OBJECTIVES: Drug compliance is the most important issue in long-term treatment outcome and prognosis of manic patients. Up to date, there has been no study about drug compliance at the point of the first manic episode and subsequent maintenance period. And also there are limited data regarding the rates of noncompliance in patients with bipolar disorder and schizoaffective disorder in Korea. So the author studied about the rate of noncompliance in manic patients and about the clinical predicting factors associated with their drug compliance. METHODS: Compliance of a patient was assessed by patient's report, family member's report, treater's estimation, investigator-administered questionnaire, record of unkept appointment and plasma concentration of mood-stabilizer. Data about patient-related, illness-related and treatment-related factors of compliance were collected by the review of medical records and interview with the patient. RESULTS: Forty patients (56.3%)were noncompliant with their pharmacologic regimen at the point of the first treatment period. Noncompliance was significantly associated with experience of childhood stressful life events(p=.035) presence of psychotic symptoms(p=.020)and treatment with combination of mood-stabilizers(p=.002) CONCLUSION: Patients who experienced serious life event in their childhood, had delusion or hallucination during the manic episode, or received the combination therapy of mood-stabilizer are prone to fail in treatment adherence.
Bipolar Disorder ; Compliance* ; Delusions ; Hallucinations ; Humans ; Korea ; Medical Records ; Plasma ; Prognosis ; Psychotic Disorders ; Surveys and Questionnaires ; Treatment Outcome

BACKGROUND: We aimed to evaluate the performance of serum cystatin C-based equations in calculating the glomerular filtration rate (GFR) in patients with varying stages of chronic kidney disease (CKD). METHODS: Serum cystatin C and creatinine levels were measured in 615 CKD patients. The CKD stage was determined by the creatinine-based estimated GFR (eGFR) equation using the four-variable abbreviated Modification of Diet in Renal Disease equation suggested by the Kidney Disease Outcome Quality Initiative with the addition of a coefficient applicable to Korean populations (K-aMDRD). In each CKD stage, the ratio of serum cystatin C to creatinine was calculated and six different cystatin C-based equations were used to estimate GFR. Cystatin C-based eGFR and aMDRD eGFR values were compared using the paired t test, Pearson correlation test, and the Bland-Altman plot. RESULTS: The mean age of patients was 53.21+/-14.45 years; of the 615 patients, 346 were male. The serum cystatin C-to-creatinine ratio was inversely correlated with the CKD stage. Compared with the K-aMDRD values, the results of the Hoek, Filler, and Le Bricon's cystatin C-based eGFR equations were lower in CKD Stages 1-3 and higher in Stages 4 and 5. However, the results of the Orebro-cystatin (Gentian) equation [GFR=100/ScytC (mL/minute/1.73m2) - 14] were similar to those of the K-aMDRD equation in CKD Stages 4 and 5 (15.44+/-9.45 vs. 15.17+/-9.05mL/minute/1.73m2, respectively; P=0.722; bias=0.27+/-8.87). CONCLUSION: The eGFRs obtained from the six cystatin C-based equations differed widely. Therefore, further studies are required to determine the most accurate equation to estimate GFR in Koreans with CKD.
Creatinine ; Cystatin C ; Diet ; Glomerular Filtration Rate* ; Humans ; Kidney Diseases ; Male ; Renal Insufficiency, Chronic*

Familial adenomatous polyposis(FAP) is a rare hereditary disorder characterized by the development of hundreds to thounds polyps throughout the colon and rectum. Moreover, several extracolonic manifestations are seen. Recently, this disease is recognized as a adenomatous polyposis syndrome which can involve the entire astrointestinal tract. Several reports have demonstrated a high incidence of gastroduodenal polyps in patients with familial adenomatous polyposis. These colon polyps can be eventually developed as colon cancer, if not be treated. So early diagnosis is needed and prophylactic surgery should be erformed. We experienced a case of familial adenomatous polyposis with a large sentinel polyp on the sigmoid colon, presenting hematochezia and mucoid diarrhea. He was early treated before progression to carcinoma by total colectomy, rectal mucosectomy and J pouch ileoanal anastomosis.
Adenomatous Polyposis Coli* ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Pouches ; Diarrhea ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Polyps* ; Rectum

Approximately one-third of all patients with renal cell carcinoma have metastasis at the time of diagnosis. Metastatic lesions of renal cell carcinoma are most commonly seen in the lung, and they are frequently seen in the bone and liver. However, spleen and rectal metastases are extremely rare. A 63-year-old man had undergone left radical nephrectomy for renal cell carcinoma. About 22 months later, computed tomography revealed multiple enhanced masses in the spleen. Spleen metastasis was suspected and splenectomy was then performed. One year later, the patient visited with complaints of voiding difficulty. A huge pelvic mass was detected by performing prostate ultrasonography and MRI. The mass was 13cm in diameter and it was between the rectum and the prostate. Removal of the pelvic mass and lower anterior resection with end colostomy was done. Histologically, the resected specimens were diagnosed as metastases from the renal cell cancer. Herein, we report on a case of metachronous splenic and rectal metastasis from renal cell carcinoma.
Carcinoma, Renal Cell* ; Colostomy ; Diagnosis ; Humans ; Liver ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Neoplasm Metastasis* ; Nephrectomy ; Prostate ; Rectum ; Spleen ; Splenectomy ; Ultrasonography

No abstract available.
Breast Neoplasms* ; Breast* ; Ultrasonography*

A 42-year-old male was hospitalized with abdominal pain, dyspnea, and turbid peritoneal fluid. He was diagnosed with hypertension, diabetes and started continuous ambulatory peritoneal dialysis (CAPD) 11 months ago. He was treated with intraperitoneal cefazolin and ceftazidime, and then white blood cell counts of dialysate decreased. Incidentally, liver abscess was found in chest CT performed for the evaluation of dyspnea, and patient was febrile persistently. So percutaneous abscess drainage was done by pigtail catheter. We changed the antibiotics to ceftriaxone and metronidazole, and hemodialysis was started. Klebsiella pneumoniae was cultured from peritoneal fluid and blood simultaneously. We concluded that liver abscess is a primary cause of CAPD peritonitis.
Abdominal Pain ; Abscess ; Adult ; Anti-Bacterial Agents ; Ascitic Fluid ; Catheters ; Cefazolin ; Ceftazidime ; Ceftriaxone ; Drainage ; Dyspnea ; Humans ; Hypertension ; Klebsiella ; Klebsiella pneumoniae ; Leukocyte Count ; Liver ; Liver Abscess ; Male ; Metronidazole ; Peritoneal Dialysis, Continuous Ambulatory ; Peritonitis ; Renal Dialysis ; Thorax

Hemorrhagic cystitis (HC), a serious form of cystitis, is characterized by diffuse bladder mucosal inflammation with hemorrhage. The known causes of HC are radiation, chemotherapy, drug, and infection. But, most cases happen without definite etiology. Radiation induced HC can be developed at any time from 6 months to 10 years after pelvic irradiation therapy, and can appear as late as 2 decades. The complications of HC are anemia, chronic cystitis, and acute renal failure (ARF). However, HC- induced severe postrenal ARF is rare. We experienced a case of a postrenal ARF caused by hematoma in HC. A 55-year-old woman had past history of pelvic irradiation therapy for carcinoma of the cervix 13 years ago. She was initially treated by bladder catheterization and bladder irrigation with normal saline. HC and renal function were improved. However, HC was recurred shortly after stopping irrigation and serum creatinine was elevated again. Thus, we treated this patient successfully with both percutaneous nephrostomy and antegrade double J stent catheterization.
Acute Kidney Injury ; Anemia ; Catheterization ; Catheters ; Cervix Uteri ; Cinnarizine ; Creatinine ; Cystitis ; Female ; Hematoma ; Hemorrhage ; Humans ; Inflammation ; Middle Aged ; Nephrostomy, Percutaneous ; Stents ; Urinary Bladder

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Breast Neoplasms* ; Breast* ; Ion Transport* ; Sodium Iodide* ; Sodium*

No abstract available.
Bony Callus* ; Fractures, Bone*