No abstract available.
Aged* ; Child* ; Dislocations* ; Hip* ; Humans

PURPOSE: To investigate the results of Advanced Surface Ablation (ASA) coupled with "smoothing" to smooth the ablation surface after covering masking fluid. METHODS: ASA was performed in 61 eyes with ablation depth of more than 75 microm. The mean refractive error was -5.88 +/- 1.27 D and mean ablation depth was 102.93 +/- 12.06 microm. Smoothing was performed in all patients (mean depth 16.79 +/- 2.43 microm, mean diameter 8.77 +/- 0.16 mm). Customized Aspheric Transition zone (CATz) was used in the laser algorithm. RESULTS: The mean refractive error was -0.29 +/- 0.41 D at postoperative 6 months and 97% of patients had an UCVA of 1.0 or better at postoperative 6 months. There was no statistically significant difference in magnitude of high-order aberrations at postoperative 6 months. The magnitude of total spherical aberrations increase was 0.084 microm at postoperative 6 months (p<0.05, paired t-test). The cornea was maintained clear in the majority of eyes. CONCLUSIONS: Excellent results were obtained by ASA coupled with "smoothing" in high myopia patients with an ablation depth greater than 75 microm.
Cornea ; Eye ; Humans ; Masks ; Myopia ; Refractive Errors

Cerebrovascular diseases associated with neurofibromatosis type 1 (NF-1) are not frequent. Ischemic stroke have been reported quite well in the literature, but cerebral hemorrhage associated with intracranial steno-occlusion were very rare and has not been reported in Korea. We report a 28-year-old woman with NF-1, who presented with cerebral hemorrhage. She had the history of multiple episodes of transient left hemiparesis. Sudden right occipital headache and left hemiparesis, followed by loss of consciousness, brought her to our emergency room and right thalamic hemorrhage with intraventricular extension was detected. Angiogram showed occlusion of the right supraclinoid internal carotid artery (ICA) and the left anterior cerebral artery, focal narrowing of the right petrous and the left supraclinoid ICA, and diffuse narrowing of the basilar artery. We discussed the genetic aspect and the pathophysiology of vascular occlusive disease in patients with NF-1.
Adult ; Anterior Cerebral Artery ; Basilar Artery ; Carotid Artery, Internal ; Cerebral Hemorrhage* ; Emergency Service, Hospital ; Female ; Headache ; Hemorrhage ; Humans ; Korea ; Moyamoya Disease ; Neurofibromatoses* ; Neurofibromatosis 1* ; Paresis ; Stroke ; Unconsciousness

Objectives: This study surveyed the quality of psychotherapy training and psychotherapy competencies during residency in Korea. Methods: A questionnaire developed by The Committee of Residency Training of the Korean Neuropsychiatric Association was completed by fourth-year residents of Korean psychiatry (n=120). The questionnaire examined their demographic characteristics, their experience of clinical psychotherapy training, their degree of satisfaction in the quality of psychotherapy training, and self-rated competence regarding the six types of psychotherapies, including supportive psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, psychoanalytic psychotherapy, group psychotherapy, and family psychotherapy. Results: The degree of satisfaction of the residents with the psychotherapy training was diverse among the types of psychotherapy and contents of training. Across all types of psychotherapies, the satisfaction levels of the quantity and quality of supervision education were low, except for psychoanalytic psychotherapy. Overall, more than 70% of residents were not satisfied with the theoretical education, clinical practice, and supervision education in three types of psychotherapies, including interpersonal psychotherapy, group psychotherapy, and family psychotherapy. A positive correlation was found between the degree of satisfaction with the quality of training experience and self-rated competence of psychotherapy. Specifically, the self-rated competence of psychotherapy was more highly correlated with the experience of clinical cases and supervision than theoretical education Conclusion This study showed the quantitative and qualitative status of psychotherapy training in Korean psychiatry residency programs, and the satisfaction level of psychotherapy education was low except for psychoanalytic psychotherapy. There is a strong need for the improvement of psychotherapy training programs in Korea.

Objectives: This study surveyed the quality of psychotherapy training and psychotherapy competencies during residency in Korea. Methods: A questionnaire developed by The Committee of Residency Training of the Korean Neuropsychiatric Association was completed by fourth-year residents of Korean psychiatry (n=120). The questionnaire examined their demographic characteristics, their experience of clinical psychotherapy training, their degree of satisfaction in the quality of psychotherapy training, and self-rated competence regarding the six types of psychotherapies, including supportive psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, psychoanalytic psychotherapy, group psychotherapy, and family psychotherapy. Results: The degree of satisfaction of the residents with the psychotherapy training was diverse among the types of psychotherapy and contents of training. Across all types of psychotherapies, the satisfaction levels of the quantity and quality of supervision education were low, except for psychoanalytic psychotherapy. Overall, more than 70% of residents were not satisfied with the theoretical education, clinical practice, and supervision education in three types of psychotherapies, including interpersonal psychotherapy, group psychotherapy, and family psychotherapy. A positive correlation was found between the degree of satisfaction with the quality of training experience and self-rated competence of psychotherapy. Specifically, the self-rated competence of psychotherapy was more highly correlated with the experience of clinical cases and supervision than theoretical education Conclusion This study showed the quantitative and qualitative status of psychotherapy training in Korean psychiatry residency programs, and the satisfaction level of psychotherapy education was low except for psychoanalytic psychotherapy. There is a strong need for the improvement of psychotherapy training programs in Korea.

BACKGROUND AND OBJECTIVES: In patients with rheumatoid arthritis (RA), sensorineural (SN), conductive, and mixed hearing loss (HL) have been reported in increased rates compared with persons without RA. The object of this study was to evaluate the prevalence and type of HL in patients with RA. We also examined the correlation between HL and the clinical data and determined which factors may be involved in the pathogenesis of RA-related HL. SUBJECTS AND METHOD: In this prospective controlled study, we compared 40 RA patients with 40 age and sex-matched controls. All patients underwent rheumatologic evaluation including ESR, CRP, rheumatoid factor, rheumatoid nodule, etc. Audiologic assessment consisting of pure tone, speech, impedence audiometry, and tone decay test was performed. Statistical analysis of the two groups was carried out. RESULTS: The prevalence of the SNHL (air conduction threshold of >30 dB at > or =1 frequency or >25 dB at > or =2 frequencies and both air and bone conduction thresholds within 10 dB of each other) was significantly higher in the RA group (42.5%), and the majority was bilateral and cochlear type. Air conduction threshold at 8,000 Hz differed significantly between the patients and the control group (p< 0.05). Speech and impedence audiometry did not differ in both groups. The presence of SNHL in patients with RA was related to ESR, CRP, patients' age, and medication such as prednisolone. CONCLUSION: SNHL of the cochlear type is increased in patients with RA especially at 8,000 Hz.
Arthritis, Rheumatoid ; Audiometry ; Bone Conduction ; Hearing ; Hearing Loss ; Hearing Loss, Mixed Conductive-Sensorineural ; Humans ; Prednisolone ; Prevalence ; Prospective Studies ; Rheumatoid Factor ; Rheumatoid Nodule

Sacroiliitis is a prototyical feature of the seronegative spondyloarthropathies. It has been reported rarely in patients with systemic lupus erythematosus. We report a case of bilateral sacroiliitis in a 26 year-old female who presented 5 out of 11 ARA criteria for systemic lupus erythematosus. She complained of right low back pain since 1 week after delivery. Plain roentgenogram, computed tomogram and magnetic resonance imaging revealed no evidence of subluxation or pyogenic infection that may be possibly related to delivery, but bilateral sacroiliitis especially more severe in the right side that showed concordantly increased uptake on bone scan. Also she had neither HLA DR-3 nor B-27 antigens and had no other clinical findings of limitation of motion of spine and chest expansion, which suggest that there is a less likelihood of coexistent ankylosing spondylitis. In this case, we suggested that sacroiliitis may be a infrequent manifestation of systemic lupus erythematosus.
Adult ; Female ; Humans ; Low Back Pain ; Lupus Erythematosus, Systemic* ; Magnetic Resonance Imaging ; Sacroiliitis* ; Spine ; Spondylarthropathies ; Spondylitis, Ankylosing ; Thorax

Pituitary apoplexy is a rare but potentially life-threatening clinical syndrome caused by the sudden enlargement of a pituitary adenoma secondary to hemorrhage or infarction. Pituitary apoplexy after cardiac surgery is a very rare perioperative complication. Factors associated with open heart surgery that may lead to pituitary apoplexy include hemodynamic instability during cardiopulmonary bypass and systemic heparinization. We report a case of pituitary apoplexy after mitral valvuloplasty with cardiopulmonary bypass. After early pituitary tumor resection and hormonal replacement therapy, the patient made a full recovery.
Cardiopulmonary Bypass ; Hemodynamics ; Hemorrhage ; Heparin ; Humans ; Infarction ; Mitral Valve Insufficiency ; Pituitary Apoplexy* ; Pituitary Neoplasms ; Postoperative Complications ; Thoracic Surgery

Paradoxical embolism refers to the embolic entry of a venous thrombus into the systemic circulation through a right-to-left shunt. Impending paradoxical embolism, in which a venous thrombus extends from the right atrium through a patent foramen ovale (PFO) into the left atrium, is usually diagnosed with echocardiography. The most common cause of paradoxical embolism through a PFO is the acute pulmonary embolism. We report a case of a 78-year-old woman with acute pulmonary embolism, complicated by impending paradoxical embolism.
Aged ; Echocardiography ; Embolism* ; Embolism, Paradoxical ; Female ; Foramen Ovale, Patent ; Heart Atria ; Humans ; Pulmonary Embolism* ; Thrombosis

Gastric carcinogenesis has been studied in various aspects. Helicobacter pylori (Hp) infection and mutation of the p53 tumor suppressor gene have recently been argued to be important factors of gastric carcinogenesis. There have been many studies to determine the precise mechanism of how Hp is related to gastric cancer, but it is so far still unknown. We studied the relationship of Hp infection and p53 overexpression and tried to discover some significance in clinicopathologic factors such as age, sex, stage, site, differentiation and gross morphology. Ninety-six patients who were diagnosed with gastric cancer at Severance Hospital, Yonsei University Medical College from November 1995 to March 1996, and 96 control patients of non-ulcer dyspepsia (NUD) were studied by endoscopic biopsy of normal gastric tissue and cancer tissue. They also underwent the CLO (Delta West, Melbourne, Western Australia) test for Hp positivity and p53 immunohistochemical stain for p53 positivity. These data were analyzed for comparison with the clinicopathologic characteristics of gastric cancers. In conclusion, the differentiated group cancer had a significantly high Hp positivity and p53 positivity. There is a possibility that Hp infection and p53 tumor suppressor gene mutation might be significantly related in the gastric carcinogenic process of well- and moderately-differentiated adenocarcinomas, but further study is necessary to determine more direct clues on the carcinogenic roles of these factors.
Adenocarcinoma/metabolism* ; Adult ; Aged ; Female ; Helicobacter Infections/metabolism* ; Helicobacter pylori* ; Human ; Male ; Middle Age ; Protein p53/analysis* ; Stomach Neoplasms/metabolism*