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Objective@#This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment during the coronavirus disease 2019 (COVID-19) pandemic. @*Methods@#Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID-19 and tested regularly at least three times within the last 5 years were included (1st, the initial screening; 2nd, the test immediately before the COVID-19 pandemic; 3rd, the most recent test after the pandemic). Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID-19. @*Results@#When comparing CDR changes before and after COVID-19, there was no significant difference between the two groups (p=0.317). Alternatively, the main effect of the time when the test was conducted was significant (p<0.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/ improved group significantly decreased before COVID-19 (1st–2nd) (p=0.045). After COVID-19 (2nd–3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<0.001). Mini-Mental State Examination recall memory and changes in activity during COVID-19 were significantly associated with CDR deterioration. @*Conclusion@#Memory dysfunction and decreased activity during the COVID-19 pandemic are strongly related to the deterioration of cognitive impairment.
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Objective@#: The aim of this study was to verify the equivalence and effectiveness of the tablet-administered Korean Repeatable Battery for the Assessment of Neuropsychological Status (K-RBANS) for the prevention and early detection of dementia. @*Methods@#: Data from 88 psychiatry and neurology patient samples were examined to evaluate the equivalence between tablet and paper administrations of the K-RBANS using a non-randomly equivalent group design. We calculated the prediction scores of the tablet-administered K-RBANS based on demographics and covariate-test scores for focal tests using norm samples and tested format effects. In addition, we compared the receiver operating characteristic curves to confirm the effectiveness of the K-RBANS for preventing and detecting dementia. @*Results@#: In the analysis of raw scores, line orientation showed a significant difference (t=-2.94, p<0.001), and subtests showed small to large effect sizes (0.04–0.86) between paper- and tablet-administered K-RBANS. To investigate the format effect, we compared the predicted scaled scores of the tablet sample to the scaled scores of the norm sample. Consequently, a small effect size (d≤0.20) was observed in most of the subtests, except word list and story recall, which showed a medium effect size (d=0.21), while picture naming and subtests of delayed memory showed significant differences in the one-sample t-test. In addition, the area under the curve of the total scale index (TSI) (0.827; 95% confidence interval, 0.738–0.916) was higher than that of the five indices, ranging from 0.688 to 0.820. The sensitivity and specificity of TSI were 80% and 76%, respectively. @*Conclusion@#: The overall results of this study suggest that the tablet-administered K-RBANS showed significant equivalence to the norm sample, although some subtests showed format effects, and it may be used as a valid tool for the brief screening of patients with neuropsychological disorders in Korea.
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Purpose@#The purpose of this study was to describe the ultrasonographic findings of testicular atrophy after mumps orchitis. @*Methods@#We retrospectively reviewed the case files of eight patients (14 to 24 years old; mean, 17 years) with mumps orchitis and testicular atrophy who were treated between January 2011 and September 2017. On gray-scale and color Doppler, the ultrasonographic features of volume, shape, echogenicity, and degree of blood flow in the testes were analyzed as part of both initial and follow-up ultrasonography. The duration between the initial diagnosis of mumps orchitis and the ultrasonographic diagnosis of testicular atrophy after mumps orchitis ranged from 25 to 230 days (mean, 95.9 days). @*Results@#Of the eight patients with testicular atrophy after mumps orchitis, the testes were affected unilaterally in seven patients (6 right-sided and 1 left-sided) and bilaterally in one patient. The affected testes (n=9) were 23%-55% (mean, 44.7%) smaller in volume (mean, 6.3±2.0 mL) than the contralateral normal testes (n=7) (mean, 10.8±2.3 mL) on follow-up ultrasonography (P=0.001). The shape of the atrophic testes was oblong in seven cases and elliptical in two cases. The atrophic testes were either heterogeneously hypoechoic with multiple hyperechoic islands (n=7) or heterogeneously hyperechoic (n=2). On follow-up color Doppler ultrasonography, the degree of vascularity of the atrophic testis was either similar to (n=3) or lower than (n=6) that of the contralateral testis. @*Conclusion@#On ultrasonography, atrophic testes after mumps orchitis tended to exhibit an oblong shape, heterogeneous low echogenicity with multiple hyperechoic islands, and decreased vascularity.
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Drug-induced immune hemolytic anemia is a rare disease that occurs in 1 in 1 million individuals of the general population. Rifampin-induced immune hemolytic anemia is caused by drug-dependent antibodies and this can be treated without complication by drug cessation. Herein, we present a case of rifampin-induced immune hemolytic anemia in a patient with primary Sjogren's syndrome (pSS) which occurred during treatment of pulmonary tuberculosis. At admission, the patient's laboratory tests revealed hemolytic anemia and positive direct antiglobulin test result. Since the incidence of autoimmune hemolytic anemia (AIHA) in pSS is reported to be 3 percent, which is higher than that of the general population, differential diagnosis between AIHA and rifampin-induced immune hemolytic anemia was required for planning future anti-tuberculous treatment. We identified rifampin-dependent antibody by drug-induced immune complex test and diagnosed rifampin-induced immune hemolytic anemia. Based on this experience, if rifampin administration is considered in patients with systemic autoimmune disease such as pSS, which has a high incidence of AIHA, we suggest evaluating the presence and the cause of hemolytic anemia at baseline by testing serum lactate dehydrogenase, haptoglobin, and direct and indirect antiglobulin tests before drug administration to promptly identify the cause of hemolysis if hemolytic anemia develops.
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Axillary arch is relatively common variation of muscle in the axilla. There were several attentions on axillary arch due to its anatomical and surgical importance. During educational dissection, a variant muscle was found in right arm of 68-year-old female cadaver. The variation of muscle originated from the lateral edge of the latissimus dorsi muscle as muscular form. And then, it crossed the axillary artery and median nerve as tendinous form. Finally it became wide as muscular form and inserted into the pectoralis major. We reported this variant muscle and discussed its clinical significances.
Subject(s)
Aged , Female , Humans , Arm , Attention , Axilla , Axillary Artery , Cadaver , Median Nerve , Superficial Back MusclesABSTRACT
PURPOSE: The purpose of this study was to evaluate surgical outcomes of thumb carpometacarpal osteoarthritis treated either by volar ligament reconstruction or trapeziectomy with suspensionplasty. MATERIALS AND METHODS: From July 2004 to January 2011, we treated 43 patients with thumb carpometacarpal joint arthritis by volar ligament reconstruction in stages I and II, and by trapeziectomy with suspensionplasty in stages III and IV. Out of the 43, we evaluated 19 patients (9 treated by volar ligament reconstruction, 10 treated by trapeziectomy with suspensionplasty) at an average of 36.8 months (range: 8 to 65 months) after surgery. Outcome measures included pain visual analogue scale (VAS), ranges of motion, and grip and pinch strengths. RESULTS: The mean VAS was 1.2 in the volar ligament reconstruction group and 2.0 in the trapeziectomy with suspensionplasty group at final follow-up. The ligament reconstruction group had significantly better thumb radial abduction and opposition ranges of motion, and key grip strength. No further radiographic arthritic changes were noted in the ligament reconstruction group at a mean follow-up of 39 months. CONCLUSION: The authors obtained satisfactory pain control in patients with thumb carpometacarpal osteoarthritis by volar ligament reconstruction for stages I-II and trapeziectomy with suspensionplasty for stages III-IV.
Subject(s)
Humans , Arthritis , Carpometacarpal Joints , Follow-Up Studies , Hand Strength , Ligaments , Osteoarthritis , Outcome Assessment, Health Care , ThumbABSTRACT
We describe the case of a healthy young man with a femoral head fracture by low-energy trauma that occurred without evidence of hip dislocation. While plain radiographs showed no definite fracture or dislocation, computed tomography (CT) and magnetic resonance imaging (MRI) revealed a femoral head fracture with a wedge-shaped cortical depression at the superomedial aspect of the femoral head. Our patient reported feeling that the right hip had been displaced from its joint for a moment. This probably represented subluxation with spontaneous relocation. The characteristic findings and possible mechanisms of this fracture were postulated on the basis of the sequential 3 dimensional-CT and MRI. The clinical results of conservative treatment were better than those of previously reported indentation fractures.