Objective: The effectiveness of music therapy programs for the elderly with dementia has been verified through several studies, but there is a limitation in that most of them are compared with a single group, no treatment group or waiting group. In this study, to overcome this problem, the two groups that performed similar interventions were selected and compared retrospectively. Methods: For 37 people who participated in the treatment programs for the elderly with dementia at Dongdaemun Center for De-mentia and its branch center, we retrospectively analyzed the changes in Korean version of Geriatric Depression Scale and GeriatricQuality of Life Scale-Dementia scores measured before and after treatment. Results: Prior to treatment, there is no significant difference between the groups in the demographic variables and the depression and quality of life scores. The difference between pre- and post-scores was not significant in the group at the branch center without a music therapy, but depression was significantly reduced and quality of life had improved in the group at Dongdaemun center with the music therapy program. Conclusion It was confirmed that participation in the structured music therapy program had a positive effect on the improve-ment of depression and quality of life in the elderly with dementia compared to other similar interventions.

Objective: The effectiveness of music therapy programs for the elderly with dementia has been verified through several studies, but there is a limitation in that most of them are compared with a single group, no treatment group or waiting group. In this study, to overcome this problem, the two groups that performed similar interventions were selected and compared retrospectively. Methods: For 37 people who participated in the treatment programs for the elderly with dementia at Dongdaemun Center for De-mentia and its branch center, we retrospectively analyzed the changes in Korean version of Geriatric Depression Scale and GeriatricQuality of Life Scale-Dementia scores measured before and after treatment. Results: Prior to treatment, there is no significant difference between the groups in the demographic variables and the depression and quality of life scores. The difference between pre- and post-scores was not significant in the group at the branch center without a music therapy, but depression was significantly reduced and quality of life had improved in the group at Dongdaemun center with the music therapy program. Conclusion It was confirmed that participation in the structured music therapy program had a positive effect on the improve-ment of depression and quality of life in the elderly with dementia compared to other similar interventions.

We report a case demonstrating a rapid and potent antiarrhythmic effect of biventricular pacing. A 67-year-old male patient with dilated cardiomyopathy was admitted for heart failure. The initial surface electrocardiogram revealed a left bundle branch block with a QRS complex duration of 200 ms. Echocardiographic examination revealed a left ventricular ejection fraction of 16%, a left ventricular end-diastolic dimension of 91 mm, and marked interventricular dyssynchrony. Continuous rhythm monitoring revealed frequently-recurring non-sustained monomorphic ventricular tachycardia (VT). Polymorphic VT, which persisted for 27 seconds, occurred on the third day after admission, and the R on T phenomenon recurred every two to three days thereafter. Optimal medical therapy for four weeks failed to suppress the recurrence of ventricular arrhythmias or ameliorate heart failure. Cardiac resynchronization therapy was initiated for an anticipated antiarrhythmic effect of biventricular pacing. Three days after the initiation of biventricular pacing, the ventricular arrhythmias disappeared almost completely.
Aged ; Arrhythmias, Cardiac* ; Bundle-Branch Block ; Cardiac Resynchronization Therapy* ; Cardiomyopathy, Dilated* ; Echocardiography ; Electrocardiography ; Heart Failure ; Humans ; Male ; Recurrence ; Stroke Volume ; Tachycardia, Ventricular

Sorafenib is currently the only targeted therapy available for advanced stage hepatocellular carcinoma (HCC). Cutaneous adverse events associated with sorafenib treatment include hand-foot skin reaction, but there has been no report of drug reaction (or rash) with eosinophilia and systemic symptoms (DRESS) syndrome. Here, we report a case of 72-year-old man with HCC and alcoholic liver cirrhosis who developed skin eruptions, fever, eosinophilia, and deteriorated hepatic and renal function under sorafenib treatment. He has since successfully recovered with conservative care.
Aged ; Carcinoma, Hepatocellular ; Drug Hypersensitivity Syndrome* ; Eosinophilia ; Fever ; Humans ; Liver Cirrhosis, Alcoholic ; Skin

A 35-year-old male with exertional dyspnea was transferred to our hospital for evaluation of a diastolic murmur and cardiomegaly discovered by chest X-ray. Two-dimensional and Doppler echocardiographic studies revealed an aneurysmal dilation of the right coronary artery (RCA) and diastolic inflow from the RCA to the left ventricle (LV) through a myocardial defect 11 mm in diameter in the basal inferior LV wall. Coronary computed tomography angiography (CCTA) confirmed the presence of a giant RCA to LV fistula. Due to the risks for developing overt left heart failure and spontaneous rupture of the giant RCA, the RCA was obliterated surgically. Coronary-cameral fistulas are a rare congenital coronary artery anomaly. A fistula between the coronary artery and LV, especially when combined with coronary artery aneurysm, is a rare occurrence in the literature. Here, we report a case of a giant RCA to LV fistula detected by echocardiography and CCTA.
Adult ; Aneurysm* ; Angiography ; Cardiomegaly ; Coronary Vessel Anomalies ; Coronary Vessels* ; Dyspnea ; Echocardiography ; Fistula* ; Heart Failure ; Heart Murmurs ; Heart Ventricles ; Humans ; Male ; Rupture, Spontaneous ; Thorax

PURPOSE: The study aims to classify schools based on traffic pollutants and their complex sources, to assess the environment, to determine the state of allergic diseases among students using the International Study of Asthma and Allergies in children (ISAAC) questionnaire, and to assess their connection to air pollutants. MATERIALS AND METHODS: A total of seven schools were divided into three categories according to the characteristics of their surrounding environments: three schools in traffic-related zones, two schools in complex source zones I (urban), and two schools in complex source zones II (industrial complex). ISAAC questionnaires were administered and the 4404 completed questionnaires were analyzed. RESULTS: The frequency of asthma treatment during the past 12 months showed a significant increase (p<0.05) with exposure to NO2 [1.67, 95% confidence intervals (CIs) 1.03-2.71] in the complex source zones. The frequency of allergic rhinitis treatment during the past 12 months increased significantly with exposure to Black Carbon (1.60, 95% CIs 1.36-1.90) (p<0.001), SO2 (1.09, 95% CIs 1.01-1.17) (p<0.05), NO2 (1.18, 95% CIs 1.07-1.30) (p<0.01) for all subjects. CONCLUSION: In terms of supporting children's health, care, and prevention related to major spaces for children, such as school zones, spaces used in coming to and leaving school, playgrounds, and classrooms are essential to ensuring not only the safety of children from traffic accidents but also their protection from local traffic pollutants and various hazardous environmental factors.
Adolescent ; Air Pollutants/*adverse effects ; Air Pollution/*adverse effects ; Asthma/chemically induced/*epidemiology/*etiology ; Child ; Cross-Sectional Studies ; *Environmental Exposure ; Female ; Humans ; Male ; Republic of Korea/epidemiology ; Rhinitis, Allergic, Perennial/chemically induced/*epidemiology ; Schools ; Surveys and Questionnaires ; Vehicle Emissions/analysis/toxicity

PURPOSE: It appears that much of the discordance between skin prick test (SPT) and ImmunoCAP in clinical practice. We investigated the comparison and correlation between SPT and ImmunoCAP for inhalant allergens. METHODS: A total of 1,400 patients who were tested SPT and ImmunoCAP were recruited from June 2011 to May 2014 in Dong-A University Hospital, and the results of two assays were compared for 17 inhalant allergens. For SPT, mean wheal size> or =3 mm or allergen/histamine> or =1 at 15 minutes, and the result of ImmunoCAP of > or =0.35 kU/L was considered positive, respectively. RESULTS: Of the study subjects, bronchial asthma was 29.3%, rhinitis 36.8%, atopic dermatitis 0.6%, and chronic urticaria 4.3%. The agreement rate of between two assays was 77.4%. When ImmunoCAP was compared with SPT as the reference, the sensitivity, specificity was 75.5% and 80.0%, respectively. Significant correlation was observed (r=0.59), and birch, mugwort, Japanese hop, house dust mites, and cockroach showed very strong correlation (r>0.7). CONCLUSION: The agreement, sensitivity, and specificity between SPT and ImmunoCAP was various according to allergens. We should determine the clinical relevance of the allergen sensitization using both SPT and ImmunoCAP not alone with combination of clinical symptoms.
Allergens* ; Artemisia ; Asian Continental Ancestry Group ; Asthma ; Betula ; Cockroaches ; Dermatitis, Atopic ; Humans ; Humulus ; Immunoglobulin E* ; Pyroglyphidae ; Rhinitis ; Skin Tests ; Skin* ; Urticaria

Serotonin syndrome (SS) is a potentially life-threatening drug reaction characterized by mental status change, increased neuromuscular tone, and autonomic instability. Linezolid, an oxazolidinone antibacterial agent, is widely used in general hospitals; however, it interacts with some serotonin agonists and may cause SS. We report a case of SS caused by linezolid, without the concomitant use of serotonin agonist. A 72-year-old patient was admitted due to recurrent wound infection of his left ankle. He developed fever, skin rash, and renal function deterioration, and blood eosinophils and liver enzymes increased after administration of vancomycin. The antibiotic was changed to linezolid against methicillin-resistant Staphylococcus aureus. Four days later, he developed agitation, fever, increased blood pressure, and tachycardia. There were no abnormal findings in laboratory and image tests, including brain and chest computed tomography suggesting the cause of his symptoms. He had not taken any serotonin agonists, including serotonin uptake inhibitors and monoamineoxidase-inhibiting antidepressants. When administration of linezolid was stopped, his symptoms improved within 24 hours and fully recovered within 2 days without additional treatments.
Aged ; Ankle ; Antidepressive Agents ; Blood Pressure ; Brain ; Dihydroergotamine ; Eosinophils ; Exanthema ; Fever ; Hospitals, General ; Humans ; Liver ; Methicillin-Resistant Staphylococcus aureus ; Serotonin Receptor Agonists ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Tachycardia ; Thorax ; Vancomycin ; Wound Infection ; Linezolid

Cefepime is an extended-spectrum, fourth-generation cephalosporin that has been widely used for approved indications such as febrile neutropenia. Common adverse events of cefepime include headache, skin rash, gastrointestinal problems, and fever. However, encephalopathathy caused by cefepime has been sporadically reported worldwide over the last decade. We experienced a rare case of cefepime-induced encephalopathy. A 75-year-old man with a 30-year history of chronic obstructive pulmonary disease was admitted to the medical intensive care unit under a diagnosis of pneumonia. Initial antibiotic therapy was started with piperacillin/sulbactam and ciprofloxacin. His condition was improved with this treatment. About 2 months later, his condition was aggravated again, with mild fever and purulent sputum. Intravenous cefepime was selected on the basis of antibiotic susceptibility to Pseudomonas aeruginosa isolated from his sputum. However, his mentality became drowsy 48 hours after cefepime adminstration. He showed tremors and right facial paralysis. Neurologic examination for motor power and sensory function revealed normal findings. Laboratory tests, including serum electrolytes, glucose, osmolality, and ammonia, gave normal results. Brain magnetic resonance imaging showed chronic ischemic and atropic changes, and an electroencephalography revealed triphasic waves. The administration of cefepime was stopped, and his symptoms started to improve within 48 hours. Electroencephalography results became normalized, and he completely recovered within 48 hours after discontinuation of cefepime.
Aged ; Ammonia ; Brain ; Ciprofloxacin ; Diagnosis ; Electroencephalography ; Electrolytes ; Exanthema ; Facial Paralysis ; Febrile Neutropenia ; Fever ; Glucose ; Headache ; Humans ; Intensive Care Units ; Magnetic Resonance Imaging ; Nervous System Diseases ; Neurologic Examination ; Osmolar Concentration ; Pneumonia ; Pseudomonas aeruginosa ; Pulmonary Disease, Chronic Obstructive ; Sensation ; Sputum ; Tremor

PURPOSE: We performed a pilot study to determine the benefit of high-dose chemotherapy and autologous peripheral blood stem cell transplantation (HDCT/autoPBSCT) for patients with Ewing sarcoma family of tumors. METHODS: We retrospectively analyzed the data of patients who received HDCT/autoPBSCT at Korea Cancer Center Hospital. Patients with relapsed, metastatic, or centrally located tumors were eligible for the study. RESULTS: A total of 9 patients (3 male, 6 female), with a median age at HDCT/autoPBSCT of 13.4 years (range, 7.1 to 28.2 years), were included in this study. Patients underwent conventional chemotherapy and local control either by surgery or radiation therapy, and had achieved complete response (CR, n=7), partial response (n=1), or stable disease (n=1) prior to HDCT/autoPBSCT. There was no transplant-related mortality. However, the median duration of overall survival and event-free survival after HDCT/autoPBSCT were 13.3 months (range, 5.3 to 44.5 months) and 6.2 months (range, 2.1 to 44.5 months), respectively. At present, 4 patients are alive and 5 patients who experienced adverse events (2 metastasis, 2 local recur, and 1 progressive disease) survived for a median time of 2.8 months (range, 0.1 to 10.7 months). The 2-year survival after HDCT/autoPBSCT was 44.4%+/-16.6% and disease status at the time of HDCT/autoPBSCT tended to influence survival (57.1%+/-18.7% of cases with CR vs. 0% of cases with non-CR, P=0.07). CONCLUSION: Disease status at HDCT/autoPBSCT tended to influence survival. Further studies are necessary to define the role of HDCT/autoPBSCT and to identify subgroup of patients who might benefit from this investigational treatment.
Adolescent ; Child ; Disease-Free Survival ; Humans ; Korea ; Male ; Neoplasm Metastasis ; Peripheral Blood Stem Cell Transplantation ; Pilot Projects ; Retrospective Studies ; Sarcoma, Ewing ; Stem Cell Transplantation ; Therapies, Investigational