BACKGROUND: The increasing number of dementia patients is increasing the importance of identifying them and also those at a high risk of dementia. The early diagnosis and management of dementia can slow the progression of the disease and reduce the socioeconomic burden. For these purposes, the Local Dementia Centers established in all regions of Korea are working on the early detection of dementia using neuropsychological batteries. This study investigated the utility of the Seoul Neuropsychological Screening Battery-Core (SNSB-C) in a dementia management project performed in the local community. METHODS: This study was conducted in two parts. The first part used data from the Local Dementia Centers to investigate the accuracy of detecting cognitive impairment in SNSB-C compared with the Seoul Neuropsychological Screening Battery-Second Edition (SNSB-II). The second part of this study which data from hospital examined the accuracy of diagnosing dementia using SNSB-C. RESULTS: Data were collected from 508 participants at the Local Dementia Centers in Daejeon and 50 participants at a hospital. SNSB-C had a high sensitivity and specificity for detecting cognitive impairment, and also a high sensitivity, high specificity, and positive predictive value for diagnosing dementia. CONCLUSIONS: The sensitivity in diagnosing dementia was as high for SNSB-C as for SNSB-II while taking less time. SNSB-C could therefore be a good diagnostic evaluation tool for use in local dementia centers.
Cognition Disorders ; Dementia ; Diagnosis ; Early Diagnosis ; Humans ; Korea ; Mass Screening ; Neuropsychological Tests ; Sensitivity and Specificity ; Seoul

Thyrotoxic storm is an extreme state of thyrotoxicosis and a medical emergency. The clinical presentation of thyrotoxic storm includes tachycardia, fever, organ effect of central nervous system, cardiovascular system, and gastrointestinal system dysfunction. It usually occurs in patients with untreated or partially treated Graves' disease. Although it is rare, its mortality rate has reached 10-20%. There are no specific tests for establishing the diagnosis; it can only be diagnosed based on the clinical expression and laboratory results. Rapid diagnosis and treatment are necessary when it unexpectedly occurs during the perioperative period. We report a case of unnoticed hyperthyroidism that was diagnosed due to thyrotoxic storm-induced tachycardia in the post anesthesia care unit.
Anesthesia ; Cardiovascular System ; Central Nervous System ; Diagnosis ; Emergencies ; Fever ; Graves Disease ; Humans ; Hyperthyroidism ; Liver Transplantation ; Living Donors ; Mortality ; Perioperative Period ; Tachycardia* ; Thyroid Crisis* ; Thyrotoxicosis

Cutis laxa is a rare disorder of the elastic tissue characterized by loosely hanging and folded skin giving a premature senile appearance, often with internal organ involvement. Recently, we experienced a case of cutis laxa in a neonate. The patient who presented with dyspnea and loose skin at birth was delivered by Cesarean section in our hospital. He was the third baby of his mother and his siblings had no problem including skin. Physical examination on admission revealed a dyspneic neonate with skin showing loose folds, wrinkles and sagging over the face, neck, trunk and thighs. He had no family history of skin disease suggestive of cutis laxa. Histopathologic study of the skin specimen showed widespread breakdown and decreased number of elastic fibers with granular degeneration, shortening, and fragmentation. He had been dependent on ventilatory support throughout his hospital course and finally succumbed to intractable pulmonary emphysema at the age of 220 days.
Cesarean Section ; Cutis Laxa* ; Dyspnea ; Elastic Tissue ; Female ; Humans ; Infant, Newborn ; Mothers ; Neck ; Parturition ; Physical Examination ; Pregnancy ; Pulmonary Emphysema* ; Siblings ; Skin ; Skin Diseases ; Thigh

Aspergillus bursitis is an uncommon condition demonstrated as a nonspecific soft tissue mass. To our knowledge, the ultrasonographic findings of aspergillus bursitis in immunocompromised patients have not been previously reported. Here, we report a case of aspergillus bursitis in a renal transplant recipient, accompanied by the associated ultrasonographic findings.
Aspergillosis ; Aspergillus ; Bursitis ; Humans ; Immunocompromised Host

Dental Implants ; Female ; Follow-Up Studies ; Gingivitis ; Humans ; Male ; Membranes ; Prognosis ; Prosthodontics ; Retrospective Studies ; Sinusitis ; Survival Rate ; Tooth ; Transplants

Uremic encephalopathy is usually applied to cortical involvement in uremic patients. The syndrome of acute bilateral basal ganglia lesions very rare occurs in uremic patents, especially diabetic patients. We here report a case of acute uremic encephalopathy with bilateral basal ganglia lesions in a diabetic hemodialysis patient. A 63-year-old woman with diabetes mellitus on chronic hemodialysis treatment for 3 years admitted due to dysathria, facial palsy and gait disturbance, and temporary loss of consciousness. Brain MRI demonstarted low signal in T1 image and high signal in T2 image in both ganglia. With conservative care including regular hemodialysis, the manifestations completely disappeared.
Basal Ganglia* ; Brain ; Diabetes Mellitus ; Facial Paralysis ; Female ; Gait ; Ganglia ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Renal Dialysis* ; Unconsciousness

Most cases of cytomegalovirus (CMV) colitis occur in adults with severe immuno- deficiency. There have been a few reports involving immunocompetent patients. CMV colitis may occur after colonic mucosal injury in immunocompetent patients. Henoch-Schonlein purpura (HSP) is a common systemic vasculitis in childhood. Diagnostic criteria include palpable purpura with at least one other manifestation; abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. To best of our knowledge, we describe the first case of CMV colitis in an immunocompetent patient with preceding HSP. A 38-year-old man presented with a 1-day history of abdominal pain, diarrhea and vomiting. Two-years previously, he underwent a right hemicolectomy due to intussusception. Over a 1-month period, palpable purpura was evident on both arms and legs. Colonoscopy revealed multiple, linear geographic ulcerations at an anastomosis opening site with huge ulceration at the small bowel, which was covered with white exudates. Colonoscopic biopsy showed CMV inclusion bodies and skin biopsy revealed leukocytoclastic vasculitis. The patient was successfully treated with gancyclovir and prednisolone.
Abdominal Pain ; Adult ; Arm ; Arthralgia ; Arthritis ; Biopsy ; Colitis ; Colon ; Colonoscopy ; Cytomegalovirus ; Diarrhea ; European Continental Ancestry Group ; Exudates and Transudates ; Ganciclovir ; Humans ; Immunoglobulin A ; Inclusion Bodies ; Intussusception ; Leg ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Systemic Vasculitis ; Ulcer ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Vomiting

Although diagnostic esophagogastroduodenoscopy is a reasonably safe procedure, complications may occur and can sometimes cause lift-threatening conditions. Esophageal perforation is one of the most serious complications. We report here a very rare case of esophageal perforation and mediastinitis by routine endoscopic study. A 69-year-old woman complained of edematous and painful neck area just after diagnostic endoscopy was finished. Computed tomography was performed and revealed mediastinitis at the superior mediastinum with deep neck infection by suspicious esophageal perforation. The patient completely recovered with prompt surgical intervention of incision and drainage. Because late diagnosis of the complication can lead to high mortality, endoscopists need to be aware of possible procedure-related complications.
Aged ; Delayed Diagnosis ; Digestive System ; Drainage ; Endoscopy ; Endoscopy, Digestive System ; Esophageal Perforation ; Female ; Humans ; Mediastinitis ; Mediastinum ; Neck

Although diagnostic esophagogastroduodenoscopy is a reasonably safe procedure, complications may occur and can sometimes cause lift-threatening conditions. Esophageal perforation is one of the most serious complications. We report here a very rare case of esophageal perforation and mediastinitis by routine endoscopic study. A 69-year-old woman complained of edematous and painful neck area just after diagnostic endoscopy was finished. Computed tomography was performed and revealed mediastinitis at the superior mediastinum with deep neck infection by suspicious esophageal perforation. The patient completely recovered with prompt surgical intervention of incision and drainage. Because late diagnosis of the complication can lead to high mortality, endoscopists need to be aware of possible procedure-related complications.
Aged ; Delayed Diagnosis ; Digestive System ; Drainage ; Endoscopy ; Endoscopy, Digestive System ; Esophageal Perforation ; Female ; Humans ; Mediastinitis ; Mediastinum ; Neck

An esophagobronchial fistula is a life threatening complication of esophageal carcinoma. Although placement of esophageal stents is the preferred treatment for esophagobronchical fistula, experience of stenting at the proximal esophagus is limited due to technical difficulties, patients' discomfort and high risk of complications. We report here a patient with an esophagobronchial fistula at the proximal esophagus who was successfully treated by insertion of a self expandable metal stent and earlobe fixation by a connective tube for preventing stent migration. A 46-year-old man had an inoperable esophageal carcinoma and lung abscess due to esophagobronchial fistula. Our first placement of stent at the proximal esophagus failed because of foreign-body sensations and stent migration to the proximal region. For the second time, treatment adding an earlobe fixation tool for anti-migration to the esophageal stent was successful with no serious procedure-related complications. The stent completely sealed off the fistula in the patient without further aspiration and serious discomfort symptoms. Lung abscess and pneumonia gradually improved. Anti-migration esophageal stents can be effective in preventing stent migration for the treatment of proximal esophagobronchial fistula due to malignancy.
Esophageal Fistula ; Esophagus ; Fistula* ; Humans ; Lung Abscess ; Middle Aged ; Pneumonia ; Sensation ; Stents*