No abstract available.
Eating* ; Liver* ; Pneumonia* ; Sharks*

Familial hypokalemic periodic paralysis is an autosomal-dominant channelopathy characterized by episodic muscle weakness with hypokalemia. The respiratory and cardiac muscles typically remain unaffected, but we report an atypical case of a family with hypokalemic periodic paralysis in which the affected members presented with frequent respiratory insufficiency during severe attacks. Molecular analysis revealed a heterozygous c.664 C>T transition in the sodium channel gene SCN4A, leading to an Arg222Trp mutation in the channel protein. The patients described here presented unusual clinical characteristics that included a severe respiratory phenotype, an incomplete penetrance in female carriers, and a different response to medications.
Channelopathies ; Female ; Humans ; Hypokalemia ; Hypokalemic Periodic Paralysis ; Muscle Weakness ; Myocardium ; Penetrance ; Phenotype ; Respiratory Insufficiency ; Sodium ; Sodium Channels

Sequence comparison of the RNA-dependent RNA polymerase of human caliciviruses (HuCVs) from Korean children with gastroenteritis revealed significant genetic variation among them. cDNA clones were produced from the HuCVs collected from pediatric population during a period of 1987-1994. The application of reverse transcription-polymerase chain reaction (RT-PCR) using primers directed to the RNA-dependent RNA polymerase region within ORF1 of Norwalk virus (NV) showed that 13.7% of HuCVs yielded PCR products of similar size to the NV prototype, NV8Flla/68/US, with exceptions of HuCV185/87/Korea and HuCV1115/90/Korea. Computer analyses showed that the PCR products had a continuous protein encoding frame on the positive strand, and contained GLPSG and YGDD amino acid motifs at the predicted distance from primers. Alignment of the amino acid sequences of HuCVs with previously published sequences for Snow Mountain agent (SMA), NV, and Sapporo/82/Japan indicated that these strains can be divided into four major genogroups. There were 10 (45%) SMA-like CVs, one (4.5%) NV-like HuCVs, two (9%) Sapporo-like HuCVs, and nine (41%) unidentified HuCVs. This fourth genogroup should be investigated further. HuCV185/87/Korea and HuCV1115/90/Korea, Sapporo-like CVs, were genetically distinct from previously characterized HuCVs and more closely related to known animal CVs. One of the animal CV-like strain, HuCV185/87/Korea, showed nucleotide and amino acid homology of only 67% and 73% with the prototype Sapporo/82/Japan. Further characterization of animal and human CV genomes and studies of possible cross-transmission of CVs from animals to humans are likely to be beneficial in understanding the epidemiology of HuCVs.
Amino Acid Motifs ; Amino Acid Sequence ; Animals ; Child ; Clone Cells ; DNA, Complementary ; Epidemiology ; Gastroenteritis ; Genetic Variation ; Genome ; Genotype ; Humans* ; Korea* ; Norwalk virus ; Polymerase Chain Reaction ; RNA Replicase ; Snow

The present study was designed to estimate the seroprevalence of NLVs among diarrheagenic children and in healthy adults in Seoul and its vicinity with the use of an EIA and an Western blot (WB) based on recombinant Norwalk virus capsid protein (rNV) and crude virus preparations as antigen. Seroconversion was observed in 34 (83%) of 41 tested using the EIA and in 21 (54%) of 39 using the WB, suggesting that the NLVs with epitopes common to rNV are prevalent in Seoul area. Diarrheal children who were known to have been infected with several other strains of the NLVs showed no significant antibody response to the rNV. Infection with rNV occurred earlier in life: primary infections with rNV were common before the age of 6 months and over 91% of children had evidence of infection by that age by the EIA. Since the amount of the NLV antigens available for seroepidemiologic surveys is limited, we tried to detect NLV antibody by using crude virus preparations as antigen. One crude virus preparation of a child whose stool yielded genetically distinct NLV revealed the presence of the plural number of bands upon SDS-PAGE, but precipitated only one band (62 kDa) after the WB with a serum (collected 10 days after the onset of symptoms) of another diarrheal child. The WB assay we present in this report revealed that the NLVs are prevalent among Korean population and that the sera contained antibody to a single major structural protein, with molecular sizes of 58 to 62 kDa, compatible with the sizes reported for the Norwalk virus and Snow Mountain agent proteins, respectively. When the results of the WB were compared with those obtained by the EIA, the EIA antibody assay was sensitive enough to detect an antibody rise of as much as 4096-fold but not as specific as the WB. The WB assay presented in this paper will provide a powerful tool to elucidate not only antigenic structures of the NLVs but also seroepidemiology of the NLV infection. The availability of an unlimited source of antigen will enable a large scale serologic studies that will greatly increase our understanding of the role of NLVs in human enteric illness.
Adult ; Antibody Formation ; Blotting, Western ; Capsid Proteins ; Capsid* ; Child ; Electrophoresis, Polyacrylamide Gel ; Epitopes ; Humans ; Norovirus* ; Norwalk virus* ; Seoul* ; Seroepidemiologic Studies* ; Snow

PURPOSE: This study examined the influence of meteorological phenomena on the development of spontaneous pneumothorax (SP). METHODS: We conducted this study from January to November 2004. We obtained the daily SP incidence from data requested by the National Health Insurance office from general hospital in Daejon, and we got the meteorological data from the Daejon Regional Meteorologic office. The difference in meteorological phenomena between cluster days (3 or more SP) and no SP days was analyzed using a generalized additive model (GAM) that used a specialized form of the non-parametric, non-linear regression test. RESULTS: Five hundred sixty-six SP patients were included. There were 369 male patients and 74 female patients. SP patients were associated with significantly lower atmospheric pressure and with broad swings of daily atmospheric pressure for 4-7 days prior to the hospital visits. More clouds had gathered for several days before cluster days than had gathered on days with no SP. CONCLUSION: Development of SP is related with meteorological phenomena. SP occurs when lower atmospheric pressure, broad swings of atmospheric pressure, and cloudy weather are collectively exprienced for several days before the hospital visit.
Atmospheric Pressure ; Daejeon ; Female ; Hospitals, General ; Humans ; Incidence ; Male ; Meteorological Concepts ; National Health Programs ; Pneumothorax* ; Weather

OBJECTIVE: This study was aimed to compare the efficacy and tolerability of milnacipran and sertraline treatment in patients with major depressive disorder and to evaluate the relationships between beta-adrenergic receptor responsiveness and depressive mood states. METHODS: Fifty three patients who had a diagnosis of major depressive disorder according to the DSM-IV and showed scores of 17 or more on the 17-item Hamilton Rating Scale for Depression (HAM-D) were randomly assigned to either milnacipran or sertraline treatment group. Each patient received 8 weeks of antidepressant treatment with one of the two drugs. Efficacy was assessed using the HAM-D, Beck Depression Inventory (BDI), Montgomery and Asberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI). Twenty normal control subjects who had no history of psychiatric and major medical illness and were matched with the depressed patients considering age, sex and body mass index were recruited for the comparison of beta-adrenergic receptor responsiveness between depressed patients and normal control subjects. We measured beta-adrenergic receptor density, lymphocyte cAMP ratio (ratio of isoproterenol-stimulated cAMP/basal cAMP), and receptor affinity (Kd) in all subjects. We also investigated beta-adrenergic receptor responsiveness before and after treatment in depressed patients. RESULTS: Twelve patients in milnacipran group and 15 patients in sertraline group were completed this study. In all assessment scales for depression, we found significant decrease in depression severity in both milnacipran and sertraline groups. Both of the two drugs proved equally effective for reduction of the overall symptoms of depression throughout the treatment period. And there were significant differences in the means of Kd values between control subjects and depressed patients before treatment. We found a significant negative correlation between Kd values and BDI scores. After treatment with either milnacipran or sertraline, cAMP ratio (4.8+/-1.6 vs 5.7+/-2.5, p=0.095) and Kd value (65.6+/-11.9 vs 74.6+/-7.8, p=0.066) tended to increase, but there was no significant difference in beta-adrenergic receptor responsiveness between milnacipran and sertraline group. CONCLUSION: Both milnacipran and sertraline were not different in the clinical efficacy in major depressive disorder. In depressed patients, beta-adrenergic receptor responsiveness is reduced and both milnacipran and sertraline antidepressants tended to increase beta-adrenergic receptor responsiveness.
Antidepressive Agents ; Body Mass Index ; Depression ; Depressive Disorder, Major* ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Lymphocytes ; Sertraline* ; Weights and Measures

No abstract available.
Sensation* ; Zygote Intrafallopian Transfer*

OBJECTIVE: The authors examined the efficacy of citalopram, and its effect on the quality of life in patients with panic disorder. METHOD: Seventy three patients who had panic disorder were recruited for this study. They did not have major depression and other axis I diseases. They were scheduled to be examined 4 times (at baseline, 4, 12 and 24 weeks) and took citalopram for 24 weeks with a flexible dosing schedule. The primary efficacy variables were the response and remission rates (response: HAMA total score decreased by at least 50% from baseline; remission: HAMA total score < or = 7). Other variables included the Hamilton Rating Scale for Depression, Panic Disorder Severity Scale (PDSS), Acute Panic Inventory, Clinical Global Impression Scale and Sheehan Disabilities Scale (SDS). RESULTS: The number of patients who completed 24 weeks of treatment was 33 (45.2%). Forty patients who were dropped out consisted of 4 patients with symptom improvement and 36 patients with failure to return. Response/remission rates were 56.2/31.5% in the last-observation-carried-forward methods and 87.9/69.7% in the observed case data. Treatment with citalopram improved anxiety and depressive symptoms during 24 weeks on all efficacy measures. By a completed patient analysis, citalopram also significantly improved the disability scores on SDS. In this study, any serious adverse effects were not observed. CONCLUSION: Treatment with citalopram was effective and well-tolerated for the patients with panic disorder, and also improved quality of life in the patients.
Anxiety ; Appointments and Schedules ; Axis, Cervical Vertebra ; Citalopram* ; Depression ; Humans ; Panic Disorder* ; Panic* ; Prospective Studies* ; Quality of Life ; Treatment Outcome

Gleno-humeral joint is a ball and socket joint. It has the greatest range of movement among all the joints of the body. The greatest range of movement is inevitably accompanied by a considerable loss in stability. Thirty-three persons underwent Double contrast CT arthrography of the shoulder for the evaluation of suspected shoulder derangement. We performed 62 shoulder arthrography(33 abnormal shoulders and 29 normal shoulders) and reviewed their findings retrospectively. They had recurrent shoulder dislocation(30 shoulders) or nonspecific shoulder pain(3 shoulders). Injury of the glenoid labrum was seen in 28 shoulders at double contrast CT arthrography. Among 28 cases of the labral injury, detachment was seen in 15 cases, labral tear in 5 cases, and labral erosion in 8 cases. Double contrast CT arthrography also showed Hill-Sachs in 20 shoulders. The numbers of type 1, type 2, and type 3 capsulolabral attachment in 33 shoulder instability cases were 10, 16, and 7, respectivity, while, 16, 12, and, 1 in 29 normal controls. Type 2 and 3 are more common in shoulder instability group than normal control group. Operation was done in 18 shoulders. Comparing with operation findings, the sensitivity of double contrast CT arthrography in the detection of Hill-Sachs defect was 100% with the specificity of 71% and the accuracy of 89%. The sensitivity, and accuracy of double contrast CT arthrography in the detection of labral injury were 94%, 100%, and 95, respectively. Double contrast CT arthrography is a minimally invasive and highly accurate technique for in the evaluation of glenohumeral instability.
Arthrography ; Humans ; Joints ; Retrospective Studies ; Sensitivity and Specificity ; Shoulder* ; Tears

PURPOSE: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl(R) (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. METHODS: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl(R)) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar). RESULTS: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant (p<0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. CONCLUSION: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.
Adhesives ; Cicatrix ; Emergencies ; Emergency Medicine ; Fees and Charges ; Humans ; Lacerations ; Length of Stay ; Netherlands ; Patient Satisfaction ; Prospective Studies ; Sutures ; Tissue Adhesives