This study investigated the antidepressant efficacy and it's impact on the quality of life of depressed patients. We performed Hamilton Depression Rating Scale(HDRS), and Montgomery-Asberg Depression Rating Scale(MADRS), and Health-related Quality of Life Questionnaire(HQLQ) to both tricyclic antidepressant(TCA) and sertraline groups. There were 16 subjects in the study. The tricyclic group had 9 subjects and the sertraline group had 7. The TCA and sertraline produced a similar degree of response. Both groups experienced a reduction of 70% or more in mean HDRS and MADRS total score after 6wks. In HQLQ, the TCAs group also showed improved bed disability days, alertness behavior, and social interaction, the sertraline group showed improved health perception, alertness behavior, home management, and social interaction. We suggested that the improvement of "Quality of life" were not in proportion to the clinical symptom's improvement. Therefore, clinicians should consider the benefit of antidepressant treatment in terms of quality of life.
Depression ; Humans ; Interpersonal Relations ; Quality of Life* ; Sertraline

The phamacotherapy of depression has reduced morbidity and improved outcome for many depressive patients. A wide range of classical and new antidepressants are available for their treatment. However, 30-40% of all patients do not respond sufficiently to the initial treatment and present adverse effects. Pharmacogenetics studies the genetic basis of an individual's ability to respond to pharmacotherapy. Recently, some reports on serotonin transporter gene polymorphisms and their influence on the response to antidepressive therapy provide an interesting diagnostic tool in assessing the chances of response to antidepressants. We also investigated the relationship between serotonin transprter polymorphisms(5-HTTLPR) and the long-term effect of the antidepressant treatment. 128 depressive patients were enrolled into 2nd year study. The therapeutic response of each subset was not different at 8th, 16th week. but the subset with homozygote(l/l) of long variant showed a better therapeutic response to antidepressant than the heterozygote(l/s) of long and short variant, which showed a better therapeutic response than the subset with homozygote(s/s) of short variant at 1st year and 2nd year after the antidepressant treatment. This result shows that the serotonin transporter polymorphisms may be related to the long-term effect of antidepressant treatment. The potential for pharmacogenomics. the use of genetic increasing attention pharmacogenomics will contribute to individualize drug choice by using genotype to predict positive clinical outcomes, adverse reactions, and levels of drug metabolism. Personalized medicine the use of marker-assisted diagnosis and targeted therapies derived from an individual molecular profile, will impact the antidepressant therapy and this approach will replace the traditional trial-and-error practice of medicine.
Antidepressive Agents ; Depression ; Depressive Disorder* ; Diagnosis ; Drug Therapy ; Genotype ; Humans ; Precision Medicine ; Metabolism ; Pharmacogenetics* ; Serotonin ; Serotonin Plasma Membrane Transport Proteins

No abstract available.
Aneurysm, False* ; Arteries* ; Fractures, Bone*

Miescher syndrome comprises congenital acanthosis nigricans, hypertrichosis, failure to thrive and short stature, dysmorphism especially of the jaws and oral cavity, insulin-resistant diabetes mellitus, and a characteristic general appearance. This report concerns a rare case of 12-year-old girl having insulin resistant diabetic mellitus with Miescher syndrome. The relevant literature was reviewed.
Acanthosis Nigricans ; Child ; Diabetes Mellitus* ; Failure to Thrive ; Female ; Humans ; Hypertrichosis ; Insulin ; Jaw ; Mouth

Summary: Forty three cases of the pigmentary degeneration of the retina (P.D.R.) visited N.M.C. from Nov. 1958 to Sept. 1964 were analysed clinically in regard to various factors which were also based on a review of litrature. The results of the study include following findings. 1. Among 43 cases, retinitis pigmentosa binocular were the largest (25), Laurens-Moon-Biedl Syndrome (3), Macular Involvement (2), Retinitis Pigmentosa sine pigment (2), Retinitis Pigmentosa monocular (1). 2. 6-15 years group is exceedingly largest in regard to the age of the onset. 3. Male is exceedingly prevalent (32) than female(11). 4. 51-60 years old group is the largest in regard to the duration of illness. 5. The known cases through the family history was only 10. The mode of heredity seems to be rather prevalent as recessive than dominant but the group is too small to make a definite decision. 6. Pigmentary deposits in the retina was the largest in regard to the ophthalmoscopic findings. Coneen tric contraction is the the largest as to the visual field changes. 7. Cataract is the largest (24 cases), myopia (12 cases) in the next, as to the complications. 8. As to the symptoms of the Laurens-Moon-Biedl Syndrome, Obecity, Retinitis Pigmentosa, and Mental retardation is found in all cases, but Polydactly in 2 cases, and Genital dystrophy in 1 case. None of cases were specifically related to this disease through the family history.
Cataract ; Heredity ; Humans ; Intellectual Disability ; Male ; Myopia ; Retina* ; Retinitis Pigmentosa ; Telescopes ; Visual Fields

BACKGROUND: This study was performed to evaluate our experience on laparoscopic appendectomy. METHODS: Retrospective analysis was performed on 2,856 patients who had been operated by laparoscopic appendectomy under diagnosis of acute appendicitis at the Sung-Ae Hospital and Kwang-Myoung Sung-Ae Hospital from October 1991 to July 1998. RESULTS: Among 2,856 patients who had undergone laparoscopic appendectomy,2,379 patients (83.3%) were operated due to simple acute appendicitis, 275 patients (9.6%) due to perforated appendicitis. Operation time was 44.6 minutes for simple acute appendicitis and 60.3 minutes for perforated appendicitis. In perforated appendicitis, intra-peritoneal irrigation and drain insertion was performed. The length of hospital stay in patient with simple acute appendicitis was 3.7 days (5.82 days in conventional appendectomy) and patients with perfotrated appendicitis was 6.1 days (9.91 days in conventional appen-dectomy). Complications such as wound infection, intra-abdomen abscess, trocar site bleeding, subcutaneous emphysema developed in 43 (1.5%) patients (79/1,947, 4.5% in conventional appendectomy). In 202 (7.1%) patients, appendix was normal, but another diseases were detected, including acute pelvic inflammation, ovarian cyst, mesenteric lymphadenitis, enteritis, diverticulitis in order. CONCLUSION: Overall complication rate was lower in laparoscopic appendectomy compared with conventional appendectomy and the length of hospitalization of laparoscopic appendectomy was shorter. When the acute appendicitis is suspected, especially in the reproductive women, the laparoscopic approach would be better diagnostic and therapeutic value than conventional method. Therefore laparoscopic appendectomy would be replaced with conventional appendectomy.
Abscess ; Appendectomy* ; Appendicitis ; Appendix ; Diagnosis ; Diverticulitis ; Enteritis ; Female ; Hemorrhage ; Hospitalization ; Humans ; Inflammation ; Length of Stay ; Mesenteric Lymphadenitis ; Ovarian Cysts ; Retrospective Studies ; Subcutaneous Emphysema ; Surgical Instruments ; Wound Infection

Pheochromocytoma is one of the surgically curable hypertensive syndrome and may arise wherever chromaffin cells are located. A case of a left large adrenal pheochromocytoma developed in a 49 year old male is presented with brief review of literatures.
Chromaffin Cells ; Humans ; Male ; Middle Aged ; Pheochromocytoma*

Epidermoid cysts occur rarely on the palms and soles, where hair is not present. These cysts have long been assumed to arise from traumatic implantation of epidermal fragment, but the pathogenesis is still controversial. Recently, with microscopic findings, immunohistochemical features, and molecular studies, the epidermoid cysts of the sole may be induced by the human papillomavirus. We report two cases of epidermoid cysts of the sole with the discussion of the pathogenesis.
Epidermal Cyst* ; Hair ; Humans*

Visual acuity refers to the spatial limit of visual discrimination. It is surely the single most significant measure of functional integrity of the eye. Normal visual acuity can be represented in hyperopia of less than 2 diopters or astigmatism of less than 1 diopter. The purpose of this study was to observe the prevalence, type and degree of of refractive errors in 338 eyes of 40-69 years of age with normal visual acuity(20/20 or more). The results were as follows: 1. In objective manifest refraction, 246 eyes(72.8%) had refractive error such as hyperopia(110 eyes), simple hyperopic astgmatism(61 eyes),compound hyperopic astigmatism(57 eyes) and simple myopic astigmatism(18 eyes). 2. In subjective manifest refraction, 132 eyes(39.1%) had refractive error such as hyperopia(51 eyes), simple hyperopic astigmatism(44 eyes), simple myopic astigmatism(24 eyes) and compound hyperopic astigmatism(13 eyes). 3. As to the type of astigmatism, 71 of 81 astigmatism were "against the rule" and the rest(10 eyes) "with the rule". Degree of astigmatism was less than 1.00 diopter. 4. A verage degree of refractive errors was 0.43 diopter.
Adult* ; Astigmatism ; Discrimination (Psychology) ; Humans ; Hyperopia ; Prevalence ; Refractive Errors ; Visual Acuity*

The elbow is the most frequent area of complaint in children and adolescent baseball players. The physical stresses associated with repetitive throwing create extra-ordinary forces, which may affect the normal osteochondral and soft tissue developmental process and are the important factors causing the decrease of competitive power and shortening of life as a baseball player in adolescents. We surveyed the 114 baseball players of middle & high school in Taegu in order to evaluate the prevalance of symptoms and radiologic findings of the elbow and correlation of these findings to career & position of the baseball game. The results were as follows. 1. Of 114 players, 83 were non-pitchers and 31 were pitchers. The mean career was 3.8 years (7 months to 6 years). 2. The 77 players (67.7%) had the pain on their elbow during or after daily exercise. Other clinical symptoms were locking (30.7%), limitation of motion (18.4%), swelling (16.6%) and clicks on motion (10.5%). 3. On the radiogram of the elbow, hypertrophy or separation of medial epicondyle were seen in 34% of players, loose bodies in 17%, hypertrophy of the humerus in 12% and cystic change of the capitellum in 11%. 4. The mean career of symptomatic players was 4.4 years but non-symptomatics was 2.7 years. The mean career of players who had abnormal radiologic findings was 5.1 years but 3.1 years in players who had no abnormal radiologic fingings. 5. Symptoms and pathologic changes were more common in the elbow of pitcher' s group due to throwing frequency & pitching style. 6. Among the 77 players who had any kinds of problem of the elbow, 49 players of them had no experience of visiting hospital. 7. To prevent these injuries of the elbow, the following recommendations were made. First, restrict the number of innings pitched per game. Second, avoid throwing the curve ball in this age group. Third, ensue an adequate warm up period before exercise or rest after games. Fourth, inform parents and coaches of possible harmful nature of excessive throwing.
Adolescent* ; Baseball* ; Child ; Daegu ; Elbow* ; Humans ; Humerus ; Hypertrophy ; Parents