Canalith repositioning maneuver is effective to treat benign paroxysmal positional vertigo(BPPV). This case showed complicated form of the BPPV such as changes of canalolithiasis to cupulolithiasis, involvement of one canal to two canals and from unilateral to bilateral involvement during the reposition maneuver. This patient was diagnosed as left lateral canalolithiasis at first. After left barbecue maneuver, the type was changed to the right posterior cupulolithiasis. Semont maneuver was performed and then the type of BPPV was changed to combined type with right posterior canalolithiasis and left lateral canalolithiasis. We performed left barbecue maneuver and right Epley maneuver. Then the type of BPPV was changed to left lateral cupulolithiasis. After Brandt-Daroff maneuver and left barbecue maneuver, nystagmus and dizziness disappeared finally.
Dizziness ; Humans

OBJECTIVES: To assess clinical improvement and change in plasma brain-derived neurotrophic factor(BDNF) level after repetitive transcranial magnetic stimulation(rTMS) in patients with treatment-resistant schizophrenia. METHODS: Seven patients with DSM-IV schizophrenia, who were proven to be treatment-resistant, were treated with 15 sessions of rTMS for three weeks as an adjuvant therapy to antipsychotic treatment. Clinical improvement and change in plasma BDNF level were measured after the treatment period. The symptom severity was assessed with the Positive and Negative Syndrome Scale(PANSS) and the Korean Version of Calgary Depression Scale for Schizophrenia(K-CDSS) at baseline and 7 days after the treatment. Plasma BDNF level was measured by enzyme-linked immunosorbent assay(ELISA) at baseline and 7 days after the treatment. RESULTS: After the rTMS treatment, there was no significant improvement in PANSS total score(Z=-1.693, p=0.090) and no significant change in plasma BDNF was found(Z=-1.183, p=0.237). Negative correlations were found between percentage change in PANSS positive subscale score and duration of illness(rho=-0.991, N=7, p<0.0005, two-tailed), and PANSS negative subscale score at baseline and percentage change in plasma BDNF level(rho=-0.821, N=7, p=0.023, two-tailed). CONCLUSION: This preliminary study suggests that rTMS didn't make a significant change in clinical symptoms nor in plasma BDNF level in treatment-resistant schizophrenia. Percentage change in plasma BDNF, however, might be correlated with treatment resistance in schizophrenic patients. This is a pilot study with a small sample size, therefore, a further study with a larger sample size is needed.
Brain-Derived Neurotrophic Factor ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Magnetics ; Magnets ; Pilot Projects ; Plasma ; Sample Size ; Schizophrenia

No abstract available.
Endometriosis* ; Female ; Humans

No abstract available.
Hemorrhage* ; Kidney Transplantation*

Patient death with a functioning graft(DFG) has been a predominant cause of graft loss. According to conventional graft survival(C-GS) analysis, DFG is considered as a graft failure. However, such survival analysis may obscure immunologic graft loss and distort the overall graft results as well as risk factors affecting the graft survivals. In functional graft survival(F-GS) analysis, the DFG is considered as censored data(in which the graft survived until patient death) which is more closely related with the immunologic graft loss. We designed our study to identify the differences and significance of F-GS compared to C-GS. From April 1984 to October 1995, 1242 living donor kidney transplantations under cyclosporine were performed at Yonsei University Medical Center. At least a 1-year follow-up was possible in all the patients. The graft survival rate was calculated by both C-GS and F-GS analyses. The recipient's and the donor's ages, the donor-recipient relationship, the degree of HLA matching, the degree of ABO blood type matching, the episodes of acute rejection within 1 year, and the presence of diabetes mellitus were monitored as risk factors affecting the graft survival in the two analysis methods. Univariate and multivariate analyses for risk factors were done by the Kaplain-Meier method and the Cox proportional harzard model. The C-GS rate were 96.3% at 1 year, 81.8% at 5 years, and 58.4% at 10 years compared to 98.5%, 88.1%, and 67.9%, respectively in the F-GS analysis. Elderly recipients(> or =50), elderly donors(> or =50), presence of acute rejection within 1 year post-transplant, ABO blood type minor mismatching, and diabetic recipients were risk factors affecting long-term graft survival in the C-GS analysis. However, elderly recipients and diabetic recipients were no longer considered as risk factors in the F-GS analysis. In fact, elderly recipients or diabetic recipients showed equal or even better graft survivals in the F-GS analysis compared with younger or non-diabetic recipients. The differences between the C-GS and the F-GS analyses in such subgroups suggests that the primary cause of graft loss in these groups was non-immunologic. Death with functioning graft(DFG) needs to be considered in analyzing kidney-transplant outcomes. Hence, we propose that all transplant graft survival data be presented in two ways, by conventional and functional graft analyses.
Academic Medical Centers ; Aged ; Cyclosporine ; Diabetes Mellitus ; Follow-Up Studies ; Graft Survival* ; Humans ; Kidney Transplantation ; Living Donors ; Multivariate Analysis ; Risk Factors ; Transplants*

No abstract available.
Lung Neoplasms* ; Lung*

Patients with achondroplasia manifest various neurologic symptoms including megaencephaly, hydrocephalus, and progressive myelopathy or radiculopathy secondary to spinal stenosis. However, only anecdotal postmortem reports proved ruptured aneurysm or vascular malformation as a source of intracranial hemorrhage. We herein report a case of a 26-year-old woman with achondroplasia who underwent uneventful surgical treatment for the aneurysmal subarachnoid hemorrhage. In this literature, we review the pathophysiologic mechanism and emphasize the necessity of considering the possibility of sudden mental deterioration in achondroplastic patient.
Achondroplasia* ; Adult ; Aneurysm* ; Aneurysm, Ruptured ; Female ; Humans ; Hydrocephalus ; Intracranial Aneurysm ; Intracranial Hemorrhages ; Neurologic Manifestations ; Radiculopathy ; Spinal Cord Diseases ; Spinal Stenosis ; Subarachnoid Hemorrhage* ; Vascular Malformations

OBJECTIVES: The purpose of this study was to investigate the prevalence of musculoskeletal symptoms in oriental melon-growing farmers and to evaluate the ergonomic risk factors of melon cultivation. METHODS: The study included 217 subjects growing oriental melons mainly in 3 villages. Subjects were interviewed by means of a structured questionnaire. Instruments used the general features and symptom table of NIOSH to evaluate tasks using ergonomic tools (REBA, OWAS). RESULTS: A total of 202 final respondents answered. The prevalence of musculoskeletal symptoms based on the NIOSH standard criteria was 162 (75.2%). The prevalence per body part for lower back, knee and shoulder were 102 (50.5%), 86 (42.6%) and 71 (35.1%), respectively. The prevalence of pain complaints of the musculoskeletal symptom was 91 (45.0%). The prevalence of complaints per body part of lower back, knee and shoulder were 54 (26.7%), 41 (20.3%) and 37 (18.3%), respectively. Logistic regression analysis showed men were at higher risk compared to women (OR=2.409, 95% CI=1.071~5.389), and ore than 30 years of work having a higher risk compared to less than 30 years of work (OR=2.445, 95% CI=1.150~5.197). High risk tasks were moving around boxes and nursery plants for planting, transplanting nursery plants, and picking melons. CONCLUSIONS: Musculoskeletal symptoms were very highly prevalent in oriental melon-growing farmers, showing up in 75.2% of cases. They were exposed to ergonomic high risk factors such as squatting. These risk factors must be improved in some way.
Cucurbitaceae ; Data Collection ; Female ; Humans ; Knee ; Logistic Models ; Male ; National Institute for Occupational Safety and Health (U.S.) ; Nurseries ; Plants ; Prevalence ; Questionnaires ; Risk Factors ; Shoulder ; Transplants

BACKGROUND:Many patients with symptom of recurrent episodic vertigo can neither be diagnosed nor treated. The purpose of this study is to review clinical features of a group of patients with recurrent episodic vertigo that is not defined to specific diagnosis of vertigo and to test the effectiveness of phenytoin sodium in the patients. METHOD & MATERIAL:11 of 32 patients with recurrent vertigo not defined to specific diagnostic category of vertigo who visited dizziness center of a tertiary care university hospital from November 1995 to April 2004 were studied. The patient's charts were reviewed retrospectively. A thorough otolaryngologic and neurotologic evaluation was performed in every case to determine the specific cause of dizziness. Vestibular function test, hearing test, magnetic resonance imaging of brain, electroencephalogram, and 24 hour Holter EKG monitoring were performed in all cases. Consultations to psychiatrist and neurologist were obtained. All patients were treated with phenytoin sodium. RESULT:The results of the vestibular function test, audiogram, MRI of brain, electroencephalogram, 24-hr holter monitoring were normal. Any definitive diagnosis could not be reached to this group. Vertigo was controlled by phenytoin sodium in all 11 cases. CONCLUSION:We report a group of patients with recurrent episodic vertigo that is not defined to any specific diagnosis of vertigo. The vertigo symptom was controlled successfully by phenytoin sodium. This patients were diagnosed as benign episodic vertigo as a separate disease entity.
Brain ; Diagnosis ; Dizziness ; Electrocardiography ; Electrocardiography, Ambulatory ; Electroencephalography ; Hearing Tests ; Humans ; Magnetic Resonance Imaging ; Phenytoin* ; Psychiatry ; Referral and Consultation ; Retrospective Studies ; Sodium* ; Tertiary Healthcare ; Vertigo* ; Vestibular Function Tests

OBJECTIVES: The purpose of this study was to analyze the relationship between subjective well-being and other clinical parameters such as sociodemographic and clinical variables, which include positive and negative symptoms, depressive symptoms, insight, and side effects. METHODS: Fifty-one outpatients diagnosed with schizophrenia were recruited in this study. Subjective well-being was assessed using a self-rating scale, the Subjective Well-being under Neuroleptics-Short form (SWN-K). Sociodemographic variables were also evaluated and other evaluations were conducted using the Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS), Korean Version of the Revised Insight Scale for Psychosis (KISP), and Multidimensional Scale of Perceived Social Support (MSPSS). The relationship between subjective well-being and these clinical variables was assessed. RESULTS: Education years and social support scores were positively correlated with the total SWN-K scores, but severity of illness, severity of depression, severity of side effect, and the scores on insight were negatively correlated. The stepwise multiple regression analyses indicated that the total SWN-K score of the patients with schizophrenia was associated with negative symptoms and insight. CONCLUSION: Better insight and more severe negative symptoms in patients with schizophrenia may be associated with worse subjective well-being. Results indicate that careful evaluation of subjective well-being is essential for proper management of patients with schizophrenia.
Depression ; Education ; Humans ; Outpatients ; Psychotic Disorders ; Schizophrenia*