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

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

Extracranial carotid stenosis is a well-established, modifiable risk factor for stroke. Asymptomatic extracranial carotid stenosis is increasingly being detected due to the introduction of less-invasive and more-sensitive advanced diagnostic technologies. For severe asymptomatic stenosis, earlier pivotal clinical trials demonstrated the benefit of carotid endarterectomy over the best medical therapy. Since then, great advances have been made in interventional and medical therapies as well as surgical techniques. The first edition of the Korean Stroke Clinical Practice Guidelines for primary stroke prevention for the management of asymptomatic carotid stenosis reflected evidences published before June 2007. After the publication of the first edition, several major clinical trials and observational studies have been published, and major guidelines updated their recommendation. Accordingly, the writing group of Korean Stroke Clinical Practice Guidelines (CPG) decided to provide timely updated evidence-based recommendations. The Korean Stroke CPG writing committee has searched and reviewed literatures related to the management of asymptomatic carotid stenosis including published guidelines, meta-analyses, randomized clinical trials, and nonrandomized studies published between June 2007 and Feb 2011. We summarized the new evidences and revised our recommendations. Key changes in the updated guidelines are the benefit of intensive medical therapy and further evidence of carotid artery stenting as an alternative to carotid endarterectomy. The current updated guidelines underwent extensive peer review by experts from the Korean Stroke Society, Korean Society of Intravascular Neurosurgery, Korean Society of Interventional Neuroradiology, Korean Society of Cerebrovascular Surgery, and Korean Neurological Association. New evidences will be continuously reflected in future updated guidelines.
Carotid Arteries ; Carotid Stenosis ; Constriction, Pathologic ; Endarterectomy, Carotid ; Neurosurgery ; Peer Review ; Primary Prevention ; Publications ; Risk Factors ; Stents ; Stroke ; Writing

Aortobronchial fistula may cause a massive fatal hemoptysis. Recently prosthetic aortic graft insertion or endovascular stent graft is a cause of aortobronchial fistula. We report a rare case of hemoptysis from a fistula between an aortic arch aneurysm and the left main bronchus in a patient who had undergone an endovascular stent graft in pseudoaneurysm of descending thoracic aorta one year before.
Aneurysm ; Aneurysm, False ; Aorta, Thoracic ; Blood Vessel Prosthesis* ; Bronchi ; Fistula* ; Hemoptysis* ; Humans ; Stents* ; Transplants

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