OBJECTIVES: This study was designed to investigate the prevalence of anxiety and to identify demographic variables and clinical characteristics impacting on anxiety and quality of life in the elderly. METHODS: We analyzed data of 300 patients. Generalized anxiety disorder-7 (GAD-7), World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF), Rosenberg Self-Esteem Scale, Scale of Social Support (SSS), Brief Encounter Psychosocial instrument (BEPSI-K) were used to evaluate. Patients were divided into anxiety and non-anxiety group according to the GAD-7 score. We compared stress and quality of life between two groups and analyzed multiple linear regression with anxiety and quality of life as criterion variables. RESULTS: The prevalence of anxiety in elderly was 27% (n=81). Compared to the non-anxiety, anxiety people appeared significantly lower mean scores all of subscales in WHOQOL-BREF : General Health (t=-6.782, p<0.001), Physical Health (t=-6.935, p<0.001), Psychological Health (t=-8.816, p<0.001), Social Relationship (t=-5.409, p<0.001) and Environmental Health (t=-5.667, p<0.001). Stress, social support, education, sleep were significant explanation variables for anxiety and anxiety, stress, self-esteem were significant explanation variables for quality of life. CONCLUSION: These results show that the most important variable influencing on anxiety was stress and influencing on quality of life was anxiety.
Aged* ; Anxiety* ; Education ; Environmental Health ; Humans ; Linear Models ; Prevalence ; Quality of Life* ; World Health Organization

Menetrier's disease is a protein losing hypertrophic gastropathy characterized by hypoproteinemia, and often is associated with the development of gastric cancer. Though the cause of Menetrier's disease has been unknown, the association with Helicobacter pylori was reported. A 30-year-old man was hospitalized for the evaluation of progressive dyspepsia for 2 years, hypoproteinemia, and recently aggravated epigastric pain with weight loss. Gastroscopy revealed prominent folds and multiple variable sized polypoid eminence in the body and antrum with positive CLO test. Histological findings revealed gastritis with erosions and foveolar hyperplasia. Any other diseases causing protein losing enteropathy were excluded. After the eradication of the H. pylori and long term treatment with proton pump inhibitor, clinical, endoscopic, and biochemical resolution ensued. Thus, we suggest that H. pylori eradication should be tried in patients with Menetrier's disease before invase treatment modalities such as surgical resection.
Adult ; Dyspepsia ; Gastritis ; Gastritis, Hypertrophic* ; Gastroscopy ; Helicobacter pylori* ; Helicobacter* ; Humans ; Hyperplasia ; Hypoproteinemia ; Protein-Losing Enteropathies ; Proton Pumps* ; Protons* ; Stomach Neoplasms ; Weight Loss

BACKGROUND: There is difference between isoflurane and enflurane in the myocardial sensitization to catecholamines, and their actions on the heart. Enflurane reduces cytoplasmic calcium more than isoflurane. The hypothesis could be suggested that these two volatile anesthetics might cause the different incidences and natures of cardiac arrhythmias. METHODS: The anesthesia was induced by the intravenous injection of thiopental(6 mg, kg-1) and pipecuronium(0.1 mg, kg-1). Two groups were randomly allocated to the patients(n=80) in the maintenance: Group I inhaled isoflurane(1~2%), O2(2 L), and N2O(2 L), Group II, enflurane (1.5~2.5%). Continuous electrocardiographic recordings with Holter monitor were made of those undergoing tympanoplasty during anesthesia. The tapes recorded were scanned using analyzer, and we read out ECG complexes on the screen. Results were categorized as induction, maintenance, and emergence, and inferred from unpaired t-test, and X2-test with p<0.05 considered significant. RESULTS: The results were as follows: 1) The total incidence of cardiac arrhythmias was 65.0%. Isoflurane(52.5%) was lower than enflurane(77.5%) in the incidence. 2) During maintenance and emergence, isoflurane was lower than enflurane in the frequency of supraventicular arrhythmias. 3) Ventricular arrhythmias most frequently occurred in induction. 4) The frequency of supraventricular arrhythmias was more than two times that of ventricular ones. The arrhythmias at the AV junction were the most common, and VPC's the second. CONCLUSIONS: Greatest caution should be paid during peri-induction. It could be suggested that compared to enflurane, isoflurane better be administered for those to whom arrhythmias could be harmful.
Anesthesia ; Anesthetics ; Arrhythmias, Cardiac* ; Calcium ; Catecholamines ; Cytoplasm ; Electrocardiography ; Enflurane* ; Heart ; Incidence* ; Injections, Intravenous ; Isoflurane* ; Tympanoplasty

Background and Objectives: Toxoplasmosis is a disease caused by an intracellular parasite, Toxoplasma gondii. There has been only a few studies done on cervical toxoplasma lymphadenitis, and this study was performed to evaluate its clinical characteristics and outcomes.Subjects and Method We retrospectively reviewed the patients diagnosed with cervical toxoplasma lymphadenitis from January 2010 to December 2019. We investigated clinical pathologic findings, treatment and clinical outcomes. Results: Enrolled in the study were 21 patients who were confirmed with typical pathologic findings in an excisional biopsy (16/21) and core needle biopsy (5/21). Nine patients were male and 12 patients were female, with the mean age of 46.1±13.59 (19-70). All patients complained of neck masses and 5 (23.8%) patients showed pain or tenderness. Only one (4.8%) patient had mild fever. Fine needle aspiration cytology was performed in 5 patients, with no resulting pathognomonic outcomes in any one of the patients. CT scan was performed in 15 patients, with 8 (53.3%) patients showing multiple nodal enlargements but 7 (46.6%) patients showing a single enlarged lymph node. The most frequently involved location was level I (53.3%), followed by level II (46.6%), level V (46.6%), level III (40.0%), and level IV (20.0%). The serologic test for toxoplasma revealed positive IgG (100%) and IgM (85.7%). Treatments were excision only (61.9%) and excision with pharmacologic treatment using sulfonamide or pyrimethamine (38.1%). There was no case of recurrence after treatment. Conclusion Cervical toxoplasma lymphadenitis can be diagnosed by biopsy but needle aspiration has little role. It shows favorable clinical outcomes after treatment.

The present study was designed to investigate the characteristics of gintonin, one of components isolated from Korean Ginseng on secretion of catecholamines (CA) from the isolated perfused model of rat adrenal gland and to clarify its mechanism of action. Gintonin (1 to 30 µg/ml), perfused into an adrenal vein, markedly increased the CA secretion from the perfused rat adrenal medulla in a dose-dependent fashion. The gintonin-evoked CA secretion was greatly inhibited in the presence of chlorisondamine (1 µM, an autonomic ganglionic bloker), pirenzepine (2 µM, a muscarinic M₁ receptor antagonist), Ki14625 (10 µM, an LPA₁/₃ receptor antagonist), amiloride (1 mM, an inhibitor of Na⁺/Ca²⁺ exchanger), a nicardipine (1 µM, a voltage-dependent Ca²⁺ channel blocker), TMB-8 (1 µM, an intracellular Ca²⁺ antagonist), and perfusion of Ca²⁺-free Krebs solution with 5mM EGTA (a Ca²⁺chelater), while was not affected by sodium nitroprusside (100 µM, a nitrosovasodialtor). Interestingly, LPA (0.3~3 µM, an LPA receptor agonist) also dose-dependently enhanced the CA secretion from the adrenal medulla, but this facilitatory effect of LPA was greatly inhibited in the presence of Ki 14625 (10 µM). Moreover, acetylcholine (AC)-evoked CA secretion was greatly potentiated during the perfusion of gintonin (3 µg/ml). Taken together, these results demonstrate the first evidence that gintonin increases the CA secretion from the perfused rat adrenal medulla in a dose-dependent fashion. This facilitatory effect of gintonin seems to be associated with activation of LPA- and cholinergic-receptors, which are relevant to the cytoplasmic Ca²⁺ increase by stimulation of the Ca²⁺ influx as well as by the inhibition of Ca²⁺ uptake into the cytoplasmic Ca²⁺ stores, without the increased nitric oxide (NO). Based on these results, it is thought that gintonin, one of ginseng components, can elevate the CA secretion from adrenal medulla by regulating the Ca²⁺ mobilization for exocytosis, suggesting facilitation of cardiovascular system. Also, these findings show that gintonin might be at least one of ginseng-induced hypertensive components.
Acetylcholine ; Adrenal Glands ; Adrenal Medulla* ; Amiloride ; Animals ; Cardiovascular System ; Catecholamines ; Chlorisondamine ; Cytoplasm ; Egtazic Acid ; Exocytosis ; Ganglia, Autonomic ; Nicardipine ; Nitric Oxide ; Nitroprusside ; Panax ; Perfusion ; Pirenzepine ; Rats ; Veins

The original version of this article contained misspelled name of authors. The name of Seung-Yeol Na is replaced with Seung-Yeol Nah. The name of Mi-Sung Choi is replaced with Mee-Sung Choi.
Adrenal Medulla*

OBJECTIVE: Panic disorder (PD) is frequently comorbid with insomnia, which could exacerbate panic symptoms and contribute to PD relapse. Research has suggested that characteristics are implicated in both PD and insomnia. However, there are no reports examining whether temperament and character affect insomnia in PD. Thus, we examined the relationship between insomnia and personality characteristics in PD patients. METHODS: Participants were 101 patients, recruited from 6 university hospitals in Korea, who met the DSM-IV-TR criteria for PD. We assessed sleep outcomes using the sleep items of 17-item Hamilton Depression Rating Scale (HAMD-17)(item 4=onset latency, item 5=middle awakening, and item 6=early awakening) and used the Cloninger's Temperament and Character Inventory-Revised-Short to assess personality characteristics. To examine the relationship between personality and insomnia, we used analysis of variance with age, sex, and severity of depression (total HAMD scores minus sum of the three sleep items) as the covariates. RESULTS: There were no statistical differences (p>0.1) in demographic and clinical data between patients with and without insomnia. Initial insomnia (delayed sleep onset) correlated to a high score on the temperamental dimension of novelty seeking 3 (NS3)(F1,96=6.93, p=0.03). There were no statistical differences (p>0.1) in NS3 between patients with and without middle or terminal insomnia. CONCLUSION: The present study suggests that higher NS3 is related to the development of initial insomnia in PD and that temperament and character should be considered when assessing sleep problems in PD patients.
Depression ; Hospitals, University ; Humans ; Korea ; Panic ; Panic Disorder ; Recurrence ; Sleep Initiation and Maintenance Disorders ; Temperament

Gefitinib is a novel drug used to treat advanced non-small cell lung cancer. However, drug-related interstitial pneumonia is a major life-threatening side effect, which has a worldwide prevalence of 0.3-0.4%. In Japan, the prevalence is high as 3-4% but the actual frequency in Korea has not been officially assessed. We report two cases of gefitinib-induced interstitial lung disease during the treatment of non-small cell lung cancer. High-resolution computerized tomography (HRCT) of one case showed nonspecific ground glass opacity and the chest x-ray of another case showed diffuse bilateral ground glass opacity. The former patient showed a rapid good response to corticosteroid treatment whereas the latter died despite receiving aggressive treatment with high dose corticosteroid and empirical antibiotics.
Anti-Bacterial Agents ; Carcinoma, Non-Small-Cell Lung ; Glass ; Humans ; Japan ; Korea ; Lung Diseases, Interstitial* ; Prevalence ; Thorax

A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.
Abscess* ; Aortic Valve ; Debridement ; Endocarditis ; Humans ; Middle Aged ; Mitral Valve* ; Tricuspid Valve*

Angioimmunoblastic T-cell lymphoma (AITL) is a systemic lymphoproliferative disorder that presents with profound immune dysfunction and immunodeficiency. As in many other immunodeficiencies, Epstein-Barr virus (EBV) associated B-cell lymphoid proliferation can occur in AITL but few cases of EBV-positive B-cell lymphoma have been reported in patients with preexisting AITL. We report a case of AITL in which EBV-positive diffuse large B-cell lymphoma (DLBCL) developed 13 months after the initial diagnosis of AITL. Although the exact mechanisms remain unclear, Epstein-Barr virus may have played a role in the pathogenesis of the secondary DLBCL
B-Lymphocytes ; Herpesvirus 4, Human ; Humans ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Lymphoproliferative Disorders ; T-Lymphocytes