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*

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

PURPOSE: Spontaneous isolated superior mesenteric artery dissection (SISMAD) is defined as superior mesenteric artery (SMA) dissection without an associated aortic dissection. SISMAD is an uncommon mesenteric ischemia, but can lead to death if not recognized early. Here, we present our experience on features characterizing SISMAD in an early period and review imaging findings. METHODS: Twelve symptomatic SISMAD patients who received conservative treatment between March 2005 and February 2012 were included in this study. Their clinical characteristics, imaging findings, treatment methods and outcomes were retrospectively analyzed. A diagnosis of SISMAD was confirmed by multidetection computed tomography (MDCT) and computed tomographic (CT) angiography. RESULTS: All patients complained of severe (6 patients) or moderate abdominal pain (6 patients), and 4 patients complained of radiating back pain at the same time. Eight patients had an acute onset (< or =3 days) of abdominal pain, and 4 patients had a chronic onset of the abdominal pain. The abdominal pain was located in the upper abdomen in 7 patients and in the periumbilical area in 5 patients. Angiographic types of SISMAD were classified into Sakamoto's type I (3 patients), type II (1), type III (4), and type IV (4). The dissection occurred within 3 cm from the orifice of the SMA in 9 patients (75%). The angiographic type of SISMAD was not associated with clinical symptoms and treatment methods. Ten out of 12 patients were treated with conservative management such as expectation and anticoagulation. Aneurysmal dilation of the SMA was noted in 4 patients, and 2 patients out of these 4 underwent surgical operations due to persistent abdominal pain and a growing aneurysm. No patients had a recurrence of symptoms and lesion progression on follow-up CT angiography. CONCLUSION: Patients with an acute onset of severe abdominal pain or chronic persistent abdominal pain should be suspicious of SISMAD and CT angiography should be performed.
Abdomen ; Abdominal Pain ; Aneurysm ; Angiography ; Back Pain ; Diagnosis ; Follow-Up Studies ; Humans ; Ischemia ; Mesenteric Artery, Superior* ; Methods ; Recurrence ; Retrospective Studies

PURPOSE: Delayed neuropsychiatric sequelae (DNS) encompass a broad spectrum of neurological deficits, cognitive impairments, and affective disorders which commonly occur after a recovery from acute carbon monoxide (CO) poisoning. The early identification of patients with a high risk of DNS might improve their quality of care. Thus, we studied the role of magnetic resonance imaging (MRI) for the prediction of DNS. METHODS: This retrospective study included 41 patients with CO poisoning from January 2009 to June 2012. Magnetic resonance imaging (MRI) was performed within seven days after CO poisoning. Positive MRI findings were defined as focal or diffuse signals in fluid-attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), and T2 weighted imaging (T2WI). DNS was considered present when patients had clinical symptoms and signs of DNS within 3 months after CO poisoning. Clinical and biohumoral data were collected; univariate and multivariate statistical analyses were performed to identify the predictive role of MRI for DNS. RESULTS: DNS occurred at a rate of 58.5%, with abnormal MRI findings associated with the development of DNS in the multivariate analysis. The sensitivity of MRI to DNS was 82.6%. In contrast, a normal MRI was seen in eighteen patients (43.9%). MRI revealed abnormalities in the deep white matter (41.5%), globus pallidus (34.1%), cerebral cortex (12.2%), medial temporal lobe (MTL)/hippocampus (7.3%), and cerebellum (4.9%). Among the MRI abnormalities revealed, lesions in the deep white matter were significantly associated with DNS development. Abnormal findings of the globus pallidus, cerebral cortex, MTL/hippocampus, and cerebellum were not associated with DNS development. CONCLUSION: This study demonstrates the utility of early MRI for the prediction of DNS. Future studies will be required to ascertain the prevention of DNS with hyperbaric treatment in CO poisoning.
Carbon ; Carbon Monoxide ; Carbon Monoxide Poisoning ; Cerebellum ; Cerebral Cortex ; Diffusion ; Globus Pallidus ; Humans ; Hypoxia, Brain ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Mood Disorders ; Multivariate Analysis ; Retrospective Studies ; Temporal Lobe

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

No abstract available.
Humans ; Hyperthyroidism* ; Leydig Cell Tumor*