No Abstract Available.
Animals ; Armoracia* ; Cats* ; Horseradish Peroxidase* ; Muscles*

Atrial fibrillation (AF) is a leading cause of cardioembolic stroke, which is often fatal or disabling. Prevention of stroke is crucial in AF management, and anticoagulation with non-vitamin K oral anticoagulants (NOACs) is the mainstay of AF management for stroke prevention. Because NOAC prescriptions have been surging worldwide, the development of acute ischemic stroke in patients with AF who receive NOAC treatment is an increasingly important issue in clinical practice. Moreover, these patients show a high risk of recurrence, with more than a 50% higher risk, than do patients with AF and no prior anticoagulation therapy. Careful evaluation is mandatory to determine possible causes of ischemic stroke during NOAC therapy. Differentiation of AF-unrelated stroke and demonstration of combined cardiac disease/systemic coagulopathy are important in these patients and may provide improved results in their treatment. In addition, ensuring appropriate dosing and good adherence to NOAC treatment is important. Cardioembolism, despite sufficient anticoagulation and no other causes, is the most common and challenging complication because switching to anticoagulants or adding antiplatelets to the treatment regimen does not reduce the risk of recurrent stroke, and there are no guidelines for this specific situation. This review article aimed to present the most updated data on the prevalence, causes, and secondary prevention strategies, specifically focusing on non-pharmacological approaches, together with relevant cases of AF in patients who developed ischemic stroke on NOAC therapy.

Anesthesia, General ; Cephalometry ; Follow-Up Studies ; Head ; Humans ; Joint Diseases ; Joints ; Korea ; Mouth ; Open Bite ; Osteoarthritis ; Prostheses and Implants ; Temporomandibular Joint

We report a case of a patient with lung cancer, which invaded the left atrium and pericardium. Right middle and lower lobectomy was performed with the use of the extracorporeal circulation. Postoperative pathologic examination revealed the stage of IIIB (T4N1M0). Although the postoperative clinical course was complicated by acute localized right sided pulmonary edema and the bronchopleural fistula, the patient recovered smoothly after the procedure of omentopexy with pedicled graft of greater omentum in closing the BPF. As of August 2003, he has been followed up for 6 years and he is healthy without any evidence of recurrence. We could not find any report concerning lung cancer resection using cardiopulmonary bypass in Korean literature and believe this is the first report, especially with long-term survival.
Cardiopulmonary Bypass ; Extracorporeal Circulation* ; Fistula ; Heart Atria ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Invasiveness ; Neoplasm Staging ; Omentum ; Pericardium ; Pulmonary Edema ; Recurrence ; Transplants

OBJECTIVE: It is postulated that since aripiprazole is a dopamine partial agonist and serotonin 2A receptor antagonist, aripiprazole may be effective in Tourette syndrome with few of extrapyramidal side effects. This open label study assessed the effectiveness of aripiprazole in children with Tourette syndrome (TS). METHOD: Nineteen children, aged 6 to 13 years, diagnosed with TS were participated in a 8-week open label trial. Efficacy assessments included Korean form of Yale Global Tic Severity Scale (K-YGTSS) and Clinical Global Impression scores. Safety and tolerability evaluations included extrapyramidal symptoms and effects on weight, prolactin, and corrected QT (QTc) interval. RESULTS: A significant decrease in TS symptoms, on all scales measured, appeared in 2 weeks. Adverse effects were mild and not significant. The most frequent side effects were somnolence, light headedness and headache. CONCLUSIONS: The results of current open label trial suggests the effectiveness of aripiprazole and few of side effects in the treatment of children with TS. Double-blind, placebo-, and active comparator-controlled studies are indicated to rigorously test of the efficacy of aripiprazole in TS.
Child* ; Dizziness ; Dopamine ; Headache ; Humans ; Prolactin ; Prospective Studies* ; Receptor, Serotonin, 5-HT2A ; Tics ; Tourette Syndrome* ; Treatment Outcome* ; Weights and Measures ; Aripiprazole

OBJECTIVES:The purpose of this study is to evaluate the diagnostic validity of the three published short Geriatric Depression Scales and to identify a valid and reliable alternative to the Korean version of the Geriatric Depression Scale (GDS-K) and short form Geriatric Depression Scales (SGDS-K). METHODS:All subjects were registered elderly psychiatric patients who first visited the Geriatric Psychiatry Clinic of Seoul National University Hospital in Seoul between April 1996 and May 1999. The GDS-K, SGDS-K, Hoyl GDS-5, D'Ath GDS-4, van Marwijk GDS-4 were administered. Receiver operating characteristics (ROC) curve analysis performed to investigate the diagnostic validity of the Hoyl GDS-5, D'Ath GDS-4, and van Marwijk GDS-4. RESULTS:The best trade-off between sensitivity and specificity was achieved with a Hoyl GDS-5 score of 3 (sensitivity:0.7258, specificity:0.7717), a D'Ath GDS-4 score of 3 (sensitivity:0.5968, specificity:0.7391), and a van Marwijk GDS-4 score of 3 (sensitivity:0.6613, specificity:0.7391). The area under the ROC curves of each diagnostic tool were calculated into the Hoyl GDS-5 of 0.8198, the D'Ath GDS-4 of 0.7525, and the van Marwijk GDS-4 of 0.7528. CONCLUSION:The Hoyl GDS-5 may be utilized in screening for major depression among the elderly psychiatric patients in Korea.
Aged ; Depression ; Geriatric Psychiatry ; Humans ; Korea ; Mass Screening ; ROC Curve ; Sensitivity and Specificity ; Weights and Measures

OBJECTIVES: The purpose of this study is to determine the amount of burden placed on the caregivers of patient diagnosed as dementia and depression. The study is intended 1) to compare depression and anxiety levels of caregivers with the degree of their burden and 2) to analyze and determine the clinical factors that contributed to such levels of depression and anxiety. METHODS: 93 individuals with dementia, suspected dementia, and depression were selected between February 2001 and April 2001. In order to determine the patients decreased cognitive function and psychopathology MMSE-K and NPI were used. In addition, the burden scale recently developed from Zarit, HARS, HDRS were used on 58 caregivers. RESULTS: The MMSE-K figure form in the demented group was significantly lower than that of the non-demented group, 15.65 and 25.55 respectively. As for the NPI figures, the demented group posted higher numbers compared to the non-demented group. Among the individuals in the demented group, apathy, aberrant motor behavior, and night-time behavior showed the highest figures. On the caregiver's burden point, the demented group showed higher scores compared to the non-demented group with 76.62 and 58.30 respectively. The caregiver's burden point compared to the HDRS and HARS figures provided an evidence that there is a signigicant relationship between the groups. CONCLUSIONS: The caregiver's burden point is found to be more affected by the demented patient's progressive phase of psychopathology than conditions due totheir decreased cognitive functions. There is a probability that an increase in the caregivers burden is likely to contribute to an increase in the caregiver's depression and anxiety.
Aged* ; Anxiety ; Apathy ; Caregivers ; Dementia ; Depression ; Humans ; Psychopathology*

OBJECTIVES: Thalamic structural changes were implicated in the pathophysiology of schizophrenia by some studies. So, we investigated the differences in thalamic volumes between previously untreated patients with first-episode schizophrenia and controls. METHODS: Thalamic volumes of 24 subjects with schizophrenia and 24 controls were measured from their T1-weighted coronal magnetic resonance images using manual tracing. The thalamus was further segmented into regions that roughly reflected individual thalamic nuclei. RESULTS: Comparing to the controls, significantly smaller volumes were found in the left posterior subdivision of thalamus in patient group. Tendency of volume differences were also seen in right posterior subdivision of thalamus in patient group. These regions primarily comprised the pulvinar, a thalamic nucleus thought to be an important component of aberrant circuitry in schizophrenia. CONCLUSION: Our findings suggest the possibility of a volumetric alteration of the thalamus in patients with first-episode schizophrenia.
Humans ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Pulvinar ; Schizophrenia ; Thalamus

BACKGROUND/AIMS: Ecabet sodium is used for treating gastric ulcers and gastritis. It exhibits a bactericidal effect against Helicobacter pylori by inhibiting bacterial urease activity. Thus, ecabet sodium has been suggested to improve the efficacy of the H. pylori eradication in patients with peptic ulcers. The aim of this study was to compare the H. pylori eradication rate of lansoprazole-based triple therapy versus lansoprazole-based triple therapy plus ecabet sodium. METHODS: The subjects consisted of 363 H. pylori-positive patients who had undergone eradication therapy from February 2007 to February 2010. In total, 363 patients with H. pylori-positive peptic ulcer disease or symptomatic erosive gastritis received LAC (lansprazole 30 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d.) or LACE (lansoprazole 30 mg b.i.d., amoxicillin 1.0 g b.i.d., clarithromycin 500 mg b.i.d., ecabet sodium 1 g b.i.d.) for 1 week. Successful eradication was defined as a negative 13Curea breath test 4-5 weeks after treatment completion. RESULTS: H. pylori eradication rates were 81.4% (166/204) in the LAC group and 86.2% (137/159) in the LACE group (p = 0.159). No significant difference in eradication was observed. No significant difference was observed in the side effects experienced by the patients in the two treatment groups. CONCLUSIONS: Our results suggest that adding ecabet sodium did not improve the H. pylori eradication rate significantly in standard lansoprazole-based triple therapy for H. pylori.
Amoxicillin ; Breath Tests ; Clarithromycin ; Diterpenes, Abietane ; Gastritis ; Helicobacter ; Helicobacter pylori ; Humans ; Peptic Ulcer ; Prospective Studies ; Sodium ; Stomach Ulcer ; Urease

OBJECTIVES: To demonstrate the structural pathogenesis of schizophrenia, this study measures cerebral and cerebellar volumes of antipsychotics-navie and first episode schizophrenic patients. Also this study analyzes morphological character of patients with early schizophrenia. METHODS: Volume segmentation incorporating MRI scanning was performed on 25 patients with schizophrenia(mean age: 31.2+/-7.85yr, ranging: 14-18yr) and a control group of 29 healthy dindividuals(mean age: 29.03+/-7.02yr, ranging: 18-42yr). To carry out segmentation, the cerebrum and cerebellum were partitioned by gray matter, white matter and cerebrospinal fluid using a probabilistic histologic algorithm. These images of the segments were defined as the frontal, parietal, temporal and occipital lobes and cerebellum by using the semi-automated technique based on the atlas developed by Talairach. The area of dimension for each fraction was measured and its symmetry was compared. A statistical analysis was performed using the analysis of covariance by compensating the total brain volume with the level of covariance. RESULTS: The total brain volume of the schizophrenic patient group was significantly smaller than that of the control group(t=-1.986, d.f.=38.97, p=0.05). Female patients with schizophrenia showed a smaller right cerebellar volume than the female controls(F=4.20, d.f.=(1,51), p=0.046). Female with schizophrenia showed a larger left frontal white matter volume than their female controls and male with schizophrenia showed a smaller right frontal white matter volume than their male controls(F=6.89, d.f.=(1,51), p=0.012). Male patients with schizophrenia showed a larger right occipital white matter volume than the male controls. Females with schizophrenia showed a larger left occipital white matter volume than their female controls and male with schizophrenia showed a smaller left occipital white matter volume than their male controls(F=3.97, d.f.=(1,51), p=0.050). Female patients with schizophrenia showed a larger parietal white matter volume than the female controls(F=6.14, d.f.=(1,51), p=0.017). Female patients with schizophrenia also showed a smaller right and left cerebellar gray matter volume than the female controls(F=3.90, d.f.=(1,51), p=0.050). Female patients with schizophrenia also showed a smaller temporal gray matter volume than the female controls(F=4.74, d.f.=(1,51), p=0.034). CONCLUSION: These results demonstrate that the cerebellum and frontal lobe are involved in pathogenesis of schizophrenia, difference of white matter between schizophrenic patient and control is an important finding that suggest the importance of cortical dysconnection syndrome as pathophysiology on schizophrenia, and these findings suggest that pathogenesis of schizophrenia include many areas of brain.
Brain* ; Cerebellum ; Cerebrospinal Fluid ; Cerebrum ; Female ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Male ; Occipital Lobe ; Rabeprazole ; Schizophrenia*