PURPOSE: To evaluate the efficacy and safety of BOTULAX® in subjects with essential blepharospasm.METHODS: In this study, a total of 250 subjects with essential blepharospasm were enrolled at 15 investigational sites and a total of 220 subjects completed the study. The efficacy and safety were evaluated at weeks 4 and 16 after treatment compared with baseline. In total, 240 subjects were enrolled, treated with the investigational product, and evaluable for the primary efficacy assessment at week 4 after treatment; these subjects were included in the intention-to-treat (ITT) population. With the ITT set as the main efficacy set, efficacy assessment included Jankovic rating scale (JRS), functional disability score, investigator evaluation of global response and quality of life. Safety assessment including the incidence of adverse events was also performed.RESULTS: In terms of the primary efficacy endpoint (i.e., change in JRS total score at week 4 after treatment from baseline [ITT set]), mean change indicated a statistically significant reduction (p < 0.0001) and demonstrated the non-inferiority of the test drug to similar drugs. In terms of the secondary efficacy endpoints, mean change in JRS total score at week 16 after treatment and mean change in functional disability score at weeks 4 and 16 after treatment both exhibited a statistically significant reduction compared with baseline (p < 0.0001 for all). Among the 249 subjects treated with the investigational product in this study, 44 (17.67%) experienced 76 treatment emergent adverse events but no serious adverse events were observed.CONCLUSIONS: Based on the study results, BOTULAX® is considered to be an effective and safe treatment for essential blepharospasm.

BACKGROUND AND OBJECTIVES: The aim of the present study was to assess the feasibility of a PC-based facial asymmetry assessment program (PC-FAAP) and to compare the results of PC-FAAP with subjective regional scoring by raters in acute unilateral peripheral facial nerve paralysis (FNP). SUBJECTS AND METHODS: Participants were divided into 3 groups with 8 participants per group: group I, normal; group II, mild to moderate FNP; and group III, severe FNP. Using the PC-FAAP, the mouth asymmetry ratio (MAR), eyebrow asymmetry ratio (EAR), and complete eye closure asymmetry ratio (CAR) were calculated by comparing the movement of tracking points on both sides. The FNP grading scale (FGS) integrated each score, and the scores were weighted with a ratio of 5:3:2 (MAR:CAR:EAR). Subjective regional scoring was measured on a 0-100 scale score by three otologists. PC-FAAP and subjective scoring were compared in each group regarding the consistency of the results. RESULTS: The mean scores of the MAR, EAR, CAR, and FGS of each group were significantly different. PC-FAAP showed significant differences between the three groups in terms of MAR, EAC, CAR, and FGS. PC-FAAP showed more consistent results than subjective assessment (p < 0.001). The PC-FAAP was significantly more consistent in group I and group III (p < 0.001 and p=0.002, respectively). FGS in group III was the only parameter that showed a more consistent result in PC-FAAP than the subjective scoring (p=0.008). CONCLUSIONS: An FNP grading system using a PC-based program may provide more consistent results, especially for severe forms.
Ear ; Eyebrows ; Facial Asymmetry ; Facial Nerve ; Mouth ; Paralysis

Spontaneous hemo-pneumothorax, a hemothorax that occurs without trauma, is a very rare condition; however, as a result of excessive bleeding, it can be lethal. Also, if the bleeding is scanty, the physician might recognize hemothorax in case of performing invasive procedures, such as chest tube insertion, and may misunder stand as a complication of the procedure. For this reason, acknowledgement of the spontaneous hemo-pneumothorax in the emergency department is very important. We report on a case of a spontaneous hemo-pneumothorax in a healthy 18-year-old male presenting with chest pain who developed a spontaneous pneumothorax with a profuse amount of hemothorax.
Chest Pain ; Chest Tubes ; Emergencies ; Hemorrhage ; Hemothorax ; Humans ; Male ; Pneumothorax

New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of Panax ginseng extract administration in a 7 year-old boy with drug naive ADHD. We administered Panax ginseng extract 1,800 mg/day to him for 8 weeks. There were improvement of scores in Attention Diagnostic System, Clinical Global Improvement, Conner's ADHD Rating scale and Dupaul ADHD Rating scale.
Attention Deficit Disorder with Hyperactivity ; Panax ; Polyenes

Objectives : We developed the instrument to assess the quality of life(QOL) for demented patients, 'Geriatric Quality of Life-Dementia(GQOL-D)'. The purpose of this study was to standardize the GQOL-D and to introduce administration results in Korean demented patients. METHODS: The normal subjects were 340 elderly people, aged over 55 years old, who were physically and cognitively normal. And the patient group was consisted of 69 demented patients. RESULTS: Both in normal group and in patient group, the internal consistency, Cronbach's = 0.87, 0.90, respectively, and item-total correlation was acceptable. And the test-retest reliability revealed the stability across time by r=0.86, 0.77, respectively. Criterion validity was found to be a high correlation between each itemand overall QOL' item, and adequate correlations between the GQOL-D and scales assessing cognition, psychological wellbeing, behavior and activities of daily living convinced convergent validity. In the result of factor analysis, 2 factors with a variance percentage of 37.7% were extracted. The mean score and standard deviation of items of the GQOL-D for two groups and differences in items such as memory, recreation/leisure, self esteem, general health, and mobility between groups were presented. CONCLUSION: It was confirmed that there is no difficulty for old people to carry out the GQOL-D. As it was suggested that there is enough room for intervening in dementia patients' emotional and behavioral difficulties, the GQOL-D will be useful in research and clinical practice for the patients with dementia.
Activities of Daily Living ; Aged ; Cognition ; Dementia ; Humans ; Memory ; Middle Aged ; Quality of Life* ; Self Concept ; Weights and Measures

OBJECTIVE: Subsequent clinical experiences in risperidone treatment indicated that the initially recommended dose schedule resulted in too rapid increment of doses to the maintenance dose. The goal of this study was to establish a new optimal dose-schedule recommendation for risperidone in patients with schizophrenia. METHODS: Two hundred and eighteen schizophrenic patients were randomly assigned to the following three groups. For the first group, 1 mg of risperidone was administered on the first day, 2 mg on the second day, and the dose was increased from the third day depending on the clinical status of the patients. For second group, 0.5 mg was administered on the first two days, 1 mg on the 3-5th day, 1.5 mg on the 6-7th day, 2 mg on the 8th day, and the dose was increased from the 9th day depending on the clinical status. For third group, 0.5 mg was administered on the first three days, 1mg on the 4-8th day, 1.5 mg on the 9-13th day, 2 mg on the 14th day, and the dose was increased from the 15th day depending on the clinical status. The schizophrenic symptoms were rated by the Positive and Negative Syndrome Scale (PANSS) on days 0, 7, 14, 28 and 48 of the risperidone treatment. The tolerance of the treatment was checked by ESRS, modified UKU, and Global Impression of tolerability. The efficacy and tolerability were compared among the three regimen groups. RESULTS: After 8 weeks of treatment, the PANSS total scores, positive scores and negative scores were not significantly different among the three groups. There were no differences among the three groups regarding tolerability ratings and ESRS rating except gait/posture and tremor items which scores were high in first group at the end of the study. The sedation and fatigability items scores in the first group was significantly more higher than in the second and third group. CONCLUSION: These data suggest that the 2-week titration of risperidone may be the most favorable strategy in the treatment of schizophrenia.
Appointments and Schedules ; Drug Tolerance ; Humans ; Risperidone* ; Schizophrenia* ; Tremor

No abstract available.
Animals ; Macrophages, Peritoneal* ; Mice*

OBJECTIVE: The aim of this study is to determine effects of nefazodone on depression, anxiety, sleep and sexual function in depressive patients. SUBJECTS AND METHODS: This is an open, non-comparative, multi-center study. Antidepressant and other clinical effects of nefazodone were evaluated in 230 patients of 26 centers, aged 14 years or more, who met DSM-IV criteria to major depressive disorder or dysthymic disorder and didn't have other psychiatric disorders and were physically healthy. The clinical efficacy was assessed at week 1, 2, 4 and 8 using Clinical Global Improvement (CGI), Hamilton Depression Scale (HAM-D), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory-State Anxiety (STAI-SA). Other clinical effects were assessed with Weekly Sleep Questionnaire, Sexual Functioning Questionnaire and GHQ-QOL-12, a scale for quality of life. Adverse drug reactions were checked with a questionnaire. Post-treatment effects of drug were compared with pre-treatment baseline condition. RESULTS: The response rates by Clincal Grobal Improvement and HAM-D after 8 weeks treatment were 62.4% and 75.2% respectively. Comparing to baseline, nefazodone was proved to have significantly higher antidepressant and antianxiety effects in depressive patients and it improved also sleep, sexual functions and quality of life. Both patients and physicians satisfied with the effects of drug. Adverse drug reactions were a few and not serious, and most of them disappeared as treatment continued. CONCLUSION: These results suggest that not only nefazodone has antidepressant effects and antianxiety effects, but also it improves sleep disturbance, sexual dysfunction and the quality of life in depressive patients. Adverse drug reactions were a few and not serious.
Anti-Anxiety Agents ; Anxiety* ; Depression* ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Drug-Related Side Effects and Adverse Reactions ; Dysthymic Disorder ; Humans ; Quality of Life* ; Surveys and Questionnaires

OBJECTIVES: We tested the reliability and validity of the Korean version of the PANSS (PANSS-KV). METHODS: The PANSS ratings were obtained from 101 subjects with DSM-IV diagnoses of schizophrenia or schizophreniform disorder. To study the concurrent validity, the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) were also administrated in 38 patients. Using these data, inter-rater reliability, test-retest reliability, internal consistency, criterion validity and concurrent validity were evaluated. Factor structure was analyzed by the principal axis factoring. RESULTS: The inter-rater reliability of the Korean version of the PANSS was satisfactory in positive (r=0.92) and negative syndrome subscales(r=0.86), but somewhat low in general psychopathology subscale (r=0.78). The test-retest correlations for the 3 PANSS subscales ranged between 0.89 and 0.95, so it showed excellent test-retest reliability. The Cronbach's alpha for the positive, negative and general psychopathology subscales were 0.73, 0.84 and 0.74, respectively and thus the 3 subscales of the PANSS had good internal consistencies. All separate items revealed significant corrected item-total correlations in the positive and negative syndrome subscales, but some items of the general psychopathology subscale showed no or low corrected item-total correlations. The positive and negative syndrome subscales held a high concurrent validity in relation to the SAPS and the SANS. It was confirmed that positive and negative syndromes were independent constructs. The factor analysis by the principal axis factoring produced 5 components: cognitive, excitement, depression, positive and negative. CONCLUSION: These findings prove that the reliability and validity of the PANSS-KV are comparable to those of the original PANSS. So, the PANSS-KV can be widely and extensively used in researches for schizophrenia.
Axis, Cervical Vertebra ; Depression ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Psychopathology ; Psychotic Disorders ; Reproducibility of Results* ; Schizophrenia

Frequent anomalies causing a left-sided appendix are situs inversus and malrotation. The ectopic position of the appendix frequently causes a delay or error in diagnosis because of atypical symptoms. A physical examination is of limited value unless dextrocardia is present. A left-sided appendix is a rare anomaly, but when other diseases are ruled out, it must be considered especially at the emergency department.
Appendicitis* ; Appendix ; Dextrocardia ; Diagnosis ; Emergency Service, Hospital ; Physical Examination ; Situs Inversus