Psychopharmacological Treatment Patterns in Patients with Schizophrenia and Schizoaffective Disorder in Forensic Inpatient Settings / 대한법의학회지

The National Forensic Hospital is the only forensic psychiatric hospital in Korea. As of January 2016, the average number of patients assigned to each psychiatrist is more than 120. In this situation, the role of psychopharmacologic treatment becomes very important. To investigate the prescription patterns of major psychotropic medications (i.e., antipsychotics, mood stabilizers, and antidepressants), we reviewed the medical records of the patients diagnosed with schizophrenia and schizoaffective disorder who were admitted in January 2016. The data from 418 patients (403 with schizophrenia and 15 with schizoaffective disorder) were retrospectively collected and analyzed. The average number of major psychotropic medications prescribed for each patient during hospitalization was as follows: antipsychotics, 3.5±1.8; mood stabilizers, 0.5±0.7; and antidepressants, 0.5±0.8. The three most frequently prescribed antipsychotics were risperidone (21.7%), olanzapine (15.5%), and quetiapine (14.4%). More than half of the patients (233, 55.9%) were prescribed an antipsychotic polypharmacy regimen. This study found that patients with schizophrenia and schizoaffective disorder in forensic psychiatric hospital tend to be prescribed many psychotropic medications.

A Case of a Gastric Glomus Tumor with a Positive Cushion Sign / 대한소화기내시경학회지

Glomus tumors are commonly observed in the dermis or subcutis but are only rarely found in the stomach. A 52-year-old woman presented with an incidental finding of a submucosal tumor that showed a positive cushion sign in the stomach. Endoscopic ultrasonography (EUS) showed a 1.8x1.0 cm sized well-circumscribed homogenous hypoechoic tumor with side halos in the fourth sonographic layer of the gastric wall. Contrast enhanced abdominal computerized tomography (CT) demonstrated high enhancement of the tumor with the same level of enhancement as the portal vein for the arterial phase, with persistence of enhancement in the portal phase. For treatment, laparascopic wedge resection was performed. Histological findings of a biopsy specimen were compatible with a glomus tumor. Although it is difficult to diagnose a glomus tumor preoperatively, these characteristic findings determined with the use of EUS and CT seem to be useful to distinguish a glomus tumor from other tumors that arise from the third or fourth sonographic layer of the gastric wall.

A Case of a Pancreatic Abscess Complicating Endoscopic Sphincterotomy / 대한소화기내시경학회지

Endoscopic sphincterotomy (EST) has gained wide acceptance as a valuable tool for the management of disease of the pancreas and biliary tract. Complications associated with an EST include bleeding, perforation, pancreatitis and cholangitis, and the incidence of complications is approximately 5~10%. A pancreatic abscess can develop rarely after an EST and tends to have a more complicated course, resulting in higher morbidity and mortality. We report a case of a pancreatic abscess that complicated an EST in a 61-year-old woman with a primary common bile duct stone. The patient was successfully cured by treatment with the use of broad-spectrum antibiotics. Although a pancreatic abscess is one of the rare delayed complications that can develop after an EST, it should be considered in the differential diagnosis of patients with a complaint of abdominal pain after an EST because of a high mortality rate and the need for prompt management

Post-operative Bleeding due to Acquired Hemophilia Successfully Treated with Recombinant Factor VIIa: Case Report

Acquired hemophilia is a rare but potentially life-threatening hemorrhagic disorder caused by the development of autoantibodies against coagulation factor VIII. Concentrates of human factor VIII, desmopressin, activated prothrombin complex concentrates, recombinant activated factor VII can all be used to control episodes of acute bleeding. The recent availability of bypassing agents like recombinant activated factor VII has been shown to be clinically safe and effective as treatment for acute bleeding. In this case report, a 67 year-old male patient with Rh negative blood type developed gross hematuria and bleeding after transurethral resection due to prostatic hypertrophy. After vesicocutaneous fistular reduction operation, post-operative bleeding was presented. The acute bleeding was controlled successfully by the combined treatment with recombinant activated factor VII (Novo seven(R)) and prednisone.

A Case of Acute Myeloblastic Leukemia in a Patient with Behcet's Disease

Behcet's disease is a relapsing inflammatory disorder characterized by vasculitis of unknown cause and has been reported rarely in association with malignant diseases. In most cases the autoimmune nature of Behcet's disease and the long-term immunosuppressive therapy for disease control have been proposed to be responsible for malignant transformation. Although a few cases of various solid tumor and myelodysplastic syndrome have been reported in association with Behcet's disease, acute leukemia has seldom been associated with Beh?et's disease in Korea. We report a case of 38-year-old man with acute myeloblastic leukemia association with a Behcet's disease who had not received long-term treatment.

Primary Diffuse Large B Cell Lymphoma of the Bladder

Primary malignant lymphoma of the urinary bladder is a rare disease, and it accounts for only 0.2% of all the cases of extranodal lymphoma. The prognosis of primary bladder lymphoma has been favorable, with many patients being alive and well several years after treatment. We report here on a case of primary diffuse large B cell lymphoma of the urinary bladder in a 75-year-old man patient who presented with a one-month history of persistent dysuria. The abdominal CT revealed a mass at the posterior wall of the urinary bladder. The tissue obtained by transurethral cystoscopy showed an atypical lymphoid proliferation, which was consistent with diffuse large B cell lymphoma. The patient received systemic chemotherapy of rituximab and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) and he achieved a significant partial remission.