ABSTRACT
BACKGROUND AND PURPOSE: The effect of cognitive intervention in patients with dementia is inconsistent. This study sought to find out the effect of cognitive intervention by measuring interval change between before and after intervention. METHODS: We evaluated cognitive changes according to clinical diagnostic group across Gangwon province for 940 patients with dementia diagnosed at hospital clinics and 2,975 subjects without dementia. All subjects were treated with cognitive intervention. They underwent a cognitive and mood assessment before and after intervention. We used interval change of Mini-Mental State Examination (MMSE) scores as a primary measure of interventional outcome. RESULTS: Changes in mean MMSE score were significantly different between the non-dementia group and the dementia group (p=0.016), with changes of 0.7±2.4 and 1.0±3.7 points (±standard deviation), respectively. Cognitive improvement regarding completion of session was significantly higher in the dementia group (p=0.001), with changes of 0.41±4.51 for uncompleted group and 1.30±3.22 points for completed ones. Lower initial MMSE scores, lower age, and type of intervention were found to be independent predictive factors of subsequent cognitive changes as indicated by mean MMSE scores. CONCLUSIONS: These findings suggest that cognitive intervention might be useful for patients with dementia. Their response to treatment might be related to the type of intervention.
Subject(s)
Humans , Cognitive Behavioral Therapy , DementiaABSTRACT
No abstract available.
Subject(s)
Ataxia , Atrophy , Cerebellar Ataxia , Spinocerebellar AtaxiasABSTRACT
Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.
Subject(s)
Humans , Congenital Abnormalities , Head , Mandible , Maxilla , Methods , Oral and Maxillofacial Surgeons , Orthognathic SurgeryABSTRACT
Anisakiasis of the gastrointestinal tract is caused by the ingestion of raw fish or uncooked food infested with Anisakis larvae. A large number of cases of gastric anisakiasis have been reported in countries where the eating of raw fish is customary. However, there have been few reports of anisakiasis of the colon confirmed by colonoscopy and also very few reports of endoscopic ultrasonographic findings of anisakiasis. A 47-year-old man had epigastric pain with nausea after eating raw anchovies. Endoscopy found a living tubular structure penetrating into the lesser curvature of the stomach and the midtranseverse colon area. It was withdrawn with biopsy forceps. We report a case of anisakiasis simultaneously invading the stomach and the colon confirmed by endosopic utrasonographic findings and biopsy findings.
Subject(s)
Anisakiasis , Anisakis , Biopsy , Colon , Colonoscopy , Eating , Endoscopy , Endosonography , Gastrointestinal Tract , Larva , Nausea , Stomach , Surgical InstrumentsABSTRACT
Neuroblastoma originates in the sympathetic division of the autonomic nervous system, and is the most common extracranial solid malignancy in children; rarely developing in adults. Generally this primitive neuronal malignancy develops during fetal development or in early childhood. However, we have cared for one elderly patient with neuroblastoma. The 84-year-old woman suffered from several symptoms, such as general weakness, weight loss, and hematuria. Her abdominopelvic computed tomography showed an 8.5 x 8 cm mass, which originated from the right kidney. Pathological examination by explorative laparotomy indicated neuroblastoma. She was treated by radical nephrectomy. One year later, there has been no recurrence or solid organ metastasis, and the patient has been in good clinical condition.
Subject(s)
Adult , Aged , Female , Humans , Autonomic Nervous System , Fetal Development , Hematuria , Kidney , Laparotomy , Neoplasm Metastasis , Nephrectomy , Neuroblastoma , Neurons , Prognosis , Recurrence , Weight LossABSTRACT
Gastric wall abscess is a one form of phlegmonous gastritis and there are scare reports on this. Gastric wall abscess is a purulent inflammatory disease and it is commonly caused by a focal injury to the gastric mucosa such as a penetrating trauma from an ingested foreign body or an endoscopic biopsy where by bacterial infection occurs throughout all the layers of the gastric wall. With symptoms such as abdominal pain and fever, making the diagnosis after an operation was possible in the past, but it has recently become possible to make the diagnosis before the operation via esophagogastroduodenoscopy, endoscopic ultrasonography and/or abdominal computed tomography. We recently experienced a case of gastric wall abscess that was associated with a foreign body (presumably a fish bone) in a healthy middle aged woman. By performing generalized esophagogastroduodenoscopy and abdominal computed tomography at a primary medical institution, we made an early diagnosis and treated the patient. Herein, we report on this case and we review the relevant literature.
Subject(s)
Female , Humans , Middle Aged , Abdominal Pain , Abscess , Bacterial Infections , Biopsy , Cellulitis , Early Diagnosis , Eating , Endoscopy, Digestive System , Endosonography , Fever , Foreign Bodies , Gastric Mucosa , GastritisABSTRACT
Organophosphate insecticides are used globally and are household items in rural areas of Korea. Their ingestion for a suicidal purpose is common in Korea. Respiratory failure is the most serious manifestation and the usual cause of death in acute organophosphate poisoning, and is usually common during acute cholinergic crisis. But, respiratory failure may appear suddenly in a patient who is recovering from a cholinergic crisis, even while receiving conventional therapy. Most of these respiratory failures are associated with intermediate syndrome or pneumonia. In several recent studies, acute pancreatitis as a complication of organophosphate poisoning has been shown to be not a rare condition and respiratory failure may also occur in acute pancreatitis. However, acute lung injury developing as a complication of organophosphate intoxication-induced pancreatitis has not been hitherto reported in Korea. We described a case of a 50-year-old woman who had acute organophosphate intoxication-induced acute pancreatitis. The patient developed acute lung injury on the eighth day hospital day, after cholinergic crisis, without intermediate syndrome and pneumonia. Exclusion of other causes indicated that the acute lung injury may have developed due to acute pancreatitis.
Subject(s)
Female , Humans , Middle Aged , Acute Lung Injury , Cause of Death , Eating , Family Characteristics , Insecticides , Korea , Organophosphate Poisoning , Pancreatitis , Pneumonia , Respiratory InsufficiencyABSTRACT
Metastasis to the skin from internal malignant neoplasms is an uncommon event. Although carcinoma of the ovary is the second most common malignancy in women, cutaneous involvement originating from ovarian cancer is particularly unusual. A 30-year-old woman had been treated with chemotherapy for ovarian cancer 4 years previously. She showed an erythematous indurated subcutaneous nodule on her left shoulder and scalp. Histopathologic findings showed multiple cribriform pattern cellular masses and some cords or tubular structures floating on a mucinous pool, which were similar to primary mucinous cystadenocarcinoma. We report this case of cutaneous metastasis from ovarian cancer.
Subject(s)
Female , Humans , Neoplasm Metastasis , Ovarian NeoplasmsABSTRACT
Mucormycosis is a rare invasive fungal infection that chiefly occurs in immunocompromized patients and the outcome is generally fatal. Primary cutaneous mucormycosis is a rare phenotype of mucormycosis, and it usually follows direct inoculation of fungi on damaged skin. Many cutaneous infections mimic sprotrichosis, including virus, bacteria, acid-fast bacilli, fungi and protozoa, yet mucormycosis is very rare. We report on a case of cutaneous mucormycosis that mimicked sporotrichosis in a 77 years old woman.
Subject(s)
Female , Humans , Bacteria , Fungi , Hydrazines , Mucormycosis , Phenotype , Skin , Sporotrichosis , VirusesABSTRACT
Tinea capitis is rare in Korea, especially in adults. Microsporum canis has been the most common cause of tinea capitis in Korea from the middle of the 1970s. The infection may occur from animal to man (zoophilic). We report two cases of tinea capitis occurring in a 60-year-old female and a 73-years-old female who developed a kerion celci form and seborrheic dermatitis-like form. From the two patients Microsporum canis was isolated.
Subject(s)
Adult , Animals , Female , Humans , Middle Aged , Korea , Microsporum , Tinea , Tinea CapitisABSTRACT
Amelanotic melanomas comprise only 2% of malignant melanomas and are commonly a difficult clinical diagnosis, due to the lack of melanin pigment typically found in melanomas. Even rarer is the amelanotic malignant melanoma, which may clinically mimic a variety of other less serious cutaneous lesions such as erythema or pruritus, and therefore misdirecting the clinician toward improper treatments and frequently delaying necessary diagnostic biopsy. We report a rare case of amelanotic melanoma occurring in the left retromandibular area with a poor prognosis. A 73-year-old woman presented with a 3-year history of a erythematous lesion in the left retromandibular area. The lesion was surgically removed and biopsy was performed. The biopsy specimen showed atypical, pleomorphic tumor cells with little melanin pigment. On immunohistochemical study, the tumor cells were positive for S-100 protein, HMB-45 and Melan-A. These findings were consistent with amelanotic malignant melanoma. On positron emission tomography/computed tomography (PET/CT), hypermetabolic lesions were found in both the axillary lymph nodes. She was treated with chemotherapy. But four months later, the patient died. Amelanotic melanoma is extremely rare and is more aggressive than pigmented lesions in the similarly stage. The absence of pigmentation in the tumor may result in diagnostic confusion. The clinician should be familiar with the presentation of amelanotic malignant melanoma to facilitate prompt diagnosis. Early diagnosis is crucial since survival is related to tumor thickness and tissue invasion.
Subject(s)
Aged , Female , Humans , Biopsy , Early Diagnosis , Electrons , Erythema , Hydrazines , Lymph Nodes , MART-1 Antigen , Melanins , Melanoma , Melanoma, Amelanotic , Pigmentation , Prognosis , Pruritus , S100 ProteinsABSTRACT
BACKGROUND: Actinic keratoses (AK) have been recognized as precancerous lesions, they have been recently considered to be an early in situ squamous cell carcinoma (SCC). However, there have been few studies to determine the clinical and histopathological characteristics of AK, and especially in the Province of Chungcheongnam-do. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 80 cases of AK in the province of Chungcheongnam-do. METHODS: The authors evaluated the clinical and histopathological features of 80 patients with AK at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. RESULTS: The ratio of male to female patients was 1:4.7. The age distribution ranged from 42 to 93 years old. Single lesions are more common than multiple lesions. The duration of lesions was variable with a mean duration of 25.1 months. The most commonly involved sites were the face and especially the cheek. The color was erythematous in 63.3% of the cases, brownish in 24.5%, dark-brownish in 9.5% and gray in 2.7%. Crust and scale were noted in 37.4% and 22.4% of the cases, respectively. SCC was associated with AK in 6.3% of the cases, basal cell carcinoma was associated with AK in 1.3%, and keratoacanthoma in 1.3%. The most common histopathological types of AK were atrophic types in 20.6%, and this was followed by the hypertrophic types in 18.6% of the cases and the hypertrophic and atrophic types in 14.7% of the cases. CONCLUSION: Our results are similar to those of the previous reports. In addition, we observed a consistently higher incidence in females than males in the Korean reports and a more frequent incidence of single lesions than multiple lesions in the Asian reports. We found that AK is not easily distinguishable from SCC both clinically and cytologically. Thus, we suggest that biopsies and active treatments should be performed on AK lesions.
Subject(s)
Female , Humans , Male , Actins , Age Distribution , Asian People , Biopsy , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cheek , Incidence , Keratoacanthoma , Keratosis, ActinicABSTRACT
BACKGROUND: Actinic keratoses (AK) have been recognized as precancerous lesions, they have been recently considered to be an early in situ squamous cell carcinoma (SCC). However, there have been few studies to determine the clinical and histopathological characteristics of AK, and especially in the Province of Chungcheongnam-do. Objective: The purpose of this study was to evaluate the clinicopathological characteristics of 80 cases of AK in the province of Chungcheongnam-do. METHODS: The authors evaluated the clinical and histopathological features of 80 patients with AK at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. RESULTS: The ratio of male to female patients was 1:4.7. The age distribution ranged from 42 to 93 years old. Single lesions are more common than multiple lesions. The duration of lesions was variable with a mean duration of 25.1 months. The most commonly involved sites were the face and especially the cheek. The color was erythematous in 63.3% of the cases, brownish in 24.5%, dark-brownish in 9.5% and gray in 2.7%. Crust and scale were noted in 37.4% and 22.4% of the cases, respectively. SCC was associated with AK in 6.3% of the cases, basal cell carcinoma was associated with AK in 1.3%, and keratoacanthoma in 1.3%. The most common histopathological types of AK were atrophic types in 20.6%, and this was followed by the hypertrophic types in 18.6% of the cases and the hypertrophic and atrophic types in 14.7% of the cases. CONCLUSION: Our results are similar to those of the previous reports. In addition, we observed a consistently higher incidence in females than males in the Korean reports and a more frequent incidence of single lesions than multiple lesions in the Asian reports. We found that AK is not easily distinguishable from SCC both clinically and cytologically. Thus, we suggest that biopsies and active treatments should be performed on AK lesions.
Subject(s)
Female , Humans , Male , Actins , Age Distribution , Asian People , Biopsy , Carcinoma, Basal Cell , Carcinoma, Squamous Cell , Cheek , Incidence , Keratoacanthoma , Keratosis, ActinicABSTRACT
Cutaneous manifestations of secondary syphilis vary widely. Nodular lesions and condyloma lata on multiple sites are an uncommon presentation. A 34-year-old man presented with a 1-month history of multiple nodules and papules on the chest and multiple erythematous whitish nodules with maceration on the perineal area and anus, oral cavity, and umbilicus. On the basis of a serologic test for syphilis and skin biopsy, nodular syphilid and condyloma lata was confirmed. We report an unusual case of secondary syphilis that presented with multiple nodular syphilid on the chest and multiple condyloma lata arising in the perineum, anus, oral cavity, umbilicus.
Subject(s)
Adult , Humans , Anal Canal , Biopsy , Mouth , Perineum , Serologic Tests , Skin , Syphilis , Syphilis, Cutaneous , Thorax , UmbilicusABSTRACT
In the WHO-EORTC (World Health Organization-European Organization for Research and Treatment of Cancer) classification, the primary cutaneous B-cell lymphomas were divided into 4 groups: primary cutaneous marginal zone B-cell lymphoma, primary cutaneous follicle center cell lymphoma, primary cutaneous diffuse large B-cell lymphoma, other, and primary cutaneous diffuse large B-cell lymphoma, leg type (PCLBCL LT). PCLBCL LT is known to have more aggressive clinical behavior and a worse prognosis than the other groups of primary cutaneous B-cell lymphomas. We report here on a case of PCLBCL LT in a 55-year-old male who presented witha multiple erythematous nodules on the right leg. After chemotherapy, the skin lesions had almost cleared, but afterward the tumor was revealed to have metastasized to the brain during 1 year.
Subject(s)
Humans , Male , Middle Aged , B-Lymphocytes , Brain , Leg , Lymphoma , Lymphoma, B-Cell , Lymphoma, B-Cell, Marginal Zone , Neoplasm Metastasis , Prognosis , Skin , World Health OrganizationABSTRACT
BACKGROUND: Epidermal cysts are the most common type of epithelial cysts of the skin. There have been a few studies to determine the clinical and histopathological characteristics of epidermal cysts. OBJECTIVE: The purpose of this study was to evaluate the clinicopathological characteristics of 243 cases of epidermal cysts in the province of Chungcheongnam-do. METHODS: We retrospectively evaluated the clinical and histopathological features of 243 cases of epidermal cysts at Soonchunhyang University Hospital in Cheonan from January 1998 to December 2008. RESULTS: The ratio of male to female patients was 1.7:1. The age distribution of subjects at the first visit ranged from 11 months to 83 years. The most common site of occurrence was the face. The most common histopathological change of the cystic wall was atrophy. Cystic contents such as calcifications, parakeratotic cells, red blood cells as well as keratinous material were observed. We found stromal changes such as foreign body reactions, fibrosis and granulation tissue. Forty-seven cases were clinically misdiagnosed as other diseases, but subsequent histopathological findings demonstrated the presence of epidermal cysts. No particular relationship was found among duration, size, atrophy of the cyst wall and calcification of keratin material. CONCLUSION: We reaffirmed contiguity with previous reports. In addition, we found some cases could have been clinically misdiagnosed as other diseases. In addition, there was a poor relationship between the duration of the lesion and other variables such as the size of the lesion, the degree of atrophy of the cyst wall and calcification of keratin material.
Subject(s)
Female , Humans , Male , Age Distribution , Atrophy , Epidermal Cyst , Erythrocytes , Fibrosis , Foreign Bodies , Granulation Tissue , Keratins , Retrospective Studies , SkinABSTRACT
Langerhans cell histiocytosis (LCH) is related diseases characterized by proliferation of Langerhans cell with involvement of bone, skin, lung and other organs. LCH usually occurs in childhood and are presented as multiple small papules or eczematoid lesion mostly. We report a 50-year-old man with 3 brown lichenoid patches on left dorsal foot. He was diagnosed pulmonary LCH 5 years ago. Typical LC cells on skin lesion and CD1 complex positive staining confirm the diagnosis of LCH. We consider brown lichenoid patches may be a previously unreported cutaneous presentation in cutaneous or multisystem LCH.
Subject(s)
Humans , Middle Aged , Foot , Histiocytosis, Langerhans-Cell , Lung , SkinABSTRACT
PURPOSE: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. MATERIALS AND METHODS: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. RESULTS: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. CONCLUSION: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.