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

BACKGROUND: The implementation of intraoperative normovolemic hemodilution is a strategy used in an attempt to diminish the need for or obviate allogeneic transfusion and to avert the potential complications. The goal of this study was to evaluate the safety and efficacy of moderate intraoperative normovolemic hemodilution. METHODS: Fifteen patients scheduled for posterolateral spinal fusion underwent intraoperative normovolemic hemodilution with 10% pentastarch to a target hematocrit level of 25% (hemodilution group). All units of blood procured by hemodilution and additional allogeneic blood was transfused in the perioperative period to maintain the hematocrit level of>25%. We investigated the effect of hemodilution on whole blood coagulation as measured by the thromboelastography and, evaluated its efficacy of decreasing the need for allogeneic blood transfusion as compared to the nonhemodilution group, retrospectively. RESULTS: Hemodilution with pentastarch caused a decrease in response and coagulation time (p<0.01) but did not influence on the alpha angle and maximum amplitude on thromboelstogram. Amount of transfusion of allogeneic blood was 4.1 1.7 units for the hemodilution group and 5.0 1.5 units for the nonhemodilution group. Net red blood cell volume ""saved"" from hemodilution was about 120 ml. CONCLUSION: Moderate intraoperative normovolemic hemodilution with pentastarch does not affect the coagulability of whole blood. But its efficacy of decreasing the need for allogeneic blood transfusion is minimal.
Blood Coagulation ; Blood Transfusion ; Erythrocytes ; Hematocrit ; Hemodilution* ; Humans ; Hydroxyethyl Starch Derivatives ; Perioperative Period ; Retrospective Studies ; Spinal Fusion* ; Thrombelastography

Background: Spontaneous pneumopericardium is a very rare condition. Spontaneous pneumothorax and pneumomediastinum have been reported to be associated with an idiopathic pulmonary fibrosis (IPF). However, spontaneous pneumopericardium has not yet been reported in association with IPF. Here we report a case of spontaneous pneumomediastinum and pneumopericardium in a patient with acute exacerbation of IPF with a review of the relevant literature.
Humans ; Idiopathic Pulmonary Fibrosis* ; Mediastinal Emphysema* ; Pneumopericardium* ; Pneumothorax

BACKGROUND: Phantom limb sensation is an unusual position sense of the extremity during nerve block that the position of extremity is misinterpreted as being flexed, or elevated, when actually they are in neutral position. Whether it is from the fixation of proprioceptive input at the time of motor blockade or from unmasking of the pattern which has been already present in the CNS is still controversial. We perfomed this study under the assumption that phantom limb sensation can still be reproduced without the influence of position at the time of nerve blockade. METHODS: Thirty-six patients scheduled for elective orthopedic surgery were randomly assigned. For 26 patients, spinal anesthesia was performed with hyperbaric 0.5% tetracaine or bupivacaine at lateral decubitus position and the position was changed to supine immediately. Existence of phantom limb sensation and the level of anesthesia was recorded at 10 and 20 minutes after injection of local anesthetics. For 10 patients, same local anesthetics were injected after patient's legs were straightened in lateral decubitus position. RESULTS: Forteen out of 26 patients whose position were changed to supine immediately after the injection of local anesthetics experienced phantom limb sensations. Five out of 10 patients whose legs were kept straight before the injection of local anesthetics experienced phantom limb sensations. Previous history of trauma was positively related to the expression of phantom limb sensation. CONCLUSION: Our data showed that the expression of phantom limb sensation is reproducible. And this was not related to the position at the time of spinal anesthesia. Trauma seems to be an important factor related to the expression of phantom limb sensation.
Anesthesia ; Anesthesia, Spinal* ; Anesthetics, Local ; Bupivacaine ; Extremities ; Humans ; Leg ; Nerve Block ; Orthopedics ; Phantom Limb* ; Proprioception ; Sensation* ; Tetracaine

To study the possibility of attraction magnetic forces to expand maxillary arch, we used 2 big adult dogs, 2 small puppies, 1 small adult dog as experiments, and 1 small adult dog as a control. We measured the intercanine width and intermolar width and histologically observed in the suture and cervical and apex region of teeth and took occlusal X-rays to observe separation of suture line in the maxilla. The results were as follows: 1. Expansion velocities of intercanine (0.25mm/day) and intermolar widths (0.23mm/day) in puppies were faster than those (0.135mm/day, 0.09mm/day) in adults. 2. In all experiments in adults (0.135mm/day) and puppies (0.25mm/day), expansion velocity of intercanine widths were faster than those (0.09mm/day, 0.23mm/day) of intermolar width. 3. In all experiments ectatic changes were observed and cellularities of fibroblast increased in the suture line. Only in adults dogs the separations of palatal suture were observed in the occlusal X-ray view. 4. In the puppies bony deposition was particularly observed in the suture line and micro-bony fragments were often observed. 5. In the all experiments no root resorption was observed in the cervical and root area, but normal root resorption due to eruption of permanent teeth was observed in the puppies.
Adult ; Animals ; Dogs ; Fibroblasts ; Humans ; Maxilla ; Palatal Expansion Technique* ; Root Resorption ; Sutures ; Tooth

OBJECTIVES: The antimicrobial activity of silver nanoparticles has resulted in their widespread use in many consumer products. Yet, despite their many advantages, it is also important to determine whether silver nanoparticles may represent a hazard to the environment and human health. METHODS: Thus, to evaluate the genotoxic potential of silver nanoparticles, in vivo genotoxicity testing (OECD 474, in vivo micronuclei test) was conducted after exposing male and female Sprague-Dawley rats to silver nanoparticles by inhalation for 90 days according to OECD test guideline 413 (Subchronic Inhalation Toxicity: 90 Day Study) with a good laboratory practice system. The rats were exposed to silver nanoparticles (18 nm diameter) at concentrations of 0.7 x 10(6) particles/cm3 (low dose), 1.4 x 10(6) particles/cm3 (middle dose), and 2.9 x 10(6) particles/cm3 (high dose) for 6 hr/day in an inhalation chamber for 90 days. The rats were killed 24 hr after the last administration, then the femurs were removed and the bone marrow collected and evaluated for micronucleus induction. RESULTS: There were no statistically significant differences in the micronucleated polychromatic erythrocytes or in the ratio of polychromatic erythrocytes among the total erythrocytes after silver nanoparticle exposure when compared with the control. CONCLUSION: The present results suggest that exposure to silver nanoparticles by inhalation for 90 days does not induce genetic toxicity in male and female rat bone marrow in vivo.
Animals ; Bone Marrow ; Erythrocytes ; Female ; Femur ; Humans ; Inhalation ; Inhalation Exposure ; Male ; Mutagenicity Tests ; Nanoparticles ; Rats ; Rats, Sprague-Dawley ; Silver

Consequences of an untreated sleep related breathing disorder include failure to thrive, enuresis, attention deficit disorder, behavior problems, poor academic performance, and cardiopulmonary disease. The most common etiology of sleep related breathing disorder in children is adenotonsillar hypertrophy. Other upper airway lesion should be evaluated. We experienced a case of a child whose etiology of sleep related breathing disorder was suspected to have been caused by a tubal tonsil hypertrophy. Therefore, in this paper, we present a case of a sleep related breathing disorder in a child which was successfully treated by removing the tubal tonsil hypertrophy.
Attention Deficit Disorder with Hyperactivity ; Child* ; Enuresis ; Failure to Thrive ; Humans ; Hypertrophy* ; Palatine Tonsil ; Respiration ; Sleep Apnea, Obstructive*

Streptococcal toxic shock like syndrome is a rapidly progressive and a fatal disease like staphylococcal toxic shock syndrome. In spite of the wide expansion and development of potent antibiotics, streptococcal infection still threatens human being. Recently we experienced a patient with toxic shock like syndrome who was suffered from fever and neck pain with rapid progression to hypotension and multiorgan failure. Streptococcus pyogenes was proven in his throat culture which was done on admission. Pleural effusion and suspicious carditis with aortic and mitral valve regurgitation were examined on the third hospital day. He was treated successfully with antibiotics but we wanted to emphasize potentially fatal streptococcal toxic shock like syndrome in pediatric patients.
Anti-Bacterial Agents ; Fever ; Humans ; Hypotension ; Mitral Valve Insufficiency ; Myocarditis ; Neck Pain ; Pharynx ; Pleural Effusion* ; Shock, Septic* ; Streptococcal Infections ; Streptococcus pyogenes

PURPOSE: The aim of the present study was to develop a serodiagnostic test for differentiation infected from vaccinated animal (DIVA) strategy accompanying the marker vaccine lacking an immunodominant epitope (IDE) of nucleoprotein of Newcastle disease virus (NDV). MATERIALS AND METHODS: Recombinant epitope-repeat protein (rERP) gene encoding eight repeats of the IDE sequence (ETQFLDLMRAVANSMR) by tetra-glycine linker was synthesized. Recombinant baculovirus carrying the rERP gene was generated to express the rERP in insect cells. Specificity and sensitivity of an indirect enzyme-linked immunosorbent assay (ELISA) employing the rERP was evaluated. RESULTS: The rERP with molecular weight of 20 kDa was successfully expressed by the recombinant baculovirus in an insect-baculovirus system. The rERP was antigenically functional as demonstrated by Western blotting. An indirect ELISA employing the rERP was developed and its specificity and sensitivity was determined. The ELISA test allowed discrimination of NDV infected sera from epitope deletion virus vaccinated sera. CONCLUSION: The preliminary results represent rERP ELISA as a promising DIVA diagnostic tool.
Animals ; Baculoviridae ; Blotting, Western ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Insects ; Molecular Weight ; Newcastle disease virus* ; Newcastle Disease* ; Nucleoproteins ; Sensitivity and Specificity

Myelodysplastic syndrome (MDS) is a group of hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenia associated with dysplastic hypercellular marrow. Anemia is a frequent finding and reticulocytes are usually normal or slightly decreased in the patients with MDS. "Pseudoreticulocytosis" is a rare abnormality of patients with MDS. In these patients, the delayed maturation of reticulocytes is revealed and unusual reticulocytosis occurs with the decreased red cell production. We report a case of MDS characterized by the anemia associated with high reticulocyte count. 'In vitro reticulocyte survival test' showed that the reticulocytosis was a consequence of delayed maturation.
Anemia ; Bone Marrow ; Hematopoiesis ; Humans ; Myelodysplastic Syndromes* ; Reticulocyte Count ; Reticulocytes ; Reticulocytosis