No abstract available.
Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum*

PURPOSE: Hepatic atrophy has been recognized as a complication of hepatic and biliary disease but we have often found it in follow up CT after transcatheter arterial embolization {TACE). The purpose of this study is to evaluate the characteristics of hepatic atrophy after TACE. MATERIAL AND METHODS: Of 53 patients who had TACE, We evaluated the relationship between the incidence of hepatic atrophy and the number of TACE, and also evaluated the average number of TACE in patients with hepatic atrophy. Of 20 patients who had received more than average number of TACE for development of hepatic atrophy (2 times with portal vein obstruction, 2.7 times without portal vein obstruction in this study), we evaluated the relationship between the tipiodol uptake pattern of tumor and the incidence of hepatic atrophy. RESULTS: There were 8 cases of hepatic atrophy (3 with portal vein obstruction, 5 without portal vein obstruction), average number for development of hepatic atrophy were 2.5 times. As the number of TACE were increased, the incidence of hepatic atrophy were also increased. Of 20 patients who received more than average number of TACE for development of hepatic atrophy, we noted 6 cases of hepatic atrophy in 11 patients with dense homogenous lipiodol uptake pattern of tumor and noted only 1 case of hepatic atrophy in 9 patient with inhomogenous lipiodol uptake pattern. CONCLUSION: Hepatic atrophy was one of the CT findings after TACE even without portal vein obstruction. Average number of TACE was 2.5 times and risk factors for development of hepatic atrophy were portal vein obstruction, increased number of TACE, and dense homogenous lipiodol uptake pattern of tumor.
Atrophy* ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Incidence ; Portal Vein ; Risk Factors

OBJECTIVES: The caregiver burden means emotional, social, financial, psychological, physical problems which could be experienced by occupational caregivers or families who cared disable patients. The caregiver burden affected by primary stressors (severity of disability in dementia patients) and secondary stressors (withdrawal from society, conflict between job and caregiving, loss of personal identity) may result in physical ill-health, depression, anxiety for the caregivers. The aims of this study were to assess caregiver burden in dementia, and to identify affecting factors. METHOD: 30 caregivers for dementia patients who had been treated at the "Dementia-Geriatric Mental Health Clinic" in the Kosin University Gospel Hospital and 44 healthy volunteers were selected. Using the Screen for Caregiver Burden (SCB), the degree of caregiver burden was measured. The demographic data was obtained by structured interview. Primary and secondary stressors were also analyzed. The severity of depression and anxiety was assessed by the Hamilton Depression Scale (HDS) and Hamilton Anxiety Scale (HAS). The severity of cognitive dysfunction (MMSE, CDR, GDS), behavioral symtoms (Revised Memory and Behavior Problems Checklist, RMBPC), daily functional disability (ADL, IADL) for the dementia patients were evaluated. RESULTS: 1) The SCB scores were significantly (p<0.001) higher in dementia caregivers (8.71+/-4.90) than in controls (0.23+/-0.48). 2) The SCB scores were not correlated with age of caregivers (gamma=0.081), education (gamma=-0.163), duration of caregiving (gamma=0.275). The RMBPC scores had statistically significant positive correlation with SCB scores (gamma=0.545, p<0.01), while age of dementia patients (gamma=-0.234), onset age of dementia (gamma=-0.280), duration of dementia (gamma=0.029), CDR (gamma=0.080), GDS (gamma=-0.125), MMSE (gamma=-0.212), ADL (gamma=-0.315), IADL (gamma=0.155) had not. 3) The SCB scores had statistically significant positive correlation with degree of secondary stress (gamma=0.581, p<0.01) and anxiety (gamma=0.376, p<0.05). The degree of secondary stress had statistically significant positive correlation with degree of emotional stress (gamma=0.757, p<0.01), depression (gamma=0.482, p<0.01), anxiety (gamma=0.376, p<0.01). CONCLUSIONS: The caregiver burden in dementia seemed to be originated from primary stressors related to the behavioral symptoms as well as secondary stressors (degree of emotional stress, depression, anxiety, etc.). Therefore, active intervention by the geriatric specialists might be helpful to reduce their strain.
Activities of Daily Living ; Age of Onset ; Anxiety ; Behavioral Symptoms ; Caregivers* ; Checklist ; Dementia* ; Depression ; Education ; Healthy Volunteers ; Humans ; Memory ; Mental Health ; Specialization ; Stress, Psychological

BACKGROUND: Cellular phone has become a necessary device for communicating in hospitals. Cellular phones contaminated with bacteria may serve as a fomite in the transmission of pathogens by the hands of medical personnel. We investigated the bacterial contamination of cellular phones used by medical personnel in a tertiary hospital. METHODS: Culture swabs were obtained from 101 cellular phones and 99 anterior nasal cavities from medical personnel using cellular phones. The swabs were inoculated on blood agar, MacConkey agar, mannitol salt agar, and enterococcal broths containing 6microgram/mL vancomycin for 48 h at 37degrees C. The bacteria were identified on the basis of colony morphology, gram staining characteristics, catalase test, coagulase test, and DNase test; Microscan (Siemens, USA) was used for the identification of enterococci. RESULTS: Of the 101 cellular phones, 13 were contaminated with Staphylococcus aureus (including 4 methicillin-resistant S. aureus [MRSA]), 61 with coagulase-negative staphylococci (CoNS) (including 38 methicillin-resistant CoNS), 27 with Micrococcus spp., 11 with diphtheroids, 67 with Bacillus spp., and 4 with viridans streptococci. No gram-negative bacilli were isolated. Nasal swabs yielded 36 S. aureus, including 9 MRSA. Only 1 of 9 cellular phones used by the MRSA carriers was contaminated with MRSA. CONCLUSION: Cellular phones used by some medical personnel were contaminated with pathogens such as S. aureus or MRSA. Although, the clinical implications of pathogens isolated from cellular phones have not been fully investigated, pathogens could be transmitted by the hands of medical personnel who are cellular phone users.
Agar ; Bacillus ; Bacteria ; Catalase ; Cellular Phone ; Coagulase ; Deoxyribonucleases ; Disinfection ; Fomites ; Hand ; Hand Hygiene ; Mannitol ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Micrococcus ; Nasal Cavity ; Staphylococcus aureus ; Tertiary Care Centers ; Vancomycin ; Viridans Streptococci

Congenital diaphragmatic hernias (CDH) usually cause respiratory distress soon after birth and are associated with a high mortality rate in the early postnatal period. However, there is a milder form of CDH that does not manifest during the neonatal period. The late presenting CDH is characterized by a variable clinical picture. We present the case of an otherwise healthy 5-month-old girl, who was referred for evaluation of an 1-day history of vomiting and irritability. Chest simple X-ray and CT showed bowel loops in the left thoracic cavity, which was consistent with diaphragmatic hernia. At operation, she was found to have a small left posterolateral diaphagmatic defect with viable small bowel loops in the left thoracic cavity. After surgical reposition of the hernia, the symptoms such as vomiting and irritability subsided. The lack of typical manifestation of CDH such as respiratory distress may lead to delayed diagnosis. The possibility of late presenting CDH should not be overlooked even after the neonatal period.
Delayed Diagnosis ; Hernia ; Hernia, Diaphragmatic ; Humans ; Infant ; Parturition ; Thoracic Cavity ; Thorax ; Vomiting

PURPOSE: Acute lower respiratory tract infections (LRI) are important causes of pediatric morbidity and mortality. Recently among the common pathogens causing acute LRI in children respiratory viruses are apparently increasing rather than bacteria and mycoplasma in Korea. This study was aimed to define the distribution of age, seasonal variation and clinical manifestation of respiratory virus in children. METHODS: All 328 children in Seoul, who had hospitalized at the Pediatric ward of Hanyang University (138 children), Hallym University (61 children) and Sungkunkwan University (129 children) for the treatment of respiratory diseases were studied from March, 1997 to February, 1998. In nasopharyngeal aspirates obtained from these patients viral agents were detected by virus isolation and/or antigen detection by indirect immunofluorescent staining. But the subjects who was not found respiratory virus were excluded, although respiratory symptoms were present. RESULTS: 1) One or more agents were identified in 328 subjects. 2) The pathogens identified were Respiratory syncytial virus (RSV : 44.7%), influenza A virus (25.6 %), parainfluenza virus (14.6%), influenza B virus (14.3%), adenovirus (4.3%) and two or more viruses (3%). 3) Infections with RSV, parainfluenza virus and influenza A and B virus occured in epidemics, while adenovirus was isolated sporadically throughout the study period. 4) Clinical patterns of viral LRI were pneumonia (39%), bronchiolitis (34%), croup (18%), acute pharyngitis (7%) and asthma (2%). CONCLUSIONS: RSV was the most important in viral respiratory tract infection in children. Clinical manifestation and epidemic characterics were variable according to the agent. Accordingly, we should acknowledge the importance of respiratory virus to cause the repiratory tract diseases in children.
Adenoviridae ; Asthma ; Bacteria ; Bronchiolitis ; Child ; Croup ; Epidemiology* ; Herpesvirus 1, Cercopithecine ; Humans ; Influenza A virus ; Influenza B virus ; Influenza, Human ; Korea ; Mortality ; Mycoplasma ; Paramyxoviridae Infections ; Pharyngitis ; Pneumonia ; Respiratory Syncytial Viruses ; Respiratory System* ; Respiratory Tract Infections* ; Seasons ; Seoul*

OBJECTIVES: The aim of this study is to find out the correlation between head circumference and visuospatial function of the elderly in community. METHODS: A total of 463 subjects (170 men and 293 women) aged 60-91 years were analyzed from preliminary data of GDEMCIS (Gwangju Dementia and MCI Study). The study questionnaire consisted of demographic characteristics, current and past illness history, drug history, K-MMSE, SNSB-D. We also measured head circumference and examined ApoE genotype. RESULTS: On regression analysis, as head circumference become smaller, visuospatial memory scores (S-Rey immediate recall & delayed recall) decreased adjusted by age, height, sex, educational level, ApoE epsilon 4 allele, current smoking and alcohol drinking (beta=0.18, p=0.002, beta=0.15, p=0.01). Presence of ApoE epsilon 4 allele has no direct correlation with head circumference and cognitive decline. CONCLSION: As head circumference become smaller, only visuospatial memory scores decreased significantly. These results suggest that visuospatial memory function might be one of the sensitive markers of brain reserve differences.
Aged* ; Alcohol Drinking ; Alleles ; Apolipoproteins E ; Cognitive Reserve ; Dementia ; Genotype ; Head* ; Humans ; Male ; Memory ; Memory, Short-Term ; Neuropsychological Tests ; Surveys and Questionnaires ; Smoke ; Smoking

OBJECTIVES: The aims of this study were to assess the morale of Korean elders, to analyze the affecting factors, and to look for the ways to raise their morale. METHODS: The structured interviews and measurements of depression (Four-Item Geriatric Depression Scale and Vulnerability Factors), cognitive function (Short Portable Mental Status Questionnaire) and morale(Measurement of Morale in the Elderly Scale, MMES) were taken for the 50 Korean elders (28 females and 22 males) with age over 65 who were visiting Jong Myo during January to February in 2004. RESULTS: 1) In Korean elders, the mean scores of total MMES were 100.82+/-12.36. According to the items, mean scores of Satisfaction were 43.52+/-5.14, Equanimity 36.80+/-7.53, Will-to-live 20.00+/-4.43. 2) The total MMES scores were significantly affected by variables such as income (p<0.05), economy (p<0.005), elder abuse (p<0.01) and depression (p<0.001). While other variables including age, residence, education, number of children, sex, religion, spouse, job, illness and cognitive function were not related. CONCLUSION: To encourage morale in the Korean elders, economic support by welfarism, socio-legal prevention of elder abuse, and active involvement of geropsychiatrists into the early detection and treatment of depression must be needed.
Aged ; Child ; Depression ; Education ; Elder Abuse ; Female ; Humans ; Morale* ; Spouses

OBJECTIVES: The hippocampal atrophy has been known to be an important biological marker for the early diagnosis of mild cognitive impairment (MCI). The aims of this study are to disclose the differerence in the interuncal distance (IUD) between MCI, dementia of the Alzheimer's type (DAT) and healthy aged controls, and to identify the affecting factors. METHODS: In transaxial plane, the IUDs at the level of the suprasellar cistern on the T1-weighted images on the brain MRI were measured in patients with MCI (N=30), those with DAT (N=34), and healthy aged controls (N=20). Furthermore, demographic data about age, sex, educational level as well as cerebrovascular factors were obtained by structured interviews and medical records, and the severity of cognitive disorders were assessed using the Mini-Mental Status Examination (MMSE), the Clinical Dementia Rating (CDR) and the Global Deterioration Scale (GDS). RESULTS: 1) The mean (+/-S.D.) IUD of DAT group (26.52+/-3.37 mm) was significantly different from that of healthy aged controls (24.35+/-2.91 mm)(p=0.044). However, there were no significant differences between IUD of MCI group (25.60+/-2.66 mm) and that of DAT group (p=0.483) as well as that of healthy aged controls and that of MCI group (p=0.363). 2) Variables such as age, sex, educational level, cerebrovascular risk factors and severity of cognitive disorder were not related to the IUD. CONCLUSIONS: The measurement of IUD on the brain MRI did not seem to be a helpful biological marker for the early detection of MCI in clinical practice.
Atrophy ; Biomarkers ; Brain ; Dementia ; Early Diagnosis ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Mild Cognitive Impairment* ; Risk Factors

OBJECTIVE: Among causes of sudden death presumed to be related with use of atypical antipsychotics, all drugs which could induce torsade de pointes had been known to prolong QTc interval. Therefore, to monitor the changes of QTc interval on EKG seemed to be an important marker for the antipsychotic-induced cardiotoxicity, further to prevent sudden death due to fatal ventricular arrythmia. There are several studies and case reports about cardiac toxicity in some patients who were administered newly developed atypical antipsychotics. The aims of this study were to know whether quetiapine causes changes in QTc interval, and to identify affecting factors. METHODS: For the 31 inpatients (21 females, 10 males) with schizophrenia (N=25) or schizoaffective disorder (N=5), schizophreniform disorder (N=1) according to DSM-IV, the EKG monitoring was successively taken on baseline and the 2nd, 4th and 6th weeks after quetiapine administration, and serial changes of every EKG parameters including QTc interval was comparatively analyzed. Furthermore, variables such as cardiovascular risk factors (weight gain, hyperlipidemia, thyroid function, etc.), dose of drugs, drug combination, severity of psychotic symptoms, changes in the activity of autonomic nervous system despite of sex and age were also successively assessed on baseline and the 2, 4, and 6 weeks after quetiapine administration. RESULTS: 1) Every EKG parameters (heart rate, PR interval, QRS and QT) including QTc interval and diastolic blood pressure were not changed significantly on the 2, 4, and 6 weeks after quetiapine administration as compared with baseline. The systolic pressure was significantly declined form the 2 weeks after quetiapine administration as compared with baseline (p<0.05). 2) Among variables affecting the EKG parameters including QTc interval, age, dose of drugs, hyperlipidemia and thyroid function were not correlated with. However, the body weight on the 6 weeks after quetiapine administration had significant negative correlation with QT (gamma=-0.427)and QTc interval (gamma=-0.406), and the drug combination on the 6 weeks after quetiapine treatment had significant positive correlation with QRS (gamma=0.393) and QT (gamma=0.415), while severity of psychotic symptoms on the 4th week had correlation with QT (gamma=0.380) (p<0.05, respectively). Otherwise, the QTc interval on the 6 weeks after was significantly prolonged in female patients (p<0.05). CONCLUSION: Even though the administration of quetiapine did not cause significant changes in the QTc interval in this study, we need to pay attention toward the possibly related factors.
Antipsychotic Agents ; Arrhythmias, Cardiac ; Autonomic Nervous System ; Blood Pressure ; Body Weight ; Death, Sudden ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Female ; Humans ; Hyperlipidemias ; Inpatients ; Psychotic Disorders ; Risk Factors ; Schizophrenia ; Thyroid Gland ; Torsades de Pointes ; Quetiapine Fumarate