boundaries. First, "depression spectrum", "is there a common genetic factors in bipolar and unipolar affective disorder", "threshold model of depression" and "bipolar spectrum disorder" are reviewed. And, a new subtype of depression is so called SeCA depression that is a stressor-precipitated, cortisol-induced, serotonin-related, anxiety/aggression-driven depression. SeCA depression is discussed. But, there is with the idea that depressive disorders constitute discrete subtypes marked by relatively discontinuous boundaries. This subtypes of depressive disorder were reviewed from a variety of theoretical frames of reference. The following issues are discussed ; Dexamethasone suppression test(DST), TRH stimulation test, MHPG, Temperament Character Inventory(TCI), and heart rate variability(HRV).

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.139-152
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• 2002

Objectives：This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods：5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results：1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis；the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion：In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

• Journal of the Korean Society of Radiology
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• v.84 no.6
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• pp.1324-1336
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• 2023

Purpose This study aimed to compare the diagnostic performance of cardiac CT and transthoracic echocardiogram (TTE) depending on the degree of valvular calcification and bicuspid aortic valve (BAV) subtype. Materials and Methods This retrospective study included 266 consecutive patients (106 with BAV and 160 with tricuspid aortic valve) who underwent cardiac CT and TTE before aortic valve replacement. Cardiac CT was used to evaluate the morphology of the aortic valve, and a calcium scoring scan was used to quantify valve calcium. The aortic valves were classified into fused and two-sinus types. The diagnostic accuracy of cardiac CT and TTE was calculated using a reference standard for intraoperative inspection. Results CT demonstrated significantly higher sensitivity, negative predictive value, and accuracy than TTE in detecting BAV (p < 0.001, p < 0.001, and p = 0.003, respectively). The TTE sensitivity tended to decrease as valvular calcification increased. The error rate of TTE for CT was 10.9% for the twosinus type of BAV and 28.3% for the fused type (p = 0.044). Conclusion Cardiac CT had a higher diagnostic performance in detecting BAV than TTE and may help diagnose BAV, particularly in patients with severe valvular calcification.

• Journal of Chest Surgery
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• v.29 no.9
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• pp.1031-1035
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• 1996

International Ass ciation for the Study of Lung Cancer(IASLC) recommended the following classification of small cell lung carcinoma(SCLC) : (1) Small cell carcinoma (2) Mixed small cell/large cell carcinoma (3) Combined small cell carcinoma. Combined small cell carcinomas contain a squamous cell carcinoma or adenocarcinoma component. The prognostic significance of these elements is not known, but since the frequency and extent of non-small cell elements are considerably greater in posttherapy and autopsy tissues, it is possible that the non-SCLC elements are more resistant to therapy than the SCLC cells. Metaplasia & dysplasia of the bronchial surface epithelium are frequently observed in the bronchial biopsy specimens that contain small cell carcinoma of the lung. We report a case of combined small cell carcinoma with squamous element associated with microinvasive squamous cell carcinoma of the bronchial surface epithelium in 68 year old male patient, stage was IIIa. The two lesion are not connected n serial sections.

• Journal of Korean society of Dental Hygiene
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• v.13 no.1
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• pp.174-180
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• 2013

연구목적 : 자극성 섬유종은 만성자극에 의해 발생하는 구강내 증식성 병변이다. 상처치유의 초기 과정에서는 비만 세포와 대식 세포가 섬유모세포의 이주, 증식, 아교질합성 등에 연관되어 있는 성장인자와 사이토카인을 분비하여 상처 치유에 중요한 역할을 한다. 저자들은 자극성 섬유종을 조직학적 특성에 따라 세분하고, 각각의 조직학적 아형에서 비만 세포와 대식 세포의 발현을 조사하여 자극성 섬유종의 발생 기전을 이해하고자 하였다. 연구방법 : 본 연구에서는 82예의 자극성 섬유종을 조직 소견에 따라 4가지 유형으로 분류하였으며, 자극성 섬유종과 10예의 정상 구강점막에 톨루이딘 블루 염색과 CD 68 면역조직화학염색을 시행하였다. 이를 통계화하여 자극성 섬유종의 조직학적 아형에 따른 비만 세포와 대식 세포의 분포 정도를 관찰하였다. 연구결과 : 통계 결과 비만 세포와 대식 세포의 분포는 자극성 섬유종에서 현저히 증가하였으며, Spearman 상관계수는 0.693이었다. 결론 : 조직의 섬유화에 관여하는 비만 세포는 자극성 섬유종의 cellular type에서 유의하게 증가하였으며, 대식 세포도 자극성 섬유종의 모든 아형에서 유의하게 증가하였다. 따라서 자극성 섬유종의 형성 과정에는 비만 세포와 대식 세포의 증가가 중요한 역할을 하는 것으로 생각되었다.

• Korean Journal of Biological Psychiatry
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• v.2 no.2
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• pp.248-251
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• 1995

정신분열병의 약물치료에서 중요한 역할을 하는 도파민의 기전은 지금까지 5종류의 수용체들이 발견되고 클론되면서, 새롭고 보다 근본적인 유전학적 접근을 통해 규명될 수 있게 되었다. 특히, 도파민 수용체 D4 (DRD4)는 막단백질의 세포질쪽 세번째굴곡에 48-bp반복 다형성배열을 가지고있다. 이러한 다형성 반복배열이 신호전달에 참여할 가능성이 높은 막단백질의 세포질쪽 굴곡에 있다는것은, 각 개인의 항정신병약물에 대한 민감성의 차이를 포함하여 정신분열병에 대한 개개인의 유전적 차이를 진단할 수 있는 가능성을 제시한다. 이러한 가능성을 검증하기 위하여 주로 손쉽고 빠른 중합효소연쇄반응(PCR)을 사용하여 DRD4의 아형들을 분류하게 되는데, DRD4의 PCR은 그 반복배열과 그 주변배열의 높은 GC함량(78% G+C) 때문에 일반적인 PCR 방법을 변형시켜 사용해야한다. DRD4의 아형을 분류하기 위해 변형된 PCR은 통상적으로 7-deaza dGTP와 10% DMSO를 사용하게된다. 이러한 DRD4 PCR은 대부분의 경우 성공하지만, 항상 모든 시료에서 PCR이 성공되는것은 아니었으며 반복적으로 시도하여 증폭시킬 수 있었다. 이러한 어려움은 대부분이 template DNA에 문제가 있을것으로 의심되며 DNA정제 또는 template DNA를 제한효소로 적절하게 무작위절단하여 성공율을 높일 수 있었다.

• Journal of the Korean Society of Radiology
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• v.81 no.3
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• pp.746-752
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• 2020

Basaloid squamous cell carcinoma of the lung is now considered a subtype of squamous cell carcinoma as per the 2015 WHO classification and remains a relatively unknown type of lung cancer due to its rarity. Here we report two cases of basaloid squamous cell carcinoma of the lung and their CT findings to clarify some of the radiologic features of this type of cancer. Two patients aged 85 and 68 years with lung basaloid squamous cell carcinoma visited our institution and underwent surgical resection. On CT, the lesions were 3.1 and 2.8 cm in size, respectively, well-defined, round in shape with lobulated margins and prominent intratumoral necrosis. The latter case was followed after operation for 20 months, and there was no recurrence of the disease on CT. Although very rare, basaloid squamous cell carcinoma should be considered a subtype of lung cancer in tumors sharing these CT findings.