The dopamine D4 receptor gene has a hypervariable segment in the coding region charcterized by a varying number of 48bp repeats in exon III of the gene. Varying the numbers of repeated segments may change the length, structure, and function of the receptor, which makes this gene a possible candidate for variations in dopamine-related behaviors. such as alcoholism and drug abuse. We evaluated the dopamine D4 receptor genotype in male alcoholics and normal controls. All alcoholics and controls were unrelated and from the Korean population. Genotype and allele frequencies in 67 alcoholics were compared to 67 controls who were free of alcohol abuse. substance abuse. and major mental illness. No association was found between the dopamin D4 recepto allele and alcoholism. This result indicate that there is no association of the dopamine D4 receptor with alcoholism in Korean. Further systemized investigation to determine the role of dopamine D4 receptor gene in alcoholism with a larger sample size will be required.
Alcoholics ; Alcoholism* ; Alleles ; Clinical Coding ; Dopamine* ; Exons ; Gene Frequency ; Genotype ; Humans ; Male ; Receptors, Dopamine D4* ; Sample Size ; Substance-Related Disorders

Alcohol has extensive effects on sleep and daytime sleepiness. Alcohol has a sleep inducing effect and the effect of increased non-REM sleep and suppressed REM sleep during the first half portion of night sleep, but alcohol induces the effect of decreased non-REM sleep and increased light sleep and frequent awakenings and REM rebound during the second half portion of night sleep. Alcohol provokes chronobiological change such as the changes of amplitude or the phase shifts of hormones or core body temperature. The sleep disruption resulting from alcohol drinking may lead to daytime fatigue and sleepiness. The elderly are at particular in the increased risk of alcohol-related sleep disorders because they achieve higher levels of alcohol in the blood and brain than do younger adults after consuming an equivalent dose. Bedtime alcohol consumption among older adults may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries. Continued alcohol use for sleep induction often induces aggravation of insomnia, alcoholism or sleep related breathing disorders such as obstructive sleep apnea. Alcohol should not be used as substitution of sleep pill because of the dependence and tolerance for sleep inducing effect, and the sleep disruption produced by alcohol withdrawal.
Adult ; Aged ; Alcohol Drinking ; Alcoholism ; Body Temperature ; Brain ; Fatigue ; Humans ; Respiration ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sleep, REM ; Walking

No abstract available.
Femur* ; Phlebography* ; Prognosis*

OBJECTIVE: This study was performed to determine the prevalence and age-adjusted prevalence of anti-HCV antibody among the employees and their partners in Korea, and whether prevalence varies with job type. METHOD: The blood serum of 29, 278 people, employees and their partners aged between 20 and 60 residing in Seoul or Kyung-gee province, were tested with Immunoradiometric Assay (IRMA) method using third generation anti-HCV serum. RESULTS: Twenty-five among the 29, 278 people tested positive; a prevalence rate of 0.9 per 1, 000 (95% CI 0.6-1.3). The prevalences of different age groups were 0, 0.5, 1.3, and 4.2 per 1, 000 among the subjects in their 20s, 30s, 40s and 50s respectively, which shows the increasing rate of prevalence with age. Age adjusted prevalence among employees was 1.3 per 1, 000. The prevalences among different kinds of job were 1.9 per 1, 000 (95% CI: 0.5~7.0) for construction, 1.7 per 1, 000 (95% CI: 0.7~3.9) for finance, and 1.2 per 1, 000 (95% CI: 0.2~6.6) for telecommunication. No significant statistical difference was found in the prevalence according to job type(p>0.05). CONCLUSIONS: Employees in Korea showed a lower prevalence rate of anti-HCV antibody than that of blood donors, health screening examinees and the general population. This result is in line with that of other studies abroad and is considered to be because employees may have lower rates of Hepatitis C risk activities, such as needle sharing, than unemployed.
Blood Donors ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoradiometric Assay ; Korea* ; Mass Screening ; Needle Sharing ; Prevalence* ; Seoul ; Serum ; Telecommunications

Thirty-two patients with transitional cell carcinoma of the renal pelvis and ureter were analyzed to determine whether there was any correlation between tumor characteristics and patient survival. The patients consisted of 26 male and 6 female. Patient age ranged from 12 to 80 years with a mean of 53.6 years. Of these patients. 28 were followed for 1 to 10 years. The most common presenting symptom was hematuria (87.5% ). Excretory urogram demonstrated NVK (nonvisualization or the kidney) in 16 patients and filling defect in 10. Pathologically. 31% of the patients were stage T1. 46% stage T2, 12% stage T3 and l6% stage T4. Histologically, 16% of the patients had grade I . 47% grade II and 37% grade III disease. Recently 6 patients, of whom 5 presented with stage T2 and 1 with stage T4. were treated postoperatively with adjuvant M-VAC (methotrexate, vinblastine. adriamycin and cisplantin) chemotherapy. H these 6 patients, 3 had subsequently recurrent tumor and their mean survival was 15 months. The 2 years survival rates of 28 patients follow-up were 90.0, 45.5, 33.3 and 0% for stage T1, T2, T3 and T4 disease, respectively, and 100, 66.7 and 10% for grade I to III disease, respectively. Overall 2 years and 5 years survival rates were 53.6% and 23.1% respectively. It is concluded from this study that age, sex. NVK on excretory urogram. synchronous or metachronous bladder tumors seem to have no influence on patient survival while patient survival correlates with stage and grade of tumor.
Carcinoma, Transitional Cell* ; Doxorubicin ; Drug Therapy ; Female ; Follow-Up Studies ; Hematuria ; Humans ; Kidney Pelvis* ; Male ; Survival Rate ; Ureter* ; Urinary Bladder Neoplasms ; Vinblastine

We report a case of neurilemmoma of deep peroneal nerve sensory branch that triggered sensory change with compression test on lower extremity. After resection of tumor, there are evoked thermal changes on pre- and post-operative infrared (IR) thermographic images. A 52-year-old female presented with low back pain, sciatica, and sensory change on the dorsal side of the right foot and big toe that has lasted for 9 months. She also presented with right tibial mass sized 1.2 cm by 1.4 cm. Ultrasonographic imaging revealed a peripheral nerve sheath tumor arising from the peroneal nerve. IR thermographic image showed hyperthermia when the neurilemoma induced sensory change with compression test on the fibular area, dorsum of foot, and big toe. After surgery, the symptoms and thermographic changes were relieved and disappeared. The clinical, surgical, radiographic, and thermographic perspectives regarding this case are discussed.
Female ; Fever ; Foot ; Humans ; Low Back Pain ; Lower Extremity ; Middle Aged ; Neurilemmoma* ; Peripheral Nerves ; Peroneal Nerve* ; Sciatica ; Toes

Anxiety disorders are common psychiatric illnesses in the elderly. However, anxiety disorders in older people have not drawn much attention from researchers and clinicians alike, compared with late-life depression or dementia. The author searched for articles published from 1986 to 2006 using the key words including "anxiety", "elderly", "aged", and "pharmacological" therapy in the MEDLINE, PsychINFO, and KMbase in order to clarify effective pharmacological therapy in the elderly with anxiety disorders. Well designed studies for pharmacologic intervention in late-life anxiety disorders were rarely found. Nonetheless, studies on young adults demonstrated a number of pharmacological treatment options that can be applied to these patients. Pharmacologic treatments for the elderly include therapies using antideprssants, especially SSRI or SNRI, buspirone, or benzodiazepines. The latter requires special caution in the administration in the elderly because it can lead to adverse events. Therefore, well designed clinical trials are further needed to obtain optimal pharmacological intervention for the elderly with anxiety disorders.
Aged ; Anxiety Disorders* ; Anxiety* ; Benzodiazepines ; Buspirone ; Dementia ; Depression ; Drug Therapy* ; Humans ; Young Adult

OBJECTIVES: This study was designed to assess the change of heart rate variability (HRV) at resting, upright, and psychological stress in anxiety disorder patients. METHODS: HRV was measured at resting, upright, and psychological stress states in 60 anxiety disorder patients. We used visual analogue scale (VAS) score to assess tension and stress severity. Beck depression inventory (BDI) and state trait anxiety inventories I and II (STAI-I and II) were used to assess depression and anxiety severity. Differences between HRV indices were evaluated using paired t-tests. Gender difference analysis was accomplished with ANCOVA. RESULTS: SDNN (Standard deviation of normal RR intervals) and low frequency/high frequency (LF/HF) were significantly increased, while NN50, pNN50, and normalized HF (nHF) were significantly decreased in the upright position compared to resting state (p < 0.01). SDNN, root mean square of the differences of successive normal to normal intervals, and LF/HF were significantly increased, while nHF was significantly decreased in the psychological stress state compared to resting state (p < 0.01). SDNN, NN50, pNN50 were significantly lower in upright position compared to psychological stress and nVLF, nLF, nHF, and LF/HF showed no significant differences between them. CONCLUSION: The LF/HF ratio was significantly increased after both physical and psychological stress in anxiety disorder, but did not show a significant difference between these two stresses. Significant differences of SDNN, NN50, and pNN50 without any differences of nVLF, nLF, nHF, and LF/HF between two stresses might suggest that frequency domain analysis is more specific than time domain analysis.
Anxiety ; Anxiety Disorders* ; Autonomic Nervous System ; Depression ; Equipment and Supplies ; Heart Rate* ; Humans ; Stress, Psychological*

OBJECTIVES: Sleep disorders cause changes of autonomic nervous system (ANS) which affect cardiovascular system. Primary insomnia (PI) makes acceleration of sympathetic nervous system (SNS) tone by sleep deficiency and arousal. Obstructive sleep apnea syndrome (OSAS) sets off SNS by frequent arousals and hypoxemias during sleep. We aimed to compare the changes of heart rate variability (HRV) indices induced by insomnia or sleep apnea to analyze for ANS how much to be affected by PI or OSAS. METHODS: Total 315 subjects carried out nocturnal polysomnography (NPSG) were categorized into 4 groups - PI, mild, moderate and severe OSAS. Severity of OSAS was determined by apnea-hypopnea index (AHI). Then we selected 110 subjects considering age, sex and valance of each group's size [Group 1 : PI (mean age=41.50+/-13.16 yrs, AHI <5, n=20), Group 2 : mild OSAS (mean age=43.67+/-12.11 yrs, AHI 5-15, n=30), Group 3 : moderate OSAS (mean age 44.93+/-12.38 yrs, AHI 16-30, n=30), Group 4 : severe OSAS (mean age=45.87+/-12.44 yrs, AHI >30, n=30)]. Comparison of HRV indices among the four groups was performed with ANCOVA (adjusted for age and body mass index) and Sidak post-hoc test. RESULTS: We found statistically significant differences in HRV indices between severe OSAS group and the other groups (PI, mild OSAS and moderate OSAS). And there were no significant differences in HRV indices among PI, mild and moderate OSAS group. In HRV indices of PI and severe OSAS group showing the most prominent difference in the group comparisons, average RR interval were 991.1+/-27.1 and 875.8+/-22.0 ms (p=0.016), standard deviation of NN interval (SDNN) was 85.4+/-6.6 and 112.8+/-5.4 ms (p=0.022), SDNN index was 57.5+/-5.2 and 87.6+/-4.2 (p<0.001), total power was 11,893.5+/-1,359.9 and 18,097.0+/-1,107.2 ms2 (p=0.008), very low frequency (VLF) was 7,534.8+/-1,120.1 and 11,883.8+/-912.0 ms2 (p=0.035), low frequency (LF) was 2,724.2+/-327.8 and 4,351.6+/-266.9 ms2 (p=0.003). CONCLUSIONS: VLF and LF which were correlated with SNS tone showed more increased differences between severe OSAS group and PI group than other group comparisons. We could suggest that severe OSAS group was more influential to increased SNS activity than PI group.
Acceleration ; Anoxia ; Arousal ; Autonomic Nervous System ; Cardiovascular System ; Heart ; Heart Rate ; Polysomnography ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Sympathetic Nervous System

OBJECTIVES: Several studies suggest that psychotropic drugs may affect on lipid metabolism and body weight. And the differences of levels of seam lipids were observed in patients with several psychiatric disorders. Hence, in order to elucidate the effects of psychotropic drugs on serum lipid, lipoprotein and apolipoprotein, the authors estimated the serum lipid profile in the psych op harmacological treatment. METHODS: Thirty six patients with schizophrenia and 42 patients with depressive disorder or anxiety disorder were recruited from the inpatient psychiatric units and withdrawn from all psychotropic drugs at least far 3 months. The levels of seam total cholesterol, high-density lipoprotein cholesterol(HDL-C), trighlyceride, apolipoprotein A, apolipoprotein B, and lipoprotein(a) were measured before the treatment and after 2, 4, 8 and 12 weeks of the treatment. RESULTS: No statistically significant change was found on all serum lipid profiles in the antipsychotics group. However, the changes on serum total cholesterol, low-density lipoprotein (LDL-C), apolipoprotein A, and apolipoprotein B from the baseline to the following weeks have been observed in tricyclic antidepressants group. And the serum total cholesterol and apolipoprotein B have been observed to be changed from the baseline to the following weeks in the selective serotonin reuptake inhibitors poop. The changes on seam lipoprotein(a) were proved not to be statistically significant during all the psychotropic drugs treatment. CONCLUSION: These results implicate that all psychotropic drugs might affect on the lipid metabolism, especially for tricyclic antidepressants. Therefore, this implication could be important in clinical situation because the changes on serum lipid profiles may be related to the cardiovascular disease especially in psychiatric patients with the cardiovascular risk factor.
Antidepressive Agents, Tricyclic ; Antipsychotic Agents ; Anxiety Disorders ; Apolipoproteins* ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Depressive Disorder ; Humans ; Inpatients ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins* ; Psychotropic Drugs ; Risk Factors ; Schizophrenia ; Serotonin Uptake Inhibitors