Body surface potential map, an electric potential distribution on the body torso surface, enables us to infer the electrical activities of the heart. Therefore, observing electric potential projected to the torso surface can be highly useful for diagnosing heart diseases such as coronary occlusion. The BSPM for the heart of a patient show a higher level of sensitivity than 12-lead ECG. Relevant research has been mostly based on clinical statistics obtained from patients, and, therefore, a simulation for a variety of pathological phenomena of the heart is required. In this study, by using computer simulation, a body surface potential map was implemented according to various occlusion locations (distal, mid, proximal occlusion) in the left anterior descending coronary artery. Electrophysiological characteristics of the body surface during the ST segment period were observed and analyzed based on an ST isointegral map. We developed an integrated system that takes into account the cellular to organ levels, and performed simulation regarding the electrophysiological phenomena of the heart that occur during the first 5 minutes (stage 1) and 10 minutes (stage 2) after commencement of coronary occlusion. Subsequently, we calculated the bipolar angle and amplitude of the ST isointegral map, and observed the correlation between the relevant characteristics and the location of coronary occlusion. In the result, in the ventricle model during the stage 1, a wider area of ischemia led to counterclockwise rotation of the bipolar angle; and, during the stage 2, the amplitude increased when the ischemia area exceeded a certain size.
Cardiac Electrophysiology* ; Computer Simulation* ; Coronary Occlusion ; Coronary Vessels* ; Electrocardiography ; Electrophysiological Phenomena ; Electrophysiology ; Heart ; Heart Diseases ; Humans ; Ischemia ; Torso

OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

The accuracy of fine needle aspiration cytology (FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases (43.6%) were diagnosed as tuberculosis, 4 (10.3%) as granulomatous lymphadenitis, 3 (7.7%) as necrotizing lymphadenitis, and 15 (38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Flow Cytometry ; Hyperplasia ; Inflammation ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Lymphoma, T-Cell, Peripheral ; Polymerase Chain Reaction ; Receptors, Antigen ; Sensitivity and Specificity ; Tuberculosis

OBJECTIVES: This study was aimed to examine the prevalence of neuroleptic-induced irregular menstruation and its related factors as well as the possible relationship of irregular menstruation with psychopathology and extrapyramidal symptoms in schizophrenic patients. METHODS: Thirty five schizophrenic inpatients at Naju National Mental Hospital who satisfied the diagnostic criteria of DSM-IV were selected. They had drug-free periods for more than 1 month before admission and had been taking neuroleptics for more than 3 months after admission. From all patients, reliable information regarding the sociodemographic characteristics, the menstrual histories before and after admission and clinical characteristics, including previous and current medications were investigated. The following were also evaluated: Serum prolactin level(by radioimmunoassay), psychopathology(by positive and negative syndrome scale: PANSS), and extrapyramidal symptoms(by extrapyramidal symptom rating scale: ESRS). RESULTS: Twelve patients(34%) showed regular menstruation and 23 patients(66%) were suffering from irregular menstruation. Of those with irregular menstruation, 13 patients(37%) had oligomenorrhea and 10 patients(29%) had amenorrhea. There were no differences in sociodemographic characteristics and menstrual histories before admission between the regular and irregular menstruation groups. But, the significant differences between the two were found in the following variables: The irregular menstruation group had shorter durations of illness, higher daily doses of current neuroleptics, higher serum prolactin levels, higher scores on the general psychopathology scale of PANSS, and higher scores on the parkinsonian symptom scale, hypokinetic symptom factor and clinical global impression of ESRS. CONCLUSION: The high prevalence of the irregular menstruation in schizophrenic patients reflects a state of hyperprolactinemia due to the interference of dopamine activity by high doses of neuroleptics.
Amenorrhea ; Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; Dopamine ; Female ; Hospitals, Psychiatric ; Humans ; Hyperprolactinemia ; Inpatients ; Jeollanam-do ; Menstruation* ; Oligomenorrhea ; Prevalence ; Prolactin ; Psychopathology ; Schizophrenia

The purpose of this study was to analyse the magnetic resonance (MR) appearance of the patellar tendon autograft for anterior cruciate ligament injury. Among 35 patients of ACL reconstructions with central 1/3 of the patellar tendon autograft and interference screw fixation, 13 patients underwent MRI examination. All examination were performed on 1.5 T magnet(Signa;GE medical system). T1WI, PDI, T2WI Sagittal and coronal images were obtained together with T2WI MPGR and oblique sagittal images. A four-level grading system based on the MR appearance of the ACL graft was developed. A grade I was indiscernible in graft course, Grade II; incomplete in its course, grade III; complete but thin and grade IV; complete and thick. 2 out of 13 patients showed grade I, 3; grade II, 4; grade III and 4 grade IV. Five patients of grade I and II had a finding of roof impingement. However, only one out of 8 grade III and IV revealed such finding. In summary reconstructed ACL had various appearance in MRI, which was considered to be closely related with roof impingement.
Anterior Cruciate Ligament ; Autografts ; Humans ; Magnetic Resonance Imaging ; Patellar Ligament ; Transplants

OBJECTIVES: Galla chinensis inhibited the adherence of planktonic oral bacteria and acid production by cariogenic bacteria. However, little is known about the relevant conditions of Galla Chinensis extract (GCE) exposure time and concentration and the effect of GCE on the structural and functional activity of cariogenic bacteria. The antibacterial effects of natural G. Chinensis extract on S. mutans , S. sanguinis, and S. oralis biofilms were evaluated in vitro. METHODS: Biofilms formed on glass surfaces were treated with different concentrations of GCE at different exposure times. The effects were assessed by examining the bactericidal activity, acidogenesis, minimum inhibitory concentration, and morphology. RESULTS: There was a statistically significant difference in the bacterial growth inhibition depending on the concentration of the GCE, with bacterial growth being inhibited as the concentration of GCE increased. A concentration of 1.0 mg/ml GCE had similar bactericidal effects against S. mutans and S. oralis biofilms to those produced by 2.0 mg/ml CHX. In the 1.0 mg/ml GCE group, incomplete septa were also observed in the outline of the cell wall, together with disruption of the cell membrane. In addition, there was also a slight exudation of the intracellular content from the bacteria in the 1.0 mg/ml GCE and 2 mg/ml CHX groups. CONCLUSIONS These results indicate that GCE inhibits the growth of S. mutans, S. sanguinis, and S. oralis with increasing concentrations. It alters the microstructure of S. mutans biofilms. These results suggest that GCE might be a useful anti-bacterial agent for preventing dental caries.

Purpose: This study evaluated the impact of auricular acupressure on depression among nurses. Methods: This study used a randomized control group pretest-posttest design. Shift-work nurses with the Patient Health Questionnaire-9 (PHQ-9) score over 5 points were randomized to the experimental group(n=20) or the control group(n=20). For the experimental group, auricular acupressure was conducted at the corresponding points of depression (TGI, AH1) weekly for seven days as well as for two weeks. The PHQ-9 was completed before intervention, as well as two weeks after intervention. Results: The mean difference in the PHQ-9 score before and after auricular acupressure in the experimental group (-4.11±2.27), was more significant than in the control group (-1.72±3.82) (t=2.28, p=.03). Conclusion Result showed that nurses who received auricular acupressure had a decrease in depression, compared to those who did not receive auricular acupressure. Further research is required, to apply the other auricular acupressure points, to evaluate the impact on depressive symptoms.

Objective: Fiberoptic endoscopic evaluation of swallowing (FEES) is a standard diagnostic tool for swallowing disorders. However, it has not been used frequently in Korea because of the long test time, low cost, and the absence of a standard evaluation system. The purpose of this study was to suggest a standard fill-out form for the FEES result. Methods: From February 2019 to June 2020, a total of 98 FEES tests were performed by an otolaryngologist (JYJ) at the Wonkwang University Hospital. After the exclusion of 68 cases, 30 cases were analyzed twice by 4 raters with over 5 years of experience as otolaryngologists working in various hospitals. The results were measured for the rater’s test-retest reliability and inter-rater consistency. Results: Cohen’s kappa values for measuring the intra-rater consistency of the four raters were 0.984, 0.887, 0.848, and 0.930, respectively, meaning very good alignment of 0.8 or more, respectively. The Fleiss Kappa value for measuring inter-rater consistency was 0.276, meaning ‘fair’ for values of 0.2 or more. To examine consistency, an intraclass correlation coefficient (ICC) analysis conducted by assuming the grading score to be a constant continuous variable gave an ICC value of 0.729 (P＜0.001), showing a very reliable tendency. Conclusion In this study, all the items of the fill-out form were rated using a three-step grading scale, so the degree of agreement was high when performed twice by the same rater, but the degree of agreement among raters was relatively low. Therefore, our fill-out form for FEES will be useful in evaluating the improvement of a patient over the course of clinical treatment.

BACKGROUND: The purpose of this study is to investigate the incidence and associated factors of postoperative delirium in elderly patients with hip fracture. METHODS: We interviewed 90 patients with hip fracture with the aim of identifying underlying diseases and laboratory data. Cognitive function was measured with Mini Mental Status Exam-K (MMSE-K) before surgery. RESULTS: Delirium developed in 20 patients (22.2%). History of dementia (p=0.041) and mean score of MMSE-K (p<0.001) were significantly related to the incidence of delirium. An MMSE-K score less than 20 was an independent risk factor for postoperative delirium in patients with hip fracture. CONCLUSION: Cognitive impairment was a risk factor of postoperative delirium. MMSE-K is expected to be a simple indicator for predicting postoperative delirium in older patients with hip fracture.
Aged ; Delirium ; Dementia ; Hip ; Humans ; Incidence ; Risk Factors

Purpose: A case of a huge ethmoid sinus and orbital cyst causing ocular deviation initially diagnosed as a mucocele-like cyst and after orbitotomy eventually discovered to be a naso-orbital encephalocele is described.Case summary: A 5-year-old male with no previous medical history presented with a palpable mass in the medial canthus area with left exodeviation of the left eye. His best-corrected visual acuity was 20/25 in the right eye and 6/12 in the left eye with limitation of motion of -4 at adduction in the left eye. Brain magnetic resonance imaging scans revealed a 3.0 × 2.5 × 2.5 cm-sized cystic mass suspected as a mucocele or nasolacrimal duct cyst invading the orbital space. The cyst was removed using a Lynch and caruncle incision, and intracystic fluid was aspirated. During the excision, a small defect of the skull base was detected with cerebrospinal fluid (CSF) leakage and leaking point of dura was sealed. His pathologic result was disorganized glial and fibrous tissue, consistent with encephalocele. Three days later, CSF leakage recurred. On postoperative day 8, duroplasty was performed. A one month later, his best-corrected visual acuity was 6/12 in the left eye with orthotropic eye position. Limitation of motion was improved to -1 at adduction with enophthalmos. No other complications were detected. Conclusions Congenital naso-orbital encephalocele invading the orbit is rare. However, a cystic mass in the sinuses involving the orbit should be considered, rendering thorough physical and radiologic examinations including computed tomography scans necessary to look for bone defects.