No abstract available.

No abstract available.
Occlusive Dressings* ; Skin*

No abstract available.
Cartilage* ; Ear* ; Snails* ; Transplants*

Disasters have frequently been a problem in Korea. Many initiatives have been carried out to mitigate this problem and to respond to disasters properly. The National Medical Emergency Center organized the Disaster Medical Response Center, which operates 24 hours a day. Regional emergency medical centers were designated as hospitals that receive disaster victims. Along with the designated disaster hospitals, the Ministry of Health and Welfare, city and district governments, and community health centers were all assigned standard roles to carry out in case of disasters. Disaster medical assistance teams were developed to respond to disaster events in their regions. This system has enabled a more rapid and systematic response to disaster events, and has standardized disaster-related medical equipment and vehicles to ensure the proper treatment of disaster victims. Although many valuable systems have been developed to respond to disasters, practical training within each institution and community-wide team training are still lacking; therefore, the government needs to further develop and support such programs.
Community Health Centers ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medical Services ; Korea ; Medical Assistance

Disasters have frequently been a problem in Korea. Many initiatives have been carried out to mitigate this problem and to respond to disasters properly. The National Medical Emergency Center organized the Disaster Medical Response Center, which operates 24 hours a day. Regional emergency medical centers were designated as hospitals that receive disaster victims. Along with the designated disaster hospitals, the Ministry of Health and Welfare, city and district governments, and community health centers were all assigned standard roles to carry out in case of disasters. Disaster medical assistance teams were developed to respond to disaster events in their regions. This system has enabled a more rapid and systematic response to disaster events, and has standardized disaster-related medical equipment and vehicles to ensure the proper treatment of disaster victims. Although many valuable systems have been developed to respond to disasters, practical training within each institution and community-wide team training are still lacking; therefore, the government needs to further develop and support such programs.

OBJECTIVES: The purpose of this study was to investigate the clinical characteristics of antipsychotic medication prescription for the symptom control in patients with delirium. METHODS: One hundred and eighty-five patients referred to consultation-liaison psychiatric services for delirium due to general medical condition were included in this study. All subjects were divided into two groups (antipsychotics users vs. antipsychotics nonusers), and comparison analyses on their clinical characteristics were performed. RESULTS: One hundred and twenty nine patients (66.5%) used antipsychotics for their delirium, and 56 patients (30.3%) did not use antipsychotics. The history of psychotropic medication was more frequently observed in antipsychotic users (5.4% vs. 18.6%, χ²=5.498, p=0.022). Especially, the history of benzodiazepine use was significantly high in antipsychotics users. The total score and sub-items of delirium rating scale-severity items except for the psychomotor retardation item showed higher scores in antipsychotic users than in nonusers (all p<0.05). The total score of the delirium rating scale-diagnosis items was higher in antipsychotic users than in the nonusers (p=0.010). CONCLUSIONS Delirium patients with more severe delirium symptoms and with more history of benzodiazepine use were treated with antipsychotics more frequently than those without. These findings imply that benzodiazepine may not only exacerbate delirium but be associated with aggression or psychomotor agitation that need immediate intervention. Clinicians may need to pay attention not only these external symptoms but also to hypoactive symptoms that may lead to misdiagnosis and undertreatment.

Family psychoeducation is a potent therapeutic tool for schizophrenia and is strongly recommended in major treatment guidelines. Family psychoeducation is effective for improving the psychopathology and therapeutic adherence of the patients as well as reducing the burden of the illness and the stress of family members. Despite its effectiveness, family psychoeducation is underutilized. Group family psychoeducation appears to be quite effective because it enhances the social network of family members and activates therapeutic factors, such as universalization, acceptance, interpersonal learning, and instillation of hope in the group. This review article overviews the currently published group family psychoeducation programs in detail, including number, length, and contents of sessions. The author recommends two-track group family psychoeducation, which may be suitable for the Korean situation: 1) large open group psychoeducation course that deals with general knowledge about schizophrenia; and 2) small closed group intensive psychoeducation course that covers discussions about the psychological needs and strengths of each family, communication, and problem-solving skill training and self-care.

Vitamin D is not only a nutrient, but also a hormone that affects the musculoskeletal system. Recently, extensive attention has been drawn to the autocrine and paracrine functions of vitamin D. Consequently, its extraskeletal effect and its known effects on the skeletal system have drawn particular interest. The socioeconomic development and aging of the population of Korea have also raised interest in dietary supplements. Because vitamin D deficiency is high among Koreans, both physicians and patients are questioning whether vitamin D supplements are needed. This review assessed the skeletal and extraskeletal efficacy of vitamin D with regard to mortality, cancer, cardiovascular disease, and diabetes via an evidence-based approach. The recent interest surrounding vitamin D can be expected to motivate many more studies on its effects and adverse effects, and accordingly, the level of evidence and recommendations will be adjusted. Clinicians should familiarize themselves with updated evidence about vitamin D, and must counsel patients with that evidence in mind.
Accidental Falls ; Aging ; Cardiovascular Diseases ; Dietary Supplements ; Evidence-Based Medicine ; Humans ; Korea ; Musculoskeletal System ; Osteoporosis ; Vitamin D ; Vitamin D Deficiency ; Vitamins

A splenectomy is the main therapeutic choice for immune thrombocytopenic purpura. The authors reviewed 31 cases of patients with immune thrombocytopenic purpura that had been treated by a splenectomy during a period of 15 years and assessed the clinical characteristics, the responses to the splenectomy, and the factors affecting the long-term prognosis. There were 9 males and 22 females, and the mean age was 20.8 years. The average duration of the symptoms was 20.2 months. All but one patient received preoperative steroid therapy 19 were steroid dependent, and 11 steroid refractory. The mean platelet count at first examination was 18,900/mm3, and increased to 119,900/mm3 at the time of operation. Preoperative immunoglobulin was effective in 50.0% of the patients. Postoperatively, one case of pulmonary atelectasis developed. There was no operative mortality. The clinical response rate after the splenectomy was 80.6%(complete response 64.5%, partial response 16.1%). In the steroid-dependent patients, the response rate was superior to that in the steroid refractory patients(89.5% vs 63.7%, p<0.05). Patients younger than 15 years showed a higher response rate(92.3% vs 72.2%), but this difference was statistically insignificant. Among the patients with no response to the splenectomy, 75.0% showed a clinical response with postoperative administration of steroid and other immunosuppressive drugs. Patients with a higher platelet count at the immediate postoperative period had a better long-term prognosis. A splenectomy is safe and effective in both steroid-dependent and steroid-refractory immune thrombocytopenic purpura. In patients with no respose to the splenectomy, a better result is expected through postoperative medical treatment.
Female ; Humans ; Immunoglobulins ; Male ; Mortality ; Platelet Count ; Postoperative Period ; Prognosis ; Pulmonary Atelectasis ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy*

OBJECTIVE: Although there are several descriptions of this vessel, there is no detailed angiographic study of the accessory middle cerebral artery (AMCA) in Korea. We describe the angiographic characteristics of the cortical territory and origin of AMCA and discuss the clinical significance of this anomaly. METHODS: We searched for patients with AMCAs from a retrospective review of 1,250 conventional cerebral angiograms. We determined the origins, diameters and cortical territories of these AMCAs. RESULTS: Fifteen patients (15 of 1250 = 1.2%) had 16 AMCAs (one patient had bilateral AMCAs). AMCAs originated from the distal A1 in eleven cases, middle A1 in two, proximal A1 in two, and proximal A2 in one case. All AMCAs followed a course parallel to the main middle cerebral artery (MCA). All but three of these arteries were smaller than the main MCA. Thirteen of the smaller diameter AMCAs had cortical distribution to the orbito-frontal and prefrontal, and precentral areas. Three AMCAs had diameter as large as the main MCA. These three supplied the orbitofrontal, prefrontal, precentral, central and anterior-parietal arteries. CONCLUSION: The AMCAs originated from A1 or A2. Most had smaller diameter than the main MCA. The AMCAs coursed along the horizontal portion of the MCA, but supplied the orbital surface, the anterior frontal lobe and sometimes wider cortical territory, including the precentral, central, anterior-parietal areas.
Arteries ; Frontal Lobe ; Glycosaminoglycans ; Humans ; Korea ; Middle Cerebral Artery ; Orbit ; Retrospective Studies ; Tranexamic Acid