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

We injected tissue plasminogen activator(TPA) and expansile gas into the vitreous of 17-year-old patient who presented with traumatic macular hole and subretinal hemorrhage. Most of the subretinal hemorrhage drained into the vitreous cavity through the macular hole. Two weeks after intravitreal injection, closure of macular hole accompanied by complete posterior vitreous detachment was observed. This case suggests that the tangential vitreous traction may play an important role in the development of traumatic macular hole as in the development of idiopathic macular hole. It is speculated that the induction of posterior vitreous detachment without vitrectomy can result in removal of this traction and closure of traumatic macular hole.
Adolescent ; Hemorrhage ; Humans ; Intravitreal Injections ; Plasminogen ; Retinal Perforations* ; Traction ; Vitrectomy ; Vitreous Detachment

Hinman syndrome is a condition caused by an incoordination between the detrusor and external urethral sphincter during bladder contraction. Manifestations include day-and-night wetting, residual urine, infected urine, vesicoureteral reflux, christmas-tree shaped bladder-wall change, and upper tract damage without neurologic lesion or anatomical obstruction. Recently, this incoordination was postulated to be due to over-compensation of the external sphincter which compensates the uninhibitory detrusor contraction and pathological persistence of this "detrusor-sphincter dyssynergia" habit after brain cortical maturation. Accordingly, this syndrome is an acquired psychosocial-behavioral problem, reversible by bladder training and does not necessitate surgical intervention. We report a case of nonneurogenic neurogenic bladder who was successfully treated by biofeedback training, anticholinergic drugs and intermittent catheterization.
Ataxia ; Biofeedback, Psychology ; Brain ; Catheterization ; Catheters ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Vesico-Ureteral Reflux

No abstract available.
Humerus*

The value of ultrasonography and percutaneous transhepatic cholangiography in determining the site and etiology of biliary obstruction with surgical jaundice was studied in 30 patients. All diagnoses were subsequently made by surgery and pathology. The results were as follows; 1. In ultrasonography, the site of obstruction was delineated in 46%, while the etiology of the lesion was established in 40%, In comparison, percutaneous transhepatic cholangiography delineated the site in 100% and the etilogy in 93%. 2. Although the percutaneous transhepatic cholangiography is invasive to the human body, it is considered to be the single procedure of choicein the managment of the patient with biliary obstructive jaundice because of its diagnostic accuracy, technical simplicity and relative safety.
Cholangiography ; Diagnosis ; Human Body ; Humans ; Jaundice ; Jaundice, Obstructive ; Pathology ; Ultrasonography

BACKGROUND: Thoracoscopic sympathectomy seems to be a safe therapeutic procedure without a severe complication. Hypotension has been often reported as one of postoperative complications, but intraoperative changes in blood pressure (BP) were not studied. However, authors' past experience of thoracic sympathectomy told that intraoperative BP reduction could be observed only when measured in ipsilateral arm. During general anesthesia, BP reduction might be a crucial, which could be associated with complication. Authors conducted this study to establish whether BP reduction is confined to ipsilateral arm, or is systemic phenomenon in thoracoscopic sympathectomy. METHODS: Twenty healthy, male and female patients scheduled for one stage thoracoscopic thoracic sympathectomy were prepared for this study. Without premedication, invasive BP monitoring was taken place in bilateral radial arteries. General anesthesia was induced with low dose of fentanyl, propofol and vecuronium. Endotracheal intubation was done with double lumen tube and anesthesia was maintained with variable concentrations of isoflurane in 100% oxygen. Sympathetomies were done for T2~3 during one lung ventilation. BP and palmar temperature were recorded at arrival, after one lung ventilation, after sympathectomy, 5 min, 10 min, after two lung ventilation. BPs and temperatures were analyzed by time and groups. RESULTS: Concurrent with initiation of sympathectomy, BP was reduced only in ipsilateral radial artery. Mean BP decrement was almost 11% (right side: 80 +/- 11 mmHg -> 71 +/- 15 mmHg; left side: 80 +/- 14 mmHg -> 71 +/- 9 mmHg; both of p<0.05). It was accompanied with ipsilateral palmar temperature elevation (right side: 1.28 degrees C; left side: 1.19 degrees C; both of p<0.05). CONCLUSION: Conclusively, BP reduction in thoracic sympathectomy is a change confined to ipsilateral arm, which seems because of peripheral vasodilation.
Anesthesia ; Anesthesia, General ; Arm* ; Arterial Pressure* ; Blood Pressure ; Female ; Fentanyl ; Humans ; Hyperhidrosis* ; Hypotension ; Intubation, Intratracheal ; Isoflurane ; Lung ; Male ; One-Lung Ventilation ; Oxygen ; Postoperative Complications ; Premedication ; Propofol ; Radial Artery ; Sympathectomy* ; Vasodilation ; Vecuronium Bromide ; Ventilation

PURPOSE: An atrophic renal scar(RS) is one of the underlying causes for childhood hypertension and chronic renal failure. The risk factors for atrophic renal scar were evaluated. METHODS: 41 children, who presented with first febrile urinary tract infection at the Ewha Womans University Hospital between 1995 and 2003 and had generalized atrophic RS on 99mTc-DMSA renal scan, were retrospectively studied. Atrophic RS was divided into severe atrophic RS(n=14) if relative uptake on renal scan was below 10%, or mild atrophic RS(n= 27) if relative uptake on renal scan was between 10-35%. RS was defined as congenital if the scar was detected on the first renal scan, and as acquired if the scar developed on the follow-up renal scan from acute pyelonephritis of the first renal scan. The control group was consisted of randomly selected 41 children with segmental RS. The risk factors for atrophic RS such as the generation time, VUR, gender and ACE gene polymorphism were evaluated. RESULTS: The age distribution of atrophic RS and segmental RS did not differ significantly (P>0.05). The rate of congenital RS in atrophic RS was 61.0%(25/41), which was significantly higher than 9.8%(4/41) of segmental RS(P<0.01). Atrophic RS developed more frequently in male children(M:F 68.3%:31.7%) than segmental RS(M:F 41.4%:58.6%)(P<0.05). Vesicoureteral reflux(VUR) was found in 92.7%(38/41) of the atrophic RS, which was significantly higher than 53.7%(22/41) of segmental RS(P<0.05). In children without VUR, the male to female ratio did not differ between atrophic RS and segmental RS(P>0.05). But in children with VUR, there was a higher proportion of males with severe atrophic RS than segmental RS(85.7%:45.5%). ACE gene polymorphism did not differ between the atrophic and segmental RS groups, irrespective of the presence of VUR(P>0.05). CONCLUSION: Most atrophic RSs were congenital which could not be preventable postnatally and the major risk factors were VUR and the male gender. ACE gene polymorphism was not the significant risk factor for an atrophic RS.
Age Distribution ; Child ; Cicatrix* ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Kidney Failure, Chronic ; Male ; Pyelonephritis ; Retrospective Studies ; Risk Factors* ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections ; Vesico-Ureteral Reflux

The exercise ECG gives a valuable indirect evidence of insufficient myocardial perfusion during stress, but it has been impossible with ECG data alone to localize the site or sites of partial or complete arterial occlusion. The coronary angiography has proved to be valvuable as a technique for identifying anatomical lesions. However, arteriography alone dose not provide evaluation of the underlying myocardium. The two tests are complementary, one supplying indirect physiologic data and the other providing anatomical licalization of obstruction. The author reviewd 58 patients out of 86 patients who performed treadmill test and coronary angiography at the cardiac laboratory of Yonsei University Severance Hospital from January, 1981 through December, 1983. The following results were obtained. 1) Among the 58 patients in this study, 33 had negative exercise test and 25 had positive test. 2) Among the 14 patients who ended exercise test due to chest pain,2patients had negative exercise test. Coronary angiography on all the 14 patients showed significalt coronary artery stenosis. 3) With this multigraded treadmill test, the sensitivity was 68.8% and spedccificity was 88.7%. 4) The appreance of ischemic change during the early stage of exercise, the deeper ST segment depression and the downsloping ST segment have the higest specificity as indicators of coronary artery disease. 5) Four patients showed ST segment elevation in the exercise ECG, and their coronary angiogram showed 1-vessel disease in 1 patientts, 2-vessel dosease in 2 and 3-vessel disease in 3. All of them had multiple stenosis or complete obstruction of the left anterior descending artery on coronary angiogram and ventricualar dyskinesia on the left ventriculogram.
Angiography ; Arteries ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Dyskinesias ; Electrocardiography ; Exercise Test* ; Humans ; Myocardium ; Perfusion ; Sensitivity and Specificity ; Thorax

No abstract available.
Chin* ; Hemangioma*

Transfer of large quantities of fetal blood across the placental barrier to the maternal circulation is a rare occurrence which results in severe anemia in the newborn infants. This phenomenon is believed to occur most often during labor and delivery and apparently, is more frequent when abnormal obstetric conditions are present. However, fetal erythrocytes have been identified in the naternal circulation throughout most of pregnancy indicating some degree of constant or intermittent transplacental transfusion. We experienced a case of stillbirth due to large amount of fetomaternal transfusion. Acid elutionl test of maternal blood was positive and direct and indirect Coombs test was negative. Ultrasonographic finding on abdomen and cranium to rule out the internal hemorrhage was normal. We report a case of stillbirth due to fetomaternal transfusion with a brief review of related literatures.
Abdomen ; Anemia ; Coombs Test ; Erythrocytes ; Female ; Fetal Blood ; Fetomaternal Transfusion* ; Hemorrhage ; Humans ; Infant, Newborn ; Pregnancy ; Skull ; Stillbirth*