Bone Mineral Density in Ambulatory Epileptic Children with New Antiepileptic Drug Monotherapy / 대한소아신경학회지

PURPOSE: This study was conducted for evaluation of the effects of new antiepileptic drugs on bone mineral density in children with epilepsy. METHODS: The study group consisted of 35 age and gender matched controls and 35 epileptic children taking new antiepileptic drugs: 14 on topiramate, 10 on lamotrigine, and 11 on oxcarbazepine in monotherapy. All patients were treated for more than one year and all were normally ambulatory children. We measured serum levels of calcium, alkaline phosphatase, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D. BMD was measured by dual-energy X-ray absorptiometry at lumbar spine regions L1-L4. RESULTS: Vitamin D levels of the oxcarbazepine group (25-hydroxyvitamin D: 40.3+/-10.5 ng/mL and 1,25-dihydroxyvitamin D: 57.9+/-15.2 pg/mL) were significantly lower than in controls (44.6+/-11.5 ng/mL, 66.2+/-10.5 pg/mL, P<0.05); however, they did not differ significantly in the topiramate and lamotrigine groups. The bone mineral density value was significantly lower in the oxcarbazepine (L1-L4: 0.73+/-0.11 g/cm2) group, compared with the controls (0.84+/-0.06 g/cm2, P<0.05) or patients taking topiramate or lamotrigine. CONCLUSION: Monitoring of bone metabolism is recommended for patients treated with new antiepileptic drugs, particularly oxcarbazepine.

The School Effect on the Reliability of Clinical Performance Examination in Medical Schools / 한국의학교육

PURPOSE: The purpose of this study is to test the reliability of the clinical performance examination (CPX) using Generalizability theory (G-theory). Through G-theory, the effects of not only students and tasks but also the school will be analyzed as primary sources of error, which can affect the interpretation of the reliability of the CPX. METHODS: One thousand three hundred nineteen students from 16 medical schools that participated in the Seoul-Gyeonggi CPX Consortium 2008 were enrolled. In our research design, we suppose that student is nested within school and crossed with task. Data analysis was conducted with urGenova. RESULTS: According to our analysis, the percentage of error variance was 6.2% for school, 14.9% for student nested within school, 14.4% for task, and 3% for interaction between school and task. An effect of school on students was observed, but the interaction between task and school was insignificant. When student is nested within school, the universe score decreased and the g-coefficient was less than the g-coefficient of the p x t (p: studentm, t: task) design. CONCLUSION: The results show that generalizability theory is useful in detecting various error components in the CPX. Using the generalizability theory to improve the technical quality of performance assessments provides us with greater information compared with traditional test theories.