PURPOSE: This study aimed to identify factors affecting cognitive function in stomach cancer patients. METHODS: This was a cross-sectional study designed to obtain data from stomach cancer patients. The Global Assessment of Recent Stress, Hospital Anxiety-Depression Scale, Distress Thermometer, Korean version of the Montreal Cognitive Assessment, and electronic medical records were used to assess stress, anxiety, depression, psychological distress, and cognitive function, respectively. RESULTS: Among 182 total participants, there were statistically significant differences in sex between the group of patients who received chemotherapy and those who did not (χ2=5.32, p=.029). There were statistically significant differences in stress and cognitive function between the two groups. The factors affecting cognitive function in stomach cancer patients included distress, stress, anxiety, and depression. CONCLUSION: Cognitive function should be examined with consideration of the psychological distress, stress, anxiety, and depression in patients with stomach cancer. Moreover, an improved program to manage cognitive function is needed, which includes mediation between psychological and physiological factors including stress, anxiety, and cognitive level.
Anxiety ; Cognition* ; Cross-Sectional Studies ; Depression ; Drug Therapy ; Electronic Health Records ; Humans ; Negotiating ; Stomach Neoplasms* ; Stomach* ; Stress, Psychological ; Thermometers

BACKGROUND: Metabolic health is an emerging concept that is highly correlated with various metabolic complications, and adipocytokines have been causally linked to a wide range of metabolic diseases. Thus, this study compared serum adipocytokine levels according to metabolic health and obesity status. METHODS: Four hundred and fifty-six nondiabetic subjects (mean age, 40.5 years) were categorized into four groups according to metabolic health and obesity status: metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUHNO), and metabolically unhealthy obese (MUHO). Being metabolically healthy was defined as the presence of fewer than two of the following five metabolic abnormalities: high blood pressure, high fasting blood glucose, high triglyceride, low high density lipoprotein cholesterol, and being in the highest decile of the homeostatic model assessment of insulin resistance index. Obesity status was assessed using body mass index (BMI), with obesity defined as a BMI higher than 25 kg/m2. Levels of serum interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor alpha (TNF-alpha), and adipocyte fatty acid binding protein (A-FABP) were also evaluated. RESULTS: Of the 456 subjects, 247 (54.2%) were in the MHNO group, 66 (14.5%) were in the MHO group, 66 (14.5%) were in the MUHNO group, and 77 (16.9%) were in the MUHO group. There were no significant differences in IL-6 or MCP-1 levels among the groups, but levels of TNF-alpha and A-FABP were significantly higher in the MUHNO group compared to the MHNO group. CONCLUSION: High TNF-alpha and A-FABP levels are significantly associated with metabolically unhealthiness in nonobese Korean individuals.
Adipocytes ; Adipokines ; Blood Glucose ; Body Mass Index ; Carrier Proteins ; Chemokine CCL2 ; Cholesterol, HDL ; Fasting ; Hypertension ; Insulin Resistance ; Interleukin-6 ; Metabolic Diseases ; Obesity* ; Triglycerides ; Tumor Necrosis Factor-alpha

Sweet's syndrome is an uncommon reactive dermatoses characterized by fever, polymorphonuclear leukocytosis, painful erythematous plaques, and dense dermal infiltrate of neutrophils. Sweet's syndrome can be associated with several diseases, including infectious diseases, malignant tumors, and autoimmune diseases. However, no case of Sweet's syndrome associated with Sjogren's syndrome (SjS) has been reported in Korea. A 44-year-old woman presented with acute pustular rashes and fever. The patient had multiple papulopustular skin rashes, and complained of fever, chills, and headache. Our patient had the characteristic clinical and histopathological features of Sweet's syndrome, in association with SjS, diagnosed by salivary gland scan, positive anti-SS-A/SS-B antibody, and sicca symptoms simultaneously. Thus, we report on a case of a patient with Sweet's syndrome with concomitant diagnosis of SjS.
Adult ; Autoimmune Diseases ; Chills ; Communicable Diseases ; Diagnosis ; Exanthema ; Female ; Fever ; Headache ; Humans ; Korea ; Leukocytosis ; Neutrophils ; Salivary Glands ; Sjogren's Syndrome* ; Skin Diseases ; Sweet Syndrome*

BACKGROUND: Chronic kidney disease (CKD) is considered one of the most common risk factors for cardiovascular disease. Coronary artery calcification (CAC) is a potential mechanism that explains the association between renal function and cardiovascular mortality. We aimed to evaluate the association between renal function and CAC in apparently healthy Korean subjects. METHODS: A total of 23,617 participants in a health-screening program at Kangbuk Samsung Hospital were included in the study. Estimated glomerular filtration rate (eGFR) was assessed using the Cockcroft-Gault equation. Coronary artery calcium score (CACS) was measured via multidetector computed tomography. Subjects were divided into three groups according to the CKD Staging system with eGFR grade: stage 1, eGFR > or =90 mL/min/1.73 m2; stage 2, eGFR 60 to 89 mL/min/1.73 m2; and stage 3, eGFR 30 to 59 mL/min/1.73 m2. RESULTS: The mean age of the participants was 41.4 years and the mean eGFR was 103.6+/-21.7 mL/min/1.73 m2. Hypertension and diabetes were noted in 43.7% and 5.5% of the participants, respectively. eGFR showed a weakly negative but significant association with CACS in bivariate correlation analysis (r=-0.076, P<0.01). Mean CACS significantly increased from CKD stage 1 to 3. The proportion of subjects who had CAC significantly increased from CKD stage 1 to 3. Although the odds ratio for CAC significantly increased from stage 1 to 3 after adjustment for confounding factors, this significance was reversed when age was included in the model. CONCLUSION: In early CKD, renal function negatively correlated with the degree of CAC in Korean subjects. Age was the strongest effector for this association.
Adult* ; Calcium ; Cardiovascular Diseases ; Coronary Vessels* ; Glomerular Filtration Rate* ; Humans ; Hypertension ; Mortality ; Multidetector Computed Tomography ; Odds Ratio ; Renal Insufficiency, Chronic ; Risk Factors

BACKGROUND: The hypertriglyceridemic waist (HTGW) phenotype is a simple and inexpensive screening parameter to identify people at increased risk of cardiovascular disease. We evaluated whether the HTGW phenotype predicts diabetes in urban Korean adults. METHODS: A total of 2,900 nondiabetic subjects (mean age 44.3 years), comprising 2,078 males (71.7%) and 822 females (28.3%) who underwent annual medical check-ups at our center between January 2005 and December 2009, were recruited. The subjects were divided into four groups according to baseline serum triglyceride (TG) level and waist circumference (WC): normal WC-normal TG (NWNT) level, normal WC-high TG level, enlarged WC-normal TG level, and enlarged WC-high TG (EWHT) level. High serum TG level was defined as > or =150 mg/dL and enlarged WC was defined as > or =90 cm for men and > or =85 cm for women. New cases of diabetes were determined according to questionnaires filled in by participants and the diagnostic criteria of the American Diabetes Association. Cox proportional hazards model analysis was used to assess the association of HTGW phenotype with the incidence of diabetes. RESULTS: A total of 101 (3.5%) new diabetes cases were diagnosed during the study period. The EWHT group had a higher incidence of diabetes (8.3%) compared with the NWNT group (2.2%). The adjusted hazard ratio for diabetes for subjects with the EWHT phenotype at baseline was 4.113 (95% confidence interval [CI], 2.397 to 7.059) after adjustment for age, and 2.429 (95% CI, 1.370 to 4.307) after adjustment for age, sex, total cholesterol, systolic blood pressure, and alcohol drinking history. It was attenuated by inclusion of baseline fasting glucose level in the model. CONCLUSION: Subjects with the HTGW phenotype showed the highest risk of incident diabetes. This tool could be useful for identifying individuals at high risk of diabetes.
Adult ; Alcohol Drinking ; Blood Pressure ; Cardiovascular Diseases ; Cholesterol ; Fasting ; Female ; Glucose ; Humans ; Hypertriglyceridemia ; Hypertriglyceridemic Waist* ; Incidence ; Longitudinal Studies* ; Male ; Mass Screening ; Phenotype* ; Proportional Hazards Models ; Triglycerides ; Waist Circumference ; Surveys and Questionnaires

PURPOSE: Endoscopic thyroid surgery has been widely used because of the cosmetic advantage and the development of laparoscopic instruments. We have performed endoscopic thyroidectomy by breast approach and gasless transaxillary approach on papillary thyroid microcarcinomas. In this study, we describe these two types of endoscopic procedures with the technique of the method and surgical outcomes. METHODS: From Oct. 1999 to Oct. 2009, each procedure was performed in 162 patients divided into two groups. Breast approach group was in 91 patients and gasless transaxillary approach group was in 71 patients. We compared the results of mean ages, sex ratio, extent of operation, mean hospital stay, operating time, pathologic characteristics and postoperative complications between the breast approach group and gasless transaxillary approach group. RESULTS: Ninety-one cases treated using breast approach, and seventy-one cases treated using gasless transaxillary approach. The operation time was 197.4+/-60.7 minutes (95~350) in breast approach group, and 100.1+/-19.8 minutes (65~140) in gasless transaxillary approach group. Post operative complications are; 2 cases of transient hoarseness, 8 cases of hypocalcemia (including 2 cases of permanent hypocalcemia), 2 cases of chest wall discomfort in breast approach group, and 1 case of transient hoarseness, 2 cases of transient hypocalcemia, 1 case of postoperative bleeding in gasless axillary approach group. CONCLUSION: Endoscopic thyroidectomy is a safe and technically feasible alternative to conventional thyroidectomy in patients with benign and highly selected malignant disease. We expect it can increase the extent of surgery.
Breast ; Carcinoma, Papillary ; Cosmetics ; Hemorrhage ; Hoarseness ; Humans ; Hypocalcemia ; Imidazoles ; Length of Stay ; Nitro Compounds ; Postoperative Complications ; Sex Ratio ; Thoracic Wall ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

BACKGROUND: In Alzheimer's disease (AD), cognitive impairment is associated with functional impairment; and neuropsychiatric symptoms are common in AD patients. However, there have been few studies about the relationship between neuropsychiatric symptoms and functional state in AD. The objective of this study is to investigate the effects of neuropsychiatric symptoms on activities of daily living in AD. METHODS: We reviewed the medical records of 60 AD patients meeting the criteria of the Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) for probable AD (mean age, 75.4+/-7.0 years; 13 men, 47 women). The relationships between the Neuropsychiatric Inventory (NPI) and two functional measures, instrumental activities of daily living (IADL) and the Barthel Index, were analysed. RESULTS: The total NPI score was significantly associated with both functional measures (IADL: r=0.543; Barthel Index: r=-0.515), as were the NPI subscale scores of delusion, hallucination, agitation, depression, anxiety, and irritability. Multivariate regression analyses showed that total NPI score and duration of dementia were significant predictive factors for both IADL and the Barthel Index. In addition, the total NPI score still significantly influenced the two functional measures after controlling for age, duration of dementia, and Mini-Mental State Examination. CONCLUSION: The total NPI score was a significant predictive factor for functional status beyond the contribution of cognitive impairment in AD. Neuropsychiatric symptoms are associated with increased functional impairments in AD. Screening and management of neuropsychiatric symptoms during the course of AD would be helpful in improving functional status.
Activities of Daily Living ; Alzheimer Disease ; Anxiety ; Communication Disorders ; Delusions ; Dementia ; Depression ; Dihydroergotamine ; Hallucinations ; Humans ; Male ; Mass Screening ; Medical Records

Breast tissue is an unusual site for metastatic disease, particularly for non-small cell lung cancer (NSCLC). Aside from contralateral breast cancer, the most common tumors metastasizing to the breast are malignant melanoma and hematopoietic malignances. We recently experienced a case of a 49-year-old female patient with solitary metastasis of NSCLC to ipsilateral breast tissue. She was diagnosed as NSCLC of left lung and underwent left upper lobectomy in 2001. She was then treated with etoposide/cisplatin chemotherapy and radiation therapy. After 35 months, she was referred to our breast clinic because of a nodular opacity in the left breast revealed by screening breast ultrasound, which proved to be of pulmonary origin. She was treated by wide excision and with docetaxel/cisplatin chemotherapy. However, 37 months after breast surgery, a metastatic lesion developed in the same breast and she received modified radical mastectomy. We report this case with a review of the literature.
Breast ; Breast Neoplasms ; Carcinoma, Non-Small-Cell Lung ; Female ; Humans ; Lung ; Lung Neoplasms ; Mass Screening ; Mastectomy, Modified Radical ; Melanoma ; Middle Aged ; Neoplasm Metastasis

We report herein an uncommon tumor of the nipple. A 26 year-old woman visited our outpatient department of plastic surgery for skin lesion and discharge from the right nipple. Biopsy was performed on the lesion, and diagnosed as papillary adenoma. The nipple was resected and reconstructed including adjacent subareolar tissue. Thus, full thickness skin was harvested from labium minor and grafted on the reconstructed nipple. Donor site was primarily closed. On the histologic study, the lesion was compatible with florid papillomatosis of the nipple(adenoma of the nipple). In 2 months follow-up period, we could not find any complications such as skin necrosis, infection, wound dehiscence, or tumor recurrence. This is a case of papillary adenoma of the nipple which was excised and successfully reconstructed with local flap.
Adenoma ; Biopsy ; Breast ; Female ; Follow-Up Studies ; Humans ; Necrosis ; Nipples ; Outpatients ; Papilloma ; Recurrence ; Skin ; Surgery, Plastic ; Tissue Donors ; Transplants ; Wound Infection

Allopurinol is frequently used for the treatment of hyperuricemia and gout. Sometimes, a life-threatening reaction develops, as is illustrated by the following case report. We describe a 60-year-old male patient who was treated with allopurinol because of asymptomatic hyperuricemia, and he was presented with fever, skin rash, eosinophilia, worsening renal function and vanishing bile duct syndrome. In this report, we discussed vanishing bile duct syndrome as a serious side effect of allopurinol, and we briefly reviewed the etiology, prevention, and treatment modalities for vanishing bile duct syndrome.
Allopurinol/*adverse effects ; Bile Duct Diseases/*etiology/pathology ; Drug Hypersensitivity/*complications ; English Abstract ; Gout Suppressants/*adverse effects ; Humans ; Male ; Middle Aged