National Estimates of Narcolepsy in Korea

Hea Ree Park,Pamela Song,Seo-Young Lee 대한신경과학회 2023 Journal of Clinical Neurology Vol.19 No.1

Background and Purpose Epidemiological data on narcolepsy are rare in South Korea. We aimed to provide an overview of the burden of narcolepsy and its temporal trend in South Korea. Methods Patients with narcolepsy were identified by their registration in the Rare and Intractable Disease (RID) register and the Health Insurance Review and Assessment database. Individuals registered in the RID program with the code V234 were considered as having ‘definite narcolepsy’, while those who claimed health insurance with G47.4 as the primary diagnostic code were considered as having ‘probable narcolepsy’. We estimated the annual prevalence, incidence, and medical costs of narcolepsy between 2010 and 2019. Results The prevalence of definite narcolepsy was 8.4/100,000 in 2019, peaking at 32.0/100,000 in those aged 15–19 years. The prevalence was higher in males, with a relative risk of 1.72. The prevalence has increased over the past 6 years, with an average annual growth rate (AAGR) of 12.2%. The prevalence of probable narcolepsy was 10.7/100,000 in 2019. The incidence of definite narcolepsy increased up to 1.3/100,000 in 2019 with an AAGR of 7.1%. Annual medical expenditure for definite narcolepsy gradually increased up to 4.1 billion KRW in 2019, with a compound annual growth rate of 11.9%. Conclusions This study has provided the first nationwide estimates for narcolepsy in South Korea. The prevalence of diagnosed narcolepsy in South Korea was at the low end of the range of narcolepsy prevalence rates reported for other countries. However, the prevalence and incidence have been steadily increasing over the past decade.

제대 염전을 동반한 단일 양막성 쌍태임신에서 sulindac 사용을 통한 양수감량과 초음파를 이용한 집중적 태아감시 후 양측 태아 모두 생존 출생한 1예

박혜리 ( Hea Ree Park ),김현철 ( Hyun Chul Kim ),문명진 ( Myoung Jin Moon ),장성운 ( Sung Woon Jang ),강석호 ( Suk Ho Kang ),안은희 ( Eun Hee Ahn ),백민정 ( Min Jung Baek ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.10

일양막성 쌍태임신은 일란성 쌍태임신의 드문 형태로 주산기 사망률이 약 30~70%로 높다. 특히 제대 염전 발생하였을 경우에 태아의 사망률이 50% 이상에 달하기 때문에, 일양막성 쌍태아에서 제대 사고를 감소시키기 위한 적극적인 치료는 무엇보다 중요하다. 본 증례는 산전에 제대 염전이 발견된 단일 양막성 쌍태임신에서, 28주부터 sulindac을 사용한 양수 감량과 초음파 및 태아 전자감시를 이용하며 집중적 태아 감시를 시행하여, 임신 32주 4일에 계획적 제왕절개술 후 양측태아 모두 건강히 생존 출생하였기에 문헌 고찰과 함께 보고하는 바이다. Monoamniotic twin pregnancies are relatively rare, but perinatal mortality is high about 30-70%. The major cause of fetal death is cord accident, congenital anomalies, twin-twin transfusion syndrome, and intrauterine growth restriction. Especially cord entanglement occurs; perinatal mortality is about 50%. So the active management of monoamniotic twins to reduce the complication of cord entanglement is important. This is a case of monoamniotic twin pregnancy with cord entanglement and both fetuses survival by elective cesarean section at 32+4 weeks after medical amnioreduction and intensive fetal surveillance.

자궁각임신에서 질식초음파 유도하에 KCl과 MTX의 국소투여법을 통한 치료방법

박혜리 ( Hea Ree Park ),문명진 ( Myoung Jin Moon ),신승주 ( Seung Joo Shin ),장성운 ( Sung Woon Jang ),안은희 ( Eun Hee Ahn ),정상희 ( Sang Hee Jung ),심성신 ( Sung Shin Shim ),강석호 ( Suk Ho Kang ),김현철 ( Hyun Chul Kim ),황윤 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.1

목적: 자궁각임신의 치료에 있어서 질식초음파나 복강경 유도하에 KCl과 MTX의 국소투여를 통한 치료방법의 효용성과 안정성에 대해 알아보고자 한다. 연구 방법: 2005년부터 2007년 8월까지 분당차병원 산부인과에서 자궁각임신으로 진단받은 환자에서 질식초음파나 복강경 유도하에 KCl과 MTX의 국소투여를 시행한 8명의 환자를 후향적으로 조사하였다. 결과: 처음 내원당시 평균 β-hCG는 53,331.6 mIU/mL (14,332~125,721 mIU/mL)이었다. 진단 당시 평균 임신주수는 48.3일 (40~65일)이었다. 8명 중 2명은 복합임신인 경우였다. 이 중 6명은 질식초음파 유도하에 KCl과 MTX를 국소투여 하였으며, 3명은 복강경과 질식초음파 유도하에 국소투여하였고, 2명에서는 MTX의 전신 요법을 병행하였다. 모든 시술 후에는 태아의 심박동이 완전히 정지한 것을 확인하였으며, 이후 초음파와 β-hCG혈액검사를 통해 추적 관찰하였다. 모든 경우에서 성공하였으며, 이후 β-hCG추적 조사에서 급격히 감소하는 것을 관찰할 수 있었다. 복합 임신 2예에서는 시술 이후 자궁내임신을 유지하여 모두 만삭에 성공적으로 분만을 할 수 있었다. 결론: 자궁각임신에서 혈액학적으로 안정적인 환자에 있어서 MTX나 KCl를 국소주입함으로써 안전하고 효율적으로 치료할 수 있을 뿐만 아니라 자궁각임신을 동반한 복합 임신에서는 KCl을 국소주입함으로써 자궁내임신을 유지함에 있어서 매우 효과적인 방법임을 알 수 있었다. Objective: To evaluate efficacy and safety of local injection of potassium chloride (KCl) and methotrexate (MTX) in the treatment of cornual pregnancy. Methods: We retrospectively reviewed all cases of cornual pregnancy treated conservatively from 2005 through August 2007. Eight cases were identified and two cases were heterotopic interstitial pregnancy. All cases were managed with local injection of KCl or methotrexate under ultrasound guidance and 2 cases were treated with intra-muscular injection of MTX in combination. After the procedure all cases with cardiac activity was confirmed to be aborted by ultrasound. Also serial follow-up sonographic examination and serum β-hCG measurement were performed. Results: The mean initial β-hCG level was 53,331.6 mIU/mL and ranged from 14,332 mIU/mL to 125,721 mIU/mL. Mean gestational age was 48.3 days from 40 to 65 days. All cases were aborted successfully and follow up β-hCG were declined abruptly. Two cases of hetero-topic pregnancy resulted in successful deliveries at full term. Conclusion: Cornual resection or hysterectomy should no longer be the first line of treatment for hemodynamically stable patients with cornual pregnancy. They can be successfully treated through local injection of MTX or KCl by ultrasound guidance.

Effects of Organic Light-Emitting Diodes on Circadian Rhythm and Sleep

Jo Hyunjin,Park Hea Ree,Choi Su Jung,Lee Soo-Youn,Kim Seog Ju,Joo Eun Yeon 대한신경정신의학회 2021 PSYCHIATRY INVESTIGATION Vol.18 No.5

Objective Organic light-emitting diodes (OLEDs) emit less blue light than traditional light-emitting diodes (LEDs), and we previously found that early-night OLED light exposure (LE) delays the melatonin phase by less than LED at a color temperature of 4,000 K. As a follow-up study, we investigated the effects of OLED and LED at a different color temperature (3,000 K) on melatonin profile, sleep, and vigilance.Methods 24 healthy subjects (27.5±5.1 years) were exposed to three light conditions [OLED, LED, and dim light (DL)] from 17:30 to 24:00, in a random order and with a 1-week interval. Saliva samples for melatonin were taken every hour from 18:00 to 24:00. Polysomnography (PSG) and a psychomotor vigilance test (PVT) were performed.Results Melatonin onset time was significantly delayed under OLED and LED compared with DL, with no significant difference between OLED and LED. The mean melatonin level at 24:00 under LED was lower than that under DL, but there was no significant difference between OLED LE and DL. The percentage of slow wave sleep (N3) in LED was significantly lower than in OLED.Conclusion Exposure to light in the evening can suppress melatonin secretion late at night and disturb deep sleep, and those effects are slightly worse under LED than OLED.

A Sensitive and Specific Liquid Chromatography-Tandem Mass Spectrometry Assay for Simultaneous Quantification of Salivary Melatonin and Cortisol: Development and Comparison With Immunoassays

Shin Sunghwan,Oh Hyeonju,Park Hea Ree,Joo Eun Yeon,이수연 대한진단검사의학회 2021 Annals of Laboratory Medicine Vol.41 No.1

Melatonin and cortisol are clinically important for diagnosing sleep and mood disorders. We developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for simultaneous measurement of salivary melatonin and cortisol concentrations according to the Clinical and Laboratory Standards Institute guidelines. Additionally, we compared the LC-MS/MS assay with immunoassays, ELISA (Direct Salivary Melatonin Elisa EK-DSM, Bühlmann Laboratories AG, Schönenbuch, Switzerland) and electrochemiluminescence immunoassay (Cortisol II, Roche, Mannheim, Germany), using 121 saliva samples. The LC-MS/MS assay exhibited good performance in terms of linearity, precision, accuracy, limit of detection, lower limit of quantification, extraction recovery, carry-over, and matrix effect. The LC-MS/MS assay and immunoassays showed strong correlation (Pearson’s r=0.910 for melatonin, r=0.955 for cortisol), but demonstrated a significant mean bias of 23.2% (range 54.0–143.7%) for melatonin and 48.9% (range 59.7–184.7%) for cortisol. Our LC-MS/MS assay provided more sensitive and reliable salivary melatonin and cortisol quantification results compared with immunoassays.

Case Report : A case of Full Term Delivery After Selective Fetocide with Potassium Chloride in Heterotopic Cornual Pregnancy

( Eun A Kim ),( Myoung Jin Moon ),( Hea Ree Park ),( Eun Hee Ahn ),( Sang Hee Jung ),( Sung Woon Chang ),( Young Sin Park ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.7

Heterotopic pregnancy is the simultaneous occurrence of intrauterine and ectopic gestations. Possible risk factors include past pelvic inflammatory disease, previous pelvic surgery, or uterine anomalies. Its incidence is very rare, 1 in 30,000 in natural pregnancies but it has been increased in frequency by the advent of assisted reproductive technology. In cases of heterotopic pregnancy with intrauterine pregnancy and ectopic pregnancy, the diagnosis can be even more difficult. And the management of heterotopic pregnancy still remains controversial. We have experienced a case of heterotopic pregnancy with cornual pregnancy after in vitro fertilization and embryo transfer. which was successfully treated by selective fetocide with ultrasonographically guided potassium chloride injection of cornual pregnancy while maintaining the viabillity of the intrauterine gestation.

무심장 쌍둥이 임신에서 고주파 융해술 후 정상 태아 생존 출생한

장지현 ( Ji Hyon Jang ),문명진 ( Myoung Jin Moon ),박혜리 ( Hea Ree Park ),안은희 ( Eun Hee Ahn ),정상희 ( Sang Hee Jung ),이유미 ( Yu Mi Lee ),김은아 ( Eun A Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.5

Acardiac twin is a rare anomaly that occurs 1% in monochorionic twins and 1 in 35,000 pregnancies overall. Acardiac twin, also known as twin-reversed arterial perfusion (TRAP) sequence, involves a “pump” or donor twin perfusing a recipient or “acardiac” twin through vascular (usually arterial-arterial and venous-venous) anastomoses. Perinatal mortality rate for the pump twin has been reported to be 50~75%, mainly as a result of polyhydramnios, preterm labor, and congestive heart failure. Therefore, occlusion of the circulation to the acardiac twin has been recommended to improve perinatal outcome of the pump twin. Radiofrequency ablation of the acardiac twin effectively protects the pump twin from high-output cardiac failure and death. We report our experience in the treatment of patients with TRAP sequence using radio frequency ablation to stop perfusion to the acardiac twin.

산전진단된 중복홀배수체 염색체 이상 48, XXY, +21의

김영란 ( Young Ran Kim ),장성운 ( Sung Woon Chang ),정상희 ( Sang Hee Jung ),문명진 ( Myoung Jin Moon ),박혜리 ( Hea Ree Park ),장지현 ( Ji Hyon Jang ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.12

The occurrence of double aneuploidy in the same individual is a relatively rare phenomenon and the incidence varies according to the literature. We report an exceptional case of double aneuploidy with an additional chromosome 21 characteristic of Down syndrome and an additional XXY complement characteristic of Klinefelter syndrome. In this woman the first-trimester screening test, nuchal translucency was 3.8 mm. Then early genetic diagnosis by chorionic villi sampling was done. The result was double aneuploidy (48, XXY, +21) and the pregnancy resulted in a spontaneous abortion at 13th weeks of gestation. We report a case of double aneuploidy with a review of the literature of other cases of Down-Klinefelter double aneuploidy to determine the prevalence, phenotype, sonographic findings, and pathogenesis.

장을 침범한 자궁내막증에 의해 야기된 장폐색

신지은 ( Ji Eun Shin ),나영정 ( Young Jeong Na ),이찬 ( Chan Lee ),정상근 ( Sang Guen Jung ),박혜리 ( Hea Ree Park ),김태헌 ( Tae Heon Kim ),황윤영 ( Yeun Young Hwang ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.11

Endometriosis is a common disease in women of reproductive age, intestinal involvement has been estimated to occur in 3% to 37% of women with endometriosis, in rectosigmoid colon, appendix, ileum and cecum, in order of decreasing frequency. On the other hand, endometriosis of the small bowel, especially symptomatic small bowel involvement, is very unusual. Endometriosis is a rare cause of intestinal obstruction, and preoperative diagnosis is very difficult. It should be considered in the differential diagnosis of women of reproductive age who present with symptoms of obstruction. The definitive treatment includes resection of the involved segment with primary anastomosis. We report a 34-year-old woman following up infertility and ovarian endometrioma. She had nausea, vomiting and low abdominal pain who was operated on acute intestinal obstruction. Pathologic finding was endometriosis involving the ileum, cecum, appendix We present the case with a brief review of literature.