Effects of Dietary Habits on General and Abdominal Obesity in Community-dwelling Patients with Schizophrenia

Objective@#To investigate the effects of dietary habits on general and abdominal obesity in community-dwelling patients with schizophrenia spectrum disorder according to sex. @*Methods@#A total of 270 patients with schizophrenia spectrum disorder registered at mental health welfare centers and rehabilitation facilities were recruited. General obesity was defined as a body mass index ≥ 30 kg/m 2 , and abdominal obesity was defined as a waist circumstance ≥ 90 cm in men and ≥ 85 cm in women. Dietary habits were evaluated using dietary guidelines published by the Korean Ministry of Health and Welfare. Demographic and clinical characteristics along with dietary habits and information related to obesity were collected. Factors related to obesity were evaluated separately by sex. @*Results@#Dietary habits differed according to sex, in that scores for healthy eating habits were lower in men than in women. In men, the prevalences of general and abdominal obesity were 17.0% and 37.3%, respectively. In women, the prevalences of general and abdominal obesity were 23.1% and 38.5%, respectively. Regression analysis showed that the scores of regular eating habits were negatively associated with general and abdominal obesity in men, and the scores of healthy eating habits were negatively associated with general and abdominal obesity in women. @*Conclusion@#Among patients with schizophrenia, regular eating habits might reduce the risk of obesity in men, and healthy eating habits might reduce the risk of obesity in women. Nutrition education should be provided to community-dwelling patients with schizophrenia to prevent obesity in this population.

Effects of a Horticultural Therapy Program for Patients with Mental Illness / 정신간호학회지

Purpose@#This study aimed to identify the effects of the Horticultural Therapy Program on interpersonal relations, self-efficacy, and stress awareness for patients with mental illness. @*Methods@#This was a non-equivalent control group pre and post-test design study. Participants were recruited from a closed ward of mental health hospitals located in the G city. 23 patients from two hospitals were in the experimental group and 20 patients from four hospitals were in the control group. A ninety-minute horticultural program was performed once a week for 8 weeks. @*Results@#Results revealed that the Horticultural Therapy Program was effective for self-efficacy (z=-3.06 p=.002) and stress awareness (z=2.92, p=.004) for patients with mental illnesses. @*Conclusion@#These results indicate that the Horticultural Therapy Program is effective for self-efficacy and stress awareness in patients with mental illnesses. Therefore, the Horticultural Therapy Program is recommended as an effective psychiatric nursing intervention for mental health promotion and rehabilitation.

Characteristics of Nasal Resonance and Perceptual Rating in Prelingual Hearing Impaired Adults

OBJECTIVES: Resonance problems in hearing impaired (HI) individuals have been described as aspects of nasality. However, there are limitations in being able to explain the range of resonance problems. Therefore, this study suggests a perceptual rating that will effectively explain the characteristics of resonance problems in HI individuals. METHODS: Nasalance scores were obtained from 32 subjects in each of HI and normal hearing (NH) groups using a nasometer. The subjects were categorized into groups based on normal and abnormal nasalance ranges. The abnormal nasalance range group was further divided into hyper-, hypo-, and mixed-nasal groups. Nasalance scores were based the individuals performance in a series of passage and syllable tasks. The perceptual rating was evaluated using a newly introduced tool, 'vertical focus of resonance' (VFR), which focuses on the resonance energy in the frontal, throat, pharyngeal and nasal locations. RESULTS: The NH group demonstrated a significantly lower nasalance score in the oral coupling and passage tasks than the HI group. Based on the results of nasalance correlation analysis, the HI group showed highly significant correlations between syllable and passage tasks, as contrasted with the NH group. There were significant differences in VFR between the nasalance types in both the NH and the HI groups. CONCLUSION: The HI hyper-nasal group showed tendencies of velopharyngeal opening, as opposed to the HI hypo-nasal group which showed tendencies of velopharyngeal closure. The HI mixed-nasal group showed inappropriate coordination of velopharyngeal function. In the HI group, the results of VFR showed that the air flow and the resonance energy were not released from the cavity of resonance. The suggested VFR tool explains the focusing characteristics of resonance energy within a continuation of speech sound regardless of the phonetic environment. Therefore, VFR may be a useful tool in explaining the deviant resonance patterns of HI individuals.

Validity and Reliability of a Korean Version of the National Institutes of Health Stroke Scale

BACKGROUND AND PURPOSE: The National Institutes of Health Stroke Scale (NIHSS) is a clinical assessment tool that is widely used in clinical trials and practice to evaluate stroke-related neurological deficits. The aim of this study was to determine the validity and reliability of the Korean version of the NIHSS (K-NIHSS) for evaluating Korean stroke patients. METHODS: The K-NIHSS was translated and adapted with regard to cultural and linguistic peculiarities. To examine its content validity, we quantified the Content Validity Index (CVI), which was rated by 11 stroke experts. The validity of the K-NIHSS was assessed by comparison with the Glasgow Coma Scale (GCS), the modified Rankin Scale (mRS), and the Barthel Index. The reliability of the K-NIHSS was evaluated using the unweighted kappa statistics for multiple raters and an intraclass correlation coefficient (ICC). RESULTS: The CVI of the K-NIHSS reached 0.91-1.00. The median K-NIHSS score at baseline was 3 (interquartile range, 2-7), and the mean+/-SD score was 6.0+/-6.6. The baseline K-NIHSS had a significantly negative correlation with the GCS at baseline and the Barthel Index after 90 days. The K-NIHSS also had a significantly positive correlation with the mRS after 90 days. Facial paresis and dysarthria had moderate interrater reliability (unweighted kappa, 0.41-0.60); kappa values were substantial to excellent (unweighted kappa, >0.60) for all the other items. The ICC for the overall K-NIHSS score was 0.998. The intrarater reliability was acceptable, with a median kappa range of 0.524-1.000. CONCLUSIONS: The K-NIHSS is a valid and reliable tool for assessing neurological deficits in Korean acute stroke patients.

Voice Characteristics of Adductor Spasmodic Dysphonia before and after Botulinum Toxin-A Injection / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Botulinum toxin type A (BTX-A) injection is well known for its effectiveness in the treatment of "Spasmodic dysphonia". However, studies on the efficacy of BTX-A injection have not been attempted in Korea. Therefore, this study was carried out to investigate the effects of BTX-A. SUBJECTS AND METHOD: The study examined 12 female patients with 'adductor spasmodic dysphonia'. Objective assesments included aerodynamic analysis and electoroglottography (EGG) of each patient before and after BTX-A. Subjective assessments included using the Korean-version of Voice Handicap Index-30 (KVHI-30) and a patient self-rating scale. RESULTS: Aerodynamic analysis revealed that only maximum phonation time (MPT) was significantly shortened after the injection of BTX-A (p<0.05). In the EGG, the mean frequency distribution was significantly increased, while the mean amplitude and the mean closed quotient distribution were significantly decreased (p<0.05). The KVHI-30 and patient self-rating scale scores were significantly decreased (p<0.01) as well, demonstrating the effects of BTX-A on the quality of life. CONCLUSION: Our results show the effects of BTX-A objectively by comparing voice characteristics, which were measured through EGG before and after BTX-A injection, as well as by determining aerodynamic characteristics. The subjective self-assessment on the quality of life is significant as it may serve as a clinically relevant measure. This study may be helpful in elucidating treatment efficacy of BTX-A in many ways.

Relationship between Gross Motor Function, Oromotor Function and Nutritional Status in Children with Cerebral Palsy

OBJECTIVE: To investigate the non-speech mechanism function in relation with functional status and find out the relationship between nutritional status and non-speech mechanism function in children with cerebral palsy (CP). METHOD: Eighty four children with CP were participated in this study. Non-speech mechanism function was investigated with a simple scale of oral motor status (OMS) and a feeding-swallowing evaluaton protocol for children (FEP-C). Higher score represents more severe in dysfunction in both tests. As well, Gross motor function classification system (GMFCS), the nutritional status based on body mass index were assessed in these subjects. GMFCS level I to III were grouped into high functioning group while GMFCS level IV and V were grouped into low functioning group. RESULTS: Fifty seven (67.9%) individuals with CP showed dysphagia symptoms (OMS sore > or =1). The mean scores of non-speech mechanism function in low functioning group were higher than in high functioning group (p<0.05). The mean scores of both OMS and FEP-C were higher in individuals with underweight (p<0.05). Compared to high functioning individuals with CP, underweight was more prevalent along with higher scores in oral motor function in low functioning group. OMS scores were significantly correlated with the mean scores of non-speech mechanism in all subareas (p<0.05). CONCLUSION: Non-speech mechanism function was closely related with GMFCS level. As well, this study revealed that the oromotor function and nutritional status in these individuals with CP related with non-speech mechanism function.

Development of the Korean Affective Word List / 신경정신의학

OBJECTIVES: As interest in the field of affective science continues to increase, research into the arousal of emotions by the use of facial stimuli, event pictures, and stimulus words is now being actively pursued. The purpose of this study was to develop a Korean Affective Word List for eliciting emotional reactions. METHODS: The preliminary selection process was more carefully divided into the primary process when the words were extracted which the author thought elicited the emotions of happiness, sadness, fear, anger, and disgust from the Korean-Language Dictionary according to vocabulary frequency, the secondary process when the words were extracted which the Affective Words Selection Committee judged elicited only a single category of emotion. The affective words selected in the two-stage preliminary process were then presented to normal, young subjects, who were asked to allocate each word on the basis of their emotional reaction to one of the following emotional categories: happiness, sadness, fear, anger, disgust, and surprise. After the selected words caused the intended-emotional response with inter-rater agreement in more than 80%, a total of 166 words were selected except surprise. The complementary selection process was carried out following the preliminary process in order to make up for the lack of surprise words and the relative want of anger words. RESULTS: A total of 184 words were finally selected: 83 words for happiness, 36 for sadness, 24 for fear, 10 for anger, 20 for disgust, and 11 for surprise. CONCLUSION: These Korean affective words are expected to be widely used for eliciting emotions in future Korean research on emotion.

Open-Set Monosyllabic Speech Perception Test for Preschool Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An open-set monosyllabic speech perception test is necessary, not only to devise habilitation programs but to select candidates and estimate performance in pediatric cochlear implant program. The purpose of this study is to develop a validated open-set monosyllabic speech perception test for preschool children. SUBJECTS AND METHOD: Qualitative test development was based on vocabulary familiarity, syllabic and phonemic frequency, and phonetic balancing between the lists. The devised test lists were applied to 138 normal hearing children and 46 children with cochlear implant to examine the validity and reliability. RESULTS: The final two test lists were made up of 100 items with 260 phonemics. The consequential validity of this devised test was proven by the applied results that the speech perception score of children with implanted devices was significantly lower than that of normal children, when controlling for the length of auditory experience. CONCLUSION: The developed monosyllabic speech perception test is the validated instrument for preschool children. It is sensitive to perceptual characteristics of articulatory function in cochlear implanted children. The validity of this test needs to be enhanced by clinical application and further item analysis.

Horizontal versus Vertical Reading in Neglect Dyslexia: A Case Study

BACKGROUND: Neglect dyslexia is a type of neglect syndrome, in which patients with unilateral hemisphere injury omit or misread the contralateral side of a text or the initial letters of a word. Hangul can be arrayed vertically (vertical reading, VR) as well as horizontally (horizontal reading, HR). Thus, HR and VR can be differentially affected in neglect dyslexia. We conducted an experiment in a 66 year-old woman who suffered from neglect dyslexia after a right cerebral infarction. We compared HR with VR in terms of error frequencies and patterns. METHODS: Stimuli for neglect dyslexia consisted of 227 words. The 227 words were written horizontally or vertically (total 554 words) and were pre-sented in random order. The patient was asked to read the words and the examiner recorded the patient's responses and reaction times. RESULTS: The differences in HR and VR were as follows: 1) the error frequency in HR (59.0%) was higher than the error frequency in VR (20.3%), 2) the most frequent error in HR was syllabic deletion (79.1%) whereas phonemic substitution (89.1%) predominated in VR, 3) the error rate was highest at the first syllabic position in HR whereas no position effect was noted in VR. CONCLUSIONS: Patients with neglect dyslexia make less error in VR than in HR. The neural processing of HR may be different from that of VR. VR may be an alternative reading strategy that may be useful during the recovery stage of neglect dyslexia.

Neuropsychological and Neuroimaging Findings of Semantic Dementia

BACKGROUND: Semantic dementia (SD) is a temporal variant of frontotemporal lobar degeneration (FTLD), which is characterized by naming difficulty, decreased comprehension of words, prosopagnosia and object visual agnosia. We report clinical features, neuropsychological and neuroimaging findings of 4 patients with SD. METHODS: Of 55 patients diagnosed as having FTLD between Jan 1995 and May 2001 at Samsung Medical Center, four patients fulfilled the diagnostic criteria of SD proposed by consensus on FTLD diagnostic criteria. We investigated their clinical features such as presenting symptoms and abnormal behaviors, neuropsychological and neuroimaging findings. Neuropsychological tests included the Seoul Neuropsychological Screening Battery, the Korean-version of Western Aphasia Battery and Hanja reading and writing. All patients underwent brain MRI and FDG-PET. RESULTS: All of the patients showed naming difficulty as a presenting symptom. Language assessments showed severe naming and compre-hension difficulties with preserved fluency and repetition, which were compatible with transcortical sensory aphasia. Whereas Hangul reading aloud and writing were intact, three patients were impaired at Hanja reading and writing. Other neuropsychological tests were remarkable for prosopagnosia, object visual agnosia and memory loss. Brain MRI showed asymmetric temporal atrophies, mainly left antero-inferior temporal cortices. FDG-PET also showed hypome-tabolism in bilateral anterior temporal lobes, more severe on the left. CONCLUSIONS: Our SD patients had characteristic neuropsychological and neuroimaging findings, which can be differentiated from other neurodegenerative diseases. We also found Hanja alexia and agraphia in SD patients, which has not been reported yet.

Two Cases of Palilalia

BACKGROUND: Palilalia is characterized mainly by compulsive repetitions of words and phrases, which are attenuated in loudness and increased in rate. Up to date, approximately 29 cases of palilalia secondary to various neurological insults were reported mostly as a single case study. To our knowledge, there has been no reported case of palilalia in Korea until now. In this report, we present two patients with palilalia. CASES: The first patient KH, a 52-year-old man, with vascular parkinsonism, exhibited the repetition after an episode of stroke in the bilateral basal ganglia area. The second patient SH, a 60-year-old man with idiopathic Parkinson's disease, also manifested the repetition of words and phrases. The speech performance of both patients varied with the type of speech tasks, for instance, propositional language as opposed to automatic language. COMMENT: Palilalia should be differentlly diagnosed from neurogenic stuttering, echolalia, or aphasic perseveration. A pathophysiological explanation of patient KH's palilalia would be an widespread extrapyramidal impairment that resulted in destruction of the inhibitory motor circuit which might lead to the abnormal, uncontrolled speech-related neuronal firing in the frontal lobe. On the other hand, patient SH's palilalic speech may result from hyperexcitation of downstream of dopaminergic system related to peak-dose dyskinesia.