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Purpose@#Bony mallet finger is commonly seen in the young sports population, and surgical intervention is often necessary in cases where the joint surface is compromised. After surgical treatment, compliance with wound management tends to be poor and return to sports activities is delayed, resulting in decreased patient satisfaction.Therefore, the authors suggest that early return to sports can be facilitated through the modified Kirschner wire (K-wire) extension block technique and wound management. @*Methods@#From March 2022 to February 2023, surgical treatment was performed on 24 patients with bony mallet fingers who had closed fractures with more than one-third involvement of the joint surface or subluxation of the distal interphalangeal joint. Surgeries were conducted within 2 weeks of the injury, employing the K-wire extension block technique. At the first outpatient department follow-up after 1 week, suture knots were removed, medical skin adhesive bonds were applied and an opencast was utilized to fix only distal interphalangeal joint allowing for immediate showering and engagement in physical activities. @*Results@#All patients expressed satisfaction from both functional and cosmetic perspectives and were able to return to sports activities early. According to Crawford evaluation criteria, the results were as follows: excellent in 68.8%, good in 25.0%, and fair in 6.2%. There were no cases of poor outcomes. @*Conclusion@#In cases where early return to sports activities is desired, the K-wire extension block technique with burying the K-wires beneath the skin and employing opencast can be an alternative method that can facilitate early return to sports.
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Although humans exist as Homo Empathicus, human society is actually constantly divided and conflicted between groups. The human empathy response is very sensitive to the justice of others, and depending on the level of others’ justice, they may feel empathy or schadenfreude to the suffering of them. However, our empathy to others’ suffering are not always fair, and have inherent limitations of ingroup-biased empathy. Depending on whether the suffering other persons belongs to an ingroup or an outgroup, we may feel biased empathy or biased schadenfreude to them without even realizing it. Recent advances in information and communication technology facilitate biased access to ingroup-related SNS or ingroup media, thereby deepening the establishment of a more biased semantic information network related groups. These processes, through interacting with the inherent limitation of empathy, can form a vicious cycle of more biased ingroup empathy and ingroup-relat-ed activities, and accelerate divisions and conflicts. This research investigated the properties and limitations of empathy by reviewing studies on the neural mechanism of empathy. By examining the relationship between empathy and justice from a neuroscientific point of view, this research tried to illuminate the modern society of di-vision and conflict in a different dimension from the classical perspective of social science.
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Objectives@#：This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. @*Methods@#：The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. @*Results@#：The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. @*Conclusions@#：This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.
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Objectives@#: In this study, we evaluate psychological stress, symptoms of anxiety and depressed mood and resilience which medical residents and interns perceived during COVID-19 event, then investigate the associations between stress and the symptoms and mediating effect of resilience on the associations. @*Methods@#: In this study, we made a self-reporting form to evaluate psychological stress with perceived stress scale (PSS), symptoms of anxiety and depressed mood with Hospital anxiety and depression scale (HAD), and resilience with Conner-Davidson Resilience Scale (CD-RISC). Medical residents and interns, who worked in a hospital during COVID-19 event, filled the self-reporting forms from july, 2020 to august, 2020. We conducted a Pearson correlation coefficient and a multiple regression to confirm association between psychological stress and symptoms of anxiety and depressed mood, then mediating effect of resilience. @*Results@#: The higher stress perceived, the more symptoms of anxiety and depressed mood were reported by medical residents and interns. The higher resilience is associated with lower stress and less symptoms of anxiety and depressed mood, which resilience is proven to mediate partially the association between stress and symptoms of depressed mood. @*Conclusions@#: This study shows that resilience has a partial mediating effects on the association between stress and psychological pathology especially depressed mood, given that medical residents and interns were under psychological distress during COVID-19 event. This suggests that resilience is the key for medical trainees to overcome the future crisis like COVID-19 event.
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A 52-year-old woman with a gastric outlet obstruction (GOO) caused by pyloric cancer underwent pyloric endoscopic self-expandable metal stent (SEMS) insertion. She presented with abdominal distension 40 days later. The SEMS was dysfunctional, and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) was performed using an endoscopic nasobiliary drainage tube. A 16 mm×31 mm Niti-S ™ HOT SPAXUS™ (TaeWoong Medical, Gimpo, Korea) was inserted successfully between the stomach and the adjacent jejunum. After the procedure, the patient had a good oral intake for more than seven months. GOO is a mechanical obstructive condition caused by various benign and malignant conditions. Traditionally, surgical GJ and SEMS insertion have been used to treat GOOs. EUS-GJ is a feasible treatment option for patients with GOO and a pyloric metal stent dysfunction.
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Objectives@#：The aim of the present study is to investigate the impact of COVID-19 on the incidence and severity of childhood and adolescent self-harm. @*Methods@#：Medical records were retrospectively reviewed for patients under the age of 18 who visited the emergency room of Konyang University Hospital to compare the rate of self-harm attempts and the demographic, clinical, and self-harm-related of self-harm attempters aspects before and after the COVID-19 outbreak. @*Results@#：During 11 months after the COVID-19 outbreak, the proportion of the number of children and adolescents patients with self-harm and their episodes increased significantly compared to that during 11 months be-fore the COVID-19 outbreak (χ2 =14.397, p<0.001; χ2 =24.156, p<0.001). Between about the year before and after the outbreak of COVID-19, there was a significant difference in the prior self-harm history and psychiatric history among children and adolescents who visited the emergency room and the ratio of hospitalization to other departments than department of psychiatry (p<0.05; p<0.05; p<0.05). @*Conclusions@#：In the COVID-19 situation, the proportion of children and adolescents who visited the emergency room due to self-harm and admission to other departments are increasing. And it has been shown that the inci-dence of self-harm has significantly increased in children and adolescents with a history of prior self-harm and psychiatric past history. These findings underscore the need for the psychiatric evaluation and intervention of self-harm related high-risk groups among children and adolescents in pandemic situations.
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Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient.
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Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient.
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Objectives@#：Clozapine has been known to increase the possibility of developing cardio/cerebrovascular diseases, and the platelet activation has been deemed to be related to the occurrence of them. In author’s previous study, we observed the increase of platelet activity with short-term clozapine administration. This study was conducted, as a follow-up study, to investigate the effect of clozapine on the platelet activity when administered continuously for long-term period of time of 1 year. @*Methods@#：The medical records of the patients with schizophrenia or schizoaffective disorder who were treated with clozapine for 1 year were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. @*Results@#：Total of 24 patients were enrolled. 9 of them (37.5%) were male and 15 of them (62.5%) were female. In the Wilcoxon sign-ranks test, no significant change was observed between the mean platelet factor values at the beginning and at the end of one year. @*Conclusions@#：No significant changes of mean platelet activity were observed after continued administration of clozapine for 1 year. Considering the author’s previous findings that observed a prominent decrease of mean platelet component after short-term clozapine administration, the result of this study suggests the possibility that the activity of the platelet may change depending on the duration of the clozapine administration.
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OBJECTIVES: Clozapine is a widely prescribed antipsychotic drug for schizophrenia and is known to increase the risk of cardiovascular disease due to its metabolic side effects. However, little is known about the effect of clozapine on the platelet activation, another important factor in the development of cardiovascular disease. In this study, we tried to investigate the effect of clozapine on platelet activity in patients with schizophrenia by comparing the mean platelet component (MPC) values before and after the clozapine administration. METHODS: A retrospective review of medical records of patients with schizophrenia, who newly started clozapine treatment from September 1st, 2003 to April 30th, 2007 at the Department of Psychiatry, Konyang University Hospital in Republic of Korea was performed. The final statistical analysis included 14 participants. Bayer ADVIA 120® system was used to measure MPC. RESULTS: Among the 14 participants, five subjects were males (28.60%), and ten subjects were females (71.40%). The mean age of participants was 37.50±11.64 years. Average of duration of illness was 91.00±93.96 months, with the mean dosage of clozapine taken by participants at the time of the last blood test was 337.50±109.52 mg. The mean MPC measurement before and after receiving clozapine was 26.12±2.22 g/dL and 25.14±2.08 g/dL respectively. Wilcoxon signed rank test showed that there was a statistically significant decrease in MPC levels after clozapine administration (V=16, p=0.024). CONCLUSIONS: Decreased MPC levels after clozapine administration implies that clozapine may increase platelet activation which could have an adverse effect on the occurrence of thromboembolic disease. Our findings also suggest that careful monitoring of the risk factors of cardiovascular diseases, such as platelets activity, is necessary when administering clozapine.
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Femenino , Humanos , Masculino , Plaquetas , Enfermedades Cardiovasculares , Clozapina , Pruebas Hematológicas , Registros Médicos , Activación Plaquetaria , República de Corea , Estudios Retrospectivos , Factores de Riesgo , EsquizofreniaRESUMEN
OBJECTIVES: Depression is a common mental illness and a major cause of suicide. Although serum lipids have been associated with depression and suicide, there has been much debate. In this study, we investigated the relationship between depression, suicide, and serum lipids in patients admitted with depressed mood. METHODS: A total of 134 subjects were divided into 86 non-suicide patients and 48 suicide attempters. The serum lipid levels and sub-scores of the Korean Symptom Checklist-95 (KSCL95) were compared. We also investigated the relationship between serum lipids and sub-scores of KSCL95 and investigated whether serum lipids were risk factors for suicide attempts. RESULTS: There was no difference in serum lipids between the two groups. Among the sub-items of KSCL95, obsession was higher in non-suicide group. Triglyceride showed positive correlations with anxiety, phobic anxiety, agoraphobia, schizophrenia, and self-regulation problem. High triglyceride was a risk factor for suicide attempts. CONCLUSIONS: Triglyceride is associated with depression, anxiety, and self - regulation, and high serum triglyceride levels may be a risk factor for suicide attempts.
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Humanos , Agorafobia , Ansiedad , Colesterol , Depresión , Conducta Obsesiva , Factores de Riesgo , Esquizofrenia , Autocontrol , Suicidio , TriglicéridosRESUMEN
Multiple endocrine neoplasia type 1 (MEN1) syndrome is a relatively rare disease, characterized by the occurrence of multiple endocrine tumors in the parathyroid and pituitary glands as well as the pancreas. Here, we report a case of MEN1 with neuroendocrine tumors (NETs) in the stomach, duodenum, and pancreas. A 53-year-old man visited our hospital to manage gastric NET. Five years prior to his visit, he had undergone surgery for incidental meningioma. His brother had pancreatic nodules and a history of surgery for adrenal adenoma. His brother's daughter also had pancreatic nodules, but had not undergone surgery. The lesion was treated by endoscopic submucosal dissection and diagnosed as a grade 1 NET. Another small NET was detected in the second duodenal portion, resected by endoscopic submucosal dissection, which was also diagnosed as a grade 1 NET. During evaluation, three nodules were detected in the pancreas, and no evidence of pituitary, parathyroid tumors, or metastasis was observed. After surgery, the pancreatic lesions were diagnosed as NETs, with the same immunohistochemical patterns as those of the stomach and duodenum. Genetic testing was performed, and a heterozygous mutation was detected in the MEN1 gene, which is located on 11q13.
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Humanos , Persona de Mediana Edad , Adenoma , Duodeno , Endoscopía , Pruebas Genéticas , Mutación de Línea Germinal , Mutación INDEL , Meningioma , Neoplasia Endocrina Múltiple Tipo 1 , Metástasis de la Neoplasia , Tumores Neuroendocrinos , Núcleo Familiar , Páncreas , Hipófisis , Enfermedades Raras , Hermanos , EstómagoRESUMEN
OBJECTIVES: Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. METHODS: Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test–retest reliability was analyzed with Pearson and Intra-class correlations. RESULTS: Patients with schizophrenia showed high test–retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test–retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. CONCLUSIONS: The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test–retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.
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Humanos , Hormigas , Estudios de Casos y Controles , Mano , Tiempo de Reacción , Reproducibilidad de los Resultados , EsquizofreniaRESUMEN
OBJECTIVES: There has been long lasting trend of deinstitutionalization and public health centered care in management of individuals with disabling mental illness. We aimed to investigate current vocational rehabilitation state and effectiveness of system in korea. METHODS: We carried basic survey via telephone and e-mail beforehand to figure out how many and which institutions are operating vocational rehabilitation programs to psychiatric patients. A questionnaire packages were sent to total of 108 institutions in Korea which were operating occupation rehabilitation program. RESULTS: Of 108 institutions, 40.74% were returned with answers. The person in charge of vocational rehabilitation at each institution was mainly mental health social worker(48.8%), and the budget under \1,000,000 was the majority(61.5%) among surveyed institutions. The most commonly used vocational rehabilitation programs was case management(23.1%), followed by psychosocial rehabilitation program(21.2%), and on-the-job training(17.9%). The most effective program was case management(27.4%), followed by psychosocial rehabilitation program(19.8%), on-the-job training(17.9%). The main barrier of occupation rehabilitation to be conducted widely was ‘worries about being excluded from beneficiary of National Basic livelihood Protection Act’. CONCLUSIONS: Our results suggest that, in spite of high demand in vocational rehabilitation programs, government financial support is still lacking.
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Humanos , Presupuestos , Desinstitucionalización , Correo Electrónico , Apoyo Financiero , Programas de Gobierno , Corea (Geográfico) , Trastornos Mentales , Salud Mental , Ocupaciones , Rehabilitación Psiquiátrica , Salud Pública , Rehabilitación , Rehabilitación Vocacional , Esquizofrenia , TeléfonoRESUMEN
PURPOSE: Subluxation of the extensor tendon that result from sagittal band injury at the metacarpophalangeal (MCP) joint can lead to joint pain and limit the range of motion in fingers. Upon the injury mechanism, other causes except rheumatoid arthritis are relatively uncommon, and studies regarding the operative management are also sparse. We performed a direct repair of sagittal band and attempted to report clinical results of our experience in patients without application of conservative management. MATERIALS AND METHODS: Authors retrospectively reviewed the medical records of 26 patients who underwent operative treatment for extensor tendon subluxation. There were 23 males and 3 females with the mean age of 39.9 years old. All patients had an injury on the long finger, and presenting an ulnarward extensor tendon subluxation. Nine patients were injured from the direct blow, 14 patients from the flicking finger, and 3 patients from the resisted finger flexion. The mean time interval between the injury and operation was 27.5 days. The mean duration of follow-up was 14.6 months. As clinical results, authors evaluated visual analogue scale, MCP joint range of motion, total active motion (TAM), 3rd finger tip pinch power, and recurrence of extensor tendon. RESULTS: The mean final MCP joint flexion was 89.6° with 22.8° of extension. The mean TAM was 248° without a significant difference between opposite hands. The mean tip-pinch power was 3.4 kg (7.5 lb), which also did not have any significant difference with contralateral hand. Herein, we did not experience subluxation recurrence, and all but one was pain-free at the final outpatient clinic follow-up. CONCLUSION: A direct repair of the sagittal band for the extensor tendon subluxation presented a favorable clinical outcome. Therefore, we can suggest that such a method can be a treatment option for patients not undergoing conservative management.
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Femenino , Humanos , Masculino , Instituciones de Atención Ambulatoria , Artralgia , Artritis Reumatoide , Dedos , Estudios de Seguimiento , Mano , Articulaciones , Registros Médicos , Articulación Metacarpofalángica , Métodos , Rango del Movimiento Articular , Recurrencia , Estudios Retrospectivos , TendonesRESUMEN
Empathy is the ability to identify with or make a vicariously experience of another person's feelings or thoughts based on memory and/or self-referential mental simulation. The default mode network in particular is related to self-referential empathy. In order to elucidate the possible neural mechanisms underlying empathy, we investigated the functional connectivity of the default mode network in subjects from a general population. Resting state functional magnetic resonance imaging data were acquired from 19 low-empathy subjects and 18 medium-empathy subjects. An independent component analysis was used to identify the default mode network, and differences in functional connectivity strength were compared between the two groups. The low-empathy group showed lower functional connectivity of the medial prefrontal cortex and anterior cingulate cortex (Brodmann areas 9 and 32) within the default mode network, compared to the medium-empathy group. The results of the present study suggest that empathy is related to functional connectivity of the medial prefrontal cortex/anterior cingulate cortex within the default mode network. Functional decreases in connectivity among low-empathy subjects may reflect an impairment of self-referential mental simulation.
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Empatía , Neuroimagen Funcional , Giro del Cíngulo , Imagen por Resonancia Magnética , Memoria , Corteza PrefrontalRESUMEN
OBJECTIVES: The deficit of recognition memory has been found as one of the common neurocognitive impairments in patients with schizophrenia. In addition, they were reported to fail to enhance the memory about emotional stimuli. Previous studies have shown that bilateral eye movements enhance the memory retrieval. Therefore, this study was conducted in order to investigate the memory enhancement of bilaterally alternating eye movements in schizophrenic patients. METHODS: Twenty one patients with schizophrenia participated in this study. The participants learned faces (angry or neutral faces), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analysed. Two-way repeated measure analysis of variance was performed for statistical analysis. RESULTS: There was a significant effect of bilateral eye movements condition in mean response time(F=5.812, p<0.05) and response bias(F=10.366, p<0.01). Statistically significant interaction effects were not observed between eye movement condition and face emotion type. CONCLUSIONS: Irrespective of the emotional difference of facial stimuli, recognition memory processing was more enhanced after bilateral eye movements in patients with schizophrenia. Further study will be needed to investigate the underlying neural mechanism of bilateral eye movements-induced memory enhancement in patients with schizophrenia.
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Humanos , Sesgo , Movimientos Oculares , Memoria , Tiempo de Reacción , EsquizofreniaRESUMEN
Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs in approximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapy has been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severe swallowing difficulty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid at infancy. She had undergone several previous bougie and balloon dilations but the stricture did not improve. We performed sequential treatment comprising incision with an insulated-tip knife, balloon dilation, and an oral steroid, which resulted in the patient’s symptoms markedly improving. Thus, we report this case of an intractable caustic esophageal stricture, which was successfully treated using combined endoscopic sequential treatment.
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Femenino , Humanos , Persona de Mediana Edad , Ácido Acético , Cáusticos , Constricción Patológica , Deglución , Trastornos de Deglución , Dilatación , Estenosis Esofágica , Tracto Gastrointestinal , RecurrenciaRESUMEN
OBJECTIVES: The objective of this study was to investigate the characteristics of language profiles according to whether or not Korean children with autism spectrum disorder(ASD) also have ADHD, and to examine the relationship with executive function. METHODS: Participants in the study were boys with ADHD aged 6 to 11 years who visited the clinic from January 2012 to December 2013. In this study, 25 boys with ASD were included, and completed scales included the Korean version of Autism Diagnostic Interview-Revised(K-ADI-R), Korean version of Autism Diagnostic Observation Schedule(K-ADOS), Korean ADHD Rating Scale(K-ARS), and Korean-Conners' Parent Rating Scale(K-CPRS). They also completed neuropsychological tests and assessed language profiles. Patients were categorized into two groups(with ADHD and without ADHD). T-test and Multivariate analysis of covariance (MANCOVA) was used for analysis. RESULTS: Statistically, no difference was found in receptive and expressive language ability between the ASD groups with and without ADHD. However, a lower score in Test of Problem solving(TOPS) was observed for ASD with ADHD than for ASD without ADHD, with problem solving and finding cues showing significant differences. CONCLUSIONS: These findings suggest that language profiles in the ASD group without ADHD could be similar to those in the ASD group with ADHD, but comorbid ADHD could lead to more difficulty in linguistic ability for problem solving and could be related with executive function of the frontal lobe.
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Niño , Humanos , Trastorno del Espectro Autista , Trastorno Autístico , Señales (Psicología) , Función Ejecutiva , Lóbulo Frontal , Lenguaje , Lingüística , Análisis Multivariante , Pruebas Neuropsicológicas , Padres , Solución de Problemas , Pesos y MedidasRESUMEN
Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature.