OBJECT: This study was devised to examine the demographic characteristics, psychopathology and associated psychiatric disorder of the Kleptomania offenders. METHODS: Kleptomania offenders who was referred to the National Forensic Psychiatric Hospital was concerned. RESULTS: Most of the Kleptomania offenders were women(92.6%, N=25) and lived alone(71.4%, N=20). In their first stealing, 25(92.6%) reported stressful situation just before stealing behavior but at admission 14(51.9%) is reported. Kleptomania experienced physical and sexual abuse during childhood; 9(33.3%) in case of physical abuse and 12(44.4%) in case of sexual abuse. At admission, Most of them complains of depressive mood(88.9%, N=24) and anxiety(88.9%, M=24), and any disorders like delusion was rare(7.4%, M=2). Most of Kleptomania offenders were comorbid psychiatric disorder; mood disorder(48.1%, N=13), personality disorder(40.7%, N=11), psychotic disorder(25.9%, N=7), anxiety disorder(14.8%, N=4) and alcohol dependence(14.8%, N=4). 24(88.9%) responded to the psychiatric treatment and 16(59.2%) of them had good prognosis. CONCLUSION: Most of Kleptomania offenders were single women and were abused physically or sexually during childhood. They had comorbid psychiatric disorder that responded to the psychiatric treatment and had good prognosis.
Anxiety ; Criminals* ; Delusions ; Female ; Hospitals, Psychiatric ; Humans ; Disruptive, Impulse Control, and Conduct Disorders* ; Prognosis ; Psychopathology* ; Sex Offenses ; Theft

Severe, occlusive spiral dissection during diagnostic coronary angiogram is very rare. A 41-year old female patient was admitted because of chest pain at night. Her left coronary angiogram revealed no significant stenosis with diffuse luminal narrowing. Immediately after right coronary artery (RCA) injection, sudden occlusion of middle RCA was noted, which was not improved despite multiple injections of intracoronary nitrate. The patient complained of severe chest pain and ST segment elevation was observed on electrocardiogram monitoring. After wiring into true lumen of RCA, distal flow was improved and intravascular ultrasound revealed spiral dissection flap extending from proximal to middle RCA. Final coronary angioram showed patent RCA with spiral dissection and good distal flow into the distal RCA. The patient had no clinical events during 2-month clinical follow-up.
Adult ; Catheters ; Chest Pain ; Constriction, Pathologic ; Coronary Angiography* ; Coronary Disease ; Coronary Vessels ; Electrocardiography ; Female ; Follow-Up Studies ; Humans ; Phenobarbital ; Ultrasonography

BACKGROUND AND OBJECTIVES: The aim of this study was to examine the histolopathogical effects among the biolimus, zotarolimus, and everolimus eluting stent (EES) in the porcine coronary restenosis model. SUBJECTS AND METHODS: Pigs were randomized into three groups in which the coronary arteries (15 pigs, 10 coronaries in each group) had either a biolimus A9 eluting stent (BES, n=10), zotarolimus eluting stent (ZES, n=10) or an EES (n=10). Histopathologic analysis was performed at 28 days after stenting. RESULTS: There were no significant differences in the injury score among the three groups. There was a significant difference in the internal elastic lamina, lumen area, neointima area, percent area stenosis, and the fibrin and inflammation score among the three groups (4.3+/-0.53 mm2, 2.5+/-0.93 mm2, 1.8+/-1.03 mm2, 40.7+/-20.80%, 1.7+/-0.41, 1.4+/-0.72 in the BES group vs. 5.1+/-0.55 mm2, 2.3+/-1.14 mm2, 2.8+/-1.00 mm2, 55.4+/-21.23%, 2.0+/-0.39, 1.6+/-0.76 in the ZES group vs. 4.4+/-0.53 mm2, 1.7+/-1.22 mm2, 2.8+/-1.23 mm2, 64.0+/-26.00%, 1.8+/-0.76, 2.1+/-0.90 in the EES group, respectively). BES is more effective in inhibiting neointimal hyperplasia compared to ZES and EES (p<0.0001). According to the fibrin and inflammation score, BES and EES are more effective in decreasing the fibrin deposition compared to ZES (p<0.001). Moreover, BES and ZES are more effective in reducing the inflammatory reaction compared to EES (p<0.001). CONCLUSION: The result demonstrates that BES shows better histopathological characteristics than ZES and EES at one month after stenting in the porcine coronary restenosis model.
Alkanesulfonic Acids ; Constriction, Pathologic ; Coronary Restenosis* ; Coronary Vessels ; Drug-Eluting Stents ; Fibrin ; Hyperplasia ; Inflammation ; Neointima ; Percutaneous Coronary Intervention ; Sirolimus ; Stents* ; Swine ; Everolimus

OBJECTIVES: Children are one of the most vulnerable populations to the impact of disasters. We aimed to examine children's mental health in the area affected by the Hebei Spirit oil spill accident on December 7, 2007. METHODS: A cross-sectional questionnaire survey was conducted using the Korean versions of the Children's Depression Inventory and State Anxiety Inventory for Children on 1,362 children attending elementary schools in the affected area. The information on distances between the nearest contaminated coastline to the child's residential house or attending school were obtained using a web-based map by inputting two address points. The symptom risks of depression and state anxiety were estimated by multiple logistic regression analyses adjusted for age, gender, and other covariates. RESULTS: Children with the closest distance (in the fourth quartile) to the school from the contaminated coastline showed a significantly higher symptom risk of depression compared to those with the farthest distance (first quartile)(odds ratio, 2.73; 95% confidence interval, 1.40-5.33), while there was no significant association between anxiety symptoms and distance. CONCLUSIONS: Children, a vulnerable population for mental health impact by the oil spill accident, should be included in mental health programs in the community along with their family as victims of the disaster.
Anxiety ; Child ; Depression ; Disasters ; Humans ; Logistic Models ; Mental Health* ; Petroleum Pollution* ; Vulnerable Populations ; Surveys and Questionnaires

Ultraviolet (UV) irradiation is a relevant environment factor to induce cellular senescence and photoaging. Both autophagy- and silent information regulator T1 (SIRT1)-dependent pathways are critical cellular processes of not only maintaining normal cellular functions, but also protecting cellular senescence in skin exposed to UV irradiation. In the present studies, we investigated whether modulation of autophagy induction using a novel synthetic SIRT1 activator, heptasodium hexacarboxymethyl dipeptide-12 (named as Aquatide), suppresses the UVB irradiation-induced skin aging. Treatment with Aquatide directly activates SIRT1 and stimulates autophagy induction in cultured human dermal fibroblasts. Next, we found that Aquatide-mediated activation of SIRT1 increases autophagy induction via deacetylation of forkhead box class O (FOXO) 1. Finally, UVB irradiation-induced cellular senescence measured by SA-β-gal staining was significantly decreased in cells treated with Aquatide in parallel to occurring SIRT1 activation-dependent autophagy. Together, Aquatide modulates autophagy through SIRT1 activation, contributing to suppression of skin aging caused by UV irradiation.
Autophagy ; Cell Aging* ; Fibroblasts ; Humans ; Skin ; Skin Aging

BACKGROUND: Cardiogenic shock (CS) after acute myocardial infarction (AMI) develops in 5~10% of patients and it is associated with high mortality. The aim of this study is to assess the predictive factors of mortality for patients with AMI and CS. METHODS: Two hundred fifty five AMI patients with CS (the mean age was 66.0 +/- 11.0 years, M: F=156: 99) out of 1, 268 AMI patients who admitted at Chonnam National University Hospital between July 2000 and June 2002 were analyzed according to the clinical characteristics, coronary angiographic findings and MACE during admission and for the 1-year clinical follow-up. RESULTS: Among the enrolled patients, 129 patients survived without MACE (Group I, mean age 64.2 +/- 10.6 years, M: F=76: 53), and 126 patients had MACE (Group II, mean age 68.1 +/- 10.0 years, M: F=80: 46) during admission or during the 1-year follow-up period. There were significant differences in age between the Groups I and II (64.2 +/- 10.6 vs. 68.1 +/- 11.0 years, respectively, p=0.004) and the previous MI history (0 vs. 17.4%, respectively, p< 0.001). The left ventricular ejection fraction (EF) was lower in Group II (Group I vs. II: 49.1 +/- 13.0 vs. 39.1 +/- 12.9%, p< 0.001). The levels of troponin (Tn) I and C-reactive protein (CRP) were higher in Group II (Group I vs. II: 29.2 +/- 7.72 vs. 50.8 +/- 5.17 ng/dL, p=0.017, 3.8 +/- 0.48 vs. 9.9 +/- 1.21 mg/dL, p< 0.001 respectively). Left main stem lesion (LMSL) was more common in Group II than in Group I (0.7% vs. 22.0%, respectively, p=0.004). In-hospital death was associated with low Thrombolysis In Myocardial Infarction (TIMI) flow after coronary revascularization. CONCLUSION: Old age, a previous MI history, high Tn and CRP, low EF and LMSL are associated with higher MACE for patients with AMI and CS. Coronary revascularization with TIMI 3 flow lowers the in-hospital mortality.
Aged ; Female ; Hospital Mortality ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Myocardial Infarction/complications/*mortality ; Prognosis ; Shock, Cardiogenic/etiology/*mortality

BACKGROUN: Platelet activation and aggregation with resultant arterial thrombus formation play pivotal roles in the pathophysiology of acute coronary syndrome. We prospectively evaluated the long-term clinical effect of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, with low molecular weight heparin (LMWH) in the treatment of non-ST segment elevation myocardial infarction (NSTEMI). METHODS: We divided consecutive 90 patients with NSTEMI who underwent percutaneous coronary intervention (PCI) between August 2001 and April 2002 at Chonnam National University Hospital into 2 groups: Group I (n=45: LMWH alone, 62.3 +/- 9.8 years, 32 male) and II (n=45: tirofiban with LMWH, 59.2 +/- 10.2 years, 36 male). Major adverse cardiac events (MACE) were analyzed between two groups at 7 days after admission, and during 3-month and 6-month clinical follow-up. RESULTS: Mean age, sex and risk factors were not different between two groups. Minor bleeding developed in 1 patient (2.2%) of each group (p=NS). Cardiac death occurred in 4 (8.9%) of group I and 3 patients (6.7%) of group II, and revascularization was required in one patient (2.2%) of each group until 7 days after admission (p=NS). During 3-month follow-up period, revascularization was required in 7 (15.6%) of group I and 5 patients (11.1%) of group II (p=NS). MACE during 6-month follow-up occurred in 11 patients (24.4%) of group I and 4 patients (8.9%) of group II (p=0.012): revascularization was required in 4 (8.9%), myocardial infarction occurred in 2 (4.4%), and cardiac death in 5 patients (11.1%) of group I, and revascularization in 1 (2.2%) and cardiac death in 3 patients (6.7%) of group II. CONCLUSION: Tirofiban with LMWH is safe without significant bleeding complications and improve long-term prognosis in patients with NSTEMI underwent PCI.
Acute Coronary Syndrome ; Angioplasty ; Blood Platelets ; Death ; Follow-Up Studies ; Glycoproteins ; Hemorrhage ; Heparin, Low-Molecular-Weight* ; Humans ; Jeollanam-do ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Prospective Studies ; Risk Factors ; Thrombosis

BACKGROUND AND OBJECTIVES: Treating coronary in-stent restenosis (ISR) has become one of the major challenges for interventional cardiologists. The aim of this study was to compare the clinical effect of performing cutting balloon angioplasty (CBA) with implanting drug eluting stent (DES) for treating the focal type of instent restenosis (ISR). SUBJECTS AND METHODS: We retrospectively analyzed 56 patients who were treated by CBA (Group I: 59.6+/-9.6 years, male : female=46 : 10) and 20 patients who were treated by DES (Group II: 61.0+/-8.5 year, male : female=15 : 5) between January 2002 and December 2004. All the patients had the focal type of ISR (Group I - type IB : IC : ID=23 : 9 : 26, Group II - type IB : IC : ID=10 : 3 : 7). The 6-month angiographically determined late loss and the major adverse cardiac events (MACE) were compared between the two groups. RESULTS: The baseline clinical characteristics were similar between the two groups except for the high proportion of old myocardial infarction [4 (7.1%) and 3 (15%); respectively, p=0.02] and low left ventricular ejection fraction (62.6+/-8.8% vs. 55.2+/-13.8%, respectively, p=0.02) in group II. The acute gain after the procedure was higher in group II (1.86+/-0.53 mm vs. 2.54+/-0.20 mm, respectively, p<0.01). Follow-up angiography at 6 months was achieved in 40 of 56 (71.4%) patients in group I and in 15 of 20 patients (75%) in group II. The late loss was lower in group II than in group I (0.49+/-0.35 mm vs. 0.14+/-0.24 mm respectively, p<0.01). MACE during the 6-month follow-up developed in 8 patients (14.3%) of group I and in 1 patient (5.0%) of group II (p=0.04). CONCLUSION: DES is associated with a better clinical outcome than CBA for the treatment of the focal type of ISR.
Angiography ; Angioplasty, Balloon* ; Constriction, Pathologic ; Coronary Disease ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Male ; Myocardial Infarction ; Retrospective Studies ; Stents ; Stroke Volume

BACKGROUND AND OBJECTIVES: Angiotensin converting enzyme inhibitor is known to be effective in the prevention of left ventricular remodeling following myocardial infarction. However, little data is available concerning the clinical effects of angiotensin (AT) receptor blocker in ischemic cardiomyopathy. This study evaluated the clinical effects of the concomitant use of losartan with low doses of hydrochlorthiazide in cases of ischemic cardiomyopathy. SUBJECTS AND METHODS: A combined agent of 50 mg of losartan potassium with 12.5 mg of hydrochlorthiazide (HCTZ) was administrated once daily over a 12-week period to 29 patients (M:F=26:3, 61.4+/-8.7 years) who were diagnosed with ischemic heart failure (ejection fraction lower than 50% by echocardiography) at Chonnam National University Hospital. RESULTS: Clinical symptoms of dyspnea in the 29 patients improved from 2.08+/-0.49 to 1.15+/-0.38 as measured by New York Heart Association class. The systolic and diastolic blood pressure did not change significantly following treatment (116.5+/-18.0/77.0+/-11.9 mmHg vs. 118.7+/-15.1/78.1+/-11.1 mmHg). The ejection fraction following administration of Losartan/HCTZ increased from 40.3+/-8.1% to 46.7+/-10.8% (p=0.001). Losartan/HCTZ was well tolerated in all patients without significant adverse effects or laboratory changes. CONCLUSION: A fixed combination of losartan and low dose hydrochlorthiazide is effective in patients with ischemic heart failure.
Angiotensins ; Blood Pressure ; Cardiomyopathies ; Diuretics ; Dyspnea ; Heart Failure* ; Heart* ; Humans ; Jeollanam-do ; Losartan* ; Myocardial Infarction ; Peptidyl-Dipeptidase A ; Ventricular Remodeling

BACKGROUND AND OBJECTIVES: Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term follow-up, compared with thrombolytic therapy for acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients. SUBJECTS AND METHODS: Two hundred and twenty three patients (Group I: n=66, age> or =75 years, Group II: n=157, age<75 years), who underwent primary PCI for AMI at Chonnam National University Hospital, between 2000 and 2002, were analyzed according to their clinical, angiographic characteristics, inhospital and one-year survival. RESULTS: Group I had a higher percentage of women (45.5% vs. 19.1%, p=0.00), multi-vessel disease (42% vs. 28%, p=0.031), right coronary artery disease (52% vs. 33%, p=0.021), and more frequent histories of diabetes mellitus (35% vs. 22%, p=0.039) and less smoking (38% vs. 60%, p=0.003) than Group II. Successful reperfusion by PCI was achieved in 97 and 96 %, respectively (p=NS). The rates of in-hospital mortality were similar in both groups (12.1% vs. 8.2%, p=NS). There were no significant differences in the major adverse cardiac events between the two groups during the one-year clinical follow-up (31.4 % vs. 36.9 %, p=NS). CONCLUSION: Primary PCI in AMI patients older than 75 years can be performed with comparable procedural success rates and long-term clinical outcomes to those of younger patients.
Aged ; Angioplasty ; Coronary Artery Disease ; Diabetes Mellitus ; Female ; Follow-Up Studies ; Hospital Mortality ; Humans ; Jeollanam-do ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Reperfusion ; Smoke ; Smoking ; Thrombolytic Therapy