Background: Mental illness is known to be caused by genetic, biological, and environmental risk factors. Although previous studies have established the link between mental illness and job stress, most of them are limited to major depression disorder. Therefore, this study examined the relationship between job stress and bipolar spectrum disorder (BSD). Methods: This is a cross-sectional study based on a survey conducted in April 2017 at an electronic parts manufacturing company in Busan. In a total of 441 workers, the degree of BSD was identified using the Korean version of the Mood Disorder Questionnaire, and the degree of job stress was identified using the Korean Occupational Stress Scale Short Form.This study also identified general characteristics of workers and job-related factors. The χ2 test and Fisher's exact test was conducted to determine the differences among the variables, based on BSD. Multiple logistic regression analysis was conducted to determine the influence of independent variables on BSD. Results: Cross-analysis showed significant differences between the BSD high-risk and lowrisk groups regarding age, sex, occupation, smoking, problem drinking, job stress total score, occupational climate, and major depression disorder symptom. In addition, the significant differences between the BSD high-risk and low-risk groups about job stress were observed in terms of job demand, job insecurity, and occupational climate. A multiple logistic regression analysis revealed that the high-risk group in the job stress group had a higher effect on BSD than the low-risk group (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.10–4.88). Among the categories of job stress, high-risk groups in 3 areas—job demand (OR: 2.56, 95% CI: 1.27–5.17), job insecurity (OR: 4.42, 95% CI: 1.19–16.42), and occupational climate (OR:2.55, 95% CI: 1.29–5.05)—were more likely to have an impact on BSD than the low-risk groups. Conclusions This study demonstrated that the high-risk groups of job stress total score, job demand, job insecurity, and occupational climate had a more significant effect on BSD than the low-risk groups. As workers with BSD may have difficulties in their work and personal lives, there is a need to manage job stress to prevention of BSD.

Background: Mental illness is known to be caused by genetic, biological, and environmental risk factors. Although previous studies have established the link between mental illness and job stress, most of them are limited to major depression disorder. Therefore, this study examined the relationship between job stress and bipolar spectrum disorder (BSD). Methods: This is a cross-sectional study based on a survey conducted in April 2017 at an electronic parts manufacturing company in Busan. In a total of 441 workers, the degree of BSD was identified using the Korean version of the Mood Disorder Questionnaire, and the degree of job stress was identified using the Korean Occupational Stress Scale Short Form.This study also identified general characteristics of workers and job-related factors. The χ2 test and Fisher's exact test was conducted to determine the differences among the variables, based on BSD. Multiple logistic regression analysis was conducted to determine the influence of independent variables on BSD. Results: Cross-analysis showed significant differences between the BSD high-risk and lowrisk groups regarding age, sex, occupation, smoking, problem drinking, job stress total score, occupational climate, and major depression disorder symptom. In addition, the significant differences between the BSD high-risk and low-risk groups about job stress were observed in terms of job demand, job insecurity, and occupational climate. A multiple logistic regression analysis revealed that the high-risk group in the job stress group had a higher effect on BSD than the low-risk group (odds ratio [OR]: 2.32, 95% confidence interval [CI]: 1.10–4.88). Among the categories of job stress, high-risk groups in 3 areas—job demand (OR: 2.56, 95% CI: 1.27–5.17), job insecurity (OR: 4.42, 95% CI: 1.19–16.42), and occupational climate (OR:2.55, 95% CI: 1.29–5.05)—were more likely to have an impact on BSD than the low-risk groups. Conclusions This study demonstrated that the high-risk groups of job stress total score, job demand, job insecurity, and occupational climate had a more significant effect on BSD than the low-risk groups. As workers with BSD may have difficulties in their work and personal lives, there is a need to manage job stress to prevention of BSD.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

Since dysphagia is a common occurrence after a stroke, assessing the swallowing function in stroke patients is important. Killian-Jamieson diverticulum is a rare esophageal diverticulum that leads to various complications.However, few studies have reported the presence of the Killian-Jamieson diverticulum subsequent to a cerebral infarct. A 66-year-old woman diagnosed with left periventricular white matter infarction complained of dysphagia.A suspected diverticulum observed in the first videofluoroscopic swallowing study (VFSS) was thought to be unrelated to the patient’s symptoms. However, since the patient continued to complain of dysphagia, computed tomography was performed to detect any anatomical abnormalities that could cause dysphagia. An approximately 12 mm-sized Killian-Jamieson diverticulum was found on the left side of the esophagus at the C5-6 level. A reversed flow from the diverticulum was observed in the following VFSS. No treatment was administered as the caregiver disagreed with the patient’s aggressive treatment options, which included surgical procedures such as diverticulectomy and cricopharyngeal myotomy. Only periodic VFSS follow-up was continued. The association between Killian-Jamieson diverticulum and cerebral infarction remains unclear. This case underlines the importance of considering an esophageal diverticulum in patients with aggravated swallowing difficulties after cerebral infarction.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

Background: and Purpose All young males in South Korea must undergo a physical examination for their participation in military service. We aimed to determine the prevalence rate (PR) of various neuromuscular diseases in young South Korean males using the data of exempted patients and soldiers. Methods: The number of males exempted based on specific items of physical examination corresponding to neuromuscular disease during 2011–2020 were obtained from the records of the Military Manpower Administration. The list of enlisted soldier patients who were discharged from military service due to neuromuscular diseases during 2011–2020 was obtained from the Armed Forces Medical Command, and their medical records were reviewed. Results: The PR of neuromuscular diseases was calculated among 948 identified males: 713 exempted males and 235 soldiers. The PRs of overall hereditary neuropathies, Hirayama disease (HD), myasthenia gravis (MG), and inherited muscle diseases in South Korean males in their early 20s were 8.34 (95% confidence interval [CI], 7.39–9.30), 5.54 (95% CI, 4.76–6.32), 2.97 (95% CI, 2.40–3.55), and 10.38 (95% CI, 9.31–11.46) per 100,000 persons, respectively.Among the enlisted soldiers, hereditary neuropathy with liability to pressure palsy was the most common neuromuscular disease, with a prevalence among the enlisted soldiers of 3.11 (95% CI, 2.42–3.80) per 100,000 persons. Myotonic dystrophy was the most prevalent myopathy, followed by facioscapulohumeral muscular dystrophy. Conclusions The 10-year PRs of hereditary polyneuropathies, HD, MG, and inherited muscle diseases in young South Korean males have been reported. These data could be valuable to understanding each neuromuscular disease in the young male population of South Korea.

Anaplastic carcinomas of the pancreas, also known as pleomorphic, sarcomatoid, or undifferentiated carcinomas, are in most cases variants of duct-derived carcinomas. However, their appearance is so distinctive and their behavior so aggressive that a distinction from the ordinary ductal adenocarcinoma is warranted. They comprise about 7% of all non-endocrine pancreatic malignancies. Most tumors are large and apparently more likely to involve the body or tail of the pancreas rather than the head. Most patients are above the age of 50 at the time of diagnosis, and there is a distinct male predilection. Here we report on a 50-year woman who diagnosed pathologically as a anaplastic carcinoma of the pancreas. The patient underwent Whipple's operation because of a distal common bile duct cancer 6 years ago. Distal pancreatectomy and splenectomy were performed. The patient was discharged with a good general condition.
Adenocarcinoma ; Carcinoma* ; Common Bile Duct* ; Diagnosis ; Female ; Head ; Humans ; Male ; Pancreas* ; Pancreatectomy ; Splenectomy

BACKGROUND/AIMS: Blood loss and blood transfusion are extremely important determinants of morbidity and mortality following hepatic resection. This is attributed to increased risks of coagulopathy, acute respiratory distress syndrome and multiorgan failure. The hypothesis is that a low pressure in the central veins would be accompanied by a low pressure in the hepatic veins and sinusoids, thereby decreasing blood loss during hepatic resection. This study evaluates the effectiveness of continuing low central venous pressure comparing with high central venous pressure during major hepatic resection. METHODS: 20 consecutive major hepatic resections between March 2000 and August 2000 were studied prospectively concerning central venous pressure which was analysed for 10 cases with a central venous pressure less than 10 mmHg, and greater than or equal to 10 mmHg. The central venous pressure was monitored continuously using a Narkomed Anaesthetic Component Monitoring System (Drager Inc., USA). RESULTS: Low central venous pressure allowed a smaller intraoperative blood loss (<10 mmHg: 1010+/-465.3 ml vs. > or =10 mmHg: 1770+/-916.5 ml, p<0.05), a smaller perioperative transfusion (<10 mmHg: 139+/-276.2 ml vs. > or =10 mmHg: 807+/-799.2 ml, p<0.05), a lower postoperative peak AST (<10 mmHg: 167.4+/-53.2 IU/L vs. > or =10 mmHg: 293.0+/-123.2 IU/L, p<0.05), a lower postoperative peak ALT (<10 mmHg: 96.1+/-55.3 IU/L vs. > or =10 mmHg: 193.2+/-103.5 IU/L, p<0.05), and a earlier resumption of a normal hepatic enzyme (<10 mmHg: 6.4+/-0.9 days vs. > or =10 mmHg: 8.7+/-1.6 days, p<0.05) in comparison to high central venous pressure. There was no postoperative mortality in both group. CONCLUSIONS: Maintaining a low central venous pressure throughout major hepatic resection reduced blood loss, blood transfusion requirements and enzyme recovery periods. Lowering the central venous pressure is a simple and effective way during hepatic resection.
Blood Transfusion ; Central Venous Pressure* ; Hepatic Veins ; Mortality ; Prospective Studies ; Respiratory Distress Syndrome, Adult ; Veins