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AN OBSERVATIONAL MULTI-CENTER STUDY FOR EVALUATION OF EFFICACY, SAFETY AND PARENTAL SATISFACTION OF METHYLPHENIDATE-OROS IN CHILDREN WITH ADHD (주의력결핍과잉운동장애 아동에게 Methylphenidate-OROS 투여시 효용성과 안전성 및 부모 만족도를 평가하기 위한 다기관관찰연구)

  • Kim, Bong-Seog;Park, Eun-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.2
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    • pp.279-285
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    • 2005
  • Objectives : This study was performed to evaluate the efficacy and safety of MPH-OROS and parental satisfaction for treatment of children with ADHD Method : The 569 participants were clinically diagnosed for ADHD using DSM-IV criteria. We switched current medication to MPH-OROS or introduced MPH-OROS for treatment of ADHD. We assessed the clinical global impression severity of illness (CGI-S), the clinical global impression severity of improvement(CGI-I). And the parents of participants measured the Korean version of Conners rating scale at baseline, the 1 st week and the 3rd week after MPH-OROS trial. At the 3rd week, the parents measured the parent satisfaction questionnaire. Results : $13\%$ of participants dropped out because of several causes including side effects. The change of CGI-S was significantly decreased. Using CGI-I, the improvement was $72.3\%$ at the 1st week and $87.4\%$ at the 3rd week. The total score of the Korean version of Conners parent rating scale was significantly decreased. The participants complaining one or more of side effects were 119$(20.7\%)$, and the most common side effect was anorexia. The $94\%$ of parents replied that they were overall satisfied with MPH-OROS trial. Also the advantages of MPH-OROS of parental report were the long duration of the drug, the improvement of schoolwork and attitude, the improvement of home behavior and homework and the improvement of overactivity. Conclusion : MPH-OROS is effective and well-tolerated in actual clinical use for ADHD.

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Status and Awareness of Excessive Heat Exposure among Agricultural Workers (일부 농업인의 고온노출에 대한 실태와 인지도 조사)

  • Lee, Dong-Hyun;Kim, Dong-Seob;Chung, Jin-Wook;Lee, Kwan;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.43 no.1
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    • pp.9-17
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    • 2018
  • Objectives: This study was to assess the status and awareness of excessive heat exposure among agricultural workers. Methods: We selected a total of 90 farmers from a villages of Gyeongju-si, during August, 2015. We carried out the temperature measurement for nine times and derived Health Index (HI) and Wet Bulb Globe Temperature (WBGT) index. We compared the HI, WBGT and excessive heat warnings. Status of high temperature exposure, lifestyle, medical history, and awareness about excessive health related exposure illness assessed using survey questionnaires. Results: The matching rates between the WBGT and the HI during excessive heat warning were high, but when it was a non-excessive heat warning, there were days of excessive HI or WBGT. Out of 90 farmers surveyed, 78 cases (86.7%) were in their 60s and older age group. Slightly more than two third (71.1%) farmers were farming in the dawn-morning (71.1%), and the daily working hours were less than 4 hours (54.4 %), but only 23.3% among farmers took regular breaks. Of total, 14.4% farmers experienced excessive heat exposure related illness in order of tiredness, lethargy, dizziness, headaches, and sweating. Overall, the awareness of the danger for excessive heat and the heat wave warnings were high at 70.0% and 74.4%, respectively. Conclusions: Politically, the excessive heat warnings should not be taken into account the simple temperature measurement but, have to consider WBGT and HI standards at the same time. Farmers need to be promoted and educated to prevent the excessive heat related illness by periodically increasing their rest time during farming.

Clinical Characteristics and Heart Rate Variability of Foreign Domestic Violence Victims in Korea (국내 거주 외국인 가정폭력 피해 여성의 임상적 특징 및 심박변이도)

  • Kim, Kyu-Lee;Choi, Jin-Sook;Jang, Yong-Lee;Lee, Hae-Woo;Sim, Hyun-Bo
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.46-54
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    • 2017
  • Objectives: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. Methods: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. Results: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. Conclusion: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.

Treatment Outcome of Langerhans Cell Histocytosis (랑게르한스 세포 조직구증의 치료 결과)

  • Chung, So Hak;Kim, Jae Do;Jo, Hyun Ik
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.1
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    • pp.14-21
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    • 2014
  • Purpose: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. Materials and Methods: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. Results: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. Conclusion: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.

The Severity and Variables Influencing Depression in Cancer Patients with Pain (통증이 있는 암환자의 우울 정도 및 우울에 영향을 미치는 요인)

  • Kim, Hyun-Sook;Yun, Young-Ho;Lee, So-Woo;Heo, Dae-Seog;Son, Haeng-Mi;Huh, Bong-Yul
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.125-137
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    • 1999
  • Purpose : Surveying the rates, severity, and variables influencing depression and their correlation between pain and depression in Korean cancer patients, we attempted to provide a basic database for the effective depression management program. Methods : The results of survey were colleted from 10 patients who were hospitalized at Seoul National University Hospital for cancer treatment from February to June of 1999. Factors of depression and the level of pain were examined by self-reported survey employing Korean version of Beck Depression Inventory(BDI) and an abridged version of Brief pain Inventory respectively. The purpose of this study and guidelines for the questionnaires were clearly explained to participating patients by Resgitered Nurses before answering the survey. Demographic and clinical characteristics of patients were compiled by reviewing their medical records in corporation with a family physician. The difference in the level of depression among patient groups was analyzed with the t-test and ANOVA, and the correlation between variables with Pearson correlation coefficient. Results : 1) 142 subjects comprised 79 male and 63 female, and their mean age was 51.86. 2) The mean scores of the worst pain for last 24-hours was 6.08(SD 2.23), the average pain for last 24-hours 4.44(SD 1.85), and the mean scores of pain at the time of survey 3.48(SD 2.25), while the mean scores of the least pain for last 24-hours 2.25(SD 1.83). 3) The mean BDI scores were 23.73(SD 0.99), and 55.6% of patients were evaluated to be in depression(cutting point 21). Scores of depression for cancer patients were higher than normal population. 4) The correlation between worst pain for last 24-hours and depression(r=0.252, P=0.002), average pain for last 24-hours and depression(r=0.225, P=0.007), present pain and depression(r=0.291, P=0.000) were significant. 5) Significant differences were found among groups of cancer patients with pain with respect to gender(t=3.59, p=0.000), level of education(F=4.063, P=0.009), ECOG(F=3.352, P=0.021). There was significant positive correlation between depression and pain(r=0.171, P=0.042). Conclusions : More than 50% of cancer patients with pain are suffering from depression. We have shown that the variables like the degree of pain, gender, level of education, ECOG, and age are significantly related to the depression in cancer patients. The findings of this study may be used for assessing high-risk patients in need of intervention and for planning effective therapeutic strategies for them after the routine assessment. Further study is necessary to investigate the cultural differences and the variables influencing on depression in Korean cancer patients.

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Clinical Experience on Mycobacterial Diseases Other Than tuberculosis (비결핵마이코 박테리엄증의 임상 경험)

  • Lew, W.J.;Ahn, D.I.;Yoon, Y.J.;Cho, J.S.;Kwon, D.W.;Kim, S.J.;Hong, Y.P.
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.5
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    • pp.425-432
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    • 1992
  • Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while for at least the recent 10 years, the frequency of disease attributable to mycobacteria other than tuberculosis (MOTT) began to increase both in actual numbers and in the proportion of the total burden of mycobacterioses. Method: Twenty nine cases, diagnosed as having pulmonary disease due to MOTT on the basis of repeated isolations of the relevant organisms from sputum specimens and chest X-ray findings from Jan. 1982 throught Dec. 1991 at the Chest Clinic of the Korean Institute of Tuberculosis, were reviewed in terms of clinical features and courses. Results: 1) Nineteen cases (66%) were infected with Mycobacterium avium-intracellulare, 5 cases (17%) with M. fortuitum, 4 cases (14%) with M. chelonei, and 1 cases (3%) with M. szulgai. 2) The ratio of male versus female patients was 1.9:1. 3) The peak incidence was in the fifth decade. 4) Eighteen cases (62%) had moderately advanced disease and 11 cases (38%) had far advanced disease on chest P-A film. 5) The common symptoms were cough (59%), sputum (52%), and dyspnea (34%). 6) All cases had a previous history of tuberculosis. 7) Most of the isolates were highly resistant to the major antituberculosis drugs and 48~52% showed a sensitivity to cycloserine, kanamycin or enviomycin. 8) Of 19 cases which were treated and followed-up for over 12 months, 3 cases attained negative conversion on cultures (2 M. fortuitum infections, 1 M. szulgai infection). Sixteen cases failed in attaining negative conversion on cultures. However, their clinical courses were chronic and indolent despite of persistant culture positivity. Conclusion: Treatment of these patients has been difficult because of the frequency of severe underlying conditions and the natural resistance of most of the nontuberculous mycobacteria to the presently available drugs.

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Expectations of the First Visit to Orofacial Pain Clinic for the Patients with Temporomandibular Disorders (구강안면통증클리닉에 처음 내원한 턱관절장애 환자들의 내원 목표)

  • Won, Sang-Yeon;Kim, Hye-Kyung;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.265-273
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    • 2010
  • Understanding patients' expectation for health visits and providing appropriate care may increase patients' satisfaction with health care, leading to more positive treatment outcome. The study aimed to investigate expectations of the patients with temporomandibular disorders (TMD) at their first visit to university-based orofacial pain clinic and to evaluate any relation with duration of pain, presence of previous treatment, pain severity and pain interference. Inclusion criterion was patients aged over and 18 years old and diagnosed as TMD during 3 months' period from Aug to Nov 2010. They were asked to complete the questionnaires for patients' expectation and the Brief Pain Inventory (BPI) at waiting room prior to consultation. 322 TMD patients participated in the study(M:F=1:1.5, mean age=36 years old). The study indicated that the most important top 3 expectations were 'cure of pain', 'understanding their problem' and 'doctor-patient communication' in order. This finding was not affected by gender, duration and previous treatment history but affected by sub-category of TMD and BPI pain severity and pain interference. 'Pain relief' and 'understanding their problems' were relatively highlighted in the patients with muscle disorders and combination (joint-muscle) disorders of TMD than those with joint disorders who wanted communication and further investigation relatively more (p=0.000). While expectation for pain relief was expected more with increase of pain severity and interference, patients with mild level of pain severity and interference expected communication and further investigation relatively more (p=0.000, 0.017, respectively). Based on the results of the study, though pain relief was the primary concern for TMD patients suffering from pain, their satisfaction with care may be increased by explanation for etiology and mechanism of TMD to make them understand their problems better and doctor-patient communication and collaborative decision-making for treatment. Importance of patient-centered consultations and availability of written material or web sites for patient information should be stressed out.

Review of Primary Chest wall Tumors (원발성 흉벽종양의 임상적 고찰)

  • Sohn, Sang-Tae;Chon, Soon-Ho;Shin, Sung-Ho;Kim, Hyuck;Chung, Won-Sang;Kim, Young-Hak;Kang, Chung-Ho;Park, Moon-Hang;Jee, Heng-Ok
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.988-994
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    • 1998
  • Background: Chest wall tumors can classified into soft tissue tumors and bone tissue tumors and can be subclassified into benign and malignant tumors. Materials and methods: We report an analysis of 68 patients with primary chest wall tumors treated at the department of thoracic and cardiovascular surgery at Hanyang University Hospital from January, 1973 to September 1997. Results: Among a total of 68 patients 33(48.5%) were males and 35(51.5%) were females. The ages of the patients ranged from 10 to 79 years with a mean age of 39.3 years. According to the age distribution, 23 patients (33.8%) were from the 4th decade, 12 patients(17.6%) were from the 6th decade, and 10 patients(14.7%) were from the 5th decade. Among the primary chest wall tumors, 53 cases were benign and 15 cases were malignant. Among the benign tumors, 17 cases(32.1%) were in the 4th decade and among the malignant tumors, 6 cases(40%) were in the 4th decade. In both malignant and benign tumors the most common ages were in the 4th decade. The most common tumors were fibrous dysplasia and chondroma, each with a total of 14 cases(26.4%). Osteochondroma and lipoma each had 8 cases(15.1%). Among malignant tumors, osteosarcoma was most common with 8 cases (53.3%). According to location, 49 cases occured in both bone and cartilage tissue, 19 cases occurred in cartilage. Among the presenting symptoms, palpable mass was present in all cases. Fifty-one patients complained of tenderness and among cases with involvement of the lung, 3 patients had complained of respiratory distress. Among the malignant tumors 6 cases underwent a radical operation and 4 cases of benign tumors underwent a radical operation. Postoperativly, there was one case with recurrence from a desmoid tumor. There were no deaths postoperativly and no deaths due to complications(and their postoperative courses were uneventful). Conclusions: Most patients with primary chest wall tumors initially present with mass at admission. Resection is sufficient treatment for benign tumors but in malignant tumors wide resection of the chest wall is needed and mchest wall reconstruction.

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Bacterial meningitis in children experienced at a university hospital, 1993-2006 (서울의 한 대학병원에서 경험한 소아의 세균성 수막염: 1993-2006)

  • Cho, Sung Yoon;Kim, Tae Yeon;Lee, Hyunju;Kim, Kyung Hyo;Yoo, Eun Sun;Kim, Hae Soon;Park, Eun Ae;Ryu, Kyung Ha;Sohn, Sejung;Seo, Jeong Wan;Lee, Seung Joo
    • Clinical and Experimental Pediatrics
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    • v.51 no.10
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    • pp.1077-1084
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    • 2008
  • Purpose : Despite the seriousness of bacterial meningitis in children, there is little information on the incidence, causative organisms, mortality rate and age distribution. We studied the frequency by age group and causal pathogens, and clinical characteristics in children with bacterial meningitis in the private sector in Korea. Methods : The medical records containing the data on bacterial meningitis patients under 18 years of age confirmed by cerebrospinal fluid (CSF) findings were retrospectively analyzed from September, 1993 to August, 2006 at Ewha Womans University Mokdong Hospital. Results : Eighty-one cases of bacterial meningitis were observed. Overall the most common organism was Streptococcus agalactiae (group B streptococcus, GBS) (30 cases, 37.0%) followed by Haemophilus influenzae (22 cases, 27.2%), Streptococcus pneumoniae (12 cases, 14.8%), Escherichia coli (3 cases, 3.7%), Neisseria meningitidis (1 case, 1.2%) and others (13 cases, 16.0%). In neonates and young infants under 2 months, the most common organism was GBS. In children between 3 months, and 5 years, the most common organism was H. influenzae. S. pneumoniae was the most common organism in children over 5 years of age. Thirty-one patients (38.3%) had complications. Of all ages, the mortality rate of bacterial meningitis markedly decreased compared with the previously reported rate. Conclusion : In neonates, GBS meningitis was most common. The frequency of H. influenzae meningitis decreased after the introduction of H. influenzae type b vaccination. A strategy for the prevention of GBS meningitis in neonates should be established. The influence of the pneumococcal conjugate vaccine on S. pneumoniae meningitis should be studied.

Excellent Local Tumor Response after Fractionated Stereotactic Radiation Therapy for Locally Recurrent Nasopharynx Cancer (국소 재발 비인강암에 대한 정위적 방사선 분할 치료의 적용)

  • Lim Do Hoon;Chio Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Baek Chung-Hwan;Chu Kwang Chol;Yoon Sung Soo;Park Keunchil;Ahn Yong-Chan
    • Radiation Oncology Journal
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    • v.15 no.1
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    • pp.19-26
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    • 1997
  • Purpose : This study is to report experience with Fractionated Stereotactic Radiation Therapy (FSRT) for locally recurrent nasopharynx cancer after curative conventional radiation therapy. Materials and Methods : Three Patients with locally recurrent and symptomatic nasopharynx cancer were given FSRT as reirradiation method between the Period of September of 1995 and August of 1996 For two Patients, application of FSRT is their third radiation therapy directed to the nasopharynx. Two patients were given low dose chemotherapy as radiation sensitizer concurrently with FSRT Authors used 3-dimensional coordinate system by individually made, relocatable Gill-Thomas-Cosman (GTC) stereotactic frame and multiple non-coplanar arc therapy dose Planning was done using Xknife-3. Total of 45 Gy/18 fractions or 50 Gy/20 fractions were given. Results : Authors observed satisfactory symptomatic improvement and remarkable objective tumor size decrease by follow-up MR images taken 1 month Post-FSRT in ali three patients, while no neurologic side effect attributable to reirradiation was noticed. Two died at 7 and 9 months with loco-regional and distant seeding outside FSRT field, while one patient is living for 4 month. Conclusion Authors experienced satisfactory therapeutic effectiveness and safety of FSRT as reirradiatlon method for locally recurrent nasopharynx cancer Development of more effective systemic chemotherapeutic regimen is desired for distant metastasis

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