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BACKGROUNDS: As the lifetime is prolonged, the chances of operation of elderly people are increased concomitantly. In general, elderly patients have more frequent and severe psychiatric problems as depression and cognitive dysfunction than young patients. But, the prevalence rate of depression and cognitive dysfunction pre and postoperatively is known a little. Also, the delirium which makes the surgeon embarrassed is high in dementia and elderly patients even diagnosed normally preoperatively. We tried to know how many elderly people has depression and cognitive dysfunction pre and postoperatively, also how many elderly patients become delirious postoperatively. METHOD: We obtained questionnaires from 100 elderly patients(mean age 75.0) undergoing operation pre and postoperatively. We used Short Portable Mental Status Questionnaire(SPMSQ) which calculated the wrong answer for the fact to evaluate the cognitive dysfunction and short version of Geriatric Depression Scale(GDS) which calculated the wrong answer defined previously to study the depression. The depression was suggestted if GDS score was above 6 and cognitive dysfunction was suggested if SPMSQ score was above 3. The dementia and postoperative delirium patients were diagnosed and managed by the psychiatrist and the operator. RESULTS: Pre and postoperative mean score of GDS was 10.1 and 9.5 respectively. Pre and postopera- tive incidence of depression was 65% and 67% respectively. Pre and postoperative mean errors of SPMSQ was 6.5 and 6.7 respectively. Pre and postoperative incidence of cognitive dysfunction was 30% and 31% respectively. The dementia patients were ten. The postoperative delirium patients were six. Three of them were dementia patients diagnosed preoperatively and the others had non-cognitive dysfunction preoperatively. CONCLUSION: The incidence of depression and cognitive dysfunction in elderly patients is relatively high. And the postoperative delirium is high in dementia patients. Even the patients diagnosed non- cognitive dysfunction preoperatively have high incidence rate than young people. So, we must do critical care with elderly patients pre and postoperatively and know the appropriate management of depression and cognitive dysfunction to prevent prolonged hospitalization, poor quality of life and conflict with patient`s family.
Aged ; Critical Care ; Delirium ; Dementia ; Depression* ; Hospitalization ; Humans ; Incidence ; Prevalence ; Psychiatry ; Quality of Life ; Surveys and Questionnaires

No abstract available.

Astrocytes are major glial cells in central nervous system (CNS) and are known to express death receptors or ligands that can induce apoptosis of astrocytes or other brain cells. We have previously confirmed that cultured human astrocytes express fas and fas ligand and their expression may be regulated by various cytokines found in CNS. Because fas can rnediate cell death known as apoptosis, we investigated fas-mediated cell death in cultured human astrocytes and evaluated factors that may influence the fas-mediated apoptosis in astrocytes. Pretreatment of interferon-r and TNF-a increased cell death in astrocytes. Cell death induced by fas ligation was confirmed as apoptosis by phosphatidylserine translocation in cell membrane. Cycloheximide, protein synthesis inhibitor, potentiated fas-mediated cell death. However, buthionine sulfoxine did not potentiate fas-mediated apoptosis. Dexamethasone blocked cell death in dose-dependent and time-dependent manners. These findings collectively show that fas expressed on cultured human fetal astrocytes can induce apoptotic cell death after pretreatment of interferon-r and/or TNF-a. Therefore, the fas-fas ligand system in CNS may regulate the glial degeneration and may participate the neuronal loss in certain conditions. Furthermore, fas-mediated apoptosis of astrocytes can be potentiated by protein synthesis inhibitors and can be blocked by dexamethasone.
Apoptosis ; Astrocytes* ; Brain ; Cell Death ; Cell Membrane ; Central Nervous System ; Cycloheximide* ; Cytokines ; Dexamethasone* ; Fas Ligand Protein ; Humans* ; Ligands ; Ligation ; Neuroglia ; Neurons ; Protein Synthesis Inhibitors ; Receptors, Death Domain ; Signal Transduction

Anti-HLA antibody related neonatal thrombocytopenia is an uncommon disorder caused by platelet antigen incompatibility between mother and fetus in Korea. Mothers who lack the specific platelet antigen produce the IgG against the platelet antigen which the fetus inherits from the father. These IgG antibodies are then transported across the placenta into the fetal circulation where they lead to the destruction of fetal platelets. We report a case of neonatal alloimmune thrombocytopenia related with anti-HLA antibody in second baby of dizygotic twin who had petechia on trunk and platelet count 43,000/mm. Initially, mother and twin showed the positives in antiplatelet antibodies. In microlym- phocytotoxic test at 6 months of age, anti-HLA antibodies was negative in twins but anti-HLA A2, A24 was positive in their mother. The patient was treated with intravenous immunoglobulin and clinically improved and her platelet count was norrnalized.
Acrocephalosyndactylia* ; Antibodies ; Blood Platelets ; Fathers ; Fetus ; Humans ; Immunoglobulin G ; Immunoglobulins ; Infant, Newborn ; Korea ; Mothers ; Placenta ; Platelet Count ; Thrombocytopenia, Neonatal Alloimmune ; Twins ; Twins, Dizygotic

No abstract available.
Ophthalmology*

BACKGROUND: Pap smear is well known as a useful method for early detection of the cervical cancer and known to be widely performed by women. But the cervical cancer is the most common cancer in Korean women until now. So we surveyed to find out the status of womens practice and the result of Pap smear. METHODS: A questionnaire was filled up by the 270 women who had taken Pap smear from June to July in 1994 at the department of family medicine of Kyung Hee Medical Center. The family physicians gynecological findings at Pap srnear and the results of Pap smear were obtained. Af ter then we analyzed the data by SAS(Statistical Analysis System). The data which were not answered at each item were excluded in the analysis of each item. RESULTS: Among the 270 women, thirties were 98 persons(36.3%), forties were 115 persons(42.6%). The women who had never been taken Pap smear before were 34.6%. At the age performed Pap smear first, 30-39 years old was most common as of 39.8%. In the interval of Pap smear among the performed, 2 years interval was 36.8%. The medical facility usually being performed Pap smear was obstetrics and gynecological clinic as of 49.7%. At the opinion of int,erval which they think they should take Pap smear, the women answered that 1 year interval was appropriate were 50.7% and the opinions of the experienced group were statistically different from those of the non-experienced group(P<0.01). Gynecological findings showed normal in 74.8%, the cytological results of Pap smear showed class I as of 88.9%, class II 6.3%, class III 4.4% and class IV 0.4%. CONCLUSIONS: Almost of them knew correctly the appropriate interval of Pap smear they should take, but the practice rate was very low. They had good results in the final cytological results of Pap smear, but the cervical cancer is the most common cause of cancer death in Korean women until now. So they should continuously get public informations and be educated to take Pap smear at the appropriate interval for the reduction of death due to cervical cancer.
Female ; Humans ; Obstetrics ; Physicians, Family ; Uterine Cervical Neoplasms ; Surveys and Questionnaires

We herein present two cases of angioleiomyoma with unusual location and number of cutaneous lesion. One was 58-year-old male who has two small peasized nodules on the left palm and volar aspect of the left fifth finger. The other was 63-year-old male with three small pea-sized nodules on the left palm, volar aspect of the left middle finger and the right sole. We confirmed these as angioleiomyoma by clinical and histopathological findings.
Angiomyoma* ; Fingers ; Humans ; Male ; Middle Aged

Sixty-one cases in which the diagnosis of epithelial cysts had been made studied. The data were collected from our own clinical records and a review of all histopathologic slides of epithelial aysts that had been filed at Departrnent of Dermatology, Chosun University Hospita.l during the past g years from July, 1979 to June, 1984. The results were as follows: 1) Among the 61 cases of epithelial cysts, 41 cases were epidermal cysts, 10 cases of milia, 7 cases of steatocystoma. multiplex, 2 cases of pilar cysts and 1 case of eruptive vellus hair cyst. 2) The average age of these patients was third decade. 3) The commonest site of epidermal cyst and milium was face. Two cases of pilar cyst occurred only on the scalp. Fteatocystoma multiplex was developed on the several sites, but not on the scalp and scrotum, 4) The average diameter was 6. 5 mm for epidermal cyst, p 6 mm for milium, 3 1 mm for steatocystoma multiplex and 17 mm for pilar cyst.
Dermatology ; Diagnosis ; Epidermal Cyst ; Hair ; Humans ; Scalp ; Scrotum ; Steatocystoma Multiplex

PURPOSE: The aim of this prospective study was to evaluate whether additional intraoperative injection of Tarasyn (ketorolac tromethamine) provided a preemptive analgesic effect that improved postoperative pain. METHODS: Sixty patients scheduled for hemorrhoidectomy were randomly assigned to the study and control groups. For the control group (n=32), patients were treated with standard intravenous injections of Nubain (Nalbuphine hydrochloride; Jeil Pharmaceuticals Co, Seoul) per 8 hours for three times postoperatively for pain relief. In the study group (Tarasyn group, n=28), 60 mg of Tarasyn (ketorolac tromethamine; Roche Korea, Seoul) was injected into the internal sphincter muscle and around the operative wound at the time of hemorrhoidectomy as well as standard intravenous injections of Nubain . Parameters were measured of pain score from 0 (no pain) to 10 (agonizing pain), painless sound sleep, additional analgesic requirements, time to first bowel movement, and postoperative urinary retention. RESULTS: Rate of painless sound sleep was 75.0% and 53.1% in the Tarasyn and the control groups, respectively, which was significant statically between two groups (P<0.05). Time to first bowel movement was 2 and 3.2 days in Tarasyn and the control groups, respectively, which was also significant statistically (P<0.05). Voiding difficulty developed in one case (3.5%) in the Tarasyn group and he needed catheterization. In the control group, however, the number (15 cases, 46.9%; P<0.001) was much higher requiring more catherization (13 cases, 40.9%; P<0.001). Mean pain scores was significant statically between two groups (P<0.001). CONCLUSION: The data suggest that the use of intraoperative injection of Tarasyn is associated with a significant decrease in pain and urinary complications after hemorrhoidectomy.
Catheterization ; Catheters ; Hemorrhoidectomy* ; Humans ; Injections, Intravenous ; Korea ; Nalbuphine ; Pain, Postoperative ; Prospective Studies* ; Tromethamine ; Urinary Retention ; Wounds and Injuries