BACKGROUND: In spite of relative high risk of extrapyramidal side effect and tardive dyskinesia, it is common clinical practice to use antipyschotics in treatment of bipolar I disorder. But in Korea, there has been few study about clinical factors related with antipsychotics treatment in bipolar disorder patients. So the author studied about the clinical factors related with antipsychotics treatment in bipolar inpatients focusing on the comparison of risperidone and classical antipsychotics. METHOD: By reviewing medical record retrospectively, datas about patient-related, illness-related, and treatment-related clinical factors on antipsychotics use were collected. Association between antipsychotics dose and duration and clinical factors were analysed by statistical method. RESULTS: Aggressive behavior was only statistically significant factor associated with antipsychotics use. And in the case of aggression, maintenance dose of risperidone was not changed(p=0.84), but dose of classical antipsychotics was increased significantly(p=0.005). Total hospital days and antipsychotics treatment duration showed no difference between risperidone and classical antipsychotics treatment groups. CONCLUSION: Clinical factors associated with antipsychotics use was aggressive behavior. In the case of aggression, risperidone required lesser dose increment compared with classical antipsychotics.
Aggression ; Antipsychotic Agents* ; Bipolar Disorder ; Humans ; Inpatients* ; Korea ; Medical Records ; Movement Disorders ; Retrospective Studies ; Risperidone*

Intersphincteric resection (ISR) is the ultimate sphincter saving procedure for low rectal cancer. Hemorrhoids are a common benign condition. We present and discuss a case of ISR which developed painful edematous hemorrhoids after ISR. A 62-year-old female with low rectal cancer received neoadjuvant chemoradiotherapy with successful down staging of tumor before undergoing robot assisted ISR with coloanal hand-sewn anastomosis. She had pre-existing external hemorrhoids which were not excised. She developed painful and edematous external hemorrhoids 4 days after surgery. These were treated conservatively before discharge. Many colorectal surgeons performing ISR have experienced similar situations in their patients, but none have reported on this phenomenon. We discuss the possible factors that may contribute to this situation. A possible solution is prophylactic excision of the hemorrhoids during coloanal anastomosis. Painful hemorrhoids may occur after ISR and if managed conservatively, the outcome is skin tags.
Chemoradiotherapy ; Female ; Hemorrhoids ; Humans ; Middle Aged ; Rectal Neoplasms ; Skin

There are many studies of the spousal bereavement as an important etiologic factor of depression in elders. But there are some differernt natures of spousal bereavement between the Korean and the western elderly. The problems of spousal bereavement in Korean would be more persistent than that in western. And the depressive symptoms of Korean elders are different with that of western elders due to the differences of sociocultural background. The authors studied the effect of the spousal bereavement to the depressive symptoms of elders by using KGDS (Korean Form of Geriatric Depression Scale), which already has been standardized in Korea. The subjects were consist of one hundred seventy-five, 60 years and older. The authors compared KGDS and its 5 factors in the spousal bereaved subjects group (SBG) with those in the spousal non-bereaved subjects group (SNG), and also investigated the differences according to sex and children living with the subject in the SBG. And the authors analysed the correlations between ages at spousal death, durations after spousal death and KGDS in the SBG. The mean KGDS scores in the SBG were significantly higher than that of the SNG, and especially Factor 1, Factor 2 and Factor 4 were significant. In the SBG, the mean KGDS scores of the female were significantly higher than that of the male, and especially Factor 2, Factor 3, and Factor 5 were significant. And in the SBG, the mean KGDS scores of the subjects living with children were slightly higher than those of the subjects living without children. And also in the SBG, there were negative correlations between KGDS scores and ages at spousal death, and positive correlations between KGDS scores and durations after spousal death. The authors found that the spousal bearevement could be an important etiologic factor of geriatric depression, and the risk factors of depression were female, younger at spousal death and longer duration after spousal death in bereaved elders, as the earlier studies in the western. However, the authors found that, in Korea, there were some different results from the western, such as the longer duration after spousal death and higher ratio of the widower to the widow than that in the western, the spousal bereaved elders living with children were rather depressive than who living without children.
Aged ; Bereavement ; Child ; Depression* ; Female ; Humans ; Korea ; Male ; Risk Factors ; Widowhood

OBJECTIVE: The implantation failure after embryo-transfer (ET) is a major continuing problem in in vitro fertilization (IVF). This study was undertaken to determine the effectiveness of intravenous immunoglobulin for treatment of individuals experiencing repeated unexplained in vitro fertilization-embryo transfer (IVF-ET) failure. METHODS: A total of nine consecutive infertile patients who failed to become pregnant after previous IVF-ET replacing at least three or more normal developed embryos each were included in our study. During the subsequent new IVF-ET cycle, each women received intravenous immunoglobulin 500mg/kg before the embryo transfer. RESULTS: Only one implantation occurred. There were no remarkable side effects. A specific effect of intravenous immunoglobulin for patients with repeated IVF-ET failure could not be demonstrated. CONCLUSION: High-dose intravenous immunoglobulin may not be useful for patients with repeated failure of embryo transfer.
Embryo Transfer ; Embryonic Structures ; Female ; Fertilization in Vitro ; Humans ; Immunoglobulins*

OBJECTIVE: Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). METHODS: This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. RESULTS: Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group (31.2±30.3% vs. 55.1±37.5% vs. 54.0±36.9%, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. CONCLUSION: CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.
Cardiopulmonary Resuscitation* ; Energy Metabolism* ; Heart Rate ; Humans ; Manikins* ; Oxygen ; Students, Medical ; Thorax* ; Ventilation

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has led to significant global casualties. This study examines the postoperative impact of COVID-19 on patients who underwent gastrointestinal surgery, considering their heightened vulnerability to infections and increased morbidity and mortality risk. Methods: This retrospective observational study was conducted at a tertiary center and patients who underwent gastrointestinal surgery between January 2022 and February 2023 were included. Postoperative COVID-19 infection was defined as the detection of severe acute respiratory syndrome coronavirus 2 RNA by RT-PCR within 14 days after surgery. Propensity score matching was performed including age, sex, American Society of Anesthesiology physical status classification, and emergency operation between the COVID-19-negative (–) and -positive (+) groups. Results: Following 1:2 propensity score matching, 21 COVID-19(+) and 42 COVID-19(–) patients were included in the study. In the COVID-19(+) group, the postoperative complication rate was significantly higher (52.4% vs. 23.8%, P = 0.023).Mechanical ventilator requirement, intensive care unit (ICU) admission, and readmission rate did not significantly differ between the 2 groups. The median length of ICU (19 days vs. 4 days, P < 0.001) and hospital stay (18 vs. 8 days, P = 0.015) were significantly longer in the COVID-19(+) group. Patients with COVID-19 had a 2.4 times higher relative risk (RR) of major complications than patients without COVID-19 (RR, 2.37; 95% confidence interval, 1.254–4.467; P = 0.015). Conclusion COVID-19 infection during the postoperative period in gastrointestinal surgery may have adverse outcomes which may increase the risk of major complications. Preoperative COVID-19 screening and protocols for COVID-19 prevention in surgical patients should be maintained.

OBJECTIVES: The anthors examined health-seeking behavior about using herbal medicine in psyciatric and other clinical patients. The effect, side effect and motives in selecting herbal medicine were examined also. This study aimed at presenting treatment guide for psychiatric patients hereafter. METHOD: Subjects were consisted of 277 patients who were 93 medical, 81 surgical, and 102 psyhiatric patients. We made a questionnaire checking circumstances on taking herbal medicine. The investigating psychiatrist conducted person to person semi-structured interview using this questionnaire. RESULTS: Psychiatric patients preferred herbal medicine to western medicine, as other clinical patients did. In their health seeking behavior, classical illness model of oriental herbal medicine occupied a central position. In addition, psychiatric patients not only regarded herbal medicine as a more symtom-specific therapeutic medication, but also accepted side effects of herbal medicine uncritically than other clinical patients. CONCLUSIONS: As it is known that many psychiatric patients take both oriental and western medical treatment, we should not have exclusive attitude to emphasize one side between oriental and western medicine. Rather, we should deepen our understandings about oriental herbal medicine.
Herbal Medicine ; Humans ; Medicine, East Asian Traditional ; Psychiatry ; Surveys and Questionnaires

The authors examined 3,169 fecal specimens from inhabitants of seven localities such as City, Eups and Myons in Cheju Do on July 1970 with cellophane thick smear technique. The results were analysed and summarized as follows: The overall egg positive rate of helminths was 82.2% and it was attributed to high rates of soil-transmitted helminths as in case of other parts in Korea. The infection rates of each species were; A. lumbricoides 44.3%, T. trichiurus 65.6%, hookworm 1.5%, T. orientalis 0.8%, C. sinensis 0.2%, P. westermani 0.4%, M. yokogawai 0.9%, Taenia sp. 12.7% and H. nana 1.4%. The infection rates of soil-transmitted helminths were relatively lower than those of mainland Korea especially in case of hookworm and T. orientalis. The proportion of unfertilized ova passers among the Ascaris infected case was 22.1%. The ova of heterophyids, most probably Metagonimus yokogawai were detected in lower percentage but discovered throughout the localities surveyed and in all age groups. It is certainly presumed that Metagonimus infection is autochthonous. The most interesting results were obtained in Taenia sp. infection and the higher rates were shown in rural area than in urbanized areas. The positive rates were within 5% in childhood and adolescence but abruptly increased up to 36.4 % in adults.
parasitology-helminth-nematoda-trematoda-cestoda ; Ascaris lumbricoides ; Trichuris trichiura ; hookworm ; Trichostrongylus orientalis ; Clonorchis sinensis ; Paragonimus westermani ; Metagonimus yokogawai ; Taenia sp. ; Hymenolepis nana

PURPOSE: Acupuncture has recently been accepted as a treatment option for managing postoperative ileus (POI) and various functional gastrointestinal disorders. Therefore, we conducted a prospective randomized study to evaluate the effect of acupuncture on POI and other surgical outcomes in patients who underwent gastric surgery. MATERIALS AND METHODS: Thirty-six patients who underwent distal gastrectomy for gastric cancer from March to December 2015 were randomly assigned to acupuncture or non-acupuncture (NA) groups at 1:1 ratio. The acupuncture treatment was administered treatment once daily for 5 consecutive days starting at postoperative day 1. The primary outcome measure was the number of remnant sitz markers in the small intestine on abdominal radiograph. The secondary outcome measure was the surgical outcome, including the times to first flatus, first defecation, start of water intake, and start of soft diet, as well as length of hospital stay and laboratory findings. RESULTS: The acupuncture group had significantly fewer remnant sitz markers in the small intestine on postoperative days 3 and 5 compared to those in the NA group. A significant difference was observed in the numbers of remnant sitz markers in the small intestine with respect to group differences by time (P<0.0001). The acupuncture group showed relatively better surgical outcomes than those in the NA group, but the differences were not statistically significant. CONCLUSIONS: In this clinical trial, acupuncture promoted the passage of sitz markers, which may reflect the possibility of reducing POI after distal gastrectomy.
Acupuncture* ; Defecation ; Diet ; Drinking ; Flatulence ; Gastrectomy* ; Gastrointestinal Diseases ; Humans ; Ileus* ; Intestinal Pseudo-Obstruction ; Intestine, Small ; Length of Stay ; Outcome Assessment (Health Care) ; Prospective Studies ; Stomach Neoplasms*

No abstract available.
Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Toes*