OBJECTIVES: The purpose of this study is to examine the psychosocial and obstetric factors associated with postpartum depressive symptoms in Korea. METHODS: At the 1-week and 4-week postpartum visit, 61 postpartum women completed Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), Stait-Trait Anxiety Inventory (STAI), and Symptom Check List-90-Revised (SCL-90-R). Data related to psychiatric and obstetric characteristics, pregnancy and delivery related events were collected from standard medical records. 42 women without a history of pregnancy or delivery within 6 months were recruited as a control group. The postpartum group were divided into depressive and non-depressive groups according to the EPDS and BDI results of 4-week postpartum. RESULTS: Compared to the normal control group, the mean scores of EPDS and BDI at 1-week postpartum were significantly higher (p<.05 and p<.01, respectively) in the postpartum group. The postpartum group also scored significantly higher in the somatization, psychoticism, and global severity index profiles according to the SCL-90-R results (p<.05). The mean score of BDI at 4-week postpartum was significantly higher (p<.01) in the postpartum group. There were significant correlations (p<.01) between the EPDS and BDI reports at 1- and 4-week postpartum. The rates of having experienced severe emotional stress during pregnancy and of smokers and drinkers before pregnancy were significantly higher (p<.05) in the postpartum depressive group (EPDS > or =10 and BDI > or =10) compared to the postpartum non-depressive group. The rate of having experienced depressive symptoms at 1-week postpartum was also significantly higher in the postpartum group. The depressive symptomatology at 1-week postpartum was identified as a significant risk factor for the depressive symptoms of 4-week postpartum when multiple logistic regression analysis was performed after controlling for age and education level. CONCLUSION: These findings suggest that postpartum women in Korea have many psychiatric problems such as depressive mood and somatization which necessitate proper care and assessment during the early postpartum period. Stress management during pregnancy may be helpful as a measure of preventing postpartum depression.
Anxiety ; Depression* ; Depression, Postpartum ; Education ; Female ; Humans ; Korea ; Logistic Models ; Medical Records ; Postpartum Period* ; Pregnancy ; Psychology ; Risk Factors ; Stress, Psychological

No abstract available in English.
Clinical Study ; Femur ; Hip Fractures

BACKGROUND: Good documentation of electrical injuries at the time of presentation is very important to emergency management, so this study was designed to investigate the clinical characteristics and the outcomes of patients with electrical injury. METHODS: A review of 75 cases of electrical injuries admitted to our hospital via the emergency department over a 4 year period from 1996 to 1999 was conducted. RESULTS: There were 49 patients with high-voltage injuries and 19 patients with low-voltage injuries. All but 4 patients were males, with a mean age of 29.5 years. The most common type of injury was 14.5% TBSA in the high-voltage group and 2.5% in the low-voltage group. Forty-nine(72.1%) of the injuries were work related. The number of patient with compartment syndrome was 19, and fasciotomies were performed in all but one patient. Myoglobinuria was noted in 22 patients, but no patient developed acute renal failure due to myoglobinuria. In the high-voltage group, 10 limb amputations were performed. Complication were observed in 12 patients. The most common complication was neurological injury. The average length of hospital stay was 50.7 days in the high-voltage group and 13.8 days in the low-voltage group. The overall mortality rate was 4.3%. CONCLUSION: Prevention of electrical injuries is very important. Education and compliance with safety measures, as well as basic knowledge and precaution in dealing with electricity, are essential to avoid these injuries.
Acute Kidney Injury ; Amputation ; Burns* ; Compartment Syndromes ; Compliance ; Education ; Electricity ; Emergencies ; Emergency Service, Hospital ; Extremities ; Humans ; Length of Stay ; Male ; Mortality ; Myoglobinuria

N-acetylcysteine (NAC) is widely recognized as the antidote of choice for acetaminophen overdose. Acetaminophen is a commonly used analgesic and antipyretic agent, and its use is one of the most common causes of poisoning worldwide. Acetaminophen toxicity may occur acutely when supratherapeutic amounts are ingested purposefully or unintentionally. Liver failure may occur in severe toxicity. However, if treated early, patients with acetaminophen poisoning generally recover uneventfully. Acetaminophen is metabolized to N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified by conjugation with glutathione. In overdose, hepatic stores of glutathione are depleted and NAPQI binding to hepatocytes induces cell death and hepatic necrosis. NAC replenishes hepatic glutathione and may also act as a glutathione substitute, combining directly with the toxic metabolite. Intravenous NAC is indicated in patients who present with a history of acetaminophen overdose within the previous 8 to 10 hours, patients unable to tolerate oral NAC, and patients who present with evidence of fulminant hepatic failure. However, caution should be used in patients who have experienced previous hypersensitivity or anaphylactoid reactions to intravenous NAC, as well as in patients with asthma. The most common anaphylactoid reactions include rash, flushing, and bronchospasm. Adults should receive 150 mg/kg administered for 45 minutes, followed by 50 mg/kg administered for 4 hours, followed by 100 mg/kg administered for 16 hours. The total dose is 300 mg/kg delivered over 21 hours. Additionally, caution should always be used when intravenous NAC is prescribed and the amount of diluent is calculated. Monitoring of patients with a should include repeated neurologic and hemodynamic assessment.
Acetaminophen* ; Acetylcysteine* ; Adult ; Antidotes ; Asthma ; Benzoquinones ; Bronchial Spasm ; Cell Death ; Exanthema ; Flushing ; Glutathione ; Hemodynamics ; Hepatocytes ; Humans ; Hypersensitivity ; Imines ; Liver Failure ; Liver Failure, Acute ; Necrosis ; Poisoning*

BACKGROUND: More than 90% of acute stroke patients have measurable cardiovascular sequelae, but we have been often overlooked in formal discussions of treatment. If we estimate the incidence of myocardial injury in patient with spontaneous SAH, we may figure the possibility of cardiac dysfunction in such patients. This study was designed to investigate the incidence of myocardial injury in patients with spontaneous SAH using cardiac troponin I(cTnI). METHODS: A prospective single emergency center study was performed to determined preoperative incidence of unrecognized cardiac injury in patients suffering spontaneous SAH. We include the spontaneous SAH patients who underwent serum measurements of the cardic troponin I immediately upon admission last six month period. ECG, CK, CK-MB and myoglobin were also performed at admission. We excluded the spontaneous SAH patients who had past history of myocardial ischemia and ECG abnormality. RESULTS: Fifty-two patients(34 females, 18 males) with spontaneous SAH were studied prospectively. 18 patients(34.6% of the total study population) had cTnI level above 0.5ng/ml. ECG was performed in 52 patients and was abnormal in 15 of the 52 patients(28.8%). CONCLUSION: The measurement of cTnI has provided physicians with a myocardial marker that has a cardiac sensitivity for cardiac injury equal to that of CK-MB yet with greater specificity. So, cardiac troponin I is useful to estimate the incidence of myocardial injury in patients with spontaneous SAH. And we may estimate the possibility of cardiac dysfunction in such patients. This knowledge will hopefully aid in the care and improve the outcome.
Electrocardiography ; Emergencies ; Female ; Humans ; Incidence* ; Myocardial Ischemia ; Myoglobin ; Prospective Studies ; Sensitivity and Specificity ; Stroke ; Troponin I* ; Troponin*

Spinal cavernous hemangiomas of the cauda equina are extremely rare vascular malformations. We report a case of intradural extramedullary cavernous hemangioma of the cauda equina with it's clinical, radiologic and surgical findings. This is the twelveth case of cavernous hemangioma of the cauda equina in the literature. The pertinent literatures are reviewed.
Cauda Equina* ; Hemangioma, Cavernous* ; Vascular Malformations

PURPOSE: This study was performed to determine the usefulness of blood culture in the management of febrile immunocompetent patients presenting emergency department. METHODS: We prospectively analysed the medical characteristic and the result of blood culture of febrile immunocompetent patients who presented to Chonnam National University Hospital emergency center form April 2005 to October 2005. RESULTS: The study included 182 patients. The characteristic associated with the positive result of blood culture on multivariate analysis was the low initial level of albumin. Of the 182 culture, only 26 were true positive(14.3%). Of them, the result of blood culture influenced management in five patients (2.7%). CONCLUSION: The blood cultures has usually been ordered in febrile immunocompetent patients at emergency department has the limited usefulness. The emergency physician who initially treats them has to consider this limitation of it.
Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Jeollanam-do ; Multivariate Analysis ; Prospective Studies

BACKGROUND/AIMS: Hepatocytes on the hepatic lobule mipate from portal zone to centrilobular mea as the DNA synthesis within it. And also, the xenobiotic reactions reveal characteristic differences associated with zone specific metabolism in the liver acinus. In this study, the zonal distribution of ethylnitrosourea (ENU)-induced hepatic precancerous lesion was stereologically investigated. METHODS: Nine B6C3F1 mices were given I.p. injection of ENU (60 ug/pn body weight) when the pups were 15 days old prior to sacrifices at 8 weeks of life. All the 150 consecutive sections, 3 p m in thickness, were stained with hematoxylin and eosin and identified the basophilic precancerous lesions with 80-165 p m diameter in equatorial plane by the Zeiss microprojector. And then the distances from the center of selected foci to terminal hepatic vein or portal vein branches were estimated under the microscopic fields. As a control group, the same estimations were performed from the random points by the appointments of random digit table. RESULTS: Mean distance between ENU-induced 52 hepatocellular foci and the nearest terminal hepytic vein was 181.15+112.39 p m (Mean+ SD), but that of randomly selected 104 points was 291.73+157.98pm (Mean+5D) (Students t-test, p<0.0005). Substantially, 52.7% of ENU-induced 52 hepatocellular foci were within 300 p m from the terminal hepatic vein, but randomly selected 104 points were only 50.9% (Shapiro Wilk W test, w=0.819857, p=0.048038). Mean distance from ENU-induced 52 foci to portal vein was 398.85+149.98pm (Mean+SD), but that from the randomly selected 104 points was 315.87+145.79 pm (Mean+SD)(Students t-test, p<0.0005). CONCLUSION: Stereologically, ENU-induced mice liver cell foci distribute non-randomly to Zone III, centrilobular zone of mouse hepatic acini where promote invasion toward terminal hepatic veins.
Animals ; Appointments and Schedules ; Basophils ; Cholestasis ; DNA ; Eosine Yellowish-(YS) ; Ethylnitrosourea ; Fluconazole ; Hematoxylin ; Hepatic Veins ; Hepatocytes ; Liver ; Metabolism ; Mice* ; Portal Vein ; Veins

It has recently become possible to record electrical activity originationg from abnormally conducting myocardium from the body surface with high-gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz (p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration. SELECTION OF SUBJECTS: For this study, normal healthy young adult volunteers (age : mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. SIGNAL-AVERAGED ELECTROCARDIOGRAPHY: In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording.
Cardiovascular Diseases ; Echocardiography ; Electrocardiography* ; Electrodes ; Female ; Humans ; Internal Medicine ; Male ; Myocardium ; Noise ; Patient Selection ; Reference Values ; Skin ; Students, Medical ; Supine Position ; Tachycardia, Ventricular ; Volunteers ; Young Adult*

A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.
Arrhythmias, Cardiac ; Atherosclerosis ; Dyspnea ; Electrocardiography ; Female ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Ischemia ; Shock ; Ultrasonography