No abstract available.

PURPOSE: The purpose of this study was to evaluate the clinical results of fixation of the unstable osteochondral dissecans (OCD) lesion with autologous osteochondral plugs. MATERIALS AND METHODS: This study was conducted in 19 patients who were relevant to the International Cartilage Repair Society 2, 3, or 4 who were treated with autologous osteochondral plugs and followed-up for more than 2 years from January 2004 to January 2012. Clinical evaluation was performed by comparing the preoperative and last follow-up scores of Lysholm score and subjective International Knee Documentation Committee (IKDC) score. RESULTS: All patients were male and the average age was 19.1 years. Of the 19 cases, there were 16 cases of medial femoral condyle lateral side lesion, 2 cases of lateral femoral condyle articular surface, and 1 case of femoral intercondylar notch lesions. The average size of the lesion was 5.68 mm2, and average use of osteochodral plugs were 4.3. Average follow-up period was 38 months. Preoperative Lysholm score, IKDC subjective score showed significant improvement. CONCLUSION: Fixation with autologous osteochondral plugs for unstable OCD uses the remnant tissues therefore conserving it, which is thought to be the positive aspect of this type of operation.
Cartilage ; Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Male

In the face of rapid changes of society and medical environment, we now come to a crisis in which the identity of psychiatry is threatened. The regulations of a society are rules made in order to govern the way its activities are done or to control the way its members behave. So, the amendment of the regulations of Korean Neuropsychiatric Association (KNPA) are needed to cope with current difficulties efficiently. The planning committee drew up a revised version of regulations based on the intent of KNPA, i.e., developing neuropsychiatry, enhancing the mental health of people, promoting friendship among the members and extending the rights of members. As the need of the hour, the establishment of an institute to carry out the development of mental health polices on a long-term basis, the reestablishment of the relations with connected organizations and academic societies, and the reconstitution of the KNPA organization to heighten the efficiency of operations were chosen. In this article, the details of revised regulations were proposed and discussed.
Friends ; Human Rights ; Humans ; Mental Health ; Neuropsychiatry ; Social Control, Formal*

After publishing 2001 version of the Korean Medication Algorithm for Schizophrenia, the strategy of pharmacologic treatment for schizophrenia has been altered with the rapid advancement in the area of psychopharmacology. Currently, the feasibility of this algorithm has been evaluated. Guidelines require updating when significant new evidence appears. Recently, several guidelines of the treatment of schizophrenia including the APA practice guideline, the Expert Consensus Guideline Series and the Texas Medication Algorithm Project (TMAP) Antipsychotic Algorithm for Schizophrenia were revised. In this review, the authors briefly discussed the problems and limitations of the Korean Medication Algorithm for Schizophrenia and presented the direction of future revision on the model of above-mentioned guidelines.
Consensus ; Drug Therapy ; Methods* ; Practice Guidelines as Topic ; Psychopharmacology ; Schizophrenia* ; Texas

After the discovery of antipsychotic drugs, the nature of clinical practice entered a period of inexorable transition. The advances of psychopharmacotherapy have interacted in complex ways with clinical practice, and the economics and policy of mental health care systems. The study of the mechanisms of action of these drugs has guided the development of hopefully improved treatment, and stimulated biological research on the pathophysiology of severe mental disorders. Despite the considerable effort to modify and change existing antipsychotic drugs, progress has been modest. This review describes the history of antipsychotic drugs and their impact on clinical practice and the study of psychiatric disorders, and offer prospects for future developments. Although finding new knowledge and methodologies to bring innovative discovery is imperative, as of now, it is important to provide comprehensive care, including the optimal use of existing antipsychotic drugs.
Antipsychotic Agents ; Mental Disorders ; Mental Health

OBJECTIVES: Many chronic schizophrenics are suffered from treatment-refractory hallucinations. As a countermeasure, the combined use of neuroleptics and benzodiazepines has been studied. In this context, the authors tried to evaluate the anti-hallucinatory effect of neuroleptics-clonazepam combination therapy. METHODS: At first, the authors described 3 cases of chronic schizophrenics who reported alleviation of hallucinations, which are resistant to neuroleptic treatment, after adding clonazepam. And then, prospective open study including 6 female chronic schizophrenic inpatients having neuroleptic-refractory hallucinations was done. In addition to existing psychiatric medication, these patients were treated with clonazepam 1.5 mg for 6weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 6 weeks of treatment. The psychopathology was assessed by the items of hallucinatory behavior and anxiety/tension of PANSS and BPRS. Clinical improvement was defined by fall-off of the hallucinatory behavior below the moderate level. The side effects were assessed by UKU Side Effect Rating Scale. RESULTS: All patients completed 6 weeks' trial. At the end of 6 weeks, 2 (33.3%) of 6 patients showed decrement of the hallucinatory behavior below the moderate level, when evaluated by PANSS and BPRS. However, the courses of anti-hallucinatory effect were different in these 2 patients. Another one patient showed that the hallucinatory behavior assessed by BPRS fell to the moderate level, but not when assessed by PANSS. The item of anxiety/tension was unchanged in all 6 patients. Except very mild sedation in one patient, there was no side effect. CONCLUSION: This study suggests that neuroleptics-clonazepam combination therapy is effective against treatment-refractory hallucinations in some schizophrenics and generally safe.
Antipsychotic Agents ; Benzodiazepines ; Clonazepam* ; Female ; Hallucinations* ; Humans ; Inpatients ; Prospective Studies ; Psychopathology ; Schizophrenia

BACKGROUND: Anesthesia and surgery may exacerbate liver function in patients with pre-existing liver disease so it is important to choose less hepatotoxic anesthetics in patients with chronic liver disease. METHODS: This study was designed to examine the postoperative liver function test in 150 patients after hepatectomy with portal triad clamping through retrospective chart review. Patients were divided into an isoflurane group (group I, n = 56) and a propofol group (group P, n = 57) by used anesthetics for maintaining anesthesia. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, alkaline phosphatase, total bilirubin, albumin, and prothrombin time were checked at preoperation, and postoperatively at 1, 3, 7 and 14 days in the two groups. Indocyanine retention rate (ICG-R15) was measured at preoperation, and postoperatively at 1 and 7 days. RESULTS: AST values increased postoperatively at 1, 3, 7, and 14 days compared with preoperation. ALT values increased postoperatively at 1, 3 and 7 days compared with preoperation and there was difference between group I (443.8 +/- 52.1 U/L) and group P (202.7 +/- 24.7 U/L) at postoperative 1 day. Other values had no significant difference between the two groups. CONCLUSIONS: Though it might need a well controlled study to find the differences in effect between isoflurane and propofol on the postoperative liver function test, we concluded that total intravenous anesthesia using propofol is also one of the safest anesthetic methods for hepatic resection with minimal hepatotoxicity.
Alanine Transaminase ; Alkaline Phosphatase ; Anesthesia ; Anesthesia, Intravenous ; Anesthetics ; Aspartate Aminotransferases ; Bilirubin ; Constriction* ; Hepatectomy ; Humans ; Isoflurane* ; L-Lactate Dehydrogenase ; Liver Diseases ; Liver Function Tests* ; Liver* ; Propofol* ; Prothrombin Time ; Retrospective Studies

PURPOSE: This study was conducted to investigate the prognostic factors of postpsychotic depressive symptoms in patients with schizophrenia. MATERIALS AND METHODS: Eighty patients were selected based on the diagnostic criteria from the DSM-IV, PANSS and ESRS. For all patients information was collected on demographic and clinical characteristics. The subjective depressive symptoms and the objective depressive symptoms, as well as patients insight regarding psychosis were evaluated. The subjective depressive symptoms were evaluated by BDI and ZDS; the objective depressive symptoms were evaluated by HDRS and CDSS, and patient insight into the psychosis was evaluated by KISP. RESULTS: The comparisons using demographic and clinical characteristics showed that HDRS and CDSS had significant difference with regard to gender and suicide attempts; the BDI was associated with difference in education level and age of onset. The patients with scores above cuff-off score for each scale were 20 (25.0%) for the BDI, 16 (20.0%) for the ZDS, 18 (22.5%) for the CDSS and 6 (7.5%) for the HDRS. The results of the stepwise multiple regression analysis showed that the scores for the KISP, education levels, gender and suicide attempts were the main prognostic factors in patients with the psychotic depressive disorder of schizophrenia. CONCLUSION: The main prognostic factors in psychotic depressive disorder of schizophrenia included: insight into psychosis, suicidal attempts. Insight into the psychosis was the most reliable prognostic factor but this characteristic had a negative relationship to the with depressive symptoms.
Age of Onset ; Depression ; Depressive Disorder* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Prognosis ; Psychotic Disorders ; Schizophrenia* ; Suicide

BACKGROUND: Recent studies demonstrated that volatile anesthetics suppress the NO-cGMP system in the vascular system. It has been known that the hemodynamic changes produced by volatile anesthetics in septic patients are mediated by upregulation of iNOS leading to excessive release of NO. The mechanisms underlying suppression of the NO-cGMP system by anesthetics are still controversial. It has been elucidated that nitric oxide synthase (NOS) plays a major role in the regulatory function in the L-arginine-NO system. So we examined the effects of NOS inhibitor (L-NAME, aminoguanidine) and NO scavenger (hydroxocobalamin) on vascular smooth muscle contractile function in lipopolysaccharide (LPS)-treated rat aorta during halothane administration. METHODS: Aortic ring preparations were obtained from LPS-treated (1.5 mg/kg, ip, for 18 h) rats. We evaluated the effects of hydroxocobalamin, L-NAME and aminoguanidine on contractile responses to phenylephrine during halothane (1 & 2 MAC) administration respectively. Statistical significances (P<0.05) were analyzed according to data characterictics by repeated measures ANOVA test and student's t-test. RESULTS: The contractile responses to phenylephrine in LPS-treated rats aorta were significantly (P<0.05) increased in the presence of hydroxocobalamin and L-NAME. During the halothane (1 and 2 MAC) administration, the contractile responses to phenylephrine in LPS-treated rats aorta were increased significantly (P<0.05) in the presence of hydroxocobalamin and L-NAME. CONCLUSIONS: From these results, it is suggested that hydroxocobalamin and L-NAME may be useful in the therapy of septic shock.
Anesthetics ; Animals ; Aorta ; Halothane* ; Hemodynamics ; Humans ; Hydroxocobalamin* ; Muscle, Smooth, Vascular ; NG-Nitroarginine Methyl Ester* ; Nitric Oxide Synthase ; Phenylephrine ; Rats* ; Shock, Septic ; Up-Regulation

OBJECTIVE: Several tests can be used to screen for alcohol dependence (AD), a prevalent disease with a heterogeneous etiology. As some patients with AD have a strong familial tendency in this regard, a family history of alcohol use disorders can affect the outcomes of screening tests and diagnostic evaluations for AD. In this study, we evaluated associations between a family history of alcohol use disorders and evaluations using the Cut down, Annoyed, Guilty, Eye-opener (CAGE) test, Alcohol Use Disorder Identification Test (AUDIT), and Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) diagnostic criteria among patients with AD. METHODS: We recruited 487 male patients with AD from eight hospitals in Korea. Patients were evaluated using the CAGE, AUDIT, and DSM-IV diagnostic criteria. Patients with and without family histories were compared in terms of these assessment tools. RESULTS: Drinking initiation, uncontrollable drinking, and problem drinking occurred earlier and CAGE "annoyed" scores were higher in patients with a family history. Alcohol problems before the age of 25 years, frequency of spontaneous or compulsive alcohol-seeking behavior, and frequencies of psychological dependence and guilt related to alcohol use were also higher. CONCLUSION: Earlier drinking problems, higher scores on specific items of the CAGE, and AUDIT, and meeting more diagnostic criteria indicate more dependent, harmful drinking by patients with AD who have a family history of this condition. Clinicians should consider patients' family history of alcohol use disorders when screening for AD to identify the correct diagnosis and develop appropriate treatment plans for these patients.
Alcoholism ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Guilt ; Humans ; Korea ; Male ; Mass Screening