• Korean Journal of Psychosomatic Medicine
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• v.26 no.1
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• pp.59-67
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• 2018

Objectives : The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. Methods : From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). Results : 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/ executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p<0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p<0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p<0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. Conclusions : The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.71-75
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• 2006

Purpose : Because migraine in children has different characteristics from that in adults, it is inappropriate to apply migraine criteria for adults to children. Recently, the International Headache Society(IHS) revised criteria regarding children's characteristics. Therefore, we reviewed the characteristics of childhood migraines without auras based on the revised criteria and compared the data with the findings of childhood migraine by the previous criteria. Methods : Among 102 children who visited the outpatient clinic of Kangbuk Samsung Hospital for the chief complaint of headache, we analyzed the clinical findings of 34 patients, who were diagnosed as migraine without aura, and probable migraine based on the revised criteria. Results : Migraines without aura were diagnosed in 27 patients(26.5 percent) and probable migraines were observed in seven patients(6.8 percent). The usual duration of headache attacks over 2 hours was observed in 12 patients(44.4 percent). On the contrary, 15 patients(55.6 percent) usually experienced headaches for one to two hours. According to the location of headaches, there were temporal areas in 14 cases, frontal areas in nine cases, occipital areas in two cases and diffuse areas in two cases. The striking point in probable migraines is that the length of headache was below one hour in five patients. Nine patients were diagnosed as migraine without aura, when the first edition criteria was applied to same patients. Conclusion : We found that the prevalence of migraine without aura increased by the revision of IHS criteria. We hope that migraines in children will be diagnosed correctly by the new IHS criteria.

• Korean Security Journal
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• no.9
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• pp.99-131
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• 2005

Terrorism which became today's common phenomena over the world is one of the most serious threats the world confront. Although International society make and operate outstanding anti-terrorism system, terror would never end without solving fundamental problems. The main body of terrorism converts from nation to organization and from organization to cell, which makes it difficult for us to recognize the main body. Since the target of today's new terrorism is many and unspecified persons, terrorists will never hesitate to use mass destruction weapons such as nuclear, biological, chemical weapons, and also use cyber-technique or cyber-terrorism. So, effective counter-terrorism measures should be performed as follows. First, it must be better for international society should make long-time plan of solving fundamental problems of terrorism other than to operate directly on terror organization and its means. Second, preventive method should be made. The most effective method of eradicating terrorism is prevention. For this, it is necessary to remove environmental elements of terrorism and terrorist bases, and to stop inflow of money and mass destruction weapons to terrorists. Third, integrated anti-terror organization should be organized and operated for continuous counter-terrorism operations. Also international alliance for anti-terrorism should be maintained to share informations and measures. Fourth, concerned department in the government should prepare counter-terrorism plans in their own parts as follows and make efforts to integrate the plans. - Ministry of Government Administration and Home Affairs : conventional terror - Ministry of Health and Welfare : bio-terror - Ministry of Science and Technology : nuclear-terror Especially, they should convert their policy and operation from post-terror actions to pre-terror actions, designate terror as national disaster and organize integrated emergency response organization including civil, government, and military elements. In conclusion, pre-terror activities and remedy of fundamental causes is the best way to prevent terror. Also, strengthening of intelligence activities, international cooperations, and preventive and comprehensive counter-measures must not ignored.

• Journal of Genetic Medicine
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• v.5 no.1
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• pp.26-33
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• 2008

Purpose : Phenylketonuria(PKU) is an inborn error of metabolism and a genetic disorder resulting from a deficiency of phenylalanine hydroxylase(PAH) and decreased activity of tetrahydrobiopterin(BH4).In this study the correlation between the DNA mutation and clinical manifestations was investigated and PAH DNA mutations were compared bewteen Asian and Caucasian populations. Methods : DNA was isolated from peripheral leukocytes. The PAH gene was amplified by Polymerase Chain Reaction(PCR) and the sequence was analyzed with Multiplex Ligation-dependent Probe Amplification(MLPA). Results : We characterized the PAH gene of 102 independent Korean patients with PKU. PAH nucleotide sequence analysis revealed 44 different mutations, including 10 novel mutations comprising 9 missense mutations(N207D, K95del, A447P, G344D, P69S, S391I, A202T, G103S, and I306L) and 1 novel splice-site variant mutation(IVS10-3C>G). R243Q was the most prevalent mutation in this study. A259T has not previously been reported in Asian populations, but we found that this mutation had a frequency of 10.1% in our study. Furthermore, the genotypes of $BH_4$ responsive patients were analyzed and were divided into two groups: $BH_4$ medication-only group and $BH_4$ medication with diet therapy group. In the $BH_4$ medication-only group and $BH_4$ medication with diet therapy group, R241C was the most common mutation. Conclusion : Novel mutations in the PAH gene of PKU patients are still being discovered. Additional information as to the frequency of mutations in the tetrahydrobiopterine responsive gene is also accumulating. We anticipate that knowledge of these PKU gene mutations will assist the diagnosis, genetic counseling, and therapeutic treatment of PKU patients in future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.2
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• pp.122-129
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• 2005

Purpose: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. Methods: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. Results: Five males and one female were included. The mean age when bloody stool was identified was $79.2{\pm}56.1$ days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count $11,763{\pm}3,498/mm^3$, eosinophils $17.0{\pm}4.3%$, absolute eosinophil count $2,044{\pm}996/mm^3$) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. Conclusion: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

• Pediatric Infection and Vaccine
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• v.7 no.2
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• pp.218-224
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• 2000

Purpose : In Korea, vivax malaria has been reemerged since 1993 after being abscent for more than 10 years. There are several possibilities of casuality of recent epidemic, although it is still unclear. The epidemiologic studies including case analysis and entomological reseach have been undertaken for a successful control measure. But, unfortunately those studies have been rarely dealt with cases of children. Therefore, this study was designed to figure out the characteristics of epidemiolgic and clinical features in children with indigenous vivax malaria. Methods : The study 21 cases below 15 years of age, who were diagnosed as vivax malaria and resided in kyounggi-do province area during 1998. 9~1999. 8. We retrospectively analyzed epidemiologic data concernig with occurrence of vivax, and clinical manifestations, abnormal laboratory findings and outcomes including therapeutic responses. Results : All cases were inhabitants of the endemic areas for vivax malaria in northwestern part of Kyonggi-do or western Kangwon-do, and Paju-gun was the most prevalent. Indigenous malaria cases of this study were more prevalent in children above 10 years old age, and in male. Seasonally, vivax malaria in children occurred throughout the year except January, March and November, and the incidence was the highest in July. Clinical manifestations revealed that 48 hour cyclic fever pattern was the major fever pattern, and other symptoms such as headache, vomiting, poor appetites, chilling, abdominal pain and diarrhea were concomitantly developed. And splenomegaly revealed the main abnormal findings on physical examination, and anemia was the most frequent abnormal finding in laboratory examinations. Young trophozoite was frequently observed on peripheral blood smears. The therapeutic responses of chlorquine were very good in all cases, and no recurrence developed in follow up cases. Conclusion : Geographical and seasonal occurrence distributions of indigenous vivax malaria cases in children were very similar to those of adults as followings; Inhabitants of the endemic region, more prevalent in male, and more common during the summer season. Clinically, 48 hour cyclic fever pattern, splenomegaly and anemia were most frequent and important manifestations in children cases, and clinical courses were not serious. On blood smears, young trophozoite was most dominantly examined in children. Generally, the therapeutic outcomes were excellent, and recurrences were not observed.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.73-79
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• 2012

Purpose: The association of mitochondrial DNA (mtDNA) mutations, deletions and copy number with progressive changes in patients with some glomerular disease and end-stage renal disease have been reported. In this study, we performed mtDNA mutation analysis in children with IgA nephropathy to investigate its role in progressive clinical course. Methods: Seven children with IgA nephropathy were involved in this study. MtDNA isolated from platelet was amplified by PCR and sequenced entirely. Results: The mean age at renal biopsy was $11.5{\pm}2.2$ year and the mean age at latest evaluation was $17.9{\pm}3.2$ year. The mean follow-up period were $7.8{\pm}3.1$ years. Patients was divided into 2 groups according to the amount of proteinuria at presenting manifestation. Group 2 patients were nephrotic syndrome. Renal function reveals within normal range in all patients. In group 2 patients, the mean serum albumin level was significantly lower than those of group 1 ($3.7{\pm}0.6g/dL$ vs. $4.7{\pm}0.2g/dL$, P=0.0241) and the mean total cholesterol level was significantly higher than those of group 1 ($222.7{\pm}35.7mg/dL$ vs. $148.3{\pm}29.1mg/dL$, P=0.0283). In Group 2 patients, total amount of protein of 24 hour collected urine also significantly higher than those of group 1 ($1,466.0{\pm}742.5mg$ vs. $122.5{\pm}48.1mg$, P=0.0135). Pr/Cr ratio in random urine sample was also higher in group 2 than those of group 1 but the statistical significance was not noted ($1.8{\pm}1.6$ vs. $0.2{\pm}0.2$, P=0.0961). Deletion of mtDNA nt 8272-8281 were observed in two patients, one patient in each groups, respectively. This is noncoding lesion. No patients demonstrated the mtDNA mutations. Conclusions: We have identified a deletion of mtDNA nt 8272-8281 in two children with IgA nephropathy. Further studies are needed to clarify the role of mitochondrial function in the progressive change of IgA nephropathy.

• Clinical and Experimental Pediatrics
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• v.45 no.5
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• pp.646-653
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• 2002

Purpose : The incidence of type 2 diabetes mellitus in children has been increasing worldwide recently, which is thought to be related to the increasing prevalence of obesity. We investigated to evaluate the incidence and the characteristics of type 2 diabetes mellitus in children and also analysed the relationship between intrauterine growth retardation and type 2 diabetes mellitus. Methods : We investigated 25 children diagnosed as type 2 diabetes mellitus between March 1990 and December 2000. The analysis was performed retrospectively with medical records based on the clinical characteristics and laborotory findings. Results : Incidence of type 1 and type 2 diabetes mellitus in children has been increasing since 1990. We demonstrated an increase in the percentage of type 2 diabetes mellitus children from 5.3% in 1990 to 21.0% in 2000. Sixty eight percent of patients(17/25) were classified as obese group. Initial symptoms at first visit were polyuria, polydipsia and polyphagia 48%(12/25), asymptomatic glycosuria 40% (10/25), weight loss 8%(2/25) and obesity 4%(1/25). The mean age at diagnosis was $12.9{\pm}1.8$ years. 64%(16/25) of patients had positive family history of type 2 diabetes mellitus. Autoanti-bodies were positive in 18.1%(4/22) of patients. Twenty eight percent (7/25) of patients had an associated disease and two patients had fatty liver in association with obesity. Treatment consisted of diet, exercise, education and oral hypoglycemic agents. Three patients were treated with insulin as well as oral hypoglycemic agents because of poor blood glucose control. Long-term diabetic complications occurred in 4 patients. Intrauterine growth retardtion was found in 34.6%(9/25); 88.9% (8/9) of these patients were non-obese group. Conclusion : The increase in the incidence of type 2 diabetes mellitus in children is thought to be related to the increasing prevalence of obesity. The non-obese group of patients might be associated with intrauterine growth retardation.

• Tuberculosis and Respiratory Diseases
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• v.48 no.6
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• pp.909-921
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• 2000

Background : Defects in apoptotic signaling pathways play important role in tumor initiation, progression, metastasis and resistance to treatment. Several proteins which may promote tumorigenesis by inhibiting apoptosis were identified. The survivin protein is the member of inhibitor of apoptosis protein(IAPs) family which inhibits apoptosis. Unlike other IAPs, it is expressed in during the fetal period but not in adult differentiated tissues. Many reports have stated that survivin is selectively expressed in many cancer cell lines and cancer tissues. We performed immunohistochemical analysis for survivin expression in non-mall cell lung cancer to get evaluate its clinical implication. Methods : Twenty nine surgically resected lung cancers were examined. Immunohistochemical staining were performed by immuno-peroxidase technique using avidin-biotinylated horseradish pemxidase complex in the formalin-fixed, paraffin-embedded tissue $4{\mu}m$ section. Anti-survivin polyclonal antibody was used for primary antibody and anti-p53 monoclonal antibody was also used to analyze the correlation between survivin and p53 expression. The survivin expression scores were determined by as the sum of the stained area and intensity. Results : Immunohistochemical analysis showed cancer specific expression of survivin in 20 of 29 cases (69.0%). Western blot analysis also showed the selective survivin expression in tumor tissue. There was no correlation between survivin expression and clinicopathological parameters and prognosis. We analyzed the ∞π'elation between survivin expression and p53 expression, but found none. Conclusion: We confirmed the tumor specific expression of survival in non-small cell lung canær. But this expression was not correlated with clinical parameters as well as histology, tumor stage, recurrence, and survival rate. Also it was not statistically correlated with the expression of p53.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.801-814
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• 1996

Background: Korean people could abuse healthy foods as well as medications, which might cause serious side effects. The aim of this study was elucidating liver dysfunction due to the self-medications of hepatotonics, healthy foods and herb medications by nested case-control study. Methods: Study subjects were drawn from male members of Seoul Cohort Study who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the age of 40 and 59 years through the program of biennial health check-up offered by Korea Medical Insurance Corporation(KMIC). The liver dysfunction was defined as the level of serum AST and ALT above 40 IU/L and increased in more than one hunderd per-cent during the 2 year follow-up period. To estimate the odds ratio between self-medication and liver dysfunction after controlling for potential confounders, logistic regression was performed. Results: During the follow-up period, 30 members were identified to fit into case criteria and 2,625 members were selected as control. In logistic regression analyses, history of healthy foods intake, age under 45 years, obesity, and habit of regular exercise were significantly associated with liver dysfunction. The following factors exhibited no statistical significance: intake of hepatotonics, of herb medicine; history of disease in family, of operation, and of radiologic examination; smoking habits and drinking amounts. Conclusion: The significant association between the intake of healthy foods and the liver dysfunction illustrates that chronically optional overuse of healthy foods might bring to hazards to health. As the increasing trend of the size of purchasing healthy foods in Korea, pharmacoepidemiologic studies evaluating the safety and efficacy of the widely used healthy foods should be performed in the near future.