No abstract available.
Pneumothorax* ; Thoracotomy*

OBJECTIVES: The purpose of this study was to examine whether Symptom Management Module-Korean Brief Version(SMM-B) is effective as a psychosocial treatment of the inpatients with chronic schizophrenia. We also questioned which of demographic and clinical characteristics could be predictors of differential treatment response. METHODS: The subjects were composed of 30 inpatients with chronic schizophrenia, who were trained with weekly session of SMM-B for 5 weeks. Before and after the training, the level of psychopathology, knowledge about schizophrenia were assessed as dependent variables by using Clinical Global Impression(CGI) and Scale to Assess Unawareness of Mental Disorder(SUMD). RESULTS: Overall, patients showed improvement over the treatment period on psychopathology as well as knowledge about psychosis. Total scores of SUMD were changed from 16.9+/-4.0 before training to 12.9+/-4.2 after training(p<0.01) and scores of CGI were improved from 3.7+/-0.9 to 2.8+/-0.8 (p<0.01). However age, gender, years of education, age of onset, duration of illness, duration of admission, numbers of psychiatric admission, and clinical status evaluated by CGI were not correlated with un-awareness of psychosis. CONCLUSION: These results suggest that SMM-B could be a reliable method to improve self-awareness of psychosis in patients with chronic schizophrenia and one of important elements in rehabilitation.
Age of Onset ; Education ; Humans ; Inpatients* ; Psychopathology ; Psychotic Disorders ; Rehabilitation ; Schizophrenia*

OBJECTIVE: To assess the influence of reflex sympathetic dystrophy (RSD) on functional status and recovery of the hemiplegic upper extremity in stroke patients. METHOD: Retrospective chart review was performed in 561 patients. Among 561 stroke patients, 116 subjects were recruited and classified into two groups: patient group, 43 cases with RSD; control group, 73 cases without RSD. Upper extremity function was assessed based on feeding, dressing and personal hygiene scores of the modified Barthel index at the beginning of rehabilitation treatment and at the time of discharge. Causes of stroke and length of stay were recorded. Median nerve-somatosensory evoked potential studies were performed and assessed. RESULTS: The incidence of RSD was 7.7% and the time to development of RSD was 62.3+/-34.1 days after the onset of stroke. There was no significant difference in functional status between two groups at initial and final evaluation. The upper extremity function had improved in both groups although the length of stay was longer in patient group. SSEP abnormalities were more frequent in the patient group. CONCLUSION: The presence of well-managed RSD affected neither the functional status nor the functional recovery of upper extremity in stroke patients.
Bandages ; Evoked Potentials ; Evoked Potentials, Somatosensory ; Humans ; Hygiene ; Incidence ; Length of Stay ; Reflex Sympathetic Dystrophy* ; Reflex* ; Rehabilitation ; Retrospective Studies ; Stroke* ; Upper Extremity*

Ceramide has emerged as a novel second messenger for intracellular signalling. It is produced from sphingomyelin and is involved in the control of cell differntiation, proliferation, and apoptosis. C2- ceramide, short chain ceramide, plays a role in mediating contraction of cat esophageal smooth muscle cells. We examined the effect of synthesized ceramide analogues on the C2-ceramide and ACh-induced contraction in esophageal smooth muscle cells isolated with collagenase. CY3523, CY3525, or CY3723 inhibited C2-ceramide induced contraction, in a time dependent manne. Each analogue also inhibited the contraction in concentration dependent manners. CY 3523, CY 3525, and CY 3723 had no effect to the contraction induced by PMA. The inhibition with CY3523, CY3525 and CY3723 on the C2- ceramide induced contraction was recovered by PMA. These analogues decreased the density of MAPK bands (p44/42 or p38) in the western blot. These results suggest that ceramide analogues can inhibit C2-ceramide induced contraction via PKC and MAPK dependent pathway.
Animals ; Apoptosis ; Blotting, Western ; Cats ; Collagenases ; Contracts ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Negotiating ; Protein Kinase C ; Relaxation ; Second Messenger Systems ; Sphingosine

BACKGROUND: To investigate the usage patterns of sedatives, analgesics and neuromuscular blocking agents (NMBAs) in patients requiring mechanical ventilation more than 72 hours in intensive care units (ICUs) of Korea. METHODS: A total of 536 patients continuing mechanical ventilation more than 72 hours had been enrolled among the twenty-one ICUs of Korea from May 2003 to July 2003. Data about mechanical ventilation, the use of sedatives, analgesics, and NMBAs were prospectively collected for four weeks. We analyzed the patterns of using these drugs and effects on outcomes. RESULTS: More than half of the patients (50.4%) received sedative drug alone. Most commonly used sedatives and analgesics were midazolam and morphine. NMBAs were administered in 41% of the patients. Volume controlled ventilation mode was associated with more frequent use of NMBAs. There were no significant differences in outcome variables among the usage patterns of sedatives, analgesics and NMBAs. CONCLUSIONS: Our investigation shows that analgesics were much less frequently used in the intensive care units of Korea compared with the use of sedatives. And the use of NMBAs were quite a common.
Analgesics ; Humans ; Hypnotics and Sedatives ; Critical Care ; Intensive Care Units ; Korea ; Midazolam ; Morphine ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Prospective Studies ; Respiration, Artificial ; Ventilation

Background: Current international guidelines recommend against deep sedation as it is associated with worse outcomes in the intensive care unit (ICU). However, in Korea the prevalence of deep sedation and its impact on patients in the ICU are not well known. Methods: From April 2020 to July 2021, a multicenter, prospective, longitudinal, noninterventional cohort study was performed in 20 Korean ICUs. Sedation depth extent was divided into light and deep using a mean Richmond Agitation–Sedation Scale value within the first 48 hours. Propensity score matching was used to balance covariables; the outcomes were compared between the two groups. Results: Overall, 631 patients (418 [66.2%] and 213 [33.8%] in the deep and light sedation groups, respectively) were included. Mortality rates were 14.1% and 8.4% in the deep and light sedation groups (P = 0.039), respectively. Kaplan-Meier estimates showed that time to extubation (P < 0.001), ICU length of stay (P = 0.005), and death P = 0.041) differed between the groups. After adjusting for confounders, early deep sedation was only associated with delayed time to extubation (hazard ratio [HR], 0.66; 95% confidence inter val [CI], 0.55– 0.80; P < 0.001). In the matched cohort, deep sedation remained significantly associated with delayed time to extubation (HR, 0.68; 95% 0.56–0.83; P < 0.001) but was not associated with ICU length of stay (HR, 0.94; 95% CI, 0.79–1.13; P = 0.500) and in-hospital mortality (HR, 1.19; 95% CI, 0.65–2.17; P = 0.582). Conclusion In many Korean ICUs, early deep sedation was highly prevalent in mechanically ventilated patients and was associated with delayed extubation, but not prolonged ICU stay or in-hospital death.