BACKGROUND: This study was designed to investigate the relationship between psychiatric disease and systemic Internal Medical disease in psychiatric inpatients who were consulted to department of Internal Medicine and was directed to assess the physical problems and possible ways to resolve them in a closed psychiatric unit. METHOD: Through evaluation of medical records of 1549 inpatients who had consulted in department of internal medicine in Seoul National(mental) Hospital from January 1, 2002 to December 31, 2002. We classified the Physical illness according to ICD-9-CM and psychiatric disease according to DSM-IV RESULTS: The results were as follows: 1) In age and sex distribution, male was 64.4% and 45.9% of the subject was 4th and 5th decades. 2) The most systemic diagnosis were disease of respiratory system, disease of digestive system and endocrine system. 3) schizophrenia showed the highest rate in respiratory disease. Rate of digestive disease was the highest in alcohol use disorder. Disease of respiratory system and disease of digestive system were the most frequent in mood disorder 4) In 1st decade, Digestive system digease was the most frequent, others were respiratory system disease. 5) onset age of psychiatric disease was the oldest in circulatory disease. In genitourinary system disease, duration of psychiatric disease was the longest CONCLUSION: The clinical characteristics of psychiatric disease influenced to get systemic disease in psychiatric patients.
Age of Onset ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Digestive System ; Endocrine System ; Humans ; Inpatients* ; Internal Medicine ; International Classification of Diseases ; Male ; Medical Records ; Mood Disorders ; Respiratory System ; Schizophrenia ; Seoul ; Sex Distribution ; Urogenital System

A total of 213 fine needle aspirations from pulmonary lesions in 193 patients performed from January, 1986 to March, 1989 were analyzed. The cytologic diagnoses were unsatisfactory in 10, negative in 60, atypical in 6, suspicious in 11 and malignant in 126 cases. The cytologic types of the malignant cases were 47 squamous cell carcinomas, 40 adenocarcinomas, 10 small cell carcinomas, 6 large cell carcinomas and 10 metastatic tumors. They were verified by the histologic confirmation in 31 cases and by the clinical data in the remainder. There were 5 false-negative cases and none was false-positive, representing 96% sensitivity and 100% specificity. Primary lung cancers were accurately typed in 73% of histologically confirmed case. Cell blocks, prepared in 99 cases, were helpful in tumor typing of 11 cases.
Neoplasm Metastasis ; Lung Neoplasms

OBJECTIVE: There are two established surgical treatment options for carotid artery stenosis. Carotid endarterectomy (CEA) has been accepted as a gold standard for surgical treatment while carotid artery stenting (CAS) has recently become an alternative option. Each treatment option has advantages and disadvantages for the treatment outcomes. We propose a protocol for selection of a proper surgical treatment option for carotid artery stenosis. MATERIALS AND METHODS: A total of 192 published articles on management of carotid artery stenosis were reviewed. Preoperatively considerable factors which had been repeatedly noted in those articles for the risk/benefits of CEA or CAS were selected. According to those factors, a protocol with four categories was established. RESULTS: CEA or CAS is indicated when the patient has a symptomatic stenosis > or = 50%, or when the patient has an asymptomatic stenosis > or = 80%. Each treatment option has absolute indications and favorable indications. Each absolute indication is scored with three points, and each favorable indication, one point. Based on the highest scores, a proper treatment option (CEA or CAS) is selected. CONCLUSION: We have been treating patients according to this protocol and evaluating the outcomes of our protocol-based decision because this protocol might be helpful in assessment of risk/benefit for selection of a proper surgical treatment option in patients with carotid artery stenosis.
Carotid Arteries ; Carotid Stenosis* ; Constriction, Pathologic ; Endarterectomy, Carotid ; Humans ; Stents

OBJECTIVE: The aim of this study was to determine factors affecting the long-term survival of subjects with aortic aneurysm (AA). METHODS: We included 294 Korean patients aged ≥30 years who were hospitalized from 1994 through 2004. Diagnosis was confirmed in 267A subjects (75.8% with abdominal only AA (AAA) and 24.2% with thoracic AA (TAA)) by computed tomography angiography in Samsung Medical Center, Seoul, Korea. AA repair direct operation or percutaneous endovascular AA repair (Revascularized group) was performed in 60.3% of the total patients. Death data were obtained from all participants between 1994 and 2009. RESULTS: The mean age of AA subjects was 68.7 (±8.1) years. The proportion of males was 82%. Five- and 10-year survival rates were 89.8% and 82.6%, respectively. The 5- and 10-year survival rates were 92.3% and 84.9% in revascularized group and 86.4% and 79.5% in non-revascularized group, respectively. Adjusted hazard ratios were 1.11 {95% confidence interval (CI) 1.04-1.21} in ages and 3.07 (95% CI 1.26-7.90) in smoking for AA. CONCLUSIONS: Age and smoking contributed to death in Korean AA patients. In addition, the 10-year survival rate for AA patients in Korea was over 80%.
Angiography ; Aortic Aneurysm* ; Diagnosis ; Humans ; Korea ; Male ; Seoul ; Smoke ; Smoking ; Survival Rate*

BACKGROUND: Though caudal block is a relative simple technique, it has not been widely used in adults because of a high failure rate. We assumed that any tests to quantify the changes of sympathetic tone in the affected areas would be excellent indicators of successful block. We tested the usefulness of two candidates (pulse oximetry plethysmographic waveform amplitude measured at 5th toe and calf minus 5th toe skin temperature gradient) as indicators of successful caudal block. METHODS: In 45 adult patients undergoing anal surgery with caudal block, these two variables were simultaneously measured at 2-min intervals for 20 min. A two-fold increase in the plethysmographic waveform amplitude from baseline and skin temperature gradient of 0oC were predefined as test criteria of successful block. RESULTS: While the sensitivity, specificity, positive predictive value, and negative predictive value of the skin temperature gradient test were 45.9%, 100%, 100%, and 9.1%, those of the plethysmographic waveform test were 86.5%, 100%, 100%, and 28.6%. The plethysmographic waveform test showed a significantly higher discriminative capacity than the skin temperature gradient test (94.9% vs. 48.7%, P < 0.05) CONCLUSIONS: Unlike the skin temperature gradient test, the plethysmographic waveform test showed a considerably high validity in detecting successful block. Considering its simple and real time monitoring potentials together with a high failure rate of caudal block in adults, we cautiously recommend it as a supplemental diagnostic tool to predict successful block, especially when verbal communication with patient is difficult.
Adult ; Humans ; Oximetry* ; Sensitivity and Specificity ; Skin Temperature* ; Skin* ; Toes

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.
Alcoholics* ; Alcoholism ; Diagnosis ; Humans ; Reproducibility of Results*

Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage.'luid in previously healthy adults.
Adult ; Anoxia ; Biopsy ; Bronchoalveolar Lavage Fluid ; Dyspnea ; Eosinophilia ; Eosinophils* ; Humans ; Hypersensitivity ; Lung ; Lung Diseases ; Pleural Effusion ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence

Acute eosinophilic pneumonia is one of a recently described idiopathic eosinophilic lung disease, which differs from chronic eosinophilic pneumonia. Patients with acute eosinophilic pneumonia develop acute onset of dyspnea, hypoxemia, diffuse pulmonary infiltrates and pleural effusion on chest radiograph, and show an increase in number of eosinophils in bronchoalveolar lavage fluid or lung biopsy specimen. Prompt and complete response to corticosteroid therapy without any recurrence is characteristically seen in patient with this disease. Although the etiology of acute eosinophilic pneumonia is not known, it has been suggested to be related to a hypersensitivity phenomenon to an unidentified inhaled antigen. We report four cases of acute eosinophilic pneumonia presented with acute onset of dyspnea, diffuse pulmonary infiltrates on chest radiograph, and eosinophilia in bronchoalveolar lavage.'luid in previously healthy adults.
Adult ; Anoxia ; Biopsy ; Bronchoalveolar Lavage Fluid ; Dyspnea ; Eosinophilia ; Eosinophils* ; Humans ; Hypersensitivity ; Lung ; Lung Diseases ; Pleural Effusion ; Pulmonary Eosinophilia* ; Radiography, Thoracic ; Recurrence

BACKGROUND AND OBJECTIVES: The clinical characteristics of patients with diastolic dysfunction characterized by a relaxation abnormality with possible elevated filling pressure is remain to be determined. We sought to test whether diastolic stress echocardiography (DSE) is useful for characterization of these patients. METHODS: A total of 120 patients (58 men, mean age of 64±7 years) with E/A ratio < 1.0 (mean±SD, 0.7±0.1) and 10≤ E/e' < 15 at rest echocardiography was enrolled prospectively for supine bicycle exercise up to 50 W. RESULTS: During exercise, 47 patients (39%) showed high left ventricular filling pressure (E/e' > 15, hLVFP) and 40 (30%) developed exercise-induced pulmonary hypertension (systolic pulomary arterial pressure > 50 mmHg, EiPH) without hLVFP. The remaining 33 patients did not show hLVFP or EiPH. The incidence of EiPH with hLVFP was 21% (25/120). By multivariate analysis, age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.00–1.13; p=0.039) and systolic pulmonary artery pressure at rest (OR, 1.14; 95% CI, 1.02–1.27; p=0.02) were associated with EiPH, whereas late diastolic transmitral velocity (OR, 1.04; 95% CI, 1.00–1.08; p=0.03) and diastolic blood pressure (OR, 0.94; 95% CI, 0.90–0.99; p=0.02) were associated with hLVFP during exercise. CONCLUSIONS Patients with relaxation abnormality and possibly hLVFP showed markedly heterogeneous hemodynamic changes during low-level exercise and DSE was useful to characterize these patients.

BACKGROUND AND OBJECTIVES: The clinical characteristics of patients with diastolic dysfunction characterized by a relaxation abnormality with possible elevated filling pressure is remain to be determined. We sought to test whether diastolic stress echocardiography (DSE) is useful for characterization of these patients. METHODS: A total of 120 patients (58 men, mean age of 64±7 years) with E/A ratio < 1.0 (mean±SD, 0.7±0.1) and 10≤ E/e' < 15 at rest echocardiography was enrolled prospectively for supine bicycle exercise up to 50 W. RESULTS: During exercise, 47 patients (39%) showed high left ventricular filling pressure (E/e' > 15, hLVFP) and 40 (30%) developed exercise-induced pulmonary hypertension (systolic pulomary arterial pressure > 50 mmHg, EiPH) without hLVFP. The remaining 33 patients did not show hLVFP or EiPH. The incidence of EiPH with hLVFP was 21% (25/120). By multivariate analysis, age (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.00–1.13; p=0.039) and systolic pulmonary artery pressure at rest (OR, 1.14; 95% CI, 1.02–1.27; p=0.02) were associated with EiPH, whereas late diastolic transmitral velocity (OR, 1.04; 95% CI, 1.00–1.08; p=0.03) and diastolic blood pressure (OR, 0.94; 95% CI, 0.90–0.99; p=0.02) were associated with hLVFP during exercise. CONCLUSIONS: Patients with relaxation abnormality and possibly hLVFP showed markedly heterogeneous hemodynamic changes during low-level exercise and DSE was useful to characterize these patients.
Arterial Pressure ; Blood Pressure ; Diastole ; Echocardiography ; Echocardiography, Doppler ; Echocardiography, Stress ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Incidence ; Male ; Multivariate Analysis ; Prospective Studies ; Pulmonary Artery ; Relaxation