Elderly Patient Trends in a Chronic Mental Hospital and Accompanying Medical Diseases

OBJECTIVE: It investigated the tendency of the increase of elderly patients in a psychiatric hospital. In this regard, it examined whether the number of patients with outpatient consultant, discharge, medical diseases, and neurocognitive disorder increased or not. METHODS: It retrospectively reviewed inpatient medical records for the years 2008, 2011, 2014, 2017. To investigate the changes of elderly patients admitted to psychiatry, it examined the changes of patients who are older than 50 or 60 years in addition to the people who are older than 65 years. It analyzed diagnosis, discharge, medical diseases, and outpatient consultant of the three groups respectively. RESULTS: It confirmed that the number of elderly patients who are older than 50, 60, and 65 years has increased in mental hospital for 10 years. There was a significant increase in the number of neurocognitive disorder patients, the ratio of consultant outpatient, and the mean number of outpatient consultant. Diabetes increased in all three groups. Especially it has significantly increased for patients who are older than 50 and 60 years. In the case of patients discharged due to transfer, the number of patients increased in all three groups but it was statistically significant for the patients who are older than 50 years. CONCLUSION: The study shows that the number of elderly patients increased with the trend of aging society. In relation to this, the rate of outpatient consultant and discharge, including diabetic and dementia patients, also increased. Therefore, if the mental health department provides a system to manage the elderly ward or nursing ward to respond to the increase of elderly patients, or to manage the accompanying chronic diseases such as diabetes and its complications, it could solve the inconvenience of patients due to the consultation outside a hospital or discharge.

Relationship between Metabolic Syndrome and Cognitive Functions in Patients with Chronic Schizophrenia / 정신신체의학

OBJECTIVES: The aim of this study was to investigate the relationship between metabolic syndrome and cognitive functions among chronic schizophrenia patients. METHODS: The survey participants were 105(40 metabolic syndrome and 65 non-metabolic syndrome) chronic schizophrenia patients at Yang-san Hospital. Each score of cognitive test(A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet, stroop test), Positive and Negative Syndrome Scale, Hamilton rating scale for Depression were assessed. Statistical analysis of the relationship between various tests of A Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet and metabolic syndrome were performed using ANCOVA and logistic regression. RESULTS: Schizophrenia patients with lower score on construction praxia were likely to be included in Metabolic syndrome group. However, there were no significant relationships in other tests between the two groups. CONCLUSION: This study found metabolic syndrome caused cognitive decline in chronic schizophrenia patients, especially Construction praxia. This study could be a basis to show metabolic syndrome has to be treated appropriately in schizophrenia patients and suggests the necessity of following longitudinal designed study.

Late Presentation of Metastatic Renal Cell Carcinoma as a Bleeding Duodenal Mass / 대한내과학회지

Gastrointestinal metastasis of a renal cell carcinoma is very rare, and the clinical course of the disease ranges from months to several decades. We experienced a case of solitary duodenal metastasis about 22 years after a right nephrectomy for clear-cell type renal cell carcinoma in a 77-year-old man who complained of melena. This case is the longest reported time interval between surgical nephrectomy to presentation with a duodenal metastasis. Patients usually present with recurrence within a year after radical nephrectomy but can present after many years, warranting lifelong surveillance.

Concurrent Thin Basement Membrane Disease and Minimal Change Disease: A Case Report / 대한내과학회지

Thin basement membrane disease is defined as diffuse thinning of the glomerular basement membrane, and is clinically characterized by persistent hematuria, minimal proteinuria, normal renal function, and a benign course. It can occur together with other glomerular diseases. We experienced a case of thin basement membrane disease concurrent with minimal-change disease. Treatment with corticosteroid resulted in improved proteinuria and peripheral edema during the follow-up period.

A Case of Primary Prostate Sarcoma / 대한내과학회지

Primary prostate sarcomas are rare neoplasms that accounts for less than 0.1% of primary prostate malignancies. Leiomyosarcoma is the most common histologic type in adults, whereas rhabdomyosarcoma is more common in pediatric patients. Historically, long-term survival rates for adult patients with prostate sarcoma are have been poor. So, early diagnosis is very important. Surgery has been the mainstay of treatment. We experienced a case of primary stromal sarcoma of the prostate. We review the literature to discuss the clinical, diagnostic, and therapeutic aspects of this uncommon tumor.

Left Ventricular Metastasis From Renal Cell Carcinoma Causing Left Ventricular Outflow Tract Obstruction

Most cases of cardiac metastasis from renal cell carcinoma (RCC) involve the vena cava or right atrium. Left ventricular metastases from RCC without involving the vena cava or right atrium are extremely rare. Herein we report a case of RCC with left ventricular metastasis causing left ventricular outflow obstruction (LVOT).

Is End-tidal Carbon Dioxide Tension Useful to Predict Arterial Carbon Dioxide Tension during One Lung Ventilation?: A Comparison with during Two Lung Ventilation / 대한마취과학회지

BACKGROUND: End-tidal carbon dioxide tension (PETCO2) is widely used to estimate arterial carbon dioxide tension (PaCO2) under various clinical conditions. This study was conducted to determine if PETCO2 during one lung ventilation (OLV) is as useful as PETCO2 during two lung ventilation (TLV) for predicting PaCO2. METHODS: Forty patients undergoing thoracic surgery were enrolled in this study. During OLV (n = 20) and TLV (n = 20), PaCO2 and PETCO2 were measured. The arterial-end tidal carbon dioxide difference (Pa-ETCO2) was then calculated and a correlation between PaCO2 and PETCO2 was evaluated during OLV and TLV. RESULTS: Pa-ETCO2 was significantly higher during OLV (8.9 +/- 5.1 mmHg) than during TLV (6.1 +/- 3.9 mmHg). In addition, the correlation between PETCO2 and PaCO2 was less significant during OLV (R(2) = 0.43) than during TLV (R(2) = 0.59). CONCLUSIONS: PETCO2 during OLV was not as accurate as PETCO2 during TLV for predicting PaCO2, which indicates that greater attention should be given to the maintenance of normocarbia during OLV than during TLV.