No abstract available.
Depression* ; Humans ; Inpatients*

No abstract available.
Depression* ; Humans ; Inpatients*

No abstract available.
Korea*

No abstract available.
Korea*

OBJECTIVES: The purpose of this study is to analyse sleep habits and sleep disorders in the elderly population ased 65-84 years. METHODS: Epidemiological survey was performed at home by means of semistructured interviews in the city of Pusan, Korea. Subjects were randomly selected. The questionnaire consisted of 128 items including demographic findings, sleep habits, sleep disorders, somatic illnesses, and psychological distresses. RESULTS: (1) The mean retiring time was 10.28 h (SD1.30 h) and the mean wake-up time was 5.24 h (SD 1.33 h). The mean duration of sleep was 5.63 h (SD 1.80 h ). The subjects reported they woke up an average of 2.05 (SD 1.59) times per night. All of the above results were not related to age or gender. However, the mean frequency of difficulty in initiating/maintaining sleep was 2.2 times for men and 3.2 times for women (p<0.05). (2) The prevalence of insomnia was 57.7% and was not related to age or gender. Difficulty in initiating sleep was the most commonly reported insomnia complaint(52.4%). Early morning awakening was reported by 50.0% of patients and difficulty in maintaining sleep was reported by 45.1% of them. Worrying in bed and physical pain were strong contributing factor to insomnia. CONCLUSIONS: The results of our study showed several characteristics of sleep habits in the elderly. Sleep disorder in old age is not inevitable or trivial. Since sleep disturbance in older adults is common and distressing, it has implications for general health and well-being. Active concern and therapeutic intervention for the sleep habits and sleep disorders in the elderly are needed.
Adult ; Aged* ; Busan* ; Female ; Humans ; Korea ; Male ; Prevalence ; Surveys and Questionnaires ; Sleep Wake Disorders* ; Sleep Initiation and Maintenance Disorders

OBJECTIVES: Psychological distresses and complaints in sleep, in addition to physical distresses such as pruritus and bone pain, are common in patients with hemodialysis. The purposes of this study were to investigate 1)the severity of physical distresses, 2)the severity of depression and anxiety, 3)the sleep disturbances, and 4)the correlation of the above variables in patients with hemodialysis. METHODS: The patients with hemodialysis (male 87, female 66)and controls (male 58, female 55)completed a self-administered questionnaire package, which included Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and questions characterizing the reported sleep problems and quantitating the severity of the self-perceived physical and psychological conditions with linear visual analogue scales. RESULTS: The results indicated that patients with hemodialysis complained of more physical distresses, more depressed mood, and more sleep disturbances suggesting insomnia, restless legs syndrome, periodic limb movement disorder, nightmare and obstructive sleep apnea syndrome, etc. There were significant positive correlations of physical distresses, depressed mood and sleep disturbances. However, there were no significant differences in state and trait anxiety between both groups. CONCLUSIONS: The authors suggest that the quality of life in patients with hemodialysis will be improved if their emotional and sleep disturbances are properly ameliorated.
Anxiety* ; Depression* ; Dreams ; Female ; Humans ; Nocturnal Myoclonus Syndrome ; Pruritus ; Quality of Life ; Surveys and Questionnaires ; Renal Dialysis* ; Restless Legs Syndrome ; Sleep Apnea, Obstructive ; Sleep Initiation and Maintenance Disorders ; Weights and Measures

BACKGROUND: This scientific statement is intended to provide a systematic review of new evidences in dyslipidemia and inflammation for primary stroke prevention. METHODS: Using a structured literature search, we identified major observational studies, clinical trials, meta-analyses, and updated major guidelines published between July 2007 and November 2010. In addition to the brief summary of earlier evidences employed in the first edition of Korean clinical practice guideline for primary prevention of stroke, we summarized the newly identified evidences. RESULTS: For dyslipidemia, observational studies further support a strong association between ischemic stroke and high total and low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol. Two clinical trials and 6 meta-analyses confirm statin efficacy for primary prevention of stroke in high risk patients. Efficacy of other lipid-lowering agents is not established. For inflammation, inflammatory markers might help to identify patients having high risk for stroke or cardiovascular event and to decide whether statin therapy is indicated, but its usefulness for broad population needs to be confirmed. CONCLUSIONS: Writing committee will continue to keep an eye on upcoming evidences to timely update the guideline for primary stroke prevention in dyslipidemia and inflammation.
Cholesterol ; Dyslipidemias ; Eye ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Inflammation ; Lipoproteins ; Meta-Analysis as Topic ; Practice Guidelines as Topic ; Primary Prevention ; Stroke ; Writing

Pivotal clinical trials testing the efficacy of new antithrombotics for the prevention of stroke and systemic embolism in patients with atrial fibrillation have been published since the release of the first edition of Korean clinical practice guidelines for primary stroke prevention. From July 2007 to August 2012, 5 clinical studies and update of guidelines in Europe and North America were identified through systematic search. In patients with atrial fibrillation who were unsuitable for warfarin, the combination of clopidogrel and aspirin reduced the risk of stroke at the cost of increased major bleedings as compared to aspirin. In patients with nonvalvular atrial fibrillation and risk factors for stroke, new oral anticoagulants, dabigatran, rivaroxaban and apixaban, were as effective as or more effective than warfarin in preventing stroke or systemic embolism. The risks of major bleeding with novel anticoagulants were similar to or lower than that of warfarin. Particularly, the risk of intracranial bleeding was significantly lower with novel anticoagulants than with warfarin. In this report, we summarized the new evidences and updated our recommendations for primary stroke prevention in patients with atrial fibrillation.
Anticoagulants ; Aspirin ; Atrial Fibrillation ; Benzimidazoles ; beta-Alanine ; Embolism ; Europe ; Hemorrhage ; Humans ; Morpholines ; North America ; Primary Prevention ; Pyrazoles ; Pyridones ; Risk Factors ; Stroke ; Thiophenes ; Ticlopidine ; Warfarin ; Dabigatran ; Rivaroxaban

BACKGROUND: The diagnostic and therapeutic approaches to mediastinal tumors and cysts have changed over the past three decades. This report summarizes our forty-two years of experience with these tumors. METHODS: This study retrospectively reviewed 479 patients with primary mediastinal tumors and cysts that were diagnosed and managed over the past 17-year period (1985~2002) and compared them to the report of the previous 25-year result (1960~1985) in Yonsei University College of Medicine, Severance Hospital in Seoul, Korea. RESULTS: During the 17 years, there were 479 cases of pathologically proven mediastinal tumors and cysts. Thymoma (38.2%) was the most common mediastinal tumor and has increased noticeably during recent years. The gender ratio showed a male predominance (1.3:1) and the age distributions were even over all the age groups. The most common sites of the tumor and the proportion(28.6%) of malignant tumors were the same as that previously reported. A diagnosis of a tumor in asymptomatic patients was possible in 174 cases (36.3%), which was higher that reported previously. The diagnostic yield of a fine needle aspiration biopsy was 68.6% in the total tumors and 80.9% in the malignant tumors. A surgical resection was the most frequently chosen treatment modality and was performed in 405 cases (84.6%). The complete resection rate was 91.1%, which is higher than the previous result of 78.8%. CONCLUSION: These results showed that the prevalence of mediastinal tumors and cysts, particularly thymoma, increased. A fine needle aspiration biopsy was a valuable preoperative differential diagnostic method for malignant tumors. The surgical and complete resection rate increased remarkably possibly due to the better applicable chest CT scans, the more frequent health check-up provided by the regular health promotion program for all people as a health insurance policy, and the improved diagnostic techniques in the pathologic, radiological, and clinical fields.
Age Distribution ; Biopsy ; Biopsy, Fine-Needle ; Diagnosis* ; Health Promotion ; Humans ; Insurance, Health ; Korea ; Male ; Prevalence ; Retrospective Studies ; Seoul ; Thymoma ; Tomography, X-Ray Computed

The first edition of Korean Clinical Practice Guidelines for Stroke, which was published in 2009, reflected evidence published prior to June 2007. Since then, many clinical trials and well-designed observational studies provided new evidence that may be pertinent to clinical practice. Accordingly, investigators of the Clinical Research Center for Stroke have timely updated the guidelines. This article summarizes the recent evidence and updated guidelines regarding the use of aspirin for primary stroke prevention, the management of asymptomatic carotid stenosis, the use of antithrombotics in atrial fibrillation for stroke prevention, the diagnosis and management of unruptured aneurysm, intravenous and intra-arterial thrombolysis in acute ischemic stroke, antiplatelet therapy for secondary stroke prevention in patients with non-cardioembolic stroke or transient ischemic attack, and the management of symptomatic carotid stenosis for secondary stroke prevention.
Aneurysm ; Aspirin ; Atrial Fibrillation ; Carotid Stenosis ; Humans ; Ischemic Attack, Transient ; Research Personnel ; Stroke