• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권4호
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• pp.273-278
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• 2015

Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.

• 대한임상검사과학회지
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• 제38권1호
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• pp.26-33
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• 2006

Recently, the rapid increase in extended-spectrum ${\beta}$-lactamase (ESBL) producing clinical isolates has become a serious problem. In this study, the epidemiologic features and molecular characteristics of ESBL among clinical isolates of Escherichia coli and Klebsiella pneumoniae, antibiotic susceptibility testing, genotype of the ESBL and patterns of chromosomal DNA from PFGE (pulsed field gel electrophoresis) were observed. A total of 53 ESBL-producing clinical isolates (30 of E. coli and 23 of Klebsiella pneumoniae) were collected from two university hospitals in the period of June to July in 2002 and 2003 respectively. The antibiotic resistance frequency of those 53 strains was tested by the disk agar diffusion method with the result that all the strains were resistant to cephalothin. To other antibiotics, the resistance rates of E. coli (30 isolates) were in order of ceftazidime (90.0%), cefotaxime and aztreonam (respectively 83.3%). Also, the resistance rates of K. pneumoniae (23 isolates) were in order of aztreonam (78.3%), ceftazidime (73.9%) and cefotaxime (65.3%). Also the sensitivity of ceftazidime-clavulanic acid were 100% in E. coli and 95.7% in K. pneumoniae. And the sensitivity of cefotaxime-clavulanic acid was 96.7% in E. coli and 91.3% in K. pneumoniae. The types of the ESBL genes were determined by using polymerase chain reaction (PCR). Among the 30 isolates of ESBL-producing E. coli, 6 (20.0%) have SHV only, 5 (16.7%) have TEM only and, 18 (60.0%) have both of TEM and SHV. Among the 23 isolates of ESBL-producing K. pneumoniae, 7 (30.4%) have SHV only, 2 (8.7%) have TEM only, and 14 (60.9%) have both of TEM and SHV. These results show that 52 strains, with only one exception, were confirmed as either TEM or SHV. The patterns of Xba I-digested chromosomal DNA of ESBL-producing E. coli and K. pneumoniae isolates were analyzed by PFGE. PFGE patterns of E. coli and K. pneumoniae were multiclonal, but many strains were grouped into a few types. Therefore, it seems that there were clonal outbreaks or possible horizontal spread. In conclusion, the TEM and SHV ${\beta}$-lactamase are most widely spread in E. coli and K. pneumoniae in Korea. As these types are usually carried by plasmids, the spread of these ${\beta}$-lactamase genes could compromise the future usefulness of third generation cephalosporins for the treatment of infections caused by E. coli and K. pneumoniae.

• Clinical and Experimental Pediatrics
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• 제64권10호
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• pp.538-542
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• 2021

Background: The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) remains unknown. Purpose: This meta-analysis aimed to investigate the relationship between SGA and the risk of ASD. Methods: We searched PubMed, Web of Science, and Scopus databases from inception to November 2020. The heterogeneity across studies was explored using the I² statistic. The possibility of publication bias was assessed using Begg test. The results were reported using the odds ratio (OR) and 95% confidence interval (CI) using a random-effects model. Results: The literature search yielded 824 articles with 8,752,138 participants. We assessed the association between SGA and the risk of ASD in cohort and case-control studies. Based on the random-effects model, compared with SGA, the estimated OR of the risk of ASD was 1.17 (95% CI, 1.09-1.24). Therefore, there was a significant association between SGA and the risk of ASD. Conclusion: Based on OR reports in epidemiological studies, we showed that SGA is a risk factor for and can increase the risk of ASD. The association between SGA and ASD risk has further relevance to the current public health emphasis on appropriate prepregnancy weight and pregnancy weight gain.

• Korean Journal of Radiology
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• 제1권4호
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• pp.198-207
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• 2000

Uterine cervical carcinoma is one of the most common malignant tumors occurring in females. After primary treatment, patients are usually followed up with CT or MRI and the findings of these modalities may be the first sign of recurrent disease. Because earlier additional treatment by chemotherapy or radiation therapy may improve the prognosis, the early detection of recurrent cervical carcinoma is clinically important. In this article, we review the CT and MR imaging findings of recurrent uterine cervical carcinoma, and assign them to one of four groups: a) recurrence at the primary site, involving the intrapelvic organs, b) extension to the pelvic side-wall, c) metastases to pelvic and extrapelvic lymph nodes, or d) metastases to distant organs. A further contribution of CT and MR imaging is the detection of hydronephrosis due to ureteral obstruction. The cases in each group are illustrated and discussed, and since an awareness of the spectrum of imaging findings of recurrent cervical carcinoma is likely to lead to its early detection, radiologists should be familiar with the information presented.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2361-2367
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• 2016

Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1031-1037
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• 2008

Macrolide antimicrobial agents including erythromycin, roxithromycin, clarithromycin, and azithromycin are commonly used in the treatment of respiratory tract infections in children. Newer macrolides that have structural modifications of older drug erythromycin show improved change in the spectrum of activity, dosing, and administration. However, recent studies reported that increasing use of macrolide antibiotics is the main force driving the development of macrolide resistance in streptococci. In particular, azithromycin use is more likely to select for macrolide resistance with Streptococcus pneumoniae than is clarithromycin use, a possible reflection of its much longer half life. Recently, erythromycin resistance rates of S. pneumoniae and Streptococcus pyogenes are rapidly increasing in Korea. Two main mechanisms of acquired macrolide resistance have been described, altered binding site on the bacterial ribosome encoded by the ermB gene and active macrolide efflux pump encoded by the mef gene. Relationship between the susceptibility of S. pneumoniae and the response to macrolides has been shown in studies of acute otitis media, but less clear in cases of pneumonia. This article reviews the spectrum of activity, pharmacokinetic properties, mechanisms of action and resistance, and clinical implication of resistance on the treatment of respiratory tract infections in children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.228-234
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• 2017

Objectives: The aim of this study was to investigate the clinical characteristics of aggressive behavior problems in children and adolescents with autism spectrum disorder (ASD). Methods: Children and adolescents with ASD, aged 6-18 years, were included in this study. We divided them into two groups according to the presence or absence of aggressive behavior. They were assessed using three scales, the Korean-Child Behavior Checklist (K-CBCL), Behavior Problem Inventory, and Social Communication Questionnaire, which were completed by their parents, who conducted a continuous performance test to evaluate their attention function. The statistical analysis was done using the Mann-Whitney U-test between the two groups at a p-value of 0.05. Results: A total of 17 children participated in this study. Ten children (7 boys, $12.4{\pm}4.27years$) were included in the group with aggressive behavior problems and 7 children (6 boys, $13.8{\pm}3.53years$) in the group without aggressive behavior problems. There were no significant differences in the age, gender or intelligence quotient of the two groups. The children with aggressive behavior problems showed a trend of higher T-scores in the attention problems and anxiety/depressed subscale of the CBLC (p<0.1). Conclusion: The results suggest that aggressive behavior problems in children with ASD may be related to their attention problems, anxiety and depression.

• Archives of Pharmacal Research
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• 제24권6호
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• pp.590-596
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• 2001

A new extended-spectrum ${\beta}-lactamase$ with an isoelectric point (pl) of 6.2 was detected in Klebsiella pneumoniae Fl 61 that was isolated from a patient with infection. This strain was highly resistant to the third or fourth generation cephalosporins such as cceftazidime ceftriaxone, cefoperzaone, and cefpirome. Analysis of this strain by the double disk diffusion test showed synergies between amoxicillin-clavulanate (AMX-CA) and cefotaxime, and AMX-CA and aztreonam, which suggested that this strain produced a extended-spectrum ${\beta}-lactamase$ (ESBL). Cenetic analysis revealed that the resistance was due to the presence of a 9.4-kb plasmic, designated as pkpl 61, encoding for new ${\beta}-lactamase$ gene (bla). Sequence analysis showed that a new bla gene of pkpl 61 differed from $bla_{TEM-1}$ by three mutations leading to the following amino acid substitutions: $Val_{84}{\rightarrow}lie,{\;}Ala_{184}{\rightarrow}Val,{\;}and{\;}Gly_{238}{\rightarrow}Ser$. These mutations have not been reported previously in the TIM type ${\beta}-lactamases$ produced by clinical strains. The novel ${\beta}-lactamase$ was overexpressed in E. coli and purified by ion exchange chromatography on Q-Sepharose and CM-Sepharose, and then further purified by gel filtration on Sehadex G-200. The catalytic activity of th8 purified ${\beta}-lactamase$ was confirmed by the nitrocefin disk.

• 생물정신의학
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• 제1권1호
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• pp.17-30
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• 1994

Several different classes of antidepressants(ADs) with newer drugs becoming available have been used for the phamacological management of a broad spectrum of mental disorders, among which depressive disorder is most commonly indicated. Successful clinical use of ADs requires a complete understanding of the psychopharmacological properties of ADs and on accurate knowledge of patients, characteristics based on clinical experience and theoretical framework. This paper aims at providing some practical information on the clinical use of ADs to assist clinicians in treating patients with major depression. The author describes (1) different classes of ADs and their presumed mechanisms of action, (2) clinical characteristics of ADs focusing on side-effect profiles, (3) some issues arising during the treatment course such as : a) pretreatment tasks, b) choice of ADs, c) therapeutic drug dose and monitoring of drug concentration, d) three stages of treatment and e) strategies in refractory depression and (4) ADs in special patient groups.

• 분석과학
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• 제24권2호
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• pp.78-84
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• 2011

본 연구에서는 양성 및/또는 음성 이온 방식으로 저에너지 충돌-유발 분해(CID)를 이용한 serine protease 저해제인 camostat 와 그것의 분해산물인 4-(4-guanidinobenzoyloxy)phenylacetic acid (GBPA)의 분해 패턴을 전자분무 소스가 있는 사중극자 텐덤 질량분석기(ESI-MS/MS)를 이용하여 최초로 조사하였다. Camostat의 양이온 CID 질량 스펙트럼 분석결과, 분자구조내 에스테르 결합을 이루는 카르보닐 기와 산소 원자사이의 단일 결합(C-O) 분해가 우선적으로 일어나고, guanidine 기의 초기 손실보다는 N,Ndimethylcarbamoylmethyl기의 초기 손실이 더 잘 일어난다는 것이 특징적으로 확인되었다. GBPA의 양이온 CID 스펙트럼의 경우는, 4-guanidinobenzoyloxy 기에 있는 카르보닐 기와 산소원자 사이의 초기 분해가 일어나서 m/z 145에서 가장 강도가 높은 피크를 만들었다. 반면에, GBPA의 음이온 스펙트럼은 m/z 312의 모분자 이온에서 $CO_2$와 NH=C=NH의 순차적인 중성 손실로 인하여 m/z 226의 가장 강도가 높은 피크가 특징적으로 생성되었다.