No abstract available.
Fatigue Syndrome, Chronic* ; Fibromyalgia

No abstract available.
Arthritis, Rheumatoid* ; Humans

No abstract available.
Tenosynovitis*

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

No Abstract available.
Ankle* ; Sarcoidosis* ; Tenosynovitis*

PURPOSE: The purpose of this study was to investigate the influence of social support, self - esteem, hope, and health conservation of the vulnerable elderly people with diabetes. METHODS: Participants were 100 vulnerable elderly people with diabetes living in D or K cities. Data collection was done through interviews from February to March, 2016. Social support was measured with the MOS-SSS (Medical Outcomes Study Social Support Survey), self-esteem with Self-Esteem Scale, hope with the Nowotny Hope Scale, and health conservation with the Sung's Health Conservation Scale. IBM SPSS 20.0 was used to analyze descriptive statistics, one-way ANOVA, independent t-test, Pearson correlation, and stepwise multiple regression. RESULTS: Factors affecting the health conservation of the vulnerable elderly people were social support, hope, education level and subjective health status. These factors explained 64.9% of the health conservation. CONCLUSION: It is necessary to construct a comprehensive nursing classification system for elderly people with diabetes in vulnerable class and to develop integrated health conservation program and nursing care as a new social support resource.
Aged* ; Classification ; Data Collection ; Diagnostic Self Evaluation ; Education ; Hope* ; Humans ; Nursing ; Nursing Care ; Self Concept ; Vulnerable Populations

PURPOSE: To evaluate quantification results of single breath-hold (SBH) magnetic resonance (MR) cine imaging compared to results of conventional multiple breath-hold (MBH) technique for left ventricular (LV) function in patients with cardiac arrhythmia. MATERIALS AND METHODS: MR images of patients with arrhythmia who underwent MBH and SBH cine imaging at the same time on a 1.5T MR scanner were retrospectively reviewed. Both SBH and MBH cine imaging were performed with balanced steady state free precession. SBH scans were acquired using temporal parallel acquisition technique (TPAT). Fifty patients (65.4 ± 12.3 years, 72% men) were included. End-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), myocardial mass, and LV regional wall motion were evaluated. RESULTS: EF, myocardial mass, and regional wall motion were not significantly different between SBH and MBH acquisition techniques (all P-values > 0.05). EDV, ESV, and SV were significant difference between the two techniques. These parameters for SBH cine imaging with TPAT tended to lower than those in MBH. EF and myocardial mass of SBH cine imaging with TPAT showed good correlation with values of MBH cine imaging in Passing-Bablok regression charts and Bland-Altman plots. However, SBH imaging required significantly shorter acquisition time than MBH cine imaging (15 ± 7 sec vs. 293 ± 104 sec, P < 0.001). CONCLUSION: SBH cine imaging with TPAT permits shorter acquisition time with assessment results of global and regional LV function comparable to those with MBH cine imaging in patients with arrhythmia.
Arrhythmias, Cardiac* ; Humans ; Retrospective Studies ; Stroke Volume ; Ventricular Function, Left*

The chest radiographs and angiograms were retrospectively evaluated in 47 patients with pulmonary atresia (PA) and ventricular septal defect (VSD) to determine the characteristic findings of major aortopulmonary collateral arteries (MAPCSs) on the chest radiographs. Of 47 patients, 23 had MAPCAs and 24 had only PDA for blood supply of whole right and left lung. Chest radiographs enabled identification of 16 of 23 patients with MAPCAs. The most common finding of MAPCAs was inappropriately large peripheral pulmonary vasculature (n=16, 69.6%). The other findings were tortuosity of pulmonary vasculature (n=12, 52.2%), focal unevendistribution of pulmonary vasculature (n=12, 52.2%), and two descending pulmonary arteries (n=4, 17.4%). When chest radiographs showed two or more findings of MAPCAs, MAPCAs could be differentiated from PDA with statistical significance (p<0.005). It is concluded that chest radiographs may help to identify MAPCAs before angiography if two-dimensional echo ardiography suggests PA with VSD.
Angiography ; Arteries* ; Heart Septal Defects, Ventricular* ; Humans ; Lung ; Pulmonary Artery ; Pulmonary Atresia* ; Radiography, Thoracic ; Retrospective Studies ; Thorax*

Complications after a median sternotomy incision, which is used currently in most open heart surgery, are serious, although it is infrequent. Reconstruction of the sternal defect resulting from dehiscence of median sternotomy is still big challenge to the most plastic surgeons. Since vascularized greater omentum was transposed to eliminate mediastinal wound problems, many vascularized regional muscle flaps became mainstay in reconstruction of median sternotomy wound. We treated 13 patients with median sternotomy dehiscence between October of 1993 and March of 1998. In two patients, the wound problems were so confined to superficial tissue that debrided and closed primarily. Eleven patients with deep wound infection were managed with vigorous debridement of all necrotic tissues and resultant defects were covered with regional muscle flaps: rectus myocutaneous flap(3) and bilateral pectoralis advancement flap(8). We used the pectoralis major advancement flaps without counter incision at humeral insertion site and the dissections were limited only medial to the anterior axillary line to preserve the axillary fold. In five patients with larger defects, we elevated muscle and cutaneous flaps separately to make these flaps more mobile. Large portion of two rectus abdominis flaps could not survive, whereas pectoralis advancement flaps had mo special wound problems. Only one patient developed fistula due to remained wire, regardless to flap surgery.
Debridement ; Fistula ; Humans ; Omentum ; Rectus Abdominis ; Sternotomy* ; Thoracic Surgery ; Wound Infection ; Wounds and Injuries

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*