OBJECTIVES: The purpose of this study was to evaluated the difference of depressive symptoms and attention between estrogen user and non-user in postmenopausal women. METHODS: 30 Estrogen users and 30 non-users were participated in this study. They were all menopausal for at least 1 year and have 12 or more education years. We used BDI(Beck Depression Inventory), digit span and digit symbol to evaluate depressive symptoms and attention in both groups. We also measured the plasma estradiol level and identified the correlation between estradiol level and BDI, digit span and digit symbol. RESULTS: The demographic data was not different between both groups. Estrogen users scored higher than non-users in digit span(forward) and lower than non-users in BDI. The correlation between estradiol level BDI, digit span and digit symbol was not significant. CONCLUSION: Estrogen replacement therapy was effective in alleviation depressive symptoms but ineffective in improving attention in postmenopausal women.
Depression* ; Education ; Estradiol ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Plasma

Objectives: The objective of this study was to develop strategies aimed at reducing disparity of physical activity in urban community. Methods: The study was conducted in a urban vulnerable area, focusing on the establishment and operation of a community health organization through the residents' autonomy council. Training programs were provided to the members of the council to enhance their capabilities. The research project was planned and implemented using a living lab approach. Based on these activities, the health division of residents autonomy council was newly established. Results: The findings demonstrated the potential and feasibility of utilizing the residents' autonomy council as a community-led health organization. A health project model centered on the health division of the residents' autonomy council was developed. Conclusions This study concluded that it is possible to effectively promote health projects to reduce the health disparity through the resident-led participation strategy on the residents’ autonomy council in the community.

OBJECTIVES: Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas. METHODS: The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year. RESULTS: A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance. CONCLUSIONS: Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.
Adolescent ; Adolescent Behavior ; Adolescent Psychology ; Alcohol Drinking ; Depression ; Humans ; Internet ; Logistic Models ; Male ; Odds Ratio ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Rural Population ; Smoking/*epidemiology/trends ; Tobacco Smoke Pollution

The prediction of successful recanalization following thrombolytic or endovascular treatment may be helpful to determine the strategy of recanalization treatment in acute stroke. Thrombus can be detected using noncontrast computed tomography (CT) as a hyperdense artery sign or blooming artifact on a T2*-weighted gradient-recalled image. The detection of thrombus using CT depends on slice thickness. Thrombus burden can be determined in terms of the length, volume, and clot burden score. The thrombus size can be quantitatively measured on thin-section CT or CT angiography/magnetic resonance angiography. The determination of thrombus size may be predictive of successful recanalization/non-recanalization after intravenous thrombolysis and endovascular treatment. However, cut-offs of thrombus size for predicting recanalization/non-recanalization are different among studies, due to different methods of measurements. Thus, a standardized method to measure the thrombus is necessary for thrombus imaging to be useful and reliable in clinical practice. Software-based measurements may provide a reliable and accurate assessment. The measurement should be easy and rapid to be more widely used in practice, which could be achieved by improvement of the user interface. In addition to prediction of recanalization, sequential measurements of thrombus volume before and after the treatment may also be useful to determine the efficacy of new thrombolytic drugs. This manuscript reviews the diagnosis of thrombus, prediction of recanalization using thrombus imaging, and practical considerations for the measurement of thrombus burden and density on CT.
Angiography ; Arteries ; Artifacts ; Diagnosis ; Endovascular Procedures ; Fibrinolytic Agents ; Methods ; Reperfusion* ; Stroke* ; Thrombolytic Therapy ; Thrombosis*

Video-assisted thoracoscopic surgery (VATS) has advantages compared with open thoracotomy. One lung ventilation, is indispensible to VATS, commonly is accomplished with a double-lumen endotracheal tube. For infants and small children, there is no double-lumen endotracheal tube suitable, various modified techniques are used to achieve one lung ventilation. Recently introduced a small sized wire-guided endobronchial blocker gives us another choice of one lung ventilation for VATS in small children. Using a wire-guided endobronchial blocker and multiport adapter for young children under flexible bronchoscope, we provided one lung ventilation (OLV) during VATS successfully without complications.
Bronchoscopes ; Child ; Humans ; Infant ; One-Lung Ventilation ; Thoracic Surgery, Video-Assisted ; Thoracotomy

BACKGROUND: Somatosensory evoked potentials (SSEPs) have been frequently used to monitor cerebral ischemia during cerebral aneurysm surgery. The relation of SSEP changes and postoperative neurologic deficits due to ischemia have been studied many times but the relation according to the location of temporary clips have not yet been evaluated. METHODS: We studied 81 patients undergoing cerebral aneurysm surgery. Median nerve SSEP was used for temporary clipping of internal carotid artery (ICA) or middle cerebral artery (MCA) and posterior tibial nerve SSEP for temporary clipping of anterior cerebral artery (ACA). SSEPs were recorded after induction of anesthesia and dural opening (control value), during temporary clipping, and after relieving temporary clips. A change in cortical amplitude of more than 50%, as compared with control was considered as `significant'. The presence of significant SSEP changes and neurologic deficits according to the location of temporary clips were analyzed using 2 test. RESULTS: Significant changes in M-SSEP were recognized in 7 of 31 patients of MCA clipping. 2 patients showed neurologic deficits in these 7 patients. Significant changes in M-SSEP were recognized in 7 of 26 patients of ICA clipping, but there was no neurologic deficit. Significant changes in P-SSEP were recognized in 4 of 24 patients of both ACAs clipping. Only 1 patient showed neurologic deficit, but SSEP change of this patient was insignificant. Temporary clip time was significantly prolonged if there were neurologic deficits. CONCLUSION: SSEPs may be able to be used to detect significant cerebral ischemia due to temporary clipping. Especially, M-SSEP was useful to detect cerebral ischemia due to MCA temporary clipping.
Anesthesia ; Anterior Cerebral Artery ; Brain Ischemia ; Carotid Artery, Internal ; Cerebral Arteries* ; Evoked Potentials, Somatosensory* ; Humans ; Intracranial Aneurysm ; Ischemia ; Median Nerve ; Middle Cerebral Artery ; Neurologic Manifestations ; Tibial Nerve

BACKGROUND: Significant improvements in the treatment of acute myelogenous leukemia (AML) has been contributed by the development of remission induction and consolidation chemotherapy. But the infection is one of the most important and fatal complications in patients with AML. Therefore the effective treatment and preventive strategies of these infections are essential in order that more patients may achieve a complete remission and long-term disease free-survival. The purpose of this study was to determine the recent incidence of infections and to evaluate response for the empiric antibiotic treatment during chemotherapy. METHODS: The records of 102 patients from a consecutive series of 206 admission episodes between April 1985 to December 1997 were reviewed retrospectively. When fever was developed, samples for microbiologic cultures and radiologic studies were done. Fine needle aspiration and/or biopsy from suspected lesions were done, if the studies mentioned above are unrevealing. RESULTS: Febrile episodes were developed in 123 of 206 admission session. The microbiologically defined infection (MDI) and clinically defined infection (CDI) were developed in 51.2% and 37.4% of episodes, respectively. Fever was developed in 80.7%, 30.2%, and 77.8% in cases receiving remission induction chemotherapy, standard dose-consolidation therapy, and intensified consolidation therapy, respectively. The most frequent sites of infections were lung (27.8%) and blood (27.8%). Staphylococcus epidermidis was the most common causative organism of bacteremia. The initial antimicrobial therapy was not modified in 8 of 123 febrile episodes. The rate of overall response to antimicrobial therapy was 65%. The rate of overall response to antimicrobial therapy during remission induction chemotherapy, standard dose-consolidation therapy, and intensified consolidation therapy was 70.4%, 89.4%, 71.4%, respectively. CONCLUSION: Infection has been a major cause of morbidity and mortality in acute myelogenous leukemia. Thus, intensive treatment needs for infection. More effective approaches should be evaluated by using more effective prophylactic and treatment modalities including new antimicrobials and by considering the changing spectrum of microbials.
Adult* ; Bacteremia ; Biopsy ; Biopsy, Fine-Needle ; Consolidation Chemotherapy ; Drug Therapy ; Fever ; Humans ; Incidence ; Leukemia, Myeloid, Acute* ; Lung ; Mortality ; Remission Induction ; Retrospective Studies ; Staphylococcus epidermidis

BACKGROUND: The goal of acute myelogenous leukemia(AML) therapy is to obtain the complete remission(CR) and to improve disease-free survival. Advances in chemotherapy and supportive care provided significant improvement in CR rate up to 60~85% patients with AML. METHODS: Forty two patients with previously untreated AML at Yeung Nam University Hospital from April 1985 through November 1996 were treated with AD(7-3) regimen for induction chemotherapy and followed by two courses of consolidation with AD(5-2) regimen. And the authors analyzed clinical factors related to the CR and overall survival. RESULTS: Twenty-four of the 42 patients achieved CR, and median duration of remission in 24 patients achieved CR was 56 weeks(4~ 305 +weeks). Median duration of survival in all 42 cases was 46 weeks(2~340 + weeks), and in 24 cases achieved CR was 73 weeks(12~340 +weeks). Causes of induction failure included infection in 9 cases, bleeding in 3 cases and drug resistance in 6 cases. Among the potential prognostic variables including age, initial WBC count, performance status, and presence of Auer rods and infection at the time of diagnosis, none was statistically significantly related to the prognosis. CONCLUSION: Further clinical trials for effective remission induction and postremission chemotherapy are necessary to overcome drug resistance and to increase the CR rate and duration.
Adult* ; Diagnosis ; Disease-Free Survival ; Drug Resistance ; Drug Therapy* ; Hemorrhage ; Humans ; Induction Chemotherapy ; Leukemia, Myeloid, Acute* ; Prognosis ; Remission Induction* ; Survival Rate

PURPOSE: The objective of this study was to obtain improved susceptibility weighted images (SWI) of the cervical spinal cord using respiratory-induced artifact compensation. MATERIALS AND METHODS: The artifact from B0 fluctuations by respiration could be compensated using a double navigator echo approach. The two navigators were inserted in an SWI sequence before and after the image readouts. The B0 fluctuation was measured by each navigator echoes, and the inverse of the fluctuation was applied to eliminate the artifact from fluctuation. The degree of compensation was quantified using a quality index (QI) term for compensated imaging using each navigator. Also, the effect of compensation was analyzed according to the position of the spinal cord using QI values. RESULTS: Compensation using navigator echo gave the improved visualization of SWI in cervical spinal cord compared to non-compensated images. Before compensation, images were influenced by artificial noise from motion in both the superior (QI = 0.031) and inferior (QI = 0.043) regions. In most parts of the superior regions, the second navigator resulted in better quality (QI = 0.024, P < 0.01) compared to the first navigator, but in the inferior regions the first navigator showed better quality (QI = 0.033, P < 0.01) after correction. CONCLUSION: Motion compensation using a double navigator method can increase the improvement of the SWI in the cervical spinal cord. The proposed method makes SWI a useful tool for the diagnosis of spinal cord injury by reducing respiratory-induced artifact.
Artifacts ; Cervical Cord ; Compensation and Redress ; Diagnosis ; Methods ; Noise ; Qi ; Respiration ; Spinal Cord ; Spinal Cord Injuries

BACKGROUND: Intravenous fentanyl has been used for acute postoperative pain management, but has not always provided reliable adequate analgesia, including patient-controlled analgesia (PCA). The purpose of this study was to investigate the efficacy of time-scheduled decremental infusion of fentanyl for postoperative analgesia. METHODS: Ninety-nine patients, aged 20-65 years, undergoing laparoscopic-assisted hysterectomy using total intravenous anesthesia (TIVA) were randomly assigned into one of the three groups. Their background infusions of fentanyl diluent (2 ml/hr of diluent was equivalent with 0.5 microg/kg/hr of fentanyl) with PCA were maintained at the fixed-rate of 2 ml/hr until the postoperative 24 hr (FX2-2-2), or at the decremental rates of 6.0, 4.0, 2.0 ml/hr (D6-4-2) and 8.0, 4.0, 2.0 ml/hr (D8-4-2). The visual analogue score (VAS), incidence of inadequate analgesia, frequency of PCA intervention, and side effects were evaluated. RESULTS: VAS was significantly higher in FX2-2-2 than in D6-4-2 and D8-4-2 until postoperative 3 hr (P < 0.05). After postoperative 4 hr, VAS was significantly higher in FX2-2-2 than D8-4-2 (P < 0.05). The incidence of inadequate analgesia of FX2-2-2 was significantly greater than D6-4-2 (P = 0.038) and D8-4-2 (P < 0.001) until postoperative 1 hr. None of the patients had ventilatory depression, and postoperative nausea and vomiting were not significant among the groups. CONCLUSIONS: The time-scheduled decremental background infusion regimens of fentanyl, based on the pharmacokinetic model, could provide more effective postoperative pain management after TIVA, and the side effects and the risk for morbidity were not different from the fixed-rate infusion regimen.
Analgesia ; Analgesia, Patient-Controlled* ; Anesthesia, Intravenous* ; Fentanyl* ; Humans ; Hysterectomy ; Incidence ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Respiratory Insufficiency