Objectives: Psychiatry in North Korea is still poorly understood. Therefore, it is necessary to study the psychopathology and diagnostic classification of North Korean psychiatry. This study examined North Korea’s psychopathology and diagnostic classification system and how it differs from international standards. Methods: This study reviewed North Korean medical books and medical journals available at the Information Center on North Korea. This literature review and qualitative content analysis examined 15 medical books and 227 medical articles. Results: North Korea’s psychiatric diagnostic classification is based on the International Classification of Diseases, 10th edition (ICD-10), but with some modifications to reflect the circumstances of North Korea. While the research journals mainly used the ICD-10 diagnostic criteria, North Korea has its own diagnostic criteria, which it refers to as the “existing diagnostic criteria.” ‘Neurotic disorders’ were the most common, both in the classification in the medical books and the list of disorders covered in the medical journals. There was an interest in ‘organic mental disorders,’ such as postconccusional syndrome and ‘mental disorders due to encephalic parasitism,’ but relatively little research on mood disorders. There were no studies on suicide and a view that alcohol is abused in capitalist countries. Conclusion This study examined the diagnostic classification system of North Korean psychiatry.Further analyses of the characteristics of the psychopathology used in North Korea can be used to understand North Korean society.

The purpose of this study was to evaluate the influence of sodium ascorbate on microtensile bond strengths of total-etching adhesive system to pulp chamber dentin treated with NaOCl. Pulp chambers of extracted human non-caries permanent molars were treated as follows: group 1, with 0.9% NaCl; group 2, with 5.25% NaOCl; group 3, with 5.25% NaOCl and 10% sodium ascorbate for 1min; group 4, with 5.25% NaOCl and 10% sodium ascorbate for 1 min and 10ml of water; group 5, with 5.25% NaOCl and 10% sodium ascorbate for 5 min; group 6, with 5.25% NaOCl and 10% sodium ascorbate for 5 min and 10ml of water; group 7, with 5.25% NaOCl and 10% sodium ascorbate for 10 min; group 8, with 5.25% NaOCl and 10% sodium ascorbate for 10 min and 10ml of water. Treated specimens were dried, bonded with a total-etching adhesive system (Single bond), restored with a composite resin(Z250) and kept for 24h at 100% humidity to measure the microtensile bond strength. NaOCl-treated group (group 2) demonstrated significantly lower strength than the other groups. No significant difference in microtensile bond strengths was found between NaCl-treated group (group 1) and sodium ascorbate-treated groups (group 3-8). The results of this study indicated that dentin treated with NaOCl reduced the microtensile bond strength of Single bond. Application of 10% sodium ascorbate restored the bond strength of Single bond on NaOCl-treated dentin. Application time of sodium ascorbate did not have a significant effect.
Adhesives ; Ascorbic Acid ; Bisphenol A-Glycidyl Methacrylate ; Dental Pulp Cavity ; Dentin ; Humans ; Humidity ; Molar ; Sodium ; Water

The safety and efficacy of Poly-L-lactic acid (PLLA) as an injectable facial volumizer for the treatment of lipoatrophy and facial rejuvenation has been widely proven. We experienced a remarkable case of deep-seated nodules on both the cheeks of 57-year-old female 18-months after administration of PLLA filler injection for cosmetic purpose and performed a skin biopsy. With hematoxylin and eosin stain, the nodule showed non-caseating granulomas consisting of histiocytes with central foreign bodies in the dermis. This case report represents the late-onset foreign body reaction due to PLLA facial injections.

PURPOSE: The aim of this study was to evaluate recent improvements in the survival rate of extremely low birth weight (ELBW) infants and to identify perinatal and management factors that are associated with improved survival. METHODS: Two groups of ELBW infants who were admitted to our neonatal intensive care unit (NICU) during two distinct eras: November 1994-December 1999 (Period 1: n=100) and January 2000-April 2004 (Period 2: n=166) were retrospectively reviewed. RESULTS: Despite the younger gestational age and smaller birth weight of the ELBW infants in period 2, not only did their survival rate increased to 75 percent from 60 percent in period 1, but their incidence of morbidities such as bronchopulmonary dysplasia, confimed sepsis and intraventricular hemorrhage (> or =Grade III) also declined. Factors significantly associated with improved survival included the use of antenatal steroids, a longer duration of nasal continuous positive airway pressure and the absence of intraventricular hemorrhage (> or =Grade III). CONCLUSION: We believe that optimized clinical practice, that emphasized less invasive care, contributed to the recent improvements in the survival rate of ELBW infants.
Infant ; Male ; Female ; Infant, Newborn ; Humans ; Incidence

PURPOSE: This study was aimed to investigate the risk factors of cholestasis in very low birth weight infants (VLBWI). METHODS: The study includes 466 VLBWI admitted to the neonatal intensive care unit at Samsung medical center from November 1994 to January 2003 and the data were collected retrospectively from their medical records. They were divided into two groups; cholestatic group (group 1) and control group (group 2) by level of direct bilirubin at 2.0 mg/dL. RESULTS: The mean gestational age and birth weight were lower in group 1. In group 1, enteral feeding was started later, time to achieve full and near full enteral feeding were delayed and duration of parenteral nutrition was longer than group 2. The incidence of bronchopulmonary dysplasia was significantly higher in group 1, but the incidences of sepsis and necrotizing enterocolitis were not different between the two groups. After adjusting for birth weight and gestational age, logistic regression analysis of the above factors revealed that the factors significantly related to cholestasis were longer duration of parenteral nutrition and longer time to achieve near full enteral feeding. CONCLUSION: Earlier near full enteral feeding and shorter duration of parenteral nutrition decreased the incidence of cholestasis.
Bilirubin ; Birth Weight ; Bronchopulmonary Dysplasia ; Cholestasis* ; Enteral Nutrition ; Enterocolitis, Necrotizing ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Logistic Models ; Medical Records ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Retrospective Studies ; Risk Factors* ; Sepsis

PURPOSE: It has been reported that all-trans retinoic acid (ATRA) can inhibit glioma growing in vitro. However, clinical trials with ATRA alone in gliomas revealed modest results. ATRA has been shown to increase radiosensitivity in other tumor types, so combining radiation and ATRA would be one of alternatives to increase therapeutic efficacy in malignant gliomas. Thus, we intended to know the role of catalase, which is induced by ATRA, for radiosensitivity. If radiation-reduced reactive oxygen species (ROS) is removed by catalase, the effect of radiation will be reduced. MATERIALS AND METHODS: A rat glioma cell line (36B10) was used for this study. The change of catalase activity and radiosensitivity by ATRA, with or without 3-amino-1, 2, 4-triazole (ATZ), a chemical inhibitor of catalase were measured. Catalase activity was measured by the decomposition of H2O2 spectrophotometrically. Radiosensitivity was measured with clonogenic assay. Also ROS was measured using a 2, 7-dichlorofluorescein diacetate spectrophotometrically. RESULTS: When 36B10 cells were exposed to 10, 25 and 50microM of ATRA for 48 h, the expression of catalase activity were increased with increasing concentration and incubation time of ATRA. Catalase activity was decreased with increasing the concentration of AT (1, 10 mM) dose-dependently. ROS was increased with ATRA and it was augmented with the combination of ATRA and radiation. ATZ decreased ROS production and increased cell survival in combination of ATRA and radiation despite the reduction of catalase. CONCLUSION: The increase of ROS is one of the reasons for the increased radiosensitivity in combination with ATRA. The catalase that is induced by ATRA doesn`t decrease ROS production and radiosensitivity.
Animals ; Catalase* ; Cell Line ; Cell Survival ; Glioma* ; Radiation Tolerance* ; Rats* ; Reactive Oxygen Species ; Tretinoin*

Vertebral, anal, cardiac, tracheo-esophageal, renal, and limb(VACTERL) association is defined as the presence of at least three of the above-mentioned six manifestations. An estimated incidence of the VACTERL association is 1 in 20,000 to 35,000 live births although the diagnostic criteria vary. The VACTERL association is highly heterogeneous in clinical presentation. It may represent a spectrum from the less severely affected to the more severely affected. Diagnosis is difficult because of the number of disorders that have overlapping features with trisomy 13 syndrome, trisomy 18 syndrome, trisomy 21 syndrome, Feingold syndrome, and so on. The incidence of trisomy 18 syndrome, a type of a chromosomal disorder, is estimated to be 1 in 6,000-8,000 live births. It includes characteristic craniofacial anomalies, clenched hand with overlapping of index finger over third, fifth finger over fourth, underdeveloped thumbs, short sternum, cardiac anomalies such as ventricular septal defect, and renal anomalies such as horseshoe kidney. Approximately over 50% of infants with trisomy 18 syndrome live less than one week. In 1983, Khoury et al. reported VACTERL association combined with trisomy 18 syndrome. Here, we report a case of a low birth weight female infant with VACTERL association, whose second diagnosis is Edward syndrome, and that she also has another combined anomaly, meningomyelocele. To the best of our knowledge, this is the first reported case of VACTERL association with meningomyelocele combined with trisomy 18 syndrome in Korea.
Chromosome Disorders ; Diagnosis ; Down Syndrome ; Female ; Fingers ; Hand ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Kidney ; Korea ; Live Birth ; Meningomyelocele* ; Sternum ; Thumb ; Trisomy*

BACKGROUND: Diffusion-perfusion mismatch (DPM) on MRI has been considered an ischemic penumbra. However, several reports have demonstrated limitation of DPM on MRI as a predictable marker of the ischemic penumbra. In this study, we investigated the relationship between DPM and the clinical progression in acute ischemic stroke patients. METHODS: We consecutively recruited fifty-seven patients showing acute ischemic stroke (within 24 hours) in the middle cerebral artery (MCA) territory. The clinical outcomes were determined by serial measurement of National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) during 30 days after their ischemic event. We also evaluated the relationship among the parameters of perfusion MRI and the clinical worsening in patients with DPM on initial MRI. RESULTS: Nineteen (33.3%) patients had DPM on MRI within 24 hours after stroke onset. Even though the frequency of clinical worsening for 30 days after stroke onset was higher in DPM group (26%) than in non-DPM group (11%), it did not reach statistical significance (p=0.143). However, extent of MCA stenosis (p<0.001) and time to peak (TTP) delay on MRI (p<0.001) were significantly greater in patients with DPM than in those without DPM. Among several parameters of the perfusion MRI, only relative cerebral blood volume (rCBV) was significantly related to the clinical worsening (62.9+/-24.7% vs 96.1+/-19.2%, p=0.007) in patients with DPM. CONCLUSIONS: This study shows that DPM on MRI does not always predict the clinical worsening in acute ischemic stroke. To overcome this problem, we should analyze rCBV map based DPM as well as TTP map based DPM.
Blood Volume ; Brain ; Constriction, Pathologic ; Diffusion ; Humans ; Magnetic Resonance Imaging ; Middle Cerebral Artery ; Perfusion ; Stroke ; Thymine Nucleotides

BACKGROUND: Despite of numerous researches on the mechanisms and new therapeutic methods of chronic pain, patients are still suffering even with the help of opioids. In recent years, however, with the development of molecular-biology cell transplantation gives us a new chance for treating intractable chronic pain. The major purpose of the present study was to determine if the chromaffin cells have robust analgesic effects in the spinal atlanto-occipital subarachnoid space even without nicotine stimulation. METHODS: In order to determine whether cultured bovine adrenal medullary chromaffin cells transplanted in the spinal cord can produce analgesic effects, we purified adrenal medullary chromaffin cells and implanted them into the subarachnoid space of rats' (n = 10) spinal cord without immunosuppression, and investigated the hot sensitivity of rats' hind-paw by a light-beam test. RESULTS: It was found that compared with the control group, hot response latency of the group which received adrenal medullary chromaffin cells had increased at 14 days and the analgesic efficacy was maintained for at least 3 months. CONCLUSIONS: Adrenal medullary chromaffin cells transplanted in the rats' spinal cord may provide a permanent and locally available source of neuropeptides for the relief of intractable pain. Furthermore, these kinds of analgesic effect even produced without any stimulation such as nicotine.
Analgesics, Opioid ; Animals ; Cell Transplantation ; Chromaffin Cells* ; Chronic Pain ; Humans ; Immunosuppression ; Neuropeptides ; Nicotine ; Pain, Intractable ; Rats* ; Reaction Time ; Spinal Cord* ; Subarachnoid Space ; Transplants

Patients with severe neurological deficit, such as hypoxic ischemic injury, cerebral infarction, and traumatic brain injury, often show comatose mental status and require maintenance of long-term tracheostomy for pulmonary toileting. However, several complications, which are mostly related to the cannula, invariably occur. Permanent tracheostoma is a short, skin-lined, noncollapsing, self-sustaining opening by suturing the denuded skin lining to the margin of the tracheal stoma. This tube-free method is a useful alternative to make long-term airway without tube-related complications in chronic diseases, such as obstructive sleep apnea, and laryngeal cancer, however, it has not yet been reported in chronic brain injured patients. This case report illustrates 3 cases of vegetative patients in our rehabilitation clinic who underwent successful procedure of permanent tracheostoma. Permanent tracheostoma has some benefits associated with the free of tube-related complications, and can be considered as a useful alternative way for chronic brain injured patients with long-term tracheostomy.
Brain Injuries/complications/*rehabilitation ; Humans ; Male ; Middle Aged ; Trachea/*surgery ; Tracheostomy/*methods ; Treatment Outcome