• Title/Summary/Keyword: Severity of symptoms

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Restless Legs Syndrome and Quality of Life in Hemodialysis Patients (혈액투석을 받는 만성신부전 환자에서 하지불안증후군과 삶의 질)

  • Choi, Hyun-Seok;Kang, Seung-Gul;Boo, Chang-Su;Lee, Heon-Jeong;Cho, Won-Yong;Kim, Hyoung-Kyu;Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.14 no.2
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    • pp.99-106
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    • 2007
  • Objective: Restless legs syndrome (RLS) is known to be associated with chronic renal failure (CRF) patients on hemodialysis, however the prevalence of RLS in CRF patients on hemodialysis is variable due to different diagnostic criteria or dialysis technique. A few reports have indicated the association between RLS symptom and lower life quality in CRF patients on hemodialysis. This study aims to investigate the prevalence of RLS and its association with the quality of life in CRF patients of a single dialysis unit in Korea. Methods: A total of 83 Korean CRF patients on hemodialysis in the Korea University Hospital were examined. International Restless Legs Syndrome Study Group (IRLSSG) criteria and International Restless Legs Scale (IRLS) were used to determine the diagnosis and severity of RLS. Questionnaires including Athens Insomnia Scale (AIS), Epworth sleepiness scale (ESS), and Medical Outcome Study Form-36 (SF-36) were administered to all the patients for the assessment of sleep and quality of life. Hamilton Depression Rating Scale (HDRS) and Clinical Global Impression (CGI) were also measured for depression and status of mental illness by psychiatrist. Results: Of the 83 patients, 31 (37.3%) patients were found to have RLS and 43 (51.8%) patients met at least one of the RLS diagnostic criteria. The AIS (t=2.40, p=0.019), ESS (t=2.41, p=0.018), HDRS (t=3.85, p<0.001) and CGI (t=3.52, p=0.001) were higher in the subjects with RLS compared to other subjects. The SF-36 scores were significantly lower in the patients with RLS except physical functioning and bodily pain. Total (p=0.005), physical component (p=0.019), and mental component scores (p=0.019) of SF-36 were significantly lower in patients with more severe RLS symptoms. Conclusion: There was significant relationship between RLS and poor quality of sleep and life. More severe RLS symptom was proven to be an important factor to make a quality of life worsen.

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Clinical Characteristic and Respiratory Disturbance Index as Correlates of Sleep Architecture in Obstructive Sleep Apnea Syndromes Diagnosed with Polysomnography (수면다원기록법으로 확진된 폐쇄성 수면무호흡증 환자의 임상특성, 그리고 호흡장애지수와 수면 구조간의 상관관계)

  • Kim, Seog-Joo;Park, Doo-Heum;Kim, Yong-Sik;Woo, Jong-Inn;Ha, Kyoo-Seob;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.8 no.2
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    • pp.113-120
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    • 2001
  • Objectives: Obstructive sleep apnea syndrome is common and may produce various symptoms and serious complications. A substantial number of research articles on obstructive sleep apnea syndrome have been published in Korea. However, we found such limitations as lack of sufficient sample size and lack of polysomnography-proven cases. Therefore, we aimed at studying clinical features and sleep structure in a sufficient number of Korean patients with obstructive sleep apnea syndrome diagnostically confirmed with polysomnography. Methods: We studied 801 subjects referred to the Division of Sleep Studies, Seoul National University Hospital, who were diagnosed as having obstructive sleep apnea syndrome with polysomnography. Subjects were excluded if they had central sleep apnea syndrome, periodic limb movement disorder, narcolepsy or REM sleep behavior disorder. Foreign patients were also excluded. First of all, we studied the clinical features of the subjects. Secondly, we compared sleep-related parameters of the study subjects with those of age/sex-matched normal values. Thirdly, correlations of respiratory disturbance index (RDI) with each of the sleep-related parameters were calculated. Results: Among the 801 subjects, 668 were male subjects (83.4%) and 133 female subjects (16.4%). Their mean age was 46.6 years (${\pm}13.5$). The mean body mass index (BMI) was 25.8 (${\pm}3.8$) and subjects with BMI was over 28.0 accounted for 22.8% of the total. Fifty subjects (6.2%) were found to take benzodiazepines. Mean RDI and mean nocturnal oxygen saturation of all subjects was 31.2 (${\pm}24.4$) and 94.5% (${\pm}3.6$), respectively. In comparison with normal values, the subjects showed longer sleep latency, lower sleep efficiency, decreased total slow wave sleep % (TSWS %), and decreased total REM sleep % (TREM %)(p<0.01 in all). RDI had a negative correlation with each TSWS % and TREM % (p<0.01, p<0.01). However, RDI did not have significant correlation with either sleep latency or sleep efficiency. Conclusion: In this study, 6.2% of patients diagnosed as having obstructive sleep apnea syndrome were found to take benzodiazepines, although they are generally considered to be of litte benefit or even dangerous because of the respiratory suppressing effect. The proportion of obese subjects was only 22.8% and Korean patients with obstructive sleep apnea syndrome seem to be less obese than those described in foreign journals. This study also suggests that the severity of obstructive sleep apnea syndrome may have a more significant effect on sleep architecture defined as TSWS % and TREM % than on sleep efficiency.

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A Study of Pulmonary Function and HRCT Findings in Asthma Patients According to the Response after Treatment (기관지 천식 환자에서 치료 반응의 차이에 따른 폐 기능 및 고해상 CT 소견의 고찰)

  • NamKung, Eun-Kyung;Kim, Kyung-Ho;Kim, Ki-Up;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Park, Jae-Sung
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.5
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    • pp.1051-1062
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    • 1997
  • Background : In asthma, airway obstruction is usually reversible, either spontaneously or with treatment. However, the responses to treatment are variable and some patients show an irreversible component of airflow obstruction. This may be associated with structural changes in the airway. To assess the relationship between the difference in airway reversibility and structural changes, we evaluated the HRCT findings and pulmonary function test. Methods : We studied 40 asthmatic subjects who had had acute exacerbation of symptoms and had showed normal chest X-ray findings. They had monitered PEFR daily, and had performed PFT and HRCT within three days after initiation of treatment. According to serial PEFR, they were grouped into 3 categories (Group 0 ; initial PEFR was within normal limit, Group 1 ; revealed increment of 30% in PEFR within 3 days after initiation of treatment, Group 2 ; revealed within 2 weeks) and then grouped again into 4 (Group 0, Group 3 ; reached to normal value of PEFR within 3 days after initiation of treatment, Group 4 ; within 2 weeks, Group 5 ; not within 2 weeks). Results : (1) Age in Group 0 was significantly lower than other groups(p<0.05), but there was no significance in other groups. (2) Duration of asthma in Group 2 was significantly longer than Group 0, 1(p<0.05). (3) FVC(%) and FEV1(%) were significantly decreased with delayed response to the treatment (p<0.05). (4) $FEV_1$/FVC(%) in Group 1, 2 were significantly lower than Group 0(p<0.05). $FEV_1$/FVC(%) in Group 5 was significantly lower than Group 0,3,4 (p<0.05). (5) Air trapping was increased significantly with delayed response to the treatment (p<0.05). (6) Mucus impaction in Group 0 was significantly larger than Group 1,2 (p<0.05). $FEV_1$/FVC(%) in Group 0,4,5 were significantly larger than Group 3 (p<0.05). Conclusion : Difference in reversibility of airway obstruction was associated with age, duration of asthma and severity of initial airflow obstruction There was no definite difference in HRCT findings in asthma.

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Diurnal Variation and Sleep Pattern in Depressive Patients (우울증 환자의 주간기분변동과 수면 양상)

  • Park, Young-Min;Kim, Leen;Suh, Kwang-Yoon;Joe, Sook-Haeng;Kang, Seung-Gul;Yoon, Ho-Kyung
    • Sleep Medicine and Psychophysiology
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    • v.8 no.1
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    • pp.30-36
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    • 2001
  • Object: Diurnal variation is included in the diagnostic criteria of the major depressive disorder, melancholic specifier. But there has been controversy over whether diurnal variation is an unique depressive symptoms or a symptom related to a change of sleep patterns, or that of another mechanism, when the previous studies are reviewed. We investigated the existence of diurnal variation according to the subtype of depression and whether diurnal variation is charateristic of melancholic depression or not. We also compared sleep variables according to the existence of diurnal variation. Method: We examined diurnal variation, sleep patterns, severity of depression using the Visual Analogue Mood Scale, Pittsburgh Sleep Quality Index, and Hamilton Depression Rating Scale. Patients recorded their mood state on the Visual Analogue Mood Scale twice a day, morning and evening, for diurnal variation. We divided depressive patients into two groups,-diurnal variation group and nondiurnal variation group,-and compared the mood and sleep variables using SPSS. Results: The frequency of diurnal variation is not significantly different among the subtypes of depression. Significant differences between the diurnal variation group and the nondiurnal variation group existed in middle insomnia and sleep time (p<0.05). In melancholic type, al significant difference between the diurnal variation group and the nondiurnal variation group was noticed in PSQI total, sleep latency, sleep disturbances, daytime dysfunction as well as middle insomnia and sleep time (p<0.05). Conclusions: Diurnal variation existed in other types of depression as well as melancholic type. The results showed that diurnal variation was not a specific symptom of melancholic type, and existence of diurnal variation might be related to sleep patterns.

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Effects of a Soil-Born Paenibacillus spp. Strain KPB3 on Suppression of Bacterial Wilt Disease Caused by Ralstonia solanacearum (토양에서 분리한 Paenibacillus spp. KPB3의 Ralstonia solanacearum에 의한 세균성 풋마름병 억제 효과)

  • Suk, Jung-Ki;Ipper, Nagesh S.;Lee, Seon-Hwa;Shrestha, Anupama;Park, Duck-Hwan;Cho, Jun-Mo;Hur, Jang-Hyun;Kim, Byung-Sup;Lim, Chun-Keun
    • The Korean Journal of Pesticide Science
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    • v.10 no.4
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    • pp.313-319
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    • 2006
  • Two hundred bacterial strains were isolated from the soil around healthy tomato plants in a polyvinyl house, where most of the other plants showed bacterial wilt symptoms. The strains were screened in vitro for their antibacterial activity. Among them, a strain, KPB3 showed strong bactericidal activity against bacterial wilt pathogen, Ralstonia solanacearum. The strain KPB3 was identified using physiological and biochemical tests, and 16S rRNA analyses. Based on these tests, the strain was found to be closer to genus Paenibacillus. To control the bacterial wilt caused by R. solanacearum, greenhouse experiments were conducted to determine the effectiveness of the Paenibacillus strain KPB3. Drench application of this strain ($4{\times}10^8$ CFU $mL^{-1}$) into the pots containing tomato plants, post-inoculated with the pathogen, R. solanacearum could drastically reduce the disease severity, compared to the non-treated plants. To evaluate effectiveness of this strain under field conditions, experiments were carried out in polyvinyl houses infested with R. solanacearum, during spring and autumn of the year 2006. It was observed that, during spring, bacterial wilt was more prevalent compared to the autumn. During spring, 50.9% disease incidences occurred in non-treated controls, while, Paenibacillus strain KPB3 treated plants showed 24.6% disease incidences. Similarly, during autumn, around 17.2% plants were infected with bacterial wilt in non- treated polyvinyl houses, compared to the Paenibacillus strain KPB3 treated plants, which showed 7.0% disease incidences. These results demonstrated that, Paenibacillus strain KPB3 is a potential biological control agent against bacterial wilt caused by R. solanacearum, effective under greenhouse as well as field conditions. This is the first report showing biocontrol of R. solanacearum using a Paenibacillus spp. under field conditions.

Construction of Tomato yellow leaf curl virus Clones for Resistance Assessment in Tomato Plants (토마토 작물의 TYLCV 저항성 평가에 이용할 수 있는 감염성 클론 개발)

  • Choi, Seung Kook;Choi, Hak Soon;Yang, Eun Young;Cho, In Sook;Cho, Jeom Deog;Chung, Bong Nam
    • Horticultural Science & Technology
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    • v.31 no.2
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    • pp.246-254
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    • 2013
  • Five isolates of Tomato yellow leaf curl virus (TYLCV) collected from various regions of Korea were amplified using PCR and determined the sequences of full-length genome, respectively. The PCR-amplified DNA of each TYLCV isolate was introduced into a binary vector to construct infectious clone containing 1.9 copies of the corresponding viral genome. Various cultivars and breeding lines of tomato were inoculated with Agrobacterium tumefaciens harboring infectious clone of each TYLCV isolate to assess resistance against TYLCV. Susceptible cultivar 'Super-sunread' revealed typical yellowing and narrowing of the upper leaves. In contrast, breeding linesTY12, GC9, GC171, and GC173, which contained the TY-1 and/or TY-3 genes that confer resistance against TYLCV in nature, were completely symptomless, suggesting that the lines were resistant to challenging TYLCV isolates. Symptoms of TYLCV in susceptible tomato cultivars are significantly different from those of TYLCV in the resistant tomato cultivars at 30 days after agroinfiltration. Although genomic DNAs of TYLCV were detected from the breeding lines TY12, GC9, GC171, and GC173 using real-time PCR analysis with specific primers, levels of TYLCV DNA accumulation in the resistant breeding lines were much lower than those of TYLCV DNA accumulation in susceptible tomato cultivars. Similar symptom severity and levels of TYLCV DNA accumulation were observed from TYLCV infections mediated by Bemisia tabaci in the resistant and susceptible tomato cultivars. Concentration of agrobacterium did not affect the response of tomato cultivars against TYLCV inoculation. Taken together, these results suggest that TYLCV inoculation via agroinfiltration is as effective as inoculation through Bemisia tabaci and is useful for breeding programs of TYLCV-resistant tomato.

The Study of Normal Tissue Complication Probability(NTCP) for Radiation Pneumonitis by Effective Volume Method (유효체적 방법과 임상분석을 통한 방사선에 의한 정상 폐조직의 부작용 확률에 관한 연구)

  • Ahn Seung Do;Choi Eun Kyung;Yi Byong Yong;Chang Hyesook
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.243-249
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    • 1997
  • Purpose : In radiation therapy, NTCF is very importart indicator of selecting the optimal treatment plan. In our study, we tried to find out usefullness of NTCP in lung cancer by comparng the incidence of radiation pneumonitis with NTCP. Materials and Methods : From August 1993 to December 1994, thirty six patients with locally advanced non=small cell lung cancer were treated by concurrent chemoradiation therapy. Total dose of radiation therapy was 6480cGy (120cGy, bid) and chemotherapeutlc agents were mitomycin C. vinblastion, cisplatin (2 cycles, 4 weeks interval). We evaluated the development of raniation pneumonitis by CT scan, chest x-rar and clinical symptoms. We used grading system of South Western Oncology Group (SWOG) for radiation pneumanitis. Dose Volume Histograms (DVH) were analyzed for ipsilateral and whole lung, Non uniform DVH was translated to uniform DVH by effective volume method. With these data, we calculated NTCP for ipsilateral and whole lung. Finally we compared the clinical results to NTCP. Results : Eight of thrity six patients developed radiation pneumonitis. Of these 8 patients , 6 had grade I severity and 2 had grade II. The average NTCP value cf the patients who showed radiation pneumonitis was significantly higher than that uf the patients without pneumonitis $(66\%\;vs.\;26.4\%)$. But the results of pulmonary function test was not correlated with NTCP. Conclusion : NTCP of lung is very good indicator for selecting rival treatment planning in lung cancer. According to the results of NTCP, it may be possible to adjust target volume and optimize target dose. In the near future, we are going to anaiyze the effect of hyperfractionation and concurrent chemotherapy in addition to NTCP.

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Development of an Efficient Screening System for Resistance of Watermelon Plants to Didymella bryoniae (수박 덩굴마름병에 대한 효율적인 저항성 검정 방법 개발)

  • Lee, Ji Hyun;Jang, Kyoung Soo;Choi, Yong Ho;Kim, Jin-Cheol;Choi, Gyung Ja
    • Research in Plant Disease
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    • v.22 no.2
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    • pp.72-80
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    • 2016
  • Gummy stem blight, caused by the fungus Didymella bryoniae, is major disease of watermelons worldwide. The objective of the present study was to establish an efficient screening system to identify watermelon resistant to D. bryoniae. An GSB3 isolate was prepared from a watermelon plant showing typical symptoms of gummy stem blight in Haman-gun and identified as D. bryoniae based on molecular analysis of internal transcribed spacer sequence. A simple mass-production technique of inoculum was developed based on spore production of D. bryoniae GSB3 under several incubation conditions and their virulence on watermelon plants. Resistance degrees of 22 commercial watermelon cultivars to the GSB3 isolate were evaluated. Among them, four watermelon cultivars showing different degree of resistance response were selected for further study. Development of disease on the cultivars according to various conditions including inoculum concentrations, incubation periods in dew chamber, and incubation temperatures was investigated. From the results, we suggest an efficient screening method for resistant watermelon cultivars to gummy stem blight. Seeds of watermelon cultivar are sown and grown in a greenhouse until plant stage of 2-fully expanded leaves. Seedlings are inoculated with D. bryoniae by spraying spore suspension of the fungus at a concentration of $5.0{\times}10^5spores/ml$. The infected plants are incubated in humidity chamber at $25^{\circ}C$ for 48 hours and then transferred to a growth chamber at $25^{\circ}C$ and 80% relative humidity with 12-hour light a day. Three to four days after inoculation, disease severity of the plant are measured using percentage of infected leaf area.

Jet Lag and Circadian Rhythms (비행시차와 일중리듬)

  • Kim, Leen
    • Sleep Medicine and Psychophysiology
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    • v.4 no.1
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    • pp.57-65
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    • 1997
  • As jet lag of modern travel continues to spread, there has been an exponential growth in popular explanations of jet lag and recommendations for curing it. Some of this attention are misdirected, and many of those suggested solutions are misinformed. The author reviewed the basic science of jet lag and its practical outcome. The jet lag symptoms stemed from several factors, including high-altitude flying, lag effect, and sleep loss before departure and on the aircraft, especially during night flight. Jet lag has three major components; including external de synchronization, internal desynchronization, and sleep loss. Although external de synchronization is the major culprit, it is not at all uncommon for travelers to experience difficulty falling asleep or remaining asleep because of gastrointestinal distress, uncooperative bladders, or nagging headaches. Such unwanted intrusions most likely to reflect the general influence of internal desynchronization. From the free-running subjects, the data has revealed that sleep tendency, sleepiness, the spontaneous duration of sleep, and REM sleep propensity, each varied markedly with the endogenous circadian phase of the temperature cycle, despite the facts that the average period of the sleep-wake cycle is different from that of the temperature cycle under these conditions. However, whereas the first ocurrence of slow wave sleep is usually associated with a fall in temperature, the amount of SWS is determined primarily by the length of prior wakefulness and not by circadian phase. Another factor to be considered for flight in either direction is the amount of prior sleep loss or time awake. An increase in sleep loss or time awake would be expected to reduce initial sleep latency and enhance the amount of SWS. By combining what we now know about the circadian characteristics of sleep and homeostatic process, many of the diverse findings about sleep after transmeridian flight can be explained. The severity of jet lag is directly related to two major variables that determine the reaction of the circadian system to any transmeridian flight, eg., the direction of flight, and the number of time zones crossed. Remaining factor is individual differences in resynchmization. After a long flight, the circadian timing system and homeostatic process can combine with each other to produce a considerable reduction in well-being. The author suggested that by being exposed to local zeit-gebers and by being awake sufficient to get sleep until the night, sleep improves rapidly with resynchronization following time zone change.

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Prevalence and Its Correlates of Restless Legs Syndrome in Outpatients with Bipolar Disorders (양극성장애 환자의 하지불안증후군 유병율과 관련 특성)

  • Lee, Neung-Se;Yoon, Bo-Hyun;Lee, Hyun Jae;Sea, Young-Hwa;Song, Je-Heon;Park, Suhee;Lee, Ji Seon
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.2
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    • pp.121-129
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    • 2014
  • Objectives : This study was to assess the prevalence and its correlates of restless legs syndrome(RLS) in outpatients with bipolar disorder. Methods : A total of 100 clinical stabilized bipolar outpatients were examined. The presence of RLS and its severity were assessed using the International Restless Legs Sydrome Study Group(IRLSSG) diagnostic criteria. Beck's Depression Inventory(BDI), Spielberg's State Anxiety Inventory(STAI-X-1), Pittsburgh Sleep Quality Index(PSQI), Korean version Drug Attitude Inventory(KDAI-10), Subjective Well-Beings under Neuroleptic Treatment Scale-Short Form(SWN-K) and Barnes Akathisia Rating Scale(BARS) were used to evaluate the depressive symptomatology, level of anxiety, subjective quality of sleep, subjective feeling of well-being, drug attitude, presence of akathisia, respectively. Results : Of the 100 bipolar outpatients, 7(7%) were met to full criteria of IRLSSG and 36(36%) have at least one of the 4 IRLSSG criterion. Because of relatively small sample size, non-parametric analysis were done to compare the characteristics among 3 groups(full-RLS, 1 ${\geq}$positive RLS-symptom and Non-RLS). There were no significant differences in sex, age, and other sociodemographic and clinical data among 3 groups. BDI, STAI-X-1 and PSQI are tended to be impaired in RLS and 1 ${\geq}$positive RLS-symptom groups. Conclusions : This is the first preliminary study for studying the prevalence and its correlates of RLS in bipolar disorder. The results shows that relatively small proportion of RLS was present in bipolar disorder patients when compared to patients with schizophrenia. Same tendencies shown in schizophrenic patients were found that bipolar patients with RLS had more depressive symptoms, state anxiety and poor subjective sleep quality. Further systematic studies may be needed to find the characteristics of RLS in bipolar patients.

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