No abstract available.
Humans ; Stomach Neoplasms* ; Stomach*

The estimation of power spectrum based on the heart rate variability is studied to evaluate the variation of the tension and physiological workloads by the activity of the autonomic system as evaluation parameter. In this paper, we made an attempt to apply the pulse wave to estimate the variation of physiological condition quantitatively instead of the evaluation of power spectrum of HRV through electrocardiogram in the past by comparing and analyzing time series data for the similarity of the heart rate of electrocardiogram and pulse wave. For the similarity of two signals, we can get the likeness by calculating an average, a variance, a correlation coefficient, and the power peak and the shape of power spectral density from the time series data. In the experimental result, it is shown that same subject have a similar variation of time series and power spectrum density for electrocardiogram and pulse wave. As a result, it is expected to estimate a change of the tension and physical condition quantitatively through the evaluation of a power ~pectrum of HRV by Pulse Wave in the future.
Electrocardiography* ; Heart Rate* ; Heart*

PURPOSE: We examined the relationship and concordance between end-tidal carbon dioxide (Petco2) and arterial CO2 (Paco2) in acute asthmatic patients presenting to emergency department. METHODS: This was prospective observational cohort study of acutely ill adult asthmatic patients observed March 2005 to February 2006. Data Collected were age, sex, vital sign, treatment, simultaneous Paco2 and Petco2 value and peak expiratory flow rate (PEFR). Concordance between Paco2 and Petco2 was represented by Bland-Altman plot, using pre-specified limits of agreement of +/-6 mmHg difference and described by interclass correlation coefficient. RESULTS: The study population consisted 51 adult asthma patients admitted during the study period. There was 92 Paco2 and Petco2 pairs. The Pearson correlation coefficient was 0.773 (p=0.000). The mean GAP (The difference Paco2 and Petco2) is 6.04mmHg. PEFR and GAP were negative correlation (R=-0.370). We obtained a Receiver operating characteristic (ROC) curve from PEFR and GAP, using a PEFR cutoff value of 30.5%. The interclass correlation coefficient between Paco2 and Petco2 was 0.652 for patients with PEFR above 30.5%, 0.362 for patients with PEFR below 30.5%, and 0.575 for patients with undetectable PEFR. CONCLUSION: Good correlation exists between Paco2 and Petco2, butr concordance is poor (among all patients the interclass correlation coefficient was 0.508). We attribute this to ventilation-perfusion mismatch. We concluded that in severely asthmatic patients with low PEFR or mechanical ventilation, end-tidal carbon dioxide is not concordant with arterial carbon dioxide.
Adult ; Asthma* ; Capnography ; Carbon Dioxide* ; Carbon* ; Cohort Studies ; Emergency Service, Hospital ; Humans ; Peak Expiratory Flow Rate ; Prospective Studies ; Respiration, Artificial ; ROC Curve ; Vital Signs

PURPOSE: Intra-abdominal fluid collection is one of the risk factors associated with postoperative morbidity or mortality for patients who undergo gastric cancer surgery. The aim of this study was to analyze the clinicopathological characteristics of the patients with postoperative intra-abdominal fluid collection and to identify the indications for inserting a percutaneous drain (PCD) in patients with intra-abdominal fluid collection. MATERIALS AND METHODS: Among the 1,277 patients who underwent operations for gastric cancer at Seoul National University Hospital between April 2005 and July 2006, the data of 117 patients with an intra-abdominal fluid collection were reviewed. RESULTS: The number of patients' with pathologic stage I, II, III and IV disease was 42 (36.8%), 23 (20.2%), 16 (14%) and 33 (28.9%), respectively. Forty-three patients (36.3%) underwent PCD insertion and the other 43 patients received conservative management. A univariate analysis of multiple clinical variables revealed that age, gender, diabetes, liver disease, lymph node dissection, the pathologic stage and the body mass index (BMI, kg/m2) were not significantly associated with PCD insertion (P>0.05). However, the univariate analysis showed that two characteristics were associated with a significantly high incidence of PCD insertion: a diameter of an intra-abdominal fluid collection greater than 4 cm and infectious signs such as leukocytosis, fever and bacteremia. CONCLUSION: About two thirds of the intra-abdominal fluid collections after surgery for gastric cancer were managed with only conservative method without other morbidities of mortality. Surgeons should consider performing PCD insertion if the largest diameter of an intra-abdominal fluid collection is over 4 cm or if infectious signs are seen.
Bacteremia ; Body Mass Index ; Fever ; Humans ; Incidence ; Leukocytosis ; Liver Diseases ; Lymph Node Excision ; Risk Factors ; Stomach Neoplasms

BACKGROUND: The incidence of diphtheria has been markedly reduced and almostly eradicated by widespread use of DTP vaccines in developed countries. However, outbreaks of this disease may be occurred under some circumstances of ineffective immunization. In recent time, some studies reported persistent outbreaks of diphtheria in developed countries and indicated the existence of a large pool of susceptible individuals with potential for epidemic infection. In Korea, diphtheria vaccination has been well maintained since 1956 with high acceptant vaccination rates. So, there has been no reported diphtheria patient since 1987. But, there has been few study to diphtheria serosuvey, and no assessment of diphtheria immunization. Also, we do not use Td vaccine in adults for maintenance of diphtheria immunity. In this aspect, we conducted age related seroepidemiology of diphtheria and indirectly assessed the immunity of diphtheria vaccines, used in Korea. METHODS: For the evaluation of age related serosurvey of diphtheria immunity in Korean populations, study subjects below 10 years old aged children were classified into 10 groups (A~J) with one year interval, and beyond this age to 60 years old aged adults were classified into 5 group (K~O) with 10 years interval. And the adults over 60 years old age was classified into the last group (P). The numbers of each group were 100, and sex distributions of each group were almostly equal. And for the indirect assessment of diphtheria immunization in Korean children, children under 15 years old were classified into 6 groups (I~ VI) according to the status of DTaP vaccination. The numbers of this each group were 30, and sex ratio was almostly equal. Detection of specific IgG antibody to diphtheria toxin were determined by ELISA (contained fragment A & B toxin; IBL, Germany). RESULTS: In age related groups, the antibody titers to diphtheria toxin were well maintained until 10 years old age group, thereafter the titers abruptly decreased below 0.1 IU/mL and then slightly elevated after 30 years old age group and then maintained with low levels. In the groups related DTaP vaccine status, the antibody titers were very low (below 0.07 IU/mL) in prevaccination status, but the titers after primary vaccinations were markedly increased and maintained (above 0.6 IU/mL) until 15 years. And diphtheria antitoxin levels in the groups (L, M, N) showed no significant differences between males and females. CONCLUSION: The results of our study showed that the antibody titers to diphtheria toxin in the 20~50 years old aged groups dramatically decreased. This result indicated that vaccine induced diphtheria immunity did not last throughout life, and Td vaccination program in adults should be considered for maintenance of diphtheria immunity. And the immunity to diphtheria in Korean children indicated that 3 timesprimary and 2 times booster diphtheria immunizations were optimal.
Adolescent ; Adult ; Child ; Developed Countries ; Diphtheria Antitoxin ; Diphtheria Toxin ; Diphtheria* ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Immunization ; Immunoglobulin G ; Incidence ; Korea ; Male ; Middle Aged ; Seroepidemiologic Studies* ; Sex Distribution ; Sex Ratio ; Vaccination ; Vaccines

OBJECTIVES: The in-training examination (Performance Examination, PE) for psychiatric residents in Korea was launched 5 years ago by the Korean Neuropsychiatric Association (KNPA). This article analyzes 5-year accumulated data on the PE, and tries to make some suggestions for further development of the PE. METHODS: The 5-year data, previously utilized for the generation of formal annual reports were reanalyzed, with an emphasis on longitudinal trends. RESULTS: The analyses indicated the following; 1) Higher-year residents earned definitely higher scores than their lower-year colleagues on the PE. This trend was especially prominent in the area of psychopharmacology-biological psychiatry, geriatric psychiatry, child and adolescent psychiatry, and the emergency-organic psychiatry. There was no year-related performance difference in the area of psychoses. 2) In the area of anxiety-somatization disorder, psychophysiological disorder, and geriatric psychiatry, the residents in the university-affiliated hospitals outperformed those in the specialized psychiatric hospitals. 3) Through analyzing multiple-times examinees, it was found that their first-and second-time performances were moderately correlated, and that their ranks tended to improve, demonstrating a continuously improving performance according to the training year. CONCLUSION: These result suggested that the KNPA PE is a feasible measure for the estimation of an individual resident's performance as well as the adequacy of the environment provided by the training institutes.
Academies and Institutes ; Adolescent ; Adolescent Psychiatry ; Child ; Child Psychiatry ; Geriatric Psychiatry ; Hospitals, Psychiatric ; Humans ; Korea ; Psychophysiologic Disorders ; Psychotic Disorders