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

Clinical types of glomus tumors can be divided into the more common solitary type and the rare multiple types. The latters are subdivided into disseminated, regional, and congenital plaquelike type. We report a 25 year old man with a red to blue colored soft nodular plaques on the back. The lesions were soft reddish patches since birth and gradually enlarged. These were gradually changed to blue colored soft nodular plaques with mild tenderness. The histologic findings were compatible with the glomus tumor.
Adult ; Glomus Tumor* ; Humans ; Parturition

OBJECTIVE: The purpose of this study is to evaluate the usefulness of administration of benzodiazepines in patients with major depression being treated with the antidepressant mirtazapine. METHODS: The subjects of this study included 503 patients between 18 and 65 years of age. They were diagnosed with major depression according to the ICD-10 and scored over 18 at baseline on the 17-item HAM-D scale. They were among the 925 patients who have participated in the Remeron (mirtazapine) post-marketing surveillance carried out between September 1999 and December 2000 at 33 institutes in Korea. The patients were initially started on 15 mg/day or 30 mg/day of mirtazapine orally and the dosages could be changed according to clinical judgment during the trial. Benzodiazepines could also be administrated according to clinical judgment. The clinical effects were evaluated before and 1, 2 and 6 weeks after treatment initiation. The therapeutic action of mirtazapine was evaluated using the 17-item HAM-D and CGI. The adverse effects were rated according to patient reports. RESULTS: Their mean age was 45 years old and 61.6% were women. 391 subjects (77.3%) from a total of 503 patients completed the trials. 313 (62.2%) patients were administrated benzodiazepines during the trial. These were alprazolam 37.0%, lorazepam 12.5%, clonazepam 9.1% and diazepam 7.0%. The reasons for prescribing benzodiazepines were: anxiety 43.1%, insomnia 18.3% and somatic symptoms 3.8%. The HAM-D scores of total patients were reduced from 26.1 to 10.9, and CGI scores from 4.5 to 3.0 after 6 weeks with significant changes beginning after 1 week of treatment. No significant differences were found in terms of each interval changes on the HAM-D and CGI scores between the groups with and without benzodiazepines. There were no significant differences of each interval changes of anxiety/agitation factors and sleep disturbance factors between the two groups. The occurrence of side effects was not significantly different between the two groups. CONCLUSION: Administration of benzodiazepines in patients with major depression being treated with mirtazapine may not be useful in reducing depressive symptoms, even for anxiety/agitation and sleep disturbance symptoms.
Academies and Institutes ; Alprazolam ; Anxiety ; Benzodiazepines* ; Clonazepam ; Depression* ; Diazepam ; Female ; Humans ; International Classification of Diseases ; Judgment ; Korea ; Lorazepam ; Middle Aged ; Sleep Initiation and Maintenance Disorders

OBJECTIVE: The purpose of this study is to evaluate the usefulness of administration of benzodiazepines in patients with major depression being treated with the antidepressant mirtazapine. METHODS: The subjects of this study included 503 patients between 18 and 65 years of age. They were diagnosed with major depression according to the ICD-10 and scored over 18 at baseline on the 17-item HAM-D scale. They were among the 925 patients who have participated in the Remeron (mirtazapine) post-marketing surveillance carried out between September 1999 and December 2000 at 33 institutes in Korea. The patients were initially started on 15 mg/day or 30 mg/day of mirtazapine orally and the dosages could be changed according to clinical judgment during the trial. Benzodiazepines could also be administrated according to clinical judgment. The clinical effects were evaluated before and 1, 2 and 6 weeks after treatment initiation. The therapeutic action of mirtazapine was evaluated using the 17-item HAM-D and CGI. The adverse effects were rated according to patient reports. RESULTS: Their mean age was 45 years old and 61.6% were women. 391 subjects (77.3%) from a total of 503 patients completed the trials. 313 (62.2%) patients were administrated benzodiazepines during the trial. These were alprazolam 37.0%, lorazepam 12.5%, clonazepam 9.1% and diazepam 7.0%. The reasons for prescribing benzodiazepines were: anxiety 43.1%, insomnia 18.3% and somatic symptoms 3.8%. The HAM-D scores of total patients were reduced from 26.1 to 10.9, and CGI scores from 4.5 to 3.0 after 6 weeks with significant changes beginning after 1 week of treatment. No significant differences were found in terms of each interval changes on the HAM-D and CGI scores between the groups with and without benzodiazepines. There were no significant differences of each interval changes of anxiety/agitation factors and sleep disturbance factors between the two groups. The occurrence of side effects was not significantly different between the two groups. CONCLUSION: Administration of benzodiazepines in patients with major depression being treated with mirtazapine may not be useful in reducing depressive symptoms, even for anxiety/agitation and sleep disturbance symptoms.
Academies and Institutes ; Alprazolam ; Anxiety ; Benzodiazepines* ; Clonazepam ; Depression* ; Diazepam ; Female ; Humans ; International Classification of Diseases ; Judgment ; Korea ; Lorazepam ; Middle Aged ; Sleep Initiation and Maintenance Disorders

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*

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

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