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

An organizing hematoma with tumor-like presentation in association with a chronic subdural hematoma(CSDH) has not been reported. Most reported cases of an intracranial mass in association with a CSDH have been associated with primary or metastatic neoplasm. A 72-year-old man presenting with an intracranial contrast-enhancing mass in association with a CSDH in magnetic resonance images is reported. Operative exploration revealed the mass to be an organized hematoma adjoining cortical draining veins between the outer and inner membranes of a chronic subdural hematoma. This report adds another important differential diagnosis to various primary and metastatic neoplasms that have been reported in the literature when encountering an intracranial mass in association with a CSDH. Neurosurgeons should be aware of the possibility and, if necessary, should apply more diagnostic modalities than magnetic resonance images before deciding management plans.
Aged ; Diagnosis, Differential ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Membranes ; Veins

PURPOSE: The present study proposes to examine the change of IOP in response to the rise of abdominal pressure and in response to position change during laparoscopic surgery. METHODS: The subjects of the present study included 28 patients who had laparoscopic appendectomy and 20 patients who had laparoscopic cholecystectomy. In both groups, the IOP was measured before surgery, after general anesthesia, after the occurrence of pneumoperitoneum, after position change according to operative method, after the removal of pneumoperitoneum and under general anesthesia. RESULTS: When comparing the IOP before and after the occurrence of pneumoperitoneum, the IOP after the occurrence increased by 3.70 +/- 0.96 mm Hg in the appendectomy group and by 3.15 +/- 0.5 mm Hg in the cholecystectomy group. After the occurrence of pneumoperitoneum, the IOP measured in the head-low position was 3.25 +/- 0.16 mm Hg higher than measured in the level position in the appendectomy group, and the IOP measured in the head-high position was 2 +/- 0.12 mm Hg lower than measured in the level position in the cholecystectomy group. Between the 2 groups, there was a significant difference of 6.5 mm Hg in IOP according to the change of head position. CONCLUSIONS: In the present study, the occurrence of pneumoperitoneum in laparoscopic surgery increased IOP, and position change according to operative method also changed IOP. In addition, IOP was significantly different between the 2 groups. In order to prevent the patient from being exposed to high IOP for a long period during laparoscopic surgery, keeping the duration of pneumoperitoneum and a head-low position to a minimum may be helpful.
Anesthesia, General ; Appendectomy ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Head ; Humans ; Intraocular Pressure ; Laparoscopy ; Pneumoperitoneum

BACKGROUND: Vimentin is the major intermediate-size filament in the cytoplasm of cells from mesenchymal origin. The HL-60 cell is a unique human leukemic cell line capable of terminal differentiation with several chemical inducers, and then the cell line becomes a fre#quently described model system for cell differentiation in vitro. Vimentin mRNA is reduced during all-trans retinoic acid (retinoic acid) -dependent differentication but increased by 12-0-tetradecanoylphorbol-13-acetate (TPA). In this paper, we have investigated on the mechanism of transcriptional repression of vimentin gene during retinoic acid-dependent differentication of HL-60 cell. METHODS: HL-60 cells were grown in RPMI 1640 medium supplemented with 10% heat-inactivated fetal bovine serum and antibiotics in a humidified 5% CO at 37C. Total RNA was prepared by a modification of the method of Karlinsey et al. Northern blot hybridization was performed by the method of Virca et al. EcoRI fragment of pVIM-GEM was used as probe for vimentin mRNA. DNA mobility shift assay was performed by the method of Lim et al. End labeled DNA probe (Upper strand, 5-CGCITGATGAGTCAGCCG-3) for AP-1 binding activity was mixed with nuclear extracts in a 20 pL reaction volume containing 300 mM KCI, 60 mM HEPES, pH 7.9, 25mM MgC1, 1mM EDTA, 1mM DTT, 60% glycerol, and 2 pg of poly[dI-dC]. RESULTS: The level of vimentin mRNA was decreased at 12 hours after retinoic acid treatment, and not detected at 48 hours. The level of vimentin mRNA was reduced in proportion to concentration of retinoic acid, Retinoic acid-reduced vimentin mRNA was no change in cells treated with cycloheximide. Retinoic acid-dependent decrease of vimentin mRNA was partially recovered by staurosporin pretreatment. In DNA mobility shift assay, AP-1 binding activity was reduced at 48 hr during retinoic acid-induced differentiation. CONCLUSION: These results suggest that the transcriptional repression of vimentin gene during retinoic acid-induced differentiation in HL-60 cells is correlated with reduction of DNA binding activity of AP-1.
Anti-Bacterial Agents ; Blotting, Northern ; Cell Differentiation ; Cell Line ; Cycloheximide ; Cytoplasm ; DNA ; Edetic Acid ; Electrophoretic Mobility Shift Assay ; Glycerol ; HEPES ; HL-60 Cells* ; Humans ; Hydrogen-Ion Concentration ; Repression, Psychology* ; RNA ; RNA, Messenger ; Transcription Factor AP-1 ; Tretinoin ; Vimentin*

Malignant mixed m llerian tumor (MMMT) of the ovary is very rare neoplasm consisting of both a sarcomatous and carcinomatous component and represent is fewer than 1% of all ovarian malignancies. Characteristically, ovarian MMMTs follow an aggressive clinical course, and long-term survival is unusual. Almost all MMMTs are found in postmenopausal women, often with low parity and usually in an advanced stage. Stage has been recognized as the single most important prognostic factors. However, a major improvement in prognosis for this rare malignancy has not yet been achieved. The authors have experienced one case of primary malignant mixed m llerian tumor of the ovary and report our experience with a brief review of literature.
Female ; Humans ; Ovary* ; Parity ; Prognosis

OBJECTIVE: Our purpose was to evaluate the changing trends of the incidence and histopathology of female genital malignancies through the three time periods (1975-1984, 1985-1994 and 1995-2000). METHODS: A retrospective review was carried out of all the female genital malignancies with the exception of trophoblastic disease which reported to the Keimyung University Dongsan Medical Center between 1975 and 2000. RESULTS: For 26 years (1975-2000), 5,846 cases of the genital malignancies were registered. In the period from 1995 to 2000, the average frequency of cervical cancer was 73.5%, ovarian cancer followed with 15.6%, uterine corpus with 8.7%, vaginal cancer with 1.0%, vulvar cancer with 0.9%, tubal cancer with 0.1%. Third time period (1995-2000) comparing to others (1975-1984, 1985-1994), the frequency of cervical cancer was decreased (93.4% in 1975-1984, 86.0% in 1985-1994) and the incidence of corpus (1.6% in 1975-1984, 3.6% in 1985-1994) and ovarian cancer (2.4% in 1975-1984, 6.3% in 1985-1994) were increased. The most frequent histologic type of cervical cancer was squamous cell carcinoma, and followed by adenocarcinoma. Adenocarcinoma of the cervix showed a gradual increase in incidence (12.4% in 1995-2000, 5.0% in 1975-1984, 8.2% in 1985-1994). The peak age incidence of cervical cancer was noted between 40-49 years. Based on the FIGO staging system for cervical cancer, stage I was most frequent during last 6 years. According to invasiveness of the cervix, the frequency of cervical intraepithelial neoplasm was increased (62.8% in 1995-2000, 25.7% in 1975-1984, 38.4% in 1985-1994). Ovarian cancer was the second most common malignancy and gradually increased. The peak age was 50-59 years. According to histologic subtype, an epithelial ovarian tumor was most frequent. Corpus cancer was the third most common malignancy. The peak age was 50-59 years during the study period and endometrial cancer was most common. CONCLUSIONS: This study shows that the frequency of invasive cervical cancer was decreased whereas the incidence of endometrial cancer and ovarian cancer were increased. The frequency of cervical intraepithelial neoplasm was increased compared with invasive cervical cancer.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Endometrial Neoplasms ; Female* ; Humans ; Incidence* ; Ovarian Neoplasms ; Retrospective Studies ; Trophoblasts ; Uterine Cervical Neoplasms ; Vaginal Neoplasms ; Vulvar Neoplasms

No abstract available.

No abstract available.
Parkinsonian Disorders

BACKGROUND: Oriental medicines have been associated with severe psychiatric, neurological, and other adverse medical events. These medicines occasionally cause a typical reversible toxic encephalopathy, but most such cases are not recognized because these adverse events are complex and are associated with other systemic signs and symptoms. CASE REPORT: We describe a married couple with rapid progressive cognitive impairment and akinetic mutism after taking the same oriental medicines on the same day. Brain magnetic resonance images of the couple showed typical leukoencephalopathy in the periventricular white matter and basal ganglia regions, bilaterally. CONCLUSIONS: The development of neurobehavioral symptoms and toxic leukoencephalopathy in both patients following the ingestion of oriental medicines is suggestive of a cause-and-effect association, although such a relationship needs to be verified.
Akinetic Mutism ; Basal Ganglia ; Brain ; Eating ; Humans ; Leukoencephalopathies ; Magnetic Resonance Spectroscopy ; Medicine, East Asian Traditional ; Neurotoxicity Syndromes

PURPOSE: To measure intraocular pressure (IOP) as a function of positional changes of the head during heavy weight lifting. METHODS: The subjects of this study were 30 healthy adult males in their twenties to forties. This study investigated their ophthalmic examinations, BMI (body mass index), and 1RM (one repetition maximum) according to the three bench press positions. RESULTS: Before exercising, the IOP was higher in the lowered head position in the decline bench press (18.20+/-2.89 mmHg) than in the incline bench press (14.38+/-2.32 mmHg) (p<0.001). The IOP increased significantly during the bench press exercise, relative to during the pre-exercise (p<0.001). Upon lift down, IOP increased by 3.72+/-1.85 mmHg greater than upon lift up, and mean IOP increased by 2.61+/-1.63 mmHg (p<0.001). In our experiments, IOP increased to a maximum of 22.10+/-2.79 mmHg, measured during lift down in the decline bench press configuration. The BMI and the IOP before exercise showed significant correlation (p<0.05). CONCLUSIONS: IOP increased more during exercise involving a lower head position. Further study is needed to know the extent to which this result is relevant for glaucoma patients and which activities and head positions during exercise may worsen glaucoma. In the meantime, patients with severe glaucoma may need to avoid lifting heavy objects with a lowered head position.
Adult ; Glaucoma ; Head ; Humans ; Intraocular Pressure ; Lifting ; Male ; Valsalva Maneuver ; Weight Lifting