OBJECTIVES: As a part of plan to develop evidence-based treatment guidelines for depression that is more suitable for Korean situation, we investigate the present status and client's requirements for non-pharmacological treatment of depression in Korean clinical situation. METHODS: Subjects were patients with depression in 12 university hospitals which are located in metropolises in Korea. We analyzed the records from questionnaires about current clinical status and requirements for the non-pharmacological treatment of depression in Korea. RESULT: 50.8% of the subjects have experienced non-pharmacological treatments for their depression. The preference of non-pharmacological treatment method of depression is exercise/interesting activity, counseling by psychiatrists and psychotherapy, and the best effective treatment method is psychotherapy (Es=4.36). Actually, the mean consultation time by psychiatrist is 11.31+/-7.16 min, and the appropriate consultation time for client's situation is 18.39+/-8.95 min. During consultation, patients' satisfaction measurement for psychiatrist's explanation about pharmacological treatment is 64.17+/-27.11, and satisfaction measurement for psychiatrist's counseling for their depression about personal problems, resent stress, interpersonal relationship is 61.66+/-26.63. CONCLUSION: In Korea, many psychiatrists offered biologically oriented treatment to their patients with depression, and patients' satisfaction measurement about consultation by psychiatrists is low. Many patients wanted to combined pharmacological and non-pharmacological treatment for their depression, and aspired to information about complementary and self-help treatment methods. It is necessary to develop non-pharmacological treatment guideline for depression which reflect the clinical situation in Korea and meet Korean patients' need.
Counseling ; Depression* ; Hospitals, University ; Humans ; Korea* ; Psychiatry ; Psychotherapy

Hailey-Hailey disease is a rare hereditary dermatosis that begins in the 2nd or 3rd decade of life. The skin lesion is characterized by a localized, recurrent eruption of small vesicles on an erythematous base. It courses remissions and exacerbations. It seldom begins in early childhood, and main treatment modalities are conservative ones. We report a case of Hailey-Hailey disease that began on a 7-month old infant and improved by surgical treatment. In according to review of the previous reports, it is probably the earliest onset age and it is may be the first case which was treated with surgery in Korea.
Age of Onset ; Humans ; Infant ; Korea ; Pemphigus, Benign Familial* ; Skin ; Skin Diseases

An outbreak of dermatosis occurred in a livestock fodder factory at Kyongju in May 1994. Authors conducted a questionnaire survey on 60 workers in the factory and a dermatologist examined their skin lesion. Authors also collected mites and identified them. The obtained results were summarized as follows; 1. Twentyeight cases of dermatosis were identified with attack rate of 46.7%. Attack rate was not different by department, age, sex, educational level and employment duration. Attack rate was 67.5% in productive worker and 5.0% in clerical workers (p<0.01) but was not significantly different between departments among productive workers (p>0.05). 2. Three cases among 28 dermatosis cases and one subject among 32 non-cases had a history of same dermatosis last year. Only one of dermatosis cases had a history of dermatosis among family members. History of other skin lesion and allergy was very rare in both cases and non-cases. 3. Skin lesions of the cases were rice-sized erythematous papules or vesicles with a central biting point. Onset date of dermatosis was between May 1 and June 10. Duration was from one day to more than 30 days. Skin lesion was most frequent at the back(75.0%). and also observed at the arms(64.3%). abdomen(60.7%), legs(57.1%), chest(32.1%) and neck (25.0%). Skin lesion was aggravated while workers are sweeping the floor(35.7%), working at the workplace(21.4%) and in bed at night(28. 6%). 4. Total l,637 mites were collected and identified into 3 suborder, 7 families and 17 species. Dermafophagoides farinae was most frequent Nnd most of the species identified were blood sucking mites. Authors concluded that the outbreak of dermatosis was brought about by mite-bites and grain beetle parasitizing Acarophenax tribolii was the most suspected species. Further studies to identify the specific species causing dermatosis and route of import are needed.
Beetles ; Edible Grain ; Employment ; Epidemiologic Studies* ; Gyeongsangbuk-do ; Humans ; Hypersensitivity ; Korea ; Livestock ; Mites* ; Neck ; Surveys and Questionnaires ; Skin ; Skin Diseases*

No abstract available.
Foot* ; Free Tissue Flaps*

Phenylepherine HCI widely used as a mydriatic and vasoconstrictor, have been generally considered safe and innocuous. But hypertension caused by instillation of phenylepherine HCI is frequently reported, and even severe systemic adverse reactions, such as myocardial in farction, sudden death etc. are reported, recently. For the purpose of studying alteration of B.P. and systemic adverse reactions that are caused by instillation of phenylephrine HCI. we divided 42 patients into 2 groups; group 1 includes 20 patients who are instilled once a drop of 10% phenylephrine HCI viscous solution into the conjunctival cul-de-sac of bOth eyes, group 2 includes 22 patients who are instilled twice a drop at 2 minute intervals. We observed alteration of B.P. and systemic adverse reactions in both groups, next made a comparative study, and mydriatic effect too. The results was generally there was no severe reaction, but marked increase of B.P. that statistically significant was observed in 3 patients. There was no significant difference between the 2 groups. In mydriatic effect, the significant difference was not observed between the 2 groups or according to the age. When a clinician does its instillation, he should keep possible adverse reactions in mind. and especially in cardiac disease, hypertensjon, aneurysms, advanced arteriosclerosis, infants and the elderly etc., who have much chance of accompanying severe adverse reactions, he should use phenylepherine HCI cautiously. (this time it is desirable that he use low percentage of phenylepherine HCI).
Aged ; Aneurysm ; Arteriosclerosis ; Death, Sudden ; Heart Diseases ; Humans ; Hypertension ; Infant ; Mydriatics ; Phenylephrine*

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

No abstract available.
Pityriasis Lichenoides* ; Pityriasis*

PURPOSE: A moderate head injury (Glasgow coma scale 9-13) has the large variability of severity, which accounts for the wide variability in the progression of lesions and in outcomes. Computed tomography (CT) is the standard diagnostic method for head injury, and repeat CTs (RCTs) are often obtained in order to monitor for progression of intracranial lesions. The purpose of this study was to suggest guidelines for RCT for moderate head injury. METHODS: In this study we reviewed data for 219 patients with moderate head injury who were admitted to our hospital via the emergency department between January 2004 and December 2009. The main outcome was worse progression of the intracranial lesions on RCT and neurosurgical intervention. Univariate and multivariate analyses were done for clinical variables to identify risk factors for progression of intracranial lesions and neurosurgical operations. RESULTS: On RCT, progression of injury was seen in 30.1% of patients, and neurosurgical intervention was performed in 14.6% of patients. Sixty percent of CT progression and ninety percent of neurosurgical intervention were occurred in patients with neurological deterioration. Independent risk factors associated with neurosurgical operation were coagulopathy (OR=13.275), amount of intracranial hemorrhage (OR=8.539), Marshall diffuse injury type of III/IV (OR=4.455), and skull fracture (OR=4.495). CONCLUSION: Routine repeat CT is necessary within 6 hour and 24-48 hour post-injury in patients with moderate head injury and without neurological deterioration.
Brain Injuries ; Coma ; Craniocerebral Trauma ; Emergencies ; Head ; Humans ; Intracranial Hemorrhages ; Multivariate Analysis ; Organothiophosphorus Compounds ; Risk Factors ; Skull Fractures ; Tomography Scanners, X-Ray Computed

BACKGROUND: To determine whether multiple short-term surveillances are as effective as long-term surveillance for estimating the incidence rates of nosocomial infections (NIs), we prospectively performed 9-month surveillance in four intensive care units (ICUs). METHODS: NI surveillance was performed prospectively from November 2002 through July 2003, with long-term surveillance performed over the 9-month period, and short-term surveillance performed during the middle 3 weeks of each calendar quarter. The incidence rate of NIs or device-associated infections was calculated as the number of infections per 1,000 patient-days or device-days. RESULTS: We observed no significant differences between the incidence rates of total NIs determined from these two methods (9.6 [CI95 8.2-11.3] vs 10.4 [CI95 7.5-14.4], P=.66). In addition, these two methods did not differ significantly in estimating the rates of ventilator-associated pneumonia (5.1 [CI95 3.4-7.6] vs 7.5 [CI95 3.8-15.0], P=.35), catheter-associated urinary tract infection (2.4 [CI95 1.7-3.4] vs 1.7 [CI95 0.7-4.1], P=.47), and central line-associated bloodstream infection (2.2 [CI95 1.4-3.4] vs 3.7 [CI95 1.9-7.4], P=.21). Plotting of the NI rates showed that the trends in multiple short-term surveillances were similar to those in long-term surveillance, except in one ICU. CONCLUSION: Our findings suggest that multiple short-term surveillances could replace long-term surveillance in estimating the baseline incidence rates of NIs in the circumstances of the relatively large number of patients in the ICUs, which would be especially useful in countries with limited resources.
Cross Infection* ; Epidemiology ; Humans ; Incidence ; Infection Control ; Intensive Care Units ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Tract Infections

Carbon monoxide (CO) is a tasteless, odorless, and non-irritating but highly toxic gas. CO intoxication is not uncommon in South Korea. Clinical presentations of CO poisoning varied according to the sources of CO, the patient's environment, job, and suicidal intention. We report on two cases of CO intoxication presenting hemiparesis. After hyperbaric oxygen therapy, initial neurologic deterioration of the two patients showed improvement. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.
Carbon Monoxide ; Carbon Monoxide Poisoning* ; Emergencies ; Humans ; Hyperbaric Oxygenation ; Intention ; Korea ; Paresis* ; Poisoning