Delirium is a common psychiatric disorder and occurs in many hospitalized older patients and has serious consequences including increased mortality rate. Despite its importance, health care clinicians often fail to recognize delirium or misdiagnosed as other psychiatric illness. Awareness of the etiologies and risk factors of delirium should enable clinicians to focus on patients at risk and to recognize delirium symptoms early. To improve early recognition of delirium, emphasis should be given to terminology, psychopathology and knowledge regarding clinical rating scale for delirium in the specific medical and surgical clinical settings. In this study, authors introduce rating scales for delirium and knowledge of clinical diagnostic process for delirium and give rise to appropriate assessment of delirium in the clinical situation.
Delirium ; Delivery of Health Care ; Humans ; Psychopathology ; Risk Factors ; Weights and Measures

BACKGROUND: There are many suggested methods for the indirect determination of anaerobic threshold(AT) using the changes of ventilatory parameters in respones to ventilatory load accompanying the increase of blood lactic acid level during exercise and the threshold derived from them is called ventilatory threshold( VT). They include ventilatory equivalent method(VEM), End-tidal PO2 method(PETO2), V-slope method(VSM), and respiratory quotient method(RQ). But in the patients with chronic airway ohstruction(CAO), the AT determined by ventilatory methods may not reflect true AT because the patients with GAO show inadequate ventilatory response to the increase of blood lactic acid level during excercise. METHODS: For the investigation of detection rate and reliability of above four VT determination methods in the patients with GAO, we performed the symptom-limited and maximal incremental exercise test in 17 patients with GAO and 12 normal controls. The incremental workload was 10 W/min in GAO group and 25 W/min in control group. The reliability of VT in each group was investigated by the calculation of Spearman correlation coefficient. RESULTS: The detection rates of VT were 100% by RQ, 91.7% by both VEM and POETO2, and 83.3% by VSM in normal control group, while 94.1% by RQ, 64.7% by VEM and PETO2, and 83.3% by VSM in GAO group. Good correlations were noted among VEM, PETO2, and VSM except RQ in normal control group. But there was no significant correlation except between VEM and PETO2 in GAO group. CONCLUSIONS: RQ is very sensitive but crude and VEM is near similar to PETO2. The clinical usefulness of VT determined by ventilatory method might be limited in patients with severe GAO.
Airway Obstruction* ; Exercise Test ; Humans ; Lactic Acid

No abstract available.
Carcinoma, Squamous Cell* ; Osteomyelitis

We report herein a case of impetigo hepetiformis treated with etretinate. The patient was 30 year old female in the 7th month of her second pregnancy, who had suffered from generalized coalesced pustular eruption with slightly itching and hurning sensation with fever on whole body except face, both had and foot. The euption began as an erythemations patch which developed pustules along the mar gin. I'here was extensian by the develupment of fresh peripheral pustules and coaleence of these patches. Histopathological findings showed hyperkeratosis, subcorneal spongiform pustule, spon,iosis in the epidermis and vascular proliferation in the devmis, She was treated successfully with etretinate for 4 weeks.
Acitretin ; Adult ; Epidermis ; Etretinate ; Female ; Fever ; Foot ; Humans ; Impetigo* ; Pregnancy ; Pruritus ; Sensation

Electron microscopy (EM) can provide a valuable contribution to light microscopy (LM) in the interpretation of fine needle aspiration cytology (FNAC) specimen, especially in the diagnosis of the tumor. However, considerable care in processing the specimen is mandatory to recover the cells and avoid altering the fine structures. We experienced a case of malignant melanoma in 33-yrs-old female, diagnosed by EM study of FNAC specimen from the axillary mass, who was initially thought as dissem- inated carcinomatosis on LM study. The technique of EM study on FNAC specimen consisted of washing the needle and syringe in 2.5% glutaraldehyde after a rapid stain (Diff-Quik), which was used to obtain a preliminary diagnostic impression and to assure the adequacy of the EM specimen. After centrifugation in the steps of fixation and dehydration, the sediment was made into an epon block and examined. The whole processing time of EM study can be shortened within 7 or 8 hours, and results can be available within 48 to 72 hours. Our experience suggests the EM study on FNAC can be a useful diagnostic method in the diagnosis of difficult FNAC cases.
Behcet Syndrome* ; Biopsy, Fine-Needle ; Carcinoma ; Centrifugation ; Dehydration ; Diagnosis ; Female ; Glutaral ; Histiocytoma, Malignant Fibrous ; Humans ; Lung ; Melanoma ; Microscopy ; Microscopy, Electron ; Needles ; Nephrotic Syndrome* ; Syringes

STUDY DESIGN: This study was undertaken to document the effect of TGF-beta 1 and TGF-beta2 on the proliferation of lumbar facet joint capsule. OBJECTIVES: To study the effect of TGF-beta1 and TGF-beta2 on the proliferation of lumbar facet joint capsule and their proliferation mechanism. SUMMARY OF LITERATURE REVIEW: TGF-beta1 and TGF-beta proliferated mesenchymal tissue . This proliferatine mechanism was involved of PLC-gamma- 1 and tyrosine kinase in signalling. MATERIAL AND METHODS: Three lumbar facet joint capsule was cultured in DMEM-20 media. Its proliferatine and inhibited effect was studied under the metabolic inhibitors and trasnsforming growth factors . RESULTS: TGF-beta1, and TGF-beta2, increased cell proliferation dependent on time and dosage. Both of TGF-beta1, and TGF-beta 2, specific antisense oligonucleotide blocked tile autoc.me effect of growth factor, PLC-gamma-1 specific antisense oligonucleotide inhibited the effect of TGF-beta 1, and TGF-beta2, Genistin inhibited the effect of TGF-beta 1, and TGF-beta2, in time and dosage dependent manner. CONCLUSION: The cell proliferation of lumbar facet joint capsule was involved in PLC- gamma-1 and tyrosine kinase in signalling.
Cell Proliferation ; Intercellular Signaling Peptides and Proteins ; Protein-Tyrosine Kinases ; Transforming Growth Factor beta ; Transforming Growth Factor beta1* ; Transforming Growth Factor beta2* ; Zygapophyseal Joint*

The effect of Roentgen rays on carcinoma of the cervix has long been of great interest to both radiologists and gynecologists. Since most cervical carcinomas are treated by irradiation, any additional knowledge either concerning the radiosensitivity of cervical tumors or their ultimate prognosis would be of value. The vaginal smear is considered to be one of convenient and rapid methods to study the effects of radiation on cervical malignancy. We observed morphologic changes in 297 cytologic preparations obtained from 60 patients who had underwent irradiation for cancer of the cervix. With the morphologic parameters such as cytoplasmic vacuolization, cytoplasmic basophilia, multinucleated giant cell formation, polymorphonuclear leucocytes (PMNL) sticking and postradiation dysplasia, we analyzed the findings in relation to the follow up time interval. The most common effect was the cytoplasmic vacuolization with basophilia of basaloid cells, which were noted in more than 90% of followed patients. The multinucleated giant cell formation and PMNL stickering were noted in 38 cases(63%) and 48 cases(80% ) respectively. The differential diagnosis of postradiation dysplasia from recurrent or persistent carcinoma, reparative atypical cells, and regressing tumor cells was difficult and further study seems to be needed to clarify the more accurate morphologic features and biologic behavior.
Cervix Uteri ; Cytoplasm ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Giant Cells ; Humans ; Pancreas ; Prognosis ; Radiation Tolerance ; Regeneration* ; Uterine Cervical Neoplasms ; Vaginal Smears

No abstract available.
Cough* ; Humans ; Hydrogen-Ion Concentration*

No abstract available.
Polychondritis, Relapsing*

The dysplasitc melanocytic nevus(DMN) of the skin is an atypical-appearing melanocytic tumor characterized by intraepidermal atypical melanocytic preliferation. Clinically, DMN has a diameter greater than 5mm, ill-defined irregular borders, irregularly distributed pigmentation surrounded by erythems,. Histopat- hologically, there are numerous discrete nests of atypical melanocytes situated at the dermoepidermal junction of elongated rete ridges. In the dermis, concentric lamellar fibroplasia, lymphocytic infiltrates and neovascularization are noted. We report herein a case of DMN developed on the trunk of 31-year-old Korean male.
Adult ; Dermis ; Humans ; Male ; Melanocytes ; Nevus, Pigmented* ; Pigmentation ; Skin