Gender identity disorders are characterized by strong and persistent cross-gender identification (not merely a desire for any perceived cultural advantages of being the other sex), as well as a persistent discomfort with one's sex or sense of inappropriateness in the gender role of that sex. There are no well-established or exhaustive explanations for the development of gender identity disorder. Gender identity appears to be established and influenced by psychosocial factors during the first few years of life. However, many authors have argued for biological factors, if not causative, may predispose an individual to a gender identity disorder. Because most gender dysphoric individuals have adamant requests for sex reassignment (many often already taking opposite-sex hormones supplied by other physicians), it is extremely difficult to engage the patients in treatment with anything other than surgical reassignment as the goal. However, because surgery is irreversible, it is important to engage these patients in psychotherapy, even if surgery is indicated. The therapist should be careful to base the goals of therapy on what is desired by the patient. Behavior therapy has been used to modify specific cross-gender behaviors of child with gender identity disorder.
Behavior Therapy ; Biological Factors ; Child ; Diagnosis ; Gender Identity* ; Humans ; Psychology ; Psychotherapy

No abstract available.
Liver Diseases* ; Liver*

Malignant myoepithelioma is a rare neoplasm of salivary gland which may either arise de novo or develop in a pre-existing pleomorphic adenoma. The malignant myoepithelioma occurs in 0.45% of major salivary gland tumors. Malignant myoepitheliomas arising in the pleomorphic adenoma number less than 20 in English literature and 1 in Korea. We describe a case of malignant myoepithelioma arising in a recurrent pleomorphic adenoma of the left parotid gland of a 61-year-old man. The tumor was ill-defined and composed of polygonal or plasmacytoid myoepithelial cells. Infiltration to surrounding tissue, hemorrhage, necrosis, increased mitotic activity and vascular tumor emboli indicated its malignant nature. There were several satellite nodules with histologic features of typical pleomorphic adenoma. Immunohistochemically, tumor cells were reactive for S-100 protein, AE1/AE3, vimentin, smooth muscle actin and glial fibrillary acid protein.
Actins ; Adenoma, Pleomorphic* ; Glial Fibrillary Acidic Protein ; Hemorrhage ; Humans ; Korea ; Middle Aged ; Muscle, Smooth ; Myoepithelioma* ; Necrosis ; Parotid Gland ; S100 Proteins ; Salivary Glands ; Vimentin

No abstract available.
Antipsychotic Agents* ; Drug Synergism* ; Humans ; Schizophrenia*

PURPOSE: The purpose of this study was to determine whether Fas-L expression is associated with increased apoptotic induction of tumor-infiltrating lymphocytes (TIL) in human gastric carcinomas. MATERIALS AND METHODS: The author analysed 38 cases of early gastric carcinoma (EGC) and 61 cases of advanced gastric carcinoma (AGC) who received gastric resection, in whom the number of diffuse type was 38 cases and the number of intestinal type was 61 cases. The author used immunohistochemical staining for Fas, Fas-L and CD45, and TUNEL in situ apoptosis detection kit. TIL were detected by CD45 and apoptosis of TIL were detected by CD45 expression and TUNEL positivity on serial histologic sections. RESULTS: Fas-L was localized to neoplastic cells in 61% (23/38) of EGC group and 66% (40/61) of AGC group. The extent of Fas-L expression was variable, with both Fas-L positive and negative neoplastic region occuring within tumors. TIL adjacent to Fas-L expressing tumor region were decreased in number and TIL adjacent to FasL-negative tumor region were increased in number; apoptotic induction of TIL showed just the opposite pattern (p<0.05). Fas expression was found essentially homogeneously throughout the tumor mass independent of tumor stage. Fas expression showed 64% (39/61) of intestinal type and 68% (26/38) of diffuse type. Labeling indices for tumoral apoptosis in EGC and AGC were 6.72% and 7.13%, respectively and this difference was statistically insignificant. Co-expression of Fas-L and Fas, which occurred over large areas of the tumors, did not result in an enhanced rate of tumor cell apoptosis. In addition, factors such as tumor stage and other prognostic factors were not concerned in Fas and Fas-L expression, number of TIL and apoptotic induction. CONCLUSION: These findings suggest Fas-mediated apoptotic depletion of TIL in response to Fas-L expression by stomach cancers, and provide the evidence to support the Fas counterattack as a mechanism of immune escape in gastric cancer. In addition, gastric carcinoma cells of the intestinal and diffuse type did not differ in their expression of the apoptotic receptor Fas.
Apoptosis* ; Humans ; In Situ Nick-End Labeling ; Lymphocytes, Tumor-Infiltrating ; Stomach Neoplasms ; United Nations

BACKGROUND: Musculoskeletal symptoms, such as pain, numbness, and ganglions on involved joints were common problems in repetitive job workers, who exposed to prolonged, repetitive use of the wrist in factory. This study was performed to compare the degree of musculoskeletal symptoms and prevalence of soft tissue mass (esp. ganglion on wrist) in repetitive job group with those of non-repetitive job group and to evaluate the association of development of ganglion and the duration of wrist use. METHODS: Study subjects were 253 workers who work on a brick manufacturing factory and they were composed of 153 non-repetitive job workers and 100 repetitive job workers. Authors conducted a questionnaire survey among workers in the factory and examined their lesions. RESULTS: There were no significant difference statistically in age, level of education and work duration in both groups. It was statistically significant that the degree of wrist use was more frequent in repetitive job group than in non-repetitive job group(P<0.01). Musculoskeletal symptoms, such as pain and numbness on affected joints were more common in repetitive job group than in non-repetitive job group. Affected side was bilateral in three joints and right only in two joints(P<0.01, P<0.05). The prevalence of ganglions in repetitive job group(6 subjects, 6.0%) was much higher statistically than that in the non-repetitive job group(2 subjects, 1.3%). In a comparison of two groups according to the existence of ganglions, no stasistically significant differences were found in age, level of education and work duration. However, duration of wrist use was statistically significant relation with development of wrist ganglions(P<0.05). The 8 subjects with ganglion on wrist all worked on manufacturing part in the factory. The duration of work ranged from two to fourteen years. The affected sides of ganglions on wrist were right in 3 cases and left in 5 cases. Size of ganglions ranged from 0.5 to 3 cm in diameter. Painful symptom in the ganglion was complained by two cases(25%) among 8 cases. CONCLUSIONS: We suggest that prolonged, repetitive activities such as carrying a brick, have a tendency to develop musculoskeletal symptoms and ganglions in the workers. Because high prevalence of ganglions in this factory seems to be an important occupational problem among repetitive job workers, further studies on the factors contributing to development of ganglions in this factory are needed.
Education ; Ganglion Cysts* ; Hypesthesia ; Joints ; Prevalence ; Wrist ; Surveys and Questionnaires

No abstract available.
Humans ; Infant*

BACKGROUND: In this study, we investigated the early time course of expression of the major histocompatibility (MHC) antigens, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), interleukin-6 and the histopathological changes in the coronary arteries of cardiac allografts exchanged between inbred mice strains that differ in one loci of class I major histocompatibility antigen (B10.BR to B10.A). MATERIAL AND METHOD: No immunosuppressive therapy was used. Both allografts and the hearts of the recipients were harvested at 7 (group 1, n=6), 15 (group 2, n=6), 21 (group 3, n=6), and 30 (group 4, n=6) days after transplantation. They were examined by immunohistochemistry, microscopy and morphometry. All allografts had contractions at the time of harvest. RESULT: A strong MHC class I antigen expression was present on the endothelial and medial cells of the coronary arteries in group 1 and remained unchanged in the rest of the groups. However, MHC class II reactivity was none or very little at any time. Mild to moderate ICAM-1 expression was observed on the endothelial cells, but not on the medial cells at any time by 30 days. VCAM-1 expression was strong both on the endothelial and medial cells at any time. Moderate degree expression of interleukin-6 was observed from 7 to 30 day specimens. Histopathologically, percentage of affected vessels (vessels with intimal thickening) was less than 10 % in 7 day group and increased up to 50 % at 30 days. Mean percent narrowing of the lumen of the affected vessels revealed less than 20 % at 7 days and 40 % at 30 days. The area occupied by tropomyosin positive cells in the intimal lesion, graded from 0 to 3, showed gradual increase but remained between grade 0 to 1 by 30 days. Medial integrity was also well preserved at any time. Moderate perivascular mononuclear cell infiltration was observed at 7 days and it was progressively increased upto 30 days. Recipients' heart revealed no positive immunopathologic findings. CONCLUSION: In this study, the early time course of progression of the transplantation vasculopathy was demonstrated in the murine heterotopic heart transplant model.
Allergy and Immunology ; Allografts ; Animals ; Atherosclerosis ; Coronary Vessels* ; Endothelial Cells ; Heart* ; Histocompatibility ; Histocompatibility Antigens ; Immunohistochemistry ; Intercellular Adhesion Molecule-1 ; Interleukin-6 ; Mice* ; Microscopy ; Transplantation ; Tropomyosin ; Vascular Cell Adhesion Molecule-1

In the following report, we describe the case of a rapidly skeletonized corpse discovered in late summer. On the first day of September, a 57-year-old man was found almost completely skeletonized on a hill behind his house. His body lay prone, accompanied by a brush cutter at the entrance to the graveyard where his friend's parents were buried. His cap, clothes, and rubber boots were all intact and undamaged. Upon autopsy, no definite abnormalities were identified except for an old linear fracture on the frontoparietal bone. According to his friends and neighbors, he had likely died 8 or 9 days prior to the discovery of his body.
Autopsy ; Cadaver ; Friends ; Humans ; Middle Aged ; Parents ; Postmortem Changes ; Rubber ; Skeleton*

No Abstract Available.
Adult* ; Capsulorhexis* ; Cataract* ; Follow-Up Studies* ; Humans