No abstract available.

No abstract available.
Animals ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Sciatic Nerve*

Purpose: The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. Methods: Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. Results: Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. Conclusion Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

Purpose: The study was aimed at assessing the prevalence of depression in individuals with fecal incontinence (FI) and the relationship between the symptoms of depression and the severity of objective test parameters. Methods: Patients with FI for over 3 months were included in the study. The exclusion criteria were (1) diagnosis or treatment of the pelvic organ prolapse syndrome, (2) previous anorectal surgery, (3) inflammatory bowel disease, (4) previous diagnosis of psychiatric disorder, and (5) inability to read or understand the questionnaire themselves. The questionnaire included the Beck Depression Inventory-II (BDI-II) for measuring depression, and 142 patients were included for analysis. Results: Of the 142 patients, 34 were males and 108 were females, with a mean age of 67.8 years. The mean duration of FI symptoms was 38.36 months (range, 3–600 months). The mean Cleveland Clinic Incontinence Score and BDI-II were 11.96 ± 4.76 and 12.46 ± 9.84, respectively. The Cleveland Clinic Incontinence Score showed a positive correlation with the BDI-II score (P = 0.005). Of the 142 patients, 99 showed minimal to mild BDI-II scores, and 43 showed moderate-to-severe BDI-II scores. The multivariable logistic regression analysis showed that health insurance status was related to the depression in FI patients. Conclusion Mood disorders related to FI are more affected by the severity of the subjective symptoms or the surrounding environment than the objective indicators derived from the test.

BACKGROUND & PURPOSE: The ocular torsion (OT) and tilt of the subjective visual vertical (SVV) are sensitive brainstem signs and helps us to localize lesion. We calibrated the degree of OT, SVV tilt and head tilt to investigate their characteristics and temporal profiles in patients with brainstem lesion. METHODS: We selected 15 patients with acute brainstem stroke. We took serial fundus photographs and body pictures in upright position at various times after the stroke. We also determined the deviations of patient's SVV. The data measurement for this investigation ranged from day 2 to day 47. RESULTS: Eight of ten patients with lateral medullay infarction showed ipsiversive tilt of SVV and OT. Among four patients with pontine infarction, one showed ipsiversive tilt and three contraversive. One patient with midbrain hemorrhage showed cotraversive tilt. The resolution of OT and the tilt of SVV in medullary lesions occurred over the periods ranging from 7 days to more than 47 days and was slower in patients with upper brainstem lesion than lower brainstem lesion. The directions of head tilt in our patients, especially with medullary lesions, were rather different from the previous reports. CONCLUSION: The vestibular dysfunction by the brainstem lesions disturbs the eye and head stabilization and also distorts the perception of the subjective vertical in space. The direction of OT and the tilt of SVV is ipsiversive in lower brainstem lesion and contraversive in upper brainstem lesion. But head tilt is contraversive in most lower brainstem lesion as well as upper brainstem lesion. Large-grouped study for the direction of head tilt is thought to be needed. These signs are compensated in the course of clinical recovery.
Brain Stem Infarctions* ; Brain Stem* ; Head* ; Hemorrhage ; Humans ; Infarction ; Mesencephalon ; Stroke

BACKGROUND: Ureteral colic due to acute obstruction of urine flow is a frequent and painful condition presenting in the emergency department. Proper control of ureteral colic is important in the management of such a patient. Many drugs, including narcotics, had been used to control ureteral colic, and of them, nonsteroidal anti-inflammatory drugs are most commonly used. This study was carried out to compare the analgesic effect of diclofenac with that of caroverine which is used empirically in ureteral colic. METHODS: We carried out a randomized, prospective clinical trial in the emergency department of a university hospital. Sixty patients in whom ureteral colic had been diagnosed on the basis of physical signs and symptoms were included in this study. Each patients received an IM dose of diclofenac 75 mg, a IV bolus dose of caroverine 20 mg, or a continuous infusion of caroverine 60 mg. An additional dose of medication was added 20 min after the initial medication if needed. RESULTS: The main outcome was measured by using both the visual analogue scale(VAS), four-point categorial pain scale at times of 20, 40, and 60 min after initial medication. The requirement for supplemental medication was also measured. At 40 min, diclofenac was more effective than the other two treatments according to its pain- relieving capacity(p<0.05) and the categorial pain scale. By 60 min, caroverine continuous infusion was less effective than the other two treatments according to visual analogue scale(VAS) and the categorial pain scale(p<0.05). There were no significant differences between the diclofenac group and the caroverine bolus injection group at this time. The diclofenac group needed significantly less rescue medication for pain control(p<0.05). CONCLUSION: IM diclofenac, a non-steroidal antiinflammatory drug, was superior to the spasmolytics, single bolus or continuous intravenous infused, in treatment of ureteral colic.
Diclofenac* ; Emergency Service, Hospital ; Humans ; Narcotics ; Parasympatholytics ; Prospective Studies ; Renal Colic* ; Ureter*

For evaluating the reproductive performances of GTD patients, we found 115 cases of GTD patients, 77 HM and 38 GTT, who became pregnant after the completion of treatments and follow-up period. The results of this study suggest subsequent pregnancies after the completion of treatments may promise normal reproductive outcomes regardless of the chemotherapy.
Drug Therapy ; Follow-Up Studies ; Gestational Trophoblastic Disease* ; Humans ; Pregnancy

PURPOSE: The "Out-of-hospital Utstein Style" is an internationally recommended guideline for reporting outcome data for out-of-hospital resuscitation events. This study was designed to evaluate the current status of out-of-hospital cardiopulmonary resuscitation (CPR) in a tertiary emergency department and to provide basic data for a unified report on guidelines for resuscitation in Korea. METHODS: A clinical analysis of the out-of-hospital cardiac arrest (OHCA) patients, CPR performed in a tertiary emergency department, from July 1995 to December 2002 was conducted. The evaluation was made using Utstein reporting guidelines. RESULTS: Four hundred forty-nine patients were included in this study. The cardiac arrests were caused by non-cardiac medical diseases (41.9%), cardiac diseases (39.6%), unknown (10.0%), and trauma (8.5%). The initial electrocardiogram (ECG) showed asystole in 58.6% of the cases, other rhythms in 29.4%, and ventricular fibrillation/ventricular tachycardia (VF/VT) in 12.0%. Spontaneous circulation was restored (ROSC) in 41.2% of the cases. Twenty-four (5.3%) patients with witnessed and cardiogenic cardiac arrests had VF/VT on initial ECG, and of them, 5 (20.8%) patients were discharged alive. The mean circulatory arrest time was 19.7+/-13.6 minutes, and it was shorter in patients with ROSC (16.9+/-11.6) than in patients without ROSC (22.1+/-14.7, p= 0.003). CONCLUSION: The overall survival rate of OHCA patients was 6.7%, which was poorer than those of western countries. The overall duration from collapse to advanced cardiac life support (ACLS) was 19.7 minutes, which was too long. Major factors contributing to the low survival rate were most likely the lack of bystander CPR, delay in activating the emergency medical system (EMS), and inappropriate CPR by the EMT. We should make every effort to improve these areas.
Advanced Cardiac Life Support ; Cardiopulmonary Resuscitation* ; Electrocardiography ; Emergencies* ; Emergency Service, Hospital* ; Heart Arrest ; Heart Diseases ; Humans ; Korea ; Out-of-Hospital Cardiac Arrest* ; Resuscitation ; Survival Rate ; Tachycardia

We examined the hepatitis G virus infections among 227 Koreans who were healthy or were suspected of hepatitis and determined the phylogenetic relationship based on a part of the NS-5 region of 5 positive samples. Viral RNA was extracted from sera and cDNA was synthesized and subsequently amplified by RT-PCR (reverse transcription-polymerase chain reaction) or RT-nested PCR using random hexamer and NS-5 specific primers (470-20-1-77F, 470-20-1-211R, HGVNESTFO, HGVNESTRE). Five positives were found to belong to samples of patients showing symptoms of viral hepatitis. Primers used for PCR or nested PCR were derived from the NS-5 region. On the other hand, no amplification was detected using primers derived from the 5'-NCR (G-146F, G-401R). We performed TA cloning and sequencing of 5 amplified fragments, and their sequences were compared with those of foreign isolates of HGV. The phylogenetic analysis using MegAlign programme of DNAstar has shown that the Korean isolates are clustered on the phylogenetic tree. In summary, we confirmed the hepatitis G virus infection in 5 cases out of 12 patients showing the symptoms of viral hepatitis. The phylogenetic analysis of sequences of 5 amplified fragments showed that their relations to each other were closer than those to the foreign HGV isolates reported.
Clone Cells ; Cloning, Organism ; DNA, Complementary ; GB virus C* ; Hand ; Hepatitis* ; Humans ; Korea* ; Polymerase Chain Reaction ; RNA, Viral