Triple X syndrome is a relatively rare sex chromosomal anomaly, and its association with psychopathology is not well understood. The authors report one case of obsessive-compulsive disorder(OCD)with karyotype-confirmed triple X syndrome, 47,XXX. She had incomplete sexual development, seconddary amenorrhea and multiple obsessive-compulsive symptoms. Magnetic resonance imaging of the brain revealed left occipital white matter hyperintensity lesion. The patient's multiple obsessive-compulsive symptoms were responded partially with fluoxetine and adjunctive buspirone treatment, however, her overall psychological functions were much improved. With the literature reviews, the authors suggest the possibility that a certain type of sex chromosome aneuploidy might be susceptible to obsessive-compulsive spectrum disorders(OCSDs)or OCD.
Amenorrhea ; Aneuploidy ; Brain ; Buspirone ; Female ; Fluoxetine ; Humans ; Magnetic Resonance Imaging ; Obsessive-Compulsive Disorder* ; Psychopathology ; Sex Chromosomes ; Sexual Development

BACKGROUND: renal artery stenosis (RAS) is a major cause of renovascular hypertension and renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS. METHOD: From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis (11 male, 6 female). the mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu's disease in 2, and autoimmune disease (Bechet's) in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination. RESULT: the degree of renal artery stenosis was 83% (70-95%). the lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-2 stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases. CONCLUSION: Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.
Angioplasty ; Atherosclerosis ; Atrophy ; Autoimmune Diseases ; Blood Pressure ; Brachial Artery ; Constriction, Pathologic ; Emergencies ; Femoral Artery ; Fibromuscular Dysplasia ; Follow-Up Studies ; Hematoma ; Humans ; Hypertension, Renovascular ; Kidney ; Male ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Renal Artery Obstruction* ; Renal Artery* ; Stents*

No abstract available.
Temporal Bone* ; Tympanic Membrane*

No abstract available.
Dermoscopy ; Melanoma*

OBJECTIVES: In previous studies, the significant correlations between depression-anxiety symptoms and positive symptoms had been reported in schizophrenia. However, it is suggested that these correlations reflect the common influence of third variable, and akathisia-associated dysphoria may be the strong mediator of these relationships. The aim of this study is to investigate the correlations between depression-anxiety symptoms and the schizophrenic symptoms including direct measures of drug-induced akathisia. METHODS: The subjects were 57 patients with chronic schizophrenia. All patients were functioning cognitively at a level to understand and complete the several self-report inventories. Akathisia was rated using Barnes akathisia rating scale (BARS), and depression-anxiety symptoms were assessed by two self-report measures, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). The symptoms of schizophrenia were assessed using Manchester Scale. RESULTS: In the whole group of subjects, the scores on BDI and dysphoria composite index were significantly correlated with total positive symptom scores and all subscale scores of positive symptoms. In akathisia group, the scores on BDI and dysphoria composite index were still significantly correlated with total positive symptom scores and the subscale scores of delusion. In non-akathisia group, however, there were no significant correlations between self-report depression, anxiety symptoms and total positive symptom scores. CONCLUSION: These results suggest that the akathisia is the important factor in correlations between dysphoric symptoms and positive symptoms. Therefore, the caution is necessary in the interpretation of previous studies which report the direct correlations between depression and positive symptoms. Future research is needed to investigate the associations in akathisia, depression, and the schizophrenic symptom complexes.
Akathisia, Drug-Induced ; Anxiety ; Delusions ; Depression ; Equipment and Supplies ; Humans ; Psychomotor Agitation* ; Schizophrenia

No abstract available.
Condylomata Acuminata* ; Dermoscopy* ; Diagnosis, Differential* ; Lymphangioma* ; Vulva*

PNP is a rare autoimmune mucocutaneous blistering disease associated with neoplasms, most frequently of the lymphoproliferative type. As PNP is clinically characterized by polymorphous mucosal lesions and cutaneous eruptions, it is important to differentiate it from erythema multiforme, Stevens-Johnson syndrome, lichen planus, and other bullous diseases. A diagnosis of PNP can be confirmed by immunologic studies such as direct and indirect immunofluorescence, immunoblotting, immunoprecipitation. Rare PNP cases related to nonhematological solid tumors have been reported. A 54-year-old male visited us with generalized pruritic scaly lichenoid lesions on the whole body from 5 weeks prior to his first visit. He also presented with extensive painful ulcers and erosions on the oral mucosa and lips for 2 months. Histopathologic findings showed lichenoid infiltration with vacuolar interface change, lichenoid interface dermatitis, keratinocyte apoptosis, and suprabasal acantholysis with cleft. Indirect immunofluorescence using normal human skin showed IgG deposition at the intercellular space. Immunoblotting using normal epidermal extracts in the serum of patient detected antibody to the 190 kDa (envoplakin), 210 kDa (periplakin) molecules polypeptides. He also had a hepatocellular carcinoma and chemoradiotherapy done before. The diagnosis of paraneoplastic pemphigus (PNP) was made. To our knowledge, there are only two reports of PNP associated with hepatocellular carcinoma worldwide, yet no report in Korean literature. Herein, we report the first case of PNP associated with hepatocellular carcinoma in Korea.
Acantholysis ; Apoptosis ; Blister ; Carcinoma, Hepatocellular* ; Chemoradiotherapy ; Dermatitis ; Diagnosis ; Erythema Multiforme ; Extracellular Space ; Fluorescent Antibody Technique, Indirect ; Humans ; Immunoblotting ; Immunoglobulin G ; Immunoprecipitation ; Keratinocytes ; Korea ; Lichen Planus ; Lip ; Male ; Middle Aged ; Mouth Mucosa ; Pemphigus* ; Peptides ; Skin ; Stevens-Johnson Syndrome ; Ulcer

No abstract available.
Hepacivirus ; Hepatitis C* ; Hepatitis*

Experimental stem cell therapy for spinal cord injury (SCI) has been extensively investigated. The selection of effective cell transplantation route is also an important issue. Although various types of scaffold have been widely tried as a carrier of stem cells to the injured spinal cord, there was little comparative study to investigate the efficacy of transplantation comparing with conventional transplantation route. A total of 48 Sprague-Dawley rats were subjected to standardized SCI, followed by transplantation of allogeneic mesenchymal stem cells (MSCs), either via intralesional injection (IL group), or via the poly (lactic-co-glycolic acid) (PLGA) scaffold (IP group) or chitosan scaffold (IC group). Engraftment and differentiation of the transplanted cells, expression of neurotrophic factors in the injured spinal cord, and functional recovery were compared with those of the control group. The mean numbers of engrafted MSCs in the IL, IP, and IC groups were 20.6 ± 0.7, 25.6 ± 1.7 and 26.7 ± 1.8 cells/high power filed (HPF), respectively. Results showed higher success rate of MSCs engraftment in the scaffold groups compared to the IL group. Expression of neuroprotective growth factors in the SCI lesions showed no significant differences between the IL, IP, and IC groups. The mean Basso, Beattie and Bresnahan locomotor scales at 6 weeks post-transplantation in the IL, IP, IC, and control groups were 7.9 ± 1.1, 7.9 ± 2.1, 8.7 ± 2.1, and 2.9 ± 1.0, respectively. The functional improvement was most excellent in the IC group. The scaffold based MSC transplantation for acute SCI presented the better cell engraftment and neuroprotective effect compared to the intralesional injection transplantation.
Animals ; Cell Transplantation ; Chitosan ; Injections, Intralesional* ; Intercellular Signaling Peptides and Proteins ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells* ; Nerve Growth Factors ; Neuroprotection ; Neuroprotective Agents ; Rats* ; Rats, Sprague-Dawley ; Spinal Cord Injuries* ; Spinal Cord* ; Stem Cells ; Tissue Scaffolds ; Transplants ; Weights and Measures

BACKGROUND AND OBJECTIVES: Carotid artery stenting has evolved as a potential alternative to carotid endarterectomy in patients (pts) with significant carotid artery stenosis. We evaluated the feasibility and long-term outcome of carotid artery stenting in selected pts at high surgical risk. MATERIALS AND METHODS: Between May, 1996 and September 1998 we performed carotid artery stenting at 35 lesions in 25 pts. There were 23 males and 2 fe-males. Mean age was 63.2+/-6.6 (range 54 - 77). Eight four percent (21/25) of the pts had significant coronary artery disease. Sixty four percent (16/25) of the pts had significant peripheral artery lesions. Sixty percent (15/25) of the pts had neurologic symptoms or non-disabling stroke. We used Wallstent in 32 lesions and Palmaz stent in 3 lesions. Carotid stenting was undertaken in 33 internal carotid, 1 common carotid and 1 external carotid lesions. Bil-ateral carotid stenting was undertaken in forty percent (10/25) of the pts. RESULTS: Carotid stenting was successful in all lesions. One patient died due to massive cerebral hemorrhage 3 days after carotid stenting, who had und-erwent stenting as a rescue procedure for failed endarterectomy. One major stroke developed during procedure with partial recovery. For the combined endpoint of strokes and death within 30 days of procedure, the incidence was 8% and 5.7% in terms of pts and procedures, respectively. On follow-up (12+/-7 months), we found neither neurologic complications nor death. Angiographic and/or duplex sonography which were performed at 5.5 month in all (18) eligible pts with 24 lesions revealed no evidence of stent deformity or restenosis ( 50% of diameter stenosis). Mean angiographic stenosis was 20% on follow-up angiography. CONCLUSION: Carotid artery stenting can be performed with high success and low complication rate in pts with significant carotid artery stenosis especially at high surgical risk. Follow-up clinical outcome of average 12 month was good with low restenosis rate.
Angiography ; Arteries ; Carotid Arteries* ; Carotid Stenosis* ; Cerebral Hemorrhage ; Congenital Abnormalities ; Constriction, Pathologic ; Coronary Artery Disease ; Endarterectomy ; Endarterectomy, Carotid ; Follow-Up Studies* ; Humans ; Incidence ; Male ; Neurologic Manifestations ; Stents* ; Stroke