Seperation anxiety disorder(SAD) is characterized by excessive anxiety about being apart from the individuals to whom a child is most attached. We noticed a case of a 13 year old boy's SAD with symptoms of nausea/vomiting, stomachache, school refusal, and severe weight loss. His mother was overanxious and overdependent but her'dependency was frustrated due to family problem. We investigated this case from a point of developmental aspect and family dynamics and tried to attempt therapeutic approach.
Anxiety Disorders* ; Anxiety* ; Child* ; Disulfiram* ; Humans ; Mothers ; Weight Loss*

No abstract available.

We reported herein a rare case of a 65-year-old female who lead intestinal tuberculosis of about 2 months duration, with little late development of metastatit berculosis abscess of the skin. The lesions were egg tow wolnut-sized abscesses or nodules occu in, on the back, right flank and lower abdomen with no pain or mild tenderness. Physical exami saion was unremarkable on dissemination of other sites. The tuberculin test was negative. The skin esions were diagnosed by clinical, histopathologic features, and positive results for Mycobactc iuntuberculosis in smear.; and cultures in the pus discharge: as well as polymerase chain reaction nethod on the nodular lesion. A barium enema showed the findings of intestinal tuberculosis, with positive culture in the stool. A combined treatment was intituted. During the initial 4 month, utaneous lesions did not respond and in some cases worsened with the multidrug of isoniazicr fampin, pyrazinamide and streptomycin, all of which were surgically excised. Thereafter, the drugs of isoniazid and rifampin were further administered for ahout 14 months, with the complete resecution of both lesions and the systemic symptomatolo. There was no relapse at follow-up after 6 months.
Abdomen ; Abscess* ; Aged ; Barium ; Enema ; Female ; Follow-Up Studies ; Humans ; Isoniazid ; Ovum ; Polymerase Chain Reaction ; Pyrazinamide ; Recurrence ; Rifampin ; Skin* ; Streptomycin ; Suppuration ; Tuberculin Test ; Tuberculosis*

We report a case of giant cell tumor of the tendon sheath in a 36-year-old male, who presented an asymptomatic, firm, 1.0 × 0.8 × 0.4cm-sized nodule, involving the volar aspect of the distal phalanx of the right index finger about 1 year ago. Histopathologically, the enucleated lesion showed four lobules surrounded by thin connective tissue, each of which demonstrated the variable cellularity and the polymorphic cell population consisting of foam cells, spindle-shaped fibroblasts, histiocyte-like cells and multinucleated giant cells with heavy hemosiderin deposits near the periphery, in the collagenous stroma. He has done well with no recurrence during one year of follow-up since the operation.
Adult ; Collagen ; Connective Tissue ; Fibroblasts ; Fingers ; Foam Cells ; Follow-Up Studies ; Giant Cell Tumors* ; Giant Cells* ; Hemosiderin ; Humans ; Male ; Recurrence ; Tendons*

Some individuals may demonstrate a secondary phase nystagmus (SPN) following the caloric irrigation. It has been stated that if a SPN begins prior to 140 seconds after the onset of caloric stimulation and if the magnitude of the slow phase velocity is greater than 6 degrees/sec, then a premature reversal caloric nystagmus (PRCN) is said to exit. Thus far, there have been no reports describing PRCN in Korea. We described a typical PRCN in a patient with medulloblastoma within the 4th ventricle. The patient had a gaze-evoked horizontal and upbeating nystagmus. However, there was no indication of spontaneous nystagmus. A monothermal caloric test was administered. The initial left beating primary phase nystagmus was subsided at 60 seconds after right cold water stimulation and at 110 seconds, a right beating SPN with 14 degrees/sec of slow phase velocity was appeared and was continuous for 240 seconds. Although the precise mechanism of PRCN is unknown, vestibular nuclei damage may be related.
Caloric Tests ; Humans ; Korea ; Medulloblastoma ; Nystagmus, Physiologic* ; Vestibular Nuclei ; Water

BACKGROUND: Ischemic preconditioning(IP) is known to be effective in the protection of myocardial necrosis, arrhythmia, and the restoration of the myocardial function in the ischemia-reperfusion state of the heart. However the exact mechanism is not clearly understood. The purpose of this study was to elucidate the trigger mechanism of IP on the restoration of the myocardial function after ischemia-reperfusion. MATERIAL AND METHOD: By connecting a Langendorff perfusion apparatus with an isolated heart of a rat, the normal temperature of the heart was maintained. The experiment was conducted in seven groups, which were divided according to the preconditioning stimuli and blockage methods: Group I(n=10) was a group without IP, Group II(n=10) a group of three-minute IP, Group III(n=10) a group of PEIP, Group IV(n=10) a group of clonidine IP, Group V(n=10) a group of IP after reserpine, Group VI(n=10) a group of PE & prazosin IP, and Group VII(n=10) a group of clonidine & yohimbine IP. Hemodynamic parameters of DP, LVEDP, +/-dP/dT and the changes of perfusion in the coronary artery were evaluated. RESULT: Developed pressure and +dP/dT changed per unit time. After 20 minutes of reperfusion, those of Group II and III were 63.1+/-3.7%, 64.8+/-4.6% and 64.5+/-4.6%, 63.8+/-4.4%, which improved more significantly than those of Group I(P<0.05). However, there were no significant differences between the Groups V and VI, and Group I. CONCLUSION: The Brief ischemic preconditioning and pharmacological preconditioning using alpha-receptor sympathomimetics have protecting effects on the restoration of myocardial function after reperfusion. And the protecting effect of preconditioning seems to be related to sympathetic neurotransmitters and to the selective action of the alpha1-adrenergic receptor.
Animals ; Arrhythmias, Cardiac ; Clonidine ; Coronary Vessels ; Heart ; Hemodynamics ; Ischemic Preconditioning ; Ischemic Preconditioning, Myocardial* ; Necrosis ; Neurotransmitter Agents ; Perfusion ; Prazosin ; Rats* ; Reperfusion ; Reserpine ; Sympathomimetics ; Yohimbine

Noninvasive prediction of pulmonary arterial pressure is of paramount importance in heart disease. To estimate pulmonary arterial pressure, several echocardiographic techniques, including abnormal pulmonary valve motion, prolongation of RV preejection period/RV ejection time ratio and contrast echocardiography have been proposed. Recently Doppler echocardiography has been known to detect intracardiac blood quantitatively. For assessment of the benefit of several indices by Pulsed Doppler echocardiography for mean pulmonary arterial pressure, 22 patients(mean pulmonary pressure> or =20mmHg; 11, <20mmHg; 11) were compared with the mean pulmonary arterial pressure by cardiac catheterization. In comparison of mean pulmonary arterial pressure(MPAP); 1) Right preejection period / RV ejection time RPEP/RVET;r=0.278 2) Right preejection period / Acceleration time RPEP/AT : r=0.654 3) Acceleration time(AT) AT=-1.55(MPAP)+154.37(r=-0.763) AT=-92.99(log MPAP)+239.41(r=-0.752) AT is less than 105 msec in 9 or 11 pulmonary hypertension and one of 11 normal individual. 4) Acceleration time/ RV ejection time AT/RVET=-136.36(MPAP)+83.31(r=-0.817) AT/RVET=-0.29(log MPAP)+0.81(r=-0.803) 5) (Right preejection period+Decceleration time) / AT (RPEP+DT)/AT=9.6(MPAP)-0.16(r=0.806) (RPEP+DT)/AT=3.86(log MPAP)-2.46(r=0.789) In conclusion AT/RVET, (RPEP+DT)/AT and Acceleration time of 105 msec are valuable indices to estimate mean pulmonary arterial pressure by Pulsed Doppler echocardiogram.
Acceleration ; Arterial Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Doppler ; Echocardiography, Doppler, Pulsed* ; Heart Diseases ; Hypertension, Pulmonary ; Pulmonary Valve

Levator function test is one of the most useful methods of diagnosis and evaluation of blepharoptosis. Because levator function test is more difficult to measure and unreliable in children or uncooperated patients, new method evaluating blepharoptosis is needed in these patients. Therefore, we measured lid movement velocity and the correlation between levator palpe-bral muscle function and lid motility velocity was evaluated. We videotaped the eyelid movements using videocamera in 66 eyes, 33 patients before operation, and analyzed the eyelid movement velocity and com-pared the eyelid movement velocity with levator palpebral muscle function. Levator palpebral muscle function was directly related to the mean velocity of eye opening, correlation coefficiency being 0.687(p<0.05). Therefore, we conclude that the mean velocity of eye opening using video camera can be useful for evaluation of blepharoptosis in uncooperated patients.
Blepharoptosis* ; Child ; Diagnosis ; Eyelids* ; Humans

BACKGROUND: We compared elderly and adult patients and tried to find a way to make an early diagnosis and proper management for elderly patients with altered mental status in the emergency department(ED). METHODS: During one year, two groups -123 elderly patients over 65 years and 127 adult patients from 20 to 64 years who visited ED in National Police Hospital(NPH)-were selected. Sex, age, arrival time after symptom onset, means of transportation, underlying diseases, causative disease, time of notification to other departments, and pattern of discharge of two groups were analyzed. RESULTS: The average age of the elderly and the adults were 76.43+/-9.51 and 42.12+/-15.0(yrs), respectively. As for the means of transportation, 84% of the elderly used a 911 ambulance service, and 11% used other emergency services. The average times from symptom onset to arrival for two groups were 124 minutes and 69 minutes, respectively. 86.99% of the elderly and 68.38% of the adults had underlying diseases. As for final diagnosis, cerebrovascular disease for the elderly and cardiovascular disease for the adults were the main causes. When patients left the hospital, rate of transfer to other hospital was higher in the elderly(60.2%), and rate of discharge was higher in the adults(15.8%). CONCLUSION: The elderly patients had more intracranial causes and needed longer time for diagnosis than the adult patients. In the case of the patients with intracranial cause who needed an emergency care, they were usually diagnosed at the secondary medical facility and then transferred to the other hospitals for proper treatment causing bad effect on the prognosis of the treatment due to time delay.
Adult ; Aged ; Ambulances ; Cardiovascular Diseases ; Early Diagnosis ; Emergencies ; Emergency Medical Services ; Humans ; Police ; Prognosis ; Transportation

No abstract available.
Autoantibodies* ; DNA*