OBJECTIVE: Serotonin transporter(5-hydroxytryptamine transporter, 5-HTT) plays a critical role in the termination of serotonergic neurotransmission into the presynaptic neuron and represents an initial site of uptake inhibiting antidepressants, including tricyclic antidepressants and selective serotonin reuptake inhibitors. We investigated the possible association between the 5-HTT gene and major depression, and examined whether there are genotypic characteristics in 5-HTT gene that result in treatment nonresponsiveness to uptake inhibiting antidepressants. METHODS: 5-HTT gene polymorphisms are analyzed with the primers flanking the second intron and regulatory region from genomic DNA. We genotyped 142 patients with major depression and dysthymia, and 252 age and sex matched normal subjects. All individuals were Korean. RESULTS: We found no significant differences in the allele frequency(2 nd intron, p=0.941 : promoter, p=0.122) between patients and controls. However, in association studies between antidepressant responsiveness in depressive patients and allele frequencies of 5-HTT gene polymorphism in intron2 and promoter regions, there was shown significant differences in both(p<0.0001, p=0.0028, respectively by Fisher exact test). CONCLUSIONS: These results suggest that there is no major effect of 5-HTT gene polymorphisms on the susceptibility to major depressions, while antidepressant nonresponding is related with genotypic alteration in 5-HTT gene.
Alleles ; Antidepressive Agents ; Antidepressive Agents, Tricyclic ; Depression* ; DNA ; Gene Frequency ; Humans ; Introns ; Neurons ; Promoter Regions, Genetic ; Regulatory Sequences, Nucleic Acid ; Serotonin Plasma Membrane Transport Proteins* ; Serotonin Uptake Inhibitors ; Serotonin* ; Synaptic Transmission

Orthostatic proteinuria has been recognized as a benign condition with a good prognosis and has not been associated with any underlying glomerular disease. The pathogenesis of orthostatic proteinuria is unclear. Recently, a few foreign reports suggested that the nutcracker phenomenon, which is known as a cause of asymptomatic hematuria, may also be a major cause of orthostatic proteinuria. We report a case of a 12-year-old female patient presenting only with orthostatic proteinuria, who was diagnosed as having nutcracker phenomenon by Doppler study and venography.
Child ; Female ; Hematuria ; Humans ; Phlebography ; Prognosis ; Proteinuria* ; Renal Veins

The authors studied 16 cases of craniopharyngioma who admitted to the Department of Neurosurgery of Dong San Medical center, Keimyung university, during the past 5 years from 1981 to 1985. Of these 16 cases, 9 belonged to a juvenile group with ages under 20 based on full pubertal development, and 7 cases belonged to an adult group. It was observed the difference between the age groups of the clinical, neuroradiogical and histopathopathological findings. Raised ICP symptoms were showed in juvenile group and decreased vision and visual field defect in adult group, respectivelly, as the chief complaint. All cases of the juvenile group were classified as juvenile type and three cases out of seven in the adult group were adult types in their histopathological pattern. Four juvenile types of adult group showed poor outcome. We concluded that subtotal resection with radiotherapy gave a better prognosis in both group and that hormone therapy before and operation decreased mortality and morbidity and improved the quality of survival significantly.
Adult* ; Child* ; Craniopharyngioma ; Humans ; Mortality ; Neurosurgery ; Prognosis ; Radiotherapy ; Visual Fields

OBJECTIVES: Although previous studies have suggested that Type 1 or Type C personality may be associated with the development of cancer, the results have not been consistent. There have been some evidences that repression, denial, or non-expression of anger are related with the incidence of colorectal cancer. However, according to the results of recent researches, aggressive hostility was related to the development of colorectal cancer. This study attempted to delineate psychological characteristics or personality patterns of the patients with colorectal cancer based on multidemensions of anger and Type 1 personality for cancer development. METHOD: The subjects were composed of 35 patients with colorectal cancer and 37 normal controls. Grossarth-Maticek personality questionnaire and the Spielberger state-trait anger expression inventory were administered. RESULTS: In comparison with the normal control group, the colorectal cancer patient group showed significantly higher scores on anger experience, angry temperament and state anger but no significant differences on Type 1 personality scale and other subscales. In the discriminant analysis patients and control groups were classified by means of state anger, angry temperament, angry reaction, anger-in, anger-out and anger control variables. When angry temperament variable was selected as a discriminant variable, 65.8% of cases had been correctly classified. CONCLUSIONS: These results suggested the relationship between the disposition to experience and express anger without particular provocation and the development of cancer.
Anger* ; Colorectal Neoplasms* ; Denial (Psychology) ; Hostility ; Humans ; Incidence ; Surveys and Questionnaires ; Repression, Psychology ; Temperament

PURPOSE: To identify the characteristic ultrasonographic findings of the normal appendix in children in order to detect it more easily and so to exclude acute appendicitis from a diagnosis with more confidence. MATERIALS AND METHODS: Among 64 patients presenting with right lower quadrant pain, 44 patients, excluding 15 patients diagnosed as acute appendicitis and 5 patients with non-visualization of the appendix due to severe ileus and obesity, were evaluated for the point of incidence, the thickness and the presence of folding of the inner hypoechoic band of the normal appendix. The age of the patients ranged from 3 to 15 years with a mean age of 6.5 years. Two patients were operated on and we correlated the preoperative ultrasonographic findings with the histologic findings. RESULTS: In all the cases of the 44 patients with normal appendix, the inner hypoechoic band was discovered, which was seen as a linear structure without folding along the whole length of appendix. This measured as 0.75 mm (0.3-1.5 mm) for the mean thickness. The inner hypoechoic band corresponded to the mucosal layer that had abundant lymphoid tissue on the histologic examination. CONCLUSION:For the pediatric normal appendix, the inner hypoechoic band without folding is present, and this corresponds to the mucosal layer with abundant lymphoid tissue.
Appendicitis ; Appendix* ; Child* ; Diagnosis ; Humans ; Ileus ; Incidence ; Lymphoid Tissue ; Obesity ; Ultrasonography*

BACKGROUND: Notified tuberculosis (TB) cases in Korea have not decreased over the last decade (2001-2010). METHODS: To clarify the reasons, we analyzed an annual report on notified tuberculosis patients and age-specific population drift in Korea. RESULTS: Compared to the age-specific notified TB cases between 2001 and 2010, distinctive features in notified TB cases and new cases increased markedly in people aged 45-54 years and in patients over 65 years old, whereas those between 15-34 years in 2010 decreased drastically. In particular, notified TB individuals over 65 years old occupied 29.6% of the cases in 2010, which was 1.5 times higher than that in 2001. The main reason not to decrease in notified TB patients for the last decade (2001-2010) was due to the increasing elderly population as well as the aging of baby boomers, which have a higher risk of TB development. CONCLUSION: Korea needs to pay attention to the older population in order to successfully decrease the burden of TB in the future.
Aged ; Aging ; Humans ; Korea ; Population Dynamics ; Population Growth ; Tuberculosis

PURPOSE: To evaluate the usefulness and the accuracy of CT-discography in lumbar disc disease by analyzing the findings of CT-discogram and types of evoked pain during the procedure. MATERIALS AND METHODS: CT-discograms were retrospectively evaluated in 47 intervertebral discs of 20 patients with multilevel involvement of lumbardisc diseases. In 28 herniated discs confirmed at surgery, the findings of CT-discogram (28 disc levels/20 patients), MRI(23/16) and CT(21/15) were comparatively analysed. The type of pain after infusion of contrast mediaduring CT-discography was compared with that prior to the procedure. RESULTS: The accuracy for determining typesof the herniated lumbar disc when compared with postoperative results was 96.4%(27 discs/28 discs) in the CT-discogram, 82.6%(19 discs/23 discs) in MRI and 71.4%(15 discs/21 discs) in the CT scan. Pains encountered during discography were radiating pain in 12 discs and back pain in 24 discs. CT-discography was especially helpful in 10 patients with multilevel involvement of the lumbar disc diseases to evaluate the exact location of diseased disc(s) that provoked the pain. CONCLUSION: CT-discography is a highly accurate method in diagnosis ofthe herniated lumbar intervertebral discs and is very useful in determining the precise location related to the development of pain in such cases.
Back Pain ; Diagnosis ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Magnetic Resonance Imaging ; Retrospective Studies ; Spine ; Tomography, X-Ray Computed

An adenosquamous carcinoma of the penis is an exceedingly rare, highly malignant tumor, with histological features of a squamous cell carcinoma and an adenocarcinoma, which originates in the penile surface epithelium, and possibly in embryologically misplaced mucus glands of the perimeatal region of the glans mucosa. We report a case of an adenosquamous carcinoma of the penis in a 73-year-old man who had been suffering from a painful ulcerative mass on his penis for 2 years.
Adenocarcinoma ; Aged ; Carcinoma, Adenosquamous* ; Carcinoma, Squamous Cell ; Epithelium ; Humans ; Male ; Mucous Membrane ; Mucus ; Penis* ; Ulcer

OBJECTIVE: To investigate the short term results of infracoccygeal sacropexy for the management of uterine prolpase or stump prolapse. METHODS: Thirty-four Women who underwent infracoccygeal sacropexy for the management of uterine prolapse or stump prolpase were enrolled this study. Intraoperative or postoperative complications and results of the operation were evaluated and the recurrence rate of pelvic organ prolapse was checked 6 months after operation. RESULTS: Changes of hemoglobin after infracoccygeal sacropexy was 1.7+/-0.9, mean duration of bladder drainage was 3.1+/-1.0 (days). After 2.1 days of operation, foley catheter was removed. Mean inpatient day was 5.2+/-1.0, patient discharged 3.2 days after operation. Recurrence rate after 6 months was 2.9%. Preoperative mean stage of prolapse was 2.7+/-0.7 (stage) and it decreased to 0.4+/-0.6 (stage) 6 months after operation. CONCLUSIONS: Infracoccygeal sacropexy was effective method for the management of uterine/ stump prolapse.
Catheters ; Drainage ; Female ; Humans ; Inpatients ; Pelvic Organ Prolapse ; Postoperative Complications ; Prolapse* ; Recurrence ; Urinary Bladder ; Uterine Prolapse ; Uterus*

OBJECTIVES: Left ventricular hypertrophy (LVH) is one of the most common echocardiographic findings and an important prognostic factor for cardiovascular mortality in hypertensives and chronic renal failure patients. To evaluate the prevalence and the types of LVH, and left ventricular systolic and diastolic functions as worsening of renal function, and to elucidate the risk factors for LVH, we performed this study retrospectively in normal populations, hypertensives, and renal failure with or without hemodialysis. METHODS AND SUBJECTS: We recruited the study population among the patients who had taken echocardiography at Pun-Dang CHA Hospital from July, 1995 to June, 1997. They are consisted of 54 patients for normal control, 53 patients of hypertensives, 31 patients of mild renal failure with less than 4.5 mg/dl of serum creatinine (Group I), 29 patients of moderate renal failure with more than 4.5 mg/dl of serum creatinine (Group II), and 47 patients of end stage renal disease with hemodialysis (Group III). The echocardiography was performed with all standard strategies including 2 dimension, M mode, and Doppler signals. RESULTS: 1) Among the baseline characteristics, the body mass index only significantly increased in hypertensives compared with group II and III.2) The prevalences of LVH in each groups were 5.6% in control group, 49.1% in hypertensives, 83.8% in group I, 89.7% in group II, and 100% in group III respectively. And the pevalences of concentric LVH were 5.6%, 43.3%, 41.9%, 34.5%, and 25.5% and those of the eccentric hypertrophy were 0.0%, 5.7%, 41.9%, 55.2%, and 74.5% respectively. The prevalence of eccentric hypertrophy increased according to deterioration of renal function.3) The left ventricular mass index was significantly higher in hypertensives, Group I, Group II, and Group III than normal control and the left ventricular volume index was greater in all renal failure patients compared with controls and hypertensives.4) In pre-hemodialysis renal failure patients, the types of LVH were consisted of 8 of normal heart (Group A), 23 of concentric LVH (Group B), and 29 of eccentric LVH (Group C). The systolic blood pressure and mean arterial pressure were significantly higher in group C than group A but there was no significant difference between group C and B. The RBC volume was significantly decreased in group B and C compared with group A. The echocardiographic end diastolic interventricular septal thickness and posterior wall thickness were significantly thicker in group B than others but end diastolic LV dimension, LV mass index, and LV volume index were significantly increased in group C than group B and A. The LV ejection fraction and fractional shortening as markers of LV systolic function in group C revealed the lowest level among three groups. The E velocity among the Doppler study profiles was significantly higher in group C than others.5) In hemodialysis group, all the patients had any types of LV hypertrophic changes. The concentric LVH group (group B) had significantly higher systolic blood pressure and mean arterial pressure than eccentric LVH (group C) but there was no difference in diastolic blood pressure between two groups. The echocardiographic interventricular septum and posterior wall were thicker in group B than group C but end diastolic LV dimension and LV volume were significantly higher in group C than group B.6) The LV mass index in pre-hemodialysis group had positive relationship with blood pressure and serum urea nitrogen level and the LV volume index was positively correlated with systolic blood pressure and mean blood pressure.7) The LV mass index in hemodialysis group had positive relationship with age and systolic blood pressure and LV volume index was positively correlated with serum urea nitrogen level but negatively correlated with blood pressure. CONCLUSION: The prevalence of LVH was much higher in renal failure group than hypertenssives and the proportion of eccentric LVH was increased with worsening of renal function. Although the arterial hypertension is the most important risk factor for LVH, this finding suggested existence of other contributing risk factors for LVH in chronic renal failure, which included uremia, anemia, and age.
Anemia ; Arterial Pressure ; Blood Pressure ; Body Mass Index ; Creatinine ; Echocardiography* ; Heart ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic ; Mortality ; Nitrogen ; Prevalence ; Renal Dialysis ; Renal Insufficiency ; Renal Insufficiency, Chronic* ; Retrospective Studies ; Risk Factors ; Urea ; Uremia