PURPOSE: To determine the proper time frame in which to assess retinal attachment status and to evaluate the superior retinal attachment status by performing B-scan ultrasonography in different positions on patients who have undergone pars plana vitrectomy and gas tamoponade. METHODS: In this prospective study, 23 patients (23 eyes) who had undergone pars plana vitrectomy and gas tamponade were investigated between June 2005 and February 2006. SF6 (18%) was injected into the vitreous cavity of 15 eyes, and C3F8 (14%) was injected into the vitreous cavity of 8 eyes. At postoperative day 1, day 3, week 1, week 2, and week 4, B-scan ultrasonography was performed in the supine, sitting, prone, right decubitus, and left decubitus positions. RESULTS: The proper time to evaluate the retinal attachment status was three days post-operatively in 10 eyes (66.7%) with SF6 (18%) injections and two weeks post-operatively in six eyes (75%) that had C3F8 (14%) injections. The superior retinal attachment status can be evaluated from the summation of B-scan ultrasonography results performed in the right decubitus and left ducubitus positions. CONCLUSIONS: The proper time to evaluate the retinal attachment status was related to the degree of the gas absorption when performing B-scan ultrasonography after pars plana vitrectomy and gas tamponade. To evaluate the entire retina, it is useful to perform B-scan ultrasonograhy in the prone, right decubitus and left decubitus positions.
Adult ; Aged ; Aged, 80 and over ; Air ; Female ; Follow-Up Studies ; Humans ; Injections ; Male ; Middle Aged ; Postoperative Period ; Prospective Studies ; Retina/*ultrasonography ; Retinal Diseases/*surgery/ultrasonography ; Time Factors ; Treatment Outcome ; Vitrectomy/*methods ; Vitreous Body

Stroke is one of the leading causes of deaths in Korea. According to the report from Korean National Statistical Office, the mortality rate of stroke was 77.2/100,000 persons in 2002. In the past, hemorrhagic stroke was more prevalent than ischemic stroke in Korea. However, the ratio of hemorrhagic to ischemic stroke has been reversed since late-1980s. This trend might be due to the westernization of lifestyle as well as better control of stroke risk factors such as hypertension and diabetes. Of ischemic stroke, the incidence of cardioembolism is relatively low in Korea compared with in Western countries, especially in posterior circulation disorders. This observation reflects the epidemiologic characteristic of stroke in Korea where the prevalence of cardiac diseases is relatively low. The case fatality rate from one of the largest hospital-based stroke registries was 7.7% within 30 days after the onset of acute ischemic stroke, which is similar to those from other series in western countries with advanced medical care systems. However, the delay of hospital visit after the onset of stroke and the lower compliance for secondary prevention remain obstacles in managing stroke patients in Korea.
Cause of Death ; Compliance ; Epidemiology ; Heart Diseases ; Humans ; Hypertension ; Incidence ; Korea ; Life Style ; Mortality ; Prevalence ; Registries ; Risk Factors ; Secondary Prevention ; Stroke

Sinusitis is a common problem that is routinely diagnosed and treated by most primary care physicians. Although most cases usually respond to appropriate therapy, some occasionally progress to the development of intracranial complications, including meningitis, osteomyelitis, epidural and subdural empyema, intracranial mucocele or polyps, and frank brain abscess. It is important to develop a rational approach to the diagnosis and treatment of these conditions. Intracranial complications are pathologically caused by direct extension of the disease through the bony defect or hematogenous spread. Radiologic evaluation must include computerized tomography for accurate diagnosis and surgical planning. Therapy includes surgical drainage and high doses of intravenous antibiotics. Recently we have experienced one subdural abscess secondary to acute sinusitis.
Abscess ; Anti-Bacterial Agents ; Brain Abscess ; Diagnosis ; Drainage ; Empyema, Subdural ; Humans ; Meningitis ; Mucocele ; Osteomyelitis ; Physicians, Primary Care ; Polyps ; Sinusitis

Pheniramine maleate(avil(R)) is a H1-antagonist that is derived from alkylamine. Skin reactions with parenteral administration of avil(R) are uncommon. A 29-year-old woman visited our department with a 3-year history of relapsing generalized multiple pruritic evanescent erythematous wheals after antihistamine and steroid injection. Intradermal skin test with Avil(R) was positive. We treated with 5 mg of mequitazine administration three times a day for 2 years.
Adult ; Female ; Humans ; Pheniramine* ; Skin ; Skin Tests ; Urticaria*

PURPOSE: Accurate clinical diagnosis of acute appendicitis is more difficult in children since they may not be able to communicate their complaints adequately, and findings on physical examination may be nonspecific.The uncertainty in diagnosis may lead to a delay of surgery or to unnecessary laparotomy. Prompt diagnosis is important due to their complications such as perforation, abscess formation, and peritonitis. The authors conducted this study in order to find out usefulness of ultrasonography in diagnosis of acute appendicitis in children. METHODS: The authors was performed ultrasonographical examination to 290 children with abdominal pain under the age of 15 during a recent 16-months period from January 1994 to April 1995. High-resolution ultrasonography was used according to the graded compression method. The ultrasonographic findings were correlated with pathologic outcome in 87 cases. RESULTS: 1) Among 290 patients with abdominal pain, acute appendicitis was 81 cases (27.9%), and there were mesenteric lymphadenitis, terminal ileitis, intussusception, acute gastroenteritis, and nonspecific findings. 2) Sex ratio of acute appendicitis was 1.53:1. The acute appendicitis was occurred 13.6% in under the age of 5 and 86.4% in over the age of 6. Mean age was 10.6 3) The most frequent symptom was abdominal pain followed by vomiting, fever, nausea, and diarrhea. 4) Leukocytosis (>10,000/cu.mm) was occurred in 71 of 81 (87.7%) cases of acute appendicitis and 24 of 28 (85.7%) cases of acute appendicitis with perforation. 5) The perforation rate was higher in delayed diagnosis and in younger children. 6) Ultrasonography had a sensitivity of 97.5%, specificity of 96.2%, positive predictive value of 90.8%, and negative predictive value of 99.0% on diagnosis in acute appendicitis. CONCLUSIONS: Upon the above results, the authors were able to conclude that graded compression ultrasonography had high sensitivity and specificity and was useful for the diagnosis of acute appendicitis in children. And the ultrasonography can be applied as rapid, noninvasive, and well-tolerated investigation. So, it has diagnostic value as screening test in children whose chief complaint is abdominal pain.
Abdominal Pain ; Abscess ; Appendicitis* ; Child* ; Crohn Disease ; Delayed Diagnosis ; Diagnosis* ; Diarrhea ; Fever ; Gastroenteritis ; Humans ; Intussusception ; Laparotomy ; Leukocytosis ; Mass Screening ; Mesenteric Lymphadenitis ; Nausea ; Peritonitis ; Physical Examination ; Sensitivity and Specificity ; Sex Ratio ; Ultrasonography* ; Uncertainty ; Vomiting

OBJECTIVES: To investigate the nature of emotional responsiveness in normal adults, we exam the emotional responses to emotional pictures in an evaluative space defined by arousal and valence. METHODS: Subjects were instructed to rate the arousal and valence that they experienced from the presentation of one of two sets of 60 emotional pictures. These two picture sets were comprised of 107 pictures: 101 selected from International Affective Pictures System and six pictures from our own collection. According to "evaluative space model", the authors set an evaluative space defined by the arousal scores as independent variable and the valence scores as dependent variable. In this evaluative space, one-hundred-and-seven pairs of coordinates representing respective emotional pictures were plotted. With regression analyses, the steepness of the regression lines on the plots with positive emotional responsiveness (n=51) and those with negative emotional responsiveness (n=56) were compared. RESULTS: In the evaluative space, the regression line of negative emotional responsiveness was significantly different from that of positive responsiveness. The slope of negative responsiviveness was significantly steeper than that of positive responsiveness. At a low arousal level, the absolute valence of a positive stimuli was larger than that of a negative picture. CONCLUSION: This finding indicates that the function of the negative affective responsiveness might be different from that of the positive responsitiveness. IAPS also seems applicable to Korean subjects.
Adult ; Arousal ; Humans

OBJECTIVES: The present study was designed to assess the reliability and validity of Korean version of Family Questionnaire (FQ-K), a brief questionnaire measuring expressed emotion (EE). METHODS: A sample of 84 first-order relatives of schizophrenics completed the FQ-K and the data were analyzed for internal consistency and factor structure. Additionally non-random subset of participants (n=34) refilled FQ-K after two weeks for testretest reliability and naturalistic follow-up data of 36 were obtained for any re-hospitalization events to assess predictive validity. RESULTS: Internal consistency of FQ-K was good (Cronbach's alpha=.819) and principal component factor analysis revealed the two-factor structure (criticism and emotional overinvolvement) identical to previously reported for the FQ. The FQ-K also showed reasonable test-retest reliability and excellent predictive validity was indicated in that outcome of re-hospitalization was superior for low expressed emotion patients at six-month naturalistic follow-up. CONCLUSION: The Korean version of FQ proved to be a reliable and valid instrument measuring expressed emotion in relatives of Korean patients with schizophrenia.
Expressed Emotion* ; Follow-Up Studies ; Humans ; Surveys and Questionnaires* ; Reproducibility of Results* ; Schizophrenia

OBJECTIVES: Schizophrenic patients have been shown to be impaired in both emotional self-awareness and recognition of others' facial emotions. Alexithymia refers to the deficits in emotional self-awareness. The relationship between alexithymia and recognition of others' facial emotions needs to be explored to better understand the characteristics of emotional deficits in schizophrenic patients. METHODS: Thirty control subjects and 31 schizophrenic patients completed the Toronto Alexithymia Scale-20-Korean version (TAS-20K) and facial emotion recognition task. The stimuli in facial emotion recognition task consist of 6 emotions (happiness, sadness, anger, fear, disgust, and neutral). Recognition accuracy was calculated within each emotion category. Correlations between TAS-20K and recognition accuracy were analyzed. RESULTS: The schizophrenic patients showed higher TAS-20K scores and lower recognition accuracy compared with the control subjects. The schizophrenic patients did not demonstrate any significant correlations between TAS-20K and recognition accuracy, unlike the control subjects. CONCLUSIONS: The data suggest that, although schizophrenia may impair both emotional self-awareness and recognition of others' facial emotions, the degrees of deficit can be different between emotional self-awareness and recognition of others' facial emotions. This indicates that the emotional deficits in schizophrenia may assume more complex features.
Affective Symptoms ; Anger ; Humans ; Schizophrenia

Laryngeal amyloidosis is a rare disease that was first documented in 1875. The incidence of the larynx limited amyloidosis is less than 1% of all benign lesions of larynx. It may occur as primary or secondary to other diseases. Generalized secondary amyloidosis is very rare among them. It is a condition characterized by the extracellular deposition of homogenous, eosinophilic, proteinous material in the form of fibrils. The aim of treatment is to maintatin or improve voice quality and to maintain laryngeal airway. We report a case of laryngeal amyloidosis of AL (amyloid light chain) type that was treated with KTP laser (potassium titany phosphate laser).
Incidence

Purpose: Neoadjuvant chemotherapy (NAC) involving trastuzumab markedly increases pathologic complete response (pCR) rates in patients with human epidermal growth factor receptor 2-positive (HER2+) breast cancer. Despite increasing pCR rates, long-term survival gains are controversial owing to distinctive biologic behavior mediated by the presence of hormonal receptors (HRs) that may interact with HER2 receptors. We, therefore, investigated the differences in relative survival gain provided by neoadjuvant trastuzumab-based chemotherapy on HR positive (HR+) status of patients. Methods: We retrospectively ana Patient clinical characteristics were compared usin lyzed women with stage II or III HER2+ breast cancer who underwent NAC followed by a breast cancer surgery between 2008 and 2013. The survival benefits of adding trastuzumab to NAC were analyzed by classifying patients into HR+ and HR negative (HR−) groups. Results: Of 666 patients included in the study, 374 (52.1%) were HR+ and 319 (47.9%) were HR−. In the HR+ group, trastuzumab treatment led to higher pCR rates and significantly better breast cancer specific survival (BCSS) and overall survival (OS) than no trastuzumab treatment. However, among patients with HR− breast cancer, trastuzumab treatment showed no statistically significant difference between BCSS and OS following multivariate analysis. Conclusion We found that the addition of trastuzumab to NAC improved relative survival benefit in HER2+/HR+ patients than in HER2+/HR− patients, even though the pCR rate increases were lower. Although pCR has been regarded as a surrogate marker for estimating long-term survival benefits after NAC, it alone may not translate into real long-term oncologic outcomes in particular cancer subtypes after trastuzumab-based NAC. Further longer-term evaluation of the objective survival benefit after NAC driven by a dual HER2 block according to HR status is warranted.