OBJECTIVES: Electroconvulsive therapy (ECT) is the important treatment method which has a good effect on refractory depression, schizophrenia at acute stage, patients with suicidal ideation. Although ECT results in better effects and less adverse effects in acute stage of illnesses as compared with pharmacotherapy, clinical implications are decreasing. Thus, authors surveyed a view of Korean psychiatrists about ECT to find whether there are prejudices and/or misconceptions for ECT. METHODS: Authors made survey questionaire for the attitudes of ECT, based on the APA task force 14, a clinical study in Korea, Hermann et al's report, and questioned Korean psychiatrists on their opinions for ECT through the internet E-mail, who are the members of Korean Neuropsychiatric Association (KNPA) serving in hospitals with psychiatric inpatient units. RESULTS: 122 psychiatrists answered to survey questionnaire. 89.4% have positive attitude about ECT. They thought that ECT has relatively safe and potent therapeutic effects, and less adverse effects. The rate of psychiatrists who have been no experience to perform ECT was 13.9% (n=16). Interestingly all of them had been trained serve in university hospitals now. The rate of psychiatrists who had experienced practicing ECT past but, not experienced within 2 years recently was 48.7% (n=56). While psychiatrists who have been no experience of ECT were more worried about adverse effects, doctors who experienced practicing ECT thought preferably the aspect of safety and potent effects of ECT. Psychiatrists who prefer psychotherapy were more likely to concern about adverse effect of ECT, but there were no differences in other aspects when compared with others. Most psychiatrists participated in this survey had positive attitudes about application of ECT to geriatric patients, but negative at child&adolescent patients. CONCLUSION: Authors recognized that many Korean psychiatrists agreed with performing ECT, and expected good results, but in reality, it is difficult to expect for them to perform ECT. Several factors may be associated for that: the changes in trend of psychiatric treatment, production of novel psychotropic drugs, researches trends which pharmacotherapy is prevailing in the fields of psychiatry, and problems of education, that is, lack of standard educational curriculums and systemic training course at residency for ECT.
Advisory Committees ; Curriculum ; Depressive Disorder, Treatment-Resistant ; Drug Therapy ; Education ; Electroconvulsive Therapy* ; Electronic Mail ; Hospitals, University ; Humans ; Inpatients ; Internet ; Internship and Residency ; Korea ; Prejudice ; Psychiatry* ; Psychotherapy ; Psychotropic Drugs ; Surveys and Questionnaires ; Schizophrenia ; Suicidal Ideation

PURPOSE: To evaluate the CT findings of histologically confirmed endobrnchial tuberculosis(EBTB) and to access their diagnostic value by comparing with the bronchoscopic findings. MATERIALS AND METHOD: We evaluated retrospectively the CT findings of 25 patients(male : female=5 : 20) with EBTB, and classified them into 3 types by their characteristic features, which are compared with the brochoscopic findings. The 3 types of CT features were as follows ; type 1 : central mass-like lesion with coarse calcific spots associated with atelectasis, type 2: caseous pneumonia with air-bronchogram associated with atelecatasis, type 3 : irregularly distorted and narrowed bronchovascular changes. RESULTS: Comparing the characteristic CT findings with the bronchoscopic findings, they were as follows ; type 1 showed completely occluded lumen by caseous or scar-like tissue with severely swollenmucosa, type 2 showed very thick tenacious mucous plug with anthracotic pigmentation of mucosa, type 3 showed chronic inflammatory change of mucosa with severely deviated or septated bronchial lumen by out-growing caseousgranulation tissue. A tracheal tuberculosis without parenchymal lesion was noted and the bronchoscopy showed caseous materials along the tracheal lumen to the carinal level. CONCLUSION: The characteristic CT findings ofthe bronchial wall and the changes of the adjacent tissues are related to the tracheobronchial tuberculous involvement. CT is useful for diagnosis of the endobronchial tuberculosis.
Adult* ; Bronchoscopy ; Diagnosis ; Humans ; Mucous Membrane ; Pigmentation ; Pneumonia ; Pulmonary Atelectasis ; Tuberculosis* ; Tuberculosis, Pulmonary

PURPOSE: The use of cyclosporine and mini-dose methotrexate (MTX) is a common strategy for graft-versus-host disease (GVHD) prophylaxis in allogeneic transplants. We investigated whether patients who receive fewer than the planned MTX doses are at increased risk for GVHD. METHODS: The study cohort included 103 patients who received allogeneic transplants at the Department of Pediatrics of The Catholic University of Korea College of Medicine, from January 2010 to December 2011. MTX was administered on days 1, 3, 6, and 11 after transplant at a dose of 5 mg/m2 each. Within the cohort, 76 patients (74%) received all 4 doses of MTX [MTX(4) group], while 27 patients (26%) received 0-3 doses [MTX(0-3) group]. RESULTS: Although there was no difference in neutrophil engraftment between the 2 groups, platelet engraftment was significantly faster in the MTX(4) group (median, 15 days), compared to the MTX(0-3) group (median, 25 days; P=0.034). The incidence of grades II-IV acute GVHD was not different between the MTX(4) and MTX(0-3) groups (P=0.417). In the multivariate study, human leukocyte antigen mismatch was the most significant factor causing grades II-IV acute GVHD (P=0.002), followed by female donor to male recipient transplant (P=0.034). No difference was found between the MTX(4) and MTX (0-3) groups regarding grades III-IV acute GVHD, chronic GVHD, and disease-free survival. CONCLUSION: Our results indicate that deviations from the full dose schedule of MTX for GVHD prophylaxis do not lead to increased incidence of either acute or chronic GVHD.
Appointments and Schedules ; Blood Platelets ; Child* ; Cohort Studies ; Cyclosporine ; Female ; Graft vs Host Disease* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Incidence ; Korea ; Leukocytes ; Male ; Methotrexate* ; Neutrophils ; Pediatrics ; Tissue Donors

BACKGROUND: Arbekacin was introduced to treat methicillin-resistant Staphylococcus aureus (MRSA) infection. It is an aminoglycoside with proven in vitro activity against MRSA strains. Pharmacokinetic advantages such as concentration-dependant bactericidal activity, prolonged post-antibiotic effect are its feature of aminoglycoside like others. But there are only few clinical data of this new kind of antibiotics outside of Japan, the first country approved its use against MRSA infections. We studied the clinical and bacteriological efficacy and safety of arbekacin in the treatment of infections caused by MRSA. METHODS: During the period between December 2001 and October 2002, we prospectively enrolled 21 patients with culture proven MRSA infection and evaluated the clinical and bacteriological efficacy and adverse events of arbekacin. Patients were treated with arbekacin sulphate 100 mg intravenously twice daily for 14 days. RESULTS: Patients were included if they had signs and symptoms of active MRSA infection including bacteremia, soft tissue infection, urinary tract infection, pneumonia etc. A total of 21 patients with MRSA infection were enrolled. Four patients experienced adverse events; 3 nephrotoxicities, 1 hepatotoxicity. One of them with elevated creatinine was unable to continue the study. Efficacy were evaluated on 19 patients with duration of arbekacin longer than 9 days. A favorable bacteriological response (eradicated or presumed eradicated) occurred in 13 (68.5%) patients. CONCLUSION: Although this clinical study was limited in number and in proper randomization, arbekacin alone was less effective than combination therapy with glycopeptides for the treatment of MRSA infection. However, our limited data suggested the efficacy of arbekacin alone for the treatment which needs shorter duration. The combination treatment of arbekacin and glycopeptide appeared to be less nephrotoxic than other aminoglycosides. The combination therapy of arbekacin and glycopeptide appeared to be less nephrotoxic than other aminoglycoside.
Aminoglycosides ; Anti-Bacterial Agents ; Bacteremia ; Creatinine ; Glycopeptides ; Humans ; Japan ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Pneumonia ; Prospective Studies ; Random Allocation ; Soft Tissue Infections ; Urinary Tract Infections

We recently experienced a case of spontaneous perforation of infected necrosis into the colon and duodenum during the course of acute pancreatitis in a 63 year-old male patient. Enteric perforations or fistulas in the setting of acute pancreatitis implicate severe underlying pathology and have substantial morbidity and mortality. In the meantime it has generally been accepted that infected pancreatic or peripancreatic necrosis should be managed surgically as soon as possible. Enteric perforations in the present case contributed to transient improvement of the patient's infection sign and condition, and thus an early operation was able to be avoided. Delayed surgical management resulted in complete recovery of the patient without postoperative morbidity. Herein we report an unusual complication of acute pancreatitis.
Acute Disease ; Case Report ; Human ; Intestinal Perforation/*etiology ; Male ; Middle Age ; Pancreatitis/*complications

Animal models, particularly pigs, have come to play an important role in translational biomedical research. There have been many pig models with genetically modifications via somatic cell nuclear transfer (SCNT). However, because most transgenic pigs have been produced by random integration to date, the necessity for more exact gene-mutated models using recombinase based conditional gene expression like mice has been raised. Currently, advanced genome-editing technologies enable us to generate specific gene-deleted and -inserted pig models. In the future, the development of pig models with gene editing technologies could be a valuable resource for biomedical research.
Animals ; Gene Expression ; Gene Transfer Techniques* ; Mice ; Models, Animal ; Recombinases ; Swine

OBJECTIVE: This paper aims to examine the association between painful physical symptoms (PPS) and major depressive disorder (MDD) in a naturalistic clinical practice setting within a Korean population. METHODS: Patients with acute MDD that joined a multicountry, observational, three-month study in six Asian countries and regions were classified as PPS+ (mean score > or =2) and PPS- (mean score <2) using the modified Somatic Symptom Inventory. In this analysis, we report the results from the Korean subset, where depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) scale and 17-item Hamilton Depression Rating Scale (HAMD(17)). Pain severity was measured using a visual analogue scale (VAS), while the EuroQoL (EQ-5D) assessed patient well-being. RESULTS: Of 198 patients, 45.96% (91/198) of patients were classified as PPS+, of which 78.02% (71/91) were women. PPS+ patients had significantly more severe depression at baseline {CGI-S score, mean [standard deviation (SD)], PPS+: 5.09 [0.79]; PPS-: 4.63 [0.76]; p<0.001; HAMD(17) total score, mean [SD], PPS+: 24.34 [5.24]; PPS-: 20.76 [5.12]; p<0.001} and poorer quality of life [EQ-5D overall health state, mean (SD), PPS+: 39.37 (20.52); PPS-: 51.27 [20.78]; p<0.001] than PPS- patients. Both groups improved significantly (p<0.001) in depression and pain severity outcomes, as well as quality of life by endpoint, but no significant within-group baseline-to-endpoint change wase observed. CONCLUSION: The frequency of PPS was common in Korean patients with MDD, and was associated with more severe depression, poorer quality of life, and a trend towards poorer clinical outcome.
Asian Continental Ancestry Group ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Korea ; Quality of Life

OBJECTIVE: This paper aims to examine the association between painful physical symptoms (PPS) and major depressive disorder (MDD) in a naturalistic clinical practice setting within a Korean population. METHODS: Patients with acute MDD that joined a multicountry, observational, three-month study in six Asian countries and regions were classified as PPS+ (mean score > or =2) and PPS- (mean score <2) using the modified Somatic Symptom Inventory. In this analysis, we report the results from the Korean subset, where depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) scale and 17-item Hamilton Depression Rating Scale (HAMD(17)). Pain severity was measured using a visual analogue scale (VAS), while the EuroQoL (EQ-5D) assessed patient well-being. RESULTS: Of 198 patients, 45.96% (91/198) of patients were classified as PPS+, of which 78.02% (71/91) were women. PPS+ patients had significantly more severe depression at baseline {CGI-S score, mean [standard deviation (SD)], PPS+: 5.09 [0.79]; PPS-: 4.63 [0.76]; p<0.001; HAMD(17) total score, mean [SD], PPS+: 24.34 [5.24]; PPS-: 20.76 [5.12]; p<0.001} and poorer quality of life [EQ-5D overall health state, mean (SD), PPS+: 39.37 (20.52); PPS-: 51.27 [20.78]; p<0.001] than PPS- patients. Both groups improved significantly (p<0.001) in depression and pain severity outcomes, as well as quality of life by endpoint, but no significant within-group baseline-to-endpoint change wase observed. CONCLUSION: The frequency of PPS was common in Korean patients with MDD, and was associated with more severe depression, poorer quality of life, and a trend towards poorer clinical outcome.
Asian Continental Ancestry Group ; Depression ; Depressive Disorder ; Depressive Disorder, Major ; Female ; Humans ; Korea ; Quality of Life

PURPOSE: Population studies have reported that sensitization to inhalant allergens is rare in young children; however, most subjects in those studies had little or no symptoms or signs highly suggestive of allergic diseases. The aim of the present study was to assess the prevalence of sensitization to inhalant allergens in young children with symptoms and/or signs of allergic disease. METHODS: We analyzed the results of all specific IgE tests performed at our hospital laboratory in children younger than 6 years presenting with symptoms and/or signs highly suggestive of allergic diseases between 2008 and 2013. Specific IgE tests for Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria alternata, German cockroach, cat dander, egg white or egg yolk, milk, peanut, and soybean were performed on 295 children; a specific IgE concentration > or =0.35 or > or =0.2 IU/mL was considered positive. We also compared allergen sensitization rates using the two cutoff values. RESULTS: One hundred eighty-one children (61.4%) were positive to at least 1 allergen tested and 53 children (18.9%) were positive to at least 1 inhalant allergen when a specific IgE concentration > or =0.35 IU/mL was considered positive. The children were more likely to have asthma or allergic rhinitis when they were sensitized to any inhalant allergen, particularly house dust mites. The prevalence of sensitization to inhalant allergens increased with age (P<0.001). There was no significant difference in the prevalence of polysensitization among different age groups, but sensitization to both inhalant and food allergens significantly increased with age. CONCLUSION: Our results suggest that specific IgE tests to common inhalant allergens, particularly the house dust mites, may be considered when performing blood screening tests for young children presenting with symptoms and/or signs of allergic diseases.
Allergens* ; Alternaria ; Animals ; Asthma ; Blattellidae ; Cats ; Child* ; Dander ; Dermatophagoides farinae ; Dermatophagoides pteronyssinus ; Egg White ; Egg Yolk ; Humans ; Immunoglobulin E ; Laboratories, Hospital ; Mass Screening ; Milk ; Prevalence ; Pyroglyphidae ; Rhinitis ; Soybeans

Patients admitted to medical intensive care unit (MICU) are at increased risk for venous thromboembolism (VTE); and prophylaxis is recommended. However, the actual range and frequency of VTE prophylaxis administered to MICU patients are not well defined. Patients over 40 yr of age and expected MICU stay of more than 48 hr were eligible for this observational cohort study of 23 MICUs in Korea. Patients already on anticoagulation therapy or those requiring anticoagulation for reasons other than VTE were excluded. Among 830 patients, VTE prophylaxis was given to 560 (67.5%) patients. Among 560 patients, 323 (38.9%) received pharmacoprophylaxis, 318 (38.4%) received mechanical prophylaxis and 81 (9.8%) received both forms of prophylaxis. About 74% of patients in the pharmacoprophylaxis group received low molecular weight heparin and 53% of the patients in the mechanical prophylaxis group used intermittent pneumatic compression. Most of the patients (90%) had more than one risk factor for VTE and the most common risk factor was old age, followed by heart and respiratory failure. In this observational cohort study of 23 MICUs in Korea, 67.5% of patients received thromboprophylaxis. Further studies are needed to clarify the role and efficacy of VTE prophylaxis in Korean critically ill patients.
Adult ; Age Factors ; Aged ; Cohort Studies ; Female ; Heart Failure/complications ; Heparin, Low-Molecular-Weight/therapeutic use ; Humans ; *Intensive Care Units ; Length of Stay ; Male ; Mechanical Thrombolysis ; Middle Aged ; Republic of Korea ; Respiratory Insufficiency/complications ; Retrospective Studies ; Risk Factors ; Tomography, X-Ray Computed ; Venous Thromboembolism/complications/*prevention & control/therapy