No abstract available.
Fetal Death*

OBJECTIVE: Cognitive symptoms are an important component of depression and the Perceived Deficits Questionnaire-Depression is one of only a few instruments available for the subjective assessment of cognitive dysfunction in depression. Thus, the present study aimed to validate a Korean version of the PDQ-D (K-PDQ-D) using patients with major depressive disorder (MDD). METHODS: This study included 128 MDD patients who were assessed at study entry and 86 of these patients were then completed 12 weeks of antidepressant monotherapy. All subjects were assessed with the K-PDQ-D, the Montgomery-Asberg Depression Rating Scale (MADRS), the Sheehan Disability Scale (SDS), the EuroQol-5 dimensions questionnaire (EQ-5D), and the number of sick leave days taken in the previous week. The internal consistency, Guttman's split-half and test-retest reliabilities, factorial analyses, and concurrent and predictive validities of the K-PDQ-D were investigated. RESULTS: The K-PDQ-D exhibited excellent internal consistency and reliabilities, and was composed of four factors with high coefficients of determination. The concurrent validity analyses revealed that the K-PDQ-D scores were significantly correlated with the MADRS, SDS, and EQ-5D scores and the number of sick leave days taken. The K-PDQ-D scores at study entry significantly predicted changes in sick leave days and EQ-5D score from study entry to the 12-week endpoint. CONCLUSION: The newly developed K-PDQ-D is a reliable and valid instrument for the evaluation of subjective cognitive symptoms in MDD patients. The K-PDQ-D may assist in the gathering of unique information regarding subjective cognitive complaints, which is important for the comprehensive evaluation of patients with MDD.
Depression ; Depressive Disorder, Major* ; Humans ; Neurobehavioral Manifestations ; Sick Leave

No abstract available.
Humans ; Nephritis, Interstitial* ; Nephrotic Syndrome*

Polymicrobial peritonitis is a relatively uncommon complication and it's clinical characteristics, risk factor and optimal managernent remain controversial. To identify indications for catheter removal in polymicrobial peritonitis, we reviewed the 340 episodes that occured in 168 patients of CAPD peritonitis during past 7 years to identify those. Polymicribial peritonitis was the 18 epoisodes in 18 patients of all peritonitis. First, 18 patients with polymicrobial peritonitis (P-P) did not show significant differences in the demographic features compared to 130 patients with single organism peritonitis (S-P). In contrast to Staphylococcus in S-P, the most common causative organisrn in P-P was pseudomonas (23%). Also sgnificantly more catheters were removed in P-P than S-P (P=0.001). Second, we cornpared group I, the patients responded to antibiotics only, and group II, those who needed catheter removal. The group I was 7 (39%) and the group II was 11 (61%). No patient of group I died and two patients of group II died. Between group I and group II, there were no significant differences in the demographic features. However, patients whose dialysate-WBC counts were below 100 at 3rd day after start of antibiotics were more significantly frequent in group I than group II. Among combination of causative organisms in P-P, most of Pseudornonas (6/9) and fungus (4/4) were treated by catheter removal. In conclusion, more catheters were removed in P-P than S-P. When dialysate WBC at 3rd day after start of antibiotics were over 100 and causative organism included pseudomonas or fungus in P-P, catheter removal was needed. We suggest that the kinds of organisms isolated and early response to antibiotics influence on the outcome of polymicrobial peritonitis.
Anti-Bacterial Agents ; Catheters* ; Fungi ; Humans ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Pseudomonas ; Risk Factors ; Staphylococcus

To evaluate the possibility that the ginseng saponins could be developed as an anti-arteriosclerotic agent, we examined the inhibitory effects of ginseng saponins (total saponin(TS), panaxatriol(PT), panaxadiol(PD)) on the expression of c-fos mRNA and the proliferation of cultured rat aortic vascular smooth muscle cells (VSMCs) stimulated by angiotensin II (Ang II). TS and PT (1.0 mg/ml) suppressed c-fos mRNA induction in VSMCs stimulated by 10-5 M Ang II. The order of inhibitory potency was PT>TS. Ginseng saponins (0.01~1.0 mg/ml) inhibited the proliferation of VSMCs stimulated by Ang II in a concentration dependent manner, the inhibitory potency was TS> PT> PD at 0.1~1.0 mg/ml. These results suggest that ginseng saponins may suppress Ang II-stimulated proliferation of aortic VSMCs which can be seen in atherosclerosis, hypertension and restenosis.
Angiotensin II* ; Angiotensins* ; Animals ; Atherosclerosis ; Hypertension ; Muscle, Smooth, Vascular* ; Panax* ; Rats* ; RNA, Messenger* ; Saponins*

BACKGROUND: A low dose of ketamine can be an effective preemptive analgesic by preventing central sensitization when administered before surgical trauma. In this study, we assessed the preemptive analgesic effect of low-dose ketamine administered intravenously to patients undergoing arthroscopic rotator cuff repair with intra articular ropivacaine injection. METHODS: This randomized, double-blinded study included fifty-six patients scheduled for elective arthroscopic rotator cuff repair. Normal saline (group C) or 0.5 mg/kg of ketamine (group K) was injected intravenously before the skin incision. An intra articular injection using 20 ml of 0.75% ropivacaine was performed in both groups just before wound closure by the surgeon at the end of the surgery. Postoperative pain was assessed by the numeric rating scale (NRS) in the post-anesthesia care unit (PACU) and at 12, 24, and 48 hours postoperatively. The total dose of fentanyl consumption and side effects were recorded. RESULTS: There were no significant differences between the C and K groups for the NRS of pain in the PACU and at 12, 24, and 48 hours after the surgery. In addition, there was also no significant difference in total fentanyl consumption between the two groups. CONCLUSIONS: Preemptive ketamine did not reduce preemptive pain scores and fentanyl consumption in patients who underwent arthroscopic rotator cuff repair with intra articular local anesthetic injection. Therefore, more aggressive and multimodal pain control is required in patients undergoing arthroscopic shoulder surgery regardless of the use of preemptive intravenous ketamine injection.
Central Nervous System Sensitization ; Fentanyl ; Humans ; Ketamine* ; Pain, Postoperative* ; Rotator Cuff* ; Shoulder ; Skin ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: The aims of this study were to establish a reliable model of chronic mitral regurgitation (MR) in rats and verify the pathophysiological features of this model by evaluating cardiac function using serial echocardiography and a pressure-volume analysis. MATERIALS AND METHODS: MR was created in 37 Sprague-Dawley rats by making a hole with a 23 gauge needle on the mitral leaflet through the left ventricular (LV) apex under the guidance of transesophageal echocardiography. RESULTS: Serial echocardiograms revealed that the LV began to dilate immediately after the MR operation and showed progressive dilation until the 14th week (LV end-systolic dimension at 14 weeks, 4.71+/-0.25 mm vs. 6.81+/-0.50 mm for sham vs. MR, p<0.01; LV end-diastolic dimension, 8.32+/-0.42 mm vs. 11.01+/-0.47 mm, p<0.01). The LV ejection fraction tended to increase immediately after the MR operation but started to decrease thereafter and showed a significant difference with the sham group from the 14th week (70.0+/-2.2% vs. 62.1+/-3.1% for sham vs. MR). In a pressure-volume analysis performed at the 14th week, the LV end-systolic pressure-volume relationship and +dp/dt decreased significantly in the MR group. A serial treadmill test revealed that exercise capacity remained in the normal range until the 14th week when it began to decrease (exercise duration, 406+/-45 seconds vs. 330+/-27 seconds, p<0.01). A pathological analysis showed no significance difference in interstitial fibrosis between the two groups. CONCLUSION: We established a small animal model of chronic MR and verified its pathophysiological features. This model may provide a useful tool for future research on MR and volume overload heart failure.
Animals ; Echocardiography ; Exercise Test ; Fibrosis ; Heart Failure ; Mitral Valve Insufficiency ; Models, Animal ; Needles ; Rats ; Rats, Sprague-Dawley ; Reference Values ; Salicylamides ; Ventricular Remodeling

SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome designates a group of articular and osseous manifestations frequently combined with skin disorders. Its fundamental component is inflammatory, pseudoinfectious, and sterile osteitis. The anterior chest wall is the most frequent localization and all the components of this structure may be involved. Palmoplantar pustulosis, psoriasis, acne conglobata, acne ulcerans, acne fulminans, pyoderma gangrenosum can be associated with the characteristic bone lesions. We report two cases of SAPHO syndrome : A 40-year-old female presented with both buttock pain with hyperostosis, costochondritis, synovitis and pustulosis palmaris and a 23-year-old male presented with migrating polyarthritis with costochondritis, synovitis, acne, pustulosis.
Acne Vulgaris ; Acquired Hyperostosis Syndrome* ; Adult ; Arthritis ; Buttocks ; Female ; Humans ; Hyperostosis ; Male ; Osteitis ; Psoriasis ; Pyoderma Gangrenosum ; Skin ; Synovitis ; Thoracic Wall ; Young Adult

BACKGROUND/AIMS: Thymidylate synthase (TS) is a target enzyme of 5-fluorouracil (5-FU) and has a polymorphic 28 bp tandem repeated sequence. TS enhancer region (TSER) polymorphism has been associated with the efficacy of 5-FU-based chemotherapy in colon cancer. Methylenetetrahydrofolate reductase (MTHFR) plays a central role in converting folate to methyl donor for DNA methylation. The aim of this study was to determine the clinical value of TSER and MTHFR polymorphism in gastric cancer. METHODS: From October, 1995 to February, 2002, 40 gastric cancer patients underwent operation and 25 patients among those patients have received postoperative 5-FU-based chemotherapy (5-FU (+) group). Peripherial blood were sampled for TSER and MTHFR genotype analysis by PCR amplification of genomic DNA. The survival of patients according to TSER and MTHFR polymorphism were compared. RESULTS: We observed a longer survival in stage II than stage III of the patients (p=0.0037). However, the TSER and MTHFR C677T polymorphisms were not associated with better survival of gastric cancer patients as well as combined TSER and MTHFR genotypes with 5-FU chemotherapy. CONCLUSIONS: The TSER and MTHFR genotypes are not effective markers for tumor sensitivity to 5-FU-based chemotherapy in Korean gastric cancer patients after curative resection. These results may suggest further large-scale study about TSER and MTHFR polymorphism for the prediction of efficacy of 5-FU-based chemotherapy in gastric cancer in Korea.
Aged ; Antimetabolites, Antineoplastic/*therapeutic use ; Drug Screening Assays, Antitumor ; Female ; Fluorouracil/*therapeutic use ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2)/*genetics ; Middle Aged ; *Polymorphism, Genetic ; Stomach Neoplasms/*drug therapy/genetics/mortality ; Survival Rate ; Thymidylate Synthase/*genetics

PURPOSE: Recently established in 1997, Sungkyunkwan University School of Medicine was the first medical school in Korea to adopt problem-based learning (PBL) as a core curriculum from the very beginning. The purpose of this study was to evaluate the PBL curriculum from the viewpoint of the medical students. METHODS: This study used a qualitative approach to understand students' perceptions of the positive aspects of PBL. A total of 22 second-year medical students at Sungkynkwan medical school were surveyed. Student perceptions were obtained from questionnaires and face-to-face interviews. The interview was designed to evoke more personal and in-depth responses. RESULTS: Students' perceptions of the effects of PBL were found to be very favorable. Most students showed positive responses on the issues of more active learning attitude, self-directed learning, motivation to study, improved problem solving, and integrated learning. CONCLUSION: The results of this study demonstrated that the students had a good understanding of PBL and experienced its positive aspects of PBL approach. It might be concluded that PBL was successfully implemented into the curriculum and specific and expected effects of PBL accomplished.
Curriculum* ; Evaluation Studies as Topic* ; Humans ; Korea ; Learning ; Motivation ; Problem Solving ; Problem-Based Learning* ; Schools, Medical ; Students, Medical ; Surveys and Questionnaires