Background: and Purpose: The aim of this study was to investigate the effects of multicomponent exercise on cognitive function, depression, and quality of life in elderly individuals. Methods: This study prospectively recruited 605 participants, and constructed an exercise pyramid comprising even distributions of daily physical activities, aerobic exercise, musclestrengthening exercise, flexibility exercise, balance exercise, and activities that subjects could perform while sitting down. The exercise program was divided into six stages according to the participant’s level of frailty. The 12-week exercise program intervention was conducted once yearly. Results: The exercise regimen was followed by 402 of the 605 enrolled participants, giving a dropout rate of 33.6%. The 27-month exercise program was completed by 60 participants.The scores for the Mini Mental State Examination for dementia screening (MMSE-DS), short form of the Geriatric Depression Scale, World Health Organization Quality of Life Assessment (WHOQOL-BREF), International Physical Activity Questionnaire (IPAQ), fear of falling, handgrip strength, and walking speed were improved after the exercise intervention. The analysis of frailty revealed that participants in the frail group showed greater improvements for the MMSE-DS, WHOQOL-BREF, IPAQ, fear of falling, handgrip strength, and walking speed. Conclusions Individually customized, multicomponent exercise programs lead to improved levels of cognitive function, depression, and quality of life, especially among those who are more frail.

No abstract available.
Bowen's Disease*

Bronchiolitis obliterans (BO) is a late onset complication of allogeneic hematopoietic stem cell transplantation (HSCT), and treatment outcome is dismal if it does not respond to immunosuppressive therapy. A 21-year-old male diagnosed with acute myeloid leukemia received an allogeneic HSCT from human leukocyte antigen- identical sibling donor. Twenty one months after transplantation, he developed progressive dyspnea and was diagnosed BO. Despite standard immunosuppressive therapy, the patient rapidly progressed to respiratory failure and Novalung(R) interventional lung-assist membrane ventilator was applied in the intensive care unit. Three months after the diagnosis of BO, the patient underwent bilateral lung transplantation (LT) and was eventually able to wean from the ventilator and the Novalung(R). Since the LT, the patient has been under a strict rehabilitation program in order to overcome a severe lower extremity weakness and muscle atrophy. Histologic findings of the explanted lungs confirmed the diagnosis of BO. Nine months after the LT, the patient showed no signs of rejection or infectious complications, but still required rehabilitation treatment. This is the first LT performed in a patient with BO after allogeneic HSCT in Korea. LT can be an effective therapy in terms of survival for patients with respiratory failure secondary to development of BO following HSCT.
Bronchiolitis Obliterans* ; Bronchiolitis* ; Diagnosis ; Dyspnea ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Intensive Care Units ; Korea ; Leukemia, Myeloid, Acute ; Leukocytes ; Lower Extremity ; Lung Transplantation* ; Lung* ; Male ; Membranes ; Muscular Atrophy ; Rehabilitation ; Respiratory Insufficiency ; Siblings ; Tissue Donors ; Treatment Outcome ; Ventilators, Mechanical ; Young Adult

BACKGROUND: The term solitary fibrous tumor (SFT) is preferred over meningeal hemangiopericytoma (HPC), because NAB2-STAT6 gene fusion has been observed in both intracranial and extracranial HPCs. HPCs are now considered cellular variants of SFTs. METHODS: This study analyzes 19 patients with STAT6-confirmed SFTs, who were followed for over 11 years in a single institution. Ten patients (10/19, 56.2%) had extracranial metastases (metastatic group), while the remainder (9/19) did not (non-metastatic group). These two groups were compared clinicopathologically. RESULTS: In the metastatic group, the primary metastatic sites were the lungs (n = 6), bone (n = 4), and liver (n = 3). There was a mean lag time of 14.2 years between the diagnosis of the initial meningeal tumor to that of systemic metastasis. The median age at initial tumor onset was 37.1 years in the metastatic group and 52.5 in the non-metastatic group. The 10-year survival rates of the metastatic- and non-metastatic groups were 100% and 33%, respectively. The significant prognostic factors for poor outcomes on univariate analysis included advanced age (≥45 years) and large initial tumor size (≥5 cm). In contrast, the patients with higher tumor grade, high mitotic rate (≥5/10 high-power fields), high Ki-67 index (≥5%), and the presence of necrosis or CD34 positivity showed tendency of poor prognosis but these parameters were not statistically significant poor prognostic markers. CONCLUSIONS: Among patients with SFTs, younger patients (<45 years) experienced longer survival times and paradoxically had more frequent extracranial metastases after long latent periods than did older patients. Therefore, young patients with SFTs require careful surveillance and follow-up for early detection of systemic metastases.
Central Nervous System ; Diagnosis ; Follow-Up Studies ; Gene Fusion ; Hemangiopericytoma ; Humans ; Liver ; Lung ; Meningeal Neoplasms ; Necrosis ; Neoplasm Metastasis* ; Prognosis ; Solitary Fibrous Tumors* ; Survival Rate

OBJECTIVES: We aimed to explore the influence of depression on working memory in patients with mild cognitive impairment (MCI) and dementia. METHODS: Clinical and neuropsychological data of 43 subjects with mild cognitive impairment (MCI) (n=17) and dementia (n=26) who had visited Department of Psychiatry at Soonchunhyang University Seoul Hospital, were collected. The subjects were divided into depressed (n=18) and non-depressed (n=25) groups based on the Korean version of Short Geriatric Depression Scale. Two-way analysis of variance test was conducted to evaluate the influence of diagnosis (MCI and dementia), the presence of depression and their interaction on working memory which was measured by digit forward and backward span test. RESULTS: Among the patients with MCI, test score of digit backward span test in depressed group was significantly lower than in non-depressed group. However, among the patients with dementia, there was no significant difference in digit backward span test between depressed and non-depressed groups. CONCLUSION: This study suggests that the depression could deteriorate working memory measured by digit backward span test in patients with MCI, relative to in patients with dementia and it also implicates the diagnostic assessment for depression has clinically importance in patients with MCI.
Dementia* ; Depression* ; Diagnosis ; Humans ; Memory, Short-Term* ; Mild Cognitive Impairment* ; Seoul

BACKGROUND: This study was performed to compare the effectiveness of prophylactic dexamethasone and postintubation dexamethasone in reducing the incidence and severity of postoperative sore throat (POST). METHODS: This was a prospective, randomized, double-blind clinical trial. The study population consisted of 70 patients between 20 and 60 years old who were classified as American Society of Anesthesiologists I-II and were scheduled for elective laparoscopic cholecystectomy. The patients were divided randomly into two groups. Patients in the prophylactic and postintubation groups received intravenous injection of 10 mg of dexamethasone 30 min before or after tracheal intubation, respectively. The patients were interviewed 1, 6, and 24 h after the operation. The incidence and severity of POST were recorded. RESULTS: The severity scores of POST at 1 and 6 h after the operation were significantly lower in the prophylactic group than in the postintubation group. There were no significant differences in the incidence of POST during the 24 h after the operation between the two groups (22/32 in the prophylactic group vs. 27/34 in the postintubation group, P = 0.403). CONCLUSIONS: Intravenous injection of 10 mg of dexamethasone was more effective in reducing the severity of POST when administered before tracheal intubation compared with after tracheal intubation.
Cholecystectomy ; Cholecystectomy, Laparoscopic ; Dexamethasone ; Humans ; Incidence ; Injections, Intravenous ; Intubation ; Pharyngitis ; Prospective Studies

The aim of this study was to propose new more reliable peripheral nerve transection model to overcome the defect of the traditional sciatic axotomy model by specifically transecting L5 spinal nerve just after emerging from the intervertebral foramen and confining analysis area to the L5 spinal segment. The adult male Sprague-Dawley rats, weighing 300~350 g at the time of surgery, were used for the experiments. Four different experimental groups were used. 1. Sciatic nerve transection (Sc-Tx) group: transect the sciatic nerve in the popliteal fossa where it divided into the common peroneal nerve and tibial nerve. 2. L5 spinal nerve transection (L5-Tx) group: L5 spinal nerve was specifically transected. 3. Suture (Su) group: L5 spinal nerve was transected and immediately sutured. 4. Control group: the same surgical procedure with L5 spinal nerve transection group was performed except for the excision of L5 spinal nerve. To distinguish L5 motoneurons from the other level ones, the animals were received the retrograde tracer, FluoroGold into the axotomized proximal nerve stump. Serial coronal frozen sections at 40 microm thick through the L4 to L6 spinal segment was performed and the resultant total number of sections was about 180. Approximate serial 50 sections (approximately 2 mm) could be considered as the L5 segment based on the number of the fluorescent signals (above 20). L5 spinal segment could be differentiated from L4 and L6 segment based on their morphological characteristics under Cresyl violet stain. In L5-Tx group, at 2 and 4 weeks post-transection, the number of L5 spinal motoneurons was reduced by 8%. Meanwhile, Sc-Tx and Su groups showed no statistically notable changes. In this study, the authors could propose more reliable peripheral nerve axotomy model than the conventional sciatic nerve axotomy model by specifically transecting L5 spinal nerve and confining the investigating area within the L5 spinal segment.
Adult ; Animals ; Axotomy ; Benzoxazines ; Frozen Sections ; Humans ; Male ; Peripheral Nerve Injuries ; Peripheral Nerves ; Peroneal Nerve ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; Spinal Nerves ; Sutures ; Tibial Nerve ; Viola

The aim of this study was to propose new more reliable peripheral nerve transection model to overcome the defect of the traditional sciatic axotomy model by specifically transecting L5 spinal nerve just after emerging from the intervertebral foramen and confining analysis area to the L5 spinal segment. The adult male Sprague-Dawley rats, weighing 300~350 g at the time of surgery, were used for the experiments. Four different experimental groups were used. 1. Sciatic nerve transection (Sc-Tx) group: transect the sciatic nerve in the popliteal fossa where it divided into the common peroneal nerve and tibial nerve. 2. L5 spinal nerve transection (L5-Tx) group: L5 spinal nerve was specifically transected. 3. Suture (Su) group: L5 spinal nerve was transected and immediately sutured. 4. Control group: the same surgical procedure with L5 spinal nerve transection group was performed except for the excision of L5 spinal nerve. To distinguish L5 motoneurons from the other level ones, the animals were received the retrograde tracer, FluoroGold into the axotomized proximal nerve stump. Serial coronal frozen sections at 40 microm thick through the L4 to L6 spinal segment was performed and the resultant total number of sections was about 180. Approximate serial 50 sections (approximately 2 mm) could be considered as the L5 segment based on the number of the fluorescent signals (above 20). L5 spinal segment could be differentiated from L4 and L6 segment based on their morphological characteristics under Cresyl violet stain. In L5-Tx group, at 2 and 4 weeks post-transection, the number of L5 spinal motoneurons was reduced by 8%. Meanwhile, Sc-Tx and Su groups showed no statistically notable changes. In this study, the authors could propose more reliable peripheral nerve axotomy model than the conventional sciatic nerve axotomy model by specifically transecting L5 spinal nerve and confining the investigating area within the L5 spinal segment.
Adult ; Animals ; Axotomy ; Benzoxazines ; Frozen Sections ; Humans ; Male ; Peripheral Nerve Injuries ; Peripheral Nerves ; Peroneal Nerve ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; Spinal Nerves ; Sutures ; Tibial Nerve ; Viola

The simultaneous occurrence of achalasia and esophageal diverticula is rare. Here, we report the case of a 68-year-old man with multiple esophageal diverticula associated with achalasia who was later diagnosed with early esophageal cancer. He initially presented with dysphagia and dyspepsia, and injection of botulinum toxin to the lower esophageal sphincter relieved his symptoms. Five years later, however, the patient presented with worsening of symptoms, and esophagogastroduodenoscopy (EGD) was performed. The endoscopic findings showed multifocal lugol-voiding lesions identified as moderate dysplasia. We decided to use photodynamic therapy to treat the multifocal dysplastic lesions. At follow-up EGD 2 months after photodynamic therapy, more lugol-voiding lesions representing a squamous cell carcinoma in situ were found. The patient ultimately underwent surgery for the treatment of recurrent esophageal multifocal neoplasia. After a follow-up period of 3 years, the patient showed a good outcome without symptoms. To manage premalignant lesions such as achalasia with esophageal diverticula, clinicians should be cautious, but have an aggressive approach regarding endoscopic surveillance.
Aged ; Botulinum Toxins ; Carcinoma, Squamous Cell ; Deglutition Disorders ; Diverticulum ; Diverticulum, Esophageal* ; Dyspepsia ; Endoscopy, Digestive System ; Esophageal Achalasia* ; Esophageal Neoplasms* ; Esophageal Sphincter, Lower ; Follow-Up Studies ; Humans ; Photochemotherapy

OBJECTIVE: We aimed to examine the efficacy and the safety of venlafaxine extended release (venlafaxine-XR), and its effect on the quality of life in patients with generalized anxiety disorder. METHODS: Fifty three patients who had generalized anxiety disorder were recruited for this study. They showed scores of 18 or higher on the Hamilton Rating Scale for Anxiety (HAMA) and did not have major depression. They were scheduled to be examined 5 times (at baseline, 4, 8, 16 and 24 weeks) and took venlafaxine-XR for 24 weeks with a flexible dosing schedule. The primary efficacy variables were the response and remission rates (response: more than 50% reduction from baseline in HAMA total score ; remission: HAMA total score< or =7). Other variables were the Hamilton Ratng Scale for Depression, Beck Anxiety Inventory, Sheehan Disabilities Scale (SDS), and World Health Organization Quality of Life Assessment Instrument-Brief Form (WHOQOL-BREF). Also, the evaluation on adverse effects was performed. RESULTS: The number of patients who completed 24 weeks of treatment was 32 (60.4%). Twenty one patients who were dropped out included 8 patients with intolerable adverse effects and 7 patients with unsatisfactory treatment response. Response/remission rates were 43.4/32.1% in the last-observation-carried-forward methods and 71.9/53.1% in the observed case data. Treatment with venlafaxine-XR improved anxiety and depressive symptoms during 24 weeks on all efficacy measures. By a completed patient analysis, venlafaxine-XR also significantly improved the disability scores on SDS and the quality of life scores on WHOQOL-BREF. In this study, nausea, palpitation, and severe tremor were common reasons of venlafaxine-XR discontinuation in GAD patients, but any serious adverse effect did not occur. CONCLUSION: Treatment with venlafaxine-XR was effective and well-tolerated for the patients with GAD, and also improved quality of life in the GAD patients.
Anxiety Disorders* ; Anxiety* ; Appointments and Schedules ; Depression ; Humans ; Nausea ; Prospective Studies* ; Quality of Life ; Treatment Outcome ; Tremor ; World Health Organization ; Venlafaxine Hydrochloride