PURPOSE: There is a continuing question as to whether breast conserving surgery confers a measure of psychological comfort superior to that of total mastectomy for women diagnosed with breast cancer. The purpose of this study was to determine the differences of the psychiatric symptoms experienced between modified radical mastectomy and breast conserving surgery patients. METHODS: We compared 38 patients who underwent modified radical mastectomy with 16 patients who underwent breast conserving surgery from a psychiatric aspect. Psychiatric symptoms and distress were measured following surgery with two self-rating scales: the Symptom Check List-90-Revision (SCL-90-R) and the General Health Questionnaire (GHQ: 28-item version). RESULTS: There were no statistically significant differences between the modified radical mastectomy patients and the breast conserving surgery patients on the two scales. CONCLUSION: From our findings, it appears that breast conserving surgery is not superior to modified radical mastectomy in terms of psychiatric morbidity for breast cancer patients. The absence of differences between modified radical mastectomy patients and breast conserving surgery patients on psychiatric measures is probably due to several factors. In this study, these factors appeared to be a fear of cancer recurrence, the nature of breast cancer itself, the burden of radiation therapy, a late post operative period and selection bias.
Female ; Humans ; Breast Neoplasms

OBJECTIVE: Nitric oxide(NO) has been known to be associated with tolerance and preference to alcohol. It has also been known to affect various alcohol drinking behavior, alcohol withdrawal symptoms and alcohol-induced brain damage. The purpose of this study was to determine the difference, among alcohol dependence group, alcohol drinking group and abstinence group, in serum concentration of nitrite, a stable metabolite of NO, and it's relationship to clinical and biochemical markers of alcoholism. METHODS: Forty subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated for the clinical characteristics and biochemical markers of alcohol dependence including nitrite with their CIWA-Ar scores checked just after admission. Thirty-nine healthy controls were also evaluated, divided into twenty-three alcohol drinking group and sixteen abstinence group. Clinical characteristics were evaluated by CIWA-Ar, CAGE and AUDIT questionnaires. Aspartate aminotransferase(AST), alanine aminotransferase (ALT), gamma glutamyltransferase(GGT) and mean corpuscular volume(MCV) were used as the biochemical markers of alcohol dependence. Serum nitrite concentrations were measured by Griess reaction. RESULTS: 1) The concentrations of nitrite in alcohol dependence patients were not different from those in the control subjects. 2) There were no significant association between the nitrite concentrations and the CIWA-Ar scores in alcohol dependence patients. 3) Nitrites are significantly increased in alcohol dependence group and alcohol drinking group compared with abstinence group. CONCLUSIONS: These findings suggest that serum nitrite concentration has no relation with alcohol withdrawal symptoms, but alcohol drinking increases serum nitrite concentration influenced by general condition of the body.
Alanine Transaminase ; Alcohol Drinking ; Alcoholism ; Aspartic Acid ; Biomarkers ; Brain ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Nitrites ; Surveys and Questionnaires ; Substance Withdrawal Syndrome

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a Glidescope® video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA Supreme ™) rather than further intubation was successfully used to maintain the airway.
Aged ; Anesthesia, General ; Biopsy ; Bronchi ; Bronchoscopy ; Decompression ; Ganglion Cysts ; Humans ; Intubation ; Intubation, Intratracheal* ; Laryngeal Masks* ; Trachea ; Ulnar Nerve ; Vocal Cords

. The findings indicate that analog facebow transfer produced a linear deviation ranging from 3 to 16 mm and an angular deviation of the occlusal plane between 5 to 7 degrees. This case report confirms that, across two patients, analog facebow transfer can result in varying degrees of positional deviation, thereby potentially leading to inaccuracies in the fabrication of dental pros-theses. These results suggest that, in clinical practice, the use of analog facebow transfer may yield significant deviations during the process of mounting maxillary casts.

OBJECTIVE: The aims of this study were to (1) validate the inter-rater reliability of the BEHAVE-AD, Korean version, to (2) analyze the quantitative relationship between severity of Alzheimer's disease (AD) and mean scores on each of the BEHAVE-AD categories and mean total BEHAVE-AD score. DESIGN: Cross-sectional study of geriatric patients with AD evaluated at a mental hospital for the elderly. SAMPLE: Fifty-two consecutive patients diagnosed with probable Alzheimer's disease (AD) according to NINCDS-ADRDA diagnostic criteria. RESULTS: In reliability study, significant correlations were obtained for all BEHAVE-AD symptoms category scores and for mean total BEHAVE-AD scores. Analysis of BEHAVE-AD scores as a function of disease severity demonstrated a non-linear relationship between severity of behavioral symptoms and the global and cognitive advance of AD. Score analysis of the BEHAVE-AD indicates that these behavioral disturbances become most severe in the moderate and moderately severe stages of AD. CONCLUSION: All the results proved the cross-cultural validity and reliability of the BEHAVE-AD, Korean version. Furthermore, these results have implications for the methodology of pharmacological trials of putative cognitive enhancer compounds in AD.
Aged ; Alzheimer Disease* ; Behavioral Symptoms ; Cross-Sectional Studies ; Dementia ; Hospitals, Psychiatric ; Humans ; Pathology* ; Psychotic Disorders ; Reproducibility of Results

BACKGROUND: This study was to verify the necessity of a control program developed to improve compliance, by conducting a research on the status of medication compliance in the elderly with chronic diseases in rural area and analyzing the related variables. METHODS: The organized questionnaire and pill-count were used to collect information on personal details, physical status, drugs taken in the elderly over 65 years old suffering from more than two chronic diseases in one rural area. RESULTS: The mean age of the subjects was 73.13+/-6.36 (65~93), and the number of the subjects in compliance group was 60 (77.9%) and the accuracy of self-report which was identified by pill-count was 0.86. Polypharmacy and visiting several clinics were the main factors that decided a low- degree of compliance, with OR of 5.92 (95% CI 1.11~31.44, P=0.037), and 4.25 (95% CI 1.03~17.53, P=0.045), respectively. CONCLUSION: Systematic efforts are necessary and plans must be established without delay to increase compliance in the elderly in the rural, expansively to manage chronic diseases in stay-at-home elders.
Aged ; Chronic Disease ; Compliance ; Humans ; Medication Adherence ; Polypharmacy ; Republic of Korea ; Stress, Psychological ; Surveys and Questionnaires

PURPOSE: The nose of most Koreans is characterized as a low nasal dorsum, retracted columella, and an acute columella-labial angle. For the surgical correction of the tip and columella, a modified septal extension graft, along with augmentation rhinoplasty has been developed. METHODS: With this technique, a septal extension graft is fixed on the entire caudal margin of the septum (the cephalic-caudal axis) and at the same time, it is placed above the anterior nasal spine, in the membranous portion of the septum and at the base of the columella(the anterior-posterior axis). The present report describes the results obtained in 13 patients and offers an analysis of the results as judged by the columella- labial angle and 4 proportional indices(nose height index, nasal bridge length index, nasal tip projection index, columella length index), measured by photogrammetry. RESULTS: The postoperative values obtained in these 5 categories increased significantly compared to the preoperative ones, thus confirming that the projection of tip was augmented, the nose was lengthened, and the columella was advanced caudally and lengthened. Moreover, these positive outcomes were still maintained during the follow-up period, and no side effects, such as saddle nose deformity, were reported. CONCLUSION: A modified septal extension graft can be considered as an effective method for the surgical correction of the nasal tip and columella in Koreans.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Nose ; Photogrammetry ; Rhinoplasty ; Spine ; Transplants*

PURPOSE: The nose of most Koreans is characterized as a low nasal dorsum, retracted columella, and an acute columella-labial angle. For the surgical correction of the tip and columella, a modified septal extension graft, along with augmentation rhinoplasty has been developed. METHODS: With this technique, a septal extension graft is fixed on the entire caudal margin of the septum (the cephalic-caudal axis) and at the same time, it is placed above the anterior nasal spine, in the membranous portion of the septum and at the base of the columella(the anterior-posterior axis). The present report describes the results obtained in 13 patients and offers an analysis of the results as judged by the columella- labial angle and 4 proportional indices(nose height index, nasal bridge length index, nasal tip projection index, columella length index), measured by photogrammetry. RESULTS: The postoperative values obtained in these 5 categories increased significantly compared to the preoperative ones, thus confirming that the projection of tip was augmented, the nose was lengthened, and the columella was advanced caudally and lengthened. Moreover, these positive outcomes were still maintained during the follow-up period, and no side effects, such as saddle nose deformity, were reported. CONCLUSION: A modified septal extension graft can be considered as an effective method for the surgical correction of the nasal tip and columella in Koreans.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Nose ; Photogrammetry ; Rhinoplasty ; Spine ; Transplants*

OBJECTIVE: Glyphosate intoxicated patients are increasing as glyphosate use increases. This study was conducted to analyze clinical characteristics of glyphosate intoxication patients to provide early treatment to high risk patients. METHODS: We retrospectively collected data pertaining to glyphosate intoxicated patients who visited emergency department from January 2012 to December 2016 based on medical records. The patients were divided into survivors and deaths, after which their clinical characteristics and laboratory results were compared. RESULTS: Among 84 glyphosate intoxicated patients, 12 died (14.3%). The mortality group showed advanced age (P=0.006), low blood pressure (P=0.001), worse mental status (P=0.000), low arterial blood pH (P=0.000), high serum creatinine (P=0.030), high glucose (P=0.000), high serum lactate (P=0.011), and low serum albumin (P=0.034). Logistic multivariate regression analysis revealed that the mortality group had advanced age (odds ratio [OR], 1.193), high serum glucose (OR, 1.018), and low systolic blood pressure (OR, 0.961) compared to the survivor group. CONCLUSION: On the scene and emergency department, glyphosate intoxicated patients with advanced age, high serum glucose level, and low systolic blood pressure should be provided early supportive treatments and transported to a toxicology facility.
Blood Glucose ; Blood Pressure ; Creatinine ; Emergency Service, Hospital ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hypotension ; Lactic Acid ; Medical Records ; Mortality ; Retrospective Studies ; Serum Albumin ; Survivors ; Toxicology

OBJECTIVE: Under the hypothesis that 5-HTTLPR polymorphism plays some role in the susceptibility or vulnerability of some subgroup of alcohol dependence, associations of 5-HTTLPR polymorphism with alcohol dependence were examined. METHOD: This association analysis included 109 Korean alcohol dependent and 113 Korean control subjects. DNA of all subjects were genotyped for the biallelic functional polymorphism in the 5-HTTLPR. Considering the likelihood of heterogeneity in the alcohol dependence phenotype, alcohol dependent subjects were subgrouped by onset age, family history of alcohol dependence and severity of withdrawal symptoms. RESULTS: There were no significant differences in the frequencies of either the 5-HTTLPR genotype or the short vs. long allele in alcohol dependent and control subjects. The frequency of the S allele and S-carrier (LS or SS genotype) was significantly increased in the early onset alcohol dependent subjects and the familial alcohol dependent subjects compared with that in the control subjects. CONCLUSION: The results suggest that the 5-HTT 'S' promoter polymorphism is associated with an increased susceptibility or vulnerability to develop early onset alcohol dependence and familial alcohol dependence, which characterize Cloninger's type 2 alcohol dependence.
Age of Onset ; Alcoholism* ; Alleles ; DNA ; Genotype ; Humans ; Phenotype ; Population Characteristics ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin* ; Substance Withdrawal Syndrome