OBJECTIVES: The aim of this study was to investigate mortality rates and risk factors in dementia patients in a rural cohort. METHODS: A total of 114 subjects with clinically diagnosed dementia were followed up for eight years from 1997 to 2005. Their mortality was compared with sociodemographic and clinical variables using the Cox proportional hazards models after adjusting age, sex, and education. RESULTS: During follow-up, the mortality rate of subjects was 80.2% and the mean (SD) duration of survival from at diagnosis to death was 4 years. Mortality in subjects with dementia depended on old age (relative risk [RR] : 1.05 ; 95% confidence interval [CI] : 1.01-1.08), male (RR : 1.61 ; CI : 1.00-2.59), low Clinical Dementia Rating scale (RR : 1.54 ; CI : 1.14-2.10), low Activities of Daily Living (RR : 0.72 ; CI : 0.59-0.89), low Instrumental Activities of Daily Living (RR : 0.83 ; CI : 0.75-0.92), no physical activity (RR : 0.44 ; CI : 0.28-0.70), smoking (RR : 1.74 ; CI : 1.05-2.89). CONCLUSION: Mortality in dementia depended on age, sex, CDR, ADL, IADL, physical activity, smoking. These findings have important implications that contribute to make the disease management of dementia patients.
Activities of Daily Living ; Cohort Studies ; Dementia* ; Diagnosis ; Disease Management ; Education ; Follow-Up Studies ; Humans ; Male ; Mortality* ; Motor Activity ; Proportional Hazards Models ; Risk Factors* ; Smoke ; Smoking

BACKGROUND: Administering extracorporeal membrane oxygenation (ECMO) to critically ill patients with acute respiratory distress syndrome has substantially increased over the last decade, however administering ECMO to patients with hematologic malignancies may carry a particularly high risk. Here, we report the clinical outcomes of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO. METHODS: We performed a retrospective review of the medical records of patients with hematologic malignancies and severe acute respiratory failure who were treated with ECMO at the medical intensive care unit of a tertiary referral hospital between March 2010 and April 2015. RESULTS: A total of 15 patients (9 men; median age 45 years) with hematologic malignancies and severe acute respiratory failure received ECMO therapy during the study period. The median values of the Acute Physiology and Chronic Health Evaluation II score, Murray Lung Injury Score, and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction Score were 29, 3.3, and -2, respectively. Seven patients received venovenous ECMO, whereas 8 patients received venoarterial ECMO. The median ECMO duration was 2 days. Successful weaning of ECMO was achieved in 3 patients. Hemorrhage complications developed in 4 patients (1 pulmonary hemorrhage, 1 intracranial hemorrhage, and 2 cases of gastrointestinal bleeding). The longest period of patient survival was 59 days after ECMO initiation. No significant differences in survival were noted between venovenous and venoarterial ECMO groups (10.0 vs. 10.5 days; p = 0.56). CONCLUSIONS: Patients with hematologic malignancies and severe acute respiratory failure demonstrate poor outcomes after ECMO treatment. Careful and appropriate selection of candidates for ECMO in these patients is necessary.
Adult* ; APACHE ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hematologic Neoplasms* ; Hemorrhage ; Humans ; Intensive Care Units ; Intracranial Hemorrhages ; Lung Injury ; Male ; Medical Records ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency* ; Retrospective Studies ; Tertiary Care Centers ; Weaning

As a part of plan to construct a multifunctional hospital information system, We planned to develop a chemotherapy order system. First, a software developing team was established which is composed of hematooncology staffs, special pharmacists and programmer who are responsible for OCS. We set up an outline of this system after collecting various kinds of sources such as foreign examples, gathered protocol that are used for chemotherapy, and organized these protocol in programming the chemotherapy order system. This project is expected to provide accurate prescription, to shorten the time to prepare prescription, to standardize the protocol of chemotherapy within the medical center, to manage an effective dispensing schedule and to be used as a source for education and research.
Appointments and Schedules ; Drug Therapy* ; Education ; Hospital Information Systems ; Humans ; Pharmacists ; Prescriptions

OBJECTIVE: To compare the differences of hormone replacement therapy (HRT) and reproductive, life style characteristics in postmenopausal women with and without rheumatoid arthritis (RA). METHODS: A total of 360 women, 120 rheumatoid arthritis patients and 240 age matched healthy women were randomly selected from the health care center. Subjects were labeled as rheumatoid arthritis and normal menopausal women. Each group was compared for their HRT status, life style and reproductive characteristics. RESULTS: There were significantly less HRT received subjects in RA group (50.0% vs 76.1%, respectively, OR=0.30, p<0.05). More frequently alcohol consumed in RA group (26.7% vs 11.7%, respectively, p<0.05). There was no significant difference in the history of hysterectomy and smoking as well as body mass index (BMI) between the two groups. Women with serum follicular stimulating hormone (FSH) over 40 IU/L were more frequently observed in RA group (70.0% vs 57.5%, respectively, OR=1.75, p<0.05). CONCLUSION: Increased FSH and history of alcohol drinking were more frequently observed in patients with RA, whereas history of HRT was lower in RA group comparing to that of the control. A prospective study should be designed to confirim the protective effect of HRT and reproductive characteristics on postmenopausal RA patients.
Alcohol Drinking ; Arthritis, Rheumatoid* ; Body Mass Index ; Delivery of Health Care ; Female ; Hormone Replacement Therapy* ; Humans ; Hysterectomy ; Life Style* ; Postmenopause ; Smoke ; Smoking

BACKGROUND: Vascular lesions are the major cause of morbidity and mortality in hypertensive patients. However, the pathologic characteristics of gradually evolving, chronic hypertension have not been adequately studied and the mechanism by which hypertension accelerates atherosclerosis is still uncertain. This study was undertaken to invertigate the ultrastructural changes of the aorta and the effect of high cholesterol diet in spontaneously hypertensive rats(SHR). METHODS: Spontaneously hypertensive rats (n=80, male, 5 weeks old) and Wistar rats (n=40, male, 5 week old) were used. Forty SHR were fed with 2% cholestrol diete, while the remainder with control diet. Systolic blood pressure was measured weekly until 16 weeks after birth, and then biweekly until 40 weeks after birth. Transmission and scanning electron microscopy were used to evaluate ultrastrucural changes of the aorta. RESULTS: 1) The blood pressure of SHR rose stedily and progressively from the 5 weeks after birth and reached nearly 190mmHG at the 16 weeks after birth. 2) In SHR, the subendothelial component contained finely granular substances, abundant fibrillar collagen and elastin. Infiltration of the mononuclear blood leukocytes into the intima was frequently seen. 3) Endothelium from cholestrol-fed SHR did exhibit numerous pinocytotic vesicles and contained many cytoplasmic filaments. There were a number of large mononuclear lipid-filled cells in the intimal lesions. Blistering of the endothelial plasma membrane was also observed in high cholesterol diet-fed SHR. Later on, adhesion of platelets, febrin, and white blood cells as well as damage of intima shown as multiple small holes were more marked. 4) There was no significant difference in systoloic blood pressure between high cholesterol diet-fed and control diet-fed SHR. CONCLUSION: In the aorta of SHR, the most prominent change was an expansion of the subendothelial space and infiltration of the mononuclear leukocytes into the intima. The present study showed that the SHR was indeed a reliable model for the essential hypertension. In some SHR, high cholesterol diet could induce more pronounced vascular lesions, which were enhanced by hypertension.
Aorta* ; Atherosclerosis ; Blister ; Blood Pressure ; Cell Membrane ; Cholesterol* ; Cytoskeleton ; Diet* ; Elastin ; Endothelium ; Fibrillar Collagens ; Humans ; Hypertension ; Leukocytes ; Leukocytes, Mononuclear ; Male ; Microscopy, Electron ; Microscopy, Electron, Scanning ; Mortality ; Parturition ; Rats, Inbred SHR* ; Rats, Wistar

OBJECTIVES: Echocardiographically determined left ventricular hypertrophy is associated with increased risk for sudden cardiae death and for complex ventricular arrhythmias in 24-hour ambulatory electrocardiographic monitoring. In subjects with left ventricular hypertrophy, the presence of asymptomatic complex ventricular arrhythmias is associated with higher incidence of sudden cardiac death and higher cardiovascular mortality. However, their accurate relationship and prognostic significances have been remained to be established. The purpose of this study was to evaluate the relationship between complex ventricular arrhythmias, left ventricular hypertrophy, and sudden cardiac death in Korean patients. METHODS: Twenty four hour ambulatory electrocardiographic monitoring, echocardiographic data and medical records were reviewed in 360 subjects from 1991 to 1994. We evaluated the relationship between complex ventricular arrhythmias and left ventricular mass index, and the prognostic values of them. Of the 360 subjects, 187 could be followed up for one to four years. The mean follow-up period was 2.8 years. RESULTS: The incidence of complex ventricular arrhythmias was significantly correlated with left ventricular mass index and ejection fraction in all subjects. During the follow-up periods, seven of 187 subjects died from sudden cardiac death. Six of them had complex ventricular arrhythmias with left ventricular hypertrophy. CONCLUSION: The incidence of complex ventricular arrhythmias was significantly correlated with echocardiographically determined left ventricular hypertrophy and it is suggested that subjects with complex ventricular arrhythmias combined with left ventricular hypertrophy have higher risk for sudden cardiac death.
Arrhythmias, Cardiac* ; Cardia ; Death, Sudden, Cardiac ; Echocardiography ; Electrocardiography, Ambulatory ; Follow-Up Studies ; Humans ; Hypertrophy, Left Ventricular* ; Incidence ; Medical Records ; Mortality ; Prognosis

Two cases of an anomalous systemic arterial supply to the basal segments of the left lower lobe without pulmonary wequestration are presented. In the first case, a preoperative diagnosis was made by chest CT, and confirmed by angiograpy, in a 22-year old man who had a recurrent hemoptysis. There was systemic arterial supply that originated from the thoracic descending aorta and no pulmonary arterial supply to the basilar segment of the left lower lobe. However, the pulmonary parenchyma was normal without sequestration. Ligation of the abnormal artery and a left lower lobectomy were performed without complication. In the second case, there were characteristic features of this anomaly on chest CT and the angiogram in a 31-year-old man with symptoms of hemoptysis. The patient refused surgery.
Adult ; Aorta, Thoracic ; Arteries ; Bronchopulmonary Sequestration ; Diagnosis ; Hemoptysis ; Humans ; Ligation ; Tomography, X-Ray Computed

Fingerprints have been used for personal identification, for revealing physical anthropological characteristics, and for diagnosing genetic disorders. Morphology of fingerprints has been analyzed in various tribes. However, in Korean, the analytical methods of fingerprints and the numbers of subjects were not sufficient to find standard values for Korean fingerprints. In this study, fingerprints of 3216 Koreans (2095 males and 1121 females) were analyzed using the various methods and compared with those of other tribes to contribute in revealing physical anthropological characteristics of Korean and also in diagnosing genetic disorders of Korean. The results were as follows. 1. The incidence of ulnar loop type, whorl type, radial loop type, and arch type was 50.4%, 42.9%, 3.8%, and 2.9%, respectively. Data from the comparison of the incidences of fingerprint types in Korean with those in various tribes lead us to conclude that Korean belongs to the Asians and becomes closer to the Whites and Blacks in which loop type is frequent and whorl type is not frequent. 2. Fingerprint type seems to be related to the strength of finger since whorl type was frequent in male and in right hand, and arch type was frequent in female and in left hand. In addition, loop of fingerprint appears to have the tendency to open to the side bearing more physical contact since radial loop type was frequent in second finger, and ulnar loop type was frequent in fifth finger. 3. Among the subtypes of fingerprint, morphologically simple types were common. Among the subtypes of arch types, simple arch type with the same number of radial dermal ridges as ulnar ones was the most common. Among the subtypes of loop types, ulnar loop type without concentric circles or spirals was the most common. Among the subtypes of whorl types, concentric whorl type without loops was the most common. 4. Finger ridge counts were 16.9, 13.9, 11.9, 11.3, and 11.2 in first, fourth, third, second, and fifth finger, respectively; and were greater in male than in female. Finger ridge counts are greater in fingers which shows whorl type. However, there would be other factors to determine finger ridge counts; for examples, the size and behavioral habit of finger.
African Continental Ancestry Group ; Asian Continental Ancestry Group ; Dermatoglyphics* ; Female ; Fingers ; Hand ; Humans ; Incidence ; Male ; Population Groups

PURPOSE: To determine the clinical features of retinal arterial macroaneurysm (RAM). METHODS: Clinical characteristics of RAM, and its managements and results were evaluated. RESULTS: Of a total of 17 patients (17 eyes), 11 patients were women and 12 were over seventh decade. Mean follow-up period was 9.2 months. Hypertension was associated in 6 patients. Single aneurysm was temporally located in 15 eyes, which was along the temporal vascular arcade. It was on the arteriovenous crossing site in 8 eyes and followed retinal branch vein occlusion in 4 eyes. Aneurysms were located nasally in 2 eyes. Type was hemorrhagic in 15 eyes and exudative in 2 eyes. Pars plana vitrectomy was performed in 5 eyes and intraocular gas was injected in 2 eyes. Photocoagulation was performed directly in 2 eyes and indirectly in 3 eyes. Five eyes received no special managements. Visual acuity was less than 0.1 in 11 eyes and 0.3 or better in 4 on the initial visit, and less than 0.1 in 1 eyes and 0.3 or better in 10 on the final visit. Twelve eyes showed visual improvement of 2 lines or more. CONCLUSIONS: RAM usually develops along the temporal vascular arcade and induces visual disturbance due to hemorrhage and exudate. However, visual prognosis is relatively good.
Aneurysm ; Exudates and Transudates ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Hypertension ; Light Coagulation ; Prognosis ; Retinaldehyde* ; Veins ; Visual Acuity ; Vitrectomy

Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul NationalUniversity Hospital, either admitted or referred for serological verification, during recent 2 years. Radiologicalfindings were correlated with the lung specimen finding of experimentally induced leptospirosis in guinea pig. Theresults are as follows: 1. 24 cases(56%) showed positive X-ray findings. 2. Predominent radiological patterns ofinvolved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4cases, and diffuse ill-defined veilly increased density in 9 cases. 3. Distribution of pulmonary lesions werebilateral (100%), non-lobar, non-segmental(95%), and there were conspicuous tendency of peripheral lungpredominence. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rare. 5. Pulmonarylesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopicfindings of serially sacrified guinea pig's lung and a case of autopsy, authors conlcuded that fine dot-likedensity in chest X-ray was due to petechial hemorrhage in intraalveolar space at initial stage, growing up toressette density or confluent consolidation as the petechia extends to surrounding lung forming purpura andcoalescent hemorrhage.
Animals ; Autopsy ; Cardiomegaly ; Guinea ; Guinea Pigs ; Hemorrhage ; Leptospirosis ; Lung ; Pleural Effusion ; Purpura ; Seoul ; Thorax