No abstract available.
Humans ; Inpatients*

OBJECTIVES: Recently the issue on the violation of human rights has been raised in mental health system in Korea. In these cirmstances this study was conducted to investigate the length of stay of psychiatric inpatients by sociodemographic, clinical characteristics, and type of mental health facilities. METHODS: The total 1,028 subjects were randomly selected from 22 mental health facilities, including mental hospitals, general hospitals, psychiatric clinics, mental health welfare facilities, welfare facilities for homelessness, and illegal asylums. The subjects were interviewed by psychiatrists and social workers with clinical experiences. RESULTS: The average length of stay of psychiatric inpatients of mental health facilities in Korea was 1,368 days, and it was statistically different according to sociodemographic and clinical characteristics such as sex, age, education, religion, economic status, type of medical security, degree of family support, living condition before admission, diagnosis, age of onset, and number of admissions. In addition, the length of stay was associated with the type of mental health facilities. CONCLUSION: For more appropriated length of stay of psychiatric inpatients, not only various incentives for service suppliers are needed but also medical and socioeconomic incentives for patients and familiy members should be considered in order to facilitate their community-living.
Age of Onset ; Diagnosis ; Education ; Homeless Persons ; Hospitals, General ; Hospitals, Psychiatric ; Human Rights ; Humans ; Inpatients* ; Korea ; Length of Stay* ; Mental Health ; Motivation ; Psychiatry ; Social Conditions ; Social Workers

No abstract available.
Humans ; Mentally Ill Persons* ; Public Health*

OBJECTIVE: The few direct comparative studies of efficacy and tolerability of atypical antipsychotics have been done in patients commonly seen in clinical practice. We therefore compared, head-to-head, the relative efficacy and tolerability of two atypical antipsychotics, risperidone and quetiapine, commonly used in clinical practice nowadays. METHODS: This study used retrospective chart reviews of the patients who had been admitted to or treated at the outpatient department in a university hospital. The analysed population consisted of 55 patients with diagnoses of schizophrenia or schizoaffective disorder. RESULTS: Among the baseline characteristics, the proportion of patients with a history of previous antipsychotics medication was higher in the quetiapine group, as was the proportion of patients treated at the outpatient department, the proportion of female patients, and the mean age. Even though these baseline differences had been controlled as covariate, the proportion of responsive patients was higher, and the median value of the time to efficacy was shorter, in the risperidone group. The rate of sedation was higher in the quetiapine group and the rates of concomitant use of anticholinergics and benzodiazepines were higher in the risperidone group. However, these differences of sedation and concomitant use of anticholinergics and benzodiazepines were not statistically significant when controlling for the effect of baseline characteristics. Even though this study showed some useful results, the study limitations included the use of retrospective chart reviews and the small number of subjects at a single hospital, among others. Therefore, further studies controlling these limitations need to be done to confirm the results of this study. CONCLUSION: The proportion of responsive patients was higher and the median value of the time to efficacy was shorter in the risperidone group. The rates of extrapyramidal symptoms were not different between the two groups.
Antipsychotic Agents ; Benzodiazepines ; Cholinergic Antagonists ; Diagnosis ; Female ; Humans ; Outpatients ; Pilot Projects* ; Psychotic Disorders* ; Retrospective Studies ; Risperidone* ; Schizophrenia* ; Quetiapine Fumarate

Nitric oxide (NO) is known to mediate penile erection by activating intracellular cyclic GMP pathway. It is also suggested that cGMP pathway, on penile erection, has dominant role over the other secondary messenger pathway with cAMP, etc. Based on the hyposthesis that activation of NO-cGMP pathway could represent a more physiologic and effective approach in the treatment of erectile dysfunction, several NO donors and activator of cGMP have been used in human and animal studies of impotence. However the efficacy of those remains debatable. In the present study, we investigated the effect of NO donor [linsidomine chlorhydrate (SIN-1), S-nitroso-N-acetylpcnicillamine (SNAP), sodium nitroprusside (SNP)] alone and in combination with zaprinast (cGMP specific phosphodiesterase inhibitor) on penile erection in rats. NO donors used in this study, except SNP, did not induce penile erection sufficiently. SNP-induced penile erection is comparable to the erection induced by cavernosal nerve stimulation. However, direct applicaion of SNP in the treatment of impotence may not be acceptable as it causes a marked hypotension. Zaprinast given intracayernously either alone or in combination with NO donor may not be clinically effective. Combination with zaprinast is not shown to enhance the effect of NO donor on penile erection. Therefore, combination of NO donor with other drugs modulating different pathway may be a therapeutic approach to erectile dysfunction worthy of further investigation.
Animals ; Cyclic GMP ; Erectile Dysfunction ; Humans ; Hypotension ; Male ; Nitric Oxide* ; Nitroprusside ; Penile Erection* ; Rats* ; Tissue Donors*

OBJECTIVES: This study was to analyze the results of judgement on continuing hospitalization by the Mental Health Judgement Boards and to explore the present status of judging system for continuing hospitalization. METHODS: Analyzing summary and request sheets for continuing hospitalization on August 2001, we compared the number of requests for continuing hospitalization and the dissent rate at each Mental Health Judgement Board. The selationship between dissent rate and clinical characteristics such as diagnoses, caregivers, medical care systems, institute, and the clinical state was also explored. RESULTS: The summary sheets on the judgement for continuing hospitalization from 14 Mental Health Judgement Boards were collected. Total number of the requests for continuing hospitalization was 4,853 and the nationwide dissent rate was 4.2% with broad range of 0 to 32% in each Mental Health Judgement Board. The request sheets from 10 Mental Health Judgement Boards were 3,014. The proportion of schizophrenic patients was 73.0%, followed by 9.1% for alcoholics, 4.1% for mentally retarded patients, 3.8% for dementic patients, and 10.5% for others. The different of the dissent rates of schizophrenia (2.9%) and other non-schizophrenia (4.8%)was statistically signiticant (chi2=6.797, p=0.009). The dissent rates of family members (4.0%) and majors (1.6%) were statistically different (chi2=10.294, p=.001). The dissent rates of mental hospitals (3.8%) and mental health welfare facilities (2.1%) were statistically different (chi2=5.483, p=.019). The dissent rates of medicaid (3.5%) and insured (1.7%) was statistically different (chi2=4.622, p=.032). The dissent rates by the severity of clinical status were statistically different in all six categories: the risk for self-injury or injuring others (chi2=66.507, p=.000), the disability of daily self-care (chi2=136.033, p=.000), odd, eccentric, or regressed behavior (chi2=96.558, p=.000), unreal or illogical thought pattern (chi2=122.988, p=.000), negativism (chi2=62.715, p=.000), and memory, orientation or judgement problems (chi2=38.387, p=.000). CONCLUSION: The nember of requests for continuing hospitalization and the dissent rates showed wide variations among Mental Health Judgement Boards. Also, the dissent rates of the Boards were significantly different according to diagnoses, caregivers, medical care systems, institute, and the clinical status of patients. This result suggests that the standardization of the guideline on the judgement for continuing hospitalization and the practical plans for protecting human rights of patients require thorough preparation.
Alcoholics ; Caregivers ; Diagnosis ; Dissent and Disputes ; Hospitalization* ; Hospitals, Psychiatric ; Human Rights ; Humans ; Medicaid ; Memory ; Mental Health* ; Mentally Disabled Persons ; Negativism ; Schizophrenia ; Self Care

OBJECTIVE: Neurologic complications make a major contribution to morbidity and mortality in kidney transplant recipients. Most occur months or years after transplantation and may never come to the attention of the transplant surgeon. We report 5 cases of neurologic complications in kidney transplant recipients. Three of them were diagnosed as intracranial abscess by central nervous system infection and others were diagnosed as hypertensive encephalopathy. CASES: Three patients with intracranial abscess have experienced mild coughing, intermittent fever and pulmonary infection initially. During the treatment of pulmonary infection they experienced some of neurologic symptoms and signs, such as severe headache, loss of consciousness and dizziness. Brain MRI was performed and showed lesions of intracranial abscess. The etiologic organism were Nocardia in two cases and Staphylococcus epidermidis in one case. They were treated with stereotactic aspiration of abscess and antibiotics therapy. Two of them recovered but eventually one of them didn't recover. Two patients with hypertensive encephalopathy experienced severe headache, visual illusion and generalized seizure at the immediate postoperative period of kidney transplantation. Their systolic pressure was 190~210 mmHg and diastolic pressure was 140~150 mmHg. Brain MRI scan showed hyperintensity signals in T2WI and hypointensity signal in T1WI on bilateral occipital lobes. They were treated with antihypertensive agents and anticonvulsants. Seizure were well controlled and didn't recur. CONCLUSION: Meaningful survival in post-transplant neurologic complications is dependent on rapid diagnosis and initiation of effective treatment.
Abscess ; Anti-Bacterial Agents ; Anticonvulsants ; Antihypertensive Agents ; Blood Pressure ; Brain ; Brain Abscess ; Central Nervous System Infections ; Cough ; Diagnosis ; Dizziness ; Fever ; Headache ; Humans ; Hypertensive Encephalopathy ; Illusions ; Kidney Transplantation ; Kidney* ; Magnetic Resonance Imaging ; Mortality ; Neurologic Manifestations ; Nocardia ; Occipital Lobe ; Postoperative Period ; Seizures ; Staphylococcus epidermidis ; Transplantation* ; Unconsciousness

Recently, laser treatment of benign prostatic hyperplasia (BPH) is considered as a promising alternative to traditional transurethral resection of the prostate (TURP). To evaluate the effectiveness and safety of laser therapy on BPH, we compared the results of transurethral balloon laser thermotherapy (TUBALT, n=13) and Hybrid laser prostatectomy (HLP, n=21) with those of TURP (n=25) in 58 patients with mild and moderate BPH. Following data were evaluated at postoperative 1, 3 and 6 months : AUA symptom score (SS), maximal flow rate (Qmax), subjective symptom improvement (SI), postoperative complications. All 3 groups show significant improvement after treatment in the Qmax values. Among 3 groups, the Qmax value was lower in TUBALT group (12.9+/-3.3 ml/sec) than those in HLP group (15.5+/-5.2 ml/sec) and TURP group (18.7+/-5.3 ml/sec) on postoperative 6 months. The Qmax values were not significantly different between HLP and TURP groups. In the SS values, all 3 groups show significant improvement after treatment and, TUBALT (9.9+/-9.7) and HLP (10.3+/-9.4) group were comparable to TURP group (5.2+/-4.2) on postoperative 6 months. In global assessment of SI, both HLP (87.5%) and TUBALT (75%) group were also comparable to TURP (90%) group on postoperative 3 months. but TUBALT group showed delayed symptom improvement compared to TURP group. Postoperative complications were minimal both in HLP and TUBALT groups, compared to TURP group. These results suggest that both HLP and TUBALT are effective in mild and moderate BPH, Further more, HLP treatment could be considered a promising alternative to TURP.
Humans ; Hyperthermia, Induced* ; Laser Therapy ; Postoperative Complications ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

OBJECTIVES: Aims of this study were 1) to estimate prevalence rates of suicidal ideation and suicide attempt, 2) to find out whether the gender difference and age difference(13-15 years vs 16-18 years) for suicide behaviors exist, 3) to analyse correlates of suicide attempts among junior and high school adolescents aged 13-18 years old. METHODS: A self-administered questionnaire was used in a cluster random sample of 2,203 school adolescents(male 1,105, female 1,098). Data were obtained on a wide range of constructs including suicidal ideation and attempts during past 2 weeks, depressive symptoms, symptoms of DSM-IV alcohol dependence, family structure, socioeconomic status, smoking, satisfaction with school achievements, and subjective health status. Chi-square test were done for analysing gender difference and age difference of suicide behaviors. Statistical analyses including uni-variate and multi-variate logistic regression analysis were done for each sex, respectively. RESULTS: 1) The prevalence of suicide ideation during past 2 week was 30.7% in the total sample. The prevalence rates of male and female ideators were 26.9% and 34.9% respectively. The prevalence of suicide attempt during past 2 week was 5.3% in the total sample. The prevalence of suicide attempt in males was 3.4% and 7.3% in females. 2) Gender difference was significant. That is, female respondents showed higher rate of suicidal ideation and suicide attempt. In our study age difference was found only at the rate of suicide attempt. That is, older adolescents(16-18 years) showed only statistically significant higher rate of suicide attempt than younger adolescents(13-15 years). 3) Multi-variate logistic regression analysis revealed that the correlates for suicide attempt were female, moderate to severe depressive symptoms, alcohol dependence in the total sample. In males the correlate for suicide attempt was alcohol dependence. In females, were moderate to severe depressive symptoms, and alcohol dependence. CONCLUSION: Depressive symptoms, alcohol dependence, presence of suicidal ideation were strong predictors for suicide attempts. This suggest that early detection of treatment of depression and alcohol dependence is important and psychiatric approach and follow-up be needed for the prevention of suicide.
Adolescent* ; Alcoholism ; Surveys and Questionnaires ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Logistic Models ; Male ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Social Class ; Suicidal Ideation ; Suicide*

There are two factors which influence the long term outcome of renal transplantation. One is the immunological factor such as HLA typing, the other is the nonimmunological factor such as physiologic match of the donor kidney to the recipient. We analyzed the relation between serum creatinine on the day of discharge which is known as a good predictor of long term graft survival and several nonimmunological factors influencing long term outcome of renal transplantation. One hundred fourteen renal transplanted patients in Yeungnam university hospital for 3 years after 1994 were included except the patients had experienced rapid deterioration of renal function like acute graft rejection. Several indices(KW/R.BSA, KW/R.BW, KW/ R.BMI, D.BSA/R.BSA, D.BW/R.BW : KW=kidney weight, R=recipient, D=donor, BSA=body surface area, BMI=body mass index, BW=body weight) representing relative kidney size to recipient were significantly correlated with serum creatinine on the day of discharge(KW/R.BSA : r=-0.30, KW/R.BW : r=-0.35, KW/R.BMI : r=-0.41, D.BSA/R.BSA : r=-0.47, D.BW/R.BW : r=-0.44). Serum creatinine levels on the day of discharge were lower at the male kidney donated to female recipient than the female kidney donated to male recipient (0.89 vs. 1.22mg%, P<0.05). The age of donors had positive correlation with serum creatinine on the day of discharge (r=0.28). That was, when donor is more younger person, renal function after transplantation is better. But several indices by renal scan(effective renal plasma flow, perfusion index, peak renal uptake, T1/2) done after transplantation, urine output of the next day after transplantaton, renal function of donor before transplantation(creatinine level) were not correlated with serum creatinine on the day of discharge. In conclusion, nonimmunological factor such as nephron mass size, age, gender should be considered when selecting renal donor, and the more actual, new criteria for kidney transplantation and long term prognosis should be worked out by further study.
Creatinine* ; Female ; Graft Rejection ; Graft Survival ; Histocompatibility Testing ; Humans ; Kidney Transplantation* ; Kidney* ; Male ; Nephrons ; Perfusion ; Prognosis ; Renal Plasma Flow ; Tissue Donors