BACKGROUND: The purpose of this study was to examine the prevalence of and the sociodemographic risk factors for depressive symptoms among inpatients with chronic diseases who completed the Patient Health Questionnaire-9 (PHQ-9) conducted by a social work department at university medical centers. METHODS: In 2015, PHQ-9 data were collected from six medical centers affiliated with Hallym University Medical Center. The sample comprised 517 inpatients aged 18 years or over with chronic diseases. Descriptive statistics, chi-square test, simple logistic regression, and multiple logistic regression were used for data analyses. RESULTS: The prevalence of depressive symptoms among inpatients with chronic diseases was 31.7 percent. The results of the simple and multiple logistic regressions showed that the single/widowed/divorced/separated group was at higher risk for depressive symptoms than married inpatients. Having a religion or being unemployed also increased the risk of depressive symptoms among the respondents. CONCLUSIONS: Findings of this study emphasize the importance of systematic depressive symptom management for inpatients with chronic diseases.
Academic Medical Centers ; Chronic Disease ; Depression ; Humans ; Inpatients ; Logistic Models ; Prevalence ; Risk Factors ; Social Work ; Statistics as Topic ; Surveys and Questionnaires

OBJECTIVE: With the increased use of interspinous spacers in the treatment of lumbar stenosis, knowledge of the geometry of the interspinous space is important. To prevent dislodgment of an interspinous spacer, the accurate depth and width of the interspinous space needs to be established to facilitate the best intraoperative selection of correct spacer size. METHODS: To determine the depth and width of the interspinous space, two methods are available which utilize plain film and magnetic resonance imaging (MRI). Data analysis of the interspinous depth and width was undertaken in 100 patients. RESULTS: The standard deviations were variable, since skin thickness (zone 1) was altered by sex and age. The difference in the zone 1 distance between adjacent interspinous processes varied according to gender (p<0.05), but was not influenced by age [p=0.32 by analysis of variance between groups (ANOVA)]. Zone 2, the supraspinous, and zone 3, the interspinous ligament depths, comprise the operative working area during insertion of an interspinous spacer. There were no differences with regard to gender or age (p>0.05). For zones 6 and 7, the interspinous distances at the narrowest and widest points, respectively, were found to decrease with the aging process, but the decrease was not statistically significant. There were no differences with regard to gender (p>0.05). CONCLUSION: This study provides additional information on the interspinous space. This statistical data are valuable for use in the design of interspinous spacers.
Academic Medical Centers* ; Aging ; Constriction, Pathologic ; Humans ; Ligaments ; Magnetic Resonance Imaging ; Skin ; Statistics as Topic

PURPOSE: This study was correlation study to identify the factors influencing sleep quality, fatigue, and postnatal depression in mothers who have given birth during the past 6 months. METHODS: The study was conducted using a survey with questionnaires to 329 mothers who visited E University Medical Center, or three local clinics located in D city, between August and October 2013. Collected data were analyzed using the SPSS/WIN 20.0 program. RESULTS: Out of 329 subjects, 18.2% showed that they had mild postnatal depression whereas 24.3% had severe postnatal depression. Accordingly, 42.5% reported having postnatal depression. Postnatal depression had a significant correlation with sleep hours after childbirth (r=-.16, p=.003), spousal support (r=-.28, p<.001), sleep quality (r=-.35, p<.001), physical fatigue (r=.66, p<.001), psychological fatigue (r=.69, p<.001), and neurosensory fatigue (r=.56, p<.001). Factors influencing postnatal depression include psychological fatigue, sleep quality, number of child births, and neurosensory fatigue, and these accounted for 53% of postnatal depression. CONCLUSION: Results indicate that factors influencing postnatal depression involve psychological fatigue, sleep quality, number of child births, and neurosensory fatigue. Therefore for nursing intervention for postpartum mothers, it is necessary to assess the level of depression, fatigue, and sleep quality, and to provide interventions to relieve depression.
Academic Medical Centers ; Child ; Depression ; Depression, Postpartum* ; Fatigue* ; Female ; Humans ; Mothers* ; Nursing ; Parturition ; Postpartum Period ; Surveys and Questionnaires ; Statistics as Topic

INTRODUCTIONMorbidity and mortality from malignant diseases are usually the result of metastasis. The bone is the third most common site of metastasis.

METHODSThis is a retrospective study of patients with metastatic bone disease who were referred to the Orthopaedic Department of University Malaya Medical Centre, Malaysia, between January 2004 and October 2009.

RESULTSA total of 151 patients (51.0% men, 49.0% women) had metastatic bone disease, with the highest incidence at the age range of 50-59 years. The commonest primary cancer was breast (23.3%), followed by lung (21.2%), prostate (9.3%), thyroid (7.3%) and renal cell carcinoma (5.3%); unknown primary cancer was 6.6%. There was long bone involvement in 52.7% of cases, axial bone in 44.5%, and both long and axial bones in 2.8%. The majority (90.1%) were symptomatic, with pain as the commonest symptom. 106 (70.2%) patients had pathological fractures. Neurological deficit was reported in 90.7% of patients, with 41.1% having extraskeletal metastases. 67.8% of the lesions were osteolytic, 24.3% were sclerotic, and 7.9%, mixed. Palliative and therapeutic interventions were undertaken for 62.0% of patients. The mean survival times were: breast 21.0; thyroid 20.7; prostate 20.3; lung 16.0; and unknown primary cancer 32.6 months.

CONCLUSIONIn our study, breast and lung cancers were the commonest primary cancers in metastatic bone disease. Most patients had more than one site of involvement, pain at presentation and pathological fractures. Surgery is beneficial to relieve pain and improve function and neurology. Duration of survival depends on the type of primary cancer and whether systemic metastasis is present.

Academic Medical Centers ; statistics & numerical data ; Adult ; Age Distribution ; Aged ; Bone Neoplasms ; epidemiology ; secondary ; Breast Neoplasms ; pathology ; Female ; Humans ; Incidence ; Lung Neoplasms ; pathology ; Malaysia ; epidemiology ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND/AIMS: The aim of this study was to analyze comorbidity in patients with type 2 diabetes mellitus (T2DM) by using association rule mining (ARM). METHODS: We used data from patients who visited Keimyung University Dongsan Medical Center from 1996 to 2007. Of 411,414 total patients, T2DM was present in 20,314. The Dx Analyze Tool was developed for data cleansing and data mart construction, and to reveal associations of comorbidity. RESULTS: Eighteen associations reached threshold (support, > or = 3%; confidence, > or = 5%). The highest association was found between T2DM and essential hypertension (support, 17.43%; confidence, 34.86%). Six association rules were found among three comorbid diseases. Among them, essential hypertension was an important node between T2DM and stroke (support, 4.06%; confidence, 8.12%) as well as between T2DM and dyslipidemia (support, 3.44%; confidence, 6.88%). CONCLUSIONS: Essential hypertension plays an important role in the association between T2DM and its comorbid diseases. The Dx Analyze Tool is practical for comorbidity studies that have an enormous clinical database.
Academic Medical Centers/statistics & numerical data ; Algorithms ; Case-Control Studies ; Chi-Square Distribution ; Comorbidity ; Data Mining/*statistics & numerical data ; Databases, Factual/statistics & numerical data ; Diabetes Mellitus, Type 2/*epidemiology ; Dyslipidemias/epidemiology ; Humans ; Hypertension/epidemiology ; Republic of Korea/epidemiology ; Stroke/epidemiology

INTRODUCTIONIn laryngectomised patients, tracheoesophageal speech is the gold standard for voice rehabilitation. This study evaluated complications related to the tracheoesophageal puncture (TEP) and the success rate in voice prosthesis after total laryngectomy at our institution over a 10-year period.

MATERIALS AND METHODSA retrospective review of 22 TEPs was performed between January 1998 and December 2008. The timing of TEP, type of voice prosthesis, surgical and prosthesis-related complications, and TEP closure were noted.

RESULTSEighteen percent of the patients underwent primary and 82% secondary TEP. Our patients were predominantly males (95.4%) of Chinese descent with a mean age of 62.1 years. The types of voice prostheses used were ProvoxTM (n = 15), Voicemasters (n = 6), and Blom-Singer (n = 1). Prosthesis- related complications occurred in 77.3%. Notable complications were leakage (82.5%), prosthesis displacement (41.2%), intractable aspiration (29.4%), and aspiration of prosthesis (23.5%). The most common surgical-related complication was tracheostomal stenosis. An array of interventions comprising resizing or changing prosthesis type, nasogastric catheter insertion, stomaplasty, purse string suturing, and bronchoscopic removal of bronchial aspirated prosthesis were implemented to address encountered complications. In a mean follow-up of 34.8 months, 68.2% of patients achieved functional tracheoesophageal speech (75% of primary TEP and 67% of secondary TEP). There were 7 TEP closures indicated by persistent leakage, recurrent dislodgement, phonatory failure and, in 1 patient, persistent pain.

CONCLUSIONSTEP has become an integral part in the rehabilitation of a laryngectomee. However, management of the frequent complications related to TEP requires specific efforts and specialistic commitments in order to treat them.

Academic Medical Centers ; statistics & numerical data ; Adult ; Aged ; Constriction, Pathologic ; epidemiology ; etiology ; Equipment Failure Analysis ; Female ; Humans ; Incidence ; Laryngectomy ; rehabilitation ; Larynx, Artificial ; adverse effects ; Malaysia ; epidemiology ; Male ; Middle Aged ; Punctures ; adverse effects ; Retrospective Studies ; Speech, Alaryngeal ; Trachea ; surgery

Hyperhidrosis is a disorder of perspiration in excess of the body's physiologic need and significantly impacts one's occupational, physical, emotional, and social life. The purpose of our study was to investigate the characteristics of primary hyperhidrosis in 255 patients at Ajou University Hospital Hyperhidrosis Center from March 2006, to February 2008. Information collected from the medical records was: sex, sites of hyperhidrosis, age at visit, age of onset, aggravating factors, hyperhidrosis disease severity scale (HDSS) rank, family history, occupation, and past treatment. A total of 255 patient records were reviewed; 57.6% were male. Patients with a family history (34.1%) showed a lower age of onset (13.21+/-5.80 yr vs. 16.04+/-9.83 yr in those without family history); 16.5% had previous treatment, most commonly oriental medicine. Palmar and plantar sites were the most commonly affected, and 87.9% of patients felt their sweating was intolerable and always interfered with their daily activities. Our study provides some original information on the Korean primary hyperhidrosis population. Patients who have a family history show signs of disease in early age than those without family history.
Academic Medical Centers/statistics & numerical data ; Adult ; Female ; Genetic Predisposition to Disease/*epidemiology/*genetics ; Hospitalization/*statistics & numerical data ; Humans ; Hyperhidrosis/*epidemiology/*genetics ; Incidence ; Male ; Risk Assessment ; Risk Factors

BACKGROUND: Irradiated blood is used to prevent transfusion-associated graft-versus host disease in high risk patients. The guidelines for usage of irradiated blood components vary from one country to other according to their needs. But in Korea, little information is available on the current usage of and the guidelines for irradiated blood. Therefore, we analyzed the usage of irradiated blood components in Hanyang University Medical Center. METHODS: Medical records were reviewed for 187 patients who had been transfused with irradiated blood products during the period from January 2004 to June 2005. And we investigated the proportion of irradiated blood products among the total number of blood products that were transfused during a one-year period. RESULTS: Hematologic diseases and solid cancer patients comprised 63.7% and 24.6% respectively. The proportion of irradiated blood products among the total blood components were 25.7% of platelet concentrates, 61.4% of apheresis platelets, and 5.1% of packed red cells. Total transfused amount by disease categories and the average transfused units per patient of irradiated blood components were high in a group of patients with several hematologic diseases such as acute leukemia. CONCLUSIONS: The use of irradiated blood components takes a great proportion in total blood product transfusions and the majority of blood components were transfused to a group of patients with a few hematologic diseases. The proper use of blood should be guided by the promotion and education of a modified usage protocol for irradiated blood products and by a continuous data analysis.
Academic Medical Centers ; Blood Component Removal ; Blood Platelets ; Education ; Hematologic Diseases ; Humans ; Korea ; Leukemia ; Medical Records ; Statistics as Topic

This study was undertaken to analyze and evaluate the diagnosis and principal treatment methods for congenital choledochal cyst, focusing on various surgical procedures and clinical outcome. A comprehensive, retrospective study was conducted on 72 adult patients who presented with choledochal cyst from 1985 to 2002. Surgical procedures were cyst excision with hepaticojejunostomy in 25 cases for type I or type IV-B, extrahepatic cyst excision with hepaticojejunostomy in 8 cases for type IV-A, extrahepatic cyst excision with modified hepaticojejunostomy in 2 cases for type IV-B, non-cyst excision with or without hepaticojejunostomy in 27 cases for types I, II, IV-A, IV-B. The early postoperative morbidity and mortality rate were 16.1% (9/62) and 6.5% (4/62) respectively, and the complication rate related to surgical procedure was 30.6% (19/62). The incidence of cholangiocarcinoma with non-cyst excision or non-operated congenital choledochal cyst was 10.8% (4/37). One patient died of primary hepatocellular carcinoma after cyst excision with hepatojejunostomy. In conclusion, our results showed that complete exci-sion of choledochal cyst for types I, II, and IV-B and complete excision of extra-hepatic choledochal cyst from the hepatic hilum in type IV-A with hepaticojejunostomy or modified hepaticojejunostomy are the treatment of choice for choledochal cyst in adult patients.
Academic Medical Centers/trends ; Adolescent ; Adult ; Choledochal Cyst/*epidemiology/*surgery ; Female ; Hepatectomy/*methods/*statistics & numerical data ; Humans ; Jejunostomy/*methods/*statistics & numerical data ; Korea/epidemiology ; Male ; Middle Aged ; Postoperative Complications/*epidemiology ; Retrospective Studies ; Treatment Outcome

PURPOSE: This study was done to identify stress, fatigue, and self efficacy in patients on dialysis and identify their effect on quality of life. METHOD: The participants (n=149) who agreed to participate in the research were selected from among those who were on dialysis treatment at C University Medical Centers in Seoul and Inchon, and at C University Medical Center in Jeju. The data were collected from July, 2001 to March, 2002 using interviews. Data analysis was done with t-test, ANOVA, and multiple stepwise regression using the SAS program. RESULT: Quality of life was significantly different according to economic status, and type of dialysis. Quality of life for the group with higher economic status was better than for the group with lower economic status, and the group on peritoneal dialysis had higher quality of life scores than the group on hemodialysis. As for self-efficacy, there were significant difference according to duration of disease, type of dialysis, and duration of dialysis. Stress was significantly different according to marital status. Quality of life was significantly predicted by stress (40.02%) and fatigue (3.85%). CONCLUSION: To improve quality of life for people on dialysis, their stress should be treated positively, also multi-dimensional nursing interventions to provide emotional support and nursing interventions to diminish fatigue are required.
Academic Medical Centers ; Dialysis* ; Fatigue ; Humans ; Incheon ; Marital Status ; Nursing ; Peritoneal Dialysis ; Quality of Life* ; Renal Dialysis ; Self Efficacy ; Seoul ; Statistics as Topic