OBJECTIVES: Despite remarkable development of pharmacotherapy for schizophrenia, some patients continuously have had violence problems. The violence of psychotic patients is recently becoming the focus of the attention. The aim of this study is to investigate the influence of Cognitive Behavioral Therapy (CBT) on patients with schizophrenia having violence related history. METHODS: 15 Patients with schizophrenia spectrum disorder of crime history were treated with individual CBT for 12 sessions, and assessed with 4 scales (Korean version of Aggression Questionnaire, Korean version of the Barratt Impulsiveness Scale-11-Revised, Beck Cognitive Insight Scale and Positive and Negative Syndrome Scale) to evaluate anger, impulse, insight and clinical symptoms respectively at baseline and post treatment. The comparison group consisted of 15 patients with schizophrenia spectrum disorder of crime history. They were also assessed with the same scales during the same period. RESULTS: Although impulsivity is not changed significantly after treatment, but there was significant improvement in clinical symptom, insight and aggression, especially self-reflectiveness and anger respectively. CONCLUSION: CBT can be one of the good therapeutic tools for patients with schizophrenia having violence problems in that it reduces aggression and enhances insight of patients with schizophrenia spectrum disorder.
Aggression ; Anger ; Case-Control Studies* ; Cognitive Therapy* ; Crime* ; Drug Therapy ; Humans ; Impulsive Behavior ; Surveys and Questionnaires ; Schizophrenia* ; Violence ; Weights and Measures

The shoulder pain is one of the most common problems to orthopaedic surgeons in clinic. Among therapeutic modality used to manage this pain, joint and periarticular injection, as well as suprascapular nerve block, show good clinical outcome. Ultrasound guidance is a safe technique, increasing the safety and accuracy of the procedure and reducing complications. An accurate understanding of the surface anatomy is important in performing the ultrasound-guided shoulder injections. This article aims to describe the surface anatomy and sono anatomy of both the shoulder and the surrounding structures and also summarize different infiltration techniques and peripheral nerve blocks.
Arthralgia ; Nerve Block ; Peripheral Nerves ; Shoulder Joint ; Shoulder Pain ; Shoulder ; Surgeons ; Ultrasonography

BACKGROUND/AIMS: Capsaicin (8-methyl-N-vanillyl-6-ninenamide), a compound found in hot peppers, has been reported to have different physiological actions on different cell types. Not much work has been done about the effect of capsaicin on the function of interstitial cells of Cajal (ICC). In the present study, we examined the action of external application of capsaicin on pacemaker activity in the cultured ICC from the small intestine of mouse. METHODS: We investigated the effect of capsaicin on pacemaker currents in cultured ICC from the small intestine of mouse using a whole cell patch-clamp technique and Ca2+-imaging analysis. RESULTS: When capsaicin was applied externally to the pacemaker generating ICC, it completely inhibited the pacemaker potential under current-clamp mode (I = 0) and the pacemaker current under voltage-clamp mode at a -70 mV of holding potentials. The effect of capsaicin on pacemaker activity in ICC was shown dose dependently. The effect of capsaicin was not through the transient receptor potential of the vanilloid type 1 (TRPV1) channel as capsazepine did not block the effect of capsaicin. L-NAME, an inhibitor of nitric oxide synthase, also did not block the capsaicin-induced effects. When the action of capsaicin was examined in the intracellular calcium oscillation, it completely abolished the calcium oscillation. CONCLUSIONS: These results prove that the capsaicin has the inhibitory effects on the ICC which is carried out neither through TRPV channel nor the nitric oxide production. Intracellular Ca2+ was also an important target for actions of capsaicin on ICC.
Animals ; Calcium Signaling ; Capsaicin ; Gastrointestinal Motility ; Interstitial Cells of Cajal ; Intestine, Small ; Mice ; NG-Nitroarginine Methyl Ester ; Nitric Oxide ; Nitric Oxide Synthase ; Patch-Clamp Techniques

Aspergillus tracheobronchitis, an uncommon form of invasive pulmonary aspergillosis, is characterized by the development of a pseudomembrane, ulcers, or an obstruction that is predominantly confined to the tracheobronchial tree. Pseudomembranous Aspergillus tracheobronchitis is the most severe form of Aspergillus tracheobronchitis, and only a few cases have been reported in Korea. We report the characteristic chest CT findings in a patient diagnosed with pseudomembranous Aspergillus tracheobronchitis after bronchoscopy and successfully treated by proper antifungal treatment.

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

Adrenocortical carcinoma is a rare tumor in children. This tumor is more likely to be hormonally active in children than in adults and tends to cause a variety of symptoms. These tumors are usually diagnosed at the advanced stages and have a dismal prognosis. Here we report a case of a functioning adrenocortical carcinoma in a child with a review of the relevant literature.
Adrenocortical Carcinoma* ; Adult ; Child* ; Humans ; Prognosis ; Virilism

PURPOSE: To assess the efficacy of superselective intra-arterial chemotherapy (SSIAC) via the bilateral uterine arteries in cases of cervical carcinoma. MATERIALS AND METHODS: Eighteen patients with stage IIa (n=10), IIb (n=7), or IIIa (n=1) cervical carcinoma underwent one (n=2) or two (n=16) courses of preoperative SSIAC with Vincristine, Cisplatin, and Mitomycin C. We estimated the extent of reduction of tumor volume and improvement of stage, comparing pre-SSIAC MRI to postoperative results. Tumor vascularity, as seen on uterine arteriography, and procedural complications, were also evaluated. RESULTS: A marked reduction in tumor volume was observed in all patients, an average reduction volume of 94.7%. Improvement of stage was noted in 16 patients, and in six of these, no residual viable tumor or microinvasive residual tumor was seen. On angiography, tumor hypervascularity was demonstrated in seven patients, but its degree was not substantially related to therapeutic response. In no case did significant systemic complications of result from chemotherapy; in one patient, however, we experienced a serious complication of necrotizing cystitis due to malpositioning of a catheter in the superior vesical artery. CONCLUSION: SSIAC via the bilateral uterine arteries is an effective complementary modality for the treatment of various stages of cervical carcinoma.
Angiography ; Arteries ; Catheters ; Cisplatin ; Cystitis ; Drug Therapy* ; Humans ; Magnetic Resonance Imaging ; Mitomycin ; Neoplasm, Residual ; Tumor Burden ; Uterine Artery* ; Vincristine

No abstract available.
Aneurysm* ; Carotid Artery, Internal* ; Cluster Headache ; Headache* ; Intracranial Aneurysm

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

PURPOSE: One of the problems using laser doppler flowmetry is variability in the measurements. The purposes of this study were to investigate the regional differences of vaginal blood flow using laser Doppler flowmetry and to suggest a method to enhance the accuracy of measurement. MATERIALS AND METHODS: In New Zealand White female rabbits(3.0~3.5 kg, n=10), vaginal blood flow was measured by laser doppler flowmetry using a surface probe. Flow was measured at the anterior, posterior, left, and right side of vaginal wall in each vaginal introitus and proximal 2 cm of the vaginal wall. Each site was measured 3 times separately. The data were analyzed using two-way ANOVA and repeated measures ANOVA. RESULTS: Regional vaginal blood flows(ml/min/100 gm tissue) at the anterior, posterior, left, and right vaginal wall were 19.7+/-8.7, 19.6+/-7.3, 19.3+/-7.8, 18.8+/-7.2 at vaginal introitus and 27.3+/-8.8, 18.9+/-7.5, 22.6+/-7.1, 20.8+/-5.7 at the proximal 2 cm of vaginal introitus, respectively. Differences were not statistically significant(p> 0.05), as there was a wide range of variation. CONCLUSIONS: Vaginal blood flow did not show any regional differences in the distal part of the rabbit vagina. Repeated measurements may decrease the variation of vaginal blood flow by laser Doppler flowmetry.
Female ; Humans ; Laser-Doppler Flowmetry* ; New Zealand ; Vagina