Cyclopia is rare congenital craniofacial anomaly, in which the eyes are fused together and located in a single orbit. It is consistently associated with severe holoprosencephaly, which is the failure of cleavage of the prosencephalon with a deficit in the midline facial development. chromosomal study revealed 47, X( ), +13 (Patau syndrome).
Holoprosencephaly ; Orbit ; Prosencephalon ; Trisomy*

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

Mobius syndrome is a rare congenital condition of uncertain etiology, characterized by facial diplegia, bilateral external rectus paralysis, and various abnormalities of other tissues such as extremities and branchial musculature. We have experienced a case of Mobius syndrome, reporting it with a review of literature.
Extremities ; Mobius Syndrome* ; Paralysis

Since researches and clinical experiences up to now provide us with little helps in predicting what type of spinal tuberculosis will result in good healing by chemotherapy alone without kyphosis or with minimum kyphosis, it seems impractical to await natural healing with unsightly kyphosis. Therefore, my opinion is that surgery to achieve early cure and to correct and/or prevent kyphosis is desirable. The two-stage operation
Child ; Drug Therapy ; Follow-Up Studies ; Humans ; Immobilization ; Kyphosis ; Parents ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Background: We aimed to validate Baveno VI and expanded Baveno VI criteria using two dimensional shear-wave elastography (2D-SWE) in compensated advanced chronic liver disease (cACLD) patients with alcohol as the main etiology. Methods: Clinical data from 305 patients with cACLD who underwent a liver stiffness measurement (LSM) with 2D-SWE and endoscopy were consecutively collected. Results: Among 305 patients, high-risk varix (HRV) was identified in 21.3% (n = 65). The main etiology was alcoholic liver disease (51.8%), followed by hepatitis B virus (29.8%) and hepatitis C virus (9.1%). Baveno VI criteria spared endoscopy in 118 of the 305 (38.7%) patients, and 7 (5.9%) were missed with HRV. Expanded Baveno VI criteria spared more endoscopies (60.0%), but missed more HRV (9.8%) compared with Baveno VI criteria. The other classification described as the modified Baveno VI criteria were LSM < 25 kPa and PLT ≥ 150 × 103/mm3. In total, 131 of the 305 (43.0%) patients were within the modified Baveno VI criteria, of whom seven (5.3%) had missed HRV. After adding spleen diameter < 12 cm to the modified Baveno VI criteria, the number of spared endoscopies increased by 106/305 (34.8%), with three (2.8%) presenting with HRV, indicating a risk of missing HRV. Conclusion Baveno VI and expanded Baveno VI criteria with 2D-SWE were insufficient with an HRV miss rate of over 5%. The modified Baveno VI criteria with spleen diameters < 12 cm with 2D-SWE spared more endoscopies with a minimal risk of missing HRV in cACLD patients with alcohol as the main etiology.

We report 2 cases of serotonin syndrome with variable symptoms after being treated with antidepressants. A 57-year-old woman developed agitation, diaphoresis, and tremor after combination therapy with fluoxetine and trazodone. The second patient, a 76-year-old female woman, became partially disoriented and developed brief, jerky myoclonus of all extremities after discontinuation of sertraline and consecutive imipramine treatment. These two patients rapidly improved with supportive care. The serotonin syndrome is not always easy to diagnose and sometimes causes a serious and fatal event. For this reason, if possible, the practice of multiple serotonergic drugs should be avoided because of the risk for potential serious pharmacodynamic drug interactions. Clinicians should not view the serotonin syndrome as an idiosyncratic reaction, but rather, as a predictable one with a variability in occurrence and severity among patients. Heightened awareness by clinicians will help to minimize pharmacodynamically mediated interactions that may occur between prescribed drugs and, ideally avoid this syndrome.
Aged ; Antidepressive Agents ; Dihydroergotamine ; Drug Interactions ; Extremities ; Female ; Fluoxetine ; Humans ; Imipramine ; Middle Aged ; Myoclonus ; Serotonin Agents ; Serotonin Syndrome* ; Serotonin* ; Sertraline ; Trazodone ; Tremor

A 40-year-old female patient who had tethered spinal cord with intraspinal lipoma and intractable pain of the lower leg and foot is reported. The pain started 5 years ago and exaggerated recently. A pea-size mass had been noted since birth at sacral region, which was excised 2 months prior to admission at the other clinic. Neurological examination revealed diffuse muscular wasting of the left foot, especially the sole, hypesthesia of the left sole with dysesthesia, bilaterally increased knee jerks, and absent left ankle jerk. The patient underwent L5 laminectomy, subtotal removal of extradural, intradural and intramedually lipoma with dural repair, and dorsal rhizotomy of ipsilateral L5 and S1 roots. At surgery, the neural elements were untethered with mass removal, adhesiolysis, and division of thickened arachnoid septum. The pain improved much after and was tolerable with some analgesics.
Adult* ; Analgesics ; Ankle ; Arachnoid ; Female ; Foot* ; Humans ; Hypesthesia ; Knee ; Laminectomy ; Leg ; Lipoma* ; Neurologic Examination ; Pain, Intractable* ; Paresthesia ; Parturition ; Rhizotomy ; Sacrococcygeal Region ; Spinal Cord*

Contrast-enhanced ultrasonography (CEUS) using microbubble ultrasonography contrast agent can show the vascular structure and unique contrast enhancement patterns of focal liver lesions, including hepatocellular carcinoma (HCC). CEUS shows three phases, similar to a vascular pattern on computer tomography (CT), and typical arterial enhancement and portal or late phase washout in HCC. CEUS can show real-time images without nephrotoxicity or radiation hazard and can be used as guidance for loco-regional treatment and estimation of treatment response of HCC. In addition, some data recently revealed the usefulness of CEUS in the early estimation of response to anti-cancer pharmacological (i.e., sorafenib) therapy in advanced HCC. Although CEUS has limitations in clinical practice and more investigation is needed for its validation, it is recommended as a main diagnostic modality in a few major clinical practice guidelines for HCC. Thus, greater understanding of CEUS is necessary to extend its application in real practice for diagnosis and management of diseases.
Carcinoma, Hepatocellular ; Diagnosis ; Liver ; Microbubbles ; Ultrasonography

No abstract available.
Occupational Diseases*

PURPOSE: Superior cervical sympathectomy was performed on argon laser induced experimental branched retinal vein occlusion in rabbits to evaluate its effect on retinal blood flow. METHODS: Branched retinal vein occlusion (BRVO) was induced by argon laser in 30 eyes (15 pigmented rabbits) divided into three groups. One and 3 weeks after inducing BRVO, superior cervical sympathectomy was performed in Group 1 (early) and 2 (late), respectively. Group 3 was left as a control group. Fundus photography, fluorescien angiography and Heidelberg Retinal Flowmetry (HRF) were performed prior to and after sympathectomy. Pathologic examination was done after enucleation. RESULTS: The sympathectomy groups, especially Group 1 (early), showed better recovery of retinal blood flow, volume, and velocity. CONCLUSIONS: Sympathetic block appears to produce dilatation of the retinal blood system, and we suggest stellate ganglion block technique as an effective treatment modality on human beings with BRVO.
Angiography ; Argon ; Dilatation ; Humans ; Photography ; Rabbits* ; Retinal Vein Occlusion ; Retinaldehyde* ; Rheology ; Stellate Ganglion ; Sympathectomy* ; Veins*