Depression is one of most frequent psychiatric disorders in the elderly. Major depression has higher prevalence in the elderly compared with younger subjects. Depression in the elderly is a major health concern that can be life threatening, if not recognized and not treated. An untreated depression may result in needless suffering, institutionalization, and suicide. Inadequated treatment may occur because the signs and symptoms of depression in the elderly are different from those in the young, and because the depressive symptoms may be viewed by the physician as a normal part of aging. The purpose of this study is to evaluate depressive factors in the Korean elderly. Four hundred and sixty eight Koreans were evaluated for depressive factors in 60 years old or more. The author performed a clinical evaluation guide, an intensive questionnaire, and Mini-Mental Status Examination-Korean version (MMSE-K). Stastically ANOVA, Scheffe, Duncan and Chi-square methods were used to find out depressive factors in the Korean elderly. Depression, dissatisfaction, suicidal idea and distress factors were evaluated in the Korean elderly depressed persons. Depressive factors were associated with physical health problems, family problems, psychiatric health problems, loneliness, economic problems, interpersonal conflicts, and occupational problems. Among these depressive factors, physical health problems were most frequently dominant in the elderly. Physical health problems are closely related to depression in the elderly. Depressive syndromes in the elderly are frequently combined with somatic complaints. And depression may be masked by multiple somatic complaints or by pain, for which no organic cause can be found. However, the etiology and mechanism of the association between physical illness and depression are unkown. Such factors as described above may be important in reducing the high prevalence of depression in elderly people.
Aged* ; Aging ; Depression ; Depressive Disorder ; Humans ; Institutionalization ; Loneliness ; Masks ; Middle Aged ; Prevalence ; Surveys and Questionnaires ; Suicide

Depression is one of most frequent psychiatric disorders in the elderly. Major depression has higher prevalence in the elderly compared with younger subjects. Depression in the elderly is a major health concern that can be life threatening, if not recognized and not treated. An untreated depression may result in needless suffering, institutionalization, and suicide. Inadequated treatment may occur because the signs and symptoms of depression in the elderly are different from those in the young, and because the depressive symptoms may be viewed by the physician as a normal part of aging. The purpose of this study is to evaluate depressive factors in the Korean elderly. Four hundred and sixty eight Koreans were evaluated for depressive factors in 60 years old or more. The author performed a clinical evaluation guide, an intensive questionnaire, and Mini-Mental Status Examination-Korean version (MMSE-K). Stastically ANOVA, Scheffe, Duncan and Chi-square methods were used to find out depressive factors in the Korean elderly. Depression, dissatisfaction, suicidal idea and distress factors were evaluated in the Korean elderly depressed persons. Depressive factors were associated with physical health problems, family problems, psychiatric health problems, loneliness, economic problems, interpersonal conflicts, and occupational problems. Among these depressive factors, physical health problems were most frequently dominant in the elderly. Physical health problems are closely related to depression in the elderly. Depressive syndromes in the elderly are frequently combined with somatic complaints. And depression may be masked by multiple somatic complaints or by pain, for which no organic cause can be found. However, the etiology and mechanism of the association between physical illness and depression are unkown. Such factors as described above may be important in reducing the high prevalence of depression in elderly people.
Aged* ; Aging ; Depression ; Depressive Disorder ; Humans ; Institutionalization ; Loneliness ; Masks ; Middle Aged ; Prevalence ; Surveys and Questionnaires ; Suicide

PURPOSE: The purpose of this study was to identify effects of abdominal skin massage and warming therapy on the pain and anxiety to breast cancer patients who underwent hormone injections. METHODS: The subjects for the study were 60 breast cancer patients who underwent hormone injections (20 in the control group, 20 in the abdominal skin massage group, and 20 in the warming therapy group). Abdominal skin massage was conducted following KSMA's (Korea science massage association) advice and warming therapy was executed at 48 ℃ for 20 minutes. The results were checked using subjective and objective measurement tools. RESULTS: After abdominal skin massage and warming therapy, subjective (Visual Analogue Scale, VAS) and objective (facial expression and vocal change) pain scores were significantly decreased (p<.001) Also, Anxiety state was significantly decreased compared to the control group (p =.043). CONCLUSION: The results of this study indicate that abdominal skin massage and warming therapy were highly effective in alleviating pain and anxiety in patients who underwent hormone injections.
Anxiety* ; Breast Neoplasms* ; Breast* ; Humans ; Injections, Subcutaneous ; Massage* ; Skin*

Arterial blood pressure, pulse rate and rate pressure product changes following tracheal intubation were studied in 50 patients undergoing elective surgical procedures who received a thiopental-succinylcholine anesthetic intubation sequence. Three treatment groups and a control group were observed. Intravenous labetalol doses of 0.25 mg/kg, 0.5 mg/kg and 1.0 mg/kg, injected prior to anesthesia, were compared with respect to their effect on the cardiovascular sequences to direct laryngoscopy followed by the passage of an endotraeheal tube. The increases in heart rate and rate-pressure product associated with tracheal intubation were significantly prevented in labetalol treated patients, significantly. The increase in arterial pressure was prevented, insignificantly. However, it was dose-dependent. From the above result, a pre-induction dose of labetalol was effective in attenuating the pressure response to laryngoscopy and intubation.
Anesthesia ; Arterial Pressure ; Heart Rate ; Humans ; Intubation ; Intubation, Intratracheal* ; Labetalol* ; Laryngoscopy* ; Surgical Procedures, Elective

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

PURPOSE: To elucidate the characteristic gene transcription profiles among various hepatic ischemia conditions, immediately transcribed genes and the degree of ischemic injury were compared among total ischemia (TI), intermittent clamping (IC), and ischemic preconditioning (IPC). METHODS: Sprague-Dawley rats were equally divided into control (C, sham-operated), TI (ischemia for 90 minutes), IC (ischemia for 15 minutes and reperfusion for 5 minutes, repeated six times), and IPC (ischemia for 15 minutes, reperfusion for 5 minutes, and ischemia again for 90 minutes) groups. A cDNA microarray analysis was performed using hepatic tissues obtained by partial hepatectomy after occluding hepatic inflow. RESULTS: The cDNA microarray revealed the following: interleukin (IL)-1beta expression was 2-fold greater in the TI group than in the C group. In the IC group, IL-1alpha/beta expression increased by 2.5-fold, and Na+/K+ ATPase beta1 expression decreased by 2.4-fold. In the IPC group, interferon regulatory factor-1, osteoprotegerin, and retinoblastoma-1 expression increased by approximately 2-fold compared to that in the C group, but the expression of Na+/K+ ATPase beta1 decreased 3-fold. CONCLUSION: The current findings revealed characteristic gene expression profiles under various ischemic conditions. However, additional studies are needed to clarify the mechanism of protection against IPC.
Adenosine Triphosphatases ; Apoptosis ; Constriction ; Hepatectomy ; Interferon Regulatory Factor-1 ; Interleukins ; Ischemia ; Ischemic Preconditioning ; Microarray Analysis ; Necrosis ; Oligonucleotide Array Sequence Analysis ; Osteoprotegerin ; Rats, Sprague-Dawley ; Reperfusion ; Reperfusion Injury ; Transcriptome

Cardiopulmonary bypass with moderate hypothermia and hemodilution is an extremely non- physiologic state. The stress responses to cardiopulmonary bypass were evaluated in open heart surgery by measuring the change of plasma cortisol concentration. Patients were anesthetized with fentanyl 20 ug/kg, 50% nitrous oxide in oxygen and a supplementary dose of droperidol and halothane. In each case, at the onset of cardiopulmonary bypass, the hematocrit value was reduced to 25-30% and was maintained around this level during perfusion. Moderate hypothermia was induced to 28-30 degrees C (28.9+/-1.5 degrees C). Blood samples were obtained after sternotomy, at the onset of cardiopulmonary bypass, during moderate hypothermia and after cardiopulmonary bypass. Plasma cortisol concentration was measured by radioimmunoassay technique. Compared with the pre-cardiopulmonary bypass cortisol value (11.12+/-2.19 ug/dl), plasma cortisol concentration at the onset of cardiopulmonary bypass (17.39+/-5.15 ug/dl) was significantly increased (p<0,05). And during cardiopulmonary bypass, especially during the hypothermia period, the plasma cortisol concentration (19.17+/-8.09 ug/dl) was significantly increased (p<0.05). After cardiopulmonary bypass, the plasma cortisol concentration (43.0+/-11.2 ug/dl) was significantly increased when compared with other values (p<0.05). We conclueded that the significant increase of plasma cortisol concentration is secondary to the stress response to cardiopulmonry bypass.
Cardiopulmonary Bypass* ; Droperidol ; Fentanyl ; Halothane ; Hematocrit ; Hemodilution ; Humans ; Hydrocortisone* ; Hypothermia ; Nitrous Oxide ; Oxygen ; Perfusion ; Plasma* ; Radioimmunoassay ; Sternotomy ; Thoracic Surgery

Spontaneous renal allograft rupture is an uncommon complication of renal transplantation, but it represents a life-threatening emergency that requires prompt recognition and treatment. The incidence of spontaneous renal allograft rupture is variable and range between 3.6 and 9.6 percent of all transplants. In the majority of cases the rupture is associated with acute rejection episodes and with renal vein thrombosis. Most frequently, the allograft rupture occurs within the first 2 weeks of transplantation. in addition, most ruptures reported have occurred in cadaveric renal allograft. Debate on the management of such allograft salvage versus transplant nephrectomy. It appears that the recent trend is toward performing surgical repair of the graft if the rupture is secondary to rejection and oo evidence of renal vein thrombosis ; otherwise, graft nephrectomy be done. We report a case of spontaneous renal allograft rupture due to renal vein thrombosis occurred in a 21-year-old woman 6 days after transplantation. Unusual severe localized pain, swelling over at allograft site, and hypotension, a triad frequently seen in renal allograft rupture, were present. Management by graft nephrectomy was inevitable because of the patient's downhill course.
Allografts* ; Cadaver ; Emergencies ; Female ; Humans ; Hypotension ; Incidence ; Kidney Transplantation ; Nephrectomy ; Renal Veins ; Rupture ; Rupture, Spontaneous* ; Thrombosis ; Transplants ; Young Adult

OBJECTIVES: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). METHODS: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. RESULTS: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p > 0.001). CONCLUSIONS: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was 24 kg/m2 (ENT-C) rather than 23 kg/m2 (APR-C).
Aged* ; Body Mass Index* ; Body Weight ; Chronic Disease* ; Classification ; Dyslipidemias ; Entropy* ; Female ; Humans ; Hypertension ; Korea ; Logistic Models ; Nutrition Surveys ; Obesity ; Odds Ratio ; Overweight ; ROC Curve ; Sensitivity and Specificity