• Title/Summary/Keyword: First episode

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A Case of Transient Psychosis Suspected to be Induced by Arachnoid Cyst, Which was Responsive to Risperidone (거미낭으로 일과성 정신병 유발이 의심되고 리스페리돈 치료에 효과적이었던 증례)

  • Bahk, Won-Myong;Pae, Chi-Un;Jun, Taeyoun;Kim, Kwang-Soo;Lew, Tae-Yul
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.153-155
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    • 2001
  • There had been few reports of arachnoid cyst accompanying psychiatric disturbance and no report treated with low-dose risperidone administration. We report a patient, developed first-transient psychotic episode considered to be provoked by an arachnoid cyst, responsive to risperidone, which was found in the middle cranial fossa as follows. A 57-year-old man was admitted by suddenly developed headache, auditory hallucination, delusion of persecution and, an arachnoid cyst in the anteromedial aspect of middle cranial fossa was found on MRI after admission. The psychotic episode was first to him and he was also negative to other clinical evaluation including endocrine abnormality, his psychotic symtom was suspected to be induced by arachnoid cyst and was well controlled to low-dose risperidone administration. He left hospital free from psychotic symptoms on 14 hospital days.

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Estimating Influence of Biogenic Volatile Organic Compounds on High Ozone Concentrations over the Seoul Metropolitan Area during Two Episodes in 2004 and 2007 June (자연배출량이 수도권 고농도 오존 사례에 미치는 영향범위 추정: 2004년과 2007년 6월 사례를 중심으로)

  • Kim, Soon-Tae
    • Journal of Korean Society for Atmospheric Environment
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    • v.27 no.6
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    • pp.751-771
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    • 2011
  • Biogenic Volatile Organic Compound (BVOC) emissions are estimated with BEIS3.12 (Biogenic Emissions Inventory System version 3.12) over the Seoul Metropolitan Area (SMA) and then used in CMAQ (Community Multiscale Air Quality) simulations for two high ozone episodes in 2004 and 2007 June. The first- and second-order sensitivity coefficients of ozone to BVOC emissions are estimated with High-order Decoupled Direct Method (HDDM) simulation in order to estimate the influence of BVOC emissions on ozone using the Zero-Out Contribution (ZOC) approach. ZOC analysis shows that relative contribution of BVOC emissions on daily maximum 1-hr ozone is as high as 30% for high ozone days above 100 ppb. However simulated isoprene concentrations were over-estimated by a factor of 2 when compared to the observations at the PAMS (Photochemical Air Monitoring Station) for the 2007 episode. When assumed that actual BVOC emissions are 50% less than estimated, the ZOC of BVOC emissions on daily maximum ozone drops by more than 10 ppb for the episode. The result indicates that uncertainty in BVOC emissions may have significant impact on high ozone prediction in the SMA.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Journal of Audiology & Otology
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    • v.25 no.2
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    • pp.89-97
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    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

Sequential Vestibular Neuritis: Report of Four Cases and Literature Review

  • Comacchio, Francesco;Mion, Marta;Armato, Enrico;Castellucci, Andrea
    • Korean Journal of Audiology
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    • v.25 no.2
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    • pp.89-97
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    • 2021
  • Background and Objectives: Bilateral sequential vestibular neuritis (BSVN) is a rare condition in which an inflammation or an ischemic damage of the vestibular nerve occurs bilaterally in a sequential pattern. We described four cases of BSVN. Subjects and Methods: Every patient underwent video-head impulse test during the first and the second episode of vestibular neuritis (VN), furthermore they have been studied with radiological imaging. Results: Contralateral VN occurred after a variable period from prior event. Vestibular function recovered from the first episode in one case. The other three patients developed contralateral VN. One case was due to a bilateral VN in association with a Ramsay-Hunt syndrome, in another patient clinical records strongly suggested an ischemic etiology, whereas in two cases aetiology remained uncertain. Two patients subsequently developed a benign paroxysmal positional vertigo involving the posterior canal on the side of the latest VN (Lindsay-Hemenway syndrome). Conclusions: Instrumental vestibular assessment represents a pivotal tool to confirm the diagnosis of VN and BSVN.

A Case with Subdural Hemorrhage as the First Symptom of Extrahepatic Biliary Atresia (경막하 출혈에 의하여 발견된 선천성 담도폐색증 치험 1예)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.1 no.1
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    • pp.63-67
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    • 1995
  • Although bleeding was reported before as the first symptom in a few cases of biliary atresia, this association is not generally known. We treated 115-day-old female with extrahepatic biliary atresia presented with subdural hemorrhage rather than with prolonged jaundice. Four years after craniectomy and Kasai's hepatic portojejunostomy, she looks happy without jaundice nor brain damage sequela even though she had recent episode of esophageal variceal bleeding.

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Analysis of the high PM10 concentration episode on July 2005 at Seoul (2005년 7월 서울시 미세먼지 고농도 현상에 대한 분석)

  • Lee, Hyung-Min;Kim, Jung Youn;Kim, Yong Pyo
    • Particle and aerosol research
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    • v.7 no.2
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    • pp.49-57
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    • 2011
  • High concentration of PM10 was reported on late July, 2005 in Seoul along with high particulate ion concentrations in PM2.5. To identify the reason for the severe air pollution episode, time series analysis of the PM10 concentration in the monitoring sites over Korea, wind sector analysis, trend analysis of the ion concentrations, and air mass trajectory analysis were carried out. It was found that the episode could be classified into two separate periods; first one between July 22 and 27 and second one between July 28 and 31. During the first period, the PM10 concentrations at Seoul were in good correlation with the PM10 concentration three hours before at Chuncheon. Trajectory analysis showed that air mass moved from north and turned to west at Kangwon province to Seoul. The concentrations of PM10 mass and ionic species were lower than the second period. During the second period, air mass moved from northern China to Seoul directly and the PM10 concentrations all over the mid-Korean peninsula showed the same trend. These observations suggest that the air pollution during the second period was affected by direct transport of air pollutants from northern China. Thus, the air quality at Seoul during both periods were influenced by long-range transport from outside rather than by local sources, but with different transport patterns.

An Evaluative Analysis of the Referral System for Insurance Patients (보험진료체계 개편의 효과에 대한 연구)

  • Han, Dal-Sun;Kim, Byungy-Ik;Lee, Young-Jo;Bae, Sang-Soo;Kwon, Soon-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.485-495
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    • 1991
  • This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

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Utilization of health insurance data in an environmental epidemiology

  • Ha, Jongsik;Cho, Seongkyung;Shin, Yongseung
    • Environmental Analysis Health and Toxicology
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    • v.30
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    • pp.12.1-12.7
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    • 2015
  • Objectives In South Korea, health insurance data are used as material for the health insurance of national whole subject. In general, health insurance data could be useful for estimating prevalence or incidence rate that is representative of the actual value in a population. The purpose of this study was to apply the concept of episode of care (EoC) in the utilization of health insurance data in the field of environmental epidemiology and to propose an improved methodology through an uncertainty assessment of disease course and outcome. Methods In this study, we introduced the concept of EoC as a methodology to utilize health insurance data in the field of environmental epidemiology. The characterization analysis of the course and outcome of applying the EoC concept to health insurance data was performed through an uncertainty assessment. Results The EoC concept in this study was applied to heat stroke (International Classification of Disease, 10th revision, code T67). In the comparison of results between before and after applying the EoC concept, we observed a reduction in the deviation of daily claims after applying the EoC concept. After that, we categorized context, model, and input uncertainty and characterized these uncertainties in three dimensions by using uncertainty typology. Conclusions This study is the first to show the process of constructing episode data for environmental epidemiological studies by using health insurance data. Our results will help in obtaining representative results for the processing of health insurance data in environmental epidemiological research. Furthermore, these results could be used in the processing of health insurance data in the future.

The Effect of Extracellular Glutamate Release on Repetitive Transient Ischemic Injury in Global Ischemia Model

  • Lee, Gi-Ja;Choi, Seok-Keun;Eo, Yun-Hye;Kang, Sung-Wook;Choi, Sam-Jin;Park, Jeong-Hoon;Lim, Ji-Eun;Hong, Kyung-Won;Jin, Hyun-Seok;Oh, Berm-Seok;Park, Hun-Kuk
    • The Korean Journal of Physiology and Pharmacology
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    • v.13 no.1
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    • pp.23-26
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    • 2009
  • During operations, neurosurgeons usually perform multiple temporary occlusions of parental artery, possibly resulting in the neuronal damage. It is generally thought that neuronal damage by cerebral ischemia is associated with extracellular concentrations of the excitatory amino acids. In this study, we measured the dynamics of extracellular glutamate release in 11 vessel occlusion(VO) model to compare between single occlusion and repeated transient occlusions within short interval. Changes in cerebral blood flow were monitored by laser-Doppler flowmetry simultaneously with cortical glutamate level measured by amperometric biosensor. From real time monitoring of glutamate release in 11 VO model, the change of extracellular glutamate level in repeated transient occlusion group was smaller than that of single occlusion group, and the onset time of glutamate release in the second ischemic episode of repeated occlusion group was delayed compared to the first ischemic episode which was similar to that of single 10 min ischemic episode. These results suggested that repeated transient occlusion induces less glutamate release from neuronal cell than single occlusion, and the delayed onset time of glutamate release is attributed to endogeneous protective mechanism of ischemic tolerance.

Risk factors for recurrent urinary tract infections in young infants under the age of 24 months

  • Min Hwa Son;Hyung Eun Yim
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.35-43
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    • 2024
  • Purpose: Recurrent urinary tract infections (UTIs) in children is a major challenge for pediatricians. This study was designed to investigate the risk factors for recurrent UTIs and determine the association between recurrent UTIs and clinical findings, including growth patterns in infants and children younger than 24 months of age. Methods: We retrospectively reviewed the medical records of 147 patients <24 months of age with UTIs who were hospitalized between August 2018 and October 2021. The patients were divided into recurrent and single UTI episode groups. Clinical findings and anthropometric and laboratory data were compared between the two groups. Results: In the recurrent UTI group, the weight-for-length (WFL) percentile at the first UTI diagnosis was lower compared to the single UTI episode group, and the weight-for-age percentile at 3-month and 6-month follow-ups after the first UTI decreased (all P<0.05). In univariable logistic regression analysis, higher birth weight, lower WFL percentile, the presence of hydronephrosis, acute pyelonephritis or vesicoureteral reflux, the use of prophylactic antibiotics, and non-Escherichia coli infections were associated with the development of recurrent UTIs (all P<0.05). However, in the multivariable analysis, only the presence of hydronephrosis and prophylactic antibiotic use were independently related to UTI recurrence (P<0.05). Conclusions: The presence of hydronephrosis at the first UTI can be helpful for predicting UTI recurrence in young children aged <24 months. Antibiotic prophylaxis may be associated with UTI recurrence. Potential growth delay should be carefully monitored in infants with recurrent UTI.