OBJECTIVE: The abacus, first used in Asian countries more than 800 years ago, enables efficient arithmetic calculation via visuo-spatial configuration. We investigated whether abacus-trained children performed better on cognitive tasks and demonstrated higher levels of arithmetic abilities compared to those without such training. METHODS: We recruited 75 elementary school children (43 abacus-trained and 32 not so trained). Attention, memory, and arithmetic abilities were measured, and we compared the abacus with the control group. RESULTS: Children who had learned to use an abacus committed fewer commission errors and showed better arithmetic ability than did controls. We found no significant differences between children with and without abacus training in other areas of attention. CONCLUSION: We speculate that abacus training improves response inhibition via neuroanatomical alterations of the areas that regulate such functions. Further studies are needed to confirm the association between abacus training and better response inhibition.
Asian Continental Ancestry Group ; Case-Control Studies* ; Child ; Cognitive Science ; Humans ; Mathematics ; Memory

Background: Failure of mitral valve repair sometimes may be ascribed to severe or progressive alteration of the subvalvar apparatus. The aim of this study was to evaluate the effects of new chordae formation on mitral repair. Material and Method: From March 1997 to February 1999, 26 patients underwent mitral valve repairs with new chordae formation, we compared the symptoms and echocardiographic findings checked at preoperative state, and intraoperative period, discharge, and their last OPD visit. There were 15 male , and 11 female patients, and their mean age was 51.2+/-13.4 years. Etiology of the lesions was degenerative (18), rheumatic (6), infective (1) and ischemic (1). Chordal lesions were caused by rupture (18), elongation (6), and a combination of two causes (2). Associated lesions included atrial septal defect (2), tricuspid insufficiency (7), aortic insufficiency(4), and a combination of previous two factors (2). The number of mean artificial chordae was 3.6+/-1.6. Annuloplasty was performed in all cases. The CPB time was 182.1+/-63.7 minutes and the ACC time was 133.1+/-45.6 minutes. Average follow up period was 49.2+/-7.1 months. Result: There was no early death. Early reoperation was performed in two patients, one patient received mitral valve replacement because of an abnormality of annuloplasty and another received pericardiostomy due to postoperative pericardial effusion. During the follow up of 49.2+/-7.1 moths, there was no late mortality. Postoperative NYHA functional class checked at last OPD visit was class I in 22 patients (88%), class II in 2 (8%), and class III in 1 (4%). Regarding the late echocardiogram MR was absent in 20 patients (78%), I in 4 (15%), and II in 1 (4%). The postrepair mitral valve area was 2.2+/-0.35 cm(2). Conclusion: This study suggests that mitral valve repair using new chordae formation provides good early and mid term survivals and functional improvement. We think that the artificial chorda formation with polytetrafluoroethylene suture might be safe and effective technique for mitral valve repair.
Echocardiography ; Female ; Follow-Up Studies ; Heart Septal Defects, Atrial ; Humans ; Intraoperative Period ; Male ; Mitral Valve* ; Mortality ; Moths ; Pericardial Effusion ; Pericardial Window Techniques ; Polytetrafluoroethylene ; Reoperation ; Rupture ; Sutures

OBJECTIVE: Mild traumatic brain injury (mTBI) is frequently associated with psychiatric symptoms and cognitive dysfunction, as well as with the receipt of workers' compensation, as many mTBIs occur due to work-related accidents. We hypothesized that depression and insufficient cognitive effort mediate the relationship between sociodemographic variables and cognitive dysfunction in mTBI. METHODS: A retrospective chart review study was conducted using 115 records of patients with mTBI. Cognitive effort was measured based on scores on the Rey 15-Item Test. Multivariate linear regression analysis was performed to examine factors predictive of cognitive functions. Path analysis was subsequently performed to investigate the mediating effects of depression and cognitive effort in relation to receipt of workers' compensation and demographic variables. RESULTS: Fifteen of the 115 participants (13.0%) received failing scores on the Rey 15-Item Test, which indicated insufficient cognitive effort. Path analysis indicated that cognitive effort mediated the effects of age and workers' compensation on cognitive functions. CONCLUSION: Given the significant mediating effects of cognitive effort on cognitive performance, it is important to address patient motivation and encourage mTBI patients covered by workers' compensation to perform tests with authentic effort.
Brain Concussion ; Brain Injuries* ; Compensation and Redress ; Depression* ; Retrospective Studies ; Executive Function* ; Humans ; Intelligence* ; Linear Models ; Memory* ; Motivation ; Negotiating* ; Neuropsychological Tests ; Workers' Compensation

Mental health policy influences the mental health system and promotion in the medium and longer term. Thus, many countries develop a mental health plan suitable for their countries. In 2012, the suicide rate in Korea was 28.1 per 100000 persons, representing a nine-year high among countries in the Organization for Economic Co-operation and Development. In addition, suicide rates in Korea increase as a function of age. For example, the prevalence of suicide per 100000 persons is 19.3 among people in their 20 s and 83.2 among those in their 70 s, respectively. Another important mental health issue in Korea is a need for 'positive psychiatry', which generally aims to improve mental health and psychiatric conditions, not only in patients with psychiatric illnesses but also in the general population. As the definition of mental health is being broadened, psychiatrists should expand their range of activities and collaborate more with other professional and civic groups. Psychiatrists belonging to various institutions, such as mental health groups, clinics, mental health hospital, and general hospital, also need to find ways to expand the importance of their roles. Given the growing responsibilities for the mental health policy, the Policy Research Institute of the Korean Neuropsychiatric Association planned eight review articles on the mental health of Korea in the medium and longer term.
Academies and Institutes ; Health Policy ; Health Promotion ; Hospitals, General ; Humans ; Korea ; Mental Health ; Prevalence ; Psychiatry ; Suicide

BACKGROUND: The most widely used pulmonary function test is spirometry. It is a relatively simple and noninvasive test that measures the volume of air expelled from fully inflated lungs. However, spirometry is an effort-dependent test that requires careful instruction and the full cooperation of the test subject. Because the old patients have relatively longer expiration time than the young patients, it is difficult for both old age and technician to fulfill the end of test criteria for forced vital capacity (FVC) maneuver. In the present study, we aimed to investigate whether forced expiratory volume in six seconds (FEV6) could be utilized in place of FVC in the detection of airway obstruction for the old age. METHODS: Total 353 old age (> or =65years) were enrolled in this study and performed spirometry. Subjects were divided into two groups by FEV1/FVC as the gold standard for diagnosing obstructive airway disease; Group I: 132 patients with FEV1/FVC> or =70% , Group II: 221 patients with FEV1/FVC<70% The relationship between FVC and FEV6 values were analyzed in both groups and differences between the groups were investigated. RESULTS: The mean difference of FVC and FEV6 values (FVC-FEV6) was 138.4+/-23.0 mL (5.06+/-2.86%). This difference was found to be higher in group II (189.4+/-162.5 mL, 7.0+/-5.4%) than group I (52.9+/-47.3 mL, 1.9+/-1.5%). When FEV1/FVC is taken as the gold standard, FEV1/FEV6 had negative predictive value of 87.4% and a sensitivity of 91.4% in the detection of obstructive airway disease. Conclusion: FEV6 was a relative good candidate for parameter in the detection of airway obstruction in the old age for whom it is difficult to fulfill acceptable FVC maneuver. However, additional researches are needed to determine the usefulness of FEV6 in detecting obstructive airway disease of old age.
Airway Obstruction ; Diagnosis* ; Forced Expiratory Volume ; Humans ; Lung ; Respiratory Function Tests ; Spirometry ; Vital Capacity

Informed consent is the procedure that respects the autonomy of patients ; doctors protect patients' choices and rights through informed consent. Competence and voluntariness are prerequisite for the informed consent. In recent years, the necessity of informed consent from the Psychiatric department has been raised. Regarding informed consent from the Psychiatric department, there is a need to consider from two perspectives : respect for the patient's decision-making ability and the psychiatrist's legal self-protection. In competence and voluntariness, psychiatric patients were excluded due to lack of decision-making ability and willingness. However, not all psychiatric patients were able to perform the given task. Therefore, informed consent is needed in the point of view regarding the decision-making ability of psychiatric patients. Psychotropic medications, particularly antipsychotics, can cause several side effects, including extrapyramidal syndrome and metabolic syndrome. Therefore, preannouncement of these patients for these side effects is needed. However, when the informed consent is only applied to psychiatric hospitals, it may increase prejudices and misconceptions about psychiatric medications and treatment. Therefore, the informed consent should first be considered carefully and thoughtfully.
Antipsychotic Agents ; Hospitals, Psychiatric ; Human Rights ; Humans ; Informed Consent* ; Mental Competency ; Prejudice

Bupropion is a unique antidepressant with enhancing both noradrenergic and dopaminergic neurotransmission without altering serotonergic system. Given its pharmacodynamics and structural similarity to amphetamine, the possibility of bupropionrelated psychosis has been reported. The authors describe a 22-year-old woman who presented psychotic symptoms after taking 10 tablets of sustained release bupropion (bupropion SR) 150 mg (total 1,500 mg) and lorazepam 0.5 mg (total 5 mg). Visual hallucinations developed at 17 hours after overdose, while paranoid ideation and aggressive behaviors developed at 24 hours after overdose. The psychotic symptoms remitted on the fifth day of antipsychotics treatment. She remained psychiatrically stable without any clinically significant symptoms during 3-month follow-up. This case raises issue about the possible relationship between bupropion overdose and transient psychosis.
Amphetamine ; Antipsychotic Agents ; Bupropion ; Female ; Follow-Up Studies ; Hallucinations ; Humans ; Lorazepam ; Morphinans ; Psychotic Disorders ; Synaptic Transmission ; Tablets ; Young Adult

BACKGROUND: Gastric cancer remains the main cause of cancer-related death in Korea. Accurate preoperative staging of gastric cancer is essential to predict prognosis and to plan optimal treatment. Although there are many reports dealing with the diagnostic values of conventional methods, controversies are still present especially in the field of preoperative staging. In this study, we evaluated the accuracy of gastroscopy and upper gastrointestinal series(UGI) for diagnosis of gastric cancer, and determined the usefulness of ultrasonography and computed tomography for preoperative staging. METHODS: One hundred twenty-three patients, who underwent operation from Aug. 1991 to Mar. 1995 under the diagnosis of gastric cancer were analyzed. We excluded 15 patients because their postoperative definitive stagings were undetemined. RESULTS: 1) Among 123 patients, the proportion of early gastric cancer was 26.0%(32/123) and that of the advanced gastric cancer was 74.0%(91/123). 2) The sensitivity of endoscopic diagnosis of gastric cancer was 96.7%(119/123), and the accuracy to determine the depth of invasion was 82.9% (102/123). 3) The sensitivity of UGI study for gastric cancer was 89.9%(98/109), and the accuracy to determine the depth of invasion was 61.5%(61/109). 4) The sensitivity of abdominal ultrasonography to detect the tumor was 11.3%(8/71), the accuracy to determine the T stage was 29.2%(28/96), and the sensitivity and specificity to detect lymph node metastasis was 13.6%(8/59), 100%(37/37), respectively. 5) The sensitivity of abdominal CT to detect the tumor was 74.3%(26/35), the accuracy to determine the T stage was 32.5%(13/40), and the sensitivity and specificity to detect lymph node metastasis were 34.5%(9/29), 72.7%(8/11), respectively. 6) The accuracy of preoperative staging was 45.5%(56/123). The 49.6%(62/123) of gastric cancer was downstaged, whereas only 4.1%(5/123) was overstaged. CONCLUSION: Our results show that high accuracy for diagnosis of gastrie cancer with the gastroscopy and UGI. However preoperative staging with ultrasonography and computed tomograpy was often underestimated, which could be concluded that the usefulness of the radiologic methods was limited.
Diagnosis* ; Gastroscopy ; Humans ; Korea ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sensitivity and Specificity ; Stomach Neoplasms* ; Tomography, X-Ray Computed ; Ultrasonography

OBJECTIVES: To examine the association of subjective depressive symptoms and cognitive dysfunction in patients with mild traumatic brain injury (mTBI). METHODS: 36 patients with mTBI without structural abnormality in the brain imaging study were recruited. Participants were subdivided into two groups by a cutoff score of 70T in the Beck Depression Inventory (BDI). Cognitive functions including intelligence, memory, and executive function were significantly lower in the <70T group compared to the > or =70T group. In addition, BDI scores were negatively correlated with performances in most of the neuropsychological tests. RESULTS: Patients group who scored 70T or more in the BDI showed significantly lower scores in most items of the neuropsychological tests. CONCLUSION: High subjective depression is associated with low neuropsychological performance in mTBI.
Brain Injuries ; Depression ; Executive Function ; Humans ; Intelligence ; Memory ; Neuroimaging

Flash pulmonary edema is characterized by a sudden episode of dyspnea resulting from acute pulmonary venous congestion, which resolves rapidly. We report a case of renal artery stenosis presenting as flash pulmonary edema in a patient with solitary kidney treated by angioplasty with stent implantation. A 75-year-old man with solitary kidney visited the emergency room with acute shortness of breath. His blood pressure had risen to 206/90 mmHg and a chest radiograph revealed pulmonary edema. Echocardiography and coronary arteriography showed no clear abnormalities, but abdominal computed tomography revealed severe focal stenosis in the left proximal renal artery. A captopril renal scan found that the time to peak and half-time of radioactivity were delayed in the left kidney. Percutaneous transluminal angioplasty was performed, followed by stent implantation. After this procedure, the stenotic segment was completely dilated and blood pressure returned to the normal range.