BACKGROUND: The purpose of this study was to make a comparative analysis of the clinical outcomes after the operative treatment of refractory medial epicondylitis between the suture anchor group and the non-suture anchor group. METHODS: We enrolled 20 patients (7 men and 13 women) with recalcitrant medial epicondylitis who were able to receive operative treatment in a minimum of an 18-month follow-up. The mean age was 48.6 years (range, 36-59 years). The patients were allocated into either the suture anchor group (7 patients) or the non-suture anchor group (13 patients). We evaluated clinical outcomes using the visual analog scale (VAS), the pain grading system of Nirschl and Pettrone, and postoperative grip strength. RESULTS: The VAS score decreased from 8.8 to 2.0 for the suture anchor group and from 8.6 to 1.3 for the non-suture anchor group (p=0.16). The postoperative grip strength was 95%, 93% of the non-treated arm in both groups (p=0.32). The postoperative satisfaction level was good in 5 patients and fair in 2 for the suture anchor group and excellent in 5 patients, good, in 4, and fair, in 4 for the nonsuture anchor group (p=0.43). The clinical outcomes did not show a statistically significant difference between the two groups. CONCLUSIONS: We found that patients with recalcitrant medial epicondylitis were treated reliably with satisfactory clinical outcomes whether or not suture anchors were used. We believe the use of suture anchors when more than 50% of the tendon origin is affected provides an effective and favorable treatment modality.
Arm ; Elbow ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Suture Anchors* ; Sutures* ; Tendons ; Visual Analog Scale

OBJECTIVES: Risperidone, an atypical antipsychitics which blocks both dopaminergic and serotonergic receptors, have a good response to the negative symptoms as well as positive symptoms, and improve cognitive dysfunction of schizophrenic patients. Furthermore, it has few extrapyramidal side effects and tardive dyskinesia. Although it had been reported that the atypical antipsychotics have less effect on prolactin(PRL) than the classical antipsychotics, we could experience PRL-associated symptoms such as amenorrhea, galactorrhea and hyperprolactinemia in practice. Therefore we tried to identify the sex differences of risperidone-induced hyperprolactinemia, to evaluate factors affecting PRL levels, and to know the association between cognitive disorders and PRL. METHODS: The baseline levels of PRL and TSH prior th risperidone administration were measured by enzyme immunoassay method for 50 patients (25 males and 25 females) admitted with schizophrenia, schizoaffective disorder or schizophreniform disorder according to the DSM-IV classification, and the measurements of PRL were repeated on the 2nd and the 4th wks of risperidone administration. Concomitantly, the severity of psychotic symptoms using CGI, BPRS and PANSS, and the cognitive dysfunction using PANSS-CF were assessed prior to, on the 2nd and the 4th wks of risperidone administration. The PRL and TSH levels of 54 healthy controls(29 males and 25 females) who had no medical, neurological and psychiatric illnesses were also evaluated. Furthermore, the correlation with the psychiatric diagnosis, education, age, sex, duration of illnesses, risperidone dosage, duration of risperdone administration, TSH concentration, cognitive function, severity of psychotic symptoms were also identified. RESULTS: 1) The baseline PRL levels of female schizophrenics(74.3+/-49.6ng/ml) were significantly(p<0.005) higher than those of males(36.3+/-24.6ng/ml), which wee significantly(p<0.0001 respectively) higher than those of controls(females 16.9+/-6.1ng/ml, males 13.3+/-4.9ng/ml). The PRL levels measured on the 2nd wks(females 133.7+/-47.8ng/ml, males 56.9+/-23.6ng/ml) and on the 4th wks(females 146.1+/-45.9ng/ml, males 70.0+/-31.5ng/ml) after risperidone administration were significantly(p<0.0001 respectively) higher in females. The mean dosages of risperidone on the 2nd wks were 3.8+/-1.7mg(2-6mg) for the females and 4.0+/-1.6mg(2-6mg) fore the males, and on the 4th wks were 4.5+/-2.1mg(2-8mg) fore the females and 5.4+/-2.2mg(2-8mg) for the males. 2) The rise of PRL levels were positively correlated with increased risperidone dosage in males(y=0.307 on the 2nd wks and y=0.280 on the 4th wks), while they were not correlated with dosages in females. For the females, the PRL levels were negatively correlated(y=-0.320) with decrease of TSH concentration. The baseline PRL levels were not correlated with age, education, duration of illnesses, psychopathology, cognitive disorders in both males and females, while it was negatively correlated with TSH levels only in females(y=-0.320). 3) The cognitive dysfunction was correlated with PRL levels in males, while PANSS-CF scores were negatively correlated with PRL levels(y=-0.220 on the 2nd wks and y=-0.366 on the 4th wks) in females. The psychopathology was positively correlated with cognitive dysfunction in both males and females. Therefore, the risperdone-induced cognitive improvement seemed to be correlated with improvement of psychopathology in both males and females, and with increase in PRL levels only in females. CONCLUSIONS: The fact that the serum PRL levels of schizophrenics were higher than those of controls, especially in females suggested that it could be related with risperidone dosage in males and with primary pathological process in females. The risperidone-associated cognitive improvement seemed to be related with general improvement of psychopathology as well as the rise of PRL levels especially in females. The facts that the effect of risperidone-induced hyperprolactinemia and the cognitive function were more in females suggested that somewhat different mechanisms could be exerted on them.
Amenorrhea ; Antipsychotic Agents ; Classification ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Female ; Galactorrhea ; Humans ; Hyperprolactinemia ; Immunoenzyme Techniques ; Male ; Mental Disorders ; Movement Disorders ; Pregnancy ; Prolactin* ; Psychopathology ; Psychotic Disorders ; Risperidone* ; Schizophrenia ; Sex Characteristics

Tracheal tumors are uncommon comprising less than 0.1% of all malignancies. Metastatic tracheal tumors, especially form the extrathoracic sites, are exceedingly rare. Ovarian cancer tends to metastasize to the serous cavities and the lymph nodes. One large autopsy study reported tracheal involvement in 1% of patients who had died from ovarian cancer. Other studies have not mentioned tracheal involvement at all. Since the main symptoms of cough, hemoptysis, or wheezing are nonspecific, patients may be initially treated for other conditions including asthma or bronchitis. Here we describe a metastatic tracheal tumor from an overain carcinoma that was initally treated for bronchial asthma.
Asthma ; Autopsy ; Bronchitis ; Cough ; Hemoptysis ; Humans ; Lymph Nodes ; Ovarian Neoplasms ; Respiratory Sounds

OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.
Anxiety ; Clonazepam ; Cyproheptadine ; Emergency Service, Hospital ; Epilepsy ; Fever ; Fluoxetine* ; Flushing ; Gait Ataxia ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Hypotension ; Lorazepam ; Male ; Memory ; Middle Aged ; Myoclonus ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline* ; Shivering ; Tachycardia ; Tremor ; Valproic Acid

OBJECTIVES: The aim of this study was to analyze factors affecting quality of life (QOL) among Korean dementia patients. METHODS: The subjects were consisted with 54 patients with dementia of the Alzheimer's type and 54 normal aged controls with age over 60. The QOLs were assessed with the Korean Version of the Quality of Life in Alzheimer's Disease: Patient and Caregiver Report (KQOL-AD). For analyzing factors affecting QOL in dementia, the clinical data were obtained by structured interview and medical records, serum homocysteine levels were measured, and the severity of dementia (Mini-Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional activities (Activities of Daily Living, Instrumental Activities of Daily Living) and depression (Geriatric Depression Scale) were evaluated using various rating scales. RESULTS: 1) The mean (+/-S.D.) score of KQOL-AD in patients with dementia of the Alzheimer's type (24.30+/-5.06) was significantly (p<0.005) lower than those in normal aged controls (26.56+/-3.25). 2) The factors influencing on KQOL-AD in patients with dementia of the Alzheimer's type were age (p<0.01), cognitive function (p<0.01), severity of dementia (p<0.01), activities of daily living (p<0.01), depression (p<0.01) and serum homocysteine levels (p<0.05). CONCLUSION: In conclusion, multiple factors including problems originated from dementia itself as well as causes fundamentally related with pathophysiology of dementia might influence on the quality of life in patients with the Alzheimer's dementia.
Activities of Daily Living ; Alzheimer Disease ; Caregivers ; Dementia* ; Depression ; Homocysteine ; Humans ; Medical Records ; Quality of Life* ; Weights and Measures

OBJECTIVES: The aim of this study was to analyze factors affecting quality of life (QOL) among Korean dementia patients. METHODS: The subjects were consisted with 54 patients with dementia of the Alzheimer's type and 54 normal aged controls with age over 60. The QOLs were assessed with the Korean Version of the Quality of Life in Alzheimer's Disease: Patient and Caregiver Report (KQOL-AD). For analyzing factors affecting QOL in dementia, the clinical data were obtained by structured interview and medical records, serum homocysteine levels were measured, and the severity of dementia (Mini-Mental State Examination, Clinical Dementia Rating, Global Deterioration Scale), functional activities (Activities of Daily Living, Instrumental Activities of Daily Living) and depression (Geriatric Depression Scale) were evaluated using various rating scales. RESULTS: 1) The mean (+/-S.D.) score of KQOL-AD in patients with dementia of the Alzheimer's type (24.30+/-5.06) was significantly (p<0.005) lower than those in normal aged controls (26.56+/-3.25). 2) The factors influencing on KQOL-AD in patients with dementia of the Alzheimer's type were age (p<0.01), cognitive function (p<0.01), severity of dementia (p<0.01), activities of daily living (p<0.01), depression (p<0.01) and serum homocysteine levels (p<0.05). CONCLUSION: In conclusion, multiple factors including problems originated from dementia itself as well as causes fundamentally related with pathophysiology of dementia might influence on the quality of life in patients with the Alzheimer's dementia.
Activities of Daily Living ; Alzheimer Disease ; Caregivers ; Dementia* ; Depression ; Homocysteine ; Humans ; Medical Records ; Quality of Life* ; Weights and Measures

There are numerous agents with potential toxic effects on the lung. In particular, cytotoxic drugs constitute the largest and most imprtant group of agents associated with lung toxicity. Bleomycin is commonly used, either alone or in combination with other chemotherapeutic agents, in the treatment of squamous cell carcinoma(head and neck, esophagus, and genitourinary tract), lymphoma, and germ cell tumor. One of the therapeutic advantages of bleomycin is its minimal bone marrow toxicity. However, pulmonary toxicity is one of the most serous adverse side effect. Classically, pulmonary toxicity manifests as a diffuse interstitial process or less commonly as a hypersensitivity reaction. This pulmonary toxicity is generally considered to be dose related and can progress to a fatal fibrosis. It is also possible that bronchiolitis obliterans organizing pneumonia(BOOP) is another manifestation of bleomycin induced toxicity. Bleomycin induced BOOP is less common and has a favorable response to steriod therapy. Here we present a case that demonstrates a BOOP, secondary to a relatively small cumulative dose of bleomycin(225mg/??, may be reversible.
Bleomycin* ; Bone Marrow ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Cryptogenic Organizing Pneumonia ; Esophagus ; Fibrosis ; Hypersensitivity ; Lung ; Lymphoma ; Neck ; Neoplasms, Germ Cell and Embryonal ; Pneumonia*

OBJECTIVES: The aims of this study were to know whether Korean healthy elderly and family with dementia patients were wishing to disclose the diagnosis of dementia, to identify reasons of their wishing and unwishing to disclose, and to analyze influencing factors on the disclosing of dementia. METHODS: We obtained data from 78 healthy elderly with age over 60 and 73 family with dementia patients by interviewing with questionnaire about attitudes toward disclosing dementia. RESULTS: 1) 51.3% of healthy elderly and 58.9% of family with dementia patients were wishing to disclose dementia. Other relatives whom they wanted to tell were spouse or adult children. Most family with dementia patients wanted to have predictive tests in preparation for their future. 2) The main reasons for wishing to disclose were to make advance planning in healthy elderly, and to be careful and cooperate well to treat if they aware their illness in family with dementia patients (p<0.005, respectively). The main reasons for unwishing to disclose were whether they might be frightened or upset in healthy elderly (p<0.025), and to worry about being depressed in family with dementia patients (p<0.005). The main reasons why family wanted to be told were family's right to know and to explore treatment options. 3) The influencing factors on disclosing dementia seemed to be sex (p<0.01) and marital status (p<0.005) in healthy elderly, and education (p<0.005), marital status (p<0.005), religion (p<0.025) and socioeconomic status (p<0.01). CONCLUSION: The attitude toward disclosing diagnosis of dementia in Korean healthy elderly and family with dementia patients seemed to be more active. Therefore, doctors should prepare in mental attitude and knowledge to satisfy their need by active provision of information and education.
Adult Children ; Aged* ; Dementia* ; Diagnosis* ; Education ; Humans ; Marital Status ; Surveys and Questionnaires ; Social Class ; Spouses

BACKGROUND: The purpose of this study was to make a comparative analysis of the clinical outcomes after the operative treatment of refractory medial epicondylitis between the suture anchor group and the non-suture anchor group. METHODS: We enrolled 20 patients (7 men and 13 women) with recalcitrant medial epicondylitis who were able to receive operative treatment in a minimum of an 18-month follow-up. The mean age was 48.6 years (range, 36-59 years). The patients were allocated into either the suture anchor group (7 patients) or the non-suture anchor group (13 patients). We evaluated clinical outcomes using the visual analog scale (VAS), the pain grading system of Nirschl and Pettrone, and postoperative grip strength. RESULTS: The VAS score decreased from 8.8 to 2.0 for the suture anchor group and from 8.6 to 1.3 for the non-suture anchor group (p=0.16). The postoperative grip strength was 95%, 93% of the non-treated arm in both groups (p=0.32). The postoperative satisfaction level was good in 5 patients and fair in 2 for the suture anchor group and excellent in 5 patients, good, in 4, and fair, in 4 for the nonsuture anchor group (p=0.43). The clinical outcomes did not show a statistically significant difference between the two groups. CONCLUSIONS: We found that patients with recalcitrant medial epicondylitis were treated reliably with satisfactory clinical outcomes whether or not suture anchors were used. We believe the use of suture anchors when more than 50% of the tendon origin is affected provides an effective and favorable treatment modality.
Arm ; Elbow ; Follow-Up Studies ; Hand Strength ; Humans ; Male ; Suture Anchors ; Sutures ; Tendons ; Visual Analog Scale