• Archives of Pharmacal Research
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• v.27 no.10
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• pp.1065-1072
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• 2004

Depression is associated with a dysfunctional serotonin (5-hydroxytryptamine; 5-HT) system. More recently, several lines of evidence suggest that an important factor in the development of depression may be a deficit in the function and expression of $5-HT_{1A}$ receptors. The present study assessed if Nelumbinis Semen (N. s.) had an anti-depression effect through reversing a decrease in $5-HT_{1A}$receptor binding in rats with depression-like symptoms induced by chronic mild stress. Using a $5-HT_{1A}$ receptor binding assay, with a specific $5-HT_{1A}$receptor agonist, 8- OH-DPAT (8-hydroxy-2-(di-n-propylamino) tetralin), the mechanism of the anti-depression effect of N. s. on rats was investigated, and the effects compared with two well-known antidepressants, Hyperium Perforatum (St. Johns Wort) and fluoxetine (Prozac). Animals were divided into five groups: the normal (N) group without chronic mild stress (CMS), the control (C) group under CMS for 8 weeks, the Nelumbinis Semen (N. s.) treatment group under CMS for 8 weeks, the Hyperium Perforatum (H. p.) treatment group under CMS for 8 weeks and finally, the fluoxetine (F) treatment group under CMS for 8 weeks. Each treatment was administered to rats during the last 4 weeks of the 8-week CMS. A sucrose intake test was performed to test the anti-depression effect of N. s. The N. s. treatment significantly reversed the decreased sucrose intake under CMS (P<0.05 compared to control group under CMS). In the CA2 and CA3 regions of the hippocampus, both N. s. and H. p. reversed the CMS-induced decrease in $5-HT_{1A}$receptor binding. In the I to II regions of the frontal cortex, N. s. and H. p. also reversed the CMS-induced decrease in$5-HT_{1A}$receptor binding, and even showed a significant increase in $5-HT_{1A}$receptor binding compared to the F treatment group (N. s. vs. P, p<0.05, H. p. vs. P, p<0.05). However, in the hypothalamus, all treatments reversed the CMSinduced decrease in $5-HT_{1A}$receptor binding. This reversal effect of N. s. on the decrease in $5-HT_{1A}$receptor binding in the frontal cortex, hippocampus and hypothalamus of rat brains was very similar to that of H. p, but different from that of F. It is concluded that N. s. presents an anti-depression effect through enhancing $5-HT_{1A}$receptor binding.

• Journal of agricultural medicine and community health
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• v.30 no.1
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• pp.39-50
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• 2005

Objectives: This investigation was carried out to explore the source and the mode of transmission of the diarrhea outbreak in Seongju-gun, Gyeongbuk, 2004 Methods: The authors conducted a questionnaire survey among the 275 persons (students, staff members and cooks) who ingested the possibly contaminated foods. We also investigated the drinking water and the dining facility, and we reviewed the process of cooking the salad, which was the presumed cause of the Enteropathogenic Escherichia coli(EPEC) diarrhea. The confirmed EPEC diarrheal case was defined as culture positive for EPEC, and the suspicious case was defined as diarrheal case with symptoms more than one of fever, vomiting and tenesmus. Results: The attack rate of EPEC diarrhea was 36.7%, and there were 8 confirmed cases. The possibility of the drinking being a source of the infection was very low, for chlorine was detected in all the drinking water via reviewing the past records and using a portable detector. The foods that were significantly associated with diarrhea were found. The relative risk (RR) for the lunch served Jul 7 was 4.12 (95% CI: 1.39-12.20). Among the non-boiled foods that were finally served, the RR for the salad was 1.66 (95% CI: 1.07-2.57). The cause of this outbreak was presumed to be the contaminated foods that were prepared by cooks using rubber glove with holes, and especially the salad and foods that were served sans boiling on Jul 7. Conclusions: Though this EPEC infection was not so clinically important, if a larger outbreak occurred, it might severely affect the public health. It is recommended to develop the more safe methods for cooking foods, and to strengthen the sanitary processing foods.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.223-235
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• 2004

Objectives: This study was to evaluate the actual condition of falls among community-dwelling elderly people and its related factors to prepare for the establishment of comprehensive prevention programs of senior population. Methods: The study subjects included 460 home residents over 65 years in a district of Chungnam Province and interviews were given to all of them, asking about experiences of falls and their related factors. The analysis of study results came to the following conclusions. Results: The rate of falls among total subjects was 35.5%. With the percentage by age and sex, over 70's and female were significantly higher than male(p=0.000) and under 69 (p=0.008). The groups with poor visual acuity and hearing ability had higher rate of falls than the normal groups based on their health status. In terms of place they experienced falls, out-door occurrence accounted for 53.4% of total falls, which was higher 46.6% of in-door. By season when falls are experienced, "winter" showed the greatest rate, and by time of the day, evening had the highest rate. By causes of falls, "Slippery ground"accounted for 30.5% and "Tumbled over" 23.5% of total falls, respectively, showing the major role of environmental causes for falls. For individual factors, "Irritability" and "Carelessness" occupied 11.3%, 10.8% of total falls, respectively. The Odds Ratios for falls in women was 2.19 times higher than in men, and those in 70's are 2.01 times higher than in 60's, and those with abnormal BMI was 3.68 times higher than in normal groups, and those with perceived symptoms was 1.94 times higher than those without. Conclusions: It is suggested that more consideration should be directed toward taking comprehensive and systematic prevention measures ranging from setting-up the injury-protective environments to allowing senior citizens to have competence in ADL activity as well as proper general health conditions, considering the higher rate of falls for elderly persons in a rural part of this country than that of western countries and the greater proportion of falls which can be ascribed to environmental factors.

• Sleep Medicine and Psychophysiology
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• v.9 no.2
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• pp.106-114
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• 2002

Objectives: Daytime sleepiness is a common symptom and is associated with sleep behavior, sleep deprivation, and night shift, etc. It is also one of the most important symptoms of sleep disorders like obstructive sleep apnea (OSA). According to our survey on Korean literature, a few studies have dealt with daytime sleepiness, and we have not been able to locate any study comparing normal subjects with polysomnography-proven sleep disorder patients regarding daytime sleepiness. We aimed at comparing daytime sleepiness among normal healthy daytime workers, medical students being expected to have daytime sleepiness due to chronic sleep deprivation, and patients having sleep disorders diagnosed with polysomnography. We also studied the association between subjective daytime sleepiness and objective polysomnographic findings in patients with sleep disorders. Methods: One hundred three hospital workers, 137 medical students, and patients with sleep disorders were studied. Sleep disorders included OSA, periodic limb movements in sleep (PLMS), insomnia, and narcolepsy. The degree of subjective sleepiness in each group was measured by the Korean version of Epworth sleepiness scale and compared. The relationship between polysomnographic findings reflecting severity of sleep disorder in each patient group and subjective sleepiness was analyzed. As for patients with narcolepsy, the relationship between the mean sleep latency and subjective sleepiness was studied. Results: There was a significant difference of ESS score (F=68.190, dF=5.752, p<0.001) among daytime workers, medical students, and sleep disorder patients. In OSA patient group, the degree of the sleepiness had no significant correlation either with mean O2 satuaration (p=0.062) or with RDI (p=0.807). In PLMS patient group, there was no correlation between periodic limb movement index (PLMI) and subjective sleepiness (p=0.761). In narcolepsy patient group, the subjective sleepiness had no correlation with mean sleep latency measured with MSLT (p=0.055). Conclusion: We found a significant difference of subjective sleepiness among daytime workers, medical students, and patients with sleep disorders. However, no consistent correlation was found between severity of subjective sleepiness and objective polysomnographic findings reflecting severity of each sleep disorder. This research confirms that the evaluation of subjective sleepiness is important clinically, but it cannot substitute the objective measures such as nocturnal polysomnography and MSLT.

• Tuberculosis and Respiratory Diseases
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• v.61 no.5
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• pp.440-446
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• 2006

Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

• Journal of Genetic Medicine
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• v.8 no.2
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• pp.119-124
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• 2011

Purpose: Supernumerary marker chromosome (SMC) could be associated with various phenotypic abnormalities based on the chromosomal origin of SMCs. The present study aimed to determine the genomic contents of SMCs using chromosomal microarray and to analyze molecular cytogenetic characterizations and clinical phenotypes in patients with SMCs. Materials and Methods: Among patients with SMCs detected in routine chromosomal analysis, SMCs originating from chromosome 15 were excluded from the present study. CGH-based oligonucleotide chromosomal microarray was performed in 4 patients. Results: The chromosomal origins of SMCs were identified in 3 patients. Case 1 had a SMC of 16.1 Mb in 1q21.1-q23.3. Case 2 showed 21 Mb gain in 19p13.11-q13.12. Case 3 had a 4.5 Mb-sized SMC rearranged from 2 regions of 2.5 Mb in 22q11.1-q11.21 and 2.0 Mb in 22q11.22-q11.23. Conclusion: Case 1 presented a wide range of phenotypic abnormalities including the phenotype of 1q21.1 duplication syndrome. In case 2, Asperger-like symptoms are apparently related to 19p12-q13.11, hearing problems and strabismus to 19p13.11 and other features to 19q13.12. Compared with cat-eye syndrome type I and 22q11.2 microduplication syndrome, anal atresia in case 3 is likely related to 22q11.1-q11.21 while other features are related to 22q11.22-q11.23. Analyzing SMCs using high-resolution chromosomal microarray can help identify specific gene contents and to offer proper genetic counseling by determining genotype-phenotype correlations.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.576-581
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• 2005

Background : Thoracic actinomycosis is a relatively uncommon anaerobic infection caused by Actinomyces israelii. There have been only a few case reports of endobronchial actinomycosis. The aim of this study was to evaluate the clinical manifestation and treatment of endobronchial actinomycosis. Material and Methods : Seven patients with endobronchial actinomycosis, who were diagnosed in the past 10 years, were retrospectively reviewed. Results : Cough and sputum were the most common symptoms. The chest radiograph and computed tomography showed necrotic consolidation (n=3), atelectasis (n=2), mass (n=1) and an endobronchial nodule (n=1). Proximal broncholithiasis was observed in five patients. All cases were initially suspected to have either lung cancer or tuberculosis. In these patients, the median duration of intravenous antibiotics was 3 days (range 0-12 days) and the median duration of oral antibiotics was 147 days (range 20-412 days). Two patients received oral antibiotic therapy only. There was no clinical evidence of a recurrence. Conclusion : Endobronchial actinomycosis frequently manifests as a proximal obstructive calcified endobronchial nodule that is associated with distal post-obstructive pneumonia. The possibility of endobronchial actinomycosis is suggested when findings of broncholithiasis are present at chest CT. The traditional recommendation of 2-6 weeks of intravenous antibiotics and 6-12 months of oral antibiotic therapy are not necessarily essential in all cases of endobronchial actinomycosis.

• Clinics in Shoulder and Elbow
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• v.12 no.1
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• pp.53-60
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• 2009

Purpose: Primary osteoarthritis on the elbow is the result of the growth of osteophytes and contracture of the capsule. It often causes disability on joint motion and pain while exercising. As arthroscopy has developed, the arthroscopic diagnosis and treatment of the elbow have recently become more generalized as well. Therefore, we like to report on arthroscopy for treating elbow arthritis and its results. Materials and Methods: This study includes 23 cases of elbow arthritis that were seen between 2005 June to 2007 June and these patients didn't response to conservative treatment. From this we excluded 18 cases that underwent arthroscopic surgery and among these 18 cases, 6 cases underwent ulnar nerve transfer. The average observation time was 21.3 months and the average age was 48.4 years (range: 22-66 years). The pre and post operative pain was evaluated with using the Visual Analogue Scale (VAS) and functional evaluation was done with using the Mayo elbow Performance Score (MEPS) with the range of joint motion. Results: The VAS score at the last follow up was significantly decreased from 3.4 to 1.9 compare to the preoperative score. The range of joint motion was improved by 25 (0-40) to 8.5 (0-20) in extension and 101.7 (80-140) to 125.2 (85-140) in flexion (p<0.05). The MEPS always showed significant improvement by showing an increase from 65.4 (40-85) to 87.9 (55-100). However, 3 cases showed a decreased range of motion after the operation. One case showed ulnar nerve symptoms after surgery. Conclusion: An arthroscopic procedure can treat the pathologic processes associated with arthritis of the elbow and it was safe and effective in this series.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.158-165
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• 2002

Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.99-107
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• 2001

Objective : Hydrocephalus and vasospasm are the common complications following subarachnoid hemorrhage (SAH). In spite of development of perioperative management and operative technique, hydrocephalus cause neurological deficit and poor prognosis. Usually CSF drainage procedure(external ventricular drainage(EVD) or shunt) is needed in hydrocephalus following SAH. The aim of this study was to investigate whether the need for shunting and the outcome after shunting in hydrocephaus following SAH can be related to the duration, daily and total amount of cerebrospinal fluid(CSF) drainage at EVD. Material and Method : IVH is one of several factors which cause hydrocephalus. In this retrospective study, firstly we investigated the incidence of IVH in total cases and frequency of IVH according to aneurysmal site and then prognosis of IVH following SAH. Among 629 patients with SAH, hydrocephalus was diagnosed by CT scan and symptoms. And then those 102 hydrocephalus following SAH were divided into two groups which were hydrocephalus with IVH group and without IVH group. In these two groups, we investigated and compared the incidence of hydrocephalus in all case, frequency of hydrocephalus according to aneurysmal site, the outcome according to H-H grade on admission and the need rate of shunt, etc. Of those hydrocephalus, 100 EVD procedures were done. The duration, daily and total amount of CSF drainage at EVD were investigated. Fifty cases expired during EVD was excluded. We analyzed whether the need rate of shunt and the final outcome after shunting can be related to IVH, the duration and daily and total amount of CSF drainage. Result : The incidence of hydrocephalus following SAH was 20%(with IVH group ; 64%, without IVH group ; 11%). As H-H grade on admission was better, the outcome of hydrocephalus was also better. The mortality rate of hydrocephalus with IVH was 64% which was higher than 40% that of hydrocephalus without IVH. The need rate of shunt in all cases of hydrocephalus following SAH was 20%, but those with IVH group excluding expired patients before shunt was 40%. This was very similar to 41% of the need rate of shunt in hydrocephalus without IVH. The total amount of CSF drainage was statistically related to the need rate of shunt(total amount : need rate of shunt/<1000cc : 15%, 1000-2000cc : 40%, >2000cc : 50%). The duration and daily amount of CSF drainage were not statistically related to the need rate of shunt, but as daily amount of CSF drainage was more and duration was longer, the need rate of shunt was increased(daily amount : need rate of shunt /<100cc : 16%, 100-200cc : 25%, >200cc : 40%//duration : need rate of shunt/<1week : 8%, 1-2weeks : 30%, >2weeks : 47%), and also the final outcome after shunting was poor. Especially the total amount of CSF drainage was significant related to the final outcome after shunting(total amount : GOS/<1000cc : I&II(3/4), 1000-2000cc : II(2/4), III(2/4), >2000cc : III&IV(6/7)). Conclusion : This study revealed that the incidence and mortality rate of hydrocephalus following SAH were influenced by IVH. So SAH associated IVH has the higher incidence of hydrocephalus and poor outcome. As the CSF drainage amount was more and duration of drainage was longer, the need rate of shunt was increased and the final outcome after shunting was poor. Especially the total amount of CSF drainage were strongly related to the need rate of shunt and the outcome after shunting.