Lifetime psychopathological characteristics associated with comorbid obsessive-compulsive disorder in clinically stable patients with chronic schizophrenia.

Obsessive-compulsive symptoms (OCS) commonly occur in the course of schizophrenia. The aim of this study was to investigate the rate of obsessive-compulsive disorder (OCD) in patients with chronic schizophrenia and evaluate lifetime correlates of the comorbidity. Subjects were clinically stable patients with chronic schizophrenia (n = 320). Patients having comorbid OCD and those without OCD were compared in terms of symptoms dimensions and cognitive function. OCD was found in 20.6 % of subjects. Earlier age at onset, male gender, higher level of education, comorbid panic disorder, and specific phobia were associated with comorbid OCD. In terms of lifetime symptoms, depression (p = 0.001) and anxiety (p = 0.014) showed significant association with the comorbidity, which corroborates with our previous study findings regarding OCD in bipolar disorder. In addition, decreased emotional response (p = 0.016), less formal thought disorder (p = 0.007), and less prodromal impairment (p = 0.005) were independently associated with the comorbidity. The OCD group showed better performance in working memory domain (p = 0.027) while other cognitive domains did not show any significant difference between the two groups. Association of OCSs with depressive symptoms and other comorbid anxiety disorders seems to be a common finding across schizophrenia and bipolar disorder. This study also suggests that comorbidity of OCD in schizophrenia is associated with less impairment of thought process and cognitive function throughout the disease course.

Psychopathologic structure of bipolar disorders: exploring dimensional phenotypes, their relationships, and their associations with bipolar I and II disorders.

BACKGROUND: Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders. METHODS: We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling. RESULTS: We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders. CONCLUSIONS: We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.

Traumatic Posterior Dislocation of the Sternoclavicular Joint: A case Report / 대한정형외과학회잡지

Dislocation of the clavicle at its sternal end is relatively rare, as compared with acromioclavicular dislocation. Among them, the posterior dislocation of the sternoclavicular joint was extremely rare. So, not more than fifty cases had been reported in the literature. Of these three main typesanterior, superior, and posterior-the anterior one is by far the most common. Most authors have stressed the difficulty in confirming the diagnosis with routine radiographs. We experienced a case of traumatic posterior dislocation of the sternoclavicular joint treated successfully by manipulative reduction. So, we report it with review of literature.

The Use of Flexible Intramedullary Nails in Fracture of the Tibial Shaft / 대한정형외과학회잡지

Forty five cases of adult tibial shaft fractures were treated with flexible intramedullary nails under image intensifier at the department of orthopaedic surgery, Capital Armed Forces General Hospital during between April 1986 to July 1988. The results were summarized as follows: 1. 45 cases were all male, the average age was 24.3 years and the most common cause of fractures was sports injury(20 cases) and the second most common cause was traffic accident(18 cases). 2. 11 cases out of 45 cases were open fracture and 34 cases were closed fracture. Eight cases of open fraeture were grade I and three cases were grade II. Twenty eight cases were comminuted fracture. The most common level of the fracture was middle third of the tibial shaft. 3. Average interval from injury to Ender nailing was 13.5 days and the mean duration of permission to full weight bearing was 9.2 weeks. 4. Out of 2 cases of delayed union, the average time of clinical bone union was 9.7 weeks and that of roentgenological bone union was 14 weeks. 5. 11 cases of complication were noted among the 45 cases of tibial shaft fracture which were treated by PGP nailing such as angulation, rotation, ankle joint stiffness, delayed union, shortening, and soft tissue infection. 6. PGP nailing is considered to be a valuable method in treating tibial shaft fracture because of their relative ease of nailing, allowing early weight bearing and decreased complication.

The Treatment of Acromioclavicular Separation / 대한정형외과학회잡지

There are many procedures described for the treatment of acromioclavicular separation. Eleven cases were operated on by technique of Weaver and Dunn method and ten cases by modified Phemister method and four cases by Dewar and Barrington method, and one cases by Mumford method, Dept. of Orthopaedic Surgery, Capital Armed Forces General Hospital from March 1986 to March 1989. The following results were obtained. l. All patients were male and the peak incidence was in 3rd decade(77%). 2. The most common causes of the injuries were athletic accidents and followed by traffic accidents. 3. Twenty three patients were grade III by Allman's classification and grade II in three cases. 4. Clinical results were good in 19 cases(73.1%), fair in 5 cases(19.2%) and poor in 2 cases(7.7%). 5. The operative procedures in grade III may be good treatment of acromioclavicular separation.

99mTc Pyrophosphate Knee Scintigraphy as a Diagnostic tool for the Tear of the Meniscus of the Knee / 대한정형외과학회잡지

We tried to evaluate the possibility that the radionuclide imaging of the knee with 99mTc-pyrophosphate be the diagnostic tool for the patients with the suspected tear of the meniscus of the knee. Among the 142 cases in which 99mTc-pyrophosphate scan was performed, both arthrogram and knee scintigraphy were performed in 60 cases, but only 25 cases were done arthroscopy & arthrotomy for identification to intraarticular legion. We observed 4 types of abnormally increased uptake in the scintigraphy from 16 cases of 19 cases that identified to the meniscus tear. These patterns were seen with 1) diffuse increased uptake, 2) focal increased uptake, 3) plate-like increased uptake in or near the joint space, 4) diffuse increased uptake with plate-like accentuation. Among the 25 cases, 18 cases were found to have consistent scintigraphy & operative findings, 3 cases were observed not tear of meniscus but other legions in the knee joint. And only 4 cases were seen differented to findings of arthrotomy & scintigraphy. We could conclude that the knee scintigraphy with 99mTc-pyrophosphate could be used as a helpful method of the initial evaluation of the internal derangement of the knee in the patients with the suspected tear of the meniscus of the knee.

An Isolated Dislocation of Tarsal Navicular Bone: a Case Report / 대한정형외과학회잡지

Dislocation involving tarsal navicular is a extremely rare injury compare to dislocation of other tarsal bone. One case of the tarsal navicular dislocation associated with subluxation of the midtarsal joint treated by open reduction and arthrodesis was reported.