OBJECTIVES: Amenorrhea, one of the most common side effects of neuroleptics, has known to be associated with prolactin elevation. Hyperprolactinemia seriously affects mental health causing depression, anxiety or hostility, while also affecting physical health causing amenorrhea, galactorrhea or sexual dysfunction. The possible correlation between risperidone-induced amenorrhea and depression, anxiety and quality of life was evaluated in a cross-sectional open study. METHODS: During a five-month period, WHO quality of life-BREF (WHOQOL), Beck depression inventory (BDI) and Statetrait anxiety inventory (STAI) were applied twice at two-month intervals for 30 patients with risperidone-induced amenorrhea and 22 patients without amenorrhea. RESULTS: Amenorrhea group had significantly higher scores in BDI and STAI-state, while showing lower scores in the quality of life than control group. The total BDI and STAI-state scores were more negatively correlated with WHOQOL score in amenorrhea group. CONCLUSION: Patients with risperidone-induced amenorrhea rated themselves significantly more depressed and more anxious, and a lower quality of life compared to the control group. Clinicians should be more active in evaluating and treating hyperprolactinemic side effects such as amenorrhea, galactorrhea, depression and anxiety.
Amenorrhea* ; Antipsychotic Agents ; Anxiety* ; Depression* ; Female ; Galactorrhea ; Hostility ; Humans ; Hyperprolactinemia ; Mental Health ; Pregnancy ; Prolactin ; Quality of Life* ; Risperidone* ; Schizophrenia

Traumatic subdural hygroma has received little attention in the literature, the authors experienced 17 cases of traumatic subdural hygroma after introduction of Computerized Tomography(CT) since October 1977 in Kyung Hee University Hospital. Characteristics in CT of our experienced traumatic subdural hygromas were almostly bilateral and located on the anterior aspect of the interhemispheric fissure, frontal and frontotemporal side with decrease density as like cerebrospinal fluid. Subdural hygroma easily differentiated with subdural hematoma by use of the CT scan. Subdural hygroma usually respond readily to evacuation of watery yellowish or cerebrospinal fluid-like fluid through simple burr hole, conservative treatment effected only 3 cases out of 17 subdural hygromas.
Cerebrospinal Fluid ; Hematoma, Subdural ; Subdural Effusion* ; Tomography, X-Ray Computed

OBJECTIVES: The objective of this study is to evaluate the prevalence of endometrial premalignant and malignant polyps in women who underwent hysteroscopic polypectomies, and to investigate whether clinical parameters predict histopathologic outcomes. METHODS: A review was carried out on the medical records of patients who had undergone hysteroscopic endometrial polypectomy from January 2010 to December 2011. One thousand one hundred ninety-six women who ranged in age from 16 to 81 years were included in the study. Polyps were classified as benign (endometrial polyps and polyps with non-atypical simple hyperplasia and non-atypical complex hyperplasia), premalignant (polyps with atypical simple hyperplasia or atypical complex hyperplasia), or malignant. A statistical analysis was then performed. RESULTS: Histopathologically, 96.7% benign, 1.1% premalignant, and 2.2% malignant lesions were detected. Abnormal uterine bleeding and postmenopause were the only factors which were determined to be associated with a higher risk of malignancy, with an odds ratios of 5.07 (95% CI, 2.25-11.41) and 3.41 (95% CI, 1.14-10.24), respectively. CONCLUSION: The risk factors associated with premalignant and malignant endometrial polyps include abnormal uterine bleeding and menopause.
Endometrial Neoplasms ; Female ; Humans ; Hyperplasia ; Hysteroscopy ; Medical Records ; Menopause ; Metrorrhagia ; Odds Ratio ; Polyps ; Postmenopause ; Prevalence ; Risk Factors ; Uterine Hemorrhage

We present the rare case of solitary xanthogranuloma in the upper cervical column mimicking a Brown-Sequard syndrome. A 29-year-old man complained with right hemiparesis and left hypoesthesia after a car accident. Computed tomography and magnetic resonance images revealed a lobulated homogenously well-enhancing mass in between posterior arch of the atlas (C1) and spinous process of the axis (C2) resulting in a marked spinal canal narrowing with cortical erosions. The patient was managed by complete resection of the tumor with partial laminectomy with lower half of C1 posterior arch and upper half of C2 spinous process. The authors advise complete removal of the xanthogranuloma and consideration as a differential diagnosis of lesions among upper cervical lesions.
Adult ; Axis, Cervical Vertebra ; Brown-Sequard Syndrome ; Cervical Vertebrae ; Diagnosis, Differential ; Female ; Humans ; Hypesthesia ; Laminectomy ; Magnetic Resonance Spectroscopy ; Male ; Paresis ; Spinal Canal ; Spine ; Xanthogranuloma, Juvenile

PURPOSE: Low-birth-weight(LBW) neonates often need multiple transfusions during their neonatal period. The routine use of the 500ml mono-bag system in Korea, even in neonatal transfusions, results in a great waste of blood and exposes the neonate to multiple blood donors. To reduce the waste of blood and the number of exposures, we used quadruple blood bags in the transfusion of LBW neonates. METHODS: From November 1995 to April 1997, 86 neonates weighing less than 2,000gm were enrolled in this study. Forty-four of those neonates needed blood transfusions. Using quadruple blood bags, we were able to safely make 3 units of packed red blood cell(RBC) from each directed donors. RESULTS: Seventy-seven units of packed RBC could be made from 29 directed donors and 58 of those units were actually transfused to the 25 neonates. Blood age of the directed donor blood prepared in the quadruple blood bags were relatively older than those of bank bloods at the time of transfusion, thus, K+ concentration was higher but the total K+ amounts infused through transfusions were within tolerable ranges in both groups. CONCLUSION: Using quadruple blood bag in the transfusion of LBW neonates, we could reduce the number of donor exposures and also the waste of blood. K+ loads to the neonates through the transfusion of directed donor blood were within tolerable range in the neonatal physiology.
Blood Donors ; Blood Transfusion ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Infant, Newborn* ; Korea ; Physiology ; Tissue Donors

This study compared the effects of programs according to management type by preparing a manual for oral muscle exercises that integrates oral movement and oral massage. The program was performed on 14 elderly patients in a seniors' college self-practice program group and 28 elderly patients in a social welfare center expert intervention group. In the self-practice group, an expert demonstrated oral muscle exercises and subsequently encouraged self-practice by selecting an oral muscle exercise leader. In the expert intervention group, an expert demonstrated oral exercises on a one-on-one basis and subsequently gave oral muscle massages. In the self-practice group, there was no difference in saliva secretion (p=0.213) or oral dryness (p=0.206), after the intervention, the expert intervention group showed improvements in saliva secretion (p=0.009) and oral dryness (p=0.007). There was no difference in program satisfaction between groups (p=0.143), and both groups reported high satisfaction. As seniors may have difficulty in maintaining oral health behaviors, a certain amount of expert intervention may be needed. The results suggest that both a self-practice oral exercise program and an expert intervention program can be effective elderly patients.
Aged* ; Exercise ; Gangwon-do* ; Humans ; Massage ; Oral Health ; Saliva ; Social Welfare ; Xerostomia

Acupuncture appears to be a clinically effective treatment for acute and chronic pain. A considerable amount of research has been conducted to evaluate the role that acupuncture plays in pain suppression; however, few studies have been conducted to evaluate the side effects of the acupuncture procedure. This case report describes a suspected postdural puncture headache following acupuncture for lower back pain. Considering the high opening pressure, cerebrospinal fluid leakage, and the patient's history of acupuncture in the lower back area, our diagnosis was iatrogenic postdural puncture headache. Full relief of the headache was achieved after administration of an epidural blood patch.
Acupuncture ; Blood Patch, Epidural ; Cerebrospinal Fluid Pressure ; Chronic Pain ; Headache ; Low Back Pain ; Needles ; Post-Dural Puncture Headache

OBJECTIVE: To present the incidence and management of dural tears and cerebrospinal fluid leakage during corrective osteotomy [Pedicle Subtraction Osteotomy (PSO) or Smith-Petersen Osteotomy (SPO)] for ankylosing spondylitis with kyphotic deformity. METHODS: A retrospective study was performed for ankylosing spondylitis patients with fixed sagittal imbalance, who had undergone corrective osteotomy (PSO or SPO) at lumbar level. 87 patients were included in this study. 55 patients underwent PSO, 32 patients underwent SPO. The mean age of the patients at the time of surgery was 41.7 years (21-70 years). Of the 87 patients, 15 patients had intraoperative dural tears. RESULTS: The overall incidence of dural tears was 17.2%. The incidence of dural tears during PSO was 20.0%, SPO was 12.5%. There was significant difference in the incidence of dural tears based on surgical procedures (PSO vs. SPO) (p<0.05). The dural tears ranged in size from 12 to 221 mm2. A nine of 15 patients had the relatively small dural tears, underwent direct repair via watertight closure. The remaining 6 patients had the large dural tears, consequently direct repair was impossible. The large dural tears were repaired with an on-lay graft of muscle, fascia or fat harvested from the adjacent operation site. All patients had a successful repair with no patient requiring reoperation for the cerebrospinal fluid leak. CONCLUSION: The overall incidence of dural tears during PSO or SPO for ankylosing spondylitis with kyphotic deformity was 17.2%. The risk factor of dural tears was complexity of surgery. All dural tears were repaired primarily using direct suture, muscle, fascia or fat graft.
Cerebrospinal Fluid* ; Congenital Abnormalities* ; Fascia ; Humans ; Incidence* ; Osteotomy* ; Reoperation ; Retrospective Studies ; Risk Factors ; Spondylitis, Ankylosing* ; Sutures ; Transplants

OBJECTIVE: Ossification of the posterior longitudinal ligament (OPLL) has a strong genetic component. Specific gene polymorphisms may be associated with OPLL in several genes which regulate calcification in chondrocytes, change of extracellular collagen matrix and secretions of many growth factors and cytokines controlling bone morphogenesis. Toll-like receptor 5 (TLR5) may play a role in the pathogenesis of OPLL by intermediate nuclear factor-kappa B (NF-kappaB). The current study focused on coding single nucleotide polymorphisms (SNPs) of TLR5 for a case-control study investigating the relationship between TLR5 and OPLL in a Korean population. METHODS: A total of 166 patients with OPLL and 231 controls were recruited for a case-control association study investigating the relationship between SNPs of TLR5 gene and OPLL. Four SNPs were genotyped by direct sequencing (rs5744168, rs5744169, rs2072493, and rs5744174). SNP data were analyzed using the SNPStats, SNPAnalyzer, Haploview, and Helixtree programs. Multiple logistic regression analysis with adjustment for age and gender was performed to calculate an odds ratio (OR). RESULTS: None of SNPs were associated with OPLL in three alternative models (codominant, dominant, and recessive models; p > 0.05). A strong linkage disequilibrium block, including all 4 SNPs, was constructed using the Gabriel method. No haplotype was significantly associated with OPLL in three alternative models. CONCLUSION: These results suggest that Toll-like receptor 5 gene may not be associated with ossification of the posterior longitudinal ligament risk in Korean population.
Case-Control Studies ; Chondrocytes ; Clinical Coding ; Collagen ; Cytokines ; Genetic Association Studies ; Haplotypes ; Humans ; Intercellular Signaling Peptides and Proteins ; Linkage Disequilibrium ; Logistic Models ; Longitudinal Ligaments ; Morphogenesis ; Odds Ratio ; Ossification of Posterior Longitudinal Ligament ; Polymorphism, Single Nucleotide ; Spine ; Toll-Like Receptor 5 ; Toll-Like Receptors

Tumors of the pineal area are a small proportion of neoplasm of the brain and the majority of these tumor are pathologically classified as pinealoma, Until recently, ventriculography was the most useful diagnostic methods in suspected cases of pineal tumor. However, the diagnosis of posterior third ventricular tumor may be established easily with computed tomography(CT) and its size, shape, component of tumor and the direction of expansion may be visualized. Authors had experienced nine cases of the pineal tumor during about two years from October 1977 to July 1979, which were diagnosed with CT, EMI-5005 in type. We presented a clinical findings for our cases and attempted to assess clinically. The result were summarized as following; 1. The age range was from 5 months after birth to 39 years. Of 9 cases, 6 cases were below age of 20 years and 3 over age of 20 years. All but one were found in males. 2. The duration of symptoms varied from two weeks to eighteen months. The average was approximately 7 months. 3. The symptoms and signs depend on the route taken by the expanding tumors. In our series, headache found in all cases initially, vomiting in 7 cases, and papilledema in 7 cases on admission. Parinaud's sign showed in 5 cases of all patients and papillary change in 3 cases. Of 9 cases, 3 cases had a transient DI symptoms and 2 cases manifested cerebellar dysfunction in corresponding to CT findings. 4. We had performed CT scan on all cases and diagnosed pineal tumor. In pre-enhancement CT, increased density around pineal area showed in 5 cases, isodensity in 2 cases and low density in 2 cases. Among the 9 cases, 5 cases, showed well outlined a lesion by contrast enhancement. All of the cases showed symmetrical dilatation of lateral ventricles with variable degree and distortion and compression defect to the posterior third ventricle disclosed in 6 cases. 5. We had treated 8 cases with V-P shunt following irradiation therapy ranged 3000-600 Rad. in total amount for 5-6 weeks. A case of the pineal tumor had treated with V-P shunt alone because of full coma at admission. We performed biopsy through the infratentorial supracerebellar approach in one case only and confirmed pineocytoma histopathologically. 6. The result of treatment obtained as follows with excellent in 3 cases, good in 4, poor in one, and death in one case. Two cases with exellent result of treatment spend their life happily without any symptoms and follow up CT disclosed no evidence of previous tumor shadow and normal sized ventricles. A poor case developed quadriplegia during irradiation therapy due to tumor seeding to cervical cord probably.
Biopsy ; Brain ; Cerebellar Diseases ; Coma ; Diagnosis ; Dilatation ; Follow-Up Studies ; Headache ; Humans ; Lateral Ventricles ; Male ; Papilledema ; Parturition ; Pinealoma* ; Quadriplegia ; Third Ventricle ; Tomography, X-Ray Computed ; Vomiting