No abstract available.
Family Practice* ; Humans

BACKGROUND: It is well-known that dyspeptic symptoms in functional dyspepsia are related to psychological factors such as stress and mood disorder. But it is still controversial whether H. pylori infection is a important factor for functional dyspepsia. We conducted this study to investigate whether H. pylori infection or stress are related to dyspeptic symptom severity in functional dyspepsia. METHODS: From Mar. 1 1999 to Apr. 30 1999, attendees to a Health Screening Center and a Family Practice Center were eligible study subjects. The subjects were responded to questionnaire including dyspeptic symptom severity items and BEPSI-K(stress scale). And among eligible subjects, one hundred and thirty two diagnosed with functional dyspepsia by gastrofibroscopy were final study subjects. H. pylori infection was confirmed by antral biopsies & smear (Giemsa stain). RESULTS: In functional dyspepsia, high BEPSI-K score group(upper tertile) complained more severe dyspeptic symptom severity than low BEPSI-K score group(lower tertile) after adjusted for other variables(adjusted OR=8.389, 95% C.I.=2.232-31.231). But the dyspeptic symptom severity was not associated with H. pylori infection status (adjusted OR=1.514, 95% C.I.=0.567-4.046). CONCLUSIONS: The dyspeptic symptom severity in functional dyspepsia was associated with stress but not with H. pylori infection status.
Biopsy ; Dyspepsia* ; Family Practice ; Helicobacter pylori* ; Helicobacter* ; Mass Screening ; Mood Disorders ; Psychology ; Surveys and Questionnaires

The authors analysed statically 420 Cases of the ocular trauma among 35,460 patients who visited to the emergency department, from Jul. 1995 to Jun. 1996. Ocular trauma is one of the commonest causes of eye diseases and blindness, but its patterns and incidences are variable according to the environment. A large number of patients can be readily treated in the emergency department. Prevention is, of course, the best management, but when an ocular injury occurs, proper emergency treatment can often prevent permanent damage.
Blindness ; Emergencies* ; Emergency Service, Hospital* ; Emergency Treatment ; Eye Diseases ; Humans ; Incidence

To minimize the period of brain ischemia and the potential for neurologic damage during aortic arch replacement, we used the arch-first technique. First case was a 28-year-old female with extensive aneurysm involving ascending, arch and descending thoracic aorta. Exposure was obtained via a bilateral via a bilateral thoracotomy (clamshell incision) in the anterior 4th right and 3rd left intercostal space with oblique sternotomy. To prepare for arch perfusion, the side-arm graft(10mm) was anastomosed to the aortic graft, opposite the site of the planned anastomosis to the arch vessels. After completing the arch anastomosis under total circulatory arrest(37min) and retrograde cerebral perfusion(12min), aortic graft was clamped on either side and the arch was perfused via side-arm graft for 36min. When distal aortic anastomosis was finished, distal clamp of aortic graft was released and arch vessels were perfused via common femoral artery, and the proximal aortic anastomosis was accomplished. The patient was discharged with no event. Second case was a 48-year-old male with extensive aneurysm involving ascending, arch, and aortic regurgitaiton(grade III/IV). This case was also done using the clamshell incision. Aortic valve replacement was done by valved-conduit(Vascutek 30mm), both coronary artery anastomosis using Cabrol's procedure. Last operation procedure was the same as the 1st case.
Adult ; Aneurysm* ; Aorta, Thoracic* ; Aortic Valve ; Brain Ischemia ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Male ; Middle Aged ; Perfusion ; Sternotomy ; Thoracotomy ; Transplants

It has been known that clozapine treatment combining with cytotoxic antitumor therapy for schizophrenia is not recommended because both durgs have agranulocytosis as their side effect. Since the introduction of granulocyte colony-stimulating factor(G-CSF), it has been used to treat agranulocytosis or granulocytopenia associated with antitumor chemotherapy or clozapine. We report a case with schizophrenia on clozapine treatment who developed agranulocytosis following combined cytotoxic chemotherapy for a sex-cord stromal tumor which was successfully treated with G-CSF. The hematological status before combining with antitumor chemotherapy had been within normal range, and agranulocytosis following the antitumor chemotherapy returned to normal after treatment with G-CSF. This suggests that clozapine could be administered in combination with cytotoxic antitumor agents if the following indications are met : normal hematological status before starting antitumor chemotherapy, carefully monitoring hematological status by oncologist and psychiatrist, and prepared G-CSF administration when agranulocytosis is anticipated.
Agranulocytosis ; Antineoplastic Agents ; Clozapine* ; Drug Therapy* ; Granulocyte Colony-Stimulating Factor ; Granulocytes ; Psychiatry ; Reference Values ; Schizophrenia

OBJECTIVES: The purpose of this study was to examine the factor structure of the Adolescent Personality Assessment Inventory (PAI-A) in a standardized adolescent sample using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). METHODS: For this purpose, three models about factor structure of the PAI-A were explored with EFA in 490 adolescents and then were evaluated with CFA in 268 young offenders. RESULTS: The results showed that the five factor model was considered to be most appropriate for factor structures of the PAI-A in EFA. However, none of the factor models were appropriate for the factor structures of the PAI-A in CFA. CONCLUSION: These findings suggest that the "five factor model" is thought to explain the PAI-A the best, but further studies are needed.
Adolescent* ; Criminals ; Factor Analysis, Statistical* ; Humans ; Neuropsychological Tests ; Personality Assessment* ; Psychometrics

PURPOSE: To determine the effect of intraluminal brachytherapy on stent patency and survival after metallic stent placement in patients with primary bile duct carcinoma. MATERIALS AND METHODS: Twenty-seven patients with primary bile duct carcinoma underwent metallic stent placement; in 16 of the 27 intraluminal brachytherapy with an iridium-192 source (dose, 25 Gy) was the performed. Obstruction was due to either hilar (n=14) or non-hilar involvement (n=13). For statistical comparison of patients who underwent/did not undergo intraluminal brachytherapy, stent patency and survival were calculated using the Kaplan-Meier method and an independent t test. RESULTS: The mean durations of stent patency and survival were 9.1 and 10.0 months respectively in patients who underwent intraluminal brachytherapy, and 4.2 and 5.0 months in those who did not undergo this procedure (p<0.05). The mean durations of stent patency and survival among the 22 patients who died were 7.6 (range, 0.8 -16.1) and 8.3 (range, 0.8-17.3) months, respectively, in the eleven patients who underwent intraluminal brachytherapy, and 4.2 (range, 0.9-8.0) and 5.0 (range, 0.9-8.4) months in those whom the procedure was not performed (p<0.05). CONCLUSION: Intraluminal brachytherapy after stent placement extended both stent patency and survival in patients with primary bile duct carcinoma.
Bile Ducts* ; Bile* ; Brachytherapy* ; Humans ; Stents*

BACKGROUND AND OBJECTIVES: Many studies have shown that coronary artery bypass graft (CABG) surgery prolongs the life of patients with left main coronary artery disease (LMCD). Recently, percutaneous coronary intervention (PCI) has been applied to treat LMCD, with good clinical results. However, a significant portion of patients decline any revascularization therapy, so receive medical treatment only. The aim of this study was to evaluate the long term clinical outcome in these patients with LMCD, according to the treatment strategies. SUBJECTS AND MEHTODS: The clinical outcomes of 281 consecutive patients, with significant LMCD, between January 1997 and December 2000, were evaluated. The patients were divided into three groups, according to their initial treatment strategies;1) CABG, 2) PCI and 3) medical treatment. The mean follow-up duration was 37.4+/-14.9 months. RESULTS: The 1- and 3-year survival rates in the CABG group (97.4+/-1.5% and 95.6+/-1.9%) were significantly higher than those of the medical group (89.8+/-3.9% and 76.1+/-5.9%;p=0.03). The survival rates in the PCI group (one year and 3-year survival rate, 98.1+/-1.3% and 93.8+/-2.5%) were similar to those of the CABG group (p=0.93). The incidence of 3-year MACE in the medical group (40.7%) was higher than those of the CABG (10.5%, p<0.001) and PCI groups (20.4%, p=0.007). There was no significant difference between the CABG and PCI groups (p=0.06). CONCLUSION: In patients with LMCD, a CABG remains the standard therapy for prolonging survival and lowering the incidence of MACE. PCI offers similar survival benefits in selected patients. Medical treatment is associated with a significantly higher mortality and MACE. Active revascularization therapy should be the treatment of choice for the patients with LMCD.
Angioplasty ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies* ; Humans ; Incidence ; Mortality ; Percutaneous Coronary Intervention ; Survival Rate ; Transplants

BACKGROUND: Naloxone,an opioidant agonist, has been s hown t o have a c ar di ovascular pressor effect in states of hemorrhagic and endotoxic shock.We determined the direct inotropic effect of naloxone using guinea pig right ventricular papillary muscles. METHODS: With institutional approval,isometric contractile force was measured in normal and 26mM K+ Tyrode's solution at various stimulation rates.Normal and slow action potentials (APs) were measured with conventional microelectrode technique.The effects of naloxone on sarcoplasmic recticulum function were evaluated by measuring rapid cooling contractures (RCCs)in normal Tyrode 's solution and rested-state (RS)contraction in low Na+ (25 mM)Tyrode's solution.Patch clamp study was performed to examine the direct effect on Ca2+ current in myocytes. RESULTS: Naloxone (50,100,200 micro M)caused dose-dependent depression of peak force and maximal rate of peak force (dF/dt-max)by 30,50 and 70%,respectively.Modest depression was shown in RS contraction in low Na+ Tyrode's solution.In 26 mM K+ Tyrode's solution,100 micro M naloxone markedly depressed late force development.100 micro M naloxone depressed RCCs by 20%. While 100 micro M naloxone did not alter amplitude or dV/dt-max in normal and slow APs at 0.25 Hz, AP duration was prolonged significantly.In patch clamp study,50 micro M naloxone depressed Ca2+ current by 50%. CONCLUSIONS: Naloxone depresses contractile force.Myocardial depressant effect partly seems to be caused by depressed Ca2+ influx through cardiac membrane.Rapid release of Ca2+ from the sarcoplasmic reticulum by depolarization and release by rapid cooling seems to be minimally affected.
Action Potentials ; Animals ; Contracture ; Depression ; Guinea Pigs ; Heart ; Microelectrodes ; Muscle Cells ; Myocardial Contraction ; Myocardium ; Naloxone* ; Papillary Muscles ; Sarcoplasmic Reticulum

Damages on the recurrent laryngeal nerve (RLN) during thyroid surgery is the most common iatrogenic cause of vocal cord paralysis. Identification of the recurrent laryngeal nerve and meticulous surgical techniques can significantly decrease the incidence of this complication. The nonrecurrent inferior laryngeal nerve is an exceedingly rare anomaly of the recurrent laryngeal nerve. The nonrecurrent inferior laryngeal nerve is associated with abnormal development of the aortic arch, where the innominate (brachiorephalic) artery is not found and the right common carotid artery rises directly from the aortic arch. The aberrant right subclavian artery can always be felt against the vertebral column behind the esophagus. Surgeons need to be aware of the positions of these arteries to avoid damaging them. We experienced a case of nonrecurrent inferior laryngeal nerve in the right side with the aberrant right subclavian artery. The patient received a total thyroidectomy with neck dissection for thyroid carcinoma with nodal metastasis. Incidentally, we also found nonrecurrent inferior laryngeal nerve, and also found an aberrant right subclavian artery by the computed tomography scan. The patient presented transient vocal cord paralysis but gained complete recovery of vocal cord mobility after one and a half month later.
Aorta, Thoracic ; Arteries ; Carotid Artery, Common ; Esophagus ; Humans ; Incidence ; Neck Dissection ; Neoplasm Metastasis ; Recurrent Laryngeal Nerve* ; Spine ; Subclavian Artery ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Vocal Cord Paralysis ; Vocal Cords