No abstract available.

No Abstract available.
Ankle* ; Sarcoidosis* ; Tenosynovitis*

OBJECTIVES: Medically unexplained physical symptoms comprised the predominant complaints of patients with depression in clinical settings. Previously, tricyclic antidepressants, which inhibit both presynaptic reuptake of serotonin and norepinephrine, had been used to relieve pain as well as treat depression. The objective of this study was to evaluate the efficacy of venlafaxine ER, which also has the effects on both serotonin and norepinephrine, in patients suffering from depression with somatic symptoms. METHODS: The subjects were recruited from outpatients who had been treated for depression with venlafaxine ER. They were divided into two groups, based on whether they voiced somatic symptoms as their chief complaint (somatic group) or not (non-somatic group). In addition, they were also divided into two groups according to whether they met the criteria of multisomatoform disorder (DSM-IV, Primary Care Version). The duration from the time venlafaxine ER was used to the point when treatment was changed because of the recurrence of symptoms or side effects was assessed and compared using survival analysis in the two groups. RESULTS: Sixty-four patients fulfilled the inclusion criteria of this study, and 39 patients 'were placed into the somatic group', while the other 25 patients 'were placed into the non-somatic group'. The survival rates of maintenance treatment in the somatic group was significantly higher than in the non-somatic group (logrank test p=0.033), and the mean duration of maintenance treatment in the somatic group was 41.5+/-3.38 weeks, while that in the non-somatic group was 26.0+/-4.95 weeks. When the subjects were classified by the criteria of multisomatoform disorder, no significant difference was observed between the two groups (logrank test p=0.314). CONCLUSION: In the present study, treatment venlafaxine ER was maintained longer in patients suffering from depression with somatic complaints, which suggests the efficacy of venlafaxine ER on somatic symptoms of these patients. Large-scale, controlled trials are needed to confirm our findings.
Antidepressive Agents, Tricyclic ; Depression ; Depressive Disorder, Major* ; Humans ; Norepinephrine ; Outpatients ; Primary Health Care ; Recurrence ; Serotonin ; Survival Rate ; Venlafaxine Hydrochloride

OBJECTIVE: Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician's experience. The goal of this study was to examine and compare the trend of prescription patterns for major depressive disorder at a university hospital between year 2001 and 2006. METHODS: We evaluated the medication usage of inpatients with major depressive disorder in 2001 and 2006, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the time to switching and combination of antidepressant in 2001 and 2006. RESULTS: The antidepressants used as first line drug were SSRIs (49.3%), mirtazapine (24.0%), and TCAs (4.8%) in 2001, and SSRIs (50.0%), mirtazapine (24.7%) and venlafaxine (19.0%) in 2006, in frequency order. The antidepressants used as switching drug were TCAs (33.3%), mirtazapine (25.0%), and nefazodone (16.7%) in 2001, and SSRIs (33.3%), mirtazapine (33.3%), and venlafaxine (19.0%) in 2006. As combination treatment, SSRIs and TCAs combination was used mostly by far in 2001 (87.5%), but in 2006, various combination were used including SSRIs and mirtazapine, SSRIs and TCAs, mirtazapine and venlafaxine (36.8%, 23.6%, 18.4%, respectively). The time to combination in 2001 and 2006 year were not different significantly (17.4+/-7.9 day vs 18.0+/-12.9 day, respectively; p=0.829) but the time to switching was significantly shorter in 2006 than in 2001 (13.1+/-7.5 day vs 24.1+/-11.7day; p=0.009). The use of typical antipsychotics as augmentation agent decreased and the use of atypical antipsychotics increased significantly in 2006. Most frequently used atypical antipsychotic was quetiapine in 2006. The use of thyroid hormone and trazodone were significantly decreased in 2006, but the use of mood stabilizer was not changed between 2001 and 2006. While the use of lithium decreased, the use of lamotrigine increased in 2006. CONCLUSION: The results of the present study suggested that there were lots of change in prescription patterns for major depressive disorder between 2001 and 2006. Especially, these changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics and lamotrigine. It can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of treatment of depression.
Antidepressive Agents ; Antipsychotic Agents ; Depression ; Depressive Disorder, Major* ; Humans ; Inpatients* ; Lithium ; Prescriptions ; Psychopharmacology ; Thyroid Gland ; Trazodone ; Quetiapine Fumarate ; Venlafaxine Hydrochloride

OBJECTIVE: Prescription patterns have changed rapidly due to the development of new drugs, results of new researches, and increment of clinician's experience. The goal of this study was to examine and compare the trend of prescription patterns for major depressive disorder at a university hospital between year 2001 and 2006. METHODS: We evaluated the medication usage of inpatients with major depressive disorder in 2001 and 2006, including antidepressants used as the first choice, switching, and combination, and various augmentation agents. And we evaluated the time to switching and combination of antidepressant in 2001 and 2006. RESULTS: The antidepressants used as first line drug were SSRIs (49.3%), mirtazapine (24.0%), and TCAs (4.8%) in 2001, and SSRIs (50.0%), mirtazapine (24.7%) and venlafaxine (19.0%) in 2006, in frequency order. The antidepressants used as switching drug were TCAs (33.3%), mirtazapine (25.0%), and nefazodone (16.7%) in 2001, and SSRIs (33.3%), mirtazapine (33.3%), and venlafaxine (19.0%) in 2006. As combination treatment, SSRIs and TCAs combination was used mostly by far in 2001 (87.5%), but in 2006, various combination were used including SSRIs and mirtazapine, SSRIs and TCAs, mirtazapine and venlafaxine (36.8%, 23.6%, 18.4%, respectively). The time to combination in 2001 and 2006 year were not different significantly (17.4+/-7.9 day vs 18.0+/-12.9 day, respectively; p=0.829) but the time to switching was significantly shorter in 2006 than in 2001 (13.1+/-7.5 day vs 24.1+/-11.7day; p=0.009). The use of typical antipsychotics as augmentation agent decreased and the use of atypical antipsychotics increased significantly in 2006. Most frequently used atypical antipsychotic was quetiapine in 2006. The use of thyroid hormone and trazodone were significantly decreased in 2006, but the use of mood stabilizer was not changed between 2001 and 2006. While the use of lithium decreased, the use of lamotrigine increased in 2006. CONCLUSION: The results of the present study suggested that there were lots of change in prescription patterns for major depressive disorder between 2001 and 2006. Especially, these changes could be seen in use of various antidepressants, increment in use of atypical antipsychotics and lamotrigine. It can reflect not only the current progress of psychopharmacology and clinical experience, but also the clinical complexity of treatment of depression.
Antidepressive Agents ; Antipsychotic Agents ; Depression ; Depressive Disorder, Major* ; Humans ; Inpatients* ; Lithium ; Prescriptions ; Psychopharmacology ; Thyroid Gland ; Trazodone ; Quetiapine Fumarate ; Venlafaxine Hydrochloride

Laminin, an extracellular matrix glycoprotein composed of three polypeptide chains such as alpha , beta, and gamma is distributed in basement membranes of epithelium, muscle, and nervous tissues. Laminin functions as an extracellular cytoskeleton and regulates the differentiation and polarization of cells adjacent to the basement membrane. Along with type IV collagen and heparan sulfate proteoglycan, laminin forms a spike -like structure in the renal glomerular basement membrane (GBM). It has been previously demonstrated that the distribution and immune reaction of laminin are changed in response to the conditions of glomerulonephritis and that laminin plays a role in the reformation of GBM as well as the regeneration of renal glomerular cells. In the present study, the profile of expression and distribution of laminin/laminin beta1 chain were examined in different developmental stages and upon adriamycin administration. Kidney obtained from fetuses (16, 18, and 20 days old) and infants (1 and 7 days old) of Sprague -Dawley rats were either cryosectioned for immunohistochemical assays or ultrathin -sectioned for electron microscopy using immunogold staining methods. The results were as follows: 1. Intensive expression of laminin was observed in the GBM and surrounding mesenchymal tissues obtained from 16, 18, and 20 days old fetuses and in the glomerulus from one day neonates, whereas the level of staining decreased in the glomerulus from 7 days old infants. 2. Immunogold particles were observed in the comma -shaped nephron, in particular in cisternae of rough endoplasmic reticulum, vesicles and nuclear membrane of endothelial cells and mesangial cells obtained from 18 days old fetuses. 3. The immune reactions of laminin beta1 chain were trace detected in the kidney from fetuses (16, 18, and 20 days old) and weakly in tissues surrounding blood capillary and mesangial tissues from one day old neonates. 4. After 24 hours following adriamycin treatment, the reactivity of laminin was slightly enhanced in the renal glomerulus, when compared with that of untreated controls. This enhancement persisted up to 1 week of adriamycin treatment. Laminin beta1 chain was weakly detectable, while further treatment with adriamycin for another 24 hours reduced the intensity of laminin beta1 chain. Taken together, these results suggest that laminin is localized in the GBM at the high level during early fetal stages but the expression levels decrease after birth. Moreover, administration with adriamycin may result in an increase in the immune reactivities of laminin and laminin beta1 chain by renal tissue damage followed by renal regeneration.
Animals ; Basement Membrane ; Capillaries ; Collagen Type IV ; Cytoskeleton ; Doxorubicin ; Endoplasmic Reticulum, Rough ; Endothelial Cells ; Epithelium ; Extracellular Matrix ; Fetus ; Glomerular Basement Membrane ; Glomerulonephritis ; Glycoproteins ; Heparan Sulfate Proteoglycans ; Humans ; Infant ; Infant, Newborn ; Kidney* ; Laminin* ; Mesangial Cells ; Microscopy, Electron ; Nephrons ; Nuclear Envelope ; Parturition ; Rats* ; Regeneration

BACKGROUND: The use of uncrossmatched group O, Rh-negative RBCs has enabled immediate transfusion of patients who need critical care in life-threatening situations. We examined our 1-year experience with uncrossmatched group O, Rh-negative RBC transfusion in a tertiary care university hospital. METHODS: Uncrossmatched group O, Rh-negative RBCs were available for immediate transfusion upon request without performing any of the following pretransfusion tests: ABO and RhD typing, irregular antibody screening, crossmatching test. The characteristics of the transfused patients were studied retrospectively. RESULTS: Twenty-five patients received 56 units of uncrossmatched group O, Rh-negative RBCs from November 2005 to October 2006. An average of 2.24 units was issued to each patient, with no more than 4 units per patient being given; subsequent transfusion was done with type-specific, crossmatched blood. The average turnaround time for the release of uncrossmatched group O, Rh-negative RBCs was 1.8 minutes (mean+/-standard deviation: 1.8+/-1.96, range: 0~7 minutes). Seventeen patients died (68%), which included 16 patients who had received cardiopulmonary resuscitation. CONCLUSION: Patients admitted for traffic accident, falling down injury, gastrointestinal bleeding and aortic dissection received 72% of the emergency group O, Rh-negative RBCs, with a 72.2% mortality rate, which indicates the dire condition of these patients. The majority of RBCs for transfusion were available within 5 minutes upon request. Though group O, Rh-negative RBCs are recommended in emergency situations in which the blood group of the patient is unknown, the use of group O, Rh-positive RBCs may be an alternative blood supply, when considering the short supply of Rh-negative RBCs.
Accidents, Traffic ; Cardiopulmonary Resuscitation ; Critical Care ; Emergencies* ; Hemorrhage ; Humans ; Mass Screening ; Mortality ; Retrospective Studies ; Tertiary Healthcare

PURPOSE: The use of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography-computed tomography as a routine preoperative modality is increasing for gastric cancer despite controversy with its usefulness in preoperative staging. In this study we aimed to determine the usefulness of preoperative positron emission tomography-computed tomography scans for staging of gastric cancer. MATERIALS AND METHODS: We retrospectively analyzed 396 patients' positron emission tomography-computed tomography scans acquired for preoperative staging from January to December 2009. RESULTS: The sensitivity of positron emission tomography-computed tomography for detecting early gastric cancer was 20.7% and it was 74.2% for advanced gastric cancer. The size of the primary tumor was correlated with sensitivity, and there was a positive correlation between T stage and sensitivity. For regional lymph node metastasis, the sensitivity and specificity of the positron emission tomography-computed tomography were 30.7% and 94.7%, respectively. There was no correlation between T stage and maximum standardized uptake value or between tumor markers and maximum standardized uptake value. Fluorodeoxyglucose uptake was detected by positron emission tomography-computed tomography in 24 lesions other than the primary tumors. Among them, nine cases were found to be malignant, including double primary cancers and metastatic cancers. Only two cases were detected purely by positron emission tomography-computed tomography. CONCLUSIONS: Positron emission tomography-computed tomography could be useful in detecting metastasis or another primary cancer for preoperative staging in gastric cancer patients, but not for T or N staging. More prospective studies are needed to determine whether positron emission tomography-computed tomography scans should be considered a routine preoperative imaging modality.
Electrons ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms ; Biomarkers, Tumor

PURPOSE: This study aimed to assess the characteristics of thyroid nodules among infants diagnosed with congenital hypothyroidism. METHODS: A retrospective study of 660 infants (374 males, 286 females) diagnosed with congenital hypothyroidism was carried out at the Pediatric Endocrine Clinic in Soonchunhyang University Hospital, Korea, between May 2003 and February 2013. The average age at diagnosis was 1.16+/-1.68 months. RESULTS: Of the 28 patients (4.2%) with thyroid nodules, 17 (2.6%) had cystic thyroid nodules and 11 (1.6%) had solid thyroid nodules. There were no significant differences in gender or age between congenital hypothyroidism patients who hadthyroid nodules and those who did not. All nodules were asymptomatic. The average age at diagnosis of congenital hypothyroidism with nodules was 1.42+/-1.39 months. All detected nodules measured less than 1 cm in diameter. Twenty-two of the 28 infants (78.6%) had only one nodule, while multiple nodules were found in 6 infants (21.4%). Of the 28 infants diagnosed with nodules, 16 underwent thyroid ultrasonography during follow-up and 8 of them (50%) showed no signs of nodules at thyroid ultrasonography. CONCLUSION: The prevalence of thyroid nodules in infants with congenital hypothyroidism was 4.2%. Most thyroid nodules were small in size and benign, disappearing during follow-up observation. We therefore conclude that thyroid nodules in infants with congenital hypothyroidism can simply be observed and do not require direct treatment.
Congenital Hypothyroidism* ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Korea ; Male ; Prevalence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography

Pediatric infection with Helicobacter pylori may occur early in childhood and persist lifelong. Global pediatric clinical studies have reported a decreasing tendency in the overall rate of H. pylori eradication. In pediatric patients with H. pylori infection, pediatric patients with peptic ulcer, and the first-degree relatives of patients with a history of gastric cancer, it is commonly recommended that H. pylori strains be eradicated. Antibiotic drug resistance to H. pylori, which has been reported to vary widely between geographic regions, is mainly associated with treatment failure in these patients. It is therefore imperative that the antibiotic resistance rates of H. pylori in children and adolescents be meticulously monitored across countries and throughout geographic regions. This paper particularly focuses on the antibiotic drug resistance of H. pylori and the thearpy of pediatric H. pylori infection cases.
Adolescent ; Anti-Bacterial Agents* ; Child* ; Drug Resistance ; Drug Resistance, Microbial ; Helicobacter pylori* ; Helicobacter* ; Humans ; Peptic Ulcer ; Stomach Neoplasms ; Treatment Failure