Catatonia is a pathological condition in which the patient shows inappropriate motor, behavioral and affective responses to external stimuli. Catatonia can be observed in major depressive disorder, bipolar disorder, schizophrenia, and other conditions. Although the overall prevalence of catatonia has decreased dramatically, nearly 10% of schizophrenic inpatients still exhibit catatonic symptoms that are divided into immobility, abnormal repetitive behaviors and extreme emotional responses. Although numerous pharmacotherapies have been investigated for catatonia, benzodiazepine remains the treatment of choice. NMDA receptor antagonists such as amantadine and memantine have emerged as promising alternatives. As an effort to explain catatonia, 'GABA-NMDA collaboration model' has been proposed. According to this model, functional impairment of GABA-ergic orbitofrontal cortex can lead to disinhibition of subcortical motor system which utilize NMDA as neurotransmitter. This model was able to explain many aspects of catatonia.
Amantadine ; Benzodiazepines ; Bipolar Disorder ; Catatonia ; Cooperative Behavior ; Depressive Disorder, Major ; gamma-Aminobutyric Acid ; Humans ; Inpatients ; Memantine ; N-Methylaspartate ; Neurotransmitter Agents ; Prevalence ; Schizophrenia

No Abstract Available.
Gardnerella vaginalis* ; Gardnerella* ; Vaginosis, Bacterial*

No Abstract Available.
Gardnerella vaginalis* ; Gardnerella* ; Vaginosis, Bacterial*

BACKGROUND: The survival rate of children with neuroblastoma has been improved over 20 years, excluding the metastatic disease, in which it does not exceed 20% so far. New treatment modalities have been developed to improve the outcome in metastatic disease. Preoperative chemotherapy reduce the size, the vascularity and the adhesiveness, so increase the resectability of the primary tumor. This retrospective clinical study was designed to review the survival rate in neuroblastoma and to analyze the effect of preoperative chemotherapy in the view point of neoadjuvant therapy on long-term survival in advanced disease. METHODS: One hundred and thirty-four cases were reviewed from 135 patients with neuroblastoma registered at the Department of Pediatrics in Seoul National University Children's Hospital from January, 1985 till December, 1995. The survival rate was reviewed according to the stage. The age, sex of the patients, the stage, anatomical site of the tumor, the level of serum ferritin and neuron-specific enolase were analyzed for the risk factors on survival. RESULTS: Ranges of age at diagnosis were from 1 month to 166 months with the median of 39 months. Five year survival rates and five year disease-free survival rates were 100%, 100% in stage 1(n=5), 90.9%, 90.9% in stage 2(n=13), 43.4%, 40.6% in stage 3(n=19), 27.1%, 19.8% in stage 4(n=95) and 100%, 100% in stage 4S(n=2), respectively. In stage 3, five year survival rate was 52.5% in group receiving neoadjuvant chemotherapy, 28.6% in control group(P=0.02). Five year disease-free survival rate was also noted as 48.6%, 28.6% in each group(P=0.02). In stage 4, five year and ten year survival rates were 27.6%, 23.6% in group receiving neoadjuvant chemotherapy, 26.9%, 0% in control group(P=0.02). Five year and ten year disease-free survival rates were 14.3%, 14.3% in group receiving neoadjuvant chemotherapy, 20%, 0% in control group (P=0.11). In univariate analysis, the age, the stage, and the site of primary tumor appeared to affect the long-term survival. CONCLUSION: Neoadjuvant chemotherapy and delayed primary surgery contribute for advance in survival in advanced neuroblastoma via increasing the resectability of the primary tumor.
Adhesiveness ; Child ; Diagnosis ; Disease-Free Survival ; Drug Therapy* ; Ferritins ; Humans ; Neoadjuvant Therapy ; Neuroblastoma ; Pediatrics ; Phosphopyruvate Hydratase ; Retrospective Studies ; Risk Factors ; Seoul ; Survival Rate

This article was conducted to understand the Buddhist doctrine of 'not-self' (anatta) in respect of psychotherapy. The author reviewed the earliest Buddhist canons (Nikayas) and extracted the thoughts of 'not-self'. The Buddhist self (or ego) is not equal to the recent psycological self (or ego). It is rather the systemic being than the single one, which is composed of 5 aggregates. 'Anatta' does not mean 'no self' but 'not-self'. Buddha regards that self or ego is not real but conceptual. The Buddhist doctrine of 'anatta' is based upon the theory of the dependent origination (paticcasamuppada). Buddhism and psychotherapy consent that one could be emancipated from sufferings not by belief, but by introspection. Just as the emotional insight may lead to the change of behavior and personality in psychotherapy, so the true insight to Enlightenment in Buddhism. The psychotherapeutic significance of 'not-self' implies both the recognition and extinction of the conscious and the unconscious adherence. Therefore psychotherapeutic analysis can be introduced into Buddhism and the meditative contemplation of 'paticcasamuppada' can be adopted by psychotherapy.
Buddhism ; Ego ; Psychotherapy

No abstract available.
Antigens, CD4*

The diagnosis of soft tissue osteochondroma should be considered when a well-defined osseous mass is located in the soft tissues. The differential diagnosis includes myositis ossificans, tumoral calcinosis, synovial chondromatosis, and soft tissue osteosarcoma, true osteochondroma which arises from bone. One case of soft tissue osteochondroma in the knee, a lesion of uncertain pathogenesis is reported.
Calcinosis ; Chondromatosis, Synovial ; Diagnosis ; Diagnosis, Differential ; Knee ; Myositis Ossificans ; Osteochondroma* ; Osteosarcoma

A 54-year-old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.
Anxiety ; Clonazepam ; Cyproheptadine ; Emergency Service, Hospital ; Epilepsy ; Fever ; Fluoxetine* ; Flushing ; Gait Ataxia ; Hospitalization ; Hospitals, Psychiatric ; Humans ; Hypotension ; Lorazepam ; Male ; Memory ; Middle Aged ; Myoclonus ; Serotonin Syndrome* ; Serotonin Uptake Inhibitors ; Serotonin* ; Sertraline* ; Shivering ; Tachycardia ; Tremor ; Valproic Acid

The mechanical derangement, developmental anomaly, infection amd tumor should be considered as a cause of low back pain in adolescents. Disc herniation in adolescents is very rare and some of that are due to fracture of the epiphyseal ring. We report a case of fracture of the first sacral epiphyseal ring simulating disc rupture.
Adolescent ; Epiphyses ; Humans ; Low Back Pain ; Rupture

BACKGROUND: Psychogenic and physical aspects of health is interesting issue in the field of family medicine. We intended to study the relationship between physical illness and symptoms with self esteem, and hoped to understand disease in general behavioral context. METHODS: We selected 124 persons who visited family medicine OPD in Paik Hospital from August 3 to August 20, 1995, and answered questionnaire frankly. The qestionnaire consisted of Rosenberg self esteem scale as paremeter of self esteem and Hopkins symptom check list as parameter of physical health. The third author analyzed the medical record and rated the severity of disease as grade I-VII, for another parameter of physical health. The other factors-age, sex, marriage, education level, family, income-were analyzed by self esteem. RESULTS: We divided the study population into two groups, low self esteem group and high self esteem group. In low self esteem group, the persons complain more symptoms in Hopkins symptom check list significantly(P=0.009). Those who were highly educated had significantly higher self esteem(P=0.047). The severity of disease, sex, age, marriage, type of family, income showed no significant relationship with self esteem. CONCLUSIONS: The education level was the factor that influence self esteem. The person of low self esteem complains more symptoms. So we should consider self esteem in medical practice.
Education ; Hope ; Humans ; Marriage ; Medical Records ; Self Concept* ; Surveys and Questionnaires