The 26 year old male with the hypertrophic cardiomyopathy confirmed by M-mode and 2-D echocardiography is reported with the review of the literatures.
Adult ; Cardiomyopathy, Hypertrophic* ; Echocardiography ; Humans ; Male

Rapid growth of the population of persons 65 years of age and older in Korea is projected to reach 7.1% of the total population by the year 2,000, and more than 13% by 2,020. Prevalence data for demented persons among the elderly vary, ranging from 7% to 10% of the population. Thus, the number of demented elderly will be about total 280,000 by the year 2,000. Most of the caring needs of the demented elderly have been fulfilled by female family members of the household, especially daughters-in-law. Recently women tend to engaged in social and job activities, and accordingly, caring for the demented elderly by the female family member will decrease, and caring for them by professional carers will increase. For setting desirable health care delivery systems for the elderly dementia, the authors presented four points that need to be considered. First, nationwide epidemiological studies for the prevalence of dementia are needed. The informations from epidemiology help give a more complete picture of the appropriate and accurate estimation of residential care facility for the dementia elderly. Second, programs for the care for, and management of patients with dementia in community settings are needed. More than two thirds of the dementia patients are mildly to moderately impaired in severity that can be managed in community setting. Third, organizations that perform diagnosis, evaluation and management of dementia, and organize comprehensive services for dementia patients is needed in community in which they live. Pre-existing organizations such as health center, or community mental health center, or new organization may be considered. Fourth, centers that play a role in educating dementia-related personnel, making and evaluating of programs for the management of dementia every year is needed. A central center should be placed in every province, and it should be connected to one another functionally.
Aged ; Caregivers ; Delivery of Health Care* ; Dementia* ; Diagnosis ; Epidemiology ; Family Characteristics ; Female ; Humans ; Korea* ; Mental Health ; Prevalence

Development of a malignant tumor within a mature cystic teratoma is a serious event, and occurs in about 1%~4% of cases. The malignant transformation occurs most frequently in the squamous epithelium with the formation of a squamous cell carcinoma. There are 10 cases reported in the literature, in Korea. We report 4 additional cases, which include 3 squamous cell carcinomas and 1 adenosquamous carcinomas, arising in cystic teratoma of the ovary.

Many investigators have reported that collagen gel contraction reflects the mechanism of wound contraction. In 1995, Tsai et al. reported that hypertrophic scar-derived fibroblasts in a connective tissue model possessed the greatest contraction potency when compared with those of normal skin and normal oral mucosa-derived CTMs. In this study, we studied the effect of collagen gel contraction by growth factors such as epidermal growth factor, platelet-derived growth factor, transforming growth factor-bata1, and transforming growth factor-bata3, Skin fibroblasts used in this study were obtained from the explant of rat skin culture. Fibroblasts were cultured in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum. Growth factors were added per FPCL in the desired concentrations and we measured the collagen gel diameters in growth factor-treated FPCL on day 1,2,3, and 4 respectively after starting incubation. We examined the effects of EGF, PDGF, TGF-bata1, TGF-bata3 and the effects of combinations of TGF-bata1 + EGF, TGF-bata1 + PDGF, and TGF-bata1 + TGF-bata3 to contract a collagen gel. EGF has little influence on collagen gel contraction. TGF-bata1 and TGF-bata3 increase the collagen contraction. TGF-bata1 enhanced the contractility of collagen gel according to the concentrations. While TGF-bata3 alone had stimulatory contraction effects at low dose, high doses of TGF-bata3 decreased the potency of collagen gel contraction. A combination of TGF-bata1 and EGF minimally decrease TGF-bata1 activity. A combination of TGF-bata1and PDGF had an effect similar to TGF-bata1 activity. A combination of TGF-bata1 and TGF-bata3 decreased TGF-bata1 activity. According to reports that FPCL contraction is equivalent to the process of wound contraction, growth factors which enhance gel contraction may be related to wound contraction and wound healing. TGF-bata1 is reported to enhance scar formation in fetal wound. EGF accelerates wound healing and inhibits the promotion of hypertrophic scar formation. Compared to the effect of collagen gel contraction in this study, the combination of TGF-bata1 and TGF-bata3 that inhibited the promotion of collagen gel contraction are thought to diminish the formation of scar tissue. As well, EGF that has not enhanced collagen gel contraction is thought to diminish the production of scar tissue. We will study the interactive effects of TGF-bata3, EGF and TGF-bata1 on the contraction of collagen gels in the future.
Animals ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen* ; Connective Tissue ; Epidermal Growth Factor ; Fibroblasts ; Gels ; Humans ; Intercellular Signaling Peptides and Proteins* ; Platelet-Derived Growth Factor ; Rats ; Research Personnel ; Skin ; Wound Healing ; Wounds and Injuries*

Objectives: There was no previous report about the electrical cardioversion for the patients with atrial fibrillation after successful percutaneous ballon mitral valvuloplasty (PBMV). We performed electrical cardioversion after PBMV to evaluate the effectiveness of this procedure in the view of conversion to and maintenance of the sinus rhythm. METHODS: 28 patients who had persistent atrial fibrillation after successful PBMV were included in this study. All patients were anticoagulated with warfarin. Amiodarone was loaded and maintained before cardioversion. The PBMV procedures were guided by transesophageal echocardiography in all patients. Transthoracic echocardiography was done before and after PBMV and cardioversion, and was followed. RESULTS: The number of patients were 28 (male 9 and female 19) within the mean age of 50.3+/-12.0 years (24-66). Initially 24 patients (86%) succeeded in electrical cardioversion. The energy required for successful conversion was 230+/-75J, on average. There were no complications except for the transient sinus bradycardia in 2 cases. The mean follow-up duration was 357+/-144 days and when followed-up, the sinus rhythm was maintained in 15 patients out of 24 with initial success (63%). No factor was significantly related to the success of cardioversion, but left atrial dimension after 1 month of PBMV was significantly related to the maintenance of the sinus rhythm. CONCLUSIONS: This study suggests that electrical cardioversion of atrial fibrillation after successful PBMV is favorable and recommendable treatment modality of chronic valvular atrial fibrillation with high conversion rate (88%) and good maintenance rate (63%).
Amiodarone ; Atrial Fibrillation* ; Bradycardia ; Echocardiography ; Echocardiography, Transesophageal ; Electric Countershock* ; Female ; Follow-Up Studies ; Humans ; Warfarin

Wear of polyethylene liner and osteolysis appear to be topical problems after long-term follow-up in total hip arthroplasty(THA). Age and activity of patients, manufacturing procedure of polyethylene liner, thickness of the liner, position of acetabular cup, and material of artificial femoral head have of effects on the degree of wear. In addition, conformity, congruency and micromotion between liner and metal cup are likely to be related to the wear. The purpose of this study is 1) to determine the stress caused by contact between metal and polyethylene components, 2) to evaluate the effects of conformity, congruency, and fixation between metal and polyethylene components, on contact stress in acetabular cups and 3) to identify the design parameters of the commercial acetabular cup within the constraints imposed by the overall functional requirements of total joint replacement. The specimens applied to six different commercial cups made in five companies. The methods was performed on dynamic test and static test to rely on load conditions, estimated the gap between the components through LM. The results showed H-G II cup had the most excellent congruency because of the narrowest interval between two components.
Acetabulum ; Head ; Hip ; Humans ; Joints ; Osteolysis ; Polyethylene*

OBJECT: This study was aimed to find the contributing factors that influence the length of stay in mental health related facilities and to present future direction for the mental health policy. METHODS: The 1,875 patients who are aged between eighteen and sixty-five are chosen by the stratified random sampling from ten psychiatric hospitals, six psychiatric nursing facilities and five homeless asylums. We investigate about length of stay of all subjects by sociodemographic characteristics, socioeconomic status, functional status, disease related characteristics and analyse contributing factors. RESULTS: From total subjects, average length of stay was 1,906 days, and facilities, where subjects are institutionalized, explains 40% of length of stay. Other related factors are female, old age, single, lack of supportive system before admission and after discharge, medical assistance type I, unavailable of public transportation and utility, long duration of illness, and psychotic disorder. CONCLUSION: For lowering the rate of long-term hospitalization, evaluation of appropriateness is needed for admission to nursing facility and homeless asylum and make up for the medical payment system and the supportive system from family and community.
Female ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Length of Stay* ; Medical Assistance ; Mental Health ; Nursing ; Psychiatric Nursing ; Psychotic Disorders ; Social Class ; Transportation

OBJECTIVES: The aims of this study were 1) to estimate prevalence rates of drinkers, two subtypes of drinkers-drinkers without dependence and drinkers with probable alcohol dependence(AD) using CAGE, and 2) to find out the correlates of sociodemographic variables and drinking patterns of the drinkers with probable AD by comparing those of the drinkers without dependence, 3) to analyse risk factors for the drinkers with probable AD. METHODS: Using data from face-to-face interviews conducted during 1995, we investigated the prevalence and characteristics of two subtypes of drinkers in a national probability sample of 1,695 drinkers 20 years of age and older. We defined drinkers with CAGE scores 2 and over as drinkers with probable AD, and scores less than 1 as drinkers without dependence. The comparisons of sociodemographic characteristics and drinking patterns between two subtypes of drinkers were examined through chi-square test using weighted data. Statistical analysis including multiple logistic regression analysis were done for each sex, respectively. Because of the large number of coefficients estimated, Bonferroni's method was used to compute p values. RESULTS: The results were as follows: 1) Prevalence of the drinkers was 33.7% in the total sample. Prevalence rate of male and female drinker were 26.3% and 7.40%, respectively. Prevalence of the drinkers with probable AD was 10.9%. For males the prevalence of the drinkers with probable AD was 9.99% and for females 0.94%. 2) According to sociodemographic variables between drinkers without dependence and drinkers with probable AD, males drinkers with probable AD were older, less educated, more depressive, married marital status and were more likely to have occupations of service section than male drinkers without dependence. Female drinkers with probable AD were less educated, more depressive and had less monthly income than drinkers without dependence. 3) As for the drinking patterns, male drinkers with probable AD drank more frequently, had more drinks, had more trying to quit drinking and preferred Soju. Female drinkers with probable AD drank more frequently, had more drinks, were more trying to quit drinking, too. 4) Multiple logistic regression analysis showed that the risk factors for male drinkers with probable AD were lower education(< or =6 years) and depressive symptoms. For females, depressive symptoms and lower education(< or =6 years) were strongly indicative of risk factors though not reaching the statistical significance. CONCLUSIONS: Prevalence of the drinkers with probable AD was 10.9%, and male to female ratio was 10.6:1, which was lower than previous results. Depressive symptoms and lower education proved to be strong predictors for alcohol dependence. This suggest that early detection and treatment of depression and public education for the lower education group should be important.
Adult* ; Alcoholism* ; Depression ; Drinking ; Education ; Female ; Humans ; Logistic Models ; Male ; Marital Status ; Occupations ; Prevalence ; Risk Factors* ; Sampling Studies*

This study investigated the patterns of alcohol disorder comorbidity with other psychiatric disorders, using Korean nationwide epidemiological data. By two-stage cluster sampling, 5,176 adult household residents of Korea were interviewed using the Korean version of the Diagnostic Interview Schedule. Psychiatric disorders strongly associated with alcohol disorders were, other drug abuse or dependence, major depression, simple phobia, antisocial personality disorder, tobacco dependence, and pathological gambling. Male alcoholics had a tendency to begin with tobacco dependence, and some male pathological gamblers first had alcohol disorders. The presence of comorbid psychiatric disorders was associated with a more severe form and the later onset of alcohol disorders, and associated with help-seeking for alcohol abuse/dependence.
Adolescent ; Adult ; Age of Onset ; Aged ; Alcohol-Induced Disorders/*epidemiology/physiopathology/psychology ; Alcoholism/*epidemiology/physiopathology/psychology ; Cluster Analysis ; Comorbidity ; Female ; Humans ; Interviews as Topic ; Male ; Mental Disorders/*epidemiology/physiopathology ; Middle Aged ; Patient Acceptance of Health Care ; Time Factors

OBJECTIVE: The purpose of the present study was to investigate the association between Body Mass Index, suicide, perceived stress, and life dissatisfaction in a general population sample of Korean adults. METHODS: A total of 6,022 nationally representative adults aged 18 to 74 were selected using a multistage cross-sectional cluster sampling method. Questionnaires regarding suicide behaviors, perceived stress, and life satisfaction were completed by the participants. They also reported their heights and weights, which were used to calculate BMI. Psychiatric disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using the Korean version of the Composite International Diagnostic Interview. RESULTS: The results showed that being underweight was associated with higher risk for suicide ideation [odds ratio (OR), 1.6; 95% confidence interval (Cl), 1.18–2.05] and suicide attempt (OR, 2.0, 95% Cl, 1.23–3.31). Likewise, obesity also increased the risk of suicide ideation (OR, 1.3; 95% Cl, 1.11–1.56) although not suicide attempt. Furthermore, underweight individuals were more likely to report severe level of perceived stress (OR, 1.7; 95% Cl, 1.26–2.17) and life dissatisfaction (OR, 1.3; 95% Cl, 1.07–1.68). All of the results remained significant after adjusting for age, gender, education, and psychiatric illnesses. CONCLUSION: This study found that being underweight is a significant risk factor for suicide and poor subjective wellbeing in Korea. It suggests that BMI status may be an important modifiable factor for improving mental health in Korea.
Adult ; Body Mass Index* ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Korea ; Mental Health ; Methods ; Obesity ; Risk Factors ; Suicide* ; Thinness ; Weights and Measures