Aggressive and violent behaviors are an important problem in psychiatric department. Treatment-resistant schizophrenia with aggressive and violent behavior is more and more growing problem in treatment and management. A 45-year-old treatment-resistant schizophrenic male patient with aggressive and violent behavior was treated with long-acting injectable risperidone, added to previous antipsychotic medication. After adding long-acting injectable risperidone, his violent and aggressive behavior had been much improved. Patient's poor drug compliance was also improved, which is associated with frequent seclusion or restraint, and sedation induced by antipsychotic injection. This case shows the benefit of long-acting injectable risperidone, for aggressive and violent schizophrenic patient with treatment-resistant feature. In addition, this case proposed that the difficulty of administering antipsychotics to uncooperative patients with any cause, such as none of insight for diseases or aggressive and violent behavior, is added to the definition of drug compliance or adherence.
Antipsychotic Agents ; Compliance ; Humans ; Male ; Middle Aged ; Risperidone* ; Schizophrenia*

OBJECTIVES: In order to explore effects of board-game therapy for cognitive rehabilitation in patients with schizophrenia, we investigated the change of executive cognitive function over a 2-month period of board-game therapy in patients with schizophrenia. METHODS: Two groups of chronic schizophrenic inpatients were participated in this study. One group(n=21) were treated with board-game therapy for 2 months and the other control group(n=19) were not treated. For the evaluation of the executive cognitive function, a Wisconsin Card Sorting Test(WCST) was administered before and after the introduction of the board-game therapy. PANSS score change was also evaluated. RESULT: At the beginning of this study, there was no significant difference in performance of cognitive function tests, demographical data or clinical severity between both patient groups. After 2 months of treatment with the board-game therapy, the board-game therapy group showed significant improvements of executive cognitive function without any significant change of their schizophrenic symptoms. On the contrary, there was no change in control group. CONCLUSION: This study showed that a board-game therapy is effective for the enhancement of executive cognitive function in patients with chronic schizophrenia. A board-game therapy could be introduced with ease into psychiatric fields, such as inpatients' or outpatients' clinic wards and day hospital. Our result indicates that the board-game therapy is a promising tool for the enhancement of cognitive function, especially executive cognitive function and helpful for cognitive rehabilitation for schizophrenic patients.
Humans ; Inpatients ; Rehabilitation* ; Schizophrenia* ; Wisconsin

OBJECTIVES: The purpose of present study was to investigate the effect, safety and tolerability of risperdal sachet(oral solution) with lorazepam tablet versus intramuscular haloperidol and lorazepam injection for management of acute psychotic symptom in the elderly with organic mental disorder. METHODS: Total 37 patients who have dementia, medical or physical diseases, associated with acute psychotic symptom were randomly assigned to oral treatment with 1mg of risperdal sachet(oral solution) plus 1mg of lorazepam(N=17) or to intramuscular treatment with 2.5mg of haloperidol plus 2mg of lorazepam(N=20). The change of CGI scores was used for the evaluation of efficacy. RESULTS: Mean score improvements at 15, 30, 60, and 120 minutes after treatment were statistically significant at each time point in both groups(p<0.001) and were similar in both groups(p=0.189). CONCLUSION: A single oral dose of risperdal sachet(oral solution) plus lorazepam was as effective and tolerable as parenterally administered haloperidol plus lorazepam for the rapid control of acute psychotic symptom in the elderly with organic mental disorder.
Aged* ; Delirium ; Neurocognitive Disorders* ; Dementia ; Haloperidol* ; Humans ; Lorazepam*

One hundred forty eight complications in 135 cases of long bone fractures experienced during the period from May 1971 to December 1979, at the Chosun University Hospital and analysed its retrospectively. The results were obtained as follows. 1. The order of incidence of complications were as follows; infection (39.8%), delayed union(23.6%). malunion (13.5%), ankylosis of joint (12.2%). nonunion (8.1%) and peripheral nerve injury (2. 8%). 2. Of all 127 patients, 97 patients were male and 30 patients were female, and 72 patients (56.7%) were cauesd by traffic accidents. The sex ratio between male and female was 3.2: l. 3. The major complications were frequently associated with other fractures and dislocations, brain injuries. 4. Those of open, comminuted fracture and delayed transfer cases to the Orthopedic Surgeon were predisposing factors to development of the severe complication.
Accidents, Traffic ; Ankylosis ; Brain Injuries ; Causality ; Dislocations ; Female ; Fractures, Bone ; Fractures, Comminuted ; Fractures, Open ; Humans ; Incidence ; Joints ; Male ; Orthopedics ; Peripheral Nerve Injuries ; Retrospective Studies ; Sex Ratio

Tracheoesophageal fistula (TEF) occurs in approximately 1 in 3,000 to 5,000 live births. TEF arises from failure of normal division of proximal foregut into separate respiratory and digestive tracts at 4 weeks' gestation. TEF and esophageal atresia are interrelated anomalies, and TEF usually occurs with esophageal atresia. These are usually diagnosed shortly after birth. However, the diagnosis is often delayed in TEF without esophageal atresia, because babies with this anomaly are usually normal in size and seldom have other anomalies. Therefore, sometimes TEF without esophageal atresia is found during operation for an unrelated condition when positive pressure ventilation causes massive inflation of the gastrointestinal tract. We report a case of TEF in adult patient found during general anesthesia for emergency exploratory laparotomy.
Adult ; Anesthesia, General* ; Diagnosis ; Emergencies* ; Esophageal Atresia ; Gastrointestinal Tract ; Humans ; Inflation, Economic ; Laparotomy* ; Live Birth ; Parturition ; Positive-Pressure Respiration ; Pregnancy ; Tracheoesophageal Fistula*

The Persistent auditory hallucinations may provoke the uncomfortable feeling and can be dangerous according to its contents in treatment-resistant schizophrenic patients. Previous functional brain imaging studies on auditory hallucinations reported that the abnormal activations of the normal auditory pathway and the activations of the left upper temporal lobe were found while patients were hallucinating voices. Base on the these findings, we treated a female schizophrenic patient with persistent auditory hallucinations that were treatment-refractory with rTMS and the ECT continuously while she was on the drug treatment. The total amount of pulses applied in each trial ranged from 240 to 1000pulses. Fourteen trials were done and resulted in decrease by 30% in the subject severity of auditory hallucinations and the improvement of the affect. Two weeks after the completion of rTMS trials, nine trials of ECT were administered which leaded to complete disappearance of auditory hallucinations. This result suggest that ECT is more effective than rTMS in treating persistent auditory hallucinations in treatment-resistant schizophrenic patients.
Auditory Pathways ; Female ; Functional Neuroimaging ; Hallucinations* ; Humans ; Schizophrenia ; Temporal Lobe ; Transcranial Magnetic Stimulation ; Voice

OBJECTIVE: The prescription rates of long-acting injectable (LAI) antipsychotics are very low around 1% in Korea. This study was aimed to explore the preference of LAIs in patients with schizophrenia, who are currently living in community, and their caregivers. METHODS: The patients, diagnosed with schizophrenia by DSM-IV TR and were registered in the 31 mental health centers of Gyeonggi province and their caregivers were inquired the knowledge of the LAIs. The questionnaires contained information such as demographic characteristics, history of psychiatric treatment, and so on. RESULTS: About 5,318 were registered in 31 community mental health centers of Gyeonggi province in February 2012. The questionnaires of 614 patients and 365 caregivers were gathered from 20 community mental health centers. The mean ages (+/-SD) of patients and caregivers were 41.9 (+/-10.2) and 62.2 (+/-13.4) years old, respectively. 272 patients (44.6%) had experienced the discontinuation of medications without doctor's consent. 217 patients (35.9%) and 97 caregivers (27.1%) knew about the LAIs. The preference rates for LAIs were 35.2% and 46.8% for the patients and caregivers, respectively. CONCLUSION: There is still huge discrepancy between the preference and the real prescriptions of LAIs in community-dwelling patients and their caregivers, much higher than in those of hospital settings. This study suggests that both patients and caregivers registered in the community mental health centers have a strong commitment to live in the community. The obstacles against the benefits of LAIs need to be resolved.
Antipsychotic Agents ; Caregivers ; Community Mental Health Centers ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Korea ; Mental Health ; Prescriptions ; Surveys and Questionnaires ; Schizophrenia

No abstract available.
Congenital Abnormalities* ; Head*

No abstract available.
Leg* ; Myocutaneous Flap*

Normal aging causes changes in the brain volume, connection, function and cognition. The brain changes with increases in age and difference of gender varies at all levels. Studies about normal brain aging using various brain magnetic resonance imaging (MRI) variables such as gray and white matter structural imaging, proton spectroscopy, apparent diffusion coefficient, diffusion tensor imaging and functional MRI are reviewed. Total volume of brain increases after birth but decreases after 9 years old. During adulthood, total volume of brain is relatively stable. After 35 years old, brain shrinks gradually. The changes of gray and white matters by aging show different features. N-acetylaspartate decreases or remains unchanged but choline, creatine and myo-inositol increase with aging. Apparent diffusion coefficient decreases till 20 years old and then becomes stable during adulthood and increase after 60 years old. Diffusion tensor properties in white matter tissue are variable during aging. Resting-state functional connectivity decreases after middle age. Structural and functional brain changes with normal aging are important for studying various psychiatric diseases such as dementia, schizophrenia and bipolar disorder. Our review may be helpful for studying longitudinal changes of these diseases and successful aging.
Adult ; Aging* ; Bipolar Disorder ; Brain* ; Child ; Choline ; Cognition ; Creatine ; Dementia ; Diffusion ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging* ; Middle Aged ; Parturition ; Protons ; Schizophrenia ; Spectrum Analysis ; Young Adult