PURPOSE: Obesity is a risk factor for cardiovascular morbidity and is frequently associated with coronary artery disease, hypertension, and diabetes mellitus. Conventional Doppler technique is limited by the absence of an adequate apical window to assess the transmitral flow in obese patients. Tissue Doppler imaging(TDI) and strain rate imaging(SRI) were performed to assess the influence of obesity on left ventricular systolic function. METHODS: In 13 obese and 15 normal adolescents aged 16 to 17 years, height, weight, body mass index(BMI), and obesity index(OI) were measured. Fat mass, body fat percent, and abdominal fat percent were estimated by bioelectrical impedance. Ejection fraction(EF) and myocardial performance index(MPI) were estimated by conventional echocardiography to evaluate left ventricular systolic function. Systolic myocardial velocity and strain rate were estimated by TDI and SRI. RESULTS: EF(63.8+/-6.4% vs 55.7+/-3.4%) was significantly lower in obese adolescents than normal controls. MPI(0.34+/-0.03 vs 0.48+/-0.06) was significantly higher in obese adolescents than normal controls. Systolic myocardial velocity and strain rate were significantly lower in obese adolescents than normal controls. Strain rate showed a negative correlation with arm circumference(r=-0.558, P<0.05) and BMI(r=-0.332, P<0.05). Strain rate was positively correlated with EF(r=0.557, P<0.05) at the base of left ventricle by SRI CONCLUSION: Significant decrease in left ventricular systolic function was noted in the moderate degree of obesity. SRI may be a more useful diagnostic tool in evaluating systolic dysfunction in patients with moderate degree of obesity.
Abdominal Fat ; Adipose Tissue ; Adolescent* ; Arm ; Body Weight ; Coronary Artery Disease ; Diabetes Mellitus ; Echocardiography ; Electric Impedance ; Heart Ventricles ; Humans ; Hypertension ; Obesity ; Risk Factors

BACKGROUND: Infectious complications frequently occur after cardiac arrest and may be even more frequent after therapeutic hypothermia. Pneumonia is the most common infectious complication associated with therapeutic hypothermia, and it is unclear whether prophylactic antibiotics administered during this intervention can decrease the development of early-onset pneumonia. We investigated the effect of antibiotic prophylaxis on the development of pneumonia in cardiac arrest patients treated with therapeutic hypothermia. METHODS: We retrospectively reviewed the medical records of patients who were admitted for therapeutic hypothermia after resuscitation for out-of-hospital cardiac arrest between January 2010 and July 2015. Patients who died within the first 72 hours or presented with pneumonia at the time of admission were excluded. Early-onset pneumonia was defined as pneumonia that developed within 5 days of admission. Prophylactic antibiotic therapy was defined as the administration of any parenteral antibiotics within the first 24 hours without any evidence of infection. RESULTS: Of the 128 patients admitted after cardiac arrest, 68 were analyzed and 48 (70.6%) were treated with prophylactic antibiotics within 24 hours. The frequency of early-onset pneumonia was not significantly different between the prophylactic antibiotic group and the control group (29.2% vs 30.0%, respectively, p = 0.945). The most commonly used antibiotic was third-generation cephalosporin, and the class of prophylactic antibiotics did not influence early-onset pneumonia. CONCLUSION: Antibiotic prophylaxis in cardiac arrest patients treated with therapeutic hypothermia did not reduce the frequency of pneumonia.
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Heart Arrest* ; Humans ; Hypothermia* ; Medical Records ; Out-of-Hospital Cardiac Arrest ; Pneumonia* ; Resuscitation ; Retrospective Studies

Purpose: There are various neurogenic bladder patterns that occur in patients during stroke. Among these patterns, the focus was mainly on the patient’s facial parsy diagnosis. Stroke requires early response, and it is most important to identify initial symptoms such as facial parsy. There is an urgent need for a diagnostic technology that notifies patients and caregivers of the onset of disease in the early stages of stroke. We developed an artificial intelligence (AI) stroke early-stage analysis software that can alert the early stage of stroke through analysis of facial muscle abnormalities for the elderly neurogenic bladder prevention. Methods: The method proposed in this paper developed a learning-based deep learning analysis technology that outputs the initial stage of stroke after acquiring a high-definition digital image and then deep learning face analysis. The applied AI model was applied as a multimodal deep learning concept. The system is linked and integrated with the existing urine management integrated system to support patient management with a total-care concept. Results: We developed an AI stroke early-stage analysis software that can alert the early stage of stroke with 86% hit performance through analysis of facial muscle abnormalities in the elderly. This result shows the validation result of the landmark image learning model based on the distance learning model. Conclusions We developed an AI stroke early-stage diagnostic system as a wellness personal medical service plan and prevent cases of missing golden time when existing stroke occurs. In order to secure and facilitate distribution of this, it was developed in the form of AI analysis software so that it can be mounted on various hardware products. In the end, it was found that using AI for these stroke diagnoses and making them quickly and accurately had a positive effect indirectly, if not directly, on the neurogenic bladder.

Cancer is the most frequent cause of death in both developing and developed countries, including Korea. The aim of this study was to present survival rates of Korean cancer patients. Survival analysis was carried out with data collected under the Korea Central Cancer Registry Program, which included all cancer patients diagnosed from January 1, 1997 to December 31, 1997. We have analyzed the effects of age at diagnosis and sex on cancer survival from the cancer registry data of 64,240 Korean patients diagnosed of cancer in 1997. The overall survival rate of all Korean cancer patients (both men and women) was 67% at 1 yr and 57% at 2 yr. The 1- and 2-yr survival rates for all cancers in men were 58% and 47%, respectively, while those in women were 77% and 69%, respectively. Men had a lower survival rate than women in most malignancies. The pancreatic cancer was shown the lowest 1-yr survival rate.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Korea ; Male ; Middle Aged ; Neoplasms/*mortality ; Survival Analysis ; Survival Rate

PURPOSE: To characterize autonomic dysfunction in patients with benign prostatic hyperplasia(BPH), we measured heart rate variability(HRV) and analyzed them compared with those of normal population. MATERIALS AND METHODS: ECG signals were obtained from 11 male patients(mean age, 63.1 years) and 23 healthy male controls(mean age, 57.0 years) in resting state. We analyzed their parameters of HRV and compared them between groups. RESULTS: Time domain analysis including standard deviation of NN interval(SDNN), square root of mean of sum of squares of differences between adjacent NN intervals(RMSSD) in patients with BPH were not significantly different with those of controls. There were suggested evidence of decreased total power(TP), high frequency (HF) in patients with BPH(p<0.05) while no significant difference in other frequency domain such as very low frequency(VLF), low frequency(LF) and LF/HF ratio. CONCLUSION: This preliminary study shows that patients with BPH have different results on HRV study comparing to controls. With the exception of LF and LF/HF ratio, all parameters of HRV in patients with BPH lower than normal controls. TP, HF in patients with BPH significantly lower than that of normal controls. The decreased values of HRV study means that they may have some kinds of disease or imbalance in autonomic nervous system(ANS). So we suggest that HRV study may be a tool to describe the possibility of altered ANS activity in patients with BPH.
Autonomic Nervous System ; Electrocardiography ; Heart Rate* ; Heart* ; Humans ; Male

Three fungi newly intercepted from importing plants were identified in 2004. They were Ascochyta chrysanthemi on Lactuca sativa from China, A. spinaciicola on Spinacia oleracea from Denmark, and Leptosphaerulina australis on Brassica oleracea var. capitata from China. The characters of these fungi were described and illustrated.
Brassica ; China ; Denmark ; Fungi* ; Korea* ; Lettuce ; Spinacia oleracea

PURPOSE: Cancer has become the major cause of deaths in Korea. Planning care for patients with terminal cancer is difticult. The prediction of length and prognostic factors of survival in the terminal cancer can facilitate the planning of a supportive care program aimed at patients need. The aim of this study was to identify length and those related factor of survival in the patients with terminal cancer. MATERIALS AND METHODS: This retrospective study was performed on 271 patients, who were diagnosed as terminal cancer in Seoul National University Hospital from March 1991 to February 1996. For getting the further informations about the patient, we interviewed with surviving relatives by telephone, and we requested administrative helps in order to take the informations about date of death. We examined the relations of 10 factors with survival in patients with terminal cancer. RESULTS: We could confirm 229 patients' death(84.5%) in 271 subjects. The median length of survival in patients with terminal cancer was 11 weeks(95%CI 10.0~14.0). By univariate analysis, history of surgery(p<0.01), performance(p<0.05), severity of pain(p <0.001), and dyspnea(p<0.05) were clinical factors in predicting survival. According to Cox's proportional hazard model including sex, age, history of surgery, performance, severity of pain, and dyspnea as variables, absence of surgery history(RR 1.398, 95%CI 1.038~1.882) and severity of pain(RR 1.398, 95%CI 1.044 ~1.872) showed independent prognostic value. CONCLUSION: The median survival was 11 weeks, and absence of surgery history and severity of pain were the independent prognostic factors for patients with terminal cancer.
Cause of Death ; Cohort Studies* ; Dyspnea ; Humans ; Korea ; Proportional Hazards Models ; Retrospective Studies ; Seoul ; Telephone

There are few reports about the systemic toxicity of mepivacaine, which is widely used for regional nerve blocks, because of its short onset time and intermediate duration, during or after blockades. We report two cases. In the first, a 70 year-old female with chronic renal failure and hypertension was scheduled for arteriovenous fistula formation under axillary brachial plexus block using 30 ml of 1.5% mepivacaine. In the second, a 69 year-old female with hypertension who was scheduled for total knee replacement under femoral/sciatic nerve block with lateral femoral cutaneous nerve block using 45 ml of 1.5% mepivacaine. Both had an exaggerated hemodynamic response (of increased blood pressure and heart rate) with symptoms and signs of central nervous system excitation not evolving to convulsions, which was induced by mepivacaine during or soon after the blockades. Possible causes and mechanisms of the events are discussed based on the literature.
Arteriovenous Fistula ; Arthroplasty, Replacement, Knee ; Blood Pressure ; Brachial Plexus ; Central Nervous System ; Female ; Femoral Nerve ; Heart ; Hemodynamics ; Humans ; Hypertension ; Kidney Failure, Chronic ; Mepivacaine ; Nerve Block ; Sciatic Nerve ; Seizures

OBJECTIVES: This study determined the work schedules of public project workers who work an irregular shift and assessed the effect of these schedules on depression. METHODS: Study subjects were 2934 laborers who are members of seven labor unions. Each was given a questionnaire requesting basic personal information, habits, socioeconomic status, and work schedules. Information gathered on work schedules included daytime, nighttime, and weekend work hours. Depression was evaluated using the Beck Depression Inventory (BDI), with Laborers who checked "not depressed" and "slightly depressive" categorized to a low-risk group, whereas laborers who checked "depressed" and "severely depressed" were categorized to a high-risk group. We used the Chi-square test and multivariate logistic regression to examine associations between work schedules and depression. RESULTS: Laborers on an irregular work schedule averaged 47.8 hours/week and laborers who working over 48 hours/week comprised over half (54.5%) of the total population. Laborers performing night work, Sunday work, and Saturday work more than once in a month made up 25.7%, 30.8% and 33.5% of the examined population, respectively. A high-risk for depression was identified in 10.4% of laborers. Using logistic regression, depression was statistically associated with working : over 10 hours a day (OR=1.63, 95% CI 1.10~2.43), night work (OR=2.20, 95% CI 1.46~3.32), Sunday work (OR=1.81, 95% CI 1.15~2.85) and Saturday work (OR=1.82 95% CI 1.18~2.82). CONCLUSION: A significant number of laborers with irregular working shifts work long hours and on weekends. Depression was significantly associated with this type of work schedule.
Appointments and Schedules ; Depression ; Humans ; Labor Unions ; Logistic Models ; Public Sector ; Questionnaires ; Social Class

Abdominal pregnancy is a very rare and life threatening varient of ectopic pregnancy with high maternal mortality and perinatal mortality. A 26-year-old woman, gravida 2, para 0, abortion 2, visited our emergency department for amenorrhea for 11 weeks and lower abdominal pain. Diagnostic transvaginal ultrasonographic finding suggested ruptured ectopic pregnancy. Serum Hemoglobin level was 8.1 mg/dL, and Hematocrit value was 25.2%. On laparatomy about 2.000 mL of blood was filled in the abdomen and severe adhesion was found on right adnexa, posterior cul-de-sac and omentum. A live fetus was attached to uterus. After adhesiolysis, we removed conceptus from uterine surface. We performed subtotal hysterectomy and excised right fallopian tube. 10 pints of packed red blood cell and 3 pints of fresh frozen plasma were given to the patient during and after the operation. Patient recovered postoperatively without any complications and discharged at postoperative seventh day. We experienced a case of first trimester secondary abdominal pregnancy after tubal reanastomosis and reported it with brief of a literature review.
Abdomen ; Abdominal Pain ; Adult ; Amenorrhea ; Emergency Service, Hospital ; Erythrocytes ; Fallopian Tubes ; Female ; Fetus ; Hematocrit ; Humans ; Hysterectomy ; Maternal Mortality ; Omentum ; Perinatal Mortality ; Plasma ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Sterilization Reversal* ; Uterus