No abstract available.
Cluster Headache ; Frontal Sinus ; Frontal Sinusitis ; Headache ; Magnetic Resonance Imaging ; Sinusitis

Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache, diffuse dural thickening, and enhancement in magnetic resonance imaging. Cerebral venous thrombosis (CVT) has been reported to be a rare complication of SIH. There is no consensus in anticoagulation treatment of CVT secondarily caused by SIH. We report a female patient with SIH complicated by CVT and spontaneously regressed CVT not by anticoagulation but by epidural blood patch.
Blood Patch, Epidural ; Consensus ; Female ; Headache ; Humans ; Intracranial Hypotension ; Magnetic Resonance Imaging ; Venous Thrombosis

BACKGROUND AND PURPOSE: Two conversion scales between the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) have been validated for Korean patients with Parkinson's disease. The aim of the present study was to validate these conversion scales for all patients with cognitive impairments regardless of dementia subtype. METHODS: Medical records of 323 subjects who completed both MMSE and MoCA on the same day were retrospectively reviewed. Mean, median, and root mean squared error (RMSE) of the difference between true and equivalent MMSE scores were calculated. Intraclass correlation coefficients (ICCs) between true and equivalent MMSE scores were also calculated. The validity of MoCA-MMSE conversion scales was evaluated according to educational level (low educated: ≤6 years; high educated: ≥7 years) and subtypes of cognitive impairment. RESULTS: The difference between true and equivalent MMSE scores had a median value of 0, a mean value of 0.19 according to the van Steenoven scale, a mean value of 0.57 according to the Lawton scale, RMSE value of 2.2 according to the van Steenoven scale, and RMSE value of 0.42 according to the Lawton scale. Additionally, ICCs between true and equivalent MMSE scores were 0.92 and 0.90 on van Steenovan and Lawton conversion scales, respectively. These results were maintained in subgroup analyses. CONCLUSIONS: Findings of the present study suggest that both van Steenovan and Lawton MoCA-MMSE conversion scales are applicable to transforming MoCA scores into MMSE scores in patients with cognitive impairments regardless of dementia subtype or educational level.
Cognition Disorders* ; Dementia ; Humans ; Medical Records ; Methylenebis(chloroaniline) ; Parkinson Disease ; Retrospective Studies ; Weights and Measures*

OBJECTIVES: The purpose of this study is to investigate the professional knowledge and perceptions of the early screening of Autism Spectrum Disorder (ASD) in practitioners who have contact with patients with ASD. METHODS: A survey was carried out among 674 practitioners in total, where practitioners are defined as those who work at primary medical centers, public institutions, educational institutions and treatment institutions. The survey was carried out both online and offline, and it mainly focused on 1) knowledge about ASD symptoms, 2) knowledge about the early screening of ASD, 3) measures taken after ASD detection, 4) thoughts on the development of early screening tools for ASD, and 5) the current status of ASD treatment. The data collected were analyzed through descriptive statistics, analysis of frequency and cross tabulation analysis using SPSS WIN 22.0. RESULTS: The results of this study suggest that the practitioners were not aware of the exact symptoms of ASD and their professional knowledge and the environment for early screening were insufficient. Furthermore, very few and inappropriate measures were taken after the detection of ASD. In addition, there was a high demand for early ASD screening tools to be used on site and, regarding treatment, the significance of the implementation of evidence based treatments as well as the continuity of relevant research came to the fore. CONCLUSION: It seems that there is a lack of knowledge and perception of the early screening of ASD and that education and training among practitioners is urgently required. This issue is discussed in more detail in the paper.
Autism Spectrum Disorder* ; Autistic Disorder* ; Education ; Humans ; Mass Screening*

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

BACKGROUND: Based on trends demonstrated in the United States, a very insignificant number of people have shown a predisposition to left-sided skin cancer. However, to date, no systematic review or meta-analysis has demonstrated the predominance of left-sided skin cancers over right-sided skin malignancies. OBJECTIVE: We systematically reviewed and meta-analyzed all data pertaining to locations of skin cancers. METHODS: All data were pooled using the Mantel-Haenszel method (random-effects weighting); an inverse variance model featuring fixed-effects weighting was applied to explore the robustness of modeling. Heterogeneity was evaluated using the I2 test. Dichotomous outcomes with respect to the prevalence of left- and right-sided skin cancers are presented as relative risks (RRs) with 95% confidence intervals (CIs). RESULTS: Nine studies were included in our evaluation. Our study sample included: 182,840 patients with malignant melanoma (MM), 1,419 patients with basal cell carcinoma (BCC), and 331 patients with squamous cell carcinoma (SCC). Meta-analyses of pooled observational data revealed greater prevalence of left-sided MM compared to right-sided MM (RR 0.91, 95% CI 0.89~0.92, p<0.01), while left-sided SCC was more prevalent than right-sided SCC (RR 0.83, 95% CI 0.71~0.97, p=0.02). However, right-sided BCC was more prevalent than left-sided BCC (RR 1.07, 95% CI 0.95~1.19, p=0.26). CONCLUSION: Observational studies vary greatly in terms of design, methodological quality, and types of patients studied. Of note, only a few studies analyzing BCC and SCC were included in our present meta-analysis. Additionally, a selection and reporting bias could have affected our results. Our meta-analysis suggests that both MM and SCC demonstrate a left-side bias, but BCC does not.
Bias (Epidemiology) ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Humans ; Melanoma ; Methods ; Population Characteristics ; Prevalence* ; Skin Neoplasms* ; Skin* ; United States

BACKGROUND: Depression is known to affect family function and communication. However, the distress experienced by those who have spouse with depression has not been properly assessed to date. This study attempted to examine the effect of depression on family function and communication as reported by the spouses of the depressed patients. METHODS: The participants of this study were 445 couples who visited 28 family doctors from April 2009 to June 2011. The Family Adaptability and Cohesion Evaluation Scale III (FACES-III) was used to evaluate the family function, and the family communication scale in FACES-IV was used to evaluate communication among family members. A score of more than 21 points on the CES-D scale was used to indicate depression. The relationships between family type, family communication, and the depression of one's spouse were analyzed using the chi-square test and logistic regression. RESULTS: The odds ratios, indicating how the family is heading towards an extreme level, were statistically significant in all male and female respondents (male: odds ratio [OR] 3.08, 95% confidence interval [CI] 1.73-5.48; female: OR 2.09, 95% CI 1.02-4.27). On the other hand, only female respondents with depressed spouses reported their family communication not to be good (male: OR 1.65, 95% CI 0.88-3.07; female: OR 2.48, 95% CI, 1.25-4.93). CONCLUSIONS: This study revealed people perceive their family function and communication not good when they have spouses with depression. There was no gender difference in the evaluation of their family function, but the perception on their family communication were different by gender.
Surveys and Questionnaires ; Depression* ; Family Characteristics ; Female ; Hand ; Head ; Humans ; Logistic Models ; Male ; Odds Ratio ; Spouses

Breast cancer is the second most common malignancy among Korean women. The 2002 National Cancer Center screening guideline breast cancer was revised via an evidence-based approach to provide medical personnel with a standard protocol of screening breast cancer. There is moderate-level evidence that biennial screening mammography in asymptomatic women aged 40 to 69 reduces breast cancer mortality, while low-level evidence suggests that screening mammography in women 70 years or older does not reduce breast cancer mortality. The committee concluded that the current evidence is insufficient to assess the benefits and harms of either ultrasonography or clinical breast examination as screening modalities for breast cancer. Future researches about the benefits and harms of the National Breast Cancer Screening Program in Korea are strongly required because the characteristics of breast cancer in Korea are different from those in the West, especially regarding dense breast. In conclusion, the committee recommends biennial screening mammography in asymptomatic women aged 40 to 69 years (grade B recommendation). The committee recommends selective screening mammography in women 70 years or older according to individual risk and preference (grade C recommendation). The committee neither recommends nor opposes ultrasonography and clinical breast examination as screening modalities (grade I recommendation). Symptomatic and high-risk women, however, should be offered complementary measures including ultrasonography and clinical breast examination under clinical supervision.
Breast ; Breast Neoplasms* ; Female ; Humans ; Korea ; Mammography ; Mass Screening* ; Mortality ; Organization and Administration ; Ultrasonography

OBJECTIVES: The purposes of this study were to examine the reliability and validity of the Korean version of Social Communication Questionnaire (K-SCQ) and to determine cut-off scores for diagnosis of autism spectrum disorder (ASD). METHODS: A total of 166 subjects with ASD and their 186 unaffected siblings were recruited through child psychiatry clinics of university hospitals. Board certified child psychiatrists screened all probands suspected to have ASD based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To confirm the diagnoses, the Korean versions of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised (K-ADI-R) were administered to all the subjects. All parents completed the K-SCQ and Social Responsiveness Scale (SRS). The non-ASD siblings were evaluated with the same instruments as the probands with ASD. We performed a factor analysis to examine the structure of K-SCQ. For testing the validity of K-SCQ, we compared the difference in Lifetime and Current scores of probands with ASD and their non-ASD siblings using t-test and analysis of covariance. Correlations between the K-SCQ and other measurements of ASD symptomatology, including K-ADI-R totals and domain scores and SRS, were examined. Receiver operation characteristic curve analysis was performed to extract cutoff scores discriminating affection status. RESULTS: Four factors were extracted through factor analysis of K-SCQ ; 1) social relation and play, 2) stereotyped behavior, 3) social behavior, and 4) abnormal language. Cronbach's internal consistency was .95 in K-SCQ Lifetime, and .93 in K-SCQ Current. There were significant differences in total score of K-SCQ, both in Lifetime and Current between the ASD group and non-ASD siblings group (p<.001). K-SCQ scores were significantly correlated with K-ADI-R subdomain scores and SRS total scores (p<.001). The best-estimate cut-off scores of K-SCQ for diagnosis of ASD were 12 for 48 months and over, and 10 for below 47 months. CONCLUSION: Our findings suggest that the K-SCQ is a reliable and valid instrument for screening autistic symptoms in the Korean population. Lower cut-off scores than the original English version might be considered when using it as a screening instrument of ASD.
Appointments and Schedules ; Autistic Disorder ; Child ; Autism Spectrum Disorder ; Child Psychiatry ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Hospitals, University ; Humans ; Mass Screening ; Parents ; Psychiatry ; Reproducibility of Results ; Siblings ; Social Behavior ; Stereotyped Behavior

BACKGROUND: In order to evaluate the factors of compliance with a lipid lowering therapy, a prospective observational study of patients with hypercholesterolemia using rosuvastatin was carried out. METHODS: A total of 2,607 patients who were newly prescribed rosuvastatin were enrolled from 32 family physicians in Korea from March 2009 to December 2009. Of them, 301 patients were excluded due to incomplete data or follow-up compliance data. The patients were regularly observed to ascertain the compliance associated with rosuvastatin at intervals of 12 and 24 weeks. We collected risk factors for the compliance using a structured questionnaire. The criteria for evaluating compliance are to measure clinic attendance, to assess the continuity of therapy, and to calculate the percentage of doses taken. RESULTS: Among a total of 2,306 patients, the degree of compliance was 54.1%. According to logistic regression analysis, the factors for compliance with the lipid lowering drug included old age (odds ratio [OR], 2.68; 95% confidence interval [CI], 2.09 to 3.45), frequent exercise (OR, 1.76; 95% CI, 1.43 to 2.18), previous statin therapy (OR, 4.02; 95% CI, 3.22 to 5.01), hypertension (OR, 1.80; 95% CI, 1.48 to 2.19), diabetes mellitus (OR, 2.20; 95% CI, 1.69 to 2.87), concomitant medication (OR, 2.28; 95% CI, 1.88 to 2.77), and high coronary heart disease (CHD) risk category (OR, 1.82; 95% CI, 1.39 to 2.38). The compliance decreased with high low density lipoprotein cholesterol levels (OR, 0.20; 95% CI, 0.16 to 0.26). CONCLUSION: The compliance of patients using rosuvastatin was 54.1% in primary care. The factors related to higher compliance were old age, regular exercise, previous statin therapy, concomitant medication, presence of hypertension or diabetes, and higher CHD risk level.
Cholesterol ; Cholesterol, LDL ; Compliance ; Coronary Disease ; Diabetes Mellitus ; Fluorobenzenes ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Hypertension ; Korea ; Lipoproteins ; Logistic Models ; Physicians, Family ; Primary Health Care ; Prospective Studies ; Pyrimidines ; Risk Factors ; Sulfonamides ; Rosuvastatin Calcium ; Surveys and Questionnaires