OBJECTIVES: Regarding the relationship between the laterality of seizure focus and depression in temporal lobe epilepsy (TLE), previous studies reported inconsistent results. The role of frontal function as moderating variable between laterality and depression had been proposed. We attempted to replicate functional involvement of frontal lobe (FIFL) and, as an effort to extend previous findings, to test the functional involvement of parietal lobe (FIPL) to prove the hypothesis derived from Heller's valencearousal theory of emotion. METHODS: In study 1, patients with TLE (right 19, left 17) performed MMPI-D as a depression measure, Wisconsin Card Sorting Test (WCST) as a frontal function measure, and block design (BD) as a parietal function measure in the course of pre-operation assessment. Multiple regression model of depression which includes the interaction terms both between laterality and WCST and between laterality and BD were tested. In study 2, patients underwent anterior temporal lobectomy (ATL;right 20, left 25) were assessed and analyzed in the same way as study 1. RESULTS: In study 1, contrary to the FIFL and FIPL prediction, interaction of laterality with WCST or BD were not significant. In study 2, the interaction with frontal function was significant. Consistent with FIFL prediction, depression came to be evident when seizure focus was lateralized to the left side and simultaneously frontal function declined. But the interaction with BD remained insignificant, which suggests the invalidity of FIPL hypothesis. CONCLUSION: We replicated the FIFL hypothesis in the depression of ATL patients. The relation of depression with frontal function was more evident in post rather than pre operation sample. This pattern may be due to the inter-hemispheric interference of frontal functions in pre-operation sample and to the release-of-function phenomenon in post-operation sample. On the other hand, we did not succeed in confirming the role of parietal function in depression. Intactness of the parietal function in TLE was considered as the main cause of the negative finding.
Anterior Temporal Lobectomy ; Depression* ; Epilepsy, Temporal Lobe* ; Frontal Lobe ; Hand ; Humans ; Parietal Lobe* ; Rabeprazole* ; Seizures ; Temporal Lobe* ; Wisconsin

OBJECTS: The purpose of this study was to present a model of inpatient group psychotherapy led by a doctor in charge, to evaluate this model in practice, and to give a effective inpatient treatment by application of this model. METHODS: The subject composed of 25 psychiatric inpatient. The authors performed this model of group psychotherapy for 6 months and evaluate this model by objective data. Also we analyzed this model globally to get comprehensive understandings. RESULTS: The results of the objective data were as follows: 1) This model was effective to subside patients' symptoms. And the patients estimated this model to be important and helpful to them. 2) Identification with therapist' among therapeutic factors was high rank. This meant that therapist him- or her-self is a important tool for therapy. 3) Therapeutic factors in upper level group was much different from those in lower level group. And various therapeutic factors was used complementarily between two groups. 4) To check '13 therapeutic factors' repeatedly made the patients acquire therapeutic factors spontaneously. And to check 'the most important event' repeatedly gave the opportunity of self-reflection. The results of global analysis to this model were as follows: 1) This group psychotherapy gave a field in which a therapist met patients as human being. 2) This model was easy to perform, and helpful to a comprehensive therapeutic approach. 3) This model was able to make the basis of continuous outpatient and day hospital treatment, and the basis of outpatient group psychotherapy or individual psychotherapy. 4) In this model, social workers, nurses, or students in practice played a role of the healthy ego. Therefore they were able to activate group psychotherapy. 5) This model was a practical and useful tool of the education for psychiatric residents, medical students, social works, and other students. CONCLUSION: This model of group psychotherapy was useful f3r inpatient treatment and easy to perform in general.
Education ; Ego ; Humans ; Inpatients* ; Outpatients ; Psychiatry* ; Psychotherapy ; Psychotherapy, Group* ; Social Workers ; Students, Medical

Objectives: Aripiprazole is an antipsychotic that functions as a partial agonist in hypodopaminergic states and a dopamine antagonist in hyperdopaminergic states. Methods: This paper reports a series of five clinical cases of worsening psychotic symptoms in schizophrenic patients related to the initiation of aripiprazole, oral and injection, as combination therapy. Results: In all five cases, the switching of aripiprazole improved the psychotic symptoms. Conclusion Even with the suggestive relationship between aripiprazole therapy and the worsening of psychotic symptoms, further research is needed.

Patients with hypertrophic cardiography often complain of chest pain and have electrocardioagrams suggesting myocardial damage or ischemia. Some of three patients have associated coronary arterial atherosclerosis. Transmural myocardial infarction may occur in patients with hypertrophic cardiomyopathy in the absence of significant atherosclerosis of the extramural coronary arteries, about which several pathophysiologic exlpanations were discussed. Presented here, a case of 49-year-old man with hypertrophic cardiomyopathy accompanied with myocardial infarction and angiographically normal coronary arteries is reported. Asymmetric septal hypertrophy, characteristic morphologic abnormality of hypertrophic cardiomyopathy, was progressed to dilated cardiomyopathy after the occurrence myocardial infarction.
Atherosclerosis ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Coronary Vessels ; Humans ; Ischemia ; Middle Aged ; Myocardial Infarction*

No abstract available.
Leukemia, Lymphocytic, Chronic, B-Cell*

OBJECTIVES: We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. METHODS: This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. RESULTS: Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (+/- SD) -25.9 +/- 14.4, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (> or = 10%) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. CONCLUSIONS: Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.
Antipsychotic Agents ; Anxiety ; Body Weight ; Diagnostic and Statistical Manual of Mental Disorders ; Dihydroergotamine ; Headache ; Humans ; Incidence ; Korea ; Psychomotor Agitation ; Schizophrenia ; Sleep Initiation and Maintenance Disorders ; Weight Gain ; Paliperidone Palmitate

OBJECTIVES: The second to fourth digit ratio (2D : 4D) is known to reflect testosterone level during intrauterine period. Testosterone is essential for masculinization of brain. Cloninger's type II alcoholism is characterized by early age at onset and largely limited to males. Compared with type I alcoholism, type II alcoholism is thought to be masculine. There is a possibility that the digit ratio of type II alcoholism is low compared with type I. We examined digit length ratio in Cloninger's type I and II alcoholism to understand the effects of intrauterine testosterone on the development of alcoholism. METHODS: The participants were 87 alcohol dependent patients. We divided two subtypes of patients by Irwin's symptom list, based on Cloninger's concept. We captured the images of both palms by the scanner and measured the lengths of digits by the graphic program. Then we analyzed the digit ratios by independent-sample t-test. RESULTS: The mean 2D : 4D of type I was 0.942 (right), 0.952 (left). The mean 2D : 4D of type II was 0.927 (right), 0.940 (left). In both hands, 2D : 4D of type II was significantly lower than type I. CONCLUSIONS: Type II alcoholism showed masculine type of digit length ratio compared with type I. It suggests the exposure of testosterone during intrauterine period might play an important role in determining the course and feature of alcoholism.
Alcoholism ; Brain ; Hand ; Humans ; Male ; Testosterone

INTRODUCTION: The practicing of patient-centered medical services means a change in the pattern of the nature of doctor-patient relationship. The doctor oriented relationship is now moving to the pattern that patients resolve problems autonomously and participate in the decision-making in medical services. Authors performed this study to investigate the patient centeredness and influencing variables in medical students. METHODS: Authors recruited 94 medical students before psychiatric clinical clerkship and all subjects were assessed by structured questionales including socio-demographic data, frequency of receiving doctor-patient relationship lectures, Minnesota multiphasic personality inventory (MMPI), Meyers-Briggs type indicator (MBTI), the authoritarian personality scale (AP), job satisfaction scale (JS), patient practitioner orientation scale (PPOS), problem-solving decision-making scale (PSDM), and Beisecker locus of authority in decision-making scale (BLAS), and the questionnaire of JS, PPOS, PSDM, and BLAS were rechecked after psychiatric clinical clerkship. RESULTS: After psychiatric clinical clerkship, the score of JS, PPOS were higher than before. The group who had a good memory for taking a doctor-patient relationship lecture showed higher scores of the BLAS and PSDM than unexposed group. The AP was related with MBTI, correlated with the subscale of MMPI, however, inversely correlated with PPOS after psychiatric clinical clerkship. CONCLUSION: The authoritarian personality trait was related not only with other personality trait including introversion and psychopathic deviation (Pd) but also with patient-centeredness. Taking a lecture in doctor-patient relationship is positively related to the patient-centeredness.
Clinical Clerkship ; Humans ; Introversion (Psychology) ; Job Satisfaction ; Lectures ; Memory ; MMPI ; Surveys and Questionnaires ; Students, Medical*

OBJECTS: The purpose of this study was to present a day hospital model(hereinafter called as "this model") for integrated therapy, to evaluate the result of performing this model, and thus to develop day hospital model for helping psychotic patients effectively and promoting social readaptation. METHODS: The authors performed this day hospital model from 1996, May to December, A total of 25 psychotic Patients participated in this study. BPRS, Life Satisfaction Self-Rating Scale, Program Helpfulness Scale, 13 Therapeutic Factors, Scale, and Most Important Event Questionnaire were used at the start of day hospital treatment and at the end. RESULTS: The results were as follows: 1) In this model, it was possible to offer the wide treatment to heterogeneous patients who varied in age, number of admission, duration of illness, and functional level. 2) In the aspect of therapeutic effect, this model contributed for improving negative symptoms and increasing subjective life satisfaction. 3) When the patients were divided into the higher functional level group and the lower functional level group, the higher functional level group set a high value on group psychotherapy and psychodrama that were unstructured and could make patients explore their inner side deeply, But the lower functional level group did not so. Therefore dividing into two groups by functional level may be more effective for day hospital treatment. 4) Therapeutic factors were different between the periods of day hospital treatment, And in the higher functional level group, 'interpersonal learning' was important at the last period, but in the lower functional level group, 'socializing technique' was important at the last period. So long-term group psychotherapy may be more suitable for the after-care of the higher functional level group, and day care or other psychosocial rehabilitation programs may be more suitable for the after-care of the lower functional level group. 5) This model was easy to apply to Korean day hospital setting, and made staffs treat patients efficiently CONCLUSION: This day hospital model would be used effectively in Korean day hospital setting.
Day Care, Medical ; Humans ; Psychodrama ; Psychotherapy, Group ; Surveys and Questionnaires ; Rehabilitation

OBJECTIVES: The purpost of this study was to present general system,operation,and program of a day care model managed by a psychiatrist,to evaluate the results of performing this model,and thus to developa day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. METHODS: We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale,Life Satisfaction Self-Rating Scale were used before beginning this model-and after three months of performing this model. Program Helpfulness Scale,13 Therapeutic Factors Scale were used at one month of day care and after three months of day care. RESULTS: 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activeity therapy, played an important fole,for recovering Physical,psychological,and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists,guidance of therapists,and the corrective recatitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integration the multidisciplinary therapeutic team and the various therapeutic methods. CONCLUSION: This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.
Altruism ; Art Therapy ; Day Care, Medical* ; Hope ; Humans ; Psychotherapy, Group ; Quality of Life ; Rehabilitation*