OBJECTIVES: The purpose of this study was to make empirical evidence of community based detection, assessment and allocation system for early psychosis. METHODS: We analysed 222 youths who were referred to Seoul Early Management and Improvement Services (SEMIS) for early psychosis during six years from 2007 to 2012. RESULTS: 44% of referrals were from suicide hotline, 23% from web-based SEMIS assessment program, 20% from other service areas such as military services and 11% were self referred. Among 222 youths, 139 (62.6%) were completed Structured Interview for Prodromal Syndrome (SIPS). After SIPS, 23% had untreated or early psychosis, another 17% were found to be at high risk of psychosis and 18% of completed SIPS were found to have other mental illness such as depression, yielding an efficiency ratio of 58%. 70% of youths who were categorized as psychosis or high risk of psychosis or other mental illness were referred to psychiatric hospital or case management services. CONCLUSION: This study shows the effectiveness and limitations of community-based assessment and intervention system for early psychosis. Integrated community program is necessary to improve the efficiency of early intervention and for the better outcomes.
Adolescent ; Case Management ; Depression ; Early Intervention (Education) ; Hospitals, Psychiatric ; Hotlines ; Humans ; Military Personnel ; Prodromal Symptoms ; Psychotic Disorders ; Referral and Consultation ; Suicide

BACKGROUND: Relative changes of astroglial volume constitute the major part of brain edema, which is related to delayed neuronal damage. Several factors including glutamate may contribute to astroglial swelling. Intravenous anesthetic, ketamine was known to restore neuronal damage by inhibiting NMDA receptor activity. Therefore, we decided to investigate the effect of ketamine on the astrocyte swelling by glutamate in the present study. METHODS: To analyze cell swelling in vitro, glial cell line, U1242MG was used. The effects of glutamate (1, 2, 3 mM), and glutamate with ketamine (1 mM) on the regulation of astrocyte volume were achieved by flow cytometry system. To eliminate the dead cells from experimental cell suspension and to assess cell viability, fluorescent dye propidium iodide was used. RESULTS: Glutamate addition (1, 2, 3mM) caused astroglial swelling both in calcium present and calcium absent buffer. The difference of cellular swelling dependent on glutamate concentration was only seen in calcium free buffer (p<0.05). Ketamine per se did not affect astroglial volume. However, when it was added to glutamate perfusion, 1 mM ketamine diminished cellular swelling by glutamate during first 10 minutes (p<0.05), and cellular shrinkage by glutamate after 1 hour incubation (p<0.05). CONCLUSIONS: Ketamine (1 mM) is effective in the regulation of astroglial volume alterations induced by glutamate in both short time and long time perfusion.
Astrocytes ; Brain Edema ; Calcium ; Cell Survival ; Flow Cytometry ; Glutamic Acid* ; Ketamine* ; N-Methylaspartate ; Neuroglia ; Neurons ; Perfusion ; Propidium

Subtrochanteric fracture is well known for its difficulty in management, though various devices of rigid fixation have been developed. Each internal fixation device requires a lot of surgical instruments and the surgeon must be skillful in using them. Osteo self-compression plate which was preoperatively bent to fit the contour of the lateral surface of the subtrochanteric region was proved to be technically easy to fix these fractures without causing major complication. Present authors recommend to use this prebent Osteo self-compression device to treat this fracture when the surgical instruments are not fully equipped, and suitable fixation devices are not available, and/or the surgeon has no experience in handling the newly developed surgical instruments for the subtrochanteric fracture.
Internal Fixators ; Surgical Instruments

PURPOSE: To verify the expression of mouse homologue of glucosamine-6-phosphate deaminase (GNPDA) in mouse epididymis. MATERIALS AND METHODS: GNPDA expression was examined in mouse epididymis using the polyclonal antibody raised against a synthetic oligopeptide of N-terminus of mouse homologue of GNPDA. RESULTS: In Western blot, immunoreactive band of Mr. 33 kDa was detected in the cauda epididymal extracts. In immunostaining, positive signal was found in the cytoplasm and stereocillia of epithelial cells of cauda epididymal tubule, and interstitial cells of adult epididymis. CONCLUSION: Expression of GNPDA in epididymis suggests that it possibly involved in absorption and intracellular digestion of luminal contents, and the remodeling of epithelia in mouse epididymis.
Absorption ; Adult ; Animals ; Blotting, Western ; Cytoplasm ; Digestion ; Epididymis* ; Epithelial Cells ; Humans ; Male ; Mice* ; Phenobarbital

PURPOSE: This study was done to test the effects of Oketani breast massage on breast pain and breast milk pH of mothers, and sucking speed of neonates. METHODS: A nonequivalent control group and a pretest-posttest design was used. Postpartum mothers complaining of breast pain were recruited at a postpartum care center. The application of Oketani breast massage by an Oketani massage therapist was the experimental treatment. The control group received the conventional massage technique from a nurse at the postpartum care centre. The collected data were analysed using a chi2-test and a t-test with the SPSS WIN 12.0 program. RESULTS: The participants were homogeneous in age, gestation period, and birth weight. Breast pain (t=8.384, p<.001) was significantly relieved, and breast milk pH (t=4.793, p<.001) was significantly increased in the experimental group compared to the control group. The sucking speed of the neonates in the experimental group was significantly increased compared to the control group (t=9.920, p<.001). CONCLUSION: These findings indicate that Oketani breast massage is effective in relieving breast pain and increasing breast milk pH as well as the sucking speed of neonates.
Birth Weight ; Breast ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn ; Massage ; Mastodynia ; Milk, Human ; Mothers ; Postnatal Care ; Postpartum Period ; Pregnancy

No abstract available.
Leukemia, Neutrophilic, Chronic*

Spinal epidural lipomatosis, which causes symptomatic compression of neural elements, is a relatively uncommon disease. Although it has been reported frequently in association with the administration of exogenous steroids, a few cases of epidural lipomatosis with no association to exogenous steroids, have been reported. Idiopathic spinal epidural lipomatosis may be a separate disease from that induced by steroid. Here, the authors present two cases of symptomatic epidural lipomatosis with no history of steroid-dependent diseases and review the relevant literature.
DNA Transposable Elements ; Lipomatosis* ; Steroids

Recently microvascular decompressive approach to the hyperactive type of low cranial nerves dysfunction has been popular procedures in neurosurgical operation. The neurosurgical teams at St. Paul's Hospital, Catholic Medical College operated on 11 patients employing this technique for 2 years. The patients were diagnosed as 9 patients with hemifacial spasm, one with trigeminal neuralgia, and one with glossopharyngeal neuralgia. The results were very encouraging of the 10 patients. But remaining one patient was failed with therapy. The authors would like to share with you their experiences employing the microvascular surgical technique, the results & the prognosis.
Cranial Nerves* ; Glossopharyngeal Nerve Diseases ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Prognosis ; Trigeminal Neuralgia

Moyamoya disease is an unusual vascular disorder highlighted by progressive bilateral internal carotid artery occlusion and collateralization of intracranial blood flow. The purposes of the bypass procedures : 1) reduce or arrest of the chance of repeated ischemic attack by making the additional collateral blood flow, 2) decrease the chance of repeated bleeding by reducing the number of moyamoya vessels. During the period from June 1989 through February 1991, 8 moyamoya diseases associated with intraventricular hemorrhage were operated by STA-MCA anastomosis plus EMS. Results are as follows : 1) Slightly female dominancy in incidence(5 : 3), and all of the patients were middle aged(range 32 to 55 years). 2) All of the patients had sudden onset of headache, and most patients whad neck stiffness and vomiting. 3) In all of the patients, confirmatory diagnosis could be done by angiography, and all of the patients had gypical angiographic findings of moyamoya disease. 4) All of the patients had IVH in brain CT scan. 5) All of the patients were surgically treated : STA-MCA anastomosis plus EMS. 6) The postoperative revascularization rate was 89%(8 sides in 9 sides). 7) The postoperative results were excellent in 5, good in 1, and death in 2. The rarity of such lesions in KOrea and their surgical results are reviewed briefly.
Angiography ; Brain ; Carotid Artery, Internal ; Diagnosis ; Female ; Headache ; Hemorrhage* ; Humans ; Korea ; Moyamoya Disease* ; Neck ; Tomography, X-Ray Computed ; Vomiting

PURPOSE: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. MATERIALS AND METHODS: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gatingof sequential Tc-99m-MTBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF), Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. RESULTS: Enddiastolic volumes (EDV) ranged from 58 mi to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 mi to 174 mi (65 ml +1- 39 ml), and EF from 20% to 68% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval:0.83-0.90) for assessment of wall thickening. CONCLUSION: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.
Heart ; Humans ; Tomography, Emission-Computed, Single-Photon*