OBJECTIVES: Contemporary empirical studies have suggested high rates of comorbid attention-deficit hyperactivity disorder(ADHD) or obsessive compulsive disorder(OCD) in children with tic disorders. Not infrequently, ADHD or OCD is as source of greater impairment than are the tic symptoms. The studies in the pathophysiology of tic disorder have implicated abnormalities of dopamine, serotonin and norepinephrine. The studies in pathophysiology of ADHD or OCD also have implicated abnormalities of dopamine, serotonin and norepinephrine. This study was purposed to examine the differences in tic severities and in the levels of plasma homovanillic acid(HVA) and 5-hydroxyin-doleacetic acid(5-HIAA) according to the presence of comorbid ADHD or OCD in patients with chronic tic disorders. METHODS: In fifty chronic tic patients, OCD or ADHD was also diagnosed. And then tic symptoms, obsessive-compulsive symptoms, and attention-deficit hyperactive symptoms were assessed using Yale global tic severity scale(YGTSS), Leyton obsessional inventory-child version(LOI-CV), and Conners parent rating scale. The plasma HVA and 5-HIAA levels were measured using high performance liquid chromatography with electrochemical detection method. RESULTS: Fifty-eight percent of the patients with chronic tic disorders had comorbid ADHD or OCD. But severities of tic did not differ regardless of the presence of comorbid ADHD or OCD. There was a significant positive correlation between tic severities and plasma HVA levels but none between tic severities and plasma 5-HIAA levels. There was a significant inverse correlation between resistance and interference scores and plasma 5-HIAA levels. Plasma HVA levels showed significant positive correlations with plasma 5-HIAA levels. CONCLUSION: These results showed that tic severities didn't vary according to the presence of comorbidities, and that tic severities were correlated with plasma HVA levels, not with plasma 5-HIAA levels. These results suggested that the pathophysiology of chronic tic disorder was strongly correlated with abnormalities of dopaminergic system.
Child ; Chromatography, Liquid ; Comorbidity* ; Dopamine ; Homovanillic Acid* ; Humans ; Hydroxyindoleacetic Acid ; Norepinephrine ; Obsessive Behavior ; Obsessive-Compulsive Disorder ; Parents ; Plasma* ; Serotonin ; Tic Disorders* ; Tics*

Pheochromocytoma, the catecholamine-producing tumor of chromaffin tissue, is associated with a curable form of hypertension. Recently we report the case of a 59 year-old male admitted for an acute myocardial infarction and who subsequently developed late recurrent severe ventricular arrhythmia coincident with transient hypertensive episodes. A pheochromocytoma was diagnosed on the basis of the urinary concentration of catecholamines and computerized tomography of the adrenal glands. After stabilization of his cardiac rhythm and blood pressure with alpha adrenergic blockade, the left adrenal gland, which contained the tumor, was subsequently resected. The diagnosis of a pheochromocytoma should be considered when recurrent ventricular arrhythmia are associated with intermittent hypertension after acute myocardial infarction.
Adrenal Glands ; Arrhythmias, Cardiac ; Blood Pressure ; Catecholamines ; Diagnosis ; Humans ; Hypertension ; Male ; Middle Aged ; Myocardial Infarction* ; Pheochromocytoma*

OBJECTIVES: The purpose of this study was to identify and compare the difference and related factors with general characteristic and health behaviors, a experience of diagnosis and treatment of chronic diseases between rural and urban among elderly in Korea. METHODS: We used the data of Community Health Survey 2017 which were collected by the Korean Center for Disease Control and Prevention. The study population comprised 67,835 elderly peopled aged 65 years or older who participated in the survey. The chi-square test, univariate and multivariate logistic regression analysis were used to analyze data. RESULTS: We identified many significant difference of health behaviors, an experience of diagnosis and treatment with chronic diseases between rural and urban. Compared to urban elderly, the odds ratios (ORs) (95% confidence interval) of rural elderly were 1.136 (1.092–1.183) for diagnosis of diabetes, 1.278 (1.278–1.386) for diagnosis of dyslipidemia, 0.940 (0.904–0.977) for diagnosis of arthritis, 0.785(0.736–0.837) for treatment of arthritis, 1.159 (1.116–1.203) for diagnosis of cataracts, and 1.285(1.200–1.375) for treatment of cataracts. In the experience of diagnosis and treatment of chronic diseases, various variables were derived as contributing factors for each disease. Especially, there were statistically significant difference in the experience of diabetes diagnosis, arthritis diagnosis, cataract diagnosis and dyslipidemia except for hypertension diagnosis (p<0.01) between urban and rural elderly. There were statistically significant differences in the experience of treatment for arthritis and cataract (p<0.01), but there was no significant difference in the experience of treatment for hypertension, diabetes, dyslipidemia between urban and rural elderly. CONCLUSION Therefore, it would be necessary to implement a strategic health management project for diseases that showed significant experience of chronic diseases with diagnosis and treatment, reflecting the related factors of the elderly chronic diseases among the urban and rural areas.