This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence.
Adolescent ; Adult ; Age of Onset ; Aged ; Alcohol-Induced Disorders/*epidemiology/physiopathology/psychology ; Alcoholism/*epidemiology/physiopathology/psychology ; Cluster Analysis ; Comorbidity ; Female ; Humans ; Interviews as Topic ; Male ; Mental Disorders/*epidemiology/physiopathology ; Middle Aged ; Patient Acceptance of Health Care ; Time Factors

OBJECTIVES: The aims of this study were 1) to estimate prevalence rates of drinkers, two subtypes of drinkers-drinkers without dependence and drinkers with probable alcohol dependence(AD) using CAGE, and 2) to find out the correlates of sociodemographic variables and drinking patterns of the drinkers with probable AD by comparing those of the drinkers without dependence, 3) to analyse risk factors for the drinkers with probable AD. METHODS: Using data from face-to-face interviews conducted during 1995, we investigated the prevalence and characteristics of two subtypes of drinkers in a national probability sample of 1,695 drinkers 20 years of age and older. We defined drinkers with CAGE scores 2 and over as drinkers with probable AD, and scores less than 1 as drinkers without dependence. The comparisons of sociodemographic characteristics and drinking patterns between two subtypes of drinkers were examined through chi-square test using weighted data. Statistical analysis including multiple logistic regression analysis were done for each sex, respectively. Because of the large number of coefficients estimated, Bonferroni's method was used to compute p values. RESULTS: The results were as follows: 1) Prevalence of the drinkers was 33.7% in the total sample. Prevalence rate of male and female drinker were 26.3% and 7.40%, respectively. Prevalence of the drinkers with probable AD was 10.9%. For males the prevalence of the drinkers with probable AD was 9.99% and for females 0.94%. 2) According to sociodemographic variables between drinkers without dependence and drinkers with probable AD, males drinkers with probable AD were older, less educated, more depressive, married marital status and were more likely to have occupations of service section than male drinkers without dependence. Female drinkers with probable AD were less educated, more depressive and had less monthly income than drinkers without dependence. 3) As for the drinking patterns, male drinkers with probable AD drank more frequently, had more drinks, had more trying to quit drinking and preferred Soju. Female drinkers with probable AD drank more frequently, had more drinks, were more trying to quit drinking, too. 4) Multiple logistic regression analysis showed that the risk factors for male drinkers with probable AD were lower education(< or =6 years) and depressive symptoms. For females, depressive symptoms and lower education(< or =6 years) were strongly indicative of risk factors though not reaching the statistical significance. CONCLUSIONS: Prevalence of the drinkers with probable AD was 10.9%, and male to female ratio was 10.6:1, which was lower than previous results. Depressive symptoms and lower education proved to be strong predictors for alcohol dependence. This suggest that early detection and treatment of depression and public education for the lower education group should be important.
Adult* ; Alcoholism* ; Depression ; Drinking ; Education ; Female ; Humans ; Logistic Models ; Male ; Marital Status ; Occupations ; Prevalence ; Risk Factors* ; Sampling Studies*

OBJECTIVE: This study was to estimate the prevalence of and identify the predisposing risk factors of delirium and to determine the effect of delirium on the prognosis, especially death in burn patients. METHOD: The study was completed by thorough examination of medical records, with additional confirmation, of the 245 patients who were admitted to the Burn ICU in Burn treatment center of Hangang Sacred Heart Hospital during last one year (Jan. 1. 1998-Dec. 31. 1998). Delirium was retrospectively diagnosed according to DSM-IV. Only when disturbance of consciousness and attention, cognitive dysfunction especially disorientation, or perceptual disturbance were observed, diagnosis of delirium were given. Final outcome such as death was discriminated through examination of medical records or question to those who knew the patient. RESULTS: One year prevalence of delirium in burn patients is 34.4%. Statistically significant predisposing risk factors of delirium were five;Age 65 and over (OR=45.51, 95% CI:6.07-341.11), burn size over 60% of total body surface (OR=6.48, 95% CI:3.16-13.28), current psychiatric disorder (OR=6.81, 95% CI:1.42-32.57), current medical disease (OR=3.00, 95% CI:1.40-6.45), alcohol abuse (OR=3.17, 95% CI:1.07-9.43) Statistically significant deathrelated risk factors were three;burn size over 60% of total body surface (OR=4.58, 95% CI:2.00-10.46), delirium (OR=2.94, 95% CI:1.25-6.94), current psychiatric disorder (OR=4.09, 95% CI:1.05-15.87). Aging is not the death-related factor in this study. CONCLUSION: Three factors, such as delirium, organic brain damage, and burn size over 60% of total body surface may predict higher risk of death in burn patients.
Aging ; Alcoholism ; Brain ; Burns* ; Consciousness ; Delirium* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart ; Humans ; Critical Care* ; Medical Records ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Factors

We examined whether wogonin (WO) improved hippocampal neuronal activity, behavioral alterations and cognitive impairment, in rats induced by administration of trimethyltin (TMT), an organotin compound that is neurotoxic to these animals. The ability of WO to improve cognitive efficacy in the TMT-induced neurodegenerative rats was investigated using a passive avoidance test, and the Morris water maze test, and using immunohistochemistry to detect components of the acetylcholinergic system, brain-derived neurotrophic factor (BDNF), and cAMP-response element-binding protein (CREB) expression. Rats injected with TMT showed impairments in learning and memory and daily administration of WO improved memory function, and reduced aggressive behavior. Administration of WO significantly alleviated the TMT-induced loss of cholinergic immunoreactivity and restored the hippocampal expression levels of BDNF and CREB proteins and their encoding mRNAs to normal levels. These findings suggest that WO might be useful as a new therapy for treatment of various neurodegenerative diseases.
Animals ; Brain-Derived Neurotrophic Factor ; Cholinergic Neurons ; Cognition Disorders ; Cyclic AMP Response Element-Binding Protein ; Immunohistochemistry ; Learning ; Memory ; Neurodegenerative Diseases ; Neurons* ; Rats* ; RNA, Messenger ; Water

BACKGROUND AND OBJECTIVES: Apolipoprotein A-I is the major lipoprotein constituent of high density lipoprotein in plasma. In this study, the role of two polymorphisms in the apo A-I gene was investigated on the serum lipid profiles and apo A-I levels in healthy men and women. SUBJECTS AND METHODS: Blood samples were obtained from 417 subjects (M : F=169 : 248, mean age 47.2 years). The apo A-I genotypes were determined by SNP-IT assays using the SNPstream 25KTM system. RESULTS: The frequencies of the A allele at the XmnI restriction site and position -75 bp were 0.25/0.23 and 0.19/0.17 in men and women, respectively. A strong positive linkage disequilibrium (D'=0.990) between two polymorphisms was detected. In men, the A allele at the XmnI restriction site was associated with significantly lower levels of triglyceride (p=0.028) compared to the G/G subjects, but no significant associations were detected between the G-75A polymorphism and any of the lipid traits examined. In women, each A allele for the XmnI restriction site and -75 bp polymorphisms were significantly associated with higher levels of apo A-I (p=0.032 and p=0.012). In the multiple regression analysis, the HDL, being a current drinker and the A allele of the XmnI restriction site polymorphism were major determinants of the serum apo A-I levels in women (R2=0.272, p<0.05). CONCLUSION: Our study showed that the A allele at XmnI restriction site in the apo A-I gene was associated with decreased triglyceride levels in men. Each A allele of two polymorphisms was associated with an elevated apo A-I level in women.
Alleles ; Apolipoprotein A-I* ; Apolipoproteins* ; Female ; Genotype ; Humans ; Linkage Disequilibrium ; Lipoproteins ; Male ; Middle Aged* ; Plasma ; Triglycerides

beta-asarone (BAS) is an active component of Acori graminei rhizoma, a traditional medicine used clinically in treating dementia and chronic stress in Korea. However, the cognitive effects of BAS and its mechanism of action have remained elusive. The purpose of this study was to examine whether BAS improved spatial cognitive impairment induced in rats following chronic corticosterone (CORT) administration. CORT administration (40 mg/kg, i.p., 21 days) resulted in cognitive impairment in the avoidance conditioning test (AAT) and the Morris water maze (MWM) test that was reversed by BAS (200 mg/kg, i.p). Additionally, as assessed by immunohistochemistry and RT-PCR analysis, the administration of BAS significantly alleviated memory-associated decreases in the expression levels of brain-derived neurotrophic factor (BDNF) and cAMP-response element-binding protein (CREB) proteins and mRNAs in the hippocampus. Also, BAS administration significantly restored the expression of Bax and Bcl-2 mRNAs in the hippocampus. Thus, BAS may be an effective therapeutic for learning and memory disturbances, and its neuroprotective effect was mediated, in part, by normalizing the CORT response, resulting in regulation of BDNF and CREB functions and anti-apoptosis in rats.
Animals ; Apoptosis* ; Brain-Derived Neurotrophic Factor ; Corticosterone* ; Dementia ; Hippocampus* ; Immunohistochemistry ; Korea ; Learning ; Medicine, Traditional ; Memory ; Memory, Short-Term* ; Neuroprotective Agents ; Rats* ; RNA, Messenger ; Water

BACKGROUND AND OBJECTIVES: Retension of inflammatory cells and cytokines in the middle ear cleft can result in ongoing chronic otitis media with effusion. This study aims to investigate the role of these inflammatory cells and cytokines in the middle ear effusion (MEE) of children with otitis media with effusion. MATERIALS AND METHOD: We analyzed 46 pediatric middle ear effusion samples for IL-6, IL-10, TNF-alpha and inflammatory cells and tried to elucidate the relationship between the concentration of these cytokines, inflammatory cells and clinical features. RESULTS: 1) The concentration of TNF-alphain MEE from children younger than 2 years was significantly higher than the levels of children older than 2 years (p<0.05). 2) The concentration of TNF-alpha in MEE of preoperative medication group was significantly lower than the levels of non-medication group (p<0.05). 3) The concentration of IL-6 in MEE of the ears with hearing threshold poorer than 35 dB was significantly higher than the levels of the ears with hearing threshold better than 35 dB (p<0.05). CONCLUSION: The results showed that TNF-alpha and IL-6 are intimately involved in the inflammatory cascade of the middle ear and suggest regulation of these cytokines as possible sites of future therapeutic intervention in otitis media with effusion.
Child ; Cytokines* ; Ear ; Ear, Middle ; Hearing ; Humans ; Interleukin-10 ; Interleukin-6 ; Otitis Media with Effusion* ; Otitis Media* ; Otitis* ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: Gentamicin (GM) is well known for its vestibulotoxicity. There have been many reports about vestibulotoxicity, however, its mechanism is still unclear. So far, it is known that GM affects the voltage-dependent K+ current and nitric oxide (NO) production. Epigallocatechin-3-gallate (EGCG) is the major component of green tea and is known to have anti-oxidative and anti-toxic effect. This study was undertaken to investigate the protective effect of EGCG against gentamicin on vestibular hair cell (VHC). MATERIALS AND METHOD: White guinea pigs (200-250 g) were rapidly decapitated and the temporal bones were immediately removed. Under a dissecting microscope, the crista ampullaris was obtained. The dissociated VHCs were transferred into a recording chamber mounted onto an inverted microscope. Whole-cell membrane currents and potentials were recorded using standard patch-clamp techniques. In addition, measurements of NO production were obtained using the NO-sensitive dye, 4,5-diamino-fluorescein diacetate (DAF-2DA). RESULTS: Type I VHCs Voltage-dependent K+ current was activated from low depolarizing stimulation. As the stimulation increased, higher current was detected. Voltage-dependent K+ current in type I VHCs was decreased when GM (200 microM) was administrated and GM effects of K+ current inhibition was significantly blocked by EGCG. Extracellular GM-induced an increase in DAF-2DA fluorescence, which thus indicates NO production in VHCs. Also, the GMinduced NO production was inhibited by EGCG. CONCLUSION: GM inhibits voltage-dependent K+ current by releasing NO in isolated type I VHCs. EGCG blocks this inhibitory effects, suggesting a protective role on GM vestibulotoxicity.
Animals ; Fluorescence ; Gentamicins* ; Guinea Pigs* ; Hair Cells, Vestibular* ; Membranes ; Nitric Oxide ; Patch-Clamp Techniques ; Semicircular Ducts ; Tea ; Temporal Bone

PURPOSE: To correlate the degree of renal cortical enhancement, objectively evaluated by means of spiral CT, with the serum level of creatinine, and to determine the extent to which this degree of enhancement may be used to detect renal parenchymal disease. MATERIALS AND METHODS: Eighty patients [M:F=50:30; age=25 -90 (mean, 53) years] with available serum level of creatinine who underwent spiral CT between September and October 1999 were included in this study. In fifty patients the findings suggested hepatic or biliary diseases such as hepatoma, biliary cancer, or stone, while in thirty, renal diseases such as cyst, hematoma, or stone appeared to be present. Spiral CT imaging of the cortical phase was obtained at 30 -40 seconds after the injection of 120 ml of non-ionic media at a rate of 3ml/sec. The degree of renal cortical enhancement was calculated by dividing the CT attenuation number of renal cortex at the level of the renal hilum by the CT attenuation number of aorta at the same level. The degree of renal cortical enhancement was compared with the serum level of creatinine, and the degree of renal cortical enhancement in renal parenchymal disease with that of the normal group. Among eighty patients there were five with renal parenchymal disease and 75 with normal renal function. RESULTS: The ratio of the CT attenuation number of renal cortex to that of aorta at the level of the renal hilum ranged between 0.49 and 0.99 (mean, 0.79; standard deviation, 0.15), while the serum level of creatinine ranged between 0.6 and 3.2 mg/dl. There was significant correlation (coefficient of -0.346) and a statistically significant probability of 0.002 between the ratio of the CT attenuation numbers and the serum level of creati-nine. There was a significant difference (statistically significant probability of less than 0.01) between those with renal parenchymal disease and the normal group. CONCLUSION: The use of spiral CT to measure the degree of renal cortical enhancement provides not only an effective index for estimating renal functional status but also a means of differentiating between patients with renal parenchymal disease and those who are normal.
Aorta ; Carcinoma, Hepatocellular ; Creatinine ; Hematoma ; Humans ; Kidney* ; Tomography, Spiral Computed*

BACKGROUND AND OBJECTIVES: A significant ST segment depression is known to be an independent risk factor for acute coronary syndrome (ACS). Defining high risk groups in non ST elevation myocardial infarction (NSTEMI) is especially important due the poor long term prognosis of these patients. The purpose of this study was to determine the prognostic significance of the degree of ST depression on admission, as determined by a novel ST depression scoring system. SUBJECTS AND METHODS: 68 patients, admitted to Yonsei Cardiovascular Hospital between Jan 2001 and Aug 2002, and diagnosed with acute non ST elevation myocardial infarction were included in this study. Analysis of the initial ECG on admission was retrospectively performed. RESULTS: ST depression scores > or =1 and <1 were present in 36 (Group I) and 32 (Group II) patients, respectively. The rate of multivessel disease was significantly higher in group I than II (76.7 vs. 50%, p=0.032), the use of glycoprotein IIb/IIIa inhibitors was more frequent in group I than II (25 vs. 6.3%, p=0.041) and the left ventricular ejection fraction was significantly lower in group I than II (44.6+/-14.5 vs. 54.5+/-11.6%, p<0.05). The one-year survival rates were 68.9 and 93.7% for Groups I and II, respectively; p=0.0095), with Group I having a significantly higher early in-hospital mortality rate compared to group II.( 27.8 vs. 3.1%, p=0.0058) The event free survival rate in group I was lower than that in group II (55 vs. 90.6%, p=0.001). CONCLUSION: The ST depression score may be useful as an objective prognostic factor in acute NSTEMI, which may be especially useful for prediction of the early in hospital prognosis.
Acute Coronary Syndrome ; Depression* ; Disease-Free Survival ; Electrocardiography ; Glycoproteins ; Hospital Mortality ; Humans ; Myocardial Infarction* ; Prognosis ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate