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

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

No abstract available.
Thrombocytopenia, Neonatal Alloimmune*

Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

Vascular complications such as hematoma, pseudoaneurysm and arteriovenous fistula that occur after intracoronary or intracardiac procedures are responsible for considerable morbidity and some mortality. Iatrogenic aneurysms are usually postcatheterization pseudoaneurysms of the femoral artery. Nowadays, it is not uncommon as a consequence of more complex interventional procedures, larger catheters and prolonged anticoagulation treatment. Surgical repair has been mainstay of treatment for pseudoaneurysm. However, recently has it been shown that color Doppler ultrasound-guided direct, noninvasive compression of the pseudoaneurysm stops the blood flow in the communication and lead to pseudoaneurysm clotting and obliteration. We report a case of pseudoaneurysm in femoral artery, which was developed at the right inguinal puncture site in 74 year old male patient with myocardial infarction who had received continuous intravenous infusion of heparin and had undergone primary percutaneous coronary angioplasty and temporary pacemaker insertion treated successfully with color Doppler ultrasound guided direct compression.
Aged ; Aneurysm ; Aneurysm, False* ; Angioplasty ; Arteriovenous Fistula ; Cardiology* ; Catheters ; Femoral Artery* ; Hematoma ; Heparin ; Humans ; Infusions, Intravenous ; Male ; Mortality ; Myocardial Infarction ; Punctures ; Ultrasonography

No abstract available.
Gardnerella vaginalis* ; Gardnerella*

PURPOSE: Current results of autologous stem cell transplantation (SCT) suggest that this procedure may prolong disease free survival in patients with acute myeloid leukemia (AML). Autologous SCT is increasingly used as treatment for AML in first remission. The aim of this study was to evaluate the outcome of autologous SCT for patients with AML in first remission treated by autologous SCT using cytarabine, melphalan and total body irradiation (TBI) as the conditioning regimen. MATERIALS AND METHODS: Between January 1995 and December 1999, 29 patients with AML in first remission underwent autologous SCT. The median age of patients was 33 years (range, 16 to 47). The conditioning regimen consisted of cytarabine (3.0 gm/m2 for 3 days), melphalan (100 mg/m2 for 1 day) and TBI (total 1000 cGy in five fractions over 3 days). RESULTS: The median follow up was 40 months with a range of 3 to 58 months. The 4-year cumulative probability of disease free survival was 69.0%, and median survival was 41.5 months. The 4-year relapse rate was 27.6%. The factor influencing disease free survival and relapse rate was the French-American-British (FAB) classification (M3 group vs. other groups; p=0.048, p=0.043). One patient died from treatment-related toxicity. CONCLUSION: Although the small number of patients does not allow us to draw any firm conclusion, our results were encouraging and suggest that the association of cytarabine, melphalan and TBI as a conditioning regimen for autologous SCT for AML in first remission appears to be safe and effective.
Classification ; Cytarabine* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Leukemia, Myeloid, Acute ; Melphalan* ; Recurrence ; Stem Cell Transplantation* ; Stem Cells* ; Whole-Body Irradiation*

PURPOSE: Preoperative radiotherapy has been used to induce tumor regression and allow complete resection of rectal cancer with a sphincter preservation surgery. This study was performed to determine the effectiveness of preoperative radiotherapy for T2, T3 distal rectal carcinoma. MATERIALS AND METHODS: From November 1995 to June 1997, fifteen patients with invasive distal rectal cancer were treated with preoperative radiotherapy followed by sphincter preservation surgery. Classification by preoperative T stage consisted of 7 T2 and 8 T3 tumors. Radiation therapy was delivered with 6 MV and 15 MV linear accelerator, at 1.8 Gy fractions for 5 days per week. Total radiation doses were 45 Gy to 50.4 Gy (median : 50.4 Gy). Sphincter preservation surgery was performed 4~6 weeks after the completion of radiotherapy. Median follow-up was 22 months (range : 16~37 months). RESULTS: One patient (6.7%) had a complete pathologic response. Comparing the stage at the diagnostic workup with the pathologic stage, tumor downstaging of T stages occurred in 11 of 15 patients (73.3%) and N1 stages occurred in 2 of 5 patients (40%). No patient developed progressive disease undergoing treatment. Two patients suffered local recurrence at 7 and 20 months, and one a distant metastasis at 30 months. No grade 3 or 4 toxicity was observed. CONCLUSION: Our experience suggests that preoperative radiotherapy followed by sphincter preservation surgery is well tolerated, and can significantly reduce the tumor burden for T2, T3 distal rectal cancer.
Classification ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Particle Accelerators ; Radiotherapy* ; Rectal Neoplasms* ; Recurrence ; Tumor Burden

BACKGROUND/AIMS: Gastrointestinal (GI) diseases impose a heavy economic burden. We aimed to provide the first report on the health care utilization and costs of GI diseases in Korea. METHODS: We collected the data from all insurance claims database of National Health Insurance Corporation in Korea and the cause of death database in 2007 of Korea National Statistical Office. We compiled information about all digestive disease as a primary diagnosis on clinic visits, hospitalization, and cause of death from these databases. RESULTS: Seventeen million people (35.6%) had a diagnosis of GI diseases during the year 2007. Among them, the proportion of patients with upper GI diseases was prevalent in 54.9% (9.5 million patients/year). The 1/4 patients in out-patients clinic had any one of gastroesophageal reflux disease, irritable bowel syndrome and constipation. Thirteen percent of the total direct cost in 2007 was attributed to all GI diseases, which was 3,649 billion won (0.4% of GDP). The patients with hospitalization occupied by 5% of all patients with GI diseases, however, attributed to 58.9% of GI-related direct costs. GI malignancy was the major cause of medical expenses in hospitalization. Stomach cancer continues to be the leading cause of GI-related death in Korea. CONCLUSIONS: GI diseases causes a heavy socioeconomic burden with high morbidity of functional GI disorders in outpatients care and high mortality of GI malignancy in inpatient care. This report highlights the healthcare utilization burden of GI diseases for researchers and public health policy maker to create new directions of integrated researches and health care plan.
Databases, Factual ; Gastrointestinal Diseases/*economics ; Gastrointestinal Neoplasms/economics/mortality ; *Health Care Costs ; Hospitalization/economics ; Humans ; National Health Programs/economics ; Republic of Korea ; Survival Analysis

BACKGROUND/AIMS: Management of irritable bowel syndrome (IBS) imposes a heavy economic burden. This study was to estimate the epidemiologic features of IBS and to report the IBS burden for the first time in the Korean population. METHODS: A cross-sectional study was conducted using the National Health Insurance (NHI) system database, which covers the entire population of Korea. IBS was defined as diagnostic code -10 in adults with any outpatient clinic visits or hospitalization related to IBS. We excluded diseases that mimic IBS symptoms. RESULTS: A total of 2.42 million (58.2% female) individuals were identified as patients with IBS, yielding an age- and gender-adjusted prevalence of 5.1% in males and 6.9% in females. The prevalence of IBS increased proportionally with age, with higher medical costs in middle-aged patients. Outpatient clinics were visited by 98.6% of IBS patients, and 1.9% were treated upon admission. Of these patients, 87.6% were given a prescription. Co-morbidities that commonly accompanied IBS included upper gastrointestinal (36.1%), respiratory (12.3%), musculoskeletal (8.0%) disease, somatoform (4.3%) and depression/anxiety disorders (3.1%). The NHI costs of IBS, which include the NHI covered cost and beneficiary copayment charges, were estimated to be 155 million USD, which accounts for 0.46% of the total NHI costs for the entire Korean population. CONCLUSIONS: According to the Korean national claims database, about 6% of the Korean population seeks medical care for IBS at least once per year. This high prevalence places a large economic burden on the Korean healthcare system, accounting for 0.46% of overall national medical expenditure.
Adult ; Ambulatory Care Facilities ; Cost of Illness ; Cross-Sectional Studies ; Delivery of Health Care ; Epidemiology ; Female ; Health Expenditures ; Hospitalization ; Humans ; Irritable Bowel Syndrome* ; Korea ; Male ; National Health Programs ; Prescriptions ; Prevalence