INTRODUTION: The gamma-aminobutyric acid type A (GABAA) receptor is an important pharmacological target of alcohol. The phamacological characteristics of the receptor are largely determined by its subunit composition. Compared with all other alpha subtypes, the alpha6- containing receptors are more sensitive to GABA and less sensitive to benzodiazepines. The purpose of this study was to address a role for GABAAalpha6 receptor subunit gene in the development of alcohol dependence. The differential manifestation of alcohol withdrawal symptoms related to GABAAalpha6 polymorphism in patients treating with benzodiazepines was also examined. METHODS: Eighty-seven inpatients with alcohol dependence, and sixty healthy controls were evaluated using CIWA-Ar scale. Each patient was genotyped for GABAAalpha6 subunit. Association between GABAAalpha6 polymorphism and severity of withdrawal symptom were determined. RESULTS: No significant difference was found in GABAAalpha6 receptor genetic type and allelic distribution between the alcohol dependent and control subject. Tremor was more severe in CC than TT type. TT type had higher degree of anxiety, agitation and headache than CC type. The GABAAalpha6 C allele increased the average score of tremor significantly, and T allele increased that of agitation. CONCLUSION: The results suggested that GABAAalpha6 genetic polymorphism was not associated with alcohol dependence and with severity of alcohol withdrawal symptoms. But in benzodiazepine treated patients, GABAAalpha6 polymorphism and allelic type show the difference in severity of each withdrawal symptom. These differences of severity are partly responsible for the unique pharmacological properties associated with the GABAAalpha6 subunit.
Alcoholism ; Alleles ; Anxiety ; Benzodiazepines ; Dihydroergotamine ; gamma-Aminobutyric Acid ; Headache ; Humans ; Inpatients ; Polymorphism, Genetic ; Receptors, GABA ; Substance Withdrawal Syndrome* ; Tremor

PURPOSE: Recently, paranasal sinus(PNS) CT has increasingly been used because of the wide applications of a functional endoscopic sinonasal surgery(FESS) as one of the therapeutic modalities of the chronic sinonasal inflammatory disease. MATERIALS AND METHODS: We retrospectively analyzed PNS CT findings in 76 patients with chronic sinonasal inflammatory disease who had undergone the PNS CT from April 1991 to July 1992. RESULTS: There were 5 sinonasal patterns of inflammation ;4 cases of infundibular type(5.3%), 14 cases of ostiomeatal unit(OMU) type(18%), one case of sphenoethmoidal(SER) type(1%), 56 cases of sinonasal polyposis type(74%), and one case of sporadic type(1%). The mucosal abnormality was seen in 74 OMU cases, 71 maxillary sinus cases, 69 ethmoidal sinus cases, 55 frontal sinus cases, 49 SER, and 46 sphenoidal sinus cases. The normal bony variant included ethmoid bulla(25 cases, 335), concha bullosa (20 cases 25%), Hailer cells(10 cases, 13%), paradoxical curvature of middle turbinate (4 cases, 5%), lateral deviation of uncinate process(3 cases, 4%), and deviation of nasal septurn(31 cases, 41%). CONCLUSION: The PNS CT is an excelleht imaging method providing detailed informations about the mucosal abnormality, pathological pattern, the anatomical structure and landmark, and bony variants prior to an operation.
Frontal Sinus ; Humans ; Inflammation ; Maxillary Sinus ; Retrospective Studies ; Turbinates

No abstract available.
Arnold-Chiari Malformation*

PURPOSE: To evaluate the age-related risk factors, clinical manifestations, and prognosis in infectious keratitis. METHODS: Records of patients with infectious keratitis who visited one of the two tertiary medical centers at Jeolla-do from January 2000 to December 2007 were reviewed. Risk factors depending on patient age distribution standardized over and under the age of 60 were reviewed retrospectively by analyzing sex, age, previous history of trauma, systemic disease, previous ocular disease, causative organism and treatment. RESULTS: A total of 757 patients (757 eyes) visited either one of the two tertiary medical centers. The mean age was 58.2+/-18.0 (4 to 93) years, and patients included 437 males (57.7%), and 320 females (42.3%). The most common risk factor among all age groups was trauma, especially due to vegetable matter. The second most frequent risk factor among the younger patients was contact lens use (19.2%), and common risk factors among the elderly were previous ocular disease (20.0%), systemic disease (15.5%), and ocular surgery (9.7%). The most prevalent causative organisms among all age groups were Gram-positive bacteria, in particular Staphylococcus epidermidis. Elderly patients had a higher frequency of corneal perforation than did younger patients. In addition, elderly patients had a worse prognosis and more often required surgical treatment. CONCLUSIONS: Infectious keratitis has more severe clinical manifestations and complications and a worse prognosis in elderly than in younger patients. Elderly patients have more diverse risk factors. Prevention should aim at avoiding ocular trauma, especially by vegetable matter, and at controlling ocular surface diseases, such as exposure keratitis and bullous keratopathy.
Age Distribution ; Aged ; Corneal Perforation ; Female ; Gram-Positive Bacteria ; Humans ; Keratitis ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Staphylococcus epidermidis ; Vegetables

Fecal incontinence is a disabling condition with devastating psychosocial impact due to diverse etiology. This study was performed to assess various causes of fecal incontinence, clinical evaluation, and adequate surgical treatment. METHODS: Eighty patients presenting fecal incontinence during July 1989 and June 1997 were included. They were evaluated by clinical parameters and physiologic tests including the defecography, electromyography, transanal ultrasonography, and anorectal manometry. Surgery was performed in 31 patients based on those evaluation. Pre- and post-operative comparison of manometric findings, clinical assessment, incontinence score, and the outcome of surgery were assessed. Mean postoperative follow-up was 22 (2~84) months. RESULTS: Inappropriate anal surgery was the most common cause, and then injuries during delivery, trauma, rectal prolapse, and hysterectomy in descending order. Defecography was performed in 21 patients and mean values of anorectal angles were 115+/-15degrees at rest, 98+/-18degrees during squeezing, and 136+/-10degrees during push. Electromyography was performed in 8 patients showing pudendal neuropathy in 2, bilateral lumbosacral polyradiculopathy in 4, and normal finding in 2 patients, respectively. Transanal ultrasonography was performed in 33 patients and 22 among them showed finding of an injury of the anal sphincters. Surgery was performed in 31 patients due to anal sphincter damage, rectovaginal fistula, and anal stricture in descending order. Type of surgery was determined by respective cause: plication, triple repair (sphincteroplasty, anoplasty, perineorrhaphy), and posterior rectopexy in descending order. Nerve preserving graciloplasty was performed in a 12 year-old girl who had severe defect of the anal sphincters by traffic accident, showing sound recovery with a good functional outcome. Although there was no significant difference of manometric variables between pre- and post-operative periods, sphincter length, and maximum resting and squeezing pressure, revealed an increasing tendency postoperatively. According to the clinical assessment between pre- and post-operative periods, urgency to evacuate, soiling, sensation on defecation, and quality discrimination were significantly improved postoperatively (P<0.01). Incontinence score was markedly decreased from 10.6+/-6.1 during preoperative period to 2.9+/-4.7 during postoperative period (P<0.01). Eighty one percent of the patients undergone surgery experienced a significant symptomatic improvement. CONCLUSIONS: According to the analysis of the causes of fecal incontinence, inappropriate anal surgery, injuries during delivery, and trauma were main causes. Adequate application of physiologic tests, such as, defecography, electromyography, transanal ultrasonography, and anorectal manometry, were helpful in determining treatment modality and types of surgery. We got satisfactory results with adequate surgery based on the physiologic tests.
Accidents, Traffic ; Anal Canal ; Child ; Constriction, Pathologic ; Defecation ; Defecography ; Discrimination (Psychology) ; Electromyography ; Fecal Incontinence* ; Feces ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Manometry ; Polyradiculopathy ; Postoperative Period ; Preoperative Period ; Pudendal Neuralgia ; Rectal Prolapse ; Rectovaginal Fistula ; Sensation ; Soil ; Ultrasonography

Recently, the incidence of pertussis has been increasing; however, reports on mixed infection of pertussis with other respiratory pathogens are rare in highly immunized populations. We report the case of a 10-year-old girl who presented with cough, post-tussive emesis, and fever. She was subsequently diagnosed with bronchopneumonia. Although she had received five doses of diphtheria-tetanus-acellular pertussis vaccine, polymerase chain reaction of her nasopharyngeal aspirate confirmed Bordetella pertussis infection. In addition, serologic testing for Mycoplasma pneumoniae was also positive. The patient was treated with roxithromycin without any complications. This is the first report of mixed B. pertussis and M. pneumoniae infection in Korea. To avoid under-diagnosis, pertussis should be considered in patients with chronic cough even when other respiratory pathogens have been documented.
Bordetella pertussis ; Bronchopneumonia ; Child* ; Coinfection ; Cough ; Female* ; Fever ; Humans ; Incidence ; Korea ; Mycoplasma Infections* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pertussis Vaccine ; Pneumonia ; Pneumonia, Mycoplasma ; Polymerase Chain Reaction ; Roxithromycin ; Serologic Tests ; Vomiting ; Whooping Cough*

OBJECTIVES: Aeromonas species is a gram-negative, facultative anaerobe of the family Vibrionaceae. The organism has been recognized as a pathogen associated with illness in human, such as acute gastroenteritis, cellulitis, septicemia, and other rare diseases. METHODS: To evaluate the clinical significance of Aeromonas bacteremia in Korea and it's susceptibility of antibiotics, we evaluated the 17patients with Aeromonas bacteremia. Identification was done by use of API 20E system and antibiotic susceptibility was tested with disk diffusion method. RESULTS: Male to female ratio was 11:6, and mean age was 54.1years(8-85years) old. Liver cirrhosis was the most common underlying disease(10cases of 17patients, 58.8%a). Other underlying diseases were as follows: gallstone in 2cases, cholangiocarcinoma in 2cases, and aplastic anemia in 1case, cerebral infarction in 1case. But one had no underlying disease. So Aeromonas bacteremia were occurred in 14immunocompromised patients(82.3%), and in 10patients with hepatobiliary diseases, A. hydrophila was most commonly isolated(13cases, 764%), and the A sobria(4cases, 23.5%) was infrequently isolated. The overall fatality was 47%, and there had no significant difference in fatality between A. hydrophila and A sobria All Aeromonas species had resistance to ampicillin and carbenicillin. CONCLUSION: Because Aeromonas bacteremia may occur through water-borne route, especially in immunocompromised host. We should pay attention to immunocompromised patients, espacially having hepatobiliary disease.
Aeromonas* ; Ampicillin ; Anemia, Aplastic ; Anti-Bacterial Agents ; Bacteremia* ; Carbenicillin ; Cellulitis ; Cerebral Infarction ; Cholangiocarcinoma ; Diffusion ; Female ; Gallstones ; Gastroenteritis ; Humans ; Immunocompromised Host ; Korea ; Liver Cirrhosis ; Male ; Rare Diseases ; Sepsis ; Vibrionaceae

IL-28RA is one of the important candidate genes for complex trait of genetic diseases, but there is no published information of the genetic variation in this gene. We scanned the seven exons and their boundary introns sequence of IL-28RA including the promoter regions to analyze genetic variation sites, and identified eighteen single nucleotide polymorphisms (SNPs) and two variation sites. We chose seven SNPs (g.-1193 A>C, g.-30 C>T, g.17654 C>T, g.27798 A>G, g.31265 C>T, g.31911 C>T and g.32349 G>A) of them for large sample size genotyping, and assessed the association of genotype and allele frequencies of these SNPs between allergic rhinitis patients and non-allergic rhinitis controls. We also compared the genotype frequencies between Korean controls and Han Chinese control or Korean Chinese control. We investigated the frequencies of haplotype constructed by these SNPs between allergic rhinitis patients and non-allergic rhinitis controls. Our results suggested that the g.32349 G>A polymorphism of IL-28RA might be associated with susceptibility to allergic rhinitis (P=0.032), but seems to have no relationship with serum total IgE levels. The haplotype frequencies by these SNPs also show significant association between controls and allergic rhinitis patients.
Variation (Genetics) ; Rhinitis, Allergic, Seasonal/blood/*genetics ; Rhinitis, Allergic, Perennial/blood/*genetics ; Receptors, Cytokine/*genetics ; Promoter Regions (Genetics)/genetics ; Polymorphism, Single Nucleotide/*genetics ; Male ; Immunoglobulin E/blood ; Humans ; Haplotypes ; Genotype ; Genetic Predisposition to Disease/genetics ; Gene Frequency ; Female ; Exons/genetics ; Case-Control Studies ; Alleles ; Adult

PURPOSE: Cyclooxygenase (COX) is an important enzyme that transforms arachidonic acid into prostaglandins and exists as two types of isoenzyme, COX-1 and COX-2. Recently, the expression of COX-2 was presented as an important factor in determining the prognosis in colorectal cancer, and the expressed COX-2 was related with recurrence and liver metastasis after an operation for colorectal cancer. Thus this study was to investigate the relationship between COX-2 expression and the prognosis for colorectal cancer. METHODS: We studied colorectal cancer patients who received operations at the Catholic University of Korea from Jan. 1993 through Dec. 2000, by reviewing their medical records and pathological reports. We used immunohistochemistry to determine the expression rate of COX-2 and to study its relationship with other clinical variables, the disease-free survival rat, and the recurrence rate. RESULTS: Among the 217 cases, 171 cases (78.8%) showed positive COX-2 expression. The COX-2 expression increased with the differentiation and was lower in cases with lymph-node metastasis. However, no statistically significant difference in age, sex, location of lesion, invasiveness, stage, organ of metastasis, disease-free survival rate, and recurrence existed between patients with positive COX-2 expression and those with negative COX-2 expression. CONCLUSIONS: There is no evidence that COX-2 expression is associated with a poor prognosis for colorectal cancer.
Animals ; Arachidonic Acid ; Colorectal Neoplasms* ; Cyclooxygenase 2* ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Korea ; Liver ; Medical Records ; Neoplasm Metastasis ; Prognosis ; Prostaglandin-Endoperoxide Synthases ; Prostaglandins ; Rats ; Recurrence

In renal transplantation, cardiovascular disease is a frequent cause of mortality and morbidity. Post-transplant lipoprotein abnormalities may contribute to the development of cardiovascular disease and chronic renal allograft rejection. Post- transplant hyperlipidemia is commonly related to immunosuppressive therapy. Lovastatin effectively lowers cholesterol in patients after renal transplantation and may be of potential benefit in preventing graft atherosclerosis with a few side effects. But the drug can cause severe complication. Rhabdomyolysis is one of the complications, which can cause acute renal failure. In Korea, lovastatin use after renal transplantation is common, but rhabdomyolysis is rarely reported. So, we report three cases of rhabdomyolysis. Physicians should be aware of the dose of lovastatin and potential risks of combined therapy with cyclosporin in renal transplant patients.
Acute Kidney Injury ; Allografts ; Atherosclerosis ; Cardiovascular Diseases ; Cholesterol ; Cyclosporine ; Humans ; Hyperlipidemias ; Kidney Transplantation* ; Korea ; Lipoproteins ; Lovastatin* ; Mortality ; Rhabdomyolysis* ; Transplants