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

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

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*

BACKGROUND: Lymphocytic gastritis (LG) is defined as an infiltration of more than 25 intraepithelial lymphocytes (IELs) per 100 surface epithelial cells, and the histological differential diagnosis of LG and residual mucosa associated lymphoid tissue (MALT) lymphoma can be difficult. Helicobacter pylori (H. pylori) is regarded as one of the possible causes of LG, but its clinicopathologic features of LG have not been clarified in Korea, which has a much higher prevalence of H. pylori infection than Western countries. We analyzed the clinicopathologic findings of LG in Korean patients and compared the cytologic findings of IELs of LG with those of MALT lymphoma. METHODS: Sixty six cases of LG and 59 cases of MALT lymphoma were selected and clinicopathologic features were analyzed. RESULTS: Eighteen cases (27.3%) of LG were found to be associated with H. pylori infection. The IELs in LG were found to diffusely and regularly infiltrate in the epithelium, but MALT lymphoma showed patchy IELs. IELs in LG and MALT lymphoma were CD 8+T lymphocytes and CD20+B lymphocytes, respectively. The mean nuclear size of IELs in LG was 4.37 micrometer, which was significantly smaller than those in MALT lymphoma (5.19 micrometer). CONCLUSION: LG, a rare variant of chronic gastritis is partly associated with H. pylori infection and more complex unknown causative factors. In addition to the immunophenotyping, the nuclear sizes of IELs can be helpful in the differential diagnosis of LG and residual MALT lymphoma.
Diagnosis, Differential ; Epithelial Cells ; Epithelium ; Gastritis* ; Helicobacter pylori ; Humans ; Immunophenotyping ; Korea ; Lymphocytes ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Mucous Membrane ; Prevalence

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

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

No abstract available.
Endoderm* ; Endodermal Sinus Tumor*

BACKGROUND: Hypotension associated with spinal anesthesia for cesarean delivery is most common and serious adverse effect despite the use of uterine displacement and volume preload. This study evaluated the role of ephedrine and fluid preload for prevention of hypotension during spinal anesthesia. METHODS: Sixty healthy women undergoing elective cesarean delivery under spinal anesthesia at term were allocated randomly to receive ephedrine 10microgram/kg/min followed by 4 mg bolus IV (E group, n = 20); ephedrine 10microgram/kg/min followed by 4 mg bolus IV and rapid administration of 500 ml hydroxyethyl starch solution (EH group, n = 20); and ephedrine 10microgram/kg/min followed by 4 mg bolus IV and rapid administration of 500 ml lactated Ringers solution (ER group, n = 20). Heart rate, blood pressure, hypotension incidence, and total ephedrine administration were checked after spinal anesthesia. Umbilical blood gas analysis and APGAR score were checked after delivery. RESULTS: Maternal blood pressure, maternal heart rate, APGAR score were similar in three groups. But umbilical blood PaO2 and PvO2 is significantly low in hypotensive group than normotensive group (P <0.05). CONCLUSION: The results of the present study support the intravenous administration of ephedrine (4 mg bolus with 10microgram/kg/min) with or without 500 ml colloid or crystalloid infusion is not effective for blood pressure maintenance. Once the maternal hypotension induces the umbilical blood low oxygen tension, it is necessary for anesthesiologists to concentrate more on the maintenance of the blood pressure.
Administration, Intravenous ; Anesthesia, Spinal* ; Apgar Score ; Blood Gas Analysis ; Blood Pressure ; Colloids ; Ephedrine* ; Female ; Heart Rate ; Humans ; Hypotension* ; Incidence ; Oxygen ; Starch

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