A case of Lewy body dementia in a 71 year-old male patient was reported and related articles were also reviewed. He has been ill with Parkinsonism since 1988, and referred to the neuropsychiatrist because of depression since 1989. Episodically he has experienced dizziness, falls and low blood pressure. Mild cognitive decline including memory, attention, language, and visuospatial ability accompanied by occasional fluctuation of consciousness, confusion, visual hallucination and disorientation was developed on February 9th in 2000. Such symptoms were repeated thereafter, and responded on donepezil in addition to the antiparkinsonian drugs.
Aged ; Consciousness ; Depression ; Dizziness ; Hallucinations ; Humans ; Hypotension ; Lewy Bodies* ; Lewy Body Disease* ; Male ; Memory ; Parkinsonian Disorders

OBJECTIVES: The aging process can influence sexual functions by physiological, pathological, behavioral and psychosocial changes. Studies on sex among elderly are scarce. However, sexual activities remain throughout life in different forms. The aim of this study was to identify sexual problems and dysfunctions among dementia patients and compare with healthy aged persons. METHODS: The sexual problems and affecting factors were evaluated by structured interview and sexual problem screening instruments for 46 dementia patients according to DSM-IV and 60 healthy Koreans aged over 60. RESULTS: 1) Frequency of erection was less than once a day in 68.0% of controls, while more than once a day in 47.6% of dementia. Trouble in attaining erection was found in 50.0% of dementia as compared with 65.4% of controls. Awake with erection was less than once a week in 37.8% of controls, while less than once a week in 22.2% and more than once a week in 10.0% of dementia. Maintaining erection was better in controls (92.0%) as compared with dementia (55.0%)(p<0.01). Number of sex partner was one in 75.0% and none in 25.0% of controls, while one in 80.0%, none in 16.0% and more than one in 4.0% of dementia. Pain during with intercourse was less in dementia (22.7%) than controls (73.2%)(p<0.001). Frequency of ejaculation and masturbation, frequency of intercourse, thoughts and dreams of sex, feeling of desire was higher in dementia than controls (p<0.05). In 41.7% of dementia patients, sexual activity cf. sexual desire was less(desired>activity). Satisfaction in sex life (41.7%), partner's satisfaction (31.8%), satisfaction with partner (45.5%) and men's interest in sex decline with age (54.5%) were higher in dementia (p<0.001, respectively). 2) The recognition of sexual problems was higher in healthy elderly (74.1%). Most of sexual dysfunctions except sexual desire disorder (83.3% in controls vs 40.0% in dementia) was higher in demetia, that is, erectile disorder (30.0%), premature ejaculation (20.0%), and orgasmic disorder (10.0%). The duration over 5 years of sexual problems was the most in both (46.7% in controls vs 53.3% in dementia). 3) Problematic sexual behaviors seen among dementia patients were obscene remarks/sexual hallucination (30.8%, respectively), public exposure (15.4%), inappropriate contact/physical contact with others/sexual seduction toward other patients (1.7%, respectively) in that order. Appea-rance time of sexual problems was over 1 year of dementia (50.0%), within 1 year of dementia (32.4%), and with the initiation of dementia (17.6%). The frequency was more than once a week in 60.0% and less than once a week in 40.0% of dementia. Place of sexual misbehavior was one's own room (68.6%), other place (22.9%), toilet (5.7%), activity therapy room (2.9%) in that order. Targets of sexual misbehavior were other patients (40.0%), caregivers (31.4%), medical personnel/others (14.3%, respectively) in that order. For the management of sexual misbehavior, most of the doctors chose non-pharmacological methods (83.9%). CONCLUSION: The sexual activity among Korean elderly with age over 60 was more active in healty controls than dementic patients, while sexual dysfunction except sexual desire disorder was more in dementic patients than healthy controls. Therefore, special interest and proper management was needed toward hypersexuality as well as sexual hypoactivity, and most of all, conceptual changes of doctors and caregivers toward sexual problems in the elderly must be preceded.
Aged* ; Aging ; Caregivers ; Dementia ; Diagnostic and Statistical Manual of Mental Disorders ; Dreams ; Ejaculation ; Hallucinations ; Humans ; Korea* ; Male ; Mass Screening ; Masturbation ; Premature Ejaculation ; Sexual Behavior ; Sexual Dysfunctions, Psychological

Andersen-Tawil syndrome (ATS), a rare autosomal dominant disorder, is characterized by periodic paralysis, dysmorphic features and cardiac arrhythmias. This syndrome is caused by mutations of KCNJ2 gene, which encodes inward rectifying potassium channel. Here, we report an 18-year-old girl who was presented with life-threatening cardiac arrhythmia and acute respiratory distress. She was diagnosed with ATS, based on dysmorphic features, ventricular arrhythmia, and periodic paralysis. This is the first case to be reported in Korea who experienced a fatal cardiac arrest and respiratory failure caused by ATS.
Andersen Syndrome ; Arrhythmias, Cardiac ; Heart Arrest ; Humans ; Korea ; Paralysis ; Potassium Channels ; Respiratory Insufficiency ; Tachycardia ; Tachycardia, Ventricular

PURPOSE: New-onset postoperative atrial fibrillation (POAF) is associated with poor short- and long-term outcomes after isolated coronary artery bypass graft (CABG) surgery. This study evaluated gender differences in the long-term clinical implications of POAF. MATERIALS AND METHODS: After propensity score matching, a gender-based comparison of long-term (>1 year) newly developed atrial fibrillation (LTAF) and mortality between 1664 (480 females) consecutive patients with (POAF) and without POAF (no-POAF) who had undergone CABG was performed. RESULTS: During a follow-up of 49±28 months, cumulative survival free of LTAF was lower in the POAF group than in the no-POAF group for both males (92.1% vs. 98.2%, p<0.001) and females (84.1% vs. 98.0%, p<0.001). However, female patients with POAF more frequently developed LTAF than male POAF patients (13.9 % vs. 6.9%, p=0.049). In multivariate analysis, POAF was a significant predictor of LTAF among males [hazard ratio (HR) 4.91; 95% confidence interval (CI) 1.22–19.79, p=0.031] and females (HR 16.50; 95% CI 4.79–56.78; p<0.001). POAF was a predictor of long-term mortality among females (adjusted HR 3.96; 95% CI 1.13–13.87, p=0.033), but not among males. CONCLUSION: Although POAF was related to LTAF in both genders, cumulative survival free of LTAF was poorer among females than among males. Additionally, a significant correlation with long-term mortality after CABG was observed among female patients with POAF.
Atrial Fibrillation* ; Coronary Artery Bypass* ; Coronary Vessels* ; Female ; Follow-Up Studies ; Humans ; Male ; Mortality ; Multivariate Analysis ; Postoperative Complications ; Propensity Score ; Transplants