BACKGROUND: The kidney plays an important role in excretion and catabolization of hormones in body. The possible role of hyperprolactinemia in the sexual abnormalities of patients with end stage renal disease was reported. So, we evaulated the prolactin levels in patients undergoing long-term hemodialysis and the response to bromocriptine. METHODS: Basal serum levels of prolactin were measured in 11 patients undergoing long term hemodialysis by enzyme immunoassay. Blood samples were drawn just before dialysis and at the end of same dialysis session. We also examined 11 male normal person as controls. We evaluated the sexaul activity and serum prolactin level after administration of bromocriptine to the patients with hyperprolactinemia for 6 weeks. RESULTS: The average age of 11 male patients undergoing long-term hemodialysis was 40.2 years. The patients has been received hemodialysis for 38.5 months at time of the study. Prolactin levels in patients undergoing hemodialysis before hemodialysis were 2045.1 mIU/L, after hemodialysis 2341.2 mIU/L, and normal male persons 212.8 mIU/L. Serum prolactin levels were decreased progressively for 2 week after oral administration of bromocriptine. Thereafter, prolactin were maintained within normal value until from 4th weeks to 8th weeks. Sexual activity in end stage renal disease patients with hyperprolactinemia was markedly improved after 6th weeks. CONCLUSIONS: The serum prolactin levels in patients undergoing long-term hemodialysis were higher than that of the controls. The high serum prolactin level may be related with decreased sexual function. In patients with decreased sexual function, treatment with dopamine agonist can decreased serum prolactin levels and can improve symptoms such as decreased libido and impotence.
Administration, Oral ; Bromocriptine ; Dialysis ; Dopamine Agonists ; Erectile Dysfunction ; Humans ; Hyperprolactinemia ; Immunoenzyme Techniques ; Kidney ; Kidney Failure, Chronic ; Libido ; Male ; Prolactin* ; Reference Values ; Renal Dialysis* ; Sexual Behavior

No abstract available.

OBJECTIVES: To compare the white matter microstructure of dyslexic children with normal children using diffusion tensor imaging. METHODS: Twenty one dyslexic children and 24 normal control children were recruited in the second and third grade of elementary school students. The fractional anisotropy (FA) values of 20 representative white matter tracts were estimated from the diffusion tensor imaging data of each subject using the Johns Hopkins University-white matter tractography atlas to determine the difference in white matter integrity between the dyslexic children and normal children. RESULTS: Compared to the normal control group, the FA values of the left inferior longitudinal fasciculus [F(1,39)=5.908, p<0.05] and temporal part of the right superior longitudinal fasciculus [F(1,39)=7.328, p=0.010] were significantly higher in the dyslexic group and there was no significant difference in the other tracts. CONCLUSION: In dyslexic children, compensatory pathways develop in the left inferior longitudinal fasciculus and in the temporal part of the right superior longitudinal fasciculus.
Anisotropy ; Case-Control Studies ; Child ; Diffusion Tensor Imaging ; Dyslexia ; Humans ; White Matter

Dental caries is the most common disease in the oral cavity. However, the mechanism and treatment of dental caries is not completely understood since many complex factors are involved. Especially the effect of pH on remineralization of early stage of dental caries is still controversial. In this study, dental caries in dentin was induced by using lactic acidulated buffering solutions and the loss of inorganic substance was measured. Also decalcified specimens were remineralized by three groups of solution with different pH (group of pH 4.3, 5.0, and 5.5). Then, the amount and the area of inorganic substance precipitation was quantitatively analyzed with microradiograph. Also a qualitative comparison of the normal phase, the demineralized phase, and the remineralized phase of hydroxyapatite crystal was made under SEM. The results were as follows; 1. In microradiograghic analysis, as the pH increased, the amount of remineralization in decalcified dentin tended to increase significantly. As the pH decreaced, deeper decalcification, however, occurred along with remineralization. The group of pH 5.5 had a tendency to be remineralized without demineralization (p < 0.05). 2. In SEM view, the remineralization in dentine caries occurred from the hydroxyapatite crystal surface surrounding the mesh of organic matrix, and eventually filled up the demineralized area. 3. 5 days after remineralization, hydroxyapatite crystal grew bigger with deposition of inorganic substance in pH 4.3 and 5.0 group, and the crystal in the remineralized area appeared to return to normal. After 10 days, the crystals in group of pH 4.3 and 5.0, which grew bigger after 5 days of remineralization, turned back to their normal size, but in group of pH 5.5, some crystals were found to double their size. In according to the results of this experiment, the decalcifying and remineralizing process of dentine is neither simple nor independent, but a dynamic process in which decalcification and remineralization occur simultaneously. The remineralization process occurred from the hydroxyapatite crystal surface.
Dental Caries ; Dental Enamel ; Dentin* ; Durapatite ; Hydrogen-Ion Concentration* ; Mouth

Complex Physical Therapy (CPT) is one of the variable conservative methods of lymphedema and recently used in many countries with great success. The main concept of CPT is to improve central lymph flow by opening non-functioning lymphatic pathway and by stimulating collateral lymphatic channels to drain the swollen area into adjacent areas where lymph flow is normal. CPT consists of 4 main parts; 1. meticulous skin care, 2. manual lymph drainage, 3. multilayered non-stretching compression bandages and compression garments, 4. special exercise. We tried to assess the immediate and maintenance effects of CPT in patients with lymphedema. CPT was used on 25 patients (male 5, female 20) with 10 upper and 15 lower extremity edemas for 2weeks such as 5 days per week, 1.5 hours per day at out-patient clinic. Immediately, the reduction of edema volume was 25.5+/-13.8% at the upper extremity and 27.5+/-15.5% at lower extremity in 2 weeks after treatment. All these were well maintained following 3 months without any significant variation. In comparison between proximal and distal parts, there was no significant difference except the immediate post-treatment result of the lower extremity. But the maintenance of volume reduction of distal part was better than proximal part through 3 months after treatment. We also found the reduction of skin subcutaneous thickness according to the volume reduction. In conclusion, CPT is a effective treatment method for patients with lymphedema but follow up study will be needed for identifying long term maintenance effect.
Compression Bandages ; Drainage ; Edema ; Female ; Follow-Up Studies ; Humans ; Lower Extremity ; Lymphedema* ; Outpatients ; Skin ; Skin Care ; Upper Extremity

Nonimmune hydrops fetalis(NIHF) is a heterogenous disorder resulting from a vast number of underlying pathologies. Chromsomal abnormalities underlie a large percentage of cases of NIHF in most series. There are many reports identifying the association of Turner syndrome and Trisomy 21, 18, 13 with NIHF, but few reports about Klinefelter syndrome. In this article, we experienced a case of Klinefelter syndrome combined with hydrops fetalis and report the case with brief review of literature.
Down Syndrome ; Edema* ; Hydrops Fetalis* ; Klinefelter Syndrome* ; Pathology ; Turner Syndrome

Many neurologic disorders manifest as psychiatric symptoms. Anti-N-Methyl-D-Aspartate (NMDA) receptor encephalitis is an autoimmune disease of the brain characterized by numerous neurological and psychiatric features. Despite being rare, its prevalence is rapidly increasing and early management is critical in ensuring successful and sustainable recovery. Therefore, the illness should be considered as a differential diagnosis when clinically assessing patients. This report presents a case of a female child who was hospitalized for acute psychiatric manifestations, which was later confirmed as anti-NMDA receptor encephalitis. She recovered relatively successfully after combined neurological and psychiatric treatment. This report provides information on the clinical course of early onset anti-NMDA receptor encephalitis, including treatment strategy and prognosis.
Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Autoimmune Diseases ; Brain ; Child ; Diagnosis, Differential ; Encephalitis ; Female ; Humans ; Nervous System Diseases ; Prevalence ; Prognosis ; Psychotic Disorders ; Receptors, N-Methyl-D-Aspartate ; Rituximab ; Teratoma

Nocardiosis is a rare infection seen most commonly in immunocompromized patients. Most patients have pulmonary involvement, but some develop disseminated infection. A 52-year-old man, treated with immunosuppressive drugs for 3 months after kidney transplantation, developed pulmonary nocardiosis and disseminated infection involving brain, skin, and both uvea. The diagnosis was made by open lung biopsy specimens showing characteristic weak acid fastness with modified Ziel-Neelsen stainig and histologic examination. Immunosuppressive therapy was continued and combination of surgical drainage of brain abscess and chemotherapy with Minocycline were successful. With the increasing number of allograft recipients and concomitant immunosuppression, the possibility of an increase in Nocardia opportunistic infections exists.
Allografts ; Biopsy ; Brain ; Brain Abscess ; Diagnosis ; Drainage ; Drug Therapy ; Humans ; Immunosuppression ; Kidney Transplantation ; Kidney* ; Lung ; Middle Aged ; Minocycline ; Nocardia ; Nocardia Infections* ; Opportunistic Infections ; Skin ; Transplantation* ; Uvea

Aortoenteric fistula is a rare and life-threatening cause of upper gastrointestinal hemorrhage. Fistulas may be classified as primary or secondary. Secondary aortoenteric fistulas usually occur at the suture line following arterial reconstruction with prosthetic material and developed in 0.5~2.4% of the patients. The incidence of primary fistulas was reported in 0.04~0.07% in a large autopsy series and is 0.69~2.36% in patients with abdominal aortic aneurysm. Atherosclerosis is now the dominant cause. The mortality rate of patients with primary aortoduodenal fistula (ADF) is extremely high, principally because the diagnosis is difficult and seldomly established before the massive bleeding results in emergency operation or death. This occurs predominantly in the third and fourth parts of the duodenum. Symptoms of ADF consist of flank pain or abdominal pain, hematemesis, melena, and an abdominal mass. ADF is curable, if diagnosed and treated with surgical intervention before the onset of lethal massive hemorrhage. We report a case of primary ADF with a review of the literatures.
Abdominal Pain ; Aortic Aneurysm, Abdominal ; Atherosclerosis ; Autopsy ; Diagnosis ; Duodenum ; Emergencies ; Fistula* ; Flank Pain ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage ; Humans ; Incidence ; Melena ; Mortality ; Sutures