Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosome-autosome translocation with a literature review.
Female ; Gonads ; Hand ; Humans ; Menopause ; Menopause, Premature* ; Menstruation ; Oocytes ; Primary Ovarian Insufficiency ; X Chromosome

Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ.
Exanthema ; Ganglia, Sensory ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Incidence ; Leg ; Male ; Neuralgia, Postherpetic

Background: Gastrointestinal microbiota, which comprises hundreds of different types of microbes, biologically plays crucial roles in the host’s health. Probiotics (PRO) did not always have a positive benefit on the host, depending on strains of microbes and the physiochemical properties of prebiotics (PRE), indicating that the properties of PRE in combination with PRO might have different effects on the gut ecology. The aim of this study was to assess the effects of insoluble or soluble PRE with PRO on intestinal digestive hydrolase, the fecal microbes, and immunological biomarkers in SD rats fed an AIN-93G diet. Results: Forty, 8-week-old SD rats were randomly assigned to 4 groups with 10 replicates in each; cellulose (CELL), cellulose + probiotics (CELPRO), oatmeal (OATS), and oatmeal + probiotics (OATPRO) groups. After 4-week feeding trial, rats were treated with saline or lipopolysaccharide (LPS, 1 mg/kg) to examine the alleviating effects of PRO and PRE on immunological responses. There was a significant (p < 0.05) decrease in feed intake of rats fed the oatmeal supplemented diet without affecting growth performance. Blood triglyceride was significantly (p < 0.05) decreased in rats fed the oatmeal diet, and aspartate aminotransferase (AST) was significantly (p < 0.05) decreased in rats fed the PRO supplemented diet. Intestinal maltase, sucrose, and lactase activities were significantly (p < 0.05) higher in rats fed PRO compared with rats not fed PRO. Rats fed the oatmeal showed a significant (p < 0.01) increase in the fecal colony forming units (CFU) of Lactobacillus plantarum, Bacillus subtilis, and Saccharomyces cerevisiae compared with those fed cellulose. LPS-treated rats fed PRO showed a significant (p < 0.05) increase in blood secretory immunoglobulin A (sIgA) compared with those not fed PRO. The LPS-treated rats fed PRO resulted in decreased (p < 0.05) blood IL-6 compared with those not fed PRO, indicating that a dietary PRO alleviated inflammatory response in LPS-treated rats. Conclusions Dietary oatmeal increased fecal microbes, and PRO supplement resulted in increased intestinal hydrolase and immune functions of the host, demonstrating that soluble PRE with supplemented with PRO could be a more bioactive combination of synbiotics in SD rats.

BACKGROUND AND OBJECTIVES: It has been suggested that the combination of a leukotriene receptor antagonist with an antihistamine may have beneficial effects in the treatment of allergic rhinitis. The aim of this study were to evaluate the effects of combining a leukotriene receptor antagonist, pranlukast, and an antihistamine, cetirizine, to treat nasal symptoms of allergic rhinitis and the quality of life of the patients. SUBJECTS AND METHOD: Thirty-three patients with allergic rhinitis were enrolled in this study. The control group (n=12) received 5 mg cetirizine plus 120 mg pseudoephedrine twice a day while the study group (n=21) received 5 mg cetirizine plus 225 mg pranlukast twice a day. Patients completed a daily symptom-score list for nasal obstruction, rhinorrhea, sneezing, nasal itching during the 7-day treatment period. They also answered the quality of life questionnaire before and after the completion of 7-day treatment. RESULTS: There were significant improvements in the nasal symptoms after the treatment in the control and the study group. However, there was no significant difference between the control and the study group on the improvement of nasal symptom-scores except for the rhinorrhea symptom-score. There were significant improvements in the quality of life domain after the treatment in the control group and the study group. However, there was no significant difference between the control and the study group on the improvement in quality of life domain except for activity limitations. CONCLUSION: A combination of pranlukast and cetirizine is as effective as a combination of pseudoephedrine and cetirizine in treating allergic rhinitis. Therefore, a combination of pranlukast and cetirizine may be another therapeutic alternative for allergic rhinitis patients who are not tolerable of pseudoephedrine.
Cetirizine* ; Histamine Antagonists ; Humans ; Hypersensitivity ; Leukotrienes ; Nasal Obstruction ; Pruritus ; Pseudoephedrine ; Quality of Life ; Surveys and Questionnaires ; Receptors, Leukotriene ; Rhinitis* ; Sneezing

Quetiapine is an atypical antipsychotic drug that can cause sinus tachycardia, hypotension, coma, etc. with overdose, and rarely convulsions, rhabdomyolysis and neuroleptic malignant syndrome. Posterior reversible encephalopathy syndrome usually occurs in association with hypertension, but can occur rarely in rhabdomyolysis accompanied by acute kidney injury and arginine vasopressin axis hyperstimulation. We report the experience of a patient hospitalized with a quetiapine overdose who developed drug-induced rhabdomyolysis and reversible encephalopathy without hypertension after acute renal injury.

Objectives: ：This study aimed to investigate quality of life, severity of depression, suicidality, subjective health and subjective stress of depression with subjective cognitive decline in Korean adults. Methods: ：We used the 7th KNHANES data to enroll 415 participants with a score of 10 or higher on Patient Health Questionnaire-9 (PHQ-9), aged 20-64. Depression was divided into two groups based on the presence/absence of subjective cognitive decline. Demographic and psychological characteristics were compared between two groups. Correlation analysis of subjective cognitive decline, quality of life, depression, suicidal idea was car-ried out. To detect which variables influenced quality of life, a multiple regression analysis was carried out. Results: ：Among the 415 participants, 98 had depression with subjective cognitive decline. We identified sig-nificant differences in age, marital status, education, employment between the two groups. After adjusting for these variables, depression with subjective cognitive decline had lower EuroQol-5D index scores, more severe depressive symptoms without cognition and worse subjective health than depression without cognitive decline. There was a significant correlation between subjective cognitive decline and quality of life (r=-0.236, p<0.001), suicidal idea (r=0.182, p<0.001), depression score without cognition (r=0.108, p=0.028). Through multiple regression analysis, subjective cognitive decline was predictor of reduced quality of life (β=-0.178, p<0.001). Conclusions ：Depression with subjective cognitive decline has poor quality of life and severe depression. Cognitive decline should be considered to improve treatment result in depression.

PURPOSE: The aim of our study was to evaluate the association of several factors with spontaneous stone expulsion, including ureteral stone characteristics (size, location, hydronephrosis, perinephric stranding), types of medications prescribed (alpha-blocker, low-dose steroid), and other possible demographic and health-history factors (gender, age, serum creatinine, underlying diabetes mellitus [DM], and hypertension). MATERIALS AND METHODS: A total of 366 patients with ureteral stones were enrolled. All patients underwent watchful waiting without any invasive procedures. Initial diagnoses of ureteral stones were confirmed by computed tomography scans, which were taken at approximately 1-month intervals to check for stone expulsion. Univariate and multivariate analyses were conducted to identify significant factors that contributed to stone expulsion. RESULTS: Among 366 patients, 335 patients (91.5%) experienced spontaneous stone passage during a mean follow-up period of 2.95+/-2.62 weeks. The patients were divided into two groups depending on the success of spontaneous stone passage. Univariate analyses revealed that stone location (p=0.003), stone size (p=0.021), and underlying DM (p<0.001) were significant predictors of stone passage. Multivariate analyses confirmed that stone size (p=0.010), stone location (p=0.008), and underlying DM (p=0.003) were independent predictive factors affecting stone passage. CONCLUSIONS: Stone size, location, and underlying DM were confirmed to be significant predictive factors for spontaneous passage of ureteral stones. Urologists should consider active procedures, such as shock wave lithotripsy or ureteroscopy, rather than conservative management in patients presenting with proximally located stones, large ureteral stones, or underlying DM.
Adult ; Aged ; Diabetes Complications/*therapy ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Remission, Spontaneous ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ureteral Calculi/pathology/radiography/*therapy ; *Watchful Waiting

OBJECTIVES: It has been proposed that microbial persistence, superantigen (SA) production, and host T-cell response may be involved in the development of chronic rhinosinusitis. According to the SA hypothesis, a single intranasal application of SA such as staphylococcal enterotoxin B (SEB) may induce chronic eosinophilic rhinosinusitis. This study aimed to develop a rat model of rhinosinusitis induced by intranasally applied SEB. METHODS: Forty microliter of SEB (100 microgram/mL) or phosphate buffered saline was applied intranasally through each naris in 4 weekold Sprague-Dawley test rats (N=36) and controls (N=16), respectively. Following sacrifice at 1, 5, 14, and 28 days, the obtained nasal cavity and sinuses were prepared for histologic investigation. The histologic sections were examined in a blind manner for the ratio of the sinus spaces occupied by inflammatory cell clusters and the number of inflammatory cells in the lamina propria. RESULTS: Infiltration of neutrophils in the lamina propria and appearance of neutrophil clusters in the sinus spaces were observed in the SEB-applied rats. The ratio of the sinus spaces occupied by neutrophil clusters and the number of neutrophils infiltrated in the lamina propria increased significantly at day 1 as compared with the control rats. CONCLUSION: Intranasally applied SEB induces acute neutrophilic rhinosinusitis in rats. Eosinophilic inflammation was not demonstrated. The mere presence of SA in the nose does not necessarily induce SA-induced inflammation, as suggested by the SA hypothesis.
Animals ; Enterotoxins ; Eosinophils ; Inflammation ; Mucous Membrane ; Nasal Cavity ; Neutrophils ; Nose ; Rats ; Sinusitis ; T-Lymphocytes

OBJECTIVES: It has been proposed that microbial persistence, superantigen (SA) production, and host T-cell response may be involved in the development of chronic rhinosinusitis. According to the SA hypothesis, a single intranasal application of SA such as staphylococcal enterotoxin B (SEB) may induce chronic eosinophilic rhinosinusitis. This study aimed to develop a rat model of rhinosinusitis induced by intranasally applied SEB. METHODS: Forty microliter of SEB (100 microgram/mL) or phosphate buffered saline was applied intranasally through each naris in 4 weekold Sprague-Dawley test rats (N=36) and controls (N=16), respectively. Following sacrifice at 1, 5, 14, and 28 days, the obtained nasal cavity and sinuses were prepared for histologic investigation. The histologic sections were examined in a blind manner for the ratio of the sinus spaces occupied by inflammatory cell clusters and the number of inflammatory cells in the lamina propria. RESULTS: Infiltration of neutrophils in the lamina propria and appearance of neutrophil clusters in the sinus spaces were observed in the SEB-applied rats. The ratio of the sinus spaces occupied by neutrophil clusters and the number of neutrophils infiltrated in the lamina propria increased significantly at day 1 as compared with the control rats. CONCLUSION: Intranasally applied SEB induces acute neutrophilic rhinosinusitis in rats. Eosinophilic inflammation was not demonstrated. The mere presence of SA in the nose does not necessarily induce SA-induced inflammation, as suggested by the SA hypothesis.
Animals ; Enterotoxins ; Eosinophils ; Inflammation ; Mucous Membrane ; Nasal Cavity ; Neutrophils ; Nose ; Rats ; Sinusitis ; T-Lymphocytes

PURPOSE: We aimed to evaluate the early (<30 days) results and to analyze risk factors for the development of stroke and new brain infarction (NBI) after carotid endarterectomy (CEA). METHODS: From September 2003 to August 2008, 233 CEAs were performed on 222 patients with critical internal carotid artery (ICA) stenosis in a single center. Patient characteristics, history of neurological symptoms, procedural details, and postoperative complications were examined based on the medical records. The incidence and risk factors for early postoperative stroke were evaluated. After excluding CEAs without performing diffusion-weighted brain MRI, 128 CEAs were investigated for frequency and the risk factors of NBI were analyzed. Chi-square test, Fisher's exact test, Student T-test, and logistic regression model were used for statistical analysis. RESULTS: Of a total of 233 CEAs, any and ipsilateral stroke rates were 1.3% and 0.4%, respectively. There was no early postoperative mortality. Early postoperative complications included 4.3% in transient cranial nerve injury, 1.7% in myocardial infarction, and 3.4% in hematoma. In univariate analysis, the significant risk factor for stroke was plaque ulceration (P=0.04). The frequency of NBI and ipsilateral NBI were 8.4% and 3.1%, respectively. The ulceration on ipsilateral ICA revealed statistically significant risk factors for the development of NBI (RR, 5.29; 95% CI, 1.024~27.325; P=0.04). CONCLUSION: Our study showed a lower incidence of stroke and NBI after carotid endarterectomy and that it is safe procedure for the treatment of patients with severe (>70%) carotid stenosis. We also found that plaque with ulceration was a significant risk factor for the development of postoperative NBI.
Brain ; Brain Infarction ; Carotid Arteries ; Carotid Artery, Internal ; Carotid Stenosis ; Constriction, Pathologic ; Cranial Nerve Injuries ; Endarterectomy ; Endarterectomy, Carotid ; Hematoma ; Humans ; Incidence ; Logistic Models ; Medical Records ; Myocardial Infarction ; Postoperative Complications ; Risk Factors ; Stroke ; Ulcer