An association of low total cholesterol in blood with psychiatric diseases and suicidal behavior has been suggested. As part of an attempt to further explore this relationship, we examine first, whether serum cholesterol levels in psychiatric patients with suicidal attempt would be lower than in non-suicidal psychiatric inpatients or normal controls, second, whether such significant difference of cholesterol levels would be present when the diagnostic groups are analyzed separately, third whether low cholesterol level would be associated with a history of serious suicidal attempts, and finally, whether low cholesterol level in suicide attempters is as state or a trait marker. We determined the serum cholesterol levels in 231 patients admitted to an emergency room following an suicidal attempt, in the same numbers of age-, sex- and diagnosis-matched non-suicidal psychiatric controls, and in the same numbers of age-, sex matched normal controls. The seriousness of an attempt was divided into 5 grades according to the degree of the resulting medical injury. Total cholesterol levels in suicide attempters were significantly lower compared with both psychiatric and normal controls, when sex, age, and nutritional status(i.e., body mass index) were controlled for. This significant relationship was observed in major depressive disorders and personality disorders, but not in schizophrenia and bipolar type I disorders. The severity of suicide by a lowering of blood cholesterol was related to the magnitude of the cholesterol reduction. After treatment of their psychiatric ailments, the cholesterol levels in suicide attempters were significantly increased. This result suggests that low cholesterol level in psychiatric patients might be a potential biological marker of suicide risk. It is hypothesized that low cholesterol levels is associated with the suicide by modifying the serotonin metabolism, the production of interleukin-2 and melatonin metabolism in psychiatric patients.
Biomarkers ; Cholesterol* ; Depression ; Depressive Disorder, Major ; Emergency Service, Hospital ; Humans ; Inpatients ; Interleukin-2 ; Melatonin ; Metabolism ; Personality Disorders ; Schizophrenia ; Serotonin ; Suicide*

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

Contact urticaria refers to a wheal-and-flare response after cutaneous exposure to certain chemicals. If contact urticaria is accompanied by systemic symptoms, it is referred to as contact urticaria syndrome. Herein we report two cases of contact urticaria syndrome occur-ring in nurses due to occupational exposure to cefotiam.
Cefotiam ; Occupational Exposure ; Urticaria*

OBJECTIVE: It has been reported that the sleep apnea syndrome in the asthmatic patients is prevalent, however, the systematic study in this field using polysomnography has rarely been performed. The aim of this study is to investigate the relationship between the apnea-hypopnea index (AHI) and the pulmonary function in asthmatic children. METHODS: This study enrolled 19 male and 12 female asthmatic children aged 6-13 years (average 8.2+/-1.7 years old). Complete overnight polysomnography and pulmonary function test were performed for the participants. RESULTS: Of the 31 asthmatic children, 21 (67.7%) met the diagnostic criteria of the pediatric sleep apnea and the average AHI was 1.7+/-1.5/h. The children with higher AHI showed poorer pulmonary function (FEV1/FVC ratio : p=0.002, FEV1%pred : p=0.047). CONCLUSION: These results suggest that the prevalence of the pediatric sleep apnea could be very high among the asthmatic children and the severity of the sleep apnea correlates with the pulmonary function. However, the case-control study to compare the AHI between the asthma and control groups is absolutely necessary because few normative data are available for the children.
Aged ; Asthma ; Case-Control Studies ; Child ; Female ; Humans ; Male ; Polysomnography ; Prevalence ; Respiratory Function Tests ; Sleep Apnea Syndromes

PURPOSE: To report a case of iridocorneal endothelial syndrome with pigmentary glaucoma. METHODS: We encountered a 44-year-old unilateral glaucoma patient who complained of intermittently decreased visual acuity in the right eye. For differential diagnosis, we carried out ophthalmic and systemic examination. RESULTS: Binocular corrected visual acuity was 1.0. His intraocular pressure, measured using a Goldmann applanation tonometer, was 50 mm Hg in the right eye and 18mm Hg in the left. Upon examination of the right eye, we found pigments with a Krukenberg's spindle appearance on the corneal endothelium, peripheral anterior synechia extending beyond Schwalbe's line, trabecular hyperpigmentation, endothelial pleomorphism, polymegathism, cell loss, dark area within the cells, a light central spot and light peripheral zone, retinal nerve fiber layer defects, and visual field defects, which together led to the diagnosis of iridocorneal endothelial syndrome with pigmentary glaucoma. We observed progressed glaucomatous injury upon examination of the disc stereo photograph, retinal nerve fiber layer photograph, and visual field test, even though we used topical IOP reducers. Eventually, we performed a trabeculectomy in the right eye. CONCLUSIONS: We experienced a case of iridocorneal endothelial syndrome with unilateral pigmentary glaucoma. The glaucoma was not well-controlled with topical IOP reducers. The glaucoma was then treated by a trabeculectomy. We report this case with a review of the literature.
Adult ; Diagnosis ; Diagnosis, Differential ; Endothelium, Corneal ; Glaucoma ; Glaucoma, Open-Angle* ; Humans ; Hyperpigmentation ; Intraocular Pressure ; Iridocorneal Endothelial Syndrome* ; Nerve Fibers ; Retinaldehyde ; Telescopes ; Trabeculectomy ; Visual Acuity ; Visual Field Tests ; Visual Fields

Statement of problem. Proliferation of Candida albicans is primarily within the plaque on the fitting surface of the denture rather than on the inflamed mucosa. Consequently, the treatment of the denture is equally important as treatment of the tissue. Cleansing and disinfection should be efficiently carried-out as the organisms can penetrate into the voids of the acrylic resin and grow in them, from which they can continue to infect and reinfect bearing tissues. Purpose. The purpose of this study was to evaluate the applicability of photocatalytic reaction to eliminate Candida albicans from acrylic resin denture base, and to investigate the antifungal effect with various UVA illumination time. Materials and Methods. The specimens were cured by the conventional method following the manufacturer's instruction using thermal polymerized denture base resin (Vertex RS; Dentimex, Netherlands). TiO2 photocatalyst sol(LT), which is able to be coated at normal temperature, was made from the Ti-alkoxide progenitor. The XRD patterns, TEM images and nitrogen absorption ability of the TiO2 photocatalyst sol(LT) were compared with the commercial TiO2 photocatalyst P-25. The experimental specimens were coated with the mixture of the TiO2 photocatalyst sol(LT) and binder material (silane) using dip-coater, and uncoated resin plates were used as the control group. Crystallinity of TiO2 of the specimen was tested by the XRD. Size, shape and chemical compositions were also analyzed using the FE-SEM/EDS. The angle and methylene blue degradation efficiency were measured for evaluating the photocatalytic activity of the TiO2 film. Finally, the antifungal activity of the specimen was tested. Candida albicans KCTC 7629(1 ml, initial concentration 105cells/ml) were applied to the experiment and control group specimens and subsequently two UVA light source with 10W, 353 nm peak emission were illuminated to the specimens from 15cm above. The extracted 2 microliter of sample was plated on nutrient agar plate (BactoTM Brain Heart Infusion; BD, USA) with 10 minute intervals for 120 minute, respectively. It was incubated for 24 hours at 37 degree C and the colony forming units (CFUs) were then counted. Results. Compared the characteristics of LT photocatalyst with commercial P-25 photocatalyst, LT were shown higher activity than P-25. The LT coated experimental specimen surface had anatase crystal form, less than 20 nm of particle size and wide specific surface area. To evaluate the photocatalytic activity of specimens, methylene blue degradation reaction were used and about 5% of degradation rate were measured after 2 hours. The average contact angle was less than 20.indicating that the LT photocatalyst had hydrophilicity. In the antifungal activity test for Candida albicans, 0% survival rate were measured within 30 minute after irradiation of UVA light. Conclusion. From the results reported above, it is concluded that the UVA-LT photocatalytic reaction have an antifungal effect on the denture surface Candida albicans, and so that could be applicable to the clinical use as a cleaning method.
Absorption ; Agar ; Brain ; Candida albicans* ; Candida* ; Crystallins ; Denture Bases* ; Dentures* ; Disinfection ; Heart ; Hydrophobic and Hydrophilic Interactions ; Lighting ; Methylene Blue ; Mucous Membrane ; Nitrogen ; Particle Size ; Polymers ; Stem Cells ; Survival Rate

Several reports on burst fractures of the thoracolumbar spine have noted that the neural canal encroachment caused by bone in the canal did not correlate with the neurologic status of the patient. But in the thoracolumbar spine the average percent compromise was significantly higher in those patients with complete and incomplete lesions, compared with those patients with no neural deficits. In this study, we evaluated 38 patients with unstable thoracolumbar fractures, operated from March 1989 to February 1993 to know the amount of neural canal compromise, demonstrated on computed tomography scans with neurologic status, level of injury and type of fractures. Among them 22 patients had neurologic deficit and 16 did not neurologic deficit. The results were as follows; 1. 19(76%) of 22 patients with disruption of the posterior spinal elements had neurologic defictis. 2. In the group with neurologic deficits, the stenotic ratio was 44% at the epiconus level, 55% at the conus medullaris, level and 63% at the cauda equna level. 3. The average A-P diameter of the bony fragments retropulsed into the spinal canal was 4.5mm at the epiconus level, 5.2mm at the conus medullaris level and 6.0mm at the cauda equina level. 4. Unstable bursting fracture and fracture dislocation showed higher incidence of neurologic injury and percentage of spinal stenotic ratio than those of flexion distraction and wedge compression fracture. In conclusion, the higher the level of the injured vertebrae, the smaller the size of the retropulsed fragment needed compromise the neural tissues. We suggest that it is necessary to get enough decompression for restoration of spinal canal and recovery of neurological function and computed tomography was more sensitive than any other modality in detection the reduction of the retropulsed bony fragment into spinal canal.
Cauda Equina ; Decompression ; Dislocations ; Fractures, Compression ; Humans ; Incidence ; Neural Tube ; Neurologic Manifestations ; Spinal Canal ; Spinal Cord ; Spine ; Tomography, X-Ray Computed

No abstract available.

No abstract available.
Hyperlipoproteinemia Type IV* ; Hyperlipoproteinemias ; Xanthomatosis*

Although seclusion and restraint are required for the treatment of mentally ill patients in psychiatric hospitals, these procedures involve potential violations of human rights and pose a potential risk to patients' physical condition. Nursing staffs in psychiatric hospitals often have to manage psychiatric patients who display aggressive, violent, or challenging behavior. However, the guidelines for the use of seclusion and restraint in Korea are too broad to apply in clinical situations. The guidelines in the United States, Australia, the United Kingdom, and New Zealand emphasize that patients' basic needs have to be met and stipulate that patient–staff interaction must be continued during seclusion and restraint procedures. Mental health workers in psychiatric hospitals should pay close attention to patients' verbal and non-verbal expressions while communicating with them. This study reviews the guidelines for seclusion and restraint used in foreign countries to improve current Korean guidelines and provides strategies of the nursing activities to be implemented when patients require seclusion and restraint.
Australia ; Great Britain ; Hospitals, Psychiatric ; Human Rights ; Humans ; Korea ; Mental Health ; Mentally Ill Persons ; New Zealand ; Nursing Staff ; Nursing ; Psychiatric Nursing ; United States