BACKGROUND: Quinidine appeared to increase serum digoxin levels when given with quinidine. Therefore elevated serum digoxin concentrations and clinical toxicity have been reported in patient receiving quinidine. Currently, Bayesian method which estimates the most probable parameters of the drug for each patient from population parameters data is useful approach for adjusting digoxin dosage. To increase the accuracy of Bayesian method, it is desirable to use population parameters of Korean. Therefore we evaluated the effect of quinidine on digoxin clearance in Korea. METHOD: Patient's records from 19 adult cardiac disease without CHF having normal renal and liver function from Seoul National University of Hospital respectively wre evaluated. Digoxin pharmacokinetic parameters, CL and Vd, were obtained from serum concentration of digoxin of single and combined therapy at each steady-state by using bayesian method. RESULTS: This study show that quinidine reduced the total body clearance of digoxin from 2.39+/-0.17 to 1.51+/-0.08ml/min/kg(p<0.05) and reduced the digoxin volume of distribution from 8.57+/-0.29 to 4.98+/-0.19L/kg(p<0.05). This results show that digoxin dosage reduced to 40-50% in Korean, if quinidine therapy is initiated.
Adult ; Bayes Theorem ; Digoxin* ; Drug Interactions ; Heart Diseases ; Humans ; Korea ; Liver ; Pharmacokinetics ; Quinidine* ; Seoul

BACKGROUND: Exercise intensity may induce changes in inflammatory markers and adipocytokines. However, it is not clear whether acute exercise-induced change to adiponenctin is associated with inflammatory markers and other adipocytokines in obese middle-aged individuals. The aim of this study was to investigate the effects of acute aerobic exercise on circulating adipocytokines and inflammatory markers in obese middle-aged women. METHODS: Using a crossover design, 10 obese middle-aged women (aged 48.4+/-5.1 years; body mass index 29.6+/-2.9 kg/m2) exercised on the treadmill at different durations and velocities at 60% and 80% maximum oxygen consumption (VO2max) in order to equalize energy expenditure (400 kcal). Blood samples were drawn to measure glucose, insulin, fibrinogen, high-sensitive C-reactive protein, leptin, tumor necrosis factor-alpha (TNF-alpha), and adiponectin concentrations. RESULTS: Glucose, fibrinogen, and hsCRP increased significantly (P<0.05) after exercise whereas homeostasis model assessment-insulin resistance decreased significantly (P<0.05). Adiponectin, leptin, and TNF-alpha levels did not change significantly at immediate postexercise, and there were also no significant time x intensity interactions for all variables. The percentage change in adiponectin concentration from baseline to the end of exercise correlated with the percentage change in leptin concentration (r=-0.642, P<0.05) with 60% VO2max exercise. CONCLUSIONS: Our results indicated that, in obese middle-aged women, neither 60% nor 80% VO2max exercise alters adiponectin concentration, in spite of the changes to insulin resistance and inflammatory markers. However, after acute moderate exercise, adiponectin concentration may be associated with the change in leptin levels.
Adipokines ; Adiponectin ; Body Mass Index ; C-Reactive Protein ; Cross-Over Studies ; Energy Metabolism ; Exercise ; Female ; Fibrinogen ; Glucose ; Homeostasis ; Humans ; Inflammation ; Insulin ; Insulin Resistance ; Leptin ; Obesity ; Oxygen Consumption ; Tumor Necrosis Factor-alpha

PURPOSE: This study was to identify the effects of hope intervention on the hope and quality of life of cancer patients staying at home. METHOD: The study adopted the randomized control group design. The subjects consisted of randomly selected forty cancer patients who were registered at S-Gu Public Health Center. Hope intervention which was composed of hope assessment, positive self identity formation, hope objective setting, therapeutic relationship and spiritual & transcendental process improving, and hope evaluation was provided from October 22, 2007 to November 30, 2007. RESULT: Hypothesis 1-1 "The experimental group that received hope intervention will have a higher score of hope than the control group", was supported(t=-3.108, p=.004). Hypothesis 1-2 "The experimental group that received hope intervention will have a higher level of hope index than the control group", was supported (t=-4.219, p=.000). Therefore, Hypothesis 1 "The experimental group that received hope intervention will have a higher level of hope than the control group" was supported. Hypothesis 2 "The experimental group that received hope intervention will have a higher level of quality of life than the control group", was not supported (t=-1.726, p=.092). CONCLUSION: Hope intervention is an effective nursing intervention to enhance hope for patients with cancer staying at home.
Hope* ; Humans ; Nursing ; Public Health* ; Quality of Life*

No abstract available.
Child* ; Humans

We observed the patients admitted to the department of pediatrics of Seoul Red Cross Hospital during the past twenty years form Jan. 1971 to Dec. 1990. The results were as follows: 1) The total number of pediatric inpatients during 20 years was 15,800, of which 9,683 were male, 6,117 were female and male to female ratio was 1.58:1. 2) On age distribution, neonates and infants less than 1 year of age were 6,224 cases (39.4%). 3) Monthly distribution of the inpatients showed the highest incidence in October. 4) Infectious and parasitic diseases were 4,759 cases (30.1%) and respiratory tract diseases, 3,556 cases (22.5%) and disease of these two group occupied more than one half of total admission. 5) Major 10 leading causes of hospitalization were diarrheal disease (14.2%), convulsion (7.0%), acute bronchiolitis (6.8%), pneumonia, tuberculosis, URI, neonatal hyperbilirubinemia, prematurity and low birth weight infant, acute glomerulonephritis and laryngitis in the order of frequency. 6) There was marked decrease in the number of the admitted patients with typhoid fever, bacillary dysentery, tuberculous meningitis, hepatitis, pyogenic meningitis, rheumatic fever, and acute glomerulonephritis. But the patients with URI, bronchial asthma, neonatal hyperbilirubinemia and Kawasaki disease have increased.
Age Distribution ; Asthma ; Bronchiolitis ; Dysentery, Bacillary ; Female ; Glomerulonephritis ; Hepatitis ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal ; Incidence ; Infant ; Infant, Low Birth Weight ; Infant, Newborn ; Inpatients ; Laryngitis ; Male ; Meningitis ; Mucocutaneous Lymph Node Syndrome ; Parasitic Diseases ; Pediatrics ; Pneumonia ; Red Cross ; Respiratory Tract Diseases ; Rheumatic Fever ; Seizures ; Seoul ; Tuberculosis ; Tuberculosis, Meningeal ; Typhoid Fever

Motor evoked potentials(MEP) have been recently introduced as intraoperative monitoring of descending motor pathways. Transcranial electrical or magnetic MEP have been using clinically, but there are still some limitations of using in operating room. Furthermore, according to anesthetic regimens, MEP responses vary significantly. The authors observed the effects of the various anesthetics (thiopental, fentanyl, ketamine, nitrous oxide and isoflurane) on electocortical MEP in a patient who had been previously undertaken electrocortico-graphic grid insertion operation for seizure monitoring. Electromyographic responses were recorded from contralateral arm flexor and extensor using needle type electrode. Most anesthetics except ketamine decreased the amplitude of MEPs reversibly and there were differences in electromyographic responses according to measuring compound muscles.
Anesthetics* ; Arm ; Efferent Pathways ; Electrodes ; Evoked Potentials, Motor ; Fentanyl ; Humans ; Isoflurane ; Ketamine ; Monitoring, Intraoperative ; Muscles ; Needles ; Nitrous Oxide ; Operating Rooms ; Seizures ; Thiopental

OBJECTIVES: This study was aimed to compare abstract reasoning in patients with mental disorders;Depression, Schizophrenia, Organic Brain Syndrome(OBS), and normal control group using Standard Progressive Matrices(SPM), known as a test measuring visual pattern matching ability and reasoning ability by analogy. METHODS: SPM test in Vienna Test System was administered to 82 normal adults, 29 schizophrenic patients, 22 depression patients, and 32 OBS patients. SPM total score and 5 subtest scores in four groups were compared, using ANOVA and post-hoc comparison. SPM subtest scores in OBS and normal group were compared, using discriminant function analysis. RESULTS: SPM total score and all subtest scores in mental disorders group(schizophrenia, depression, OBS) were lower than in normal control group. SPM total score and all subtest scores in OBS group were lower than in schizophrenia and depression group. No difference between SPM total score in Schizophrenia and depression group was found. Discriminant function of B, E subtest was the hightest. CONCLUSION: The impairment of higher cognitive function, especially abstract reasoning impairment in OBS, was qualitatively different from that of schizophrenia and depression. SPM can differentiate specific pattern of abstract reasoning impairment in mental disorders, so SPM can be used not only as a substitute for intelligence test but also as a neuropsychological test.
Adult ; Brain ; Depression ; Humans ; Intelligence Tests ; Mental Disorders* ; Neuropsychological Tests ; Schizophrenia

BACKGROUND AND OBJECTIVES: Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. MATERIALS AND METHODS: Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. RESULTS: After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. CONCLUSION: Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.
Acoustics ; Humans ; Laryngoplasty ; Phonation ; Vocal Cords ; Voice*

PURPOSE: To report a case of endogenous endophthalmitis with an elbow abscess spread from a liver abscess in a patient with hypervirulent Klebsiella pneumoniae (hvKP) invasive syndrome.CASE SUMMARY: A 33-year-old healthy male presented with painless visual loss in his right eye. He experienced pain, a febrile sensation, and swelling in his right elbow for 1 week prior. He had no trauma history. Many inflammatory cells, hypopyons, and cyclitic membranes were present in the anterior chamber of the eye but no ocular injection was performed. With a provisional diagnosis of panuveitis, topical antibiotics, steroid, and cycloplegics were administered and subtenon triamcinolone was injected. After orthopedic consultation, an elbow abscess was suspected and surgery was performed. Two days after the surgery, the patient experienced ocular pain and an injection was performed. Fever, chill, and acute deterioration of his general condition were noted which suggested infective endophthalmitis. Emergency vitrectomy was performed but because subretinal and choroidal abscesses were observed during surgery, the surgery was changed to enucleation. A liver abscess was observed using abdominal computed tomography after transfer to the infection medical department and hvKP was positive in the blood, liver, elbow, and eye cultures. CONCLUSIONS A primary liver abscess caused by hvKP occurred in a healthy young man and metastatic infection occurred with endogenous endophthalmitis and a rare elbow abscess. Because hvKP endogenous endophthalmitis has a poor prognosis, rapid diagnosis followed by appropriate treatment is required.

The purpose of this study was to investigate factors affecting recovery time after sedation for upper gastrointestinal endoscopy. The study population included 1310 patients in the national gastric cancer screening program who received sedation for upper gastrointestinal endoscopy from April 15, 2015 to December 31, 2018. Multivariate regression analysis was performed to identify factors related to recovery time. The mean recovery time after examination was 51.2 minutes (SD=13.3). Patients with a history of hypertension had a recovery time 2.59 minutes shorter than that of patients without hypertension (p=0.006, Bonferroni-corrected p=0.108). Patients with a history of stroke had a recovery time 9.41 minutes longer than that of patients without stroke (p=0.007, Bonferroni-corrected p=0.124). Patients who received 3 mg midazolam had a recovery time 2.99 minutes longer than that of patients received 2 mg (p=0.001, Bonferroni-corrected p=0.010), and patients who received less than 6 cc of propofol had a recovery time 2.90 minutes longer than those that of patients received 7-12 cc of propofol (p<0.001, Bonferroni-corrected p=0.005). These results suggest that receiving high doses of midazolam and having a history of stroke are associated with longer recovery times. Patients meeting these criteria should be managed carefully after sedation for upper gastrointestinal endoscopy.