OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

Pulmonary embolism is a common clinical problem in patients with immobilization, cancer, indwelling central venous catheter and surgery. However, although rare, it may occur in patients with inherited thrombophilia. Protein S deficiency is known to increase the risk of venous thrombosis and pulmonary embolism. There are many reports of venous thrombosis with protein S deficiency, but there are few reports of arterial thrombosis, especially recurrent acute pulmonary embolism. Here, we report a case of recurrent pulmonary embolism associated with type II protein S deficiency.
Blood Coagulation Disorders, Inherited ; Central Venous Catheters ; Humans ; Immobilization ; Protein S ; Protein S Deficiency ; Pulmonary Embolism ; Thrombophilia ; Thrombosis ; Venous Thrombosis

PURPOSE: The present study explored novel methods in visual field tests that actively induce the gaze of the examinee to the fixation target in the center vision and compared their effectiveness. METHODS: Four gaze induction methods (dot-on, dot-off, number-on, and number-off) were prepared by combining 2 types of fixation targets (dot and number) and 2 conditions of sound presence (on and off). The gaze induction methods were implemented to a PC-based visual field testing system and the 24-2 visual field testing protocol was administered to 14 participants without glaucoma. The performance of the gaze induction method was evaluated in terms of fixation error rate, target detection rate, and subjective satisfaction (7-point scale, 1 for least satisfied and 7 for most satisfied). RESULTS: The fixation error rates of dot-on (5.7%) and number-on (6.4%) were relatively lower than the other methods; the target detection rates of the induction methods were very high (95-96%) without significant differences, and the subjective satisfaction levels of dot-on (5.7) and number-on (5.4) were significantly higher than the other methods. CONCLUSIONS: In the present study we determined number-on as the preferred effective gaze induction method compared to the conventional dot-off method when fixation error rates and subjective satisfaction were considered.
Glaucoma ; Vision, Ocular ; Visual Field Tests ; Visual Fields

PURPOSE: The methods for vasovasostomy are varied, and many authors have reported various success rates. This study aimed to assess a new method for vasovasostomy with a Prolene stent. MATERIALS AND METHODS: Among 85 patients who underwent vasovasostomy with a Prolene stent, 69 patients were retrospectively reviewed at our hospital between October 2004 and December 2007. The average age at the time of vasovasostomy was 42.2 years (range: 24.0-52.0 years). The obstructive interval was 6.25 years (range: 0.7-20.0 years). The cases were divided into 2 groups according to obstructive interval: group A (above 8 years) and group B (8 years and less), with 18 (26.1%) and 51 (73.9%) cases, respectively. Patency was defined as a sperm concentration of more than 10x106/ml on semen analysis. RESULTS: The overall patency and pregnancy rates were 76.8% and 43.4%, respectively. The patency and pregnancy rates of group A were 61.1% and 33.3%. Those of group B were 82.3% and 47.0%. The mean duration to pregnancy was 10.9 months (range: 4-31 months). The mean operation time was 90.2 minutes (range: 50.0-165.0 minutes). CONCLUSIONS: The new method of vasovasostomy with the Prolene stent has good efficacy and safety. Its benefits are the maintenance of good patency, a good pregnancy rate, and a diminished operating time.
Humans ; Polypropylenes ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Semen Analysis ; Spermatozoa ; Stents ; Vasovasostomy

The method of lower limb reconstruction surgery is selected based on a patient's underlying conditions, general conditions, and wound status, and it usually varies from direct closure to skin graft and flap coverage. Herein, we describe a patient with Duchenne muscular dystrophy who developed critical limb ischemia after femoral cannulation for extracorporeal membrane oxygenation was used during knee disarticulation, which was followed by reconstruction of the defect around the knee using a pedicled anterolateral thigh flap and skin graft.
Catheterization ; Disarticulation ; Extracorporeal Membrane Oxygenation ; Extremities ; Humans ; Ischemia ; Knee ; Lower Extremity ; Methods ; Muscular Dystrophy, Duchenne ; Skin ; Surgical Flaps ; Thigh ; Transplants ; Wounds and Injuries

PURPOSE: Soft tissue defects in the lumbosacral area can be challenging to treat, and various methods to accomplish this have been proposed, including the use of perforator flaps. Herein, we present our experience with superior gluteal artery perforator (SGAP) and inferior gluteal artery perforator (IGAP) flaps for the reconstruction of lumbosacral defects. MATERIALS AND METHODS: From March 2013 to July 2016, 28 cases (27 patients) of lumbosacral defects were treated by reconstruction with SGAP or IGAP flaps. The defects were caused by pressure sores (21 cases), burns (3 cases), tumor resection (2 cases), scars (1 case), or foreign body infection (1 case). Reliable perforators around the defect were found using Doppler ultrasound. The perforator flaps were elevated with a pulsatile perforator and rotated to cover the defects. RESULTS: Twenty-three SGAP and 5 IGAP flap reconstructions were performed. The mean flap size was 9.2×6.1 cm² (range, 5×3 cm² to 16×10 cm²). Donor sites were closed by primary closure. Partial flap necrosis occurred in two cases, and minor complications of wound dehiscence occurred in 3 cases, which were healed by primary closure. The mean follow-up period was 4.4 months (range, 1~24 months). CONCLUSION: Gluteal-based perforator flaps can be safely harvested due to pliability and reliable vascularity in the gluteal area, reducing donor site morbidity without sacrificing the underlying muscles. Thus, these flaps are useful options for the reconstruction of lumbosacral defects.
Arteries* ; Burns ; Cicatrix ; Follow-Up Studies ; Foreign Bodies ; Humans ; Muscles ; Necrosis ; Perforator Flap* ; Pliability ; Pressure Ulcer ; Soft Tissue Injuries ; Tissue Donors ; Treatment Outcome* ; Ultrasonography ; Wounds and Injuries

OBJECTIVE: To evaluate the feasibility of laparoscopic salpingectomy using one-port in tubal pregnancy compared to conventional laparoscopic surgery. METHODS: From June 2008 to June 2011, 63 women were treated with laparoscopic salpingectomy due to tubal pregnancy, which was diagnosed by ultrasonography. These patients were divided into two groups. Of these 63 patients, 32 women were treated with conventional laparoscopic salpingectomy (CLS) in group I, 31 women underwent laparoscopic salpingectomy using one port (OPLS) in group II. In group I, rigid 0degrees or 30degrees, 10 mm laparoscope, rigid instruments were used. In group II, 30degrees, 10 mm laparoscope, rigid or flexible angulated tip instruments were used during the surgery. We reviewed and compared clinical characteristics, clinical outcomes of these patients. RESULTS: Patients in Group I were compatible with the patients in group II in clinical characteristics. Clinical outcomes were not different between two groups in terms of Hemoglobin change (g/dL), hospital stay (days), hemoperitoneum (mL), transfusion. Mean operative time was significantly longer in group II (59.7+/-15.7 min vs. 46.5+/-15.0 min, p=0.001). The mean length of skin incision was obviously shorter in group II; the difference was highly statistically significant (15.5+/-3.0 mm vs 23.5+/-3.0 mm, p<0.001). CONCLUSION: It seems that OPLS is feasible alternative to CLS to treat hemodynamically stable patients without complications. Additionally, this technique also results in better cosmetic outcomes than CLS. Randomized prospective clinical studies with larger scale are necessary in the future to confirm these results.
Cosmetics ; Female ; Hemoglobins ; Hemoperitoneum ; Humans ; Laparoscopes ; Laparoscopy ; Length of Stay ; Operative Time ; Pregnancy ; Pregnancy, Tubal ; Salpingectomy ; Skin

Central neurogenic hyperventilation (CNH) is characterized by sustained tachypnea inspite of an elevated arterial PaO2, pH and a low arterial PaCO2. CNH is common in patients with brainstem injury accompanied by a decreased level of consciousness but this also has been described in some alert patients with an invasive brainstem tumor. We report one case with CNH resulting from a unilateral pontine infarction. His consciousness was clear, and CNH spontaneously disappeared without any medication.
Brain Stem ; Brain Stem Neoplasms ; Consciousness ; Humans ; Hydrogen-Ion Concentration ; Hyperventilation* ; Infarction* ; Tachypnea

Tuberculosis involving the central airway occasionally results in diffuse stenosis in the distal trachea and main bronchus. When the stenosis is more limited to the main bronchus, sleeve resection can be performed with high likelihood of a good result. Bronchial stenosis limited to 2 cm is considered favorable for bronchial sleeve resection. However, a longsegment stenosis may make sleeve resection difficult or impossible, and pneumonectomy or therapeutic bronchoscopy may be performed. An extended sleeve lobectomy is a procedure to remove more than one lobe using a bronchoplasty technique and its applications to the patients with locally advanced lung cancer were reported. We performed an extended sleeve lobectomy in a patient with tuberculous bronchial stenosis involving the right main bronchus, bronchus intermedius, right middle lobar bronchus and right lower lobar bronchus, and report this case with review of literatures.
Bronchi ; Bronchoscopy ; Constriction, Pathologic ; Humans ; Lung Neoplasms ; Pneumonectomy ; Trachea ; Tuberculosis

Urachal xanthogranuloma is an extremely rare disease. A 23-year-old man presented with severe lower abdominal pain and voiding frequency. Computed tomography revealed a urachal mass with bladder invasion, which was suspected to be a urachal carcinoma or abscess. Laparoscopic urachal resection was performed with a minimal incision. Histopathologic examination identified the mass as a urachal xanthogranuloma.
Abdominal Pain ; Abscess ; Humans ; Laparoscopy ; Pyelonephritis, Xanthogranulomatous ; Rare Diseases ; Urachal Cyst ; Urinary Bladder ; Urinary Bladder Neoplasms ; Young Adult