OBJECTIVES: This study was performed to investigate the relationship between age of onset in late-life depression and T2 hyperintensities observed in the brain MRI, we tried to see part of pathophysiology of late-life depression. METHOD: The subjects consisted of 18 patients whose first depressive episode occurred before age 50, and 20 patients whose first depressive episode occurred after age 50 years, and 20 agematched controls. Depressive patients were diagnosed according to DSM-IV. Established hyperintensity rating systems were used to analyse the T2 weighted images and blood pressure, cholesterol level, DM, EKG were measured to compare the relationships. RESULTS: 1) Signal hyperintensities on T2 weighted image were more severe in late-life depressive patients whose first depressive episode after age 50 (p<0.05) and there is no significant difference between patients whose first episode before age 50 and age-matched control subjects. 2) Mild signal hyperintensities were observed in all elderly depressed patients and control subjects, but severe hyperintensities were observed in late-onset depression. 3) Signal hyperintensities were related to age, hypertension, blood cholesterol level (p<0.05). CONCLUSION: The late onset depressive patients had more white matter hyperintensities on T2 weighted image than early onset depressive patients. this results support previous hypothesis that white matter change is the important biological factor of late-onset elderly depression and old age, hypertension, hypercholesterolemia may be associated with signal hyperintensities.
Age of Onset ; Aged ; Biological Factors ; Blood Pressure ; Brain* ; Cholesterol ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Humans ; Hypercholesterolemia ; Hypertension ; Magnetic Resonance Imaging*

Systemic lupus erythematosus is a connective tissue disease which can affect every organ system. Neurologic abnormalities are common, occuring in approximately half of all patients at some time during the course of their illness. But symptoms of nervous system as the sole presenting symptoms occur in less than 1% of lupus patients. In patients initially presenting with neurologic symptoms and signs, differential diagnosis is difficult and sometimes it may be misdiagnosed. Therefore extensive laboratory investigations should be carried out in all patients with unusual neurological symptoms, since early diagnosis of lupus can help in providing effective treatment. We report a patient with systemic lupus erythematosus who presented with dysarthria and dysphagia resembling multiple sclerosis.
Connective Tissue Diseases ; Deglutition Disorders ; Diagnosis, Differential ; Dysarthria ; Early Diagnosis ; Humans ; Lupus Erythematosus, Systemic* ; Multiple Sclerosis* ; Nervous System ; Neurologic Manifestations

This study was performed to investigate the knowledge and attitude of workers in small scale industries on health management, and to provide the basic data for more effective service by the group occupational health service system. The knowledge and attitude of 247 workers and 46 health personnel in the industries scattered around Incheon were investigated from December 1992 to February 1993. The results were summarized as follows; 1. There were significant differences between the workers and the health personnel by age, sex, marriage status, job-position and education level. 2. The recognition level of the workers to contract work related disease was significantly higher than that of health personnel, and recognition level of the workers on environmental hazards and on the utility of measuring hazards were lower than that of health personnel. 3. The recognition level on the content of the group occupational health service system was significantly different between workers and health personnel, 72.6% of the responses from the workers answered that they did not know what the group occupational health service system was, but 82.2% of the responses from the health personnel answered that they knew well what it was. And 79.0% of all respondents thought it was necessary for worker's health. 4. seventy three percent of the respondents from the workers indicated that they had never taken health education. However, 93.0% of all respondents answered positively for the need of health education to promote their health. 5. current health service system was judged to be insufficient for the demand of workers for better health. Most of the respondents prefered a formal but flexible health service system and they wanted the periodic health examination to be followed up. It was revealed that despite of poor knowledge, the demand of workers for health service was higher than the current supply. Therefore, this study suggests that educating both health personnel and workers to obtain correct knowledge on the hazards to work environment and health management is needed for effective occupational health service.
Surveys and Questionnaires ; Education ; Health Education ; Health Personnel* ; Health Services ; Humans ; Incheon ; Marriage ; Occupational Health Services

A fifty-eight years old male patient was given general anesthesia for the clipping of aneurysm on the posterior communicating artery. The respiration of the patient was controlled with Ohmeda 7000 anesthesia ventilator. During the surgery there appeared curare cleft on the capnogram which did not disappear after the administration of neuromuscular blocker, but disappeared after the change of the anesthesia ventilator with another one. After that another curare cleft was made by the transient obstruction of the outlet of the excess patient circuit gas of the new anesthesia ventilator. It may be said that inappropriately functioning pop-off valve of the anesthesia ventilator can be one of the causes of curare cleft on the capnogram.
Anesthesia ; Anesthesia, General ; Aneurysm ; Arteries ; Curare* ; Humans ; Male ; Neuromuscular Blockade ; Respiration ; Ventilators, Mechanical

To evaluate the surgical results, the author made a clinical analysis on 70 patients of postmeningitic hydrocephalus who had been treated surgically. And the results were summarized as follows. 1) The tuberculous meningitis was the most common type causing the postmeningitic hydrocephalus(72.9%). 2) Among 70 patients, 51 were male and 19 were female. About 40% of cases were under 5 years old. 3) The most common clinical symptom was vomiting(67%). Headache, fever and generalized seizure were symptoms in order of frequency. Neurological sings represented neck stiffness, cranial nerve palsy and motor weakness. 4) The most common clinical condition on admission was stage 3 (advanced cases with unconciousness and severe neurological deficits). 5) The spinal fluid analysis showed more abnormal findings comparing to the ventricular fluid. But ventricular pressure was higher than spinal fluid pressure. 6) Plain skull x-rays, carotid angiograms were useful diagnostic methods but CT brain scan was though to be the most accurate, noninvasive method which showed size of ventricle and effectiveness of shunting procedures with Evans'ratio. In enhanced CT brain scans, the basal cistern enhancement was the most common finding beside ventricular enlargement (64.1%). 7) Ventriculoperitoneal shunting was the most common procedure in this series. 8) The initial revision rate was 12/70(19%) and the most of the revision was performed within 6 months after the initial shunting. 9) The revision rate in relation to shunting system and cerebrospinal fluid finding was not statistically significant. 10) The most common cause of the shunt malfuntion was obstruction of the ventricular catheter. 11) Forty one patients(58.6%) showed favorable outcome. The motality rate was 14/70(20%) and they were all belong to the stage 3. About half of the patients in stage 2 and stage 3 showed dramatic improvement after early shunting procedures. So the timing of operation was the most important factor influencing their outcome.
Brain ; Catheters ; Cerebrospinal Fluid ; Cerebrospinal Fluid Pressure ; Child, Preschool ; Cranial Nerve Diseases ; Female ; Fever ; Headache ; Humans ; Hydrocephalus* ; Male ; Neck ; Seizures ; Skull ; Tuberculosis, Meningeal ; Ventricular Pressure ; Ventriculoperitoneal Shunt

Esophageal perforation is a rare disease, which require emergent diagnosis and therapeutic procedure. In this paper, we present one case of esophageal perforation by traction of toothbrush which was swallowed during pharyngeal irritation. After the toothbrush was inserted to stomach by gastroscope, gastrostomy was performed for removal of toothbrush and the esophageal perforation was repaired by operation.
Diagnosis ; Esophageal Perforation* ; Gastroscopes ; Gastrostomy ; Rare Diseases ; Stomach ; Traction

We analyzed ERCP findings of 15 patients with clonorchiasis, that were confirmed by stool examination and operation from May, 1976 to September, 1980. The results were as follows. 1) Filling defects due to adult worm of clonorchis sinensis were significant direct findings of clonorchiasis. 2) Irregular stenosis, fuzziness, raggedness, peripheral dilation and disturbance of peripheral filling of intrahepatic bile ducts were significant indirect findings of clonorchiasis. 3) ERCP was excellent method to evaluate biliary tree in patients with clonorchiasis, who showed obstructive jaundice.
Adult ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Clonorchiasis* ; Clonorchis sinensis ; Constriction, Pathologic ; Humans ; Jaundice, Obstructive

A 25 year old male was admitted for the reduction of right side mandible fracture. The patient was injured during a fight with someone under the influence of liquor. Nine days after the halothane anesthesia, the patient began to suffer from acute hepatitis with symptoms of fever, diarrhea, nausea, vomiting, and jaundice. The patient was cared for at the department of internal medicine and discharged after 49 day's hospitalization. The exact causes of the acute hepatitis were still unknown.
Adult ; Anesthesia ; Anesthesia, General* ; Diarrhea ; Fever ; Halothane* ; Hepatitis* ; Hospitalization ; Humans ; Internal Medicine ; Jaundice ; Male ; Mandible ; Nausea ; Vomiting

OBJECTIVES: Auditory verbal hallucination (AVH) is knoun for its high prevalence and difficulty in evaluation. Authors hypothesized that it may be possible to find useful dimensions of AVH that reflect the clinical status of schizophrenic patients by assessing the multi-dimensional changes and linguistic forms' of AVH during antipsychotic treatment. METHODS: 33 schizophrenic patients with AVH were selected and periodically assessed with the 11 items of hallucinations subscale of 'The Psychotic Symptom Rating Scales (PSYRATS)'. In addition, to assess the linguistic forms observed in the AVH, the evaluations of sentence structure of AVH reported by the patients were conducted. RESULTS: PSYRATS showed the multidimensionality inherent in AVH. The changes in the quantitative dimensions did not correlate well with patients' subjective distress. However, qualitative changes in the cognitive and emotional dimensions showed more favorable correlation with clinical course of the patient. The sentence structures of AVH showed tendency to change from "sentence" to "non-sentence" type with overall improvement during treatment. CONCLUSION: Multi-dimensional approach to AVH can give us more information about the changing patterns of multi-faceted structure of AVH and clinical status of patients than one-dimensional or categorical approach.
Hallucinations* ; Humans ; Linguistics ; Prevalence ; Weights and Measures

OBJECTIVES: Auditory verbal hallucination (AVH) is knoun for its high prevalence and difficulty in evaluation. Authors hypothesized that it may be possible to find useful dimensions of AVH that reflect the clinical status of schizophrenic patients by assessing the multi-dimensional changes and linguistic forms' of AVH during antipsychotic treatment. METHODS: 33 schizophrenic patients with AVH were selected and periodically assessed with the 11 items of hallucinations subscale of 'The Psychotic Symptom Rating Scales (PSYRATS)'. In addition, to assess the linguistic forms observed in the AVH, the evaluations of sentence structure of AVH reported by the patients were conducted. RESULTS: PSYRATS showed the multidimensionality inherent in AVH. The changes in the quantitative dimensions did not correlate well with patients' subjective distress. However, qualitative changes in the cognitive and emotional dimensions showed more favorable correlation with clinical course of the patient. The sentence structures of AVH showed tendency to change from "sentence" to "non-sentence" type with overall improvement during treatment. CONCLUSION: Multi-dimensional approach to AVH can give us more information about the changing patterns of multi-faceted structure of AVH and clinical status of patients than one-dimensional or categorical approach.
Hallucinations* ; Humans ; Linguistics ; Prevalence ; Weights and Measures