PURPOSE: This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years. METHODS: We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention. RESULTS: A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation; herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases, 10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71. CONCLUSION: This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.
Centers for Disease Control and Prevention (U.S.) ; Child ; Echovirus 9 ; Enterovirus ; Enterovirus B, Human ; Enterovirus Infections ; Genotype ; Herpangina ; Humans ; Korea ; Meningitis, Aseptic ; Pharynx

Purpose: The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. Methods: Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. Results: Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. Conclusion Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

Purpose: The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. Methods: Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. Results: Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. Conclusion Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

BACKGROUND: Brief episode of coronary artery occlusion (i.e., ischemic preconditioning) makes the heart more resistant to injury from a subsequent ischemic insult. Although a great deal of effort has been made in studying ischemic preconditioning, the underlying mechanism of ischemic preconditioning and its effect on hypothermic insult has not been elucidated. This study was performed to see whether ischemic preconditioning protects against the depression of cardiac contractility induced by hypothermic cardioplegic arrest/reperfusion. And recently, adenosine was known to have some correlation with the mechanism of preconditioning. If so, does this effect remain after the blockade of adenosine receptor by 8-phenyl theophylline? METHOD: Twenty-four Sprague-Dawley rat weighed 250-350g were used and divided into three groups. Rat hearts were removed rapidly, and each isolated heart paced with a rate of 180/min was perused by modified Krebs-Hensleit buffer(KHB) solution on a Langendorff apparatus far an hour. After obtaining baseline data including left ventricular pressure(LVP), dp/dt, and coronary flow, cardiac arrest was induced by perfusion of 0degrees C crystalloid cardioplegic(St Thomas) solution. After that, all hearts were stored in the same St Thomas solution at salute temperature far 2 hours. In group I (control group), the hear was reperfused by KHB solution. In group II(preconditioning group), the heart was subjected to two 2-minute episode of global ischemia followed by 5 minute reperfusion with KHB solution(preconditioning) before cardiac arrest. In group III(phenyl theophylline group), the heart was subjected to preconditioning procedure and 8-phenyl theophylline at 10muM in concentration was added to KHB solution at time of reperfusion. Observing parameter was obtained in each group at 10, 20, 40 and 60 minutes after starting reperfusion and compared statistically by use of one way ANOVA test(STASTICA, release 4.5). P-value less than 0.05 was considered significant. RESULTS: Although depressed LVP, dp/dt, and Coronary flow were seen in all groups during the reperfusion period, the preconditioned group showed more effective recovery of LVP than that of the control group, especially at 10, 20 and 40 minutes(p<.05). We failed to demonstrate the difference between the phenyl theophylline group and the control group(p=NS). CONCLUSION: These results suggest that ischemic preconditioning has protective effect on recovery state of hypothermic cardioplegic arrest/reperfusion. Its protective effect was limited during early reperfusion stage and was blocked by adenosine blocker.
Adenosine ; Animals ; Coronary Vessels ; Depression ; Heart Arrest ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardium* ; Perfusion ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic P1 ; Reperfusion ; Theophylline

No abstract available.

The alcoholic neuropathies developed in approximately 34% of chronic alcoholics and the sexual dysfunction had been experienced in 8-54% of male alcoholics(Schiavi 1990). The aims of this study were to identify the prevalence of subclinical polyneuropathies and sexual disorders in alcohol dependence, and to evaluate the association between them. The nerve conduction velocity(NCY), electromyography(EMG), and pudendal somatosensory evoked potentials(SEPs were tested for the male alcoholics(N=34) and controls(N=17 for NCV & EMG, N=25 for pudendal SEPs). The pudendal SEPs were measured by the following procedures, in which we simulated the dorsal nerve of penis attached by the ring electrode(stimulus intensity, three times of threshold ; stimulus rate, 1-4.7Hz: stimulus duration, 0.1 or 0.2msec), and recorded at the scalp(active electrode, 2cm behind Cz ; reference electrode, Fz. The NCV and EMG detected signs of peripheral neuropathies in 79.4% of alcoholics. Among the alcoholics, 64.7% were abnormal on the pudendal SEPs. Among the alcoholics who revealed abnormality on EMG and NCV, 81.4% were abnormal on the pudendal SEPs, in which 51.9% were not responded. The P1 latencies between peripheral neuropathies and sexual disorders in the alcoholic. The prevalence of subclinical neuropathies and sexual disorders seemed to be much higher in alcohol dependence that expectation, and these two problems were relatively correlated, and our results suggested that the peripheral polyneuropathies were one of the prerequisites of sexual disorders.
Alcoholic Neuropathy ; Alcoholics ; Alcoholism* ; Electrodes ; Humans ; Male ; Neural Conduction ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Prevalence ; Pudendal Nerve

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.
Anxiety ; Clonazepam ; Cyproheptadine ; Emergency Service, Hospital ; Epilepsy ; Fever ; Fluoxetine* ; Flushing ; Gait Ataxia ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Hypotension ; Lorazepam ; Male ; Memory ; Middle Aged ; Myoclonus ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline* ; Shivering ; Tachycardia ; Tremor ; Valproic Acid

OBJECTIVES: The aims of this study were to know whether Korean healthy elderly and family with dementia patients were wishing to disclose the diagnosis of dementia, to identify reasons of their wishing and unwishing to disclose, and to analyze influencing factors on the disclosing of dementia. METHODS: We obtained data from 78 healthy elderly with age over 60 and 73 family with dementia patients by interviewing with questionnaire about attitudes toward disclosing dementia. RESULTS: 1) 51.3% of healthy elderly and 58.9% of family with dementia patients were wishing to disclose dementia. Other relatives whom they wanted to tell were spouse or adult children. Most family with dementia patients wanted to have predictive tests in preparation for their future. 2) The main reasons for wishing to disclose were to make advance planning in healthy elderly, and to be careful and cooperate well to treat if they aware their illness in family with dementia patients (p<0.005, respectively). The main reasons for unwishing to disclose were whether they might be frightened or upset in healthy elderly (p<0.025), and to worry about being depressed in family with dementia patients (p<0.005). The main reasons why family wanted to be told were family's right to know and to explore treatment options. 3) The influencing factors on disclosing dementia seemed to be sex (p<0.01) and marital status (p<0.005) in healthy elderly, and education (p<0.005), marital status (p<0.005), religion (p<0.025) and socioeconomic status (p<0.01). CONCLUSION: The attitude toward disclosing diagnosis of dementia in Korean healthy elderly and family with dementia patients seemed to be more active. Therefore, doctors should prepare in mental attitude and knowledge to satisfy their need by active provision of information and education.
Adult Children ; Aged* ; Dementia* ; Diagnosis* ; Education ; Humans ; Marital Status ; Surveys and Questionnaires ; Social Class ; Spouses

BACKGROUND: The purpose of this study was to find out what factors affect revisits by elderly patients to the emergency department (ED) with the same symptoms within 72 hours and hospitalization after a revisit. Delineating these factors can reduce unnecessary revisits to the ED and minimize problems with diagnosing and treating, improving the quality of treatment provided and of discharge decisions. METHODS: This is a retrospective study involving 3790 elderly patients who presented initially to a general hospital ED between May 1, 2007 to June 30, 2009. Of these, 176 cases revisited the ED within 72 hours with the same symptoms. Their medical records were reviewed. A comparative analysis was conducted of the early revisit group by classifying them into 'discharge' and 'admission' considering age, gender, insurance status, means of arrival, chief complaint, diagnosis, length of stay, time of arrival, comorbidity disease, time lapse, and day of the week. RESULTS: The factors affecting revisits were age (< or =79 years), insurance status (medical aid), means of arrival (walk-in), and chief complaint (dysuria.flank pain, skin rash). The factors affecting hospitalization after a revisit were age (> or =80 years), means of arrival (by ambulance), increasing length of stay, and high comorbidity index (> or =2). CONCLUSION: The factors affecting revisits to the ED or hospitalization after a revisit were age, insurance status, means of arrival, chief complaint, length of stay, and comorbidity index. Physicians should be more careful when deciding discharge for elderly patients, especially those with the above factors.
Aged ; Comorbidity ; Emergencies ; Hospitalization ; Hospitals, General ; Humans ; Insurance Coverage ; Length of Stay ; Medical Records ; Retrospective Studies ; Skin

BACKGROUND: Ureteral colic due to acute obstruction of urine flow is a frequent and painful condition presenting in the emergency department. Proper control of ureteral colic is important in the management of such a patient. Many drugs, including narcotics, had been used to control ureteral colic, and of them, nonsteroidal anti-inflammatory drugs are most commonly used. This study was carried out to compare the analgesic effect of diclofenac with that of caroverine which is used empirically in ureteral colic. METHODS: We carried out a randomized, prospective clinical trial in the emergency department of a university hospital. Sixty patients in whom ureteral colic had been diagnosed on the basis of physical signs and symptoms were included in this study. Each patients received an IM dose of diclofenac 75 mg, a IV bolus dose of caroverine 20 mg, or a continuous infusion of caroverine 60 mg. An additional dose of medication was added 20 min after the initial medication if needed. RESULTS: The main outcome was measured by using both the visual analogue scale(VAS), four-point categorial pain scale at times of 20, 40, and 60 min after initial medication. The requirement for supplemental medication was also measured. At 40 min, diclofenac was more effective than the other two treatments according to its pain- relieving capacity(p<0.05) and the categorial pain scale. By 60 min, caroverine continuous infusion was less effective than the other two treatments according to visual analogue scale(VAS) and the categorial pain scale(p<0.05). There were no significant differences between the diclofenac group and the caroverine bolus injection group at this time. The diclofenac group needed significantly less rescue medication for pain control(p<0.05). CONCLUSION: IM diclofenac, a non-steroidal antiinflammatory drug, was superior to the spasmolytics, single bolus or continuous intravenous infused, in treatment of ureteral colic.
Diclofenac* ; Emergency Service, Hospital ; Humans ; Narcotics ; Parasympatholytics ; Prospective Studies ; Renal Colic* ; Ureter*