A Study on the Policy Decision Making Process of Seoul-Type Paid Sick Leave:Applying Kingdon’s Multiple Streams Model / 보건행정학회지

In 2019, the Seoul metropolitan government established its own ‘Seoul-type paid sick leave project’. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon’s multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa’s three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon’s model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.

Combination of In Vivo ¹²³IFP-CIT SPECT and Microdialysis Reveals an Antipsychotic Drug Haloperidol-induced Synaptic Dopamine Availability in the Rat Midbrain and Striatum

Synaptic dopamine (DA) is mainly regulated by the presynaptic DA transporter (DAT). Single-photon emission computerized tomography (SPECT) with the DAT radiotracer [¹²³I]FP-CIT assesses changes in synaptic DA availability when endogenous DA displaces [¹²³I]FP-CIT or competes for DAT. Here, we investigated the effects of haloperidol (HAL) and clozapine (CLZ) on [¹²³I]FP-CIT binding in the rat striatum and midbrain to assess the utility of [¹²³I]FP-CIT SPECT to quantify changes in synaptic DA availability. Rats underwent [¹²³I]FP-CIT SPECT after intraperitoneal administration of normal saline (vehicle), HAL (1 and 7 mg/kg), CLZ (10 and 54 mg/kg) and bupropion (BUP, a DAT blocker, 20 and 100 mg/kg). In the striatum and midbrain, percent differences in the nondisplaceable binding potential (BP(ND)) of [¹²³I]FP-CIT compared to the vehicle were calculated for the various drugs and doses. In another experiment, changes in endogenous striatal DA concentration were measured by in vivo microdialysis under the conditions used in the SPECT study. BUP dose-dependently occupied DAT at considerable levels. Compared to the vehicle, HAL decreased [¹²³I]FP-CIT BP(ND) in the striatum (−25.29% and −2.27% for 1 and 7 mg/kg, respectively) and to a greater degree in the midbrain (−58.74% and −49.64% for 1 and 7 mg/kg, respectively), whereas the CLZ-treated group showed a decrease in the midbrain (−38.60% and −40.38% for 10 and 54 mg/kg, respectively) but an increase in the striatum (18.85% and 38.64% for 10 and 54 mg/kg, respectively). Antipsychotic-induced changes in endogenous striatal DA concentrations varied across drugs and doses. The data demonstrate that [¹²³I]FP-CIT SPECT may be a useful preclinical technique for detecting increases in synaptic DA availability in the midbrain and striatum in response to HAL, with results comparable to those of in vivo microdialysis.

Enhanced Antioxidant and Anticancer Properties of Processed Eucommiae Cortex

Eucommiae Cortex (EC), bark of Eucommia ulmoides, has been known as a traditional medicine to regulate hypertension and immune system. Because silk of gum in the EC blocks the release of active ingredients, EC generally has been utilized after processing with carbonization or salt-water to breakdown it. This study aimed to investigate the differences of non-processed EC and processed EC on antioxidant and anticancer properties. Antioxidant capacity was assessed by measuring the content of total polyphenols, reducing power, and ABTS radical scavenging effect. And anticancer effects were examined by evaluating the viability of pancreatic cancer cells and wound healing ability. The results demonstrated that processed EC contained more content of polyphenols and exhibited more potent reducing power and radical scavenging effect than non-processed EC. In addition, processed EC more efficiently inhibited proliferation and migration of pancreatic cancer cells. These results suggest that processing of medicinal plants can improve the biological properties such as antioxidant or anticancer activity, which may lead to the development of herbal medicine treatment technology.

Regional Cerebral Glucose Metabolism in Novelty Seeking and Antisocial Personality: A Positron Emission Tomography Study

Novelty seeking (NS) and antisocial personality (ASP) are commonly exhibited by those who suffer from addictions, such as substance abuse. NS has been suggested to be a fundamental aspect of ASP. To investigate the neurobiological substrate of NS and ASP, we tested the relationship between regional cerebral glucose metabolism and the level of NS, determining the differences between individuals with and without ASP. Seventy-two healthy adults (43 males, mean age±SD=38.8±16.6 years, range=20~70 years; 29 females, 44.2±20.1 years, range=19~72 years) underwent resting-state brain positron emission tomography (PET) 40 minutes after 18F-fluorodeoxyglucose (FDG) injection. Within 10 days of the FDG PET study, participants completed Cloninger's 240-item Temperament and Character Inventory (TCI) to determine NS scores. Participants with and without ASP were grouped according to their TCI profiles. Statistical parametric mapping analysis was performed using the FDG PET and TCI profile data. NS scores positively correlated with metabolism in the left anterior cingulate gyrus and the insula on both sides of the brain and negatively correlated with metabolism in the right pallidum and putamen. Participants with ASP showed differences in cerebral glucose metabolism across various cortical and subcortical regions, mainly in the frontal and prefrontal areas. These data demonstrate altered regional cerebral glucose metabolism in individuals with NS and ASP and inform our understanding of the neurobiological substrates of problematic behaviors and personality disorders.

A Study of the Relationship between Headache and Epilepsy in Childhood / 대한소아신경학회지

PURPOSE: Headache, especially migraine disorders, have been thought to be pathophysiologically related to epilepsy. We sought to elucidate the differential diagnostic clues between headache and epilepsy by analyzing the clinical characteristics of patients who presented with a chief complaint of headache and who had been subsequently diagnosed with epilepsy. METHODS: We studied 399 patients with headache who had been followed-up in Pediatrics Department of Ilsan Hospital from January 2005 to July 2009. Patients were divided into two groups and analyzed retrospectively. The test group included 15 patients who had been diagnosed with epilepsy. The control group included 305 patients whose symptoms had been diagnosed as primary headache. We compared the type of headache, presence of aura, subtype of aura, family history of migraine disorders, EEG findings, and response to a hyperventilation test between the two groups. RESULTS: 305 patients had primary headache, 20 patients secondary headache, and 74 patients unclassified headache. Between the two groups, there was no statistically significant difference in mean age, sex, type of headache (P=0.23), type of aura (P=0.64), or associated family history (P=0.84). However the epilepsy group had more migraine with aura (P<0.05), more EEG abnormalities (P<0.0001), and more abnormal hyperventilation test (P<0.0001), which were all statistically significant. CONCLUSION: The presence of aura, probably visual aura, and EEG abnormalities or abnormal response in hyperventilation test are very useful differential diagnostic clues for epilepsy in headache patients. Therefore, we highly recommend that EEG are performed in order to rule out the possibility of epilepsy in those children who present with headache and have migraine headache with aura and abnormal result on hyperventilation test.

A Case of Childhood Idiopathic Intracranial Hypertension, Possibly Associated with Obesity / 대한소아신경학회지

Idiopathic intracranial hypertension(IIH), as known as pseudotumor cerebri, which commonly presents with headache, nausea, vomiting, pulsatile tinnitus, diplopia, arises from increased intracranial pressure although with no structural abnormality nor any mass in the intracranial cavity. Various factors including hormonal abnormalities, medication, infection and obesity are considered for causes of IIH, among which obesity shows a strong influence. As the incidence of obesity in children increases in Korea, prevalence of this disease is also likely to rise among children. We experienced a case of newly diagnosed IIH from an obese female child presenting with intermittent diplopia. We would like to report this case to alarm clinicians for considering IIH in obese child who consistently complains of symptoms related to IIH. Because belated diagnosis or negligence can be directly linked to poor prognosis, such as loss of eyesight, close observation and accurate diagnosis are critical for obese child with symptoms in relation to IIH.