Depression is a common psychiatric disorder, but accurate recognition of depression is somewhat difficult because of different symptom presentation by age. The consequence of not recognizing to depression is that clinically significant and potentially treatable depression might be overlooked, misdiagnosed, and mistreated in depressive patients. The overlap of somatic symptoms of depression and physical illness and minimal expression of sadness is common in old age. Because of that reasons, alternative approach to identifying depression should be provided by proper screening instruments.
Depression ; Humans ; Mass Screening

Fine needle aspiration cytology of the salivary lesions was performed on 221 patients at Soonchunhyang University Hospital for 10 years. Of 221 aspirates, 6 aspirates(2.7%) were inadequate, 116 cases(52.5%) were non-neoplastic lesions, 76(34.4%) cases were benign neoplasms and 23 cases(10.4%) were malignant neoplasms. The cytologic diagnoses could be correlated with histologic findings in 58 cases. FNAC correctly discriminated between neoplastic and nonneoplastic lesions in fifty-seven lesions and failed in a case, and overall accuracy, sensitivity, and specificity were 98.3%, 98.0%, and 100.0%. FNAC correctly discriminated malignant neoplasms from benign neoplastic/non- neoplastic lesions in fifty-three cases and failed in five cases, and overall accuracy, sensitivity, and specificity were 91.3%, 72.7%, and 95.7%. Among three false negative cases, two mucoepidermoid carcinomas were misdiagnosed as mucocele and benign neoplasm, and an acinic cell carcinoma were misdiagnosed as Warthin's tumor. Two false positive cases were a Warthin's tumor misdiagnosed as squamous cell carcinoma and a pleomorphic adenoma misinterpretated as suggestive of malignancy. In conclusion, diagnostic accuracy of FNAC of salivary lesions is high, and the possibilities of low grade mucoepidermoid carcinoma and acinic cell carcinoma should be considered on hypocellular smears with mucoid or fluidy background.
Adenoma

BACKGROUND: Ketorolac is a potent anlagesic drug which has anti-inflammatory action and this drug may decrease the needed amount of opioids when used together with them for postoperative pain control. Preemptive analgesia with these drugs is still controversial. The analgesic effect and the presence of preemptive analgesia of a nalbuphine-ketorolac combination were examined in upper abdominal surgical patients. METHODS: Thirty patients undergoing elective upper abdominal surgery were randomly allocated into two groups. Each group received 10 mg of nalbuphine as a bolus dose just before starting IV-PCA which contained nalbuphine 70 mg and ketorolac 150 mg in 88 ml of 5% dextrose water. Group I (n=15) received drugs before starting the operation and group II received them at the end of the operation. The basal rate, PCA dose and lock-out interval were 1.5 ml, 1.5 ml and 10 minutes, respectively. In each group, the postoperative visual analogue scale (VAS) score, degree of satisfaction, total amount of drug used and side effects were checked and compared with corresponding figures in the other group for two postoperative days. RESULTS: Postoperative pain after upper abdominal surgery was controlled well in all patients and there were no significant differences in VAS scores between the two groups. Most patients were satisfied with this regimen. There were no remarkable side effects. Preemptive analgesia of nalbuphine-ketorolac combination was not found. CONCLUSIONS: IV-PCA administration of nalbuphine 70 mg and ketorolac 150 mg combination is an effective method to control postoperative pain in upper abdominal surgical patients. Preemptive analgesia is not found with this regimen.
Analgesia ; Analgesics, Opioid ; Glucose ; Humans ; Ketorolac ; Nalbuphine ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Water

PURPOSE: We performed this study to evaluate the alterations in renal function for patients with ileal conduit and ileal orthotopic neobladder MATERIALS AND METHODS: From January 1999 to June 2004, 48 patients who had undergone radical cystectomy with urinary diversion were included in our study. The patients were divided into two groups according to the types of urinary diversion. One group consisted of 29 patients with ileal conduit and the other group consisted of 19 patients with ileal W neobladder. The mean age of the ileal conduit group and the ileal W neobladder group were 65.6+/-9.9 years and 60.8+/-8.3 years, respectively. The preoperative and postoperative blood urea nitrogen/creatinine (BUN/Cr) levels, postoperative complications and postoperative GFR, as measured by (99m)Tc-DTPA scans, were compared between the two groups. RESULTS: For the postoperative complications, stricture at the ureterovesical anastomosis site occurred in 1.7% (1/58 renal units) of the ileal conduit group and in 10.5% (4/38 renal units) of the ileal W neobladder group. Acute pyelonephritis occurred in 5.2% (3/58 renal units) of the ileal conduit group and in 5.3% (2/38 renal units) of the ileal W neobladder group. The pre- and postoperative serum BUN/Cr levels were 20.8/1.3 and 24.8/1.6, respectively, in the ileal conduit group, and 17.2/1.1 and 18.8/1.2, respectively, in the ileal W neobladder group. There were no statistical significant differences between the pre- and postoperative changes of the serum BUN/Cr levels for both groups. The GFR, as measured by (99m)Tc-DTPA scans, were 77.6 and 78.7ml/ min/1.73m2 in the ileal conduit group and the ileal W neobladder group, respectively. There were no statistical significant differences between the two groups. CONCLUSIONS: There were no significant differences in renal function between the ileal conduit and ileal W neobladder.
Constriction, Pathologic ; Cystectomy ; Humans ; Postoperative Complications ; Pyelonephritis ; Urea ; Urinary Diversion*

BACKGROUND/AIMS: Gabexate, a protease inhibitor, has been known to prevent pancreatic damage following ERCP. We conducted a prospective and randomized study to assess the preventive effect of gabexate. Methods: Of the 96 patients enrolled, 46 were treated with gabexate and 50 with placebo. The groups were similar with regard to sex, age, body-mass index, and the final diagnosis of ERCP. RESULTS: 24 patients (25.0%) had elevated pancreatic-enzyme levels; the frequency was similar in the two groups (P=0.48). Mean serum amylase value at 4 hours after ERCP was similar in patients with elevated basal level (220.5+/-43.2 U/L) and those with normal basal level (170.4+/-31.2 U/L). After the procedures, serum amylase values were lower in the gabexate group (137.1+/-19.8 U/L) than in the placebo group (212.0+/-50.4 U/L). The differences were not significant in the mean levels of amylase between the groups for any of imaging of the pancreatic ducts (pancreatic-duct imaging, 201.5+/-49.4 U/L, bile-duct imaging, 153.7+/-30.0 U/L). But in the patients with pancreatic duct imaging, serum amylase values were significantly higher in the placebo group (295.0+/-97.6 U/L) than in the gabexate group (112.0+/-10.6 U/L)(p<0.05). CONCLUSIONS: Prophylactic treatment with gabexate does not reduce pancreatic damage related to ERCP, but only in the patients with pancreatic duct imaging there were the significant differences between in the gabexate group and in the placebo group.
Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Gabexate* ; Humans ; Pancreatic Ducts ; Pancreatitis ; Prospective Studies ; Protease Inhibitors

OBJECTIVES: The aims of this study were to develop an instrument for detection of relapse in psychotic disorder and to validate the instrument. METHODS: A total of 55 outpatients with psychotic disorder (schizophrenia, schizoaffective disorder, bipolar disorder) and 46 of their caregivers were enrolled. We developed the Questionnaire for Relapse Assessment in Psychotic disorder (QRAP), a self/report inventory. The patients and caregivers drew up the QRAP at two different time points, 'current' and 'the best state during the past three months'. In addition, we rated other established scales in order to evaluate psychotic and mood symptoms of patients. We divided patients into two groups, stable (n=30) and impending relapse (n=35) and evaluated the effectiveness of QRAP by calculating sensitivity and specificity. RESULTS: For all patients and caregivers, QRAP total score at 'current' was higher than 'the best state during the past three months' and showed significant positive correlation with other established scales. As expected, QRAP total score at 'current' in the impending relapse group was higher than that of the stable group. With cut off criteria 1, the QRAP demonstrated 80.0% sensitivity and 56.3% specificity in caregivers and effectively detected impending relapse. CONCLUSION: The results of our study suggest the effectiveness of QRAP as an instrument for detection of relapse in patients with psychotic disorder.
Caregivers ; Humans ; Outpatients ; Psychotic Disorders* ; Surveys and Questionnaires* ; Recurrence* ; Sensitivity and Specificity ; Weights and Measures

BACKGROUND: Ideal Body Weight(IBW) is commonly used to determine obesity levels because of its usefulness as target weight. This study was attempted to evaluate the comparative consistency between standards of determining obesity levels using the BMI and IBW. And the authors here provide a definition of IBW and attempt to suggest a new classification of obesity by IBW. METHODS: The test subjects for the research were 24,816 patients who received treatment at the SNUH Health Promotion Center between May 1, 1996 and December 31, 1999. The comparative consistency between standards of determining obesity levels using the BMI and IBW were analyzed calculating the kappa value. RESULTS: The IBW from the Broca method produced a kappa value of 0.668(p<0.001), while the calculation method for IBW recommended by the Japan Obesity Institute produced a kappa value of 0.664(p<0.001). On the other hand, an IBW calculated as 21(kg/m2)X[height(m)]2 (kg) produced the highest value of consistency at a kappa value of 0.911(p<0.001). After calculating IBW as 21(kg/m2)X[height(m)]2 (kg) and comparing the kappa values while adjusting the boundary zone standards, it was found that defining underweight as below 88% of IBW and obesity as above 145% produced the highest value of concurrence at a kappa value of 0.935(p<0.001). CONCLUSION: The validity and confidence with respect to the definition of IBW and the determination method for obesity as proposed by the authors may be confirmed through the methods high level of consistency [kappa value=0.935(p<0.001)] with determination methods using the BMI.
Body Mass Index* ; Classification ; Hand ; Health Promotion ; Humans ; Ideal Body Weight* ; Japan ; Obesity* ; Thinness

This study was conducted to find out the risk factors of hypertension and the effect of thesefactors on blood pressure. The eighteen factors were collected on the subjects of 932 from November 1994 to January 1995 through questionnaire and laboratory test - those were age, sex, education level, body mass index(BMI), family history of hypertension (FHH), triglyceride (TG), blood sugar and lactate dehydrogenase(LDH), etc. The status of blood pressure was classified by the classification of hypertension proposed by Joint National Committee of hypertension, USA. The prevalence of diastolic hypertension was 17.7% and the prevalence of systolic hypertension was 11.6 %. In the frequency analysis on the status of blood pressure, by age, education level, smoking habit, RM, BMI, FBS, LDH, TG, the prevalences were significantly different for both diastolic and systolic hypertension(p(0. 05). By stepwise logistic regression with dichotemization of blood pressure, the following odds ratios were significantly high (p, 0.05) - for diastolic hypertension, age 1.973, BMI 2. 106, FHH 2, 102, LDH 2. 773, TG 1.715, and for systolic hypertension, age 4.414, BMI 1.563, FHH 2.125, RM 0.487, LDH 3.814, TG 2. 707. By multiple regression analysis with blood pressure as dependent variable and these factors as independent variables, the regression equationswere diastolic hypertension =51.07+0.20.age+0.07 BMI+0.02.TG+0.02.LDH+3.22.FHH, and systolic hypertension = 88. 59+0.23.age+0.06.BMI+5.46.FHH-2.62.RM+0.03.LDH+0,03.TG By this study, the significant risk factors of hypertension were age, BMI, TG, family history of hypertension, LDH, and efficient control of hypertension would be expected through control of these factors.
Blood Glucose ; Blood Pressure* ; Classification ; Education ; Humans ; Hypertension* ; Joints ; Lactic Acid ; Logistic Models ; Odds Ratio ; Prevalence ; Risk Factors* ; Smoke ; Smoking ; Triglycerides ; Surveys and Questionnaires

OBJECTIVES: We assessed the availability of Aberrant Behavior Checklist (ABC) for the evaluation of the pharmacological effect in autistic disorder. METHODS: A retrospective review of the medical records of 27 children with autistic disorder, who visited the department of child and adolescent psychiatry of Kyungpook National University Hospital, from October 2011 to February 2013, was conducted. After treatment with risperidone, changes in the severity and improvement of symptoms were measured using ABC at the baseline, 2nd visit and 3rd visit, respectively. RESULTS: The mean daily dose of risperidone increased from 0.66+/-0.27mg (baseline, initial dose) to 1.02+/-0.50mg, 2nd visit, and 1.19+/-0.50mg, 3rd visit. According to ABC, irritability, lethargy, hyperactivity, and inappropriate speech subscale scores decreased significantly from the baseline to 2nd visit. Irritability and Hyperactivity subscale scores decreased significantly from the 2nd to 3rd visit. All subscales and total scores of ABC decreased significantly from the baseline to 3rd visit. CONCLUSION: The results of this study suggest that ABC can be used as an efficient tool to measure the symptoms of autistic disorder and to evaluate the medication effect on continuous treatment.
Adolescent ; Adolescent Psychiatry ; Autistic Disorder* ; Checklist* ; Child* ; Humans ; Lethargy ; Medical Records ; Retrospective Studies ; Risperidone

No abstract available.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Danazol/therapeutic use ; Humans ; Kidney Neoplasms/*complications/pathology/surgery ; Male ; Middle Aged ; Nephrectomy ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic/blood/drug therapy/*etiology