BACKGROUND: Non ulcer dyspepsia(NUD) is a commonly encountered disease at the primary practice. The relations of functional gastrointestinal disorder and Irritable bowel syndrome with depression or stress were suggested by previous studies. But the contributions of the anxiety, depression and stress as a whole to the NUD were not assessed. In this study, we wanted to show the associations of the anxiety, depression and stress levels with NUD. METHODS: This study was performed by case and control method from Aug. 1 to Sep. 7 at the outpatient department of Family Medicine and at the Health Management and Service department in Pusan Paik Hospital. The both groups were matched by sex and age. The case was defined who has three or more symptoms among nine upper gastrointestinal symtoms like dyspepsia, epigastric pain and anorexia etc. frequently or alwalys and who has no ulcer at the gastrofibroscope. The anxiety, depression, stress levels were measured by questionnaire which was validated by previous studies. The questionnaire was composed of Trait-STAI, Jung's Self Depression Scale(SDS), Modified BEPSI, and Grobal Assessment of Recent Stress(GARS) Scale. RESULTS: The total subjects were 136 persons(NUD group : 86 persons/control group : 86 persons). There were. significant differances in regularity of diet(P<0.001), levels of education(P=0.009), and history of medications(P<0.001) between two groups. The two group had higher scores than the control group in the depression score, anxiety score and modified BEPSI score(P<0.001). All items in GARS showed higher scores in NUD group than in control group(P<0.001). CONCLUSIONS: NUD group had higher degree of anxiety and depression than the control group. It seems that the NUD may have streeful status. When we encounter the NUD in outpatiet department, we had better consider the underlying psychogenic or stressful conditions.
Anorexia ; Anxiety* ; Busan ; Depression* ; Dyspepsia* ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Outpatients ; Ulcer* ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to compare the changes induced in the pharyngeal airway space by orthodontic treatment with bodily retraction of the mandibular incisors and mandibular setback surgery without extraction. METHODS: This retrospective study included 63 adult patients (32 men and 31 women). Thirty-three patients who had been treated via four-bicuspid extraction and bodily retraction of the mandibular incisors (incisor retraction, IR group) were compared with 30 patients who had been treated via mandibular setback surgery (MS group) without extraction. Lateral cephalograms were acquired and analyzed before (T1) and after treatment (T2). RESULTS: The superior pharyngeal airway space did not change significantly in either group during treatment. The middle pharyngeal airway space decreased by 1.15 ± 1.17 mm and 1.25 ± 1.35 mm after treatment in the IR and MS groups, respectively, and the decrease was comparable between the two groups. In the MS group, the inferior pharyngeal airway space (E-IPW) decreased by 0.88 ± 1.67 mm after treatment (p < 0.01). The E-IPW was larger in the MS group than in IR group at T1, but it did not differ significantly between the two groups at T2. No significant correlation was observed between changes in the pharyngeal airway space and the skeletal and dental variables in each group. CONCLUSIONS: The middle pharyngeal airway space decreased because of the posterior displacement of the mandibular incisors and/or the mandibular body. The E-IPW decreased only in the MS group because of the posterior displacement of only the mandibular body.
Adult ; Humans ; Incisor* ; Male ; Retrospective Studies

Human cytomegalovirus (HCMV) is a common human pathogen that causes morbidity and mortality in hematopoietic stem cell transplantation (HSCT) recipients. Early diagnosis of HCMV infection or reactivation, and setting threshold values for effective pre-emptive therapies, are required for appropriate HCMV disease prevention in HSCT recipients. We compared the HCMV infections detected by the two methods, LightCycler-based PCR (LC PCR) and in-house immediate early protein PCR (in-house IE PCR) with the results of a pp65 antigenemia assay as the reference. The sensitivity and specificity for the in-house IE PCR were 79.3% and 72.7%, respectively, and 82.9% and 40.7%, respectively, for the LC PCR. The correlation between the HCMV viral load and pp65 antigenemia in HSCT recipients was r=0.603 with in-house IE PCR and r=0.525 with LC PCR. The discordant results between methods and relatively low (r) values suggest that we need more study to set threshold values according to the using methods with clinical outcome.
Cytomegalovirus ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Viral Load

Human cytomegalovirus (HCMV) is a common human pathogen that causes morbidity and mortality in hematopoietic stem cell transplantation (HSCT) recipients. Early diagnosis of HCMV infection or reactivation, and setting threshold values for effective pre-emptive therapies, are required for appropriate HCMV disease prevention in HSCT recipients. We compared the HCMV infections detected by the two methods, LightCycler-based PCR (LC PCR) and in-house immediate early protein PCR (in-house IE PCR) with the results of a pp65 antigenemia assay as the reference. The sensitivity and specificity for the in-house IE PCR were 79.3% and 72.7%, respectively, and 82.9% and 40.7%, respectively, for the LC PCR. The correlation between the HCMV viral load and pp65 antigenemia in HSCT recipients was r=0.603 with in-house IE PCR and r=0.525 with LC PCR. The discordant results between methods and relatively low (r) values suggest that we need more study to set threshold values according to the using methods with clinical outcome.
Cytomegalovirus ; Early Diagnosis ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Sensitivity and Specificity ; Viral Load

PURPOSE: Biliary atresia, one of the major causes of neonatal cholestais, is an idiopathic, serious disorder, affecting the newborn that results in complete obstruction of biliary tract. Successful reestablishment of bile flow is dependent on early surgical intervention, early diagnosis is imperative. The authors evaluate the utility of Tc-99m-labeled diisoprpyliminodiacetic acid (DISIDA) hepatobiliary scintigraphy in the diagnosis of biliary atresia. METHODS: From January, 1995 to August, 1999, total 60 patients with neonatal cholestasis underwent Tc-99m DISIDA hepatobiliary scintigraphy at Asan Medical Center. RESULTS: The undelying causes of neonatal cholestasis were biliary atresia in 14, neonatal hepatitis in 33, intrahepatic bile duct paucity in 9, and total parenteral nutrition induced cholestasis in 4. All patient with biliary atresia were interpreted correctely in DISIDA hepatobiliary scintigraphy, showing 100% sensitivity. Of the 46 patients with neonatal hepatitis and other causes, 37 patients had intestinal radioactivity showing 80% specificity. CONCLUSION: Visualization of DISIDA in the intestinal tract indicates patency of the biliary ducts and excludes the diagnosis of biliary atresia. But the absence of intestinal excretion on the DISIDA hepatobiliary scintigraphy dose not necessarily indicate biliary atresia.
Bile ; Bile Ducts, Intrahepatic ; Biliary Atresia* ; Biliary Tract ; Cholestasis ; Chungcheongnam-do ; Diagnosis* ; Early Intervention (Education) ; Hepatitis ; Humans ; Infant, Newborn ; Parenteral Nutrition, Total ; Radioactivity ; Radionuclide Imaging* ; Sensitivity and Specificity

PURPOSE: In the present study, we aimed to determine the risk factors for the development of cystic periventricular leukomalacia (CPVL) in very low birth weight (VLBW) infants. METHODS: We reviewed the medical records of 309 infants weighing less than 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Medical Center, Seoul from April 2007 to December 2012. Thirty-nine infants died within 28 days of birth. Of the remaining 270 infants, 21 with CPVL established by cranial ultrasonography, and 63 without CPVL, who were matched for gestational age, were enrolled in this study. Univariate and multivariate analyses of maternal, perinatal, and neonatal risk factors for CPVL were performed through retrospective assessment of data collected from the medical records. RESULTS: Necrotizing enterocolitis (NEC > or =stage II: 42.9% vs. 9.5%, P=0.002), culture-proven sepsis (66.7% vs. 34.9%, P=0.021), hypotension with sepsis (33.3% vs. 6.3%, P=0.004), and severe intraventricular hemorrhage (> or =grade III: 61.9% vs. 22.2%, P=0.002) were associated with the development of CPVL on univariate analysis. Using multivariate logistic regression analysis, two variables were found to be statistically significant independent risk factors: NEC (> or =stage II: adjusted OR, 5.12; 95% CI, 1.219-21.514; P=0.026) and hypotension with sepsis (adjusted OR, 8.23; 95% CI, 1.194-56.713; P=0.032). CONCLUSION: NEC (> or =stage II) and hypotension with sepsis were associated with an increased risk of developing CPVL in VLBW infants.
Academic Medical Centers ; Enterocolitis, Necrotizing ; Gestational Age ; Hemorrhage ; Humans ; Hypotension ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Medical Records ; Multivariate Analysis ; Parturition ; Retrospective Studies ; Risk Factors* ; Seoul ; Sepsis ; Ultrasonography

BACKGROUND: Although bone marrow (BM) or mobilized peripheral blood (PB) is frequently used as the source of hematopoietic stem cells, hematopoietic stem cell transplantation (HSCT) using cord blood (CB) is gradually gaining popularity in many countries. However, BM or PB is still preferred over CB in Korea. Therefore, we tried to assess the awareness of CB transplantation (CBT) among domestic HSCT physicians and develop strategies for boosting its utilization by administering questionnaires to some of these physicians. METHODS: A direct questionnaire survey was conducted using the "Audience Response System" among 301 members who attended the annual meeting of the Korean Society of Blood and Marrow Transplantation. The data were analyzed for only 67 board certified physicians who were directly involved in HSCT activities. RESULTS: The poor outcomes resulting from insufficient experience in CBT was designated by the physicians as the main reason for the low domestic implementation of HSCT using CB. Other reasons identified in the survey were distrust in the quality and management of domestic CB and the high cost of obtaining CB. CONCLUSION: Increasing the use of donated CB would foremost require increasing the inventory of donated CB containing a sufficient cell number for CBT and securing structured quality control of the CB banks. In addition, it would be necessary to minimize CB supply costs and continue to provide academic data, including CBT guidelines, so that clinicians could perform CBT with more confidence.
Bone Marrow ; Cell Count ; Fetal Blood* ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Korea ; Quality Control ; Surveys and Questionnaires

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.
Adult* ; Aortic Valve ; Aortic Valve Insufficiency ; Causality ; Chest Pain ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Femoral Artery ; Heart Diseases ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensation ; Thromboembolism

Midazolam, a benzodiazepine derivatives, is widely used in intensive care unit for sedation of patients who require mechanical ventilation. Although midazolam has a short acting time, it might cause a prolonged sedation, especially in patients with renal failure. We report the case of a 76-year-old man who received peritoneal dialysis and showed prolonged sedation after stopping continuous infusion of midazolam. The patient who has received maintenance hemodialysis for five months admitted in intensive care unit to manage pneumonia and severe congestive heart failure. In ICU, hemodialysis was transferred to peritoneal dialysis due to severe cardiac dysfunction. He was treated with mechanical ventilation under sedation with midazolam. However, even though stopping midazolam, deep sedation by midazolam was not restored. The patient completely recovered from sedation after 280 hours.
Aged ; Benzodiazepines ; Deep Sedation ; Heart Failure ; Humans ; Intensive Care Units ; Kidney Failure, Chronic ; Midazolam ; Peritoneal Dialysis ; Pneumonia ; Renal Dialysis ; Renal Insufficiency ; Respiration, Artificial

Arteriovenous vascular access infection associated with S. aureus bacteremia may cause metastatic complications, which relate to a poor outcome especially if proper diagnosis and treatment are delayed. We report a case of a 61-year-old male patient on maintenance hemodialysis who developed multiple metastatic infections associated with arteriovenous graft infection caused by methicillin-resistant Staphylococcus aureus (MRSA). At 7th hospital day, multiple metastatic infections, including osteomyelitis of clavicle, vertebral osteomyelitis, and tendinitis of the 5th finger proximal interphalangeal joint, were diagnosed by CT of chest, ultrasonography of hands, and whole body bone scan. Infected arteriovenous graft was removed and antibiotics was administrated for 18 weeks. Thereafter, MRSA bacteremia and clinical symptoms and signs related to metastatic infections were improved.
Anti-Bacterial Agents ; Bacteremia ; Clavicle ; Fingers ; Hand ; Humans ; Joints ; Kidney Failure, Chronic ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Osteomyelitis ; Polymethacrylic Acids ; Renal Dialysis ; Tendinopathy ; Thorax ; Transplants