OBJECTIVE:Ultrasound estimation of amniotic fluid volume (AFI) is a critical component of antenatal surveillance. Alterations in AFI have classically been considered an indication of fetal compromise. Thus, this study was undertaken to determine whether there is any association between idiopathic polyhydramnios or oligohydramnios and adverse perinatal outcome. METHODS:Women delivered between December 1999 and November 2005, and who underwent ultrasonography from 26 to 41 weeks gestation were analyzed. Twenty-seven consecutive women with singleton pregnancies complicated by idiopathic polyhydramnios (amniotic fluid index>25) and 31 women complicated by oligohydraminos (amniotic fluid index<5) were included in this study. We reviewed the perinatal outcomes including preterm delivery, birth weight, primary cesarean section rate and indication, Apgar score (1-min and 5-min), and admission to NICU (neonatal intensive care unit). These findings were compared with those of 50 matched control patients with normal amniotic fluid volume. RESULTS:We observed that idiopathic oligohydramnios was significantly associated with primary perinatal outcome (Cesarean delivery for fetal distress) as well as secondary outcome variables such as birthweight, SGA (small for gestational age), Apgar score<7 at 1-min, 5-min, and NICU admission rates. On the other hand, idiopathic polyhydramnios did not correlate with any other perinatal outcome, except for rates of LGA (large for gestational age). CONCLUSION:The present study suggests that AFI is a weak predictor of perinatal outcome than has been classically suggested. But we demonstrated that the AFI identification of polyhydramnios was helpful in identifying LGA, and idiopathic oligohydramnios was a significant predictor of poor perinatal outcome.
Amniotic Fluid ; Apgar Score ; Birth Weight ; Cesarean Section ; Female ; Hand ; Humans ; Critical Care ; Oligohydramnios* ; Polyhydramnios* ; Pregnancy ; Ultrasonography

Priapism is an abnormal persistent penile erection that continues for more than 4 hours, without sexual stimulation according to the definition of the AUA (American Urological Association) guideline on the management of priapism. It was relatively rare in the past but has been increasing in the incidence since the advent of pharmacological agents. Stuttering priapism is a recurrent form of ischemic priapism and its treatment goal is to prevent the recurrences of priapism and resultant erectile dysfunction. We present the case of a patient who took tadalafil and thereafter had idiopathic recurrent episodes of ischemic priapism during the sleep and we show several treatment options of stuttering priapism with review of recent related articles.
Carbolines ; Erectile Dysfunction ; Humans ; Incidence ; Male ; Penile Erection ; Priapism ; Recurrence ; Stuttering ; Tadalafil

Binder`s syndrome(maxillonasal dysplasia) is a disorder characterized by midface hypoplasia, flattened nose, convex upper lip, broad philtrum, crescent-shaped nostrils, acute nasolabial angle, absent anterior nasal spine and Class III malocclusion. Three defects(short maxilla, perialar flattening, and the hypoplastic nose) should be considered for appropriate correction method. A 25 years old man visited for correction of saddle nose deformity. The authors designed simple method for correction by using a silicone rubber and porous high density polyethylene sheet, Medpor(R), for nasal dorsal augmentation and the result was excellent. The most important part of Binder's syndrome correction seemed to be the correctioning the hypoplastic nose and it was highly effective only by simple correction of nasal augmentation with implants.
Adult ; Congenital Abnormalities ; Humans ; Lip ; Malocclusion ; Maxilla ; Nose ; Polyethylene ; Silicone Elastomers ; Spine

The purpose of this study was to assess the comorbid axis-II disorders of obsessive compulsive disorder(OCD) patients and to investigate the relationship between symptoms of OCD and the comorbid personality traits. The subjects were 59 patients who met DSM-IV criteria for obsessive-compulsive disorder and 32 normal controls. All subjects completed Personality Disorder Questionnaire-IV(PDQ-IV). The patients completed Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI), and were rated with Yale-Brown Obsessive Compulsive Scale(YBOCS). The results were as follows. 1) The OCD patients showed significantly higher prevalence of avoidant, depresssive and borderline personality disorder(p<0.01) compared to controls. 2) The BAI score had significant effect on the avoidant personality score(t=3.23, p<0.003). The BDI score had significant effect on the depressive personality score(t=3.08, p=0.004). The YBOCS(t=2.10, p=0.043) and BAI(t=2.60, p=0.014)scores had significant effects on the borderline personality score. We found that OCD patients had higher prevalence of avoidant, depressive, and borderline personality disorders. We also found that obsessive-compulsive symptoms have significant effect on the severity of borderline personalty traits. We suggest that it would be very helpful to consider Axis-II disorders for managing patients with obsessive-compulsive disorder.
Anxiety ; Borderline Personality Disorder ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Obsessive-Compulsive Disorder* ; Personality Disorders ; Prevalence

PURPOSE: The aim of this study was to evaluate the relationships among various psychosocial factors, behavior problems, and depressive symptoms reported by parents, and to investigate self-reported depression in Korean children using a community sample. MATERIALS AND METHODS: The sample consisted of 1279 children between 9 and 12 years of age. The children were evaluated using the Korean version of the Child Behavior Checklist (K-CBCL) and the Child Depression Inventory (CDI). RESULTS: The average self-reported depression score as measured by the CDI was 12.34 (SD: 6.79), and a cut-off point of 19 identified approximately 14% of the children as depressed. The group difference was identified by the age at which younger children were found to have higher CDI scores. Univariate logistic regression analysis showed that the high-CDI group and the low-CDI group differed in all behavioral domains identified in the parent-reported subscales of the K-CBCL. Age and father's education level were also independently associated with the risk for childhood depression. In addition, results from the logistic regression analyses indicated that parental reporting of problem internalization, total behavior problems, and social competence were independent predictors of child depression not identified by the anxious/depressed subscale. CONCLUSION: It is believed that extensive behavioral problems reported by parents and several sociodemographic factors are related to childhood depression. However, parents tend to under-report depressive symptoms relative to what their own children report. Thus, clinicians must consider the self-reports of children related to depression in their diagnosis and intervention, because reports of depressive symptoms from children are more valid measures than those from parents.
Age Distribution ; Child ; Depression/*epidemiology ; Female ; Humans ; Korea/epidemiology ; Male ; *Self Disclosure ; Sex Characteristics

BACKGROUND: Cell growth is a balance between cell proliferation and cell death. Insulin-like growth factor-I(IGF-I), which binds IGF-I receptor (IGF-IR), mediates cellular proliferation as a potent mitogen. IGF binding protein-3 (IGFBP-3) as a circulating major IGFBP can inhibit or enhance the effects of IGF-I on cellular growth by binding IGFs. METHODS: We investigated the expressions of mRNA of IGF-I and IGF-IR by northern blot and phosphorylation of IGF-IR with the treatment of IGF-I by western blot in 3T3 fibroblast cells. The cellular proliferations of 3T3 cells with the treatments of IGF-I were evaluated using 3H-thymidine incorporation and MTT assay. Also to observe the effect of IGFBP-3 on cellular proliferation, 3T3 cells were treated with anti-IGFBP-3 and alpha IR3(monoclonal antibody to IGF-IR) alone or in combination. RESULTS: Our results demonstrated that 3T3 cells showed mRNA expressions of IGF-I and IGF-IR and the IGF-I increased phosphorylation of IGF-IR. The treatments of 3T3 cells with IGF-I increased cellular proliferation in 5% and 1% seruma-containing media, not in serum-free media. The addition of anti-IGFBP-3 to neutralize IGFBP-3 showed 2-fold increase of cellular proliferation, and also co-incubation of anti-IGFBP-3 and alpha IR3 together showed similar increase of cellular proliferation in 3T3 cells. Interestingly, when the cells were prethreated with alpha IR3 for 4 hr, prior to the simultaneous addition of alpha IR3 and anti-IGFBP-3, anti-IGFBP-3-mediated cellular proliferation was decreased to control level. All of these results suggest that free IGF-I released from IGF-I/IGFBP-3 complex would be involved in the cellular proliferation. CONCLUSION: IGF-I action by binding IGF-I.
3T3 Cells ; Animals ; Blotting, Northern ; Blotting, Western ; Cell Death ; Cell Proliferation* ; Culture Media, Serum-Free ; Fibroblasts* ; Insulin* ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Mice* ; Phosphorylation ; Receptor, IGF Type 1 ; RNA, Messenger

Arteriovenous malformation(AVM) is the rare cause of neonatal intracranial hemorrhage. It is a congenital vascular lesion that can arising anywhere in the body. We report here on an unusual case of AVM in a full-term newborn infant who has no symptoms except enlarged bulging anterior fontanelle. AVM of other organs or adult cases were reported occasionally, but postoperative surviving intracranial AVM in a newborn infant has not been reported in Korea so far. The hematoma which was in the cortex of left temporal area, was removed surgically and the baby is living well under regular neurological check up.
Adult ; Arteriovenous Malformations ; Cerebral Hemorrhage* ; Cranial Fontanelles ; Hematoma ; Humans ; Infant, Newborn* ; Intracranial Hemorrhages ; Korea

We report a 46-year-old woman with primary biliary cirrhosis (PBC) presenting with Sjogren's syndrome and systemic mononuclear inflammatory vasculopathy. Biopsy specimens of sural nerve showed findings consistent with vasculitic neuropathy. Perivascular inflammatory mononuclear cell infiltration was observed on muscle biopsy specimen. The findings of abdominal computed tomography and brain magnetic resonance imaging were suggestive of vasculitis. Clinical manifestations and radiologic findings were improved after high dose prednisolone therapy.
Biopsy, Needle ; Case Report ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Human ; Liver Cirrhosis, Biliary/diagnosis+ACo- ; Liver Cirrhosis, Biliary/complications+ACo- ; Middle Age ; Prednisone/administration +ACY- dosage ; Sjogren's Syndrome/pathology ; Sjogren's Syndrome/diagnosis+ACo- ; Sjogren's Syndrome/complications ; Sural Nerve/pathology ; Treatment Outcome ; Vasculitis/pathology ; Vasculitis/drug therapy ; Vasculitis/diagnosis+ACo- ; Vasculitis/complications

OBJECTIVES: To investigate the etiologies of urinary bladder involvement in patients with systemic lupus erythematosus (SLE), the clinicoradiologic features of gastrointestinal tract manifestations and clinical outcomes in patients with lupus cystitis accompanied by gastrointestinal manifestations. METHODS: We conducted a retrospective chart review on 413 patients with SLE. Patients were selected for review on the basis of lower urinary tract symptoms including urinary frequency, urgency and urinary incontinence. Radiologic studies were analyzed in patients with lupus cystitis. RESULTS: Ten consecutive patients, complicated with lower urinary tract symptoms, were identified. Underlying etiologies were as follows: lupus cystitis in five, neurogenic dysfunction secondary to transverse myelitis in three, cyclophosphamide-induced cystitis in one and tuberculous cystitis in one patient. All patients with lupus cystitis showed gastrointestinal manifestations, such as abdominal pain, nausea, vomiting and/or diarrhea during the periods of cystitis symptoms. In all patients with lupus cystitis, paralytic ileus was demonstrated on plain abdominal X-ray and ascites, bilateral hydroureteronephrosis and thickened bladder wall were identified on abdominal ultrasound or CT. Abdominal CT revealed bowel wall thickening in four of the five patients. The main sites of thickened bowel on abdominal CT were territory supplied by superior mesenteric artery. Two of five patients with lupus cystitis expired during the follow-up period. CONCLUSION: Diverse etiologies may cause lower urinary tract symptoms in patients with SLE. Lupus cystitis is strongly associated with gastrointestinal involvement and abdominal CT can be a useful radiologic tool to investigate the gastrointestinal tract involvement in patients with lupus cystitis.
Adolescence ; Adult ; Cystitis/radiography ; Cystitis/etiology+ACo- ; Cystitis/epidemiology ; Female ; Gastrointestinal Diseases/radiography ; Gastrointestinal Diseases/etiology+ACo- ; Gastrointestinal Diseases/epidemiology ; Human ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/complications+ACo- ; Male ; Middle Age ; Prevalence ; Prognosis ; Retrospective Studies ; Risk Assessment ; Tomography, X-Ray Computed

OBJECTIVES: In the present study, we investigate the association between homozygosity of the 4-repeat allele (4/4) at the DRD4 and the response to the treatment with MPH in Korean children with ADHD. METHODS: The present study included 71 children with ADHD (8.231.78 years) from two children's psychiatric clinics in South Korea. All drug-naive children with ADHD were treated with MPH for about 8 weeks. The subjects who showed improvement of over 50% compared with the baseline ARS score after 8 weeks of treatment were termed as the 'good response' group. The subjects who showed an improvement of less than 50% were considered as the 'poor response' group. After genotyping for DRD4 were performed, we investigated correlation between homozygosity for 4-repeat allele at DRD4 and the response to MPH treatment. RESULTS: We found that while 79.5% (31/39) of the subjects with homozygosity of 4-repeat allele at DRD4 showed good response to MPH treatment, 68.8% (22/32) of the subjects without homozygosity of 4-repeat allele at DRD4 showed poor response to MPH treatment according to ARS scores assessed by their parents (chi2=16.762, df=1, p<0.01). We also found that while 61.5% (24/39) of the subjects with homozygosity of4-repeat allele at DRD4 showed good response to MPH treatment, 87.5% (28/32) of the subjects without homozygosity of the 4-repeat allele at DRD4 showed poor response to MPH treatment according to ARS scores assessed by their teachers (chi2=17.698, df=1, p<0.01). CONCLUSION: Our findings support an association between the homozygosity of 4-repeat allele and a good response to MPH in ADHD of Koreans.
Alleles ; Child* ; Dopamine* ; Humans ; Korea ; Methylphenidate* ; Parents ; Receptors, Dopamine D4*