OBJECTIVETo explore the better therapy for chronic tension-type headache (CTTH).

METHODSTwo hundred and eighty-eight cases were randomized into a sticking needling group (150 cases) and an acupuncture group (138 cases). In the sticking needling group, the manual sticking needling technique was adopted to stimulate the galea tendon-muscle node. In the acupuncture group, the conventional acupuncture therapy was applied to Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Taiyang (EX-HN 5), Touwei (ST 18), Hegu (LI 4), etc. The treatment was given once a day, and 30 days made one session. After two sessions of treatment and after three months follow-up, CTTH score (including the score of headache attack frequency and the score of headache severity) was observed and compared before and after treatment separately. The efficacy was evaluated in two groups.

RESULTSCTTH score was all reduced after treatment in the two groups (both P<0.01), the score in the sticking needling group was lower than that in the acupuncture group (2.38 +/- 1.22 vs 4.16 +/- 2.54, P < 0.01). The effective rate was 97.3% (146/150) in the sticking needling group, which was better than 88.4% (122/138) in the acupuncture group (P < 0.05).

CONCLUSIONThe manual sticking needling technique at galea tendon-muscle node achieves the superior results of reducing the pain attack frequency and severity of CTTH as compared with the acupuncture therapy of the routine acupoint selection.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Muscles ; physiopathology ; Tendons ; physiopathology ; Tension-Type Headache ; physiopathology ; therapy ; Treatment Outcome

Objective To investigate children′s myelodysplastic hematopoietic cells reaction to interleukin (IL)-15.Methods CD 34 + cells in bone marrow from 18 myelodysplast syndrome(MDS) patients were purified by an immunomagnetic beads sorting system. Apoptosis of hematopoietic precursors was assayed by propidium iodine staining and flow cytometric analysis.Results On 8th cultured day,when IL-15 concentration was between 0-100 ng/ml,it could suppress apoptosis of hematopoietic cells in MDS patients in a dose-and- time dependent manner. IL-15 in study group significanthy lower than that of control group.Conclusion IL-15 may partly suppress apoptosis of hematopoietic cells in MDS patients.

Objective To evaluate the effect of multiplex polymerase chain reaction(Multiple-PCR) in identification of Brucella strains.Methods Six standard Brucella strains (Brucella abortus,Brucella melitensis,Brucella suis,Brucella canis,Brucella ovis,Brucella neotomae) were used as positive controls and Escherichia coli O∶157 and Yersinia enterocolitica O∶9 were used as negative controls.A total of 29 Brucella strains were tested.Brucella strains were amplified by BCSP31-PCR and the species of Brucella with positive results were identified with Multiple-PCR method.Results The results of all 29 amplified Brucella strains were positive with BCSP31-PCR.The identified results of all Brucella strains were positive with Multiple-PCR,including 20 strains of Brucella melitensis,5 isolates of Brucella suis,3 strains of Brucella abortus and 1 strain of Brucella canis.Conclusion Multiple-PCR method is a rapid,specific,simple and low risk method for identification of Brucella species.

Cognitive deficits due to posttraumatic stress disorder (PTSD) affect patients’ social and occupational functioning and lead to social costs. Thus, it is important to understand the nature and extent of PTSD-related neurocognitive deficits to clarify the mechanisms underlying cognitive changes, identify factors that interfere with treatment, and help interpret clinical profiles. This study reviewed recent studies on the relationships between PTSD and neurocognitive domains. The magnitude of the influence of PTSD differs across cognitive function domains. Also, the extent of the effect on any given domain may also differ according to the type of trauma experienced by the subject. In addition to its negative effects on cognitive functioning, PTSD was associated with increased response to threats or trauma-related stimuli, which compromised task performance. Although each PTSD symptom may have a different effect on each cognitive function, it was difficult to generalize the results. This study is significant in that our conclusions, which emerged through a review of studies regarding the relationship between PTSD and cognitive functioning, provide a theoretical basis for further research.

OBJECTIVETo observe therapeutic effects of different acupuncture methods for recovery of mimetic function in the patient of spontaneous facial paralysis.

METHODSOne hundred and thirty-four cases of facial paralysis were randomly divided into a mimetic muscle acupuncture group (mimetic muscle group, n = 79) and a routine acupoint group (n = 55). The mimetic muscle group were treated by encircling needling frontal belly of epicranial muscle, orbicular muscle of eye, orbicular muscle of mouth and buccinator muscle, and the routine acupoint group with acupuncture at Dicang (ST 4), Jiache (ST 6), Yangbai (GB 14), Sibai (ST 2), Cuanzhu (BL 2), etc. on the affected side. Their therapeutic effects were compared after they were treated for 2 courses.

RESULTSThe effective rate and the good rate were 94.9% and 92.4% in the mimetic muscle group and 70.9% and 52.7% in the routine acupoint group, respectively, with a significant difference between the two groups (P < 0.05).

CONCLUSIONThe therapeutic effect of needling the mimetic muscle on spontaneous facial paralysis is superior to that of the routine acupuncture therapy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Facial Muscles ; physiopathology ; Facial Paralysis ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Liver abscess is a rare disease but shows a high mortality rate. The standard treatment is complete drainage of the abscess through surgery or insertion of a percutaneous catheter and proper antibiotic treatment. However, successful percutaneous drainage in a multiseptated abscess has several drawbacks, such as the necessity for inserting more than one catheter for proper drainage, a necessity for repetitive cathterization and moreover, the ultimate failure of effective drainage causing surgery to become inevitable. The authors used 80,000 IU urokinase three times per day over 5 days to lyse the fibrous septum in a 9-year-old child with multiseptated liver abscess. Catheter drainage with urokinase under radiologic intervention yielded successful a outcome in the treatment of a multiseptated liver abscess.
Abscess ; Catheters ; Child ; Drainage* ; Humans ; Liver Abscess* ; Liver* ; Mortality ; Rare Diseases ; Urokinase-Type Plasminogen Activator*

BACKGROUND: The etiology of choledochal cysts is unknown, but the theory of pancreatobiliary reflux through an anomalous pancreatobiliary ductal union (APBDU) is widely accepted. The aim of this study was to evaluate the correlation between choledochal cysts and APBDUs in children. METHODS: We retrospectively analyzed 33 pediatric patients with choledochal cyst who had undergone excision of the whole extrahepatic bile duct along with hepaticoenterostomy at the Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine, from 1993 to 1998. RESULTS: The mean age of the patients was 51 months, and the ratio of males to females was 1:2.3. Anatomical types were Ia (n=17, 52%), Ic (n=11, 33%), III (n=1, 3%), and IVa (n=4, 12%) in the Todani classification of biliary cysts. We performed endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, or intraoperative cholangiopancreatography in all cases. An APBDU was identified in 24 patients (73%): right angle union (n=11, 33%), acute angle union (n=11, 33%), or a complex union (n=2, 6%) in the Todani classification of APBDUs. Type Ia cystic lesions correlated with right angle unions whereas Type Ic cylindrical lesions correlated with acute angle unions. The mean age of patients with a Type Ic, acute angle union was older than that of patients with a Type Ia, right angle union. In Type Ic, the amylase levels in serum and bile were elevated, but in Type Ia, they were not. CONCLUSIONS: APBDUs correlated highly with the shape of the extrahepatic dilatation, the age at onset, and the reflux of pancreatic juice. We think the excision of the entire extrahepatic duct along with a hepaticoenterostomy and appropriate evaluation of the APBDU are essential for the treatment of choledochal cysts in children.
Amylases ; Bile ; Bile Ducts, Extrahepatic ; Child* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst* ; Classification ; Dilatation ; Female ; Humans ; Male ; Pancreatic Juice ; Retrospective Studies

A national sample survey of medical students about their perception and evaluation on medical study, career plan, and medical care system was conducted in December 1997 through January 1998. About 10% of all the medical students in 32 medical schools that had students from freshman to senior in November 1997 were systematically sampled for a questionnaire survey. Out of 1,386 students, 1,233(89.0%) had responded and 12 of them were excluded from the analysis because of incomplete response. This report is the second part of the study regarding career plan of students after graduating from medical school. Criteria of medical students for choosing specialty of medicine are professional reward and personal interest. Among the respondents, 92.2% plan to choose clinical medicine, 2.5% basic medical sciences, and 4.8% special areas of medicine such as health administration, medical engineering, forensic medicine, medical education, and health economics. If it is guaranteed that they will be a professor after training, 8.8% of them want to study special areas of medicine, and 7.3% basic medical sciences. The students who had admitted to a medical school after obtaining bachelor's degree were more prone to choose clinical medicine than other students. The most common reason for not choosing basic medical sciences was lower income than clinician. Among the students who want to be a clinician, 92.2% want to be a specialist and the preferred specialties were internal medicine 36.0%, orthopedics 9.0%, general surgery 7.7%, psychiatry 7.5%, and pediatrics 5.7%. Comparing with the findings of 1983 study, the proportions of students who want to major internal medicine and minor subjects were markedly increased and that of general surgery increased slightly while that of pediatrics was decreased. The places of work that the students prefer in the future were university hospital 43.2% (10% point increase from the finding in 1983), general hospital 37.1% and private practice 9.4% (10% point decrease from the finding in 1983). It was noticeable that some of the students want to be a medical missionary and health administrator. The students prefer their university hospital most for post-graduate training and the reason is only because it is their alma mater. One can anticipate from these findings that it will be very difficult to get basic medical scientists and primary physicians in the future.
Administrative Personnel ; Clinical Medicine ; Surveys and Questionnaires ; Education, Medical ; Forensic Medicine ; Hospitals, General ; Humans ; Internal Medicine ; Missions and Missionaries ; Orthopedics ; Pediatrics ; Private Practice ; Reward ; Schools, Medical* ; Specialization ; Students, Medical* ; Workplace

Primary splenic tumors are rare and mainly found incidentally on radiologic studies. Among them, sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion. Most SANTs have no clinical symptoms and are occasionally accompanied by other splenic diseases such as malignancies. So, the exact diagnosis of the nature of the splenic tumor is mandatory for further treatment. But, preoperative diagnosis is not easy since it is difficult to obtain the tissue from the spleen for pathological study. Recently, laparoscopic splenectomy has become the more standard procedure for the spleen for diagnosis and treatment. Here, we report a rare case of SANT diagnosed following laparoscopic splenectomy.
Spleen ; Splenectomy ; Splenic Diseases

No abstract available.
Congenital Hypothyroidism*