OBJECTIVES: Alcohol use disorder (AUD) is closely associated with attention-deficit/hyperactivity disorder (ADHD). However, the mechanism involved in this association remains unclear. Impulsivity is one of the core traits of ADHD, and an elevated level of impulsivity increases the risk of onset of AUD. Our study focused on impulsivity as the common trait factor of these disorders. We examined the effects of ADHD symptoms and impulsivity on the abstinence period of patients with AUD. METHODS: Male participants with AUD completed the contents of the Adult ADHD Self-Report Scale and the Barratt Impulsiveness Scale. We investigated participant alcohol abstinence period to evaluate severity and frequency of relapse. RESULTS: Both ADHD symptom presence and abstinence period were significantly correlated with impulsivity. Motor impulsivity showed the highest correlations with ADHD and abstinence. The results of hierarchical regression analysis showed that impulsivity is a predictor of abstinence period, while ADHD had a moderating effect on the relationships between impulsivity and abstinence period. Moreover, we undertook hierarchical regression analysis of motor, cognitive, and non-planning impulsivity ; only motor impulsivity and ADHD symptom showed a statistically significant interaction with abstinence period. CONCLUSION: The results indicate a possible causal relationship between the treatment of ADHD symptoms and the extension of AUD abstinence period. In other words, treatment of ADHD symptoms may prevent AUD relapse. Impulsivity, especially motor impulsivity has an important role in the base mechanisms of these two disorders.
Adult ; Alcohol Abstinence ; Humans ; Impulsive Behavior* ; Male* ; Recurrence

Image findings of hepatic lymphoma have been reported as variable, ranging from single or multiple small nodules to diffuse infiltrative patterns. On MRI, most hepatic lymphomas show T1 low signal intensity, T2 high signal intensity. Dynamic imaging reveals a hypointense appearance in the arterial phase, followed by delayed enhancement in the portal venous and transitional phase. In the hepatobiliary phase using a hepatocyte-specific contrast agent (which have recently aided in increasing the access to the focal liver lesions), hepatic lymphoma is known to exhibit low signal intensity. We report a case of hepatic lymphoma, which shows iso-signal intensity on hepatobiliary phase, using gadoxetic acid (Gd-EOB-DTPA).
Liver ; Lymphoma* ; Magnetic Resonance Imaging*

OBJECTIVES: Alcohol use disorder (AUD) is often comorbid with adult attention-deficit hyperactivity disorder (ADHD) and other psychiatric illnesses. When associated with other mental problems, the prognosis of the AUD can be more serious. This study shows research on the clinical and neuropsychological characteristics according to whether or not ADHD symptoms and AUD were comorbid. METHODS: MethodsA total of 64 adult inpatients who completed AUD scales about adult ADHD, alcohol dependence, depression, anxiety, and impulsiveness. They also completed neuropsychological tests about attention and executive function. According to the Adult ADHD Self-Report Scale score, patients were categorized into two groups (ADHD symptom positive/negative group). RESULTS: Fourteen among the 64 subjects were part of the ADHD symptom positive group (21.9%). They had statistically significant shorter abstinence periods and a higher rate of history of 'rule violation during school' and 'physical damage in childhood' compared to the ADHD symptom negative group. CONCLUSION: The comorbidity rate with ADHD symptom in adult AUD is higher than the general population. The ADHD symptom positive group suffered from more severe and refractory AUD. Considering the more frequent history of rule violation during school in the ADHD symptom positive group, the association between ADHD and AUD may be mediated by conduct disorder. Therefore we suggest the necessity of careful evaluation and intervention in children and adolescents with ADHD and conduct disorder.
Adolescent ; Adult* ; Alcoholism ; Anxiety ; Child ; Comorbidity ; Conduct Disorder ; Depression ; Executive Function ; Humans ; Impulsive Behavior ; Inpatients ; Neuropsychological Tests ; Prognosis ; Weights and Measures

OBJECTIVES: The aim of this study is to assess the career paths and practice patterns of child and adolescent psychiatrists in South Korea. METHODS: A survey on demographic data, work environment, opinion on fellowship training program, and current practice patterns was conducted in 76/223 (34.0%) of all child and adolescent psychiatrists (N=223) were from 1980 to 2008. The survey data from the responders were analyzed. RESULTS: More than half of those surveyed were women. The mean age of survey participants was 40.8 years; most were married, and lived in the Seoul National Capital Area. In general, the responders were very satisfied with their work. They worked in private practice, public sector, group practice, and as consultants. Up to 87% of the patients treated were children and adolescents. The most common treatment modalities were medication and parent psychoeducation. Social skills training and play therapy were applied mainly for children aged 4 to 12 years old. Cognitive behavioral therapy and counseling were preferred in adolescents. CONCLUSION: The current study used a database approach in order to define current practice patterns. These data may be helpful in consideration of future training programs, workforce issues in child and adolescent psychiatry in South Korea, and also in collaboration with other mental health providers.
Adolescent Psychiatry ; Adolescent* ; Child* ; Cognitive Therapy ; Consultants ; Cooperative Behavior ; Counseling ; Education ; Fellowships and Scholarships ; Female ; Group Practice ; Humans ; Korea ; Mental Health ; Parents ; Play Therapy ; Private Practice ; Psychiatry* ; Public Sector ; Seoul

BACKGROUND AND OBJECTIVES: Recent works have demonstrated the existence of ocular vestibular evoked myogenic potentials (OVEMPs), which reflects otolith-ocular reflex. The purpose of this study was to identify an appropriate gaze position to detect OVEMPs produced by air-conducted sound stimulation in healthy subjects. SUBJECTS AND METHOD: Twenty four healthy subjects (35 ears) were included in this study. Surface electromyographic activity was recorded from active electrodes placed inferior to each eye. Stimulation with 500 Hz short tone bursts was used to activate the vestibular end-organs. RESULTS: Sound stimulation evoked negative-positive biphasic responses on both ipsilateral and contralateral eyes, while responses were contralateral eye-dominant. Contralateral eye responses had higher response incidence and larger amplitudes. Altering the direction of gaze generally changed the incidence and size of the inter-peak amplitudes. The higher incidence and larger amplitudes were recorded when the eyes are directed to the superior and ipsilateral side to the sound stimulation. In that gaze position, the amplitude was 5.3 micronV, the first negative peak latency was 10.5 ms and the following positive peak latency was 15.4 ms on the average. CONCLUSION: OVEMPs can be evoked using an air-conducted 500 Hz tone burst and are best recorded contralaterally with a upward gaze towards the source of sound stimulation. Further changes of the test parameters are needed for higher and consistent responses.
Electrodes ; Evoked Potentials ; Eye ; Incidence ; Reflex ; Reflex, Vestibulo-Ocular ; Saccule and Utricle ; Vestibular Evoked Myogenic Potentials

OBJECTIVES: The goals of the study were to compare the middle ear (ME) volumes from both normal and lesioned ears, and these ME volumes were measured by a digital image processing computed tomography (CT) program in patients with unilateral chronic otitis media, and we wanted to compare the ME volumes of the lesioned ears by comparing the ME volumes obtained by tympanometry with those ME volumes measured by the digital image processing CT program. METHODS: Forty-four patients who had unilateral chronic otitis media (COM) and contralateral normal tympanic membranes (TM) and 100 subjects with normal TMs were included in the study. The normal volumes of the external auditory canal (EAC) were measured in the normal group. The tympanometric ME volumes in the ears with a perforated TM were calculated as the difference of the tympanometric volumes measured from the both ears in patients with unilateral COM. The CT ME volumes were measured by a digital image processing program. RESULTS: The tympanometric volumes of the EACs in the ears with normal TMs were 1.4+/-0.3 mL. There were no significant differences according to gender, age and the side of the face the ear was on. The tympanometric volumes of the EAC in the normal-side ear of the patients with unilateral COM showed no significant differences when compared with those from the normal group. The ME volumes of the intact ears, as measured by CT, showed significantly higher values than those ME volumes of the lesioned ears. The ME volumes of the lesioned ears, as measured by tympanometry, showed a strong, significant linear correlation with those ME volumes calculated by CT; however, the ME volumes of the lesioned ears, as measured by tympanometry (1.5+/-1.4 mL), were significantly larger than those ME volumes measured by CT (1.1+/-0.8 mL). CONCLUSION: Our results show that chronic otitis media causes reduced ME volumes compared to those ME volumes of the contralateral normal ears. Tympanometry can provide a valuable estimation of the ME volumes in chronic ears, although it tends to overestimate the ME volumes, and especially for the ears with a larger ME volume.
Acoustic Impedance Tests ; Aminocaproic Acids ; Ear ; Ear Canal ; Ear, Middle ; Humans ; Mastoid ; Otitis ; Otitis Media ; Tympanic Membrane

BACKGROUND AND OBJECTIVES: It has been reported that vibration applied either on the mastoid or the sternocleidomastoid (SCM) muscles induces nystagmus in patients after unilateral vestibular neuritis. The aims of the study were to characterize the vibration-induced nystagmus (VIN) in patients with various vestibular disorders and to compare the results of VIN to unilateral weakness in caloric test. MATERIALS AND METHODS:Fifthy-four patients with Meniere's disease, 58 patients with unilateral vestibular neuritis, 170 patients with migraine-associated dizziness, and 78 patients with chronic recurrent vestibulopathy were included. We recorded eye movements during unilateral 100-Hz vibration on the mastoids and SCM muscles. The bithermal caloric test was also performed. Abnormal criteria of VIN were slow-phase slow-phase velocity (SPV) at 4 all different conditions > or = 2degrees/s with the same directions or mean of SPV at vibration on both mastoids or both SCM muscles > or = 5degrees/s with the same directions. RESULTS: In Meniere's disease, 28 of 57 (49.1%) of patients show pathologic VIN, 21 of 57 (36.8%) show pathologic canal paresis. 14 of 57 (24.6%) show abnormalities in both tests, and 35 of 57 (61.4%) show any abnormalities in either test. In unilateral vestibular neuritis, 43 of 58 (77.6%) showed pathologic VIN, 58 of 58 (100%) show canal paresis. In migraine-associated dizziness, 48 of 170 (28.2%) showed pathologic VIN, 58 of 170 (18.8%) show canal paresis. 15 of 170 (8.8%) showed abnormalities in both tests, and 65 of 170 (38.2%) show any abnormalities in either test. In chronic recurrent vestibulopathy, 23 of 78 (29.5%) of patients show pathologic VIN and 17 of 78 (21.8%) show pathologic canal paresis. Seven of 78 (9.0%) showed abnormalities in both tests, and 33 of 78 (42.3%) show any abnormalities in either test. CONCLUSION: VIN test can increase the sensitivity in detecting vestibular imbalance in vestibular disorders when combined with caloric test.
Caloric Tests ; Dizziness ; Eye Movements ; Humans ; Mastoid ; Meniere Disease ; Muscles ; Paresis ; Vestibular Neuronitis ; Vibration

BACKGROUND AND OBJECTIVES: It has been reported that vibration applied either on the mastoid or on the sternocleidomastoid (SCM) muscles induces nystagmus in normal subjects. The aims of the study were to characterize the direction and velocity of slow-phase eye movement which is induced by vibration in normal subjects and to propose the mechanism of vibration-induced nystagmus (VIN) in normal subjects. MATERIALS AND METHOD: We recorded eye movements during unilateral 100-Hz vibration on the mastoid bone and SCM muscles in 56 normal subjects. The subjects were divided into 4 groups in ages (20s, 30s, 40s, 50~60s). The directions of VIN, the degree of maximal slow-phase eye velocities were analyzed according to age. Positive value means slow-phase velocity (SPV) to the right side. RESULTS: In 20s, vibration on right/left mastoids induced SPV of 1.2+/-2.0degrees/sec, 0+/-2.1degrees/sec and on right/left SCM muscles, 1.1+/-1.9degrees/sec, -1.2+/-2.5degrees/sec. In 30s, vibration on right/left mastoids induced SPV of 3.3+/-3.8degrees/sec, -0.3+/-1.4degrees/sec and on right/left SCM muscles, 2.8+/-4.2degrees/sec, -1.0+/-1.5degrees/sec. In 40s, vibration on right/left mastoids induced SPV of 0+/-1.7degrees/sec, -0.2+/-1.2degrees/sec and on right/left SCM muscles, 0+/-1.8degrees/sec, 0+/-1.0degrees/sec. In 50~60s, vibration on the right/left mastoids induced SPV of -1.3+/-1.3degrees/sec, 1.2+/-1.3degrees/sec and on right/left SCM muscles, -0.6+/-0.9degrees/sec, 0.9 +/-1.5degrees/sec. The directional preponderance of the slow-phase eye movement to the vibrated side was statistically significant in 20s and 30s, however, the preponderance of the slow-phase eye movement changed into the non-vibrated side in 50~60s. CONCLUSION: The proprioceptive input, changing major rotator from the inferior oblique muscle to the sternocleidomastoid muscles might explain the change of the directional preponderance of the slow-phase eye movements in normal subjects according to ages. Although this directional preponderance is not consistent in all age groups, it is still important in discriminating normal responses from abnormal responses which can be induced by vibration.
Eye Movements ; Humans ; Mastoid ; Muscles ; Vibration

BACKGROUND AND OBJECTIVES: The aim of this study was to verify if vibration-induced nystagmus in patients with vestibular neuritis changed over time and to compare the results of vibration-induced nystagmus (VIN) test to those of caloric test. MATERIALS AND METHOD: We compared VIN results with those of caloric testing in 23 patients (M:F = 11:12, 15~67 years old) with unilateral vestibular neuritis seen at onset and in follow-up for around 2 months. The eye movement recordings were made and the maximum slow-phase eye velocities (SPV) were calculated during vibration. If spontaneous nystagmus was present, it was subtracted from the slow-phase eye velocities of VIN. RESULTS: In acute stage, VIN of which SPV was directed towards the lesioned side was observed in 21 (91%). In follow-up, VIN of which SPV was directed towards the lesioned side was observed in 19 (83%). There was a significant decrease of the SPV of VIN over time. Significant correlations were observed in between canal paresis & SPV of VIN in both acute and follow-up stages. CONCLUSION: Our findings show that VIN test can predict the severity of vestibular asymmetry not only in acute stage but also in follow-up stage. Our results suggest that vibration-induced nystagmus might represent the peripheral vestibular asymmetry in patients with vestibular neuritis.
Caloric Tests ; Eye Movements ; Follow-Up Studies* ; Humans ; Paresis ; Vertigo ; Vestibular Function Tests ; Vestibular Neuronitis* ; Vibration

BACKGROUND AND OBJECTIVES: The aims of the study were to characterize the vibration-induced nystagmus (VIN) and air caloric test in patients with unilateral chronic otitis media, and to clarify the clinical availability of VIN by comparing the results of VIN test with those of air caloric test. MATERIALS AND METHODS: Nineteen patients with unilateral chronic otitis media who had had no vestibular symptoms in past history were investigated. Pure tone audiometry (PTA), air caloric, VIN and subjective visual vertical (SVV) tests were done and the results were analyzed to estimate the utility for investigating vestibular imbalance. RESULTS: If we consider a patient with abnormal results from two or more tests as a patient with latent vestibular imbalance, because they had no previous vestibular symptoms, 3 patients was considered to have latent asymmetric vestibular function. False positive rate were 32% in air caloric test, 5% in VIN test and 0% in SVV test. CONCLUSION: Our findings show that vestibular imbalance in patients with chronic otitis media should be determined through various tests and vibration-induced nystagmus test can be more useful than air caloric test in estimating the vestibular imbalance.
Audiometry ; Caloric Tests* ; Humans ; Otitis Media* ; Otitis* ; Vertigo*