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

PURPOSE: To evaluate the efficacy of the arterial phase of dynamic spiral CT in the detection of pancreatic adenocarcinoma compared with the late phase. MATERIALS AND METHODS: Two phase spiral CT images of seventeen patients with pathologically proven pancreatic ductal adenocarcinomas were compared retrospectively. CT scans were performed with 5mm collimation at 1:1 pitch table speed. Images of arterial and late phases were obtained at 35 seconds and 180 seconds after initiation of administration of 100mL of contrast material(3mL/sec), respectively. Images of the arterial phase were compared with those of the late phase. RESULTS: Images of the arterial phase showed sufficient contrast between the tumor and adjacent pancreatic parenchyma in 12 cases, insufficient in four cases, and no significant contrast in one case. Images of the late phase showed sufficient contrast in five cases, insufficient in five cases, and no significant contrast in seven cases. Images of the arterial phase was superior to that of the late phase in 12 patients(70.6%). In six of the 12 patients, only the images of the arterial phase showed contrast between the tumor and the adjacent parenchyma. The images of late phase showed only one case of three metastasis detected on the images of the arterial phase. CONCLUSION: The arterial phase of spiral CT is superior to the late phase that is comparable with conventional CT in the detection of pancreatic adenocarcinoma.
Adenocarcinoma* ; Humans ; Neoplasm Metastasis ; Pancreatic Ducts ; Retrospective Studies ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

BACKGROUND: There have been a few reports suggesting involvement of neutrophil as well as eosinophil in inducing bronchoconstriction aft,er inhalation of TDI. OBJECTIVE: In order to observe the source of chemokines in TDI-induced asthma, this investigation was designed to determine whether IL-8 and RANTES could be produced by human bronchial epithelial cells and whether dexamethasone had any effects on their production. Materials and METHODS: We cultured Beas-2B, a bronchial epithelial cell line, with five concentrations of TDI-human serum albumin (HSA) conjugate and compared them with those having no conjugate. The levels of IL-8 and RANTES in the supernatant were measured by ELISA. To evaluate the effect of pro-inflammatory cytokines, cells were incubated with peripheral blood mononuclear cell (PBMC) culture supernatant, which was derived from PBMC culture of a TDI -induced asthmatic subject under exposure to TDI-HSA conjugate, and then compared to those without PBMC supernatant addition. To evaluate the effect of dexamethasone, four concentrations of dexamethasone were pre-incubated and the same steps were repeated. RESULTS: There was significant production of IL-8 from bronchial epithelial cells with addition of TDI-HSA conjugate in a dose-dependent manner (p<0.05, respectively), which was significantly augmented with additions of PBMC supernatant (p<0.05, respectively) at each concentration. RANTES production was negligible, however, it increased significantly with addition of PBMC supernatant and TDI-HSA conjugate in a dose response manner(p<0.05, respectively). Compared to the untreated sample, pre-treatment of dexamethasone induced remarkable inhibitions of IL-8 and RANTES production. CONCLUSION: These results suggest that IL-8 and RANTES released from bronchial epithelial cells may contribute to neutrophil and eosinophil recruitment occurring in TDI-induced airway.
Asthma ; Bronchoconstriction ; Chemokine CCL5* ; Chemokines ; Cytokines ; Dexamethasone ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Epithelial Cells* ; Humans ; Inhalation ; Interleukin-8 ; Neutrophils ; Serum Albumin ; Toluene 2,4-Diisocyanate* ; Toluene*

We analyzed 20 cases of traumatic carotid cavernous fistula(CCF) during the recent 10 years The results are summarized as follows: 1) In 18 cases(90%), the clinical symptoms & signs of CCF occurred within 2 months after trauma. 2) The sites of fistulae were common in horizontal segment(40%) and at the junction(30%) between horizontal segment and posterior ascending segment of cavernous portion of internal carotid artery. 3) The main draining veins of CCF were the superior ophthalmic vein(90%) and the inferior petrosal sinus(70%). 4) The methods of treatment were occlusion of fistula with balloon(9 cases), occlusion of cavernous ICA with balloon(2 cases), ligation of cervical ICA with Poppen's clamp(4 cases) and trapping(2 cases). Two patients were not treated and another patient was healed spontaneously. 5) The frequency and severity of complication was significantly decreased in cases treated by detachable balloon occlusion than by direct cervical ICA ligation or trapping procedures. 6) The procedure using the self-sealed goldvalve balloon was simple, but had a risk of premature separation and premature deflation.
Balloon Occlusion ; Carotid Artery, Internal ; Fistula* ; Humans ; Ligation ; Veins

No abstract available.
Situs Inversus*

Antibiotics induced anaphylaxis is one of the most acute and potentially fatal drug-related adverse reactions. Cefaclor, an oral second-generation cephalosporin with a beta lactam ring, is used various infectious diseases of the respiratory tract. Few cases of cefaclor anaphylaxis have been rarely reported. Here we report a case of anaphylactic reaction to cefaclor in a 40-year-old female patient. She developed systemic reaction comprised of generalized hives with itching, vomiting, abdominal pain, and hypotension. She was treated on our ER with intravenous fluids, intravenous diphenhydramine and subcutaneous epinephrine. Since four month ago, she had developed generalized pruritic eruptions with flu-like symptoms. The rash resolved the same day after treated with intravenous diphenhydramine. On detailed history taking for medication, we had known that she received a same prescription containing a cefaclor at every episode. Subsequently we tested the patient with cefaclor and conducted an intradermal skin test and an ELISA to cefaclor-HSA conjugate. She showed a positive response. Cefaclor is widely used for common infections, physicians should anticipate the possibility of anaphylactic reaction treated with this agent, particularly in cases of multiple exposure.
Abdominal Pain ; Adult ; Anaphylaxis* ; Anti-Bacterial Agents ; Cefaclor* ; Communicable Diseases ; Diphenhydramine ; Enzyme-Linked Immunosorbent Assay ; Epinephrine ; Exanthema ; Female ; Humans ; Hypotension ; Immunoglobulin E ; Prescriptions ; Pruritus ; Respiratory System ; Skin Tests ; Urticaria ; Vomiting

PURPOSE: The purpose of this study was to describe quality of life (QOL) in Korean school-age children by identifying dimensions and attributes of QOL from the child's point of view. METHOD: In-depth interviews with focus questions were used for the study. Twelve children, aged 10 to 13 years, were recruited from Seoul and rural areas. The interviews were audio-taped and transcribed before content analysis. The data were analyzed for themes and attributes. The researchers read the data together and discussed their conclusions until a consensus was reached. RESULTS: Eight dimensions, 57 subdimensions and 101atttributes were identified for QOL in school-age children. The eight dimensions of QOL were physical, social, emotional, learning, leisure, family, self-value, and material aspects. CONCLUSION: The study results can be utilized in developing reliable instruments to measure quality of life specific to school-age children. It is proposed that a consistent and unified policy should be established by school, family, and community for the purpose of improving the QOL of school-age children.
Child* ; Consensus ; Humans ; Learning ; Leisure Activities ; Quality of Life* ; Seoul ; Child Health

Direct operation for ruptured aneurysm should be the choice of treatment in elderly patients same as in younger cases. The early operation is an effective and reliable method to reduce the occurrence of rebleeding, vasospasm, ischemic complication, medical complication & to shorten lengths of hospitalization. To evaluate the risk of early operation of elderly patients with ruptured cerebral aneurysm. conducted a retrospective analysis 81 elderly patients with ruptured aneurysms who were over aged 60 years between Jan 1985 to June 1988. Of these, 47 case were performed early operation in which the direct intracranial operation was carried out within 3 days after last subarachnoid hemorrage. 77 % had favorable outcome and 13% died.
Aged* ; Aneurysm, Ruptured* ; Hospitalization ; Humans ; Intracranial Aneurysm ; Retrospective Studies

Testicular feminization is an uncommon genetic disorder with considerably familial predisposition and results in total feminization due to end-organ unresponsiveness to androgens. It is characterized by the presence of testes in phenotypically female with adequate breast development, normal extemal genitalia, absence of mullerian structures, and meager or absence of body hair. These patients characteristically have male karyotype(XY) and negative sex chromatin and are at increased risk of undergoing malignant transformation of the undescended gonad. In recent times, the malignant potential of the dysgenetic gonads in the intersex patients with a Y chromosome has been stressed by many authors, but few reports of an association between testicular feminization syndrome and benign tumors such as Sertoli cell adenomas. In the present study, postoperative pathology revealed that the gonads were Sertoli cell adenomas. The main features of clinical presentation and histological studies are briefly discussed with a review of the literature.
Adenoma* ; Androgen-Insensitivity Syndrome* ; Androgens ; Breast ; Female ; Feminization ; Genitalia ; Gonads ; Hair ; Humans ; Male ; Pathology ; Sex Chromatin ; Testis ; Y Chromosome

BACKGROUND: Nitric oxide (NO) is a selective pulmonary vasodilator, and inhaled NO has bronchodilatory action due to their relaxation effect on conducting airway smooth muscle. The aim of this study was to evaluate the effects of inhaled NO on respiratory system mechanics in cats. METHODS: Nineteen cats were divided into 3 groups according to the doses of NO administered; group C (control, n=7), group 20 (20 ppm of NO, n=7), and group 40 (40 ppm of NO, n=5). After measuring the baseline value, methacholine chloride 25 microgram/kg/min was infused to induce bronchoconstriction. Inhalation of NO was started for each group 15 minutes after methacholine infusion. Pressure, volume, and flow rate were monitored with Bicore CP100 pulmonary monitor and the data were transferred to a personal computer and analyzed by a processing software. Respiratory system, airway and tissue viscoelastic resistances, and dynamic and static compliances were calculated. RESULTS: Methacholine infusion increased both airway and tissue resistances. Fifteen minutes after inhaling NO, airway resistances for NO 20 ppm and 40 ppm decreased to 65.8+/-8.5% and 62.2+/-8.9% of the control value (p<0.05). The values of tissue resistances for NO 20 ppm and 40 ppm decreased to 72.4+/-10.8% and 78.2+/-10.5% of the control value respectively (p<0.05). And thirty minutes after inhaling NO, there were also decreases of airway and tissue viscoelastic resistances in both groups but had no differences compared with fifteen minutes' values. There were no significant differences between the NO 20 ppm and 40 ppm in the values of airway and tissue viscoelastic resistances. CONCLUSION: Inhaled NO of 20 ppm and 40 ppm decreased both airway and tissue viscoelastic resistances and airway resistance was decreased more markedly than tissue resistance. There were no significant differences between 20 ppm and 40 ppm of NO in respiratory system mechanics in cats.
Airway Resistance ; Animals ; Bronchoconstriction* ; Cats* ; Inhalation ; Mechanics* ; Methacholine Chloride ; Microcomputers ; Muscle, Smooth ; Nitric Oxide* ; Relaxation ; Respiratory System*