No Abstract Available.
Humans ; Physicians, Primary Care* ; Primary Health Care*

OBJECTIVE: Many evidences raise the possibility that the panic disorder (PD) patients with respiratory subtype (RS) may have characteristic structural abnormalities. We aimed to explore the structural differences between PD patients with and without the respiratory symptoms. METHODS: Patients with PD were recruited from the Department of Psychiatry at Korea University Anam Hospital. Respiratory subtype (RS) was diagnosed when at least 4 out of 5 of the following respiratory symptoms were present during the panic attack: fear of dying, chest pain/discomfort, shortness of breath, paresthesias, and a choking sensation. We acquired high-resolution MRI scans and used FreeSurfer to obtain a measure of cortical thickness for each patient. RESULTS: Cluster based analysis revealed significantly decreased cortical thickness in the left hemisphere in the caudal-middle-frontal, superior frontal, and posterior parietal areas in the RS group. No significant difference was observed in any of the limbic areas. CONCLUSION: Respiratory symptoms of panic disorder were associated with a reduction in cortical thickness in the left frontal and parietal areas. This finding leads to the assumption that the frontoparietal network is the crucial component in a larger cortical network underlying the perception of dyspnea in RS.
Airway Obstruction ; Dyspnea ; Humans ; Korea ; Magnetic Resonance Imaging ; Panic Disorder* ; Panic* ; Paresthesia ; Rabeprazole ; Sensation ; Thorax

BACKGROUND: The aim of our study was to investigate the diagnostic value of interleukin-18 (IL-18) and other cytokines in chronic liver disease patients with hepatitis B virus (HBV), including chronic hepatitis B infection (CHB), liver cirhhosis (LC) with HBV, and hepatocellular carcinoma (HCC) with HBV. METHODS: Serum levels of IL-18, interferon-gamma (INF-gamma), IL-4 and tumor necrosis factoralpha (TNF-alpha) were evaluated using ELISA in 87 patients with liver diseases with HBV (asymptomatic carriers, 9; CHB, 19; LC, 40; and HCC, 19), 13 patients with non-hepatic diseases (NHD), and 9 normal controls. RESULTS: Serum IL-18 levels of CHB, LC with HBV and HCC with HBV patients were higher than those of healthy controls and asymptomatic carriers (P<0.05). Serum IFN-gamma and IL-4 levels were not significantly increased in all groups, but TNF-alpha levels were increased in LC and HCC patients (P<0.05). CONCLUSIONS: Determination of IL-18 may be useful in assessing the severity and predicting the prognosis of liver dieases with HBV.
Carcinoma, Hepatocellular ; Cytokines ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis, Chronic ; Humans ; Interferon-gamma ; Interleukin-18* ; Interleukin-4 ; Liver ; Liver Cirrhosis ; Liver Diseases ; Necrosis ; Prognosis ; Tumor Necrosis Factor-alpha

The association of Graves' disease and idiopathic thrombocytopenic purpura(ITP) is a rather rare, but well documented condition, and has also been reported a few times in Korea. At present, two main hypothetical mechanisms are used to explain the association of the two diseases; the presence of autoimmunity, which leads to both diseases, and activation of the reticuloendothelial system by thyroid hormone. A 33 year old female patient visited our hospital with mucosal bleeding and purpura over her entire body of 3 days duration. Her initial platelet count was 2x109/L, and the thyroid function tests showed a suppressed TSH level of 0.09 mU/L(0.4~3.1) and elevated levels of triiodothyronine and free thyroxine. The levels of anti-thyroglobulin Ab anti-TPO Ab, and anti-TSH receptor Ab were also elevated. The clinical, laboratory and bone marrow findings were compatible with Graves' disease associated with ITP. She was treated with methylprednisolone and propylthiouracil, after which her platelet count increased and thyroid function normalized. We report a case of Graves' disease associated with ITP, which was treated well by glucocorticoid and antithyroid medications
Adult ; Autoimmunity ; Bone Marrow ; Female ; Graves Disease* ; Hemorrhage ; Humans ; Korea ; Methylprednisolone ; Mononuclear Phagocyte System ; Platelet Count ; Propylthiouracil ; Purpura ; Purpura, Thrombocytopenic, Idiopathic* ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine ; Triiodothyronine

PURPOSE: In emergency departments (ED), the treatment of acute coronary syndrome (ACS) should be rapid and result from comprehensive diagnostic evaluation. There are increasing needs for supplies in the ED both for monitoring patients and for follow-up diagnostic measures to rule out ACS. The purpose of this study was to determine the effectiveness of a triple prediction test including Ischemia-modified albumin (IMA) as a tool for promptly ruling out ACS in lower-risk patients in ED. METHODS: Between September 2005 and July 2006, we analyzed patients with acute chest pain who were older than 28 years, who visited the ED within 3 hours from the last onset of chest pain, and who had normal or non-diagnostic electrocardiograms (ECG). The triple prediction test was defined as a nondiagnostic ECG, negative cardiac markers (creatine kinase-MB, troponin I), and a lower cutoff value for IMA. RESULTS: We analyzed 149 patients (male: female=105 : 44) whose mean age was 57.9+/-12.1 years. Thirty-two patients fell into IMA-negative group and 117 patients were in the IMA-positive group was 117 patients. There was no difference in sex, age, serum albumin level and medical history between groups. The area under the ROC curve was 0.640. At an IMA cutoff value of 85 U/ml, patients without ACS were negative (below the cutoff value) 4.0 times more than patients with ACS by ROC curve analysis. CONCLUSION: In ruling out ACS, triple predictive test including cardiac markers, ECG, and IMA had insufficient efficacy in the ED. Further studies warranted to reveal IMA is a clinical useful diagnostic test to rule out ACS.
Acute Coronary Syndrome ; Angina Pectoris ; Biomarkers ; Chest Pain ; Diagnostic Tests, Routine ; Electrocardiography ; Emergencies ; Equipment and Supplies ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Myocardial Ischemia ; ROC Curve ; Serum Albumin ; Troponin

PURPOSE: To demonstrate the existence in human umbilical cord blood (hUCB) of circulating mesenchymal stem/progenitor cells(MSPC), the adherent cells developed in cultures from hUCB were characterized and induced to differentiate into osteoblasts. MATERIALS AND METHODS: Fifty hUCB harvests were cultured in the media supplemented with 10% fetal bovine serum. Homogeneously adherent fibroblast-like cells obtained during successive subcultivation were characterized by immunophenotyping analysis and induced to differentiate into osteoblasts. Reverse transcription-polymerase chain reaction of osteogenic markers, alkaline phosphatase (ALP) stain, and von Kossa stain were performed. RESULTS: The adherent fibroblast-like cells developed in cultures from hUCB positively expressed the MSPCrelated antigens, but, did not express the hematopoietic, HLA-DR, osteoclast, or endothelial antigens. These cells were well proliferated during successive subcultivation. Under osteogenic condition, these cells showed increased levels of osteogenic mRNAs and strong positivity in ALP and von Kossa stains at 4th week. CONCLUSION: The homogeneous fibroblast-like cells developed in cultures from hUCB were considered to be MSPC. Morphological and immunophenotypical characteristics of these cells were very similar to those of bone marrow-derived MSPC, and well differentiated into osteoblasts.
Alkaline Phosphatase ; Coloring Agents ; Fetal Blood* ; HLA-DR Antigens ; Humans* ; Immunophenotyping ; Osteoblasts ; Osteoclasts ; RNA, Messenger ; Umbilical Cord*

BACKGROUND: A predominant accumulation of adipose tissue in abdominal region confers increased risk of cardiovascular disease. The best technology available for measurement of regional fat distribution is computed tomography. However, computed tomography is limited its use for clinical purposes by cost. The aim of this study is to identify the best simple anthropometric index of abdominal visceral fat accumulation. METHODS: To quantify the relationship between anthropometric indices of abdominal obesity(waist circumference, waist to hip ratio, waist to height ratio, body mass index, abdominal sagittal diameter) and abdominal(total, visceral, subcutaneous) fat areas measured by computed tomography, correlation and multiple regression analyses have been conducted. RESULTS: No significant difference for waist circumference, body mass index and sagittal diameter between men and women have been found. Mean value of waist to hip ratio is larger in women, but waist to height ratio is larger in men. The mean abdominal total fat area and mean subcutaneous fat area are higher in women. Interestingly, men, despite lower total fat area, have higher mean abdominal visceral area. Thus, the mean visceral fat to subcutaneous fat ratio is much higher in men. Abdominal sagittal diameter shows the highest correlation(men: 0.69, women: 0.76) with abdominal visceral fat area in both genders. Stepwise regression analyses have been performed to determine the best simple anthropometric index of abdominal visceral fat accumulation. In men, the significant indices are abdominal sagittal diameter, body mass index, and waist to height ratio. In women, abdominal sagittal diameter is the only significant index. CONCLUSION: Abdominal sagittal diameter, in comparison with the waist circumference, waist to hip ratio, waist to height ratio and body mass index, is the best predictor of the amount of abdominal visceral fat.
Adipose Tissue ; Body Mass Index ; Cardiovascular Diseases ; Female ; Hip ; Humans ; Intra-Abdominal Fat* ; Male ; Obesity ; Subcutaneous Fat ; Waist Circumference ; Waist-Hip Ratio

We analyzed 77 patients with lumbosacral radiculopathy on the basis of electromyography and radiologic study including CT scan and myelography. The results were as followings: 1. In the 62 male and 15 female subjects with a mean age of 39.3 years. The peak incidence was between ages 20 and 40 years (64%). 2. The causes of lumbosacral radiculopathy were herniated lumbosacral intervertebral disc (78%), lumbar strain (9%), fracture of lumbar vertebra (6%), spinal cord tumor (4%), spinal stenosis(3%) in order. 3. Most common involving site was L5 root on EMG and L4-5 intervertabral disc space on radiological study. 4. The prognosis of the patients with normal EMG finding was better than that of the patients with abnormal EMG finding(p<0.05). 5. There was no significant difference between the prognosis of the patients with abnormal radiologic finding and that of the patients with normal radiologic finding.
Electromyography ; Female ; Humans ; Incidence ; Intervertebral Disc ; Male ; Myelography ; Prognosis* ; Radiculopathy* ; Spinal Cord Neoplasms ; Spine ; Tomography, X-Ray Computed

BACKGROUND: Intraperitoneal(IP) vancomycin has been widely used for the treatment of peritonitis or exit-site infection associated with continuous ambulatory peritoneal dialysis(CAPD). However, some previous reports in the literature have suggested that IP administration of certain vancomycin may be associated with chemical peritonitis in CAPD patients. METHODS: Between 1 February 1994 and 1 February 1997, 35 consecutive CAPD patients requiring treatment with intraperitoneal vancomycin for either exit-site infection or peritonitis in the Yeungnam University Hospital were recruited retrospectively into the study. We compared retrospectively the incidence of chemical peritonitis after using two different preparations of vancomycin from different pharmaceutical companies, namely vancocin CP(R) and vancomycin(R). RESULTS: Thirty-three cases(all 26 cases given vancocin CP(R) and 7 out of the 9 cases given vancomycin(R)) showed improvement. None of them developed fever, abdominal pain or cloudy dialysate. Out of the 9 cases given IP vancomycin(R), two who currently did not have abdominal pain and cloudy dialysis effluent develolped these symptom and sign at 5 and 6 hours after administration of IP vancomycin. The chemical peritonitis may be secondary to prolonged contact of the peritoneal membrane with one or more of the impurities present in vancomycin preparation. CONCLUSION: In summary, it is necessary for the nephrologists to be aware of the possible chemical peritonitis which can be caused by the impurities of certain brand of vancomycin.
Abdominal Pain ; Dialysis ; Fever ; Humans ; Incidence ; Membranes ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Retrospective Studies ; Vancomycin*

Colonic gastrointestinal stromal tumors (GISTs) are rare and behave aggressively compared to GISTs in other parts of the gastrointestinal tract. Therefore, accurate diagnosis of GISTs and their distinction from other mesenchymal tumors is important for proper patient management and follow-up. Herein, we present an unusual case of a colonic GIST mimicking an inflammatory fibroid polyp with a novel 63 bp deletion mutation in exon 11 of the c-kit gene, which has not previously been reported. The tumor consisted of loosely arranged spindle cells and many inflammatory cells scattered throughout the tumor. Immunohistochemically, the tumor cells were focally and weakly positive for c-kit and diffusely positive for CD34, but were negative for PKC-theta, SMA, S-100 protein, ALK-1, and desmin. Our case re-emphasizes the broad morphologic spectrum of GISTs.
Colon ; Colonic Polyps ; Desmin ; Exons ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Humans ; Leiomyoma ; Polyps ; S100 Proteins ; Sequence Deletion