The dysfunction of either or both noradrenaline and serotonin system are important in the pathophysiology of depression. Previous reports have suggested that there may be an important interaction between these two systems. Recently, some investigators have suggested that the combination of tricyclic antidepressants(TCAs and selective serotonin reuptake inhibitors(SSRIs would produce a rapid synergistic effect on down-regulation of either or both of these two systems and that this combination may produce a more rapid and absolute antidepressant effect. We compared the treatment efficacy, treatment associated side effects, treatment satisfaction, and the quality of life between the combination therapy of dothiepin-sertraline as well as the therapy of dothiepin alone in the treatment of major depressive disorder and dysthymic disorder. In our study, the combination therapy of dothiepin and sertraline produced a more rapid and absolute antidepressant effect than dothiepin alone. And the patients with combination therapy experienced relatively high treatment satisfaction than the patients with dothiepin therapy. The patients quality of life improved more rapidly in the combination therapy, especially, in the health perception, social behavior, and life satisfaction, that dothiepin alone. These results support the hypothesis that the combination of TCA an SSRI may produce a rapid synergistic effect on either or both norepinephrine and serotonin system, and more rapid antidepressant effect and high treatment satisfaction.
Depression ; Depressive Disorder* ; Depressive Disorder, Major ; Dothiepin* ; Down-Regulation ; Dysthymic Disorder ; Humans ; Norepinephrine ; Quality of Life ; Research Personnel ; Serotonin ; Sertraline ; Social Perception ; Treatment Outcome

PURPOSE: To evaluate the MR appearance of the accessory hepatic veins. MATERIALS AND METHODS: The study included 87 consecutive patients for whom abdominal MR images were obtained. The subjects who had liver lesion or hepatic vascular abnormalities were excluded. Couinaud classified accessory hepatic veins into inferior and middle right hepatic veins. Our major interests were evaluation of the incidence, morphology, and location of the accessory hepatic vein. RESULTS: Inferior right hepatic vein was demonstrated in 43 out of 87 patients(49%). The morphology was linear in 35 patients(80.5%), and V-shaped in 8 patients(19.5%). In 40 patients(93%), the inferior right hepatic vein was located in the posteroinferior aspect of the right lobe. Middle right hepatic vein was demonstrated in 7 out of 87 patients(8%). All were single linear in morphology, combined with the inferior right hepatic vein, and located between the right hepatic vein and inferior right hepatic vein. CONCLUSION: The accessory hepatic vein was demonstrated in 49% among the Korean adult population, and was located in posteroinferior portion of the liver, in 93%.
Adult ; Hepatic Veins* ; Humans ; Incidence ; Liver ; Magnetic Resonance Imaging*

PURPOSE: The aim of this study was to analyze of the risk factors for surgical procedure on ileo-colic intussusception without leading point in children. METHODS: We retrospectively reviewed medical records of patient treated for ileo-colic intussusception between January 2003 and December 2014. We exclude the patients who had leading point. Because of the large difference on patient's numbers between non-operative group (cases of ileo-colic intussusceptions successfully reduced by air reduction) and operative group (cases underwent operation due to failed air reduction), we compared the data of operative group of patients without leading point between 2003 and 2014 with the data of non-operative group as control group from 2013 to 2014. Clinical features such as gender, age, body temperature, body weight in diagnosis, growth curves for age-gender-body weight, and laboratory data of blood test were compared. RESULTS: In non-operative group, total 94 patients who were treated successfully by the non-operative air reduction. In operative group, total 21 patients treated by surgical procedure. The age under 12 months, weight over upper 75 percentile group, increased segment neutrophil count, decreased hemoglobin level and lymphocyte count were significantly associated with a requirement for surgical procedure. CONCLUSION: We conclude that younger age, higher weight percentile group, increased segment neutrophil, decreased hemoglobin and lymphocyte are the independent risk factors related to operative treatment for ileo-colic intussusception in children. If primary air reduction is failed in patients with such risk factors, operative treatment over ultrasonography or secondary reduction can prevent unnecessary effort and complications, thus emphasizing the consideration of operative treatment when selecting treatment methods.
Body Temperature ; Body Weight ; Child* ; Diagnosis ; Hematologic Tests ; Humans ; Intussusception* ; Lymphocyte Count ; Lymphocytes ; Medical Records ; Neutrophils ; Retrospective Studies ; Risk Factors* ; Ultrasonography

PURPOSE: To evaluate the result of arthroscopic modified Brostrom procedure with suture anchor for chronic lateral ankle instability. MATERIALS AND METHODS: Fifty-two patients with chronic lateral ankle instability were analyzed, who underwent arthroscopic modified Brostrom procedure between December 2010 and May 2012. Clinical evaluation was performed using AOFAS scroring and Sefton grading system. RESULTS: The average AOFAS hind foot score increased from preoperative 61.9 to 88.8 at the last follow up. There were 35 excellent, 9 good, 4 fair, 4 poor results according to Sefton grading system. For one patient, lateral ankle instability recurred. CONCLUSION: Arthroscopic modified Brostrom procedure is considered to be an effective and satisfactory technique.
Ankle* ; Arthroscopy ; Follow-Up Studies ; Foot ; Humans ; Suture Anchors

59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during taperring and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0% ) between non-recurrent and recurrent group.
Child ; Electroencephalography ; Epilepsy* ; Gangwon-do ; Humans ; Nervous System Diseases ; Pediatrics ; Recurrence* ; Retrospective Studies ; Risk Factors* ; Seizures

Kawasaki disease is described by fever lasting five days or more, bilateral conjunctival injection, changes of lips and oral cavity, polymorphous exanthema, acute non-purulent cervical lymphadenopathy, and changes of extremities. Atypical Kawasaki disease is defined as fewer than 4 of 6 criteria described above including coronary artery abnormalities. Especially, atypical clinical manifestations of Kawasaki disease appear in infants younger than 6 months old of age. Thus we recommend echocardiography in early infancy who has prolonged fever in order to diagnose atypical Kawasaki disease and treat early. We have experienced three cases of atypical Kawasaki disease with coronary aneurysm who were admitted because of fever and revealed coronary aneurysm on echocardiography.
Coronary Aneurysm* ; Coronary Vessels ; Echocardiography ; Exanthema ; Extremities ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome*

Gastrointestinal angiodysplasia is a distinct disease entity which causes frequent gastrointestinal bleeding. It predominantly arises at the stomach and duodenum in the upper gastrointestinal tract and cecum and ascending colon in the lower gastrointestinal tract. The general histological finding of the angiodysplasia is a submucosal vascular ectasia and tortuosity. We have experienced two cases of the intestinal angiodysplasia. The first case occurred on a jejunum in a 22-year-old woman who had anemia. The second case occurred on a sigmoid colon in a 59-year-old man who had constipation. In addition to the general histologic finding of the angiodysplasia, the microscopic findings of the first case revealed some capillary hemangioma-like areas; and in the second case, there was a marked ischemic change and the thickening of the wall.
Anemia ; Angiodysplasia* ; Capillaries ; Cecum ; Colon, Ascending ; Colon, Sigmoid ; Constipation ; Dilatation, Pathologic ; Duodenum ; Female ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Jejunum ; Lower Gastrointestinal Tract ; Middle Aged ; Stomach ; Upper Gastrointestinal Tract ; Young Adult

No abstract available.
Hand* ; Humans

No abstract available.
Bronchiectasis* ; Bronchography*

Additional a case of ectopic kidney with a literatural review was presented. The terms renal ectopia describe kidneys which are congenitally located in abnormal anatomic positions. Its clinical interest is that it often confused with retroperitoneal tumor and pelvic tumor and other abdominal conditions. We experienced a case of ectopic kidney that was clinically confused with retroperitoneal tumor in 22-year old Korean male.
Humans ; Kidney* ; Male ; Young Adult