PURPOSE: Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors. MATERIALS AND METHODS: The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI. RESULTS: Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number> or =12 (p=0.024), body mass index (BMI)>25 kg/m2 (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m2 (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI. CONCLUSIONS: Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Antibiotic Prophylaxis/methods ; Cross Infection/etiology/prevention & control ; *Drug Resistance, Bacterial ; Fluoroquinolones/*therapeutic use ; Humans ; Image-Guided Biopsy/*adverse effects/methods ; Incidence ; Male ; Middle Aged ; Prostatic Neoplasms/*pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional ; Urinary Tract Infections/epidemiology/*etiology/prevention & control

OBJECTIVE: Some patients with schizophrenia may need mirtazapine augmentation to improve negative and cognitive symptoms. However there have been a few studies about the tolerability of mirtazapine augmentation to antipsychotics such as akathisia, extrapyramydal symptoms, weight gain, and body mass index (BMI). METHODS: This study was an eight-week double-blind, randomized controlled trial (RCT) of mirtazapine augmentation to risperidone. Twenty-one stabilized participants diagnosed with schizophrenia and undergoing treatment with risperidone were randomized to adjunctive treatment with mirtazapine (15 mg/day for the first two weeks, 30 mg/day for the next six weeks) or placebo. Eleven patients were assigned to the mirtazapine group, and nine patients were given placebo. RESULTS: There was no significant difference between the mirtazapine and placebo groups with respect to Barnes Akathisia rating Scale (BAS) and Sympsom-Angus Scale (SAS). However, the mirtazapine group exhibited a statistically significant increase in weight and BMI (p<0.05). CONCLUSION: These results suggest that mirtazapine augmentation can be tolerable in schizophrenic patients treated with risperidone; however, we should pay attention to the weight gain with mirtazapine. Our results should be replicated in a large-scale lengthy trial.
Antipsychotic Agents ; Body Mass Index ; Humans ; Mianserin ; Neurobehavioral Manifestations ; Psychomotor Agitation ; Risperidone ; Schizophrenia ; Weight Gain

BACKGROUND: This study was performed to evaluate the effect of group intervention by primary care physicians on the changes of drinking behaviors in Korean heavy drinkers. METHODS: A total of 32 male heavy drinkers participated in group intervention by family physicians of Chungnam National University Hospital. Initially, they were assessed for general characteristics, family function and drinking characteristics prior to the intervention conducted 4 times (about 40 minutes/each session). Reassessment on their drinking frequencies (times/week), drinking amounts (drinks/drinking day) and Alcohol Use Disorders Identification Test (AUDIT) score was achieved at directly, at 12 weeks and at 1 year after intervention. RESULTS: The mean drinking frequency was significantly (P < 0.01) decreased from 5.2 +/- 1.7 before to 3.5 +/- 2.4 at directly, 3.9 +/- 2.3 at 12 weeks and 4.0 +/- 2.3 at 1 year after intervention. The mean drinking amounts were significantly (P < 0.01) decreased from 17.0 +/- 16.5 before to 11.0 +/- 16.9 at directly, 14.2 +/- 17.8 at 12 weeks and 13.9 +/- 17.8 at 1 year after intervention. The mean AUDIT score was significantly (P < 0.01) decreased from 29.4 +/- 5.8 before to 19.1 +/- 11.0 at directly, 21.8 +/- 9.1 at 12 weeks and 23.0 +/- 9.4 at 1 year after intervention. The number of heavy drinkers and binge drinkers were significantly (P < 0.05) decreased from 32 (100%) and 32 (100%) before to 20 (62.5%) and 22 (68.8%) at directly, 23 (71.9%) and 24 (75.0%) at 12 weeks, and 22 (68.8%) and 19 (59.4%) at 1 year after intervention. CONCLUSION: It is suggested that group intervention by family physicians may be effective on the improvement of drinking behavior at 12 weeks and 1 year after the intervention in heavy drinkers.
Drinking ; Drinking Behavior ; Family Characteristics ; Follow-Up Studies ; Humans ; Male ; Physicians, Family ; Physicians, Primary Care ; Primary Health Care

Jr(a) is a high-frequency antigen found in all ethnic groups. However, the clinical significance of the anti-Jr(a) antibody has remained controversial. Most studies have reported mild hemolytic disease of the newborn and fetus (HDNF) in Jr(a)-positive patients. Recently, fatal cases of HDNF have also been reported. We report the first case of HDNF caused by anti-Jr(a) alloimmunization in twins in Korea. A 33-yr-old nulliparous woman with no history of transfusion or amniocentesis was admitted at the 32nd week of gestation because of vaginal bleeding caused by placenta previa. Anti-Jr(a) antibodies were detected in a routine laboratory examination. An emergency cesarean section was performed at the 34th week of gestation, and 2 premature infant twins were delivered. Laboratory examination showed positive direct antiglobulin test and Jr(a+) phenotype in the red blood cells and the presence of anti-Jr(a) antibodies in the serum in both neonates. The infants underwent phototherapy for neonatal jaundice; this was followed by conservative management. They showed no further complications and were discharged on the 19th postpartum day. Preparative management to ensure the availability of Jr(a-) blood, via autologous donation, and close fetal monitoring must be performed even in cases of first pregnancy in Jr(a-) women.
Adult ; Blood Group Antigens/immunology ; *Blood Group Incompatibility ; Diseases in Twins/diagnosis/*immunology ; Erythroblastosis, Fetal/*diagnosis/immunology ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Isoantigens/immunology ; Jaundice, Neonatal/complications/immunology/therapy ; Male ; Phenotype ; Phototherapy ; Pregnancy ; Pregnancy Complications, Hematologic/diagnosis/*immunology ; Twins

OBJECTIVES: Mindfulness-base cognitive therapy (MBCT) has been used to treat patients with depression to prevent relapse. The purpose of this study was to examine the effectiveness of Mindfulness- Base Cognitive Therapy for patients who suffer with generalized anxiety disorder or panic disorder for 1 year. METHODS: 19 patients with generalized anxiety disorder or panic disorder were assigned to receive MBCT for a period of 8 weeks. The Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used at 0 weeks, 8 weeks and 1 year to assess the results. RESULTS: MBCT demonstrated significantly decreases on all the anxiety scale scores (HAM-A, p=0.00 ; BAI, p=0.00) and depressive scale scores (HAM-D, p=0.00 ; BDI, p=0.00). The patients who received 8-week of MBCT showed a higher remission rate (15/19, 78%) during the 1-year followup period. CONCLUSION: MBCT may be effective at relieving the anxiety and depressive symptoms of patients who suffer with generalized anxiety disorder or panic disorder for 1 year. However, further well-designed controlled trials are needed to assess the value of MBCT.
Anxiety ; Anxiety Disorders ; Cognitive Therapy ; Depression ; Follow-Up Studies ; Humans ; Panic ; Panic Disorder ; Recurrence

There has been increasing recognition of pediatric bipolar disorder in the psychiatric field during the past 10 years. The clinical presentation of this disorder in preadolescent is greatly debated and few studies have been conducted in Korea. The authors report 3 cases of children with bipolar I disorder whose clinical symptoms were improved after pharmacotherapy. The authors also review current concepts, debates and treatment of pediatric bipolar disorder.
Bipolar Disorder ; Child ; Drug Therapy* ; Humans ; Korea

OBJECTIVES: The purpose of this study was to identify psychosocial factors associated with biological markers in Korean patients with human immunodeficiency virus (HIV) infection. METHODS: 50 patients with HIV infection were enrolled. We administered Stress Response Inventory (SRI), the Coping Scale, and the Korean version of Smithklein Beecham quality of life scale (QOL) to the 50 patients and measured CD4+ cell count and HIVRNA copies. RESULTS: Simple correlation analysis showed significant correlation between psychosocial factors and CD4+ cell count. Tension, aggression, depression, frustration subscale in SRI and distancing, self controlling in coping scale had negative correlation with CD4+ cell count, whereas QOL showed positive correlation. Multiple regression analysis showed significant negative association between distancing and CD4+ cell count. There were no differences in CD4+ cell count and HIVRNA between homosexual patients and heterosexual patients. However, aggression, confrontation in SRI, and distancing in coping scale scored significantly higher in heterosexual patients than homosexual patients. CONCLUSION: These results suggest that CD4+ cell count may be associated with psychosocial factors in Korean patients with HIV infection, and passive coping strategy like distancing may be one of important factors in the progression of HIV infection. These findings also suggest that psychosocial intervention programs are needed for Korean patients with HIV infection.
Aggression ; Biomarkers* ; CD4 Lymphocyte Count ; Depression ; Frustration ; Heterosexuality ; HIV Infections ; HIV* ; Homosexuality ; Humans ; Humans* ; Psychology* ; Quality of Life

OBJECTIVES: The object of this study was to examine the effectiveness of Qigong-based stress management program in patients with anxiety disorder. METHODS: An 8-week controlled clinical trial compared 24 patients with anxiety disorder assigned to a Qigong-based stress management program with 22 patients with anxiety disorder assigned to an education control program. Beck depression inventory (BDI), Spielberger trait state anxiety inventory (STAI), Hamilton depression rating scale (HAM-D), Hamilton anxiety scale (HAM-A), and Symptom checklist-90-revised (SCL-90-R) were used to assess the effectiveness of Qigong-based stress management program. RESULTS: Qigong-based stress management group showed significant improvement compared to the education control group on anxiety symptoms and hostility, but Qigong group showed inconsistent findings on depressive symptoms. Qigong-based stress management group did not show significant improvement on somatization, obsessive-compulsive symptoms, interpersonal sensitivity, or phobic anxiety subscale of SCL-90-R compared to the education control group. CONCLUSION: This study showed that Qigong-based stress management program can be an effective method for patients with anxiety disorder in relieving anxiety symptoms. However, well-designed randomized controlled trials are needed before these kind of interventions.
Anxiety Disorders* ; Anxiety* ; Depression ; Education ; Hostility ; Humans ; Qigong

PURPOSE: To improve the management of a medical linear accelerator, the records of operational failures of a Varian CL2100C over a ten year period were retrospectively analyzed. MATERIALS AND METHODS: The failures were classified according to the involved functional subunits, with each class rated into one of three levels depending on the operational conditions. The relationships between the failure rate and working ratio and between the failure rate and outside temperature were investigated. In addition, the average life time of the main part and the operating efficiency over the last 4 years were analyzed. RESULTS: Among the recorded failures (total 587 failures), the most frequent failure was observed in the parts related with the collimation system, including the monitor chamber, which accounted for 20% of all failures. With regard to the operational conditions, 2nd level of failures, which temporally interrupted treatments, were the most frequent. Third level of failures, which interrupted treatment for more than several hours, were mostly caused by the accelerating subunit. The number of failures was increased with number of treatments and operating time. The average life-times of the Klystron and Thyratron became shorter as the working ratio increased, and were 42 and 83% of the expected values, respectively. The operating efficiency was maintained at 95% or higher, but this value slightly decreased. There was no significant correlation between the number of failures and the outside temperature. CONCLUSION: The maintenance of detailed equipment problems and failures records over a long period of time can provide good knowledge of equipment function as well as the capability of predicting future failure. More rigorous equipment maintenance is required for old medical linear accelerators for the advanced avoidance of serious failure and to improve the quality of patient treatment.
Humans ; Particle Accelerators* ; Retrospective Studies

PURPOSE: To improve the management of a medical linear accelerator, the records of operational failures of a Varian CL2100C over a ten year period were retrospectively analyzed. MATERIALS AND METHODS: The failures were classified according to the involved functional subunits, with each class rated into one of three levels depending on the operational conditions. The relationships between the failure rate and working ratio and between the failure rate and outside temperature were investigated. In addition, the average life time of the main part and the operating efficiency over the last 4 years were analyzed. RESULTS: Among the recorded failures (total 587 failures), the most frequent failure was observed in the parts related with the collimation system, including the monitor chamber, which accounted for 20% of all failures. With regard to the operational conditions, 2nd level of failures, which temporally interrupted treatments, were the most frequent. Third level of failures, which interrupted treatment for more than several hours, were mostly caused by the accelerating subunit. The number of failures was increased with number of treatments and operating time. The average life-times of the Klystron and Thyratron became shorter as the working ratio increased, and were 42 and 83% of the expected values, respectively. The operating efficiency was maintained at 95% or higher, but this value slightly decreased. There was no significant correlation between the number of failures and the outside temperature. CONCLUSION: The maintenance of detailed equipment problems and failures records over a long period of time can provide good knowledge of equipment function as well as the capability of predicting future failure. More rigorous equipment maintenance is required for old medical linear accelerators for the advanced avoidance of serious failure and to improve the quality of patient treatment.
Humans ; Particle Accelerators* ; Retrospective Studies