OBJECTIVES: The purpose of this study was to make empirical evidence of community based detection, assessment and allocation system for early psychosis. METHODS: We analysed 222 youths who were referred to Seoul Early Management and Improvement Services (SEMIS) for early psychosis during six years from 2007 to 2012. RESULTS: 44% of referrals were from suicide hotline, 23% from web-based SEMIS assessment program, 20% from other service areas such as military services and 11% were self referred. Among 222 youths, 139 (62.6%) were completed Structured Interview for Prodromal Syndrome (SIPS). After SIPS, 23% had untreated or early psychosis, another 17% were found to be at high risk of psychosis and 18% of completed SIPS were found to have other mental illness such as depression, yielding an efficiency ratio of 58%. 70% of youths who were categorized as psychosis or high risk of psychosis or other mental illness were referred to psychiatric hospital or case management services. CONCLUSION: This study shows the effectiveness and limitations of community-based assessment and intervention system for early psychosis. Integrated community program is necessary to improve the efficiency of early intervention and for the better outcomes.
Adolescent ; Case Management ; Depression ; Early Intervention (Education) ; Hospitals, Psychiatric ; Hotlines ; Humans ; Military Personnel ; Prodromal Symptoms ; Psychotic Disorders ; Referral and Consultation ; Suicide

The eruptive collagenoma is a connective tissue nevus without family history. We report a case of eruptive collagenoma in a 5 year old boy, who had multiple, variable sized orange colored nodules on his back since birth. The histopathologic finding showed increased number and size of collagen fiber and increased dermal thickness.
Child, Preschool ; Citrus sinensis ; Collagen ; Connective Tissue ; Humans ; Male ; Nevus ; Parturition

The N-terminal sequence of HIV1 gp41 (amino acid residues 584-623) was known to be the immundominant region of HIV1 gp41 protein. In order to determine epitope for gp41 protein of Korean anti-HIV1 positive sera, multiple antigenic peptides (MAPs) for the sequences corresponding to 584-604, 590-612, 604-623 and 584-618 of HIV1 gp41 were synthesized by solid phase method using Fmoc-Lys (Fmoc)-OH and used as coating antigens for ELISA. The reactivities of the synthetic peptides with Korean HIV1 positive (21 samples) and anti-HIV1 negative sera (22 samples) obtained from healthy blood doner were estimated by an indirect ELISA. MAPs for 584-604, 590-612 and 604-623 of gp41 reacted with 62 %, 100 % and 81 % of Korean anti-HIV1 positive sera tested, respectively. The results suggest that the epitope for HIV1 gp 41 for Korean anti-HIV1 positive sera is located in the region of amino acid 590-612 of gp41. MAP for gp41 (584-618) reacted with all (100 %) of anti-HIV1 positive sera tested, but did not react with anti-HlV1 negative sera. In addition, this MAP reacted stronger with seven samples of anti-HIV1 positive sera of anti-HIV1/2 combo performance panel than the mixture of 584-604, 590-612 and 604-623 of gp41, but did not react with anti-HIV negative serum. The high sensitivity and selectivity of MAP of gp41 (584-618) suggest that this peptide as a coating antigen in an ELISA system will be useful for antibody detection of HIV1.
Enzyme-Linked Immunosorbent Assay ; Epitope Mapping* ; Immune Sera* ; Peptides*

The influence of normal late pregnancy on insulin action and insulin secretion was studied in the Sprague-Dawley female rats. On 20th day after mating, intravenous glucose tolerance test(IVGTI) was performed in non pregnant control and pregnant rats. As results of IVGTT, glucose disappearance rate was not significantly different in both groups, but secretory response of insulin was significantly(p<0.05) increased in pregnant rat. And the ratio of insulin/ .glucose was significantly higher in pregnant rats, which means existence of insulin resistance. These insulin resistance was overcomed by increased secretory response of pancreatic insulin. Insulinogenic index( A insulin/glucose - 5 min) was highly significantly (r=0.62, p<0.01) correlated with progesterone concentration. Glycogen level and amounts of "C-glucose incorporated into glycogen after IVGTT were significantly(p<0. 05) decreased in the liver, but were not changed significantly in soleus. Glycogen synthase activity of soleus and liver was not differ significantly in the both groups. Insulin binding at varying concentrations of insulin to crude membrane of pregnant liver was not significantly different from control. In conclusions, although these pregnant rats were normal glucose tolerance due to increased secretory response of insulin, that was correlated with progesterone concentration, pregnant rat had insulin resistance. The mechanisms of insulin resistance were not related to defect of insulin binding phase and glycogen synthase, but suggest pre-receptor and/or postreceptor phase.
Animals ; Female ; Glucose ; Glucose Tolerance Test ; Glycogen ; Glycogen Synthase ; Humans ; Insulin Resistance* ; Insulin* ; Liver ; Membranes ; Pregnancy ; Progesterone ; Rats* ; Rats, Sprague-Dawley ; Receptor, Insulin

BACKGROUND AND OBJECTIVES: We investigated if gated and/or attenuation-corrected SPECT improved performance of experienced or in-experienced operators in the diagnosis of coronary artery disease (CAD) or stenosed arteries in patients having intermediate or high pretest likelihood. MATERIALS AND METHODS: Rest/dipyridamole stress gated attenuation-corrected SPECT was performed in 81 patients (M:F=48:33, 62+/-8.6 years old, of high (n=38) or intermediate (n=43) pre-test likelihood for CAD, 1 vessel; 14, 2 vessel; 19, 3 vessel disease; 31, normal; 17). Two experienced and one novice physicians graded 1 (normal) to 5 (definitely abnormal) for each artery 1) by conventional rest Tl-201/stress Tc-99m-MIBI SPECT, 2) 1) plus viewing gated SPECT (+gated) and 3) 2) plus attenuation-corrected SPECT (+AC gated). Areas under curves (AUC) of receiver operating characteristic (ROC) curves were compared. RESULTS: AUC was greater in patients with high likelihood than intermediate likelihood. Novice physician performed better in diagnosing RCA stenosis (AUC: 0.53 for usual, 0.58 for +gated, and 0.66 for +AC gated) in patients with intermediate likelihood. AUC was not different for the diagnosis of CAD and LAD or LCx. Performance of experienced physicians was not different regardless of pre-test likelihood. Novice operator's specificity increased from 53% to 73% for CAD, and 62% to 89% (p<0.05) for RCA in patients with intermediate likelihood. CONCLUSION: We conclude that gated attenuation-corrected SPECT was helpful only for novice physician to diagnose RCA stenosis by increasing specificity in patients with intermediate likelihood. Even for inexperienced physician, these methods were not helpful in patients with high pre-test likelihood or for LAD or LCX.
Area Under Curve ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Humans ; ROC Curve ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

Dermatomyositis and polymyositis are uncommon, acquired idiopathic inflammatory myopathies of an unknown etiology. Although there are 9 reported cases in the literature of developing dermatomyositis or polymyositis after collagen dermal injection, it is still controversial whether there is a link between injectable filler materials and autoimmune diseases, and specifically dermatomyositis/polymyositis. We experienced a case of a 40-year-old woman who developed dermatomyositis after repeated injections of multiple filler materials, including collagen for cosmetic purposes, which suggests a temporal relation between the two factors. The benefit-to-risk ratio should be assessed for repeated cosmetic surgical procedures that use filler materials.
Adult ; Aluminum Hydroxide ; Autoimmune Diseases ; Carbonates ; Collagen ; Cosmetics ; Dermatomyositis ; Female ; Humans ; Myositis ; Polymyositis

PURPOSE: Either gated myocardial perfusion SPECT or attenuation corrected SPECT can be used to improve specificity in the diagnosis of coronary artery disease. We investigated in this study whether gating or attenuation correction improved diagnostic performance of rest/stress perfusion SPECT in patients having intermediate pre-test likelihood of coronary artery disease. MATERIALS AND METHODS: Sixty-eight patients underwent rest attenuation-corrected T1-20l/dipyridamole stress gated attenuation-corrected Tc-99m-MIBI SPECT using an ADAC vertex camera (M:F=29:39, aged 59+/-12 years, coronary artery stenosis> or =70%. one vessel: 13, two vessel: 18, three vessel: 8, normal: 29). Using a five-point scale, three physicians graded the post-test likelihood of coronary artery disease for each arterial territory (1 normal, 2: possibly normal 3:equivocal, 4: possibly abnormal, 5: abnormal). Sensitivity, specificity and area under receiver-operating-characteristic curves were compared for each operator between three METHODS: (A) non-attenuation-corrected SPECT; (B) gated SPECT added to (A); and (C) attenuation-corrected SPECT added to (B). RESULTS: When grade 3 was used as the criteria for coronary artery disease, no differences in sensitivity and specificity were found between the three methods for each operator Areas under receiver- operating-characteristic curves for diagnosis of coronary artery disease revealed no differences between each modality (p>005). CONCLUSION: In patients at intermediate risk of coronary artery disease, gated SPECT and attenuation-corrected SPECT did not improve diagnostic performance.
Coronary Artery Disease* ; Coronary Vessels* ; Diagnosis ; Humans ; Perfusion* ; ROC Curve ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*

The survey was undertaken among the 105 ostomates who attended the 2nd Workshop for Stoma Rehabilitation on Aug. 30th, 1997 by the Department of Surgery, Kyung-Hee University Hospital to assess the physical, psychosocial and sexual problems with a stoma. The 97% of ostomates had permanent colostomies following abdominoperineal resection. The 67% of ostomates had one or more physical problems caused by stoma. Frequent bowel movement (94.3%), impairment of irrigation (64.6%), unpleasant odor (27.3%), and urinary frequency (21.3%) were common problems encountered by ostomates. Concerning the psychosocial problems, 3.8% of them suffered from profound restriction of social activities and 1.9% of them had psychologic problems such as depression. 42 of 58 ostomates (72.4%) who were employed before operation returned to their work. Among 71 men, 44 (62%) were impaired by sexual function. Most ostomates suffered physical, social, psychologic and sexual problems in their daily life and needed helps of experts such colorectal surgeons, enterostomal therapists, and ostomy association. Attention is needed more to improve the quality of life for the ostomates.
Colostomy ; Depression ; Education ; Humans ; Male ; Odors ; Ostomy ; Quality of Life ; Rehabilitation

PURPOSE: This study was to determine the effects of abdominal breathing training using biofeedback on stress, immune response, and quality of life. METHOD: The study design was a nonequivalent control group pretest- posttest, quasi-experimental design. Twenty-five breast cancer patients who had completed adjuvant chemotherapy were enrolled. The experimental group(n=12) was provided with abdominal breathing training using biofeedback once a week for 4 weeks. State anxiety, cancer physical symptoms, serum cortisol, T cell subsets(T3, T4, T8), NK cell and quality of life were measured both before and after the intervention. RESULT: Though state anxiety, cancer physical symptoms, and serum cortisol were reduced after 4 weeks of abdominal breathing training using biofeedback, there was no statistical significance. It showed, however, improvement in quality of life (p=.02), and T3(p=.04). CONCLUSION: Abdominal breathing training using biofeedback improves quality of life in breast cancer patients after a mastectomy. However, the mechanism of this beneficial effect and stress response requires further investigation with special consideration in subject selection and frequency of measurement. Nurses should consider this strategy as a standard nursing intervention for people living with cancer.
*T-Lymphocyte Subsets ; Stress, Psychological/psychology/therapy ; *Quality of Life ; Middle Aged ; Mastectomy/*psychology/rehabilitation ; Hydrocortisone/blood ; Humans ; Female ; *Breathing Exercises ; Breast Neoplasms/immunology/*psychology/surgery ; *Biofeedback (Psychology) ; Adult

A phenomenological study was conducted to investigate the experiences of mothers pregnant via in vitro fertilization (IVF). Sample of nine mothers participated. Ten theme clusters emerged when the formulated meanings were organized into categories. During the infertility period, the participants were subject to self- depreciation, envy, anxiety, and depression. It changed their priorities in life from a job-oriented life to one where having a baby was the most important thing. After trying numerous alternative therapies, IVF became their last hope in having a baby. Since the success rate for IVF is low (only 20-30%), the participants for the treatment were overwhelmed with uncertainty, and it led to further anxiety, depression and despair. Success of pregnancy gave them extreme satisfaction, but they became very cautious in their day-to-day life because of their fear of abortion and early delivery. Some were even worried about the side effect of IVF during the pregnancy. Finally, the delivery of the baby gave them relief from the obligation of having a baby. Women did not have any difficulties in rearing a "test tube baby" except in the case of twins. Most women had no ethical difficulty in having a baby by IVF. However they did not wish this information to be revealed to other people. They again turned to IVF to have a son(s) when the resultory child(s) was a daughter(s). This is because of the strong preference for sons in Korean society.
Anxiety ; Complementary Therapies ; Depreciation ; Depression ; Female ; Fertilization in Vitro* ; Hope ; Humans ; Infertility ; Mothers* ; Pregnancy ; Twins ; Uncertainty