Current Status of Korean Red Cross HLA-Matched Platelet Donor Registry / 대한수혈학회지

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

Current Status of Korean Red Cross HLA-Matched Platelet Donor Registry / 대한수혈학회지

HLA-matched platelet transfusion is required for patients with platelet refractoriness due to HLA alloimmunity. From 2013 to 2019, the Korean Red Cross has recruited 4,080 donors for HLA-matched platelets. The patient’s HLA information should be submitted to the Korean Red Cross in accordance with the WHO HLA serologic specificities. When HLA-matched platelets are requested, the Korean Red Cross selects the appropriate donors based on Duquesnoy’s matching grade classification (1977) and CREGs defined by Takemoto, Fuller, and Rodey (2007) and then contacts them to request blood donations. Platelets of HLA-matched donors are collected by apheresis and supplied to the hospital. To make this process more efficient, the Korean Red Cross introduced a systemic standard work procedure using a computer program for blood donor management and HLA matching. Owing to the extensive polymorphism of the HLA types, expansion of the donor pool would be required to supply HLA-matched platelets sufficiently. As the number of registered donors for HLA-matched platelets is limited, it should only be ordered when the indication criteria for its use are met. The Korean Red Cross is planning to study genotype-based matching strategies for patients with rare HLA types and receive patients’ laboratory test results from medical institutions to evaluate the effectiveness of HLA-matched platelet transfusions.

A Multicenter Study Investigating Empathy and Burnout Characteristics in Medical Residents with Various Specialties

We assessed empathy in medical residents, including factors modifying empathy and the relationship between empathy and burnout. Participants (n = 317 residents, response rate = 42%) from 4 university hospitals completed a socio-demographic questionnaire, the Jefferson Scale of Empathy (Health Professional version, Korean edition), and the Maslach Burnout Inventory (MBI). Participants were classified by medical specialty: “people-oriented specialty” (POS group) or “technology-oriented specialty” (TOS group), with more women in the POS than in the TOS group, χ2 = 14.12, P < 0.001. Being female, married, and having children were factors related to higher empathy (gender, t = -2.129, P = 0.034; marriage, t = -2.078, P = 0.038; children, t = 2.86, P = 0.005). Within specialty group, POS residents showed higher empathy scores in the fourth as compared to the first year, F = 3.166, P = 0.026. Comparing POS and TOS groups by year, fourth year POS residents had significantly higher scores than did fourth year TOS residents, t = 3.349, P = 0.002. There were negative correlations between empathy scores and 2 MBI subscales, emotional exhaustion (EE) and depersonalization (DP). Additionally, first year POS residents had higher DP scores than did first year TOS residents, t = 2.183, P = 0.031. We suggest that factors important for empathy are type of medical specialty, marriage, siblings, and children. Burnout state may be related to decreasing empathy.

The Distributional Changes in the First-Visit Psychiatric Child and Adolescent Outpatients at a University Hospital over a Ten-Year Period

OBJECTIVES: The purpose of this study was to investigate changes in child and adolescent outpatients at a university hospital in Daegu from 2004 to 2013. METHODS: The subjects were first-visit patients under 18 years old, who visited Dongsan Medical Center, Keimyung University, from January 1, 2004 to December 31, 2013. Computerized medical records of 2,738 patients (male 1,906, female 832) were reviewed. RESULTS: The ratio of male to female was 2.3 : 1 in the period of study. The most prevalent age category was 7-9 years. The mean age was 10.12+/-4.68 years (9.84+/-4.59 years in males, 10.76+/-4.81 years in females). The ratio of child and adolescent patients to total outpatients was 27.0%. The most common diagnostic category was the attention-deficit hyperactivity disorder (ADHD) group, followed by the mental retardation (MR) group. In males, the ADHD, MR, communication disorder groups were more prevalent, but in females, the MR, ADHD, depressive disorder groups were more prevalent. CONCLUSION: The female to male ratio and total mean age were on the rise. The ADHD group was the most prevalent and the depressive disorder group was also on the rise in this period.

The Standardization of the Korean Version of the Patient Health Questionnaire-2 / 신경정신의학

OBJECTIVES: An early diagnosis to improve the outcome of depression demands a briefer and more reliable measure than any other diagnosis. The Patient Health Questionnaire (PHQ) is reliable measure made in 1999. In this study, we tried to verify the reliabilty and validity of two types of PHQ-2, and to compare these two types. METHODS: From July of 2011 to September of 2012, a total of 74 outpatients and inpatients in the Department of Psychiatry, Keimyung University Dongsan Medical Center performed the depression scales. As a normal control group, 58 individuals working in the hospital performed the PHQ-2 and PHQ-9. RESULTS: The internal consistency and test-retest reliabilty were favorable. Two types of the PHQ-2 were statistically significant in correlation between item and total scores. In comparison of mean scores of the PHQ-2 between two groups, the differences between groups were statistically significant. Correaltion of the total scores of other depression scales with those of the PHQ-2 was statistically significant both in scales. Examined according to the severity of depression by other scales, the total mean scores of the PHQ-2 tended to increase according to the severity of depression. The optimal cut-off score was 3 in Scaled PHQ-2 (Sensitivity : 91.9%, Specificity : 100%). CONCLUSION: The assessed reliabilty and validity of the PHQ-2 made it an attractive measure for depression screening over other scales. Scaled PHQ-2 was more reliable and valid than Yes or No PHQ-2. Therefore, the PHQ-2 is a briefer and more useful measure for screening depression.

Study on Standardization of Korean Version of Psychiatric Diagnostic Screening Questionnaire : The Optimal Cutoff Scores / 신경정신의학

OBJECTIVES: An exact diagnosis and comorbidity analysis are important in psychiatric disorders. The Psychiatric Diagnostic Screening Questionnaire (PDSQ) is both useful as a self-reporting test for screening psychiatric disorders and available for clinical settings due to its simplicity and convenience. This study, as a part of standardization of Korean version of Psychiatric Diagnostic Screening Questionnaire (K-PDSQ), evaluated optimal cutoff scores. METHODS: The samples were 696 patients in total, who were selected from the psychiatric departments of 3 university hospitals from March 2008 to August 2011. Diagnosing by Mini-International Neuropsychiatric Interview-Plus (MINI-Plus), we evaluated sensitivity, specificity, cutoff scores, ROC curve, and area under the curve (AUC) of K-PDSQ. SPSS version 12.0 for Windows and MedCalc version 12.0 were used to analyze the results. RESULTS: With a cutoff score of 9 for major depressive disorder in K-PDSQ, both the sensitivity and specificity were 80%. The cutoff scores of PTSD, OCD, panic disorder, agoraphobia, psychosis, alcohol related problem, GAD, hypochondriasis, and social phobia of K-PDSQ were 5, 2, 4, 2, 1, 2, 5, 4, and 5, respectively. In most of the subscales, each AUC was above 0.75. CONCLUSION: By applying the cutoff scores estimated above, we expect K-PDSQ to help provide diagnostic assessments and to grasp comorbidities before a clinical interview in the setting of busy outpatient clinics.

Dopamine Transporter Gene and Dopamine D2, D3, D4 Receptor Gene Polymorphisms in Attention Deficit Hyperactivity Disorder

OBJECTIVES: The aim of this study was to examine the association of attention-deficit hyperactivity disorder (ADHD) in Korean populations with functional polymorphisms of six genes dopamine receptors (Ser311/Cys311 polymorphism, Taq1 A polymorphism, and Taq1 B polymorphism in DRD2, BalI polymorphism in DRD3, and promoter -521 C/T polymorphism and exon III 48 bp repeat polymorphism in DRD4) and one gene in dopamine transporter (DAT1). METHODS: Participants were 58 children with ADHD and 110 control children. The genotypes were determined by PCR. RESULTS: There was a statistically significant difference in genotype frequency of -521 C/T polymorphism within the promoter region of the DRD4 between two groups. Furthermore, in the male group, both genotype and allele frequencies showed statistically significant differences. CONCLUSION: Findings of the study indicate that -521 C/T polymorphism in promoter region of DRD4 appears to be a possible candidate gene for ADHD in Korean population.

Clonazepam Treatment of Pathologic Childhood Aerophagia with Psychological Stresses

The treatment of pathologic aerophagia has rarely been discussed in the literature. In this retrospective study, the authors investigated the effects of clonazepam on the management of pathologic childhood aerophagia (PCA) with psychological stresses (PS), but not with mental retardation. Data from 22 consecutive PCA patients with PS (aged 2 to 10 yr), who had been followed up for over 1 yr, were reviewed. On the basis of videolaryngoscopic views, the authors observed that the pathology of aerophagia was the result of reflex-induced swallowing with paroxysmal openings of the upper esophageal sphincter due to unknown factors and also observed that these reflex-induced openings were subsided after intravenous low dose benzodiazepine administration. Hence, clonazepam was administered to treat paroxysmal openings in these PCA patients with PS. Remission positivity was defined as symptom-free for a consecutive 1 month within 6 months of treatment. The results of treatment in 22 PCA patients with PS were analyzed. A remission positive state was documented in 14.3% of PCA patients managed by reassurance, and in 66.7% of PCA patients treated with clonazepam (p=0.032). Thus, clonazepam may produce positive results in PCA with PS. Future studies by randomized and placebo-controlled trials are needed to confirm the favorable effect of clonazepam in PCA.

The Relationship between the Therapeutic Response to Antipsychotic Drugs and the Dopamine D2, D3, and D4 Receptor Gene Polymorphisms in Korean Schizophrenic Patients

OBJECTIVES: A considerable number of pharmacogenetic studies have been performed in recent years to define the association of antipsychotic drug response with dopamine receptor polymorphisms. The purpose of this study was to investigate the relationship between the therapeutic response to anti-psychotic drugs and the polymorphisms of the dopamine D2, D3, and D4 receptor genes(DRD2, DRD3 and DRD4, respectively). METHODS: We conducted retrospective chart review of 200 consecutively hospitalized patients with the diagnosis of schizophrenia(DSM-IV) who were treated with various antipsychotics(94% atypical antipsychotics) at Bugok National Hospital, Korea. The patients were divided into two groups, responders and non-responders, by responsiveness to antipsychotic drugs according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. We analyzed the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48 bp repeat polymorphism in the DRD4. RESULTS: Among the total patients of 200, 141(70.5%) were categorized as responders. There were no significant differences in the frequencies of the DRD2, DRD3, and DRD4 alleles and genotypes between responders and non-responders. CONCLUSION: These results suggest that the Ser311Cys polymorphism in the DRD2, the Ser9Gly polymorphism in the DRD3, and the exon III 48bp repeat polymorphism in the DRD4 are not associated with the therapeutic response to antipsychotic drugs in Korean schizophrenic patients. A larger prospective study is needed to elucidate the association between antipsychotic response and dopamine receptor gene polymorphism.

Long Term Effects of Hospital Information System on Nurses' Job Pattern and Satisfaction, and Attitudes Toward HIS / 대한의료정보학회지

OBJECTIVE: The purpose of this study was to examine the long-term effects of Hospital Information System(HIS) on nurses' job pattern and satisfaction, and attitudes toward electronic medical record system. METHODS: Prospective survey using repeated measures design was performed to compare the changes between 2 years and 4 years after introduction of HIS in a tertiary hospital. Participants were 374 nurses working in the target hospital. Questionnaire was developed by researchers based on Walker, Eyman, Krall, Prophet, and Flanagan(1996)'s study and consisted of 21 questions about job pattern, job satisfaction, and attitudes toward computerization and paper record system. RESULTS: Overall time for documentation, shift reporting, communication with other departments were reduced. Otherwise, direct nursing time was not increased after HIS. Nurses showed positive responses on changes of job pattern after HIS while job satisfaction has been decreased. In addition, nurses' attitudes toward hospital information system and paper medical record system showed they were accepting computerized information system. CONCLUSION: This study identified the long-term positive effects of HIS and the need for nursing sensitive hospital information system.

The Factors Affecting General Coping Styles in Chronic Renal Failure Patients / 신경정신의학

OBJECTIVES: This study was to investigate the factors affecting general coping styles, especially the correlations between coping styles and the variables related to disease history in chronic renal failure patients. METHODS: The subjects included 97 chronic renal failure patients who were hospitalized or treated through outpatient service. The Coping Styles Questionnaire (CSQ), Beck Depression Inventory-II and Beck Anxiety Inventory were administered. RESULTS: The patients who were more anxious or depressive used less rational and detachment coping and more emotional and avoidance coping. There were no significant difference in coping styles according to sex, age, education, marital state, occupation, economic state and religion. Number of previous admission was correlated positively with depression and anxiety, and also with emotional and avoidance coping. Duration of illness was correlated positively with detachment and avoidance coping. Duration of dialysis was correlated positively with avoidance coping. After controlling for depression and anxiety, number of previous admission was correlated positively with avoidance coping. CONCLUSION: These results suggest that maladaptive coping has an important role in development and maintenance of depression and anxiety in chronic renal failure patients. Psychotherapeutic strategies for lessening the maladaptive coping, especially emotional coping, would be necessary for chronic renal failure patients with emotional distress.

The Emotional Problem and Its Relation to Lesion Location in Stroke Patient

OBJECTIVE: This study is aimed at the pathoanatomic correlates of emotional problem in the patients with stroke. METHOD: Thirty patients with single, unilateral hemispheric lesion and no predisposing factors for psychiatric disorder were selected. Several neuropsychological assessments such as Mini- mental status examination-Korean (MMSE-K), Minnesota multiphasic personality inventory (MMPI), Symptom checklist-90-Revision (SCL-90-R) and Functional independence measure (FIM) were performed on all patients by a clinical psychologist and an occupational therapist. RESULTS: There were statistically significant differences between right and left hemisphere lesion group in emotional problems. Right hemispheric lesion group showed significantly higher scores of psychasthenia (MMPI), Obsessive-compulsive (SCL-90-R) and self care (FIM) than left hemispheric lesion group did. But there were no statistically significant differences between cortical and subcortical lesion group. Groups of left cortical lesion, right cortical lesion, left subcortical lesion and right subcortical lesion were not significantly different in their neuropsychological assessments and FIM except self care. CONCLUSION: Obsessive-compulsive and anxious emotional problems are more closely related with right hemispheric lesion. Therefore patients with right hemispheric lesion need more careful psychological and psychiatric evaluation. However, because of the small numbers of subjects involved in the study, the role of lesion location remains unclear so that consecutive follow-up studies are needed.

The relationships of motor function, education, age and cognitive function to the physical activities of daily living

The physical activities of daily living are a final outcome of many functions and dependent on many factors. This study was aimed at exploring the relationships of motor function, dementia, education, age, and cognitive function to the physical activities of daily living in 67 elderly people residing in an institution in Taegu, Korea. Their mean ( +/- SD) age was 75.6 +/- 8.1 and 24 (35.8%) were men. Twenty-eight (41.8%) were classified as having definite cognitive impairment, 17 (25.4%) as having questionable impairment, and 22 (32.8%) as having no impairment by the Korean version of the mini-mental state examination. Of the aforementioned 5 variables, the Motoricity Index could account for 42% of the Barthel Activities of Daily Living variance. If the modified Blessed Dementia Rating Scale was included in the multiple regression, the accountable portion of the Activities variance increased by 4% only. Using the 2 variables, regression equation, y = 0.248 x chi 1-0.359 x chi 2-6.250 (y: Barthel Activities of Daily Living score, chi 1: Motoricity Index score, chi 2: modified Blessed Dementia Rating Scale score) could be produced. Conclusively, the physical activities of daily living of elderly people could be related mainly with motor function of the limbs and severity of dementia.

Brain computed tomographic findings in autistic children / 신경정신의학

No abstract available.

Sonographic findings of postoperative cheek cyst / 대한이비인후과학회지

No abstract available.

Chromosome analysis in autistic children / 신경정신의학

No abstract available.

Prevalence of dementia in the elderly in a Myun area of Yungil county, Kyungpook province / 신경정신의학

No abstract available.

Prevalence of dementia in the elderly in a Myun area of Yungil county, Kyungpook province / 신경정신의학

No abstract available.