Length of Stay in the Mental Health Facilities in Korea / 신경정신의학

We have randomly selected 1,200 psychiatric inpatients from the whole psychiatic inpatients population in Korea, and analyzed their length of stay far the purpose of contributing to community mental health practice in Korea. The results were as follows: 1) The half of total samples' length of stay were within 761 days, and 75% of them wihin 2, 613 days. 2) As for length of stay P50, asylums showed the length of stay within 2,303 days for the half of selected samples: 483 days for private mental hospitals and they showed very long-term hospitalization compared to university hospital(20 days), general hospitals(41 days), private psychiatric clinics(45 days) and national mental hospitals(83 days). 3) As for length of stay according to age distributions, the older the patients were, length of stay showed the longer. 4) Among the length of stay at P50 according to diagnoses, mental retarded patients were the longest hospitalization group in private hospitals(707 days) and small psychitric inpatient units(below 30 beds, 166 days). But schizophrenics were the longest hospitalization group(2, 560 days) at asylums. 5) Length of stay at P50 according to medical security had great differences between the medical aid group and medical insurance group, especially in asylum(2,461 days vs. 1,715 days) and mental hospitals(615 days vs. 271 days). From the above results, the authors propose that for diminishing the length of stay policy, Korean mental health system should develop new rehabilitation programs for acute symptom relieved schizophrenic patients. In addition, the treatment for the younger mentally-ill patients should be more active and intensive.

Focal Xanthogranulomatous Pyelonephritis: Reports of 2 Cases

Xanthogranulomatous pyelonephritis is a chronic inflammatory condition which in most cases involves either an entire non-duplicated kidney or a moiety of a duplicated kidney. These cases present with quite characteristic radiologic findings including an enlarged non functioning kidney and renal stones. However, when the condition involves only a part of a non-duplicated kidney and especially where there is an absence of the specific findings described above, differentiation from cystic neoplasm may be difficult. We report the radiologic findings of twosuch cases of focal xanthogranulomatous pyelonephritis.

Activation of Ca(2+)-activated K+ channels by beta agonist in rabbit coronary smooth muscle cells

Isoproterenol (ISO), a beta agonist, causes hyperpolarization of coronary smooth muscle cells via an increase in K+ conductance. This hyperpolarization may cause the coronary vasorelaxation by decreasing the cytoplasmic Ca2+ concentration. It is well known that the activation of beta adrenoreceptors stimulates the adenylate cyclase activity, and the resulting K+ channel phosphorylation by cAMP-dependent protein kinase may be responsible for ISO-induced increase in K+ channel activity. However, it is not clear whether the increase in K+ channel activity by ISO is exclusively due to the activation of adenylate cyclase or not. In this research, the effect of ISO on the isometric tension and the mechanism of ISO-induced K+ channel activation were investigated in various patch clamp conditions. The summarized results are as follows. ISO- and pinacidil induced vasorelaxation was significantly inhibited by the application of TEA or by increasing the external K+ concentration. In the whole cell clamp mode, application of ISO increased K+ outward current, and this effect was completely eliminated by propranolol. In the cell-attached patch, application of ISO or forskolin increased Ca(2+)-activated K+ channel activity. Application of ISO to the bath in the outside-out patches or GTP in the inside-out patches stimulated Ca(2+)-activated K+ channels. From the above results, both A-kinase dependent channel phosphorylation and direct GTP-binding protein mediated effect might be responsible for the the activation of Ca(2+)-activated K+ channel by ISO in rabbit coronary smooth muscle cells. And this K+ channel activation also contributes to the ISO-induced vasorelaxation.