A Total of 498 cases of hemophilia which were reported by sixteen medical centers in Korea were reviewed and analyzed. Hemophilia A comprised 425 cases (85.3%) and the remaining 73 cases (14.7%) were hemophilia B. One case was female and all other cases were male. There were known hemophilia patients in the family in 43.0% of cases and the involved members were brothers, maternal cousins, maternal uncles, and maternal grandfathers in descending order of frequency. The major symptoms of the patients were hemorrhagic, such as easy bruising and hemarthrosis followed by prolonged bleeding after trauma and soft tissue hematoma. The incidence of hemarthrosis increased significantly with age. The pediatric age group below the age of 15 consisted of 67.1% of the cases. According to the age at diagnosis, half (54.2%) of the severe cases were diagnosed before the age of 1 year. APTT was prolonged over 40 seconds in all cases and 291 cases showed severe prolongation over 80 seconds. Of 498 cases 273 cases (54.8%) belonged to the severe form (factor VII or IX level, less then 1%), whereas 182 cases (36.5%) and 43 cases (8.7%) belonged to the moderate (factor VIII or IX, 2-5%) and mild form (factor VIII or IX, 6-25%), respectively, Chronic arthropathy was present in 236 cases (49.6%), and the incidence increased significantly with age. The management of chronic arthropathy most commonly employed was rehabilitation in 25.4% of cases, but in 50.8% no management was given at all. The involved joints in descending order of frequency were knees, elbows and ankles. The complications were intracranial hemorrhage, Gl bleeding and nerve palsy in 48, 24, and 13 cases, respectively.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; HIV Antibodies/immunology ; Hemophilia A/complications/*epidemiology/genetics ; Hemophilia B/complications/*epidemiology/genetics ; Humans ; Infant ; Joint Diseases/*etiology ; Male ; Questionnaires

A Total of 498 cases of hemophilia which were reported by sixteen medical centers in Korea were reviewed and analyzed. Hemophilia A comprised 425 cases (85.3%) and the remaining 73 cases (14.7%) were hemophilia B. One case was female and all other cases were male. There were known hemophilia patients in the family in 43.0% of cases and the involved members were brothers, maternal cousins, maternal uncles, and maternal grandfathers in descending order of frequency. The major symptoms of the patients were hemorrhagic, such as easy bruising and hemarthrosis followed by prolonged bleeding after trauma and soft tissue hematoma. The incidence of hemarthrosis increased significantly with age. The pediatric age group below the age of 15 consisted of 67.1% of the cases. According to the age at diagnosis, half (54.2%) of the severe cases were diagnosed before the age of 1 year. APTT was prolonged over 40 seconds in all cases and 291 cases showed severe prolongation over 80 seconds. Of 498 cases 273 cases (54.8%) belonged to the severe form (factor VII or IX level, less then 1%), whereas 182 cases (36.5%) and 43 cases (8.7%) belonged to the moderate (factor VIII or IX, 2-5%) and mild form (factor VIII or IX, 6-25%), respectively, Chronic arthropathy was present in 236 cases (49.6%), and the incidence increased significantly with age. The management of chronic arthropathy most commonly employed was rehabilitation in 25.4% of cases, but in 50.8% no management was given at all. The involved joints in descending order of frequency were knees, elbows and ankles. The complications were intracranial hemorrhage, Gl bleeding and nerve palsy in 48, 24, and 13 cases, respectively.
Adolescent ; Adult ; Child ; Child, Preschool ; Female ; HIV Antibodies/immunology ; Hemophilia A/complications/*epidemiology/genetics ; Hemophilia B/complications/*epidemiology/genetics ; Humans ; Infant ; Joint Diseases/*etiology ; Male ; Questionnaires

In thirty patients with acute leukemia and severe aplastic anemia receiving random single donor platelet transfusions, the development of refractoriness by consecutive platelet transfusions with cytapheresis and its relationship to the appearance of anti-platelet antibodies were investigated. The median number of platelet transfusions inducing refractoriness was 13 times, and 20% of the patients remained unrefractory despite of the repeated multiple platelet transfusions up to 20 to 25 times. The results of anti-platelet antibody tasts by the enzyme-linked immunosorbent assay(ELISA) and immunofluorescent techniques(IFT) showed no statistically significant relationship with the refractoriness (p greater than 0.1). Although there was significant correlation between the results of ELISA and IFT, both tests were insufficient to find out refractoriness even with the use of pooled platelets from multiple donors as target cells. This study shows that 13 single donor platelet transfusions result in refractoriness, that both ELISA and IFT are insufficient to detect refractoriness despite of their significant correlation, and that other methods than these are needed in order to detect alloimmunization.
Adolescent ; Adult ; Aged ; Anemia, Aplastic/therapy ; Anemia, Refractory/*etiology ; Antibodies/metabolism ; *Blood Platelets/immunology ; *Blood Transfusion ; Female ; Humans ; Leukemia/therapy ; Male ; Middle Aged

OBJECTIVE: It is well-known that antipsychotics are widely used in the treatment of bipolar disorder. So, the aim of this study was to examine the subjective response to antipsychotics in acute manic patients. METHODS: Data were gathered through the study for feasibility testing of Korean Medication Algorithm for Bipolar Disorder (KAMP-BP), which 17 nationwide clinical centers were entered into the study. A total 126 bipolar patients were enrolled and then 92 were treated according to the treatment algorithm. The data of 58 patients were completely recorded from baseline to 2 weeks of treatment and were entered into analysis. Drug Attitude Inventory-10 (DAI-10) was used for evaluating patient's subjective response to antipsychotics and patients were grouped as subjective non-dysphoric and dysphoric as the total score of DAI-10. For assessing the clinical status, Young Mania Rating Scale (YMRS), Clinical Global Impression- Severity scale (CGI-S), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF) and Liverpool University Neuroleptic Side-Effect Rating Scale (LUNSERS) were used. RESULTS: Dysphoric group was younger and has more females in sex distribution than non-dysphoric group. YMRS and CGI-S were severer in dysphoric group. The prescription patterns were not different between two groups: Combinations of mood stabilizers and antipsychotics were administered to all patients and atypical antipsychotics were prescribed over 90% of the patients. At 2 weeks of treatment, more patients were turned into remission in non-dysphoric group. Dysphoric patients showed more changes of positive subjective response in DAI-10 from baseline and more patients turned toward the non-dysphoric group. CONCLUSION: Although the subjective response to antipsychotics using DAI-10 was not typically characterized in acute manic patients, it seems that atypical antipsychotics may have a role in determining the subjective feelings of the acute bipolar manic patients.
Antipsychotic Agents* ; Bipolar Disorder ; Depression ; Female ; Humans ; Prescriptions ; Sex Distribution

We report a rare case of thyroid metastasis from early gastric cancer with lymph node metastasis in a 63-yr old woman. She was diagnosed with metastatic adenocarcinoma one and a half years after distal subtotal gastrectomy, by fine needle aspiration (FNA) using thyroid sonography. Thyroid metastasis from gastric cancer is extremely rare, and this case is particular in that it is the first report of thyroid metastasis from early gastric cancer.
*Adenocarcinoma/pathology/secondary ; Biopsy, Fine-Needle ; Fatal Outcome ; Female ; Humans ; Lymphatic Metastasis/*pathology ; Middle Aged ; Stomach Neoplasms/*pathology ; Thyroid Neoplasms/pathology/*secondary

BACKGROUND AND OBJECTIVES: This study was designed to evaluate relation between frequencies of noise and tinnitus in noise-induced hearing loss and to elucidate mechanism of tinnitus in noise-induced hearing loss. MATERIALS AND METHODS: Four factories were selected, of which noise frequencies were different except one factory. Preliminary screening hearing test with a pure tone audiometer on 1000 and 4000 Hz was done. And if the hearing threshold was over 40 dB, history taking, otological examination, tympanometry, pure tone audiometry on 500, 1000, 2000, 4000, 6000 Hz were done. Noise was measured in 125, 250, 500, 1000, 2000, 4000, 8000 Hz. Tinnitus was measured using 1000, 2000, 4000 Hz pure tone. RESULTS: 1) Hearing loss was most severe in the 4000, 6000 Hz range. 2) In A factory, noise was most intense on 4000 Hz, in B factory on 2000 Hz, and in C and D factory on 1000 Hz. 3) Forty-three workers (42.2%) of total 102 subjects complained tinnitus. And frequency of tinnitus was 4000 Hz in 71 ears (89.9%) among 79 ears with tinnius. CONCLUSION: Regardless of the frequency of noise, most workers complain of 4 kHz tinnitus. And it was in accord with frequency of most severe hearing loss in the noise-induced hearing loss.
Acoustic Impedance Tests ; Audiometry ; Ear ; Hearing ; Hearing Loss ; Hearing Loss, Noise-Induced* ; Hearing Tests ; Mass Screening ; Noise* ; Tinnitus*

OBJECTIVE: Bipolar depression has a disabling course and its treatment represents a major challenge. Recently, a randomized, controlled trial of quetiapine monotherapy in patients with bipolar depression showed significant reductions in depressive symptomatology. The purpose of this study was to evaluate the efficacy of quetiapine in bipolar depression in the clinical setting. METHODS: This study was a multi-center, prospective, open-label, observational, 8-week evaluation of the efficacy of quetiapine in patients with bipolar depression. Patients with a DSM-IV-TR diagnosis of bipolar depression (bipolar I disorder, most recent episode depressed and bipolar II disorder, most recent episode depressed) were included and treated with quetiapine. The dose of quetiapine was flexible and concomitant mediations were permitted, by clinical judgment. Clinical improvements were rated with the Clinical Global Impression-Bipolar version (CGI-BP) and Montgomery-Asberg Depression Rating Scale (MADRS) at baseline, week 4, and week 8. RESULTS: A total of 1,193 patients were recruited and 46 (3.9%) patients were dropped from the study. The mean initial dose of quetiapine was 192.3+/-181.9 mg/day and the mean doses at weeks 4 and 8 were 315.2+/-229.7 mg/day and 337.1+/-229.9 mg/day, respectively. CGI-BP and MADRS were significantly improved at weeks 4 and 8, compared with baseline. In addition, improvements at week 8 were greater than at week 4. Subjectively, about 75% of the patients reported therapeutic compliance above 75% at weeks 4 and 8. Seven (0.6%) and four (0.3%) patients showed manic/hypomanic episodes at weeks 4 and 8, respectively. CONCLUSION: This study suggests that quetiapine improves depressive symptoms in bipolar depression, with minimal incidence of manic switching. We suggest that quetiapine could be an effective and safe option in treating bipolar depression.
Bipolar Disorder ; Compliance ; Depression ; Dibenzothiazepines ; Humans ; Incidence ; Judgment ; Prospective Studies ; Quetiapine Fumarate

OBJECTIVE: The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) as a reference for clinical decisions. The purpose of this study was to investigate the effects of pharmacological treatments with the KMAP-BP on quality of life in patients with bipolar disorder. METHODS: Brief Form of World Health Organization Quality of Life assessment (WHOQOL-BREF), at baseline and 4 months after treatment, was used to evaluate the quality of life in this study. Also Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF), and two scales of Clinical Global Impression (CGI-S, CGI-I) were rated by clinicians. Data from 76 of 92 bipolar patients, treated according to the algorithm, were attained at baseline, 55 at 4 months after treatment, and 47 at both. RESULTS: It was found that the treatments following the KMAP-BP for 4 months could not make improvement in all 4 domains of WHOQOL-BREF. There was no difference in change of QOL domains after treatment according to some variables such as sex, age, age of onset, age of first treatment, clinical feature of mania, and so on. Compared with mania, in which quality of life was aggravated a little after treatment, all domains of WHOQOL-BREF were improved in bipolar depressed patients. The improvement of YMRS score had a negative correlation with physical health domain. The decrease in HAM-D score was correlated positively with improvement in physical health and psychological domains. But there was no correlation between increase in quality of life and the improvement of GAF, CGI-S, and CGI-I scores. CONCLUSION: Quality of life was not improved in bipolar patients at 4 months after treatment, in which the KMAP-BP was applied. But it did not mean that the application of the algorithm to treat bipolar patients was not effective. Because their functions were not recovered yet, even though the symptoms were remitted. Long-term follow-up studies using various tools to estimate the quality of life are needed.
Age of Onset ; Bipolar Disorder ; Depression ; Follow-Up Studies ; Humans ; Quality of Life* ; Schizophrenia ; Weights and Measures ; World Health Organization

Scopulariopsis brevicaulis is a ubiquitous soil saprophyte that commonly causes onychomycosis, accounting for 1-10% of such infections. Rarely, it may be responsible for cutaneous lesions or more severe infections, especially after traumatic or surgical injuries. We report of a 54-year-old female patient who developed facial cellulitis caused by S. brevicaulis, which occurred one year after the patient underwent cosmetic surgery of the face. The patient suffered from febrile sense, pain and a growing mass lesion on her left cheek, which were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. Three pus cultures from the mass lesion which performed at a week interval yielded the same S. brevicaulis. Surgical removal and drainage by using liposuction procedure resulted in a favorable outcome. To our knowledge this is the first report of S. brevicaulis infection associated with cosmetic surgery in Korea.
Cellulitis ; Cheek ; Drainage ; Female ; Humans ; Intraoperative Complications ; Korea ; Lipectomy ; Middle Aged ; Onychomycosis ; Scopulariopsis* ; Soil ; Suppuration ; Surgery, Plastic*

OBJECTIVE: In the last decade, a number of pharmacological agents have shown efficacy in the treatment of bipolar disorder. Traditionally, lithium has been considered as the treatment of choice of bipolar disorder. However, more recently, atypical antipsychotics and newly developed anticonvulsants have become increasingly popular alternatives to lithium. This study examined the prescribing patterns for medications to treat bipolar disorder in office-based psychiatric practice. METHODS: The data for the present study were collected by using structured record form from November 2005 to December 2005. Psychotropic medications were grouped into six categories ; atypical antipsychotics, typical antipsychotics, lithium, anticonvulsants, antidepressants, and minor tranquilizers. Prescription data of 700 cases with a diagnosis of bipolar disorder according to DSM-IV from 70 Korean psychiatrists were accessed. Severity, mood episode, psychiatric comorbidity and point of diagnosis related utilization rates were computed focusing on atypical antipsychotics. RESULTS: In 695 patients who were prescribed major psychotropic medications, atypical antipsychotics were prescribed in 62.4% of subjects, anticonvulsants in 58.7%, lithium in 47.8%, antidepressants in 17.6%, and typical antipsychotics in 15.5% of subjects. About seventeen percent of subjects were treated with the monotherapy. Atypical antipsychotics prescription was favored in subjects with manic and mixed episodes or severe episode. Lithium and typical antipsychotics prescription were less frequent in depressive subjects than subjects with other mood episodes. Prescription of atypical antipsychotics and antidepressants were more frequent in subjects who were recently diagnosed as bipolar disorder or prescribed new medications. CONCLUSION: The rapid progress of psychopharmacology has been reflected in the prescription pattern of psychotropic medications in Korea. This study suggests that atypical antipsychotics have played major role in treatment of bipolar disorder.