• The Korean Journal of Applied Statistics
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• v.33 no.2
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• pp.203-213
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• 2020

The self-controlled case series (SCCS) study measures the relative risk of exposure to exposure period by setting the non-exposure period of the patient as the control period without a separate control group. This method minimizes the bias that occurs when selecting a control group and is often used to measure the risk of adverse events after taking a drug. This study used SCCS to examine the increased risk of side effects when two or more drugs are used in combination. A conditional Poisson model is assumed and analyzed for drug interaction between the narcotic analgesic, tramadol and multi-frequency combination drugs. Bayesian inference is used to solve the overfitting problem of MLE and the normal or Laplace prior distributions are used to measure the sensitivity of the prior distribution.

• Korean Journal of Psychosomatic Medicine
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• v.7 no.1
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• pp.103-115
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• 1999

Objectives : A large of studies have found an association between premenstrual syndrome and affective disorder, in particular, depression. Some studies have reported that women with depressive disorders may experience menstrual cycle-associated changes in the severity of their symptoms. This study was designed to compare the characteristics of premenstrual changes between control group and affective patient group, and to assess possible risk factors for premenstrual changes in patients. Methods : Eighty normal controls and eighty outpatients given maintenance therapy with fixed dose for at least more than four weeks were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and functional impairment. In addition, to compare the characteristics of premenstrual changes, 16 items based on DSM-IV criteria A for premenstrual dysphoric disorder were rated on the following scale : 0(no change), 1(mild), 2(moderate), 3(severe). Moderate or severe change in each item was considered as premenstrual change and the subjects who reported more than one premenstrual change were defined as premenstrual change group. Results : The results were as follows : 1) The percentage of premenstrual change group was 32.6% in patient group and 50% in control group. 2) Frequently reported premenstrual changes were as follows in control group : breast tenderness; anger ; affective liability ; lethargy, easy fatigability, or marked lack of energy ; abdominal pain or discomfort. In patients, the mood or behavioral changes were frequently reported. The changes were as follows : lethargy, easy fatigability, or marked lack of energy ; change in appetite; affective liability ; sense of difficulty in concentrating : hypersomnia or insomnia. 3) In the premenstrual change group, the patients with only mood or behavioral changes were significantly more than those with only physical changes or both changes. 4) The severity of functional impairment was significantly correlated with the frequency of mood or behavioral changes in patients. 5) There were no significant differences in menstrual characteristics between patients with premenstrual changes and patients without them except the severity of dysmenorrhea. And the severity of dysmenorrhea was correlated with the frequency of premenstrual change. Conclusion : The proportion of patients with affective disorder, who reported moderate-to-severe premenstrual changes, experiencing mood or behavioral changes larger than those experiencing physical changes during premenstrual period. It is possible that some patients with affective disorder, who reported premenstrual mood or behavioral changes, suffer from coexisting premenstrual syndrome with affective disorder or premenstrual exacerbation of affective disorder. Since the more premenstrual changes, the severer functional impairment, the patients reporting mood or behavioral disturbance in premenstrual period should be carefully evaluated, and appropriate therapeutic stategies might be considered.

• Journal of the Korean Society of Radiology
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• v.81 no.5
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• pp.1184-1193
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• 2020

Purpose This study was performed to evaluate the relationship between callosal microbleeds and anoxic brain injury. Materials and Methods Twenty-seven patients with anoxic brain injuries were analyzed and retrospectively compared to the control group of patients without a history of anoxic brain injury using Fisher's exact test regarding comorbidities and cerebral microbleeds. The patient group was subdivided according to the presence of callosal microbleeds. Fisher's exact test was used to compare the presence of typical MRI findings of anoxic brain injury, use of cardiopulmonary resuscitation, and prognosis. The Mann-Whitney U test was used to compare the interval between the occurrence of anoxic brain injury to MRI acquisition. Results The prevalence of cerebral microbleeds in the patient group was 29.6%, which was significantly higher than that in the control group at 3.7% (p = 0.012). All cerebral microbleeds in the patient group were in the corpus callosum. Compared with the callosal microbleed-absent group, the callosal microbleed-present group showed a tendency of good prognosis (6/8 vs. 11/19), fewer typical MRI findings of anoxic brain injury (2/8 vs. 10/19), and more cardiopulmonary resuscitation (6/8 vs. 12/19), although these differences did not reach statistical significance (p = 0.35, p = 0.19, and p = 0.45, respectively). Conclusion Callosal microbleeds may be an adjunctive MRI marker for anoxic brain injury.

• Progress in Medical Physics
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• v.16 no.1
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• pp.32-38
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• 2005

Impaired processing of facial information is one of the broad ranges of cognitive deficits seen in patients with schizophrenia. The purpose of this study was to elucidate the differences in brain activities involved in the process of facial working memory between schizophrenic patients and healthy comparison subjects. Ten patients with schizophrenia were recruited along with matched healthy volunteers as a comparison group. Functional magnetic resonance imaging (fMRI) was used to assess cortical activities during the performance of a 1-back working memory paradigm using images of neutral faces as mnemonic content. The patient group performed the tasks with reduced accuracy. Group analysis revealed that left fusiform gyrus, right superior frontal gyrus, bilateral middle frontal gyri/insula, left middle temporal gyrus, precuneus and vermis of cerebellum and showed decreased cortical activities in the patient group. On the other hand, an increased level of activation in lateral prefrontal cortex and parietal lobule was observed from the patient group, all in the right hemisphere. A decreased level of activity in the left fusiform gyrus among the patient group implicates inefficient processing of facial information. An increased level of activation in prefrontal and parietal neural networks from the patient group confirms earlier findings on the impaired working memory of patients with schizophrenia.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.45-49
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• 2005

Objectives: To compare the biogenetic temperament and character patterns of subjects with narcolepsy and those of healthy control subjects. Methods: Twenty-two subjects with narcolepsy, diagnosed with the International Classification of Sleep Disorder (ICSD) criteria, and 22 healthy control subjects were recruited. The Korean version of the Temperament and Character Inventory was administered to all subjects. Results: Compared to healthy control subjects, subjects with narcolepsy showed significantly higher Novelty-Seeking (ANCOVA, F=5.42, p=0.025), lower Persistence (F=8.41, p=0.006) and lower Self-Directedness scores (F=4.70, p=0.036). Conclusion: Narcoleptic patients have a distinct pattern of biogenetic temperament and character. Our findings suggest that narcoleptic patients are exploratory in response to novelty but give up easily. In addition, our findings show that narcoleptic patients consider themselves ineffective, purposeless, and fragile.

• Progress in Medical Physics
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• v.16 no.1
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• pp.1-9
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• 2005

The effect of the developed symmetric upper extremity motion trainer on the cortical activation pattern was investigated in three chronic hemiparetic patients using both fMRI and Fugl-Meyer test. The training program was performed at 1 hr/day, 5 days/week during 6 weeks. Fugl-Meyer tests were performed every two weeks during the training. fMRI was performed at 3T scanner with wrist flexion-extension in two different tasks before and after the training program: the only unaffected hand movement (Task 1) and passive movements of affected hand by the active movement of unaffected hand (Task 2). fMRI studies in Task 1 showed that cortical activations decreased in ipsilateral SMC but increased in contralateral SMC. Task 2 showed cortical reorganizations in bilateral SMC, PMA and SMA. Therefore, it seems that the cortical reorganization in chronic hemiparetic patients can be induced by the training with the developed symmetric upper extremity motion trainer.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.203-210
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• 1996

Objects : To investigate the relationship between the age of onset with the atrophy and the white matter hyperintensities observed in the brain MRI of Alzheimer patients. Methods : The authors measured volumetrically cortical and ventricular brain atrophy and rated semiquantitatively white matter signal hyperintensities in nine presenile and 18 senile Alzheimer patients, who were matched for dementia severity, according to NINCDS-ADRDA criteria and in age-matched 10 presenile and 11 senile control subjects. Results : Presenile Alzheimer patients showed significantly greater cortical and ventricular atrophy indices(p<0.05) but no difference in white matter hyperintensity scores compared to the age-matched control group. On the contrary, senile Alzheimer patients showed significantly greater white matter hyperintensity scores(p<0.05) but no difference in cortical and ventricular atrophy indices compared to the age-matched control group. Conclusion : An earlier onset was related to marked brain atrophy with less white matter lesions and a later onset is related to marked white matter lesions with less brain atrophy in Alzheimer's disease. Our results suggested the passible difference in the pathophysiology between the presenile and the senile-onset Alzheimer's disease.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.12 no.2
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• pp.256-262
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• 2001

Objective：The enlargement of the lateral ventricle is well established finding in adult-onset schizophrenia, but in the patients with early-onset psychotic disorder(EOPD) is still controversal. To identify structural abnormalities of the lateral ventricle in patients with EOPD and difference of the brain developmental course in EOPD group, planimetrical assessment of the lateral ventricle was conducted by means of retrospective quantitative neuroimaging. Methods：The brain MR images of 14 patients with EOPD(mean age $14.0{\pm}2.1$ years) who met the DSM-III-R diagnostic criteria for schizophrenia and bipolar disorder and 24 control subjects with simple headache(mean age $10.0{\pm}2.1$ years) were collected. Single best view for the lateral ventricle, one axial slice was selected for analysis. MR images were redigitalized with flatbed scanner and data were analyzed with NIH IMAGE software. Results：In the patients with EOPD, there were significant correlations between aging and lateral ventricular sizes and between aging and ventricular brain ratio(VBR). The statistical significance of normal asymmetry of the lateral ventricle was not observed for the EOPD group. The EOPD group had larger lateral ventricular sizes and VBR than control group, but these results were not statistically significant. Conclusion：These findings suggest that the brain abnormalities in patients with EOPD progress from the earlier course of the disorders and the course of brain development in EOPD group is different from control group.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.54-70
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• 1998

Objectives : The purpose of this study is to evaluate the role of structural and functional changes of the brain in the pathophysiology of schizophrenia. Methods : The authors measured the regions of interest on the magnetic resonance imaging of the brain in 20 patients with paranoid schizophrenia(15 men and 5 women) and 23 control subjects(15 men and 8 women). We also assessed the neurocognitive functions with the Wisconsin Card Sorting Test, the Benton Neuropsychological Assessment, and the Weschler IQ test-Korean version, soft neurologic signs, and psychiatric symptoms in the patient group. Results : In the patient group, all ventricles and basal ganglia including caudate nucleus and globus pallidus were significantly enlarged. Although there were no significant differences between the two groups in the values of right frontal lobe and left temporal lobe, there was a tendency of decrease in the values of right frontal lobe and left temporal lobe. There were significant positive correlations between the values of ventricles and the frequency of previous hospitalization. However, there were no significant correlations between other values of regions of interest and clinical data. The value of the right frontal lobe was significantly correlated with the score of soft neurologic signs, which is suggestive of the neurodevelopmental abnormalities. There were significant correlations between the value of frontal lobe and the scores of the various subscales of Benton Neuropsychiatric Inventory. In contrast, the value of left amygdala and putamen showed significant correlation with the score of verbal IQ on the Weschler IQ test. Structural changes of the temporal lobe areas were related with the positive and general symptom scores on PANSS, while those of the basal ganglia were related with the negative symptom scores. Conclusions : These results suggest that the structural changes of the brain in the patients with schizophrenia show the dual process, which is suggestive that the enlarged ventricle show the neurodegenerative process, while enlarged basal ganglia, and shrinked right frontal and left temporal lobe show the neurodevelopmental abnormalities. Among these changes, structural changes of the frontal lobe related with various neuropsychological deficits, while those of left temporal lobe related with language abnormality. Relative to the relation between structural changes and psychiatric symptoms, structural changes of the temporal lobe areas were related with the positive and general symptoms, while those of the basal ganglia were related with the negative symptoms.

• Tuberculosis and Respiratory Diseases
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• v.44 no.3
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• pp.583-591
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• 1997

The functional derangement of skeletal muscles which may be attributed to chronic hypoxia has been accepted as a possible mechanism of exercise impairment in patients with chronic obstructive pulmonary disease (COPD). The metabolic changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation, early activation of anaerobic glycolysis and excessive lactate and hydrogen ion production with exercise. But the cause of exercise limitation in patients with chronic lung disease without hypoxia has not been known. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the exercise limitation in chronic lung disease patients without hypoxia, we compared the muscular metabolic data of seven male patients which had been derived from noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) with those of five age-matched normal male control persons. $^{31}P$ MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and the 30% of MVC force was constantly loaded to each patient during the isometric exercise. There were no differences of intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr) at baseline, exhaustion state and recovery period between two groups. But pHi during the exercise was lower in patients group than the control group (p < 0.05). Pi/PCr during the exercise did not show significant difference between two groups. These results suggest that the exercise limitation in chronic lung disease patients without hypoxia also could be attributed to the abnormalities in the skeletal muscle metabolism.