Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.
Arthropathy, Neurogenic ; Diagnosis ; Edema ; Joints ; Radiography ; Range of Motion, Articular ; Rare Diseases ; Shoulder* ; Syringomyelia*

OBJECTIVES: Dance therapy can be applied as one of various psychiatric rehabilitation programs in clinical situations. This study was aimed to investigate applicability of dance therapy to schizophrenic outpatients, in regard to improving social adjustment and quality of life for these patients. METHODS: Twenty one psychiatric outpatients enlist who met DSM-IV criteria for schizophrenia were studied. We conducted dance therapy session once a week, totally 8 sessions. The assessments were done before and after dance therapy. Patients reported Self & Others Representation Inventory-Adjective Checklist (SORI), Self-esteem Scale, and Relationship Change Scale (RCS) and Doctors assessed Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), and Quality of Life Scale (QoLS) in interview. RESULTS: After 8 sessions of dance therapy, patients showed significant improvements in sociability in SORI, satisfaction, intimacy, sensitiveness, openness, comprehensiveness in RCS, and significant decrease of symptoms in BPRS, SANS. QoLS also was improved significantly. There was no significant change in Self-esteem Scale. CONCLUSION: These results suggested that dance therapy could be applied to schizophrenic outpatients in clinical situations, and it helped to improve self-representation, interpersonal relationship, and quality of life.
Brief Psychiatric Rating Scale ; Checklist ; Dance Therapy ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Outpatients ; Quality of Life ; Schizophrenia ; Social Adjustment

Neuropathic shoulder arthropathy or Charcot's shoulder is an extremely rare disease, and sometimes it is associated with cervical syringomyelia. Clinical symptoms of the disease include edema of the shoulder and restriction in range of motion. Radiological diagnosis can be made through plain radiography through a characteristic, atrophic destruction of the joint. We experienced a Charcot's joint of the shoulder wherein destruction of the joint progressed extremely quickly and reviewed the literature concerning this condition.
Arthropathy, Neurogenic ; Diagnosis ; Edema ; Joints ; Radiography ; Range of Motion, Articular ; Rare Diseases ; Shoulder ; Syringomyelia

Solitary fibrous tumors (SFT) are rare fibroblastic mesenchymal neoplasms which are originally described as neoplasms of the pleura originating from the spindle cells. Although it can originate from extrapleural sites including the head and neck, it is exceedingly rare in the sinonasal tract. There has been no reported cases of SFT involving the paranasal sinuses in Korea; however, there was case of a 34-year-old man who presented with persistent left nasal obstruction and watering of the left eye. Imaging by CT and MRI revealed a large, highly vascular tumor occupying the maxilloethmoidal sinus cavities associated with bony wall destruction, masquerading as maxillary sinus cancer. The tumor mass occupying sinus cavities was removed through endoscopic and Caldwell-Luc approach. Histopathological examination of the tumor was consistent with SFT. We report this case to further insights regarding the diagnosis and management of this rare tumor.

BACKGROUND: Leukocyte reduced (LR) and irradiated (IR) blood components are used to prevent immunological transfusion-related adverse reactions. However, so far, reports on the usage of LR or IR blood components in Korea are scarce. METHODS: Data from January, 2007 to December, 2013 provided by the Health Insurance Review and Assessment Service of Korea were analyzed. Disease categories of the patients were classified according to the Korean Standard Classification of Disease. RESULTS: In 2013, 26.7% of total transfused blood components were leukocyte reduced and an increase of 5.3% compared to 2007. The proportion of IR components increased from 21.4% in 2007 to 27.9% in 2013. The percentage of LR (IR) blood components for RBCs, platelets, and SDPs was 15.4% (14.7%), 35.1% (38.8%), and 75.2% (80.1%), respectively, in 2013. In particular, the percentage of IR FFPs units increased gradually over the years, from 11.2% in 2007 to 22.7% in 2013. LR and IR components were used mainly in hemato-oncology patients but the proportion showed a downward trend. Due to aging of the society, transfusion of LR and IR components has inclined trends in the 70's or more. CONCLUSION: Although the transfusion rate of both LR and IR blood component is increasing, it is still remarkably lower than that in developed countries. Therefore, LR and IR blood components should be used more extensively. For this, reimbursement criteria for National Health Insurance for these blood components should be extended and the fee schedule for LR and IR blood components should be adjusted to reflect clinical practice and patient need.
Aging ; Classification ; Developed Countries ; Fee Schedules ; Humans ; Insurance, Health ; Korea* ; Leukocytes* ; National Health Programs

OBJECTIVES: The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. METHODS: The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. RESULTS: The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence (CMA > or =80%) rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. CONCLUSIONS: The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
Adult ; Aged ; Antihypertensive Agents/*administration & dosage ; Comorbidity ; Disabled Persons/*statistics & numerical data ; Drug Utilization ; Female ; Health Services Accessibility ; Humans ; Insurance Claim Review ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; National Health Programs ; Patient Compliance/*statistics & numerical data ; Residence Characteristics ; Socioeconomic Factors

BACKGROUND: The purpose of this study was to compare postoperative morbidities and functional outcomes of pectoralis major myocutaneous (PMMC) flap and cutaneous free flap reconstruction approaches in hypopharyngeal squamous cell carcinoma patients. METHODS: We retrospectively reviewed records from 99 patients who underwent hypopharyngeal reconstruction with a cutaneous free flap (n=85) or PMMC flap (n=14) between 1995 and 2013. Morbidity was classified into hospitalization, medical, or flap-related complications. Functional outcomes were classified into oral re-alimentation and decannulation time. RESULTS: The overall flap-related complication rate was higher in the PMMC flap group (n=8, 57.1%; P=0.019), but the medical morbidity rate was higher in the cutaneous free flap group (n=68, 80%; P=0.006). The rate of pneumonia was higher in the cutaneous free flap group (n=48, 56.5%; P=0.020). Pulmonary premorbidity was the variable most significantly associated with pneumonia (odds ratio=3.012, P=0.012). There was no statistically significant difference in oral re-alimentation and decannulation time between the two groups. CONCLUSIONS: Although the functional superiority of free flaps has been reported in many studies, our results do not support this hypothesis. One limitation of our study is the relatively smaller flap size and fewer PMMC flap cases compared with the cutaneous free flap group. The low postoperative medical morbidity incidence rate in the PMMC flap group was clinically significant; however, the free flap group had more flap-related complications. Thus, PMMC flaps should be considered a viable option, especially for patients with pulmonary premorbidities.
Carcinoma, Squamous Cell* ; Free Tissue Flaps* ; Hospitalization ; Humans ; Hypopharynx ; Incidence ; Pneumonia ; Postoperative Complications ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Irritable bowel syndrome (IBS) is prevalent in the general population, but there are few reports on bowel habits and IBS in high school students in Korea. This study aims to describe the prevalence of IBS in high school students in Korea and to investigate the influence of lifestyle factors including dietary habits, on the IBS. This study also investigates relationship between anxiety, depression and IBSprevalence. SUBJECTS AND METHODS: This study is a cross-sectional study on 1,018 students (451 males and 567 females) form freshman to senior of a high schools in Seoul. All students were requested to fill in a self-reported questionnaire. IBS was diagnosed based on the Rome II criteria. Those having past medical history of organic gastrointestinal disorders and any one of the 'alarm factors'(e.g. continuous hematochezia, weight loss, or anemic symptom) were excluded from the IBS group. For the evaluation of risk factors on the IBS, we surveyed dietary habit, health behavior, past medical history, the Hollingshed index for the measurement of socioeconomic status, Beck's Anxiety Inventory for the anxiety, and the Children's Depression Inventory for the depression. RESULTS: The prevalence of IBS was 19.1%. Family history of abdominal discomfort (odds ratio 2.07, 95% 1.46-2.92) and having night snack (odds ratio 1.46, 95% CI 1.09-1.94) were significantly different between the IBS group and non-IBS group. There was a linear trend towards the higher prevalence of IBS with fewer hours of exercise (odds ratio 0.99, 95% CI 0.95-1.04). Menstruation, stress, and irregular eating were the significant provocation factors of IBS. Anxiety and depression was not significantly higher in in the IBS group. CONCLUSIONS: Prevalence of the IBS in high school students from this study was higher compared with those reported in college students in Korea. This study shows that family history, dietary factors, lifestyle, and grade were significantly related to IBS. From our study, we found that there are multifaceted health aspects required to reduce symptoms, such as dietary education and encouragement to change lifestyle for controlling stress.
Adolescent ; Anxiety ; Cross-Sectional Studies ; Depression ; Eating ; Education ; Female ; Food Habits ; Gastrointestinal Hemorrhage ; Health Behavior ; Humans ; Irritable Bowel Syndrome* ; Korea ; Life Style ; Male ; Menstruation ; Prevalence* ; Risk Factors* ; Seoul ; Snacks ; Social Class ; Weight Loss ; Surveys and Questionnaires

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.

Objectives: ：This study looked at the effects of chronic IPV on suicide ideation among married women in the country. Methods: ：This study used data from the five-year-old Korea Welfare Panel and analyzed using questions about verbal and physical violence, depression and suicide ideation that were investigated every year. Age, education, and economic levels, drinking, religion, chronic disease, satisfaction with family relationship, satisfaction with social relationship, were included as variables. Results: ：The five-year cumulative score of verbal violence had a statistically significant effect on the depres-sive symptom, and the relative risk was 1.180. The relative risk of five-year-old cumulative score of verbal violence in suicidal ideation was 1.276, and it was also significant even if they exclude the effects of depressive symptom.On the other hand, the five-year cumulative score of physical violence was found to have no significant impact on suicide ideation if they excluded the effects of depressive symptom. Conclusions ：Unlike previous studies, this study found that chronic verbal IPVs increase suicide ideation,even though they do not contain effects of depression. Such findings suggest that intervention in IPV in married women may help reduce the nation's suicide rate.