BACKGROUND: Dementia has emerged as a leading public health problem with elderly persons and its early detection is important for treatment in curable cases. Although dementia screening tests are available, they are still complex and time consuming in practice and therefore difficult to use. Our goal was to validate the time and change(T&C) test, a simple, standardized method for detecting dementia in the elderly populations. METHODS: Participants were 59 patients aged 65 years or older at an urban hospital from November 1 to December 31, 2001. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability making 1,000 Won from a group of coins consisting one 500 Won, seven 100 Won, seven 50 Won. T&C ratings were validated against a reference standard based on physician`s diagnosis. Test-retest reliability and inter-observer reliability were assessed. RESULTS: The T&C test had a sensitivity of 73.0%, specificity of 90.9%, positive predictive value of 93.1%, and negative predictive value of 66.7%. Test-retest and inter-observer agreement rates were 95% and 95%, respectively. The T&C test was not influenced by education. The time and change tests took a mean of 7.5 seconds and 19.6 seconds to complete respectively, and was acceptable to participants. When timed cut points were added, the T&C test had a sensitivity of 86.5%, specificity of 40.9% and test-retest and inter-observer agreement rates were 77.3% and 81.8%, respectively. CONCLUSION: The T&C test is a simple, accurate reliable, performance-based tool for detection of dementia in the elderly.
Aged* ; Dementia* ; Diagnosis ; Education ; Hand ; Hospitals, Urban ; Humans ; Mass Screening* ; Numismatics ; Public Health ; Sensitivity and Specificity

BACKGROUND: Alexithymia refers to a specific disturbance in psychic functioning characterized by difficulties in capacity to verbalize affect and to elaborate fantasies. Although initially described in the context of psychosomatic illness, alexithymic characteristics may be observed in patients with a wide range of medical and psychiatric disorders. OBJECTIVE: The present study was to evaluate the relationship between the alexithymia and bronchial asthma, and to compare the results with finding from a group of acute infectious illness subjects. MATERIAL AND METHOD: Alexithymia was measured with on Korean translation of the TAS-20 (Toronto Alexithymic Scale-20 Korea version) and the Scored Archetypal 9 Test(SAT9). Thirty patients with bronchial asthma and thirty patients with acute infectious illness completed these tests. The SAT9 and the TAS-20K scores were compared in the both group, considering the age, gender, education level, and duration of illness. RESULT: Bronchial asthma patients had significantly higher score of on the TAS-20K and SAT9 compared with those with infectious illness(p<0.05). The two scales correlated in expected direction. Alexithymia was significantly related to education level(SAT9: r=0.335, TAS-20K: r=-0.376, p<0.01) and duration of illness(asthma group, SAT9: r=-0.383, TAS-20K: r=0.288, p<0.05). CONCLUSION: Bronchial asthma patients had significantly higher alexithymic scores. This finding suggests that psycliathic consultation may be considered for the management of asthmatic patients with alexithyria.
Affective Symptoms* ; Asthma* ; Education ; Fantasy ; Humans ; Korea ; Weights and Measures

Recently, we experienced a patient with a B cell leukemia which could not be classified as chronic lymphocytic leukemia (CLL), prolymphocytic leukemia (PL) or follicular lymphoma in leukemic phase. He is a 58-year-old male and suffered from progressive lymphadenopathy at both inguinal and cervical areas. His blood film showed lymphocytosis (79%), and the cells were heterogeneous in size and shape. Twenty-five percent of the lymphocytes had nuclear irregularities or cleavages unlike the lymphocytes of CLL In which the cells often shows monomorphic features, small size with scanty cytoplasm and round nucleus. The bone marrow trephine biopsy specimen showed a diffuse pattern of infiltration of atypical Iymphoid cells. The lymph node histology showed atypical lymphoid colls proliferated as wide mantles around non-neoplastic appearing germinal centers. The immunophenotype of circulating lymphocytes in peripheral blood showed strong reactivity with CD5, CDl9 and CD20 without expression of CD2, CD3, CD7, CD10, CD22 and CD23. Although this case resembled CLL, the laboratory features showed major differences, notably in the Peripheral blood morphology, histology Patterns and the membrane Phenotype. By combining these data, we diagnosed this case as a leukemic phase of mantle cell lymphoma.
Biopsy ; Bone Marrow ; Cytoplasm ; Germinal Center ; Humans ; Leukemia, B-Cell ; Leukemia, Lymphocytic, Chronic, B-Cell ; Leukemia, Prolymphocytic ; Lymph Nodes ; Lymphatic Diseases ; Lymphocytes ; Lymphocytosis ; Lymphoma, Follicular ; Lymphoma, Mantle-Cell* ; Male ; Membranes ; Middle Aged ; Phenotype

This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Anxiety ; Depression ; Factor Analysis, Statistical ; Female ; Gwangju ; Humans ; Jeollanam-do ; Male ; Mass Screening* ; Middle Aged ; Surveys and Questionnaires*

The household survey was performed in a urban slum and a rural Chonnam areas to measure the level of illness and medical care utilization and to find the determinants of physician utilization. The data revealed that age-adjusted prevalence rates of acute and chronic diseases were much the same in both areas ranged between 10.0 to 11.3%. But medical care utilization was more frequent in urban slum than in rural area. The facility of the first medical contact was also different. Some personal and disease related variables including disease severity and activity restricted day were significantly, but somewhat differently by area, associated with physician utilization pattern. When applying Anderson model, the medical need factors explained 42.2 and 40.4% of physician utilization in urban slum and in rural areas respectively, while the enabling factors explained 18.0 and 12.2% and the predisposing factors explained 17.1 and 8.9% correspondingly.
Causality ; Chronic Disease ; Family Characteristics ; Humans ; Jeollanam-do ; Poverty Areas ; Prevalence

No abstract available.
Antigens, Surface* ; Oncogenes*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

No abstract available.
Fallopian Tubes* ; Female ; Pregnancy*

BACKGROUND: For the rapid sequence induction of general anesthesia, succinylcholne, a depolarizing muscle relaxant, has been used. But succinylcholine has many side effects, so various efforts using nondepolarizing muscle relaxants have been tried. We have tried and observed the effect of a curonium-lidocaine mixture administration. METHODS: 120 patients who were scheduled for elective surgery were randomly assigned in 6 groups (Group I, II, III, IL, IIL, IIIL). For groups I, II and III vecuronium was administered only 0.10 mg/kg, 0.12 mg/kg, and 0.15 mg/kg, respectively. For each member of groups IL, IIL and IIIL, lidocaine 1.5 mg/kg was added to the dose of vecuronium of groupI, II and III. The vecuronium or vecuronium- lidocaine mixture was injected for 15 seconds and then thiopental sodium was injected for 15 seconds. 90 seconds after the administration of the vecuronium or vecuronium-lidocaine mixture, every patient was intubated. Intubation condition scores, TOF responses of the adductor pollicis of the thumb, arrhythmia, heart rates, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were checked and compared. RESULTS: Intubation condition scores were better in groups IL, IIL and IIIL in comparison with groups I, II and III. The TOF responce of the adductor pollicis of the thumb showed a statistically signifiant difference between the lidocaine groups and the nonlidiocaine groups. The time elapsed before the disappearance of TOF was less in the lidocaine groups. Changes of systolic pressure, diastolic pressure, mean arterial blood pressure and heart rate were no difference in the lidocaine groups and the nonlidocaine groups. CONCULUSIONS: The results suggest that administration of a vecuronium-lidocaine mixture administraion improves the intubation condition score during a rapid sequence induction of general anesthesia and shortens the time of the disapprearance of the TOF response.
Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Humans ; Intubation ; Lidocaine ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Thumb ; Vecuronium Bromide*

BACKGROUND: For the rapid sequence induction of general anesthesia, succinylcholne, a depolarizing muscle relaxant, has been used. But succinylcholine has many side effects, so various efforts using nondepolarizing muscle relaxants have been tried. We have tried and observed the effect of a curonium-lidocaine mixture administration. METHODS: 120 patients who were scheduled for elective surgery were randomly assigned in 6 groups (Group I, II, III, IL, IIL, IIIL). For groups I, II and III vecuronium was administered only 0.10 mg/kg, 0.12 mg/kg, and 0.15 mg/kg, respectively. For each member of groups IL, IIL and IIIL, lidocaine 1.5 mg/kg was added to the dose of vecuronium of groupI, II and III. The vecuronium or vecuronium- lidocaine mixture was injected for 15 seconds and then thiopental sodium was injected for 15 seconds. 90 seconds after the administration of the vecuronium or vecuronium-lidocaine mixture, every patient was intubated. Intubation condition scores, TOF responses of the adductor pollicis of the thumb, arrhythmia, heart rates, systolic blood pressure, diastolic blood pressure and mean arterial blood pressure were checked and compared. RESULTS: Intubation condition scores were better in groups IL, IIL and IIIL in comparison with groups I, II and III. The TOF responce of the adductor pollicis of the thumb showed a statistically signifiant difference between the lidocaine groups and the nonlidiocaine groups. The time elapsed before the disappearance of TOF was less in the lidocaine groups. Changes of systolic pressure, diastolic pressure, mean arterial blood pressure and heart rate were no difference in the lidocaine groups and the nonlidocaine groups. CONCULUSIONS: The results suggest that administration of a vecuronium-lidocaine mixture administraion improves the intubation condition score during a rapid sequence induction of general anesthesia and shortens the time of the disapprearance of the TOF response.
Anesthesia, General ; Arrhythmias, Cardiac ; Arterial Pressure ; Blood Pressure ; Heart Rate ; Humans ; Intubation ; Lidocaine ; Neuromuscular Blockade* ; Succinylcholine ; Thiopental ; Thumb ; Vecuronium Bromide*