PURPOSE: To evaluate the effect of acupuncture on regional cerebral blood flow (rCBF) at acupoints suggested by oriental medicine to be related to the treatment of cerebrovascular diseases. MATERIALS AND METHODS: Rest/acupuncture-stimulation Tc-99m ECD brain SPECT using a same-dose subtraction method was performed on 54 normal volunteers (34 males, 20 females, age range from 18 to 62 years) using six paradigms: acupuncture at acupoints GV. 20, GV. 26, LI. 4, ST. 36 and SP. 6. In the control study, needle location was chosen on a non-meridian focus 1 cm posterior to the right fibular head. All images were spatially normalized, and the differences between rest and acupuncture stimulation were statistically analyzed using SPM for Windows . RESULTS: Acupuncture applied at acupoint GV. 20 increased rCBF in both the anterior frontal lobes, the right frontotemporal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at GV. 26 increased rCBF in the left prefrontal cortex. Acupuncture at LI. 4 increased rCBF in the left prefrontal and both the inferior frontal lobes, and the left anterior temporal lobe and the left cerebellar hemisphere. Acupuncture at ST. 36 increased rCBF in the left anterior temporal lobe, the right inferior frontal lobes, and the left cerebellum. Acupuncture at SP. 6 increased rCBF in the left inferior frontal and anterior temporal lobes. In the control stimulation, no significant rCBF increase was observed. CONCLUSION: The results demonstrated a correlation between stimulation at each acupoint with increase in rCBF to the corresponding brain areas.
Acupuncture Points* ; Acupuncture* ; Brain* ; Cerebellum ; Female ; Frontal Lobe ; Head ; Healthy Volunteers ; Humans ; Male ; Medicine, East Asian Traditional ; Needles ; Prefrontal Cortex ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

We herein report a case of transient acrodermatitis enteropathica in a 3-month-old, breast-fed, full-term infant. The patient was presented with a 2-month history of diarrhea and crusted erythema- tous patches on the periorificial area. Similar lesions were seen in his siblings. His serum zinc level and the zinc level in his mother's breast milk were markedly reduced. Diarrhea and skin lesions disappeared promptly with oral zinc supplementation and did not recur when zinc was discontinued after three weeks. Our case indicates that even full-term infants, who feed excl-usively on mothers milk, run a risk of developing zinc deficiency, if the concentration of zinc in the breast milk is very low.
Acrodermatitis* ; Diarrhea ; Humans ; Infant* ; Milk ; Milk, Human ; Mothers ; Siblings ; Skin ; Zinc

PURPOSE: The purpose of this study was to investigate the physiological index, anxiety and depression by the severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia. METHODS: This research was conducted from the 4th to the 27th of May in 2016 on112 patients with benign prostatic hyperplasia. The data were analyzed using a chi-square test, ANOVA, and Pearson Correlation Coefficients. RESULTS: The results demonstrated a difference depending on the dysuria period of each lower urinary tract symptom, marital status, occupation and perceived health state of the patient. The physiological index by lower urinary tract symptoms showed a difference in the maximum flow rate, amount of post-void residual urine and Prostate-Specific Antigen (PSA), and anxiety and depression factors also revealed a difference. Lower urinary tract symptoms showed a positive correlation to the amount of post voided residual urine and PSA, a negative correlation to the maximum flow rate and also indicated a positive correlation to depression. CONCLUSION: The results of the study belonging to the moderate and severe categories were high when the result was based on the categorization of subjects with benign prostatic hyperplasia with lower urinary tract symptoms. Considering that depression levels increase as the symptom intensifies and the anxiety score is also high with mild symptoms, psychological support intervention is needed when a pattern of benign prostatic hyperplasia appears.
Anxiety* ; Depression* ; Dysuria ; Humans ; Lower Urinary Tract Symptoms* ; Marital Status ; Occupations ; Prostate-Specific Antigen ; Prostatic Hyperplasia* ; Urinary Tract

Tubular apocrine adenoma(TAA) is a rare tumor characterized by papillary projection and apocrine differentiation. We report two cases of tubular apocrine adenomas. One patient was a 13-year-old male who had had a finger-tip sized asymptomatic cystic mass on his scalp since birth. Microscopically, the mass was composed of various sized cystic spaces and tubular structures lined by two layers of epithelia with nonvillous intraluminal papillary projections, decapitation secretions and connection with the epidermis. The other patient was a 55-year-old female who had had a 1.3x0.3cm sized dark red hard nodule on the left forearm since birth. Histopathologic finding showed a well circumscribed dermal neoplasm that predominantly consisted of multiple tubular structures lined by double layers of epithelial cells with decapitation secretions and intraductal papillary projections, and accompanied by underlying apocrine nevus. In both cases, immunohistochemical and enzyme studies showed positive findings in EMA, CEA, pancytokeratin, lysozyme, alkaline phosphatase, GCDFP-15.
Adenoma* ; Adolescent ; Alkaline Phosphatase ; Decapitation ; Epidermis ; Epithelial Cells ; Female ; Forearm ; Humans ; Male ; Middle Aged ; Muramidase ; Nevus ; Parturition ; Scalp

PURPOSE: To evaluate the clinical features of high myopic eyes with cataracts implanted with negative power intraocular lenses (IOLs) at the time of cataract surgery. METHODS: A retrospective chart review was conducted of 18 eyes of 14 patients who underwent cataract surgery with negative power IOLs and 10 eyes in 9 patients with low power IOLs. We investigated axial length, IOL power, preoperative and postoperative best-corrected visual acuity (BCVA) and preoperative and postoperative spherical equivalent (SE) refractive errors. RESULTS: Mean BCVA showed significant improvement in both groups. We measured postoperative SE refraction and the difference between the mean intended and the mean achieved SE refractive errors in the negative power group (17 eyes) was +1.59 ± 1.34 D and +0.31 ± 0.50 D in the low power group. CONCLUSIONS: BCVA was significantly improved in the majority of eyes, although they had myopic macular degeneration or posterior staphyloma. However, the mean achieved postoperative SE refraction was more hyperopic than the predicted postoperative SE error. Additionally, hyperopic refractive error was greater in the negative power group than the low power group. Therefore, we recommend that postoperative hyperopic refractive error should be considered when performing cataract surgery in high myopic patients.
Cataract Extraction* ; Cataract* ; Humans ; Lens Implantation, Intraocular* ; Lenses, Intraocular* ; Macular Degeneration ; Myopia* ; Refractive Errors ; Retrospective Studies ; Visual Acuity

OBJECTIVE: Panic disorder has been suggested to be divided into the respiratory and non-respiratory subtypes in terms of its clinical presentations. The present study aimed to investigate whether there are any differences in treatment response and clinical characteristics between the respiratory and non-respiratory subtypes of panic disorder patients. METHODS: Among the 48 patients those who completed the study, 25 panic disorder patients were classified as the respiratory subtype, whereas 23 panic disorder patients were classified as the non-respiratory subtype. All patients were treated with escitalopram or paroxetine for 12 weeks. We measured clinical and psychological characteristics before and after pharmacotherapy using the Panic Disorder Severity Scale (PDSS), Albany Panic and Phobic Questionnaire (APPQ), Anxiety Sensitivity Index-Revised (ASI-R), State-Trait Anxiety Inventory (STAI-T, STAI-S), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D). RESULTS: The prevalence of the agoraphobia was significantly higher in the respiratory group than the non-respiratory group although there were no differences in gender and medication between the two groups. The respiratory group showed higher scores on the fear of respiratory symptoms of the ASI-R. In addition, after pharmacotherapy, the respiratory group showed more improvement in panic symptoms than the non-respiratory group. CONCLUSION: Panic disorder patients with the respiratory subtype showed more severe clinical presentations, but a greater treatment response to SSRIs than those with non-respiratory subtype. Thus, classification of panic disorder patients as respiratory and non-respiratory subtypes may be useful to predict clinical course and treatment response to SSRIs.
Agoraphobia ; Anxiety ; Citalopram ; Classification ; Depression ; Drug Therapy ; Humans ; Panic ; Panic Disorder* ; Paroxetine ; Prevalence ; Surveys and Questionnaires ; Serotonin Uptake Inhibitors ; Treatment Outcome

This study compared the microtensile bond strength (microTBS) of single step adhesives to different dentin depths. Superficial or deep dentin was exposed in 30 molar teeth by sectioning immediately under the DEJ or 1.5 mm area from central pit, respectively. After polishing with 600-grit SiC paper, the dentin surfaces were assigned to three groups: AQ group-AQ Bond, L-Pop group-Adper Prompt L-Pop, Xeno group-Xeno III. The bonded specimens were sectioned into sticks and subjected to microTBS testing with a crosshead speed of 1 mm/minute. The results of this study were as follows; The microTBS to superficial dentin was higher than that to deep dentin in all group. The microTBS of Xeno group was significantly higher than that of L-Pop group and AQ group in both superficial and deep dentin (p < 0.05).
Adhesives* ; Dentin* ; Molar ; Tooth

Bullous pemphigoid (BP) is an acquired autoimmune disease characterized by subepidermal vesicles and bullae. It is now well-accepted that BP could be associated with therapeutic drugs. Immunotherapy can induce BP; however, few reports of tyrosine kinase inhibitor of fibroblast growth factor receptor-induced BP exist in the literature. A 67-year-old male presented with pruritic erythematous variable-sized patches with bullae on entire body. The patient was diagnosed with left renal cancer and treated by erdafitinib for clinical trial purposes. Bullae formation began at the start of the 11th month of erdafitinib administration. Histopathologic examination of the skin lesion showed subepidermal blister with eosinophils and other inflammatory cells in epidermis and dermis. Direct immunofluorescence showed a linear pattern of immunoglobulin G and C3 deposition along the basement membrane zone. The results of ELISA with recombinant purified BP180 and BP230 were positive. Consequently, the patient was diagnosed with erdafitinib-related BP.

Carotid stenosis is an important etiology of ischemic stroke. Most of the strokes associated with carotid stenosis are caused by artery-to-artery embolism. The risk of embolism highly depends on the stenosis degree and the vulnerability of the carotid plaque. Carotid ultrasonography is useful for evaluating the characteristics of carotid plaque. This review aims to provide information on performing and interpreting the result of carotid ultrasonography and the treatment of carotid artery disease based on the current guidelines. The degree of stenosis can be measured by the diameter reduction and flow velocity criteria. The risk of embolism is highest when the stenosis degree is around 70% to 80%. A heterogeneous echolucent plaque with an irregular surface or an ulcer shows a high risk of embolism. Appropriate treatment is important for the patients with carotid stenosis. In symptomatic patients, a potent antiplatelet treatment, especially during the acute stage, is beneficial. Patients with asymptomatic stenosis over 50% can also be considered for antiplatelet treatments. The associated risk factors should be managed according to the targets. Medically intractable cases or patients with high risk of embolism may receive carotid endarterectomy or carotid artery stenting depending on the concomitant disease and the degree of carotid stenosis. Considering the safety of ultrasound imaging, treatment may be followed-up by carotid ultrasonography.

Although ERCP is a therapeutic endoscopic procedure in pacreatico-biliary diseases, its rare complications, including pancreatitis, duodenal perforation, and bleeding, can be fatal. An 87-year-old woman with a history of gallbladder cancer presented with jaundice and general weakness. Her skin color was yellowish and epigastric tenderness was confirmed on a physical examination. On abdomen CT, the gallbladder cancer directly invaded the duodenum, common bile duct, and liver parenchyma. Enlarged portocaval lymph nodes obstructed the extrahepatic bile duct. ERCP was performed for bile duct decompression. When shortening of endoscopy was achieved, the duodenal lateral wall was perforated because of the endoscopic tip pressure. After inserting endoscopic retrograde biliary drainage and endoscopic nasobiliary drainage, endoclips were placed evenly around the defect, and a detachable snare was tightened around the endoclips. Three days later, the duodenal wall was not sealed on the abdomen CT scan. Repeat endoscopy was achieved, and the endoscopic nasobiliary drainage, endoscopic retrograde biliary drainage, endoclips, and detachable snare were removed. From the distal margin of the perforation, band ligation was performed, and a detachable snare was applied. The patient's condition improved after the second procedure. A percutaneous biliary stent was inserted, and she was discharged. This case highlights the successful endoscopic management of ERCP-related duodenal perforation.