Mental retardation (MR) is classically deficits in adaptive behavior and manifest during the developmental period. The causes of mental retardation were not understood in many cases. This study was undertaken to identify the etiologies of mentally retarded children enrolled in a special educational institution under the hypothesis that clarifying causes of MR can not only provide basic epidemiological data on MR in Korea, but also imply possibly preventable measures to avoid MR in some cases. In this study, complete medical history was taken in addition to a thorough individual physical examination with collection of urine specimens for metabolic screening tests including ferric chloride, DNPH, nitrosonaphthol, nitroprusside, CTAB, and reducing substance tests in 259 mentally retarded children aged between 3 through 18 year old. The cytogenetic, molecular genetic, and endocrine studies wire performed in 14 children with high clinical suspicion of chromosomal abnormalities and congenital hypothyroidism. Dysmorphism syndromes were delineated using computer software software program. Definite or presumptive etiological diagnosis has been made in 122 (47%) mentally retarded children, Among three major identifiable causes, perinatal brain damage resulted from difficulties in labor, prematurity, kernicterus, and neonatal sepsis, was most commonly found in 57 children (22%), followed by chromosomal abnormalities including Down's syndrome and fragile-X syndrome in 35 children (13.5%), and dysmorphism syndrome in 10 children (3.9%) in order. Other identifiable causes for mentally retarded children were listed as autism (2.3%), endocrine & hereditary metabolic disease (1.9%), central nervous system malformations, neurophakomatoses (1.9%), and postnatal accidents, poisoning, infection (1.5%). In conclusion, aforementioned data suggested that one fourth of MR can be avoided or treated by making efforts to improve peri, postnatal care and early detection. Routine urinary metabolic screening tests for inborn errors cannot be justified though CTAB test showed high specificity for the diagnosis of mucopolysaccharidosis. Some mentally retarded children's families need genetic counselling since Mendelian inherited disorders are culpable for causing MR in some children.
Adaptation, Psychological ; Adolescent ; Autistic Disorder ; Brain ; Central Nervous System ; Child* ; Chromosome Aberrations ; Classification* ; Congenital Hypothyroidism ; Cytogenetics ; Diagnosis ; Down Syndrome ; Humans ; Intellectual Disability ; Kernicterus ; Korea ; Mass Screening ; Mentally Disabled Persons* ; Metabolic Diseases ; Molecular Biology ; Mucopolysaccharidoses ; Nitroprusside ; Physical Examination ; Poisoning ; Postnatal Care ; Sensitivity and Specificity ; Sepsis

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes. METHODS: The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17), RESULTS: The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa. CONCLUSIONS: We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.
Arginine ; Bias (Epidemiology) ; Calcium* ; Chungcheongbuk-do ; Electrolytes* ; Gases ; Heparin* ; Humans ; Lithium ; Potassium ; Salts* ; Sodium ; Thrombin

No abstract available.
Humans ; Inpatients*

OBJECTIVES: Ambivalence of self-image is considered to be important in patients with schizophrenia since impairment of self-referential processing and increment in ambivalence are illness-related symptoms. This study aimed to evaluate quantitative and qualitative properties of ambivalence of self-image in patients with schizophrenia. METHODS: Twenty patients with schizophrenia and 20 normal controls performed a set of 'self-image reflection task' and then the level of ambivalence towards actual and ideal self-image were numerically scored. Ambivalence scores were compared between groups and correlation analyses with psychometric scales were done in each group. RESULTS: Patients with schizophrenia had higher level of ambivalence towards both actual and ideal self-image (p<0.001). Normal controls showed significant correlations with the scales representing level of self-concept clarity (r=-0.480, p=0.033), depression (r=0.479, p=0.033), and self-esteem (r=-0.555, p=0.011 ; R=-0.600, p=0.005) while the patients did not. CONCLUSION: Ambivalence towards one's self-image is more intense in patients with schizophrenia. This symptom may be considered to exist as an independent symptom in schizophrenia.
Depression ; Humans ; Psychometrics ; Schizophrenia* ; Weights and Measures

The anti-inflammatory effects of an ethanol extract of Angelica gigas (EAG) were investigated in vitro and in vivo using croton oil-induced inflammation models. Croton oil (20 microgram/mL) up-regulated mRNA expression of cyclooxygenase (COX)-I and COX-II in the macrophage cell line, RAW 264.7, resulting in the release of high concentrations of prostaglandin E2 (PGE2). EAG (1~10 microgram/mL) markedly suppressed croton oil-induced COX-II mRNA expression and PGE2 production. Application of croton oil (5% in acetone) to mouse ears caused severe local erythema, edema and vascular leakage, which were significantly attenuated by oral pre-treatment with EAG (50~500 mg/kg). Croton oil dramatically increased blood levels of interleukin (IL)-6 and PGE2 without affecting tumor-necrosis factor (TNF)-alpha and nitric oxide (NO) levels. EAG pre-treatment remarkably lowered IL-6 and PGE2, but did not alter TNF-alpha or NO concentrations. These results indicate that EAG attenuates inflammatory responses in part by blocking the COX-PGE2 pathway. Therefore, EAG could be a promising candidate for the treatment of inflammatory diseases.
Angelica/*immunology ; Animals ; Cell Line ; Cyclooxygenase 1/genetics/*immunology ; Cyclooxygenase 2/genetics/*immunology ; Dinoprostone/genetics/immunology ; Inflammation/drug therapy/enzymology/*immunology ; Interleukin-6/blood ; Macrophages ; Male ; Mice ; Mice, Inbred ICR ; Nitric Oxide/blood ; Phytotherapy/*methods ; Plant Extracts/*pharmacology/therapeutic use ; Plant Roots/immunology ; RNA, Messenger/chemistry/genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Tumor Necrosis Factor-alpha/blood

No abstract available.
Classification* ; von Willebrand Diseases* ; von Willebrand Factor*

Objective: Little has been explored about a reflection towards self-image in schizophrenia, though it can be related to heterogeneous symptoms of the illness. We identified the neural basis of ambivalence towards ideal self-image in patients with schizophrenia. Methods: 20 patients with schizophrenia and 20 healthy controls underwent functional MRI while the self-image reflection tasks of determining whether to agree with sentences describing their actual or ideal self-image that contained one of the adjective pairs with opposite valence. The interaction between the group and ideal ambivalence score was examined, and group differences in functional connectivity related to ambivalence towards ideal self-image were further studied. Results: The interaction of group-by-ideal ambivalence score was shown in the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex, where activities were positively correlated with the level of ideal self-image ambivalence in patients, but not in controls. Task-related decrease in functional connectivity was shown between the orbitofrontal cortex and cerebellum in patients. Conclusion The process of reflecting on ambivalent ideal self-image in schizophrenia may be related to aberrant prefrontal activity and connectivity. Abnormality in the prefrontal regions that take part in cognitive conflict monitoring and value judgment may underlie the pathophysiology of increased ambivalence towards ideal self-image.

Background: Medical nutrition therapy is a fundamental part of diabetes management; however, it is very difficult for patients to maintain the recommended diet programs. We investigated whether providing home-delivered therapeutic meals designed by registered dietitians could be useful in lowering blood glucose levels in patients with type 2 diabetes. Methods: During a 12-day study period, we monitored the blood glucose levels of 19 patients with type 2 diabetes by continuous glucose monitoring. For the first six days, the participants maintained their usual lifestyles and were allowed to eat freely (free meal period). During the last six days, two out of the three main meals per day were replaced with home-delivered therapeutic meals designed for diabetes management (therapeutic meal period), during which snacks and exercise were freely allowed. Blood glucose levels and estimated glycated hemoglobin (eHbA1c) were compared between the two periods. Results: Between the free meal period and the therapeutic meal period, mean blood glucose level and eHbA1c dropped by 11.9 mg/dL (P < 0.001) and 0.4% (P = 0.002), respectively. These results were mainly due to the decrease in postprandial glucose levels rather than preprandial glucose levels. Conclusion Providing home-delivered therapeutic meals designed for diabetes management was effective in lowering the blood glucose levels in patients with type 2 diabetes.

Background: Medical nutrition therapy is a fundamental part of diabetes management; however, it is very difficult for patients to maintain the recommended diet programs. We investigated whether providing home-delivered therapeutic meals designed by registered dietitians could be useful in lowering blood glucose levels in patients with type 2 diabetes. Methods: During a 12-day study period, we monitored the blood glucose levels of 19 patients with type 2 diabetes by continuous glucose monitoring. For the first six days, the participants maintained their usual lifestyles and were allowed to eat freely (free meal period). During the last six days, two out of the three main meals per day were replaced with home-delivered therapeutic meals designed for diabetes management (therapeutic meal period), during which snacks and exercise were freely allowed. Blood glucose levels and estimated glycated hemoglobin (eHbA1c) were compared between the two periods. Results: Between the free meal period and the therapeutic meal period, mean blood glucose level and eHbA1c dropped by 11.9 mg/dL (P < 0.001) and 0.4% (P = 0.002), respectively. These results were mainly due to the decrease in postprandial glucose levels rather than preprandial glucose levels. Conclusion Providing home-delivered therapeutic meals designed for diabetes management was effective in lowering the blood glucose levels in patients with type 2 diabetes.

BACKGROUND: Measurement of the plasma adrenocorticotropic hormone (ACTH) level has been recommended as the first diagnostic test for differentiating between ACTH-independent Cushing syndrome (CS) and ACTH-dependent CS. When plasma ACTH values are inconclusive, a differential diagnosis of CS can be made based upon measurement of the serum dehydroepiandrosterone sulfate (DHEA-S) level and results of the high-dose dexamethasone suppression test (HDST). The aim of this study was to assess the utility of plasma ACTH to differentiate adrenal CS from Cushing' disease (CD) and compare it with that of the HDST results and serum DHEA-S level. METHODS: We performed a retrospective, multicenter study from January 2000 to May 2012 involving 92 patients with endogenous CS. The levels of plasma ACTH, serum cortisol, 24-hour urine free cortisol (UFC) after the HDST, and serum DHEA-S were measured. RESULTS: Fifty-seven patients had adrenal CS and 35 patients had CD. The area under the curve of plasma ACTH, serum DHEA-S, percentage suppression of serum cortisol, and UFC after HDST were 0.954, 0.841, 0.950, and 0.997, respectively (all P<0.001). The cut-off values for plasma ACTH, percentage suppression of serum cortisol, and UFC after HDST were 5.3 pmol/L, 33.3%, and 61.6%, respectively. The sensitivity and specificity of plasma ACTH measurement were 84.2% and 94.3%, those of serum cortisol were 95.8% and 90.6%, and those of UFC after the HDST were 97.9% and 96.7%, respectively. CONCLUSION: Significant overlap in plasma ACTH levels was seen between patients with adrenal CS and those with CD. The HDST may be useful in differentiating between these forms of the disease, especially when the plasma ACTH level alone is not conclusive.
Adrenocorticotropic Hormone* ; Cushing Syndrome* ; Dehydroepiandrosterone Sulfate ; Dexamethasone ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Humans ; Hydrocortisone ; Pituitary ACTH Hypersecretion* ; Plasma* ; Retrospective Studies ; Sensitivity and Specificity