OBJECTIVES: Contemporary understanding of schizophrenia has evolved over the last century, yet its pathogenesis is not clear. Environmental stresses in early gestational period, which in turn, can cause neurodevelopmental abnormalities, is one possible etiologic factors in the development of schizophrenia. Heat shock protein 70(HSP70), which is thought to be a protective factor against environmental stresses in a cell, might be involved in the development of schizophrenia. Abnormal immunoreactivity to HSP70 has been identified in patients with schizophrenia. Therefore, genes for HSP70 might be candidates that affect susceptibility to schizophrenia. Three genes encoding HSP70 such as HSP70-1, HSP70-hom and HSP70-2 have been identified in the MHC class III region and they have been known to have genetic polymorphisms. We examined the association of schizophrenia and polymorphisms of HSP70-1, HSP70-hom and HSP70-2 genes in this study. METHODS: We investigated 161 patients with schizophrenia and 165 controls. DNA analysis with polymerase chain reaction(PCR) followed by enzyme restriction was used for the allelic typing of each polymorphism of HSP70-1, HSP70-hom and HSP70-2. The significances of genetic association of the polymorphisms with the disease and with clinical variables were estimated by chi-square test and analysis of variances. RESULTS: 1) There were no significant differences in allelic or genotype frequencies of HSP70-1 and HSP70-hom between the group of patients with schizophrenia and controls. 2) There was a tendency of difference in genotype frequency of HSP70-2, and a significant difference in allelic frequency of HSP70-2 between the group of patients with schizophrenia and controls. 3) There were no significant differences in terms of severity of symptoms and age at onset among the three HSP70 genotypes in the group of patients with schizophrenia. CONCLUSION: These results suggest that polymorphism of HSP70-2 might be related to the pathogenesis of schizophrenia.
DNA ; Genotype ; Heat-Shock Proteins* ; Hot Temperature* ; HSP70 Heat-Shock Proteins* ; Humans ; Polymorphism, Genetic ; Schizophrenia*

This patient was an 53-year-old man who had undergone Sengstaken-Blackmore tube insertion for esophageal varix bleeding. Two days after Sengstaken-Blackmore tube insertion, he developed severe left hemothorax and was transferred to our hospital. The esophagoscopic findings revealed a large perforation lengthening 8-cm in the intrathoracic esophagus. A left thoracotomy was performed 33 days after the injury due to repeated varix bleedings and poor conditions. An 8-cm longitudinal perforation of the intrathoracic esophagus with gross suppurative empyema was found. Primary repair and esophageal exclusion was performed 2cm proximal and distal to the perforation, using rows of nonabsorbable staplers (TA stapler 60x4.8) and large bore thoracostomy tubes were placed for local drainage. Six days after intrathoracic esophageal exclusion, an esophagogram revealed a leakage at just above the proximal stapling site. A cervical esophageal exclusion was performed using the same method. One hundred thirty seven days after exclusion operation for the intra-thoracic esophageal perforation, the patient was able to eat per orally without any secondary esophageal reconstructive surgery.
Drainage ; Empyema ; Esophageal and Gastric Varices ; Esophageal Perforation* ; Esophagus ; Hemorrhage ; Hemothorax ; Humans ; Iatrogenic Disease ; Middle Aged ; Thoracostomy ; Thoracotomy ; Varicose Veins

Descending nectorizing mediastinitis (DNM) represents a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high morbidity mortality associated with this disease. Intr.avenous broad-spectrum antibiotic therapy alone is not efficient without adequate surgical drainage of the cervical and mediastinal collections, extensive debridement and excision of necrotic tissue, and wide mediastino-pleural irrigation. A 38-year-old man admitted via emergency room with painful left neck swelling and uncontrolled high fever. Chest computed tomogram showed left paratracheal abscess descending into the superior and anterior mediastinum. Transcervical mediastinal drainage was performed with 26 Fr. chest tube and left paratracheal drainage was performed with Penrose drain in urgency. Culture and sensitivity test grew Yeast. The drains removed via gradually shortening on day 39 after surgery.
Abscess ; Adult ; Chest Tubes ; Debridement ; Diagnosis ; Drainage ; Emergency Service, Hospital ; Fever ; Humans ; Mediastinitis* ; Mediastinum ; Mortality ; Neck ; Necrosis ; Thorax ; Yeasts*