BACKGROUND: Since dysthymia begins in late childhood or adolescence and has a chronic course, long-term pharmacotherapy may be required. New generation antidepressant, moclobemide, with more acceptable side effect profiles, is effective in the treatment of dysthymia. The main objective of this study was to determine whether they exhibit comparable efficacy and tolerability in dysthymia to amitriptyline. METHOD AND MATERIALS: The efficacy and tolerability of the moclobemide and amitriptyline, were compared in a eight-week single-centre double-blind study in patients(n=37) with dysthymia using he HAMD-17, the Clinical Global Impression Scale(CGI), the Montgomery-Asberg Depression Rating Scale(MADRS), Efficacy Index-Therapeutic Index(EITE), 4-point Index Side Effect Scale(4-PISES), and Efficacy Index-Side Effect Scale(EISE). RESULTS: A total of 37 patients entered the study, 19 were randomly assigned to the moclobemide group and 18 to be amitriptyline group. Demographic and illness characteristics were similar in both groups. There were no significant difference between two groups at the total 17-HDRS score, the HAMD-17% improvement, the total MADRS score, CGI response, and the EITE. In the comparison of EISE between two groups, the scores of the moclobemide group were relatively lower than the amitriptylinen group in full treatment. And the differences were significant(moclobemide group 1.39+/-0.61 ; amitriptyline group 2.00+/-0.85, p<.001). At the 4-PISE. There was no serious or treatment threatening side effects. And there was no specific difference in side effects between two groups. The moclobemide group reported higher EIR scores than the amitriptyline group at every follow up day, but the differences were not significant. And there was no significant differences in the scores of five HRQOL subcategories which is compared between two groups at every follow up days. CONCLUSIONS: In terms of 17-HDRS and MADRS, moclobemide and amitriptyline are equally effective at least in allevating dysthymic symptoms. But moclobemide tended to be less troubling and better tolerated than amitriptyline. Therefore, moclobemide treatment can be used as a safe, and higher satisfactory treatment strategy for the dysthymia.
Adolescent ; Amitriptyline* ; Depression ; Double-Blind Method ; Drug Therapy ; Dysthymic Disorder* ; Follow-Up Studies ; Humans ; Moclobemide*

BACKGROUND: Scabies outbreaks have been reported in long-term care facilities, but less commonly in acute care facilities. We experienced an outbreak of scabies that occurred in neurosurgery-intensive care unit of a general hospital, Seoul, Korea. METHODS: An outbreak of scabies was noticed on September 2006 when hospital staffs of NICU were diagnosed with scabies. The infection control nurse reviewed medical records and interviewed all of patient in NICU and health care workers. The epidemic spread of scabies from a patient to other patient, hospital employees and their families and associates was identified from historical, clinical, and microbiologic skin preparation data. RESULTS: Forty-three NICU patients and 22 health care workers were investigated. Five scabies cases were identified in total of 42 cases who are exposed to index case with attack rate of 11.9%. The attack rate of scabies in health care workers and NICU patients were 10% and 13.6%, respectively. Tertiary cases also occurred among the family members of workers, with a tertiary attack rate of 44%. CONCLUSION: The patient of acute care facilities also have chances of being exposed to scabies outbreak, since sensorimotor deficits or cognitive disorders make it difficult for individuals to communicate and understand the implication of risky contacts.
Delivery of Health Care ; Disease Outbreaks ; Hospitals, General ; Humans ; Infection Control ; Long-Term Care ; Medical Records ; Scabies ; Skin

OBJECTIVE: Hypertensive disorder in pregnancy is one of the most serious obstetrical complications. Apolipoprotein E (Apo E) genotype is polymorphic and recently it was reported to be associated with preeclampsia. We undertook this study to clarify whether polymorphic marker of apolipoprotein E is associated with the development of hypertensive disorder in pregnancy. METHODS: Retrospective chart review was done. DNA was extracted from maternal blood of 124 healthy pregnant women and 253 women with hypertensive diseases in pregnancy. Hypertensive disorders complicating pregnancy include gestational hypertension (n=44), preeclampsia (n=158; mild=56, severe=102), preeclampsia superimposed preeclampsia (n=30), and chronic hypertension (n=21). Apo E allele was amplified by polymerase chain reaction, size fractionated on 4% agarose gels, and stained with ethidium bromide. RESULTS: We found all six possible genotypes of Apo E. However, three genotypes, E2/2, E2/4 and E4/4, were uncommon in Korean. We analysed the data according to each allele. Allele frequencies of the Apo epsilon2, epsilon3 and epsilon4 were as follows: 6.8%, 83.0%, 10.2% in women with gestational hypertension, 4.5%, 84.8%, 10.7% in women with mild preeclampsia, 5.9%, 85.3%, 8.8% in women with severe preeclampsia, 1.7%, 91.7%, 6.7% in women with superimposed preeclampsia, 0.0%, 90.5%, 9.5% in women with chronic hypertension, and 5.2%, 86.5%, 8.5% in normal controls. No significant difference in Apo E alllele frequency was found among these groups (P>0.05). CONCLUSIONS: The study suggests that specific allele of apolipoprotein E does not appear to be a risk factor for hypertensive disorders complicating pregnancy in Korean population.
Alleles ; Apolipoproteins ; Apolipoproteins E ; DNA ; Ethidium ; Female ; Gels ; Gene Frequency ; Genotype ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Polymerase Chain Reaction ; Pre-Eclampsia ; Pregnancy ; Pregnant Women ; Retrospective Studies ; Risk Factors ; Sepharose

PURPOSE: The purpose of this study was to measure meaning in life for a normal adult and to offer basic data for developing nursing strategies for improving the meaning in life of adults. METHOD: There were 351 subjects, from 20 to 60 years old, staying in Busan and KyungNam Province. The data was collected from August to October 2000. The instrument was designed by researchers. The data were analyzed with frequency, mean(+/-SD), t test and ANOVA. RESULT: 1. The mean MIL for adult was 187.7(+/-18.1). 2. The mean MIL of basic premise phase for discovery of meaning was 30.5, method phase for discovery of meaning was 111.1, and result phase for discovery of meaning was 46.4. 3. The levels of MIL, 56.4% of the subjects were in pursuit of meaning in life, 23.3% felt a loss of meaning in life. 4. There were significant differences in MIL according to the level of education(P=0.00), marital status(P=0.01) and monthly income (P=0.00). CONCLUSION: On the viewpoint of the above results, 23.3% of the subjects were in a level of existential vaccum which required keens Logotherapy. Therefore, it shows that developing nursing-logotherapy to improve the meaning in life for adults is demanded.
Adult* ; Busan ; Gyeongsangnam-do ; Humans ; Middle Aged ; Nursing ; Psychotherapy

The depressive symptoms are frequent and important ones in the elderly population. We studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly (more than 65 years old; n=490) in Seoul area (city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination (MMSE) Geriatric Depression Scale (GDS) Korean Depression Scale(KDS: under development)were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1)the loss of spouse, 2)a current physical illness, and 3)low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.
Aged* ; Depression* ; Education ; Humans ; Logistic Models ; Marital Status ; Memory ; Seoul ; Social Class ; Spouses

Traditionally, radical hysterectomy is the main surgical method for the treatment of early cervical carcinoma and always results in the loss of fertility. But, large numbers of young women are recently being diagnosed with cervical carcinoma and fertility preservation has become a concern. So, there has been a move towards more conservative approaches for the treatment of cervical carcinoma in recent years. Radical trachelectomy, which allows preservation of uterus but removes the cervix, parametrium and upper one third of the vagina, is a conservative but locally radical procedure. We performed radical abdominal trachelectomy with pelvic lymphadenectomy for two cases of invasive cervical carcinomas, which may be the first report in korea. One patient was 37 years old single women who had stage Ib cervical cancer and was disease free for 17 months after treatment. The other patient was 19 years old student who was also single and had stage IIa cervical cancer and was disease free for 14 months after treatment. We report the first two cases and review the literature on radical trachelectomy.
Adult ; Cervix Uteri ; Female ; Fertility ; Fertility Preservation ; Humans ; Hysterectomy ; Korea ; Lymph Node Excision* ; Uterine Cervical Neoplasms ; Uterus ; Vagina ; Young Adult

IgA nephropathy can occur rarely as a complication of D-penicillamine treatment, but it is exact pathogenesis remains unclear. If a patients has gross or microscopic hematuria during D-penicillamine treatment, D-penicillamine induced IgA nephropathy should be suspected as a cause of hematuria. In those cases, renal biopsy should be taken for diagnosis and proper management. We experienced a case of IgA nephropathy confirmed by renal biopsy in a 39-years-old female patient with scleroderma during D-penicillamine therapy and report this case with a review of literature.
Biopsy ; Diagnosis ; Female ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Immunoglobulin A* ; Penicillamine*

The major risk factors for diabetics undergoing surgery are the end-organ diseases associated with diabetes. Autonomic neuropathy is relatively common in diabetic patients and associated with an increased risk of perioperative cardiovascular instability. We experienced a case of severe bradycardia and hypotension during general anesthesia for subtotal gastrectomy in a 59 year-old male diabetic patient. Anesthesia was induced with thiopental and vecuronium, and was maintained with nitrous oxide, oxygen and enflurane. Five minutes after induction, severe bradycardia and hypotension developed without specific events. The bradycardia was unresponsive to intravenous atropine and ephedrine, but the blood pressure was restored by administration of ephedrine. During operation his blood pressure was maintained in normal range but the bradycardia was not restored by additional administration of atropine. Postoperatively, myocardial infarcton was ruled out. The test performed after operation suggested that his cardiovascular autonomic nervous system was severely impaired. We think that cardiovascular autonomic dysfunction should be evaluated during preoperative period to plan the anesthetic management and to prevent severe cardiovascular complications in diabetic patients.
Anesthesia ; Anesthesia, General* ; Atropine ; Autonomic Nervous System ; Blood Pressure ; Bradycardia* ; Diabetes Mellitus ; Enflurane ; Ephedrine ; Gastrectomy ; Humans ; Hypotension ; Male ; Middle Aged ; Nitrous Oxide ; Oxygen ; Preoperative Period ; Reference Values ; Risk Factors ; Thiopental ; Vecuronium Bromide

beta-amyloid peptide (Abeta) consisting of 40 to 42 amino acid is the principle constituent of senile plaques in Alzheimer's disease. Although, the hypothesis that deposition of AP triggers a cascade of events leading to the pathology of Alzheimer's disease has been widely accepted, direct evidence for triggering accumulation of phosphorylated tau in paired helical filament is rare. In this study, we examined neurotoxicity induced by 3 kinds of beta-amyloid peptides 1 ~28, 25~,35 and 1~40 to elucidate the way of mechanism trading to neuronal cell death caused by Abeta using cultured hippocampal neurons. For this purpose, we measured lactate dehydrogenase (LDH) in the culture media after treatment with Abeta combined with anti-oxidant drug, trolox, or not. By histochemical and TUNEL method, we studied the change of immunoreaction to anti-MAP-2 (microtubule associated protein -2, the main component of neuritis) and detected apoptotic cells, respectively, in the hippocampal neurons treated with Abeta. To investigate whether tau phosphorylation involve neurotoxicity induced by Abeta, we immunostained the neurons with anti-SMI-31 to recognize phosphorylated Ser 396/404 of tau. From our data, we suggested that Abeta1-40 and Abeta25-35 induced marked neurodegenerative changes, and the mechanism responsible for cell death caused by Abeta -neurotoxicity was associated with the apoptosis. Because Abeta-neurotoxicity was not inhibited by anti-oxidant, trolox, we suggested that anti-oxidant did not protect the neuronal cells against the damage induced by Abeta in ou. expo.imental envi.onment. Finally, we suggested that AP treatment did not potentiate the immunoreactivity to anti-phosphorylated tau antibody and we speculated that Abeta-neurotoxicity led hippocampal cells to apoptosis without tau phosphorylation.
Alzheimer Disease ; Apoptosis* ; Cell Death ; Culture Media ; In Situ Nick-End Labeling ; L-Lactate Dehydrogenase ; Neurons* ; Pathology ; Peptides* ; Phosphorylation* ; Plaque, Amyloid

A 36-year-old female amateur cyclist developed mononeuropathy of the deep branch of the ulnar nerve due to nerve compression adjacent to the ulnar tunnel (type II Guyon’s canal syndrome) caused by prolonged bicycle riding.The patient’s signs and symptoms persisted even after refraining from cycling for 4 weeks; thus, she underwent decompression of the deep branch of the ulnar nerve in the palm and wrist. Three months postoperation, she recovered nearly full power and function of her left hand.