No abstract available.

OBJECTIVES: Oriental medicine has affected the way in which Koreans seek psychiatric help and how they understand psychiatric symptoms and mental illnesses. In this study, we investigated the concept of psychosis in traditional oriental medicine and compared it with how modern western medicine understands the same concept. METHODS: We searched for descriptions of psychotic symptoms or illnesses in traditional medical documents of various periods. Four psychiatrists then analyzed the contents of these descriptions in terms of DSM-IV. RESULTS: The concept of psychosis in oriental medicine has two symptom domains: positive and negative symptoms, which are similar to the positive and negative symptoms of schizophrenia in modern psychiatry. However, there were differences in the basic concepts of disease entities and in the approaches to the illness. CONCLUSION: This descriptive study showed that, in oriental medicine, psychopathology is based on oriental philosophy, and that this creates wide differences between oriental and western medicine.
Medicine, East Asian Traditional ; Medicine, Traditional ; Philosophy ; Psychiatry ; Psychopathology ; Psychotic Disorders ; Schizophrenia

We report a case of atypical neuroleptic malignant syndrome (NMS) induced by olanzapine. It was expected that this atypical agent would not cause dystonia or NMS due to its unique mechanism of action with attenuated anti-dopamin-ergic activity and potentiated antiserotonergic activity, as well as other anti-cholinergic activity. We report the case of a 74-year-old male patient with Alzheimer's disease in whom signs and symptoms consistent with NMS developed following 2 weeks of olanzapine therapy. The patient presented with fever, changes in mental status, tremor, and rigidity. His laboratory findings were significant for increased serum creatine phosphokinase. The NMS subsided after treatment and the restart of olanzapine therapy was performed successfully. There have been few reported cases of olanzapine-induced NMS. Health care providers should be aware of the risk of olanzapine-induced NMS.
Aged ; Alzheimer Disease ; Creatine Kinase ; Dystonia ; Fever ; Health Personnel ; Humans ; Male ; Neuroleptic Malignant Syndrome ; Tremor

Infantile fibrosarcoma is a rare malignant soft tissue tumor occurring especially in newborn and young children under 2 years. We experienced three cases of infantile fibrosarcoma presenting in the neonatal period. Case 1 presented with a multiseptated cystic mass on his left thigh at birth that was diagnosed as lymphangioma. After picibanil injection, we noted the size of the mass doubled and a solid lesion was prominent in the magnetic resonance image. Case 2 was found to have a reddish mass on his lower back mimicking hemangioma. Over 2 weeks, the mass grew rapidly with internal hemorrhaging. Case 3 was noted to have an encircling mass around the splenic flexure, which developed into congenital bowel obstruction. All of the tumors were resected completely, but microscopic resection margin was not clear in two patients. The two patients received adjuvant chemotherapy and all patients are well without evidence of recurrence.
Chemotherapy, Adjuvant ; Child ; Colon, Transverse ; Fibrosarcoma ; Hemangioma ; Humans ; Infant, Newborn ; Lymphangioma ; Magnetic Resonance Spectroscopy ; Parturition ; Picibanil ; Recurrence ; Thigh

Eleven cases of arthroscopic ankle arthrodesis were reviewed. Average age of patients was 59 years, 4 male and 7 female. Underlying diseases were osteoarthritis in 7 cases, rheumatoid arthritis in 3 cases and one post-traumatic arthritis. At the mean follow up of 15 months, fusion rate was 100%, mean time to complete union was 9.5 weeks. There were no complications such as nonunion, infection and skin problems. All patients stayed at the hospital just overnight after the surgery. Patients satisfaction was high and the functional clinical grade was excellent in 9 patients, good in 1 patient and fair in 1 patient. We concluded that arthroscopic technique was a simple and effective method for ankle arthrodesis in the selected patients and had significant advantages over the open technique.
Ankle* ; Arthritis ; Arthritis, Rheumatoid ; Arthrodesis* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Osteoarthritis ; Skin

Since the first report by Berberich and Hirsch in 1923, conventional angiography had been playing essential roles in diagnosis and treatment in the field of Orthopedic Surgery. Angiography is still the most definitive method for evaluating arterial disease, and is also an invaluable aid in the diagnosis of certain abnormalities which characteristically alter the normal vascular pattern. But the clinical use of conventional angiography as a routine diagnostic study has been limited by the risk associated with arterial catheterization cost, and poor patient acceptance. With improvement of radionuclide angiography and development of the methods for the identification and amplification of signals from small quantities of intravascular administered iodinated contrast agent and their combination with image subtraction (so called digital subtraction angiography, DSA), we have partially substituted the DSA and Radionuclide angiography for conventional angiography in diagnosis and post-operative evaluation of orthopedic patients. We have analyzed and compared the 197 cases who had taken conventional angiography from August, 1981 to July, 1985, and 16 cases who had taken radionuclide angiography from January, 1983 to July, 1985, and 21 cases who had taken DSA from October, 1983 to July, 1985 in Department of Orthopedic Surgery, Seoul National University Hospital. The results were as follow: 1. Conventional angiography is the most reliable and most widely used method in diagnosis of peri pheral arterial disease and evaluating the distribution of peripheral circulation of patient who need arterial reconstruction. But the clinical use of the angiography has been limited by the risk of complications. 2. DSA is simple, relatively non-invasive and can be done in out-patient basis. DSA is particulary useful and can replace the conventional angiography in post-operative assessment of peripheral vascular reconstruction, in the assessment of blunt and penetrating peripheral arterial trauma, and in the evaluation of peripheral aneurysm and vascular malformation. 3. Radionuclide angiography is also simple, and has no morbidity and useful in the patients who may be allergic to the contrast medium. Radionuclide angiography is useful in the evaluation of obstruction of major artery, deep vein thrombosis, and in repeated post-operative evaluation of arterial reconstruction.
Aneurysm ; Angiography ; Angiography, Digital Subtraction ; Arteries ; Catheterization ; Catheters ; Diagnosis ; Extremities ; Humans ; Methods ; Orthopedics ; Outpatients ; Radionuclide Angiography ; Seoul ; Vascular Malformations ; Venous Thrombosis

OBJECTIVES: Apathy Evaluation Scale (AES) is one of the most frequently used scales to evaluate apathy. The purpose of this study was to evaluate the reliability and validity of the Korean version of the AES (K-AES) and to apply the K-AES in examining the characteristics of apathy in the Korean patients with schizophrenia. METHODS: 129 healthy people and 29 patients with schizophrenia have been evaluated using the K-AES, Physical Anhedonia Scale (PAS), Social Anhedonia Scale (SAS), and the Beck's Depression Inventory (BDI). Split-half reliability and internal consistency were evaluated and factor analysis and correlation analysis was conducted. Between-group comparison was conducted using independent sample t-tests. RESULTS: K-AES showed good reliability and validity. Factor analysis confirmed 3 factors, which represented interest and drive, initiative, self-awareness and self-assessment. Patients with schizophrenia showed significantly higher K-AES and BDI scores than the healthy group. K-AES scores in patients with schizophrenia were significantly correlated with the PAS score, but did not correlate with SAS and BDI scores. CONCLUSION: This study demonstrates the reliability and validity of the K-AES. Our findings also suggest that the K-AES may be a reliable instrument in assessing apathy as a negative symptom in patients with schizophrenia.
Anhedonia ; Apathy* ; Depression ; Factor Analysis, Statistical ; Humans ; Reproducibility of Results* ; Schizophrenia* ; Self-Assessment ; Weights and Measures

Several case reports suggest that neurosurgical operations can improve symptoms in patients with severe treatment-refractory obsessive-compulsive disorder (OCD). However, it is unclear which procedure is best and which may produce the most side-effects. We also review recent ethical issues related to the procedures. We review the literature on the efficacy and complications of frequently used neurosurgical procedures that are used to treat refractory OCD and related ethical issues. Since the vast majority of patients who underwent surgery were severely and chronically disabled, it is likely that these procedure were of assistance in alleviating some of their symptoms. It is currently impossible to determine which surgical procedure is the best for a particular patient. Since the psychosurgery is reported as effective in the area of human behavior and psychopathology, the indication for operation demand strict ethical process. Recent studies report that strict informed consent and the evaluation for competence to decide whether to get operation with free will should be taken so as to stress the autonomy of patients for the treatment. Despite a lack of controlled data and inconsistencies in the literature, it appears that when nonsurgical treatments have failed to improve OCD symptoms significantly in severely ill patients, at least partial relief can be obtained by some people with OCD by neurosurgery. Results of cumulative studies strongly support the need for continued research in this area.
Ethics* ; Humans ; Informed Consent ; Mental Competency ; Neurosurgery ; Neurosurgical Procedures ; Obsessive-Compulsive Disorder* ; Personal Autonomy ; Psychopathology ; Psychosurgery

Clinical studies have shown various relationships between soft neurological signs and therapeutic effects of antipsychotic drugs in patients with schizophrenia. This study was purposed to compare soft neurological signs in patients before and after administration of antipsychotic drugs and thus to confirm the relationships between soft neurological signs and therapeutic effects of antipsychotic drugs in patients with schizophrenia. Twenty-five schizophrenic patients were treated with antipsychotic drugs for 8 weeks after at least 7 days of drug-free period. The soft neurological signs were assessed by using the Neurological Evaluation Scale-Korean Version(NES-K). The baseline assessment was performed just before the antipsychotic drug trial and following assessments were repeated every 4 weeks until the end of 8-week antipsychotic drug treatment. The therapeutic effects were assessed by using Positive and Negative Syndrome Scale(PANSS) at baseline just before antipsychotic drug trial, and every 4 weeks until the end of 8-week antipsychotic drug treatment. Total scores of NES-K, scores of its subcategories including sensory integration, motor coordination, sequencing of complex motor acts, and other items were shown to decrease significantly 8 weeks after initiation of antipsychotic drugs. Among those above scores, both the changes of total scores of NES-K and other items were significantly correlated with the changes of negative scores, general psychopathology scores, and total scores of PANSS. Thirteen patients who were categorized as responders, showed at least 20% decrease in PANSS total score. The responders showed more decrement(p<0.05) in total scores of NES-K and scores of sequencing of complex motor acts than twelve nonresponders. These results showed that the scores of NES-K were significantly correlated with the improvement of PANSS score. It is therefore reasonable to suggest that the changes of NES-K scores were significantly correlated with the therapeutic effects of antipsychotic drugs. The changes of soft neurological signs in patients with schizophrenia may be associated with the antipsychotic drug effect.
Antipsychotic Agents* ; Humans ; Psychopathology ; Schizophrenia*

In addition to severe deficits in speech production and auditory comprehension, patients with global aphasia general-ly have a dense hemiplegia. However, acute global aphasia without hemiparesis (GAWH) occurs rarely and only a few cases of GAWH have been reported with variable conclusions regarding lesion localization, etiology, and prognosis. We report an unusual case of GAWH in which magnetic resonance imaging (MRI) and single photon emission comput-ed tomography (SPECT) revealed only a single lesion of the left superior temporal area. Our case supports the notion that the functional anatomy of aphasia may be complex and that GAWH may have a more benign prognosis than typi-cal global aphasia with hemiparesis.
Aphasia* ; Comprehension ; Hemiplegia ; Humans ; Magnetic Resonance Imaging ; Paresis* ; Prognosis ; Tomography, Emission-Computed, Single-Photon