PURPOSE: This study was conducted to examine the degrees of depression and activities of daily living (ADLs), and to identify factors that predict depression in elderly patients. METHODS: The sample was149 patients (80% female; mean age 79.1) from three geriatric hospitals located in small cities and who agreed to participate in the study. Data were collected by staff nurses involved in direct patient care from October to September 2009. The level of depression was measured on a daily basis for seven days using a 13-item scale. Patients' ADLs was measured using a modified 10-item Bathel ADLs scale. Data were analyzed using SPSS/WIN 17.0. RESULTS: Mean depression score was 10.05+/-4.77 out of 26 points and about 27% was assessed as depressed with more than 13 points. Multiple regression analysis showed that low educational level, absence of spouse and fewer family visits predict depression. In addition, low ADLs and sleep disturbance predict depression. CONCLUSION: Nursing care providers need to be concerned about ADLs of older patients and should develop nursing activity programs to increase their in-hospital physical activities. It is also important care for older patients' sleep and encourages family visits to decrease their depression.
Activities of Daily Living ; Aged ; Depression ; Humans ; Motor Activity ; Nursing Care ; Patient Care ; Spouses

A fine needle aspiration biopsy specimen of a retroperitoneal mass in a 26-year-old man who had had an orchiectomy for seminoma was submitted for cytologic evaluation. Cytologic features of the specimen included uniform neoplastic cells found singly or in groups of several cells intermingled with lymphocytes in a characteristic foamy, lacelike background. These cells varied from 10 to 20 m in diameter. The nuclei were round to ovoid with fine or reticular chromatin and one or more prominent nucleoli. The poorly defined cytoplasm stained pale-blue or blue with cytoplasmic vacuoles. The cytologic appearance was consistent with seminoma. Documented reports of the cytological appearance of seminoma are rare. The diagnosis of primary gonadal seminoma by fine needle aspiration biopsy is probably not indicated since the treatment of a primary gonadal tumor, regardless of its histogenesis, requires surgical resection. However, fine needle aspiration biopsy is extremely valuable in the diagnosis of extragonadal as well as metastic and recurrent seminoma.
Adult ; Biopsy ; Biopsy, Fine-Needle ; Chromatin ; Cyclosporine* ; Cytoplasm ; Diagnosis ; Endothelin-1* ; Gonads ; Humans ; Liver ; Lymphocytes ; Nephrosis, Lipoid* ; Orchiectomy ; Plasma* ; Seminoma ; Vacuoles

Pediatric patients (younger than 19 years) account for approximately 25% of all emergency patients. Pediatric patients have large proportions of toddlers (aged 1–5 years), low severity, illness (rather than injury), and after-hours visits. Considering these features, the authors, affiliated with the policy research team in the Korean Society of Pediatric Emergency Medicine, suggest the establishment of the pediatric certified emergency center (PCEC) to stratify Korean pediatric emergency medical system according to the Korean Acuity and Triage Scale (KTAS). The PCEC is a facility dedicated to the emergency care for a large population of KTAS 3–4 patients (i.e., mildly ill). In addition, the PCEC may perform early stabilization and transfer to the pediatric emergency centers for pediatric patients having KTAS 1–2 illnesses and injuries. To facilitate the application of emergency centers for the PCEC, the designation criteria should be flexible in terms of manpower, facility, and equipment. Financial support from the government is essential for sustainable PCEC.
After-Hours Care ; Child ; Emergencies* ; Emergency Medical Services* ; Emergency Medicine ; Emergency Service, Hospital ; Financial Support ; Humans ; Triage

Eosinophilic gastrointestinal disorder (EGID) is a rare disease in children that affects the bowel wall, with eosinophilic infiltration in the absence of any other causes for eosinophilia. The etiology remains unknown, but allergies and immunological imbalance are suspected triggers. We encountered a case of serosal EGID presenting as intractable vomiting and ascites in a 9-year-old girl, after influenza virus infection. Peripheral eosinophilia was not present. The diagnosis was confirmed by biopsy of the bowel wall through laparotomy and endoscopy, and controlled by 2 courses of steroid therapy due to recurring symptoms. Influenza virus infection was assumed to play a role in the onset of EGID through a Th2 response that stimulated eosinophilic infiltration in the GI tract. We therefore report this case along with a literature review.
Ascites* ; Biopsy ; Child ; Diagnosis ; Endoscopy ; Eosinophilia ; Eosinophils* ; Female* ; Gastrointestinal Tract ; Humans ; Hypersensitivity ; Influenza A virus ; Laparotomy ; Orthomyxoviridae ; Rare Diseases ; Serous Membrane ; Vomiting*

No abstract available.
Down Syndrome* ; Myeloproliferative Disorders*

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.
B-Lymphocytes ; Biopsy, Needle ; Body Image ; Fatigue ; Female ; Follow-Up Studies ; Hepatomegaly ; Humans ; Liver ; Lymphoma ; Lymphoma, B-Cell ; Middle Aged ; Spleen ; Weight Loss

Adult-onset Still's disease (AOSD) is an inflammatory disorder that's characterized by daily, spiking high fever, arthritis and an evanescent, salmon-pink rash. AOSD is diagnosed purely on the basis of the typical clinical features of the illness. The symptoms commonly include swelling of the lymph nodes, enlargement of the spleen and liver, and a sore throat. AOSD is difficult to differentiate from systemic lupus erythematosus (SLE) due to the similar clinical manifestations. We report here on a case of a 16-year-old female patient with autism and epilepsy and who complained of daily spiking fever for 20 days. The patient had maculopapular skin rashes on the face and whole body and lymphadenopathy. The liver function tests were elevated mildly. The initial rheumatoid factor (RF) and antinuclear antibody (ANA) tests were negative. We diagnosed her as having adult-onset Still's disease according to the criteria of Yamaguchi. We successfully treated her with oral prednisolone. But her antinuclear antibody test was changed to positive after discharge. So we finally diagnosed her as having SLE.
Adolescent ; Antibodies, Antinuclear ; Arthritis ; Autistic Disorder ; Epilepsy ; Exanthema ; Female ; Fever ; Humans ; Liver ; Liver Function Tests ; Lupus Erythematosus, Systemic ; Lymph Nodes ; Lymphatic Diseases ; Pharyngitis ; Prednisolone ; Rheumatoid Factor ; Spleen ; Still's Disease, Adult-Onset

PURPOSE: To compare surgically induced corneal astigmatism following trabeculectomy versus deep sclerectomy and collagen implant (DSCI). METHODS: 37 consecutive eyes of 28 patients having glaucoma surgeries for uncontrolled open-angle glaucoma were retrospectively analyzed. 16 eyes had trabeculectomy and 21 eyes had DSCI. Visual acuity, intraocular pressure (IOP) and autorefractokeratometry of both groups were evaluated preoperatively and 1, 7 days, 1, 3, 6, 12 months postoperatively. Postoperative changes in corneal astigmatism were evaluated using vector analysis. RESULTS: Mean age was 51.63 +/- 12.73 years in the trabeculectomy group and 39.95 +/- 15.09 years in the DSCI group and differed between groups (p = 0.015). Visual acuity was significantly decreased after surgery compared with preoperative values and was improved slowly in both groups. Intraocular pressure was lower in the trabeculectomy group than in the DSCI group at postoperatively 1 and 6 months (p = 0.046 and 0.029, respectively). There was no significant difference in surgically induced corneal astigmatisms (SIA) between both surgeries, which decreased over time in the group with stable postoperative IOP. They showed with-the-rule astigmatism immediate postoperatively. The DSCI group with MMC showed less SIA than the group without MMC. CONCLUSIONS: Surgically induced astigmatisms following trabeculectomy and deep sclerectomy with collagen implant were not differ significantly between two surgeries.
Astigmatism ; B-Lymphocytes ; Collagen ; Eye ; Glaucoma ; Glaucoma, Open-Angle ; Humans ; Intraocular Pressure ; Lymphoma, B-Cell ; Mitomycin ; Orbit ; Retrospective Studies ; Sinusitis ; Trabeculectomy ; Visual Acuity

No abstract available.
Niemann-Pick Disease, Type A*

PURPOSE: To report a case of uremic optic neuropathy occurring in a patient with chronic renal failure. CASE SUMMARY: A 40-year-old male who was diagnosed with chronic renal failure and treated with peritoneal dialysis and hemodialysis for 17 years presented with blurred vision and a moving pain in his left eye for 2 days. The best corrected visual acuity (BCVA) was 0.2 in his left eye, and an inferior altitudinal visual field defect was noted on Humphrey perimetry. Fundus examination and optical coherence tomography showed optic disc swelling in his left eye; the right eye was unremarkable. These findings were compatible with a diagnosis of uremic optic neuropathy or anterior ischemic optic neuropathy of his left eye. After treatment of hemodialysis and intravenous high dose steroid pulse therapy, the BCVA in his left eye was 0.8. However, since he refused oral steroid maintenance therapy, his BCVA later decreased to 0.4. After treatment with subtenon triamcinolone injection, the BCVA in his left eye was 1.0 and showed a stable disease course. CONCLUSIONS: When patient with chronic renal failure presents with acute decrease in visual acuity and visual field defect, optic neuropathies including uremic optic neuropathy should be considered and prompt hemodialysis and systemic steroid treatment should be done.
Adult ; Diagnosis ; Humans ; Kidney Failure, Chronic* ; Male ; Optic Nerve Diseases* ; Optic Neuropathy, Ischemic ; Peritoneal Dialysis ; Renal Dialysis ; Tomography, Optical Coherence ; Triamcinolone ; Uremia ; Visual Acuity ; Visual Field Tests ; Visual Fields