OBJECTIVES: Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics. METHODS: Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery. RESULTS: 'Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intra-individual variability. 'Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses. CONCLUSION: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.
Appointments and Schedules ; Cognition ; Consensus ; Delusions ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Phenotype ; Schizophrenia*

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."
Aneurysm* ; Cesarean Section ; Female ; Fetal Growth Retardation ; Fetal Monitoring ; Fetus ; Genetic Diseases, Inborn ; Humans ; Hypertension ; Incidence ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Obstetric Labor, Premature ; Pre-Eclampsia* ; Pregnancy* ; Pregnant Women ; Stillbirth ; Ultrasonography ; Vertebral Artery*

Pancreatic pseudocyst occurs as a complication of pancreatitis or trauma, which results in the escape of pancreatic enzymes from the parenchyma or ductal system of pancreas. At that time, serum amylase may have returned to normal level, and the patient may be subjectively asymptomatic. In this phase, the radiologic findings are relatively greater significance than laboratory data. In the conventional radiologic study, pancreatic pseudocyst have been frequently confused with other retroperitoneal mass, but recently with clinical application of ultrasound and CT scan, more accurate diagnosis can be obtained. The brief results are as follows; 1. Male to female ratio was 3:2 in 15 patients. Incidence was most common in young adult age. Most frequent symptom was epigastic pain, and which was noted in 11 cases of patients. 7 cases of patients had past history of abdominal trauma and past history of pancreatitis was only in 1 case. Most common laboratory finding was leukocytosis in 8cases of patients and elevated serum amylase was also noted in 7 cases. 2. In each 5 cases of patients, plain chest roentgenologic evidence of left side pleural effusion and hemidiaphragm elevation were observed. 3. On flat abdomen film, soft mass shadow was visualized in 8 cases of patients. On UGI series, evidence of retrogastric space widening was observed in 11 cases of patients. 4. The location of pseudocyst is mainly in body and tail of pancrease in 11 cases of patients. 5. More accruable diagnosis can be obtained through application of ultrasound and CT scan.
Abdomen ; Amylases ; Diagnosis ; Female ; Humans ; Incidence ; Leukocytosis ; Male ; Pancreas ; Pancreatic Pseudocyst ; Pancreatitis ; Pancrelipase ; Pleural Effusion ; Tail ; Thorax ; Tomography, X-Ray Computed ; Ultrasonography ; United Nations ; Young Adult

PURPOSE: Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. MATERIALS AND METHODS: In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. RESULTS: Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear (type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). CONCLUSION: In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.
Artifacts ; Computer Simulation ; Heart ; Magnetic Resonance Imaging

No abstract available.
Anemia, Aplastic* ; Pregnancy*

BACKGROUND: Hepatitis B virus (HBV) infection is the leading cause of liver disease in Korea and, is usually diagnosed with serologic testings. The automated immunoassay analyzer, Roche Modular Analytics E170 (Roche Diagnostics, Mannheim, Germany; E170) tests HBV serologic markers based on electrochemiluminescence (ECL) method. We would like to evaluate analytical performances of E170 for HBV serologic markers. METHODS: We evaluated the precision of E170 for 6 serologic markers (HBsAg, anti-HBs, HBeAg, anti-HBe, IgG anti-HBc, IgM anti-HBc) with positive pooled serum. A comparison study with the AxSym immuoassay analyzer (Abbott Laboratories, Abbott Park, IL USA) was performed using patient's sera. HBsAg confirm test was evaluated using the specimens with cutoff index (COI) between 1 and 10 for HBsAg. RESULTS: The total coefficients of variations were below 5% for all of the 6 serologic markers. Method comparisons between E170 and AxSYM showed a good concordance rate; the rates of positive and negative agreements were more than 90% for almost all the serologic markers. HBsAg confirm tests for 84 samples with COI between 1 and 10 revealed that only 36 samples (43%) were true positive for HBsAg. Among 36 true positive samples, 9 samples (25%) were anti-HBs positive concurrently, but these showed low antibody titer (<50 IU/L). CONCLUSIONS: The E170 showed good precision for all HBV serologic markers and a high concordance rate with the AxSYM. Therefore, E170 can be used as a routine immunoassay analyzer for the testing of HBV serologic markers. In addition, HBsAg confirmatory test might be useful to confirm the true positivity when a specimen has low cut-off index (1-10).
Germany ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Immunoassay ; Immunoglobulin G ; Immunoglobulin M ; Korea ; Liver Diseases ; Serologic Tests

OBJECTIVES: Delirium of hospitalized patients is common and it is significantly associated with increased mortality rate. Misdiagnosis rates of delirium are reported in a range of 36.7 to 63% in clinical setting. We aimed to identify the clinical features and symptomatic characteristics associated with misdiagnosis of delirium. METHODS: Subjects were 256 inpatients who were referred for psychiatric consultation and diagnosed with delirium by a psychiatrist at a university hospital between January 1 and June 30, 2012. Clinical data were obtained with retrospective chart review. Patients were divided into misdiagnosed group and correct diagnosed group, after reviewing the reason which were described in the consultation request form. RESULTS: Sixty nine(27%) subjects of the 256 patients were referred for other reasons(mood, substance, anxiety, dementia etc.) than "delirium/confusion" by clinician(misdiagnosed group). In misdiagnosed group, use of antipsychotics was more common. There were no differences between the two groups in age, gender, and department of referring clinician. Fluctuation score of DRS-R-98 was higher in the correct diagnosed group. CONCLUSIONS: In this study, the risk of misdiagnosis was higher when the patients have taken antipsychotics or less symptom fluctuation. Careful clinical attention is needed for diagnosis for delirium in these patients.
Antipsychotic Agents ; Anxiety ; Delirium* ; Dementia ; Diagnosis ; Diagnostic Errors ; Humans ; Inpatients ; Mortality ; Psychiatry ; Retrospective Studies

BACKGROUND: The present study aimed to examine the association between cigarette smoking, alcohol consumption and colorectal cancer risk among Korean adults. METHODS: Data from the Korean Multi-center Cancer Cohort between 1993 and 2005 were analyzed. The study population comprised 18,707 subjects aged older than 20 years old. The subjects were followed until December 31, 2011 (median follow-up of 11.2 years). The Cox proportional hazard model was used to estimate the hazard ratio (HR) and 95% confidence intervals of cigarette smoking and alcohol consumption for colorectal cancer risk. RESULTS: In men, longer duration and higher average amount of alcohol consumption were associated with elevated risk of colorectal cancer (HR 1.93 [1.17-3.18] for > or = 30 years of consumption compared to non-drinkers; HR 2.24 [1.31-3.84] for > or = 30 g/d). Former smokers showed a non-significantly elevated risk of colorectal cancer in men. There was no apparent association between alcohol consumption or cigarette smoking and colorectal cancer risk among women. CONCLUSIONS: Alcohol consumption was associated with increased colorectal cancer risk among Korean men, and both a longer duration and a higher amount of consumption were associated with elevated risk.
Adult ; Alcohol Drinking* ; Cohort Studies* ; Colorectal Neoplasms* ; Female ; Follow-Up Studies ; Humans ; Male ; Proportional Hazards Models ; Prospective Studies ; Smoking* ; Tobacco Products*

OBJECTIVES: We carried out tests for neurobehavior by using WHO-NCTB (neurobehavioral core test battery) and Perdue pegboard score test to identify differences between lacunar infarction cases and controls. METHODS: Among the subjects who underwent MRI between February 2001 and March 2002 in a university hospital located in Seoul and who were diagnosed only as lacunar infarction without any intracranial disease, 46 patients were selected as cases (male: 21, female: 25). Controls were selected who had no cerebrovascular disease on MRI by matching age (5 years), gender, and education (2 years) in a ratio of 1: 1. Among WHO-NCTB, the following 5 tests and Perdue pegboard score test were used to categorize the study subjects: digit and symbol matching, simple reaction time, Benton visual retention, digit span, and Pursuit aiming test. RESULTS: Among the above 6 tests of neurobehavior, lacunar infarction cases showed lower score than controls except for the simple reaction time test. As the controlling variables of multivariate analysis in the stepwise regression analysis, the followings were selected due to their significant association: age, education, BMI, gender, drinking, exercise, and systolic blood pressure. From multivariate regression analysis, there was significant difference (p< 0.05) between lacunar infarction cases and controls in digit and symbol matching, Benton visual retention, digit span, pursuit aiming, and Perdue pegboard score test, but not in the score of simple reaction time test. CONCLUSIONS: We suggest that the above 5 tests for neurobehavior, with the exception of the simple reaction time test, might be used as the basis for recommendation of further treatment and other neurological tests by the earlier detection for neurological abnormality in lacunar infarction.
Blood Pressure ; Case-Control Studies* ; Cerebrovascular Disorders ; Drinking ; Education ; Female ; Humans ; Magnetic Resonance Imaging ; Multivariate Analysis ; Reaction Time ; Seoul ; Stroke, Lacunar*

OBJECTIVES: The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.
Adult ; Aged ; Alcohol Drinking/*adverse effects ; Cohort Studies ; Educational Status ; Female ; Humans ; Korea/epidemiology ; Lung Neoplasms/epidemiology/*etiology ; Male ; Middle Aged ; Proportional Hazards Models ; Smoking/*adverse effects ; Tuberculosis, Pulmonary/*complications