No abstract available.
Sternotomy*

BACKGROUND: We evaluated all ambulatory surgeries conducted at our center using several factors (the utility rate and the number of ambulatory surgery, unanticipated admission and its reasons) in order to improve the performance of our facility. We hope that this data could be an indicator of ambulatory surgeries in Korea, which will help strengthen the basis for its development. METHODS: We investigated this study by utilizing the retrospective methods. Data were obtained from hospital records over a period of 5 years (January 2006 to December 2010) for patients who underwent day surgeries at our Day Surgery Center (DSC). RESULTS: The utility rate of ambulatory surgery was 20.38%, 20.91%, 17.03%, 16.73% and 17.70% from 2006 to 2010 each year. The total number of ambulatory surgeries performed in our DSC from 2006 to 2010 was 6875, 7168, 7423, 7417 and 7798 for each year. The unanticipated admission rate were 19 patients (0.57%), 30 patients (0.93%), 20 patients (0.62%), 46 patients (1.26%) and 48 patients (1.25%), respectively. The major causes of admission were due to surgeon request and wish of patients. CONCLUSIONS: In the review of our DSC, although the number of ambulatory cases have been increased from 6875 to 7798, the trend of the utility rate of ambulatory surgery is slightly downward from 20.38% to 17.70% for the recent 5 years. All of the unanticipated admission rate per year was below 1.5% and most of the reasons of the unanticipated admission after ambulatory surgery were non-medical.
Ambulatory Surgical Procedures ; Hospital Records ; Humans ; Korea ; Retrospective Studies

BACKGROUND: The estrogen receptor (ER) in breast cancer specimens has traditionally been assessed using a biochemical ligand binding assay (LBA). Recently, the application of an immunohistochemical method (IHC) for formalin-fixed breast carcinoma tissue has greatly increased. Controversy exists over the accuracy of IHC compared with that of LBA in determining ER. METHODS: Breast-carcinoma tissues were obtained from 247 patients. ER was determined within 1 week or at 4 weeks after surgery by using the traditional LBA and by using IHC with monoclonal antibodies. The ER status was assessed with respect to age, size of tumor, and stage according to the two methods. RESULTS: The concordant rate of ER status was 75% between IHC and LBA. IHC-negative/LBA- positive results occurred in 31 cases (13%) and IHC-positive/LBA-negative were observed in 30 cases (12%). ER-positive cases were more common in older patients. The disconcordant rate was much higher in premenopausal females. There was a significantly lower ER positivity in tumors of larger than 5 cm. ER positivity was significantly lower at 4 weeks compared to within 1 week in both methods, but this did not change the concordance rate between the two methods. CONCLUSIONS: The ER-IHC method appears to be a reasonable substitute for a biochemical ligand binding assay. This is based on a 75% concordance of the method as well as on the findings in the disconcordant cases. The appropriate measured time for ER was within 1 week after the cancer tissues were obtained.
Antibodies, Monoclonal ; Biochemistry ; Breast Neoplasms* ; Breast* ; Estrogens* ; Female ; Humans ; Immunohistochemistry

OBJECTIVE: We aimed to examine the rates, correlates, methods, and precipitating factors of suicide attempts among adolescent patients admitted for psychiatric inpatient care from 1999 to 2010 in a university hospital in Korea. METHODS: The subjects consisted of 728 patients who were admitted for psychiatric inpatient care in a university hospital over a 12-year period and who were aged 10-19 years at the time of admission. We retrospectively investigated the information on suicidal behaviors and other clinical information by reviewing the subjects' electronic medical records. Whether these patients had completed their suicide on 31 December 2010 was determined by a link to the database of the National Statistical Office. RESULTS: Among 728 subjects, 21.7% had suicidal ideation at admission, and 10.7% admitted for suicidal attempts. Female gender, divorced/widowed parents, and the presence of mood disorders were associated with a significantly increased likelihood of suicide attempts. Most common method of suicide attempts was cutting, and most common reason for suicide attempts was relationship problems within the primary support group. A diagnosis of schizophrenia was associated with increased risk of death by suicide after discharge. CONCLUSION: These results highlight the role of specific psychosocial factor (e.g., relational problems) and psychiatric disorders (e.g., mood disorders) in the suicide attempts of Korean adolescents, and the need for effective prevention strategies for adolescents at risk for suicide.
Adolescent* ; Diagnosis ; Electronic Health Records ; Female ; Humans ; Inpatients* ; Korea ; Mood Disorders ; Parents ; Precipitating Factors* ; Psychology ; Retrospective Studies ; Risk Factors ; Schizophrenia ; Self-Help Groups ; Suicidal Ideation ; Suicide*

PURPOSE: To evaluate the incidence of arm morbidity following breast cancer surgery including axillary dissection and to identify related factors. MATERIASL AND METHODS: One hundred and fifty nine patients were studied using a self-report questionnaire and a clinical examination. Lymphedema, reduction of range of motion in shoulder joint and subjective symptoms (pain, impaired arm movement, numbness, stiffness) were evaluated. As related factors, demographic, oncologic characteristics and types of treatment were analysed. RESULTS: The incidence of lymphedema (> or =2 cm difference comparing to unaffected arm) was 6.3%, 10.7%, 22.6% and 23.3% at each 10 cm, 20 cm, 30 cm, and 40 cm from wrist. Reduction of range of motion in shoulder joint (> or =20 degree difference comparing to unaffected arm) was noted in more than 1/3 patients for flexion, abduction and internal rotation. Especially the reduction of range of motion in internal rotation was severe (> 50% reduction) in 1/3 patients. Approximately 50 to 60% of patients complained impaired arm movement, numbness, stiffness and pain. Body mass index (BMI) was the significant risk factor for lymphedema. CONCLUSION: Lymphedema was present in 1/3 of patients and the common sites of edema were 30 cm 40 cm proximal from the wrist. Also most severe reduction of range of motion in shoulder joint was with internal rotation. There needs weight control for lymphedema because BMI was the significant risk factor for lymphedema. Also rehabilitation program for range of motion especially internal rotation in shoulder joint should be developed.
Arm* ; Body Mass Index ; Breast Neoplasms* ; Breast* ; Demography ; Edema ; Humans ; Hypesthesia ; Incidence ; Lymphedema ; Surveys and Questionnaires ; Range of Motion, Articular ; Rehabilitation ; Risk Factors ; Shoulder Joint ; Wrist

BACKGROUND: Helicobacter pylori-induced destruction of the gastroduodenal mucosal barrier is initiated with mucosal infiltration of inflammatory cells. Cytokines and chemokines have been suggested to play important roles in the migration and activation of these inflammatory cells into the mucosa. The present study aimed to investigate expression rates of cyto-chemokine mRNAs using gastric mucosal biopsy specimens. METHODS: In 98 patients infected with Helicobacter pylori, mucosal mRNA expression rates of cytokines (IL-1beta, IL-6, and IL-10), C-C chemokines (macrophage inflammatory protein 1alpha [MIP-1alpha], and macrophage inflammatory protein 1beta [MIP-1beta], monocyte chemotactic and activating factor [MCAF], regulated on activation, normal T cell expressed and presumably secreted [RANTES]) and C-X-C chemokines (IL-8 and growth regulated alpha [GRO-alpha]) were examined using reverse transcription polymerase chain reaction (RT-PCR). RESULTS: The expression rates of mRNA for IL-8, GRO-alpha, MIP-1alpha and RANTES were significantly more increased in H. pylori-positive patients than in H. pylori- negative patients. However, the expressions of IL-1beta, IL-6 and IL-10 mRNA were statistically not different between two groups. After eradication of H. pylori, expressions of mRNA for three cytokines (IL-1beta, IL-6 and IL-10), four C-C chemokines (MIP-1alpha, MIP-1beta, MCAF and RANTES) and two C-X-C chemokines (IL-8 and GRO-alpha) were significantly decreased. CONCLUSION: These results suggest that C-X-C chemokines and some C-C chemokines play important roles in H. pylori-associated peptic ulcer diseases.
Adult ; Aged ; Aged, 80 and over ; Chemokines, CC/metabolism ; Chemokines, CXC/metabolism ; Chi-Square Distribution ; Cytokines/*metabolism ; Female ; Gastric Mucosa/*immunology/metabolism ; Helicobacter Infections/*immunology/metabolism ; *Helicobacter pylori ; Human ; Male ; Middle Age ; Prospective Studies ; RNA, Messenger/metabolism

OBJECTIVE: We tested for association of the catechol-O-methyltransferase (COMT) Val158-Met (rs4680) polymorphism with attention-deficit hyperactivity disorder (ADHD) using family-based test in Korean trios. METHODS: A total of 181 subjects with ADHD along with both of their biological parents were recruited from University Hospitals in Korea. We performed a transmission disequilibrium test (TDT) on 181 trios. RESULTS: In the TDT, we found the over-transmission of the Val allele in children with ADHD (chi2=4.21, p=0.040). CONCLUSION: These results suggest that the COMT Val158-Met polymorphism is associated with ADHD among the Korean population. However, this study must be replicated in larger populations.
Alleles ; Catechol O-Methyltransferase* ; Child* ; Hospitals, University ; Humans ; Korea ; Parents

OBJECTIVE: There are no published prevalence estimates of elimination disorders and their association with disruptive-behavior disorders among children in the Asian region using standardized diagnostic interviews. This study was conducted to determine the prevalence of elimination disorders and its association with disruptive-behavior disorders in a representative sample of children in Seoul, Korea. METHODS: The diagnosis of enuresis and encopresis was derived from parent-reported data for "enuresis and encopresis," collected using the Diagnostic Interview Schedule for Children, from a representative sample of 6- to 12-year-old children (n=1,645) who participated in the 2005 Seoul Child and Adolescent Mental Health Survey. Prevalence data for attention deficit and disruptive-behavior disorders were collected from the same sample. RESULTS: The overall 12-month prevalence of nocturnal enuresis and encopresis was 1.8% and 0.6%, respectively. Enuresis and encopresis prevalence in boys was significantly greater than that in girls. Enuresis and encopresis was most common at 7 to 9 years of age. Enuresis was significantly associated with ADHD (OR 2.6, 95% CI 1.0-6.9) and conduct disorder (CD; OR 4.7, 95% CI 1.0-22.4). CONCLUSION: Enuresis is significantly associated with ADHD and CD, so these conditions must be assessed together during the evaluation of children with enuresis.
Adolescent ; Asian Continental Ancestry Group ; Attention Deficit and Disruptive Behavior Disorders ; Attention Deficit Disorder with Hyperactivity* ; Child ; Comorbidity ; Conduct Disorder* ; Diagnosis ; Elimination Disorders ; Encopresis ; Enuresis ; Humans ; Mental Health ; Nocturnal Enuresis* ; Prevalence

OBJECTIVES: We compared the clinical presentations of manic and depressive episodes and the treatment response among children and adolescents with bipolar disorder (BD) types I and II and BD not otherwise specified (NOS). METHODS: The sample consisted of 66 patients, aged between 6 and 18 years, who were admitted for BD to a 20-bed child and adolescent psychiatric ward in a university hospital located in Seoul, Korea. RESULTS: Patients with BD type I were more likely to have lower intelligence quotients and exhibit violent behaviors during manic episodes than patients with BD type II or BD NOS and to show better treatment responses during manic episodes than patients with BD NOS. Patients with BD NOS were more likely to have an irritable mood rather than a euphoric mood during the manic phase than patients with BD type I or II and to exhibit violent behaviors during the depressive phase and chronic course than patients with BD type II. CONCLUSION: Pediatric BD patients are heterogeneous with respect to their clinical characteristics. Implications for the usefulness of the current diagnostic subtype categories should be investigated in future studies.
Adolescent ; Bipolar Disorder* ; Child ; Humans ; Inpatients* ; Intelligence ; Irritable Mood ; Korea ; Seoul

No abstract available.
Ambulatory Surgical Procedures* ; Korea*