BACKGROUND: Drug-induced Parkinsonism(DIP) is the second commonest cause of Parkinsonism, after idiopathic Parkinson's disease(IPD). DIP is frequently produced by antipsychotic drugs. But the clinical characteristics of DIP did not get attention by neurologist. So we studied the clinical profiles of DIP patients. METHODS: We studied the clinical profiles of thirthone patients who showed parkinsonism after antipsychotic drug treatment. We compared the score of motor part of the Unified Parkinson's Disease Rating Scale(UPDRS) between trihexyphenidyl(n=15) & amantadine(n=16) monotherapy group(initial & 4 week after treatment). RESULTS: The mean age of patients was 45 years. Bradykinesia was the 1st symptom in 26 patients(94%), tremor in 5 patients(6%). In 25 patients(81%), the first symptom appeared within 1 week after sntipsychotic treatment. There was a statistical significant negative correlation between the dosage of antipsychotic drug and the symptom-onset interval following treatment with antipsychotic drugs(simple correlation analysis, p>0.01). Bradykinesia and rigidity were appeared in all DIP patients, symmetric distribution was more common(94%, 87%) Tremor occurred in 27 patients (87%). In patients with tremor, postural or action tremor was dominant in 15 patients(56%) asymmetric distribution was more common(16/27, 59%). There are no statistical difference in motor score of UPDRS between trihexyphenidyl & amantadine monotherapy group(student t-test, p<0.05) CONCLUSIONS: Bradykinesia was the most common 1st symptom in DIP patients. Asymmertrical postural or action tremor was relativelly common in DIP. Amantadine showed the same efficacy in the treatment of DIP compared to anticholinergics.
Amantadine ; Antipsychotic Agents ; Cholinergic Antagonists ; Humans ; Hypokinesia ; Parkinson Disease ; Parkinsonian Disorders* ; Tremor ; Trihexyphenidyl

BACKGROUND: Surgical correction of the full spectrum of esophageal atresia with tracheoesophageal fistula has improved over the years, but the mortality and morbidity assoiated with repair of these anomalies still remains high. MATERIAL AND METHOD: We retrospectively analyzes 27 surgically treated patients with esophageal atresia and tracheoesophageal fistula at Dong-A University Hospital between January 1992 and March 1997. RESULT: There were 21 male and 6 female patients. Mean birth weight was 2.62+/-.385 kg(2.0~3.4 kg). Twenty- four(88.9%) had esophageal atresia with distal tracheoesophageal fistula, and 3(11.1%) had pure esophageal atresia. Four(14.8%) infants were allocated to Waterston risk group A, 18(66.7%) to group B, and 5(18.5%) to group C. In eighteen(66.7%) infants with associated anomalies, cardiovascular anomalies were the most common. Three had a gap length of 3.5 cm or greater(ultra-long gap) between esophageal segments, 7 had 2.0 to 3.5 cm(long gap), 8 had 1.0 to 2.0 cm(medium gap), and 9 had 1 cm or less(short gap) gap length. Among 27 neonates, 3 cases underwent staged operation, late colon interposition was done in 2, and all other 24 cases underwent primary esophageal anastomosis. Oerative mortality was 2/27(7.4%). Causes of death included acute renal failure(n=1), empyema from anastomotic leak(n=1), necrotizing enterocolitis(n=1), sepsis(n=1), insulin-dependent diabetus mellitus(n=1 . There were 4 anastomosis- related complications including stricture in 3, leakage in 1. Mortality was related to the gap length(p<.05). CONCLUSION: Although the complication rate associated with surgical repair of these anomalies is high, this does not always implicate the operative mortality. The overall survival can be improved by effective treatment for combined anomalies and intensive postoperatve care.
Birth Weight ; Cause of Death ; Colon ; Constriction, Pathologic ; Empyema ; Esophageal Atresia* ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mortality ; Retrospective Studies ; Tracheoesophageal Fistula

BACKGROUND: The SF-6D, derived from the SF-36, is a preference-based instrument measuring health-related quality of life (HRQOL). Using this tool, we measured the HRQOL of persons disabled by stroke dwelling in Gyeongju city and identified factors affecting the HRQOL. METHODS: As of March 2008, 991 persons who had had a stroke and were aged 50 and over were identified on the Gyeongju city disabled registry. Interviewers specifically trained for this face-to-face survey gathered pertinent information including general and clinical characteristics from June to October 2008. In addition, the health status was measured using the Modified Rankin Scale, the Barthel ADL index, and the SF-36. The SF-6D index was derived from the SF-36. We analyzed the known-group construct validity and convergent validity. Finally, we performed multiple regression analyses to identify factors affecting the HRQOL. RESULTS: Of the 991 potential subjects, 498 persons participated in the interviews (response rate: 50.3%). The SF-6D indices for females and those aged 70 and over were lower than indices for males and those aged 60 and less. Correlation coefficients between the Modified Rankin Scale, the Barthel index, and the SF-6D index were relatively high (-0.533 and 0.555, respectively) and statistically significant (P<0.001). Multiple regression analyses showed that sex, age, smoking, alcohol use, comorbidity, the Modified Rankin Scale, and the Barthel index had an effect on the SF-6D index of persons with stroke, and the Barthel index was the most important factor. CONCLUSIONS: Our results indicate that the SF-6D can be a valid tool for evaluating health states of persons disabled by stroke, and functional limitation was the main factor affecting the HRQOL.
Activities of Daily Living ; Aged ; Comorbidity ; Disabled Persons ; Female ; Humans ; Male ; Quality of Life ; Smoke ; Smoking ; Stroke ; Value of Life ; Surveys and Questionnaires

No abstract available.

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.
*Attitude of Health Personnel ; Humans ; Program Development ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration ; Republic of Korea

PURPOSE: Cough is a frequent symptom in bronchial asthma. Acoustic digital analysis of cough has been reported using digital signal processing techniques. Differences between asthmatic and control cough sounds are presented. The main purpose of this study was to examine whether overall spectral energy and the visual observation of the fine details of the cough spectrographs, explain the differences in cough between normal subjects and asthmatic patients. METHODS: We presented data from 7 asthmatic patients and 8 non-asthmatic subjects using a new method of acoustic analysis. Cough sound was digitalized at a sampling rate of 5 kHz. Individual coughs were divided into two or three phases, presents the data of RMS (Root Mean Square), duration, RMS in the frequency band. Factor analysis and iogistic regression analysis were performed to identify groups of variables. RESULTS: Duration of cough was longer in asthmatics cough. The number of additional cough sounds showed no difference. RMS of cough in total cough and 2nd phase cough was stronger for asthmatics cough. Energy of frequency band is significantly different in 1,000-1,500 Hz, 1,500-2,000 Hz, 5,000-5,500 Hz, 5,500-6,000 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at total phase, 0-500 Hz, 1,000-1,500 Hz, 2,000-2,500 Hz, 5,000-5,500 Hz, 6,000-6,500 Hz, 9,000-9,500 Hz at 1st phase. Factor analysis and logistic regression analysis for the two groups provoded a classification table of 96.3% of sensitivity and 86.0% of specificity. CONCLUSION: We provided a new approach to the analysis of cough sounds. Significant differences were found between asthmatic and non-asthmatic cough sounds. It has potential as a tool with which to study the pathophysiology of cough and diagnosis the respiratory disease.
Acoustics ; Asthma ; Classification ; Cough* ; Diagnosis ; Humans ; Logistic Models ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted

The occurrence of carcinoma in a congenital uterine anomaly is uncommon. Indeed, malignancy of the uterine fundus with congenital uterine anomaly is quite rare, with fewer than 50 cases reported in the world liturature. Many patients go through life without the knowledge of their presence, and they are discovered at autopsy. Early diagnosis and proper management is necessary to decrease the high mortality. We present a case of endometrial carcinoma in a single horn of a bicornuate uterus.
Animals ; Autopsy ; Early Diagnosis ; Endometrial Neoplasms* ; Female ; Horns* ; Humans ; Mortality ; Uterus*

Authors presented two cases of typical Groenblad-Strandberg's syndrome and reviewed concerning pathogenesis, histology, heredity and its related conditions. Followings are to be considered in these cases. 1. Pseudoxanthoma elasticum, generally considered; mainly appears from 25 to 50 years of life, but we met in case 2 that he was eleven years old. 2. In ocular complications Case 1 showed disciform macular degeneration of the left eye and macular hemorrhages in superficial layers of retina of the right eye. The other case was several retinal exudates of the left eye without any amcular complications. 3. Case 2 had suggestive signs of Paget's disease in radiograms of the skull and pelvic bone. Routine laboratery studies including serum calcium, phosphorus and alkaline phosphatase were normal. 4. Suspicious heroditary occurrence was noted in case 2. 5. There were no significant abnormalities in blood and cardiovascular system.
Alkaline Phosphatase ; Calcium ; Cardiovascular System ; Exudates and Transudates ; Hemorrhage ; Heredity ; Macular Degeneration ; Pelvic Bones ; Phosphorus ; Pseudoxanthoma Elasticum ; Retina ; Retinaldehyde ; Skull

No abstract available
Dermatitis, Atopic* ; Eczema* ; Humans ; Nipples*

The authors analyzed ultrasonographic findings of 112 cases of trophoblastic disases which were confirmed byD&E or hysterectomy at Wallace Memorial Baptist Hospital from September 1980 to December 1984. The results were asfollows; 1. Of all 112 cases, hydatidiform moles were 99 cases, invasive moles were 3 cases and choriocarcinomas were 10 cases. 2. 81 cases (72%) occurred in 3rd decades. 3. The sized of uterus was large for gestational weeksin 65 cases(56%) and smaller in 13 cases(13%). 4. The contour of uterus was globular in 59 cases(53%), diffuse in49 cases(44%) and nodular in 4 cases(3%). 5. The internal echopatterns of uterus revealed numerous small vesicular snowstorm patterns in all cases, and revealed internal degeneration in 67 cases(60%). 6. Uterine walls in 89 cases(79%) were well delineated but uterine walls in 23 cases(21%) were poor delineated. 7. Multiseptated ovarian thecalutein cysts were seen in 36 cases (32%). 8. Invasive trophoblastic disease(invasive moles 3 cases andchoriocarcinomas 10 cases) revealed similiar ultrasonographic findings with H-mole, but more irregular internalechoes and irregular echoes in uterine wall. 9. Diagnostic accuracy was diagnostic in 98 cases (88%) , nonspecificin 11 cases (10%) and error in 3 cases(2%).
Choriocarcinoma ; Female ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Hysterectomy ; Pregnancy ; Protestantism ; Trophoblasts ; Uterus