BACKGROUND: Aging population correspond with an increase in the numbers of dementia patients. Dementia decreases the quality of life of patients and care-givers. However, current pharmacological treatment is limited by modest efficacy and adverse effect. Nonpharmacological treatment for dementia has been considered to be a substitute treatment. Recently we developed a special planned program for dementia with depression. The aim of this study was to evaluate therapeutic effect of this program. METHODS: We included patients aged 65 and older who diagnosed dementia with depression in a geriatric institution from April to June, 2006. We surveyed their sex, age, education period, and histories of hypertension, smoking, and alcohol intake. Patients in experimental group carried out our program, including cooking, painting, recreation, and activity, 9 times for 60 minutes a session. All included patients were checked Korean Mini-Mental State Examination (K-MMSE) and Korean Form of Geriatric Depression Scale (KGDS) before starting program and after 3 months when programs finished. RESULTS: There was no difference in demographic factors between two groups. K-MMSE was significantly improved in experimental group compared with control group (P = 0.01). And, the KGDS was significantly improved in experimental group compared with control group (P = 0.00). CONCLUSION: Multidivisional program for social skill improvement was effective on treatment for patients of dementia with depression. Nonpharmacological treatment for dementia with depression would be developed and studied to enhance the qualities of life of patients and care of dementia.
Aged ; Aging ; Alzheimer Disease ; Cooking ; Dementia ; Demography ; Depression ; Humans ; Hypertension ; Paint ; Paintings ; Quality of Life ; Recreation ; Smoke ; Smoking

PURPOSE: To investigate the changes of voiding methods according to the time after discharge and to clarify the reason of changing voiding method. MATERIALS AND METHODS: One hundred and seventeen patients with spinal cord injury were enrolled. We classified these patients into five groups such as normal voiding, reflex voiding, intermittent catheterization, Foley catheter, and suprapubic cystostomy group. We interviewed the patients for necessary information including current voiding method and reason of changing voiding method. RESULTS: 50% of intermittent catheterization patients changed to reflex voiding method. 66% of these patients changed the voiding method without consult with their physician. Higher percentage of the paraplegic patients with intermittent catheterization changed to reflex voiding than the quadriplegic patients. Moreover, female patients indwelt the catheters due to absence of external collecting device than males. CONCLUSION: It is necessary to follow up the voiding methods of patients with spinal cord injury more closely to avoid the following inadvertent complications.
Catheterization ; Catheters ; Cystostomy ; Female ; Follow-Up Studies ; Humans ; Male ; Reflex ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Catheterization

Homograft has been the conduit of choice in various types of congenital malformations which require right ventricular outflow tract reconstruction. However it has been proven to be less than ideal in young age group because of early failure of the conduite due to valve dysfunction and calcification. Furthermore limitation of availability of homograft particularly small sized conduits for neonates and infants is the most serious problem. A 19 month old female patient with pulmonary atresia and ventricular septal defect was operated on with a bovine jugular venous valved conduit as an alternative to the homograft for her right ventricular outflow tract reconstruction. Postoperative hemodynamic performance of the conduit was excellent without pressure gradient or valve regurgitation. With this early result bovine jugular venous valved conduit seems to be another excellent conduit because of good hemodynamics and size availability but long term follow up is necessary.
Allografts ; Female ; Follow-Up Studies ; Heart Septal Defects, Ventricular ; Hemodynamics ; Humans ; Infant ; Infant, Newborn ; Pulmonary Atresia

BACKGROUND: Irbersatan, an orally active antihypertensive agent, effectively reduce blood pressure by directly blocking angiotensin II receptors without any significant adverse effects. The purpose of this study is to evaluate the efficacy and safety of irbesartan in patients with mild to moderate hypertension. METHODS: This study enrolled 83 patients who had diastolic pressure above 95 mmHg and below 110 mmHg on two measurements. Sixty eight patients were administered 150mg of irbesartan, an angiotensin II receptor blocker, daily for four weeks as an initial dosage. If the sitting diastolic pressure was equal to or greater than 90 mmHg after a 4 week treatment period, the dosage was doubled until the end of 8 weeks. Baseline pressures, antihypertensive effect, side effects, laboratory findings were compared before and after treatment. RESULTS: Fourty two patients out of 53 patients having completed this study showed decreased blood pressure equal to or more than 5 mmHg of the sitting diastolic pressure (response rate=79%). Twenty one patients out of 53 patients showed normalized blood pressure below 90 mmHg of the sitting diastolic pressure (normalization rate=40%). The extent of decrease in diastolic and systolic blood pressure after eight week treatment was an average 11.7+/-10.1 mmHg and 16.3+/-18.9 mmHg, respectively (p<0.05). Nineteen ontoward side effects was observed in 17 patients out of 68 patients with medication (frequency of ontoward effects=25%). Only one case with headache was considered to be related to the medication. Abnormal laboratory findings were observed in eight patients, and only one case with elevation of bilirubin and ALT levels was considered to be related to the medication. CONCLUSION: In conclusion, irbesartan is a safe and effective antihypertensive drug in patients with mild to moderate hypertension with tolerable side effects.
Bilirubin ; Blood Pressure ; Headache ; Humans ; Hypertension* ; Receptors, Angiotensin

In this study, we report the first clinically identified case of severe fever with thrombocytopenia syndrome (SFTS) in a 73-year old man from Jeju Island, South Korea. Although his initial manifestation suggested tsutsugamushi disease with cutaneous lesion, later the patient presented with symptoms characteristic of SFTS. Despite intensive medical therapies upon the clinical diagnosis of SFTS, patient's condition rapidly deteriorated. SFTS is a fatal disease that requires early diagnosis and appropriate supportive treatment.
Diagnosis ; Early Diagnosis ; Fever* ; Humans ; Korea ; Scrub Typhus ; Thrombocytopenia*

No abstract available.
Fasciitis, Necrotizing* ; Sepsis* ; Vibrio*

The incidence of community-associated, methicillin-resistant, Staphylococcus aureus (CA-MRSA) has increased in North America and Europe. One of most important reasons is the spread of Panton-Valentine leukocidin (PVL) positive CA-MRSA strains. On the other hand, CA-MRSA is not associated with the PVL positive strain in South Korea. Few cases of PVL positive CA-MRSA infections were reported in South Korea. We encountered a case of a submandibular abscess caused by MRSA in an otherwise healthy 29-year-old foreign female resident in a military camp. The CA-MRSA infection was confirmed by culture after abscess aspiration. Staphylococcal cassette chromosome mec (SCCmec) typing, multilocus sequence typing and spa typing revealed type IV, ST8 and t008, respectively. The PVL gene was also identified.
Abscess ; Bacterial Toxins ; Community-Acquired Infections ; Europe ; Exotoxins ; Female ; Hand ; Humans ; Incidence ; Leukocidins ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Military Personnel ; Multilocus Sequence Typing ; North America ; Republic of Korea ; Sprains and Strains ; Staphylococcus ; Staphylococcus aureus

OBJECTIVE: In current urodynamic studies, rectal catheters can cause erroneous result affecting detrusor pressure, and the catheter itself is not comfortable to the patients. To reduce these problems we investigated the relationship between the motor unit action potentials (MUAP) of rectus abdominis muscle and the abdominal pressure measured by rectal catheter. METHOD: Healthy seven men and three women volunteers (mean age: 49 years) with no neurological abnormality were enrolled. Possible maximal abdominal pressure (Pmax) was attained by Valsalva maneuver for 5 seconds. The MUAPs of the rectus abdominis muscle were recorded with surface electrodes for analysis. These recordings were done on 100, 80, 60, 40, and 20% of Pmax. The parameters of MUAP such as mean frequency, median frequency, turns, mean amplitude, and RMS (root mean square) were measured. RESULTS: Turns, mean amplitude, and RMS were increased in a proportion to the increment of abdominal pressure in all subjects(R=0.840, 0.879, and 0.984, respectively). CONCLUSION: These findings suggested that the surface MUAP of rectus abdominis muscle might be used indirectly for more convenient measurement of the abdominal pressure.
Action Potentials* ; Catheters ; Electrodes ; Female ; Humans ; Male ; Rectus Abdominis* ; Urodynamics ; Valsalva Maneuver ; Volunteers

A mother-in-law and a daughter-in-law suffered chronic low back pain and they were injected epidural steroid on same day. Eleven days after injection, the daughter-in-law showed weakness of right lower extremity and lost filling sensation of bladder. Radiologic findings of Magnetic Resonance Imaging for lumbar spine revealed epidural abscess encompassing from L1 to sacral spine. After emergency surgical procedure and antibiotics therapy, the symptoms and the signs disappeared. Seven days after injection, the mother-in-law was diagnosed as pyogenic arthritis of right knee joint and then epidural abscess. Although the surgical procedure for right knee joint and antibiotics therapy were done, the epidural abscess didn't disappear. Moreover, surgical procedure for the epidural abscess couldn't be done due to septic condition, which was the cause of death. We report two cases of epidural abscess showing the importance of early management and serious end result. Prevention of these complication through extreme caution is needed.
Anti-Bacterial Agents ; Arthritis* ; Cause of Death ; Emergencies ; Epidural Abscess* ; Humans ; Injections, Epidural* ; Knee Joint* ; Knee* ; Low Back Pain ; Lower Extremity ; Magnetic Resonance Imaging ; Sensation ; Spine ; Urinary Bladder

BACKGROUND: The diagnosis of emphysema during life is based on a combination of clinical, functional, and radiographic findings, but this combination is relatively insensitive and nonspecific. The development of rapid, high-resolution third and fourth generation CT scanners has enabled us to resolve pulmonary parenchymal abnormalities with great precision. We compared the chest HRCT findings to the pulmonary function test and arterial blood gas analysis in pulmonary emphysema patients to test the ability of HRCT to quantify the degree of pulmonary emphysema. METHODS: From October 1994 to October 1995, the study group consisted of 20 subjects in whom HRCT of the thorax and pulmonary function studies had been obtained at St. Mary's hospital. The analysis was from scans at preselected anatomic levels and incorporated both lungs. On each HRCT slice the lung parenchyma was assessed for two aspects of emphysema: severity and extent. The five levels were graded and scored separately for the left and right lung giving a total of 10 lung fields. A combination of severity and extent gave the degree of emphysema. We compared the HRCT quantitation of emphysema, pulmonary function tests, ABGA, CBC, and patients characteristics(age, sex, height, weight, smoking amounts etc.) in 20 patients. RESULTS: 1) There was a significant inverse correlation between HRCT scores for emphysema and percentage predicted values of DLco(r = -0.68, p < 0.05),DLco/VA(r = -0.49, p < 0.05),FEVl(r = -0.53, p < 0.05),, and FVC(r = -0.47, p < 0.05). 2) There was a significant correlation between the HRCT scores and percentage predicted values of TLC(r = 0.50, p < 0.05),RV(r = 0.64, p < 0.05). 3) There was a significant inverse correlation between the HRCT scores and PaO2(r = -0.48, p < 0.05) and significant correlation with D(A-a)02(r = -0.48, p < 0.05) but no significant correlation between the HRCT scores and PaCO2. 4) There was no significant correlation between the HRCT scores and age, sex, height, weight, smoking amounts in patients, hemoglobin, hematocrit, and wbc counts. CONCLUSION: High-Resolution CT provides a useful method for early detection and quantitating emphysema in life and correlates significantly with pulmonary function tests and arterial blood gas analysis.
Blood Gas Analysis ; Diagnosis ; Emphysema* ; Hematocrit ; Humans ; Lung ; Pulmonary Emphysema ; Respiratory Function Tests ; Smoke ; Smoking ; Thorax