OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*

No abstract available.

No abstract available.
Hernia, Diaphragmatic*

No abstract available.
Humans ; Hypertension* ; Perindopril*

Adult onset Stills Disease (AOSD) is a systemic inflammatory disease characterized by spiking high fevers, arthritis, and an evanescent rash. Although many patients respond to nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid, some patients fail to do so or are found to be resistant and require high doses of corticosteroid which induce severe side effects. Recently, treatment with intravenous immunoglobulin (IVIG) has been reported to be effective in patients with AOSD who were refractory to NSAIDs. Here, we report a case of AOSD treated with IVIG with a review of the literature.
Adult* ; Anti-Inflammatory Agents, Non-Steroidal ; Arthritis ; Exanthema ; Fever ; Humans ; Immunoglobulins* ; Immunoglobulins, Intravenous ; Still's Disease, Adult-Onset*

No abstract available.
Adult ; Biopsy ; *Brunner Glands/pathology/surgery ; Duodenal Diseases/*complications/diagnosis/surgery ; Duodenal Obstruction/diagnosis/*etiology/surgery ; Duodenoscopy ; Gastric Outlet Obstruction/diagnosis/*etiology/surgery ; Hamartoma/*complications/diagnosis/surgery ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome

OBJECTIVE: We report an outcome of surgical treatment of the elderly patients with spinal stenosis, managed by a bilateral narrowed spinal canal widening technique through unilateral approach. METHODS: The operations were performed in 16 patients who diagnosed with spinal stenosis. All individuals had been presented with low-back pain, neurogenic claudication or radiculopathy and unresponsive to conservative treatment over six months. We perfomed hemi-laminectomy at the appropriate levels on the most symptomatic side preserving the facet joint. And the ligamentum flavum, as well as the cortical bone on the ventral surface of the contralateral laminae were removed. The spinous process was left as possible as we can, and the contralateral side of the spinal canal was decompressed completely. RESULTS: The mean age of the patients was 71 years. The mean operation time was 73 minutes. Despite of old age, the patients were able to walk in three days after the surgery. The significant pain scale improvement(7.73 to 2.68) and widening of the spinal canal diameter(7.60+/-1.75 to 17.77+/-1.47mm) were noted after the operation. No patient was presented spinal instability on their follow-up period over 24 months. CONCLUSION: The bilateral canal widening technique through the unilateral approach, minimizes the damage to the inter-spinous ligament and the inter-spinous muscle, and saves the operation time because it is not necessary to use the instruments which prevent spinal instability, despite spinal canal was sufficiently enlarged.
Aged* ; Follow-Up Studies ; Humans ; Ligaments ; Ligamentum Flavum ; Radiculopathy ; Spinal Canal ; Spinal Stenosis* ; Zygapophyseal Joint

PURPOSE: A scoring system could be clinically useful in determining cases in which a throat culture may be omitted or in cases whether antibiotics may be initiated or not. We propose to make a clinical guideline of antibiotics administration in patients with pharyngitis. METHODS: From Apr. 1996. to Mar. 1997, throat cultures were taken from 321 cases (72 cases from Kyung-Hee Medical Center, 249 cases from 3 local pediatric clinics). On the first day of visit, 9 clinical items on a score-card were checked and a tentative diagnosis for streptococcal or non-streptococcal infection was made. These clinical scores were compared with the results of the throat swab cultures. RESULTS: Of 321 cases with pharyngitis, 55 cases (17%) proved to have group A streptococci by throat culture. The positive culture rate of group A streptococci was 18.5% from 3 local pediatric clinics, and 12.5% from Kyung-Hee Medical Center. The positive culture rate of group A streptococci were 40% in above 31 points of score, 31.5% in 29 to 30 points, 20.5% in 27 to 28 points. The sensitivity and specificity of the scoring system using a score at least 28 above points were 71% and 67%, respectively. CONCLUSION: The clinical diagnosis of streptococcal pharyngitis indicates that patients age 5 to 10 years, findings of abnormal pharynx, high fever and no past history of antibiotics use. Further modification of the scoring system for diagnosis of streptococcal pharyngitis should be made to prevent antibiotics abuse and correct diagnosis of pharyngitis.
Anti-Bacterial Agents ; Diagnosis* ; Fever ; Humans ; Pharyngitis* ; Pharynx ; Sensitivity and Specificity

We report a case of borderzone infarction which was developed after the coil embolization of unruptured internal carotid-posterior communicating artery aneurysm. Post-procedural angiography and brain computerized tomographic scan did not reveal any abnormality. However, brain magnetic resonance image (MRI) showed a wedge-shaped borderzone cerebral infarction between left middle cerebral artery and left anterior cerebral artery territory. It was suspected to be a manifestation of hypoperfusion in the internal carotid artery territory, caused by hemodynamic instability during the procedure. In order to prevent this unexpected serious complication, using the continuous hemodynamic monitoring during aneurysmal coil embolization, such as transcranial doppler ultrasonography, should be considered.
Aneurysm ; Angiography ; Anterior Cerebral Artery ; Arteries ; Brain ; Carotid Artery, Internal ; Cerebral Infarction ; Embolization, Therapeutic* ; Hemodynamics* ; Infarction* ; Intracranial Aneurysm* ; Middle Cerebral Artery ; Ultrasonography, Doppler, Transcranial

Urinary hippuric acid was analyzed by gas chromatography/mass spectrometry method. A simple and economical derivatization procedure using excessive methanol in acidic condition was adopted to esterify hippuric acid. Quantitative analysis was performed with two internal standards, heptadecanoic acid and hydrocinnamic acid, to evaluate the derivatization procedure as an analytical method. Using the standard addition method, linear and reproducible calibration curves were obtained for both internal standards. Calibration experiment showed that good quantitative result could also be obtained with the calibration curve obtained without urine matrix. Recovery rates for the urine samples were in the range of 95.6~111.4%. Using hydrocinnamic acid as internal standard, analysis time could be reduced.
Calibration ; Chromatography, Gas* ; Methanol ; Spectrum Analysis