OBJECTIVES: The purposes of this study are to investigate the reliability and validity of shortened premenstrual assessment form and the applicability to internet interface. METHOD: The total of 55 subjects were included in this study. Among them, 28 subjects had premenstrual dysphoric disorder, and the other 27 subjects did not. All subjects performed the shortened premenstrual assessment form through internet interface in the homepage of Severance Woman Clinic. The diagnosis of premenstrual dysphoric disorder was determined by prospective assessment for 2 months. RESULTS: The shortened premenstrual assessment form consists of 3 factors: affect, pain and water retention. The test-retest reliability of this scale was 0.80, and internal consistency (Cronbach alpha) was 0.91. The correlation coeffeciecy between scores of the premenstrual assessment form and the shortened premenstrual assessment form was 0.92. The difference of the scores of the shortened premenstrual assessment form between the group of premenstrual dysphoric disorder and the group of non-premenstrual dysphoric disorder was significant (t=5.57, p<0.001). Discriminant analysis also revealed that the shortened premenstrual assessment form was useful to differentiate between premenstrual dysyphoric disorder and non-premenstrual dysphoric disorder (eigenvalue: 0.60, canonical correlation coefficiency: 0.61, Wilk's lambda: 0.63). The cut-off point to differentiate between two groups was 27, and sensitivity (75.0%) and specificity (76.9%) of this scale for premenstrual dysphoric disorder was acceptable. CONCLUSION: In summary, the shortened premenstrual assessment form appeared to be reliable and valid for the assesment of premenstrual dysphoric disorder. And the results of this study also suggest that the shortened premenstrual assessment form is a useful tool for internet interface application.
Diagnosis ; Equidae ; Female ; Humans ; Internet* ; Prospective Studies ; Reproducibility of Results ; Sensitivity and Specificity ; Water

OBJECTIVES: The cognitive model has been suggested to explain the pathogenesis of premenstrual syndrome. In this model, it is suggested that negative cognitive style may contribute to the experience of severe premenstrual symptoms. We conducted this study to examine the relationship among cognitive style, perceived stress, and premenstrual symptoms. METHOD: Eighty six reproductive aged women older than 18 years were included in this study, to complete the Premenstrual Assessment form, Korean version of automatic thoughts Ques-tionnaire-Positive, Korean version of Automatic Thoughts Questionnaire-Negative, Korean version of Dysfunctional Attitude Scale, Perceived Stress Questionnaire. Among the subjects, twenty one were diagnosed to have a premenstrual dysphoric disorder which was determined by prospective assessment for two months. The relationships among the variables were analyzed by examining Pearson correlation coefficiency. REULTS: In the subjects without premenstrual dysphoric disorder, there exist significant correlation between the premenstrual symptom and the score of Korean-version of automatic thoughts Questionnaire-Negative(r=.36, p<.01). In the subjects with premenstrual dysphoric disorder, premenstrual symptoms had significant correlation to automatic thoughts Questionnaire-Negative(r=.65, p<.01) and Perceived Stress Questionnaire(r=.52, p<0.01). CONCLUSION: Our findings show the significant relationship between negative cognitive style and premenstrual symptoms. This relationship was more prominent in the subjects with premenstrual dysphoric disorder compared to ones without it. Our findings suggest that cognitive style and stress perception may influence on the severity of symptoms of premenstrual syndrome or premenstrual dysphoric disorder, and that cognitive behavior therapy is a possible effective therapeutic strategy for those with severe premenstrual symptoms.
Cognitive Therapy ; Female ; Humans ; Premenstrual Syndrome ; Prospective Studies ; Surveys and Questionnaires

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

473 patients who underwent orthopedic surgery of the upper extremities from July 1978 to August 1983 were studied and the results are as follows. 1) Among 473 patients 294 patients given general anesthesis. Axillary brachial piexus block(141 cases), intraveonus regional anesthesia(10 cases), interscalene block(2 cases) and continuous brachial plexus block were given to the rest of the patients. 2) 267 patients were male and 106 patients were female. Age distribution was from 2 to 74 years. 3) Physical status of the patients was A.S.A. (American Society of Anesthesiologists) class 2(52.5%), class 1(43.4%), class 3(4.4%) in the order. 47.2% of the patients underwent emergency operation. 4) There was a tendency that regional anesthesis has been increasing year by year. 5) The type of operations were open reduction(160cases), tendon repair(112cases), and surgery for neuropathy(65 cases). 6) The operations for upper arm, elbow, and forearm were performed mostly under general anesthesia, while regional anesthesia prevailled for hand, wrist, and digits operations. 7) Brachial plexus block was considered as a method of choice for upper extremity surgery, especially for emergency surgical procedures in patients with significant medical problems. 8) A new method was tried in which a flexible disaposable intravenous catheter was introduced into the neurovascular sheath in the axilla and used for injection of local anesthetic solutions to block the axillary brachial plexus. The catheter method constitutes an interesting alternative to the conventional needle techniques and offers a continuous axillary block and a method for postoperative pain relief.
Age Distribution ; Anesthesia, Conduction ; Anesthesia, General ; Arm ; Axilla ; Brachial Plexus ; Catheters ; Elbow ; Emergencies ; Female ; Forearm ; Hand ; Humans ; Male ; Needles ; Orthopedics ; Pain, Postoperative ; Tendons ; Upper Extremity* ; Wrist

We experienced a case of transient right-sided heart failure after angioplasty of membranous obstruction of the inferior vena cava confirmed by sonography and an inferior vena cavogram. Angioplasty involved the use of a self-expandable metallic stent, but after successful recanalization of the obstruction , the patient became dyspneic. Chest radiography revealed mild cardiomegaly with pulmonary congestion, but this was resolved spontaneously. For the prevention of serious heart failure, we recommend preprocedural evaluation of cardiac function.
Angioplasty* ; Cardiomegaly ; Estrogens, Conjugated (USP) ; Heart Failure* ; Humans ; Radiography ; Stents ; Thorax ; Vena Cava, Inferior*

We present three cases of malignant solitary fibrous tumors of the pleura (SFTP) that produced recurrent hypoglycemia. Removal of the tumors produced normoglycemia. The tumors were well circumscribed and lobulated, and consisted of firm masses weighing 1,150 g to 1,450 g with the greatest diameter of 15 to 20 cm. The tumors were composed of spindle cells in fascicles or in a haphazard arrangement and were highly cellular and mitotically active (3-8 mitoses/10 high-power fields), showing histologically malignant features. Ultrastructurally, fibroblastic features of the tumor cells were present. Insulin-like growth factors (IGF) have been implicated in the presentation of hypoglycemia. The serum insulin and C-peptide levels were not elevated. Serum IGF-I levels were also low with values of 97.4, 157.1 and 51.9 ng/mL (ref. 125-317 ng/mL), respectively. However, tumor cells were strongly positive for IGF-I receptor on immunohistochemical analysis. It is tempting to speculate that IGF-I contributes to the hypoglycemia, even though the circulating levels were low.
Aged ; Blood Glucose ; Coin Lesion, Pulmonary/chemistry/*complications/pathology ; Female ; Human ; Hypoglycemia/*etiology ; Immunohistochemistry ; Male ; Middle Age ; Pleural Neoplasms/chemistry/*complications/pathology ; Receptor, IGF Type 1/*analysis ; Recurrence

PURPOSE: Pylorus-preserving gastrectomy (PPG) is known to have both nutritional and functional advantages over distal gastrectomy for the treatment of early gastric cancer. Although laparoscopic surgery is a popular choice, intracorporeal anastomosis is a newly developed technique that is gaining popularity. This study aimed to determine any differences in the oncological, surgical, and functional outcomes of intracorporeal and extracorporeal anastomosis after PPG. METHODS: A retrospective analysis was performed on 90 patients for cT1N0 gastric cancer who underwent laparoscopic pylorus preserving gastrectomy from January 2015 to June 2017 at the OOO, Korea; 38 patients underwent intracorporeal (TLPPG) and 52 underwent extracorporeal (LAPPG) anastomosis. The postoperative oncological, surgical, and functional outcomes were compared between the two groups. In order to compare the outcomes in obese patients, the postoperative and functional outcomes in patients with a BMI of ≥25, and in those with abdominal wall thickness measuring ≥28 mm, were evaluated. RESULTS: The TLPPG group showed a significantly reduced wound size (4 cm (3~4) vs 5 cm (5~6), p<0.001) and had fewer wound complaints than the LAPPG group (0.0% vs 15.4%, p=0.01). Postoperative complications were not significantly different between the two groups. In the BMI ≥25 subgroup, the first flatus time after operation was shorter in the TLPPG group (2.9±0.5 vs 3.5±0.8 days, p=0.04). CONCLUSION: The study demonstrates that both TLPPG and LAPPG are safe and feasible, and that there is a potential benefit for obese patients.
Abdominal Wall ; Flatulence ; Gastrectomy ; Humans ; Korea ; Laparoscopy ; Postoperative Complications ; Pylorus ; Retrospective Studies ; Stomach Neoplasms ; Wounds and Injuries

We performed a prospective cohort trial on 220 patients undergoing elective off-pump coronary artery bypass surgery and taking aspirin to evaluate the effect of aspirin resistance on myocardial injury. The patients were divided into aspirin responders and aspirin non-responders by the value of the aspirin reaction units obtained preoperatively using the VerifyNow(TM) Aspirin Assay. The serum levels of troponin I were measured before surgery and 1, 6, 24, 48 and 72 hr after surgery. In-hospital major adverse cardiac and cerebrovascular events, graft occlusion, the postoperative blood loss and reexploration for bleeding were recorded. Of the 220 patients, 181 aspirin responders (82.3%) and 39 aspirin non-responders (17.7%) were defined. There were no significant differences in troponin I levels (ng/mL) between aspirin responders and aspirin non-responders: preoperative (0.04 +/- 0.08 vs 0.03 +/- 0.06; P = 0.56), postoperative 1 hr (0.72 +/- 0.87 vs 0.86 +/- 1.10; P = 0.54), 6 hr (2.92 +/- 8.76 vs 1.50 +/- 2.40; P = 0.94), 24 hr (4.16 +/- 13.44 vs 1.25 +/- 1.95; P = 0.52), 48 hr (2.15 +/- 7.06 vs 0.65 +/- 0.95; P = 0.64) and 72 hr (1.20 +/- 4.63 vs 0.38 +/- 0.56; P = 0.47). Moreover, no significant differences were observed with regard to in-hospital outcomes. In conclusion, preoperative aspirin resistance does not increase myocardial injury in patients undergoing off-pump coronary artery bypass surgery. Postoperative dual antiplatelet therapy might have protected aspirin resistant patients.
Aged ; Aspirin/*administration & dosage ; Cohort Studies ; Coronary Artery Bypass, Off-Pump/*adverse effects ; Coronary Disease/*surgery ; Drug Resistance ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Myocardial Reperfusion Injury/*prevention & control ; Platelet Aggregation Inhibitors/*administration & dosage ; Postoperative Hemorrhage/etiology ; Preoperative Care/methods ; Prospective Studies ; Stroke/etiology ; Troponin I/blood

Aortic intramural hematoma(AIH) is known as a variant of acute dissection due to rupture of the vasa vasorum without a intimal tear. In elderly hypertension patients patients with aortic dissection but without the characteristic echocardiographic findings of a double-channel aorta, this disease entity should be suspected and attention should be given to find segmental wall thickening of the aorta >0.7cm. AIH may progress to typical dissection or to rupture in considerable number of the patients, so careful follow-up is necessary and the same management principles for the patients with dissection can be applied in this variant. We report two cases of AIH showing typical eccentric mural thickening without dissection membrane with transesophageal echocardiographic follow-up.
Aged ; Aorta ; Echocardiography ; Echocardiography, Transesophageal* ; Follow-Up Studies ; Hematoma* ; Humans ; Hypertension ; Membranes ; Rupture ; Vasa Vasorum

BACKGROUND: Unplanned extubation is a common occurrence in mechanically ventilated patients even in spite of careful attention. It is important to decide on reintubation or the retention of the extubated state especially in the critically ill patients. We tried to formulate general guideline for evaluation and safe management in unplanned extubated liver transplant patients with high risk of multiple organ failure and high mortality rate. METHODS: We reviewed all medical records of 5 unplanned extubated cases from 27 liver transplantation cases. We checked delayed extubation criteria which included United Network Organ Sharing (UNOS) class 1 or 2, preoperative Na (below 130 mEq) and albumin (below 3.0) level, transfusion amount in operating room, severity of postreperfusion syndrome (PRS) and need of vasopressor agents in the 5 unplanned extubated cases. We also checked direct intubation determining factors such as PaO2/FiO2 ratio, respiration rate and pattern, mental state and mode of ventilation. Finally, we reviewed additional factors influencing reintubation. RESULTS: We found a rate of 18 percent of unplanned extubation (5 of 27 events), and 80 percent of reintubation incidence (4 of 5 events). CONCLUSIONS: It is rational to reintubate immediately in unplanned extubated cases which meet 3 or more delayed extubation criteria. The direct reintubation determining factors are PaO2/FiO2 ratio (below 300) and the presence of paradoxical respiration with a high respiration rate (over 28/minute).
Critical Illness ; Humans ; Incidence ; Intubation ; Liver Transplantation ; Liver* ; Medical Records ; Mortality ; Multiple Organ Failure ; Operating Rooms ; Respiration ; Respiratory Rate ; Vasoconstrictor Agents ; Ventilation