OBJECTIVES: The aim of study was to examine the prevalence of night eating syndrome(NES) and its correlates in schizophrenic outpatients. METHODS: The 14 items of self-reported night eating questionnaire(NEQ) was administered to 201 schizophrenic patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating, and weight-related quality of life using Beck's Depression Inventory(BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. RESULTS: The prevalence of night eaters in schizophrenic outpatients was 10.4%(21 of 201). Comparisons between NES group and non-NES group revealed no significant differences in sociodemographic characteristics, clinical status and BMI. Compared to non-NES, patients with NES reported significantly greater depressed mood and sleep disturbance, more binge eating pattern, and decreased weight-related quality of life. While 'morning anorexia' and 'delayed morning meal'(2 of 5 NES core components in NEQ) were not differed between groups, 'nocturnal ingestions', 'evening hyperphagia', and 'mood/sleep' were more impaired in NES group. CONCLUSION: These findings are the first to describe the prevalence and its correlates of night eaters in schizophrenic outpatients. These results suggest that NES has negative mental health implications, although it was not associated with obesity. Further study to generalize these results is required.
Ambulatory Care Facilities ; Bulimia ; Depression ; Eating* ; Humans ; Mental Health ; Obesity ; Outpatients* ; Prevalence* ; Quality of Life

This study aims to examine the effect of methylphenidate, which is the most extensively prescribed medicine treating children with Attention Deficit Hyperactivity Disorder (ADHD), on the children's neuropsychiatric functions by comparing the symptomatic differences before and after its medication. MEHTODS: The subjects of this study were 48 children who corresponded to the diagnostic criteria for ADHD of DSM-IV, did not have any problem in vision or hearing, did not have neurologic disorder such as epilepsy and brain damage, and did not have other long term medication. To evaluate the effects of behavioral response and medication, after stopping medication over a week we handed out questionnaires to the parents and conducted CPT to the subjects. A dose of 0.3-0.7 mg/kg (bid or tid) was medicated at 8AM and 1PM everyday. After 4 weeks of medication, the same tests were conducted. RESULTS: Average age of the subjects was 8.88+/-1.55. There were 44 boys (91.7%) and 4 girls (8.3%). Mean intelligence was 96.60+/-18.12 and mental processing was 102.90+/-16.51. On ADDES-HV, after medication attention, impulsivity and hyperactivity were significantly improved (p<0.05). On AcTeRS, after medication attention, impulsivity and social skill were significantly improved (p<0.05). On CAPs, after medication inattention and hyperactivity were significantly improved (p<0.05). On SNAP, after medication inattention impulsivity and hyperactivity were significantly improved (p<0.05). On the academic performance rating scale, after medication total score, learning ability, impulse control and social withdrawal were significantly improved (p<0.05). On performing CPT, after medication commissions error, hit reaction time standard error, variability of standard error and attentiveness were significantly improved (p<0.05). CONCLUSIONS: With these results, we recognized methy-lphenidate is more effective in children's impulsivity and hyperactivity than attention, contrary to the clinical observation.
Attention Deficit Disorder with Hyperactivity* ; Brain ; Child* ; Diagnostic and Statistical Manual of Mental Disorders ; Epilepsy ; Female ; Hand ; Hearing ; Humans ; Impulsive Behavior ; Intelligence ; Learning ; Methylphenidate* ; Nervous System Diseases ; Parents ; Surveys and Questionnaires ; Reaction Time

OBJECTICES AND METHODS: The purpose of this study was to examine availabilities of stop-signal task as a screening test for ADHD and as a research tool. Stop-signal task was applied to 40 ADHD patients and 18 normal children. Followings are the results of this study. RESULTS: There were significant differences between ADHD group and control group in ZRFT, mean delay x block and primary-RT of stop-signal task performance(p<0.05). There was no significant difference in results of continuous performance test. SSRT of stop-signal task had significant correlation with hit reaction time of continuous performance test, and primary-RT and primary-SD with attentiveness and hit reaction time of continuous performance test. There was no significant correlation between scores of ADDES-HV and stop-signal task performance. In change of primary-SD according to intelligence, primary-SD decreased as intelligence increased but made plateau after IQ 110, and in change of SSRT according to age, SSRT decreased as intelligence increased but made plateau after 10 year-old. In discriminant ability, mean delay x block and primary-RT showed highest discriminant ability (each 75%). In addition P-inhibit showed 63.89%, SSRT showed 58%, ZRFT showed 67%, and primary-SD showed 58% in discriminant ability. There was no significant difference in stop-signal task performance between ADHD with hyperactivity and ADHD without hyperactivity. CONCLUSION: In this point of view, stop-signal task was proved to be a useful research tool for attention deficit hyperactivity disorder as well as useful screening test tool.
Attention Deficit Disorder with Hyperactivity* ; Child* ; Executive Function ; Humans ; Intelligence ; Mass Screening ; Reaction Time ; Task Performance and Analysis

We studied and analyzed 66 cases of choledochal cyst in a 9 year period from March, 1985 to December, l993 at Hangang, Kangnam and Chuncheon Sacred Heart Hospital. The results were as follows; 1) Age ranged from 1 year to 82 years and ll of 66 cases were below 10 years. The ratio of men to women was 1: 1.9. 2) The frequency of the triad of symptoms and signs were in order of abdominal pain 53 cases(80.3%), jaundice 12 cases(18.2%) and abdominal mass 9 cases(13.6%). The classical triad of pain, mass and jaundice was present in only 2 cases(3.0%). 3) Alkaline phosphatase was elevated in 42 cases(63.6%), hyperbilirubinemia in 29 cases(43.9%) and hyperamylasemia in 9 cases(13.6%). 4) Performed diagnostic procedures were ultrasonogram in 57 cases(86.4%), endo- scopic retrograde cholangiopancreatogram in 32 cases(48.5%), DISIDA scan in 18 cases(27.3%), computed tomogram in 14 cases(21.2%) and percutaneous transhepatic cholangiagram in 6 cases(9.1%). 5) Among 38 cases which ERCP or PTC were performed, according to the Todani's classification, Type I was seen in 28 cases(73.7%), Type IVA in 7 cases(18. 4%), Type II in 2 cases(5.3%) and Type V in I case(2.6%). 6) The associated diseases were cholangitis in 15 cases(22.7%), choledocholithiasis in 12 cases(18.2%) and cholangiocarcinoma in 2 cases(3.0%). 7) Operative procedures were performed in 22 of 66 cases, excision of cyst with Roux-en-Y c~holedochojejunostomy in 17 cases, choledochocystojejunostomy in 2 cases and external drainage in 3 cases.
Abdominal Pain ; Alkaline Phosphatase ; Cholangiocarcinoma ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochal Cyst* ; Choledocholithiasis ; Classification ; Drainage ; Female ; Gangwon-do ; Heart ; Humans ; Hyperamylasemia ; Hyperbilirubinemia ; Jaundice ; Male ; Surgical Procedures, Operative ; Ultrasonography

OBJECTIVES: The aim of this study is to evaluate the clinical characteristics of night eating syndrome(NES) in bipolar disorder outpatients. METHODS: The 14 items of self-reported night eating questionnaire(NEQ) was administered to 84 bipolar patients in psychiatric outpatient clinic. We examined demographic and clinical characteristics, body mass index(BMI), subjective measures of mood, sleep, binge eating & weight-related quality of life using Beck's Depression Inventory (BDI), Pittsburgh Sleep Quality Index(PSQI), Binge Eating Scale(BES) and Korean version of Obesity-Related Quality of Life Scale(KOQoL), respectively. RESULTS: The prevalence of night eating syndrome in bipolar outpatients was 14.3%(12 of 84). Comparisons between NES group and non-NES group revealed no significant differences in demographic characteristics, BMI and clinical status except economic status and comorbid medical illnesses. However, compared to non-NES, patients with NES was more likely to have binge eating pattern and poorer weight-related quality of life. CONCLUSIONS: This study is to be the first to describe the clinical correlates of night eaters in bipolar outpatients. Although there were few significant correlates of NES in bipolar outpatients, relatively high prevalence of NES suggest that clinicians should be aware to assess the patients with bipolar disorder on NES, regardless of obesity status of patients.
Ambulatory Care Facilities ; Bipolar Disorder* ; Bulimia ; Depression ; Eating* ; Humans ; Obesity ; Outpatients* ; Prevalence ; Quality of Life

PURPOSE: To investigate the predictive role of maximum standardized uptake value (SUVmax) of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in nasopharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: Between October 2006 and April 2016, 53 patients were treated with IMRT in two institutions and their PET/CT at the time of diagnosis was reviewed. The SUVmax of their nasopharyngeal lesions and metastatic lymph nodes (LN) was recorded. IMRT was delivered using helical tomotherapy. All patients except for one were treated with concurrent chemoradiation therapy (CCRT). Correlations between SUVmax and patients’ survival and recurrence were analyzed. RESULTS: At a median follow-up time of 31.5 months (range, 3.4 to 98.7 months), the 3-year overall survival (OS) and disease-free survival (DFS) rates were 83.2% and 77.5%, respectively. In univariate analysis, patients with a higher nodal pre-treatment SUVmax (≥ 13.4) demonstrated significantly lower 3-year OS (93.1% vs. 55.5%; p = 0.003), DFS (92.7% vs. 38.5%; p < 0.001), locoregional recurrence-free survival (100% vs. 50.5%; p < 0.001), and distant metastasis-free survival (100% vs. 69.2%; p = 0.004), respectively. In multivariate analysis, high pre-treatment nodal SUVmax (≥ 13.4) was a negative prognostic factor for OS (hazard ratio [HR], 7.799; 95% confidence interval [CI], 1.506–40.397; p = 0.014) and DFS (HR, 9.392; 95% CI, 1.989–44.339; p = 0.005). CONCLUSIONS: High pre-treatment nodal SUVmax was an independent prognosticator of survival and disease progression in nasopharyngeal carcinoma patients treated with IMRT in our cohort. Therefore, nodal SUVmax may provide important information for identifying patients who require more aggressive treatment.
Cohort Studies ; Diagnosis ; Disease Progression ; Disease-Free Survival ; Electrons ; Fluorodeoxyglucose F18* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Nasopharyngeal Neoplasms ; Positron-Emission Tomography and Computed Tomography* ; Radiotherapy, Intensity-Modulated* ; Recurrence

BACKGROUND/AIMS: Quadruple therapy can be considered as a first-line therapy in areas where the resistance rate to clarithromycin is high. Comparison study of triple therapy and quadruple therapy for Helicobacter pylori (H. pylori) eradication is still lacking in Korea despite the increasing prevalence of antibiotic resistance. This study was conducted to compare the efficacy of triple and quadruple therapy as a first-line treatment in H. pylori infected patients with peptic ulcer. METHODS: Consecutive 149 cases of peptic ulcer disease associated with H. pylori infection were randomized either to proton pump inhibitor (PPI, bid), amoxicillin (1,000 mg, bid), and clarithromycin (500 mg, bid) (PAC group) or to PPI (bid), bismuth subcitrate (300 mg, qid), metronidazole (500 mg, tid), and tetracycline (500 mg, qid) (PBMT group) eradication treatments for 7 days. Outcome of eradication therapy was assessed by 13C-urea breath test performed 4-6 weeks after eradication. RESULTS: Eradication rates in PAC and PBMT group were 78.7% (59/75) and 71.6% (53/74) by intention to treat analysis, respectively (p=0.424). By per protocol analysis, eradication rates of PAC and PBMT group were 85.5% (59/69) and 85.5% (53/62), respectively (p=1.012). Adverse reactions occurred in 5 (6.6%) and 7 (9.5%) patients in PAC and PBMT group, respectively (p=0.346). CONCLUSIONS: One week-quadruple therapy as a first-line treatment for H. pylori infection does not offer any advantage over PPI-based triple therapy in Korean patients.
Adolescent ; Adult ; Aged ; Antacids/administration & dosage ; Anti-Infective Agents/administration & dosage ; Drug Therapy, Combination ; English Abstract ; Female ; Helicobacter Infections/complications/*drug therapy/microbiology ; *Helicobacter pylori ; Humans ; Male ; Middle Aged ; Peptic Ulcer/microbiology ; Proton Pumps/antagonists & inhibitors

Background/Aims: Clarithromycin resistance is a main factor for treatment failure in the contextof Helicobacter pylori infection. However, the treatment regimen for clarithromycin-resistant H. pylori infection has not yet been determined. We aimed to compare the efficacy and cost-effectiveness of 14-day bismuth-based quadruple therapy versus 14-day metronidazole-intensified triple therapy for clarithromycin-resistant H. pylori infection with genotypic resistance. Methods: This was a multicenter, randomized, controlled trial. A total of 782 patients with H. pylori infection examined using sequencing-based clarithromycin resistance point mutation tests were recruited between December 2018 and October 2020 in four institutions in Korea. Patients with significant point mutations (A2142G, A2142C, A2143G, A2143C, and A2144G) were randomly assigned to receive either 14-day bismuth-based quadruple therapy (n=102) or 14-day metronidazole-intensified triple therapy (n=99). Results: The overall genotypic clarithromycin resistance rate was 25.7% according to the sequencing method. The eradication rate of 14-day bismuth-based quadruple therapy was not significantly different in the intention-to-treat analysis (80.4% vs 69.7%, p=0.079), but was significantly higher than that of 14-day metronidazole-intensified triple therapy in the per-protocol analysis (95.1% vs 76.4%, p=0.001). There were no significant differences in the incidence of side effects. In addition, the 14-day bismuth-based quadruple therapy was more cost-effective than the 14-day metronidazole-intensified triple therapy. Conclusions Fourteen-day bismuth-based quadruple therapy showed comparable efficacy with 14-day metronidazole-intensified triple therapy, and it was more cost-effective in the context of clarithromycin-resistant H. pylori infection.

OBJECTIVES: Our school introduced a new curriculum based on faculty-directed, intensive, small-group teaching of clinical skills in the third-year medical students. To examine its effects, we compared the mean scores on an OSCE between the third- and fourth-year medical students. METHODS: Third- and fourth-year students did rotations at the same five OSCE stations. They then completed a brief self-reporting questionnaire survey to examine the degree of satisfaction with new curriculum in the third-year students and clinical practice in the fourth-year students, as well as their perception of confidence and preparedness. We analyzed the OSCE data obtained from 158 students, 133 of whom also completed the questionnaire. RESULTS: Mean OSCE scores on the breast examination and wet smear stations were significantly higher in the third-year group (P < 0.001). But mean OSCE scores of motor-sensory examination and lumbar puncture were significantly higher in the fourth-year group (P < 0.05). The mean OSCE scores had no significant correlation with satisfaction. In addition, the self-ratings of confidence had a high degree of correlation with satisfaction with new curriculum (r = 0.673) and clinical practice (r = 0.692). Furthermore, there was a moderate degree of correlation between satisfaction and preparedness in both groups (r = 0.403 and 0.449). CONCLUSIONS: There is no significant difference in the effect on the degree of clinical performance and confidence between an intensive-small group teaching and a 1-year clinical practice. If combined, intensive small group teaching and clinical practice would be useful to improve the degree of ability and confidence in medical students.
Breast ; Clinical Competence ; Curriculum ; Humans ; Spinal Puncture ; Students, Medical

PURPOSE: A pooled analysis of multi-institutional trials was performed to analyze the effect of surgical timing on tumor response by comparing short course concurrent chemoradiotherapy (CCRT) with long course CCRT followed by delayed surgery in locally advanced rectal cancer. MATERIALS AND METHODS: Three hundred patients with cT3-4N0-2 rectal adenocarcinoma were included. Long course patients from KROG 14-12 (n=150) were matched 1:1 to 150 short course patients from KROG 10-01 (NCT01129700) and KROG 11-02 (NCT01431599) according to stage, age, and other risk factors. The primary endpoint was to determine the interval between surgery and the last day of neoadjuvant CCRT which yields the best tumor response after the short course and long course CCRT. Downstaging was defined as ypT0-2N0M0 and pathologic complete response (ypCR) was defined as ypT0N0M0, respectively. RESULTS: Both the long and short course groups achieved lowest downstaging rates at < 6 weeks (long 20% vs. short 8%) and highest downstaging rates at 6-7 weeks (long 44% vs. short 40%). The ypCR rates were lowest at < 6 weeks (both long and short 0%) and highest at 6-7 weeks (long 21% vs. short 11%) in both the short and long course arms. The downstaging and ypCR rates of long course group gradually declined after the peak at 6-7 weeks and those of the short course group trend to constantly increase afterwards. CONCLUSION: It is optimal to perform surgery at least 6 weeks after both the short course and long course CCRT to obtain maximal tumor regression in locally advanced rectal adenocarcinoma.
Adenocarcinoma* ; Arm ; Chemoradiotherapy ; Humans ; Rectal Neoplasms ; Risk Factors