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

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

No abstract available.
Adult* ; Cerebral Infarction* ; Humans ; Polycythemia Vera* ; Polycythemia*

Recently we performed a modified sternum-splitting approach in surgery for anterior space-taking lesion in the upper thoracic region. In contrast to the original trans-sternal approach introduced by Cauchoix, we cut only the manubrium and split it using vertebral spreader. After reaching the anterior surface of the cervico-Thoracic vertebrae, the central portion of the vertebral body was removed with air-drill under an operating microscope. The longitudinal bone defect of the vertebral bodies was filled with a bone graft obtained from the iliac bone. Removal of the space-taking lesions in the cervico-thoracic junction and upper thoracic region can be performed safely by utilizing the modified sternum-splitting approach. This approach can be applied also to endarterectomies at the origins of the vertebral arteries and the subclavian artery.
Endarterectomy ; Manubrium ; Microsurgery ; Spine ; Subclavian Artery ; Transplants ; Vertebral Artery

Since 1967 the STA-MCA anastomosis has been popular procedure in neurosurgical operation. The meurosurgical teams at St. Paul's Hospital, Catholic Medical College, recently operated on 8 patients employing 9 times of this technique. The patients were diagnosed as four patients with complete stroke, one with traumatic middle cerebral stenosis, two with moyamoya disease, and one with huge aneurysm at intracavernous portion of ICA. The results were very encouraging of the 8 patients, 7 had favorably improved clinically, and proved by follow-up cerebral angiographies, CT Scanning, EEG or MEP recordings. The remaining one patient had intracerebral and intracerebellar hematoma, two months later after discharge, thus the result was poor. The authors would like to share with you their experiences employing the STA-MCA anastomosis technique, indications the results and the prognosis.
Aneurysm ; Cerebral Angiography ; Constriction, Pathologic ; Electroencephalography ; Follow-Up Studies ; Hematoma ; Humans ; Moyamoya Disease ; Prognosis ; Stroke ; Tomography, X-Ray Computed

20 patients who were diagnosis neurologic diseases were treated deproteinized extract Actigen for 1-2 weeks. Comparing before and after treatment, clinical state, EEG, MEP, CT Scan and CBF have been improved to postmedicated state. According to above findings, it is indirectly confirmed that Actigen is improve brain motabolism, cerebral blood flow and peripheral blood flow. During medication there are no side effects and complications.
Brain ; Diagnosis ; Electroencephalography ; Humans ; Tomography, X-Ray Computed