OBJECTIVE: This research aimed to define the usefulness of the computerized neuropsychological test (CNT) for evaluation of cognitive deficit in the patients with brain injury. METHOD: Twenty five subjects with brain injury (16 males, 9 females) were enrolled. Their mean age was 39.2 years. All patient were assessed their cognitive function using CNT. The CNT consisted of digit span, verbal learning test, visual span test, visual learning test, auditory continuous performance test, auditory controlled continuous performance test, visual continuous performance test, visual controlled continuous performance test, word-color test, hypothesis formation test and trail making test. Scores of each subtest on CNT analysed according to the brain lesion and involved hemisphere of the patients. RESULTS: In patients with left hemisphere lesion, scores in digit span and verbal-learning test were lower than that of right side lesion (p<0.05). In contrast, patients with right hemisphere lesion showed significantly lower scores in visual span and visual-learning test (p<0.05). The patients with frontal lobe lesion marked lower scores in verbal-learning and word-color test than the patients without frontal lesion (p<0.01). Whereas the patients with parietal lobe lesion showed significantly lower scores in visual learning test (p<0.05) than the patients without parietal lesion. CONCLUSION: The cognitive deficit following the brain lesion could be characterized using CNT. CNT is considered to be used as a useful tool in the patients with brain injury for the assessment of their cognitive function.
Brain Injuries* ; Brain* ; Frontal Lobe ; Humans ; Learning ; Male ; Neuropsychological Tests* ; Parietal Lobe ; Rabeprazole ; Trail Making Test ; Verbal Learning

No abstract available.
Pyelonephritis*

BACKGROUND: Ketamine and dexmedetomidine are commonly used for sedation and analgesia in patients. We tried to compare the effects of intravenous ketamine and dexmedetomidine infusion on spinal block with bupivacaine. METHODS: Ninety American Society of Anesthesiologists physical status class I or II patients, who were scheduled to spinal anesthesia were randomly assigned to one of three groups (n = 30). Normal saline 10 ml, 5 ml/hr (loading dose for 10 minutes, infusion) (Group NS), dexmedetomidine 1 microg/kg, 0.5 microg/kg/hr (Group DEX), or ketamine 0.2 mg/kg, 0.5 mg/kg/hr (Group KET) was infused intravenously before spinal anesthesia. We recorded the time to highest sensory block level, sensory and motor regression, and hemodynamic changes. RESULTS: Patients in Groups KET had a significantly faster onset time of sensory block than patients in Group NS. The highest sensory block levels were not significantly different between groups. Average time of sensory regression and knee flexion, was significantly longer in the Group KET and Group DEX than the Group NS. CONCLUSIONS: Intravenous dexmedetomidine and ketamine were found to have a similar synergistic effect with intrathecal bupivacaine. Hemodynamic stability showed better results in Group KET.
Analgesia ; Anesthesia, Spinal ; Bupivacaine* ; Dexmedetomidine* ; Hemodynamics ; Humans ; Ketamine* ; Knee

OBJECTIVES: Protein-calorie malnutrition is a common problem in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Serum albumin(SA) concentration has been used as a marker for assessing nutritional status. Hypoalbuminemia has been linked to an increased risk of morbidity and mortality and more numerous, prolonged hospitalization for peritoneal dialysis patients. The aim of this study was to determine factors affecting SA value in CAPD patients. METHODS: We performed a cross-sectional study which included patients' demographics, anthropometric data, biochemical parameters, urea kinetic data and comorbidity in 106 stable CAPD patients. RESULTS: 1) There were 50 men and 56 women with a mean CAPD duration of 43 months and mean age of 49 years. The mean concentration of SA was 3.9+/-0.5 (range 2.5-5.3) g/dl and weekly Kt/Vurea 2.0+/-0.4 (range 1.32-3.79) 2) Twenty-one patients(20%) were classified as group I(SA<3.5g/dl)and the remaining patients(80%) as group II(SA 3.5g/dl) 3) Group I patients were significantly older(55+/-11 vs 47+/-11 years, p<0.05) and had significantly higher comorbidity score(1.5+/-0.8 vs 0.7+/-0.9, p<0.05), C-reactive protein (4.5+/-0.9 vs 0.5+/-0.1 mg/dl, p<0.05), 24-hr dialysate-toplasma creatinine(D/PCr) ratio(0.84+/-0.1 vs 0.76+/-0.1, p<0.05), 24-hr dialysate protein (7167+/-2031 vs 5471+/-1515 mg, p<0.05) and had significantly lower residual renal function(RRF)(0.2+/-0.3 vs 0.7+/-1.2 ml/min, p<0.05), BUN(48+/-14.8 vs 55.6+/-14.9 mg/dl, p<0.05), serum creatinine(10.4+/-2.8 vs 12.6+/-3.5 mg/dl, p<0.05), IGF-1(186+/-99 vs 260+/-131 ng/ml, p<0.05), serum phosphorus(4.1+/-1.2 vs 5.0+/-1.3 mg /dl, p<0.05) than group II.4) SA showed positive correlation with anion gap (r=0.43, p value=0.001), transferrin(r=0.41, p value= 0.001) phosphorus(r=0.31, p value=0.001) and negative correlation with 24-hr dialysate protein loss(r=-0.51, p value=0.001), 24-hr D/PCr ratio(r=-0.49, p value=0.001), comorbidity score(r=-0.36, p vluue=0.001). NPCR(r=0.22, p value=0.023), IGF-1(r=0.30, p value=0.002), BUN(r=0.23, p value=0.016) weakly correlated with SA.5) By stepwise multiple logistic regression analysis, age, CRP, 24-hr D/PCr ratio and RRF independently influenced SA level. CONCLUSION: SA level seems to be affected by non-nutritional factors such as age, peritoneal membrane transport characteristics, residual renal function and presence of acute phase protein response manifested by CRP elevation, in addition to nutritional factors.
Acid-Base Equilibrium ; Acute-Phase Proteins ; C-Reactive Protein ; Comorbidity ; Cross-Sectional Studies ; Demography ; Female ; Hospitalization ; Humans ; Hypoalbuminemia ; Logistic Models ; Male ; Membranes ; Mortality ; Nutritional Status ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Protein-Energy Malnutrition ; Serum Albumin* ; Urea

OBJECTIVES: Primary IgA nephropathy is the most common type of glomerulonephritis, which may progress to end stage renal failure in about 30-35% of the cases. The incidence of recurrence of IgA nephropathy in transplanted kidney is approximately 50-60% but IgA nephropathy which is recurred in graft has relatively benign clinical course so the rate of graft loss due to recurrent IgA nephropathy is about 10%. Overall graft survival rate of IgA nephropathy is higher than other glomerular disorders which cause end stage renal disease according to recent clinical studies. However accurate causative disorders of end stage renal failure had seldom been reported by pathologic examination and accurate graft survival rate and recurrence rate of original disease after renal transplantation couldn't be investigated. We performed analysis of clinical outcome and prognosis for IgA group. METHODS: 1259 cases of kidney transplantation were performed in the Severance hospital between Apr 1979 and Dec.1994. We selected 178 cases of those who got renal biopsy and excluded the cases of cadaveric transplants, hepatitis B antigen carrier, diabetes mellitus and not taking cyclosporine A. 178 cases of those were divided into two groups, IgA and nonIgA group. We performed analysis of 5 year graft and patient survival rate between two groups. The IgA group was divided into two group, recurrent and not-recurrent IgA group. We also performed analysis of recurrence rate and graft survival rate between two groups. RESULTS: 1) 62 cases(35.2M) were IgA group and 116 cases were non-IgA group. 2) Male to female ratio of IgA group was 2.9:1, whose age averaged 35 years old. 3) Among 6 cases of the IgA group, 3 cases lost their graft due to chronic rejection, 2 cases due to recurrence and 1 case due to acute rejection. 4) The 5 year graft survival rate of IgA and nonIgA group were 85%, 90% each without statistical significance(p>0.05). The 5 year patient survival rate of IgA and nonlgA group after renal allograft were 100%, 97% each without statistical significance(p>0.05). 5) 266 cases of posttransplant kidney biopsies were performed and 10 cases were diagnosed as recurrent IgA nephropathy with recurrence rate of 15%. 6) Renal insufficiency was noted in 4 cases of recurrent IgA nephropathy, 2 cases of those were chronic renal failure and the other 2 cases lost their graft. The histologic findings of these cases included mesangial widening and proliferation(4 cases), glomerulosclerosis(2 cases), crescent formation(1 cases). 7) The interval between transplantation and recurrence averaged 41 months. 24hr proteinuria and serum level of creatinine at the time of diagnosis averaged 2.6g and 2.2 mg/dl each. 8) Male to female ratio, age, HLA type and degree of HLA match showed no significant difference between nonrecurrent and recurrent IgA group in graft but 5 year graft survival rate of recurrent IgA group was lower than nonrecurrent group with statistical significance(71% vs 83%, p<0.05). CONCLUSION: Recurrent IgA nephropathy in transplanted kidney might be one of major cause of graft loss with chronic rejection. However precise pathologic examination of before k after transplantation on larger patient population and more long term follow-up are advised.
Adult ; Allografts ; Biopsy ; Cadaver ; Creatinine ; Cyclosporine ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Graft Survival ; Hepatitis B ; Humans ; Immunoglobulin A* ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Male ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Survival Rate ; Transplants

BACKGROUND AND OBJECTIVES: Adenoidectomy is one of the most common procedures in the field of otolaryngology, and various hemostatic agents and techniques have been used for stanching the wound of adenoidectomy site. The aim of this study is to evaluate the hemostatic efficacy of topical application of cold hydrogen peroxide in adenoidectomy. MATERIALS AND METHOD: We randomly divided 120 candidates (aged 3-14 years) for adenoidectomy into 4 groups, and 3% hydrogen peroxide (3+/-2degrees C), 3% hydrogen peroxide (20+/-2degrees C), 0.05% epinephrine solution (3+/-2degrees C) and 0.05% epinephrine solution (20+/-2degrees C) were applied topically to each group respectively. The time consumed for bleeding control, and the hemostatic findings of adenoidectomy wound at 5 minutes after curretage, 6 hours after operation of each group were compared. RESULTS: The use of cold hydrogen peroxide significantly reduced intraoperative time when compared with uisng other hemostatic agents. And in the adenoidectomy site, it is found that the incidence of oozing and active bleeding decreased when cold hydrogen was applied. CONCLUSION: Cold hydrogen peroxide is a useful agent for hemostasis in adenoidectomy.
Adenoidectomy* ; Epinephrine ; Hemorrhage ; Hemostasis ; Hemostatics ; Hydrogen Peroxide* ; Hydrogen* ; Incidence ; Otolaryngology ; Wounds and Injuries

OBJECTIVE: To develope the computer-assisted memory rehabilitation programs and to assess the effect of these programs in the patients with brain injury. METHOD: Ten memory training programs, which included verbal/non-verbal, sequential/ non-sequential, and visual/auditory memory properties were designed and converted to the computer program using C-language. The training program included various aspects of memory such as spatial memory, sequential verbal and nonverbal recall, associated recall, categorical memory, and integrated semantic memory. Each program used familiar pictures and sounds in our living situation to give the patients comfortable feelings and interests. Seven patients with brain injury were trained using the computer-assisted memory program 3 times per week for 4 weeks. All patients were assessed their cognitive function using Seoul Computerized Neuropsychological Test (Maxmedica) before and 1 month after the treatment. RESULTS: Ten computer-associated memory training programs using C-language were successfully developed. The patients who were trained with computer-assisted memory programs showed higher performances in forward digit span, backward digit span, backward visual span, verbal learning, visual controlled continuous performance, auditory controlled continuous performance, and finger tapping tests after than before the treatment. CONCLUSION: The computer-assisted memory training can be used as an additional tool for memory rehabilitation in patients with brain injury.
Brain Injuries* ; Brain* ; Education ; Fingers ; Humans ; Learning ; Memory* ; Neuropsychological Tests ; Rehabilitation* ; Semantics ; Seoul ; Verbal Learning

Female ; Forced Expiratory Volume ; Humans ; Linear Models ; Lung ; Male ; Radiography, Thoracic ; Spirometry ; Vital Capacity

Legionella species are abundant in the built environment and are increasingly recognized as a cause of Legionnaires' disease (LD). As the number of cases of Legionnaires' disease acquired by local communities in the Seoul metropolitan area in Korea has been increased, there was concern that changes in environmental factors could affect disease outbreaks. We described the association between climatic variables and occurrence of legionellosis in Korea and Legionella detection rate in Seoul area. A total of 418 cases of legionellosis were reported between 2014 and 2017. There was a seasonal peak in summer. LD continuously occurred from early spring to winter every year and rapidly increased in summer. In the regression analysis, the primary variables of interest- PM2.5 (µg/m³), NO₂ (ppb), and a number of the date of issue O₃ warning were not significant except for average temperature (R²=0.8075). The Legionella detection rate in Seoul, Korea showed a trend similar to precipitation (P=0.708, ANOVA). A relatively high proportion of Legionella detection rate was shown, especially cooling tower (17.7%) and public bath (19.3%). This finding is in line with current understanding of the ecological profile of this pathogen and supports the assertion that legionellosis occurs through contamination of water sources.
Baths ; Disease Outbreaks ; Epidemiology ; Korea ; Legionella ; Legionellosis ; Legionnaires' Disease ; Regression Analysis ; Seasons ; Seoul ; Water

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world and is the only major disease that is continuing to increase in both prevalence and mortality. The second Korean National Health and Nutrition Survey revealed that the prevalence of COPD in Korean subjects aged > or =45 years was 17.2% in 2001. Further surveys on the prevalence of COPD were not available until 2007. Here, we report the prevalence of spirometrically detected COPD in Korea, using data from the fourth Korean National Health and Nutrition Survey (KNHANES IV) which was conducted in 2007~2009. METHODS: Based on the Korean Statistical Office census that used nationwide stratified random sampling, 10,523 subjects aged > or =40 years underwent spirometry. Place of residence, levels of education, income, and smoking status, as well as other results from a COPD survey questionnaire were also assessed. RESULTS: The prevalence of COPD (defined as forced expiratory volume in 1 sec/forced vital capacity <0.7 in subjects aged > or =40 years) was 12.9% (men, 18.7%; women, 7.5%). In total, 96.5% of patients with COPD had mild-to-moderate disease; only 2.5% had been diagnosed by physicians, and only 1.7% had been treated. The independent risk factors for COPD were smoking, advanced age, and male gender. CONCLUSION: The prevalence of COPD was 12.9% in the KNHANES IV data. Most patients with COPD were undiagnosed and untreated. Based on these results, a strategy for early COPD intervention is warranted in high risk subjects.
Aged ; Censuses ; Female ; Forced Expiratory Volume ; Humans ; Hypogonadism ; Korea ; Male ; Mitochondrial Diseases ; Nutrition Surveys ; Ophthalmoplegia ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vital Capacity