Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.
Anxiety ; Child ; Cognitive Therapy ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychiatry ; Symptom Assessment ; Tic Disorders ; Tics ; Tourette Syndrome ; Ventilation ; Weights and Measures

The clinical utility of thallium-201 SPECT combined dwith pharmacologic vasodilation induced by oral dipyridamole as an alternatiove to intravenous dipyridamole was incestigated in 21 patients who had concomitant coronary arteriography. Tomographic images were assessed visually. Sensitivity & specificity for overall detection of coronary artery disease were 93.7% and 80% respectively. Sensitivity & specificity for identification of indevidual diseased vessels were 84.6% and 87.5% for the left anterior descending artery, 75% and 84.6% for the right coronary artery, 60% and 100% for the left circumflex artery, respecitively. Of the 26 patients unergoing thallium scintigraphy 11 patients(42.3%) had some adverse effects between 20 and 50 minutes after oral dipyrdamole ingestion, including headache(26.9%), chest pain(26.9%), electrocardiographic changes(19.2%), and nausea(11.5%). Intravenous aminophylline was used to resolve these adverse effects in 8 patients & most of the adverse effects were subsided within 10 minutes. There was no ventricular arrhythmias, myocardial infarctions or deaths. In conclusion, oral dipyridamole thallium-201 SPECT is safe and accurate test for the overall detection of coranary artery disease and identification of disease in individual arteries. Furthermore it is useful for determining the necessities of coronary reperfusion and prognstically stratiofying the patients with coronary artery disease.
Aminophylline ; Angiography ; Arrhythmias, Cardiac ; Arteries ; Coronary Artery Disease* ; Coronary Vessels* ; Dipyridamole* ; Eating ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocardial Perfusion Imaging* ; Myocardial Reperfusion ; Radionuclide Imaging ; Sensitivity and Specificity ; Thallium ; Thorax ; Tomography, Emission-Computed, Single-Photon* ; Vasodilation

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Polymerase Chain Reaction*

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. Many cutaneous adverse reactions associated with G-CSF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet's syndrome, cutaneous leukocytoclastic vasculitis, and widespread folliculitis. We report a case of vasculitis with atypical myeloid cell induced by G-CSF on the lower extremities
Folliculitis ; Granulocyte Colony-Stimulating Factor* ; Granulocytes* ; Lower Extremity ; Myeloid Cells* ; Pyoderma Gangrenosum ; Sweet Syndrome ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Morphea is a rare, sclerotic connective tissue disorder and is thought to be caused by a decreased collagenase activity. Numerous treatment modalities have been tried, such as infiltration with glucocorticosteroid, D-penicillamine, antimalarial agents and cyclosporine. However, all have shown only limited success. We report a case of a 21 year- old female with localized scleroderma, who showed a marked improvement after localized therapy with high dose UVA-1.
Antimalarials ; Collagenases ; Connective Tissue ; Cyclosporine ; Female ; Humans ; Penicillamine ; Phototherapy* ; Scleroderma, Localized*

Palmoplantar lichen planus is a rare, localized variant of the disease that may create difficulty in diagnosis if it is present as an isolated finding. As palmoplantar lichen planus do not usually have the classically clinical features of lichen planus, a biopsy is very useful. Histopathologic findings are identical to classic lichen planus. According to literature, similar lichen planus may be found elsewhere on the body in palmoplantar lichen planus. We report a case of lichen planus limited to the soles in a 50 year-old female, who presents with erythematous hyperkeratotic crusted pruritic plaques on both soles.
Biopsy ; Diagnosis ; Female ; Humans ; Lichen Planus* ; Lichens* ; Middle Aged

We retrospectively evaluated postoperative refraction of four patients(five eyes)who received intraocular lens implantation after excimer laser photorefractive keratectomy (PRK).The mean age of the patients was 44.8 years and 3 patients were female and 1 patient was male.The mean interval between PRK and cataract operation was 20.2 months (1 to 45 months)and the mean follow-up time after cataract operation was 16.2 months(2~43months).Phacoemulsification and PMMA-PCL(6.0~6.5 mm)implantation were made in all cases.SRK-II formula,the most popular empirical formula was used in first 3 cases(group I),but Idem-lens formula,a primitive theoretical formula was used in another 2 cases (group II)after occurrence postoperative refraction errors in group I .In group I and II,the mean postoperative refraction error was +3.00 diopters and +0.50 diopters and uncorrected visual acuity at postoperative 2 months was 20/60 and 20/24 respectively.The mean of calculated IOL-power was -3.75 diopter in group I and -0.625 diopter in group II.From these results,the empirical formula is definitely unsuitable for the calculation of IOL power in the cataract operation following excimer laser PRK. Moreover,although a primitive one,Idem-lens theory could be temporally useful for the IOL-power calculation in such cases.In conclusion,new formula is required for the cataract operation following excimer laser PRK.
Cataract* ; Female ; Follow-Up Studies ; Humans ; Lasers, Excimer* ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Photorefractive Keratectomy ; Retrospective Studies ; Visual Acuity

PURPOSE: Neonatal jaundice is one of the most common problems in our country leading to hospitalization. Agar is low cost, low risk, and easily fed orally; it can bind bilirubin in the intestine, decreasing its enterohepatic circulation, thereby decreasing serum bilirubin levels. At present, however, the effectiveness of agar in the prevention and treament of neonatal jaundice is quite conflicting and controversy. Recently we have read Caglayan's 'Superiority of Oral Agar and Phototherapy Combination in the Treatment of Neonatal Hyperbilirubinemia'. The result was very hopeful and attractive enough, and which gave us a motivation to study if it was really of value. METHODS: From May 1995 to April 1996, a total 50 term neonates admitted in nursery of Dong-Eui Medical Center with the capillary serum bilirubin levels greater than 10mg/ dl were enrolled in the study. Those with pathologic causes and breast fed infants were all excluded. The neonates were randomly devided into two groups; 25 of conventional phototherapy alone (P group) and 25 of oral agar plus conventional phototherapy combination (A+P group). The study was terminated when the capillary serum bilirubins were decreased to 8mg/dl. Pastagar B (Pasteur Institute 64946) 500mg in 10ml distilled water were fed four times a day using 10ml syringes prior to bottle feeding. Capillary serum bilirubin levels were measured daily at 10:00 a.m. with heel pad samples. Daily stool frequency and adverse effects of treatment were observed closely. RESULTS: 1) The decrement of the serum bilirubin levels at first 24 hours of therapy was significantly different between P and A+P groups showing as 1.7+/-1.2 and 2.4+/-1.0mg/dl respectively (p<0.05). 2) Mean time for bilirubin to decrease to 8mg/dl was shorter in A+P group than in P group showing as 45.7+/-20.8 and 57.5+/-32.3 hours each other, but those differences were statistically insignificant (p>0.05). 3) No adverse effects such as rashes or abdominal pains were observed during treatment. Differences of mean stool frequency were significant between P and A+P groups showing as 3.7+/-1.2 and 4.7+/-2.0 times per day respectively (p<0.05). CONCLUSION: The agar plus conventional phototherapy combination was superior to conventional phototherapy alone at first 24 hours of therapy in neonatal hyperbilirubinemia, but further more careful researches would be necessary for using it routinely in the treatment of neonatal hyperbilirubinemia in future.
Abdominal Pain ; Agar* ; Bilirubin ; Bottle Feeding ; Breast ; Capillaries ; Enterohepatic Circulation ; Exanthema ; Heel ; Hope ; Hospitalization ; Humans ; Hyperbilirubinemia, Neonatal* ; Infant ; Infant, Newborn ; Intestines ; Jaundice, Neonatal ; Motivation ; Nurseries ; Phototherapy* ; Syringes ; Water

A case of pulmonary vein aneurysm is presented. Chest X-ray revealed round density along the right cardiac border in right lower lung field. The round density was suspected as solid tumor initially, but the angiocardiogram showed dealyed opacification of right inferior pulmonary vein. So it was confirmed as pulmonary vein aneurysm. This patient took mitral valve replacement because of mitral and aortic regurgitation. Pulmonary vein aneurysm is considered as congenital in origin and pulmonary venous hypertension has its pathogenetic role in enlarging the varix. Pulmonary vein aneurysm probably has little clinical significance although cases of spontaneous rupture have been reported. There are a few reported cases in the literature, but the actual incidence probably is much higher than reported. This is the first to be reported in Korean literature.
Aneurysm* ; Aortic Valve Insufficiency ; Humans ; Hypertension ; Incidence ; Lung* ; Mitral Valve ; Pulmonary Veins* ; Rupture, Spontaneous ; Thorax ; Varicose Veins