We reported two cases of amantadine treatment in traumatic brain injury patients and reviewed the literature of amantadine treatment of those patients. Problems with short-term memory, attention, planning, problem solving, impulsivity, disinhibition, poor motivation, and other behavioral and cognitive dificit could occur following traumatic brain injury or other types of acquired brain injury. this report described results of amantadine using in two patients with this type of symptom profile. Patients received neuropsychiatric examination as well as BPRS and Barthel index. These patients were improved, respectively from 57 point to 82 point(case 1), from 85 to 94(case 2) in Barthel index, and from 66 point to 35 point(case 1), from 55 to 32 point(case 2) in BPRS. These two patients did not reveal any other adverse effect. The rationale for using amantadine were discussed.
Amantadine* ; Brain Injuries* ; Dopamine Agonists ; Humans ; Impulsive Behavior ; Memory, Short-Term ; Motivation ; Problem Solving

No abstract available.
Blastocyst* ; Female ; Humans ; Oocytes* ; Parturition* ; Polycystic Ovary Syndrome*

No abstract available.
Korea

The purpose of licensing system is to ensure that the medicines are examined for safety, efficacy and quality. Nevertheless, off-label or unlicensed drug usages in pediatric practice is widespread in Korea and worldwide. Psychotropics are one of the most commonly used off-label or unlicensed drugs. The most valid approach to face this dilemma will be to have more evidences from pediatric pharmacological studies. Clinicians, in addition, need to monitor closely their off-label or unlicensed drug prescriptions to minimize the trial and error in practice. Researchers should publish their experiences and provide guidelines. Pharmaceutical companies, regulatory authorities, and consumer organizations should endeavor altogether for the children's right to get safe and efficacious drugs as adults do. Here, the definition as well as the current status of off-label and unlicensed drug prescriptions will be introduced. Critical issues regarding the off label drugs are discussed. In addition, I will describe the present condition as to the off-label and unlicensed drugs in child and adolescent psychiatry and the authorization process of off-label drug prescription in Korea. Lastly, direction we should like to take in this field will be mentioned.
Adolescent ; Adolescent Psychiatry ; Adult ; Child ; Consumer Organizations ; Dietary Sucrose ; Drug Labeling ; Drug Prescriptions ; Humans ; Korea ; Licensure ; Off-Label Use ; Organothiophosphorus Compounds ; Pediatrics ; Psychotropic Drugs

Recently, sexual violence is rapidly increasing in our society. A sexual assault occurs once every 1 hour and 17 minutes, nowadays. Sexual assault is a violent crime, inducing a life crisis which inflicts major psychological and physical trauma upon the victim. Posttraumatic symptoms occur immediately and leave long-term effects, such as anxiety, depression, sexual dysfunction, and impaired social adjustment. The purpose of the psychiatric intervention after a sexual violence is to assess the patient for it's psychological effects and to provide a proper treatment. Post-traumatic stress response, symptomatology and management of the victim are reviewed in a practical point of view. Adult and child victims are discussed separately.
Adult ; Anxiety ; Child ; Crime ; Depression ; Humans ; Psychopathology ; Sex Offenses* ; Social Adjustment

The aim of this study was to compare the current perception threshold (CPT) with a nerve conduction study (NCS) to evaluate the usefulness of CPT in the diagnosis of diabetic Peripheral Neuropathy (DPN). CPT measurement is quantitative method for assessment of peripheral sensory nerve function using electrical impulse. Enrolled in this study were 142 patients with type 2 diabetes who underwent both CPT testing and NCS between January 2013 and April 2016. DPN was diagnosed by NCS. CPT was performed on the right index finger and great toe of each patient. Patients with burning, tingling sensation and with longer history of diabetes tended to have a higher prevalence of DPN. In all frequencies tested (2000, 250, 5 Hz), CPT values of the DPN group were higher than the normal group. After classification in either the normoesthesia or hypoesthesia group according to CPT, the DPN group had a significantly higher prevalence of hypoesthesia than normal group. The receiver operating characteristics curve analysis showed that CPT had a high area under curve value for predicting the presence of DPN. In conclusion, CPT measurement is clinically valuable in detecting nerve dysfunction in patients with type 2 diabetes.
Area Under Curve ; Burns ; Classification ; Diabetic Neuropathies ; Diagnosis ; Fingers ; Humans ; Hypesthesia ; Methods ; Neural Conduction ; Peripheral Nervous System Diseases* ; Prevalence ; ROC Curve ; Sensation ; Toes

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.
Dataset ; Delivery of Health Care ; Female ; Gangwon-do* ; Health Policy ; Humans ; Statistics as Topic ; Tertiary Care Centers

BACKGROUND: This study purposed to analyze the spatial accessibility of women in childbearing age to the healthcare organizations (HCOs) providing delivery services in Gangwon-do. METHODS: Network analysis was applied to assess the spatial accessibility based on the travel time and road travel distance. Travel time and travel distance were measured between the location of HCOs and the centroid of the smallest administrative areas, eup, myeon, and dong in Gangwon-do. Korean Transport Database Center provided road network GIS (Geographic Information System) Database in 2015 and it was used to build the network dataset. Two types of network analysis, service area analysis and origin-destination (OD)-cost matrix analysis, applied to the created network dataset. Service area analysis defined all-accessible areas that are within a specified time, and OD-cost matrix analysis measured the least-cost paths from the HCOs to the centroids. The visualization of the number of the HCOs and the number of women in childbearing age on the Ganwon-do map and network analysis were performed with ArcGIS ver. 10.0 (ESRI, Redlands, CA, USA). RESULTS: Twenty HCOs were providing delivery services in Gangwon-do in 2016. Over 50% of the women in childbearing age were aged more than 35 years. Service area analysis found that 89.56% of Gangwon-do area took less than 60 minutes to reach any types of HCOs. For tertiary hospitals, about 74.37% of Gangwon-do area took more than 60 minutes. Except Wonju-si and Hoengseonggun, other regions took more than 60 minutes to reach the tertiary hospital. Especially, Goseong-gun, Donghae-si, Samcheok-si, Sokcho-si, Yanggu-gun, Cheorwon-gun, and Taebaek-si took more than 100 minutes to the tertiary hospital. CONCLUSION: This study provided that the accessibility toward the tertiary hospital was limited and it may cause problems in high-risk delivery patients such as over 35 years. Health policy makers will need to handle the obstetric accessibility issues in Gangwon-do.
Dataset ; Delivery of Health Care ; Female ; Gangwon-do* ; Health Policy ; Humans ; Statistics as Topic ; Tertiary Care Centers

Purpose: Conditions that limit activity constitute one of the important factors that threaten the health of the elderly. This study sought to analyze the dietary habits and nutritional intake status of the Korean elderly who were faced with activity limitations. Methods: Utilizing data from the 2019 Korea National Health and Nutrition Examination Survey, we classified 1,383 elderly people aged 65 and over into 2 groups: those with activity limitations (n = 222, LG) and those without (n = 1,161, NG). We conducted a comparative analysis of the general characteristics, dietary habits, intake of major food groups, energy, and major nutrients. The nutrient adequacy ratio (NAR), index of nutritional quality (INQ), and healthy eating practices were also analyzed. Complex sampling analysis was utilized for all the analyses with energy intake and socio-demographic variables adjusted. Results: The average age (73.8 years) of members of the LG was higher than those of the NG (72.6 years; p = 0.010). A higher percentage of participants in the LG lived alone (28.1%) compared to those in NG (17.2%; p = 0.004). The LG participants tended to regard their health status as “bad” or “very bad” (62.7%) more often than those in the NG (19.3%; p < 0.001). The LG subjects ate breakfast less frequently (p = 0.054) and ate out significantly less often than the NG subjects (p < 0.001). The LG subjects ate more grain (p = 0.001), fewer seeds (p = 0.014) and vegetables (p = 0.039). Carbohydrate made up a large percentage of their energy intake (p = 0.026). The LG subjects had significantly lower NARs of energy (p = 0.021), protein (p = 0.031), and riboflavin (p = 0.037). The LG participants also had a significantly lower rate of healthy eating practices (22.7%) compared to those in the NG (37.8%; p < 0.001). Conclusion Activity-limited elderly, despite their need for appropriate dietary management, were poorly nourished. They were likely to live alone, thereby making it hard to provide them with social support. Hence, there is a need to provide nutrition education and policy support for the elderly bearing the burden of limited activity.

Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.