Prevalence and clinical characteristics of microalbuminuria in Koreans: a population-based cross-sectional study / 대한내과학회지

BACKGROUND: Microalbuminuria (MA) is independent predictor of cardiovascular disease and it cause mortality regardless of the presence of diabetes (DM) and hypertension (HTN). However, few published studies on this topic have been reported in Korea. Therefore, we investigated the MA prevalence and relationship between MA, insulin resistance and cardiovascular risk factor. METHODS: A total of 5,915 (3,053 men and 2,852 women) health screen examinees were enrolled in this study. We measured the anthropometric and biochemical parameters of the atherogenic indexes. RESULTS: The MA prevalence was 7.7% in all participants. The prevalence of MA in the men and women was 9.5% and 5.7%, respectively. Elevated levels of serum fasting glucose, serum fasting insulin, HOMA index, total cholesterols, LDL cholesterol, TG, Body Mass Index (BMI) and the systolic and diastolic blood pressure were significantly associated with MA. The results of multiple logistic regression analysis about MA showed that frequent drinking, low BMI, newly diagnosed DM and elevated levels of HOMA index and blood pressure were significantly associated with MA prevalence. Also, excluding newly diagnosed diabetic and hypertensive subjects, the MA prevalence was 5.7% (6.9% in men, 4.7% in women) and in multiple logistic regression analysis, the MA prevalence significantly increased in the individuals with pre-HTN rather than in the normotensives. CONCLUSIONS: The MA prevalence was 7.7% in all subjects. Except the newly diagnosed diabetic and hypertensive subjects, it was 5.7%. The MA prevalence was significantly increased in the individuals with pre-HTN rather than in the normotensives and MA was related with insulin resistance.

Frequencies of Combination Treatment of Atypical Antipsychotics and Selective Serotonin Reuptake Inhibitors in a College Hospital Psychiatric Outpatient Unit / 대한정신약물학회지

OBJECTIVE: The introduction of new psychiatric medications with better efficacy and tolerance seems to increase the frequencies of co-prescriptions of various psychotropic agents. We investigated the frequencies of the combined treatments of atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) that are supposed to be common in clinical practice. METHODS: Data on 2783 outpatients from March 1, 2002 through June 31, 2002 in Seoul National University Hospital were collected. The number of cases with a co-prescription of atypical antipsychotics with SSRIs were counted and compared by diagnoses. The relations of diagnosis and age to the combined treatment were explored. RESULTS: 499 (17.4%) patients took co-prescriptions of antipsychotics with antidepressants, and 393 (13.7%) patients those of atypical antipschotics with SSRIs. Patients with obsessive compulsive disorder and schizophrenia took the combinations of atypical antipsychotics and SSRIs more frequently than patients with other diagnoses, as 41.6% and 20.8%, respectively. Controlling for diagnostic categories, age was significantly correlated with the presence of those co-prescriptions. CONCLUSION: The findings of the current study reflect evidence-based prescriptions in an educating hospital and provide basic data for further pharmaco-epidemiological studies. The co-prescription of atypical antipsychotic agents with SSRIs seems to occur only in proper indications, under the consideration of the risk of drug-drug interactions and adverse effects.

Frequencies of Combination Treatment of Atypical Antipsychotics and Selective Serotonin Reuptake Inhibitors in a College Hospital Psychiatric Outpatient Unit / 대한정신약물학회지

OBJECTIVE: The introduction of new psychiatric medications with better efficacy and tolerance seems to increase the frequencies of co-prescriptions of various psychotropic agents. We investigated the frequencies of the combined treatments of atypical antipsychotics and selective serotonin reuptake inhibitors (SSRIs) that are supposed to be common in clinical practice. METHODS: Data on 2783 outpatients from March 1, 2002 through June 31, 2002 in Seoul National University Hospital were collected. The number of cases with a co-prescription of atypical antipsychotics with SSRIs were counted and compared by diagnoses. The relations of diagnosis and age to the combined treatment were explored. RESULTS: 499 (17.4%) patients took co-prescriptions of antipsychotics with antidepressants, and 393 (13.7%) patients those of atypical antipschotics with SSRIs. Patients with obsessive compulsive disorder and schizophrenia took the combinations of atypical antipsychotics and SSRIs more frequently than patients with other diagnoses, as 41.6% and 20.8%, respectively. Controlling for diagnostic categories, age was significantly correlated with the presence of those co-prescriptions. CONCLUSION: The findings of the current study reflect evidence-based prescriptions in an educating hospital and provide basic data for further pharmaco-epidemiological studies. The co-prescription of atypical antipsychotic agents with SSRIs seems to occur only in proper indications, under the consideration of the risk of drug-drug interactions and adverse effects.

The P300 Source Localization in the Patients with Obsessive-Compulsive Disorder using the LORETA Imaging and SPM

OBJECTIVES: We investigated the characteristics of P300 generators in obsessive-compulsive disorder(OCD) patients by using voxel-based statistical parametric mapping of current density images. METHODS: P300 generators, produced by a rare target tone of 1500Hz under a frequent non-target tone of 1,000Hz, were measured in 15 right-handed OCD patients and 15 controls. Low Resolution Electromagnetic Tomography(LORETA), using a realistic head model of the boundary element method based on individual MRI, was applied to the 128-channel EEG. Statistical parametric mapping(SPM) was applied for the statistical analysis. RESULTS: We found that both groups had the mean current density of P300 in the parietal, temporal and prefrontal lobe. There was a trend for decreased current density in the prefrontal area in OCD patients. The statistical comparison showed current density increase in the supraparietal area, a statistically significant longer P300 latency and a trend for reduced P300 amplitude in OCD patients. CONCLUSION: It suggests that P300 source of both groups exists in multiple brain regions at the same time. And both groups had no statistically significant differences in the current density of P300 except for increased current density in the supraparietal area in OCD patients. But, considering the statistically significant longer P300 latency, a trend for reduced P300 amplitude and relative mean current density reduction in the prefrontal area in OCD patients, this study suggests that the frontal lobe may have a reduced normal inhibitory process in OCD patients.

A 2-Year Naturalistic Study on Trends in Pharmacotherapy and Change of Clinical Symptoms in the Patients with Obsessive-Compulsive Disorder / 대한정신약물학회지

OBJECTIVE: The purpose of this study was to examine the pharmacological treatment patterns and clinical responses in inpatients and/or outpatients with obsessive compulsive disorder (OCD) at a university hospital. METHODS: A total of 71 OCD patients were included and followed during the first 4 months, first year and second year from 1998. The patterns of medication use and clinical responses according to the Yale-Brown obsessive-compulsive scale (Y-BOCS) were analyzed descriptively in this period. RESULTS: During the first 4 months, 26.7% of the patients underwent monotherapy in which most of the drugs were serotonin reuptake inhibitors (SRIs). Therapy with two or more drugs was administered in 66.6% of the patients and combination drugs with SRIs were atypical antipsychotics and clonazepam. The clinical response rate using Y-BOCS was 24.0% compared with baseline score. During the first year, the frequency of the monotherapy decreased to 6.5%, while that of therapy with two or more drugs increased to 80.6% (two and three drug frequencies were 35.3%, and 32.3%, respectively). The clinical response rate was 26.4% during this period. During the second year, the frequency of the monotherapy was 25% and that of multidrug therapy was 70.8% (two and three drug frequencies were 20.8%, and 45.8%, respectively). The clinical response rate was 39.3% compared with baseline score. CONCLUSIONS: In this study, the frequency of the combination therapy was relatively high compared with SRI monotherapy during the first 4 months and it increased further during the first year. The combination therapy was maintained without change of SRI dosage during the second year. Most of the drugs used in the combination therapy were atypical antipsychotics and clonazepam.

MR Findings of Calvarial Eosinophilic Granuloma

PURPOSE: The purpose of this study was to evaluate the MR findings of calvarial eosinophilic granuloma. MATERIALS AND METHODS: We reviewed the MR imaging studies of nine patients [M:F=3:6, aged 6 -35 (mean, 20.5) years] with pathologically proven eosinophilic granuloma in the calvaria. The findings were evaluated for involvement of the diploic space, changes in adjacent bone marrow, distinction of the transitional zone, pattern of bone destruction, signal intensity and contrast enhancement of the tumor, and contrast enhancement of the adjacent dura. RESULTS: All lesions involved the diploic space, showed no change in adjacent bone marrow, and had a distinct transitional zone. In most (8/9) cases there was asymmetric bony destruction. On T1-weighted images, signal intensities of the tumors varied, while on T2-weighted images, hyperintensity was observed in seven cases, isointensity in one, and hypointensity in one. After the administration of contrast material, enhancement was homogeneous in four cases and inhomogeneous in five. Enhancement of the adjacent dura was demonstrated in all nine cases. CONCLUSION: The characteristic MR findings of calvarial eosinophilic granuloma are variable signal intensity on T1WI, high signal intensity on T2WI, and marked contrast enhancement; in addition, there is a distinct transitional zone, asymmetrical bony destruction, and associated dural enhancement.