Corrigendum to “Attitudes and Dispositions about Doping of the Korean National TeamWho Participated in the Incheon Asian Para Games” / 대한스포츠의학회지

The name of one of the author was incorrectly presented: Geun-Ho Lee should read Kun-Ho Lee.

Corrigendum to “The Influence of Wheelchair Use of Individuals with Spinal Cord Injury on Upper Extremity Muscular Function and Cross-Sectional Area” / 대한스포츠의학회지

The name of one of the author was incorrectly presented: Geun-Ho Lee should read Kun-Ho Lee.

Could surgical management improve the IVF outcomes in infertile women with endometrioma?: a review

Endometriosis is a chronic inflammatory condition that affects fertility and could be toxic to the ovary. Endometrioma per se and surgical interventions for endometrioma significantly reduce the ovarian reserve. Therefore, to prepare for surgical intervention for endometrioma, the high-risk group with decreased ovarian reserve must be considered. There is no evidence to support the use of surgical intervention before in vitro fertilization (IVF) to improve the reproductive outcomes of subsequent IVF in infertile women with advanced-stage endometriosis or endometrioma. As surgical treatment has few benefits, IVF could be recommended immediately for aiding conception in these women. However, the reproductive prognosis of IVF may be worse in the more advanced stages of endometriosis. When dysmenorrhea is severe or when cancer is suspected, surgery prior to IVF may be necessary and justified. When the size of the endometrioma is very large, surgery could be required prior to IVF to facilitate access to follicles during oocyte retrieval or to improve the ovarian response to controlled ovarian stimulation. Prolonged pituitary downregulation in women with surgically diagnosed endometriosis may be helpful to increase the clinical pregnancy rate in subsequent IVF cycles. The purpose of this paper was to review the efficiency and clinical application of the surgical intervention and IVF for infertile women with advanced-stage endometriosis or endometrioma.

The Influence of Wheelchair Use of Individuals with Spinal Cord Injury on Upper Extremity Muscular Function and Cross-Sectional Area / 대한스포츠의학회지

PURPOSE: This study was to compare the upper extremity muscular function and cross-sectional area (CSA) between wheelchair users and a pedestrian group and to observe how the changes in the muscle CSA affected upper extremity muscle function. METHODS: The study was conducted on 10 patients with spinal cord injury (SCI) who were divided into two groups based on whether they used wheelchairs (wheelchair using [WU] group and pedestrian [PS] group). The Mann-Whitney U-test was used to analyze the data and determine whether there were significant differences between the groups. RESULTS: Muscle mass in the WU group was significantly lower than in the PS groups (p < 0.01), while body fat percentage in the WU group was significantly higher than in the PS group (p < 0.05). The peak torque of shoulder external and right internal rotation was higher in the WU group than in the PS group (p < 0.05). Wrist muscle function was not significantly different for either group. In addition, the CSA of the right wrist extensor carpi radialis longus and left extensor digitorum communis was higher in the WU group than in the PS group (p < 0.05). CONCLUSION: Using a manual wheelchair may benefit upper extremity function by increasing CSA and muscle function in patients with SCI despite having a negative effect on body composition. However, there is an increased risk of injury with SCI associated with upper extremity overload; thus, an effective exercise protocol is needed to prevent muscle imbalance and injury.

The meaning of anti-Müllerian hormone levels in patients at a high risk of poor ovarian response / 대한생식의학회지

Measurements of ovarian reserve play an important role in predicting the clinical results of assisted reproductive technology (ART). The ideal markers of ovarian reserve for clinical applications should have high specificity in order to determine genuine poor responders. Basal follicle-stimulating hormone levels, antral follicle count, and serum anti-Müllerian hormone (AMH) levels have been suggested as ovarian reserve tests that may fulfill this requirement, with serum AMH levels being the most promising parameter. Serum AMH levels have been suggested to be a predictor of clinical pregnancy in ART for older women, who are at a high risk for decreased ovarian response. We reviewed the prognostic significance of ovarian reserve tests for patients undergoing ART treatment, with a particular focus on the significance of serum AMH levels in patients at a high risk of poor ovarian response.

Attitudes and Dispositions about Doping of the Korean National Team Who Participated in the Incheon Asian Para Games / 대한스포츠의학회지

The purpose of this study was to investigate the tendencies and awareness of the doping of the Korea national disabled athletes who participated in Incheon 2014 Asian Para Games. The subjects were composed of Korea national athletes (211 person, male 141 person, female 70 person) participated in 16 sports in Incheon 2014 Asian Para Games. Firstly, the data were collected by questionnaires measure including doping knowledge, behavior and attitude (performance enhancement attitude scale, PEAS) and analyzed using SPSS ver. 18.0 for window. The results indicate that female athletes tend to be more generous than men tendencies to for doping (p=0.027). Especially the aged groups showed significant differences in over fifty athletes (p=0.016). The PEAS score according to the sports type showed a generous doping tendency in speed/power type (p=0.01). Furthermore 43% of athletes acquire knowledge of the doping from Sports Association, directors, coaches, while Korea Anti-Doping Agency was lower by 23%. In conclusion, We need to provide education and information to improve awareness of doping for the national team players and coaches.

Skin Temperature Changes in Patients With Unilateral Lumbosacral Radiculopathy

OBJECTIVE: To clarify the relationship of skin temperature changes to clinical, radiologic, and electrophysiological findings in unilateral lumbosacral radiculopathy and to delineate the possible temperature-change mechanisms involved. METHODS: One hundred and one patients who had clinical symptoms and for whom there were physical findings suggestive or indicative of unilateral lumbosacral radiculopathy, along with 27 normal controls, were selected for the study, and the thermal-pattern results of digital infrared thermographic imaging (DITI) performed on the back and lower extremities were analyzed. Local temperatures were assessed by comparing the mean temperature differences (DeltaT) in 30 regions of interest (ROIs), and abnormal thermal patterns were divided into seven regions. To aid the diagnosis of radiculopathy, magnetic resonance imaging (MRI) and electrophysiological tests were also carried out. RESULTS: The incidence of disc herniation on MRI was 86%; 43% of patients showed electrophysiological abnormalities. On DITI, 97% of the patients showed abnormal DeltaT in at least one of the 30 ROIs, and 79% showed hypothermia on the involved side. Seventy-eight percent of the patients also showed abnormal thermal patterns in at least one of the seven regions. Patients who had motor weakness or lateral-type disc herniation showed some correlations with abnormal DITI findings. However, neither pain severity nor other physical or electrophysiological findings were related to the DITI findings. CONCLUSION: Skin temperature change following lumbosacral radiculopathy was related to some clinical and MRI findings, suggesting muscle atrophy. DITI, despite its limitations, might be useful as a complementary tool in the diagnosis of unilateral lumbosacral radiculopathy.

Vertical One-and-a-Half Syndrome With Bilateral Pseudo-Abducens Palsy From Unilateral Thalamo-Mesencephalic Infarction

No abstract available.

Elevated in Anti-GQ1b and Anti-GT1a IgG Antibody Titers in an Overlap Case of Pharyngeal-Cervical-Brachial Variant of Guillain-Barre Syndrome and Miller-Fisher Syndrome / 대한임상신경생리학회지

No abstract available.

Acyclovir-Induced Encephalopathy in a Patient with Normal Renal Function / 대한임상신경생리학회지

No abstract available.

The Relationship between Hippocampal Volume and Cognition in Patients with Chronic Primary Insomnia

BACKGROUND AND PURPOSE: Differences in hippocampal volume (HV) were compared between chronic primary insomniacs (PIs) and good sleepers (GSs), and the relationship between HV and memory function in PIs was investigated to clarify the effect of chronic sleep deprivation on brain structure and cognition. METHODS: Twenty PIs (mean age, 50 years; 18 females) and 20 age-, gender-, and education-matched GSs were enrolled. Brain magnetic resonance imaging (MRI) was performed on a 1.5-T MRI scanner. Left and right HV and intracranial volume (ICV) were measured manually. Nighttime polysomnography and neuropsychological testing were also applied to all subjects. Group differences in HV were analyzed and the relationships between HV and sleep questionnaire data, nighttime polysomnography, and neuropsychological findings were evaluated. RESULTS: Compared to GSs, PIs exhibited significantly increased sleep latency and arousal index and a decreased percentage of REM sleep in nighttime polysomnography, as well as impaired verbal and visual memory, and frontal lobe function. Absolute HV and ICV did not differ significantly between PIs and GSs. In the PIs, right and left HVs were negatively correlated with the duration of insomnia and the arousal index, and positively correlated with the recognition of visual memory. In addition, free recall in verbal memory was positively correlated with left HV in PIs. CONCLUSIONS: These findings suggest that chronic sleep deprivation impairs memory and frontal lobe function, and that a long duration of insomnia and poor sleep quality contribute to a bilateral reduction in HV.

Severe Restless Legs Syndrome in a Pregnant Woman Leading to Induced Premature Birth

Restless legs syndrome (RLS) often develops or is commonly aggravated during pregnancy in women. Due to potential teratogenic risk of the medication for RLS, non-pharmacologic management is commonly tried during pregnancy instead of medication. We report a 30-year-old pregnant woman who intentionally delivered a baby at 32 weeks 5 days to take medication due to severe RLS and insomnia. Depending on gestational period, more active treatments should be considered to prevent serious adverse pregnancy outcome for pregnant women with severe RLS.

A Case of Steroid-induced Hyperinfective Strongyloidiasis with Bacterial Meningitis / 대한소화기학회지

Strongyloides stercoralis is a soil transmitted intestinal nematode that is endemic in the tropical and subtropical regions. In most individuals who are infected, chronic, usually asymptomatic, gastrointestinal infection persists. But, in immunocompromized hosts or in patients receiving immunosuppressive therapy, autoinfection of S. stercoralis may result in the dissemination of larvae, leading to fatal hyperinfection and increased rate of complications. We report a case of hyperinfective strongyloidiasis with bacterial meningitis in a patient receiving steroid therapy. Strongyloidiasis was diagnosed by the presence of filariform larvae of S. stercoralis in the bronchoalveolar lavage cytology and upper gastrointestinal endoscopic biopsy specimen. Her clinical symptoms had progressively aggravated and developed bacterial meningitis during treatment. She died despite aggressive antibiotic and antihelminthic therapy.

Cefepime-Induced Reversible Encephalopathy with Triphasic Waves in Patients with Impaired Renal Function / 대한간질학회지

Cefepime is a widely used beta-lactam antibiotic. We first report two cases of cefepime-induced reversible encephalpathy in Korea. Two patients with renal impairment presented stupor while being treated with cefepime for pneumonia, one of whom also developed myoclonus and asterixis. Their electroencephalogram showed triphasic waves despite of normal liver function. After discontinuation of cefepime, they completely recovered with normalization of electroencephalogram. Early recognition of cefepime-induced encephalopathy and immediate withdrawal of cefepime would be important for the prognosis of the patients.

The Effects of Antiepileptic Drugs on Balance in Older People

BACKGROUND: The purpose of this study was to quantitatively assess the subclinical balance dysfunction in elderly people taking antiepileptic drugs. METHODS: We recruited sixty-three patients who were at least 50 years old, without complaint of dizziness or imbalance, and on a stable dose of carbamazepine, lamotrigine or levetiracetam. Their balance scores were compared with those of newly diagnosed untreated age- and sex-matched epilepsy patients (n=21). All the subjects underwent balance measurements that included an activities-specific balance confidence scale, quantitative caloric and rotational chair testing and posturography. The spectral frequency analysis of body sway while standing upright was also investigated. Sensory organization (SOT) and motor control tests were done by computerized dynamic posturography (CDP). RESULTS: The sway distance and area of center of pressure significantly increased in the patients treated with carbamazepine. Spectral frequency analysis of this group showed a significantly increased spectral power at low and middle frequencies on the antero-posterior (Y) plane and at low frequencies on the lateral (X) plane. CDP showed no significant differences in SOT results among the groups. However, motor control test revealed increased latencies and slowed adaptations in the carbamazepine group. CONCLUSIONS: These findings suggest that newer drugs such as lamotrigine or levetiracetam may induce less disequilibrium than carbamazepine in older people on monotherapy for epilepsy. The disturbance is likely related to slowed central postural reflexes.

Comparison of the Clinical Course of Ischemic Stroke Depending on the Stroke Subtypes

BACKGROUND: There is still scarce information on the clinical course and prognosis in acute stroke patients with different etiologies. METHODS: We studied 464 patients with acute ischemic stroke within 24 hours of onset. Patients were assigned to 5 stroke subtypes based on the TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria with slight modification: small vessel occlusion (SVO, 30%), large artery atherosclerosis (LAA, 29%), cardioembolism (CE, 23%), stroke of two or more etiologies (STM, 12%), and stroke of undetermined etiology (SUD, 7%). The NIH Stroke Scale was used to assess the neurological status at day 0, 1, 3, 7, 14, and 28 after admission. The neurological deterioration and improvement at the examination period and the extent of recovery at one month were evaluated in different stroke subtypes. RESULTS: Most of the neurological deterioration occurred within 7 days after stroke, most frequently in LAA (30%), followed by STM (24%) and SVO (17%), and least frequently in CE (13%) and SUD (10%). In contrast, the temporal profile of neurological improvement was not different between subtypes. Patients with good recovery were most common in SVO (64%), whereas those with no recovery were most common in LAA (22%) and STM (28%). CONCLUSIONS: The clinical course was different according to stroke etiologies. Patients with LAA and STM experienced more frequent neurological deterioration and poorer recovery. SVO was associated with milder stroke and better recovery. CE and SUD caused severe neurological deficit, but lead to less frequent neurological deterioration and favorable recovery.

Postural Control in the Patients with Chronic Tension-Type Headache

BACKGROUND: The purpose of this study was to investigate whether patients with chronic tension-type headache (TTH) have abnormalities of postural control, and to disclose any frequency shift of the centre of gravity while standing upright. METHODS: Thirty patients with chronic TTH diagnosed by the International Headache Society Classification criteria and with tenderness in pericranial muscles were compared with thirty age and sex matched controls. All the subjects underwent static and computerized dynamic posturography. The spectral frequency analysis of body sway while standing upright was investigated. RESULTS: The sway distance and the sway area of center of foot pressure significantly increased in the patients with TTH. Spectral frequency analysis showed a significant increase in spectral power below the 1.00 Hz frequency band. Computerized dynamic posturography showed a decreased somatosensory ratio in the patients with TTH. The patients with good response to medical treatment showed significant improvement in the follow-up posturography. CONCLUSIONS: These findings suggest a significant proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contractions causing tenderness.

A Case of Axonal Polyneuropathy Complicating Leptospirosis

No abstract available.

A Case of Twin Pregnancy with One Anencephalic Dead Fetus / 대한주산의학회잡지

Twin Pregnancies are increasing these days due to recent development of the technology in treating infertility. twin pregnancies tend to cause more congenital anomalies than singleton pregnancies do. Especially when twin pregnancies are affected with one anomalous fetus combined to a normal one, the proper management and counseling are difficult. We experienced a twin pregnancy in which one anencephalic fetus was combined to a normal one, after close counseling we decided to continue the pregnancy. At 35 weeks 6 days of gestation, an anencephalic fetus was dead, so we delivered by cesarean section due to breech-cephalic presentation. The birth weight of the normal and anencephalic fetuses were 2160 gm and 600 gm, respectively. The anencephalic fetus was combined with scoliosis, absent left upper limb, and nuchal skin defect, but the healthy one showed good crying and movement and its Apgar score was 8 in 1 minute and 9 in 5 minute. Although the infant needed intensive care for 21days in the nursery room, she was finally discharged in good condition. We present this case with a brief review of the literature.

Effect of L-dopa Medication on Postural Control in Parkinson's Disease: A Posturographic Study

BACKGROUND: The purpose of this study was to investigate abnormalities of postural control in Parkinson's disease (PD) patients during unperturbed stances and externally perturbed stances, and also to assess the effects of L-dopa medication on posture control. METHODS: Thirty PD patients were compared with 30 normal controls. Subjects' spontaneous sway during an unperturbed stance and the postural responses to anterior-posterior tilts of the support surface and of the visual scene were measured by posturography. RESULTS: During the unperturbed stance, displacement, velocity and frequency of the center of foot pressure (COP) were abnormally large in patients OFF treatment. Under L-dopa treatment, the velocity and frequency of COP and axial stiffness of PD patients were reduced, whereas sway amplitude increased. A frequency peak in the COP excursions at 0.7-1.1 Hz, which indicates a resonance behavior of the postural control loop, became reduced under therapy. Abnormal postural responses to tilting of the platform showed that the righting response of the upper body on the lower body was impaired in the PD patients. The postural responses of the PD patients to visual tilt was abnormally exaggerated and not dependent on the stability of the platform unlike the control subjects. These abnormal tilt reactions of the PD patients were resistant to treatment with L-dopa. CONCLUSIONS: These findings suggest that postural instability in PD is more critically related to high sway velocity and frequency than sway amplitude. The patients with PD are short of the ability to use the proprioceptive and visual information for the postural righting response when perturbed.