OBJECTIVES: This study aimed to evaluate the mental health status of the children of psychiatric patients in order to plan for the resources that may be necessary to help these children achieve their full potential. METHODS: Forty-eight children (age 9–18) whose parents were registered in 5 community mental health centers located in Seoul were recruited. Tests assessing 3 psychological domains were conducted: 1) cognition: Korean version of Learning Disability Evaluation Scale, Comprehensive Attention Test, 2) parent reported emotion and behavior: Korean Child Behavior Checklist, Korean attention-deficit hyperactivity disorder Rating Scale, and 3) self-reported emotion and behavior: Korean Beck's Depression Inventory-II/Children's Depression Inventory-II, Korean Youth Self Report). We defined the children as having a high risk of developing mental health problems if their test scores were over the cut-off levels in 2 or more of the 3 domains assessed. RESULTS: Twelve (25%) children were classified as having a high risk of developing mental health issues. 20 (41.6%) children scored above the cut-off in only one of the domains. CONCLUSION: Our results suggest that the children of psychiatric patients might be vulnerable to mental illness and need early prevention or interven-tions for the sake of their mental health.
Adolescent ; Checklist ; Child Behavior ; Child* ; Cognition ; Community Mental Health Centers ; Depression ; Humans ; Learning Disorders ; Mass Screening* ; Mental Health* ; Parents* ; Seoul

PURPOSE: The purpose of this study was to test the effects on stress and depression by developing and implementing an integrated stress management program for inpatients in the psychiatric closed ward. METHODS: The study was a one-group pretest-posttest design. A total of 36 patients in the closed ward participated in this study. Data were collected through self-report questionnaires to measure hospital stress and depression. Data were analyzed by using t-tests and one-way ANOVA with SPSS/WIN 21.0. RESULTS: Integrated stress management program was designed based on Lazarus and Folkman stress-appraisal-coping model. Total of eight 1-hour sessions were delivered for four weeks in the group. There were significant differences in the inpatient stress scores before and after the intervention. However, the integrated stress management program showed some reduction in depression but did not show signifiant differences statistically. CONCLUSION: Our study findings confirm that the use of the integrated stress management program can reduce stress of the patients, that enable them to stabilize their minds at hospitalization. However, further study is needed to confirm the effects on depression. Thus, it would be beneficial to provide psychiatric nursing intervention tailored to psychiatric patients' symptoms, especially for reducing inpatient stress.
Depression ; Hospitalization ; Humans ; Inpatients ; Managed Care Programs ; Psychiatric Nursing ; Stress, Psychological

PURPOSE: To observe the changes in periosteum-derived mesenchymal stem cells and different scaffold materials transplanted into rabbit long-bone defects. MATERIALS AND METHODS: Thirty-five white rabbits were grouped according to the material transplanted into their tibial bone defects: Group 1 (control group); Group 2-A (agar plus mesenchymal stem cells); Group 2-B (agar only); Group 3-A (Biocompatible Osteoconductive Polymer plus mesenchymal stem cells); Group 3-B (BOP(R) only); Group 4-A (xenograft plus mesenchymal stem cells); Group 4-B (xenograft only). After surgery, radiologic and microscopic observation were performed weekly for 8 weeks. RESULTS: Rabbits transplanted with mesenchymal stem cells showed better bone formation than those without. Mesenchymal stem cells transplanted with agar had better results than mesenchymal stem cells plus BOP(R). Rabbits receiving xenografts showed severe inflammatory reactions. CONCLUSION: Further research is needed on rigid scaffold materials which minimize immune reaction, and on how to ensure uniform distribution of mesenchymal stem cells within such materials.
Agar ; Heterografts ; Mesenchymal Stromal Cells* ; Osteogenesis ; Polymers ; Rabbits

BACKGROUND: Use of universal leukoreduction for prevention of leukocyte associated transfusion reactions is common practice in many countries. This study was conducted in order to evaluate the performance of a newly developed leukoreduction filter for red blood cells (RBCs), the RF300 (Kolon Industries, Inc, Gumi, Korea). METHODS: Filtration time, RBC recovery, residual leukocyte count, and leukocyte removal rate were evaluated. To assess the quality of RBCs after filtration, percent hemolysis was monitored for a period of 21 days. Performance of the RF300 (N=78) was compared with that of the Bio-R O2 plus (Fresenius, Hamburg, Germany), the Pall Purecell RC (Pall Co., Washington, USA), and the Sepacell R-500N (Asahi, Tokyo, Japan). RESULTS: The shortest filtration time was observed using the RF300 (P<0.05). Using the RF300, recovery of RBC was 96.5%, which was higher than that of two filters (P<0.05). Mean residual leukocyte count was 0.26x10(6)/unit, with a leukocyte removal rate of 3 log. Using the RF300, mean percent hemolysis was 0.32% at day 21, which was comparable with that of two filters, but lower than that of one filter (P<0.05). CONCLUSION: The RF300 meets all established quality requirements for conduct of safe and effective leukoreduction of RBCs.
Blood Group Incompatibility ; Collodion ; Erythrocytes ; Filtration ; Hemolysis ; Leukocyte Count ; Leukocytes ; Tokyo ; Washington

Diabetic neuropathy is one of the most common complications of diabetic mellitus and has myriad clinical presentations. Amitriptyline is an effective drug for painful diabetic neuropathy, but has a wide variety of cardiovascular effects. We report a case of amitriptyline-induced ventricular tachycardia in a patient with painful diabetic neuropathy. A 48-year-old man with no history of heart disease was treated with amitriptyline for the past 2 months. The dosage of this drug was gradually increased and the maximal dose was 170 mg per day. Prior to administration of this drug, his chest X-ray and electrocardiogram were normal. On admission he complained of chest discomfort and palpitation for 3 days, but his vital sign was stable. The electrocardiogram showed a wide QRS complex with a rate of 170 beats per minute. The ventricular tachycardia was successfully treated with electrical cardioversion.
Amitriptyline* ; Diabetic Neuropathies* ; Electric Countershock ; Electrocardiography ; Heart Diseases ; Humans ; Middle Aged ; Tachycardia, Ventricular* ; Thorax ; Vital Signs

A 66-year-old female who had undergone surgery for a herniated disc at the L5-S1 level at another hospital 3 months earlier was admitted with persistent back and leg pain. She was diagnosed with spondylodiscitis at the L5-S1 level by magnetic resonance imaging. A biopsy was performed, and Candida parapsilosis and Enterococcus faecium were isolated from the excised material. We report herein a case of successful treatment of polymicrobial spondylodiscitis in accordance with accurate microbiological diagnosis. Based on this case, we hope to encourage physicians to perform biopsies more aggressively or repeatedly to improve the diagnostic yield.
Aged ; Biopsy ; Candida ; Coinfection ; Diagnosis ; Discitis* ; Enterococcus faecium ; Female ; Hope ; Humans ; Intervertebral Disc Displacement ; Leg ; Magnetic Resonance Imaging

BACKGROUND: Most depth of anesthesia (DOA) monitors rely on the temporal characteristics of a single-channel electroencephalogram (EEG) and cannot provide spatial or connectivity information. Phase lag entropy (PLE) reflects DOA by calculating diverse connectivity from temporal patterns of phase relationships. The aim of this study was to compare the performance of PLE and bispectral index (BIS) monitors for assessing DOA during anesthesia induction, nerve integrity monitoring (NIM), and anesthesia emergence. METHODS: Thirty-five patients undergoing elective thyroid surgery with recurrent laryngeal nerve NIM received propofol and remifentanil via target-controlled infusion. After applying PLE and BIS monitors, propofol infusion was initiated at a calculated effect site concentration (Ce) of 2 µg/mL and then increased in 1-µg/mL Ce increments. After propofol Ce reached 5 μg/mL, a remifentanil infusion was begun, and anesthesia induction was considered complete. During NIM, PLE and BIS values were compared at a specific time points from platysma muscle exposure to subcutaneous tissue closure. PLE and BIS values were recorded continuously from preanesthetic state to full recovery of orientation; bias and limits of agreement between monitors were calculated. RESULTS: PLE and BIS values decreased progressively with increasing propofol Ce during anesthetic induction and increased by stages during emergence. The prediction probabilities of PLE and BIS for detecting propofol Ce changes were 0.750 and 0.756, respectively, during induction and 0.749 and 0.746, respectively, during emergence. No aberrant PLE or BIS values occurred during NIM. Correlation coefficients for BIS and PLE were 0.98 and 0.92 during induction and emergence, respectively. PLE values were significantly higher than BIS values at full recovery of orientation. Estimated bias between monitors was −4.16 ± 8.7, and 95% limits of agreement were −21.21 to 12.89. CONCLUSION: PLE is a reasonable alternative to BIS for evaluating consciousness and DOA during general anesthesia and during NIM. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003490
Anesthesia ; Anesthesia, General ; Bias (Epidemiology) ; Consciousness ; Consciousness Monitors ; Electroencephalography ; Entropy ; Humans ; Information Services ; Propofol ; Recurrent Laryngeal Nerve ; Subcutaneous Tissue ; Superficial Musculoaponeurotic System ; Thyroid Gland

Atraumatic splenic rupture (ASR) in a patient undergoing peritoneal dialysis (PD) is uncommon, but can be life-threatening. According to recent systematic reviews, the major causes of ASR are 1) neoplastic (30.3%), 2) infectious (27.3%), 3) non-infectious inflammatory (20.0%), 4) iatrogenic (9.2%), 5) mechanical (6.8%), and 6) idiopathic (6.4%). It is diagnosed by imaging studies, most commonly ultrasonography and computed tomography (CT). Due to its rarity, the early diagnosis of ASR is difficult, and no standard treatment has been described. Here, we report a case of idiopathic ASR in a patient undergoing PD. The diagnosis was established by abdominal CT scan, and splenectomy was performed. Thus, hemoperitoneum in a PD patient should raise suspicion of ASR. Early diagnosis and appropriate treatment will lead to a better outcome.
Diagnosis ; Early Diagnosis ; Hemoperitoneum ; Humans ; Peritoneal Dialysis ; Splenectomy ; Splenic Rupture ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: To evaluate changes in the sciatic nerve of rabbits according to the degree of femoral lengthening. MATERIALS AND METHODS: Acute and gradual bone lengthening of the femur were performed after osteotomy, using external fixators in 36 rabbits of both sexes weighing 2, 500 gm. According to the lengthening amount and the percent increase (PI), 21 rabbits (acute lengthening) were divided into seven subgroups and 15 rabbits (gradual lengthening) into five subgroups. A nerve conduction study, light microscopic and electromicroscopic analysis of the sciatic nerve were performed. RESULTS: Acute femoral lengthening between 0.5-0.75 cm (PI= 6-9%) caused remarkable electrophysiologic and microscopic changes in the sciatic nerve, gradual lengthening between 0.75-1.0 cm (PI= 9-13%) induced significant electrophysiologic changes, and gradual lengthening between 1.0-1.5 cm (PI=13-19%) caused significant pathologic change. CONCLUSION: Gradual bone lengthening is safer for nerves than acute bone lengthing because of its safety margin, in terms of PI, is double that of acute bone lengthening. The results in this study provide helpful data to those in human nerve research upon the effects of acute and gradual bone lengthening.
Bone Lengthening ; External Fixators ; Femur ; Humans ; Neural Conduction ; Osteotomy ; Rabbits* ; Sciatic Nerve*

Background: Propofol-based total intravenous anesthesia (TIVA) improves long-term outcomes after cancer surgery compared with inhalation anesthesia. However, its effect on patients undergoing non-small cell lung cancer (NSCLC) surgery remains unclear. We aimed to compare the oncological outcomes of TIVA and inhalation anesthesia after curative resection of early-stage NSCLC. Methods: We analyzed the medical records of patients diagnosed with stage I or II NSCLC who underwent curative resection at a tertiary university hospital between January 2010 and December 2017. The primary outcomes were recurrence-free survival (RFS) and overall survival (OS) according to anesthesia type. Results: We included 1,508 patients with stage I/II NSCLC. The patients were divided into the TIVA (n = 980) and Inhalation (n = 528) groups. The two groups were well-balanced in terms of baseline clinical characteristics. The TIVA group demonstrated significantly improved RFS (7.7 years, 95% CI [7.37, 8.02]) compared with the Inhalation group (6.8 years, 95% CI [6.30, 7.22], P = 0.003). Similarly, TIVA was superior to inhalation agents with respect to OS (median OS; 8.4 years, 95% CI [8.08, 8.69] vs. 7.3 years, 95% CI [6.81, 7.71]; P < 0.001). Multivariable Cox regression analysis revealed that TIVA was an independent prognostic factor related to recurrence (hazard ratio [HR]: 1.24, 95% CI [1.04, 1.47], P = 0.014) and OS (HR: 1.39, 95% CI [1.12, 1.72], P = 0.002). Conclusions Propofol-based TIVA was associated with better RFS and OS than inhalation anesthesia in patients with stage I/II NSCLC who underwent curative resection.