Rud's syndrome (RS), basically composed of ichthyosis, mental deficiency and hypogonadism, is a rare hereditary disease. Some varying dermatologic, neurologic, endocrinologic, ophthalmologic and musculoskeletal abnormalities have coincided with RS. No case of RS has been documented from Asian countries except one from Japan. We describe a 16-year-old girl who presented with lamellar ichthyosis, mental retardation, hypogonadism, short stature, alopecia, sparse eyebrows, strabismus, cataracts, and congenital dislocation of the hip. To our knowledge, RS coexisting congenital dislocation of the hip herein is the first case in English literature.
Adolescent ; Alopecia ; Asian Continental Ancestry Group ; Cataract ; Dislocations ; Eyebrows ; Female ; Genetic Diseases, Inborn ; Hip ; Humans ; Hypogonadism ; Ichthyosis ; Ichthyosis, Lamellar ; Intellectual Disability ; Japan ; Musculoskeletal Abnormalities ; Strabismus

Ultrasonographic and radiographic findings in 72 cases of pelvic masses which have been provedhistopathologically were analyzed. The results were as follows; 1. Among 72 cases, 28 cases were uterine massesand 44 cases were adnexal masses. 2. Pathologic accuracies of ultrasonographic diagnosis were 64.3% in uterinemasses, 70.5% in adnexal masses, and 68.1% in all pelvic masses. 3. Plain or IVP findings were not specific indiagnosis and showed secondary mass effects or functional disturbances. 4. Because of its high accuracy ofpathologic diagnosis and safety, ultrasonography can be regared as the most valuable and preferential study. Butin cases of cystic myomas, endometrioses, cystic missed abortions and huge masses, the accurate diagnoses weredifficult.
Abortion, Missed ; Diagnosis ; Endometriosis ; Female ; Myoma ; Pregnancy ; Ultrasonography

PURPOSE: To evaluate the clinical outcomes of balanced deep lateral and medial orbital wall decompression and to estimate surgical effects using computed tomography (CT) images in Korean patients with thyroid-associated ophthalmopathy (TAO). METHODS: Retrospective chart review was conducted in TAO patients with exophthalmos who underwent balanced deep lateral and medial orbital wall decompression. Exophthalmos was measured preoperatively and postoperatively at 1 and 3 months. Postoperative complications were evaluated in all study periods. In addition, decompressed bone volume was estimated using CT images. Thereafter, decompression volume in each decompressed orbital wall was analyzed to evaluate the surgical effect and predictability. RESULTS: Twenty-four patients (48 orbits) with an average age of 34.08 ± 7.03 years were evaluated. The mean preoperative and postoperative exophthalmos at 1 and 3 months was 18.91 ± 1.43, 15.10 ± 1.53, and 14.91 ± 1.49 mm, respectively. Bony decompression volume was 0.80 ± 0.29 cm3 at the medial wall and 0.68 ± 0.23 cm3 at the deep lateral wall. Postoperative complications included strabismus (one patient, 2.08%), upper eyelid fold change (four patients, 8.33%), and dysesthesia (four patients, 8.33%). Postsurgical exophthalmos reduction was more highly correlated with the deep lateral wall than the medial wall. CONCLUSIONS: In TAO patients with exophthalmos, balanced deep lateral and medial orbital wall decompression is a good surgical method with a low-risk of complications. In addition, deep lateral wall decompression has higher surgical predictability than medial wall decompression, as seen with CT analysis.
Decompression* ; Exophthalmos ; Eyelids ; Graves Ophthalmopathy ; Humans ; Orbit* ; Paresthesia ; Postoperative Complications ; Retrospective Studies ; Strabismus ; Troleandomycin

Chondrosarcoma is an uncommon neoplasm originated from cartilage cells. This occurs less than 10% in the head and neck region. Chondrosarcoma of the condyle affects mainly women. The most common symptom is swelling in the preaucricular region, limited mouth opening and pain on chewing. This report describes a case of chondrosarcoma, which occurred in the mandibular condyle.
Cartilage ; Chondrosarcoma ; Female ; Head ; Humans ; Mandibular Condyle ; Mastication ; Mouth ; Neck

OBJECTIVE: We investigated the deficit in the recognition of facial emotions in a sample of medicated, stable Korean patients with schizophrenia using Korean facial emotion pictures and examined whether the possible impairments would corroborate previous findings. METHODS: Fifty-five patients with schizophrenia and 62 healthy control subjects completed the Facial Affect Identification Test with a new set of 44 colored photographs of Korean faces including the six universal emotions as well as neutral faces. RESULTS: Korean patients with schizophrenia showed impairments in the recognition of sad, fearful, and angry faces [F(1,114)=6.26, p=0.014; F(1,114)=6.18, p=0.014; F(1,114)=9.28, p=0.003, respectively], but their accuracy was no different from that of controls in the recognition of happy emotions. Higher total and three subscale scores of the Positive and Negative Syndrome Scale (PANSS) correlated with worse performance on both angry and neutral faces. Correct responses on happy stimuli were negatively correlated with negative symptom scores of the PANSS. Patients with schizophrenia also exhibited different patterns of misidentification relative to normal controls. CONCLUSION: These findings were consistent with previous studies carried out with different ethnic groups, suggesting cross-cultural similarities in facial recognition impairment in schizophrenia.
Collodion ; Ethnic Groups ; Humans ; Schizophrenia

OBJECTIVE: Although clinical guidelines for major depressive disorder (MDD) recommended sufficient duration of treatment, many patients discontinue antidepressant medication early in the course of treatment in clinical practice. In this study, we investigated the rate of early treatment-discontinuation and risk factors related to the discontinuation. METHODS: Medical records of 400 outpatients were reviewed. Patients who were diagnosed as MDD according to the DSM-IV criteria and were prescribed a single antidepressant were included in this study. Information on age, sex, education, marital status, job, disease recurrence, clinical severity and type of antidepressant medications were obtained. The rate of early treatment-discontinuation and factors leading to early discontinuation were also investigated. RESULTS: Data of 354 patients were analyzed. Mean age was 50.6+/-15.9 years and female patients were 225 (63.6%). Treatment-discontinuation rate was 29.1% at 2 weeks and 43.5% at 6 weeks. Logistic regression analysis demonstrated that severity of depression decreased the risk of treatment-discontinuation at 2 weeks. Other clinical factors and type of antidepressant medications did not affect the risk of early treatment-discontinuation. CONCLUSION: This study shows that the rate of early treatment-discontinuation is high in patients with MDD in usual clinical practice. Considering chronicity and high relapse rate of MDD, education programs to enhance drug compliance in patients and their family are needed to reduce early treatment-discontinuation in MDD patients.
Female ; Humans ; Risk Factors

OBJECTIVES: The purpose of this study was to investigate whether elderly and young adults differ in their recognition of facial expressions of emotion. METHODS: A total of 120 (elderly group 53, young group 67) subjects participated in this study. Korean facial expressions of emotion including happiness, sadness, fear, anger, disgust, surprise and neutral were used as stimuli for facial affect recognition test. Computerized facial affect recognition test that consists of facial affect discrimination test and facial affect intensity test was performed. RESULTS: For facial affect discrimination test, there was a significant difference between two groups (F=3.986, p<.01) after controlling the effect of education. Elderly participants showed significantly less correct recognition rate with sadness, anger and disgust (p<.05). For facial affect intensity test, there was no significant difference between the groups in recognition of emotional intensity. Chi-square test or t-test was done according to the clinical variables. Multivariate analysis of covariance was done to test group differences of correct recognition rate and emotional intensity. CONCLUSION: This is the first report of differential decrease of facial affect recognition in elderly using Korean facial expressions. This study suggests that the decrement of facial affect recognition maye be a part of normal aging process.
Aged* ; Aging ; Anger ; Discrimination (Psychology) ; Education ; Facial Expression ; Happiness ; Humans ; Multivariate Analysis ; Young Adult

OBJECTIVE: This study investigated the impact of executive function on the performance of two different affective tasks, the Facial Affect Identification Task (FAIT) and the Iowa Gambling Task (IGT), in patients with schizophrenia. METHODS: Thirty-nine patients with schizophrenia and 33 healthy controls completed the FAIT and the IGT, followed by the Wisconsin Card Sorting Test (WCST) and the intelligence quotient (IQ) test. In addition to correlation analysis, regression analysis was used to determine the extent to which the performance of the WCST, in particular, perseverative error (PE), accounted for the variation in both the FAIT and the IGT. RESULTS: Relative to normal controls, patients with schizophrenia showed significant impairments in the IGT, the FAIT and the WCST even after controlling for IQ. While normal controls did not show any relationships between the WCST and two affective tasks, patients with schizophrenia showed that variables in the WCST correlated not only with the FAIT total correct score (r=-0.503, p=0.001 for PE) but also with the IGT net score (r=0.385, p=0.016 for PE). The PE score was a better predictor of the performance on the FAIT (R2=0.25) than that of the performance on the IGT (R2=0.15). CONCLUSION: Our findings imply that deficits in executive function in schizophrenia can affect performance on facial emotion recognition task more than performance on task based on emotion experience, that is, the feedback from the body. Therefore, more consideration is needed of the impact of executive function when interpreting the result of "conventional" facial affect recognition tests as opposed to interpreting the IGT.
Executive Function ; Gambling ; Humans ; Intelligence ; Iowa ; Schizophrenia ; Wisconsin

Lung lavage is an accepted modality for treatment of pulmonary alveolar proteinosis. The procedure can be accomplished by the use of double lumen endobronchial tube, with lavaging of one lung while the other is ventilated. As lung lavage is an intentional drowning, particular attention must be paid to potentially serious complications such as severe hypoxemia. We report a case of lung lavage in a patient with secondary pulmonary alveolar proteinosis performed safely by careful monitoring of oxygenation and hemodynamics.
Anoxia ; Bronchoalveolar Lavage* ; Drowning ; Hemodynamics ; Humans ; Lung ; Oxygen ; Pneumoconiosis* ; Pulmonary Alveolar Proteinosis*

BACKGROUND: A number of different weaning techniques can be employed such as spontaneous breathing trial, Intermittent mandatory ventilation(IMV) or Pressure support ventilation(PSV). However, the conclusive data indicating the superiority of one technique over another have not been published. Usually, a conventional spontaneous breathing trial is undertaken by supplying humidified O2 through T-shaped adaptor connected to endotracheal tube or tracheostomy tube. In Korea, T-tube trial is not popular because the high-flow oxygen system is not always available. Also, the timing of extubation is not conclusive and depends on clinical experiences. It is known that to withdraw the endotracheal tube after weaning is far better than to go through any period. The tube produces varying degrees of resistance depending on its internal diameter and the flow rates encountered. The purpose of present study is to evaluate the effectiveness of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube. METHODS: We analyzed the result of weaning and extubation following a 60 minutes spontaneous breathing trial with simple oxygen supply through the endotracheal tube in 18 subjects from June, 1993 to June, 1994. They consisted of 9 males and 9 females. The duration of mechanical ventilation was from 38 hours to 341 hours(mean: 105.9 +/- 83.4 hours). In all cases, the cause of ventilator dependency should be identified and precipitating factors should be corrected. The weaning trial was done when the patient became alert and arterial O2 tension was adequate(PaO2 > 55mmHg) with an inspired oxygen fraction of 40%. We conducted a careful physical examination when the patient was breathing spontaneously through the endotracheal tube. Failure of weaning trial was signaled by cyanosis, sweating, paradoxical respiration, intercostal recession. Weaning failure was defined as the need for mechanical ventilation within 48 hours. RESULTS: In 19 weaning trials of 18 patients, successful weaning and extubation was possible in 16/19(84.2% ). During the trial of spontaneous breathing for 60 minutes through the endotracheal tube, the patients who could wean developed slight increase in respiratory rates but significant changes of arterial blood gas values were not noted. But, the patients who failed weaning trial showed the marked increase in respiratory rates without significant changes of arterial blood gas values. CONCLUSION: The result of present study indicates that weaning from mechanical ventilation following a 60 minutes spontaneous breathing with O2 supply through the endotracheal tube is a simple and effective method. Extubation can be done at the same time of successful weaning except for endobronchial toilet or airway protection.
Cyanosis ; Female ; Humans ; Korea ; Male ; Oxygen ; Physical Examination ; Precipitating Factors ; Respiration* ; Respiration, Artificial ; Respiratory Rate ; Sweat ; Sweating ; Tracheostomy ; Ventilators, Mechanical ; Weaning*