No abstract available.
Arthritis* ; Open Bite*

Two cases with generalized G.A. were described. The first case was 42 years, old farmer representing slightly erythematous multiple papulonodular lesions on the face, neck, scapular areas, arms and dorsal hands. Coalescence of lesions in some areas of the dorsal hands and neck produced circinate or polycyclic pattern. The second case was 4 years old girl who developed purple to brown muliple papulonodular lesions and polygonal or round plague on the arms, dorsal hands, palms, neck, iliac crests, lower legs, dorsal feet and sole. The plague lesions mimick lichen planus.
Arm ; Child, Preschool ; Female ; Foot ; Granuloma Annulare* ; Granuloma* ; Hand ; Humans ; Leg ; Lichen Planus ; Neck ; Plague

A female newborn had the following characteristics; a congenital localized absence of skin over the lower extremities; blistering of the skin or mucous membrane, incited by trauma, which heals without scarring; and congenital absence or deformity of the nails. In respect to the characteristic manifestation, clinical course and electron microscopic features, our patient seems to fit well into Bart's syndrome. The inheritance pattern appears to be autosomal dominant but, as in this report, isolated cases have been recognized. As the review of the literatures, congenital localized absence of skin has been observed in various subsets of inherited E.B. But, we believe that the term Bart's syndrome should be used to identify patients with good prognosis as the Bart's initial description To the best of our knowedge, this is the first reported case of Bart's syndrome in the korean literature.
Blister ; Cicatrix ; Congenital Abnormalities ; Female ; Humans ; Infant, Newborn ; Inheritance Patterns ; Lower Extremity ; Mucous Membrane ; Prognosis ; Skin

The Persistent auditory hallucinations may provoke the uncomfortable feeling and can be dangerous according to its contents in treatment-resistant schizophrenic patients. Previous functional brain imaging studies on auditory hallucinations reported that the abnormal activations of the normal auditory pathway and the activations of the left upper temporal lobe were found while patients were hallucinating voices. Base on the these findings, we treated a female schizophrenic patient with persistent auditory hallucinations that were treatment-refractory with rTMS and the ECT continuously while she was on the drug treatment. The total amount of pulses applied in each trial ranged from 240 to 1000pulses. Fourteen trials were done and resulted in decrease by 30% in the subject severity of auditory hallucinations and the improvement of the affect. Two weeks after the completion of rTMS trials, nine trials of ECT were administered which leaded to complete disappearance of auditory hallucinations. This result suggest that ECT is more effective than rTMS in treating persistent auditory hallucinations in treatment-resistant schizophrenic patients.
Auditory Pathways ; Female ; Functional Neuroimaging ; Hallucinations* ; Humans ; Schizophrenia ; Temporal Lobe ; Transcranial Magnetic Stimulation ; Voice

A 7 day old female baby suffered from perinatal asphyxia and trauma at birth. Subsequently, she had a violeceous subcutaneous plaque on back. The clinical setting, the skin manifestation and the histologic findings of the lesion were diagnostic of subcutaneous fat necrosis of the newborn. Histologic findings revealed fat necrosis with infiltration of inflammatory cells, foreign body giant cells and several fat cells contain needle shaped cleft in radial arrangement. Four weeks latter, the skin lesion was healed spontaneously.
Adipocytes ; Asphyxia ; Fat Necrosis ; Female ; Giant Cells, Foreign-Body ; Humans ; Infant, Newborn* ; Necrosis* ; Needles ; Parturition ; Skin ; Skin Manifestations ; Subcutaneous Fat*

The authors would like to correct Figure 1 and 2.

Comminuted proximal humeral fractures with displaced three- or four-part fragments, fracture-dislocations, and humeral head-splitting fractures are very difficult to treat. In older patients, hemiarthroplasty or reverse shoulder arthroplasty is often the indicated treatment. Arthroplasty in this patient cohort is a very technique-dependent procedure, and relies on preserving deltoid function, proper component placement and fixation, and tuberosity fixation. Although pain relief is predictable, it is often difficult to achieve functional improvement. Results depend on the patient's age, timing of the surgery, tuberosity healing, and adequate rehabilitation.
Arthroplasty ; Cohort Studies ; Hemiarthroplasty ; Humans ; Humerus ; Shoulder ; Shoulder Fractures

Primary subacute pyogenic osteomyelitis is defined as a bone infection of insidious onset lasting for more than several weeks without any acute systemic toxic reactions and is known to have the problem of diagnosis because there is no inflammatory symptoms or signs and X-ray findings are similar to various bone tumors. Authors reviewed 29 cases of primary subacute pyogenic osteomyelitis of long bones admitted at Fatima hospital during the years between 1976 and 1984. The osteomyelitis of infants and the osteomyelitis modified by antibiotics were excluded. The diagnosis of the cases was confirmed by bacteriological examination and/or tissue examination. The results were as follows. 1. The cases were 18 males and 11 females and 19 adults and 10 children. Male predominence was noted in children. 2. The involved bones were 11 tibias, 10 femurs and all other long bones. The involved sites were 18 metaphysis and 11 shafts. 3. All of the cases has insidious onset of local pain without any acute systemic symptoms and most of the cases has local tenderness but local deep swelling noted in about half of the cases. 4. There were many cases with elevated ESR and a few cases of slight leukocytosis. 5. The confirmed infecting organism was all staphylococcus in 16 cases of the cultures from the 25 lesions. 6. The X-ray findings were Brodies abscess in 10, illdefined cavity in 3, diffuse bones absorption in 5, diaphyseal lesion of adult with localized cortical sclerosis in 5 and with localized medullary abscess in 3 and diaphyseal lesion of children with localized medullary abscess and periosteal reaction in 3 cases. 7. All of the cases cured rapidly with rare recurrence after treatment by simple local excision in 4 and curettage in 22 cases combined with antibiotic therapy and local immobilization.
Abscess ; Absorption ; Adult ; Anti-Bacterial Agents ; Child ; Curettage ; Diagnosis ; Female ; Femur ; Humans ; Immobilization ; Infant ; Leukocytosis ; Male ; Osteomyelitis ; Recurrence ; Sclerosis ; Staphylococcus ; Tibia

Objective: The relationship between benzodiazepine use and cognitive decline in insomnia patients has been reported, but still conflicting. Thus, we tried to determine whether long-term exposure of benzodiazepine might be associated with changes of cognition and electroencephalography (EEG) findings in patients with chronic insomnia. Methods: Insomniacs using benzodiazepines (n=29), drug-free insomniacs (n=27), and age- and sex-matched controls (n=28) were recruited. Neurocognitive function tested with Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease Assessment Packet Neuropsychological Assessment Battery, quantitative EEG in awake state, and information of benzodiazepine usage were obtained. Results: Drug-free insomniacs reported more severe symptoms than insomniacs using benzodiazepine (p<0.001). Insomniacs using benzodiazepine showed a decrease of executive function in Trail Making Test A than drug-free insomniacs and controls (0.73±0.66 vs. 1.27±0.38 vs. 1.09±0.47, p<0.001) and in categorical fluency than drug-free insomniacs (-0.01±0.99 vs. 1.26±0.97, p=0.002). However, such decrease of executive function was not proportional to daily dose or cumulative dose of benzodiazepine. The EEG was not significantly different between insomniacs using benzodiazepine and drug-free insomniacs, while EEG of insomniacs showed low relative theta power in frontal and parietal regions but high relative beta power in frontal region than that of controls. Conclusion Benzodiazepine users with chronic insomnia showed an impairment of executive function compared to drug-free insomniacs and controls although they showed relatively decreased severity of insomnia symptoms. Chronic insomniacs showed a hyper-arousal manifestation in front-parietal region of brain regardless of benzodiazepine exposure.

Sleep is vital for adolescents’ physical and emotional development; however, sleep disturbances and disorders frequently occur in this age group and affect their health and well-being. In this review, we investigated the prevalence, etiology, diagnosis, clinical characteristics, and treatment of sleep disorders observed among adolescents.Current Concepts: The diagnostic criteria for insomnia disorder among adolescents include difficulties in falling asleep, maintaining sleep, or waking up too early and feeling unrefreshed, which are observed at least 3 days per week over 3 or more months. Cognitive-behavioral therapy for insomnia typically includes identifying and addressing negative thoughts and behaviors associated with sleep and establishing a consistent sleep-wake schedule. Delayed sleep phase syndrome is diagnosed in individuals in whom sleep onset and wake times are persistently delayed by 2 or more hours beyond the desired or existing sleep schedule, which leads to excessive daytime sleepiness or impaired functioning. Behavioral interventions comprise sleep hygiene education, relaxation techniques, and phototherapy. Symptoms such as pronounced snoring, apnea observed by others, and gasping or pauses in breathing during sleep may indicate sleep apnea. Continuous positive airway pressure therapy is an effective treatment strategy for sleep apnea. A history of excessive daytime sleepiness and cataplexy suggests narcolepsy, and treatment options include pharmacotherapy, behavior modification, and lifestyle adjustments. Restless leg syndrome treatments include behavioral therapy, as well as anticonvulsant and dopamine receptor agonist administration.Discussion and Conclusion: Addressing sleep disorders is important to promote optimal health and well-being of adolescents and requires a multidisciplinary approach. Early detection, accurate diagnosis, and individualized treatment improve sleep and overall health outcomes and promote academic and social success.