• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.131-141
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• 2001

Purpose: We evaluated the sensitivity of the F-18 FDG PET by visual assessment and statistical parametric mapping (SPM) analysis for the localization of the epileptogenic zones in frontal lobe epilepsy. Materials and Methods: Twenty-four patients with frontal lobe epilepsy were examined. All patients exhibited improvements after surgical resection (Engel class I or II). Upon pathological examination, 18 patients revealed cortical dysplasia, 4 patients revealed tumor, and 2 patients revealed cortical scar. The hypometabolic lesions were found in F-18 FDG PET by visual assessment and SPM analysis. On SPM analysis, cutoff threshold was changed. Results: MRI showed structural lesions in 12 patients and normal results in the remaining 12. F-18 FDG PET correctly localized epileptogenic zones in 13 patients (54%) by visual assessment. Sensitivity of F-18 FDG PET in MR-negative patients (50%) was similar to that in MR-positive patients (67%). On SPM analysis, sensitivity decreased according to the decrease of p value. Using uncorrected p value of 0.05 as threshold, sensitivity of SPM analysis was 53%, which was not statistically different from that of visual assessment. Conclusion: F-18 FDG PET was sensitive in finding epileptogenic zones by revealing hypometabolic areas even in MR-negative patients with frontal lobe epilepsy as well as in MR-positive patients. SPM analysis showed comparable sensitivity to visual assessment and could be used as an aid in the diagnosis of epileptogenic zones in frontal lobe epilepsy.

• Korean Journal of Psychosomatic Medicine
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• v.11 no.1
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• pp.25-35
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• 2003

Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.315-324
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• 1996

The purpose of this study was to compare the specific binding ratio method with model-based methods in estimating the transporter parameter $k_3/k_4$ in normal controls and Parkinson's patients with [I-123]IPT SPECT and to evaluate the usefulness of [I-123]IPT SPECT. $6.5{\pm}1.1$ mCi ($239.0{\pm}40.3$ MBq) of [$^{123}I$]IPT was intravenouly injected as a bolus into six normal controls(age:$45{\pm}13$) and seventeen patients(age:$55{\pm}8$) with Pakinson's disease(PD). The transporter parameter $k_3/k_4$ was derived using the Ichise's graphical method($R_v$) and Lassen's area ratio method($R_A$) for the dynamic IPT SPECT data without blood samples. Then, the relationships between the transporter parameter $R-v,\;R_A$ and the ratio of (BG-OCC)/OCC at 115 minutes were evaluated by linear regression analysis. $R_vs$ by Ichise's graphical method for NC and PD were $2.08{\pm}0.29$ and $0.78{\pm}0.31$, respectively. $R_As$ by Lassen's area ratio method for NC and PD were $1.48{\pm}0.16$ and $0.65{\pm}0.24$, respectively. The correlation coefficients between (BG-OCC)/OCC and $R_v$, (BG-OCC)/OCC and $R_A$, and $R_v$ and $R_A$ were 0.93, 0.90, 0.99 and their corresponding slopes were 0.54, 0.34, and 0.65, respectively. The $R_v$ and $R_A$ of NC were significantly higher than the ones of PD. That is, the $k_3/k_4$ of NC was clearly separated from the one of PD. $k_3/k_4$ showed a good correlation with the ratio of (BG-OCC)/OCC. The results indicate that the noninvasive simplified quantitative methods may be useful to measure the transporter parameter $k_3/k_4$ and the specific binding ratio method can be used for quantitative studies of dopamine transporter with [I-123]IPT SPECT in humans brains.

• Journal of the Korean Society of Food Science and Nutrition
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• v.38 no.8
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• pp.1050-1061
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• 2009

The present study was performed to evaluate energy and nutrients intakes of stroke patients in Daegu Gyeongbuk region, and to analyze the relative risk of stroke related to the intake levels of energy and nutrients. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community residents who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews by trained dietitians using semiquantitative food frequency questionnaires. The odds ratios were calculated by using unconditional logistic regression. In male subjects, patient group had significantly higher consumption than the control group in mean daily intakes of energy, all energy yielding nutrients, vitamin $B_1$, $B_6$, niacin, folic acid, vitamin E, phosphorus, potassium, zinc and dietary fiber, and also in the ratio of energy intake from protein and fat. In women subjects, the patient group consumed significantly lower intakes than the control group in fat, vitamin C, folic acid, vitamin E, iron, but vice versa in carbohydrate energy ratio. As for men, the increased intakes of energy, protein, carbohydrate vitamin $B_1$, E and niacin, zinc, total fatty acids, monoand poly-unsaturated, n-6 fatty acids significantly raised the relative risk of stroke. As for women, the increased intakes of fat, vitamin A, $B_2$, $B_6$, niacin, vitamin C and E, iron, sodium, potassium, selenium, mono-, poly-unsaturated, n-6 fatty acids, cholesterol, taurine and dietary fiber significantly lowered the relative risk of stroke. The results of the study demonstrated that the effect of several nutrient intake levels, such as niacin, vitamin E and fatty acids, on the relative risk of stroke was inconsistent between sex. The reason for this sex difference needs to be elucidated in a larger scale study.

• The Korean Journal of Pharmacology
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• v.30 no.1
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• pp.29-37
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• 1994

Inhibition of the nociceptive Tail Flick Reflex (TFR) was observed with electrical stimulation of the locus coeruleus/subcoeruleus (LC/SC) in the male Sprague - Dawley rats under light anesthesia, and the involved neurotransmitter (s) were characterized. Electrical stimulation of LC/SC induced the analgesia with the stimulation threshold (intensity of the current, given for 100 usec and in 100 Hz frequency, which caused the TF latency longer than 6.5 sec) around 55 uA. Intrathecal administrations of ${\alpha}_2$ antagonist, yohimbine (30 ug) or opioid antagonist, naloxone (20 ug) increased the stimulation threshold by 147% and 123% respectively (from 55 uA to 135 uA,9 and from 54 uA to 123 uA;P0.01, n=5, each). The basal TF latency without stimulation (3.1 sec) was reduced by the antagonists (to 2.5 sec by yohimbine, p<0.05, n=5; to 2.6 sec by naloxone, p<0.1, n=5), vehicle only did not show any effect. Noradrenaline(NA) in the spinal cord superfusates measured with HPLC was increased by the LC/SC stimulation, from 4.18 ng/ml before to 7.74 ng/ml after stimulation (P<0.05, n=10). The result suggest that analgesia induced by LC/SC stimulation is mediated, at least in part, by the noradrenergic system in which ${\alpha}_2$ receptor is involved, as well as the opioid system.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.378-387
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• 2016

This study sought to investigate interrelationships and differences of brachial-ankle pulse wave velocity (baPWV), body composition and cardiovascular variables between genders who have been exercised or not in elderly. One hundred fifty participants were classified four groups. Especially out of variables, in male elderly group who had participated in exercise program the PWV range were significantly correlated with muscle mass (r=0.357, p=0.026), SBP (r=0.468, p=0.003), right baPWV (r=0.406, p=0.010), and left baPWV (r=0.333, p=0.038). In male elderly group who had not participated in exercise program, the PWV range were significantly correlated with heart rate (r=0.395, p=0.014), right baPWV (r=0.598, p=0.000), and left baPWV (r=0.602, p=0.000). In female elderly group who had participated in exercise program, the PWV range were significantly correlated with name of diagnosis (r=0.321, p=0.044), SBP (r=0.399, p=0.011), DBP (r=0.545, p=0.000), right baPWV (r=0.648, p=0.000), and left baPWV (r=0.676, p=0.000). In female elderly group who had not participated in exercise program, the PWV range were significantly correlated with age (r=0.471, p=0.003), right baPWV (r=0.836, p=0.000), and left baPWV (r=0.801, p=0.000). The PWV among four groups were not significant different after experiment. However, there were significant differences in the waist/hip ratio (F=9.197, p=0.000), muscle mass (F=74.295, p=0.000), and %fat (F=35.045, p=0.000) from body composition. And there were significant differences in the SBP (F=3.525, p=0.017) after experiment. In conclusion, these data show that regular exercise is associated with arterial compliance (PWV range, right or left PWV) and differed from genders. In other words, this paper may support the concept that regular exercise program may exert a protective effect on arterial compliance, body composition and cardiovascular systems.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.153-165
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• 2017

Objectives : Recent neuroimaging studies focus on dysfunctions in connectivity between cognitive circuits and emotional circuits: anterior cingulate cortex that connects dorsolateral orbitofrontal cortex and prefrontal cortex to limbic system. Previous studies on pediatric depression using DTI have reported decreased neural connectivity in several brain regions, including the amygdala, anterior cingulate cortex, superior longitudinal fasciculus. We compared the neural connectivity of psychotropic drug naïve adolescent patients with a first onset of major depressive episode with healthy controls using DTI. Methods : Adolescent psychotropic drug naïve patients(n=26, 10 men, 16 women; age range, 13-18 years) who visited the Korea University Guro Hospital and were diagnosed with first onset major depressive disorder were registered. Healthy controls(n=27, 5 males, 22 females; age range, 12-17 years) were recruited. Psychiatric interviews, complete psychometrics including IQ and HAM-D, MRI including diffusion weighted image acquisition were conducted prior to antidepressant administration to the patients. Fractional anisotropy(FA), radial, mean, and axial diffusivity were estimated using DTI. FMRIB Software Library-Tract Based Spatial Statistics was used for statistical analysis. Results : We did not observe any significant difference in whole brain analysis. However, ROI analysis on right superior longitudinal fasciculus resulted in 3 clusters with significant decrease of FA in patients group. Conclusions : The patients with adolescent major depressive disorder showed statistically significant FA decrease in the DTI-based structure compared with healthy control. Therefore we suppose DTI can be used as a bio-marker in psychotropic drug-naïve adolescent patients with first onset major depressive disorder.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.2
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• pp.129-135
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• 2017

Objectives : Little is known about the influence of urinary incontinence and depression on individual's QOL(Quality of life). We aimed to clarify how the interaction between urinary incontinence and depression influences one's QOL. Methods : A total of 1262 patients were enrolled in this study from April, 2011 to July, 2011. We estimated the severity of depressive symptoms and QOL, using SGDS-K, EQ-5D. We also investigated the morbidity of urinary incontinence for each patient in person or by questionnaire. Comparisons of QOL between groups with or without depression, with or without urinary incontinence were established using t-test, ANOVA and Scheffe's post hoc analysis. The interaction between urinary incontinence and depression was analyzed by each domain of QOL, using multiple regression analysis. Results : Patients with depression and urinary incontinence showed significantly higher EQ-5D scores on every domain of QOL than other patients, which means significantly lower QOL. Patients with depression, no urinary incontinence reported lower QOL, especially in the domain of 'usual activity', 'anxiety' and 'visual analogue scale(VAS)', whereas those with urinary incontinence, no depression showed lower QOL in 'motility', 'usual activities' and 'pain' domain. Statistically significant interaction effects of two diseases were observed in the domain of 'VAS', 'self care' and 'anxiety'. Conclusions : Comorbidity of urinary incontinence and depression showed significantly lower QOL of patients, compared with urinary incontinence or depression respectively, which implies additive interaction effects of the two diseases. Optimal diagnosis and treatment of depression should be emphasized for patients with urinary incontinence.

• Clinical and Experimental Pediatrics
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• v.52 no.2
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• pp.199-204
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• 2009

Purpose : Seizure associated with fever may indicate the presence of underlying inherited metabolic diseases. The present study was performed to investigate the presence of underlying metabolic diseases in patients with complex febrile seizures, using analyses of urine organic acids. Method : We retrospectively analyzed and compared the results of urine organic acid analysis with routine laboratory findings in 278 patients referred for complex febrile seizure. Results : Of 278 patients, 132 had no abnormal laboratory findings, and 146 patients had at least one of the following abnormal laboratory findings: acidosis (n=58), hyperammonemia (n=55), hypoglycemia (n=21), ketosis (n=12). Twenty-six (19.7 %) of the 132 patients with no abnormal findings and 104 (71.2%) of the 146 patients with statistically significant abnormalities showed abnormalities on the organic acid analysis (P<0.05). Mitochondrial respiratory chain disorders (n=23) were the most common diseases found in the normal routine laboratory group, followed by PDH deficiency (n=2) and ketolytic defect (n=1). In the abnormal routine laboratory group, mitochondrial respiratory chain disorder (n=29) was the most common disease, followed by ketolytic defects (n=27), PDH deficiency (n=9), glutaric aciduria type II (n=9), 3-methylglutaconic aciduria type III (n=6), biotinidase deficiency (n=5), propionic acidemia (n=4), methylmalonic acidemia (n=2), 3-hydroxyisobutyric aciduria (n=2), orotic aciduria (n=2), fatty acid oxidation disorders (n=2), 2-methylbranched chain acyl CoA dehydrogenase deficiency (n=2), 3-methylglutaconic aciduria type I (n=1), maple syrup urine disease (n=1), isovaleric acidemia (n=1), HMG-CoA lyase deficiency (n=1), L-2-hydroxyglutaric aciduria (n=1), and pyruvate carboxylase deficiency (n=1). Conclusion : These findings suggest that urine organic acid analysis should be performed in all patients with complex febrile seizure and other risk factors for early detection of inherited metabolic diseases.

• Clinical and Experimental Pediatrics
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• v.51 no.4
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• pp.415-419
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• 2008

Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.