PURPOSE: We carried out this study to determine if there is any difference in the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG and if there are any factors influencing on the occurrence rate of EEG. METHODS: This study included 178 epileptic children who had visited neurology clinic of the department of pediatrics, Pusan National University Hospital from July 2005 to July 2006. The medical and EEG records of these children who had had both awake EEG and sleep EEG were reviewed. We analysed the occurrence rate of the epileptiform discharge between awake EEG and sleep EEG. We investigated the related clinical factors which included sex, seizure types, underlying causes, age at first seizure, antiepileptic drug (AED) medication, age at recording, and background activity. RESULTS: Among 178 epileptic children, 91 patients (51.1%) showed epileptiform discharge in awake or sleep states, 10 patients (11.0%) abnormal only in awake, 40 patients (44.0%) abnormal only in sleep, 41 patients (45.0%) abnormal in both awake EEG and sleep EEG. The occurrence rate of sleep EEG was 81 of 178 patients (45.5%) which was more than that of the awake EEG (28.7%) (P<0.001). The occurrence rate of sleep EEG is more than that of the awake EEG regardless of sex and underlying causes. But there is no significant difference from awake EEG and sleep EEG in finding the epileptiform discharge in the patient with generalized seizure, younger than 5 years old at first seizure, younger than 10 years old at recording, no antiepileptic medication, and abnormal background activity. CONCLUSION: The sleep EEG is thought to be more helpful in the diagnosis of childhood epilepsy.
Child ; Electroencephalography ; Epilepsy ; Humans ; Neurology ; Pediatrics ; Seizures

PURPOSE: The purpose of this study was to test the effectiveness of a comprehensive smoking cessation program for Korean adolescents. METHOD: The study design was quasi-experimental with one pre and three post-tests. The three posttests were done immediately after, three months later, and six months after the completion of the program. A total of 43 high school students who smoked participated in the study with 22 in the experimental group and 21 in the control group. The smoking cessation program consisted of 9 sessions with content on enhancement of self-efficacy, stress management, correction of distorted thoughts, consciousness raising, and assertiveness training. The study variables were urine cotinine levels, self-efficacy, stress, and stages of changed behavior. RESULTS: Urine cotinine levels significantly decreased in the experimental group after the program (F=3.02, p=.06) but significantly increased in the control group (F=6.32, p=.004). Self-efficacy and the degree of stress did not change in either group. The stages of smoking cessation behavior tended to change when compared with raw data for the experimental group. For most participants, the stages of change had been precontemplation and contemplation, but changed to action and maintenance stage among the experimental group. CONCLUSION: The program was effective in smoking cessation and influencing stages of change but did not change psychosocial factors such as self-efficacy and stress. It is suggested a program should be developed to change psychosocial variables on a long-term basis. It is also desirable to involve peers and families of adolescents who smoke when planning programs to enhance social support.
Adolescent ; Adolescent Behavior ; Adolescent Health Services/*organization & administration ; Adolescent Psychology ; Analysis of Variance ; Attitude to Health ; Cotinine/urine ; Educational Status ; Health Knowledge, Attitudes, Practice ; Humans ; Korea ; Longitudinal Studies ; Needs Assessment ; Patient Education as Topic/*organization & administration ; Personality Inventory ; Program Development ; Program Evaluation ; Questionnaires ; School Health Services/*organization & administration ; Self Efficacy ; Smoking/*prevention & control/psychology/urine ; Smoking Cessation/*methods/psychology ; Stress, Psychological/complications/psychology

Background: Although cardiovascular outcome trials using sodium-glucose cotransporter-2 inhibitors (SGLT-2i) showed a reduction in risk of 3-point major adverse cardiovascular events (MACE), they did not demonstrate beneficial effects on stroke risk. Additionally, meta-analysis showed SGLT-2i potentially had an adverse effect on stroke risk. Contrarily, pioglitazone, a type of thiazolidinedione (TZD), has been shown to reduce recurrent stroke risk. Thus, we aimed to compare the effect of SGLT-2i and TZD on the risk of stroke in type 2 diabetes mellitus (T2DM) patients. Methods: Using the Korean National Health Insurance Service data, we compared a 1:1 propensity score-matched cohort of patients who used SGLT-2i or TZD from January 2014 to December 2018. The primary outcome was stroke. The secondary outcomes were myocardial infarction (MI), cardiovascular death, 3-point MACE, and heart failure (HF). Results: After propensity-matching, each group included 56,794 patients. Baseline characteristics were well balanced. During the follow-up, 862 patients were newly hospitalized for stroke. The incidence rate of stroke was 4.11 and 4.22 per 1,000 person-years for the TZD and SGLT-2i groups respectively. The hazard ratio (HR) of stroke was 1.054 (95% confidence interval [CI], 0.904 to 1.229) in the SGLT-2i group compared to the TZD group. There was no difference in the risk of MI, cardiovascular death, 3-point MACE between groups. Hospitalization for HF was significantly decreased in SGLT-2i-treated patients (HR, 0.645; 95% CI, 0.466 to 0.893). Results were consistent regardless of prior cardiovascular disease. Conclusion In this real-world data, the risk of stroke was comparable in T2DM patients treated with SGLT-2i or TZD.

Hyponatremia and hyperkalemia in infancy can be attributed to various causes, originating from a variety of renal and genetic disorders. Pseudohypoaldosteronism type 1 (PHA1) is one of these disorders, causing mineralocorticoid resistance that results in urinary salt wasting, failure to thrive, metabolic acidosis, and dehydration. PHA1 is heterogeneous in etiology. Inactivating mutations in the NR3C2 gene (4q31.1), which encodes the mineralocorticoid receptor, causes a less severe autosomal dominant form that is restricted to the kidney, while mutations in the amiloride-sensitive epithelial sodium channel gene (alpha subunit=SCNN1A, 12p13; beta subunit=SCNN1b, 16p12.2-p12.1; gamma subunit=SCNN1G, 16p12) causes a more severe autosomal recessive form, which has systemic effects. Here we report a neonatal case of kidney restricted PHA1 (renal type of PHA1) who first showed laboratory abnormalities before obvious PHA1 manifestations, with two functional polymorphisms in the NR3C2 gene. This is the second genetically confirmed case in Korea and the first to show functional polymorphisms that have previously been reported in the literature.
Acidosis ; Dehydration ; Epithelial Sodium Channels ; Failure to Thrive ; Humans ; Hyperkalemia ; Hyponatremia ; Infant, Newborn* ; Kidney ; Korea ; Male* ; Pseudohypoaldosteronism* ; Receptors, Mineralocorticoid*

A patient with encephalopathy associated with autoimmune thyroid disease (EAATD), which is one of the most important differential diagnoses of treatable dementia, presents with various neurological symptoms, such as repetitive epileptic seizures, altered mental status, and cognitive dysfunction. Steroid treatment is effective for EAATD. The incidence of EAATD increases considerably with age, particularly in female patients. Most patients with EAATD have normal thyroid function test results or mild hypothyroidism. Patients with EAATD with Graves' disease are very rarely reported. Here, we report a case of a 63-year-old woman who complained of declining cognitive ability and ataxia. She was diagnosed with EAATD accompanied by Graves' disease. Her neurological symptoms improved after intravenous steroid administration.
Ataxia ; Brain Diseases ; Dementia ; Diagnosis, Differential ; Epilepsy ; Female ; Graves Disease* ; Humans ; Hypothyroidism ; Incidence ; Middle Aged ; Thyroid Diseases* ; Thyroid Function Tests ; Thyroid Gland*

PURPOSE: Little research has been conducted on adverse drug reactions in neonates, particularly in Korea, where no studies have been reported. METHODS: We conducted a retrospectively study using medical records in a neonatal intensive care unit from August 1, 2013 to July 31, 2014. The adverse drug reactions were evaluated according to the Naranjo algorithm, World Health Organization-Uppsala Monitoring Centre, and the Korean adverse drug reaction algorithm. RESULTS: Of the 410 infants hospitalized during the study period, 57 cases of adverse drug reactions were reported in 40 infants (9.8%). The average gestational age was 28.4+/-4.3 weeks, the average birth weight was 1,184.1+/-622.0 g, and the adverse drug reactions were reported at an average of 21.0+/-29.7 days after birth. Causative agents were identified as electrolytes (36.8%), respiratory medication (14.0%), total parenteral nutrition (12.3%), lipid emulsion (10.5%), antibiotics (7.0%), non-steroidal anti-inflammatory drugs (NSAIDs, 7.0%), sedatives (7.0%), vaccine (3.5%), and an antiviral medication (1.8%). Of the 57 cases, 55 (96.5%) cases demonstrated meaningful adverse drug reactions, defined as those given a score of "possible or above" in all 3 adverse drug reaction algorithms. CONCLUSION: More emphasis is warranted in the field of neonatal adverse drug reactions.
Anti-Bacterial Agents ; Birth Weight ; Drug-Related Side Effects and Adverse Reactions* ; Electrolytes ; Gestational Age ; Humans ; Hypnotics and Sedatives ; Infant ; Infant, Newborn ; Intensive Care, Neonatal* ; Korea ; Medical Records ; Parenteral Nutrition, Total ; Parturition ; Retrospective Studies ; World Health

OBJECT: We measured the activity of telomerase in coal workers lung tissue and found a significant increase in telomerase activity compared to the control group. Pneumoconiosis has the characteristics of fibroblast proliferation and the accumulation of collagen,thus finally causing the pathologic changes,which lead to the irreversible and progressive fibrosis of the lungs. We hypothesized that this cellular proliferation causing irreversible fibrosis may induce some elongation of the life cycle in the chromosomes and lead to further cellular immortalization. METHOD: 8 postmortem(within 24 hours)pneumo-coniotic cases were examined and their telomerase activity was compared with that of the autopsied lungs of lung cancer patients and of accident victims without any respiratory diseases. Using the extracted ribo-nucleoprotein from pneumoconiotic nodules, telomeric repeat amplification assay (TRAP)was done. RESULT: The pneumoconiotic lungs showed strong telomerase activity, similar to that of the lung cancer patients, while the control group showed no such activity. CONCLUSION: Based on the results of this study, we found that coal dust-induced cellular proliferation affects telomerase-activity clinically.
Cell Proliferation ; Coal* ; Fibroblasts ; Fibrosis ; Humans ; Life Cycle Stages ; Lung Neoplasms ; Lung* ; Pneumoconiosis ; Telomerase*

OBJECTIVES: It is well known that pneumoconiotic patients experience impairments of macrophage function, as well as poor penetration of drugs into the fibrotic nodules and the immune system. Resultantly, pneumonia is frequently involved in pneumoconiotic patients and its treatment is not easy. Therefore, we conducted a clinical evaluation of immunoglobulin G which is known to be effective in severe infectious diseases. METHODS: We randomly selected 45 pneumoconiotic patients with pneumonia and classified them into 2 groups. The experimental group (IgG group) was scheduled to receive antibiotics and IgG (5 g I.V./day for 7 days). The control group was treated with antibiotics alone. Sputum gram stain (counts of WBCs and microorganisms), body temperature, arterial oxygen tension, and counts of peripheral venous blood leukocytes and band neutrophils were used as markers to assess the response effect therapy at time periods of 0, 2, 4, 6, and 8 days after completion of therapy. We compared the clinical scores between the two groups. RESULTS: The experimental IgG treated group was composed of 27 patients, and the control group comprised 18 patients. There was no statistical differences between two groups in terms of age, pneumoconiotic profusion, impairment degree of pulmonary function, or frequency of pathogen isolation in the sputum before medication. The experimental IgG treated group showed lower clinical scores as compared with the control group (p=0.083). CONCLUSIONS: These results suggest that IgG infusion with antibiotics will have an effect on pneumonia therapy in pneumoconiosis patients that are under 60 years and exhibit simple pneumoconiosis.
Anti-Bacterial Agents ; Body Temperature ; Communicable Diseases ; Humans* ; Immune System ; Immunoglobulin G* ; Immunoglobulins* ; Leukocytes ; Macrophages ; Neutrophils ; Oxygen ; Pneumoconiosis ; Pneumonia* ; Sputum

OBJECTIVES: This study was performed in order to investigate the frequency of the TNF2 allele in patients with coal workers pneumoconiosis (CWP). METHODS: We compared the genotype distribution of TNFalpha gene promoter polymorphism between 80 CWP patients and 54 healthy controls. RESULTS: The results were as follows : 1. The rare allele TNF2 was significantly more frequent in CWP patients (20.6 %) than in controls (10.2 %). 2. The spontaneous or LPS-induced release of TNFalpha from the peripheral monocytes was slightly increased in the TNF2 group, but these values were not significantly different between groups. 3. In the CWP TNF2 group, the increase of LPS-induced TNFalpha release was significant in comparison with that of the controls. CONCLUSIONS: From the above results, we suggest that the TNF2 allele is strongly associated with susceptibility to CWP development.
Alleles ; Anthracosis ; Coal* ; Genotype ; Humans ; Monocytes ; Pneumoconiosis* ; Tumor Necrosis Factor-alpha*

Tuberculosis of thyroid gland is rare. We experienced a case of tuberculosis of the thyroid gland with contralateral lymph node enlargement in a 45-year-old female patient. She had no clinical respiratory symptom and no weight change. Thyroid sonography demonstrated 5.4 × 3.8 mm sized round low echogenic mass on lower pole of left thyroid gland and right cervical lymph node enlargement. Core needle biopsy of thyroid showed epithelioid chronic granuloma in the caseous necrosis. She was administrered anti-tuberculosis therapy for 24 weeks. After medication, thyroid sonographic finding improved and thyroid mass and right cervical lymph node enlargement disappeared.
Biopsy, Large-Core Needle* ; Diagnosis* ; Female ; Granuloma ; Humans ; Lymph Nodes* ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Ultrasonography