BACKGROUND: Depressive symptoms are common in the medically ill patients although depressive disorders are considerably underdiagnosed and undertreated. Therefore, we examined the characteristics of depressive tendency in medical inpatients. METHODS: The patient group-144 subj.cts(90 males, 54 females) were selected from medical inpatients of Kae Jung hospital. 158 subjects(106 male, 52 females) with no prior history of diseases were selected for the control group. The Beck Depression Inventory(BDI) and Hamilton Rating Scale for Depression(HRSD) was used for both groups from June to December 1997. RESULTS: The patient group had a significant higher BDI and HRSD score than controls(p<0.01). In the patients, 31.3% had scores on the BDI greater than the cutting score of 21, and 26.4% had scores on the HRSD greater than the cutting score of 22. In the patients, demographic and medical variables were evaluated with respect to depression. those in their 60's, with education level of elementary school and below. the divorced, bereaved and separated, and having duration of illness more than one year were statistically more depressed, but depression was not associated with sex, religion and medical diagnosis. CONCLUSIONS: This study indicates that depressive tendency may be a common phenomena in medically ill patients. Therefore, we should suspect depression in the management of these patients.
Depression ; Depressive Disorder ; Diagnosis ; Divorce ; Education ; Humans ; Inpatients* ; Male

PURPOSE: We intended to analyze the characteristics of a pediatric low vision population. METHODS: Among 430 patients who visited our low vision clinic from May 1995 to April 2000, 137 patients(31.9%) aged 15 years or less were reviewed to study epidemiologic characteristics, prescribed aids and required magnification. RESULTS: The percentage of pediatric low vision patients was higher than that of developed countries. Male predominance was found. Optic atrophy(41.6%), congenital cataract(12.4%), macular degeneration and dystrophy(9.5%) were the major causes of low vision in this population. The most commonly prescribed low vision aid was a telescope. For near task, light-gathering magnifiers were prescribed most commonly. The visual acuity was improved significantly at near and far distance after correction with low vision aid. The mean required magnification was 3.5 xand this means that a low magnification was sufficient in the majority of cases. CONCLUSIONS: Early rehabilitation and long-range planning for the low vision child are required because of profound effect of childhood visual impairment.
Child ; Developed Countries ; Humans ; Macular Degeneration ; Male ; Optic Atrophy ; Rehabilitation ; Telescopes ; Vision Disorders ; Vision, Low* ; Visual Acuity

Acoustic stimulation test(AST), is currently being used as an alternative tool of nonstress test (NST). However, there are no standard guideline for analysis of AST. Computerized numerical analysis of AST would be helpful for development of diagnostic criteria of AST. Fifty-one normal pre-term pregnancies entered to this study after conventional 20-minutes NST and 10-minutes AST. Acoustic stimulations were performed using Fetal Acoustic Stimulator (Model 146, Corometrics, US). We analyzed the FHR response after acoustic stimulation using our on-line computerized FHR analysis system, HYFM-I & II software. The changes of loss of signal, baseline FHR, variability, number of fetal movements, and number of FHR accelerations were analyzed numerically. The loss of signal was increased about 2 fold(122.61%). The baseline FHR was increased from 144.57bpm to 156.81bpm(8.5%) after acoustic stimulation. Number of fetal movements was increased about 2 fold(from 2.1 to 4.12/10 minutes). FHR variability was also increased from 17.81 bpm to 26.37 bpm. After AST, number of FHR accelaration was increased 55.47%(10sec 10bpm) and 68.42%(15sec 15bpm), respectively. In this study, we acrumulated elemental FHR data using computerized system after AST. These data would be helpful in the accurate analysis of AST and also enable us to develop the objective interpretation system for AST.
Acceleration ; Acoustic Stimulation* ; Acoustics* ; Female ; Fetal Heart* ; Fetal Movement ; Heart Rate, Fetal* ; Pregnancy ; Pregnancy*

PURPOSE: The diagnosis of Budd-Chiari syndrome on CT is difficult if CT do not demonstrate obstruction of the IVC or hepatic vein and other parameter is needed for the correct diagnosis. The purpose of our study was to determine the usefulness of measuring the diameter of azygos-hemiazygos vein on CT to differentiate Budd-Chiari syndrome from advanced liver cirrhosis. MATERIALS AND METHODS: Fourteen patients who were proven as Budd-Chiari syndrome on vena cavography were studied for analysis. All patients showed evidence of liver cirrhosis on CT. As a control group fifteen cases of advanced liver cirrhosis who underwent endoscopic sclerotheraphy due to esophageal variceal bleeding were also included for comparison. The largest short axis diameter of azygos-hemiazygos vein was measured in all patients at the level of diaphragm on axial CT and the results were compared in both groups. RESULTS: In patients with Budd-Chiari syndrome the largest short axial diameter of azygos-hemiazygos vein ranged from 0.5cm to 2.5cm(mean ;1.5cm). Only one patient who showed hepatic venous obstruction demonstrated a diameter of less than 1 cm(0. Scm). In contrast, the diameter in patients with advanced liver cirrhosis without obstruction of IVC or hepatic vein was less than 1 cm with a range from 0.2cm to 1 cm(mean ;0.6cm). CONCLUSION: The short axis diameter of azygos-hemiazygos vein was an indicator of IVC obstruction (Budd-Chiari syndrome).
Axis, Cervical Vertebra ; Budd-Chiari Syndrome* ; Diagnosis* ; Diaphragm ; Esophageal and Gastric Varices ; Hepatic Veins ; Humans ; Liver Cirrhosis ; Veins*

Anthrax toxin consists of three separate proteins, protective antigen (PA), edema factor (EF), and lethal factor (LF). PA binds to the receptor on mammalian cells and facilitates translocation of EF or LF into its cytosol. PA is the primary component of anthrax vaccines. In this study we purified PA from culture filtrates of Bacillus anthracis. The purification involved sequential chromatography through hydroxylapatite, DEAE-Sepharose CL-4B, followed by Mono-Q. The purified PA was judged to be homogeneous on SDS-PAGE, and consisted of a single polypeptide chain with a relative molecular weight of 85,000.
Anthrax ; Anthrax Vaccines ; Bacillus anthracis* ; Bacillus* ; Chromatography ; Cytosol ; Durapatite ; Edema ; Electrophoresis, Polyacrylamide Gel ; Molecular Weight

From Nov. 1990 to Dec. 1994, authors have experienced 12 patients(13 eyes) diagnosed as posterior lens dislocation. The clinical results were evaluated in aspeets of sex and age distribution, preoperative and postoperative visual acuity, operative method, postoperative complication. The average age of patients was 57.8 years old and average follow-up period was 11.5 months. Male were 58%. They have history of ocular trauma in all 13 eyes. Dislocated lens was removed by extraction with lens spoon or loop through corneoscleral incision in 3 eyes and pars planar vitrectomy followed by lens lift with needle and extraction through corneoscleral incision in 7 eyes or with perfluorocarbon liquid and extraction with spoon or loop in 3 eyes. The best corrected visual acuity was improved in 10 eyes and remained the same in 2 patient(3 eyes) who was visited our hospital more than 10 years after dislocation and associated with optic nerve atrophy, macular degeneration, bullous keratopathy. Postoperative complications included glaucoma, choroidal detachment, retinal detachment, persistent vitreous inflammation, vitreous hemorrhage, bullous keratopathy.
Age Distribution ; Atrophy ; Choroid ; Dislocations ; Follow-Up Studies ; Glaucoma ; Humans ; Inflammation ; Lens Subluxation* ; Macular Degeneration ; Male ; Needles ; Optic Nerve ; Postoperative Complications ; Retinal Detachment ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

No abstract available.
Brain* ; Neoplasm Metastasis*

Sustained downgaze mostly occurs in association with lesions affecting the dorsal midbrain. We report sustained downgaze in a patient with hepatic encephalopathy. The sustained downgaze existed for seven more days after she regained her consciousness. The persistent downgaze even after regaining full consciousness indicates localized pretectal dysfunction rather than diffuse encephalopathy as the mechanism of sustained downgaze in our patient. The ocular motor dysfunction in hepatic encephalopathy may be due to localized dysfunction of the brainstem

The physeal injuries in children occur result of trauma, infection, metabolic or ischemic disease, and these conditions cause significant problems, such as growth disturbance, deformity and premature closure of physis. The authors experienced 7 cases of children who had angular deformity of knee and limb shortenings, but no history of obvious causes of physeal injury. All of these cases had severe osteoporosis and underlying disease, which were osteogenesis imperfecta, fibrous dyplasia and long term steroid therapy. The purpose of this study are evaluation of pathomechanism of physeal injuries in severe osteoporotic children. Patients were range of age from 4 to 9 years and had common clinical features, which were angular deformities of knee, limb shortening. Also they had common radiographic findings, that were severe porosis, metaphyseal sclerosis and in some cases, pop corn like calcification around physis. At this, we supposed that chronic mechanical stress in osteoporotic bone make physis be damaged due to loss of capillary circulation and this event appear to result from collapse of bone plate, through which epiphyseal vessel penetrate. In conclusion, the children with severe osteoporosis should be observed carefully about physeal injuries, which pathomechanism are perhaps deprivation of capillary circulation through bone plate. Therefore, We should try to protect bone plate by being conscious of its existence.
Bone Plates ; Capillaries ; Child ; Congenital Abnormalities ; Extremities ; Humans ; Knee ; Osteogenesis Imperfecta ; Osteoporosis* ; Sclerosis ; Stress, Mechanical ; Zea mays

131I-6beta-iodomethyl-19-norcholesterol(NP-59) has an advantage to assess adrenal dysfunction caused by adrenal cortical disorders. The aim of this study is to evaluate the clinical usefulness of NP-59 scintigraphy in each adrenral disease. Ten patients who did eleven NP-59 adrenal scintigraphies at Dong-A University Hospital from March 1990 to December 1996 were selected as the subject. Among the subject there were 5 cases of Cushing's syndrome, 2 cases of incidentaloma, 1 case of metastatic adrenal tumor, liver cirrhosis with hirsutism and hypertension respectively. Among 5 case of Cushing's syndrome, there were 2 cases of Cushing's disease, 2 cases of adrenal adenoma and 1 case of adrenal carcinoma. There are no disagreement between clinical diagnosis and scan finding in Cushing's syndrome. In 2 incidentaloma cases, even though one is interpretated as a functioning tumor, both of 2 cases could avoid unnecessary biopsy according to scintigraphy result. One case of hirsutism, clinically adrenal originated, revealed the normal scintigraphic hirsutism was extra-adrenal origin. One case of hypertension took the study to exclude the possibility of primary aldosteronism. Normal suppression scan finding revealed that primary aldosteronism did not exist in this case. In conclusion, NP-59 scintigraphy was very useful in diagnosis and differential diagnosis of Cushing's syndrome and it could avoid unnecessary biopsy in the incidental adrenal tumor.
Adenoma ; Adosterol ; Biopsy ; Cholecystectomy, Laparoscopic* ; Cholecystography* ; Cushing Syndrome ; Diagnosis ; Diagnosis, Differential ; Hirsutism ; Humans ; Hyperaldosteronism ; Hypertension ; Liver Cirrhosis ; Radionuclide Imaging*