The patient was a 51 year-old woman suffering fraen dysphagia due to upper esoyhageal lye stricutue whieh had developed as a result of a suicide attempt 21 years ago. Shortly after that, she underwent feeding gastrostomy and has lived in the gastrostomy state for 2l years. After admission, she underwent a barium esophagoram which revealed a near total obstruction at the cricoid cartilage level. Bougie dilatation with American Dilation System was tried on day 3. But the spring tip marked guide wire which was to be used with the American Dilation System could not be passed through the stricuture. Therefore, we performed a bougie dilatation using angiographic guide wire M(H-AG-35in-150 cm) with success. On day 14, she underwent a barium esophagogram which revealed her improved condition, and she was discharged on day 16.
Barium ; Constriction, Pathologic* ; Cricoid Cartilage ; Deglutition Disorders ; Dilatation* ; Female ; Gastrostomy* ; Humans ; Lye* ; Middle Aged ; Suicide

BACKGROUND: Adult with congenital heart disease represents a new category of specialized cardiovascular interest that requires the cooperation of a number of medical and surgical disciplines, and also requires the interactions among traditional departmental jurisdiction. Uninterrupted, long-term continuity care is essential if the concerns inherent in this new and increasing patient population are to be addressed. The purpose of this study was to analyze the clinical characteristics of congenital heart disease in adolescents and adults. METHODS: Between October 1994 and July 1996, retrospective follow-up records and registry chart of 229 consecutive patients with congenital heart disease for over 16 years in GUCH (grown-up congenital heart) clinic were reviewed by a physician and a nurse specialist. RESULTS: There were 126 female and 103 male GUCH patients with the mean age of 34+/-14.6 years old. Among the 229 patients, there were 179 natural survivors, those without cardiac repair, and 50 postoperative survivors. Congenital heart defects were 167 shunt legions, 17 obstructive and valvular legions, 14 tetralogy of Fallot, 15 complex congenital heart anomalies and 16 others. Among the 179 natural survivors; 122 (68%) required heart surgery or continuous medical surveillance, and among the 50 surgically repaired survivors; 37 (74%) required reoperation for residual heart defects, constant medical treatment or consultation from other medical divisions. The reasons for the hospital vistis were:cardiac operation or cardiac diagnosis in 128 (56%) patients, symptomatic heart conditions in 43 (19%), routine heart examinations since childhood in 31 (14%) and others in 27 (11%). Also, the patient compliances were higher in the GUCH clinic than the traditional departmental jurisdiction (p<0.001). CONCLUSIONS: To achieve continuing care for the patients with congenital heart disease in adolescents and adults, it is important to develope a specialized clinic addressing the specific needs of the congenital heart disease in adolescents and adults.
Adolescent* ; Adult* ; Diagnosis ; Female ; Follow-Up Studies ; Heart ; Heart Defects, Congenital* ; Humans ; Male ; Reoperation ; Retrospective Studies ; Specialization ; Survivors ; Tetralogy of Fallot ; Thoracic Surgery

OBJECTIVES: We investigated impulsivity and sensation seeking of pathological gambling, comparing with alcoholism and normal group. METHODS: 36 pathological gamblers, who were diagnosed by DSM-IV criteria, were compared with 31 alcoholism group and 26 healthy normal group with Barratt impulsivity scale and Zuckerman sensation seeking scale. RESULTS: 1) Pathological gamblers appeared to have much more impulsivity than alcoholism group or normal group. In respect to sensation seeking, no significant differences were founded among three groups. 2) Pathological gamblers tend to have more non-planning impulsivity, cognitive impulsivity, and motor impulsivity than alcoholic group. Comparing with normal group, pathological gamblers tend to have more non-planning impulsivity and motor impulsivity, but not in cognitive impulsivity. 3) There were no differences in three sub-scales including of thrill seeking, experience seeking and disinhibition out of four sub-scales of sensation seeking scale, among three groups. However, Boredom susceptibility was higher in pathological gamblers than alcoholics and normal group. CONCLUSIONS: These results suggested that personality of pathological gambler is most impulsive and boredom susceptible, which indicates that pathological gamblers is more serious pathological clinical disorder than alcoholism.
Alcoholics ; Alcoholism* ; Boredom ; Diagnostic and Statistical Manual of Mental Disorders ; Gambling* ; Humans ; Impulsive Behavior* ; Sensation

OBJECTIVES: We aimed to develope the Suicide Probability Scale for Adolescent (SPS-A) to evaluate the possibility of suicide behavior in adolescents. METHODS: SPS-A was adminstered to 792 middle and high school students for examining the reliability and validity. RESULTS: SPS-A was found to have significantly high internal consistency and total -subscale score correlations. Factor analysis yielded four factors of negative self-evaluation, hopelessness, suicide idea and hostility, which explained 53.28% of total variables. In the assessment of correlations with other suicide-related scales for the concurrent validity of SPS-A, Rosenberg self-esteem scale and Buss-Durkee hostility scale have significant correlations with SPS-A. However, Children's depression inventory and Hopelessness scale for adolescent did not have significant correlations with SPS-A. CONCLUSION: We concluded that SPS-A had high reliability and validity, which is usefull for evaluating suicide idea in adolescents. This study suggests that hopelessness and depressive symptoms are not for evaluating suicide risk in adolescents, unlike adult group.
Adolescent* ; Adult ; Depression ; Diagnostic Self Evaluation ; Hostility ; Humans ; Reproducibility of Results ; Suicide* ; Weights and Measures

In order to product and develop questionnaire which can assess the schizotypal personality by model of criteria in DSM-III-R it was presented 1311owing questions in this study. First, far the validation and manufacture of scale and sub-subscale that assess overall feature, nine characteristics of the schizotypal personality disorder, this study was concerned with validity, reliability and factor-analysis results of schizotypal personality questionnaire. Second, we would be present how schizotypal personality disorder trend is connected with trait-anxiety, hopelessness and self-concept. Also the difference Is compared with. Finally, 396(male 216 Ss/53,8%, female 180 Ss/45.5%) college students with mean age 21.2 years were sampled. Raine's schizotypal personality questionnaire(SOQ) which assess nine characterisitics of schizotypal personality disorder in DSM-III-R was translated and used. In this results, Raine's schizotypal personality questionnaire was appeared to have high internal validity, split-half reliability and test-retest reliability Also, 6 factors were affirmed by empirical confirmation through factor-analysis. 6 factors have been very reliable internal validity that ranges from .78 to .83. In these 6 factors, idea of reference, odd or eccentric behavior and odd speech were corresponded to the category model after DSM-III-B in Raine's scale. 'Cognitive, perceptive' dimension was centered of factor 1, 'Emotive, affective' dimension was centered of factor 2, social anxiety and constricted affect were constituted to 2nd factor. No close friends, schizoid trend and suspiciousness of schizotypal characteristics were constituted to 3rd factor by' interpersonal relationship' dimension. These empirical outcomes which confirmed through factor-analysis were very valid and connected much to Raine's scale which assessed schizotypal personality disorder, thus possibility of development and manufacture of schizotypal personality disorder scale through item revision was lighten. In 2nd study the higher schizotypal personality disorder trend, trait-anxiety and hoplessness were higher. But on the contrary, self-concept was lower. The group of high score in schizotypal personality questionnaire had more trait-anxiety and hopelessness than the group of low score in schizotypal personality questionnaire. Contrastly, positive self-concept was high in the group of low score. Also, the most predictable variable to the trait-anxiety was factor 2, predictable power R2 of factor 2 was 29.1%. To the hopelessness, factor 2 was the most powerful predictable variable. Predictable power of factor 2 was 11.2%, also. In self-concept, factor 2 explained 20.8% of self-concept, thus it was presented that factor 2 had the most powerful explanatory quantity. In these consequences, the factors which have meaningful connection to the trait-anxiety, hopelessness and low self-concept within 6 factors were really factor 2, 3, 1. Among these factors, 'Emotive' feature of factor 2 including social anxiety and constricted affect have the most effect on trait-anxiety, hopelessness and serf-concept. And next to factor 2, the isolated interpersonal relation which include no close friends and schizoid trend was some influential variable. Also peculiar, unusual perceptual experience, eccentric belief and magical thinking had some effect though small. The college students who had strong schizotypal personality trend had more social anxiety and more constricted emotional empathic ability, less self-expression, less social skill than common college students. These elements threaten, interrupt and retard identity establishment and intimacy-seeking which are important developmental tasks within this period. These experiences is accepted to ego-dystonic to schizotypal college students who have some or moderate reality testing, adaptive ability. Moreover, These peoples would feel locus of control externally, not internally and would have more control-failure experiences. All these elements elevate anxiety level, give rise to low self-concept and low expectation to the future. These outcomes all confirmed questions which presented in this study.
Anxiety ; Female ; Friends ; Humans ; Internal-External Control ; Interpersonal Relations ; Magic ; Surveys and Questionnaires ; Reality Testing ; Schizotypal Personality Disorder ; Thinking

PURPOSE: The incidence of infectious disease, which has been the cause of death in pediatric period, was decreased. But, the opportunistic exposure to toxic substance shows a tendency to increase. We performed this study in order to find out preventive measures and the latest inclination of acute poisoning in childhood. METHODS: From January 1985 to July 1996, 88 children with acute drug and chemical poisoning, who diagnosed at Presbyterian Medical Center, were analyzed retrospectively. RESULTS: 1) It occurred more frequently in male than female (1.7:1) and high incidence was noted in 0-4 year-old age group (75%). 2) Annual distribution of poisoning shows a tendency to increased. 3) There was no significant seasonal difference in frequency of poisoning. 4) The vast majority (85%) of poison exposure were accidental and therapeutic intent was present in 7.5% of cases and suicidal intent was 7.5% of cases. 5) We noticed an hourly predominance with most accidents occurring from 9 a.m. to 1 p.m. and from 5 p.m. to 9 p.m., 35% respectively. 6) Categories with the largest numbers of total exposure, in descending order by exposure frequently, include the following : drug (30.1%), insecticide (20.4), rodenticide (12.9%), glacial acetic acid (13.9%), herbicide (4.3%), Carbon monoxide (3.2%), others (13%). So, food and household material are leading cause of poisoning, except drug. Of drug, DDS was the most common and then psychotherapeutic drugs were the next. 7) The chief complaints on admission were nausea and vomiting (32%), mental change (26%) irritability (9%), peripheral cyanosis (8%), seizure (5%), and in case of 20%, the patient were found incidentally without symptoms. 8) There were complications which were pneumonia, pulmonary fibrosis, esophageal stricture and pneumothorax. And death occurred in 4 cases, due to insecticide (2 cases), herbicide and rodenticide, 1 case respectively. CONCLUSIONS: In previous report in Korea, causative substance of poisoning were drug, carbone monoxide, insecticide, rodenticide in descending order. In our study, drug was the most common cause of poisoning. But it' s proportion was decreased compared with previous report, and carbone monoxide intoxication was markedly decreased. But, we noticed that the proportion of household material, such as glacial acetic acid and other household chemical, was increased. So, we should be pay more attention to poisoning and try to prevent them.
Acetic Acid ; Carbon ; Carbon Monoxide ; Cause of Death ; Child ; Communicable Diseases ; Cyanosis ; Esophageal Stenosis ; Family Characteristics ; Female ; Humans ; Incidence ; Korea ; Male ; Nausea ; Pneumonia ; Pneumothorax ; Poisoning* ; Protestantism ; Pulmonary Fibrosis ; Retrospective Studies ; Seasons ; Seizures ; Statistics as Topic* ; Vomiting

OBJECTIVE: Personality is defined as the trait-like qualities of a person. However, it has been recently suggested that the state effect of a situation leads to changes in scores on personality assessments. We predicted that traumatic experiences would induce changes not only in personality scores but also in the factor structures of personality assessments. METHODS: MethodsaaWe conducted a cross-sectional, case-controlled study using two data sets: a traumatized adolescent sample (n=71) and a non-traumatized adolescent sample (n=296). Personality factor structures were compared between the two samples using exploratory factor analyses for 25 lower-ordered subscales of the Temperament and Character Inventory (TCI). In the non-traumatized sample, evaluation of the scree plot suggested a five-factor solution supporting TCI's original seven-factor model. RESULTS: The traumatized sample showed a three-factor structure representing a biological factor, a social factor and an existential factor. This decrease in number of personality factors was caused by strengthened correlations among personality subscales related to coping with traumatic situations. Cloninger's psychobiological model of personality (i.e., temperament-character) was adequate in capturing personality traits of non-traumatized adolescents, but the tripartite view of existential psychology (i.e., body-mind-spirit) clearly corresponded to the factor structure of the traumatized adolescents. CONCLUSION: The three-factor solution of the present traumatized group is consistent with the tripartite model of personality (i.e., body-mind-spirit), while the five-factor solution of the non-traumatized group corresponds to Cloninger's seven-factor model. This is the first study to describe the state effects of traumatic experiences on personality structure.
Adolescent ; Biological Factors ; Case-Control Studies ; Existentialism ; Humans ; Personality Assessment ; Temperament

OBJECTIVES: In our studies, we have made efforts to compare illness representation among the pathological gamblers, social gamblers, the family members of gambler, the gambling industry employees, and general adults and to investigate what kinds of illness representation make an estimate of therapy intention. METHODS: 222 gambling users, 125 family members of gambler, 95 employees in gambling industry, and 1383 general adults were included in this study. Symptom representation, negative characteristic representation, negative consequence representation, internal and external attribution representation, spontaneous recovery representation, recovery representation through therapeutic help of speciality, time lapse representation were constructed and included for illness representation of pathological gambling. RESULTS: 1) Pathological gamblers had lower symptoms, negative characteristics, negative consequences and therapeutic help seeking representation than other groups, on the other hand higher external attribution representation and spontaneous recovery representation. 2) Families of problem gambler have inconsistent characteristics higher external attribution and negative consequences and lower therapeutic help seeking representation. 3) It was founded that negative consequences representation and external representation were low in gambling industry employees. 4) The more symptom representation increased and external attribution decreased, the more therapeutic intention increased in case of problem gamblers and their families. CONCLUSION: Pathological gamblers have the lowest awareness and acceptance on mental problem caused by excessive gambling. However, suggested that family members of gambler and gambling industry employees also have partially self defensive and contradicted representations. It was suggested that awareness on severity of symptom and internal attribution representation needs to be increased in order to participate therapeutic place.
Adult ; Gambling* ; Hand ; Humans ; Intention

Although diabetes mellitus (DM) is treatable, it is still not curable. Its chronicity is associated with a high prevalence of psychiatric disorders, especially depression in type 2 DM and learned helplessness in type 1 DM. In turn, this depression and helplessness may affect a patient's adherence to medical appointments, compliance to treatment, and effective doctor-patient relationships, which are vital to promising outcomes. This study reviews the existing literature regarding the interactional relationships between depression, DM and the doctor/patient relationship, and also suggests certain aspects of the doctor/patient relationship which can contribute to more successful treatment outcomes.
Appointments and Schedules ; Compliance ; Depression ; Diabetes Mellitus ; Helplessness, Learned ; Object Attachment ; Physician-Patient Relations ; Prevalence

OBJECTIVE: Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes. METHODS: Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape. RESULTS: We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment. CONCLUSION: Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.
Benzodiazepines ; Cues ; Diazepam ; Humans ; Lorazepam* ; Memory ; Memory, Episodic ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Videotape Recording