No abstract available.
Female* ; Humans

OBJECTIVES: Adverse effects on sexual functions induced by antidepressant medications including selective serotonin reuptake inhibitors(SSRIs) have been reported. The reported incidences of sexual dysfunctions varies with the way of questioning, with relatively low on self reporting and high on direct questioning and symptom questionnaires. The purpose of this study was to evaluate the frequency and nature of sexual dysfunctions during SSRIs treatment in outpatients with depressive disorder and anxiety disorder. METHODS: Seventy seven patients on SSRI therapy(fluoxetine, sertraline, and paroxetine) were enrolled in this study. The six aspects of sexual function were investigated:sexual desire, sexual excitement, sexual pain, orgasm, erection and ejaculation. BDI, S-A, T-A and questionnaires on sexual side effects and on other side effects of SSRIs were measured. The frequency and the severity of sexual dysfunctions were measured. Sexual side effects and other side effects of SSRIs were analyzed in association with the duration and the dose of SSRI treatment and the severity of depression and anxiety. RESULTS: The frequency of sexual dysfunction during SSRI use in our study was 38.96%. Women reported more sexual dysfunction(sexual desire, sexual excitement, orgasm). Also, women's sexual dysfunction was more intense. The most common sexual dysfunction was delayed orgasm(or anorgasmia) in women and ejaculatory difficulty in men. In patients with depressive disorder, the frequency of sexual dysfunctions was higher than in patients with anxiety disorder, which was not statistically significant. CONCLUSIONS: These findings suggest that SSRIs-associated female sexual dysfunction occurs substantially higher and is more severe than expected. It is important to pay attention to female sexual dysfunction during treatment with SSRIs. The sexual problems must be questioned directly for prompt detection of them and promotion of treatment compliance with SSRIs.
Anxiety ; Anxiety Disorders ; Compliance ; Depression ; Depressive Disorder ; Ejaculation ; Female ; Humans ; Incidence ; Male ; Orgasm ; Outpatients ; Surveys and Questionnaires ; Self Report ; Serotonin* ; Sertraline

Estrogens have diverse effects on the CNS throughout the lifespan and do so via multiple mechanisms involving both genomic and non-genomic receptors. Estrogens affect not only the hypothalamus but also catecholamine, serotonin, acetylcholine and dopamine system including hippocampus, nigrostriatal, and glial cells. These systems are involved in a variety of estrogen actions on mood, locomotor activity, pain sensitivity, and cognition. Estrogens act primarily by classic genomic mechanisms through intracellular receptors to modulate transcription and protein synthesis. Estrogens also act via second messenger such as cAMP regulation, MAP kinase regulation and calcium homeostasis. These actions may be related to non-genomic receptors, the membrane-binding receptors, which are not well identified. Furthermore estrogens act as potent neuroprotective and neurotrophic factors by estrogen receptor dependent and independent mechanisms. There are some supports that estrogens are helpful for mood disturbance in reproductive-related conditions. Also inconsistent effects of estrogens on mood and cognitive functions associated with the postmenopause, Alzheimer's disease, and neurotrauma are reported. Based upon diversity of region and molecular mechanism of action of estrogens in the brain, much more research is required to establish guideline for using estrogen as a potential antidepressant, cognitive enhancer, and neuroprotective agent in the clinical practice of psychiatry.
Acetylcholine ; Alzheimer Disease ; Brain ; Calcium ; Central Nervous System* ; Cognition ; Dopamine ; Estrogens* ; Hippocampus ; Homeostasis ; Hypothalamus ; Motor Activity ; Nerve Growth Factors ; Neuroglia ; Phosphotransferases ; Postmenopause ; Second Messenger Systems ; Serotonin

Steatocystoma multiplex, a cutaneous disorder involving the appearance cysts on the trunk and upper arms, is often inherited as an autosomal dominant trait. The authors present mammographic and US findings of steatocystoma multiplex in a 35-year-old woman with breast masses. On mammograms, multiple uniform thin walled round or oval shaped oil cysts were seen in the peripheral portion of the breasts and axilla, and on US, well-defined or smooth ill-defined round or oval shaped nodules were seen in the subcutaneous layer of the breasts and axilla ; compared with subcutaneous fat, there was iso- or slightly increased echogenicity.
Adult ; Arm ; Axilla ; Breast ; Female ; Humans ; Steatocystoma Multiplex ; Subcutaneous Fat

No abstract available.

BPSD (behavioral and psychological symptoms of dementia) are common remediable cause of excess morbidity and lead to significant impairment in quality of life for both patients and their caregivers, as well as an increased risk of institutionalization. The most common treatment of BPSD is neuroleptic medication. Compared to other agents, conventional neuroleptics have been studied with relatively rigorous placebo-controlled trials. Efficacy is modest, but concerns regarding side effects, such as extrapyramidal symptoms, tardive dyskinesia, and emotional withdrawal, have often limited their uses. Treatment of BPSD with atypical antipsychotics such as risperidone or olanzapine is potentially advantageous in view of their tendency to cause considerably fewer side effects. But elderly demented patients may be particularly sensitive to untoward side effects of psychotropic drugs. The different atypical antipsychotics do have their own side effects and other limitations. Clinicians who prescribe antipsychotics for BPSD should start with a low initial dose, increasing this dose slowly until the lowest effective dose is reached. It is important to remember that although antipsychotics provide symptomatic relief, they do not cure underlying dementia. Clinicians should try to avoid prescribing multiple drugs with anticholinergic or sedative effects. Further study to determine more specific drug-responsive symptoms is needed to maximize benefits of atypical antipsychotics.
Aged ; Antipsychotic Agents* ; Caregivers ; Dementia* ; Humans ; Hypnotics and Sedatives ; Institutionalization ; Movement Disorders ; Psychotropic Drugs ; Quality of Life ; Risperidone

No abstract available.
Family Practice* ; Humans

Hemiballism-hemichorea is a rare movement disorder that presents unilateral flinging movements of the limbs. Recent studies pointed non-ketotic hyperglycemia as an underlying cause of this movement disorder. We report an elderly women with irregular, involuntary movement of the limbs after her uncontrolled diabetes mellitus was successfully managed by the control of glucose level. Characteristic magnetic resonance imaging findings and the management of this condition were discussed.
Aged ; Diabetes Mellitus ; Dyskinesias ; Extremities ; Female ; Glucose ; Humans ; Hyperglycemia ; Magnetic Resonance Imaging ; Movement Disorders*

No abstract available.
Anus, Imperforate* ; Bronchi* ; Esophageal Atresia*

PURPOSE: Developing a curriculum(DACUM) is a method of analyzing job focused competency, which is obtained from the data of an expert belonging to a certain career. In this study the DACUM method was used to analyze the jobs of operating room nurses. METHOD: Through the DACUM workshop which was arranged by two DACUM facillitators, a definition of the role of operating room nurses was developed and then duties and tasks of operating room nurses' were identified. For the workshop, a DACUM committee with 10 operating room nurses was organized. Finally, the duties and tasks which were identified were validated by 422 nurses for importance, difficulty, and frequency. RESULTS: Thirteen duties and 105 tasks were identified on the DACUM chart, where importance, difficulty, and frequency of tasks were represented by alphabet letters A, B, and C as higher degree of importance. The determinant coefficient(DC) showed that the most important duty was assisting with operations(DC=6.61), and the least, managing operating materials(DC=4.22). For tasks, the most important ones were assisting in orthostatic surgery(DC=7.60), and assisting in thoracic surgery(DC=7.38), and the least important making gauze ball(DC=2.39), and saving of operation site((DC=3.27). CONCLUSION: The results suggest a need to develop an education program using the DACUM chart as a basis for the development and as a clinical career ladder and for curriculum of operating room nursing.
Career Mobility ; Curriculum ; Job Description ; Operating Room Nursing ; Operating Rooms