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

No abstract available.
Tooth*

BACKGROUND: For the evaluation of pulmonary nrtery branches after operation of right ventricular outflow obstructive disease, we reviewed the usefulness of both simple X-ray and lung perfusion scan with 99mTc-macroaggregated albumin compared with cardiac angiography. METHODS: From March, 1986 to July, 1993, at Seoul National University Children;s Hospital, we chose 23 cases who underwent both simple X-ray and cardiac angiography among the patients who had distinct difference between right and left pulmonary blood flow in lung perfusion scan after operation of right ventricular outflow obstructive disease. So we calculated the ratio of right and left pulmonary blood flow and Spearman correlation coefficient. RESULTS: Of the 23 cases, 17 cases were tetralogy of Fallot, 4 cases pulmonary atresia, 1 case double outlet right ventricle, and 1 case truncus arteriosus. The mean age at poeration was 27 months, and the mean postoperative follow-up period was for 68 months. The correlation coefficient between cardiac angiography and simple X-ray was 0.86(p<0.01), and that beteen cardiac angiography and lung perfusion scan was 0.80(p<0.01). CONCLUSION: The cardiac angiography has been known as the best diagnostic tool for the evaluation of pulmonary artery branches after operation of right ventricular outflow obstructive ddisease, but we proposed that the lung perfusion scan should be widely used because its results were similar with those of cardiac angiography.
Angiography ; Double Outlet Right Ventricle ; Follow-Up Studies ; Humans ; Lung* ; Perfusion* ; Pulmonary Artery* ; Pulmonary Atresia ; Seoul ; Tetralogy of Fallot ; Truncus Arteriosus

We report a case of hereditary angioedema in a 48-year old female patient. She experidenced facial edema and dyspnea 5 to 6 times for a year. Similar episodes developed on some members of her family, especially her sisters and father. We examined her and her sister's serum complement levels. The results showed decreased levels of C1 esterase inhibitor and C4, compared to normal levels. We treated the patient with danazol effectively.
Angioedemas, Hereditary* ; Complement C1 Inhibitor Protein ; Complement System Proteins ; Danazol ; Dyspnea ; Edema ; Fathers ; Female ; Humans ; Middle Aged ; Siblings

No abstract available in English.

PURPOSE: Nowadays laparoscopic appendectomy is widely practiced in developed countries. The purpose of this study was to evaluate laparoscopic appendectomy in comparison with open appendectomy. METHODS: On hundred cases each of laparoscopic appendectomy and open appendectomy, performed between February 2001 and June 2002, were reviewed for age, sex, operative time, hospital days, time for first meal, number of used parenteral analgesia, number of OPD visits, etc. RESULTS: Operative time was longer in the laparoscopic appendectomy group (P>0.05) and the number of used parenteral analgesia was slightly higher in the laparoscopic group (P>0.05). However, recovery time for diet was slightly shorter in the laparoscopic group (P>0.05). None of these trends were statistically significant. The times of OPD visit after discharge was less in the laparoscopic group (P<0.05). The hospital days of pathological simple appendicitis were shorter in the laparoscopic appendectomy group (P<0.05). In the laparoscopic group, intraabdominal abscess was developed in 2 cases, wound infection in 4, and intestinal obstruction in 2. The conversion rate to open appendectomy was 7% (7/100) in the laparoscopic group. CONCLUSION: Laparoscopic appendectomy can shorten overall OPD follow up days and in case of simple appendicitis, laparoscopic appendectomy can also shorten hospital days.
Abscess ; Analgesia ; Appendectomy* ; Appendicitis ; Developed Countries ; Diet ; Follow-Up Studies ; Intestinal Obstruction ; Meals ; Operative Time ; Wound Infection

BACKGROUND: Valve replacement in children has many problems such as the durability of prosthetic valve, thomboembolism and hemorrhage. But recently, the necessity of valve replacement in children increased and the above problems were solved party. So the number of valve replacement in children increased progressively. RESULTS: Valve replacement in 47 children were done at Seooul National University Chidren's Hospital from March 1986 to July 1991. The patients were composed of 25 males and 33 females. 25 patients had congenital heart disease and 22 patients rheumatic heart disease. 45 patients received single valve repalcement, 2 patients double valve repalcement, and among all of them, 2 patients redo-replacement. The major valve lesion was mitral insufficiency and post-operative status in view of NYHA functinonal class was improved in most patients. The mechanical valves were applied to 45 patients and tissue valves to 2 patients. The indication of valve replacement were progressive increase in ventricular volume, major regurgitant fraction over grade III decrease in exercise tolerance and vegetation. The overall early mortality was 8.5% and late mortality 0%. There were post-operative complication rate of 30% and late complication rate 14%, and among the later, valve faliure was reported in 2 pantients and thromboembolism in 1 patient. The complication-free rate was 97.7% at post-operative 1 month, 91.3% at 12 months, 90% at 36 months and 60% at 48 months. 43 patients received anticoagulation and/or antiplatelet therapy, but there was no critical indication for this. CONCLUSION: These results suggest that cardiac valve replacement in children have been effective therapeutic modality even though various problems still remain, but we propose that sufficient long-term follow-up and clinical research be needed.
Child* ; Exercise Tolerance ; Female ; Follow-Up Studies ; Heart Defects, Congenital ; Heart Valves* ; Hemorrhage ; Humans ; Male ; Mitral Valve Insufficiency ; Mortality ; Rheumatic Heart Disease ; Thromboembolism

Neonatal lupus erythematous is a rare syndrome, which is characterized by a transient lupus dermatitis, hematologic abnormalities and isolated congenital heart block. We detected the atrioventricular dissociation, bradycardia and pericardial effusion by fetal echocardiography in a female fetus at 25th weeks of gestational age. The baby was born in the 38th week of pregnancy by Cesarean section with 1790 gram of body weight. In spite of atrioventricular dissociation with bradycardia and pericardial effusion, cardiac pacemaker was not needed during neonatal period because she was doing well, no evidence of congestive heart failure and around 80 beat per minute of heart rate. The serologic markers for diagnosis of neonatal lupus are the autoantibodies specific to SS-A/Ro and/or SS-B/La. These antibodies are produced by the mother and passed to the fetus through the placenta. Autoantibodies of cytoplasmic SS-A antigens or SS-B antigen were found in the blood of this patient and her mother. We report a case of neonatal lupus syndrome with congenital atrioventricular dissociation with Rt. Bundle branch block and hematologic abnormality.
Antibodies ; Autoantibodies ; Body Weight ; Bradycardia ; Bundle-Branch Block ; Cesarean Section ; Cytoplasm ; Dermatitis ; Diagnosis ; Echocardiography ; Female ; Fetus ; Gestational Age ; Heart Block* ; Heart Failure ; Heart Rate ; Heart* ; Humans ; Mothers ; Pericardial Effusion ; Placenta ; Pregnancy

Electroconvulsive therapy (ECT) is a safe and effective treatment not only for various mental disorders including depression, mania, and schizophrenia, but also for inadequacy and resistance to pharmacotherapy and the psychiatric emergences. The historical ups and downs of ECT treatment since its first introduction in 1938 were ended by the validation impacts of evidence-based medicine in the 1980s and by other clinical issues. Clinical research for the optimization of ECT to maximize therapeutic effects and to minimize adverse effects is ongoing to establish standardized procedures and educational programs through the ECT center. In addition, guidelines for ECT practices are also being developed for the clinical excellence of ECT practices in accordance with the recommendations of international organizations such as World Psychiatric Association and American Psychiatric Association. This article was prepared by reviews of the literature, direct observations of ECT practices abroad, and interviews with ECT experts around the world in order to enhance therapeutic effects with recently updated ECT practices under the belief that the most appropriate treatments should be provided to the patients in need.
Bipolar Disorder ; Depression ; Drug Therapy ; Electroconvulsive Therapy* ; Evidence-Based Medicine ; Humans ; Mental Disorders ; Schizophrenia

We reviewed 26 cases of cardiac rhabdomyoma in children which were diagnosed between 1986 and 1991 in Seoul National University Children's Hospital. Twenty-two cases were associated with tuberous sclerosis. Total tumor count was 58 and mean tumor count per patient was "daehakgyo".23. Their cardiac rhabdomyomas were diagnosed from fetal period through 12 years after birth. Median age was 9."uiwon" months. Fifteen patients were males and rest 11 patients were females. Cardiac symtoms and signs at initial diagnosis were present in 12 cases. They consisted of cardiac murmur in "hakgyo", arrhythmia in 8 and congestive heart failure in "daehakgyo" cases (one with murmur and the other with arrhythmia). Cardiomegaly was seen in 9 cases on chest X-ray and other "byeongwon" case showed abnormal left cardiac border. Electrocardiography and 24 hour Holter monitorings showed arrhythmia in 15 cases. Clinically significant arrhythmias were found in 7 cases on 24 hour Holter monitorings. They consisted of 1with frequent premature ventricular contractions, "daehakgyo uigwadaehak" with frequent premature atrial contractions, "daehakgyo" with atrial tachycardia and "daehakgyo uigwadaehak" with atrio-ventricular block ("daehakgyo" cases of atrio-ventricular block had other arrhythmias also). The locations of tumors were left ventricle in 21, interventricular septum in 21, right ventricle in 13 and atrium in "daehakgyo uigwadaehak" tumors. Mean tumor count per patient in fetal period and infancy was "daehakgyo".86 and it was statistically much more than that after infancy which was "byeongwon".5. Mean tumor area which was calculated on two dimensional echocardiography was larger in fetal period and infancy(128.9 +/- 38.2mm2)than that after infancy(47.8 +/- 11.2mm2). Mean relative tumor area to aortic root dimension was also significantly larger in fetal period and infancy than that after infancy ("daehakgyo".07vs 0.30). In tuberous sclerosis, mean mass area and mean relartive tumor area to aortic root dimension in fetal period and infancy was significantly larger than those in patients after infancy. Of 26 cases, tumorectomy was done in "daehakgyo uigwadaehak" cases due to hemodynamic obstruction and arrhythmia. One case died immediately after operation and the other "daehakgyo" cases are still alive with the follow up period of 30 and 44 months each. Of the 7 patients with significant arrhythmia on 24 hour Holter monitorings, pacemaker insertion was done in "byeongwon" case who received tumorectomy and other 1 case was treated with anti-arrhythmic drugs. All the other patients did not need anti-arrhythmic drugs or other management.
Arrhythmias, Cardiac ; Atrial Premature Complexes ; Cardiomegaly ; Child* ; Diagnosis ; Echocardiography ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Hemodynamics ; Humans ; Male ; Parturition ; Rhabdomyoma* ; Seoul ; Tachycardia ; Thorax ; Tuberous Sclerosis ; Ventricular Premature Complexes