OBJECTIVE: Tardive dyskinesia (TD) is one of the serious side effects caused by long-term treatment with neuroleptic medication. Many investigators are trying to elucidate the pathophysiological mechanism of TD, and some candidate genetic polymorphisms have been reported as associated with TD. This study investigated the association of the 5-HT2A receptor promoter gene polymorphisms with TD in Korean schizophrenic subjects. METHODS: The subjects in this study of 5-HT2A receptor gene polymorphisms were 119 schizophrenia patients, 59 with TD and 60 without. TD was evaluated by using the Abnormal Involuntary Movement Scale (AIMS). Genomic DNA was amplified by PCR and digested with MspI. RESULTS: There were no statistically significant differences in the demographic variables of age, sex ratio, duration of illness and duration of antipsychotic drug exposure between the TD and control groups. 1) A-1438G polymorphisms and TD, By comparing the TD and control groups, the -1438A/G allele was found to be associated with a significantly increased risk for TD (x2=5.560, df=1, p=0.018). 2) Three AIMS categories of TD and A-1438G genotype. There were statistically significant differences in the three AIMS categories (x2=6.835, df=2, p=0.033). CONCLUSION: These results suggest that the -1438A/G genotype of the 5-HT2A receptor gene is related to the development of TD. The -1438A/G genotypes were associated with significantly higher AIMS orofacial dyskinesia scores. These findings suggest that the 5-HT2A receptor gene is partly associated with susceptibility to TD in patients with chronic schizophrenia.
Alleles ; DNA ; Dyskinesias ; Genotype ; Humans ; Movement Disorders* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Receptor, Serotonin, 5-HT2A* ; Research Personnel ; Schizophrenia ; Sex Ratio

Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Graves disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). The diagnosis of Graves disease in patients with SLE is well known, especially in adults, but few case reports have involved children and adolescents. We report a 14-year-old female who presented with Graves disease, proteinuria, arthralgia, decreased complement, and positive antinuclear antibody and who was diagnosed with SLE. Renal biopsy revealed class IV lupus glomerulonephritis. These clinical, laboratory, and histological findings indicate that class IV lupus nephritis may be associated with Graves disease. This possibility should be borne in mind when following patients with Graves disease in order to avoid any delay in the diagnosis and treatment of serious systemic autoimmune diseases such as SLE.
Adolescent ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Biopsy ; Child ; Complement System Proteins ; Female ; Graves Disease ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Proteinuria ; Rheumatic Diseases

Autoimmune diseases are occasionally associated with other autoimmune diseases in the same patients. Graves disease has been associated with systemic rheumatic diseases including systemic lupus erythematosus (SLE). The diagnosis of Graves disease in patients with SLE is well known, especially in adults, but few case reports have involved children and adolescents. We report a 14-year-old female who presented with Graves disease, proteinuria, arthralgia, decreased complement, and positive antinuclear antibody and who was diagnosed with SLE. Renal biopsy revealed class IV lupus glomerulonephritis. These clinical, laboratory, and histological findings indicate that class IV lupus nephritis may be associated with Graves disease. This possibility should be borne in mind when following patients with Graves disease in order to avoid any delay in the diagnosis and treatment of serious systemic autoimmune diseases such as SLE.
Adolescent ; Adult ; Antibodies, Antinuclear ; Arthralgia ; Autoimmune Diseases ; Biopsy ; Child ; Complement System Proteins ; Female ; Graves Disease ; Humans ; Lupus Erythematosus, Systemic ; Lupus Nephritis ; Proteinuria ; Rheumatic Diseases

Granulocytic sarcoma, also called chloroma or myeloblastoma, is an extramedullary invasive tumor composed of neoplastic myeloid cells. In this report, we describe a 43-year-old male patient with a collision tumor composed of an adenocarcinoma and a granulocytic sarcoma in the stomach. The coexistence of a granulocytic sarcoma and adenocarcinoma in the stomach has, to the best of our knowledge, not been reported in the literature. The diagnosis of granulocytic sarcoma is very difficult; especially in the absence of concurrent hematologic disease or in the uncommon setting of coexistence with another tumor. Cautious observation is needed when a finding of unusual atypical cells admixed with an adenocarcinoma in the stomach is confronted.
Adenocarcinoma ; Adult ; Hematologic Diseases ; Humans ; Male ; Myeloid Cells ; Sarcoma, Myeloid ; Stomach

BACKGROUND: Premedication traditionally has several goals: reduction of anxiety,pain, and secretions and provision of basal or background sedation. The purpose of this study was to evaluate the efficacy and side effects of nalbuphine, midazolam and buprenorphine as premedication agents. METHODS: Two hundred thirty three patients who were scheduled to have an elective operation were included in this randomized, double-blind study. Nalbuphine 0.2 mg/kg, midazolam 0.05 mg/kg or buprenorphine 0.005 mg/kg was given intramuscularly with atropine(0.01 mg/kg) one hour before arriving at operating room. Sedation, level of anxiety, subjective rating on the effect of premedication and side effects including emesis and etc. were evaluated. RESULTS: The sedation score and the level of anxiety were not significantly different among three groups. The subjective rating on the effect of premedication was significantly higher in midazolam group than other two groups(p<0.05). The frequency of preoperative emesis was not significantly different among three group. The frequency of postoperative emesis was significantly higher in buprenorphine group than other two groups(p<0.05). Buprenorphine group showed dizziness and flushing more frequently than the other two groups(p<0.05). CONCLUSION: The present study demonstrated that, as a premedicant, midazolam increase the patient's satisfaction and decrease lessen the incidence of postoperative emesis and buprenorphine increase the incidence the side effects such as postoerative emesis, dizziness and flushing.
Anxiety ; Buprenorphine* ; Dizziness ; Double-Blind Method ; Flushing ; Humans ; Incidence ; Midazolam* ; Nalbuphine* ; Operating Rooms ; Postoperative Nausea and Vomiting ; Premedication* ; Vomiting

PURPOSE: This study examined intraoperative imaging to monitor the alignment of the acetabular cup for total hip replacement arthroplasty (THRA) using C-arm fluoroscopy and to increase the accuracy of THRA prosthetic fixation. MATERIALS AND METHODS: From March 2004 to April 2007, 54 patients underwent THRA monitored by the imaging. 40degreesinclination and a 15degreesanteversion angle was considered to be ideal. The items compared included the alignment of the acetabular cup and the follow up rates of the hip dislocation. RESULTS: There was one case of hip dislocation. The mean inclination angle of the acetabular component was 39.9degreeswith a standard deviation of 3.038. The mean anteversion angle of the acetabular component was 14.9degreeswith a standard deviation of 1.398. The mean difference examination and variance in the anteversion angle showed a significant result.(P<0.05) CONCLUSION: Intraoperative imaging increases the alignment accuracy of the acetabular cup and helps stabilize the prosthesis.
Acetabulum* ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Fluoroscopy ; Follow-Up Studies ; Hip Dislocation ; Humans ; Prostheses and Implants

We present here an operative method that uses the suture anchor technique in the case of a tiny avulsion fracture of the acetabulum along with a labral tear. Generally it is very difficult to determine how to treat patient with either the conservative method or the operative method because it is difficult to decide on the proper method to fix tiny avulsion fracture fragments to the acetabulum. Unstable hip dislocation was perceived in our case, so we tried to fix the fracture fragments to the acetabular rim&repair the labral tear that was seen on the operation field by using the sutue anchor technique. This is now a popular method to repair labral tear of the shoulder joint.
Acetabulum* ; Hip Dislocation ; Humans ; Shoulder Joint ; Suture Anchors* ; Sutures*

Purpose: To report a case of solitary fibrous tumor of the orbit in a patient with changes in tumor size and contrast enhancement.Case summary: A 64-year-old male patient presented with dizziness, discomfort on eye movement, anosmia, and proptosis. Orbital computed tomography showed an enhancing mass in the right extraconal space, lateral to the medial rectus and inferior to the superior oblique muscle. The mass appeared to be a cavernous hemangioma and the patient was monitored for changes in mass size and eye movements. After 24 months of follow-up, the mass size and symptoms of right eyelid swelling, proptosis, and diplopia had increased. Excision and biopsy of the mass were performed under general anesthesia. The biopsy confirmed that the mass was a solitary fibrous tumor. The postoperative period was uneventful and no recurrence was observed at 6 months after surgery. Conclusions Solitary fibrous tumor is a soft tissue tumor that rarely occurs in the orbit, and should be considered in cases with an intraorbital mass accompanied by increased size and changes in contrast enhancement on imaging.

PURPOSE: Mycoplasma pneumoniae is a common respiratory pathogen responsible for acute respiratory infections in young children. The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods. The objective of this study was to compare the performance of enzyme-linked immunosorbent assays (ELISA) for the detection of M. pneumoniae specific IgG and IgM antibodies and polymerase chain reaction (PCR) in diagnosis of M. pneumoniae pneumonia. METHODS: For a 1-year period, 111 patients admitted to Severance Hospital and Yongdong Severance Hospital with clinical features of pneumonia and radiographically defined pneumonia were included. Serum specimens and throat swab specimens were obtained at the time of admission. Patients who showed M. pneumoniae antibody titer 1:320 or greater or a fourfold increase in M. pneumoniae antibody titer between acute and convalescent sera obtained 5 days to 3 weeks after the onset of illness were diagnosed as having M. pneumoniae pneumonia. PCR and ELISA were also performed. RESULTS: The sensitivity, specificity, false positivity, and false negativity of PCR were 40.6 percent, 63.3 percent, 69.1 percent, and 27.5 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of ELISA IgM were 9.4 percent, 100 percent, 0 percent, and 26.9 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of the use of PCR and ELISA in combination were 46.9 percent, 63.3 percent, 65.9 percent, and 25.4 percent, respectively. CONCLUSION: These observations suggest that the use of PCR and ELISA in addition to the detection of serum antibody to Mycoplasma pneumoniae using microparticle agglutination would allow the maximal number of diagnoses to be made at a very early phase of infection.
Agglutination ; Antibodies ; Child ; Diagnosis ; Enzyme-Linked Immunosorbent Assay* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pharynx ; Pneumonia* ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction* ; Respiratory Tract Infections ; Sensitivity and Specificity

BACKGROUND: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. MATERIAL AND METHOD: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, 54~77 years). The average size of the tumors was 48.8 mm (range, 36~111 mm) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. RESULT: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A chi-square-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. CONCLUSION: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.
Cryosurgery ; Disease Progression ; Female ; Fever ; Humans ; Length of Stay ; Lung ; Lung Neoplasms ; Male ; Positron-Emission Tomography ; Retrospective Studies ; Sputum ; Subcutaneous Emphysema ; Thorax