BACKGROUND: Majority of hypertension is essential in type, so its clear cue usually is not found, and the patients are tend to be persisted of psychopathy such as emotional tension, depression, anger, anxiety and psychologic conflict, also not to be adapted to stressful event. So we decide to survey the personality characteristics of essential hypertensive patients and factors of psychopathology. METHODS: Patient group-50 persons(male 23, female 27) are selected in the course of antihypertensive medication, being in or outpatient treatment at the dept. of F.M. or I.M. in Kae-jung, Dae-sung or Jung-ang Hospital from August 1, 1995 to July 31, 1996. Control group 52 persons(male 25, female 27) are selected. Exclusision criteria are any clinical disease hystory, over 140/90mmHg of BP, under 20-year old age or no cooperation. We assessment of the MMPI, BDI and STAI results about both group. RESULTS: Comparing hypertensive group with normal control group, significantly higher F, Hs, D, Hy, Pd, Pt and Sc scales of MMPI and BDI(p<0.01), and anxiety scale of STAI(p<0.05). There were no significant differences in all scales comparing between both sexs in the hypertensive and control groups, except comparing hypertensive male with hypertensive female in Pt scale(p<0.05) and control female with control male in Hy scale(p<0.05). CONCLUSIONS: Comparing essential hypertensive group with normal control group, significant higher score was found in scales of Hypochondriasis, Depression, Hysteria, Psychopathic deviate, Psychasthenia, Schizophrenia and anxiety. And in the treatment of hypertensive patient with antihypertensive drugs, appropriate additive psychotherapy appears useful in the case of revealing psychopathy.
Anger ; Antihypertensive Agents ; Anxiety* ; Cues ; Depression* ; Female ; Humans ; Hypertension* ; Hypochondriasis ; Hysteria ; Life Change Events ; Male ; MMPI ; Outpatients ; Psychopathology ; Psychotherapy ; Schizophrenia ; Weights and Measures ; Young Adult

BACKGROUND: The chronic disease patients have various psychological problems during the treatment. Therefore, it is needed about understanding and support for chronic disease patients. The main purposes of this study are to identify the psychometric characteristics. METHODS: To evaluate the psychometric characteristics of chronic disease patients-liver cirrhosis, chronic pulmonary disease, etc. -a questionnaire(SCL-90-R) survey was performed toward 100 chronic disease patients in admission to 2 general hospital. 100 persons without any disease were investigated by the same questionnaire for comparison. The survey was performed from June to August 1996. RESULTS: The disease history among the patients, 31% of patients suffered from liver disease, 19% of patients suffered from chronic respiratory disease. 30% of patients reported that they were not expected a recovery from the disease. The patients have a significant higher score in the somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism than normal control (p<0.05). Most of the psychometric characteristics were associated with expectancy of the recovery, education about the disease, number of admission, duration of admission and type of disease(p<0.05). CONCLUSIONS: The chronic disease patients showed higher score psychological symptoms in various characteristics than normal control. Therefore it will be needed that is an proper treatment and psychological support continuously.
Anxiety ; Chronic Disease* ; Depression ; Education ; Fibrosis ; Hospitals, General ; Hostility ; Humans ; Liver Diseases ; Lung Diseases ; Psychometrics* ; Surveys and Questionnaires

BACKGROUND: The chronic disease patients have various psychological problems during the treatment. Therefore, it is needed about understanding and support for chronic disease patients. The main purposes of this study are to identify the psychometric characteristics. METHODS: To evaluate the psychometric characteristics of chronic disease patients-liver cirrhosis, chronic pulmonary disease, etc. -a questionnaire(SCL-90-R) survey was performed toward 100 chronic disease patients in admission to 2 general hospital. 100 persons without any disease were investigated by the same questionnaire for comparison. The survey was performed from June to August 1996. RESULTS: The disease history among the patients, 31% of patients suffered from liver disease, 19% of patients suffered from chronic respiratory disease. 30% of patients reported that they were not expected a recovery from the disease. The patients have a significant higher score in the somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, psychoticism than normal control (p<0.05). Most of the psychometric characteristics were associated with expectancy of the recovery, education about the disease, number of admission, duration of admission and type of disease(p<0.05). CONCLUSIONS: The chronic disease patients showed higher score psychological symptoms in various characteristics than normal control. Therefore it will be needed that is an proper treatment and psychological support continuously.
Anxiety ; Chronic Disease* ; Depression ; Education ; Fibrosis ; Hospitals, General ; Hostility ; Humans ; Liver Diseases ; Lung Diseases ; Psychometrics* ; Surveys and Questionnaires

No abstract available.

BACKGROUND: Overstimation of blood pressure(BP) by clinic measurements occur in about 20 to 30% of subjects(white-coat hypertension) who may, consequently, be misdiagnosed as hypertensives and received unnecessary medications. The clinical significance of white-coat hypertension and its effects on the cardiovascular wystem have not been studied systematically.This study was designed to evaluate the influences of white-coat hypertension and white-coat effect, defined as difference between clinic and ambulatory BP, on the LV mass and diastolic function. METHODS: LV mass index was calculated and LV systolic and diastolic function were assessed by the analysis of mitral and pulmonary venous flow velocity in 45 untreated essential hypertensives and 20 normotensives(NT). Ambulatory BP monitoring classified hypertensives as white-coat hypertensives(WCHT,n=20) and sustained hypertensives(SHT, n=25). RESULTS: 1) Left ventricular systolic indices were not different among the three groups. 2) Left ventricular mass inedx of WCHT(114.5+/-36.3g/m2) was similar to that of SHT(115.6+/-34.9g/m2) and was significantly greater than that of NT(86.5+/-37.7g/m2)(p<0.05). 3) Some of left ventricular diastolic parameters(isovolumic relaxation time, E/A ratio, A velocity, pulmonary systolic fraction, ratio of systolic to diastolic forward flow velocity) of WCHT and SHT were significantly different from those of NT(p<0.05), but there were no differences between two hypertensive groups. 4) Even though both systolic and diastolic white-coat effect in WCHT were significantly greater than those of SHT(o<0.05),white-coat effect did not influence on the left ventricular mass or function in both groups. CONCLUSION: An increased left ventricular mass and diastolic dysfunction in WCHT suggests that white-coat hypertension could not be considered as an entirely innocuous clinical condition.
Blood Pressure Monitoring, Ambulatory ; Hypertension* ; Relaxation

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

BACKGROUND: Diverticulosis of the cecum and ascending colon is a rare disease in Western countries, it is more common in the Orient. Making the diagnosis preoperatively could be difficult, and the intraoperative assessment and decision of optimal treatments are difficult. METHODS: Therefore, we reviewed the patient's charts of diverticulosis of the cecum and ascending colon at our hospital from 1992 to 1997. RESULTS: During the past 5 years, a total of 53 cases of diverticulosis of the cecum and ascending colon had been treated at this hospital. Mean age was 41.8 years (range 20-70). The male to female ratio was 1.8 : 1. Frequent complaints were abdominal pain (46 cases, 86.8%), followed by diarrhea (5 cases, 9.3%), indigestion (4 cases, 7.5%), and bowel habits change (2 cases, 3.8%). Mean duration of illness was 3.5 days(range 24 hours~15 days). In non-surgical cases, diagnoses were established with barium enema, CT scan, or ultrasonography. The accuracy of these methods was 91%, 75%, and 25%. In surgical cases, the preoperative diagnoses were appendicitis(13 cases, 50.1%), diverticulitis (7 cases, 31.8%), and abscess (2 cases, 9.1%). Treatments of the cecum and ascending colon diverticulitis were conservative management (3 teases,58.5%) and surgical treatment (22 cases,41.5%). The operative procedures were right hemicolectomies (2 cases), ileocecal resections (2 cases), diverticulectomies (6 cases) and appendectomies only (11 cases). CONCLUSION: These results suggest that correct diagnosis of the diverticulitis of the cecum and ascending colon made before treatment is very important because correct assessment of diverticulitis intraoperatively is difacut. Liberal use of diagnostic modalities could facilitate to make correct diagnosis to set a proper plan for treatment.
Abdominal Pain ; Abscess ; Appendectomy ; Barium ; Cecum* ; Colon, Ascending* ; Diagnosis ; Diarrhea ; Diverticulitis ; Diverticulum* ; Dyspepsia ; Enema ; Female ; Humans ; Male ; Rare Diseases ; Surgical Procedures, Operative ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND: Immediate operative management has been applied to infants and children with an attacks of adhesive small-bowel obstruction (ASBO), but this treatment has been controversial. We retrospectively reviewed 30 patients who were admitted from 1992 to 1996 because of adhesive small-bowel obstructions. METHODS: Immediate operation was reserved for the 7 patients that presented with fever and leukocytosis and /or localized abdominal tenderness or complete obstruction. The remaining 23 patients initially underwent conservative treatment. RESULTS: Although 20 episodes were cured with conservative treatment, 3 cases subsequently required surgical intervention. No adverse occurrences were observed during or after the delayed operations. Recurrence occurred in 3 cases after surgery and in 2 cases after conservative treatment. In the study, we found that the age at the recent laparotomy, the time elapsed between the recent laparotomy and the obstructive episode, and the primary condition necessitating the laparotomy correlated significantly with the success of conservative treatment. CONCLUSIONS: We conclude that in the treatment of ASBO in children, conservative treatment through the use of abdominal decompression, antibiotics, fluid-electrolytes, physical therapy, etc. has to be applied first for patients without significant evidence of strangulation and complete obstruction.
Adhesives* ; Anti-Bacterial Agents ; Child* ; Fever ; Humans ; Infant ; Laparotomy ; Leukocytosis ; Lower Body Negative Pressure ; Recurrence ; Retrospective Studies

PURPOSE: To examine the clinical effect of combination method of laser treatment and intravitreal triamcinolone (TA) injection for patient of macular edema with branched retinal vein occlusion (BRVO). METHODS: fifteen patients, -(15 eyes), 7 malse and 8 females, with macular edema associated with BRVO were included in the study. The mean age was 59.47 years old. The response to treatment was monitored functionally by visual acuity assessment and anatomically by Optical Coherence Tomography(OCT) for macular thickness. Four milligrams of TA were injected into the vitreous cavity. The clinical outcome and complication were reviewed, retrospectively. RESULTS: After the combination method of laser treatment and intravitreal TA injection, 13 (87%), 12 (80%), 13 (87%) of the 15 eyes showed improved the mean visual acuity at 1-, 2-, and 6-month follow-ups retrospectively. Central macular thickness as measured by OCT decreased by 37% (312.5 +/- 9 micrometer), 42% (282.1 +/- 556 micrometer), and 56% (276.9 +/- 76 micrometer), at the same follow-ups from an initial pretreatment mean of 495.9 +/- 114 micrometer. The post-operative complications were intraocular pressure elevation (1 eye, 7%), and cataract (3 eyes, 20%). However, there were no serious postoperative complication such as retinal detachment, vitreous hemorrhage, and endophthalmitis. CONCLUSIONS: The combination method of laser treatment and intravitreal TA injection may be useful for treating patient of macular edema with BRVO.
Cataract ; Endophthalmitis ; Female ; Follow-Up Studies ; Humans ; Intraocular Pressure ; Macular Edema* ; Postoperative Complications ; Retinal Detachment ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Retrospective Studies ; Triamcinolone Acetonide ; Triamcinolone* ; Visual Acuity ; Vitreous Hemorrhage

The diagnostic possibility and the incidence of ectopic pregnancy are increasing due to several factor. Furthermore, radioimmunoassay of serum β-HCG and US make it possible to diagnose early before the tubal rupture. A conventional surgical approach has been considered as a choice of treatments. Until recent years, however, surgery may have considerable risk of infertility and sugical hazard. In view of the natural tendency of some ectopic pregnancies to terminate in tubal abortion or complete resorption, we tried to cure ectopic pregnancy with nonsurgical transcervical intervention. Five of 8 patients with unruptured tubal pregnancies, it was possible to inject PGF2a into the tubes or gestational sac. 4 of them were ended up with satisfactory reduction of serum β-HCG level and improvement of symptoms & signs. In only one patient, β-HCG level remained a high level continuously, so salpingectomy was done. As a result, we consider that fluoroscopy-guided transcervical interventional procedure is a useful treatment modality for early unruptured ectopic pregnancy.
Abortion, Spontaneous ; Female ; Gestational Sac ; Humans ; Incidence ; Infertility ; Pregnancy ; Pregnancy, Ectopic* ; Pregnancy, Tubal ; Radioimmunoassay ; Rupture ; Salpingectomy