Alteration of White Matter Integrity in Dyslexic Children: Case-Control Study / 신경정신의학

OBJECTIVES: To compare the white matter microstructure of dyslexic children with normal children using diffusion tensor imaging. METHODS: Twenty one dyslexic children and 24 normal control children were recruited in the second and third grade of elementary school students. The fractional anisotropy (FA) values of 20 representative white matter tracts were estimated from the diffusion tensor imaging data of each subject using the Johns Hopkins University-white matter tractography atlas to determine the difference in white matter integrity between the dyslexic children and normal children. RESULTS: Compared to the normal control group, the FA values of the left inferior longitudinal fasciculus [F(1,39)=5.908, p<0.05] and temporal part of the right superior longitudinal fasciculus [F(1,39)=7.328, p=0.010] were significantly higher in the dyslexic group and there was no significant difference in the other tracts. CONCLUSION: In dyslexic children, compensatory pathways develop in the left inferior longitudinal fasciculus and in the temporal part of the right superior longitudinal fasciculus.

Childhood Onset of Anti-N-Methyl-D-Aspartate Receptor Encephalitis Without Teratoma Masquerading as a Psychotic Disorder

Many neurologic disorders manifest as psychiatric symptoms. Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is an autoimmune disease of the brain characterized by numerous neurological and psychiatric features. Despite being rare, its prevalence is rapidly increasing and early management is critical in ensuring successful and sustainable recovery. Therefore, the illness should be considered as a differential diagnosis when clinically assessing patients. This report presents a case of a female child who was hospitalized for acute psychiatric manifestations, which was later confirmed as anti-NMDA receptor encephalitis. She recovered relatively successfully after combined neurological and psychiatric treatment. This report provides information on the clinical course of early onset anti-NMDA receptor encephalitis, including treatment strategy and prognosis.

Prescription Pattern of Atypical Antipsychotics in a University Psychiatric Ward : 11-Year Observational Study / 대한정신분열병학회지

OBJECTIVES: This study investigated the prescribing patterns of atypical antipsychotics for the various psychiatric disorders in the psychiatric ward of a University hospital. METHODS: We reviewed the medical records of patients who were discharged from an open psychiatric ward from May, 2003 through April, 2014. The association between psychiatric disorders and prescription pattern of atypical antipsychotics was analyzed. RESULTS: The study included 3091 patients' prescription of psychiatric medication. 60% of prescription included antipsychotics; quetiapine was the most frequently prescribed antipsychotics, but the average dosage was the lowest among all the atypical antipsychotics. According to the diagnoses, prescription rates and dosage of antipsychotics were different. Prescription rates of antipsychotics were the lowest in patients with anxiety disorders, and the mean dosage were the lowest in those with delirium, dementia, and amnestic and other cognitive disorders. CONCLUSION: This observational study shows prescription patterns of atypical antipsychotics for the treatment of psychiatric disorders in a University hospital; atypical antipsychotics were widely used for the treatment of the various disorders, and there were differences in prescription patterns for each disorders. The results of this study may be used to identify the proper atypical antipsychotics effective on certain psychiatric disorders and to propose expanding the indications of each atypical antipsychotics in the future.

The Clinical Value of Residual Urine Checked by Transrectal Ultrasonography / 대한비뇨기과학회지

PURPOSE: Post-voiding residual urine hasbeen evaluated by urethral catheterization or abdomen ultrasonography in patients with benign prostatic hyperplasia. However, urethral catheterization is invasive and abdomen ultrasonography is not cost-effective for patients with benign prostatic hyperplasia. Therefore, we wished to determine the efficacy of using transrectal ultrasonography for the evaluation of the residual urine volume. MATERIALS AND METHODS: A total of 37 patients were evaluated. The mean age of the patients was 69 years, ranging from 54-84 years. The empty bladder was instilled with a random volume of saline. In addition, the bladder volume was checked by transrectal ultrasonography. RESULTS: The total mean residual urine volume checked by transrectal ultrasonography and catheterization were different statistically. When we performed a simple linear regression of the residual urine volume determined by each method, the regression coefficient was 0.699 and the determination coefficient was 58.4%. We divided the patients into two groups-one group of patients with a residual urine volume of 150ml and the other group of patients with a prostate volume of 40ml. When the residual urine volume was less than 150ml and the prostate volume was less than 40ml, each mean residual urine volume was not different statistically. The determination coefficient was more than 60% by the simple linear regression. CONCLUSIONS: We could use transrectal ultrasonography for the purpose of a residual urine volume check. Especially when the residual urine volume was less than 150ml and the prostate volume was less than 40ml, we could estimate the residual urine volume by transrectal ultrasonography more accurately.

The Usefulness of Intraoperative Needle Decompression of the Colon during Radical Gastrectomy: A Prospective and Randomized Trial

PURPOSE: Intraoperative colonic distension is associated with postoperative ileus, which contributes to a delayed hospital discharge. A randomized and prospective study was conducted to evaluate the usefulness of intraoperative needle decompression of the colon (IDC) during a radical gastrectomy for gastric cancer. METHODS: Fifty patients that had received subtotal or total gastrectomy for gastric cancer were randomly assigned to either a non-decompression (n=27) or a decompression group (n=23). Prior to the main procedure, the transverse or right colon was pulled up, and a 19-gauge disposable needle connected to suction was introduced to the colon through the taenia site of the anterior wall. Any gas that collected in the colon was aspirated. The time to the first postoperative passage of flatus or feces was measured precisely in order to evaluate the restoration of bowel function. Additional measures of the outcome were the operation time, the complication rate and the length of hospital stay. RESULTS: Demographic details, pathologic features, operation times, complication rates and the length of hospital stay were not different between the two groups. A collapsed colon was required for good surgical exposure and easy manipulation. No unexpected complications related to the procedure were found. The average time to the first flatus was 6.8 hours sooner in the decompression group than in the non-decompression, although this result was not statistically significant. CONCLUSION: This technique is a simple and safe procedure for intraoperative colon decompression during a radical gastrectomy.