Objectives This study is designed to compare the clinical characteristics of patients with early onset schizophrenia to those of adult onset schizophrenia patients in first episode. Methods Authors reviewed medical records of 16 early-onset schizophrenia patients and 22 adult-onset schizophrenia patients who had been admitted in the psychiatric ward and diagnosed as schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders, fourth Edition (DSM-IV) at Eulji University Hospital during 2004-2008. Socio-demographic data and clinical characteristics such as duration between onset and active phase, number of significant positive and negative symptoms, positive and negative symptom scores of Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S) scores, duration from onset to admission, duration of admission, and equivalent dose of antipsychotics were reviewed. These clinical characteristics of early-onset group were compared to those of adult-onset group. Correlation between age of onset and other clinical characteristics was also analyzed. Results Early-onset group showed more insidious onset pattern and had longer duration of hospitalization than adult-onset group. Early onset group also exhibited more negative symptoms, higher negative symptom scores, and higher CGI-S scores than adult-onset group after treatment. However, there were no significant differences in family history of psychosis, positive symptom frequency at discharge and equivalent dose of antipsychotics between two groups. Conclusions This study revealed that patients with early-onset schizophrenia exhibited more insidious onset, more negative symptoms, and more severe symptoms than those with adult-onset schizophrenia after treatment.
Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.
Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.
Lee, Hyun Seung;Bae, Yong Chan;Nam, Su Bong;Yi, Chang Ryul;Yoon, Jin A;Kim, Joo Hyoung
Archives of Plastic Surgery
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제48권5호
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pp.534-542
/
2021
Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients' awareness of surgical treatment for secondary upper extremity lymphedema (UEL). Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups. Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003). Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.
Severe sepsis and septic shock is a life-threatening disease. It is combined with multi-organ failure. In the past decade, early goal directed therapy has been proposed as an effective treatment strategy for better outcome. Recent epidemiologic studies showed that the outcome of sepsis has been improved with the introduction of early goal directed therapy. However, it is unclear which elements of early goal directed therapy contributed to the better outcome. Recent prospective and randomized trials suggested that some elements of early goal directed therapy did not have any effect on the outcome benefit. In this paper, recent articles about early goal directed therapy will be reviewed and the effectiveness of individual elements of early goal directed therapy will be discussed.
Background and Purpose Through ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$, Dongmu Lee Je-ma supposed the minds of management for Sasang Constitutional Symptoms, which had been accomplished through several steps from his early writings to ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901. His basic minds of treatment for disease had been supposed early in ${\ulcorner}$Gyojapyungseongjam${\lrcorner}$ and ${\ulcorner}$Gyukchigo${\lrcorner}$, and had been completed to the Sasang Constitutional Symptoms and the minds of management for it, from ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$, ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ written in 1894 to ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901. In this paper, I tried to find the minds of treatment of ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$, through classifying and researching the early minds of treatment (presented in ${\ulcorner}$Gyojapyungseongjam${\lrcorner}$, ${\ulcorner}$Gyukchigo${\ulcorner}$, ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$), and the latter minds of treatment (presented in ${\ulcorner}$Dongyi Soose Bowon${\ulcorner}$ written in 1894, ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901) Methods It was researched as bibliologically with his writings such as ${\ulcorner}$Gyojapyungseongjam${\lrcorner}$, ${\ulcorner}$Gyukchigo${\lrcorner}$, ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lrcorner}$, ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ written in 1894, ${\ulcorner}$Dongyi Soose Bowon${\lrcorner}$ published in 1901. Results and Conclusions The conclusions were as follows. 1. At early, Dongmu Lee Je-ma pursued the minds of treatment at the autonomous control through 'Acquaintance and Self-control' based on 'the Knowledge of Nature and Desire', so emphasized 'self-control' as important point in treatment. 2. From ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lcorner}$, Dongmu summarized Sasang constitutional symptoms structurally in view of Morpho-imaginary. In ${\ulcorner}$Dongyi Soose Bowon Sasang Chobongyun${\lcorner}$ and ${\ulcorner}$Dongyi Soose Bowon${\lcorner}$ written in 1894, It was described in view of small organ, but in ${\ulcorner}$Dongyi Soose Bowon${\lcorner}$ published in 1901, suggested more updated in view of both large and small organ and to which added the concept of Hot and Cold. 3. Through reinterpreting the concept of interior and exterior disease in ${\ulcorner}$Sanghanrhon${\lcorner}$, the concept of Sasang constitutional symptoms had started as the minds of treatment for individual disease, but in ${\ulcorner}$Dongyi Soose Bowon${\lcorner}$ published in 1901, it was accomplished as the minds of broad management for Sasang Constitutional Symptoms. 4. In ${\ulcorner}$Dongyi Soose Bowon${\lcorner}$ published in 1901, the broad therapeutic prescriptions for management of Sasang constitutional symptoms were proposed newly, according to the accomplishment of Sasang constitutional symptomatic patterns, so these have different aims and are more important than that proposed previously. 5. The control in view of 'Knowledge and Deed' and the minds of management for Sasang constitutional symptoms are the minds and spirits for treantment and prevention against disease, which can maximize the power of autonomous self-treatment and manage all disease broadly.
Kim, Nalee;Lee, Jeongshim;Kim, Kyung Hwan;Park, Jong Won;Lee, Chang Geol;Keum, Ki Chang
Radiation Oncology Journal
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제34권4호
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pp.280-289
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2016
Purpose: Early hypopharyngeal squamous cell carcinoma (HPSCC) is a rarely diagnosed disease, for which the optimal treatment has not been defined yet. We assessed patterns of failure and outcomes in early HPSCC treated with various therapeutic approaches to identify its optimal treatment. Materials and Methods: Thirty-six patients with stage I (n = 10) and II (n = 26) treated between January 1992 and March 2014 were reviewed. Patients received definitive radiotherapy (RT) (R group, n = 10), surgery only (S group, n = 19), or postoperative RT (PORT group, n = 7). All patients in both the R and PORT groups received elective bilateral neck irradiation. In the S group, 7 patients had ipsilateral and 8 had bilateral dissection, while 4 patients had no elective dissection. Results: At a median follow-up of 48 months, the 5-year locoregional control (LRC) rate was 65%. Six patients had local failure, 1 regional failure (RF), 3 combined locoregional failures, and 2 distant failures. There was no difference in 5-year LRC among the R, S, and PORT groups (p = 0.17). The presence with a pyriform sinus apex extension was a prognosticator related to LRC (p = 0.01) in the multivariate analysis. Patients with a bilaterally treated neck showed a trend toward a lower RF rate (p = 0.08). Conclusion: This study shows that patients with early stage HPSCC involving the pyriform sinus apex might need a tailored approach to improve LRC. Additionally, our study confirms elective neck treatment might have an efficacious role in regional control.
We compared the quality of 'Fuji' apples (Malus ${\times}$ domestica) from trees whose leaves were not removed (no artificial defoliation; NAD) with apples from trees that underwent early defoliation (ED, treated in mid September and early October) and conventional defoliation (CD, treated in early and mid October). The experiment was conducted in three consecutive years using 15-year-old 'Fuji' apple grafted on Malus prunifolia. Fruits were harvested on November 7, 16 or 12 in 2011, 2012 and 2013, respectively. Compared to NAD treatment, ED and CD treatment reduced the fresh weight by 4.7% and 0.6%, respectively. The soluble solids content of NAD apples ($14.4^{\circ}Brix$) was slightly higher than that of CD ($14.1^{\circ}Brix$) and ED ($14.0^{\circ}Brix$) apples. Soluble sugar content, flesh firmness, water-core index, and titratable acidity were not affected by defoliation treatment regardless of treatment timing. The skin blush index of NAD apples (2.3) was inferior to that of CD (3.3) and ED (3.4)- treated apples. Furthermore, artificial defoliation treatments increased skin redness ($a^*$) and yellowness ($b^*$) and significantly improved the degree of skin blush compared to NAD fruits.
Intake of caffeine during pregnancy can cause retardation of fetal development. Although the significant influence of caffeine on animal development is widely recognized, much remains unknown about its mode of action because of its pleiotropic effects on living organisms. In the present study, by using Caenorhabditis elegans as a model organism, the effects of caffeine on development were examined. Brood size, embryonic lethality, and percent larval development were investigated, and caffeine was found to inhibit the development of C. elegans at most of the stages in a dosage-dependent fashion. Upon treatment with 30 mM caffeine, the majority ($86.1{\pm}3.4%$) of the L1 larvae were irreversibly arrested without further development. In contrast, many of the late-stage larvae survived and grew to adults when exposed to the same 30 mM caffeine. These results suggest that early-stage larvae are more susceptible to caffeine than later-stage larvae. To understand the metabolic responses to caffeine treatment, the levels of expression of cytochrome P450 (cyp) genes were examined with or without caffeine treatment using comparative microarray, and it was found that the expression of 24 cyp genes was increased by more than 2-fold (p < 0.05). Among them, induction of the cyp-35A gene family was the most prominent. Interestingly, depletion of the cyp-35A family genes one-by-one or in combination through RNA interference resulted in partial rescue from early larval developmental arrest caused by caffeine treatment, suggesting that the high-level induction of cyp-35A family genes can be fatal to the development of early-stage larvae.
Kim, Jin-Woo;Bae, Tae-Hui;Kim, Woo-Seob;Kim, Han-Koo
Archives of Plastic Surgery
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제39권1호
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pp.31-35
/
2012
Background : Orbital roof fractures are frequently associated with a high energy impact to the craniofacial region, and displaced orbital roof fractures can cause ophthalmic and neurologic complications and occasionally require open surgical intervention. The purpose of this article was to investigate the clinical features and treatment outcomes of orbital root fractures combined with neurologic injuries after early reconstruction. Methods : Between January 2006 and December 2008, 45 patients with orbital roof fractures were admitted; among them, 37 patients were treated conservatively and 8 patients underwent early surgical intervention for orbital roof fractures. The type of injuries that caused the fractures, patient characteristics, associated fractures, ocular and neurological injuries, patient management, and treatment outcomes were investigated. Results : The patients underwent frontal craniotomy and free bone fragment removal, their orbital roofs were reconstructed with titanium micromesh, and associated fractures were repaired. The mean follow up period was 11 months. There were no postoperative neurologic sequelae. Postoperative computed tomography scans showed anatomically reconstructed orbital roofs. Two of the five patients with traumatic optic neuropathy achieved full visual acuity recovery, one patient showed decreased visual acuity, and the other two patients completely lost their vision due to traumatic optic neuropathy. Preoperative ophthalmic symptoms, such as proptosis, diplopia, upper eyelid ptosis, and enophthalmos were corrected. Conclusions : Early recognition and treatment of orbital roof fractures can reduce intracranial and ocular complications. A coronal flap with frontal craniotomy and orbital roof reconstruction using titanium mesh provides a versatile method and provides good functional and cosmetic results.
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