OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.
Ambulatory Care Facilities ; Evoked Potentials* ; Humans ; Noise ; Schizophrenia*

OBJECTIVES: Using 3-stimulus auditory "oddball" paradigm reflecting fronto/central and temporo/parietal functions simultaneously, we examined patients with schizophrenia. METHODS: Fifteen patients with schizophrenia from outpatient clinic and fifteen normal controls from hospital staffs were recruited for the study. To elicit P3a and P3b, 3-stimulus auditory oddball paradigm was employed. The 3-stimulus auditory oddball paradigm was composed of standard tone (1,000 Hz, 75 dB, 80%), target tone (2,000 Hz, 75 dB, 10%) and distracter (White noise, 95 dB, 10%). RESULTS: P3a and P3b were prominent in fronto/central and temporo/parietal areas, respectively, in both schizophrenics and normal controls. The P300 amplitude in patients with schizophrenia was reduced across P3a and P3b (p<0.01). The P300 latency in patients with schizophrenia was delayed across P3a and P3b (p<0.01). CONCLUSION: These results were consistent with frontal and temporo-parietal lobe dysfunctions in schizophrenics. The 3-stimulus auditory paradigm could be applied for patients with schizophrenia and useful for further exploration the disorder.
Ambulatory Care Facilities ; Evoked Potentials* ; Humans ; Noise ; Schizophrenia*

Obstructive jaundice produced by periportal tuberculous adenitis in the absence of pulmonary tuberculosis is quite rare. We are reporting the case of a 58-year-old woman who presented with constitutional symptoms and biochemical evidence of biliary tract obstruction. By abdominal sonogram and CT scan, a mass around the head of pancreas and periportal area was detected. The ERCP showed fistula connected proximal common bile duct to lymph node. The patient underwent laparotomy and recognized tuberculous adenitis of periportal lymph node which caused biliary tract obstruction with fistula.
Biliary Tract* ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Female ; Fistula ; Head ; Humans ; Jaundice, Obstructive ; Laparotomy ; Lymph Nodes ; Lymphadenitis* ; Middle Aged ; Pancreas ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary ; Yemen*

The dysregulation of the dopaminergic system has been implicated in the pathophysiology of major psychosis, including schizophrenia, with dopamine receptor genes (DRDs) presently targeted as the most promising candidate genes. We investigated DRD1-5 for association with schizophrenia using a multi-stage approach in a Korean sample. One hundred forty-two SNPs in DRD1-5 were selected from the dbSNP, and the associations of each SNP were then screened and typed by MALDI-TOF mass spectrometry using pooled DNA samples from 150 patients with major psychosis and 150 controls. Each of the suggested SNPs was then genotyped and tested for an association within the individual samples comprising each pool. Finally, the positively associated SNPs were genotyped in an extended sample of 270 patients with schizophrenia and 350 controls. Among the 142 SNPs, 88 (62%) SNPs in our Korean population were polymorphic. At the pooling stage, 10 SNPs (DRD1: 2, DRD2: 3, and DRD4: 5) were identified (P < 0.05). SNPs rs1799914 of DRD1 (P = 0.046) and rs752306 of DRD4 (P = 0.017) had significantly different allele frequencies in the individually genotyped samples comprising the pool. In the final stage, with the extended sample, the suggestive association of DRD4 with rs752306 was lost, but the association of DRD1 with rs1799914 gained greater significance (P = 0.017). In these large-scale multi-stage analyses, we were able to find a possible association between DRD1 and schizophrenia. These findings suggested the potential contribution of a multi-step strategy for finding genes related to schizophrenia.
*Genetic Association Studies ; Humans ; Linkage Disequilibrium ; *Polymorphism, Single Nucleotide ; Receptors, Dopamine/*genetics ; Receptors, Dopamine D1/*genetics ; Republic of Korea ; Schizophrenia/*genetics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

BACKGROUND: Drowning represents the third most common cause of all accidental deaths worldwide. Although few studies of submersion injury were done in Korea, the subjects were mainly pediatric patients. The purpose of this study is to describe the clinical feature of submersion injury in adults. METHODS: The medical records of 31 patients with submersion injury who were >15 years of age and admitted to Kyungpook National University Hospital from July 1990 to March 2003 were retrospectively examined. RESULTS: The most common age-group, cause, and site of submersion accidents in adults were 15-24 years of age, inability to swim, and river followed by more than 65 years of age, drinking, and public bath respectively. The initial chest radiographs showed bilaterally and centrally predominant distribution of pulmonary edema at lung base in about 90% of patients with pulmonary edema represented by submersion injury but at only upper lung zone in 10%. Eventually, 25 patients (80.6%) survived without any neurologic deficit and 2 patients (6.5%) with significant neurologic deficit, and 4 patients (12.9%) died. Age, arterial gas oxygenation, and mental status among baseline variables showed significant difference for prognosis. CONCLUSIONS: More than 65 years of age, drinking, and occurrence in public bath were relatively important in submersion injury of adults, and the successful survival of 80.6% of patients suggests that cardiopulmonary resuscitation should be intensively done in even adults.
Adult* ; Baths ; Cardiopulmonary Resuscitation ; Drinking ; Drowning ; Gyeongsangbuk-do ; Humans ; Immersion* ; Korea ; Lung ; Medical Records ; Near Drowning ; Neurologic Manifestations ; Oxygen ; Prognosis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Rivers

OBJECTIVES: Gamma-aminobutyric acid (GABA) has potential benefits in counteracting the sleep disruption and potential therapeutic effects on blood pressure, stress, cancer, and inflammatory diseases. Recently, High-dose GABA can be extracted from fermented rice germ using lactic acid bacteria. This study aimed to evaluate the effects of GABA natural extracts from fermented rice-germ on sleep latency, subjective sleep quality and insomnia symptoms. METHODS: This was a prospective randomized double-blind placebo-controlled trial performed at Kyung-Hee University hospital at Gangdong from June 2013 to October 2013. Adult (age≥30) patients who was diagnosed of insomnia according to DSM-IV criteria was enrolled. They were randomized into three groups: high dose treatment group 300 mg; low-dose treatment group, 100 mg; and placebo group. Questionnaires including Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index were performed, and 1-week actigraphy was recorded before and 1 week after the treatment. RESULTS: Total of 114 patients were randomized into 3 groups: high-dose treatment (n=37), low-dose treatment (n=38), and placebo treatment group (n=39). At 1 week after the treatment, PSQI total score and C2 (sleep latency) score significantly decreased in low-dose and high-dose treatment group than the placebo groups [Repeated measures analysis of variance (ANOVA), p=0.017, 0.004 respectively]. ISI score also decreased in the two groups in dose-dependent manner (Repeated measures ANOVA, p=0.037). There were five (4.4%) patients who reported medication adverse events. CONCLUSIONS: This study suggests that treatment of low and high-dose GABA from unpolished rice-germ decreases sleep latency and improve insomnia severity without severe adverse events.
Actigraphy ; Adult ; Bacteria ; Blood Pressure ; Diagnostic and Statistical Manual of Mental Disorders ; gamma-Aminobutyric Acid* ; Humans ; Lactic Acid ; Prospective Studies ; Sleep Initiation and Maintenance Disorders ; Therapeutic Uses

The authors calculated the number of blood cultures per 1,000 admitted patient days at seven university-affiliated hospitals in 2010, which ranged from 65 to 129 (mean 110). The number of blood cultures per 1,000 patient days could possibly be a good parameter for assessing the appropriateness of blood culture.
Humans ; Korea ; Quality Control ; Sepsis

OBJECTIVES: Nowadays most infants on exclusively breast feeding have vitamin D deficiency due to the increase of breast feeding. However, domestic research lacks appropriate materials. Therefore, we researched practical clinical aspects of vitamin D deficiency related to breast milk feeding for infants who have a high amount of alkaline phosphatase (> 500 IU/L). METHODS: The subjects of the study were 31 infants with high alkaline phosphatase level. We tested with 25-hydroxycholecalciferol (25-OHD3), parathyroid hormone, calcium, ionized calcium, phosphorus in their blood and with a wrist x-ray. Then, we divided them into two groups of breast feeding and formula feeding and compared the results. RESULTS: Eighteen infants (58%) out of 31 infants that have high alkaline phosphatase were vitamin D insufficiency or deficiency, and 16 (100%) breast feeding infants of them showed vitamin D deficiency or insufficiency. However, only 2 (13%) of 15 formula feeding infants were at insufficiency. There was a correlation between alkaline phosphatase and 25-OHD3 concentration in multiple regression analysis, but no correlation in other variables was found in group of breast milk feeding infants. There was neither correlation between vitamin D concentration and alkaline phosphatase nor other correlated variables in the group of formula milk feeding infants. CONCLUSIONS: In this study, there was a high probability of vitamin D deficiency in the breast feeding infants with a high alkaline phosphatase level. Therefore, it is considered to be worth utilizing alkaline phosphatase as a screening test for vitamin D deficiency or rickets for breast feeding infants.
Alkaline Phosphatase ; Breast Feeding ; Calcifediol ; Calcium ; Humans ; Infant ; Mass Screening ; Milk ; Milk, Human ; Parathyroid Hormone ; Phosphorus ; Rickets ; Vitamin D ; Vitamin D Deficiency ; Vitamins ; Wrist

OBJECTIVE: To determine whether local estrogen production takes place in adenomyosis and in normal endometrium. METHODS: The study included 23 cases of adenomyosis and 17 cases of normal uterine endometrium obtained through hysterectomy or curettage at Kangnam Cha Hospital. The frozen tissue specimens were examined by immunohistochemistry using P450 arom. RESULTS: P450 arom was immunolocalized exclusively in the cytoplasm of glandular cells of adenomyotic tissue. However, no apparent staining was observed in stromal cells. Aromatase was expressed in the ectopic glands (82.6%), but also in the eutopic endometrium of patients with adenomyosis (23.5%). In the case of normal endometrium, P450arom was not detected. CONCLUSION: These results suggest that the aromatase activity is correlated to the pathophysiology of adenomyosis.
Adenomyosis* ; Aromatase* ; Curettage ; Cytochrome P-450 Enzyme System* ; Cytochromes* ; Cytoplasm ; Endometrium ; Estrogens ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Stromal Cells

PURPOSE: The purpose of this study was to evaluate the clinical characteristics of children who had been diagnosed as specific language impairment as outpatients. METHODS: One hundred twenty-five speech- or language-delayed patients were enrolled in Dae-Dong Hospital from July 2007 to June 2008. Fifty-one of 125 children were diagnosed as specific language impairment in whom clinical factors such as duration of therapy and progress after therapy were evaluated. Data were obtained from telephone or direct personal interviews. RESULTS: Among 51 children diagnosed as specific language impairment, 39 (76.5%) had mixed receptive-expressive-type language disorder and 12 (23.5%) had expressive-type language disorder. Thirty children in total were studied as ten children were unavailable for follow-up and eleven dropped out during treatment. The final 30 children consisting of 23 with mixed receptive-expressive type language disorder and seven children with expressive-type language disorder were treated after diagnosis. Total average treatment duration of children with mixed receptive-expressive-type and expressive-type language disorder were 18.1 months and 8.6 months, respectively, a statistically significant difference (P = 0.014). Thirteen (57%) of 23 children with mixed receptive-expressive-type language disorder and all (100%) seven children with expressive-type language disorder completed speech therapy with an average treatment duration of 12.2 and 8.6 months, respectively; however, this difference was not statistically significant(P = 0.287). CONCLUSION: Classifying patients with specific language impairments into mixed receptive-expressive-type and expressive-type language disorder in an outpatient department can be useful for predicting duration of and prognostic effects of language therapy, as our study and other previous articles have shown. More attention is needed from pediatricians to ensure the effective assessment and management of specific language impairment.
Child ; Dietary Sucrose ; Follow-Up Studies ; Humans ; Language Disorders ; Language Therapy ; Outpatients ; Speech Disorders ; Speech Therapy ; Telephone