BACKGROUND: It is well known that patients with chronic obstructive pulmonary disease (COPD) show symptoms of depression and anxiety more often than patients with other chronic illnesses or the general population. This study was designed to evaluate the effects of depression and anxiety on quality of life in patients with COPD. METHODS: Quality of life was assessed using the Short Form-36 (SF-36) questionnaire and depression and anxiety symptoms were assessed using the Primary Care Evaluation of Mental Disorder Patient Health Questionnaire (PRIME-MD PHQ) in 129 patients with COPD visiting an outpatient clinic. We examined the correlations between the SF-36 scores and clinico-demographic features by Pearson's correlation analysis and the influence of depression and anxiety symptoms on the SF-36 scores by multiple regression analysis. RESULTS: Of the 129 patients, 48.8% were diagnosed as having major depressive syndrome, 18.6% other depressive syndromes, 23.3% panic syndrome, and 30.3% other anxiety syndrome by the PRIME-MD PHQ. The physical component summary was affected the most by depressive symptoms followed by dyspnea (P<0.05). The mental component summary was only affected by depressive symptoms (P<0.05). CONCLUSIONS: The prevalence of depression and anxiety symptoms in COPD patients is markedly increased, and depressive symptoms decrease the quality of life in these patients. Thus, there is a need for physicians to assess for and recognize such symptoms and promptly administer appropriate interventions.
Ambulatory Care Facilities ; Anxiety ; Chronic Disease ; Depression ; Depressive Disorder ; Dyspnea ; Humans ; Mental Disorders ; Panic ; Prevalence ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive ; Quality of Life ; Surveys and Questionnaires

Massive ovarian deema is a tate conditian. It is a benign enlargement of the ovary caused by accumulation of fluid, which is thought to result from intermittent partial toraion of the ovarian pedicle. Histologically, the ovaries were characterized by diffuse edema of medulla and inner cortex. Two cases of massive ovanan edema are reported with brief review of the literatures.
Edema* ; Female ; Ovary

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most common diseases of the digestive system, with a worldwide prevalence of approximately 20%. However, studies on constipation-predominant IBS in the elderly are scarce. Since Korea has the highest elderly population, with 38.2% of its population expected to be aged over 65 years by the year 2050, a study on the presence of IBS in this population is warranted. METHODS: In the present study, IBS was defined and classified according to the Rome III criteria. This study was performed by using the case and control method at the outpatient Department of Family Medicine and the health promotion center of a hospital in Gwangju. The questionnaire for the demographic characteristics and dietary habits was administered to 128 patients with IBS and 193 controls. RESULTS: Individuals who had a tendency of overeating for >3 days a week, compared to those who had a tendency of overeating for <2 days a week; those who had spicy food for >3 days a week, compared to those who had it for <2 days a week; and the time of meals showed statistically significant results. Meanwhile, the number and regularity of meals and having breakfast were not relevant factors. CONCLUSION: The weekly frequency of overeating and intake of spicy food as well as short time for meals are related to constipation-predominant IBS in the elderly aged above 65 years.
Aged* ; Breakfast ; Constipation ; Digestive System ; Food Habits* ; Gwangju ; Health Promotion ; Humans ; Hyperphagia ; Irritable Bowel Syndrome* ; Korea ; Meals ; Methods ; Outpatients ; Prevalence

It has been well known that ischemia reperfusion injury to skeletal muscle following an acute arterial occulusion causes significant morbidity and mortality. The skeletal muscle, which contains high energy phosphate compounds, has ischemic tolerance. During the ischemia, the ATP is catalyzed to hypoxanthine anaerobically and hypoxanthine dehydrogenase is converted to xanthine oxidase. During reperfusion, the hypoxanthine is catalyzed to xanthine by xanthine oxidase under O2 presence and that results in production of cytotoxic oxygen free radicals. The authors perform the present study to investigate the effects of allopurinol, the inhibitor of xanthine oxidase, on reperfused ischemic skeletal muscles by measuring of the immunoreactivities and exzyme activities of superoxide dismutase(SOD) and the formation of malondialdehyde(MDA). A total of 104 healthy Sprague-Dawley rats weighting from 200 gm to 250 gm were used as experimental animals. Under urethane(3.0mg/kg., IP) anesthesia with 3.0mg/kg of urethane, lower abdominal incision was made and the right and left common iliac artery were ligated by using vascular clamp for 2 hours. Both the quandriceps femoris muscles were obtained at 0 hour, half hour, 1 hour, 3 hours, 6 hours and 12 hours after the removal of vascular clamp. In the allopurinol pretreated group, 50mg/kg of allopurinol was administered once a day for 2 days and before 2 hours of ischemia. The specimens were sectioned in 14µm thickness with cryostat and homogenated ischemia. The specimens were sectioned in 14 µm thickness with cryostat and homegenated in the phosphate buffer. The immunoreactivities and enzyme activities of SOD were observed. The results were as follows: 1. The immunoreactivitiy and enzyme activity of SOD are decreased and the MDA level is increased in the 2 hours inchemic quadriceps femoris muscle of rats. 2. During the reperfusion of ischemic quadriceps femoris muscle of rats, the immunoreactivities of SOD in the half hour reperfused ischemic group and the enzyme activities of SOD in the 1 hour reperfused group are the highest and the immunoreactivities and enzyme activities of 6 hours reperfused ischemic group are the lowest. 3. Pertreatment of allopurionl decreased the immunoreactivities and enzyme activities of SOD during the ischemia and reperfusion of the quadriceps femoris muscles of rat. This results suggest that the allopurinol decreases the damages of skeletal muscles of rate during ischemia and reperfusion.
Adenosine Triphosphate ; Allopurinol ; Anesthesia ; Animals ; Free Radicals ; Hindlimb ; Hypoxanthine ; Iliac Artery ; Ischemia ; Mortality ; Muscle, Skeletal ; Muscles ; Oxygen ; Quadriceps Muscle ; Rats ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Superoxide Dismutase ; Superoxides ; Urethane ; Xanthine ; Xanthine Oxidase

BACKGROUNDS/OBJECTIVES: The effects of malnutrition on growth of toddlers and preschoolers by socioeconomic status are not well known. This study aimed to examine the effects of dietary intake on growth outcomes in toddlers and preschoolers by household income level. SUBJECTS/METHODS: The study population was a total of 1,687 children aged 1 to 5 years that participated in the KNHANES from 2009 to 2011. Growth of children was assessed by height for age (HFA) and weight for height (WFH). Children were classified into three groups according to children's HFA and WFH compared to the 10th and 90th percentiles of the 2007 Korean Children and Adolescent Growth Standard. Average monthly household income was divided into quartile groups. Dietary intake data were obtained by using the one day 24-hr recall method. Risks of inadequate intake of nutrients and unfavorable growth were estimated by using a multiple logistic regression model adjusted for sex, age, region, and energy intake. RESULTS: The low HFA group (< 10th percentile) had significantly lower intakes of energy, carbohydrate, and thiamin as compared with the high group (> or = 90th percentile). For WFH status, vitamin C intake was lower in the low group than in the high group. Household income level was related to WFH status but not HFA. Children from lower income households were more likely to have high WFH than those from higher income households (P for trend = 0.038). Household income status was also significantly related with risk of inadequate intake of micronutrients such as thiamin (P for trend = 0.032) and vitamin C (P for trend = 0.002), showing higher odds of inadequate intakes in children from lower income households. CONCLUSIONS: Children from lower income households were prone to be overweight and to have inadequate intakes of micronutrients such as thiamin and vitamin C. To reduce nutritional and health disparities, collective action in the public sector is required from early life.
Adolescent ; Ascorbic Acid ; Child ; Energy Intake ; Family Characteristics* ; Humans ; Logistic Models ; Malnutrition ; Micronutrients* ; Nutritional Status* ; Overweight* ; Public Sector ; Social Class

Diagnosis of acute appendicitis is often difficult in pregnant patients because the symptoms may be attributed to the pregnancy. Difficulty in diagnosis and delay in treatment may result in complication or death to the fetus or the mother. Forty pregnant women with acute appendicitis has been treated at Masan Samsung Hospital during the last 15-years. This report is a retrospective clinical analysis of 40 patients who underwent appendectomy. The results are as follows; The incidence of appendicitis during pregnancy was 1 in 655 pregnancies and the gestational stage at onset included 19 patients(47%) in the 1 trimester, 10 patients(25%) in the second trimester, and 11 patients(27%) in the third trimester. The majority of patients were 3rd decades (82%) and there was no significant difference between primiparity and multiparity in incidence of appendicitis. Twenty three(57%) patients had symptoms less than 12 hours and twenty nine (72%) patients were operated on within 12 hours following hospitalization. Vague right abdominal pain was the most predominant symptom and 19 patients had a clinical leukocytosis. Seven of the 40 patients were misdiagnosed as other than appendicitis and two patients had a exploratory laparotomy performed. Spinal anesthesia was preferably used for the first trimester and general anesthesia for the second and third trimester patients. One fetal loss occurred and no maternal deaths.
Abdominal Pain ; Anesthesia, General ; Anesthesia, Spinal ; Appendectomy ; Appendicitis* ; Diagnosis ; Female ; Fetus ; Hospitalization ; Humans ; Incidence ; Laparotomy ; Leukocytosis ; Maternal Death ; Mothers ; Parity ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Pregnant Women ; Retrospective Studies

BACKGROUND: It is expected that the number of families who provide caregiving for hospice patients will be increased in this society. Family caregiver will have fi nancial, psychological, social burden and stress related to this responsibility. Hospice patients, facing death, need not only biomedical therapy, but also systematic and continuous treatments such as mental or psycho-social intervention. The purpose of this study was to investigate the family caregiver's depression level and the associated factors. METHODS: The survey was conducted with 62 family caregivers of the hospice patients who had been hospitalized at the Gwangju Veterans Hospital from December 2005 to May 2006. The questionnaire consisted of the general characteristics of the subjects, Beck's depression inventory (BDI) evaluating the depression level and family APGAR score evaluating the family function. RESULTS: The mean age of the subjects was 58.2 years. The relationship with patients as 'spouse' accounted for 42 individuals (67.7%). The mean (+/- SD) BDI score was 25.3 (+/- 10.1) points and 58 percent of the subjects were suggested to have depression tendency (> or = 21 point). There was no relationship between the caregiver's depression level and their gender, religion, household income and Family APGAR score. However, the depression level was signifi cant related to the total caregiving duration (P = 0.001), visiting frequency of visitors (P = 0.004) and caregiving hours per day (P = 0.005). CONCLUSION: More than half of the family caregivers were suggested to have depression tendency. The depression level was infl uenced by the burden of caregiving and the visiting frequency of visitors. There is a need to activate social resources to share the burden of caregiving and to develop continuous and comprehensive care for hospice patients and their families.
Apgar Score ; Caregivers ; Depression ; Family Characteristics ; Hospices ; Hospitals, Veterans ; Humans

PURPOSE: There are several new surgical techniques for varicose vein surgery. Transilluminated Powered Phlebectomy (TIPP) and Endovenous Laser Therapy (EVLT) are accepted as useful surgical procedures for varicose veins. However, these techniques have some associated problems such as complications, remnant varicosities and are relatively expensive. We compared some of the new techniques with conventional methods and introduce new technique called Transillumination assisted EVLT (T-EVLT). METHOD: We reviewed cases with primary varicose veins involving the lower extremity in 217 patients managed by TIPP, EVLT and T-EVLT in the department of Surgery, Presbyterian Medical Center, from January 2003 to January 2007. RESULT: The distribution of age was the fifth decade (38.4%), fourth (23.8%) and third (15.2%), in order frequency. The male to female ratio was 1:1.43. The TIPP procedure had the lowest frequency of remnant varicosities (6.0%) but the second highest complication rate (17.9%). The EVLT procedure had a relatively low complication rate (9.5%) and good cosmetic results but the longest operation time and the highest frequency of remnant varicosities (21.6%). The T-EVLT procedure had the shortest operation time and the lowest frequency of remnant varicosities (19.5%) compared to the EVLT. CONCLUSION: Each of the operation methods had risks and benefits. The EVLT procedure had good cosmetic results and was easy to learn. However, had a relatively long operation time and many remnant varicosities. These problems may be overcome by the T-EVLT.
Female ; Humans ; Laser Therapy ; Lower Extremity* ; Male ; Protestantism ; Risk Assessment ; Transillumination ; Varicose Veins*

We report a case of unruptured aneurysm associated with basilar fenestration treated with coil-assisted coil embolization. A 46-year-old man had suffered from intermittent, progressive occipital headache for 2 months. Magnetic resonance (MR) angiography showed a large aneurysm at the proximal basilar artery. Both three-dimensional CT angiography and angiography demonstrated a saccular, 20x15-mm aneurysm arising at the proximal end of associated fenestration at the basilar artery. The aneurysm was successfully occluded with stent-assisted coil embolization. The patient was discharged home after 1 week and received 75 mg clopidogrel once daily for 4 weeks and 100 mg aspirin once daily for life.
Aneurysm* ; Angiography ; Aspirin ; Basilar Artery* ; Embolization, Therapeutic* ; Headache ; Humans ; Middle Aged ; Stents*

Background: Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels. Methods: Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users. Results: Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557). Conclusion In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.