This survey was conducted from January 1991 to May 1991. Two hundred and eight residents in 4 government supported homes for the aged and hundred and eleven living in the community in Taegu, Korea, were examined to evaluate the depression and the anxiety of the aged with combined anxiety and depression scale (CADS) and somatization symptom check list (SCL). There are no significant differences between residents in the home for the aged and those living in the community on the total scores of CADS and SCL. However, in the case of the total score of CADS of the female subjects in the home for the aged were significantly higher than those of the community residents. The elderly in the home for the aged tended to have pure depression, while community residents were likely to have anxiety and depression. Fifty-two subjects of home for the aged and sixty-nine of the community scored over 50 points of CADS, which indicates considerable depression or anxiety. In psychosocial factors, the subjects who in the following situations had statistically significant higher scores than others. The results were as follow. Poor health, unhappiness, unsatisfaction to the past occupation, pessimistic thought in future view for both group and unsatisfaction of the relationship with familiar people for the elderly in the community. The SCL scores of two groups subgrouped by under 49 and 50 on CADS showed significant differences between each subgroup on all of the SCL items. It could be suggested that somatic symptoms for the aged is a sign of depression.
Aged* ; Anxiety* ; Daegu ; Depression* ; Female ; Homes for the Aged ; Humans ; Korea ; Occupations ; Psychology

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Humans ; Myocardium* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: To compare the diagnostic usefulness of dobutamine stress echocardiography(DSE) and 99mTc-methoxyisobutyl isonitrile SPECT (MIBI SPECT), two studies were performed simultaneously. METHOD: Fifty-six consecutive patients undergoing coronary angiogram and MIBI SPECT for clinical indications without clincal evidence of myocardial infarction were studied prospectively. During the DSE, MIBI was injected at peak stress, and post-stress images of MIBI SPECT were required on hour later. Both echocardiographic and MIBI SPECT images were visually analysed in a blind fashion. RESULTS: On the basis of coronary angiographic findings, the sensitivites of the DSE and MIBI SPECT (n=36) were 89% and 86%, respectively. The specificities of those (n=20) were 90% and 85%, respectively. Among 33 patients without resting perfusion defect on MIBI SPECT, resting regional wall motion abnormalities on DSE were found in only one patient, whereas, resting perfusion defect on MIBI SPECT were found in 9 patients among 41 patients without resting regional wall motion abnormalities on DSE. Among 17 patients who had resting perfusion defects with partial reversibility on MIBI SPECT, resting wall motion abnormalities were present in 11 patients and five of them showed improvement in the regional wall motion during low dose dobutamine infusion. CONCLUSION: Both dobutamine stress echocardiography and MIBI SPECT are useful methods in the detection of the coronary artery disease, however, MIBI SPECT seems to overestimate the regional ischemic myocardium with contractile reserve that can hardly be evaluated with MIBI SPECT.
Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Myocardial Infarction ; Myocardium* ; Perfusion ; Prospective Studies ; Tomography, Emission-Computed, Single-Photon*

No abstract available.

No abstract available.
Intestinal Atresia*

BACKGROUND: This study aimed to investigate bradycardia as an adverse effect after administration of dexmedetomidine during 33degrees C target temperature management. METHODS: A retrospective study was conducted on patients who underwent 33degrees C target temperature management in the emergency department during a 49-month study period. We collected data including age, sex, weight, diagnosis, bradycardia occurrence, target temperature management duration, sedative drug, and several clinical and laboratory results. We conducted logistic regression for an analysis of factors associated with bradycardia. RESULTS: A total of 68 patients were selected. Among them, 39 (57.4%) showed bradycardia, and 56 (82.4%) were treated with dexmedetomidine. The odds ratio for bradycardia in the carbon monoxide poisoning group compared to the cardiac arrest group and in patients with higher body weight were 7.448 (95% confidence interval [CI] 1.834-30.244, p = 0.005) and 1.058 (95% CI 1.002-1.123, p = 0.044), respectively. In the bradycardia with dexmedetomidine group, the infusion rate of dexmedetomidine was 0.41 +/- 0.15 microg/kg/h. Decisions of charged doctor's were 1) slowing infusion rate and 2) stopping infusion or administering atropine for bradycardia. No cases required cardiac pacing or worsened to asystole. CONCLUSIONS: Despite the frequent occurrence of bradycardia after administration of dexmedetomidine during 33degrees C target temperature management, bradycardia was completely recovered after reducing infusion rate or stopping infusion. However, reducing the infusion rate of dexmedetomidine lower than the standard maintenance dose could be necessary to prevent bradycardia from developing in patients with higher body weight or carbon monoxide poisoning during 33degrees C targeted temperature management.
Atropine ; Body Weight ; Bradycardia* ; Carbon Monoxide Poisoning ; Dexmedetomidine* ; Diagnosis ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Hypothermia, Induced ; Logistic Models ; Odds Ratio ; Retrospective Studies

No abstract available.
Dermoscopy ; Hemangioma* ; Lasers, Dye

No abstract available.
Tetanus*

We report a case of neuroblastoma with multiple skin metastases as a chief complaint in a 2-month-old girl. the skin lesions were rnultiple, pea-sized, bluish, nontender, moable subcutaneous nodules on abdomen, back and scalp. Histopathology showed small round or poly gonal tumor cells which have deeply stained, basophilic, hyperchromatic nuclei with some mitoses. Th.se tumor cells showed clumping tendency which is one of early menifestations of rosette formation. Immunohistochemically positive reaction was demonstrated by anti-NSE(neuron specific enolase) antilody but negative reaction by anti-NFP (neurofilament proteiin ) antibody. She has been succesfully treated with combined chemotherapy for 10 months without relapse.
Abdomen ; Basophils ; Drug Therapy ; Female ; Humans ; Infant ; Mitosis ; Neoplasm Metastasis* ; Neuroblastoma* ; Phosphopyruvate Hydratase ; Recurrence ; Rosette Formation ; Scalp ; Skin*

A 51-year-old male patient was referred for a sudden out-of-hospital cardiac arrest. Upon arrival, he was conscious and had no chest pain complaints. There was no abnormality in initial electrocardiographic and echocardiographic examinations. However, episodes of recurrent ventricular fibrillation (VF) were documented on rhythm monitoring. Each VF episode was triggered by an isolated monomorphic ventricular premature complex (VPC). Suspecting idiopathic VF, emergency radiofrequency catheter ablation was planned for the VPCs. However, when coronary angiography was performed to exclude silent ischemia, the results showed a total occlusion of the right coronary artery posterolateral branch, which is thought to supply the left ventricular inferior and septal wall. After successful reperfusion, VF episodes and the triggering VPCs disappeared. We are documenting this case to emphasize the potential for silent myocardial infarction to cause out-of-hospital sudden cardiac arrest even in a patient without any symptom or sign of acute coronary syndrome.
Acute Coronary Syndrome ; Catheter Ablation ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Death, Sudden, Cardiac ; Echocardiography ; Electrocardiography ; Emergencies ; Heart Arrest* ; Humans ; Ischemia ; Male ; Middle Aged ; Myocardial Infarction* ; Out-of-Hospital Cardiac Arrest ; Reperfusion ; Ventricular Fibrillation* ; Ventricular Premature Complexes*