Factors Predicting Personal and Social Performance in Schizophrenia Patients / 대한정신분열병학회지

OBJECTIVES: Schizophrenia is a chronic psychiatric disorder characterized by its debilitating course. It leads to personal and social dysfunctions, burdening patients and guardians heavily. Enhancing functional outcome is a major treatment goal, but pharmacotherapy alone is usually not enough. Hence, it is important to reveal clinical factors that can predict personal and social performance in schizophrenia patients. Analyze factors influencing personal and social performance in schizophrenia patients. METHODS: 66 schizophrenia patients from three University hospitals in Korea were enrolled, completing clinical scales between January 2008 and December 2009. 38 patients dropped out during follow up. 28 patients were included in the final study. Personal and social performance was measured using the Personal and Social Performance scale (PSP) since January 2015. Correlation and multiple regression analyses were performed to reveal associations between demographic and clinical factors and PSP. RESULTS: Correlation analyses resulted in statistically significant correlations between CGI-S (r=-0.646, p<0.01), PANSS (r=-0.419, p<0.05), KISP (r=-0.523, r<0.01), KmSWN (r=0.388, p<0.05), Trail making B (r=0.608, p<0.01), KDAI (r=0.608, p<0.01), and PSP. Stepwise multiple regression analyses showed significant models with CGI-S (β=-0.485, p<0.01), and KDAI (β=0.423, p<0.01). CONCLUSION: Our results show that attitude toward drugs and symptom severity affect a patient’s personal and social performance most prominently. We advise to focus on patient education to reinforce attitude toward drugs, and to concentrate on reducing symptom severity to enhance personal and social performance in schizophrenia patients.

Factors Predicting Complications after Internal Fixation of Femoral Neck Fractures

PURPOSE: To evaluate the factors predicting complications after internal fixation using multiple cannulated screws in the patients with femoral neck fracture, the authors performed a comparative study of a success group and a failure group and reviewed the literature. MATERIALS AND METHODS: Sixty-eight patients with intracapsular femoral neck fractures were treated by multiple pinning from January 2000 to July 2007 and followed up more than one year. Relationships between the complications such as failure of union, collapse of femoral head due to osteonecrosis of femoral head and several affecting factors including the degree of displacement by Garden stage, state of reduction, position of screws, patient's age, time interval from injury to operation, anatomical fracture site and two weeks postoperative (99m)Tc-MDP bone scan were analyzed. RESULTS: Statistically significant factors were the degree of displacement by Garden stage (p<0.001), reduction state (p<0.001) and postoperative two weeks (99m)Tc-MDP bone scan (p<0.001). CONCLUSION: An accurate anatomical reduction is needed to decrease complications with multiple cannulated screws fixation of femoral neck fracture. Displacement of fracture by Garden stage and (99m)Tc-MDP bone scan are major factors predicting complications.

Clinical efficacy of entecavir therapy and factors associated with treatment response in naive chronic hepatitis B patients / 대한간학회지

BACKGROUND/AIMS: Entecavir is a potent and selective guanosine analogue that has demonstrated a significant antiviral efficacy against hepatitis B virus (HBV). The aim of this study was to characterize the response to entecavir and to examine the factors affecting that response. METHODS: We administered 0.5 mg of entecavir once daily for more than 12 months to 114 naive chronic hepatitis B (CHB) patients. We measured the levels of liver enzymes, serological markers, and serum HBV DNA at 3-month interval. RESULTS: Normalization of serum alanine aminotransferase levels was observed in 68.5% (76/114), 74.6% (85/114), and 81.6% (62/76) of patients after 6, 12, and 24 months of therapy, respectively. HBV DNA levels of <50 copies/mL (as evaluated by polymerase chain reaction) were observed in 43.9% (50/114), 71.1% (81/114), and 85.5% (65/76) of patients after 6, 12, and 24 months, respectively. Viral breakthrough was not observed. The rates of HBeAg loss and seroconversion were 43.5% (27/62) and 14.5% (9/62), respectively, after 12 months of therapy, and 56.4% (22/39) and 15.4% (6/39) after 24 months. The independent factor associated with PCR negativity was early virologic response (EVR; HBV DNA <2,000 copies/mL after 3 months of therapy, P<0.001). The independent factors predicting HBeAg loss were found to be serum albumin levels (P=0.041) and EVR (P=0.005). CONCLUSIONS: Entecavir induced excellent biochemical and virologic responses in naive CHB patients. EVR was an independent factor for predicting HBV PCR negativity and HBeAg loss.

The Clinical Outcome and Related Factors of ARF in Survived Patients after CPR / 대한신장학회잡지

BACKGROUND: The purpose of the study was to evaluate the prevalence, related factors, and outcome of acute renal failure (ARF) developed in the patients who survived following a cardiac arrest. METHODS: A retrospective analysis of medical records was underwent in 24 patients who survived among 68 patients receiving cardiopulmonary resuscitation (CPR) at the emergency center of Inha-hospital, Sungnam, Korea, from January 1999 to February 2001. Clinical factors before, during and after CPR were compared and contrasted between the patients who manifested ARF after CPR and those who did not. RESULTS: ARF occurs at 33% following CPR. ARF group showed high baseline creatine kinase (CK) level, longer duration of resuscitation, and larger dosages of epinephrine usage during CPR. During 24 hours after CPR, mean arterial pressure and hourly urine output were significantly lower and dopamine was administered significantly higher in ARF group. Among them seven patients died in 2.3+/-0.8 hospital day with a mean serum creatinine of 2.8+/-1.7 mg/dL. None required renal replacement therapy in ARF group. Mean admission durations were 4.4+/-2.8 and 14.0+/-11.5 days. Survival rate was 12.5% in ARF group, which was significantly low compared to 75% in non-ARF group. CONCLUSION: In spite of high mortality rate in ARF group, ARF by itself was not a direct cause of death. We suggest that the development of ARF is a predicting but not a causative factor of death in the survivors following CPR.

The Clinical Outcome and Related Factors of ARF in Survived Patients after CPR / 대한신장학회잡지

BACKGROUND: The purpose of the study was to evaluate the prevalence, related factors, and outcome of acute renal failure (ARF) developed in the patients who survived following a cardiac arrest. METHODS: A retrospective analysis of medical records was underwent in 24 patients who survived among 68 patients receiving cardiopulmonary resuscitation (CPR) at the emergency center of Inha-hospital, Sungnam, Korea, from January 1999 to February 2001. Clinical factors before, during and after CPR were compared and contrasted between the patients who manifested ARF after CPR and those who did not. RESULTS: ARF occurs at 33% following CPR. ARF group showed high baseline creatine kinase (CK) level, longer duration of resuscitation, and larger dosages of epinephrine usage during CPR. During 24 hours after CPR, mean arterial pressure and hourly urine output were significantly lower and dopamine was administered significantly higher in ARF group. Among them seven patients died in 2.3+/-0.8 hospital day with a mean serum creatinine of 2.8+/-1.7 mg/dL. None required renal replacement therapy in ARF group. Mean admission durations were 4.4+/-2.8 and 14.0+/-11.5 days. Survival rate was 12.5% in ARF group, which was significantly low compared to 75% in non-ARF group. CONCLUSION: In spite of high mortality rate in ARF group, ARF by itself was not a direct cause of death. We suggest that the development of ARF is a predicting but not a causative factor of death in the survivors following CPR.

Clinical Features and Prognostic Factors of Head Injury in Less Than Two-Year-Old Children

The brain and intracranial compartment undergo a multiplicity of physiologic and anatomical changes which influence the type of head injury and response to such injury, especially for those children in first two years of age in whom development of skull and brain is still undertaking. Thus, special attention to recognize and manage these children from such injury seems mandatory. Purpose of this study is to analyze the related causes for the head injury in this age group with various clinical parameters influencing the outcome. A total of 68 children less than two years of age who were admitted to our institution after head trauma were included in this retrospective study. The causes of head injury along with other clinical settings, such as type of pathologies, Pediatric Glassgow Coma Scale(PGCS), age, operation, hypoxia, shock, seizure, anemia, abnormal pupillary response, were reviewed and clinical outcome related with these parameters were analysed. The mean duration of admission period was 15 days and mean follow-up period was 29.4 months. Most common mode of injury was stairway injury(32.3%), followed by in-car accident(19.1%), with suspected child abuse being only 2.9%. Cerebral contusion was the most frequent diagnosis being 43 cases(63.2%), followed by skull fracture in 31(45.6%). For the outcome related to various categories, 5 cases of death were due to diffuse axonal injury or intracranial hemorrhage, but most simple linear fractures were not associated with underlying brain injury. Among those required the operation(18 cases), subdural and/or epidural hematoma were the most common pathology(50%), followed by subdural hygroma and depressed skull fracture. The outcome, however, was not related to type of pathology. Instead, it was rather closely related to the initial PGCS. The PGCS at admission was found out to be the major predicting factor to outcome. In overall, 34/36(94.4%) cases with normal PGCS in these age groups showed good recovery with deaths being 5/7(71.4%) cases of PGCS