A Preliminary Evaluation of NeuroGuide and IVA + Plus as Diagnostic Tools for Attention-Deficit Hyperactivity Disorder

OBJECTIVES: This study was designed to investigate the usability of IVA + Plus (Continuous Performance Test) and NeuroGuide [Quantitative electroencephalography (EEG) normative database] as an auxiliary diagnostic tools for attention-deficit hyperactivity disorder (ADHD). METHODS: The scores of IVA + Plus and resting EEG were obtained from 34 elementary school-aged children. Also, the Korean ADHD Rating Scale (K-ARS) and the Diagnostic Interview Schedule for Children version IV (DISC-IV) was done for the parent of them. From the result of the DISC-IV, we divided them into three groups, ADHD Not Otherwise Specified (NOS), and Normal Control (NC). Using NeuroGuide, the z-scores of relative power for delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz), and beta (12-25 Hz) were calculated. Then the correlation and variance analysis were done to investigate the differences between three groups. RESULTS: The scores of IVA + Plus were negatively correlated with the K-ARS. IVA + Plus have successfully discriminated the ADHD from NC and NOS. The z-scores of relative power of delta and theta were positively correlated with the K-ARS. The z-scores of relative power of alpha and beta were negatively correlated with the K-ARS. CONCLUSIONS: The IVA + Plus and NeuroGuide QEEG test are expected to be used as the valuable tools for diagnosing ADHD accurately.

Outcome of Prenatally Diagnosed Hydronephrosis: One Center Experience

PURPOSE: The detection of hydronephrosis(HN) with antenatal ultrasonography was first reported in the 1970s. Prenatal HN is diagnosed with an incidence of 1:100 to 1:500 on antenatal screening. Recently, the purpose of antenatal screening has changed from simple detection to selection for specific diagnosis-based management. this study is to evaluate the usefulness of antenatal sonography for HN and to investigate the differential causes of HN and their clinical outcomes. PATIENTS AND METHODS: 11,783 live neonates with prenatal ultrasonographic examination at Ajou University School of Medicine, from Sep. 1994 to Aug. 2001 were analyzed. RESULTS AND CONCLUSION: Hydronephrosis (>10 mm) was detected in 119 (1.0%) cases antenatally and among these, 91 were proved to have HN postnatally. Males were three times more affected than females. Additional imaging studies revealed that ureteropelvic junction obstruction was the most common postnatal diagnosis (47%), followed by multicystic dysplastic kidney, vesicoureteral junction obstruction and vesicoureteral reflux. During 20 months' follow-up (3 to 72 months), 58(48%) renal units showed spontaneous resolution and surgical interventions were necessary in 10 (7.4%) of postnatally confirmed hydronephrotic renal units.

A Case of Recurrent Tolosa-Hunt Syndrome

Tolosa-Hunt syndrome (THS) is a clinical syndrome of painful ophthalmoplegia associated with an idiopathic inflammation in the superior orbital fissure or cavernous sinus. We report a 61-year-old woman with recurrent THS. She had been treated with steroids for the painful ophthalmoplegia. After a symptom-free period, she developed similar symptoms. The postcontrast brain MRI showed increased signal in the cavernous sinus, which was also seen in the previous MRI.

Effects of Plastic Ankle-Foot Orhtosis on Hemiplegic Ambulation

OBJECTIVE: This study was performed to investigate the energy expenditure at self-selected comfortable and fast walking speeds with or without plastic ankle-foot orthosis in hemiplegic patients. METHOD: Objects of this study were 10 ambulatory hemiplegic patients. To estimate oxygen consumption, we used K2 machine and measured gait speed, stride length, stride frequency, and heart rate energy expenditure index (EEI) with or without plastic ankle-foot orthosis. RESULTS: Stride length and gait speed of the hemiplegic patients with plastic ankle-foot orthosis significantly increased at their comfortable walking speed pattern. Oxygen consumption, oxygen cost and EEI significantly decreased in hemiplegic patients with plastic ankle-foot orthosis whether their gait speed pattern. CONCLUSION: The plastic ankle-foot orthosis is useful for the hemiplegic patients to increase walking speed and to reduce energy expenditure.

6 Cases of Hand Arm Vibration Syndrome in Grinding Workers Exposed to Hand-arm Vibration / 대한산업의학회지

OBJECTIVES: To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. RESULTS: 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. CONCLUSIONS: So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.

Expression of cyclooxygenase-1, -2 in human uterine cervix during gestational period / 대한산부인과학회잡지

OBJECTIVE: To determine whether cyclooxygenase (COX)-1 and COX-2 are expressed differentially during the whole gestational period in the pregnant human uterine cervix and if they are involved in the process of labor. METHODS: Nine patients were matched for obstetrical history and maternal age were divided into an abortion group who aborted between 13 and 16 weeks(n=3), a preterm group who delivered between 20 and 37 weeks(n=3), and a term group who delivered between 37 and 42 weeks of gestation(n=3). Immediately after vaginal delivery cervical biopsy samples were obtained and immunohistochemically stained for COX-1 and COX-2 and the degree of staining was evaluated by H-scoring system. RESULTS: Expression of COX-1 and COX-2 was found in epithelial and stromal cells of uterine cervical tissues of preterm and term group. The immunohistochemical expression of COX-1 and COX-2 was strongest in the term group compared to the preterm group in stromal cells(HSCORE : 2.0 vs. 4.0 ; 2.0 vs. 3.0), and in epithelial cells(HSCORE : 1.0 vs. 3.0 ; 1.0 vs. 3.0). CONCLUSION: Although small amount of the groups were investigated, in the pregnant human uterine cervix, COX-1 and COX-2 are found to be expressed, and both shows the strongest expression in term cervical tissue. It is suggested that the uterine cervix, under the control of prostaglandins, is actively involved in the process of labor, and it is thought that the role of COX-1 and COX-2 is more important in parturition process with advancing gestational age.

The Environmental Control System for a Patient with Quadriplegia

Environmental control system (ECS) is an assistive device to help the severely disabled persons to live their daily lives more independently. An 'ECS By Voice' suitable to a 54-year old C4 quadriplegic man was developed and installed in his own room for one week. The physical and psychologic impacts of the subject and caregiver were also evaluated using questionnaires including the Activity Pattern Indicator (API) and Beck Depression Inventory (BDI) before and after the application of the device. The results were as follows: (1) The voice recognition rate of the device was 97.5% in the laboratory and there was no difference in recognition rate according to the specific commanding words. (2) While using the device, both the dependency on the attendant care and the depression tendency of the subject were decreased. (3) While using the device, both caring time and depression tendency of the caregiver were decreased. We found the usefulness of ECS for the quadriplegics and the possibility of developing a Korean model of ECS which can be commercialized at a considerably less cost.

The Effect of Overweight and Pregnancy on Endocrinologic Features and Glucose Metabolism in Patients with Polycystic Ovarian Syndrome / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study attempts to determine the endocrinologic characteristics and changes in glucose metabolism before/during pregnancy according to different body weights in women with Polycystic ovarian syndrome (PCOS). METHODS: 94 women dia with PCOS were evaluated through measuring serum hormone levels and oral glucose tolerance tests preconceptionally and gestationally. RESULTS: In patients who were of normal weight showed significantly increased serum LH levels compared to those who were overweight (12.8+/-0.9 Vs. 7.1+/-0.8 mIU/ml, p= 0.000), and the serum levels of insulin was increased significantly in the overweight group (7.1+/-0.7 Vs. 15.2+/-2.8 ulU/ml, p= 0.000). the IGFBP-I (32.8+/-10.6 Vs. 8.3+/-2.5 ng/ml, p=0.034) and SHBG (55.8+/-4.2 Vs. 37.1+/-3.1 nmol/ml, p= 0.001) were significantly lower in the ovnweight group. The oral glucose tolerance test before/after pregnancy showed increased frequency of abnormal glucose metabolism, in both of the non-obese group (38.8%, 26,9%) and the obese group (64.2%, 53.9%) compared with normal population. CONCLUSION: It is thought that in the normal weight group with polycystic ovarian syndrome androgen production is stimulated in the theca cells by abnormally high LH secretion, while in the overweight group the hyperinsulinemia state which decreases the SHBG and IGFBP-I, lead to increase biologically active hee androgens and IGF-I and increase insulin binding to its receptor. And during/before pregnancy, women with PCOS showed that incidence of abnormal glucose metabolism was significantly increased in both of non-obese and obese groups.

Hemodynamic Study of Foot in Diabetic Patient Using Portable Doppler Machine

The importance of neuropathy in the pathogenesis of foot lesions has been well recognized in diabetes. Blood flow in ischemic limbs has been extensively investigated but the circulation of limbs affected by peripheral neu ropathy has received little attention. Some studies on blood flow in peripheral neuropathy have shown a remarkable increase in resting flow, transcutaneous venous oxygen tension, and vascularity, along with loss of the spontaneous variations which occur normally with sympathetic activity of the foot in patients with diabetes. The aim of present study is to find out the effects of somatic and autonomic nervous function in early change of blood flow of foot in diabetic patients, We have studied fifty-one patients of non-insulin-dependent(type II) diabetes with no history of hypertension of diabetic foot ulcers. The evidence of neuropathy was screened by nerve conduction studies and sympathetic skin response of both lower extremities. Blood flow of dorsalis pedls and posterior tibial arteries was measured by portable doppler machine and presented as pressure index(ankle-to-arm systolic pressure ratio). The patients with sympathetic dysfunction showed significant decrease in pressure index compared to normal control and diabetic patients with normal sympathetic function, suggesting that changes of the blood flow occur in diabetic patients with sympathetic dysfunction.

Studies of Risk Factors in Stroke Patients

The correction of risk fators is very important in the prevention of stroke. This study was designed to investigate the risk factors of stroke patients and to correlate these risk factors with Functional Independence Measure(FIM) scores to be used for possible prognostic values in rehabilitation program. The subjects were 75 patients from 36 to 84 years of age. Data collection was done through chart reviews on risk factors of stroke including hypertension, transient ischemic attacks or previous stroke history, diabetes mellitus, heart disease, cigarette smoking, alcohol intake and hypercholesterolemia. Risk factors in stroke by the order of frequency were hypertension(68.0%), previous stroke history(38.7%), heart diseases(22.7%), hypercholesterolemia(24.0%), and diabetes mellitus(16.0%). The frequency of hypercholesterolemia, diabetes mellitus, heart disease, smoking in cerebral infarction group was higher than in intracerebral hemorrhagic group. There was no stastically significant correlation between risk factors and FIM scores. The results suggest that hypertension was the most important risk factor in stroke and the rate of risk factors was higher in cerebral infarction than in cerebral hemorrhage.

Polycystic ovary in torsion combined with stage in endometrial carcinoma / 대한산부인과학회잡지

No abstract available.