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Epidemiology and clinical characteristics of headache comorbidity with epilepsy in children and adolescents (소아청소년 간질 환자에서 동반된 두통의 역학과 임상적 특징)

  • Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.672-677
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    • 2007
  • Purpose : To assess the prevalence and characteristics of headache comorbidity with epilepsy in children and adolescents in a specialty epilepsy clinic. Methods : Two hundred twenty nine consecutive patients attending the Chosun University Hospital Pediatric Epilepsy Clinic (mean age $10.0{\pm}4.1\;years$, range 4-17, M:F ratio 1.1:1.0) were interviewed with a standardized headache questionnaire. Headache was classified according to the International Classification of Headache Disorders, 2nd Edition and epilepsy was classified according to the International League Against Epilepsy. Disability was assessed using pediatric migraine disability assessment (PedMIDAS). Results : Of the 229 epilepsy patients, 86 (37.6%) had co-morbid headache. Of the headache patients, 64 (74.4%) had migraine (65.6%- migraine without aura, 20.3% - migraine with aura, 14.1% - probable migraine). The mean headache frequency was $7.2{\pm}8.4$ per month, mean duration was $2.2{\pm}4.0$ hours, mean severity was $5.2{\pm}2.2$ out of 10, and mean PedMIDAS score was $13.0{\pm}35.4$. The proportion of females was not higher in epilepsy with headache patients (48.8%) compared to epilepsy patients alone (48.0%). In the patients with migraine, 48.4% had complex partial seizures, 17.2% had simple partial seizures, and 34.4% had generalized seizures (P=0.368). A postictal association of migraine was reported in 18.8% with 17.2% reporting a preictal headache, and 7.8% reporting an ictal headache. Conclusion : The prevalence of headache in pediatric epilepsy is higher than that in general pediatric population, suggesting a co-morbidity of headache in epilepsy patients with migraine being the most frequent headache disorder. Altered cerebral excitability resulting in an increased occurrence of spreading depression may explain the headache comorbidity with epilepsy. Further studies are needed to assess the etiology of this co-morbidity as well as assess the frequency, duration, severity and disability response to antiepileptic drugs.

A Efficacy of One-Stop Service in the Outpatient Clinic at the University Medical Center (3차 의료기관 외래진료에 있어 One stop service 도입의 효과)

  • Lee, Suk-Yeon;Chang, Sung-Goo
    • Korea Journal of Hospital Management
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    • v.6 no.2
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    • pp.70-85
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    • 2001
  • This study has been conducted, on the reservation of specific examinations during seven months starting from June 1999 and ending December as the Group I for these of one stop service and as the Group II for those of existing direct reservation made by patients or patrons, to understand the differences between the two groups. The survey was extended to the patients visiting specific departments of K hospital with sample sizes of 154 for the Group I and 155 for the Group II. The findings of the survey are as follows: First, as the general characteristics of the sample, male patients account for 67% of the total and female patients 33%, with the former twice as large as the latter. The average age of the patients is 51, indicating relatively high level. By the geographical area of residence, metropolitan area is 80.7% and the other area 19.3%, showing most of the patients are from metropolitan area. The general characteristics do not have statistical significance between the Group I and the Group II(p>0.05). Second, regarding the ratio by the number of examinations, the Group I shows 37.0% for one examination and 63.0% for two examinations, while the Group IT indicates 30.3% for one examination and 69.7% for two examinations. The populations by the number of examinations do not have statistical difference between the two Groups(p>0.05). Third, regarding the time required for the reservation of examinations by the number of examinations, the Group I shows 9.8 minutes for one examination and 19.8 minutes for two examinations, with the average of 16.1 minutes. The Group IT indicates 19 minutes for one examinations and 25.7 minutes for two examinations, with the average of 23.7 minutes. Though the time required for the reservation by the number of examinations do not have statistical significance, the time required for the Group I was shortened. Fourth, regarding the time required for the reservation of examinations by the age range of patients, the Group I shows 21.7 minutes for 70-79 years of age, 17.5 minutes for 60-00 years of age, and 15.2 minutes for 30-39 years of age. The Group II indicates 27.2 minutes for 70-79 years of age, 26.3 minutes for 60-69 years of age, 24.4 minutes for 50-59 years of age, and 22.4 minutes for 30-39 years of age. The time required for the reservation gets longer as the age range moves up, and has statistical significance (p<0.05). Fifth, regarding the ratio by the range of time of required for reservation, the Group I shows 41.6% for 11-20 minutes, and 38.3% for 1-10 minutes, while the Group II indicates 43.9% for 11-20 minutes, 29% for 21-30 minutes, and 14.2% for 31-40 minutes. Statistical significance is revealed (p=0.001). Sixth, concerning the length of movement course by the number of examinations, the Group I shows 37 meters regardless of the number of examinations. The Group II indicates an average of 188 meters for one examination and 189 meters for two examinations, with the difference 151 meters between the Groups, and representing statistical significance (p=0.001). Based on the above findings. one-stop service contributes to the reduction of both the time and the movement course and therefore is considered to be beneficial to the patients, and the improve the efficiency of the hospitals in terms of the space and the time.

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Alexithymia in Patients with Ulcerative Colitis and Irritable Bowel Syndrome (궤양성대장염 환자와 과민성대장증후군 환자의 감정표현불능증 비교 연구)

  • Lee, Sang-Bin;Lee, Seong-Yong;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.69-76
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    • 2003
  • Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

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Ethanol Extract of Glycyrrhiza uralensis Protects Against Oxidative Stress-induced DNA Damage and Apoptosis in Retinal Pigment Epithelial Cells (망막색소상피세포에서 감초 추출물의 산화적 스트레스에 의한 DNA 손상 및 apoptosis 유발의 차단 효과)

  • Kim, So Young;Kim, Jeong-Hwan;Kim, Sung Ok;Park, Seh-Kwang;Jeong, Ji-Won;Kim, Mi-Young;Lee, Hyesook;Cheong, JaeHun;Choi, Yung Hyun
    • Journal of Life Science
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    • v.29 no.11
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    • pp.1273-1280
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    • 2019
  • Age-related macular degeneration (AMD) is one of the leading causes of blindness in the elderly population, and damage to retinal pigment epithelial (RPE) cells due to oxidative stress contributes to the development of AMD. Glycyrrhiza uralensis Fischer is one of the most widely used herbal medicines for the treatment of various diseases in Asian countries. Although recent studies indicated that treatment with G. uralensis can protect cells from oxidative stress, its mechanisms in RPE cells remain unknown. We evaluated the effect of a G. uralensis ethanol extract (GU) on $H_2O_2$-induced oxidative injury in ARPE-19 RPE cells. The GU pretreatment attenuated reactive oxygen species (ROS) generation induced by $H_2O_2$, which was associated with induced expression of nuclear factor erythroid-derived-2-like 2 (Nrf2) and heme oxygenase-1 (HO-1). GU also suppressed $H_2O_2$-induced DNA damage and mitochondrial dysfunction. The inhibitory effect of GU on $H_2O_2$-induced apoptosis was associated with the protection of caspase-3 activation. Overall, GU appeared to protect RPE cells from oxidative injury by inhibiting DNA damage and reducing apoptosis. Further studies are needed to determine the regulation of Nrf2-mediated HO-1 expression, but our results suggest the possibility of using GU to reduce the risk of AMD.

Gender-wise analysis of the cephalometric factors affecting obstructive sleep apnea (성별에 따른 폐쇄성 수면무호흡 환자의 측모 두부방사선계측학적 관련요인)

  • Hwang, Sang-Hee
    • The korean journal of orthodontics
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    • v.41 no.3
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    • pp.164-173
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    • 2011
  • Objective: The purpose of this study was to perform gender-wise analysis of the related cephalometric factors affecting Korean patients with obstructive sleep apnea (OSA). Methods: We examined 118 adults who had visited the Sleep Disorder Clinic Center in Keimyung university, Daegu, Korea, and evaluated them by using poly-somnography (PSG) and lateral cephalograms. The patients were divided into 4 groups (male simple snorers, male OSA patients, female simple snorers, and female OSA patients) according to AHI (apnea-hypopnea index) and sex. Results: The position of the hyoid bone in the female OSA group was inferior to that in the female simple snorer group. Multiple regression analysis showed that tongue length and soft palate width were significant determinants for the severity of AHI in male OSA patients. However, inferior position of the hyoid was a significant determinant only in women. Conclusions: From a cephalometric point of view, OSA in male and female adult patients may be characterized by different pathogeneses. In particular, in female OSA patients, they might be managed by individualized treatments such as hormone replacement therapy in addition to conventional treatment.

Clinical Characteristics of Methylphenidate Use in Korean Children and Adolescents with Autism Spectrum Disorder : A Retrospective Study (소아청소년 자폐 스펙트럼장애에서 메칠페니데이트 사용의 임상적 특징에 대한 후향적 분석)

  • Park, Jin-Park;Lee, Jong-Il;Jhin, Hea-Kyung;Min, Hae-Ji;Hwang, Jun-Won;Kim, Ye-Ni
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.154-160
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    • 2012
  • Objectives : The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods : Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results : We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was $26.2{\pm}11.1$mg/day and mean duration of treatment was $31.9{\pm}28.7$ months. Mean CGI-S score improved significantly from baseline to endpoint (from $5.4{\pm}0.6$ to $4.1{\pm}0.9$ ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion : The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.

The Prevalence and Epidemiological Characteristics of Childhood Depressive Disorder in South Korea : Self Reported Study (소아기 우울장애의 유병률 및 역학적 특성 : 자가평가 연구)

  • Choi, Hae-Won;Lee, Moon-Soo;Lim, Myung-Ho;Kwon, Ho-Jang;Ha, Mi-Na;Yoo, Seung-Jin;Kim, Eun-Jeong;Paik, Ki-Chung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.134-142
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    • 2012
  • Objectives : Childhood depressive disorder one of the most prevalent chronic health conditions affecting school aged children. The objective of this study was to examine the prevalence and epidemiological characteristics of childhood depressive disorder in Korea. Methods : In this study, a survey was conducted of elementary school children in the Cheonan area from September 2009 to August 2010. A total of 12,084 children were included in the analyses. The primary measure of depression was the 27-item Kovacs' Children's Depression Inventory (CDI), the Korean Dupaul attention-deficit hyperactivity disorder Rating Scales (K-ARS), Autism Spectrum Screening Questionnaire (ASSQ) and Restless Legs Syndrome Questionnaire (RLSQ) were also administered. Results : The prevalence rate of childhood depressive disorder was 3.07%. The mean age was $9.21{\pm}1.81$ years for the control group (5,969 male, 6,054 female) and $9.91{\pm}1.83$ years for the depression group (CDI score${\geq}$22 ; 159 male, 210 female). Age, height, weight, and economic status were similar for the two groups. However, there were statistically significant differences in the distribution of sex. The distribution of school grade also differed between the two groups. Scores for CDI, K-ARS, and ASSQ in the depressive group were higher than those of the control group. Conclusions : This is the first large-scale population-based study to report on the prevalence of childhood depressive disorder in South Korea. Increased rates of childhood depressive disorder, as reported by primary caretakers, might reflect the increasing negative impact of environmental risk factors on neurobehavioral health. Longitudinal study of the prevalence of childhood depressive disorder should be considered for further evaluation.

Korea Academy of Prosthodontics criteria for longevity studies of dental prostheses (보철물 수명 연구를 위한 대한치과보철학회 표준 방안: KAP Criteria)

  • Yoon, Joon-Ho;Park, Young-Bum;Youn, Seung-Hwan;Oh, Nam-Sik
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.341-353
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    • 2016
  • Purpose: The most important factor in longevity studies of dental prostheses is objective and consistent evaluation of the prosthesis. The Korean Academy of Prosthodontics suggested developing a standardized method for longevity studies of dental prostheses. The purpose of this study is to evaluate previously-used criteria and to develop new criteria, in the form of a procedure flowchart and an evaluation sheet. These new criteria may be able to provide a unified standard for future longevity studies of dental prostheses. Materials and methods: A literature review was performed about the evaluation of dental prostheses. Taking into account the strengths and weaknesses of previously used criteria, a novel, intuitive and objective method was developed for assessment of dental prostheses. Then, a pilot survey was performed with the newly developed flowchart and evaluation sheet to determine problems and implement possible improvements. Results: Thirty cases of fixed dental prosthesis (FDP), 25 cases of removable dental prosthesis (RDP), and 13 cases of implant supported prosthesis (ISP) were evaluated. The average life expectancy estimate was 12.82 years for FDP, 5.96 years for RDP, and 4.82 years for ISP with Kaplan-Meier survival analysis. Additionally, possible improvements discovered by the pilot survey were reflected in the flowchart and evaluation sheet. Conclusion: The newly developed KAP criteria, flowchart and evaluation sheet enabled objective and consistent results in trial longevity studies of dental prostheses. It is expected that future studies will not only use the KAP criteria but also further improvement will be made on them.

A Transcultural Study for Testing Models of the Treatment-seeking Behaviors in Patients with Rheumatoid Arthritis (류마티스 관절염 환자의 치료행위 모형 검증을 위한 횡문화적 비교연구)

  • Lee, In-Sook;Lee, Eun-Ok;Eun, Young;Wilkie, Diana J.;Belza, Basia
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.253-277
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    • 1999
  • Patients with chronic disease have various treatment patterns because it shows a progressive degenerative feature. Especially various physical and emotional problems of the rheumatoid arthritis patients leave them shopping around various types of treatment. According to previous studies, over 70% of patients with arthritis experienced the traditional oriental medicine or folk remedies simultaneously with medical treatment within one year after the onset of disease. The purposes of this study are 1) to compare the patterns of treatment-seeking behaviors between Korean arthritis patients and Americans ; and 2) test two models of treatment-seeking behaviors by path analysis, one for early treatment-seeking behavior model(ETBM) and the other is chronic treatment-seeking behavior model (CTBM) in Korean sample. The interview survey was performed to 133 RA patients with structured questionnaire at out-patient clinic or public health center. Patients characteristics such as age, duration of disease were similar in two countries except higher educational background in Americans. There were no patients using only alternative therapies or no medical treatment in the US. Most of the American patients have chosen both medical treatment and alternative therapy, while the Koreans less than American. In Korea, combined treatment group usually consists of the people who are younger, more educated and higher economic status than the characters of other groups in early or chronic stages. In early stage, they tend to have strong belief of curing from the disease, satisfy the relationship with their physicians and comply with direction of the medical professional. The paths of two models were explained by 70% in ETBM and 33% in CTBM. When the models were modified, almost all paths of the CTBM were the same as the previous one, but direct determinant factor was changed from the relationship with physicians to the lay referral system in chronic model. These two models' explanation powers became 94% and 88%, respectively. The attitude or perception of disease, lay referral system and the relationship with medical personnel are the main determinants of treatment-seeking behaviors.

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Correlation Analysis of Clinical Risk Factors and Atherosclerosis Diagnosed by Carotid Artery Ultrasonography (경동맥 초음파로 진단된 죽상동맥경화증과 위험인자의 관련성 분석)

  • Jee-Yeon Park;Sung-Hee Yang
    • Journal of the Korean Society of Radiology
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    • v.17 no.3
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    • pp.465-472
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    • 2023
  • In predicting vascular disease, this study attempted to identify changes in the carotid intima-media thickness in patients who underwent carotid artery ultrasonography and hematological tests and to find out the effect of risk factors on the expression of atherosclerotic plaque. A retrospective analysis was conducted on 469 healthy adults who visited the hospital for the purpose of medical examination and performed carotid artery ultrasonography. As a result, carotid intima-media thickness, age, body mass index, waist circumference, systolic blood pressure, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and glucose were analyzed as significant predictors of atherosclerotic plaque (p<0.001). The risk ratio was calculated based on the cut off value of the risk factors of the atherosclerotic plaque determined through ROC curve analysis, followed by 8.06 times the carotid intima-media thickness, 7.53 times the age, 3.97 times the waist circumference and 2.02 times the glucose. Therefore, in this study it was possible to prepare a Korean standard for clinical risk factors that affect the presence of absence of atherosclerotic plaque and observation of carotid artery ultrasonography is thought to help diagnose or predict cardiovascular disease early.