A case was experienced involving submandibular salivary gland swelling (sialoadenopathy), developing after gastroscopy in a 15-year-old female who was suffering from epigastric pain & diarrhea and a case of parotid salivary gland swelling after gastroscopy in a 25-year-old female who was suffering from dyspepsia and epigastric pain. Both patients were the first two cases among about 5,000 gastroscopic examinations of the stomach conducted by the authors. As soon as the gastroscope was withdrawn, unilateral swelling, which was neither painful nor tender, was found in the left submandibular salivary gland area. This swelling disappeared spontaneously in about few hours later.
Adolescent ; Adult ; Diarrhea ; Dyspepsia ; Female ; Gastroscopes ; Gastroscopy* ; Humans ; Salivary Glands ; Stomach

Background: Evidence continues to accumulate that the presence or absence of early trauma (ET) implies unique characteristics in the relationships between suicidal ideation and its risk factors. We examined the relationships among recent stress, depressive symptoms, anxiety symptoms, and suicidal ideation in Korean suicidal women with or without such a history. Methods: Using data on suicidal adult females, 217 victims and 134 non-victims of ET, from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we performed structural equation modeling to investigate the contribution of recent stress, depressive symptoms, and anxiety symptoms on suicidal ideation within each group according to the presence or absence of a history of ET. Results: Structural equation modeling with anxiety and depressive symptoms as potential mediators showed a good fit. Recent stress had a direct effect on both depressive symptoms and anxiety symptoms in both groups. Only anxiety symptoms for victims of ET (standardized regression weight, 0.281; P = 0.005) and depressive symptoms for non-victims of ET (standardized regression weight, 0.326; P = 0.003) were full mediators that increased suicidal ideation. Thus, stress contributed to suicidal ideation by increasing the level of anxiety and depressive symptoms for victims and non-victims, respectively. Conclusion Tailored strategies to reduce suicidal ideation should be implemented according to group type, victims or non-victims of ET. Beyond educating suicidal women in stressmanagement techniques, it would be effective to decrease anxiety symptoms for those with a history of ET and decrease depressive symptoms for those without such a history.

Background: Evidence continues to accumulate that the presence or absence of early trauma (ET) implies unique characteristics in the relationships between suicidal ideation and its risk factors. We examined the relationships among recent stress, depressive symptoms, anxiety symptoms, and suicidal ideation in Korean suicidal women with or without such a history. Methods: Using data on suicidal adult females, 217 victims and 134 non-victims of ET, from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we performed structural equation modeling to investigate the contribution of recent stress, depressive symptoms, and anxiety symptoms on suicidal ideation within each group according to the presence or absence of a history of ET. Results: Structural equation modeling with anxiety and depressive symptoms as potential mediators showed a good fit. Recent stress had a direct effect on both depressive symptoms and anxiety symptoms in both groups. Only anxiety symptoms for victims of ET (standardized regression weight, 0.281; P = 0.005) and depressive symptoms for non-victims of ET (standardized regression weight, 0.326; P = 0.003) were full mediators that increased suicidal ideation. Thus, stress contributed to suicidal ideation by increasing the level of anxiety and depressive symptoms for victims and non-victims, respectively. Conclusion Tailored strategies to reduce suicidal ideation should be implemented according to group type, victims or non-victims of ET. Beyond educating suicidal women in stressmanagement techniques, it would be effective to decrease anxiety symptoms for those with a history of ET and decrease depressive symptoms for those without such a history.

OBJECTIVE: Depression is a very common symptom in people with mild cognitive impairment (MCI), a preclinical stage of Alzheimer's disease (AD), and in those with clinically evident AD. Moreover, MCI individuals with depression show a higher conversion rate to clinical AD than those without depression. This study aimed to elucidate the functional neuroanatomical substrate of depression in MCI. METHODS: Thirty-six patients were recruited from a University Hospital-based cohort; 18 of these subjects had MCI with depression (MCI_D); the remaining 18 subjects were age- and gender-matched, and had MCI with no depression (MCI_ND). For comparison, 16 cognitively normal (CN) elderly individuals were also included. All subjects underwent Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) scanning and regional cerebral glucose metabolism was compared among the three groups by a voxel-based method. The relationship between severity of depression, as measured by Hamilton Rating Scale for Depression (HRSD) scores, and glucose metabolism was also investigated. RESULTS: MCI_D showed lower glucose metabolism in the right superior frontal gyrus than MCI_ND. There was a significant negative correlation between HRSD score and glucose metabolism at the same frontal region for overall MCI subjects. When compared with CN, both MCI_D and MCI_ND showed decreased glucose metabolism in the precuneus, while MCI_D had, in addition, reduced metabolism in other diffuse brain regions. CONCLUSION: Given previous observations on depression in AD, our results suggest that functional disruption of the frontal region, known to be associated with primary or other secondary depression, underlies depression in preclinical AD as well as clinically evident AD.
Aged ; Alzheimer Disease ; Brain ; Depression ; Glucose ; Humans ; Mild Cognitive Impairment ; Positron-Emission Tomography

Transient ischemic colitis comprises a clinical triad of lower abdominal pain, diarrhea and rectal bleeding of sudden onset, with rapid clearance of symptoms on a non-specific management regimen. The peak age incidence of ischemic colitis is in the sixth and seventh decades, as would be expected due to progressive arterial occlusion and falling cardiac function with increasing age. In this report, transient ischemic colitis was diagnosed on the basis of colonoscopic and associated histopathological findings. Colonoscopy is a useful technique in establishing the diagnosis of transient ischemic colitis. Conservative management includes repeated careful assessment, pain management and fluid replacement. Complications are rare and the prognosis is excellent. Occasionally, patients have recurrences. We report a case of transient ischemic colitis complicated by stricture formation with review of literatures.
Abdominal Pain ; Colitis, Ischemic* ; Colon* ; Colonoscopy ; Constriction, Pathologic* ; Diagnosis ; Diarrhea ; Hemorrhage ; Humans ; Incidence ; Pain Measurement ; Prognosis ; Recurrence

Objective: To investigate the relationship between reduced glutathione (GSH), a key molecule of the antioxidant defense system in the blood, and glutathione reductase (GR), which reduces oxidized glutathione (glutathione disulfide [GSSG]) to GSH and maintains the redox balance, with the prevalence of Alzheimer’s dementia and cognitive decline. Methods: In all, 20 participants with Alzheimer’s dementia who completed the third follow-up clinical evaluation over 6 years were selected, and 20 participants with normal cognition were selected after age and sex matching. The GSH and GR concentrations were the independent variables. Clinical diagnosis and neurocognitive test scores were the dependent variables indicating cognitive status. Results: The higher the level of GR, the greater the possibility of having normal cognition than of developing Alzheimer’s dementia. Additionally, the higher the level of GR, the higher the neurocognitive test scores. However, this association was not significant for GSH. After 6 years, the conversion rate from normal cognition to cognitive impairment was significantly higher in the lower 50th percentile of the GR group than in the upper 50th percentile. Conclusion The higher the GR, the lower the prevalence of Alzheimer’s dementia and incidence of cognitive impairment and the higher the cognitive test scores. Therefore, GR is a potential protective biomarker against Alzheimer’s dementia and cognitive decline.

OBJECTIVE: We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals. METHODS: This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance. RESULTS: During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20–3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44–17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33–3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00–3.05, p=0.048) but was not associated with the risk of dementia. CONCLUSION: Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.
Aged ; Anhedonia ; Apolipoproteins ; Cognition Disorders ; Cognitive Aging ; Cohort Studies ; Dementia ; Depression ; Education ; Follow-Up Studies ; Genotype ; Humans ; Logistic Models ; Longitudinal Studies ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pleasure ; Prospective Studies ; Risk Factors

Objective: We investigated the frequency of depressive disorders in the elderly with normal cognition (NC), mild cognitive impairment (MCI) and dementia patients living in the community to find out the association between cognitive disorders and depressive disorders in the community dwelling elderly. Methods: 6,262 baseline study subjects from November 2010 through October 2012 were enrolled based on the Korean longitudinal study on cognitive aging and dementia which is the first nationwide multi-center population based prospective cohort study in Korea. Diagnosis of MCI, dementia, major depressive disorder (MDD), minor depressive disorder (mDD) and subsyndromal depression (SSD) was made by psychiatrists with expertise in dementia based on the appropriate diagnostic criteria. Results: 4,303 NC, 1,737 MCI, 222 dementia were enrolled. The frequency of MDD, mDD, SSD were highest in dementia and lowest in NC and showed significant difference among three groups. The odds ratio also increased significantly in MCI and dementia compared with NC showing highest odds ratio in dementia. Conclusion Our findings propose that MCI and dementia in the community dwelling elderly were significantly associated with various types of depressive disorders showing highest association tendency in dementia.