Association of the Comprehensive Attention Test and the Korean Wechsler Intelligence Scale for Children-Fourth Edition in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

Objectives@#This study aimed to investigate the correlation between the Comprehensive Attention Test, Korean-Wechsler Intelligence Scale for Children-Fourth Edition, and Attention-Deficit/Hyperactivity Disorder (ADHD) Rating Scale-IV scores in children and adolescents with ADHD. @*Methods@#Fifty-five children and adolescents diagnosed with ADHD and not taking psychiatric medications were included in this retrospective study. A correlation analysis was performed. @*Results@#Although simple visual and auditory selective attention have diagnostic value in traditional continuous performance tests, this study revealed that inhibition-sustained attention and interference-selective attention are also effective in evaluating ADHD. Furthermore, the correlation between the attention and intelligence test scores varied depending on the use of visual or auditory stimuli. @*Conclusion@#The findings of this study contribute to clarifying our understanding of the cognitive characteristics of children and adolescents with ADHD and can be used in future research.

The Willingness of Enduring Drug Side Effects in the Patients of Depressive Disorders: From the Results of Korean Nationwide Patients’ Perspectives Survey Study / 신경정신의학

Objectives@#There has been increased use of medications in treating depressive disorders.Nowadays, patient value is an important part of prescribing medications. This study examines depressive patients’ perspectives on the side effects of medications. @*Methods@#We administered questionnaires nationwide to 364 patients with depressive disorders. Intent or willingness to endure 21 side effects from the Antidepressant Side-Effect Checklist (ASEC) were examined and compared in patients who are less than mildly ill and who are more than moderately ill. @*Results@#In the population, decreased appetite, yawning, increased body temperature, dry mouth, sweating, and constipation are regarded as generally endurable side effects. In contrast, dizziness, light-headedness, nausea or vomiting, headaches, disorientation, problems with urination, and difficulty sleeping are hard to endure. There were differences between patients who are less than mildly ill and those who are more than moderately ill regarding the willingness to endure drowsiness, decreased appetite, sexual dysfunction, palpitations, and weight gain. @*Conclusion@#This nationwide study revealed a general willingness in depressed patients to endure side effects. Sensitive and premeditative discussions of patient value with regard to medications might contribute to finding successful treatments.

Development of the Korean Form of the Premonitory Urge for Tics Scale: A Reliability and Validity Study

Objectives@#This study aimed to evaluate the reliability and validity of the Korean Form of the Premonitory Urge for Tics Scale (K-PUTS). @*Methods@#Thirty-eight patients with Tourette’s disorder who visited Jeonbuk National University Hospital were assessed with the K-PUTS. Together with the PUTS, the Yale Global Tic Severity Scale (YGTSS), the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS), the attention-deficit/hyperactivity disorder (ADHD) rating scale (ARS), and the Adult ADHD Self-Report Scale (ASRS) were implemented to evaluate concurrent and discriminant validity. @*Results@#The internal consistency of items on the PUTS was high, with a Cronbach’s α of 0.79. The test-retest reliability of the PUTS, which was administered at 2 weeks to 2 months intervals, showed high reliability with a Pearson correlation coefficient of 0.60. There was a significant positive correlation between the overall PUTS score and the YGTSS score, showing concurrent validity. There was no correlation between the PUTS, CY-BOCS, and ASRS scores, demonstrating the discriminant validity of the PUTS. Factor analysis for construct validity revealed three factors: “presumed functional relationship between the tic and the urge to tic,” “the quality of the premonitory urge,” and “just right phenomena.” @*Conclusion@#The results of this study indicate that the K-PUTS is a reliable and valid scale for rating premonitory urge of tics.

Epidemiological Characteristics of Field Tick-Borne Pathogens in Gwang-ju Metropolitan Area, South Korea, from 2014 to 2018

ObjectivesThe importance of tick-borne diseases is increasing because of climate change, with a lack of long-term studies on tick-borne pathogens in South Korea. To understand the epidemiological characteristics of tick-borne diseases, the monthly distribution of field ticks throughout the year was studied in South Korea between May 2014 and April 2018 in a cross sectional study.MethodsThe presence of various tick-borne pathogens (Rickettsia species, Borrelia species, Anaplasma phagocytophilum) was confirmed by using polymerase chain reaction, to provide information for a prevention strategy against tick-borne pathogenic infections, through increased understanding of the relationship between seasonal variation and risk of infection with Rickettsia species. This was performed using logistic regression analysis (SPSS 20, IBM, USA) of the data obtained from the study.ResultsDuring the study period there were 11,717 ticks collected and 4 species identified. Haemapysalis longicornis was the most common species (n = 10,904, 93.1%), followed by Haemapysalis flava (n = 656, 5.6%), Ixodes nipponensis (n = 151, 1.3%), and Amblyomma testudinarium (n = 6, 0.05%) The results of this cross-sectional study showed that Haemapysalis flava carried a higher risk of transmission of Rickettsia species than other tick species (p < 0.05).ConclusionIn conclusion, due attention should be paid to preventing tick-borne infections in humans whilst engaged in outdoor activities in Spring and Autumn, particularly in places where there is a high prevalence of ticks.

Epidemiological Characteristics of Rodents and Chiggers with Orientia Tsutsugamushi in the Republic of Korea

A survey of rodents and chiggers associated with Orientia tsutsugamushi was conducted in a rural region of the Republic of Korea (Korea) between 2014 and 2018. Overall Apodemus agrarius 15.2% had the highest seropisitive for O. tsutsugamushi, followed by Myodes regulus 11.4%. Monthly risk factors using logistic regression analysis were not associated with O. tsutsugamushi infections in rodents. The overall prevalence rate of O. tsutsugamushi among chiggers was 0.3%. The chigger (Leptotrombidium scutellare) and monthly (October) risk factors were associated with O. tsutsugamushi human infections (P<0.05). Orientia tsutsugamushi infections are endemic in rodents in Korea and people, for example, soldiers who are active outdoors, must employ preventive measures, especially during October (P<0.05). When there are many reports of O. tsutsugamushi infections in Korea. The Boryong strain 85.7% (2/14) was the most common strain detected in chiggers, followed by the Shimokoshi 7.1% (1/14) and Karp 7.1% strains.

Short-term Clinical Outcomes of Micropulse TransscleralCyclophotocoagulation in Refractory Glaucoma Patients

Purpose@#We evaluated the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in refractoryglaucoma patients. @*Methods@#A retrospective chart review was performed for 23 eyes of 23 patients with refractory glaucoma who were followed for6 months after MP-TSCPC. @*Results@#The mean preoperative intraocular pressure (IOP) was 39.3 ± 15.8 mmHg and the mean number of antiglaucoma medicationswas 2.6 ± 0.6. Both significantly decreased at 6 months to 23.8 ± 15.4 mmHg (p = 0.002) and 1.8 ± 1.1 (p = 0.018).Surgical success was defined as a postoperative IOP decrease from 6-21 mmHg or more than 20% reduction from baseline. Thesuccess rate was 65.2% at 6 months. Complications of MP-TSCPC included subconjunctival hemorrhage in 6 eyes (26.1%), ocularpain in 16 eyes (69.6%), anterior chamber inflammation in 17 eyes (73.9%), and hypotony in 2 eyes (8.7%). @*Conclusions@#MP-TSCPC in patients with refractory glaucoma showed a reduction in IOP and the number of antiglaucoma medicationsin the short-term. However, additional studies are needed to determine the optimal laser settings for maximum efficacyand safety.

Molecular Epidemiology of Viral Conjunctivitis in the Southern Region of South Korea, 2012–2016

Epidemic keratoconjunctivitis (EKC) and acute hemorrhagic conjunctivitis (AHC) are common diseases caused by human adenoviruses (HAdV) and enteroviruses, respectively, in South Korea. However, there are limited studies on the molecular epidemiology of viral conjunctivitis in South Korea. The main objective of this study was to characterize the genotypes of adenoviruses and enteroviruses causing viral conjunctivitis in the southwest region of South Korea. We collected conjunctival swabs from 492 patients with suspected cases of viral conjunctivitis from 6 ophthalmic hospitals in Gwangju Metropolitan City, in South Korea, between 2012 and 2016. Of the 492 samples tested, HAdVs and enteroviruses were detected in 249 samples (50.6%) and 19 samples (3.9%), respectively. The genotype analysis detected HAdV-8 in 183 samples (73.5%), HAdV-37 in 14 samples (5.6%), and HAdV-3, and HAdV-4 in 9 samples (3.6%) each. We detected coxsackievirus A24 (CVA24) and coxsackievirus B1 (CVB1) in 8 samples (42.0%) and 4 samples (21.0%), respectively. We also reported for the first time HAdV-56-infected cases of EKC in South Korea. Furthermore, we found three cases of coinfection with HAdV and enterovirus genotypes in our samples. HAdV-8 and CVA24, the main causes of EKC and AHC, respectively, worldwide, were also found to be the predominant genotypes in our study.

Comparing Intelligence Test Profiles to Assess Tourette's Disorder with Attention-Deficit Hyperactivity Disorder

OBJECTIVES: The study compared the intelligence test profiles of Tourette's Disorder (TD), attention-deficit hyperactivity disorder (ADHD), and TD with ADHD (TD+ADHD) groups. METHODS: The Korean Wechsler Intelligence Scale for Children-third edition (K-WISC-III) and Korean Wechsler Intelligence Scale for Children-fourth edition (K-WISC-IV) were administered to 13 children and adolescents with TD, 17 children and adolescents with ADHD, and 15 children and adolescents with TD+ADHD. Each parameter was compared among the groups using the Kruskal-Wallis test. RESULTS: The mean scores of the freedom from distractibility/working memory index (FD/WMI) and the digit span and arithmetic subtests of the TD+ADHD group were significantly lower than those of the TD group. CONCLUSION: According to the intelligence test results, the comorbid ADHD+TD group showed a significant decrease in working memory compared to the TD group. These findings are similar to those of previous research on cognitive functions and suggest that the TD+ADHD comorbid and TD alone groups exhibit different endophenotypes. The results also imply that WISC-III and WISC-IV, the most commonly used intelligence tests clinically, are effective in evaluating cognitive functions such as attention. Further research is required to confirm these results.

Seroepidemiological Survey of Zoonotic Diseases in Small Mammals with PCR Detection of Orientia tsutsugamushi in Chiggers, Gwangju, Korea

Serosurveillance for zoonotic diseases in small mammals and detection of chiggers, the vector of Orientia tsutsugamushi, were conducted from September 2014 to August 2015 in Gwangju Metropolitan Area. Apodemus agrarius was the most commonly collected small mammals (158; 91.8%), followed by Myodes regulus (8; 4.6%), and Crocidura lasiura (6; 3.5%). The highest seroprevalence of small mammals for O. tsutsugamushi (41; 26.3%) was followed by hantaviruses (24; 15.4%), Rickettsia spp. (22; 14.1%), and Leptospira (2; 1.3%). A total of 3,194 chiggers were collected from small mammals, and 1,236 of 3,194 chiggers were identified with 7 species of 3 genera: Leptotrombidium scutellare was the most commonly collected species (585; 47.3%), followed by L. orientale (422; 34.1%), Euchoengastia koreaensis (99; 8.0%), L. palpale (58; 4.7%), L. pallidum (36; 2.9%), Neotrombicula gardellai (28; 2.3%), and L. zetum (8; 0.6%). L. scutellare was the predominant species. Three of 1,236 chigger mites were positive for O. tsutsugamushi by PCR. As a result of phylogenetic analysis, the O. tsutsugamushi strain of chigger mites had sequence homology of 90.1-98.2% with Boryong. This study provides baseline data on the distribution of zoonotic diseases and potential vectors for the development of prevention strategies of vector borne diseases in Gwangju metropolitan area.

The Genetic Diversity of Norovirus from Children with Diarrhea in Gwangju Metropolitan City, Korea: 2008-2012

In order to study the characteristics of norovirus in Gwangju metropolitan city, We examined norovirus in 13,931 fecal specimens collected through five years (2008-2012) from children admitted with a chief complain of acute diarrhea. Among a total of norovirus (NoV) was most frequently detected (3,025 cases, 21.7%). Concerning the frequency of virus detected by month, NoV tended to break out frequently from October to March in the following year. NoV was detected most highly in 0~3 year infants. Through examinations on NoV genotypes, among 3,025 cases that turned out to be positive, the genotypes of 2,652 cases were determined with various results including 13 types of GI and 17 types of GII. The results of analysis on GI genotypes were as follows: GI-4 (21.9%), GI-2 (15.2%), and GI-6 (10.5%). GII genotypes were as follows: GII-4 (63.9%), GII-3 (18.9%), GII-8 (4.2%), GII-2 (3.9%), GII-6 (3.3%), and GII-1 (1.9%). Eight types of variants for GII-4 genotype (427 cases) were identified. The majority of the GII-4 variants was GII-4_Farmington (181 cases, 42.4%), which peaked in 2012, while GII-4_2008b (173 cases, 40.5%) showed a high prevalence in 2011. Concerning the circulation of variants, as many as eight types of GII-4 variants were identified in 2012, showing more varieties than in other years. Therefore, this study can be used as fundamental data for the development of vaccine candidate for the prevention of viral diarrheal diseases with high-incidence.

Molecular Epidemiology of Mumps Virus Circulated in Gwangju

The recent mumps epidemic in South Korea has generated a large amount of public concern. This study has attempted to analyze molecular epidemiological changes of mumps virus circulating in Gwangju metropolitan area, South Korea. 953 throat swab samples were collected from patients with parotitis from May 2013 to July 2014. The majority (71.5%) of these cases have occurred in middle or high school students aged from 15 to 19 years. All samples were tested using a reverse transcription polymerase chain reaction (RT-PCR) that targets the short hydrophobic (SH) gene of the virus. Mumps virus SH gene was detected in 39.2% (374/953) of samples. And 82 RT-PCR products were randomly selected for nucleotide sequencing analysis. All of these sequences were determined as genotype I by phylogenetic analysis and showed the highest nucleic acid similarity (99%) with Dg1062/Korea/98 (GenBank accession no. AY309060). These results suggested that appearance of new genotype or genetic variation at the nucleotide level could be ruled out to evaluate main cause of recent mumps outbreak in Gwangju metropolitan area.

The Validities and Efficiencies of Korean ADHD Rating Scale and Korean Child Behavior Checklist for Screening Children with ADHD in the Community

OBJECTIVE: The purpose of this study is to examine the validity of primary screening tools for attention deficit hyperactivity disorder (ADHD) in a community-based sample of children using the Korean version of the Child Behavior Checklist (K-CBCL) and the Korean version of the ADHD Rating Scale (K-ARS). METHODS: A large-scale community-based study for ADHD screening was conducted in the Jeollabuk province in the Republic of Korea. In 2010-2011, we surveyed a total of 49,088 first- and fourth-grade elementary school students. All of the participants in this study were assessed by the K-ARS-Parent version (K-ARS-P) and the K-ARS-Teacher version (K-ARS-T) as the primary screening instruments. The Diagnostic Interview Schedule for Children Version IV (DISC-IV) was used for confirming the diagnosis of ADHD. DISC-IV was administered to subjects who received top 10% scores in the K-ARS-P or K-ARS-T tests. RESULTS: Of the 3,085 subjects who completed the DISC-IV, 1,215 were diagnosed as having ADHD. A reasonable level of sensitivity, specificity, and negative predictive value were obtained when the total K-ARS-P scores were > or =90th percentile. The positive predictive value and specificity increased significantly when the total K-ARS-P scores were > or =90th percentile, T scores were > or =60 in the attention problems of K-CBCL, and T scores were > or =63 in the total problems of K-CBCL. CONCLUSION: These results suggested that the K-ARS-P could effectively serve as a primary screening tool to identify elementary school children with ADHD in the community. Also, there might be some increment in the effectiveness of K-ARS-P when combined with K-CBCL-A and K-CBCL-T as a secondary screening tool.

Cyberbullying, Problematic Internet Use, and Psychopathologic Symptoms among Korean Youth

To evaluate the associations between cyberbullying behaviors and problematic internet use, and to compare psychopathologic symptoms in victims, perpetrators, and victims-perpetrators of cyberbullying to those in youths who were not involved in cyberbullying. A total of 4531 youths (11-14 years of age) were recruited from elementary and middle schools. Among 4531 youths, 9.7% were involved in cyberbullying; 3.3% were only victims; 3.4% were only perpetrators; and 3.0% were victims-perpetrators. Cyberbullying behaviors were associated with problematic internet use as well as various psychopathologic symptoms. Depressive symptoms were associated with cyberbullying victimization, and rule-breaking behaviors and aggressive behaviors have relevance to cyberbullying perpetration. Greater attention needs to be paid to identify youths earlier who are involved in cyberbullying and prevent serious adverse consequences in them.

The Molecular Epidemiology of Circulating Group A Rotavirus in Gwangju Metropolitan City, Korea: 2008~2012

Group A rotaviruses are a major cause of acute gastroenteritis in young children worldwide. For the proper management of rotavirus infections, knowledge of the distribution of G and P genotypes including detection of emerging genotype is crucial. Therefore, the aim of this study is to describe epidemiological changes in rotavirus gastroenteritis in Gwangju metropolitan city, South Korea. Stool samples were collected from 14,314 patients with diarrhea, who visited hospitals in Gwangju from 2008 to 2012. Samples were screened for rotavirus with Enzyme-Linked Immunosorbent Assay (ELISA) method and rotavirus P (VP4), G (VP7) genotypes were determined by reverse-transcription polymerase chain reaction. And we performed nucleotide sequencing analysis. Among a total of 14,314 samples investigated 1,982 samples (13.8%) were ELISA positive. Genotyping of Rotavirus was performed using 526 rotavirus samples. The most prevalent circulating G genotype was G1 (40.5%), followed by G2 (27.6%), G3 (19.4%), G9 (9.7%), G4 (2.5%) and G12 (0.4%). The predominant type of P genotypes was P[8] (69.6%), followed by P[4] (27.8%) and P[6] (2.3%). In this study, 13 G-P combinations were detected. From 2008 to 2010, G1P[8] was the most prevalent, followed by G3P[8]. Whereas, 2011 and 2012, G2P[4] was the most common, followed by G1P[8]. Rotavirus gastroenteritis is a common disease associated with significant morbidity, mortality and economic burden. Ongoing rotavirus surveillance to understand the distribution of G and P genotypes will be critical for the development of effective prevention measurements.

Characterization of Community-Associated Methicillin-Resistant Staphylococcus aureus in Gwangju, Korea

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most important nosocomial pathogens worldwide. This study was performed to investigate the characterization of MRSA isolated from healthy persons in Gwangju area. A total of 404 nasal swab samples was collected during October 2011 and May 2012 in Gwangu, Korea. A survey on MRSA was conducted with meat distributors (n=230), pre-school children (n=108), officers (n=66), respectively. To confirm the MRSA, polymerase chain reaction (PCR) for the S. aureus specific gene and mecA gene was performed. A total of 34 (8.4%) MRSA isolates was isolated from 404 nasal swab samples: 6.1% (14/230) from meat distributors, 16.7% (18/108) from pre-school children, and 3.0% (2/66) from officers samples, respectively. The most prevalent antimicrobial resistance observed in the MRSA isolates was to ampicillin 100% (34/34), followed by penicillin 97.1% (33/34), oxacillin 94.1% (32/34) and erythromycin 52.9% (18/34). All MRSA isolates were then characterized by panton-valentine leukocidin (pvl) gene detected by PCR, staphylococcal cassette chromosome mec (SCCmec) typing, and pulsed-field gel electrophoresis (PFGE) with Sma I digestion. 34 MRSA isolates from nasal carriage were pvl gene negative, SCCmec type IV; 73.5% (25/34), type II; 17.6% (6/34), type III; 2.9% (1/34), and untypable; 5.9% (2/34), respectively. 34 MRSA isolates showed 16 PFGE patterns. These results indicated that isolation rates of community-associated methicillin-resistant S. aureus (CA-MRSA) from healthy persons were low (8.4%), but continuous surveillance and monitoring should be performed to prevent the spread of MRSA in the community.

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls / 영남의대학술지

BACKGROUND: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. METHODS: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. RESULTS: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. CONCLUSION: The study results showed that serum basal LH levels are useful for screening CPP in girls.

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls / 영남의대학술지

BACKGROUND: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. METHODS: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. RESULTS: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. CONCLUSION: The study results showed that serum basal LH levels are useful for screening CPP in girls.

A Case of Lithium Intoxication with Acute Kidney Injury / 대한정신약물학회지

We report a case of 48 years-old male bipolar disorder patient with acute kidney injury due to severe lithium intoxication. He was taking lithium 300 mg per day but suddenly ingested all 30 tablets of lithium 300 mg (total 9,000 mg) at one sitting to commit suicide. On his arrival at the emergency room, the serum lithium concentration was 12.47 mEq/L. Thereafter he was treated with hemodialysis four times for 4-4.5 hour per session and recovered without any prominent sequela. The serum lithium level checked 9 days after hemodialysis was 0.1 mEq/L. Therefore we suggest that clinicians should consider such a strategy as mandatory hemodialysis in a patient with severe kidney intoxication when serum lithium concentrations are very high or rapidly increasing.

D8/17 Expression on B Lymphocytes of Children and Adolescents with Tic Disorder

OBJECTIVES: It has been reported that higher percentage of B cells react with monoclonal D8/17 antibody in patients with rheumatic fever, childhood onset obsessive-compulsive disorder, Tourette's disorder, or prepubertal anorexia nervosa. The purpose of this study is to replicate the previous studies in a Korean young population with tic disorder and to identify any relationship between D8/17 and clinical symptoms. METHODS: The binding of D8/17 to B cells was determined in patients with tic disorder (N=21) and healthy controls (N=9) by Fluorescence-Activated Cell Sorter analysis. RESULTS: In the sample examined by this study, the average percentage of B cells expressing D8/17 in tic disorder was 2.05%; healthy controls was 3.15%. No statistically significant differences were found in the mean percentages of D8/17 between the two groups. CONCLUSION: The expression of D8/17 in B cells was very low in this study. No subjects with tic disorder or healthy controls was above 12% in D8/17 positive proportion. Further studies, including higher number of patients and control group members, should be performed.

Visual Function Test for Early Detection of Ethambutol-Induced Ocular Toxicity

PURPOSE: The purpose of the present study was to investigate various visual function tests for early detection of ethambutol-induced ocular toxicity. METHODS: A prospective study of 20 eyes of 10 patients being treated with ethambutol was conducted. Visual acuity, visual field, color vision, fundus examination, contrast sensitivity, optical coherence tomography (OCT), and pattern-visual evoked potential (VEP) were assessed. Examinations were performed prior to therapy and every month for 5 months after treatment. VEP was performed every other month. The mean values of each parameter at each month were compared with the baseline examination and a p-value of <0.05 was considered significant. In addition, a greater than 2 standard deviation (SD) change in each parameter from the mean values at baseline was considered as an ocular toxicity induced change in each individual eye. RESULTS: On OCT, a significant increase of the average retinal nerve fiber layer thickness was detected after 4 months of therapy. VEP showed an increased mean latency of the P100 wave after 2 and 4 months of therapy. However, a greater than 2 SD change from the mean values of the baseline was not observed on OCT, while 30% (6/20) of the eyes showed more than a 2 SD increase in VEP latency. Visual acuity, color vision, fundus, contrast sensitivity, and visual field were not affected in any patients. CONCLUSIONS: The authors of the present study consider VEP as a sensitive test to detect early toxicity of ethambutol. VEP can be helpful in identifying subclinical ocular toxicity, especially in the high-risk patients.