Psychopathologic Profiles and Clusters in Tertiary Clinic Referred Patients with Adult Attention Deficit Hyperactivity Disorder: A Person-Centered Analysis

Objective@#Adult attention deficit hyperactivity disorder (ADHD) has a heterogeneous clinical presentation with patients showing very frequent emotional problems. In the present study, patients with adult ADHD were subtyped based on their psychopathology using a person-centered approach. @*Methods@#In the present chart review study, detailed findings of psychological evaluation conducted as part of routine care were utilized. A total of 77 subjects with adult ADHD were included in the analysis. Detailed ADHD symptoms, psychiatric comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses, and severity of mood and anxiety symptoms were evaluated in the person-centered analysis. @*Results@#Three clusters were generated using clustering analysis. DSM comorbid conditions did not significantly impact the clustering. Cluster 1 consisted of ADHD combined presentation (ADHD-C) with less mood symptoms, cluster 2 of ADHD predominantly inattentive presentation and cluster 3 of ADHD-C with significant mood symptoms. Patients in cluster 3 had adulthood functional impairment more frequently compared with patients in cluster 1. Patients in cluster 3 showed recurrent thoughts of death and suicidal ideation more frequently compared with patients in cluster 1. @*Conclusion@#Further studies are needed to confirm the relationships observed in the present study.

Psychopathologic Profiles and Clusters in Tertiary Clinic Referred Patients with Adult Attention Deficit Hyperactivity Disorder: A Person-Centered Analysis

Objective@#Adult attention deficit hyperactivity disorder (ADHD) has a heterogeneous clinical presentation with patients showing very frequent emotional problems. In the present study, patients with adult ADHD were subtyped based on their psychopathology using a person-centered approach. @*Methods@#In the present chart review study, detailed findings of psychological evaluation conducted as part of routine care were utilized. A total of 77 subjects with adult ADHD were included in the analysis. Detailed ADHD symptoms, psychiatric comorbid Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses, and severity of mood and anxiety symptoms were evaluated in the person-centered analysis. @*Results@#Three clusters were generated using clustering analysis. DSM comorbid conditions did not significantly impact the clustering. Cluster 1 consisted of ADHD combined presentation (ADHD-C) with less mood symptoms, cluster 2 of ADHD predominantly inattentive presentation and cluster 3 of ADHD-C with significant mood symptoms. Patients in cluster 3 had adulthood functional impairment more frequently compared with patients in cluster 1. Patients in cluster 3 showed recurrent thoughts of death and suicidal ideation more frequently compared with patients in cluster 1. @*Conclusion@#Further studies are needed to confirm the relationships observed in the present study.

Prevalence and Epidemiological Characteristics of Endoscopically Proven Reflux Esophagitis in Children in Korea / 대한소아소화기영양학회지

PURPOSE: The prevalence of reflux esophagitis (RE) has increased recently in Korea. Little is known concerning the prevalence and characteristics of RE in pediatric patients. This study investigated the prevalence and influence of risk factors in endoscopically proven RE in Korea in pediatric patients over a period of 14 years. METHODS: A retrospective chart review of all patients between the ages of 1 month and 20 years who underwent esophagogastroduodenoscopy at Samsung Medical Center between 2001 and 2014 was carried out. Univariate and multivariate analyses were conducted to identify independent risk factors for RE. RESULTS: The prevalence rate of endoscopically proven RE in this study was 28.7% (978/3,413). The prevalence of RE increased from 11.8% from 2001 to 2007 to 37.7% from 2008 to 2014. Multivariate logistic regression analysis revealed that residency in the Greater Gangnam area (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.02-1.44) and age (OR, 1.13; 95% CI, 1.11-1.15) were significant predictive factors for the presence of RE. CONCLUSION: The prevalence rate of endoscopically proven pediatric RE has increased over the past 14 years. Residency and older age are more important independent risk factors for pediatric RE in Korea.

Hepatocellular Carcinoma Risk of Compensated Cirrhosis Patients with Elevated HBV DNA Levels according to Serum Aminotransferase Levels

Sometimes, hepatitis B virus (HBV)-related cirrhotic patients with normal aminotransferase levels are closely followed-up for the elevation of aminotransferase levels instead of prompt antiviral therapy (AVT). We analyzed the long-term hepatocellular carcinoma (HCC) risk according to the aminotransferase levels in a retrospective cohort of 1,468 treatment-naive, HBV-related, compensated cirrhosis patients with elevated HBV DNA levels (> or =2,000 IU/mL). Based on aminotransferase levels, patients were categorized into normal ( or =40 U/L, n = 1,104). During a median of 5.3 yr of follow-up (range: 1.0-8.2 yr), HCC developed in 296 (20%) patients. The 5-yr cumulative HCC incidence rate was higher in patients with elevated aminotransferase level, but was not low in normal aminotransferase level (17% vs. 14%, P = 0.004). During the follow-up, 270/364 (74%) patients with normal aminotransferase levels experienced elevation of aminotransferase levels, and AVT was initiated in 1,258 (86%) patients. Less patients with normal aminotransferase levels received AVT (70% vs. 91%, P < 0.001) and median time to start AVT was longer (17.9 vs. 2.4 months, P < 0.001). AVT duration was an independent factor associated with HCC, and median duration of AVT was shorter (4.0 vs. 2.6 yr, P < 0.001) in patients with normal aminotransferase levels. The HCC risk of compensated cirrhosis patients with normal aminotransferase level is not low, and AVT duration is associated with lowered HCC risk, indicating that prompt AVT should be strongly considered even for those with normal aminotransferase levels.

Location of Positive Surgical Margin and Its Association With Biochemical Recurrence Rate Do Not Differ Significantly in Four Different Types of Radical Prostatectomy

PURPOSE: To analyze the location of the positive surgical margin (PSM) and its association with the biochemical recurrence (BCR) rate in cases of radical prostatectomy (RP) according to the type of surgery. MATERIALS AND METHODS: We retrospectively analyzed 1,880 cases of RP. Baseline characteristics were analyzed. Locations of the PSM were recorded in the four surgery groups as apex, anterior, posterolateral, and base and were analyzed by using chi-square test. The association of the location of the PSM with the BCR rate was analyzed by using Kaplan-Meier survival analysis according to the type of surgery, which included radical perineal prostatectomy (RPP, n=633), radical retroperitoneal prostatectomy (RRP, n=309), laparoscopic radical prostatectomy (LRP, n=164), and robot-assisted laparoscopic radical prostatectomy (RALRP, n=774). RESULTS: A PSM was found in a total of 336 cases (18%): 122 cases of RPP (18%), 67 cases of RRP (17%), 29 cases of LRP (17%), and 119 cases of RALRP (15%). The PSM rate did not differ significantly by surgical type (p=0.142). The location of the PSM was the apex in 136 cases (7.2%), anterior in 67 cases (3.5%), posterolateral in 139 cases (7.3%), and base in 95 cases (5.0%), and showed no significant difference according to surgical type (p=0.536, p=0.557, p=0.062, and p=0.109, respectively). The BCR rate according to the location of the PSM did not differ significantly for the four types of surgery (p=0.694, p=0.301, p=0.445, and p=0.309 for RPP, RRP, LRP, and RALRP, respectively). CONCLUSIONS: The location of the PSM seemed to be unrelated to type of RP. There was no significant correlation between the BCR rate and the location of the PSM for any of the RP types.

A Case of Mantle Cell Lymphoma with Skin Metastasis / 대한피부과학회지

Mantle cell lymphoma is a malignant lymphoma derived from a subset of B-cells that are localized in the mantle area of the lymphoid follicle. Extranodal involvement is frequent, and especially in the bone marrow, spleen, gastrointestinal tract and Waldeyer's ring, but skin is rarely affected. A 47-year-old male presented with a 40 day history a nodule on the abdomen on the abdomen. The histopathologic examination showed numerous atypical, small to medium sized lymphoid cells in the entire dermis. Immunohistochemically, the tumor cells were positive for CD20, CD5, CD79a and cyclin D. Our patient showed complete disappearance of his skin lesions and lymphadenopathy after combination chemotherapy.

A Survey on the Topical Steroid Prescriptions of Dermatologists / 대한피부과학회지

BACKGROUND: A recent survey on dermatology outpatients, which assessed their knowledge and behavior for topical steroid use, showed that topical steroids were often used without sufficient information or guidelines. OBJECTIVE: Our study aimed to evaluate the general pattern of which dermatologists prescribe topical steroids, the prevalence of topical steroid phobia among the dermatology outpatients and the way dermatologists managed such patients. METHODS: 236 dermatologists, including those in private clinics and those in the secondary and tertiary hospitals, were asked via mail or e-mail to fill in a questionnaire on their topical steroid prescription. RESULTS: About sixty percent of the total respondents answered that they prescribed topical steroid to more than half of their outpatients, with excluding those patients who came to the office for cosmetic purposes. Most respondents informed their patients about their prescription of topical steroids (85.61%), they explained the mechanism of its action and the clinical effects (65%), the potency and duration of application (70%), and the side effects (82%). But most respondents forgot or did not tell their patients about their steroid formulation (46%), the optimal amount to apply (74%) and the means and duration of optimal storage (82%). 45% of the respondents assumed that more than half of the outpatients to have topical steroid phobia. Yet 80% of the respondents replied that less than 10% of their outpatients had experienced side effects of topical steroids. 73% of the respondents in private clinics and 62% in secondary and tertiary hospitals were influenced by the patients' negative attitude on topical steroid prescription. CONCLUSION: The results show that the information on topical steroids, in terms of formulation, the optimal amounts to apply and the means and duration of optimal storage, were not sufficiently provided by dermatologists. The topical steroid phobia of patients has been exaggerated despite the low incidence of side effects.

Hepatitis B Serologic Markers at Birth in Babies of HBsAg-Positive Mothers

No abstract available.