PURPOSE: The purpose of this study was to identify the factors related to depression of elderly patients in geriatric hospitals. METHODS: The subjects were 195 elderly patients who met the inclusion criteria of scores more than 18 on the K-MMSE score and no reported mental disease. The data were collected from February 20 to March 20, 2009. The research instruments utilized in this study were depression (GDSSF-K), activities of daily living and self esteem (RSES), social support, life satisfaction. Data were analyzed Pearson correlation and Multiple Stepwise Regression using SPSS 15.0. RESULTS: Depression score were negatively correlation with ADL, social support, life satisfaction and self-esteem. Among the factors studied related to depression, life satisfaction had highest explanatory power of 36.5% and it was followed by physical health status and activity of daily living. These explained 43.7% of the depression. CONCLUSION: The mean GDSSF-K 8.94, which indicates the higher than middle levels of depression. The findings suggest that it is important to develop educational programs to increase life satisfaction, physical health status and activity of daily living. Nursing interventions, including volunteer activities, health promotion program, and sports program could be useful in enhancing these factors.
Activities of Daily Living ; Aged ; Depression ; Health Promotion ; Humans ; Patient Satisfaction ; Self Concept ; Sports

A 70 year old male patient experienced a sudden visual acuity decrease in his left eye below 0.1 with preretinal, retinal and subretinal hemorrhage after excessive sexual activity. Four months later, his vision improved in the affected eye without any treatment. Eight months later, there was an area of organized sugbretinal hemorrhage remained around vascular arcade. We report this case with case review.
Aged ; Hemorrhage ; Humans ; Male ; Retinaldehyde ; Sexual Behavior* ; Visual Acuity

BACKGROUND: It has been suggested that the regulation of hair growth might involve complex interaction between dermal papilla cells and hair matrix cells. Dermal papilla cells secrete diffusible factors that would act an hair matrix cells. During anagen the papilla appears to have prominent capillary loop, whereas in telogen it is nonvascularized. Vascular endothelial growth factor(VEGF) was recently reported to be produced by dermal papilla cells in rats. OBJECTIVES: We performed this study in order to evaluate the effect of VEGF on human hair growth in vitro and on the proliferation of dermal papilla cells and to define the splice forms of VEGF. METHODS: To detect the isoforms of VEGF, RT-PCR was performed on RNA isolated from dermal papilla cells and RT-PCR products were hybridized with VEGF-specific oligonucleotide probe located in exon 4. Isolated human hair follicles were cultured with various concentrations of VEGF165 and VEGF121. Hair follicle growth was measured by an Olympus inverted microscope with an eyepiece measuring graticule. RESULTS: The following results were obtained from this study. 1. Southern hybridization and size calculation of RT-PCR products revealed that mRNA species corresponding to 121, 165, 189, and 206 amino-acid forms of VEGF were praduced by cultured human dermal papilla cells. 2. 10 ng/ml of rhVEGF165, 0.1 ng/ml of rhVEGF165 and 10 ng/ml of rhVEGF121 stimulated follicle elongation in vitro(p < 0.05). 3. rhVEGF165 and rhVEGF121 had no effect on the numbers and thymidine incorporation of dermal papilla cells. CONCLUSION: These results suggest that VEGF is produced by dermal papilla cells and is able to promote hair growth in vitro. Increased hair growth by VEGF might occur other than by proliferation of dermal papilia cells.
Animals ; Capillaries ; Endothelial Growth Factors* ; Exons ; Hair Follicle ; Hair* ; Humans ; Protein Isoforms ; Rats ; RNA ; RNA, Messenger ; Thymidine ; Vascular Endothelial Growth Factor A

Palisaded neutrophilic and granulomatous dermatitis (PNGD) is an uncommon skin eruption and characterized histopathologically by the presence of granulomatous inflammation with or without leukocytoclastic vasculitis. PNGD is known to be associated with various immune-mediated connective tissue diseases such as rheumatoid arthritis and lupus erythematosus. However, to our knowledge, a case of PNGD in a patient with Behçet’s disease is extremely rare and only one case has been reported in foreign literature to date. Herein, we report an unusual case of a 60-year-old female with Behçet’s disease who presented multiple erythematous to flesh-colored papules on the extremities, buttocks, and ear lobes and was diagnosed with PNGD. After the treatment of systemic corticosteroids, colchicine and azathioprine, the skin lesions and oral ulcers improved. The patient is under observation without recurrence of skin lesions for 6 months.

Purpose: The aim of this study is to investigate the effect of the surgical hospitalist system on postoperative outcomes and hospital costs for surgical patients. Methods: We reviewed the medical records of 522 patients who were admitted to the divisions of colorectal and gastrointestinal surgery for operation from September to December 2017 at Severance Hospital, Yonsei University College of Medicine in Seoul, Korea. All patients were divided into 2 groups; one that was managed by surgical hospitalists group (HG) and another that was managed by non-hospitalist residents group (NHG) after elective surgery. Postoperative outcomes and hospital costs were analyzed for each group. Results: Two hundred ninety-eight patients were managed by HG and 189 patients were managed by NHG after surgery. The length of hospital stay in the first group was shorter (9.6 ± 5.8 days vs. 12.2 ± 7.9 days, P < 0.001), the incidence of complications was lower (44.6% vs. 55.6%, P = 0.019), and the readmission rate was lower (3.0% vs. 6.9%, P = 0.046) in the HG than in the NHG. The difference in total hospital costs was not significant between the HG and the NHG (₩8,381,304 vs. ₩9,242,493, P = 0.559), but surgery-independent hospital costs were lower in the HG than in the NHG (₩3,020,873 vs.₩3,923,308, P = 0.001). Conclusion The surgical hospitalist system reduced the length of hospital stay, the incidence of postoperative complications, and the readmission rates of surgical patients. This led to the effect of a reduction in total hospital costs.

Purpose: The aim of this study is to investigate the effect of the surgical hospitalist system on postoperative outcomes and hospital costs for surgical patients. Methods: We reviewed the medical records of 522 patients who were admitted to the divisions of colorectal and gastrointestinal surgery for operation from September to December 2017 at Severance Hospital, Yonsei University College of Medicine in Seoul, Korea. All patients were divided into 2 groups; one that was managed by surgical hospitalists group (HG) and another that was managed by non-hospitalist residents group (NHG) after elective surgery. Postoperative outcomes and hospital costs were analyzed for each group. Results: Two hundred ninety-eight patients were managed by HG and 189 patients were managed by NHG after surgery. The length of hospital stay in the first group was shorter (9.6 ± 5.8 days vs. 12.2 ± 7.9 days, P < 0.001), the incidence of complications was lower (44.6% vs. 55.6%, P = 0.019), and the readmission rate was lower (3.0% vs. 6.9%, P = 0.046) in the HG than in the NHG. The difference in total hospital costs was not significant between the HG and the NHG (₩8,381,304 vs. ₩9,242,493, P = 0.559), but surgery-independent hospital costs were lower in the HG than in the NHG (₩3,020,873 vs.₩3,923,308, P = 0.001). Conclusion The surgical hospitalist system reduced the length of hospital stay, the incidence of postoperative complications, and the readmission rates of surgical patients. This led to the effect of a reduction in total hospital costs.

Purpose: We compared the efficacy of focal laser photocoagulation and intravitreal bevacizumab injection in the treatment of chronic central serous chorioretinopathy. Methods: We conducted a retrospective analysis involving 46 eyes of 46 patients with chronic central serous chorioretinopathy who received focal laser photocoagulation (22 eyes) or intravitreal bevacizumab injection (24 eyes). Changes in best-corrected visual acuity (BVCA), central macular thickness, and rates of complete subretinal fluid (SRF) resolution and recurrence were compared over a 6-month period. Results: Although the focal laser photocoagulation and intravitreal bevacizumab injection groups demonstrated a significant reduction in central macular thickness at 6 months (p < 0.001), no statistically significant differences were observed between these groups at the end of the follow-up period. Notably, a gradual improvement in BVCA was observed in both groups following initial treatment, with significant improvement seen at 6 months (p = 0.049 and p = 0.048 for the laser and injection groups, respectively). However, no statistically significant difference in BVCA improvement was observed between the groups. Complete SRF resolution was achieved in 22 eyes in the laser group and 23 eyes in the injection group. Although recurrence of SRF was observed in 9 and 13 eyes in the laser and injection groups, respectively, there was no statistically significant difference between the groups (p = 0.229). Conclusions Focal laser photocoagulation and intravitreal bevacizumab injection significantly improved anatomical and visual acuity outcomes in patients with chronic central serous chorioretinopathy. Although focal laser photocoagulation was associated with more rapid visual recovery and a lower recurrence rate compared to intravitreal bevacizumab injection, further studies are needed to evaluate its potential complications.

No abstract available.
Female ; Humans ; Infarction* ; Meningitis*

Kidney transplantation is a ideal renal replacement therapy in the patient with end stage renal disease. It made improvement of the patients' life quality but made increase of the incidence of chances of malignant diseases of them. We report a 44-year-old male kidney recipient recently diagnosed as early gastric cancer, had diagnosed previously as malignant lymphoma 6 years ago. He received a kidney from his mother 13 years ago, and then 7 years later he was diagnosed as malignant lymphoma presented as 2.5 cm-sized solitary lung mass. Histologically, it was confirmed as diffuse large cell type lymphoma. After 2-year scheduled chemotherapy and radiation therapy, he achieved complete remission. He was diagnosed as early gastric cancer by routine Upper Gastro-Intestinal Series study. Histologically, it was defined as moderately differentiated adenocarcinoma. He underwent a subtotal gastrectomy (Billoth-II). After the operation, he preserved good graft function with no recurrence of malignancy until now. Briefing our case, a kidney recipient has been serially diagnosed different two kinds of malignancy, malignant lymphoma and early gastric cancer with interval of 7 years. He showed good responses to therapy of malignancies and excellent prognosis. We recommend specific schedule of regular malignancy screening test for kidney recipients with long duration of post-transplantation.
Adenocarcinoma ; Adult ; Appointments and Schedules ; Drug Therapy ; Gastrectomy ; Humans ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation ; Lung ; Lymphoma ; Male ; Mass Screening ; Mothers ; Prognosis ; Quality of Life ; Recurrence ; Renal Replacement Therapy ; Stomach Neoplasms ; Transplants

The purpose of this article is to systematically review the literature that describes training and assessment that use an integrated patient simulator (IPS). We also tried to determine how to train learners with simulators, plan, and perform research on simulator-based education. Literature searches were conducted to identify articles from PubMed, EMBASE, and KMbase that were related to training and assessment that use an IPS, published from January 1999 to September 2008. Forty articles met the criteria and were analyzed. The results were as follows: Studies on IPS are the most common in graduate medical education (GME). The impact of IPS-based education is relatively greater in GME versus undergraduate medical education (UME) or continuing medical education (CME). IPS research in GME is characterized by addressing the effectiveness of clinical application, the training of procedures, and algorithms, rather than knowledge or simple skills. And research design is more elaborate in GME than UME or CME. IPS training in CME focuses mostly on specific clinical skills. Most training sessions in UME are offered to groups, but assessment is performed for a single student. Also, inter-rater reliability is checked unsatisfactorily in UME. IPS research in UME is characterized by limitations in design due to connections to the regular curriculum. According to findings above, we propose that: more detailed research design should be performed to overcome the limitations of UME research. For GME, increasing simulator-based training opportunities is desired, because its effectiveness and adaptability are relatively high.
Clinical Competence ; Computer Simulation ; Curriculum ; Education, Medical ; Education, Medical, Continuing ; Education, Medical, Graduate ; Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Research Design ; Review Literature as Topic