Chlinnical observation was conducted on 10 cases of infants of diabetic mother at II Sin Woman's Hopital and the Busan National University Hospital during 19 months from Jan. 1977 to Jul. 1978. The results were summarized as follows : 1. Frequency of diabetic mothers was 0.094% and most of them were in 3rd decade of age. 5 mothers treated, two of them treated irregularly, and five not treated during pregnacy had the mean duration of 3 years from onset of diabetic symptoms to delivery. 2. Diabetic mother whose mean gravidity was 3.6 had histories of toxemia(50%), natural abortions or stillbirths(19%), and I case of polyhydramniosis and pyelonephritis respectively. 3. Among 10 cases of infants of diabetic mothers (5 full terms and 5 preterms), four large for gestational age, three appropriate for gestational age, and three small for gestational age, seven of them were delivered with vaginal and three with C-S deliveries. 4. Among 10 cases of infants of diabetic mothers, two of three infants with hypoglycemia had Apgar score below 6 at 1 minute and died soon after birth, and I case showed hypoglycemic symptoms such as tremor, sweating and so on. Hyperbilirubinemia ranging from 10 to 18 mg/dl in 3 cases, RDS 2 cases, and congenital anomaly 3 cases were also observed.
Apgar Score ; Busan ; Gestational Age ; Gravidity ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Infant* ; Mothers* ; Parturition ; Pyelonephritis ; Sweat ; Sweating ; Tremor

Aging of the population in industrialized countries, as a result of increased life expectancy, is known to be associated with an increased risk of dementia, especially Alzheimer's disease. Estrogen use by postmentopausal women has been reported to have favorable effects on health, cognitive function, and prevention of Alzheimer's disease in old age, which now represents a revitalized area of clinical research. And may investigator reported that estrogen promotes the growth and survival of cholinergic neurons and could decrease cerebral amyloid deposition, both of which may delay the onset or prevent Alzheimer's disease. But more propective studies are needed to establish the dose and duration of estrogen required to provide these benefits and to assess its safety in elderly postmentopausal women.
Aged ; Aging ; Alzheimer Disease* ; Cholinergic Neurons ; Dementia ; Developed Countries ; Estrogens* ; Female ; Humans ; Life Expectancy ; Plaque, Amyloid ; Research Personnel

BACKGROUND: Glomus tumor is a benign neoplasm derived from the normal glomus body. This tumor includes the following types; solitary, multiple, proliferating, and acral arteriovenous. Histologically, it was subdivided into solid type, glomangioma, and glomangiomyoma. Its malignant counterpart - glomangiosarcoma - was reported. OBJECTIVES: The purposes of this study were aimed to evaluate the clinical and pathologic presentations of glomus tumor. METHODS: A total of 17 patients who have been diagnosed with glomus tumor by histopathologic examination were reviewed. RESULTS: Male patients were ten and female patients were seven. The age of the onset of glomus tumor varied from birth to 61 years. The location of tumors were as follows: arm (7 cases), finger (6 cases), back (2 cases), leg (1 case), foot (1 case). The digit was the most common site for female patients. Clinical manifestations showed solitary bluish papule (6 cases), subcutaneous nodule (5 cases), nail discoloration (3 cases), nail dystrophy (1 case), bluish plaque (1 case). One patient had no specific lesion but tenderness. The most characteristic symptom was pain in 15 (88.2%) of the 17 patients, and the other two patients had no symptom. Two asymptomatic lesions were located on the forearm and histopathologically showed glomangioma. Histopathologically, 13 (76.5%) of the 17 patients classified as solid type, and 4 (23.5%) the glomangioma variety. CONCLUSION: Glomus tumors were most commonly seen as a painful nodule on the upper extremity and especially female patients showed predilection for subungual location. We speculate that multiple, mild symptomatic lesions might be a tendency to be glomangioma.
Arm ; Female ; Fingers ; Foot ; Forearm ; Glomus Tumor ; Humans ; Leg ; Male ; Parturition ; Upper Extremity

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These rare benign disorders are considered as congenital diseases caused by malformed differentiation of ductal plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically proven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.
Bile Ducts ; Cholecystitis* ; Diagnosis ; Hamartoma ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Ultrasonography

OBJECTIVE: Although antipsychotic treatments are effective for schizophrenia, at least 25% of schizophrenic patients have little response to conventional neuroleptics. Although patients respond well to antipsychotics initially, they often result in heavy loss of costs and social burden due to the frequent relapse which often require intensive institutional care while the patients experience significant social and functional disabilities. Many studies have come out recently concerning the cost of schizophrenia and its cost-effectiveness in treatment. Clozapine has the risk of agranulocytosis and greater initial cost, however, it has been reported to be cost-effective for the treatment of refractory schizophrenia because of its highly effectiveness, in addition, it has reduced rehospitalization rates and hospital stays. The purpose of this retrospective study was to ascertain the cost-effectiveness of clozapine treatment for patients with refractory schizophrenia in Korea. METHOD: We studied 17 patients with refractory schizophrenia treated by clozapine over a two year period. The numbers of hospitalization, hospital stays two years before clozapine treatment, and two years after clozapine treatment were investigated. Direct costs of psychiatric hospitalization, outpatient treatment, and other costs were estimated. Data on patients' clinical characteristics, use of mental health services and information about the cost of treatments were collected from psychiatric hospitalization records, outpatient records and hospital administration records. Some of the patient data information before the introduction of clozapine treatment were gathered through direct interviews of their families. Therapeutic outcome measures included the Clinical Global Impression (CGI) scale and Global Assessment of Functioning (GAF) score. RESULT: At the initial clozapine treatment, the mean age of subjects was 29 (+/- 7.9) years old. The mean duration of previous psychiatric treatment was 8 (+/- 3.0) years. Average total direct costs were reduced from \4,106,480 in the second pretreatment year to \2,338,427 in the second posttreatment year while the mean hospitalization costs, a percentage of total direct costs, were reduced from 82.9% to 27.4%. Also, the mean hospital stays per year were decreased from 83.4 days to 15.7 days, the mean numbers of hospitalization from 0.59 to 0.18. CGI scale scores and GAF scores showed a statistically significant clinical improvement between before and after clozapine treatment. CONCLUSION: These results suggest that a long-term treatment of clozapine for patients with refractory schizophrenia is indeed more cost-effective than conventional neuroleptic treatment. We suggest more comprehensive and prospective study due to the limitations of this retrospective study.
Agranulocytosis ; Antipsychotic Agents ; Clozapine* ; Hospital Administration ; Hospitalization ; Humans ; Korea ; Length of Stay ; Mental Health Services ; Outcome Assessment (Health Care) ; Outpatients ; Recurrence ; Retrospective Studies ; Schizophrenia*

BACKGROUND/AIMS: The hepat it is C virus (HCV) genotypes have been shown to be differently distributed among distinct geographic areas and as sociated with different clinical present at ions. The aut hors investigated the distribution of HCV genotypes in Korean patients with chronic HCV infection and the as sociation of HCV genotypes with age, sex, severity of the liver disease, and the possible mode of transmission. METHODS: The study population consisted of 143 patients with chronic HCV infect ion: 13 with normal ALT , 78 with chronic hepatitis , 35 with cirrhosis , 17 with hepat ocellular car cinoma (HCC). HCV genotypes were determined by line probe assay. RESULTS: The principal HCV genotype was 1b ( 56%) and followed by 2a/ c ( 32%), mixed (8%), 2b ( 3%), and 1a (1%). Patients infected with type 1b and 2a/ c were older than those with ot her genotypes (p< 0.05). Genotype 1b tended to be more prevalent among patients with HCC ( 76% compared with 53% for patients with other liver diseases ; p=0.07). There was no significant relations hip bet ween genotypes and sex or mode of transmission. CONCLUSION: The most common HCV genotype in Korea was type 1b and followed by 2a/ 2c. Although patients infected with type 1b and 2a/c were older than those with other genotypes, there was no correlation between genotypes and sex, severity of liver disease, or mode of transmission.
Fibrosis ; Genotype ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Hepatitis, Chronic ; Hip ; Humans ; Ions ; Korea ; Liver Diseases

OBJECTIVES: In previous researches the measure of quality of life was assessed either by the subjective experience only or by the objective assessment only, but there have been few studies done using both of these measures and the relationship between these two sides. The aim of this study is to examine the relationship between the subjective experience and the objective assessment of the quality of life in schizophrenic patients and to find out whether the self-rating of these patients is reliable. Also, the relationship between the assessment of the quality of life and the psychopathology of schizophrenia was investigated. METHODS: The subjects are 48 out-patients, from either Yongdong Severance Hospital or Seoul Paik Hospital, whose diagnosis were schizophrenia according to DSM-IV. The standardized Korea version of Quality of Life Scale(K-QOLS) was used for evaluating the objective assessment of quality of life, while both the Korean modification of the Scale to Measure Subjective Well-being under Neuroleptic treatment(KmSWN, 2000) and the Satisfaction of Life Scale(SOL) was used in the evaluation of subjective experience of satisfaction of life. The psychopathology of each patient was assessed by the Positive and Negative Syndrome Scale(PANSS). The patient underwent all the scales on the same day, and the relationship between each scale were analysed by the Spearman's correlation coefficient. RESULTS: The results came out that the total score of PANSS showed negative correlations with the total score of K-QOLS, especially the negative subscale score and the general psychopathology subscale score was correlated more significantly. The total score of KmSWN showed no correlations with neither the total score nor the positive/negative subscale score of PANSS, but the general psychopathology subscale score showed negative correlations with KmSWN significantly. The score of K-QOLS, reflecting the objective assessment, and the score of KmSWN, reflecting the subjective experience, showed positive correlations with each other. But the total score of SOL, reflecting the subjective experience also, showed no correlations with K-QOLS. The score of KmSWN showed positive correlations with the subdomains of interpersonal relations and intrapsychic foundation of K-QOLS, but did not correlate with occuaptional role and daily acitivities. Especially the emotional regulation, the subdomain of KmSWN showed positive correlations with the subscales of K-QOLS. And the subjective and objective quality of life scale both showed negative correlations with the duration of illness and dosages of drugs. CONCLUSIONS: These results suggested that the more severe the psychopathology, the lower the objective quality of life in out-patients with schizophrenia, and the more severe the general psychopathology, the lower the subjective quality of life. The positive relationships between the subjective measure and the objective measure in quality of life were also proved, suggesting that the self-rating of these patients is reliable. The longer the duration of illness and the higher the dosages of drugs, the lower the quality of life in patients with schizophrenia.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Interpersonal Relations ; Korea ; Outpatients ; Psychopathology* ; Quality of Life* ; Schizophrenia* ; Seoul ; Weights and Measures

No abstract available.
Mouth* ; Pathology* ; Tongue* ; Ultrasonography*

OBJECTIVES: Mirtazapine is a newly introduced antidepressant in Korea. The purpose of this study is to evaluate effectiveness and safety of mirtazapine as an antidepressant for the first time in Korean patients with major depression. METHODS: This study is an open, non-comparative, multicenter study treated with mirtazapine for 6 weeks in patients with DSM-IV diagnosis of major depression who have 17-item HAMD score> or = 18 and who are between 18 and 65 years of age. Mirtazapine was administered 30 mg orally as an initial dose and could be increased to 45 mg from the 14th day of treatment, depending on the therapeutic responses of subjects. The clinical efficacy of mirtazapine was assessed at the baseline and at the 1st, 2nd, 4th, and 6th week of treatment. To assess the clinical efficacy of the drug, well-trained psychiatrists have evaluated subjects using 17-item HAMD and CGI on each evaluation periods. Also, for the evaluation of subjective symptoms of patients, BDI was used. Adverse experiences associated with mirtazapine were evaluated on each visit, with recordings of blood pressure, heart rate and weight. The responders were defined as patients with > or = 50% decrease from baseline in total 17-item HAMD scores and remitted patients with a total 17-item HAMD score of < or = 7. RESULTS: Out of 79 subjects enrolled, 45 were completed this study. After 6 weeks, the score of 17-item HAMD, CGI and BDI demonstrated statistically significant decrease compared with at the baseline. This decrease was observed as early as the 1st week of mirtazapine treatment. Moreover, the meaningful reduction in each total scores of these different parameters on each evaluation period could be detected, except in case of 2-4 week and 4-6 week of BDI. The responder rate was 15.6% at the first week of mirtazapine treatment, 88.9% at the 6th week. The rate of remission was 2.2% at the first week and 60.0% at the 6th week. The most frequent adverse events during 6 weeks were somnolence(31.6%), drowsiness(19%) and weight gain(17.7%). Aside from sedation and weight gain, anticholinergic, cardiovascular and stimulating side effects are less than 10%, and no one complained about sexual dysfunction. The dropouts(34 subjects, 43%) were caused by adverse events(38.2%), insufficient compliance(35.3%) and uncooperation with the study(20.6%). CONCLUSION: Mirtazapine has shown to have superior antidepressant effect in this study. Especially, this effect appeared from the early treatment phase, the 1st week of treatment. The most frequent adverse events reported were somnolence, drowsiness and weight gain. Anticholinergic, cardiovascular, stimulating adverse events as well as sexual dysfunction were rarely reported, and there was no clinical significant change on physical examinations. Therefore this study showed that mirtazapine is a superior and safe antidepressant in patients with major depression.
Blood Pressure ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Korea ; Physical Examination ; Psychiatry ; Sleep Stages ; Weight Gain

OBJECTIVES: Mirtazapine is a newly introduced antidepressant in Korea. The purpose of this study is to evaluate effectiveness and safety of mirtazapine as an antidepressant for the first time in Korean patients with major depression. METHODS: This study is an open, non-comparative, multicenter study treated with mirtazapine for 6 weeks in patients with DSM-IV diagnosis of major depression who have 17-item HAMD score> or = 18 and who are between 18 and 65 years of age. Mirtazapine was administered 30 mg orally as an initial dose and could be increased to 45 mg from the 14th day of treatment, depending on the therapeutic responses of subjects. The clinical efficacy of mirtazapine was assessed at the baseline and at the 1st, 2nd, 4th, and 6th week of treatment. To assess the clinical efficacy of the drug, well-trained psychiatrists have evaluated subjects using 17-item HAMD and CGI on each evaluation periods. Also, for the evaluation of subjective symptoms of patients, BDI was used. Adverse experiences associated with mirtazapine were evaluated on each visit, with recordings of blood pressure, heart rate and weight. The responders were defined as patients with > or = 50% decrease from baseline in total 17-item HAMD scores and remitted patients with a total 17-item HAMD score of < or = 7. RESULTS: Out of 79 subjects enrolled, 45 were completed this study. After 6 weeks, the score of 17-item HAMD, CGI and BDI demonstrated statistically significant decrease compared with at the baseline. This decrease was observed as early as the 1st week of mirtazapine treatment. Moreover, the meaningful reduction in each total scores of these different parameters on each evaluation period could be detected, except in case of 2-4 week and 4-6 week of BDI. The responder rate was 15.6% at the first week of mirtazapine treatment, 88.9% at the 6th week. The rate of remission was 2.2% at the first week and 60.0% at the 6th week. The most frequent adverse events during 6 weeks were somnolence(31.6%), drowsiness(19%) and weight gain(17.7%). Aside from sedation and weight gain, anticholinergic, cardiovascular and stimulating side effects are less than 10%, and no one complained about sexual dysfunction. The dropouts(34 subjects, 43%) were caused by adverse events(38.2%), insufficient compliance(35.3%) and uncooperation with the study(20.6%). CONCLUSION: Mirtazapine has shown to have superior antidepressant effect in this study. Especially, this effect appeared from the early treatment phase, the 1st week of treatment. The most frequent adverse events reported were somnolence, drowsiness and weight gain. Anticholinergic, cardiovascular, stimulating adverse events as well as sexual dysfunction were rarely reported, and there was no clinical significant change on physical examinations. Therefore this study showed that mirtazapine is a superior and safe antidepressant in patients with major depression.
Blood Pressure ; Depression* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Heart Rate ; Humans ; Korea ; Physical Examination ; Psychiatry ; Sleep Stages ; Weight Gain