OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

Follicular adenoma is a benign encapsulated tumor with evidence of follicular cell differentiation. It is the most common thyroid neoplasm, usually solitary and has a well-defined fibrous capsule. We experienced a case of follicular adenoma occurring in congenital goiter and reported with the brief review of related literature
Adenoma* ; Cell Differentiation ; Goiter* ; Thyroid Neoplasms

No abstract available.
Osteoma

We report a case of ureteral migration of a surgical clip after partial nephrectomy in which the clip was misdiagnosed as a ureteral stone. A 37-year-old woman had undergone laparoscopic partial nephrectomy of right renal cell carcinoma at another hospital 2 years previously. Postoperatively, she had gradually acquired lower urinary tract symptoms. Then, she complained of sudden right flank pain for a week. A plain X-ray and enhanced abdominopelvic computed tomography scan were performed. A 0.5 cmx1.0 cm right upper ureteral opacity with borderline hydronephrosis was seen but could not be found on the X-ray. Ureteroscopy revealed a medium-sized Hem-o-Lok clip on the right upper ureter that was removed with a stone basket. We concluded that a Hem-o-Lok clip used for collecting system sealing had migrated to the ureter and had been misdiagnosed as a ureteral stone on a computed tomography scan.
Carcinoma, Renal Cell ; Female ; Flank Pain ; Humans ; Hydronephrosis ; Lower Urinary Tract Symptoms ; Nephrectomy ; Surgical Instruments ; Ureter ; Ureteral Calculi ; Ureteroscopy

BACKGROUND: This is a retrospective, descriptive study, evaluating the observed agreement between 1996 & 2002 Centers for Disease Control and Prevention (CDC) definitions of nosocomial pneumonia (NP) for medical intensive care unit (MICU) and surgical intensive care unit (SICU) patients. METHODS: A total of 476 adult patients who were over 15 years of age and had been admitted to the MICU & SICU of a university hospital between August 1, 2005 and August 1, 2007 were enrolled. Data were collected from electronic medical records according to the 1996 & 2002 CDC definitions of NP. RESULTS: According to the 1996 CDC definitions of NP, there were a total of 116 NP cases and incidence rate was 11.6 per 1,000 patient-days; when analyzed with the 2002 CDC definitions of NP, 75 cases met the criteria and the incidence rate was 7.5 per 1,000 patient-days. Kappa value measuring agreement between the two definitions was 0.67 (95% confidence interval 0.601-0.706). When 1996 CDC definitions were compared with 2002 CDC definitions, sensitivity, specificity, positive predictive value, and negative predictive value were 93.3, 88.5, 60.3, and 98.6%, respectively. CONCLUSION: Even though the aforementioned NP criteria had been applied to the same study population, the number of patients that met the definitions changed depending on which criteria had been used. Therefore, it is necessary to consider the differences when making a comparison.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Electronic Health Records ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Pneumonia ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Carcinosarcoma* ; Female ; Ovary*

BACKGROUND: Postoperative admission to the surgical intensive care unit (S-ICU) is commonly planned to prevent and treat complications, unnecessary admission to the S-ICU increases medical costs and length of hospital stay. This study aimed evaluated outcome and the predictive factors for mortality in patients admitted to the S-ICU after abdominal surgery. METHODS: The 168 patients admitted to the S-ICU immediately after abdominal surgery were reviewed retrospectively from January to December 2011. RESULTS: The mortality rate of patients admitted to the S-ICU after abdominal surgery was 8.9% (15 of 168). Two preoperative factors (body mass index [BMI] < 18.5 kg/m2 [p < 0.001] and serum albumin < 3.0 g/dL [p = 0.018]), two operative factors (the need for transfusion [p = 0.008] or vasopressors [p = 0.013] during surgery), and three postoperative variables (mechanical ventilation immediately following surgery [p < 0.001], sequential organ failure assessment [p = 0.001] and SAPS II [p = 0.001] score) were associated with mortality in univariate analysis. After adjusting for age, gender, and SAPS II by a Cox regression, which revealed that BMI < 18.5 kg/m2 (p < 0.001, hazard ratio [HR] 9.690, 95% confidence interval [CI] 2.990-25.258) and the use of mechanical ventilation on admission to S-ICU (p < 0.001, HR 34.671, 95% CI 6.440-186.649) were independent prognostic factors. CONCLUSIONS: In patients in S-ICU after abdominal surgery, low BMI and postsurgical mechanical ventilation should be considered important predictors of mortality.
Abdomen* ; Body Mass Index ; Humans ; Critical Care ; Intensive Care Units ; Length of Stay ; Mortality ; Postoperative Complications ; Prognosis* ; Respiration, Artificial ; Retrospective Studies ; Serum Albumin ; Ventilation

OBJECTIVES: This study is to offer basic data to understand the relationships between mental health, level of depression, and internet addiction of high school students in farming communities for developing a mental health management program for adolescents. METHODS: The survey was carried out on a convenience sample of 299 high school students in farming communities during May of 2008. Data analysis procedure included chi-square -test, t-test, Pearson correlation among Adolescent Mental Health & Problem-behavior Screening Questionnaire (AMPQ), Children's Depression Inventory (CDI), and Scales of Internet addiction (K-scales). RESULT: First, the level of mental health according to the AMPQ for subjects from this study showed problematic behavior was lower when compared to other researches. There were statistically significant differences according to the school type for externalization problems and overall problematic behavior. Based on gender, it was even more problematic for male students in regards to externalization problems. Secondly, the level of depression was relatively low : 5.1% for potential risk and 0.3% for high risk. Thirdly, a total of 96.9% were considered normal for Internet addition levels. 1.7% for potential risk, 1.4% for high risk; however, there was no statistically significant difference between each variable. Fourthly, there was a strong relationship between subjects AMPQ, level of depression and Internet addiction. As depression worsens, Internet addiction also becomes stronger. CONCLUSION: There is a need for awareness of the mental health of adolescents and precautionary measures, the development of a program for early treatment, adequate management, and decisions on the direction of treatment.
Adolescent ; Depression ; Humans ; Internet ; Male ; Mass Screening ; Mental Health ; Rural Population ; Statistics as Topic ; Weights and Measures ; Surveys and Questionnaires

While posttraumatic occlusion of the extracranial carotid and vertebral arteries is well known, reports of occlusion of intracranial vessels following closed head injury are rare. Since Deveer and Browder reported the first case in 1942, only 22 cases of posttraumatic middle cerebral artery occlusion have been reported until now. We experienced 2 cases of posttraumatic middle cerebral artery occlusion recently. One patient was 27 years old male who developed right hemiplegia after relatively minor head injury. Reported angiograms taken on the 13th day after trauma revealed sparse middle cerebral artery branches with retrograde filling through left anterior cerebral artery in middle cerebral artery territory. He showed relatively satisfactory recovery by conservative treatment with steroid and cerebral vasodilator. The other patient became semicomatous with left hemiplegia after fall down accident from running train. Left carotid angiograms showed complete obstruction of left middle cerebral artery in its initial portion with corresponding avascular area. This patient died one week after the angiography in spite of all possible conservative care.
Adult ; Angiography ; Anterior Cerebral Artery ; Craniocerebral Trauma ; Head Injuries, Closed ; Hemiplegia ; Humans ; Infarction, Middle Cerebral Artery* ; Male ; Middle Cerebral Artery* ; Running ; Vertebral Artery

A case of anencephaly associatied with twin pregnancy that delivered by primary lo-wer flap transverse cesarean section at 35-weeks of gestation is presented with brief revi-ew of literatures.
Anencephaly* ; Cesarean Section ; Female ; Humans ; Pregnancy ; Pregnancy, Twin*