We describe a 8-year-old girl with erythrokeratodermia varibilis (EKV). This diagnosis was supported by erythematous, configurate patches over the entire body. Their size, shape and location varyed with enviromental factors and emotional state. In addition, well defined brownish, hyperkeratotic plaques were scattered over the trunk and extremities. Also, this patient had alopecia universalis, which is not typical of EKV. Etretinate therapy resulted in an almost complete clinical clearing of the plaques; however, her alopecia universalis and erythematous lesions were not affected.
Acitretin ; Alopecia* ; Child ; Diagnosis ; Erythrokeratodermia Variabilis* ; Etretinate ; Extremities ; Female ; Humans

BACKGROUND AND OBJECTIVES: Pseudo-labyrinthine symptom without any other accompanying neurologic symptoms or signs occur with cerebellar infarction. The prognosis and management of cerebellar infarction differ from those of vertigo associated with unilateral vestibulopathy. The objective of study was to analyze the clinical symptoms of cerebellar infarction mimicking unilateral vestibulopathy according to the infarction territory. MATERIALS AND METHOD: Among 273 patients who showed pseudo-labyrinthine symptoms or signs, 28 patients were diagnosed cerebellar infarction on MRI between January 2003 and October 2006. Out of the 28 patients, 9 patients accompanying with focal neurologic symptoms or signs in early stage were excluded, and a retrospective analysis of total 19 patients was done through chart reviews. Using diffusion-weighted imaging, we divided 19 patients into two groups, AICA and PICA territory infarction. Clinincal features, outcome of audiologic and vestibular function test were compared between the groups. RESULTS: Among the 19 subjects, 10 were males and 9 were females, the mean age was 63.1+/-.0. On MRI, 5 (26.3%) subjects showed infarction in unilateral AICA territory, 14(73.7%) in unilateral PICA territory. In the patients with AICA territory infarction, audiological tests confirmed unilateral sensorineuronal hearing loss in all 5 subjects. On V-ENG, 4/5 (80%) demonstrated horizontal or mixed horizontal torsional spontaneous nystagmus, and 4/5 (80%) had a canal paresis to caloric stimulation. In several days of hospital stay, 3/5 (60%) showed new neurologic signs, facial numbness. In the patients with PICA infarction, there was no hearing change. On V-ENG, 12/14(85.7%) demonstrated horizontal or mixed horizontal torsional spontaneous nystagmus, and 7/14 (50%) had a canal paresis to caloric stimulation. In several days of hospital stay, 10/14 (71.4%) accompanied with cerebellar ataxia. CONCLUSION: Cerebellar infarction simulating unilateral vestibulopathy is more common than previously thought. Early recognition of the cerebellar infarction showing pseudo-vestibular symptom may allow specific management. Also taking into account that clinical features differ by infarction territory will assist in determining the patient's status of the disease.
Cerebellar Ataxia ; Cerebellum ; Female ; Hearing ; Hearing Loss ; Humans ; Hypesthesia ; Infarction* ; Length of Stay ; Magnetic Resonance Imaging ; Male ; Neurologic Manifestations ; Paresis ; Pica ; Prognosis ; Retrospective Studies ; Vertigo ; Vestibular Function Tests

No abstract available.
Tomography, Emission-Computed, Single-Photon*

No abstract available.
Myocardial Stunning*

No abstract available.
Aorta, Thoracic*

BACKGROUND: OSCE was conducted to measure the immediate outcome of ICM. The measurement focused on basic clinical skills. METHODS: The subject of study was 115 third year medical students who took ICM course. The examination consisted of ten 5-minute stations with nine cases that represented commonly encountered problems in primary care. OSCE stations were duplicated into two sites. Therefore, same OSCE was performed six times in each sites. We evaluated the reliability of OSCE scores and compared the mean scores according to the examination sites and time sequences. Also, we got feedback from all participants by questionnaires. RESULTS: Mean of total OSCE score was 52.1. Cronbach alpha of total station was 0.559. For blood pressure check, lung physical examination, and neck mass physical examination station, there was a significant difference in mean scores as the time sequences(p<0.05). Both students and examiners evaluated the OSCE positively, and felt that OSCE was meaningful experience to prepare clinical skills. CONCLUSION: We can confirm that OSCE is a reasonable evaluation tool for ICM. However, further trials to develop the more reliable and valid examinations will be warranted.
Blood Pressure ; Clinical Competence ; Clinical Medicine* ; Humans ; Lung ; Neck ; Physical Examination ; Primary Health Care ; Students, Medical ; Surveys and Questionnaires

No abstract available.
Cystadenoma, Mucinous* ; Mucins* ; Pancreas*

To determine whether are significant diastolic left ventricular dysfunctions in mild to moderate hypertensive patients with normal systolic function, radionuclide ventriculography by in vivo red cell labelling technique using 20 mCi of (99m)Tc pertechnetate was performed in 24 hypertensive patients(mean age: 50.6+/-12.4, mean blood pressure: 156.9+/-11.8/100.6+/-7.1 mmHg) and in 11 normal subjects (mean age: 42.7+/-13.5, mean blood pressure: 123.2+/-6.8/82.3+/-3.9 mmHg). The results were as follows: 1) Ejection fraction was similar in both hypertensive and control groups (0.70+/-0.06 versus 0.70+/-0.08). 2) Mean of the peak filling rate (PFR) was significantly lower in hypertensive group (2.07+/-0.45 EDV/sec) than in control group (2.42+/-0.30 EDV/sec) (p<0.05). 3) Mean of the time to peak diastolic filling (TPDF) in hypertensive patients was 189.0+/-30.4 msec and which was significantly longer than that of control subjects (164.5+/-22.4 msec)(p<0.02). 4) Mean of the first third filling fraction (1/3 FF) in hypertensive patients was 0.22+/-0.07 and which was significantly lower than that of control subjects (0.32+/-0.09)(p<0.01). 5) Decreased PFR and delayed TPDF were also demonstrated with advances in age in both groups. Above results suggest that the diastolic evaluation of left ventricle might be necessary in the hypertensive patients with normal systolic function, and that diastolic dysfunction may precede the systolic dysfunction and clinical deterioration.
Blood Pressure ; Heart Ventricles ; Humans ; Hypertension* ; Radionuclide Ventriculography* ; Sodium Pertechnetate Tc 99m ; Ventricular Dysfunction, Left

OBJECTIVES: This study is designed to discuss the pros and cons related to the 'separation of drug prescription and dispensation' system when 5 years have passed by since the introduction of this system. METHODS: The 592 psychiatrists from 1,107 working places took part in nationwide survey by mail or E-mail from June to September, 2005. The response rate was 23.8%, most of respondents came from private clinics. RESULTS: The average age of psychiatrist was 44.6 years old, ranging from 25 to 75, most of them was predominantly male. The main results were as followings: 1) The ratio of psychiatric prescription out of hospital based on out-patients departments was the lowest in clinics, following by hospitals, general hospitals and university hospitals by order. 2) The main reasons of customer's preference for out of hospital prescription were economic advantage and self-awareness of prescription. As for the disliking for it, the most complaints were the anxiety about disclosure of psychiatric treatment, in convenience for delay and concern about drug change. CONCLUSION: Five years didn't seem to give a change on how the psychiatrists perceive the 'separation of drug prescription and dispensation' system at all. The confidentiality and human right issues on the part of psychiatric patients should never be ignored in order to manage this system successfully.
Anxiety ; Confidentiality ; Surveys and Questionnaires ; Disclosure ; Drug Prescriptions* ; Electronic Mail ; Follow-Up Studies* ; Hospitals, General ; Hospitals, University ; Human Rights ; Humans ; Male ; Outpatients ; Postal Service ; Prescriptions ; Psychiatry

Swallowing caustic materials may produce full-thickness burn and loss of esophageal function. Caustics, both acid and alkalis, can corrode and destroy living tissue. Full-thickness burn of esophiageal epithelium causes severe stricture which frequently requires surgical repair. Recently, non-operative dilatation of luminal stenosis has been utilized. Esophageal endoscopic endoprosthesis has been used widely in malignant esophageal stricture but not in benign stricture. In recurrent benign esophageal stricture following repetitive balloon dilatation, we experienced a case of an 18-year-old woman with severe stricture which was successfully managed by esophageal endoprosthesia So we report this case with the review of the literature.
Adolescent ; Alkalies ; Burns ; Caustics ; Constriction, Pathologic ; Deglutition ; Dilatation ; Epithelium ; Esophageal Stenosis* ; Female ; Humans ; Lye* ; Phenobarbital