No abstract available.

OBJECTIVE: The few direct comparative studies of efficacy and tolerability of atypical antipsychotics have been done in patients commonly seen in clinical practice. We therefore compared, head-to-head, the relative efficacy and tolerability of two atypical antipsychotics, risperidone and quetiapine, commonly used in clinical practice nowadays. METHODS: This study used retrospective chart reviews of the patients who had been admitted to or treated at the outpatient department in a university hospital. The analysed population consisted of 55 patients with diagnoses of schizophrenia or schizoaffective disorder. RESULTS: Among the baseline characteristics, the proportion of patients with a history of previous antipsychotics medication was higher in the quetiapine group, as was the proportion of patients treated at the outpatient department, the proportion of female patients, and the mean age. Even though these baseline differences had been controlled as covariate, the proportion of responsive patients was higher, and the median value of the time to efficacy was shorter, in the risperidone group. The rate of sedation was higher in the quetiapine group and the rates of concomitant use of anticholinergics and benzodiazepines were higher in the risperidone group. However, these differences of sedation and concomitant use of anticholinergics and benzodiazepines were not statistically significant when controlling for the effect of baseline characteristics. Even though this study showed some useful results, the study limitations included the use of retrospective chart reviews and the small number of subjects at a single hospital, among others. Therefore, further studies controlling these limitations need to be done to confirm the results of this study. CONCLUSION: The proportion of responsive patients was higher and the median value of the time to efficacy was shorter in the risperidone group. The rates of extrapyramidal symptoms were not different between the two groups.
Antipsychotic Agents ; Benzodiazepines ; Cholinergic Antagonists ; Diagnosis ; Female ; Humans ; Outpatients ; Pilot Projects* ; Psychotic Disorders* ; Retrospective Studies ; Risperidone* ; Schizophrenia* ; Quetiapine Fumarate

OBJECTIVES: Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. METHODS: A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. RESULTS: 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. CONCLUSION: Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.
Adolescent* ; Alcoholism ; Surveys and Questionnaires ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Logistic Models ; Male ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Social Class ; Suicidal Ideation ; Suicide*

OBJECTIVES: The purposes of the study were to assess the unmet needs of the chronic mental ill in low income class living in community and to provide basic data for developing services and programs in community mental health. METHODS: Face to face interviews were done for the subjects (n=320) who were diagnosed as schizophrenia, major depressive disorder, and bipolar I disorder. The Korean version of Camberwell Assessment of Need Short Appraisal Scale (CANSAS) was used as the assessment tool of the needs. Frequencies and rates of met needs and unmet needs of each 22 items of CANSAS were estimated. We classified 22 items into six need areas by operational definition, and then estimated mean percentages of unmet needs and met needs for each 6 need areas. We also classified subjects into 2 groups by the presence of psychiatric care needs, and then estimated mean percentage of unmet needs for other 5 need areas according to psychiatric care needs. RESULTS: Among the respondents, 77.7% of them had no spouses, and 66.4% had the education of six years and over. Of the respondents, 53.8% were males, 46.2% females. And 74.3% used medical aid in social security. Most respondents did not have present occupations and persons who were living with their parents were 48.3% and persons living alone reached 8%. The diagnosis of schizophrenia was 60.9%, major depressive disorder 15.2%, respectively. Most respondents (73.6%) had been admitted to the hospitals, but they hardly used rehabilitation services or programs during the daytimes. In estimating the unmet needs for each 22 items of CANAS, the need of company of others was the highest and that of welfare benefit and daytime activity were next. Information for treatment, intimate relationship, psychological distress, money, and psychotic symptoms follow the order. The mean percentages of unmet needs for each 6 needs area were 29.5% for income needs, 26.9% for social relation needs, 17.0% for physical care needs, 14.2% for psychiatric care needs, 11.6% for daily living skill needs, and 9.6% for residency needs. We classified subjects into 2 groups by the presence of psychiatric care needs: 49% of the subjects had no psychiatric care needs and 51% had psychiatric care needs. The group that had psychiatric care needs also had higher mean percentage of unmet need in 5 other needs areas than group that had no psychiatric care needs. And these results showed statistically significant except residency needs area. CONCLUSION: When preparing services or programs in community mental health, occupational rehabilitation and social support should be included as basic services. Other services such as physical treatment, psychiatric treatment, social skill training, and residency could be considered as optional.
Surveys and Questionnaires ; Depressive Disorder, Major ; Diagnosis ; Education ; Female ; Humans ; Internship and Residency ; Male ; Mental Health ; Mentally Ill Persons* ; Needs Assessment* ; Occupations ; Parents ; Rehabilitation ; Schizophrenia ; Social Security ; Spouses

No abstract available.
Immunotherapy*

OBJECTIVES: This study was performed to investigate the factors predicting recidivism within 6 months after release in arrested juvenile delinquents for proper screening and intervention of high-risk subjects. METHODS: The subjects consisted of 125 arrested male adolescents who were released after legal procedure in prosecutor office and court. The socio-demographic and crime-related characteristics were evaluated by police records, and the familial, psychopathology and personality characteristics, and the level of moral development measured by the Conflict Tactics Scale(CTS), Family Environment Scale(FES), Parental Behavioral Inventory, Symptom Checklist-90-Revised(SCL-90-R), Beck Depression Inventory, Beck Anxiety Inventory, Korean form of Moral Developmental Inventory for adolescents, and Personality Disorder Questionnaire-Revised(PDQ-R). RESULTS: The recidivism rate within 6 months after release was 44% of the initial sample. Recidivists were younger and had higher scores on Anger-hostility scale of SCL-90-R and lower principle morality score than nonrecidivists. More recidivists had history of physical abuse and antisocial personality disorder on PDQ-R than nonrecidivists. They also showed the crimerelated characteristics of lower percent of violence crime, higher incidence of previous conviction, younger age of the first crime. Among those variables, logistic regression showed that age of first crime, antisocial personality disorder, and history of physical abuse best predicted the recidivism within 6months after release. CONCLUSION: These results of present study suggest that the recidivism rate of arrested male adolescents is very high, and the age of first crime, antisocial personality disorder and history of physical abuse were key factors predicting recidivism. To prevent repeated crime of delinquent adolescents, the development of programs for those high-risk groups to help rehabilitation and adaptation in community would be essential.
Adolescent* ; Antisocial Personality Disorder ; Anxiety ; Crime ; Depression ; Humans ; Incidence ; Logistic Models ; Mass Screening ; Moral Development ; Morals ; Parents ; Personality Disorders ; Police ; Psychopathology ; Rehabilitation ; Violence

PURPOSE: Anomalies in the thyroglossal duct are the most common midline, or paramedian cervical lesions of congenital origin. Presenting as a thyroglossal duct cyst (TGDC) or a thyroglossal duct sinus (TGDS), they are found in all age groups. This clinical study was intended to elucidate the clinical characteristics, and the outcomes, of surgical treatment of these anomalies. METHODS: Between January 1992 and May 2002, 91 patients underwent surgery for a TGDC or a TGDS at 4 hospitals affiliated to Hallym University. The demographics of the patients, the clinical characteristics of the lesions, and the outcomes of the treatments were retrospectively evaluated. These characteristics were evaluated according to age groups; younger than 15 (38 patients) and older than 15 (53 patients) years. RESULTS: The male to female ratio was 1.67: 1 (It is better to give the actual figures.), with the first decade showing the highest incidence in the age distribution (33%). Painless masses (83.6%) were the most common presenting symptom, with most symptoms having been manifest for less than 1 year (67%). TGDCs were 90% and TGDSs were 10%. There were 62 cases of infrahyoid and 18 of suprahyoid lesions, with 80 cases on the midline and 11 on the paramedian within 2 cm from the midline. Of the paramedian lesions, 2 cases were in the younger group and 9 were in the older group. This tendency of laterality in the location by age group showed no statistical significance (p=0.172). All the patients underwent a Sistrunk operation, and one experienced a recurrence. CONCLUSION: This study justified the Sistrunk operation as the treatment of choice for anomalies of the thyroglossal duct. The lateral lesions occurred in the old age groups more frequently. A careful approach is needed with paramedian cervial lesions in adults to avoid the loss of the proper treatment of possible hidden congenital lesions.
Adult ; Age Distribution ; Demography ; Female ; Humans ; Incidence ; Male ; Recurrence ; Retrospective Studies ; Thyroglossal Cyst*

Background and Objectives: MYC, also known as an oncogenic reprogramming factor, is a multifunctional transcription factor that maintains induced pluripotent stem cells (iPSCs). Although MYC is frequently upregulated in various cancers and is correlated with a poor prognosis, MYC is downregulated and correlated with a good prognosis in lung adenocarcinoma. MYC and two other MYC family genes, MYCN and MYCL, have similar structures and could contribute to tumorigenic conversion both in vitro and in vivo. Methods: and Results: We systematically investigated whether MYC family genes act as prognostic factors in various human cancers. We first evaluated alterations in the expression of MYC family genes in various cancers using the Oncomine and The Cancer Genome Atlas (TCGA) database and their mutation and copy number alterations using the TCGA database with cBioPortal. Then, we investigated the association between the expression of MYC family genes and the prognosis of cancer patients using various prognosis databases. Multivariate analysis also confirmed that co-expression of MYC/MYCL/MYCN was significantly associated with the prognosis of lung, gastric, liver, and breast cancers. Conclusions Taken together, our results demonstrate that the MYC family can function not only as an oncogene but also as a tumor suppressor gene in various cancers, which could be used to develop a novel approach to cancer treatment.

Gastritis cystica profunda (GCP) is a disease characterized by gastric foveolae elongation along with hyperplasia and cystic dilatation of the gastric glands extending into the tisssue beneath the submucosa. It mainly occurs on the site of gastroenterostomy, but can occasionally be found in an unoperated stomach. GCP may present as a submucosal tumor or polyp, and rarely a giant gastric mucosal fold. This lesion has traditonally been regarded as a benign lesion. However, there are many debates over its malignant potential. Further investigations on the relation between GCP and gastric carcinoma may be necessary. To our knowledge, this is the second description of adenocarcinoma arising from GCP in an unoperated stomach.
Adenocarcinoma* ; Dilatation ; Gastric Mucosa ; Gastritis* ; Gastroenterostomy ; Hyperplasia ; Polyps ; Stomach

Inferior sinus venosus type atrial septal defect (ASD) is a rare congenital cardiac deformity that occurs between the inferior vena cava and right atrium. Inferior sinus venosus defect is difficult to diagnose through transthoracic echocardiography because of its location which is infero-posterior to the fossa ovalis. Increasing pulmonary arterial pressure and pulmonary vascular resistance in patients with sinus venosus defect usually occur earlier than other types of ASD. We report a case of 19-year-old man who presented exertional dyspnea due to inferior sinus venous type ASD with mild pulmonary hypertension. In this case, we found clues from slight diastolic flattening of interventricular septum and shortened acceleration time of right ventricular outflow tract on initial transthoracic echocardiography, leading right heart catheterization and transesophageal echocardiography to reveal this rare type of ASD.
Acceleration ; Arterial Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Congenital Abnormalities ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Heart Atria ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Vascular Resistance ; Vena Cava, Inferior ; Young Adult