The Factor Structure of the Korean Hamilton Depression Rating Scale(K-HDRS): A Confirmatory Factor Analysis / 신경정신의학

OBJECTIVES: The present study was conducted to examine the factor structure of a Korean version of the Hamilton Depression Rating Scale (K-HDRS), and we did so by performing a confirmatory factor analysis (CFA). METHODS: The data from the 17-item K-HDRS data was obtained from 319 South Koreans who met the DSM-IV Criteria of Major Depressive Disorder. We examined the fit of ten competing models. The CFAs were evaluated in their original first-order structures and in their hierarchically related counterparts. RESULTS: The alternative models obtained unsatisfactory fit indices, although the five-factor intercorrelated model (model 5a) demonstrated a relatively good fit to the data. The model 5a also performed better than its hierarchically related counterpart (model 5b). The Modification Indices (MIs) were used to provide a more satisfactory account of the data. The MIs suggested correlations between the unique variances of items (item 1 & 3, item 10 & 15), and these parameters were added to the model 5a. After introducing minor modifications, the 'final' model (5m) yielded an improved model fit. CONCLUSION: This study suggests that the symptoms of depression, as assessed by the K-HDRS, cluster into five factors: anhedonia/retardation, guilt/agitation, bodily symptoms, insomnia and appetite. This study provides evidence for the cross-cultural generalizability of the HDRS, although some refinement of the scale is still required.

Three cases of isolated rectal tuberculosis / 대한내과학회지

Isolated rectal tuberculosis commonly involves sigmoid, ascending, or transverse colon. Rectal involvement in tuberculosis is uncommon and poorly characterized. Isolated rectal tuberculosis was defined as focal lesions of rectum in the abscence of demonstrable lesions in the small and large bowel. Diagnosis of rectal tuberculosis was based on characteristic endoscopic appearance of lesions, histopathologic feature of tuberculosis in biopsy material and response to antitubercular therapy. Three patients with isolated rectal tuberculosis were seen at Kwak's hospital. The lesions observed was classified according to macroscopic morphology as follows: ulcerative, hypertrophic and ulcero-hypertrophic. Clinical manifestations were non-specific and consists of rectal bleeding, fever, weight loss, constipation and abdominal pain. One of the three patients had coexisting tuberculous pleurisy. Response to antitubercular chemotherapy was good.

A Case of Abdominal Actinomycosis Developed in Upper Gastrointestinal Tract / 대한소화기내시경학회지

Actinomycosis is a rare chronic suppurative disease caused by actinomyces species, which are normal flora in the oral cavity and gastrointestinal tract, and characterized by formation of sulfur granule. Actinomyces can affect cervicofacial, pulmonary, abdominal and pelvic area. However, abdominal and pelvic inflammations are less frequently observed. Most of abdominal actinomycosis develop after abdominal operation, trauma, inflammatory bowel disease or use of intrauterine devices. The definitive diagnosis was made after histopathological study of the tissues. Treatment is long-term antibiotic therapy. Herein, we report a case of a 69-year-old woman with an unusual form of abdominal actinomycosis after total gastrectomy.

Is additional acid-suppressing agents needed after the initial Helicobacter pylori eradication therapy to heal peptic ulcers? / 대한내과학회지

BACKGROUND: Helicobacter pylori (H. pylori) can now be eradicated in the majority of patients with 7 days of treatment with OAC (omeprazole+amoxicillin+clarithromycin) regimen. It is unclear if additional acid-suppressing treatment should be continued beyond 7 days in patients with active gastric or duodenal ulcers. METHODS: Ninety two patients with endoscopically proven active peptic ulcers who were H. pylori positive were randomized to receive either omeprazole 20 mg plus amoxicillin 1.0g plus clarithromycin 500mg ; twice daily for 1 week alone (OAC group) or same regimen followed by 3 weeks of omeprazole (OACP group). Endoscopy and UBT (urea breath test) were performed 8 weeks after the initiation of treatment. RESULTS: Forty four of forty five (97.8%) of OAC group and forty four of forty seven (93.6%) of OACP group were noted to have healed ulcer at week 8. CONCLUSION: In patients with H. pylori infection and peptic ulcers, one week of OAC therapy without further need for PPI may heal the ulcers. Following an l week course of H. pylori eradication therapy by OAC for peptic ulcers, further 3 weeks of acid-suppressing therapy with PPI was not proven to promote ulcer healing rate.

Treatment of Retinal Detachment occurring in Two Cases of von Hippel-Lindau Syndrome

PURPOSE: To report two cases of retinal detachment associated with von Hippel-Lindau syndrome, one case of rhegmatogenous retinal detachment combined with mild proliferative vitreoretinopathy and a case of tractional retinal detachment. METHODS: Case reports. Pars plana vitrectomy with membrane peeling and silicone oil tamponade were performed in all cases. Lens aspiration was also performed in one case. RESULTS: Successful retinal reattachment was obtained in all cases. Case 2 developed cataract and secondary glaucoma and was treated with phacoemulsification with posterior chamber lens insertion and YAG laser iridotomy. CONCLUSIONS: In two patients with retinal detachment occurring in von Hippel-Lindau syndrome, we could obtain successful retinal reattachment with stabilized visual acuity after performing pars plana vitrectomy and silicone oil injection.

A STUDY ON THE EFFECT OF THERMOCYCLING TO THE PHYSICAL PROPERTIES OF DENTURE LINERS / 대한치과보철학회지

For the improvement of denture fitness of changed residual ridge, denture liner can be used. Denture liner should be very stable physically in various environments of the mouth as well as be bonded strongly with denture resin. In this study, the specimens bonded with four kinds of soft denture liner and three kinds of hard denture liner were used to test the physical properties of the liners. All experimental groups were stored in 37+/-1degrees C distilled water for 24hours, followed by thermocycling between 15degrees C and 45degrees C with 15 second dwell time. 1000, 2000, 3000 cycles of thermocycling were excuted and physical properties were measured by Instron Universal Testing Machine. The obtained results were as follows: 1. In tensile bond test of soft liners, it was shown that both of Molloplast-B(R) specimens before and after thermocycling had the highest tensile strength, and in case of hard liners, Dura-liner II(R)speimen had the highest tensile strength before and after thermocycling. Depending on thermocycling, Soft-Relining(R), Denture-Relining(R),Molloplast-B(R), Coe-soft(R) and Kooliner(R) specimen showed significant difference(p<0.05). 2. In strain test of soft liners, it was shown that Molloplast-B(R) specimen before thermocycling and the Coe-soft(R) after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) speimen before and after thermocycling had the highest result. Depending on thermocycling. Denture-Relinig(R). Molloplast-B(R) and Dura-Lner II(R) specimen showed significant difference(p<0.05). 3. In Maximum distance test of soft liners, the Molloplast-B(R) specimen before thermocycling and the Coe-soft(R) after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) specimen before and after thermocycling showed highest results. Depending on thermocycling, Denture-Relining(R), Molloplast-B(R) specimens showed significant difference(p<0.05). 4.In elasticity test of soft liners , the Molloplast-B(R) specimen before and after thermocycling showed highest results, and in case of hard liners, the Dura-Liner II(R) specimen before thermocycling and the Tokuso-Rebase (R) after thermocycling showed highest results. Depending on thermocycling, Soft-Relining(R) , Molloplast-B(R) specimens showed significant difference(p<0.05).

Effect of Camostat Mesylate on Chemical Compositions of Bile and Crystallization in Gallbladder Stone Patients

BACKGROUND: It has been well demonstrated that trypsin inhibitor can stimulate the secretion of cholecystokinin. Camostat mesylate (C20H22N4O5 CH3SO3H) is a synthetic trypsin inhibitor. We demonstrated the effect of camostat mesylate on the chemical composition of bile and the crystallization in gallbladder-stone patients. METHODS: Gallbladder bile sample from 22 patients with GB stones were analyzed. In 11 patients, camostat mesylate (Foy-pan ) was administered orally in a dosage of 600 mg per day for more than 5 days, and the results of the bile analysis were compared to those of 11 controls. RESULTS: The total protein concentration in the camostat group was lower than that in control group (0.21+/-0.10 vs 0.24+/-0.06 g/dl) but the difference was not significant (p=0.41). The total bile acid concentration in the camostat group was significantly lower than that in the control group (5.47+/-1.56 vs 6.85+/-1.32 g/dl, p=0.04). The concentrations of cholesterol and phospholipid were lower in the camostat group (0.35 +/- 0.19 vs 0.44 +/- 0.11 g/dl, 2.10 +/- 1.19 vs 2.92 +/- 0.93, respectively), but the differences were not statistically significant (p=0.20, p=0.09, respectively). The total lipid concentration which reflects the concentrated magnitude of the bile, was significantly lower in the camostat group (7.93 +/- 2.87 vs 10.20 +/- 2.01 g/dl, p=0.04). The cholesterol saturation index didn't demonstrate a significant difference between the two groups (1.06 +/- 0.27 vs 0.95 +/- 0.31, p=0.38). Crystallization in the bile from cholesterol stone patients, was observed every day for 7 days. Crystallizations was less frequent in the camostat group, but the difference was not statistically significant (1/6 vs 4/8, p=0.39). DISIDA (disofenin iminediacetate) scans were performed in 3 healthy volunteers to observe the changes in the radioactivities and the volumes of the gallbladders before and after the administrations of camostat. The peak radioactivities, the transittime to the peak radioactivity, and the gallbladder volume at the peak radioactivity in the scan after the administration of camostat were lower than in the corresponding values before the administration. CONCLUSIONS: Camostat mesylate lowers the concentration of all bile components. We assume that the effects of Camostat mesylate are mediated by CCK, which enhances gallbladder motility and limits the concentrating function of the gallbladder.

Exercise-induced Acute Renal Failure Associated with Nonsteoidal Anti-inflammatory Drugs: Report of 2 Cases / 대한신장학회잡지

Acute nonmyoglobinuric renal failure with severe loin pain and patchy renal vasoconstriction is a clinical syndrome that occurs following exercise in previously healthy young persons. Also nonsteroidal anti-inflammatory drugs predispose to acute renal failure in conditions associated with decreased renal blood flow. Probably exercise-induced renal ischemia and prostaglandin inhibition by NSAIDs may predispose to develop this syndrome. Here, we report two cases of acute renal failure with severe loin pain after strenuous exercise while taking NSAIDs with review of literature.