Patent Ductus Arteriosus is one of the most common congenital heart diseases. The symptoms and clinical findings in patients with typical patnet ductus arteriosus are well recognized. That not all patient with ductus arteriosus have the typical clinical findings is well documented. Since the poor prognosis of untreated patent ductus arteriosus and good results of surgical intervention are fairly well established fact, it is important that all altered in according to hemodynamic changes depending on the pulmonary pressure, amount of shunt, degree of resistance of pulmonary circulation. This series comprises 165 patients of patent ductus arteriosus who had been admitted to Severance Hospital from Apr. 1964 to Aug. 1979. An attempt was made to correlate the hemodynamic data with age. The results of this study may be summarized briefly as follows : 1.Of the 165 patients, 67 were male and 98 were female. Their age range from 1 day to 48 years. About 50% of all patients was below 10 years. 2.Major symptoms on admission were frequent URI, exertional dyspnea, palpitation and evaluation of known congenital heart disease etc. 3.Of 165 patients, continuous murmur was audible in 128 patients and systolic murmur in 28 patients. 4.The children (below 15 years of age) had the variable distribution of pulmonary to systemic flow ratio (Qp/Qs) Most of adult had the Qp/Qs of below 3. 5.Severe pulmonary hypertension was noted in 13% of right heart catheterized patients. 6.There was no obvious correlation between aging and pulmonary wascular resistance or pulmonary hypertension. 7.There was linear correlation between the diameter of ductus and pulmonary blood flow. 8.The left atrium to aortic root dimension ratio in echocardiogram showed correlation with the pulmonary to systemic flow ratio measured at catherization (r=0.45) 9.Operative mortality was 2.5% in 165 cases of isolated patent ductus arteriosus.
Adult ; Aging ; Cardiac Catheters ; Child ; Ductus Arteriosus ; Ductus Arteriosus, Patent* ; Dyspnea ; Female ; Heart Atria ; Heart Defects, Congenital ; Heart Diseases ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Male ; Mortality ; Prognosis ; Pulmonary Circulation ; Systolic Murmurs

We observed 62 patients who were admitted to the Pediatric Department of Severance Hospital for the treatment of pleurisy with effusion during the period of 11 years from Apr. 1965 to May 1975. The following results was obtained. 1) Age and sex incidence : 72.6% were between the age of 3 to 12 years. The sex ratio of male to female was 1.7:1. 2) Seasonal incidence : Effusion occured most commonly in the spring(33.9%) least often in the winter(17.8%). 3) Symptoms on admission in order were fever,(77.4%) cough,(61.3%) dyspnea,(40.3%) Chest pain, (27.4%) etc. 4) There was a contact history with tuberculous family in 17 cases(27.3%). P.P.D skin test was positive in 43 cases(69%). 5) The site of effusion was 60% on the right and 40% on the left. 6) In all cases, antitubeculous drugs were used. Among 54 cases treated with prednisolone, pleural fluid was disappeared completly in 21 cases within 2 weeks.
Chest Pain ; Female ; Humans ; Incidence ; Male ; Pleurisy* ; Prednisolone ; Seasons ; Sex Ratio ; Skin Tests

BACKGROUND: The purpose of this study was to compare the physical activity and caloric intake trends of lipid-lowering drug users with those of non-users among Korean adults with dyslipidemia. METHODS: This study was a repeated cross-sectional study with a nationally representative sample of 2,635 Korean adults with dyslipidemia based on the 2010-2013 Korea National Health and Nutrition Examination Survey. Physical activity was assessed using the International Physical Activity Questionnaire, and caloric intake was estimated through 24-hour dietary recall. All statistical analyses were conducted using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The changes in physical activity and caloric intake were investigated for lipid-lowering drug users and non-users using generalized linear models. RESULTS: The proportion of lipid-lowering drug users in the 2010-2013 survey population increased from 3.5% to 5.0% (P<0.001). Among adults of dyslipidemia, total of 1,562 participants (56.6%) reported taking lipid-lowering drugs, and 1,073 (43.4%) reported not taking lipid-lowering drugs. Drug users were more likely to be older and less educated and to have a diagnosis of diabetes, higher body mass index, and lower low density lipoprotein cholesterol level. Physical activity trends were tested separately for the lipid-lowering drug users and non-users, and a significant decrease was found among the drug users during the study period. Physical activity among the drug users in 2013 was 38% lower (1,357.3±382.7 metabolic equivalent [MET]; P for trend=0.002) than in 2010 (2,201.4±442.6 MET). In contrast, there was no statistically significant difference between drug users and non-users in the trend of caloric intake during the same period. CONCLUSION: Physical activity significantly decreased among lipid-lowering drug users between 2010 and 2013, which was not observed among non-users. The importance of physical activity may need to be re-emphasized for lipid-lowering drug users.
Adult* ; Body Mass Index ; Cholesterol, LDL ; Cross-Sectional Studies ; Diagnosis ; Drug Users* ; Dyslipidemias* ; Energy Intake* ; Humans ; Korea ; Linear Models ; Metabolic Equivalent ; Morinda* ; Motor Activity* ; Nutrition Surveys

BACKGROUND: Atopic dermatitis (AD) is characterized by pruritic and eczematous skin lesions, which often cause depressive symptoms, anxiety, stress, sleep disturbances, social withdrawal, and stigmatization. METHODS: In total, 23,442 subjects (434 AD patients and 23,008 control subjects) aged 19 years or older and without a history of major medical illness or depressive disorders were selected from The Fifth Korea National Health and Nutrition Examination Survey 2007-2012. Following the initial selection, 2,170 age- and sex-matched control subjects were selected using 1:5 propensity score matching. Multiple logistic regression analysis was performed to identify the presence of depressive symptoms of at least 2 weeks in duration. RESULTS: The demographic, socioeconomic, and clinical characteristics of AD patients and control subjects were presented and compared, and some variables differed significantly between groups. Presence of depressive symptoms was set as dependent variable, and multiple logistic regression analysis was performed as follows: (1) unadjusted; (2) with alcohol use, exercise status, smoking status, and body mass index (BMI) adjusted for; and (3) with alcohol use, exercise status, smoking status, marital status, occupation, BMI, total caloric intake, history of hypertension, and history of diabetes mellitus adjusted for. Depressive symptoms were significantly higher (odds ratios, 1.46, 1.40, and 1.36; 95% confidence intervals, 1.09-1.95, 1.0.4-1.88, and 1.01-1.85, respectively) in AD patients relative to those of matched controls. CONCLUSION: AD and clinical depression interact closely, and causal relationships between the two conditions have frequently been observed. Physicians should consider mental health interventions cautiously. It is particularly important that primary care physicians provide comprehensive, continuous long-term care.
Adult* ; Anxiety ; Body Mass Index ; Depression* ; Depressive Disorder ; Dermatitis, Atopic* ; Diabetes Mellitus ; Energy Intake ; Humans ; Hypertension ; Korea* ; Logistic Models ; Long-Term Care ; Marital Status ; Mental Health ; Nutrition Surveys* ; Occupations ; Physicians, Primary Care ; Propensity Score ; Skin ; Smoke ; Smoking ; Stereotyping

BACKGROUND: Darbepoetin alfa is a new erythropoietic agent with a three fold longer terminal half-life than recombinant human erythropoietin (r- HuEPO). The aim of this randomized, open-label study is to determine whether darbepoetin alfa is as effective as r-HuEPO for the treatment of anemia in hemodialysis patients when administered at a reduced dosing frequency. METHODS: A total 74 Korean hemodialysis patients receiving r-HuEPO therapy by either the intravenous (IV) or subcutaneous (SC) route were randomized to continue r-HuEPO or to receive an equivalent dose of darbepoetin alfa at a reduced dosing frequency. Patients receiving r-HuEPO once weekly changed to once every other week darbepoetin alfa, and those receiving r-HuEPO two or three times weekly changed to once-weekly darbepoetin alfa. The initial dose of darbepoetin alfa was based on the r-HuEPO dose at the time of entry into the study, using a formula equating the peptide mass of the two molecules (200 IU r-HuEPO=1 microgram darbepoetin alfa). The doses of r-HuEPO and darbepoetin alfa were titrated to maintain hemoglobin concentrations within -1.0 to +1.5 g/dL of patients' baseline values and within a range of 8.0 to 13.0 g/ dL for up to 20 weeks (16-week dose-titration period followed by a 4-week evaluation period). The primary end point was change in hemoglobin level between baseline and the evaluation period. RESULTS: The mean change in hemoglobin from baseline to the evaluation period was similar in the darbepoetin alfa (-0.03+/-0.19 g/dL) and r-HuEPO (0.27+/-0.20 g/dL) groups, and the difference between the two treatments was -0.30 g/dL (95% CI, -0.84 to 0.23). This was not a statistically significant or clinically relevant difference, despite the reduced frequency of darbepoetin alfa administration. The safety profiles of darbepoetin alfa and r-HuEPO were similar. CONCLUSION: This study suggests that darbepoetin alfa maintains hemoglobin as effectively as r- HuEPO, but with reduced dose frequency.
Anemia* ; Erythropoietin ; Half-Life ; Hemoglobin A ; Humans ; Renal Dialysis* ; Darbepoetin alfa

Background/Aims: Endoscopic diagnosis of dysplasia or colitic cancer in patients with ulcerative colitis (UC) is more challenging than that of colorectal neoplasia in non-colitic patients. We aimed to evaluate the accuracy of the endo-scopic diagnosis of “nonpedunculated” dysplasia or colitic cancer in UC patients. Methods: Ten endoscopists from four countries were surveyed using photographs of 61 histologi-cally confirmed dysplastic or non-dysplastic lesions retrieved from the UC registry database of Asan Medical Center. The participants provided their assessment based on the given photographs and their intention to perform biopsy. Results: The overall diagnostic performance of the 10 participants is summarized as follows: sensitivity of 88.2% (95% confidence interval [CI], 84.3% to 91.5%), specificity of 34.8% (95% CI, 29.1% to 40.8%), positive predictive value of 63.0% (95% CI, 60.8% to 65.2%), negative predictive value of 70.2% (95% CI, 62.7% to 76.6%), and accuracy of 64.6% (95% CI, 60.7% to 68.4%). The interobserver agreement on the inten-tion to perform a biopsy was poor (Fleiss kappa=0.169). Of the three endoscopic characteristics of the lesions, includ-ing ulceration, distinctness of the borders, and pit patterns, only neoplastic pit patterns were significantly predictive of dysplasia (odds ratio, 3.710; 95% CI, 2.001 to 6.881). The diagnostic sensitivity and specificity of neoplastic pit patterns were 68.2% (95% CI, 63.0% to 73.2%) and 63.3% (95% CI,57.3% to 69.1%), respectively. Conclusions Diagnostic per-formance based on the endoscopist’s intention to perform a biopsy for nonpedunculated potentially dysplastic lesions in UC patients was suboptimal according to this survey-based study.