• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.51-58
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• 2018

Objectives : We aimed to investigate the discontinuation rate and reasons of doxepin base prescription pattern in insomnia outpatients of psychiatry department of a university hospital. Methods : 534 patients prescribed doxepin were screened. 201 patients were included and reviewed for their medical records retrospectively. The discontinuation rate and reasons of doxepin after 2 months of prescription were investigated. Patients were divided into three groups according to the prescription patterns. The initial group, prescribed doxepin as the first hypnotic, the add-on group, prescribed doxepin while maintaining existing hypnotics, and the switching group, prescribed doxepin after discontinuation of existing hypnotics. Results : The discontinuation rate after 2 months of prescription of doxepin was 56.2%. There were significant differences in the discontinuation rate among three groups. The initial group had the highest while the add-on group had the lowest (p=0.018). In reasons for discontinuation of doxepin among three groups, lack of efficacy (p<0.001) and adverse events (p<0.001) were significantly higher in the add-on group. In the initial group, patient's refusal (p=0.022) and unknown or loss to follow up (p<0.001) were significantly higher. Conclusions : The results of this study suggested that add-on is superior than switching method and gradual reduction of existing hypnotics is necessary to maintain doxepin treatment and prevent adverse events. Additional large scale prospective studies are needed to evaluate various factors and risks of discontinuation of doxepin.

• Korean Journal of Psychosomatic Medicine
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• v.9 no.2
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• pp.153-163
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• 2001

This study was attempted to investigate the discriminant validity of Korean version of Eating Attitude Test-26(KEAT-26) and to provide the sensitivity, specificity and efficiency according to cutting score, which may be useful to determine the optimal cutoff point on various purposes. The KEAT-26 was administered to 108 female patients with eating disorders, 179 female participants in body slimming center, 120 female athletic college students, 227 female college students, and 183 healthy normal women. Validity was tested by ANOVA and ROC curve analysis. The results revealed that the total score of the KEAT-26 showed a statistically significance between groups and that the score of the KEAT-26 of eating disorders group was significantly higher than that of the other groups in post hoc test. In comparison of the 4 subfactor score of the KEAT-26 between groups, significant differences in main effect within groups were found in all subfactors except factor IV. ROC curve analysis showed 80% of efficiency to discriminate eating disorders group from normal control group using cutoff score on maximum discriminant efficiency and 69% of efficiency to discriminate eating disorders group from high risk groups for eating disorders. Each cutoff score on maximum in efficiency was as follows ; 25 between eating disorders group and participants in body slimming center, 19 between eating disorders group and healthy normal woman, 23 between eating disorders group and athletic college students, 21 between eating disorders group and college students. Using 22(T score 65) of the KEAT-26 as the cutoff score, sensitivity was 54%, specificity was 84%, and overall efficiency was 80%. These results indicate that the KEAT-26 has a good discriminant validity in Korean population and also suggest that the KEAT-26 may be useful assessment tool to screen the disordered eating problems on clinical and epidemiological purposes.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.59-65
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• 2016

Purpose Dynamic kidney scan is a typical imaging technique that visualizes kidney function. Reproducibility of dynamic kidney scans has been evaluated by comparing low-dose kidney scans with low-dose radiopharmaceutical and standard dynamic kidney scan. With this comparative study, if reproducibility is superb, the dynamic kidney scan method with reduced radioactivity to patients is to be utilized and radiation exposure to patient is to be reduced. Materials and Methods For gamma camera, Orbiter, SymbiaE (Siemens, Germany) was used. Among patients who had used 370 Mbq (10 mCi) from January of 2013 to February 2014 and other patients who had used 185 Mbq (5 mCi) from March of 2014 to July of 2015 with identical condition, 21 subjects using DTPA and 20 subjects using $MAG_3$, 41 subjects in total, had been selected as subjects for data. From renogram of the result image, frame of the peak point was selected. Then, region of interest of kidney and background had been selected and Kidney to Background Ratio has been calculated for comparison. Results In tests using DTPA, kidney to background ratio when using 370 Mbq was $5.67{\pm}0.8$ at average while it was $5.62{\pm}0.87$ when using 185 Mbq, which didn't show much difference. Also in the tests using $MAG_3$, kidney to background ratio when using 370 Mbq was $14.95{\pm}2.58$ at average and $14.56{\pm}2.02$ in 185 Mbq, which neither showed much difference. In paired sample t-test, p-value was 0.566 in DTPA and 0.363 in $MAG_3$, which confirmed that there was no difference between the groups. Conclusion In identical patients, when dose was decreased from 370 Mbq to 185 Mbq, reproducibility of dynamic kidney scan was proven to be excellent. Low-dose Dynamic kidney scan can achieve results with fine reproducibility without improvement in performance of gamma camera and is expected to reduce radiation exposure to patient.

• Clinical and Experimental Pediatrics
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• v.45 no.12
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• pp.1528-1533
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• 2002

Purpose : Isolated noncompaction of the ventricular myocardium(INVM) is one of the unclassified cardiomyopathies that is characterized by numerous, excessively prominent trabeculations, and deep intertrabecular recesses. We performed this study to evaluate the clinical features of INVM in children. Methods : The medical records of 10 patients with INVM were reviewed. We analyzed the clinical manifestations, hemodynamics, pattern of inheritance, and long-term prognosis of INVM in children. Results : Age at diagnosis was $45{\pm}53months$(1 day-14 years) with follow-up lasting as long as 78 months. Most INVM was asymptomatic on diagnosis. Associated cardiac anomalies were noted in six patients(ventricualr or atrial septal defect, patent ductus arteriosus with mitral valve prolapse, or mitral valve cleft). Depressed or flat changes of T wave in lead II, III and aVF were observed on electrocardiography. Various arrhythmia including WPW syndrome with paroxysmal supraventricular tachycardia, third-degree atrioventricular block, and familial sick sinus node dysfuction were observed. The degree of trabeculation in INVM was significantly prominent from level of mitral valve to apex compared to age-matched control. Familial recurrences were noted in two patients. The systolic function of the left ventricle was decreased in 20% of patients during the follow-up period, but systemic embolism or ventricular tachycardia was not observed. Conclusion : INVM is not a rare disorder. The cardiac function may be deteriorated in children as well as adults during long-term follow up. Thus early diagnosis and long-term follow-up must be done. So, the nation-wide multicenter clinical study would be mandatory to evaluate the incidence, long-term prognosis, and establishment of objective diagnostic criteria of INVM.

• Clinical and Experimental Pediatrics
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• v.51 no.11
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• pp.1217-1221
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• 2008

Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

• Clinical and Experimental Pediatrics
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• v.50 no.2
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• pp.190-197
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• 2007

Purpose : Reduced growth and microvascular complications have been recognized as consequences of type 1 diabetes mellitus (T1DM). We assessed the effect of T1DM on growth and factors associated with the development of microvascular complications. Methods : We conducted a retrospective longitudinal evaluation of 154 patients above 16 years of age. We analyzed factors which affect final height standard deviation scores (SDS) and development of microvascular complications. Results : Final height SDS was $-0.11{\pm}1.15$ ($-0.26{\pm}1.33$ in females, $0.04{\pm}0.91$ in males). Final height SDS was significantly lower than midparental height SDS and height SDS at diagnosis. There was no difference in final height SDS according to age at onset, existence or nonexistence of complications, or average $HbA_{1C}$. Height SDS at onset of puberty, midparental height SDS and pubertal growth gain affected final height SDS. The number of patients with complications was 37 (24 percent). Microvascular complications developed at a younger age and after longer duration of diabetes in patients with a prepubertal onset of T1DM compared to patients with pubertal onset. Patients with complications had a higher level of average $HbA_{1C}$ than patients without complications. Patients whose microalbuminuria regressed had lower levels of average $HbA_{1C}$, systolic BP, second 24h urine microalbumin than patients with persistant or progressed microalbuminuria. Conclusion : The results suggest that degrees of glycemic control don't affect final height, but various factors associated with T1DM can impair growth potential. Additionally, the degrees of glycemic control and puberty affect the development of microvascular complications.

• Tuberculosis and Respiratory Diseases
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• v.60 no.1
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• pp.76-82
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• 2006

Background : The objective of this study was to understand sleep-related problems, and to determine whether the sleep questionnaires is a clinically useful method in patients who need polysomnography. Methods : Subjects were patients who performed polysomnography and who asked to answer a sleep questionnaires at the Sleep Disorders Clinic of St. Paul's Hospital, Catholic University of Korea. Baseline characteristics, past medical illness, behaviors during sleep-wake cycle, snoring, sleep-disordered breathing and symptoms of daytime sleepiness were analyzed to compare with data of polysomnography. Results : The study population included 1081 patients(849 men, 232 female), and their mean age was $44.2{\pm}12.8years$. Among these patients, 38.9% had an apnea-hypopnea index(AHI)<5, 27.9% had $5{\leq}AHI<20$, 13.2% had $20{\leq}AHI<40$, and 20.0% had $40{\leq}AHI$. The main problems for visiting our clinic were snoring(91.7%), sleep apnea(74.5%), excessive daytime sleepiness(8.0%), insomnia(4.3%), bruxism(1.1%) and attention deficit(0.5%). The mean value of frequency of interruptions of sleep was 1.6 and the most common reason was urination(46.3%). Epworth Sleepiness Scale(ESS) had a weak correlation with AHI(r=0.209, p<0.01). When we performed analysis of sleep questionnaires, there were significant differences in the mean values of AHI according to the severity of symptoms including snoring, daytime sleepiness, taking a nap and arousal state after wake(p<0.05). Conclusion : On the basis of statistical analysis of sleep questionnaires, the severity of subjective symptoms such as ESS, snoring, daytime sleepiness and arousal state after wake correlated with the AHI significantly. Therefore the sleep questionnaires can be useful instruments for prediction of the severity of sleep disorder, especially sleep-disordered breathing.

• Journal of the Korea Society for Simulation
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• v.29 no.1
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• pp.11-21
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• 2020

Cardio-cerebrovascular diseases (CCD) account for 24% of the causes of death to Koreans and its proportion is the highest except cancer. Currently, the risk of the cardiovascular disease for domestic patients is based on the Framingham risk score (FRS), but accuracy tends to decrease because it is a foreign guideline. Also, it can't score the risk of cerebrovascular disease. CCD is hard to predict, because it is difficult to analyze the features of early symptoms for prevention. Therefore, proper prediction method for Koreans is needed. The purpose of this paper is validating IG-MLP (Information Gain - Multilayer Perceptron) evaluation based feature selection method using CCD data with simulation. The proposed method uses the raw data of the 4^th ~ 7^th of The Korea National Health and Nutrition Examination Survey (KNHANES). To select the important feature of CCD, analysis on the attributes using IG-MLP are processed, finally CCD prediction ANN model using optimize feature set is provided. Proposed method can find important features of CCD prediction of Koreans, and ANN model could predict more accurate CCD for Koreans.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.4
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• pp.255-263
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• 2009

Objective: The objective of the study was to determine the diagnostic performance of transabdominal ultrasound by receiver operating characteristic (ROC) curve analysis, in order to evaluate the usefulness in establishing the diagnosis of polycystic ovary syndrome (PCOS). Methods: Questionnaires were given to 8,793 reproductive women reviewed at Ewha Womans University Mokdong hospital. Ultrasound examinations were performed in 701 women with a transabdominal transducer. Transabdominal ultrasounds were performed in 185 normal control women (normal menstruation without hyperandrogenism or PCO morphology) and 248 PCOS patients according to National Institutes of Health (NIH) PCOS diagnosis criteria. ROC curves were calculated for ovarian volume and follicle number. Results: In normal control group, the mean age were $23.64{\pm}4.26$ years old and the mean ovarian volume and follicle number were $6.03{\pm}1.89\;cm^3$ and $6.49{\pm}1.93$, respectively. The ovarian volume showed an area under the ROC curve (AURC) of 0.761. A ovarian volume decision threshold >$9\;cm^3$ had a sensitivity of 51.0% and a specificity of 91.4% for the diagnosis of PCOS. The follicle number showed an AURC of 0.733. A follicle number decision threshold ${\geq}9$ had a sensitivity of 54.9% and a specificity of 87.0% for the diagnosis of PCOS. A follicle number decision threshold ${\geq}10$ had a sensitivity of 53.2% and a specificity of 90.4%. A follicle number and a ovarian volume did not have a high diagnostic power for screening for PCOS. Conclusion: Our results suggest that transabdominal ultrasound assessment is not effective for the detection of PCOS in young women of reproductive age.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.15 no.2
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• pp.168-177
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• 2004

Objectives : This study was done to develop Korean form of Reynolds' SIQ-JR(Suicidal Ideational Questionnaire-Junior). Through this study we evaluated reliability and validity of Korean form SIQ-JR. Methods : Subjects were 1,160 middle and high school students and 114 adolescent psychiatric patients. SIQ-JR and 8 self-reporting scales highly related with suicidal ideation and suicide behaviors were applied to them. Results : In reliability aspect of Korean form of SIQ-JR, internal consistency, test-retest reliability and item-total correlation were statistically significant results. In factor analysis, concerning about other person was extracted as a indepenedent factor. This results reflect our cultural characteristics. There were statistical differences of SIQ-JR scores in groups by sex and age. Clinical group showed significantly(P<0.01) higher scores than general population. Among the 8 suicidal relating scales, depression(r=0.42), aggression(r=0.36), trait anxiety(r=0.35), and anger-in(r=0.31) were highly related with suicidal ideation but impulsivity and hopelessness were not significantly related with suicidal ideation. Conclusion : Korean form of SIQ-JR was useful instrument in reliability and validity. We hope that this instrument widely used in school mental health, community psychiatry and clinical setting for screening tool.