OBJECTIVES: This review strives to look through the reality of school situation in Korea which gives the most severe burden of conflict to adolescents nowadays, for the purpose of better understanding of them. METHODS: Followings comprised of the summary of the materials from the published articles and books, and from mass media regarding 'school collapse' phenomenon in Korea, and also include materials regarding school non-attenders. And discussion was done with developmental and psychiatric perspectives on the phenomenon along with on school non-attenders. CONCLUSION: School non-attenders nowadays with the issue of 'school collapse' have different characteristics from the dropouts reported in many previous studies. Psychiatrists need to accommodate their previous view on adolescents as the way of adolescents' coping has rapidly changed. It is noted that there are few researches regarding school non-attenders, as well as regarding school factors associated with non-attending in Korea. This review was done to call for future studies focused on the interdependent relationship between school processes and the individual characteristics of non-attenders, so that enable us to capture the complexity of how adolescents make their decision of hangingin or droppingout of school.
Adolescent ; Humans ; Korea* ; Mass Media ; Patient Dropouts ; Psychiatry

BACKGROUND AND PURPOSE: A carboxy-O-methyl transferase inhibitor entacapone has been introduced as an adjuvant drug for Parkinson disease (PD) patients. Although clinical trials reported beneficial role of entacapone, a long-term trial over 3 years failed to show significant effect. The goals of this study were to evaluate the clinical benefit and the efficacy of entacapone in an open clinical practice. METHODS: After the completion of a double-blind placebo-controlled entacapone study, 149 patients from 4 centers were included. Antiparkinsonian medications were optimized by the judgment of the neurologists in charge. The clinical global impression (CGI) scale was obtained at 6 months and 1 year after the initiation of entacapone treatment. RESULTS: Of the 149 patients, 117 patients chose to try entacapone in an open-label fashion. Sixty-nine (59%) patients completed the 1-year trial. Twenty-nine patients discontinued entacpaone before 6 months, and 19 between 6 months and 1 year during trial. Twelve patients out of 48 patients discontinued entacapone because of its poor efficacy. The CGI scale was 3.9 (+/-1.5) at the beginning of the trial, 4.3 (+/-1.1) at 6 month, and 3.8 (+/-1.3) at 1 year, respectively. The CGI scale of those who discontinued between 6 month and 1 year was 3.4 (+/-1.7), which was worse, but insignificantly, than that of the continuer. CONCLUSIONS: The dropout at 1 year of our study was very high at 41%. Even though entacapone is indicated for advanced PD patients with motor fluctuation, the fluctuators commonly have dyskinesia and mental symptoms, which can become more troublesome with entacapone. In the patients with advanced PD, the clinical efficacy and side effects should be carefully considered in a long-term use of entacapone.
Dyskinesias ; Humans ; Judgment ; Parkinson Disease* ; Patient Dropouts ; Transferases

One of the true success stories in clinical neurosciences over the last 30 or so years has been the development of effective drug therapies of several psychiatric disorders including schizophrenia. It is true that the effects of drug are not disease-specific. However, it if logical to find medications that will be effective in eating disorders. In spite of many limitations, some tentative conclusions regarding the role of medications in the treatment of eating disorders can now be drawn. These conclusions as a whole revealed the following ; 1) There were no clear difference in efficacy among the various drugs used. 2) Short-term abstinence rates are about 30%, and overall reductions in bulimic behavior are about 70%. 3) A significant relapse rate(30-45%) is observed if patients are followed for 4-6 months. 4) There are few predictors of who will respond to these medications. 5) Dropout rates tend to be high, in part because of side effects and in part because of some patients' attitudes toward medication use. 6) The doses used in these treatment studies have generally been similar to those employed in the treatment of depression, and with a single exception which the high-dose regimen (60 mg of fluoxetine) was clearly superior to the loll dose (20 mg of fluoxetine). However, Wakeling(1995) suggested that the pharmacotherapy for eating disorders clearly had some limited beneficial effects, at least in the short term and that many unanswered questions remained related to the acceptability of this form of treatment, the unwanted effects of drugs and the longer-term efficacy. He also insisted that at the present level of knowledge, pharmacotherapy should not be used as a sole treatment approach but only within an overall treatment programme. In clinical practice, pharmacotherapy is frequently used in the treatment of eating disorders in combination with various psychotherapuetic approaches. Therefore, the clinicians, who engage in the treatment of patients with eating disorders, should be able to identify the patients for whom drug therapy is desirable and be accustomed to the differences with the pharmacotherapy of other psychiatric patients. The author will review the results of previous studies on pharmacotherapy for eating disorders and demonstrate several important issues in the practice of pharmacotherapy for the patients with eating disorders.
Depression ; Drug Therapy* ; Feeding and Eating Disorders* ; Eating* ; Humans ; Logic ; Neurosciences ; Patient Dropouts ; Recurrence ; Schizophrenia

PURPOSE: Sildenafil citrate(Viagra(R)) has been accepted as a primary treatment of erectile dysfunction(ED). We performed this study to assess the determinants of sildenafil failure and the status of secondary treatment in sildenafil failure patients. MATERIALS AND METHODS: We reviewed the medical records of 1,023 erectile dysfunction patients who were prescribed sildenafil from September 2001 to June 2003. A specially designed sildenafil failure questionnaire was asked in 236 patients of sildenafil failure(Group I) and 127 of 787 patients with sildenafil success as a control(Group II). RESULTS: Sildenafil failure rate was 23%(236/1023). In Group I, the etiology of ED was psychogenic in 14%, organic in 36%, mixed in 32% and un-classified in 18%. Number of total medication(more than 6 times) was 47% in Group I and 61.4% in Group II. Presence of sexual stimulation after medication was 47% in Group I and 61.4% in Group II. There was no difference in time to intercourse after medication and interval of meal to medication between both groups(p>0.05). The secondary treatment in Group I was intracavernous injection(11.3%), vacuum device(7.2%), penile prosthesis(1.3%) and 81.2% of no further treatment. CONCLUSIONS: Although precise education of taking sildenafil may enhance the response rate, the best predictors for long-term use of sildenafil are the severity and cause of ED and the effectiveness of sildenafil. Due to the high dropout rate of patients who suffer sildenafil failure, precise public education and secondary treatment options should be recommended.
Education ; Erectile Dysfunction* ; Humans ; Male ; Meals ; Medical Records ; Patient Dropouts ; Sildenafil Citrate ; Vacuum

Commercial kits usually recommend certain range of the amount of DNA without PCR inhibitors for optimal results. If proper DNA is not used in STR amplification, undesirable results such as enhanced stutter effects, split peaks, allele dropout and poor peak balance could be shown. This phenomenon would happen more frequently in case of bone typing. Therefore, we checked effect of DNA concentration and PCR inhibitors on conventional STR typing results using QuantifilerTM Human DNA Quantification Kit. The 54 bone samples over a 60-year burial period were used in this study. In all samples, the DNA concentration ranged from 0.8 pg/ul to 748 pg/ul and Ct values of IPC that indicates residue of PCR inhibitors ranged from 26.69 to 35.59. The DNA concentration and the number of amplified loci showed positive correlation. The number of loci amplified using Minifiler kit was much more than using Y filer kit. Samples with high Ct value of IPC were not almost amplified with Y filer kit. These results suggested that QuantifilerTM Kit is useful to obtain information for DNA typing.
Alleles ; Burial ; DNA ; DNA Fingerprinting ; Forensic Sciences ; Humans ; Patient Dropouts ; Polymerase Chain Reaction

PURPOSE: A common finding of carotid artery on magnetic resonance angiograms(MRAs) is a signal dropout along the posterior wall of carotid bulb due to reverse flow. The purpose of this study is to evaluate variable flow patterns on bifurcated carotid arterial phantoms using steady-state flow. MATERIALS AND METHODS: We designed phantoms of a bifurcated carotid artery with acrylic materials. Flow patterns were evaluated with axial and coronal imaging of MRA(2D-TOF, 3D-TOF), color Doppler imaging, and computational fluid dynamics (CFD) within the phantoms constructed of an automated closed-type circulatory system filled with 4% sugar solution. These findings were compared with findings obtained from normal volunteers. RESULTS: Axial 3D-TOF MRA images exhibited closer resemblance to the contour of the inner wall of phantoms when compared to coronal 2D-TOF MRA imaging. However, 2D-TOF MRA showed good contrast difference of signal intensities between forward flow area and reverse flow area. Dark zones with reduced signal intensities due to reversed flow were separated from the outer wall of the internal and external carotid arteries by a thin layer of forward flow along the wall on the source slice image of MRA. The general hemodynamics of the phantoms on MRA were identical to hemodynamics on color Doppler imaging and CFD. The results obtained with the phantoms matched the findings on normal volunteers. CONCLUSION: Although representations of bifurcated carotid arterial phantoms on axial 3D-TOF MRA were excellent if ideally desinged, the zone of reversed flow could be a significant factor in creating distorted image when the zone of reversed flow contacted directly with curved or deformed arterial wall.
Carotid Arteries ; Carotid Artery, External ; Healthy Volunteers ; Hemodynamics ; Humans ; Hydrodynamics ; Magnetic Resonance Angiography* ; Patient Dropouts

BACKGROUND: Although expert panels and guidelines recommend that 5~10% weight reductions of initial body weight have beneficial effects for decreasing obesity-related complications, obese persons tend to desire greater weight losses. Little is known about the patients' expectations and the disparity of goal weight between physicians and patients. The aim of this study was to evaluate the patients' weight loss expectation, and the association between the degree of desired weight losses and treatment outcomes. METHODS: A total of 283 obese subjects (84 men, 199 women), aged > or =20 years with body mass index (BMI) over 25 kg/m2 from 19 obesity clinics were included. Patients' desired weight as evaluated using modified GRWQ (Goals and Relative Weight Questionnaire) which included goal weight, ideal weight, satisfactory weight, acceptable weight, and disappointed weight. After 12 weeks, subsequent weight changes and treatment adherence were investigated. RESULTS: Mean BMI of men and women were 30.9+/-4.2 kg/m2 and 29.1+/- 3.8 kg/m2, respectively. Men expected 13.2 kg (14.0%) mean weight reductions and women expected 10.8 kg (15.7%) mean reductions during the 3 months. The heavier the patient's weight, the greater the reduction amount was desired in both men and women. During the 3 months, the dropout rates of men and women were 40.1% and 46.2%, respectively. In women, the amount of desired weight reduction as significantly higher in the dropout group compared to the non-dropout group. Those who attained pre-determined goal weight after 3 months were 6% for men and 4% for women. After 3 months, 81% of male subjects and 80% of female subjects had not achieved even their predefined disappointed weight. CONCLUSION: Obese patients seeking treatment expected average of 15% weight reduction, greater than 'medically reasonable or successful' weight reductions. The disparities between patients' expectations and physicians' recommendations could influence treatment adherence.
Body Mass Index ; Body Weight ; Female ; Humans ; Male ; Obesity* ; Patient Dropouts ; Weight Loss

PURPOSE: Alarm interventions are effective and safe treatments for nocturnal enuresis when compared with the other treatments. However, the rate of doctors prescribing enuresis alarms is quite low in Korea. This study evaluated the application conditions and treatment results of an enuresis alarm in children with enuresis in Korea. MATERIALS AND METHODS: 147 out of 316 patients who purchased an enuresis alarm through a alarm sales agency in Korea were evaluated retrospectively. The questionnaire had two main categories: items of enuresis(number of episodes during the night, enuresis frequency during a week, etc.) and the items of the enuresis alarm(previous treatment history, a motivation of using enuresis alarm treatment, the period of using the enuresis alarm, initial success, continued success, dropout of using enuresis alarm, nocturia after treatment, etc.). RESULTS: A total 147 children participated in this study. The initial success rate was 30.6% whereas the continued success rate was 34.0%. In addition, the dropout rate was 27.2%. 46.2% of patients purchased the enuresis alarm with a doctor's prescription and 53.8% purchased the alarm without a prescription. Among the factors, the success and dropout rate were affected by only whether the patient visited the hospital. Thirty five patients who took combination therapy with medicine had a significantly lower initial success rate. CONCLUSIONS: In Korea, without a doctor's prescription, 53.7% patients attempt to treat enuresis alarm directly. The initial and continued success rate with the enuresis alarm was approximately 30% and the dropout rate was approximately 30%.
Child ; Commerce ; Enuresis ; Humans ; Korea ; Motivation ; Nocturia ; Nocturnal Enuresis ; Patient Dropouts ; Prescriptions ; Retrospective Studies

PURPOSE: Because low-quality trials may lead to erroneous conclusions, quality assessments are necessary. Thus, in this study, we scrutinized randomized controlled trials (RCTs) published in the Korean Journal of Urology (KJU) to assess their quantity and quality. MATERIALS AND METHODS: Upon extracting RCTs from all articles published in the KJU from 1991 to 2010, assessments were made on the basis of the Jadad scale and the adequacy of allocation concealment. The selections and assessments were performed independently by two researchers, and adjustment of the differences was done by a third-party researcher. In addition, the factors that may affect quality were analyzed. RESULTS: A total of 3,516 original articles were searched and 28 RCTs were extracted. In the 1990s, RCTs constituted only 0.27% of the total original articles, but in the 2000s, RCTs constituted 1.34%. The mean total Jadad score increased from 1.6 points in the 1990s to 1.65 points in the 2000s. However, the percentage of "good quality" trials also increased from 20% to 30.43%. As for adequate allocation concealment, one study was observed in the 2000s. The aspect most lacking was appropriate dropout and double-blinding. Studies with medical interventions or funded or examined by institutional review boards tended to receive higher quality assessments. CONCLUSIONS: Although RCTs consistently increased in both quantity and quality, in future studies, researchers should continue to strive toward achieving adequate allocation concealment and appropriate double-blinding. In addition, researchers must become more interested in receiving external funding and undergoing examination by institutional review boards.
Ethics Committees, Research ; Financial Management ; Humans ; Korea ; Patient Dropouts ; Prospective Studies ; Random Allocation ; Urology

PURPOSE: Some patients develop side effects from theophylline even at low serum concentrations. We designed a prospective study to evaluate the side effects of theophylline. METHODS: A Prospective, controlled trial study was conducted. The low-dose group received an intravenous continuous aminophylline dose of 5 mg/kg/day on the first day and subsequently 10 mg/kg/day on the following two days. The usual-dose group received 10 mg/kg/day for three days and the control group received normal saline for three days. Heart rate, respiratory rate, serum concentration of theophylline, and four adverse events (irritability, sleep disturbance, jitter, and vomiting) were checked at the time of admission and at 2, 12, 24, 48, and 72 h after the start of aminophylline infusions. RESULTS: Nine patients out of 37 in the low-dose group and six of 21 in the usual-dose group dropped out because of uncontrolled irritability. The serum concentrations of theophylline in dropouts (3.68+/-1.93 ig/mL) and participants (4.47+/-2.45 ig/mL) were not significantly different. Irritability was a more frequent side effect in the usual-dose group at 12 h, but there was no difference between the low-dose and usual-dose groups in terms of vomiting, sleep disturbance, and jitter. Most of the severe adverse effects were observed in children below two years of age. CONCLUSION: Some patients dropped out regardless of the initiating aminophylline dose, especially patients under the age of two years.
Aminophylline ; Asthma ; Child ; Heart Rate ; Humans ; Patient Dropouts ; Prospective Studies ; Respiratory Rate ; Theophylline ; Vomiting