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

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

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*

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.

BACKGROUND: The use of choledochoscopy has been increasing lately in open and laparoscopic surgery for bile duct stones. Intraoperative choledochoscopy is useful for assessing the biliary trees and stones and for assisting in the removal of bile duct stones. However, large or impacted bile duct stones are difficult to remove using choledochoscopy alone. Application of electrohydraulic lithotripsy (EHL) seems to be suited for these difficult cases. METHODS: Twenty-six (26) patients with bile duct stones were treated with intraoperative cho ledochoscopic EHL to remove stones which could not be retrieved using stone forceps, a basket, saline flushing, or a Fogarty catheter. We divided the 26 cases into two groups: 12 cases of laparoscopic surgery and 14 cases of open surgery. These cases were further divided into two groups: common bile duct stones and intrahepatic duct stones RESULTS: The indications of EHL in laparoscopic surgery for common bile duct stones were large stones in 2 cases and impacted stones in 4 cases. Eighteen (18) patients with intrahepatic duct stones were treated with EHL for impacted stones. Stone clearence rate was 88.5%, and complications occurred in 3 cases (11.5%). One case of a biliary fistula was managed conservatively, and two cases of mucosal bleeding of the bile duct were spontaneously controlled. CONCLUSION: Intraoperative choledochoscopic electrohydraulic lithotripsy is a safe and effective method for removing large or impacted bile duct stones.
Bile Ducts* ; Bile* ; Biliary Fistula ; Catheters ; Common Bile Duct ; Flushing ; Hemorrhage ; Humans ; Laparoscopy ; Lithotripsy* ; Surgical Instruments

Cerebral achromatopsia, which refers to a loss of color vision, is a rare complication of posterior circulation stroke. We report two patients who presented with achromatopsia and dyschromatopsia (incomplete form of achromatopsia) respectively after acute posterior cerebral artery infarction. Lingual and fusiform gyri within the occipito-temporal area are known to be responsible for color perception.
Color Perception ; Color Vision ; Color Vision Defects ; Humans ; Infarction, Posterior Cerebral Artery ; Posterior Cerebral Artery ; Stroke

OBJECTIVE: Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. METHODS: Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA). Group S received sufentanil at a dose of 4 μg/kg IV-PCA and group F received fentanyl 24 μg/kg IV-PCA. A numeric rating scale (NRS) of postoperative pain was applied before surgery, and immediately and at 1, 6, and 24 hours (hrs) after surgery. Oswestry disability index (ODI) scores were obtained before surgery and one month after surgery. Opioid-related side effects were also evaluated. RESULTS: No significant intergroup difference was observed in NRS or ODI scores at any of the above-mentioned time points. Side effects were more frequent in group F. More specifically, nausea, vomiting rates were significantly higher (p=0.04), but pruritus, hypotension, and headache rates were non-significantly different in the two groups. CONCLUSION: Sufentanil displayed no analgesic advantage over fentanyl postoperatively. However, sufentanil should be considerable for patients at high risk of GI issues, because it had lower postoperative nausea and vomiting rates than fentanyl.
Analgesia, Patient-Controlled* ; Cohort Studies ; Fentanyl* ; Headache ; Humans ; Hypotension ; Nausea ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Pruritus ; Sufentanil* ; Vomiting