OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

Pulmonary embolism is a common clinical problem in patients with immobilization, cancer, indwelling central venous catheter and surgery. However, although rare, it may occur in patients with inherited thrombophilia. Protein S deficiency is known to increase the risk of venous thrombosis and pulmonary embolism. There are many reports of venous thrombosis with protein S deficiency, but there are few reports of arterial thrombosis, especially recurrent acute pulmonary embolism. Here, we report a case of recurrent pulmonary embolism associated with type II protein S deficiency.
Blood Coagulation Disorders, Inherited ; Central Venous Catheters ; Humans ; Immobilization ; Protein S ; Protein S Deficiency ; Pulmonary Embolism ; Thrombophilia ; Thrombosis ; Venous Thrombosis

PURPOSE: The present study explored novel methods in visual field tests that actively induce the gaze of the examinee to the fixation target in the center vision and compared their effectiveness. METHODS: Four gaze induction methods (dot-on, dot-off, number-on, and number-off) were prepared by combining 2 types of fixation targets (dot and number) and 2 conditions of sound presence (on and off). The gaze induction methods were implemented to a PC-based visual field testing system and the 24-2 visual field testing protocol was administered to 14 participants without glaucoma. The performance of the gaze induction method was evaluated in terms of fixation error rate, target detection rate, and subjective satisfaction (7-point scale, 1 for least satisfied and 7 for most satisfied). RESULTS: The fixation error rates of dot-on (5.7%) and number-on (6.4%) were relatively lower than the other methods; the target detection rates of the induction methods were very high (95-96%) without significant differences, and the subjective satisfaction levels of dot-on (5.7) and number-on (5.4) were significantly higher than the other methods. CONCLUSIONS: In the present study we determined number-on as the preferred effective gaze induction method compared to the conventional dot-off method when fixation error rates and subjective satisfaction were considered.
Glaucoma ; Vision, Ocular ; Visual Field Tests ; Visual Fields

PURPOSE: The methods for vasovasostomy are varied, and many authors have reported various success rates. This study aimed to assess a new method for vasovasostomy with a Prolene stent. MATERIALS AND METHODS: Among 85 patients who underwent vasovasostomy with a Prolene stent, 69 patients were retrospectively reviewed at our hospital between October 2004 and December 2007. The average age at the time of vasovasostomy was 42.2 years (range: 24.0-52.0 years). The obstructive interval was 6.25 years (range: 0.7-20.0 years). The cases were divided into 2 groups according to obstructive interval: group A (above 8 years) and group B (8 years and less), with 18 (26.1%) and 51 (73.9%) cases, respectively. Patency was defined as a sperm concentration of more than 10x106/ml on semen analysis. RESULTS: The overall patency and pregnancy rates were 76.8% and 43.4%, respectively. The patency and pregnancy rates of group A were 61.1% and 33.3%. Those of group B were 82.3% and 47.0%. The mean duration to pregnancy was 10.9 months (range: 4-31 months). The mean operation time was 90.2 minutes (range: 50.0-165.0 minutes). CONCLUSIONS: The new method of vasovasostomy with the Prolene stent has good efficacy and safety. Its benefits are the maintenance of good patency, a good pregnancy rate, and a diminished operating time.
Humans ; Polypropylenes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Spermatozoa ; Stents ; Vasovasostomy

Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Humans ; Lung Neoplasms ; Pneumonectomy ; Trachea ; Tuberculosis

Central neurogenic hyperventilation (CNH) is characterized by sustained tachypnea inspite of an elevated arterial PaO2, pH and a low arterial PaCO2. CNH is common in patients with brainstem injury accompanied by a decreased level of consciousness but this also has been described in some alert patients with an invasive brainstem tumor. We report one case with CNH resulting from a unilateral pontine infarction. His consciousness was clear, and CNH spontaneously disappeared without any medication.
Brain Stem ; Brain Stem Neoplasms ; Consciousness ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation* ; Infarction* ; Tachypnea

BACKGROUND: The sitting position under general anesthesia is associated with hemodynamic instability. The purpose of this study was to compare the efficacy of a sequential compression device (SCD) with that of elastic stockings (ES) in reducing the incidence of hypotension and other hemodynamic instability in the sitting position during shoulder arthroscopy. METHODS: Fifty-one patients undergoing shoulder arthroscopy were randomly assigned into one of three groups to receive no treatment (control group, n = 17), SCD (SCD group, n = 17) or ES (ES group, n = 17). Hemodynamic variables were measured 5 min after induction of anesthesia (baseline values), and every 1 min from 1 to 5 min after raising the patient to a 70degrees sitting position (T1-5) with the beach-chair. RESULTS: The incidences of hypotension (proportion, 95% CI) were 12/17 (0.71, 0.47-0.87), 5/16 (0.31, 0.14-0.56) and 7/15 (0.47, 0.25-0.70) in the control, SCD and ES group, respectively. The incidence was significantly lower in the SCD group than that in the control group (P = 0.038). At 1 min after sitting position, mean arterial pressure in the control group was significantly lower than that in the SCD group and it was significantly decreased from the baseline value. CONCLUSIONS: SCD could significantly reduce the incidence of hypotension with less hemodynamic instability in the sitting position during shoulder arthroscopy. Although the incidence of hypotension was decreased with the elastic stocking, there was no statistical significance.
Anesthesia ; Anesthesia, General ; Arterial Pressure ; Arthroscopy ; Hemodynamics ; Humans ; Hypotension ; Incidence ; Shoulder ; Stockings, Compression

BACKGROUND: Carbon dioxide (CO2) has different biophysical properties under different thermal conditions, which may affect its rate of absorption in the blood and the related adverse events. The present study was aimed to investigate the effects of heating of CO2 on acid-base balance using Stewart's physiochemical approach, and body temperature during laparoscopy. METHODS: Thirty adult patients undergoing laparoscopic major abdominal surgery were randomized to receive either room temperature CO2 (control group, n = 15) or heated CO2 (heated group, n = 15). The acid-base parameters were measured 10 min after the induction of anesthesia (T1), 40 min after pneumoperitoneum (T2), at the end of surgery (T3) and 1 h after surgery (T4). Body temperature was measured at 15-min intervals until the end of the surgery. RESULTS: There were no significant differences in pH, PaCO2, the apparent strong ion difference, the strong ion gap, bicarbonate ion, or lactate between two groups throughout the whole investigation period. At T2, pH was decreased whereas PaCO2 was increased in both groups compared with T1 but these changes were not significantly different. Body temperatures in the heated group were significantly higher than those in the control group from 30 to 90 min after pneumoperitoneum. CONCLUSIONS: The heating of insufflating CO2 did not affect changes in the acid-base status and PaCO2 in patients undergoing laparoscopic abdominal surgery when the ventilator was set to maintain constant end-tidal CO2. However, the heated CO2 reduced the decrease in the core body temperature 30 min after the pneumoperitoneum.
Absorption ; Acid-Base Equilibrium ; Adult ; Anesthesia ; Bicarbonates ; Body Temperature ; Carbon Dioxide ; Heating ; Hot Temperature ; Humans ; Hydrogen-Ion Concentration ; Insufflation ; Lactic Acid ; Laparoscopy ; Pneumoperitoneum ; Ventilators, Mechanical

No abstract available.

The method of lower limb reconstruction surgery is selected based on a patient's underlying conditions, general conditions, and wound status, and it usually varies from direct closure to skin graft and flap coverage. Herein, we describe a patient with Duchenne muscular dystrophy who developed critical limb ischemia after femoral cannulation for extracorporeal membrane oxygenation was used during knee disarticulation, which was followed by reconstruction of the defect around the knee using a pedicled anterolateral thigh flap and skin graft.
Catheterization ; Disarticulation ; Extracorporeal Membrane Oxygenation ; Extremities ; Humans ; Ischemia ; Knee ; Lower Extremity ; Methods ; Muscular Dystrophy, Duchenne ; Skin ; Surgical Flaps ; Thigh ; Transplants ; Wounds and Injuries