Factors Affecting the Empowerment Experienced by Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: To identify various factors that might affect the empowerment of outpatients with schizophrenia. METHODS: Of patients who had been receiving outpatient treatments at the department of psychiatry in Dong-A university hospital, 116 patients with a DSM-IV-TR diagnosis of stable schizophrenia were enrolled in this study. The empowerment, psychiatric symptoms, social functions, insight, family attitude, social support and self-esteem were assessed through an interview or self-report measures. Overall, multiple regression analyses were performed in consideration of 11 factors (age, sex, level of education, age of onset, frequency of hospitalization, symptoms, social functions, insight, family attitude, social support, self-esteem) as explanatory variables for the empowerment. RESULTS: Multiple regression analyses using a backward elimination revealed that the following four factors were found to be significant explanatory variables for the empowerment: age of onset, social functions, family attitude and self-esteem. A coefficient of determination for these four explanatory variables was 0.65. CONCLUSION: In conclusion, the results showed that four factors, such as age of onset, social functions, family attitude and self-esteem, were found to be significant explanatory variables for the empowerment of outpatients with schizophrenia. Since these four variables accounted for 65% of total empowerment, however, further studies in a larger group of patients are warranted to identify other potential factors for the empowerment.

The Psychometric Properties of the Korean Version of the Verbal Abuse Questionnaire in University Students

OBJECTIVE: The aim of the present study was to examine the psychometric properties of the Korean Verbal Abuse Questionnaire (K-VAQ) that consists of 15 items related with life-time verbal aggression exposure. METHODS: A total of 5814 university students who agreed to take part in the study completed the K-VAQ, the Korean version of the Life Event CheckList (LEC-K) and Impact of Event Scale-Revised (K-IES-R). Internal consistency was checked by using item-total item correlation and Cronbach's alpha coefficient. Exploratory and confirmatory factor analyses were performed, and convergent and concurrent validity levels were examined. Finally, a cluster analysis was conducted to verify the validity of the cutoff point of the K-VAQ. RESULTS: The Cronbach's alpha correlation coefficient was 0.9. The K-VAQ showed a single factor structure which explained 55.34% of the total variance. The K-VAQ was significantly associated with the LEC-K (r=0.24) and K-IES-R (r=0.28), indicating good convergent validity and concurrent validity. The cluster analysis provided four clusters of trauma experiences: high, moderate, low, and minimal, with K-VAQ ranges of 43-81, 20-42, 7-19, and 0-6, respectively. In a further investigation, a K-VAQ score of 40 was found to be the appropriate cutoff point to delineate the highly verbally abused group, as used in the previous studies. A sum of 36.5% of the highly verbally abused group reported to show substantial symptoms of PTSD (K-IES-R score >22). CONCLUSION: The present findings suggest that the K-VAQ has good psychometric properties for assessing verbal aggression among the Korean population.

Characteristics Involved in Internet Addiction Tendency of Adult Males with Attention Deficit/Hyperactivity Disorder / 신경정신의학

OBJECTIVES: This study was conducted in order to investigate characteristics of temperament, depression, anxiety, attention, and impulsivity in adult males with Attention Deficit/Hyperactivity Disorder (ADHD) and internet addiction tendency. METHODS: The survey participants were 181 (121 patients and 60 healthy control subjects) adult males older than 19 years of age in Chung-Ang University Hospital and Gongju National Hospital. Subjects were divided according to ADHD with internet addiction tendency (AI), pure adults with ADHD (AD), and healthy control subjects (HC). All groups completed the Adult ADHD Scale (AADHD), Wender-Utah ADHD Rating Scale (WUADHD), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Korean Version of Young Internet Addiction Scale (YIAS-K), Barratt Impulsiveness Scale (BIS) and Temperament Character Inventory-Revised Short version for identification of relationship between ADHD and internet addiction tendency. RESULTS: AI groups were found to have higher AADHD, WUADHD, BDI, YIAS-K, and Novelty Seeking scores, compared to the AD and HC groups. The Cooperativeness score of the AI group was significantly lower than that of the AD group and HC group. The BAI and BIS scores of the AI group and AD group were significantly higher than those of the HC group. The Self-Directedness scores of the AI group and AD group were decreased, compared to the HC group. YIAS-K scores were partially related to BDI scores in the AI group. CONCLUSION: The results of this study indicate an association of higher score of BDI with internet addiction tendency in adult patients with ADHD. Management of temperament characteristics, depression, anxiety, attention, and impulsivity may be important for adults with ADHD and internet addiction tendency.

Antimicrobial Susceptibility of Stenotrophomonas maltophilia Isolates from Korea, and the Activity of Antimicrobial Combinations against the Isolates

The aim of this study was to determine antimicrobial susceptibility of recent clinical Stenotrophomonas maltophilia isolates from Korea, and to compare the activity levels of several combinations of antimicrobials. A total of 206 non-duplicate clinical isolates of S. maltophilia was collected in 2010 from 11 university hospitals. Antimicrobial susceptibility testing was performed using the Clinical Laboratory Standards Institute agar dilution method. In vitro activity of antimicrobial combinations was tested using the checkerboard method. The susceptibility rates to trimethoprim-sulfamethoxazole and minocycline were 96% and 99%, respectively. The susceptibility rate to levofloxacin was 64%. All of four antimicrobial combinations showed synergy against many S. maltophilia isolates. A combination of trimethoprim-sulfamethoxazole plus ticarcillin-clavulanate was most synergistic among the combinations. None of the combinations showed antagonistic activity. Therefore, some of the combinations may be more useful than individual drugs in the treatment of S. maltophilia infection. Further clinical studies are warranted to validate our in vitro test results.

Simultaneous Translocation of Both TCR Loci (14q11) with Rare Partner Loci (Xq22 and 12p13) in a Case of T-lymphoblastic Leukemia

The most common recurrent cytogenetic abnormalities in T-lymphoblastic leukemia (T-acute lymphoblastic leukemia [T-ALL]) involve T-cell receptor (TCR) loci and a variety of partner genes, including HOX11, HOX11L2, MYC, and TAL1. In this report, we present a rare case involving simultaneous translocation of the TCR alpha/delta loci with different partner loci (Xq22 and 12p13); this resulted in a poor prognosis. Chromosomal analysis showed 46,Y,t(X;14)(q22;q11.2),t(12;14)(p13;q11.2) and FISH analysis by using a T-cell receptor alpha delta DNA probe, Split Signal (DakoCytomation, Denmark), showed translocations at the same TCR alpha/delta locus on both chromosomes. FISH with 2 bacterial artificial chromosome clones showed break apart signal, which suggests involvement of the IRS4 gene. To our knowledge, this is the first report of T-ALL in which both TCR alpha/delta loci were translocated with different partner loci, and 1 of the partner loci, Xq22, was a rare translocation partner locus that included IRS4 gene.

Frequency of Detection of Unexpected Antibodies in Transfusion Candidates at a Secondary Hospital in Gyeongbuk Province / 대한수혈학회지

BACKGROUND: Antibody screening and identification tests are indispensable tools for protecting patients from acute hemolytic transfusion reaction. The column agglutination method has been widely used because of its simplicity and superiority to other methods for detecting warm antibodies. The purpose of this study was to analyze the frequency, distribution and clinical characteristics of unexpected antibodies found in transfusion candidates at a secondary hospital in Gyeongbuk Province, Korea. METHODS: The antibody screening tests were carried out with 9,275 sera samples using the column agglutination method from July 2009 to September 2011. The antibodies were screened and identified using the DiaMed-ID system (DiaMed, Murten, Switzerland). RESULTS: The positive rate for antibody screening tests was 0.5% (50/9,275). Unexpected antibodies were identified in 36 cases (0.4%). The most frequently detected antibody was anti-Lea in 15 cases (30%), followed by anti-Leb in 10 cases (20%) and anti-E in 8 cases (16%). Antibodies that remain unidentified were detected in 11 cases (22%). CONCLUSION: Compared with previous reports, this study demonstrated that the frequency and distribution of unexpected antibodies were no different than those found in general hospitals. This study may provide data for the frequency and characteristics of unexpected antibodies in a secondary hospital.

Mutation analysis of PAH gene and characterization of a recurrent deletion mutation in Korean patients with phenylketonuria

Phenylketonuria (PKU; MIM 261600) is an autosomal recessive metabolic disorder caused by a deficiency of phenylalanine hydroxylase (PAH; EC 1.14.16.1). Point mutations in the PAH gene are known to cause PKU in various ethnic groups, and large deletions or duplications account for up to 3% of the PAH mutations in some ethnic groups. However, a previous study could not identify ~14% of the mutant alleles by sequence analysis in Korean patients with PKU, which suggests that large deletions or duplication might be frequent causes of PKU in Koreans. To test this hypothesis, we performed multiplex ligation-dependent probe amplification (MLPA) for the identification of uncharacterized mutant alleles after PAH sequence analysis of 33 unrelated Korean patients with PKU. Bi-directional sequencing of the PAH exons and flanking intronic regions revealed 27 different mutations, including four novel mutations (two missense and two deletion mutations), comprising 57/66 (86%) mutant alleles. MLPA identified a large deletion that encompassed exons 5 and 6 in four patients, another large deletion that extended from exon 4 to exon 7 in one patient, and a duplication of exon 4 in one patient. Chromosomal walking characterized the deletion breakpoint of the most common large deletion that involved exons 5 and 6 (c.456_706+138del). The present study shows that the allelic frequency of exon deletion or duplication is 9% (6/66) in Korean PKU patients, which suggests that these mutations may be frequent causes of PKU in Korean subjects.

Analysis of Clinical Features and Hepatitis B Virus DNA Level in the Concomitant Cases of Hepatitis B Surface Antigen and Antibody / 대한임상미생물학회지

BACKGROUND: After an infection with HBV, HBsAg is the first virologic marker detectable in the serum. If anti-HBs against 'a'determinant of HBsAg appears, HBsAg will disappear and the patients will recover from the HBV infection in most cases. However, we encounter not infrequently concomitant cases of HBsAg and anti-HBs. In this study we evaluated HBV DNA levels in concomitant cases to aid in the interpretation of these serologic results. METHODS: This study included 36 cases with positivity for both HBsAg and anti-HBs in an electrochemiluminescent immunoassay as well as a radioimmunoassay. They were tested for HBeAg, anti-HBe, and HBV DNA levels. RESULTS: Chronic viral hepatitis was the most frequent diagnosis (15/36 : 41.7%) and AST and ALT levels were normal in 17 (47.2%) and 20 (55.6%) cases, respectively, among total 36 concomitant cases. HBeAg was positive in 24 and anti-HBe in 17 cases. HBV DNA was positive in 33 cases (91.7%). including all 24 HBeAg positive cases and 9 (75%) of 12 HBeAg negative cases; 6 (50%) of 12 HBeAg negative cases had HBV DNA levels higher than 105 copy/mL. CONCLUSIONS: This study showed that viral replication still exists in most cases of concomitant HBsAg and anti-HBs, and even in some HBeAg negative cases. So in the concomitant cases, HBV DNA quantitation may aid in the interpretation of clinical significance of these cases.

Similarities of Clinical Manifestations in Sibling Patients with Psychotic Disorder / 신경정신의학

OBJECTIVES: To explore the possibilities of finding a heritable phenotype(s) in patients with psychosis, we examined the similarities of clinical variables between psychotic sibling patients who share the half of genetic information. METHODS: We recruited a group of sibling patients, whose diagnoses were schizophrenia, schizoaffective disorder and bipolar disorder and confirmed the diagnosis using SCID-RV(Structured Clinical Interview for DSM-IV, Research Version). Using 30 sets of sibling patients, we examined concordances or similarities of diagnosis, diagnostic subtypes, clinical symptoms, and longitudinal outcomes. RESULTS: There were significant concordances in terms of age of onset, auditory hallucination persisted for more than 7 years, general level of functioning. No significant similarities or concordances were found in diagnosis, diagnostic subtypes, delusion, negative symptom, and thought disorder between sibling patients. CONCLUSION: Above mentioned similarities have the possibilities of genetically determined phenotypes that could be used in the future genetic studies. Concordance of hallucination persisted for more than 7 years, not the presence or absence of auditory hallucination between sibling patients suggests that it is more important to examine longitudinal patterns of symptoms than to merely examine the presence of symptoms at specific cross-sectional time points in terms of genetic studies.

A Study of the mecI, mecA and femA Genes of Methicillin-Resistant Staphylococci / 대한임상병리학회지

BACKGROUND: Staphylococcus aures and Staphylococcus epidermidis are those of the important pathogens that have revealed the increase of methicillin resistance. Because of increasing prevalence of staphylococci resistant to one or more antimicrobial agents, it is necessary to determine the antibiotic susceptibility of these microorganisms. Methicillin resistance is due to the production of PBP2', which is encoded by mecA gene in the chromosome. PBP 2' shows low affinity to the all of beta-lactam drugs. Therefore, the determination of gene is considered as a correct method for the antibiotic treatment procedures. METHOD: In order to examine effectiveness of detecting mecA and femA genes for the identification of methicillin resistant S. aureus (MRSA) and mecI gene in high-level-resistant MRSA, the presence of these genes in S. aureus and S. epidermidis was investigated by PCR. The types of genes were compared with phenotype by agar dilution method and investigated with MIC of methicillin. RESULTS: 1. The mecA gene detection was useful for the identification of MRSA with MRSA 100% and methicillin susceptable S. aureus (MSSA) 2.7% (P0.001). 2. The femA gene detection was useful for the S. aureus identification (P0.001). CONCLUSION: The study concluded that the detection of both the mecA and femA genes from staphylococci by the PCR method had been considered as a correct and useful method in the identification of MRSA. mecI gene has been deemed as a repressor gene for high-level-resistant MRSA that is clinically useful as a standard. However, it is considered that the investigation should be done with later detected nucleotide sequencing of the mecI gene.

The Effects of Coadministration of Haloperidol and Bethanechol on Plasma Haloperidol and Reduced Haloperidol Concentrations

Bethanechol, a cholinergic agonist, has been recommended for the management of peripheral anticholinergic side effects during the treatment of antipsychotic medications. But there have been few studies which have evaluated the drug interactions of antipsychotics and bethanechol, even the treatment effects of bethanechol on anticholinergic side effects. So the authors have evaluated whether psychopathology and plasma haloperidol and reduced haloperidol concentrations are significantly changed or not when bethanechol was administrated with maintained doses of haloperidol and other coadministrated drugs(such a benztropine). Also we have evaluated the abating effects of bethanechol on anticholinergic side effects during the treatment with haloperidol. Fifteen schizophrenics with higher than 5 of total score of anticholinergic side effects of 'Rating scale for side effect' were assigned to two groups, and bethanechol 30mg/day and 60mg/day were applied on each group for 4 weeks. The daily haloperidol dosages were fixed before 2 weeks of study. We assessed anticholinergic side effects by 'Rating scale for side effect' and psychopathology by BPRS, and plasma haloperidol and reduced haloperidol concentrations by HPLC at baseline, 2nd week and 4th week. The results were as followed. 1) There was no significant change of plasma haloperidol and reduced haloperidol concentration. 2) At baseline, the dosage of haloperidol showed significant correlation with the total score of anticholinergic side effect, but not at 2nd week and 4th week. 3) In 60mg/day group, dry mouth and the total score of anticholinergic side effects were significantly improved, but not in 30mg/day group. 4) There was no significant change of BPRS except withdrawal at 2nd week. These results suggest that coadministration of bethanechol influenced neither on psychopathology nor on plasma haloperidol and reduced haloperidol concentrations and that improved dry mouth and total score of anticholinergic side effects at 60mg/day.

A case of plasma cell leukemia / 대한혈액학회지

No abstract available.

A case of cioclonal gammopathy in psoriatic patient with methotrexate treated megaloblastic anemia / 대한혈액학회지

No abstract available.

A case of delayed hemolytic transfusion reaction due to anti-e identified by bromelin treatment / 대한수혈학회지

No abstract available.