Bipolar disorder is a mental illness that causes extreme mood swings and has a chronic course. However, the mechanism by which mood episodes with completely opposite characteristics appear repeatedly, or a mixture of symptoms appears, in patients with bipolar disorder remains unknown. Therefore, mood stabilizers are indicated only for single mood episodes, such as manic episodes and depressive episodes, and no true mood-stabilizing drugs effective for treating both manic and depressive episodes currently exist. Therefore, in this review, therapeutic targets that facilitate the development of mood stabilizers were examined by reviewing the current understanding of the neuromolecular etiology of bipolar disorder.

OBJECTIVES: The current study investigated the risk of smartphone addiction among children and adolescents with or without attention-deficit hyperactivity disorder (ADHD), risk of depression, anxiety, and self-esteem using the Smartphone Addiction Scale Proneness, Kovac's Children's Depression Inventory, State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale, commonly used in clinical medicine. METHODS: Ninety five students with ADHD who visited psychiatry outpatient clinics completed the questionnaire. At the same time, 592 middle and high school students living in a similar area regardless of ADHD diagnosis, completed the questionnaire as control subjects. RESULTS: Overall, 40.0% of 95 ADHD and 12.8% of 592 control subjects were classified as the smartphone addiction proneness group, 26.3% of the ADHD subjects and 8.3% of the control group were classified as the depression group, and 32.6% of the ADHD subjects and 16.2% of the control group were classified as the anxiety group. Significant differences were observed between the two groups. CONCLUSION: The results of this study suggest that ADHD subjects are more prone to smartphone addiction, becoming depressed or anxious than those in the control group. From this study, we could suggest that students with ADHD are more easily affected by smartphone addiction than normal control subjects. In addition, we might understand how some psychiatric problems like depression, anxiety, and low self-esteem are related to ADHD and smartphone addiction.
Adolescent ; Ambulatory Care Facilities ; Anxiety ; Child* ; Clinical Medicine ; Depression ; Diagnosis ; Humans ; Smartphone

BACKGROUND: The creation of pneumoperitoneum and Trendelenburg positioning during laparoscopic surgery are associated with respiratory changes. We aimed to compare respiratory mechanics while using intravenous propofol and remifentanil vs. sevoflurane during laparoscopic colectomy. METHODS: Sixty patients undergoing laparoscopic colectomy were randomly allocated to one of the two groups: group PR (propofol-remifentanil group; n = 30), and group S (sevoflurane group; n = 30). Peak inspiratory pressure (PIP), dynamic lung compliance (Cdyn), and respiratory resistance (Rrs) values at five different time points: 5 minutes after induction of anesthesia (supine position, T1), 3 minutes after pneumoperitoneum (lithotomy position, T2), 3 minutes after pneumoperitoneum while in the lithotomy-Trendelenburg position (T3), 30 minutes after pneumoperitoneum (T4), and 3 minutes after deflation of pneumoperitoneum (T5). RESULTS: In both groups, there were significant increases in PIP and Rrs while Cdyn decreased at times T2, T3, and T4 compared to T1 (P < 0.001). The Rrs of group PR for T2, T3, and T4 were significantly higher than those measured in group S for the corresponding time points (P < 0.05). CONCLUSIONS: Respiratory mechanics can be adversely affected during laparoscopic colectomy. Respiratory resistance was significantly higher during propofol-remifentanil anesthesia than sevoflurane anesthesia.
Anesthesia* ; Colectomy* ; Humans ; Laparoscopy ; Lung Compliance ; Pneumoperitoneum ; Propofol ; Respiratory Mechanics*

No abstract available.
Multiple System Atrophy

Post-transplant lymphoproliferative disorder (PTLD) is a B cell proliferative disorder that is associated with Eptstein-Bar (EBV). This is a heterogeneous group of conditions characterized by EBV-driven proliferation of B-lymphocytes in the face of impaired T-cell immune surveillance. While new treatment modalities are being tried with variable success, regular EBV surveillance and carefully monitored reduction of immunosuppression remain the mainstay of treatment. This paper reviews the current knowledge of this increasingly common complications in renal transplant recipients.
B-Lymphocytes ; Herpesvirus 4, Human ; Immunosuppression ; Kidney Transplantation ; Lymphoproliferative Disorders ; T-Lymphocytes ; Transplants

An abnormal course of carotid artery may surprise surgeons during surgery and result in an transient ischemic attack or other ischemic symptoms. We report an unusual case of kinking in the common carotid artery located below the right thyroid lobe, which was found during a total thyroidectomy in a 74-years old patient. We emphasize in this case how important it is to palpate the neck before surgeries such as tracheostomy, thyroid surgery and so on.
Carotid Arteries ; Carotid Artery, Common ; Humans ; Ischemic Attack, Transient ; Neck ; Thyroid Gland ; Thyroidectomy ; Tracheostomy

Small cell lung cancer (SCLC) is one of the most fatal cancers in humans and many factors are known to be related to its poor prognosis. Immunohistochemical (IHC) stainings were done on SCLC specimens in order to investigate the prognostic value of the apoptosis-related gene expression and the tumor proliferative maker, and the relationships among these IHC results and patients clinical characteristics, chemoresponsiveness, and survival were analyzed. The medical records of 107 patients were reviewed retrospectively. IHC stainings for p53, bcl-2 and Ki-67 expressions were performed in the 66 paraffin-embedded biopsy samples. Sixty-six out of the 107 patients were evaluable for response rate and survival. The overall response rate was 75% (95% Confidence Interval=74-76%) and the median survival time was 14 months. The median survival time of limited stage was 16 months and that of extensive stage was 10 months. The prevalence of p53, bcl-2 and Ki-67 expression was 62%, 70%, and 49%, respectively. There were no correlations among the immunoreactivities of p53, bcl-2 and Ki-67 with clinical stage, chemoresponsiveness or overall survival. The clinical stage was the only prognostic factor influencing survival. The expression rates of p53, bcl-2, and Ki-67 were relatively high in SCLC without any prognostic significance. The exact clinical role of these markers should be defined through further investigations.
Adult ; Aged ; Carcinoma, Small Cell/metabolism/*pathology ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen/analysis ; Lung Neoplasms/metabolism/*pathology ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proto-Oncogene Proteins c-bcl-2/analysis ; Survival Analysis ; Tumor Markers, Biological/*analysis ; Tumor Suppressor Protein p53/analysis

BACKGROUND: This study was conducted to prove the validity of the Korean version of the Informant Questionnaire on Cognitive Decline in the Elderly(IQCODE-K) as a screening test for Alzheimer's disease. METHOD: Informants of the elderly who visited the dementia clinic and the elderly living in community, were asked to complete IQCODE-K. Based on the final clinical diagnoses, performance of the the IQCODE-K in screening Alzheimer's disease was evaluated RESULTS: The IQCODE is showed high internal consistency and test-retesr reliability. Optimal cut-off score of IQCODE-K was 3.6, and the sensitivity and specificity at that score were 0.90 and 0.79. CONCLUSION: IQCODE-K is probably very useful to screen Alzheimer's disease. It may be also useful for the less well-educated people.
Aged ; Alzheimer Disease ; Dementia ; Diagnosis ; Humans ; Mass Screening ; Surveys and Questionnaires* ; Sensitivity and Specificity

OBJECTIVE: To evaluate the association of level of CA-125 and severity of dysmenorrhea with lesion depth in adenomyosis. METHODS: Sixty-eight women who had undergone hysterectomy and were found to have pure adenomyosis on histopathologic examination were reviewed retrospectively. Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. All women were submitted to serum determination of CA-125. Severity of dysmenorrhea was assessed by means of a modification of 10-point verbal rating scale. RESULTS: Each group was not correlated with severity of dysmenorrhea (p=0.7394 Fisher's exact test). The means of serum CA-125 levels was increased corresponding to depth of adenomyosis (p=0.0441 ANOVA test). CONCLUSION: In this study, serum CA-125 level is associated with the depth lesion and severity of dysmenorrhea is not. Therefore, the level of serum CA-125 might be useful indicator in management of adenomyosis before surgery.
Adenomyosis* ; Animals ; Dysmenorrhea* ; Female ; Humans ; Hysterectomy ; Mice ; Myometrium ; Retrospective Studies

Iliac vein compression syndrome is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein thrombosis, severe leg edema and ulceration. We experienced a 55-year-old male patient with recurrent left leg ulcer for 15 years. Skin grafting had been done three times, but none of them healed the patient. Femoral venography showed a complete occlusion of the left common iliac vein. Palma-Dale bypass grafting procedure(crossover saphenous vein bypass grafting) and arteriovenous fistula formation was done. The leg ulcer healed two months after the operation.
Arteriovenous Fistula ; Edema ; Humans ; Iliac Artery ; Iliac Vein* ; Leg Ulcer* ; Leg* ; Male ; May-Thurner Syndrome* ; Middle Aged ; Phlebography ; Saphenous Vein ; Skin Transplantation ; Transplants ; Ulcer ; Venous Thrombosis