Sleep disturbance is a one of common complaints among patients with panic disorder. However, clinicians and researchers did not give much attention to the sleep symptoms of panic disorder yet. Several previous studies suggested that the sleep disturbance in panic disorder is mediated by nocturnal panic attack. In terms of the pathophysiology of panic disorder, nocturnal panic attack seems to be closely associated with the sleep problems in panic disorder. In this article, the authors reviewed various previous studies about sleep of panic disorder and intended to give importance of evaluating sleep disturbances and nocturnal panic attack in panic disorder for both clinical and research purpose.
Humans ; Panic ; Panic Disorder

Cervical pregnancy is a rare and dangerous form of ectopic pregnancy in which the blastocyst implants within the cervical canal below the internal os of the uterine cervix. The characteristic clinical sign is a severe asymptomatic uterine bleeding in early pregnancy or during curettage. Most cervical pregnancies result in early spontaneous abortion, complicated by severe hemorrhage from the eroded blood vessels within the cervical tissue. Because of uncontrolled profuse vaginal bleeding, total hysterectomy has been the mostly necessitated to control life-threatening bleeding. Transvaginal sonography allows early diagnosis, and conservative treatment (two-time treatment : first treatement with systemic or intraamnionic methotrexate, secondly with curettage or ligature of the uterine arteries) improves the patient's fertility. Successful treatment is defined as elimination of the cervical pregnancy with preservation of the uterus. We report two cases of cervical pregnancy managed, successfully with methotrexate, leucovorin and curettage.
Abortion, Spontaneous ; Blastocyst ; Blood Vessels ; Cervix Uteri ; Curettage ; Cytochrome P-450 CYP1A1 ; Early Diagnosis ; Female ; Fertility ; Hemorrhage ; Humans ; Hysterectomy ; Leucovorin ; Ligation ; Methotrexate ; Pregnancy* ; Pregnancy, Ectopic ; Uterine Hemorrhage ; Uterus

No abstract available.

BACKGROUND/OBJECTIVES: The purpose of this study is to analyze daily kimchi, vegetable and fruit consumption by general characteristics and vegetable and fruit consumption from 1998 to 2012 by the Korean population based on the data of the KNHANES (Korea National Health and Nutrition Examination Survey). SUBJECTS/METHODS: This study is based on the 1998-2012 KNHNES. Analysis data on 54,700 subjects aged 19 years and older were obtained from health behavior interviews and the 24-hour dietary recall method. RESULTS: Daily kimchi consumption and portion size of kimchi decreased significantly from 1998 to 2012 (adjusted P for trend < 0.0001). Meanwhile, daily consumption of both non-salted vegetable and fruit with and without kimchi did not significantly change between 1998 and 2012. Reduced consumption of kimchi, non-salted vegetable, and fruit was observed for both genders as well as daily meal episodes and cooking locations. Male and female subjects with insufficient non-salted vegetable and fruit intake were increased 1.4 times and 1.3 times, respectively, in 2012 than 1998. All subjects consumed at least 400 g/day of non-salted vegetable, fruit, and kimchi in each survey year, although they consumed insufficient amounts (< 400 g/day) of non-salted vegetable and fruit without kimchi. CONCLUSIONS: Since Koreans generally consume high amounts of fermented vegetables, including kimchi, total vegetables and fruit. Consumption of these foods by the Korean adult population reached 400 g, which is the recommended intake of the WCRF/AICR. Based on this result, it is necessary to promote consumption of kimchi in the Korean population and research the development of low sodium kimchi in the future.
Adult* ; Cooking ; Eating ; Female ; Fruit* ; Health Behavior ; Humans ; Korea* ; Male ; Meals ; Nutrition Surveys* ; Portion Size ; Sodium ; Vegetables*

A 35-years-old man was hospitalized with gene-ralized edema. 6 months ago, the patient was operated by radical subtotal gastrectomy for advanced gastric adenocarcinoma. The patient presented with multiple liver metastasis and the massive proteinuria. The patients renal biopsy revealed minimal change nephrotic syndrome and treated with prednisolone and diuretics. The patient was improved clinical symptome and decreased 24 hours urine protein. In literature reviewed, gastric carcinoma was not associated with minimal change nephrotic syndrome. We experienced advanced gastric carcinoma associated with minimal change nephrotic syndrome, thus we report it.
Adenocarcinoma* ; Biopsy ; Diuretics ; Edema ; Gastrectomy ; Humans ; Liver* ; Neoplasm Metastasis* ; Nephrosis, Lipoid* ; Prednisolone ; Proteinuria

A cerebral infarction involving the nodulus usually produce contralateral lateropulsion and ipsilateral spontaneous nystagmus to the lesion. Here, we report a case of atypical isolated nodular infarction showed ipsilateral lateropulsion and contralateral spontaneous nystagmus to the lesion with a normal head impulse test. A right-handed 70-year-old man developed sudden vertigo with an unsteady gait. Neurologic examination revealed spontaneous left-beating nystagmus with a torsional component. He also displayed imbalance of walking and axial lateropulsion to the right side. Head impulse test was normal. Magnetic resonance imaging indicated acute infarction in the right nodulus on diffusion-weighted images.
Cerebral Infarction ; Gait Disorders, Neurologic ; Head ; Infarction ; Magnetic Resonance Imaging ; Neurologic Examination ; Vertigo ; Vestibular Neuronitis ; Walking

PURPOSE: To develop optimal microbubble contrast agents (MBCAs) for performing ultrasound microscopy when examining small animals. MATERIALS AND METHODS: We prepared three types of MBCAs. First, a mixture of three parts of 40% dextran and one part of 5% human serum albumin were sonicated with perfluorocarbon (PFC) (MB1-D40A5P). Second, three parts of 40% dextran and one part of 1% human serum albumin were sonicated with PFC (MB2-D40A1P). Third, all parts of 1% bovine serum albumin were sonicated with PFC (MB3-A1P). We measured the microbubbles' sizes and concentrations with using image analysis software. The acoustic properties of the microbubbles were assessed both in vitro and in vivo. RESULTS: The majority of the MB1-D40A5Ps had a diameter of 2-5 um, the mean diameter of the MB2-D40A1Ps was 2.5 um, and the mean diameter of the MB3-A1Ps was less than 2.0 um. Among the microbubbles, the MB1-D40A5Ps and MB2-D40A1Ps showed increased echogenicity in the abdominal vessels, but the duration of their contrast effect was less than 30 sec. On the contrary, the MB3-A1Ps exhibited strong enhancement in the vessels and their duration was greater than 120 sec. CONCLUSION: A microbubble contrast agent consisting of all parts of 1% serum albumin sonicated with PFC is an effective contrast agent for ultrasound microscopy.
Acoustics ; Animals ; Contrast Media* ; Dextrans ; Humans ; Microbubbles* ; Microscopy* ; Microspheres ; Serum Albumin ; Serum Albumin, Bovine ; Ultrasonography*

BACKGROUND: Spontaneous echo contrast (SEC) of the left atrium (LA) is associated with increased risk of thromboembolism in patients with mitral stenosis(MS). The determination of the presence and severity of LA spontaneous echo contrast(SEC) is of prognostic importance in these patients. Harmonic imaging(HI), a novel echocardiographic technique that differs from conventional fundamental imaging(FI) by transmitting ultrasound at one frequency and receiving at twice the transmitted frequency, produces better endocardial border definition and myocardial opacification. However, there are no data about its value on the detection of LA SEC. The purpose of this study was to investigate the utility of transthoracic noncontrast HI in the detection of LA SEC in patients with. METHODS: Seventy-four consecutive patients with MS (49 female, mean age 51) underwent standard transthoracic echocardiograms (TTE) in both HI and FI and transesophageal echocardiography (TEE) to determine the presence and severity of LA SEC. LA SEC was graded by TEE; mild if only seen at high gain, severe if visible in the entire LA at normal gain control of the equipment. Control subjects comprised of 30 patients randomly selected from patients who did not have LA SEC at TEE examination. RESULTS: Atrial fibrillation was found in 46 patients (62.2%). The mean mitral valve area and mean mitral gradient were 1.0+/-0.3cm2 and 8.2+/-4.1mmHg, respectively. Nine patients (12.2%) had episodes of systemic embolism; stroke in 8 and peripheral embolism in 1. LA thrombus was found in 11 patients (14.9%) by TEE. LA SEC was present in all but one patient by TEE (mild in 35, severe in 38 patients). FI of TTE, however, revealed LA SEC in only 5 (6.8%) of the 73 patients. In contrast, in HI, LA SEC could be detected in 63 (86.3%) of the 73 patients. In the detection of severe LA SEC, the sensitivity of FI and HI were 13.2% (5/38) and 100% (38/38), respectively. LA SEC was not observed in control subjects either by FI or HI. CONCLUSION: Transthoracic HI significantly enhances the detection of LA SEC in patients with MS.
Atrial Fibrillation ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Female ; Heart Atria ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Stroke ; Thromboembolism ; Thrombosis ; Ultrasonography

BACKGROUND: Propofol often causes pain when injected into small peripheral veins, but the pain can be minimized by using a larger vein. This study was designed to determine whether local warming of the injection site and forearm before propofol injection is effective in reducing pain. METHODS: Sixty adult patients undergoing general anesthesia for an elective surgery were randomly allocated to one of two groups. All were unpremedicated and had an 18-gauge cannula inserted into a cephalic vein on the wrist. Patients in group 1 (n = 30) received 1% propofol at room temperature. Patients in group 2 (n = 30) received 1% propofol after local warming (36-37 degrees C) of the injection site and forearm using a forced-air warming system (Bair Hugger(R)). For each patient, the pain during injection of the propofol solution was graded as none, mild, moderate, or severe. RESULTS: Overall the incidence of pain was significantly reduced in group 2 (36.7%) compared with group 1 (66.7%). No patients complained of pain at the injection site and forearm in group 2. However, there was no significant difference in the incidence or severity of pain on the elbow and axilla between the two groups. CONCLUSIONS: We found that local warming applied to the injection site (wrist) and forearm before propofol injection is significantly effective in reducing pain at the injection site and forearm, but there was no improvement of pain on the elbow and axilla when injecting.
Adult ; Anesthesia, General ; Axilla ; Catheters ; Elbow ; Forearm* ; Humans ; Incidence ; Propofol ; Veins ; Wrist

The Prader-Willi syndrome (PWS) is a rare disorder characterized by infantile hypotonia, subsequent obesity with hyperphagia. Hypogonadism, cryptorchidism, delayed psychomotor development, short status, strabismus, myopia, scoliosis, kyphosis and temperature regulation abnormality are other features. The cause of this syndrome is unknown, but a disturbance in the hypothalamus has been postulated because of the various manifestation of the syndrome. The major genetic mechanism giving rise to PWS is a paternal deletion of about the same size in the 15q11-q13 region, that occurs in 70% of the cases. The principal problems related to anesthesia are those that are secondary to the patient's hypoglycemia, skeletal muscle hypotonia and obesity. An 20-month-old boy with PWS was scheduled for surgical correction of bilateral undescended testes. The trachea was intubated with the aid of succinylcholine 7.5 mg intravenous injection. Muscle relaxation was facilitated with intermittent intravenous administration of atracurium (total dose 8 mg). No prolonged effect of muscle relaxants was observed during anaesthesia. High grade fever (38-39 degrees C) was present during anaesthesia.
Administration, Intravenous ; Anesthesia ; Atracurium ; Cryptorchidism ; Fever ; Humans ; Hyperphagia ; Hypoglycemia ; Hypogonadism ; Hypothalamus ; Infant ; Injections, Intravenous ; Kyphosis ; Male ; Muscle Hypotonia ; Muscle Relaxation ; Muscle, Skeletal ; Myopia ; Obesity ; Prader-Willi Syndrome* ; Scoliosis ; Strabismus ; Succinylcholine ; Trachea