Growing body of evidence has suggested that bipolar disorder in the elderly is important issue of mental health care. While older bipolar patients show different clinical features and response to treatment compared to younger patients, there are few studies focused on the older bipolar patients. Authors reviewed clinical features and treatment issues for bipolar disorder in the elderly.
Aged ; Bipolar Disorder ; Humans ; Mental Health ; Mood Disorders

PURPOSE: To evaluate the target refraction of patients with binocular myopia and monocular cataract after intraocular lens (IOL) implantation. METHODS: This study comprised 199 patients with binocular myopia (axial length >25 mm) and monocular cataract after IOL implantation for the removal of the monocular cataract. The research was conducted using a questionnaire method and by performing statistical analysis of the refractive outcomes. RESULTS: The patients are grouped into 3 domains (< or =-3 D group, -3~-6 D group, >-6 D group). There were no statistically significant differences among the 3 groups; whereas the satisfaction of the present corrected state was statistically low in the >-6 D group (p < 0.05). The satisfaction of the corrected state was statistically high in the group of postoperative anisometropia under 3 D (p < 0.05). There was no statistical difference between the groups on the satisfaction of target diopter (-2~-3 D or emmetropia). In terms of correction method, glasses were worn in 119 patients (60%), contact lenses were worn in 26 patients (13%), and monovision was used in 14 patients (7%) were used respectively. Forty patients (20%) with implanted IOL in both eyes did not use any of the correction methods above. Except for the contact lens group, the general satisfaction and the satisfaction of the present corrected state were statistically lower than the other group (p < 0.05). There was no statistically significant difference among the 3 groups in the percentage of cataract surgery in the fellow eye. CONCLUSIONS: There was no statistical difference between the groups in satisfaction of target diopter (-2~-3 D or emmetropia). Setting the target refraction difference between both eyes less than 3 D leads to more satisfactory outcomes.
Anisometropia ; Cataract* ; Contact Lenses ; Eyeglasses ; Glass ; Humans ; Lenses, Intraocular ; Myopia* ; Surveys and Questionnaires ; Telescopes*

PURPOSE: Myelodysplastic syndrome (MDS) in children needs to be elucidated in terms of clinical characteristics, natural history, the most effective treatment and prognostic factors, as the disease is very rare and its definition and classification has not reached a consensus by many physician. This study was aimed to describe the characteristics and the disease courses of Korean children with MDS, and to analyze the usefulness of prognostic scoring systems in the prediction of transformation to acute myelogenous leukemia (AML) and overall survival among subgroups. MATERIALS AND METHODS: Fourteen children with MDS seen at Chonnam University Hospital and additional 59 patients identified by the review of Korean literature were evaluated to define clinical characteristics and disease courses. Kaplan-Meier (K-M) probability of leukemic transformation and overall survival were plotted. FAB subtypes, subgroups by Boumemouth Scoring System (BSS), and International Prognostic Scoring System (IPSS) risk groups were compared to predict transformation to AML and overall survival. RESULTS: The median age of 14 patients was 36.5 months. The sex ratio was 3.7:1 (M: F). The frequency of FAB subtypes in Korea was similar to that of other countries except for higher proportion of RA (37%). K-M 3-yr probability of AML transformation and survival for Korean patients were 54.7%, and 49.8%, respectively. Although FAB system, BMS and IPSS were all capable of discriminating subgroups in the prediction of AML transformation and survival, they did not reach the significant level possibly due to small number of patients assigned to each subgroup. CONCLUSION: The clinical characteristics of Korean children with MDS were not different from those of other countries. This study showed the high rate of AML transformation and poor survival in children with MDS.
Child ; Classification ; Consensus ; Humans ; Jeollanam-do ; Korea ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes* ; Natural History ; Prognosis ; Sex Ratio

Anti-Xga is a rarely occurring antibody, and only two cases with this antibody have been reported in Koreans. We describe here another example of anti-Xga which was detected in a 47-year-old male. The patient suffered from burn injury on the 20% of body surface area, acute renal failure, and ulcer bleeding. Unexpected antibody identification test demonstrated anti-Xga, which was reactive only by antiglobulin phase, and the reaction disappeared after the treatment with bromelin. The red cell phenotype of this patient was Xg(a-). Fourteen units of packed red blood cell were transfused without any adverse reactions. It has an important clinical concern in safe transfusion practice to determine the specificity and the clinical significance of blood group alloantibodies.
Acute Kidney Injury ; Body Surface Area ; Bromelains ; Burns ; Erythrocytes ; Hemorrhage ; Humans ; Isoantibodies ; Male ; Middle Aged ; Phenotype ; Sensitivity and Specificity ; Ulcer

PURPOSE: To report a patient with Coats' disease who presented with a premacular membrane that was peeled off after laser photocoagulation. CASE SUMMARY: A 17-year-old male presented with decreased visual acuity of the right eye, and showed serous elevation, subretinal hemorrhage, telangiectasis and thick premacular membrane upon fundus examination. Upon diagnosis with Coats' disease, the telangiectatic area was treated with argon laser photocoagulation. Two weeks later, the premacular membrane was peeled off spontaneously and the decrease of macular thickness was verified by optical coherence tomography (OCT). The patient's visual acuity was improved to 1.0. CONCLUSIONS: The visual acuity of the patient with Coats' disease was improved by spontaneous peeling of the premacular membrane after photocoagulation.
Adolescent ; Argon ; Eye ; Hemorrhage ; Humans ; Light Coagulation ; Male ; Membranes ; Telangiectasis ; Tomography, Optical Coherence ; Visual Acuity

Pseudoterranova decipiens larva is a rare cause of anisakiasis. Indeed, prior to the present study, there had been only 12 reports of larval P. decipiens infection in the Republic of Korea. In June 2011, an anisakid larva, 32.1 mm in length and 0.88 mm in width, and finally identified as the third stage larva of P. decipiens owing to the presence of an intestinal cecum but lacking ventricular appendage, was discovered in a 61-year-old woman during the course of endoscopy executed as a part of routine physical examinations. The patient had eaten raw a rockfish 13 hr prior to the endoscopy, but showed no symptoms of anisakiasis. This paper is the 13th report of P. decipiens infection in Korea.
Animals ; Ascaridida Infections/*diagnosis/parasitology/*pathology ; Ascaridoidea/*isolation & purification ; Asymptomatic Diseases ; Endoscopy, Gastrointestinal ; Female ; Foodborne Diseases/diagnosis/parasitology/pathology ; Humans ; Larva ; Middle Aged ; Republic of Korea

OBJECTIVES: Catecholamine metabolism has been thought to be related to the pathophysiology of panic disorder. There are two human COMT alleles, coding for a low activity enzyme, COMT L(L), and a high activity enzyme, COMT H(H), respectively. We examined the distribution of COMT genotypes and the relationship between COMT genetic polymorphism and some clinical characteristics in patients with panic disorder. METHOD: We recruited 51 patients who met the DSM-IV criteria for panic disorder, and 45 normal control subjects who had neither medical nor psychiatric illnesses. Genetic polymorphism of COMT was identified in all subjects using PCR-based restriction fragment length polymorphism(RFLP) analysis. We assessed some clinical variables including treatment responses in panic patients and measured anxiety and depression levels in normal control subjects using Spielberger State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). RESULT: The frequency of the homozygous LL genotype was higher in panic patients than that in control subjects (19.6% vs. 2.2%). We found that panic disorder was significantly associated with L allele (x2=8.66, p=0.003) and LL genotype(x2=8.45, p=0.015). Panic patients with LL genotype showed poorer treatment response than those with other genotypes (F=4.98, p=0.011). CONCLUSION: These results suggest that LL genotype of the COMT gene may be related to the pathophysiology and clinical courses in some patients with panic disorder.
Alleles ; Anxiety ; Catechol O-Methyltransferase* ; Clinical Coding ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Genotype ; Humans ; Metabolism ; Panic Disorder* ; Panic* ; Pilot Projects* ; Polymorphism, Genetic*

BACKGROUND: Hemodynamic derangement during off-pump coronary artery bypass surgery (OPCAB) is mainly attributed to impaired filling and diastolic dysfunction. An elevated ratio of the mitral velocity to the early-diastolic velocity of the mitral annulus (E/e' > 15) is a relatively new indicator of diastolic function, and this was reported to be associated with impaired hemodynamics during OPCAB. We investigated the efficacy of milrinone on the perioperative hemodynamics and short term outcomes of patients with an E/e' > 15 and who underwent OPCAB. METHODS: The patients were randomly allocated into either group C (control, n = 31) or group M (n = 31) and they were treated with the same amount of either normal saline or milrinone (0.5 microg/kg/min) without bolus loading after completion of internal mammary artery harvest until the end of operation. Hemodynamic measurements were recorded after the induction of anesthesia (T1), 5 min after starting each distal anastomosis of the left anterior descending artery (T2), left circumflex artery (T3) and right coronary artery (T4), and 5 min after sternum closure (T5). RESULTS: The mixed venous oxygen saturation (SvO2) was lower through T2-T4 compared to the baseline value in both groups, while the degree of the decrease was significantly less in group M than that in group C. The other hemodynamic variables, the operative data and the postoperative outcomes were similar between the two groups. CONCLUSIONS: Intraoperative infusion of milrinone did not significantly improve the perioperative hemodynamics and the subsequent short term outcomes for the patients with preexisting diastolic dysfunction as represented by an elevated E/e' value, although it reduced the degree of decrease of the SvO2 during OPCAB.
Anesthesia ; Arteries ; Coronary Artery Bypass, Off-Pump ; Coronary Vessels ; Hemodynamics ; Humans ; Mammary Arteries ; Milrinone ; Oxygen ; Sternum

Psychological autopsy is a systematic methodology for comprehensive investigation of psychiatric and behavioral factors assumed to be causative or related to death of the deceased. In many countries, psychological autopsy is considered the most direct and valuable tool for determining the relationship between risk factors and suicide. The case of Finland revealed that successful psychological autopsy studies could greatly contribute to the national suicide prevention strategy, which consequently reduced the national suicide rate. Despite the strengths of psychological autopsy for identifying risk factors of suicide and consequently preventing suicide, it has not been successful in Korea. Implementation of psychological autopsy has been inconsistent and sporadic across the provinces. In addition, standardization of psychological autopsy protocol and qualification of interviewers are needed. With all of these methodological issues in mind, conduct of as many psychological autopsies as possible is important in order to build an evidence-based suicide prevention strategy. For successful implementation of psychological autopsy in Korea, it is necessary to improve attitudes toward suicide and psychiatric conditions. Legal, administrative, and institutional support are also important. Finally, multidisciplinary approach based on the financial and legal support should be employed.
Autopsy* ; Finland ; Korea ; Mental Health ; Risk Factors ; Suicide

OBJECTIVES: The purpose of this study was to investigate the effect of task-oriented circuit training (TOCT) using the rehabilitation tools for upper extremity function upon the daily life of patients with acute stroke. METHODS: Eighteen patients with acute stroke were randomly allocated into either the experimental group or the control group. The experimental group performed the TOCT program using rehabilitation tools, whilst the control group had neuro-developmental treatment. Both groups received 30 minutes of treatment per session, 5~6 times per week, for 4 weeks. The assessments conducted were the Fugl-Meyer assessment, motor activity log and stroke impact scale to compare the upper extremity function and activities of daily living. RESULTS: The results showed a significant improvement in the TOCT group compared with the neuro-developmental treatment group in the amount of motor activity use and high stroke impact score, indicating recovery (p < 0.05). CONCLUSION: The TOCT program using rehabilitation tools could have a positive impact on acute stroke patients use of their upper extremity.
Activities of Daily Living ; Circuit-Based Exercise* ; Humans ; Motor Activity ; Rehabilitation* ; Stroke* ; Upper Extremity