The Persistent auditory hallucinations may provoke the uncomfortable feeling and can be dangerous according to its contents in treatment-resistant schizophrenic patients. Previous functional brain imaging studies on auditory hallucinations reported that the abnormal activations of the normal auditory pathway and the activations of the left upper temporal lobe were found while patients were hallucinating voices. Base on the these findings, we treated a female schizophrenic patient with persistent auditory hallucinations that were treatment-refractory with rTMS and the ECT continuously while she was on the drug treatment. The total amount of pulses applied in each trial ranged from 240 to 1000pulses. Fourteen trials were done and resulted in decrease by 30% in the subject severity of auditory hallucinations and the improvement of the affect. Two weeks after the completion of rTMS trials, nine trials of ECT were administered which leaded to complete disappearance of auditory hallucinations. This result suggest that ECT is more effective than rTMS in treating persistent auditory hallucinations in treatment-resistant schizophrenic patients.
Auditory Pathways ; Female ; Functional Neuroimaging ; Hallucinations* ; Humans ; Schizophrenia ; Temporal Lobe ; Transcranial Magnetic Stimulation ; Voice

The purpose of this study is to analyse and evaluate the characteristics of stroke patients and the causes of their spending time in arriving emergency room and the actual conditions of using alternative medicines before entering emergency room. The subject of this study four hundred seventy six patients who was hospitalized in Western Medical and Chinese Herb Medicine of D Hospital in Pusan within two weeks after attack. The collected data are analysed by the analysis method of narration statistics through SAS program and one-way analysis through ANOVA. The important results of this study are as followings: The spending time in arriving emergency room shows that under 3 hours is 19.5%, under 6 hours is 29.0%, under 24 hours is 55.1%. In the aspects of using alternative medicines before entering emergency room, the patients of 60.1% had used alternative medicines. Through the examination and analysis it can be seen that the geographical-environmental features and the clinical features for the acute stroke patients have more effect than the populational-sociological features on the spending time in arriving emergency room. For the aspects of using alternative medicines before entering emergency room, however, the charactericstics of clinical features have more effect than the populational-sociological features and the geographical-environmental features.
Asian Continental Ancestry Group ; Busan ; Complementary Therapies* ; Emergency Service, Hospital ; Humans ; Narration ; Stroke*

No abstract available.
Aspirin* ; Coronary Aneurysm ; Mucocutaneous Lymph Node Syndrome*

No Abstract Available.
Cadaver* ; Humans* ; Spinal Cord* ; Spine*

Adult onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology and pathogenesis, characterized by systemic symptoms including high fever, evanescent rash, arthritis and a sore throat. There is no single diagnostic test, therefore the diagnosis is based upon clinical criteria. Treatment consists of anti-inflammatory medication such as aspirin, NSAIDs, corticosteroids, anti-rheumatics and immunosuppresants. We report a typical case of AOSD, in which a 29-year-old female patient presented with high fever, typical Still's rash, arthritis and a sore throat.
Adrenal Cortex Hormones ; Adult* ; Anti-Inflammatory Agents, Non-Steroidal ; Arthritis ; Aspirin ; Diagnosis ; Diagnostic Tests, Routine ; Exanthema ; Female ; Fever ; Humans ; Pharyngitis ; Still's Disease, Adult-Onset*

BACKGROUND: There are some reports that superficial cryotherapy of alopecia areata could be an effective mode of treatment with many advantages. OBJECTIVE: We retrospectively evaluated the efficacy and side effects of superficial cryotherapy in patients with alopecia areata. METHODS: We retrospectively reviewed the clinical records of 153 patients with alopecia areata, who had been treated with superficial cryotherapy for more than 4 weeks, during the twelve years since 1993. We then evaluated the efficacy of superficial cryotherapy and its relationship with various clinical factors and side effects. Superficial cryotherapy using liquid nitrogen spray for 2~3 seconds was applied to the alopecic patches, and repeated three or four times per session. Positive therapeutic response was defined as the regrowth of terminal hairs. RESULTS: The results are summarized as follows: Positive therapeutic responses were noted in 105 (68.6%) of 153 patients reviewed. Patients who responded, vellus hair appeared within 4 weeks of treatment, terminal hair within 7 weeks, and a marked recovery was achieved within 12 weeks. A relatively good response rate was obtained in those patients who had less than 4 weeks of treatment, and the area of treatment was less than one fourth of the total scalp area, or less than two alopecic patches. On the other hand, those over 50 years of age and with more than 3 weeks of treatment interval seemed to have a relatively poor response rate. Other factors were not significant. There were no significant side effects, except slight pain, swelling and erythema. CONCLUSION: Superficial cryotherapy in patients with alopecia areata can be an effective treatment modality. It is a simple and convenient method, and has relatively good therapeutic response with less side effects. Therefore, we propose the superficial cryotherapy as a first-line treatment for patients with a milder form of alopecia areata, especially in children who are vulnerable to therapeutic side effects and pain.
Alopecia Areata* ; Alopecia* ; Child ; Cryotherapy* ; Erythema ; Hair ; Hand ; Humans ; Nitrogen ; Retrospective Studies* ; Scalp

PURPOSE: To assess the relationship between the retinal thickness analyzer (RTA) parameters, and those of the GDx VCC scanning laser polarimeter (GDx VCC), Stratus OCT optical coherence tomography (Stratus OCT), and Heidelberg retinal tomograph II confocal scanning laser ophthalmoscopy (HRT II). METHODS: Twenty-nine primary open-angle glaucoma patients were retrospectively included in this study. Measurements were obtained using the RTA, GDx VCC, Stratus OCT, and HRT II. We calculated the correlation coefficients between the parameters of RTA and those of the other studies. RESULTS: Among the optic disc parameters of RTA, the cup volume was best correlated with Stratus OCT (R=0.780, p<0.001) and HRT II (R=0.896, p<0.001). Among the posterior pole retinal thickness parameters, the posterior pole abnormally thin area (PPAT) of the RTA and the inferior average of the GDx VCC were best correlated (R=-0.596, p=0.001). The PPAT of the RTA and the inferior maximum of the Stratus OCT were best correlated (R=-0.489, p=0.006). The perifoveal minimum thickness (PFMT) of the RTA and the cup shape measurement of the HRT II were best correlated (R=-0.565, p=0.004). CONCLUSIONS: Many RTA optic disc parameters were significantly correlated with those of the Stratus OCT and HRT II. The RTA posterior pole retinal thickness parameters were significantly correlated with those of the GDx VCC, Stratus OCT and HRT II. The RTA optic disc and posterior pole retinal thickness parameters may be valuable in the diagnosis of glaucoma.
Adolescent ; Adult ; Aged ; *Diagnostic Techniques, Ophthalmological ; Female ; Glaucoma, Open-Angle/*diagnosis ; Humans ; Lasers/diagnostic use ; Male ; Middle Aged ; Ophthalmoscopy ; Optic Disk/*pathology ; Optic Nerve Diseases/*diagnosis ; Retina/*pathology ; Retrospective Studies ; Tomography, Optical Coherence

PURPOSE: A prolonged administration of etoposide increases its effectiveness on the suggestion that pralonged maintenance of low levels is an important factor in determining its activity. Many studies have been tried to define the efficacy of combination of oral etoposide with other chemotherapeutic drugs such as cisplatin, 5-FU, and ifosfamide in patients with advanced non-small cell lung cancer (NSCLC). In this study, we evaluated the effectiveness and toxicities of combination chemotherapy of oral etoposide with intravenous cisplatin and ifosfamide in advanced NSCLC patients. MATERIALS AND METHODS: Thirty-three patients with inoperable NSCLC who had measurable diseases and had not been treated with chemotherapeutic drug, were enrolled in this study (from May 1995 to April 1998). Treatment consisted of intravenous cisplatin (20 mg/m(2)/day, Day 1-3) and ifosfamide (1,800 mg/m(2)/day, Days 1-3) with Mesna (1,100 mg/m(2)/day, Days 1-3), and oral etoposide (50 mg/m(2)/day, Days 4-17). This treatment was repeated every 4 weeks. Patients showing stable disease or a better response were continued on treatment with the range of one to nine cycles (medium: 3 cycles). All patients were evaluated for the response, survival, and toxicity of this combination chemotherapy. RESULTS: Eleven patients showed either complete responses [CR, 3 (9%)] or partial responses [PR, 8 (24%)]. The median number of treatment cycles were 5 (range, 3-9) for responders and 2 (range, 1-7) for non-responders. The responders had median response duration of 10 months and the overall survival of 12 months. The overall survival of responders were longer than that of non-responders (median 19 vs 5 months, p 0.0232). The toxicities of this treatment were tolerable without treatment related death. Limiting toxicities were myelosuppression and oral mucbsities, Grade 3 or 4 leukopenia and oral mucosities were observed in 34% and 9%, respectively. CONCLUSION: The combination of cisplatin, ifosfamide, and oral etoposide produced encouraging response rates and median survival duration in patients with response. Further study of this combination is warranted in comparison with standard cisplatin+etoposide regimen or intravenous etoposide, cisplatin and ifosfamide regimen.
Carcinoma, Non-Small-Cell Lung ; Cisplatin* ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Ifosfamide* ; Leukopenia ; Mesna ; Small Cell Lung Carcinoma*

BACKGROUND: Ruptured aneurysms of sinus of Valsalva are rare cardiac anomaly. Here, we analyze retrospectively patients operated on at our hospital during the last 10 years. METHODS: Seventeen cases of ruptured congenital aneurysm of sinus of Valsalva (female:male=10:7, mean age 33.2+/-15.2 year) were operated during the period of January 1989 through August 1998. A ruptured aneurysm of the sinus of Valsalva was diagnosed by transthoracic 2D echocardiography and multiplane esophageal echocardiography. The diagnoses were confirmed at operation. The majority (94.1%) arose from the right coronary sinus. The right ventricle was the most common chamber of rupture (76.5%). Ventricular septal defect was associated in 13 patients (76.5%), of which 8 (61.5%) were subarterial. Ventricular septal defect was more common in aneurysms arising from the right coronary sinus (81.2%). Aortic regurgitation was found in 5 patients (29.4%). One patient underwent aortic valve repair and one an arotic valve replacement. RESULTS: There was no early operative death and no recurrence after the initial repair. Postoperative morbidities were few. There was one late sudden cardiac death 3 months post-surgery. In the majority, the long-term follow-up was uneventful. CONCLUSION: Surgery for ruptured aneurysm of sinus of Valsalva yields gratifying results, and it should be undertaken as soon as the condition is diagnosed. With recent developments, echocardiography may prove a substitute for cardiac catheterization and angiocardiography in future, and surgery could be undertaken with the help of echocardiography alone.
Aneurysm ; Aneurysm, Ruptured* ; Angiocardiography ; Aortic Valve ; Aortic Valve Insufficiency ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Sinus ; Death, Sudden, Cardiac ; Diagnosis ; Echocardiography ; Echocardiography, Transesophageal ; Follow-Up Studies ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Recurrence ; Retrospective Studies ; Rupture ; Sinus of Valsalva*

The occurrence of a trigeminal neuropathy associated with connective tissue disease is rare. Trigeminal neuropathy in connective tissue disease is predominantly sensory and it is characterized by numbness, hypesthesia, slurred speech, and touch pain. Although the pathogenesis of trigeminal neuropathy associated with connective tissue disease remains obscure, the main pathologic findings are vasculitis and neuritis. A case of trigeminal neuropathy associated with mixed connective tissue disease is described, and the incidence, symptoms, pathophysiology, treatment of the disease is discussed.
Connective Tissue Diseases ; Hypesthesia ; Incidence ; Mixed Connective Tissue Disease* ; Neuritis ; Trigeminal Nerve Diseases* ; Vasculitis