Objectives: This study examined the responses to standard stimuli to investigate the mechanisms underlying mismatch negativity (MMN) impairments in schizophrenia. Methods: We obtained MMN data from 68 patients diagnosed with schizophrenia or schizoaffective disorder and 38 healthy controls and analyzed the electrophysiological activity of the responses to two standard stimuli before deviants using time-frequency methods. Results: As a result of RM ANOVA at evoked alpha power, there were differences not only between-subjects (F 1,104=4.35, p<0.05) but also within-subjects (F 1,104=8.62, p<0.01) without groupby-stimulus interaction (F 1,104=1.70, p=0.20). But at single-trial alpha power, there was a difference not between-subjects (F 1,104=3.81, p=0.054), but only within-subjects (F 1,104=10.14, p<0.01) with significant group-by-stimulus interaction (F 1,104=5.71, p<0.05). Moreover, between-group differences were significant in evoked alpha power (t 104=2.02, p<0.05, d=0.41) and single-trial alpha power (t 104=2.49, p<0.01, d=0.50) to standard stimuli presented not at the first instance but second. According to the order that the two standards presented, there were increases of evoked alpha power (t 37=-2.54, p<0.05, d=0.58) and single-trial alpha power (t 37=-3.41, p<0.01, d=0.78) in only the healthy controls. The positive correlations were shown in clinical features between years of education completed and event-related potential amplitude at 100 ms to both standard stimuli (Each Pearson Corr.: r=0.22, p<0.05). Conclusion These outputs suggest that the P1 alpha oscillation to standards is associated with deficits in the inhibitory control of selective attention relative to cognitive dysfunction in schizophrenia.We could also hypothesize that these deficits are involved in computing prediction errors based on the predictive coding perspective. However, further studies on this hypothesis are necessary.

Purpose: The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC. Methods: Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed. Results: The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000). Conclusion The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.

Purpose: The safety and efficacy of laparoscopic cholecystectomy (LC) in elderly patients is a matter of concern because morbidity and clinical risk are higher in elderly patients; and some clinicians recommend non-surgical supportive treatments. There is limited data reported in the literature for LC in super-elderly individuals (aged ≥ 80 years). This study compared the clinical outcome for the elderly and super-elderly patients undergoing LC. Methods: Patients who had a cholecystectomy for acute or chronic cholecystitis, and empyema of the gall bladder between January 2011 and June 2018 were analyzed retrospectively. The clinical outcomes of the super-elderly patients (≥ 80 years, Group 2) were compared with elderly patients (65-79 years, Group 1). Complications, conversion rate, postoperative hospital stays were assessed. Results: The conversion rate was 5.5% and 8.4% in Groups 1 and 2, respectively (p = 0.749). The surgical or medical complication rates were similar in both groups. A significant difference in operation time was observed between groups (p < 0.001). Although the super-elderly patients had longer postoperative hospital stays (7.10 ± 6.98) than the elderly patients (4.60 ± 6.06), there was no significant difference with between the 2 groups (p = 1.000). Conclusion The clinical outcomes of the conversion rate, complications, and mortality were similar in patients aged 65 to 79 years and ≥ 80 years. Therefore, LC is deemed to be a safe and simple procedure for the super-elderly.

Transcranial Doppler (TCD) was carried out to determine the resistive index (RI) values of normal canine cerebral arteries and its reproducibility and to evaluate the change of cerebral vascular resistance following diuretics administration. RI values of rostral cerebral artery (RCA) were compared between fontanelle window and temporal window. Normal ranges and reproducibility of the RI values were examined in the rostal cerebral artery (RCA) and caudal cerebral artery (CCA). And after administration of diuretics, TCD-derived RI values were measured at RCA and CCA. Cerebral vascular RI values of RCA and CCA were 0.55 +/- 0.05 and 0.55 +/- 0.03 in the normal dogs, respectively. There was no significant difference of RI between male and female; between fontanelle window and temporal window. Reproducibility of RI measurements between intraobserver and interobserver were relatively high. The RI of RCA and CCA were significantly increased 15 minutes after mannitol administration (p<0.01) and returned to baseline values by 30 minutes, but it did not significantly change after furosemide and saline administration. The results suggest that TCD is a useful test which can obtain reproducible results from any window and has the advantage of detecting subtle changes in cerebral vascular resistance.
Animals ; Cerebral Arteries/drug effects/*ultrasonography ; Diuretics/pharmacology ; Dogs/*physiology ; Feasibility Studies ; Furosemide/pharmacology ; Mannitol/pharmacology ; Reference Values ; Reproducibility of Results ; Ultrasonography, Doppler/*veterinary ; Vascular Resistance/drug effects/*physiology

PURPOSE: Laparoscopic subtotal cholecystectomy (LSC) can be an alternative surgical technique for difficult cholecystectomies. Surgeons performing LSC sometimes leave the posterior wall of the gallbladder (GB) to shorten the operation time and avoid liver injury. However, leaving the inflamed posterior GB wall is a major concern. In this study, we evaluated the clinical outcomes of standard laparoscopic cholecystectomy (SLC), LSC, and LSC removing only anterior wall of the GB (LSCA). METHODS: We retrospectively reviewed the medical records of laparoscopic cholecystectomies performed between January 2006 to December 2015 and analyzed the outcomes of SLC, LSC, and LSCA. RESULTS: A total of 1,037 patients underwent SLC. 22 patients underwent LSC; and 27 patients underwent LSCA. The mean operating times of SLC, LSC, and LSCA were 41, 74, and 68 minutes, respectively (P < 0.01). Blood loss was 5, 45, and 33 mL (P < 0.05). The mean lengths of postoperative hospitalization were 3.4, 5.4, and 5.8 days. Complications occurred in 24 SLC patients (2.3%), 2 LSC patients (9%), and 1 LSCA patient (3.7%). There was no mortality among the LSC and LSCA patients. CONCLUSION: LSC and LSCA are safe and feasible alternatives for difficult cholecystectomies. These procedures help surgeons avoid bile duct injury and conversion to laparotomy. LSCA has the benefits of shorter operation time and less bleeding compared to LSC.
Bile Ducts ; Cholecystectomy* ; Cholecystectomy, Laparoscopic ; Gallbladder ; Hemorrhage ; Hospitalization ; Humans ; Laparotomy ; Liver ; Medical Records ; Mortality ; Retrospective Studies ; Surgeons

Septic arthritis is rarely caused by anaerobic bacteria, which is mostly secondary to hematogenous dissemination among the immunocompromised host. We report a patient of septic arthritis on the right knee joint caused by Bacteroides thetaiotaomicron. To the best of knowledge, this is the first report of septic arthritis caused by Bacteroides spp. in Korea.
Arthritis, Infectious* ; Bacteremia* ; Bacteria, Anaerobic ; Bacteroides* ; Humans ; Immunocompromised Host ; Knee Joint ; Korea ; Multiple Myeloma*

OBJECTIVES: Tourette's Disorder (TD) is a chronic neuropsychiatric disorder characterized by multiple motor and vocal tics with onset in childhood. The aim of this study was to ascertain the increased cortical information transmission in frontal area during tic suppression in drug naive boys with TD using new nonlinear analysis of EEGs, be called Transfer Entropy (TE) which can detect the directed exchange of information between two systems. METHODS: Subjects were 11 drug naive boys with DSM-IV diagnosis of TD and 10 control boys. Clinical assessments were performed, and EEGs were recorded from 19 scalp loci of the international 10-20 systems. TE was estimated by EEG timeseries data after noise reduction. TE difference between TD and control during resting state and between tic suppression and resting state in TD were investigated. RESULTS: Elevated TE was found in extensive channels, including frontal, central and temporal channels (F7, Fz, F8,Cz, C3, P3, T3, and T4) in resting state of Tourette's disorder compared to normal controls. During tic suppression elevated TE was found in more extensive and asymmetrical channels especially prefrontal area (Fp1, Fp2, F3, Fz, F7, F8, Cz, C4, C5, T3, and T4). CONCLUSION: These findings suggest that pathogenesis of Tourette's disorder involve impaired cortical neuronal modulation in subcortical neural circuits. EEG analysis of TE may be a useful tool to investigation of cortical mechanism of psychiatric illness.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Electroencephalography ; Entropy ; Neurons ; Noise ; Scalp ; Tics* ; Tourette Syndrome*

Objectives: The optimal duration of maintenance treatment for patients with first-episode schizophrenia (FES) remains unclear. We examined the first antipsychotic treatment duration and its association with re-initiation of treatment using a nationwide claim database. Methods: Data from the Health Insurance Review and Assessment Service database in South Korea for 2007–2016 were used. Linear regression analysis and Cox proportional hazard models were used to evaluate the associations between the duration of the first antipsychotic treatment, time to re-initiation of treatment, and occurrence of treatment re-initiation. Results: Of 30,143 patients with FES, 80.4% (n=24,231) received <2 years of the first antipsychotic treatment. In patients who discontinued treatment (n=23,030), the rate of treatment re-initiation was 74.2% (n=17,086). As the duration of the first antipsychotic treatment increased, the time to re-initiation of treatment decreased (β=-0.146, p<0.001); however, the rate of treatment re-initiation was relatively constant (hazard ratio=1.001, p<0.001). Conclusion Long-term antipsychotic treatment was not significantly associated with the rate of treatment re-initiation but showed a negative association with the time to re-initiation of treatment. Further research is needed to better understand the optimal treatment duration for FES.

Paracrine interactions are imperative for the maintenance of adipose tissue intercellular homeostasis, and intracellular organelle dysfunction results in local and systemic alterations in metabolic homeostasis. It is currently accepted that mitochondrial proteotoxic stress activates the mitochondrial unfolded protein response (UPRmt) in vitro and in vivo. The induction of mitochondrial chaperones and proteases during the UPRmt is a key cell-autonomous mechanism of mitochondrial quality control. The UPRmt also affects systemic metabolism through the secretion of cell non-autonomous peptides and cytokines (hereafter, metabokines). Mitochondrial function in adipose tissue plays a pivotal role in whole-body metabolism and human diseases. Despite continuing interest in the role of the UPRmt and quality control pathways of mitochondria in energy metabolism, studies on the roles of the UPRmt and metabokines in white adipose tissue are relatively sparse. Here, we describe the role of the UPRmt in adipose tissue, including adipocytes and resident macrophages, and the interactive roles of cell non-autonomous metabokines, particularly growth differentiation factor 15, in local adipose cellular homeostasis and systemic energy metabolism.

BACKGROUND/AIMS: Minimal hepatic encephalopthy in patients with clinically asymptomatic chronic progressive liver disease may have adverse effects on daily activity. We evaluated the differences in the cognitive function of patients with chronic hepatitis and liver cirrhosis group according to the Child-Pugh classification. METHODS: We enrolled 61 consecutive chronic liver disease patients. We used the following study instruments: visual continuous performance test, a spatial memory test, the Wisconsin card-sorting test chosen from Neuroscan and STIM system (Study of the Usefulness of Computerized Neuropsychological Test, Neurosoft company, New York, NY, USA), a global-local processing test and an electroencephalogram (EEG). RESULTS: A significant correlation was found between neurologic abnormalities and the degree of liver disease. The result of the neuropsychological test and the EEG showed that cognitive function decreased according to the severity of chronic liver disease, especially in liver cirrhosis. Cirrhotic patients, especially in Child-Pugh C group, exhibited selective deficits in complex attention and fine motor skills as well as visual spatial perception, with preservation of memory. CONCLUSIONS: The STIM and EEG are simple, subjective and reproducible methods and may be used as early detection methods of minimal hepatic encephalopthy.
Adult ; Chronic Disease ; Cognition ; *Electroencephalography ; Female ; Hepatic Encephalopathy/*diagnosis/etiology ; Hepatitis, Viral, Human/complications ; Humans ; Liver Cirrhosis/complications ; Male ; Middle Aged ; *Neuropsychological Tests