OBJECTIVES: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. METHODS: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. RESULTS: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. CONCLUSION: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.
Anxiety ; Cognitive Therapy ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Outpatients ; Primary Health Care ; Sleep Initiation and Maintenance Disorders

No abstract available.
Hypothyroidism*

Congenital self-healing reticulohistiocytosis (CSHRH) typically presents at birth or in the first few weeks of life as a widespread eruption of cutaneous red-brown papulonodules that resolve spontaneously without involvement of other organs. While multiple lesions are common, a solitary lesion is rare. We describe a solitary type of CSHRH in a full-term, male neonate. He had an erythematous papule with a yellowish crust on the left heel without any systemic symptoms. Four weeks later, the skin lesion had disappeared spontaneously.
Heel ; Humans ; Infant, Newborn ; Male ; Parturition ; Skin

BACKGROUND: Recurrent recalcitrant warts are likely to increase gradually, and require more aggressive and effective treatment for remedy. According to recent foreign research materials and literature, aminolevulinic acid photodynamic therapy (ALA-PDT) is reported to prove to show high curative performances, but there has been little relevant research in Korea to date. OBJECTIVE: This study will evaluate the efficiency and side effects of ALA-PDL and PDL in treating recalcitrant viral warts. METHODS: 120 warts from 44 people were selected and sorted by their locations such as hand, foot, and periungual area, and then randomly divided into 2 groups: ALA-PDL group and PDL group. The ALA-PDL group used 20% 5-ALA as a photosensitizer, and PDL for the light-source, the other group used PDL. The setting of PDL being used in both groups is as follows: wavelength of 585 nm, spot size of 7 mm, and energy density of 7.0~10 J/cm2. RESULTS: After 3 treatment sessions, the complete clearance of ALA-PDL and PDL groups was 44/59 (74.6%), 18/61 (29.5%), partial clearance-good was 8/59 (13.6%), 20/61 (32.8%), partial clearance-poor was 7/59 (11.9%), 21/61 (34.4%) and no response was 0/59 (0%), 2/61 (3.3%). The average treatment sessions were 2.32 and 2.97 times. ALA-PDL group showed pain in 27/59 (45.8%) for the first and second treatment sessions, and postinflammatory hyperpigmentation (PIH) in 11/59 (18.6%). The PDL group showed only PIH in 3/61 (4.9%). CONCLUSION: PDT is an efficient treatment modality in recalcitrant viral warts. Especially in the case of periungual warts, it is very safe and cosmetically satisfactory without serious side effects such as nail deformity.
Aminolevulinic Acid ; Congenital Abnormalities ; Foot ; Hand ; Hyperpigmentation ; Korea ; Lasers, Dye ; Nails ; Photochemotherapy ; Triazenes ; Warts

Eosinophilic cellulitis is a rare recurrent inflammatory dermatosis, characterized clinically by well-circumscribed erythematous plaques. The histopathologic features of the lesions are dermal edema, infiltration of eosinophils and development of 'flame figures' in the dermis. A 64-year-old female presented pruritic erythematous plaques, with associated bullae, on her right hand and wrist. Histopathologic examination showed infiltration of eosinophils and characteristic flame figures in the dermis. The clinical presentation and histopathologic alterations are consistent with the diagnosis of eosinophilic cellulitis. Herein, we report a case of bullous eosinophilic cellulitis which is an uncommon variant of eosinophilc cellulitis.
Blister ; Cellulitis ; Dermis ; Edema ; Eosinophilia ; Eosinophils ; Female ; Hand ; Humans ; Middle Aged ; Skin Diseases ; Wrist

Reactive perforating collagenosis is one of a range of essential perforating disorders and is characterized by the transepithelial elimination of altered collagen. Two types have been recognized: the inherited, or childhood form and the acquired, or adult form. Acquired reactive perforating collagenosis is associated with systemic diseases, especially diabetes mellitus and/or renal failure. We report that a low-dose allopurinol showed dramatic effects on acquired reactive perforating collagenosis, which was associated with hypothyroidism and chronic renal failure caused by diabetic nephropathy.
Adult ; Allopurinol* ; Collagen ; Diabetes Mellitus ; Diabetic Nephropathies ; Humans ; Hypothyroidism ; Kidney Failure, Chronic ; Renal Insufficiency

The purpose of this study was to determine the meaning of the pain and experiences of elderly women with osteoarthritis, by adopting Colaizzi's phenomenological method. The participants were 7 elderly women over the age of 65. They were selected using a theoretical sampling technique. The Data was collected by in-depth and open-ended interviews from Dec. 1. 1999. to Feb, 28. 2000. The length of the interviews varied from 120 minutes to 180 minutes. Data was recorded and analyzed by a constant comparative method. From the data, significant statements were extracted and then organized into 48 themes, which resulted in 15 clusters of themes and 6 categories. The final descriptions turned out to be valid through the interviewee' validation process. Essential themes of the pain experiences emerged : "physical discomfortness(disturbances)", "negative state of mind", "influence of the death", "positive change in life", "Cause of pain perceived", and "change of their personal relationships". From these results, it was found that elderly women need nursing care based on a deep understanding of pain, and a reflection on their past is imperative to overcome their given situations. In conclusion, it is suggested that the care givers provide more support to solve the problems experienced by the elderly. Thus the researchers expect to provide understanding of older people and give basic data of holistic care for them.
Aged* ; Arthritis ; Caregivers ; Female ; Humans ; Nursing Care ; Osteoarthritis*

PURPOSE: Ultrasonography is being widely used as a standard test in obstetric care, studies on congenital hydronephrosis. Focusing on specific prenatal history and frequently associated anomalies in newborn infants with hydronephrosis, this investigation was intended to suggest particulars that need to be considered in making an accurate diagnosis of fetal hydronephrosis. METHODS: From May 2000 to May 2005, retrospective study was conducted on 67 patients (93 kidney) who had been diagnosed by renal ultrasonography during neonatal periods. Hydronephrosis was defined as having a pelvic diameter more than 5 mm, and was classified into three groups according to their severity;mild (grade I, II), moderate (grade III) and severe (grade IV). RESULTS: This study included 67 cases with 54 male and 13 female infants. There were 35 cases with a specific prenatal history in 22 infants such as oligohydramnios, intrauterine growth retardation, preeclampsia and others. 33 cases in 23 infants had associated anomalies such as urogenital anomalies, cardiac anomalies. Of these 67 infants (97 kidneys), 49.5% was mild, 30.1% moderate, 20.4% severe hydronephrosis. Infants with moderate hydronephrosis had more specific prenatal history and associated anomaly than the mild hydronephrosis did (68.2% vs 31.8%, P<0.001 73.7% vs 26.3%, P<0.001). CONCLUSION: Particular attention should be paid for cases with congenital hydronephrosis with a specific prenatal history to find out any associated congenital anomalies (such as urogenital or cardiac anomalies). This will enable clinicians to establish a more appropriate treatment and postnatal care.
Diagnosis ; Female ; Fetal Growth Retardation ; Humans ; Hydronephrosis* ; Infant ; Infant, Newborn* ; Male ; Oligohydramnios ; Postnatal Care ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Ultrasonography

PURPOSE: Considering popular use of fluoroquinolone eyedrops in Korea, it is important to know emerging resistant strain in treating infectious eye disease. We report methicillin resistant Staphylococcus aureus after frequent use of ofloxacin eyedrop in corneal ulcer and chronic conjunctivitis. METHODS: Four strains of ofloxacin-resistant MRSA (Methicillin-Resistant Staphylococcus Aureus) in patients with keratitis and conjunctivitis were found in our study. One strain was detected in a patient who used ofloxacin eyedrops intermittently for the treatment of recurrent corneal erosion which resulted from a bullous keratopathy after graft failure, and the others were detected in three patients using ofloxacin eyedrops intermittently or continuously for the treatment of conjunctivitis over 1 year. RESULTS: As fluoroquinolone eyedrop has been used more frequently, it is presumed that antibiotic resistance rate of ocular strains to ofloxacin might be increased. Therefore, a careful use of topical antibiotics based on the culture and antibiotic sensitivity test should be emphasized for the successful treatment of infectious ocular diseases.
Anti-Bacterial Agents ; Conjunctivitis* ; Corneal Ulcer* ; Drug Resistance, Microbial ; Eye Diseases ; Humans ; Keratitis ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus* ; Ofloxacin ; Ophthalmic Solutions ; Staphylococcus ; Staphylococcus aureus ; Transplants

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea.
Airway Resistance ; Asthma ; Child* ; Diagnosis ; Functional Residual Capacity ; Histamine ; Humans ; Infant ; Korea ; Lung* ; Mechanics ; Methacholine Chloride ; Oscillometry ; Patient Compliance ; Plethysmography ; Respiratory Function Tests ; Spirometry