PURPOSE: This study was done to assess effects of Assertive Community Treatment (ACT) in a community mental health center. METHODS: This study was a non-equivalent control group design with two groups, each of 20 clients. The instruments were the Brief Psychiatric Rating Scale (BPRS), Global Assessment of Function (GAF), Satisfaction of Life, and the number and duration of admissions. Data collection was done in March, 2010 for the pre-test, and in March, 2011 for the post-test in the S community mental health center in Gyung-gi province. The collected data were analyzed using descriptive statistics, Fisher's exact test, and Mann-Whitney U test with the SPSS/WIN program. RESULTS: The experimental group showed significant differences in the duration of admission, GAF, and Satisfaction of Life, but not on number of admissions and BPRS. CONCLUSION: The results of this study indicate that ACT can be applied as an effective case management model in Korea.
Brief Psychiatric Rating Scale ; Case Management ; Community Mental Health Services ; Data Collection ; Korea ; Mental Health

No abstract available.
Delusions* ; Hallucinations* ; Humans

BACKGROUND: The activity of drug metabolizing enzymes and the modulation of their expression by inducers in the skin are the key factors for understanding of pharmacological and toxic effects of topically applied drugs. The role of these enzymes is of major importance, as they may contribute to determine the steady-state levels of biologically active substances. 3-Methylcholanthrene and all-trans- retinoic acid have been known to be inducers of the drug metabolizing enzymes. And all-trans- retinoic acid has many biological actions including anti-cancer effects. OBJECTIVE: The purpose of this study was to evaluate the effect of all-trans-retinoic acid on inducing the expression and modulation of genetic polymorphism of drug metabolizing enzymes as well as to estimate the role of all-trans-retinoic acid in carcinogenesis and drug interactions. METHODS: We analyzed the activities of CYP1A1(Cytochrome P450 1Al), NADPH cytochrome P450-reductase, UGT1 and GST after administration of 3-methylcholanthrene and all-trans-retinoic acid to the Sprague-Dawley male rats. We observed the inducible gene expression of CYP1A1, UGT1, GSTJt by RT-PCR and the genetic polymorphism of CYP1A1, UGT1, GSTK by PCR. RESULTS: 1. The expression of CYP1A1, NADPH cytochrome P450-reductase, UGT1 and GST was induced by 3-methylcholanthrene and all-trans-retinoic acid. That of NADPH cytochrome P450-reductase and UGT1 is pronouncedly enhanced by all-trans- retinoic acid. 2. The effects of 3-methylcholanthrene and all-trans-retinoic acid on inducing the expression of CYP1A1 and UGT1 correlated with an increase of mRNA expression levels of CYP1A1 and UGT1. The modulation of mRNA expression levels of GST was downregulated by all-trans-retinoic acid. 3. The genetic polymorphism of CYP1A1 was induced by 3-methylcholanthrene and all-trans- retinoic acid, and that of GSTM1 was not affected by the inducers. The induction of genetic polymorphism of GST was down regulated by all-trans-retinoic acid. CONCLUSION: 3-Methylcholanthrene and all-trans-retinoic acid modulate the inducible expression and genetic polymorphism of drug metabolizing enzymes differentially. All-trans-retinoic acid can modulate the metabolism of procarcinogen such as 3-methylcholanthrene by inducing drug metabolizing enzymes. Furthermore, the elucidation of the molecular mechanisms underlying the regulation of drug metabolizing enzymes by 3-methylcholanthrene, all-trans-retinoic acid and other drugs could help to understand their respective roles in drug interactions and carcinogenesis.
Animals ; Carcinogenesis ; Cytochrome P-450 CYP1A1 ; Cytochromes ; Drug Interactions ; Gene Expression* ; Humans ; Male ; Metabolism ; Methylcholanthrene ; NADP ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Rats* ; Rats, Sprague-Dawley ; RNA, Messenger ; Skin* ; Tretinoin*

No abstract available.
Delusions* ; Hallucinations* ; Humans

Prader-Willi syndrome is characterized by infantile hypotonia, mental retardation, hyperhagia, hypogonadism and obesity. Approximately 60% of all PLW syndrome show an interstitial deletion of chromosome 15, 37% have apparently normal chromosome, and 3.6% have a variety of other abnormalities involving chromosome 15. Diabetes mellitus has been considered a component of PLW syndrome and the incidence is about 7%. We experienced a 17-year-old female who revealed mental retardation, hypogonadism, obesity, and non-insulin dependent type DM, compatible with Prader-Willi syndrome.
Adolescent ; Chromosomes, Human, Pair 15 ; Diabetes Mellitus* ; Female ; Humans ; Hypogonadism ; Incidence ; Intellectual Disability ; Muscle Hypotonia ; Obesity ; Prader-Willi Syndrome*

Background: This study is a 1-year follow-up study for mentally disabled people who started living independently. The purpose of this study is to confirm the performance of the supported independent housing (SIH) program for severe mental illness and to compare the effectiveness with the collective living family, a group home (GH). Methods: This study included mentally disabled people living in publicly supported SIH (n=24) and living in GH (n=31). The outcome measures were brief psychiatric rating scale, Global Assessment Function (GAF), internalized stigma, hope, self-esteem, life satisfaction, and working alliance. Analyzes were performed using descriptive methods and chi-square analysis, Independent t-test, Mann-Whitney U-test, and Friedman test. Results: In the case of the SIH group, GAF and internalized stigma showed a significant effect after 1 year, and the working alliance showed a tendency to decrease at 6 months and then increase again after 1 year. In comparison between the two groups, only GAF showed a significant difference after 1 year. Hope, self-esteem, and life satisfaction showed a significant effect in the GH group after 1 year, but not in the SIH group. Conclusions Results show that the SIH and GH housing types achieve different results over the 1-year period. GAF and internalized stigma were significant in SIH, and psychological variables were significant in GH. In GAF, SIH showed a more significant effect than GH. Housing support should take into account the various individual circumstances and preferences of the client, and above all, securing housing stability and expanding accessibility is important.

No abstract available.

Through the review of 137 cases of ankle fracture treated and followed up in Department of Orthopedic Surgery, National Police Hospital, we got the following results. 1. Slipping was the most frequent cause of the fractures(45.3%). 2. Supination-external rotation type of Lauge-Hansen classification was more common than any other types(67.9%). 3. 94 cases out of 137 cases were treated by open reduction and internal fixation, and remaining 43 cases were treated conservatively. 4. The average duration of cast immobilization was 7.3 weeks for the operatively treated cases and 9.1 weeks for the conservatively treated cases. 5. The result of treatment was good or excellent in 87 cases(92.6%) of operatively treated 94 cases and in 36 cases(83.7%) of conservatively treated 43 cases. 6. We think that the anatomical reduction of the lateral malleolar or distal fibular fracture is necessary for better end results.
Ankle Fractures ; Ankle ; Classification ; Clinical Study ; Humans ; Immobilization ; Orthopedics ; Police

Background: Despite the necessity of long-term management for fracture risk reduction, adherence to osteoporosis pharmacotherapy remains poor. We investigated the factors influencing adherence to pharmacotherapy among Korean patients with osteoporosis, with a particular focus on treatment with bisphosphonates (BPs). Methods: Data from 725,313 osteoporosis patients newly prescribed BPs or selective estrogen receptor modulators (SERMs) between 2012 and 2014, obtained from the Korean National Health Insurance Service, were analyzed. Adherence was assessed based on compliance and persistence over a two-year period, with factors associated with adherence identified using multivariable logistic regression. Results: Only 14.8% of the patients who started BPs or SERMs sustained medication compliance, with 15.8% persisting with treatment over the two-year follow-up. Compared with BPs, patients receiving SERMs showed better compliance and persistence (odds ratios [ORs], 1.44 and 1.48, respectively; P < 0.001); while patients receiving intravenous administration showed higher compliance and persistence (ORs, 2.08 and 1.76, respectively; P < 0.001) compared with those taking oral medications. Patients placed on a quarterly dosing schedule showed improved compliance and persistence (ORs, 1.55 and 1.31, respectively; P < 0.001) compared with those on other dosing intervals. Male gender, advanced age, living outside metropolitan areas, receiving treatment in non-general hospitals, and a history of previous fractures were associated with poorer two-year adherence. Conclusion This study underscores the complex nature of medication adherence among Korean osteoporosis patients, particularly those treated with BPs. These findings accordingly indicate that medication with more convenient administration regimens and fewer side effects, coupled with suitable follow-up durations, could contribute to enhancing treatment adherence.

Background: Despite the necessity of long-term management for fracture risk reduction, adherence to osteoporosis pharmacotherapy remains poor. We investigated the factors influencing adherence to pharmacotherapy among Korean patients with osteoporosis, with a particular focus on treatment with bisphosphonates (BPs). Methods: Data from 725,313 osteoporosis patients newly prescribed BPs or selective estrogen receptor modulators (SERMs) between 2012 and 2014, obtained from the Korean National Health Insurance Service, were analyzed. Adherence was assessed based on compliance and persistence over a two-year period, with factors associated with adherence identified using multivariable logistic regression. Results: Only 14.8% of the patients who started BPs or SERMs sustained medication compliance, with 15.8% persisting with treatment over the two-year follow-up. Compared with BPs, patients receiving SERMs showed better compliance and persistence (odds ratios [ORs], 1.44 and 1.48, respectively; P < 0.001); while patients receiving intravenous administration showed higher compliance and persistence (ORs, 2.08 and 1.76, respectively; P < 0.001) compared with those taking oral medications. Patients placed on a quarterly dosing schedule showed improved compliance and persistence (ORs, 1.55 and 1.31, respectively; P < 0.001) compared with those on other dosing intervals. Male gender, advanced age, living outside metropolitan areas, receiving treatment in non-general hospitals, and a history of previous fractures were associated with poorer two-year adherence. Conclusion This study underscores the complex nature of medication adherence among Korean osteoporosis patients, particularly those treated with BPs. These findings accordingly indicate that medication with more convenient administration regimens and fewer side effects, coupled with suitable follow-up durations, could contribute to enhancing treatment adherence.