We treated the persistent ruminative vomiting of a 13-year-old autistic boy by using a behavioral and psychopharmacological approach in a closed ward. Before the interventions, the patient had lost about 10kg of body weight due to very high-frequency ruminative vomiting. Together with psychopharmacological trials, the psychiatric treatment included a combination of a behavioral approach and food regulation that emphasized food restrictions, and we provided regular light meals. There was a considerable reduction of the ruminative vomiting and 2kg weight gain was achieved during the admission. These therapeutic gains were maintained at the 4-month follow-up assessment and the vomiting symptom reached a near-zero level and the weight loss were recovered by about 8kg. The issues related to the treatment approaches for ruminative vomiting with autism are discussed.
Adolescent ; Autistic Disorder ; Body Weight ; Follow-Up Studies ; Humans ; Light ; Meals ; Vomiting ; Weight Gain ; Weight Loss

Torsades de pointes, a polymorphic ventricular tachycardia associated with prolonged QT interval, is a well-known life-threatening arrhythmia, which has been found to be induced by various causes such as drugs, electrolyte imbalances, and severe bradycardia. Cisapride is a gastrointestinal prokinetic drug, which is widely used to treat gastroesophageal reflux disease or other functional gastrointestinal disorders. Cisapride can cause torsades de pointes and cases of torsedes de pointes induced by cisapride have been reported in other countries. Cases of torsades de pointes associated with antihistamine drugs have been reported in Korea, however, cisapride-induced torsades de pointes case has not been reported. We report a case of 31 year-old female patient who experienced repeated loss of consciousness due to cisapride-induced torsades de pointes.
Adult ; Arrhythmias, Cardiac ; Bradycardia ; Cisapride* ; Female ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Korea ; Tachycardia, Ventricular ; Torsades de Pointes* ; Unconsciousness

No abstract available.
Animals ; Peripheral Nerve Injuries* ; Peripheral Nerves* ; Rats* ; Sciatic Nerve*

PURPOSE: To evaluate the usefulness of automated biopsy guns in image-guided biopsy of lung, liver. pancreas and other organs. MATERIALS AND METHODS: Using automated biopsy devices, 160 biopsies of variable anatomic sites were performed:Biopsies were performed under ultrasonographic(US) guidance in 95 and computed tomographic (CT) guidance in 65. We retrospectively analyzed histologic results and complications. RESULTS: Specimens were adequate for histopathologic diagnosis in 143 of the 160 patients(89.4%)-Diagnostic tissue was obtained in 130 (81.3%), suggestive tissue obtained in 13(8.1%), and non-diagnostic tissue was obtained in 14(8.7%). Inadequate tissue was obtained in only 3(1.9%). There was no statistically significant difference between US-guided and CT-guided percutaneous biopsy. There was no occurrence of significant complication. We have experienced mild complications in only 5 patients-2 hematuria & 2 hematochezia in transrectal prostatic biopsy, and 1 minimal pneumothorax in CT-guided percutaneous lung biopsy. All of them were resolved spontaneously. CONCLUSION: The image-guided biopsy using the automated biopsy gun was a simple, safe and accurate method of obtaining adequate specimen for the histopathologic diagnosis.
Biopsy* ; Diagnosis ; Firearms* ; Gastrointestinal Hemorrhage ; Hematuria ; Image-Guided Biopsy* ; Liver ; Lung ; Pancreas ; Pneumothorax ; Retrospective Studies

We have clinically evaluated 40 cases of high myopia(47 catarctous eyes) with an axial length of over 26 mm which were treated with ECCE and posterior chamber intraocular lens implantation from January 1987 to June 1990 at the 51. Mary's Hospital in the Department of Ophthalmology of Catholic University Medical College. The results were as follows: 1. Most common axial length was from 26.00 mm to 26.50 mm in 24 eyes(51.5%)and most common anterior chamber depth was from 2.51 mm to 3.00 mm in 22 eyes(48.6%). 2. The most common associated diseaes was vitreous opacity(19 eyes: 40.4%). 3. Posterior chamber lens power ranged from +10.00D to +14.00D, and the most frequently implanted posterior chamber lens power was +10.50D. 4. Postoperative corrected visual acuity was the same as preoperative corrected visual acuity in 46 eyes(97.9%) and improved up to 0.5 or more in 31 eyes(66.0%).
Anterior Chamber ; Lens Implantation, Intraocular ; Myopia* ; Ophthalmology ; Visual Acuity

To evaluate the effects of interleukin-6(IL-6) on epithelial migration in corneal epithelial wound healing process after excimer laser surface ablation, the morphologic changes as well as the healing rate of the defect area were observed on 30 rabbits(60 eyes). The animals were divided into three groups of twenty each: the control group and the two IL-6 treated groups(eye dropping with 0.1mg/L and 1.0mg/L of IL-6). On light microscopic examination, after 9 hours, centripetal migration of epithelial cells and covering of bare stroma with monolayered epithelial cells were more remarkable in the 1.0mg/L group than in the control group, reaching the peak at 18 hours. On transmission electron microscopic examination after 18 hour, the 1.0mg/L group showed the loss of hemidesmosome beneath the leading edge of sliding epithelial cell, other intracellular structures were well preserved. On scanning electron microscopic examination, epithelial migration started at 9 hour in all three groups and the epithelial migration was more rapid in the 1.0mg/L group than in the control group. Fifteen hours and afterwards, the healing rate was significantly accelerated in the 1.0mg/L group than in the control group. In view of the above findings, it was speculated that IL-6 could be used effectively in the early treatment of excimer laser keratectomy and other corneal epithelial injury.
Animals ; Epithelial Cells ; Hemidesmosomes ; Interleukin-6* ; Lasers, Excimer* ; Rabbits* ; Wound Healing ; Wounds and Injuries*

Eight patients with cerebellopontine angle tumors larger than 3cm in diameter were operated on through retromastoid suboccipital approach with microsurgical technique. Patients were placed in lateral decubitus position with the head fixed by a three point Mayfield head-pin and the face was turned about fourty degree down as the imaginary petrous ridge directed to the floor, vertically. There are six acoustic neuromas, one meningioma and one hemangioblastoma presented in this report. The total tumor removal was done in all cases but one and the facial nerve was preserved anatomically in six of eight patients and in one of the other two the nerve was anastomosed in the same operative field following tumor excision. Functionally, two cases of facial paresis and one facial paralysis were resulted. Above results show that this approach is just suitable for total removal of the large cerebellopontine angle tumors with preservation of the facial nerve by neurosurgeon under best obtained neuroanatomical knowledge.
Cerebellopontine Angle* ; Facial Nerve ; Facial Paralysis ; Head ; Hemangioblastoma ; Humans ; Meningioma ; Neuroma, Acoustic*

The presnt study was carried out to find out any difference in terms of the rate of rebleeding, mortality and of the occurrence of vasopasm and hydrocephalus between the two groups of patients with subarachnoid hemorrhage : a group of 225 cases which were administered with epsilon aminocaproic acid(EACA) (antifibrinolytic agent) and the other a group of 221 cases without EACA treatment. Both groups were chosen from 476 patients admitted to the Department of Neurosurgery, Kyung-Hee University Medical Center within 7 days after the onset of subarachnoid hemorrhage during a period from January 1982 to December 1987. The clinical observation was done during acute period following subarachnoid hemorrhage. The major findings obtained were as follows : 1) The occurrence of rebleeding was higher within 3 days after the onset of subarachnoid hemorrhage. The rate of rebleeding was 8.4% in treated group whereas the rate was 13.1% in control group. This may suggest that administration of EACA is effective to prevent rebleeding. 2) the occurrence of vasopasm was higher within on the 7th and 8th day after the onset of subarachnoid hemorrhage. The rate of vasospasm was 28.9% in treated group whereas the rate was 12.4% in control group. This means that the rate of occurrence of vasospasm was two times higer in EACA treated group. 3) the rate of occurrence of hydrocephalus was 18.3% in treated group whereas the rate lower in control group(11.6%). 4) Within-two-weeks mortality and within-one-month mortality were 14.7% and 22.2% respectively in treated group whereas the two rates in control group were 15.1% and 24.1% respectively. No significant difference between the two groups was observed. 5) The causes of death in treated group were found to be vasospasm(55.5%) and rebleeding(28.0%) in order, whereas in control group the causes of deaths were rebleeding(40.2%) and vasospasm(21.3%). In other words, the main cause of death was vasospasm in treated and that in control group was rebleeding.
Academic Medical Centers ; Cause of Death ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Subarachnoid Hemorrhage*

Fourty six patient with chronic subdural hematoma(CSDH) were managed by simple closed drainage between January 1987 and January 1990. The osmolarity and its factors of fluid from CSDH were compared to that of simultaneously drawn venous blood in patients. The results were as follows ; 1) The values of K+ and albumin of the hematoma fluid were significantly higher than that of hematoma fluid(P<0.05). 2) Osmolarities of the hematoma fluid were higher than that of venous blood(P<0.01). 3) Osmolarity, K+ and albumin showed linear relationship between hematoma fluid and venous blood(P<0.01).
Drainage ; Hematoma* ; Hematoma, Subdural, Chronic* ; Humans ; Osmolar Concentration*

Diffuse brain swelling(bilateral swelling without shift or other lesions ; DBS) after severe head injuy in children is very common event and that DBS in children is thought to be associated with a low mortality, generally compared with adult. In this study, DBS ws compared in 9 Children and 18 adults, selected among 222 cases of severe head injured patients admitted to the Department of Neurosurgery for 4 years from January 1986 toDecember 1989. The results were summarized as follows ; 1) The incidence of DBS in children(39.1%) was about 4 time as high as for adult(9.0%). 2) There was no significant difference of mortality rate in pediatric and adult group showing DBS but there was a significant low mortality rate in pediatric group without showing DBS, in contrast to other studies.
Adult ; Brain Edema* ; Brain* ; Child ; Head* ; Humans ; Incidence ; Mortality ; Neurosurgery