A study for Patients Admitted to National Forensic Psychiatric Hospital Who Committed Homicides or Assaults to Their Parents or Offsprings / 대한법의학회지

This study analyzed demographic factors, previous history of offences and psychopathological charac-teristics of mentally ill patients who committed homicides or assaults upon their parents or offsprings. The subjects were those admitted to National Forensic Psychiatric Hospital from 1987 till 2000, among whom were excluded those admitted for forensic psychiatric evaluations by court. Homicide group of subjects was compared with assault group of subjects upon their demographic factors, previous history of offences and psychopathological characteristics. The subjects who committed offences to their parents were compared with those who committed offences to their offsprings upon demographic factors, previ-ous history of offences and psychopathological characteristics. Conclusion is as follows: 1. More male subjects committed offences either homicide or assault than female subjects. 2. More male subjects committed offences to their parents than female subjects, whereas more female subjects committed offences to their offsprings than male subjects. 3. Subjects 'mean age is 32.24. The subjects under 30 years of age committed more homicide than subjects older than 30. Subjects older than 30 committed more assaults than subjects under 30. Subjects under 30 committed more homicides to their parents, and subjects older than 30 committed more homi-cides to their offsprings. 4. Subjects with education level above 9th grade committed more homicide than subjects with educa-tion level below 9th grade. 5. Subjects without spouse committed more offences their parents, whereas subjects with spouse com-mitted more offences to their offsprings. 6. Subjects with no previous offence or with one previous offence committed more offences to their parents or offsprings than those with 2 or more previous offences. 7. Offences to parents is more frequent for schizophrenic subjects and offences to offsprings is more frequent for non-schizophrenic subjects.(esp. mood disorder). 8. Offences to parents is more frequent for subjects with previous history of psychiatric admission. Offences to offsprings is more frequent for subjects without previous history of psychiatric admission.

Clinical Manifestations and Diagnosis of Extra pulmonary Tube rculosis / 감염

BACKGROUND: The spectrum of clinical presentations of extrapulmonary tuberculosis (EPT) is so diverse that it may mimic other systemic diseases and often leads physicians to misdiagnosis. Since its diagnosis is largely depended on physician's suspicion of the disease, it would be worthwhile to scrutinize the clinical characteristics of EPT. We retrospectively evaluated clinical manifestations of 312 patients who were diagnosed as EPT in a tertiary referral hospital. METHODS: The medical records of 312 patients, diagnosed as having EPT at Youngdong Severance hospital from January 1997 to December 1999, were reviewed retrospectively. RESULTS: Total 312 patients, 149 (47.8%) men and 163 (52.2%) women with age ranged from 13 years to 87 years, were included in this study. The most common site of the involvement was pleura (35.6%). Patients complained of localized symptoms (72.4%) more frequently than systemic symptoms (52.2%). The most common symptom was pain on infected site (48.1%). Leukocytosis, anemia, and elevated ESR and CRP were found in 12.8%, 50.3%, 79.3%, and 63.1% of the patients, respectively. Twenty-four percent of patients had underlying medical illnesses such as old age over 60 years, diabetes mellitus or liver cirrhosis. In 67.3% of patients, tuberculosis was suspected at initial visit. However, tuberculosis was microbiologically proven in only 23.7% of patients. Histopathological diagnosis of EPT was made in 48.7% of patients. The time interval from symptom onset to diagnosis varied, and mean duration was 96 days. Pulmonary parenchymal abnormal lesions were found in 133 patients (42.6%) on chest radiographs. CONCLUSION: Although EPT had a wide spectrum of clinical manifestations and its diagnostic methods were lack, high index of suspicion could be obtained from chest radiograph, localized or systemic symptoms, and several laboratory parameters reviewed in this descriptive study. In case of doubt, early treatment instead of awaiting microbiological result may be necessary to avoid the devastating complications.