A Family-Based Association Analysis of Estrogen Metabolism (ESR1, COMT) Gene in a Korean Population with Schizophrenia: A Pilot Study / 생물치료정신의학

Objectives@#：A recent study of a European sample implied that the 14 genes previously known to be related with schizophrenia may play little roles. But much work remains before dismissing these genes from their connection to schizophrenia. This is a pilot study for family based association test (FBAT) analysis of estrogen metabolism gene in a Korean population with schizophrenia. @*Methods@#：27 probands with schizophrenia were recruited with their parents and siblings. The subjects were interviewed using Korean versions of diagnostic interview for genetic studies and family interview for genetic studies. We analyzed 2 single nucleotide polymorphism (SNP) of ESR1, COMT gene. We performed FBAT and linkage disequilibrium analyses for each individual SNP. @*Results@#：We found a significant SNP of ESR1 gene in chromosome 6 for the qualitative phenotype of schizophrenia. That result was replicated for the quantitative phenotype of apparent onset, apparent onset of psychosis, and first treatment age. We also found a significant SNP of ESR1 gene in chromosome 6 for the quantitative phenotype of any delusions. @*Conclusions@#：Our results show that quantitative traits such as age of onset, any delusions, and any hallucinations could be continuous with qualitative trait in schizophrenia. But we should be very cautious because there are clear limitations in some nominal number of SNPs and the small incomplete pedigrees. In the future, FBAT analyses in families with subtyped schizophrenic probands according to personality, working memory, cognition will facilitate fine mapping analyses for searching candidate genes of schizophrenia.

A Comparative Study on the Cognitive and Clinical Characteristics of Childhood/Adolescent- and Adult-Onset of Bipolar Disorder / 생물치료정신의학

Objectives@#：Childhood/adolescent-onset of bipolar disorder presents functional impairments on emotional, academic, and social aspects. These impairments could continue into adulthood. However, there are few studies comparing cognitive function between childhood/adolescent- and adult-onset using psychological test. This study aims to improve understanding of childhood/adolescent-onset of bipolar disorder by comparing differences in cognitive function, clinical and demographic features between the two groups. @*Methods@#：This study was conducted on 145 patients diagnosed with bipolar disorder type I, II, and other specified bipolar disorder by DSM 5 at the time of discharge from 2016 to 2019 at the Department of Psychiatry, Pusan National University Yangsan Hospital. Demographic information, clinical data, and results of psychological tests (K-WISC-IV, K-WAIS-IV) were collected and reviewed. @*Results@#：Childhood/adolescent-onset group was significantly low in total potential IQ and in language understanding than adult-onset group (p=0.008 and p=0.013). The childhood/adolescent group had significantly more psychiatric comorbidities than the adult group (p<0.001). The average number of prescribed antipsychotic agents was 1.18 (SD= ±0.64) in the childhood/adolescent group, and 1.78 (SD=±0.82) in the adult group. The difference was statistically significant (p<0.001). @*Conclusion@#：Patients with childhood/adolescent-onset bipolar disorder have lower total potential IQ and language understanding comparing patients with adult-onset bipolar disorder. This highlights the importance of conducting a well-designed prospective study to find out more about the characteristics of childhood/adolescent-onset bipolar disorder.

Difference in Cognitive Function by First Onset Age of Alcohol Induced Blackout and Its Duration

OBJECTIVE: Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. METHODS: Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, 30 years). We then examined differences in neurocognitive function among these groups. RESULTS: O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). CONCLUSION: Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.

The Effect of Oral Administration of Black Sticky Rice with Giant Embryo on Brain GABA Concentrations

OBJECTIVE: Black sticky rice with giant embryo (BSRGE) contains high GABA content and affects alcohol-related indices among social drinkers, and alcohol intake and anxiety-related behavior of mice. However, it is unknown whether the intake of BSRGE affects GABAergic activity of brain directly. The purpose of this study is to elucidate the effect of oral administration of BSRGE on brain GABA concentrations compared with commercially available GABA compound and regular feeds. METHODS: Twenty-one male C57BL/6 mice were assigned to BSRGE, a regular feed (AIN-76) lacking GABA, and a regular feed containing GABA compound. After feeding freely for 48 h, the cortex and striatum were separated from the brain. An enzyme-linked immunosorbent assay was conducted to measure GABA and glutamate concentrations in mouse brain. RESULTS: The GABA concentration of the BSRGE group was higher than that of regular feed and GABA compound group (p<0.001). However, the GABA compound group showed no significant difference from the regular feed group (p=0.50). CONCLUSION: Intake of BSRGE containing high GABA content increased GABA concentrations in mouse brain compared with regular feed unlike GABA compound. The results of this study constitute an important basis for further investigations into the clinical applications of BSRGE.

Accuracy of Imputation of Microsatellite Markers from BovineSNP50 and BovineHD BeadChip in Hanwoo Population of Korea

Until now microsatellite (MS) have been a popular choice of markers for parentage verification. Recently many countries have moved or are in process of moving from MS markers to single nucleotide polymorphism (SNP) markers for parentage testing. FAO-ISAG has also come up with a panel of 200 SNPs to replace the use of MS markers in parentage verification. However, in many countries most of the animals were genotyped by MS markers till now and the sudden shift to SNP markers will render the data of those animals useless. As National Institute of Animal Science in South Korea plans to move from standard ISAG recommended MS markers to SNPs, it faces the dilemma of exclusion of old animals that were genotyped by MS markers. Thus to facilitate this shift from MS to SNPs, such that the existing animals with MS data could still be used for parentage verification, this study was performed. In the current study we performed imputation of MS markers from the SNPs in the 500-kb region of the MS marker on either side. This method will provide an easy option for the labs to combine the data from the old and the current set of animals. It will be a cost efficient replacement of genotyping with the additional markers. We used 1,480 Hanwoo animals with both the MS data and SNP data to impute in the validation animals. We also compared the imputation accuracy between BovineSNP50 and BovineHD BeadChip. In our study the genotype concordance of 40% and 43% was observed in the BovineSNP50 and BovineHD BeadChip respectively.

Spicy Food Preference and Risk for Alcohol Dependence in Korean

OBJECTIVE: Previous studies have reported that both preference for spicy food and drinking behavior are associated with the activity of the opioid system in the central nervous system. The relationship between the preference for spicy food and the risk of alcohol dependence by comparing spicy food preference in alcohol-dependent patients vs. healthy controls was investigated. Also the association between the preference for spicy food and OPRM1 A118G was studied. METHODS: A total of 150 Korean male patients with alcohol dependence and 100 normal male control subjects were included in this study. Preference for spicy food was measured using the Food Preference Scale (FPS). DNA analysis was conducted to detect the A118G polymorphism. RESULTS: The mean FPS score was significantly higher in the alcohol-dependent patients (61.2±24.2) than in the normal control subjects (53.0±22.0). FPS scores differed significantly between alcohol-dependent patients and normal control subjects who had the G allele in OPRM1 A118G, but not between the two groups with the AA genotype. CONCLUSION: A strong preference for spicy food can be assumed to be a risk factor for alcohol dependence, particularly in those carrying the G allele in OPRM1 A118G.

Times to Discontinue Antidepressants Over 6 Months in Patients with Major Depressive Disorder

OBJECTIVE: The aim of the present study was to investigate differences in discontinuation time among antidepressants and total antidepressant discontinuation rate of patients with depression over a 6 month period in a naturalistic treatment setting. METHODS: We reviewed the medical records of 900 patients with major depressive disorder who were initially prescribed only one kind of antidepressant. The prescribed antidepressants and the reasons for discontinuation were surveyed at baseline and every 4 weeks during the 24 week study. We investigated the discontinuation rate and the mean time to discontinuation among six antidepressants groups. RESULTS: Mean and median overall discontinuation times were 13.8 and 12 weeks, respectively. Sertraline and escitalopram had longer discontinuation times than that of fluoxetine, and patients who used sertraline discontinued use significantly later than those taking mirtazapine. No differences in discontinuation rate were observed after 24 weeks among these antidepressants. About 73% of patients discontinued antidepressant treatment after 24 weeks. CONCLUSION: Sertraline and escitalopram tended to have longer mean times to discontinuation, although no difference in discontinuation rate was detected between antidepressants after 24 weeks. About three-quarters of patients discontinued antidepressant maintenance therapy after 24 weeks.

Melatonin in Psychiatric Disorders / 수면정신생리

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.

Accuracy and precision of integumental linear dimensions in a three-dimensional facial imaging system / 대한치과교정학회지

OBJECTIVE: A recently developed facial scanning method uses three-dimensional (3D) surface imaging with a light-emitting diode. Such scanning enables surface data to be captured in high-resolution color and at relatively fast speeds. The purpose of this study was to evaluate the accuracy and precision of 3D images obtained using the Morpheus 3D(R) scanner (Morpheus Co., Seoul, Korea). METHODS: The sample comprised 30 subjects aged 24-34 years (mean 29.0 +/- 2.5 years). To test the correlation between direct and 3D image measurements, 21 landmarks were labeled on the face of each subject. Sixteen direct measurements were obtained twice using digital calipers; the same measurements were then made on two sets of 3D facial images. The mean values of measurements obtained from both methods were compared. To investigate the precision, a comparison was made between two sets of measurements taken with each method. RESULTS: When comparing the variables from both methods, five of the 16 possible anthropometric variables were found to be significantly different. However, in 12 of the 16 cases, the mean difference was under 1 mm. The average value of the differences for all variables was 0.75 mm. Precision was high in both methods, with error magnitudes under 0.5 mm. CONCLUSIONS: 3D scanning images have high levels of precision and fairly good congruence with traditional anthropometry methods, with mean differences of less than 1 mm. 3D surface imaging using the Morpheus 3D(R) scanner is therefore a clinically acceptable method of recording facial integumental data.

Effect of Zhubin (KI9) acupuncture in reducing alcohol craving in patients with alcohol dependence: A randomized placebo-controlled trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To examine the effect of acupuncture on Zhubin (KI9) in reducing alcohol craving in alcohol-dependent patients.</p><p><b>METHODS</b>Twenty male alcohol-dependent patients were randomly assigned to two groups, a treatment group (10 cases, age 43.0±6.8 years) and a placebo group (10 cases, age 44.5±7.9 years). The treatment group was treated with real needle acupuncture on Zhubin (KI9) twice a week for 4 weeks, and the control group was treated with placebo needle acupuncture. Both groups were given acupuncture treatment using Park Sham Device (PSD). Alcohol craving was measured by the Visual Analogue Scale (VAS) before treatment to establish a baseline, and after 1, 2, and 4 weeks of treatment. Repeated measures ANOVA was used to determine the main and interaction effects of time and on the outcome measure (VAS).</p><p><b>RESULTS</b>There was a significant effect of time on VAS score (df=3, F=13.3, P<0.01). Main effect of group on VAS score was significant (df=1, F=10.9, P<0.01) and the time×group interaction was also significant (df=3, F=4.7, P<0.01).</p><p><b>CONCLUSIONS</b>Real-needle acupuncture therapy on Zhubin (KI9) showed effectiveness in reducing alcohol craving. These results strongly suggest the usefulness of acupuncture therapy on Zhubin (KI9) in preventing a relapse in alcohol dependent patients.</p>

Psychophysiological Characteristics of Insomnia Patients Measured by Biofeedback System / 수면정신생리

BACKGROUND AND OBJECTIVES: Insomnia is the most prevalent sleep disorder in the general population and is considered to be a disorder of hyperarousal. The aim of this study was to measure the psychophysiological responses in insomnia patients using a biofeedback system, and to compare them with results from normal healthy subjects. MATERIALS AND MATHODS: Eighty patients with primary insomnia (35 males and 45 females, average age 49.71 +/- 12.91 years) and 101 normal healthy controls (64 males and 37 females, average age 27.65 +/- 2.77) participated in this study. Electromyography (EMG), heart rate (HR), skin conductance (SC), skin temperature (ST), and respiratory rate (RR) were recorded using a biofeedback system during 5 phases (baseline, stress 1, recovery 1, stress 2, recovery 2) of a stress reactivity test, and average values were calculated. Difference in values between the two groups in each corresponding phase was analyzed with independent t-test, and change in values across phases of the stress reactivity test was analyzed with paired t-test (all two-tailed, p<0.05). RESULTS: Compared to normal controls, insomnia patients had higher EMG in all 5 phases (baseline : 7.72 +/- 3.88 microV vs. 4.89 +/- 1.73 microV, t = -6.06, p<0.001 ; stress 1 : 10.29 +/- 5.16 microV vs. 6.63 +/- 2.48 microV, t = -5.84, p<0.001 ; recovery 1 : 7.87 +/- 3.86 microV vs. 5.17 +/- 2.17 microV, t = -5.61, p<0.001 ; stress 2 : 10.22 +/- 6.07 microV vs. 6.98 +/- 2.98 microV, t = -4.37, p<0.001 ; recovery 2 : 7.88 +/- 4.25 microV vs. 5.17 +/- 1.99 microV, t = -5.27, p<0.001). Change in heart rate across phases of the stress reactivity test were higher in normal controls than in insomnia patients (stress 1-baseline : 6.48 +/- 0.59 vs. 3.77 +/- 0.59, t = 3.22, p = 0.002 ; recovery 1- stress 1 : -5.36 +/- 0.0.59 vs. -3.16 +/- 0.47, t = 2.91, p = 0.004 ; stress 2-recovery 1 : 8.45 +/- 0.61 vs. 4.03 +/- 0.47, t = 5.72, p<0.001 ; recovery 2-stress 2 : -8.56 +/- 0.65 vs. 4.02 +/- 0.51, t = -5.31, p<0.001). CONCLUSION: Psychophysiological profiles of insomnia patients in a stress reactivity test were different from those of normal healthy controls. These results suggest that the sympathetic nervous system is more highly activated in insomnia patients.

Difference of the Naltrexone's Effects in Social Drinkers by Spicy Food Preference

The purpose of this study was to investigate the differences in subjective acute effects of alcohol and naltrexone among those who prefer spicy food to varying degrees. Acute biphasic alcohol effects scale (BAES), visual analogue scale for craving (VAS-C), blood alcohol concentration (BAC) and food preference scale were measured in 26 men. Repeated measures ANOVA (2 preference groupsx4 time blocks) on the stimulative subscale of BAES revealed a significant group by block interaction in naltrexone condition (N+) (P<0.001), but not in non-naltrexone condition (N-). Furthermore, repeated measures ANOVA (2 drug groupsx4 time blocks) on the stimulative subscale of BAES revealed a significant group by block interaction in strong preference for spicy food (SP) (P<0.001), but not in lesser preference for spicy food (LP). The paired t-test revealed that significant suppression of the stimulative subscale of BAES was observed at 15 min (P<0.001) and 30 min (P<0.001) after drinking when N+ compared with N- in SP. For those who prefer spicy food, the stimulative effect of acute alcohol administration was suppressed by naltrexone. This result suggests that the effect of naltrexone may vary according to spicy food preference.

Sleep and Psychological Problems in Medical Students / 수면정신생리

INTRODUCTION: Although it is well known that medical students are not getting an adequate amount of sleep, there have been only a few studies on the sleep patterns of medical students and the related factors. Therefore, the present study aimed to investigate the medical students' sleep patterns and the related factors. METHODS: A questionnaire package was administered to the 1st to 4th year medical students at one medical school. It consisted of questions asking about their lifestyles as well as Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), global assessment of recent stress scale (GASS), the center for epidemiologic studies-depression scale (CES-D), and Moudsley obsessive-compulsive inventory (MOCI). A total of 352 students (206 males and 146 females) responded to the survey and the result was analyzed using the independent t-test, the chi-square test, the paired t-test, Pearson's correlation and ANOVA. p-values of less than 0.05 were considered statistically significant in analyses. RESULTS: The weekend bedtime was significantly delayed (0 : 49 on weekday ; 1 : 34 on weekend ; t=-5.23, p<0.001), the weekend rise time was delayed (6 : 58 on weekday ; 9 : 30 on weekend ; t=-24.48, p<0.001) and the total sleep time was increased on weekends (5 : 36 on weekday ; 7 : 39 on weekend ; t=15.94, p<0.001). The PSQI score of all subjects was 6.43+/-2.64. PSQI was positively correlated with ESS (r=0.383, p<0.001), GASS (r=0.326, p<0.001), CES-D (r=0.393, p<0.001), and MOCI (r=0.247, p<0.001), but not with GPA (r=0.072, p=0.228. The more senior students had lower PSQI, GASS, CES-D, and MOCI score (p<0.05). CONCLUSION: Medical students were experiencing a lack of sleep during weekdays as they have a later bedtime and earlier rise time, and consequently had more hours of sleep on weekends. Overall, the medical students were experiencing poor sleep quality and sleep deprivation. Poor sleep quality is associated with psychological problems (daytime sleepiness, stress, depression, and obsessive tendency).

Sleep and Alcohol / 수면정신생리

Alcohol has been used as sedatives historically. The effect of alcohol on sleep is different according to its dose, timing of ingestion, and drinking frequency. Sleep problems may play a role in the development and course of alcohol-related disorders. Insomnia in alcohol-dependent patients is common and early treatment of insomnia may reduce the rate of relapse. Sleep apnea, restless legs syndrome, periodic limbs movement disorder, and altered circadian rhythm may be more frequent in this patients. Management of sleep and alcohol problems is important in treating alcohol-related disorder and sleep disorders, respectively.

Clinical Characteristics of Completed versus Non-Completed Suicide and Re-Attempt Rates in 2-4 Years / 신경정신의학

OBJECTIVES: We compared demographic and some clinical characteristics of completed and noncompleted suicide victims with those of non-completed. Additionally, we analyzed Re-attempt rates of non-completed suicides' in 22-4 years re-attempt ratesfrom index-attempt were also analyzed. METHODS: Subjects were 198 suicide victims visited admitted to the Pusan National University Hospital Eemergency medical center after attempting suicide of Pusan national university hospital during 2005.1.1-to 2006.12.31. Data In February 2009, we retrospectively collected the data on these persons were collected retrospectively in Feb. 2009 fromvia medical records and telephone interviews. We analyzed their demographic data, history of previous suicide attempts, psychiatric treatments, if any, and number of re-attempts in during the 2-4 years after the index-attempt were analyzed. RESULTS: Thirty-three were deadvictims were killed by the attempt (completed suicides), and 165 were discharged alive (non-completed suicides). Only 94 cases victims (47.5%) were consulted referred to the psychiatric department. Among the 121 survivors followedsurvivors we followed-up on, 17 (14.0%) re-attempted within 2-4 years and 2 (1.2%) were dead eventuallydied within that time frame. Twenty one (63.6%) of the 33 completed suicidesuicides, 21 (63.6%) were making their were dead by the first suicide attempt. No psychiatrist was contacted regarding these victims and did not received any psychiatric evaluation nor treatment. The completed group was characterized ascharacteristically consisted of men who were'older, married, and/or physically ill men'. Fortyfive (27.3%) of 165 non-completed suicides had previous historiesy of suicide attempts. The noncompleted group was characterized by higher rates of previous history of psychiatric treatment, psychiatric referrals, and re-attempts during the followed-up period. Sixty-five (53.7%) of the survivors received psychiatric treatments for 8.9+/-15.4 months (mean+/-SD), but their re-attempt rate (16.9%) in over 2-4 years did not significantly differ from that (10.7%) of those who did not receive treatment (10.7%). CONCLUSION: About 2/3 of completed suicides occurs at the first attempt. These cases were on in psychiatry' the blind spot, of psychiatry because most of them did not visited psychiatry receive psychiatric attention when they were alive and were not reported to the psychiatry department after death. Psychiatric autopsies on such victims arey is necessary to develop more effective suicide screening tools and preventionve programs.

A Case of Pulmonary Sarcoidosis Combined with Neurosarcoidosis / 결핵및호흡기질환

Sarcoidosis is a multi-systemic syndrome of an unknown etiology, and it is characterized by the formation of multiple noncaseating granulomas that disrupt the architecture and function of the tissues in which they reside. The most commonly affected organs are lung, skin and lymph nodes. Overt clinical involvement of the nervous system is uncommon and this occurs in about 5% of all patients during the course of their disease. The most common manifestations are granulomatous leptomeningitis, cranial nerve palsy, electrolyte or other endocrinologic abnormalities, but isolated memory impairment is a rare manifestation. This is a case of 59 years-old male with recent memory impairment, and he was previously diagnosed with pulmonary sarcoidosis by transbronchial lung biopsy. The brain MRI imaging revealed the leptomeningeal and parenchymal involvement of sarcoidosis. He was treated with high dose corticosteroid and his memory function was improved to nearly a normal level. We report here on a case of successful treatment of pulmonary sarcoidosis combined with neurosarcoidosis with using high dose corticosteroid, and the patient presented with recent memory impairment.

The Morris Water Maze Performance in Androgenized Female Rats: Sexual Dimorphisms in Spatial Memory and Effects of Testosterone / 신경정신의학

OBJECTIVES: It is widely accepted that gonadal steroids are involved in organization and activation of sexual dimorphism in the brain areas related with spatial learning. This study aimed to test the following hypothesis: 1) spatial memory is affected by sex, 2) this difference is related with brain differentiation by exposure to testosterone in the neonatal period, and/or 3) the sexual difference of spatial memory is the result of the interaction between organization of sexual dimorphism in the brain and the circulating testosterone after growing up. METHODS: Testosterone enanthate 100 microgram ('androgenized') or vehicle ('control') was randomly administered to 28 female and 25 male rat pups within 24 hour of birth. The escape latencies (EL) in Morris water maze were measured in 15 and 16 week of age with vehicle ('baseline') and with 10 micromol/kg of testosterone ('with testosterone'), respectively. Each session consisted of 10 trials, and means of the last 5 trials were analyzed. RESULTS: The baseline EL of the males were significantly shorter than females regardless of neonatal exposure to testosterone. With testosterone, EL of the androgenized females were significantly shorter than control females and comparable to those of males. CONCLUSION: Neonatal exposure to testosterone in female rats may develop a tesosterone-dependent male-like spatial learning system.

A Case of Successful Management of Sarcoidosis with Chylothorax Using Octreotide / 결핵및호흡기질환

Sarcoidosis is a multi-system granulomatous disorder of an unknown etiology and affects individuals worldwide. It is characterized pathologically by the presence of non-caseating granulomas in more than one involved organ. However, pleural involvement of sarcoidosis is rare and there are no reported cases in Korea. Traditionally, sarcoidosis has often been treated with systemic corticosteroids or cytotoxic agents. In particular, chylothorax with sarcoidosis is usually treated with corticosteroid for approximately 3~6 months, followed by repeated therapeutic thoracentesis, talc pleurodesis, dietary treatment, or thoracic duct ligation where needed. We encountered a 46 years old female patient presenting with cough, dyspnea and both hilar lymphadenopathy (stage I) on chest radiograph. The patient was diagnosed with a non-caseating granuloma, sarcoidosis by a mediastinoscopic biopsy. For one month, she had suffered from dyspnea due to right side pleural effusion, which was clearly identified as a chylothorax on thoracentesis. Corticosteroid therapy with dietary adjustment was ineffective. She was treated successfully with a subcutaneous injection of octreotide for 3 weeks and oral corticosteroid. We report a case of successful and rapid treatment of chylothorax associated with sarcoidosis using octreotide and oral corticosteroid.

Applicability of American and European Spirometry Repeatability Criteria to Korean Adults / 결핵및호흡기질환

BACKGROUND: The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. METHODS: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and FEV1 (dFEV1) from prebronchodilator spirometry. Analyses included the distribution of dFVC and dFEV1, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spirometric variability. RESULTS: About 95% of subjects were able to reproduce FVC and FEV1 within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. CONCLUSION: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.

A Case of Metastatic Hemangiopericytoma in Lung / 결핵및호흡기질환

Hemangiopericytoma is a rare neoplasm that originates from small peri-capillary spindle shaped cells called pericytes. The most common sites of origin are the thigh, the pelvis and the retroperitoneum. A primary pulmonary hemangiopericytoma is particularly unusual. However, more than 50% of hemangiopericytoma cases metastasize to the lungs, the bone, and the liver. A long-term clinical and radiological follow up is recommended due to the high risk of recurrence of a potential malignancy. We report a case of a metastatic hemangiopericytoma in the lung that had initially developed in the thigh of a 53 year-old woman 6 years ago. The authors emphasize the long-term follow-up of this type of rare sarcoma.