Modified electroconvulsive therapy (ECT) which started in 1950s is a safe and efficacious treatment for several mental disorders including mood disorders and psychotic disorders. However, its usage in present days is still limited by misconceptions and stigmata of ECT. This paper overviews the background from which the stigmata of ECT stemmed and the current status of stigmata surrounding ECT among the public and medical professionals. In addition, a few potential strategies for reducing stigmata of ECT are provided in this review.

Modified electroconvulsive therapy (ECT) which started in 1950s is a safe and efficacious treatment for several mental disorders including mood disorders and psychotic disorders. However, its usage in present days is still limited by misconceptions and stigmata of ECT. This paper overviews the background from which the stigmata of ECT stemmed and the current status of stigmata surrounding ECT among the public and medical professionals. In addition, a few potential strategies for reducing stigmata of ECT are provided in this review.

Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.
Advisory Committees ; Family Characteristics ; Focus Groups ; Food Supply ; Government Agencies ; Nutrition Surveys ; Public Health ; Surveys and Questionnaires

Malignant hyperthermia is a rare, fatal pharmacogenetic disorder that occurs during general anesthesia following exposure to a depolarizing muscle relaxant, such as succinylcholine, or volatile anesthetics. Clinical findings in malignant hyperthermia include muscle rigidity, sinus tachycardia, increased CO2 production, skin cyanosis with mottling, and marked hyperthermia. For treatment, cooling techniques must be accompanied by discontinuation of the provocative medication. Furthermore, dantrolene administration is the mainstay of treatment for malignant hyperthermia, and should be initiated as soon as the diagnosis is suspected. We recently experienced a case with post-operative fever of 41.0degrees C refractory to conventional anti-pyretic measures and finally resolved with dantrolene administration, in a patient with methicillin-sensitive Staphylococcus aureus monoarthritis of the knee and rapid progression of diffuse septic pneumonia requiring mechanical ventilation.
Anesthesia, General ; Anesthetics ; Arthritis ; Cyanosis ; Dantrolene ; Fever ; Humans ; Knee ; Malignant Hyperthermia ; Muscle Rigidity ; Muscles ; Pneumonia ; Respiration, Artificial ; Skin ; Staphylococcus aureus ; Succinylcholine ; Tachycardia, Sinus

Biloma is a rare disorder, and is defined as an abnormal extrahepatic or intrahepatic collection of bile within a defined capsular space. The common causes of biloma are iatrogenic and trauma. Spontaneous biloma, especially caused by pancreatic cancer, is very rare. An 86-year-old man was admitted with abdominal pain and fever. The patient denied a history of abdominal surgery, endoscopic retrograde cholangiography, or trauma. Abdominal computed tomography demonstrated a huge collection of fluid in the left lobe of the liver, dilatation of the intra and proximal common bile duct, and a heterogeneous enhancing mass in the pancreatic head portion. Percutaneous drainage under ultrasound guidance was performed, and the fluid analysis was compatible with biloma. A plastic stent was endoscopically inserted into the common bile duct to treat continuous drainage of the fluid despite percutaneous drainage. We report a case of biloma developed spontaneously in a patient with pancreatic cancer and successfully treated by endoscopic biliary stenting.
Abdominal Pain ; Aged, 80 and over ; Bile ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Dilatation ; Drainage ; Fever ; Head ; Humans ; Liver ; Pancreatic Neoplasms ; Plastics ; Stents

OBJECTIVE: We evaluated cell viability and proliferation activity of peripheral lymphocytes as potential models of neuronal death in Alzheimer's disease (AD). METHODS: We analyzed the cell viability and proliferation activity of phytohemagglutinin (PHA)-activated lymphocytes from 68 AD patients and 33 normal controls. The cellular measures were made at baseline (0 hr), 24 hrs, 48 hrs, 72 hrs, and 96 hrs after PHA stimulation. RESULTS: Cell viability in the AD patients was significantly decreased at 72 hrs and 96 hrs, compared with the normal controls. The declining ramp of the proliferation activity from 48 hrs to 72 hrs after PHA stimulation was significantly related to cell viability at 72 hrs and at 96 hrs in the AD patients. CONCLUSION: Lymphocytes from patients with AD have altered viability and proliferation characteristics in culture following PHA stimulation. These findings suggest that lymphocytes may be used as a peripheral tissue model of cell cycle dysregulation in AD.
Alzheimer Disease ; Architectural Accessibility ; Cell Cycle ; Cell Death ; Cell Survival ; Humans ; Lymphocytes ; Neurons

The Korean Cancer Pain Assessment Tool (KCPAT), which was developed in 2003, consists of questions concerning the location of pain, the nature of pain, the present pain intensity, the symptoms associated with the pain, and psychosocial/spiritual pain assessments. This study was carried out to evaluate the reliability and validity of the KCPAT. A stratified, proportional-quota, clustered, systematic sampling procedure was used. The study population (903 cancer patients) was 1% of the target population (90,252 cancer patients). A total of 314 (34.8%) questionnaires were collected. The results showed that the average pain score (5 point on Likert scale) according to the cancer type and the at-present average pain score (VAS, 0-10) were correlated (r=0.56, p<0.0001), and showed moderate agreement (kappa=0.364). The mean satisfaction score was 3.8 (1-5). The average time to complete the questionnaire was 8.9 min. In conclusion, the KCPAT is a reliable and valid instrument for assessing cancer pain in Koreans.
Adult ; Aged ; Aged, 80 and over ; Causality ; Comorbidity ; Data Collection/methods/*standards ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Neoplasms/*diagnosis/*epidemiology ; Outcome Assessment (Health Care)/*methods ; Pain/*diagnosis/*epidemiology ; Pain Measurement/*methods ; Reproducibility of Results ; Research Support, Non-U.S. Gov't ; Sensitivity and Specificity ; Severity of Illness Index

Pneumatosis cystoides intestinalis (PCI), characterized by presence of intramural gas cyst in the intestinal wall is associated with various medical condition. Polymyosistis, however, is rarely associated with PCI. Few cases are reported in the world, and none has not been reported previously in Korea. A 67-year-old woman with polymyositis developed mild abdominal pain and abdominal distension during treatment with steroid and azathioprine. Radiographic findings including CT scan showed intraperitoneal free gas and intramural air, compatible with PCI. The patient's symptom and clinical findings improved after the treatment with antibiotics and high-dose oxygen therapy.
Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Cefotaxime/therapeutic use ; Female ; Humans ; Oxygen Inhalation Therapy ; Pneumatosis Cystoides Intestinalis/complications/*diagnosis/drug therapy ; Polymyositis/complications/*diagnosis/drug therapy ; Prednisolone/therapeutic use ; Radiography, Abdominal ; Tomography, X-Ray Computed

Pneumatosis cystoides intestinalis (PCI), characterized by presence of intramural gas cyst in the intestinal wall is associated with various medical condition. Polymyosistis, however, is rarely associated with PCI. Few cases are reported in the world, and none has not been reported previously in Korea. A 67-year-old woman with polymyositis developed mild abdominal pain and abdominal distension during treatment with steroid and azathioprine. Radiographic findings including CT scan showed intraperitoneal free gas and intramural air, compatible with PCI. The patient's symptom and clinical findings improved after the treatment with antibiotics and high-dose oxygen therapy.
Aged ; Anti-Bacterial Agents/therapeutic use ; Anti-Inflammatory Agents/therapeutic use ; Azathioprine/therapeutic use ; Cefotaxime/therapeutic use ; Female ; Humans ; Oxygen Inhalation Therapy ; Pneumatosis Cystoides Intestinalis/complications/*diagnosis/drug therapy ; Polymyositis/complications/*diagnosis/drug therapy ; Prednisolone/therapeutic use ; Radiography, Abdominal ; Tomography, X-Ray Computed

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism, with recurrent muscle paralysis and hypokalemia that are caused by an intracellular shift of potassium. TPP is relatively common in Asian males, but is extremely rare in children and adolescents, even for those of Asian descent. We describe a 16-year-old Korean adolescent presenting with a two-week history of episodic leg weakness in the morning. He showed sinus tachycardia, lower leg weakness, and hypokalemia. Thyroid function test showed hyperthyroidism, and thyroid ultrasonography revealed a diffuse enlarged thyroid with increased vascularity, consistent with Graves' disease. He was treated with beta-adrenergic blocker and antithyroid drugs. He has been symptom free for one year, as his hyperthyroidism has been controlled well with antithyroid drugs. TPP should be considered in children and adolescents with acute paralysis of the lower extremities and hypokalemia.
Adolescent* ; Antithyroid Agents ; Asian Continental Ancestry Group ; Child ; Graves Disease* ; Humans ; Hyperthyroidism ; Hypokalemia ; Leg ; Lower Extremity ; Male ; Paralysis* ; Potassium ; Tachycardia, Sinus ; Thyroid Function Tests ; Thyroid Gland ; Ultrasonography