Efficacy comparison of two administration methods of fluconazole in the treatment of intractable vulvovaginal candidiasis / 局解手术学杂志

Objective To discuss the efficacy comparison of two administration methods of fluconazole in the treatment of intractable vulvovaginal candidiasis( VVC) . Methods 200 patients with intractable VVC were selected in our hospital from January 2014 to January 2017;according to the random number table,all patients were divided into single-dose group and consolidation group,each with 100 cases;the single-dose group was orally administered a single dose of 150mg fluconazole,while the consolidation group was orally administered 150mg o-ral fluconazole(1 time/d, continuous treatment for 3d, and administering it 1 time after next menstruation);the clinical symptom remission time,curative effect,adverse reaction and recurrence were compared in two groups. Results The vaginal itching,abdomen pain,vaginal se-cretion,mucosal hyperemia,edema remission time and the treatment efficiency rate,adverse reaction rate of single group and consolidation group were basically the same;and the difference was not statistically significant (P>0. 05). During the 12-month follow-up,the recurrence rate of consolidated group was significantly lower than that of single-dose group,the difference was statistically significant(P<0. 05). Con-clusion Compared with the single dose,the fluconazole consolidation therapy also has the good therapeutic efficacy and safety in the treat-ment of intractable VVC,and it can effectively reduce the recurrence of patients,so it is worth further clinical promotion.

Updates in Intractable Benign Paroxysmal Positioning Vertigo / 대한평형의학회지

Benign paroxysmal positioning vertigo (BPPV) is the most common disease that causes dizziness which is usually resolved spontaneously or by office-based physical therapy. However, clinicians sometimes encounter atypical or intractable BPPV cases which show poor effect with physical therapy including canalith reposition therapy and liberative maneuvers and frequent recurrence. There is no common definition, diagnosis and treatment protocols for intractable BPPV. Various types of intractable BPPV and reported treatment methods are discussed in this review.

Treatment of 3 cases of frequent recurrent intractable nephrotic syndrome by XUE Chang-sen / 中华中医药杂志

This article reported the treatment of 3 cases of frequent recurrent intractable nephrotic syndrome by XIE Chang-sen. On basis of the therapeutic method of invigorating the spleen and kidney, other methods should be used according to individual difference and special clinic signs and symptoms, such as other invigorating qi and consolidation of superficies, nourishing blood and dispersing stagnated liver qi, warming kidney qi to invigorate yang, replenishing essence and dispersing turbid and so on. And partner treatment is the key for cure.

Clinical Significance of Interictal Serum Prolactin Level in Male Patients with Complex Partial Seizures Involving Temporal Lobe

BACKGROUND: To investigate the clinical significance of interictal serum prolactin level (ISPL), especially in the medical intractability, in patients with complex partial seizure involving the temporal lobe. METHODS: Forty-one male patients older than 16 years, who had motionless staring, were selected. The patients were divided into paired groups according to medical intractability, secondary generalization, duration of disease, seizure frequency, number of antiepileptic drugs, hippocampal sclerosis in MRI, and interictal epileptiform discharge. Serum was sampled in the morning before breakfast, and ISPL was measured. RESULTS: ISPL of the medically intractable patients (11.43 +/- 1.25 ng/ml, n=23) was relatively higher than the treatable patients (9.67 +/- 1.52, n=18), but it was not statistically significant (p>0.05). ISPL of the patients with secondary generalization was significantly higher (11.58 +/- 1.10, n=33) than that of the patients without secondary generalization (6.84 +/- 1.39, n=8; p=0.049). The other factors did not make significant changes in ISPL (p>0.05). CONCLUSIONS: The medical intractability of epilepsy with clinically determined complex partial seizures involving temporal lobe did not change the ISPL. Therefore, ISPL may not be useful as a biochemical marker of the medical intractability of complex partial seizures involving the temporal lobe. However, there was the evidence suggesting that the secondary generalization of complex partial seizures may be an important factor to increase ISPL, which implies that more widespread robust activation of limbic structures may be needed to elevate ISPL.

The Factors Related to Intractability in Patients with Partial Epilepsy / 영남의대학술지

To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.