No Abstract Available.
Animals ; Armoracia* ; Cats* ; Horseradish Peroxidase* ; Muscles*

Atrial fibrillation (AF) is a leading cause of cardioembolic stroke, which is often fatal or disabling. Prevention of stroke is crucial in AF management, and anticoagulation with non-vitamin K oral anticoagulants (NOACs) is the mainstay of AF management for stroke prevention. Because NOAC prescriptions have been surging worldwide, the development of acute ischemic stroke in patients with AF who receive NOAC treatment is an increasingly important issue in clinical practice. Moreover, these patients show a high risk of recurrence, with more than a 50% higher risk, than do patients with AF and no prior anticoagulation therapy. Careful evaluation is mandatory to determine possible causes of ischemic stroke during NOAC therapy. Differentiation of AF-unrelated stroke and demonstration of combined cardiac disease/systemic coagulopathy are important in these patients and may provide improved results in their treatment. In addition, ensuring appropriate dosing and good adherence to NOAC treatment is important. Cardioembolism, despite sufficient anticoagulation and no other causes, is the most common and challenging complication because switching to anticoagulants or adding antiplatelets to the treatment regimen does not reduce the risk of recurrent stroke, and there are no guidelines for this specific situation. This review article aimed to present the most updated data on the prevalence, causes, and secondary prevention strategies, specifically focusing on non-pharmacological approaches, together with relevant cases of AF in patients who developed ischemic stroke on NOAC therapy.

Anesthesia, General ; Cephalometry ; Follow-Up Studies ; Head ; Humans ; Joint Diseases ; Joints ; Korea ; Mouth ; Open Bite ; Osteoarthritis ; Prostheses and Implants ; Temporomandibular Joint

One hundred and eighteen strains of Escherichia coli isolated from clinical specimens were epidemiologically analyzed for antimicrobial resistance, EcoRI restriction endonuclease analysis, southern hybridization with TEM and SHV probe of conjugative R plasmids. 1. Sixty-two to 73% of E. coli isolates were resistant to ampicillin, carbenicillin, sulfisomidine, and tetracycline, and 20-27% to kanamycin, gentamicin, tobramycin, and nalidixic acid. However more than 93% were susceptible to cephalosporins and all strains were highly susceptible to cefotetan, imipenem, aztreonam, and amikacin. 2. Twelve strains were susceptible to all drugs tested and the multiple resistant strains showed 65 resistance pattern types. 3. Thirty-six resistant strains(34%) transferred R plasmids to E. coli RG488 or RG176 by mixed culture. Fifty-six plasmids with 31 different resistant phenotype were obtained from them. 4. Some of 15 plasmids derived from 10 strains showed identical or similar EcoRI restriction endonuclease digestion patterns, hybridized fragment patterns with TEM probe by southern hybridization, and resistance levels of j3-lactams and aminoglycosides. These results indicate that the epidemic strains or plasmids were present in this hospital and molecular genetic analysis of R plasmids can be used to discriminate clinical isolates of multi- resistant E. coli.
Amikacin ; Aminoglycosides ; Ampicillin ; Aztreonam ; Carbenicillin ; Cefotetan ; Cephalosporins ; Digestion ; DNA Restriction Enzymes ; Escherichia coli* ; Escherichia* ; Gentamicins ; Imipenem ; Kanamycin ; Molecular Biology ; Nalidixic Acid ; Phenotype ; Plasmids ; R Factors ; Sulfisomidine ; Tetracycline ; Tobramycin

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1M0). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.
Cardiopulmonary Bypass ; Extracorporeal Circulation* ; Fistula ; Heart Atria ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Invasiveness ; Neoplasm Staging ; Omentum ; Pericardium ; Pulmonary Edema ; Recurrence ; Transplants

OBJECTIVE: It is postulated that since aripiprazole is a dopamine partial agonist and serotonin 2A receptor antagonist, aripiprazole may be effective in Tourette syndrome with few of extrapyramidal side effects. This open label study assessed the effectiveness of aripiprazole in children with Tourette syndrome (TS). METHOD: Nineteen children, aged 6 to 13 years, diagnosed with TS were participated in a 8-week open label trial. Efficacy assessments included Korean form of Yale Global Tic Severity Scale (K-YGTSS) and Clinical Global Impression scores. Safety and tolerability evaluations included extrapyramidal symptoms and effects on weight, prolactin, and corrected QT (QTc) interval. RESULTS: A significant decrease in TS symptoms, on all scales measured, appeared in 2 weeks. Adverse effects were mild and not significant. The most frequent side effects were somnolence, light headedness and headache. CONCLUSIONS: The results of current open label trial suggests the effectiveness of aripiprazole and few of side effects in the treatment of children with TS. Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test of the efficacy of aripiprazole in TS.
Child* ; Dizziness ; Dopamine ; Headache ; Humans ; Prolactin ; Prospective Studies* ; Receptor, Serotonin, 5-HT2A ; Tics ; Tourette Syndrome* ; Treatment Outcome* ; Weights and Measures ; Aripiprazole

OBJECTIVE: We investigated the characteristics of cellular phone use and its association with psychological problems among adolescents. METHODS: A total of 332 adolescent students were recruited for this study. The participants' self-reported characteristics of cellular phone use and the psychological problems caused by this were tested by using the Excessive Cellular Phone Use Survey (ECPUS), the Children's Depression Inventory (CDI), Spielberger's State-Trait Anxiety Inventory for Children (STAIC) and the Korea-Youth Self Report (K-YSR). RESULTS: The excessive user group made more use of text messages and they spent more time and paid higher fees than the comparison group. They expressed severer depression and anxiety and they had more behavior problems and lower school performance than the comparison group. The ECPUS score was positively correlated with score of the CDI, STAIC and the behavior problem scales of the K-YSR, and the ECPUS score was negatively correlated with the school performance scale of the K-YSR. CONCLUSION: Our findings suggest that excessive cellular phone use by adolescents may be related to psychological problems. Careful education about the use of cellular phones and intervention are recommended for adolescents who excessively use cellular phones.
Adolescent ; Anxiety ; Cellular Phone ; Child ; Depression ; Fees and Charges ; Humans ; Self Report ; Text Messaging ; Weights and Measures

OBJECTIVES: This study aimed to examine the clinical characteristics of patients who attempted suicide and the effects of their admission to a psychiatric ward after suicide attempts. METHODS: We enrolled 147 patients who had visited the emergency room of Inha University Hospital between January 2007 and December 2008. We reviewed their medical records and investigated demographic factors, clinical characteristics, and acute stressors. We compared the progress of patients who had been admitted to a psychiatric ward and the progress of patients who had not been admitted to a psychiatric ward, to investigate the effects of psychiatric admission. RESULTS: In total, 73% of patients who attempted suicide were women with a mean age of 40.5 years. On the other hand, the mean age of the men who had attempted suicide was 60. In 40% of suicide attempts, patients visited the emergency room after drinking alcohol. The most common method of suicide was drug intoxication (82%). A quarter the of patients had a history of previous suicide attempts. The most common cause of suicide attempts was interpersonal conflict, including couple relationship problems, family problems, and peer group problems. But in men, economic problems and chronic illnesses are more important stressors. Many patients who visited the emergency room due to suicide attempts refused admission to a psychiatric ward because of poor insight, aversion to psychiatric wards, and economic problems. The follow-up rate of patients who were admitted to a psychiatric ward was 78%, and their average follow-up period was 286 days. On the other hand, the follow-up rate of patients who were not admitted to a psychiatric ward was 11% and their average follow-up period was 21 days. CONCLUSION: This study implies that interpersonal conflict is a significant cause of suicide attempts for both genders. Though many patients and their families refuse admission to a psychiatric ward, admission to a psychiatric ward is very important because it can serve psychiatric treatments for patients.
Chronic Disease ; Demography ; Drinking ; Emergencies ; Female ; Follow-Up Studies ; Hand ; Humans ; Male ; Medical Records ; Peer Group ; Suicide ; Suicide, Attempted

OBJECTIVE: Although the standard of treatment for schizophrenia is antipsychotic monotherapy, overall psychotropic polypharmacy including antipsychotic polypharmacy is increasingly practiced by clinicians. However, there are very few studies that assess the prescription patterns of psychotropic drugs for patients with schizophrenia in Korea. The objective of this study is to describe changes in prescription patterns with respect to antipsychotic polypharmacy and overall psychotropic polypharmacy. METHODS: In this retrospective study, we reviewed all psychotropic drugs prescribed at the time of discharge for patients diagnosed as having schizophrenia (DSM-IV criteria) who entered a psychiatric unit of a Korean general hospital from 2001 to 2008. These included a total of 467 patients. RESULTS: Of the 467 patients in this study, 205 (43.9%) were discharged with antipsychotic monotherapy and the rest, 262 (56.1%), were discharged with a polypharmacy regimen. A total of 9% of the studied patients received more than two antipsychotic drugs. The most frequent combination of antipsychotics was clozapine and aripiprazole, followed by clozapine and amisulpride, and risperidone and olanzapine. The ratio of patients discharged with a polypharmacy regimen including antipsychotic polypharmacy increased from 2001 to 2008. In relation to the mean dose of all antipsychotic drugs at the time of discharge, mean length of hospital stay and mean initial global assessment of functioning scores on admission statistically significant differences were not detected between both monotherapy and polypharmacy groups. CONCLUSION: The main finding of this study is that polypharmacy with antipsychotics and other psychotropic medicines increased in our psychiatric unit from 2001 to 2008. The rates of antipsychotic polypharmacy in our study were less than those described in our literature review.
Antipsychotic Agents ; Benzodiazepines ; Clozapine ; Hospitals, General ; Humans ; Korea ; Length of Stay ; Piperazines ; Polypharmacy ; Prescriptions ; Psychotropic Drugs ; Quinolones ; Retrospective Studies ; Risperidone ; Schizophrenia ; Sulpiride ; Aripiprazole

OBJECTIVES: The purpose of this study is to investigate the clinical characteristics of neurocognitive functions in patients with traumatic brain injury referred for mental disability evaluation. METHODS: The neurocognitive functions of 293 patients, who were referred for mental disability evaluation, were assessed using a computerized neurocognitive test. The patients were divided into three groups according to head trauma history and brain imaging studies. We also measured their intelligence and memory, using the K-WAIS and the Rey-Kim Memory Test. RESULTS: The group with organic mental disorder showed more impaired concentration, language, memory, intelligence, executive function and visuospatial function than those with nonorganic mental disorder without traumatic brain injury. The group with organic mental disorder also showed greater impairments in selective attention, some part of language, long-term memory, and hypothesis formation than those with postconcussional disorder. The group with organic mental disorder obtained lower intelligence and memory test scores than those with postconcussional disorder and nonorganic mental disorder without traumatic brain injury. There was no difference in intelligence or memory between postconcussional disorder and nonorganic mental disorder without traumatic brain injury. CONCLUSION: Patients with postconcussional disorder share the characteristics of neurocognitive function with organic mental disorder and nonorganic mental disorder without traumatic brain injury. We suggest the computerized neurocognitive test that evaluated details of neurocognitive functions for patients with traumatic brain injury referred for mental disability evaluation.
Brain ; Brain Injuries ; Craniocerebral Trauma ; Neurocognitive Disorders ; Disability Evaluation ; Executive Function ; Humans ; Insurance ; Intelligence ; Memory ; Memory, Long-Term ; Mental Disorders ; Neuroimaging