OBJECTIVES: Recently, the main focus of etiologic study in schizophrenia has been directed to molecular genetic approach including polymorphism analysis. Abnormal immunoreactivity to IL-4 promoter and IL-4Ralpha has been identified in patients with schizophrenia. This study was designed to investigate the relationship between schizophrenia and immunologic influences by analyzing the polymorphisms of IL-4 promoter and IL-4Ralpha gene that are involved in interaction between immunologic system and CNS. METHODS: 222 schizophrenic patients diagnosed by DSM-IV and data of 165 normal controls obtained from Catholic Hemopoietic Stem Cell Information Bank, College of medicine, the Catholic University of Korea, were used in this study. DNA was extracted from whole blood and the polymorphic loci of IL-4 promoter and IL-4Ralphagene were amplified by polymerase chain reaction. Gene typing was performed by using SSCP and the results were assessed. The frequencies of allele and genotype were compared between patients and normal controls and between paranoid group and non-paranoid group. All data were analyzed chi2-test with two-tailed Fisher's exact test. RESULTS: 1) There were no significant differences in allele or genotype frequencies of IL-4 promoter and IL-4Ralpha between the group of schizophrenic patients and controls. 2) There were no significant differences in allele or genotype frequencies of IL-4 promoter and of IL-4Ralpaha between the group of paranoid schizophrenic patients and non-paranoid schizophrenic patients. CONCLSUION: These results suggest that polymorphisms of IL-4 promoter and IL-4Ralpha genes are unlikely related with the pathogenesis of schizophrenia.
Alleles ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Genotype ; Humans ; Interleukin-4* ; Korea ; Molecular Biology ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Schizophrenia ; Stem Cells

Retrospective analysis of 46 patients with intracerebral hematoma showed that the attack was most frequent in sixth decade and more prevalent in female. The most common cause of the attack was hypertension(80%) and the site of hemorrhage was putamen 32%, thalamic area 15%, subcortical area 7%, cerebellum 17%, ventricle 3%, and brain stem 4%. Mortality of total cases was 36% and there was no difference of mortality in both conservatively or operatively treated group(38% in conservative group, and 35% in operative group). The prognosis of the patient was unfavorable in the group of poor pretreatment Glasgow coma scale(GCS) and those of cases demonstrated more than 30cc of hematoma on computerized tomography(CT) of the brain. The improvement of GCS after management was better in operative group than in the conservative group.
Brain ; Brain Stem ; Cerebellum ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Mortality ; Prognosis ; Putamen ; Retrospective Studies

Stress and trauma research has traditionally focused on negative sequelae of adversity. Recently, research has begun to focus on positive outcomes, specifically post-traumatic growth (PTG) - "positive change experienced as a result of the struggle with trauma" - which emphasizes the transformative potential of one's experiences with highly stressful events and circumstances. This article describes the concept of PTG at three different perspectives. In addition we reviewed the neurobiological factors and mechanism of PTG. It has shown that PTG is mediated by adaptive changes in several neural circuits involving numerous neurotransmitter and molecular pathways. Much more study is required to achieve a deeper understanding the biological and psychological underpinnings of PTG, as well as the interactions between these factors. After all, the clinical phenomenology of PTG is very important for mental growth after trauma. The findings of this article provide further directions for research and clinical implication of PTG.
Fertilization* ; Life Change Events ; Neurobiology* ; Neurotransmitter Agents

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

BACKGROUND: Infection caused by multi-drug resistant (MDR) Gram-negative organisms such as Pseudomonas and Acinetobacter species is one of emerging important problems in modern hospitals. To treat multi-drug resistant non-fermenting Gram-negatives, polymyxins which were used in 1960s, but abandoned because of grave toxicities such as renal toxicity are reused. The objective of this study was to estimate the probability of resistance development of the clinical isolates of Pseudomonas aeruginosa to polymyxins. METHODS AND MATERIALS: Twenty-nine multidrug-resistant P. aeruginosa isolates were collected from Dankook University Hospital and Seoul National University Hospital in 2000 and tested for antimicrobial susceptibility test, minimal inhibitory concentration (MIC), mutant prevention concentration (MPC) and mutant frequency to ciprofloxacin and polymyxin B. RESULTS: The MIC50 and MIC90 of polymyxin B for the isolates were 2 and 2 microgram/mL, and those of ciprofloxacin were 0.5 and 4 microgram/mL, respectively. Thirteen of 29 isolates developed polymyxin B-resistant mutants but all 29 isolates, ciprofloxacin-resistant mutants. The MPC50 and MPC90 of polymyxin B were 32 and 64 microgram/mL, and those values of ciprofloxacin were 4 and 64 microgram/mL. Mutation frequencies of polymyxin B ranged from 2 x 10(-9) to 2 x 10(-7), and those of ciprofloxacin from 4 x 10(-10) to 5 x 10(-7). CONCLUSIONS: Mutation frequencies of polymyxin B were similar to those of ciprofloxacin, suggesting appreciable development of resistant mutants with wide usage of polymyxins.
Acinetobacter ; Ciprofloxacin ; Mutation Rate ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa* ; Pseudomonas* ; Seoul

BACKGROUND: Infection caused by multi-drug resistant (MDR) Gram-negative organisms such as Pseudomonas and Acinetobacter species is one of emerging important problems in modern hospitals. To treat multi-drug resistant non-fermenting Gram-negatives, polymyxins which were used in 1960s, but abandoned because of grave toxicities such as renal toxicity are reused. The objective of this study was to estimate the probability of resistance development of the clinical isolates of Pseudomonas aeruginosa to polymyxins. METHODS AND MATERIALS: Twenty-nine multidrug-resistant P. aeruginosa isolates were collected from Dankook University Hospital and Seoul National University Hospital in 2000 and tested for antimicrobial susceptibility test, minimal inhibitory concentration (MIC), mutant prevention concentration (MPC) and mutant frequency to ciprofloxacin and polymyxin B. RESULTS: The MIC50 and MIC90 of polymyxin B for the isolates were 2 and 2 microgram/mL, and those of ciprofloxacin were 0.5 and 4 microgram/mL, respectively. Thirteen of 29 isolates developed polymyxin B-resistant mutants but all 29 isolates, ciprofloxacin-resistant mutants. The MPC50 and MPC90 of polymyxin B were 32 and 64 microgram/mL, and those values of ciprofloxacin were 4 and 64 microgram/mL. Mutation frequencies of polymyxin B ranged from 2 x 10(-9) to 2 x 10(-7), and those of ciprofloxacin from 4 x 10(-10) to 5 x 10(-7). CONCLUSIONS: Mutation frequencies of polymyxin B were similar to those of ciprofloxacin, suggesting appreciable development of resistant mutants with wide usage of polymyxins.
Acinetobacter ; Ciprofloxacin ; Mutation Rate ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa* ; Pseudomonas* ; Seoul

OBJECTIVE: Posttraumatic embitterment disorder (PTED), a subgroup of an adjustment disorder, is a feeling with anger and helplessness. Hemodialysis may be a trigger event leading to PTED. We investigated the prevalence of PTED in patients with each categorized stages of chronic kidney disease (CKD) and the association between PTED and depression and functional impairment. METHODS: Patients were categorized into three groups according to the stages of CKD (stage I–II, III–IV, and V). CKD (I–II) group was defined as estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m², CKD (III–IV) group as eGFR <60 ml/min/1.73 m², and CKD (V) group as CKD stage V including patients ongoing hemodialysis. Patients were assessed for the prevalence of PTED, depression, and decreased quality of life by using the scale of PTED, Patient Health Questionnaire-9 (PHQ-9), and EuroQol Five Dimensional Questionnaires, Visual Analogue Scale (EQ-5D-VAS), respectively. RESULTS: A total of 445 patients were analyzed. The number of patients in CKD (I–II) was 166, CKD (III–IV) was 172, and CKD (V) was 107. Multivariate analysis by binomial logistic regression demonstrated that CKD (V) was significantly associated with the prevalence of PTED (odds ratio, 4.13; 95% confidence interval, 1.56–15.6; p=0.006) after adjustment for age, gender, and diabetes mellitus. Also, a significant correlation existed between PTED and EQ-5D-VAS in all stages, but the correlation was nonsignificant between PTED and PHQ-9 score in group CKD (V). CONCLUSION: The findings suggest that PTED is underdiagnosed in CKD patients. Acknowledgment and diagnosis of PTED in CKD patients may lead to a better quality of life.
Adjustment Disorders ; Anger ; Depression ; Diabetes Mellitus ; Diagnosis ; Dialysis ; Glomerular Filtration Rate ; Humans ; Logistic Models ; Multivariate Analysis ; Prevalence ; Quality of Life ; Renal Dialysis ; Renal Insufficiency, Chronic

Tumor lysis syndrome (TLS) defines the metabolic derangements that occur with tumor breakdown following the initiation of cytotoxic therapy. TLS results from the rapid destruction of malignant cells and the abrupt release of intracellular materials and their metabolites into the extracellular space. The syndrome causes hyperuricemia, hyperkalemia, hyperphosphatemia, secondary hypocalcemia and uremia. It can result in acute renal failure and be fatal. Early recognition of patient at risk and preventive measures are important. There is a high incidence of TLS in tumors with high proliferative rates and large burden such as acute lymphoblastic leukemia and Burkitt's lymphoma. It less commonly occurs in solid tumors such as testicular cancer, breast cancer and small cell lung cancer. There are only a few reports on TLS complicated in CML in blast crisis. So we report a 45-yr-old woman presenting with TLS associated with CML in lymphoblastic crisis after the initiation of cytotoxic chemotherapy.
Acute Kidney Injury ; Blast Crisis ; Breast Neoplasms ; Burkitt Lymphoma ; Drug Therapy ; Extracellular Space ; Female ; Humans ; Hyperkalemia ; Hyperphosphatemia ; Hyperuricemia ; Hypocalcemia ; Incidence ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Small Cell Lung Carcinoma ; Testicular Neoplasms ; Tumor Lysis Syndrome* ; Uremia

PURPOSE: The present study aimed to investigate the prevalence, characteristics, and clinical significance of concomitant specific cardiomyopathies in subjects with bicuspid aortic valves (BAVs). MATERIALS AND METHODS: A total of 1186 adults with BAV (850 males, mean age 56±14 years) at a single tertiary center were comprehensively reviewed. Left ventricular non-compaction, hypertrophic cardiomyopathy, and idiopathic dilated cardiomyopathy were confirmed when patients fulfilled current clinical and echocardiographic criteria. Clinical and echocardiographic characteristics, including comorbidities, heart failure presentation, BAV morphology, function, and aorta phenotypes, in BAV subjects with or without specific cardiomyopathies were compared. RESULTS: Overall, 67 subjects (5.6%) had concomitant cardiomyopathies: 40 (3.4%) patients with left ventricular non-compaction, 17 (1.4%) with hypertrophic cardiomyopathy, and 10 (0.8%) with dilated cardiomyopathy. BAV subjects with hypertrophic cardiomyopathy had higher prevalences of diabetes mellitus and heart failure with preserved ejection fraction, and tended to have type 0 phenotype, while BAV subjects with dilated cardiomyopathy showed higher prevalences of chronic kidney disease and heart failure with reduced ejection fraction. BAV subjects with left ventricular non-compaction were significantly younger and predominantly male, and had greater BAV dysfunction and a higher prevalence of normal aorta shape. In multiple regression analysis, cardiomyopathy was independently associated with heart failure (odds ratio 2.795, 95% confidential interval 1.603–4.873, p<0.001) after controlling for confounding factors. CONCLUSION: Concomitant cardiomyopathies were observed in 5.6% of subjects with BAV. A few different clinical and echocardiographic characteristics were found. The presence of cardiomyopathy was independently associated with heart failure.
Adult ; Aorta ; Aortic Valve ; Bicuspid ; Cardiomyopathies ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic ; Comorbidity ; Diabetes Mellitus ; Echocardiography ; Heart Failure ; Humans ; Male ; Phenotype ; Prevalence ; Renal Insufficiency, Chronic

Several studies have reported that either risperidone or olanzapine is effective and tolerable in the elderly patients with psychotic symptoms. However, there is a lack of clinical data of risperidone and olanzapine prescription for elderly patients in the Aisan population. We reviewed retrospectively the medical records of risperidone (n=112) and olanzapine (n=96) treated patients older than age 60 who were admitted to a university-affiliated hospital between October 2005 and August 2006. The mean daily dose of risperidone was 3.4+/-1.5 mg and olanzapine, 8.8+/-5.6 mg, respectively. The response rate on the CGI (much and very much improved) appeared to be 67.4% in the risperidone group and 70.8% in the olanzapine group, respectively. Adverse events were reported in 48.2% in the risperidone group and 46.9% in the olanzapine group, without serious adverse events, respectively. This study showed that either risperidone or olanzapine would be effective and tolerable in elderly patients with psychotic symptoms and that provides similar results to those reported from western countries.
Aged* ; Humans ; Inpatients* ; Medical Records ; Prescriptions* ; Psychotic Disorders ; Retrospective Studies ; Risperidone*