Clinical Predictors of Drug Response in Patients with Obsessive-Compulsive Disorder

OBJECTIVE: The aim of this study was to evaluate which clinical variables might influence the antiobsessional responses to proserotonergic drugs in a sample of patients with obsessive-compulsive disorder (OCD). METHODS: Two hundred forty-nine patients with DSM-IV OCD under-gone mean 13-month treatments with selective serotonin reuptake inhibitors. According to the treatment response, defined as a reductions of the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) total score > or =35%, patients were divided into two groups. RESULTS: One hundred fourteen patients responded to the treatment and the other one hundred thirty five patients did not. Responders had a significant long duration of medication in YUMC OCD clinic, short total duration of past treatment in other institutes, and higher frequency of drug naive cases and lower baseline Y-BOCS scores. CONCLUSION: The pre-treatment factors including total duration of past treatment, drug naive or not, baseline OCD symptoms and the factor of duration of the treatment may influence drug treatment response in OCD patients.

A Large Intrathoracic Meningocele in a Patient with Neurofibromatosis-1

A large intrathoracic meningocele, a saccular protrusion of the meninges through a dilated intervertebral foramen or a bony defect of the vertebral column, was diagnosed in a 41-year-old female patient showing clinical features of neurofibromatosis-1 (NF-1), including cafe-au-lait spots, cutaneous neurofibromas, and axillary frecklings and Lisch nodules on the iris. Her daughter and son also had similar manifestations of NF-1. Regular follow-up with periodic imaging was recommended without surgical treatment because there were no signs or symptoms. Meningocele should be differentiated from posterior mediastinal tumors such as neurofibroma, neuroblastoma, and ganglioneuroma because NF-1 has a high risk of tumor formation. We report on this case with a brief review of the literature.

Present Status of Papers on the Primary Care Quality Assessment in Korea / 가정의학회지

BACKGROUND: The analysis of the papers on the primary care quality assessment in Korea was performed to summarize existing papers, estimate the level of primary care quality, and suggest the directions and areas of the future research. METHODS: Primary care quality-related papers were selected via internet web search engines which were Korean Journal of Family Medicine homepage, KMbase, and KoreaMed. Further papers were added after consultation to primary care quality assessment specialists in Korea. RESULTS: The number of related papers was 29. Data collection was done mostly via mail or telephone questionnaire to suppliers, primary care physicians. Papers on resource capacity area were 11, on services delivery 4, on outcome by service 2, and on clinical performance 12. The total primary care score was low. The themes of clinical performance studies were common diseases in Korea. CONCLUSION: Research volume on primary care quality assessment was poor, especially on outcome area. Data collection methods and quality indicators are needed to diverse. Future researches using OECD health care quality indicators are needed to make international comparison possible, which finally contributes to primary care quality improvement in Korea.

Analysis of Family Practice Academic Dissertations

BACKGROUND: Family practice academic dissertations are the product of family practice research in the school of medicine. This paper was intended to evaluate the status of family practice academic dissertations, analyze the basic data and suggest directions for family practice research in the school of medicine. METHODS: The total number of masters' and doctoral dissertations from 1992 to February, 2005 was 124. of those, 120 were collected. They were analyzed in terms of research area, subjects, collected data, methodology, and statistical methods. RESULTS: In terms of research area, health promotion/ disease prevention was the most common (42.5%). For study subjects, out-patients and in-hospital patients were the most prevalent (38.0%), followed by health promotion center visitors and community residents (28.7%). When it came to research methodology, analytic study was the most common by a wide margin (70.8%). Among analytic studies, cross-sectional studies were the most frequent, followed by case-control studies and cohort studies. The most commonly-used data were medical records and questionnaires. CONCLUSION: Many advances have been made in research methodology and academic dissertation numbers since 1992. Many research topics, however, were not relevant to primary care. Much research was done in general hospital instead of primary-care facilities. These results must improve in the future.

Microstructural Change of Porous Surface Implant conditioned with Tetracycline-hydrochloride / 대한치주과학회지

Mechanical and chemical methods are the two ways to treat the implant surfaces. By using mechanical method, it is difficult to eliminate bacteria and by-products from the rough implant surface and it can also cause the structural change to the implant surface. Therefore, chemical method is widely used in order to preserve and detoxicate the implant surface more effectively. The purpose of this study is to evaluate the effect of tetracylcline-hydrochloride(TC-HCl) on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, SLA surface and porous surface were used in this study. Implant surface was rubbed with sponge soaked in 50mg/ml TC-HCl solution for 1/2 min., 1 min., 1 1/2 min., 2 min., and 2 1/2min. respectively in the test group and with no treatment in the control group. Then, specimens were processed for scanning electron microscopic observation. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. In the SLA surfaces, the control specimen showed that the macro roughness was achieved by large-grit sandblasting. Subsequently, the acid-etching process created the micro roughness, which thus was superimposed on the macro roughness. Irrespective of the application time of 50mg/ml TC-HCl solution, in general, test specimens were similar to control. 3. In the porous surfaces, the control specimen showed spherical particles of titanium alloy and its surface have a few shallow ridges. The roughness of surfaces conditioned with tetracycline-HCl was lessened and seen crater-like irregular surfaces relative to the application time. In conclusion, pure titanium machined surfaces and SLA surfaces weren't changed irrespective of the application time of tetracycline-HCl solution. But the porous surfaces conditioned with tetracycline-HCl solution began to be slightly changed from 2 min. This results are expected to be applied to the regenerative procedures for peri-implantitis treatment.