No abstract available.
Duodenal Obstruction*

BACKGROUND: Dementia has emerged as a leading public health problem with elderly persons and its early detection is important for treatment in curable cases. Although dementia screening tests are available, they are still complex and time consuming in practice and therefore difficult to use. Our goal was to validate the time and change(T&C) test, a simple, standardized method for detecting dementia in the elderly populations. METHODS: Participants were 59 patients aged 65 years or older at an urban hospital from November 1 to December 31, 2001. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability making 1,000 Won from a group of coins consisting one 500 Won, seven 100 Won, seven 50 Won. T&C ratings were validated against a reference standard based on physician`s diagnosis. Test-retest reliability and inter-observer reliability were assessed. RESULTS: The T&C test had a sensitivity of 73.0%, specificity of 90.9%, positive predictive value of 93.1%, and negative predictive value of 66.7%. Test-retest and inter-observer agreement rates were 95% and 95%, respectively. The T&C test was not influenced by education. The time and change tests took a mean of 7.5 seconds and 19.6 seconds to complete respectively, and was acceptable to participants. When timed cut points were added, the T&C test had a sensitivity of 86.5%, specificity of 40.9% and test-retest and inter-observer agreement rates were 77.3% and 81.8%, respectively. CONCLUSION: The T&C test is a simple, accurate reliable, performance-based tool for detection of dementia in the elderly.
Aged* ; Dementia* ; Diagnosis ; Education ; Hand ; Hospitals, Urban ; Humans ; Mass Screening* ; Numismatics ; Public Health ; Sensitivity and Specificity

BACKGROUND: Hand-foot-mouth disease (HFMD) is mainly caused by the infection of coxsackievirus A16. But recently several epidemics of HFMD with meningitis or myocarditis due to enterovirus 71 have been reported in Southeast Asia. It was necessary that the possibility of enterovirus 71 epidemic in Korea should be ruled out. This study was designed for the determination of causative agents of HFMD in Cheju province in the spring of 1998. METHODS: Serum specimens were collected from 45 pediatric patients with HFMD at Cheju Hankook Hospital in March and April,1998. Virus isolation was performed with RD cell culture through up to three passages. Reverse transcription-PCR and nucleotide sequencing were performed by the method of Oberste et al.(J Clin Microbiol 1999;37:1288-93). The serotypes of viral isolates were determined by BLAST program of National Center for Biotechnology Information, U.S.A. RESULTS: Virus could be isolates from 4 patients, whose age was ranged from 11 months to 3 years. All of 4 viral isolates showed about 430-bp product of RT-PCR using primers 011 and 012. The serotype showing the highest similarity with the nucleotide sequences of all of these viral isolates was coxsackievirus A16. CONCLUSIONS: The causative enteroviral agent of HFMD in Cheju province in the spring of 1998 was coxsackievirus A16. We could not detect enterovirus 71 from the patients' sera in Cheju Province in the spring of 1998.
Asia, Southeastern ; Base Sequence ; Biotechnology ; Cell Culture Techniques ; Enterovirus ; Humans ; Jeju-do* ; Korea ; Meningitis ; Myocarditis ; Polymerase Chain Reaction

The concept of bipolar disorder is an ongoing process, still in evolution, although its roots can be found from ancient Greek. Until recently, it was believed that no more than 1% of the general population has bipolar disorder. But literature on the lifetime prevalence of the bipolar spectrum disorder suggests rates of 4-5%. Bipolar spectrum disorder is a longitudinal diagnosis characterized by abnormal mood swings comprising some of the following cross-sectional clinical states: mania, hypomania, mixed states, hyperthymic temperament, major depressive episode, and depressive mixed state. Failure to recognize subthreshold expressions of mania, such as hypomania, cyclothymia, and hyperthymia, contributes to the frequent under-diagnosis of bipolar disorder. There are several reasons for the lower rate of recognition of subthreshold manic symptoms, when compared to the analogous pure depressive one. These include the lack of subjective suffering, enhanced productivity, egosyntonicity, diurnal and seasonal rhythmicity associated with many of the manic and hypomanic symptoms, and the psychiatrists' difficulty in differentiating with personality disorders. In addition, most patients with bipolar spectrum disorder seek treatment for depression, rather than mania or hypomania. Therefore clinicians often miss the diagnosis of bipolar spectrum disorder. The recent 10 years of researches have suggested that 30-55% of patients with major depressive disorder are actually identified with broader spectrum of bipolar disorders. However, 48% of patients of bipolar disorder consulted 3 or more professionals before receiving a correct diagnosis, and 10% consulted 7 or more for their first diagnosis of bipolar disorder. Several studies have documented that patients often wait as long as 10 years for the correct diagnosis of bipolar spectrum disorder. This delay in diagnosis often has substantial adverse results. Patients do not get the appropriate treatment to alleviate their symptoms. They may even get treatments that exacerbate their symptoms, such as prescription of antidepressants precipitating mania and producing rapid cycling. The concepts of hypomania, cyclothymia, mixed state, depressive mixed states, hyperthymic temperament are the new areas of studying mood disorders in recent 20 years. The authors will review the studies on various subtypes of bipolar spectrum disorder with their historic aspects, and introduce the suggested screening tests for bipolar spectrum disorder in clinical practice.
Antidepressive Agents ; Bipolar Disorder ; Classification ; Depression ; Depressive Disorder, Major ; Diagnosis ; Efficiency ; Humans ; Mass Screening ; Mood Disorders ; Periodicity ; Personality Disorders ; Prescriptions ; Prevalence ; Seasons ; Temperament

PURPOSE: This study was founded to identify perception and ways of coping with stress according to classification of Sasangin(4 constitutions). METHOD: The subjects were 258 regular students who majored in oriental medicine in Jechon and Seoul. Data was collected by 3 types of questionnaires for 3 months; Perceived stess, ways of coping, Questionnaires of Sasang Constitution Classification (QSCC II). Data analysis was conducted by SPSS version 10. RESULT: 1) Difference of perceived stress in Sasangin: Perceived stress by the Sasangin indicated that Soeumin perceived more stress than Soyangin and Taeumin(P=0.013). 2) Different method in coping with stress of Sasangin: It was found that Soeumin didn't make use of emotional coping way according to the analysis(P=0.040). 3) Relationship between ways of coping for stress and perceived stress in Sasangin: It was shown that as Soeumin perceived stress so higher than Soyangin and Taeumin, they tended to use the solving problem-method therefore it was shown to have a negative correlation(P=0.044). CONCLUSION: In conclusion, it was found that there were differences of Sasangin in perceived stress and ways to cope with it. The dose relationship between the perception and coping method of stress was found.
Classification ; Constitution and Bylaws ; Humans ; Medicine, East Asian Traditional ; Seoul ; Statistics as Topic ; Surveys and Questionnaires

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

BACKGROUND: The determination of serotype of enteroviruses is useful for the discrimination between sporadic and epidemic infections. The conventional serotyping method is time-consuming and labor-intensive. Recently, molecular method was introduced for the serotyping of enteroviruses. The aim of this study was to establish a method to isolate and analyze enteroviruses from various specimens utilizing molecular biological techniques and to determine which strains were phylogenetically related to clinical samples. METHODS: Clinical samples in this study included 164 cerebrospinal fluid (CSF), 136 stool, 15 sera, 6 throat swab, 5 urine, and 4 sputa, which were obtained from hospitalized patients, primarily infants or children presenting symptoms of aseptic meningitis in 1998. RD cells were used for enterovirus isolation. RT-PCR was performed with RD cell lysate showing CPE. The primers 011 and 012 were used for the VP1 region, and the primers EN1 and EN2 for 5'-UTR. The nucleotide sequences of VP1 region were determined and analyzed with BLAST program. RESULTS: Among 333 samples, only 23 samples produced CPE: 17 samples at first and six samples at the second blind passage. Fifteen isolates were related to coxsackievirus B2 two to echovirus 4, three to echovirus 6, and three to echovirus 18. All 23 viral isolates displayed a nucleotide sequence identity of 80-95%, compared with the reference serotypes. However, the identity was increased up to 93-100% when the VP1 region was translated into amino acids CONCLUSIONS: Since CB2 type was 55% among enteroviral isolates, the CB2 was determined as the major causative serotype of enteroviral meningitis in 1998. CB2 type was emerged between June and July, EC4 and EC6 was limited to July, and EC18 was in August.
Amino Acids ; Base Sequence ; Cerebrospinal Fluid ; Child ; Discrimination (Psychology) ; Echovirus 6, Human ; Enterovirus B, Human ; Enterovirus* ; Humans ; Infant ; Meningitis* ; Meningitis, Aseptic ; Pharynx ; Serotyping*

No abstract available.
Arteries* ; Cardiomyopathy, Hypertrophic* ; Humans ; Infant* ; Mothers*

Orthognathic surgery of the mandibular prognathism and the retrognathism is tend to be performed on the mandibular ramus to prevent inferor alveolar nerve injuries. The purpose of this study is to find a safe and accurate reference point on mandibular ramus for orthognathic surgery by comparative anatomical study of dentofacial deformity patients. We use 38 Korean Cadavers with normal occlusion(Group 1), 3-dimensional simulation of computerized tomogram of 23 patients with retrognathism (Group 2), 27 patients with mandibular prognathism (Group 3). Following results are obtained : 1. The maximum thickness of the mandibular ramus is 8.78+/-1.15mm for Group 2, 7.61+/-1.26mm for Group 1, 6.95+/-0.82mm for Group3 respectively (P=0001). The minimum thickness is 5.51+/-1.08mm for Group 1 , 5.06+/-0.40mm for Group 2, 4.56+/-0.78mm for Group3, respectively (p=0.0001). But, the thickness at the level of 5mm above the lingular is 0.78+/-0.65mm for Group 2, 5.63 +/-1.28mm for Group 1, 5.32+/-0.91mm for Group 3, respectively. There is no significant difference between these groups(P=0.0510). 2. The horizontal location from the midwaist point to lingular is 0.18+/-1.57mm for Group 1, 0.69+/-1.33mm for Group 2, 0.66+/-1.66mm for Group 3, and there is no significant difference between these groups(p=0.0835). But the vertical location from the midwaist point to lingular is 1.45+/-2.64mm for Group 1, 0.63+/-1.44mm for Group 2, 0.34+/-1.81mm for Group 3, and there is significant difference between these groups(p=0.0030). 3. The horizontal location from the midwaist point to mandibular foramen is 0.29+/-1.75mm for Group 1, 0.63+/-1.44mm for Group 2, 0.34+/-1.81mm for Group 3, and there is no significant difference between these groups(p=0.5403). But the vertical location from the midwaist point to mandibular foramen is -3.33+/-4.43mm for Group1, -4.79+/-2.26mm for Group 2, -6.06+/-2.99mm for Group 3, and there is significant difference between these groups(P=0.0001). 4. The horizontal length from the disto-buccal cusp tip of mandibular second molar to lingula is 30.97+/-4.17mm for Group 3, 28.29+/-2.65mm for Group 1, 25.48+/-0.77mm for Group 2 (p=0.0000), and also vertical length is 7.72+/-3.22mm for Group 3, 6.38+/-1.83mm for Group 1, 5.89+/-2.30mm for Group 2 (P=0.0014). 5. The location of lingular is 0.50 from anterior border of mandibular ramus in all groups, if it assumed the length from anterior border to posterior border is 1. And it is almost 0.33 from the sigmoid notch, if it assumed the length from sigmoid notch to antegonial notch is 1. 6. In Group 1, Antilingular prominence is located on (1.12+/-1.43mm, 4.01+/-2.36mm) from the midwaist point, and there is no correlation between antilingular prominence and lingular, mandibular foramen.
Cadaver ; Colon, Sigmoid ; Dentofacial Deformities* ; Humans ; Molar ; Orthognathic Surgery ; Prognathism ; Retrognathia

Meningococcal infectioni may range from a simple upper respiratory infection to fulminating systemic diseases such as meningitis, septcemia, endotoxin shock and disseminated intravascular coagulation. This paper reports on systemic meningococcal disease which were collected from Department of Pediatics. Yonsei University Medical College. From May, 1953 to April, 1976. Following results were obtained from this observation : 1. No striking differences were noted between boys(25 cases, and girls(27 cases) in incidence. 2. The most of cases appeared in winter and spring. 3. The clinical features may be summarized as follows : The most common compliants are fever (60%) and poor responsivess (77%) even coma. The meningeal signs (73%), skin rash (69%), vomiting (65%) and convulsion(42%) are prominent features oe disease. 4. Leukocytosis with neutrophilia was present in 80% of patients. Leukopenia or normal count were noted in 20% of patients, in the peripheral blood. 5. Ninety percent of patients revealed finding of meningitis on spinal tap. Mostly purulent type. 6. Poor prognostic signs inelude changes of mental state such as coma or semicoma, when there was no signs of meningitis on CSF at admissinn, when meningococci was found in blood culture only, normal leukocyte count or leukopenia in peripheral blood. 7. The mortality was 23% of patients and the most of expired patients were dead within 48 hours after initiation of therapy.
Coma ; Disseminated Intravascular Coagulation ; Exanthema ; Fever ; Humans ; Incidence ; Leukocyte Count ; Leukocytosis ; Leukopenia ; Meningitis ; Meningococcal Infections* ; Mortality ; Shock ; Spinal Puncture ; Strikes, Employee ; Vomiting