Ho Jang Kwon

1-Hz low frequency repetitive transcranial magnetic stimulation in children with Tourette's syndrome.

The aim of the current study was to assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA) of the cortex to children with Tourettes syndrome (TS), if rTMS over the SMA had positive effects on ameliorating tics. We designed a pilot open label 12 weeks cohort study to assess the efficacy of rTMS with TS at specific regions. We administered rTMS over SMA with slow frequency to children with TS. We examined 10 male children (mean age 11.2 ± 2.0 years) diagnosed with TS according to the Diagnostic and Statistical Manual of Mental Disorders version IV and Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version. Children with TS were treated with active rTMS to the SMA for 10 daily sessions (1 Hz, 100% of motor threshold, and 1200 stimuli/day). All subjects completed the study with no side effects and no worsening of ADHD or depressive and anxiety symptoms. Tic symptoms improved significantly over the 12 weeks of the study. Statistically significant reductions were seen in the Yale Global Tourettes Syndrome Severity Scale (YGTSS) and Clinical Global Impression (CGI). Low-frequency rTMS over the SMA appears to be effective in children with TS. Further studies using repetitive transcranial magnetic stimulation in TS are warranted, using blinded, balanced, and parallel designs. rTMS over the SMA to children with TS might result in a significant clinical improvement and a normalization of both the hemisphere hyperexcitability.

The Effects of Chronic Exposure to Aircraft Noise on the Prevalence of Hypertension

Exposure to environmental noise has been suggested to increase the prevalence of hypertension. The present study investigated whether or not chronic exposure to military aircraft noise is related to an increased prevalence of hypertension. The study population consisted of 137 subjects (mean age 60±14 years) who lived within 5 km of a helicopter airbase and 486 subjects (58±16 years) living within 5 km of a fighter-jet airbase. A control group consisted of 252 subjects (58±16 years) not exposed to aircraft noise. Overall, the subjects exposed to military aircraft noise had a higher prevalence of hypertension than those in the control group (p=0.037). However, whereas those exposed to helicopter noise had a higher prevalence than the control group (p=0.020), those exposed to fighter-jet noise did not (p=0.094). The prevalence of known hypertension in the helicopter group was higher than in the control group (p=0.024). The prevalence odds ratio for hypertension adjusted for age, gender, body mass index, current smoking, alcohol intake, diabetes, and regular exercise was 1.62 (95% confidence interval [95% CI], 1.02–2.59) for the subjects exposed to helicopter noise, and 1.23 (95% CI, 0.87–1.74) for those exposed to fighter-jet noise. In conclusion, the results of the present study suggest that chronic exposure to military aircraft noise may be associated with hypertension. The difference in the effects between helicopter and fighter-jet noise implies that different kinds of noise will have different influences on the prevalence of hypertension.

The associations between ADHD and asthma in Korean children

BackgroundThe aim of this study was to investigate the associations between attention deficit hyperactivity disorder (ADHD), the most common neuropsychiatric disorder in school children, and childhood allergic disease by evaluating their respective prevalence.MethodsSubjects were comprised of first and second grade students in twenty two elementary schools in a city in the Republic of Korea. The mode of measurement for ADHD was based on DSM-IV from clinical interviews conducted by child psychiatrists. Along with the diagnostic interviews, we also used the epidemiological questionnaires, Computerized Attention Deficit-Hyperactivity Disorder Diagnostic System, the abbreviated Conner’s Parent Rating Scale (CPRS), and DuPaul’s ADHD Rating Scales. Allergic conditions, such as asthma, have been separately evaluated based on the questionnaire items whose validity and reliability were proved by the International Study of Asthma and Allergies in Children (ISAAC). All questionnaires were completed by the subjects’ parents.ResultsThe lifetime prevalence rate of asthma in ADHD patients was 36.6%, compared to a prevalence of 24.3% in control subjects. The lifetime prevalence rate of allergic rhinitis in ADHD patients was 59.0%, compared to a prevalence of 47.0% in control subjects. Statistically significant difference has been found between the two groups. In the logistic regression model of the ADHD and the control group, the relative risk of asthma was 1.60 times higher (confidence interval 1.301-1.964), the relative risk of allergic rhinitis was 1.38 times higher (confidence interval 1.124-1.681), which showed statistical significance.ConclusionsThe findings of this study suggest significant association between ADHD and childhood asthma and allergic rhinitis. Therefore, appropriate evaluation and treatment are needed for asthmatic children with attention-deficit symptoms, or allergic rhinitis with ADHD. Besides, further research is needed to determine the etiological approach towards ADHD, asthma, and allergic rhinitis.

Study on the Health Status of the Residents near Military Airbases in Pyeongtaek City

OBJECTIVES We conducted an epidemiologic survey to evaluate the effect of the aircraft noise exposure on the health of the residents near the military airbases in Pyeongtaek City. METHODS The evaluation of environmental noise level, questionnaire survey, and health examination were performed for 917 residents. The study population consisted of four groups: subjects who lived in the village close to the fighter airbase (high exposure), subjects who lived along the course of fighters (intermediate exposure), and subjects near a helicopter airbase, and the control group. RESULTS The prevalence of the aircraft noise related accident and irritable bowel syndrome in the exposure groups were higher than that of the control group. The risks of noise induced hearing loss, hypertension and diabetes mellitus were higher in the exposed groups than in the control group. The prevalence of anxiety disorder and primary insomnia were higher in the exposed groups than in the control group. Prevalence odd ratios of the risk for primary insomnia after adjusting age, sex, agricultural noise, and occupation were 4.03 [95% confidence interval (95% CI) 1.56-10.47] for the subject near the helicopter airbase, 1.23 (95% CI 0.40-3.76) for those intermediately exposed to fighter noise, and 4.99 (95% CI 2.14-11.64) for those highly exposed to fighter noise. CONCLUSIONS The results of the present study suggest that the aircraft noise may have adverse effects on hearing function, cardiovascular health and mental health. Therefore, it seems to be needed to take proper measures including the control of the aircraft noise and the management of the exposed peoples health.

Association of mitochondrial DNA 10398 A/G polymorphism with attention deficit and hyperactivity disorder in Korean children

Mitochondria are subcellular organelles that contribute to aerobic ATP generation by oxidative phosphorylation (OXPHOS). Previous studies reported that mitochondrial dysfunction and deficiency caused by mitochondrial DNA polymorphisms is associated with various diseases. Especially, mitochondrial DNA 10398 A/G polymorphism is known to affect the regulation of mitochondrial calcium levels related to energy production, and its association with psychiatric disorders such as schizophrenia and bipolar disorder has been reported. However, there are no reports on the genetic relationship between mitochondrial DNA polymorphisms and ADHD. Thus, we evaluated the genetic association between 10398 A/G polymorphism and ADHD in the Korean children. Genotype frequency differences between the case and the control were assessed using Chi-square tests. Independent t-test was used to estimate the effects of genotype on Behavior Assessment System for Children (BASC-2) scales in ADHD children. Our results showed that mitochondrial DNA 10398 A/G polymorphism was significantly associated with the ADHD children (p<0.05). Stratified analyses for gender and subtypes showed a marginal trend toward significance (boys: p=0.059, and combined subtype: p=0.068, respectively). In the BASC-2 analysis, the 10398 A/G polymorphism was significantly associated with aggression behavior and leadership in ADHD boys (p<0.05). These findings suggest that the mitochondrial DNA 10398 A/G polymorphism play a possible role in the genetic etiology of ADHD in Korean children. Larger sample set and functional studies are necessary to further elucidation of our findings.

Genetic associations between ADHD and dopaminergic genes (DAT1 and DRD4) VNTRs in Korean children

It is well known that dopaminergic genes affect the development of attention deficit hyperactivity disorder (ADHD) in various populations. Many studies have shown that variable number tandem repeats (VNTRs) located within the 3′-untranslated region of DAT1 and in exon 3 of DRD4 are associated with ADHD development; however, these results were inconsistent. Therefore, we investigated the genetic association between two VNTRs and ADHD in Korean children. We determined the VNTRs using PCR. We examined genotype and allele frequency differences between the experimental and control groups, along with the odds ratios, using Chi square and exact tests. We observed a significant association between the children with ADHD and the control group in the 10R/10R genotype of DAT1 VNTRs (p = 0.025). In addition, the 11R allele of DAT1 VNTRs showed a higher frequency in the control group than in the ADHD group (p = 0.023). Also, the short repeat (without 11R) and long repeat alleles (including 11R) were associated with ADHD (p < 0.05). The analysis of DRD4 VNTRs revealed that the 2R allele is associated with ADHD (p = 0.025). A significant result was also observed in long and short repeats (p < 0.05). Additionally, ADHD subtypes showed that the DRD4 VNTRs are associated with combined and hyperactive-impulsive subtype groups (p < 0.05). Therefore, our results suggest that DAT1 VNTRs and DRD4 VNTRs play a role in the genetic etiology of ADHD in Korean children.