BACKGROUND: A deletion (D)/insertion (I) polymorphism of the angiotensin-converting enzyme (ACE) gene is known to be associated with hypertension, left ventricular hypertrophy, myocardial infarction. Cardiac diseases, such as atrial fibrillation, valvular heart disease, myocardiac infarction and coronary artery disease have been clearly associated with increasing the risk of ischemic stroke. We investigated the relationship between ACE gene deletion/insertion (D/I) polymorphism and the pattern of ischemic stroke. METHODS: The pattern of ACE genotypes in 59 stroke patients including symptomatic carotid artery territory cerebral ischemia were compared with 101 age-matched control subjects. In the stroke patients, the degrees of stenosis of bilateral cervical carotid arteries and their major intracranial tributaries were recorded according to duplex neck sonography and magnetic resonance angiography. DNA was extracted from peripheral blood and ACE I/D polymorphism is confirmed by PCR method. RESULTS: In the stroke patients, 25.4% showed the I I genotypes, 8.5% the ID genotypes and 66.1% the DD genotypes. In the control group, the frequencies of each genotype were 20.8%, 55.4% and 23.8%, respectively. The DD genotypes were more common in patients with ischemic stroke compared with the controls, but there was no significant association between ACE genotypes and sub-types of cerebrovascular disease. CONCLUSIONS: The deletion polymorphism in the angiotensin-converting enzyme gene may play a role in development of ischemic stroke.
Angiotensins* ; Atrial Fibrillation ; Brain Ischemia ; Carotid Arteries ; Cerebral Infarction ; Constriction, Pathologic ; Coronary Artery Disease ; DNA ; Genotype ; Heart Diseases ; Heart Valve Diseases ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Infarction ; Magnetic Resonance Angiography ; Myocardial Infarction ; Neck ; Peptidyl-Dipeptidase A* ; Polymerase Chain Reaction ; Stroke*

PURPOSE: To evaluate the types of questions and the quality of Internet information regarding basic life support (BLS) in the general public. METHODS: We identified the questions and answers by entering the following keywords into the famous Korean search engine, Naver, in the year 2015: ‘ Basic life support’, ‘ chest compression’, ‘ rescue breath’, ‘ defibrillation’, ‘ cardiac arrest’, and ‘ airway obstruction’. A total of 269 cases were identified. We classified the questions into one of 17 subgroups. The accuracy of answers was analyzed based on the contents of the 2010 American Heart Association Cardiopulmonary Resuscitation Guidelines. The reliability of the answers was analyzed by the health on the net foundation code of conduct (authoritative, attribution, transparency). RESULTS: The most frequently asked question was about ‘ when do I perform BLS?’. The second is ‘ chest compression technique’, and third is ‘ how to do BLS’. In assessing the accuracy of answers, 196 answers (72.9%) were determined to be correct. However, the reliability of answers was relatively low, except author's transparency (80.7%); authoritative is 49.4% and attribution is only 16.4%. CONCLUSION: The most common question for the general public was when to perform BLS. Other questions were ‘ how to perform BLS’ or questions regarding chest compression techniques as well as issues regarding female patient and legal problem. This result can be used to educate the public on BLS. According to our results, the accuracy of the information regarding BLS is moderate, but reliability is not acceptable. The quality of BLS information on the Internet should be managed at an expert level.
American Heart Association ; Cardiopulmonary Resuscitation* ; Female ; Humans ; Internet ; Republic of Korea ; Search Engine ; Thorax

OBJECTIVES: The purpose of this study was to examine the performance and electrophysiological characteristics of drug-naive children with attention-deficit/hyperactivity disorder (ADHD) during the Go/NoGo task. METHODS: Twenty-three boys with ADHD and 18 age-matched normal boys were recruited at a child psychiatric outpatient clinic in Seoul. All subjects were assessed by the Kiddie Schedules for Affective Disorders and Schizophrenia -Present and Lifetime version. The investigator also assessed all subjects using the ADHD Rating Scale-IV (ADHDRS). Event-related potentials were recorded from 8 scalp electrodes during the visual Go/NoGo task. RESULTS: Children with ADHD showed a larger mean of standard deviation of response time during the Go/NoGo task than normal children. The temporal N200 and P300 amplitudes were larger in children with ADHD relative to controls. The parietal N200 and P300 latencies were more prolonged in children with ADHD compared to normal controls. CONCLUSION: These results suggest that psychotropic-naive children with ADHD may have more variable performance ability, more difficulty in discriminating visual stimuli, and slower information processing speed than their normal agematched counterparts.
Ambulatory Care Facilities ; Appointments and Schedules ; Automatic Data Processing ; Child ; Electrodes ; Evoked Potentials ; Humans ; Mood Disorders ; Neuropsychological Tests ; Reaction Time ; Research Personnel ; Scalp ; Schizophrenia

OBJECTIVE: To compare swallowing function between healthy subjects and patients with pharyngeal dysphagia using high resolution manometry (HRM) and to evaluate the usefulness of HRM for detecting pharyngeal dysphagia. METHODS: Seventy-five patients with dysphagia and 28 healthy subjects were included in this study. Diagnosis of dysphagia was confirmed by a videofluoroscopy. HRM was performed to measure pressure and timing information at the velopharynx (VP), tongue base (TB), and upper esophageal sphincter (UES). HRM parameters were compared between dysphagia and healthy groups. Optimal threshold values of significant HRM parameters for dysphagia were determined. RESULTS: VP maximal pressure, TB maximal pressure, UES relaxation duration, and UES resting pressure were lower in the dysphagia group than those in healthy group. UES minimal pressure was higher in dysphagia group than in the healthy group. Receiver operating characteristic (ROC) analyses were conducted to validate optimal threshold values for significant HRM parameters to identify patients with pharyngeal dysphagia. With maximal VP pressure at a threshold value of 144.0 mmHg, dysphagia was identified with 96.4% sensitivity and 74.7% specificity. With maximal TB pressure at a threshold value of 158.0 mmHg, dysphagia was identified with 96.4% sensitivity and 77.3% specificity. At a threshold value of 2.0 mmHg for UES minimal pressure, dysphagia was diagnosed at 74.7% sensitivity and 60.7% specificity. Lastly, UES relaxation duration of <0.58 seconds had 85.7% sensitivity and 65.3% specificity, and UES resting pressure of <75.0 mmHg had 89.3% sensitivity and 90.7% specificity for identifying dysphagia. CONCLUSION: We present evidence that HRM could be a useful evaluation tool for detecting pharyngeal dysphagia.
Deglutition Disorders* ; Deglutition* ; Diagnosis ; Esophageal Sphincter, Upper ; Healthy Volunteers* ; Humans ; Manometry* ; Pharynx ; Relaxation ; ROC Curve ; Sensitivity and Specificity ; Tongue

Background: Obesity, obstructive sleep apnea (OSA), and excessive daytime sleepiness (EDS) are common conditions and are interrelated. Obesity is a risk factor for OSA and independently associated with EDS. We aimed to evaluate frequency of EDS in morbid obese patients with OSA and to identify contribution factor for EDS. Methods: This was a retrospective cross-sectional study in single sleep center. Consecutive patients with OSA (with apnea-hypopnea index 5/h or more) with morbid obesity (body mass index over 35 kg/m2) was enrolled. EDS were defined as Epworth Sleepiness Scale of 10 points or more. Clinical and polysomnographic variables were compared between those with and without EDS. Results: Total 110 morbid obese patients with OSA were enrolled, and 34 (31%) of them had EDS. Those with EDS had higher subjective symptom of insomnia and depression. Rapid eye movement sleep latency was shorter and minimum saturation was lower for those with EDS. Multivariate logistic regression analysis identified insomnia severity (odds ratio, 1.117) and minimum saturation (odds ratio, 0.952) as independent contribution factor for EDS. Conclusions Result of this study suggest that 31.4% of morbid obese patients with OSA have EDS, and it can be affected by insomnia severity and desaturation during sleep.

OBJECTIVES: This study was conducted to investigate the association between the symptoms of boys with attentiondeficit hyperactivity disorder (ADHD) and the attention-deficit hyperactivity symptoms, temperament and character patterns of their parents. METHODS: Forty-five boys with ADHD and who met the DSM-IV criteria were evaluated by using the ADHD rating scale (ADHD-RS), and their parents completed the Korean Adult ADHD scale (K-AADHDS) and the Temperament and Character Inventory (TCI). RESULTS: The parental K-AADHDS scores were not associated with the ADHD-RS total score and the subscale scores of their siblings. The most potent variable related to the ADHD-RS total score was the maternal self-directedness, and the second was the maternal persistence. The maternal self-directedness was the variable that was most correlated with the hyperactivity/impulsivity subscale scores of the ADHD-RS. CONCLUSIONS: The results suggest that the paternal ADHD symptoms may not be related to the ADHD symptoms of boys with ADHD. Higher maternal self-directedness and persistence may decrease overall the ADHD symptoms of these boys, and higher maternal self-directedness itself may predict lower hyperactivity/impulsivity symptoms of the boys with ADHD.
Adult ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Parents ; Siblings ; Temperament

OBJECTIVES: While parents who foster children with epilepsy would have considerable parenting difficulties, the parenting stress and sense of competence have not been investigated. We investigated maternal parenting stress, parenting satisfaction and sense of parenting competence in children with seizure disorders, and the associations with seizure-related variables. METHODS: Mothers of 79 children with seizure disorders (41 boys, 38 girls; mean age, 9.9+/-2.3 years) and 79 healthy comparison subjects matched for age and sex were recruited for this study. The Korean version of the Parenting Stress Index (K-PSI-SF) and the Parenting Sense of Competence (K-PSOC) were used to assess parenting stress, parenting satisfaction and parenting efficacy. RESULTS: Mothers of children with seizure disorders showed higher scores on stress related to difficult child and child learning and parenting anxiety compared to mothers of healthy children. In addition, scores on stress related to parental-child interaction and child learning were significantly associated with parental economic status. Scores on stress from parental-child interaction was also correlated with seizure severity, and stress from child learning was correlated with seizure type. Sense of parenting competence and anxiety scores were correlated with paternal educational status, respectively. CONCLUSION: These findings suggest that mothers of children with epilepsy have greater parenting stress and anxiety and social and seizure-associated factors may affect the parenting stress and anxiety.
Anxiety ; Child* ; Educational Status ; Epilepsy* ; Female ; Humans ; Learning ; Mental Competency* ; Mothers ; Parenting* ; Parents* ; Seizures*

A first-trimester ultrasound scan has become an essential part of antenatal care. The Korean Society of Ultrasound in Obstetrics and Gynecology held a first-trimester ultrasound forum on April 5, 2014. The forum aimed to present an updated review of the literature on the topic of first-trimester ultrasound in specific lectures and to host a panel discussion on several important issues regarding first-trimester scans. The forum provided evidence- and consensus-based best practice patterns for obstetricians in Korea. Here, we report the review and checklists presented from the forum.
Checklist ; Female ; Gynecology* ; Humans ; Korea ; Lectures ; Nuchal Translucency Measurement ; Obstetrics* ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Trimester, First ; Ultrasonography*

OBJECTIVE: To analyze practice patterns and checklists of second trimester ultrasonography, and to investigate management plans when soft markers are detected among Korean Society of Ultrasound in Obstetrics and Gynecology (KSUOG) members. METHODS: An internet-based self-administered questionnaire survey was designed. KSUOG members were invited to the survey. Checklists of the second trimester ultrasonography were also requested. In the questionnaire survey, general practice patterns of the second trimester ultrasonography and management schemes of soft markers were asked. In the checklists analysis, the number of items were counted and also compared with those recommended by other medical societies. RESULTS: A total of 101 members responded. Eighty-seven percent routinely recommended second trimester fetal anatomic surveillance. Most (91.1%) performed it between 20+0 and 23+6 weeks of gestation. Written informed consents were given by 15.8% of respondents. Nearly 60% recommended genetic counseling when multiple soft markers and/or advanced maternal age were found. Similar tendencies were found in the managements of individual soft markers. However, practice patterns were very diverse and sometimes conflicting. Forty-eight checklists were analyzed in context with the number and content of the items. The median item number was 46.5 (range, 17 to 109). Of 49 items of checklists recommended by International Society of Ultrasound in Obstetrics and Gynecology and/or American Congress of Obstetricians and Gynecologists, 14 items (28.6%) were found in less than 50% of the checklists analyzed in this study. CONCLUSION: Although general practice patterns were similar among KSUOG members, some of which were conflicting, and there is a need for standardization of the practice patterns and checklists of second trimester ultrasonography, which also have very wide range of spectrum.
Checklist* ; Surveys and Questionnaires ; Female ; General Practice ; Genetic Counseling ; Gynecology ; Humans ; Maternal Age ; Obstetrics ; Pregnancy ; Pregnancy Trimester, Second* ; Societies, Medical ; Ultrasonography ; Ultrasonography, Prenatal*

BACKGROUND: We investigated whether there is a difference in elastographic parameters between pregnancies with and without spontaneous preterm delivery (sPTD) in women with a short cervix (≤ 25 mm), and examined the ability of elastographic parameters to predict sPTD in those women. METHODS: E-CervixTM (WS80A; Samsung Medison, Seoul, Korea) elastography was used to examine the cervical strain. Elastographic parameters were compared between pregnancies with and without sPTD. Diagnostic performance of elastographic parameters to predict sPTD ≤ 37 weeks, both alone and in combination with other parameters, was compared with that of cervical length (CL) using area under receiver operating characteristic curve (AUC) analysis. RESULTS: A total of 130 women were included. Median gestational age (GA) at examination was 24.4 weeks (interquartile range, 21.4–28.9), and the prevalence of sPTD was 20.0% (26/130). Both the elastographic parameters and CL did not show statistical difference between those with and without sPTD. However, when only patients with CL ≥ 1.5 cm (n = 110) were included in the analysis, there was a significant difference between two groups in elasticity contrast index (ECI) within 0.5/1.0/1.5 cm from the cervical canal (P < 0.05) which is one of elastographic parameters generated by E-Cervix. When AUC analysis was performed in women with CL ≥ 1.5 cm, the combination of parameters (CL + pre-pregnancy body mass index + GA at exam + ECI within 0.5/1.0/1.5 cm) showed a significantly higher AUC than CL alone (P < 0.05). CONCLUSION: An addition of cervical elastography may improve the ability to predict sPTD in women with a short CL between 1.5 and 2.5 cm.
Area Under Curve ; Body Mass Index ; Cervix Uteri ; Elasticity ; Elasticity Imaging Techniques ; Female ; Gestational Age ; Humans ; Pregnancy ; Pregnant Women ; Prevalence ; Prospective Studies ; ROC Curve ; Seoul ; Ultrasonography