Alcohol use disorder is one of the major psychiatric problems in Korea. Inpatient treatment programs include general medical and psychiatric evaluation, detoxification and control of withdrawal symptoms, and psychosocial rehabilitation. Benzodiazepines are a common prescription for the control of withdrawal symptoms. Psychosocial therapy is a crucial element in the treatment and prognosis of alcoholism. There are many psychosocial treatment modalities in the inpatient setting. The main modalities of recently introduced psychosocial treatments of alcoholism in the inpatient setting are as follows: psychoeducation, cognitive-behavioral therapy, motivation enhancement therapy, and twelve-step facilitation therapy. In Korea, in contrast to the great social burden of alcohol-related problems, a comprehensive alcoholism treatment system is lacking. Therefore we need psychosocial treatment programs on alcoholism specifically modified and tailored to Korean people.
Alcoholism* ; Benzodiazepines ; Humans ; Inpatients* ; Korea ; Motivation ; Prescriptions ; Prognosis ; Rehabilitation ; Substance Withdrawal Syndrome

Alcohol use disorder is a one of major psychiatric problems in Korea. But after detoxification treatment, relapse is very frequent. Psychosocial therapy is a crucial element in alcoholism treatment and prognosis. There are so many psychosocial treatment modalities. In this article, various psychosocial treatments are explained. The main lists of introduced recent psychosocial treatments on alcoholism are as follows: therapeutic community, cognitive-behavioral therapy, motivation enhancement therapy, twelve step facilitation therapy, network therapy, and other community-based treatment. In Korea, in contrast to the importance of huge alcoholic problems, comprehensive alcoholism treatment system is weak. Therefore well-modified and Korean styled psychosocial treatment programs on alcoholism is requested.
Alcoholics ; Alcoholism* ; Humans ; Korea ; Motivation ; Prognosis ; Recurrence ; Therapeutic Community

OBJECTIVE: Our purpose was to compare the safety and efficacy of intravaginally administered misoprostol(PGE1) versus dinoprostone(PGE2) for labor induction in a prospective controlled trial. METHOD: One hundred eleven patients for labor induction (including preterm rupture of membranes) were randomly assigned to receive either misoprostol 50microgram or dinoprostone 3mg intravaginally. The interval of doses was 8 hours after first dose, with a potential maximum of six dose until active labor pain was achieved. RESULTS: Among 111 patients enrolled, 55 were randomized to receive misoprostol 50microgram and 56 to receive dinoprostone 3mg with every 8 hours interval intravaginally. There were no significant differences in demographic characteristics except in Bishop score(3.81+/-1.52 vs 4.38+/-1.29, P<0.05). There were no significant differences in indications for labor induction. The interval of induction to delivery was shorter in the misoprostol group(750.8+/-518.8min) than in the dinoprostone group(1264.1+/-730.7min). Delivery within 24 hours after administration occurred more often in the misoprostol group than in the dinoprostone group (86.3% vs 65.2%, P<0.05). More than two doses for completion of delivery were frequent in dinoprostone group(36.96% vs 9.8% in misoprostol group, P<0.05). Additional Oxytocin augmentation was needed more commonly in the misoprostol group(3.64%) than in the dinoprostone group(14.29%)(P<0.05), but no significant differences were noted between two groups in total oxytocin doses and indications. Tachysystole occurred more often in the misoprostol group (12.73% vs 1.79% in the dinoprostone, P<0.05) Precipitating delivery occurred more commonly in the misoprostol group(21.82% vs 7.14% in the dinoprostone group, P<0.05). No differences in the cesarean section rate, fetal heart rate abnormalities, hyperstimulation syndrome, meconium staining, fetal outcome (Apgar score at 1 and 5 minutes, birth weight), and marternal outcome (nausea and vomitting, postpartum bleeding) were noted. The cost of misoprosl is one hundredth cheaper than dinoprostone. There was no significant differences in the fetal outcome and maternal outcome. CONCLUSION: These results suggest that intravaginal misoprostol(PGE1) is a safe drug for labor induction which is more effective and cheaper compare to intravaginal dinoprostone(PGE2).
Alprostadil* ; Cesarean Section ; Dinoprostone* ; Female ; Heart Rate, Fetal ; Humans ; Labor Pain ; Meconium ; Misoprostol* ; Oxytocin ; Parturition ; Postpartum Period ; Pregnancy ; Prospective Studies ; Rupture

OBJECTIVES: Benzodiazepines are most often used for the treatment of alcohol withdrawal, but they also may result in several adverse consequencies such as sedation, respiratory depression, cognitive impairment, disinhibition, and abuse. New anticonvulsants, topiramate may have a potential to treat alcohol withdrawal effectively. This study compared the therapeutic responses of a benzodiazepine, lorazepam, and an anticonvulsant, topiramate, for the treatment of alcohol withdrawal. METHODS: Fifty-two hospitalized patients with the diagnosis of DSM-IV Alcohol dependence, after obtaining written informed consent, were randomely divided into the either lorazepam (N=27) or the topiramate (N=25) groups. Subjects were assessed with CIWA-Ar scores at the time of baseline, 1, 3, 5 day after the last alcohol drinking. Lorazepam was given 4 mg divided by 4 on day 1, tapering to 2 mg divided by 2, and topiramate was given fixed single dose of 50 mg a day. RESULTS: There were no significant differences between two groups in demographic or clinical characteristics except marital status and s-ALT level. Two groups had similar ADS scores and baseline withdrawal severity. There were no significant differences by treatment group in CIWA-Ar scores over time (F=0.883, p>0.05). CONCLUSION: Efficacy and safety were not different between the two groups. Therefore our results suggest that topiramate is a promising alternative agent to benzodiazepine for treating alcohol withdrawal.
Alcohol Drinking ; Alcoholism ; Anticonvulsants ; Benzodiazepines ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Informed Consent ; Lorazepam ; Marital Status ; Respiratory Insufficiency

OBJECTIVES: This study aimed to investigate the correlations between neurological and psychiatric symptoms at two weeks after stroke. METHODS: For 412 stroke patients, stroke severity was evaluated by the National Institutes of Health Stroke Scale (NIHSS), disability by the Barthel Index(BI) and modified Rankin Scale(mRS), cognitive function by the Korean Mini-Mental State Examination(K-MMSE), and muscle power by grip strength. Psychiatric symptoms were assessed by Symptom check list-90-Revision(SCL-90-R), consisted of nine symptom domains : Somatization, Obsessive-compulsive, Interpersonal sensitivity, Depression, Anxiety, Hostility, Phobic anxiety, Paranoid ideation, Psychoticism, and Additional items. The correlations between the neurological and psychiatric symptoms were investigated at the time of admission and before discharge(i.e. before and after treatment). RESULTS: At the time of admission, NIHSS score was associated with scores on Phobic anxiety and Additional items ; and scores on BI and mRS were associated with Depression, Phobic anxiety and Additional items. At the time of discharge, NIHSS score was associated with scores on Somatization, Depression, Phobic anxiety, and Additional items ; scores on BI and mRS were associated with scores on Depression, Phobic anxiety and Additional items ; MMSE score was associated with Obsessive-compulsive, Depression, Phobic anxiety, and Additional items ; and grip strength was associated with Somatization, Depression, Anxiety and Additional items. CONCLUSIONS: More severe neurological symptoms were associated with higher psychiatric morbidity particularly in depression, phobic anxiety, sleep and appetite disturbance at acute stage of stroke. More intensive psychiatric care and intervention are needed for the high risk group.
Anxiety ; Appetite ; Depression ; Hand Strength ; Hostility ; Humans ; Muscles ; National Institutes of Health (U.S.) ; Neurologic Manifestations ; Stroke

PURPOSE: The objective of this study was to evaluate the accuracy of color Doppler ultrasonography (CDU) and to assess the effects of microsurgical bilateral varicocelectomy on patients diagnosed with a left varicocele by CDU. MATERIALS AND METHODS: 69 patients with varicocele were enrolled between March 2005 and May 2007. The patients were randomized into 2 groups: group I-preoperative bilateral varicoceles were diagnosed by color CDU, and group II-only a left varicocele was diagnosed by CDU. All patients underwent an inguinal microsurgical varicocelectomy bilaterally. Statistical analysis was performed by paired Student's t-test and one way ANOVA. RESULTS: Mean age of the patients was 27.5+/-7.9 years. After surgery, semen parameters were significantly improved in sperm number in group I (p=0.002) and semen volume in group II (p<0.005). At the time of surgery, we found that 16 (88.9%) of 18 patients had bilateral varicoceles in group II. The accuracy of CDU to diagnose varicoceles was not perfect. CONCLUSIONS: The bilateral microsurgical varicocelectomy in patients with only a left varicocele diagnosed by CDU significantly increased their semen volume. Most (88.9%) patients diagnosed with a left varicocele actually had bilateral varicoceles. Therefore, microsurgical bilateral varicocelectomy may be appropriate for infertile men with a left varicocele diagnosed by CDU.
Humans ; Male ; Semen ; Sperm Count ; Ultrasonography, Doppler, Color ; Varicocele

PURPOSE: The objective of this study was to evaluate the accuracy of color Doppler ultrasonography (CDU) and to assess the effects of microsurgical bilateral varicocelectomy on patients diagnosed with a left varicocele by CDU. MATERIALS AND METHODS: 69 patients with varicocele were enrolled between March 2005 and May 2007. The patients were randomized into 2 groups: group I-preoperative bilateral varicoceles were diagnosed by color CDU, and group II-only a left varicocele was diagnosed by CDU. All patients underwent an inguinal microsurgical varicocelectomy bilaterally. Statistical analysis was performed by paired Student's t-test and one way ANOVA. RESULTS: Mean age of the patients was 27.5+/-7.9 years. After surgery, semen parameters were significantly improved in sperm number in group I (p=0.002) and semen volume in group II (p<0.005). At the time of surgery, we found that 16 (88.9%) of 18 patients had bilateral varicoceles in group II. The accuracy of CDU to diagnose varicoceles was not perfect. CONCLUSIONS: The bilateral microsurgical varicocelectomy in patients with only a left varicocele diagnosed by CDU significantly increased their semen volume. Most (88.9%) patients diagnosed with a left varicocele actually had bilateral varicoceles. Therefore, microsurgical bilateral varicocelectomy may be appropriate for infertile men with a left varicocele diagnosed by CDU.
Humans ; Male ; Semen ; Sperm Count ; Ultrasonography, Doppler, Color ; Varicocele

OBJECTIVE: The goal of the present study was to identify the brain mechanism involved in the attribution of person's attitude toward another person, using facial affective pictures and pictures displaying an affectively-loaded situation. METHODS: Twenty four right-handed healthy subjects volunteered for our study. We used functional magnetic resonance imaging (MRI) to examine brain activation during attitude attribution task as compared to gender matching tasks. RESULTS: We identified activation in the left inferior frontal cortex, left superior temporal sulcus, and left inferior parietal lobule during the attitude attribution task, compared to the gender matching task. CONCLUSION: This study suggests that mirror neuron system and ventrolateral inferior frontal cortex play a critical role in the attribution of a person's inner attitude towards another person in an emotional situation.
Brain ; Humans ; Magnetic Resonance Imaging ; Mirror Neurons ; Theory of Mind

OBJECTIVES: The purpose of this study was to evaluate the reliability and validity of the Korean version of Preschool Temperament and Character Inventory (K-psTCI), a questionnaire based on Cloninger's seven-factor model of personality. METHODS: The psTCI was translated into Korean and administered to 266 children aged 2-6 years. A test-retest study of the K-psTCI was conducted across a 4-month interval. Internal consistency was calculated by Cronbach alpha. Test-retest and reliability was analyzed by Pearson correlation analysis. Factor analyses for the temperament and character dimensions were performed using principal component analysis, rotating factors by varimax. The psTCI scores of Korean and United States preschoolers there compared. RESULTS: Cronbach alpha values for the K-psTCI scales ranged from .62 to .78 for each dimensions. Test-retest correlations (r) ranged from .50 to .77 for each dimensions. Explorative factor analysis with the condition of eigenvalue greater than 2 produced four factors for the temperament items and three factors for the character items like the US original version of psTCI. Through factor analyses, five items in the K-psTCI were categorized differently from the US version of psTCI. Korean preschoolers had higher mean scores on Cooperativeness (CO) in males as compared to a sample of US preschoolers. CONCLUSION: The results of this study suggests that the Korean preschool TCI is satisfactory in reliability and validity.
Child ; Humans ; Male ; Principal Component Analysis ; Surveys and Questionnaires ; Reproducibility of Results* ; Temperament* ; United States ; Weights and Measures

BACKGROUND: The Caregiver Activity Survey (CAS) has been designed to collect information about the time caregivers spend providing care during a typical 24-hour period. This study aimed to develop the Korean version of the CAS (CAS-K) in caregivers of community dwelling elderly with dementia. METHODS: The study sample consisted of 61 elderly with dementia and their caregivers. For the elderly with dementia, the data on demographic characteristics, cognitive function, activities of daily living, global severity of dementia, depressive symptoms, and physical illness were investigated. For the caregivers, CAS-K was administered, and data on demographic characteristics, care burden, and general psychopathology were assessed. Using the data above, analyses on reliabilities and validities of CAS-K were carried out. RESULTS: In the elderly with dementia, the global severity was classified into mild (N=44; 72%), moderate (N=12; 20%), and severe (N=5; 8%). The mean caregiving time per day measured by the CAS-K was seven hours across all dementia elders. However, the time was increased according to the global severity of dementia. Test-retest reliability of the CAS-K was good. Times on the CAS-K was significantly correlated with scores on cognitive function, activities of daily living, and the global severity of the elderly with dementia; and with care burden and general psychopathology of the caregivers. CONCLUSIONS: Our results suggest that the CAS-K might be a reliable and valid instrument for investigating the caregiving time required by Korean caregivers. It could be used as an outcome measure of drug trials or an indirect index of costs in the management of dementia patients.
Activities of Daily Living ; Aged* ; Caregivers* ; Dementia* ; Depression ; Humans ; Outcome Assessment (Health Care) ; Psychopathology