BACKGROUND: No association between schizophrenia and dopamine D4 receptor polymorphisms have been reported. Despite these results, it is premature to exclude the association. It has been suggested that the susceptibility to develop schizophrenia could result from variation at a number loci which may interact or co-act with each other. Therefore, we investigated a possible assoication of combinations of exon III 48bp polymorphism [D4E3] and exon I 12bp polymorphism of the DRD4 gene [D4E1] with schizophrenia. METHOD: 207 unrelated Korean schizophrenic patients and 191 healthy controls wee recruited. DRD4 genotype was established using the polymerase chain reaction. Statistical analysis consisted of chi2 tests for Hardy-Weinberg proportions and genotypic and allelic frequencies in the patients and control groups. RESULT: There were no statistically significant differences in the each polymorphisms between schizophrenics and controls. And all genotype frequencies were within Hardy-Weinberg expectations. When the combinations of the polymorphism in schizophrenia and controls were compared, however, there were significant differences at A1A2*2/4 in the distributions of the combinations of D4E1 and D4E3(p<0.01). CONCLUSION: These findings suggest that the certain combination of D4E1 and D4E3 (A1A2*2/4) has the protective role to a susceptibility for schizophrenia.
Dopamine* ; Exons ; Genotype ; Humans ; Polymerase Chain Reaction ; Receptors, Dopamine D4 ; Schizophrenia

Infantile esotropia is an esodeviation with onset before six months of age, characterized by a large stable angle and initial alternation with cross fixation. The natural history of infantile esotropia has not yet been verified. A 39-month-old girl presented with a history of esotropia. She was firstnoted to constantly cross her eyes at three months of age. At the age of five months, she was diagnosed by one of the authors[SHH]to have 25 prism-diopters of esotropia with a low hyperopic refractive error of 0.50D sphere. At that time, she fixed and followed with either eye. Ductions and versions were full. On three more examinations in her first year, she consistently showed 25~30 prism-diopters of esotropia. Against medical recommendation, she did not undergo any surgery. At the age of 39 months, she was found to be orthophoric at distance and at near by another author[JMH]. She could not identify flies or animals in random dot stereograms or Titmus stereograms. At the age of four years, she was still orthophoric at distance and at near. All the ophthalmologic findings remained the same. At the age of five years, she developed exophoria and DVD OS. She still could not identify flies. In conclusion, in rare cases infantile esotropia with a relatively small angle may spontaneously resolve without any treatment.
Animals ; Child, Preschool ; Diptera ; Esotropia* ; Exotropia ; Female ; Humans ; Natural History ; Refractive Errors

A case of right-sided infective endocarditis in a 22-year-old male with ventricular septal defect of perimembranous type, right ventricular(RV) infundibular and pulmonic valve stenosis was reported. The vegetations were found on the mural endocardium of RV infundibulum and pulmonic valve. Streptococcus viridans was identified in 5 consecutive blood cultures, Pulmonary embolism and septic infarction in the lung was associated with systemic embolization, which was manifested by left renal infarction. The RV infundibular stenosis was due to anomalous muscle bundle at the proximal portion. Therefore, we thought that the mechanism of RV infundibular vegetation was probably due to 'Venturi effect and turbulence'. Several clinical features which were found in this case were also reviewed.
Constriction, Pathologic ; Endocarditis* ; Endocardium ; Heart Septal Defects, Ventricular ; Humans ; Infarction ; Lung ; Male ; Pulmonary Embolism ; Viridans Streptococci ; Young Adult

BACKGROUND: To evaluate the role of free fatty acids on the ischemic myocardium, influences of various free fatty acids upon transmembrane action potential and ATP-sensitive K+(KATP) channel activity were examined in the ventricular myocardium and single cardiac myocytes. METHODS: KATP channel activities were measured in the enzymatically (collagenase) isolated single rat ventricular cardiac myocytes by the method of the excised inside-out and the cell-attached patch clamp, and transmembrane action potentials were recorded using the conventional 3M-KCl microelectode techniques in the rat ventricular myocardium. RESULTS: Free fatty acids [FFAs; arachidonic acid (AA), linoleic acid (LA) and lysophosphatidylcholine (LPC)] reduced the KATP channel activity in a dose-dependent manner in the inside-out patch, and 50%-inhibition concentrations (IC50) were 88 +/- 11.2, 49 +/- 12.5, and 188 +/- 17.4 M respectively. Both frequency of channel opening and the mean open-burst duration were markedly decreased, but the amplitude of single channel currents were not changed by the FFAs. AA (50 micrometer) and LPC (50 micrometer) did not affect the dinitrophenol (DNP, 50 micrometer)-induced KATP channel activity, whereas LA (50 micrometer) had a tendency to reduce the activity. The channel inhibition effects by 10 micrometer AA in the inside-out patch were significantly augmented by diclofenac (10 micrometer), but was not changed by nordihydroguaiaretic acid. FFAs never stimulated KATP channel activity, even in the inside-out patch where KATP channel activity reduced in the presence of internal ATP (100 micrometer). Time for 90% repolarization (APD90) significantly increased during superfusion of the FFAs, to 22 (50 micrometer AA), 24 (50 micrometer LA), and 18 (50 micrometer LPC) % from those of the contol at the time of 10 min superfusion, but the other action potential characteristics were not changed by the FFAs. AA (10 micrometer) attenuated cromakalim (10 micrometer)-induced APD90 shortening effects. CONCLUSION: It was inferred that FFAs inhibit the KATP channel activity directly by themselves and/or indirectly by their metabolites in the rat ventricular cardiomyocytes, and therefore, duration of action potential lengthens to be a burden over the ischemic myocardium accounting for the injury of myocardium at the late stage of ischemia.
Action Potentials* ; Adenosine Triphosphate ; Animals ; Arachidonic Acid ; Cromakalim ; Diclofenac ; Fatty Acids, Nonesterified* ; Ischemia ; Linoleic Acid ; Lysophosphatidylcholines ; Masoprocol ; Myocardium* ; Myocytes, Cardiac ; Potassium Channels* ; Potassium* ; Rats*

PURPOSE: To determine causative factors of persistent diplopia after local anesthesia for ophthalmic surgery. METHODS: Prism and alternate cover test in the diagnostic positions of gaze and ductions/versions testing were performed in 26 patients with persistent diplopia six months after local anesthesia. Lancaster test, Bielshowsky head tilt test, double Maddox rod test, funduscopic examination for torsion, forced duction test, force generation test, tensilon test, thyroid function test, and/or orbit CT were done when necessary. RESULTS: Most of the patients (24 patients, 92%) did not have diplopia before local anesthesia. Of the thirteen patients with strabismus resulting from trauma to extraocular muscles, eleven patients showed vertical rectus overaction (10 superior recti, 1 inferior rectus) and two patients, mild vertical rectus underaction. Eight patients were presumed to have sensory deviation. In the remaining patients, one patient had childhood esotropia and another, old superior oblique palsy. Three patients showed a small vertical deviation without any specific cause. CONCLUSIONS: Fifty percent of diplopia was related with the surgical trauma to extraocular muscles, in which overactions (42%) were more common than underactions (8%). Thirty-five percent of the patients were presumed to have sensory deviation, which suggested the importance of preoperative examination for strabismus as well as the explanation about the risk of postoperative diplopia before surgery.
Anesthesia, Local* ; Diplopia* ; Edrophonium ; Esotropia ; Head ; Humans ; Muscles ; Orbit ; Paralysis ; Strabismus ; Thyroid Function Tests

Objective: To investigate the diagnostic performance of contrast-enhanced ultrasound (CEUS) and its role as a second-line imaging modality after gadoxetate-enhanced MRI (Gd-EOB-MRI) in the diagnosis of hepatocellular carcinoma (HCC) among at risk observations. Materials and Methods: We prospectively enrolled participants at risk of HCC with treatment-naïve solid hepatic observations (≥ 1 cm) of Liver Imaging Reporting and Data System (LR)-3/4/5/M during surveillance and performed Gd-EOB-MRI. A total of one hundred and three participants with 103 hepatic observations (mean size, 28.2 ± 24.5 mm; HCCs [n = 79], non-HCC malignancies [n = 15], benign [n = 9]; diagnosed by pathology [n = 57], or noninvasive method [n = 46]) were included in this study. The participants underwent CEUS with sulfur hexafluoride. Arterial phase hyperenhancement (APHE) and washout on Gd-EOB-MRI and CEUS were evaluated. The distinctive washout in CEUS was defined as mild washout 60 seconds after contrast injection. The diagnostic ability of Gd-EOB-MRI and of CEUS as a second-line modality for HCC were determined according to the European Association for the Study of the Liver (EASL) and the Korean Liver Cancer Association and National Cancer Center (KLCA-NCC) guidelines. The diagnostic abilities of both imaging modalities were compared using the McNemar’s test. Results: The sensitivity of CEUS (60.8%) was lower than that of Gd-EOB-MRI (72.2%, p = 0.06 by EASL; 86.1%, p < 0.01 by KLCA-NCC); however, the specificity was 100%. By performing CEUS on the inconclusive observations in Gd-EOB-MRI, HCCs without APHE (n = 10) or washout (n = 12) on Gd-EOB-MRI further presented APHE (80.0%, 8/10) or distinctive washout (66.7%, 8/12) on CEUS, and more HCCs were diagnosed than with Gd-EOB-MRI alone (sensitivity: 72.2% vs. 83.5% by EASL, p < 0.01; 86.1% vs. 91.1% by KCLA-NCC, p = 0.04). There were no false-positive cases for HCC on CEUS. Conclusion The addition of CEUS to Gd-EOB-MRI as a second-line diagnostic modality increases the frequency of HCC diagnosis without changing the specificities.

Objective: This study aimed to analyze the clinical characteristics of patients with acute glufosinate ammonium (GLA) poisoning and investigate the indicators associated with the severity of neurotoxicity in GLA-poisoned patients. Methods: We retrospectively collected the data of patients who were admitted due to GLA poisoning from 2018 to 2022, to gather the factors that could influence neurologic outcomes. These outcomes were estimated based on the Glasgow Coma Scale (GCS) scores at admission, the worst GCS score during impaired consciousness, the GCS score at discharge, and the presence and duration of seizures. Results: Among the 67 GLA-poisoned patients, the average GCS score at admission was 13.8±2.6 points, the worst GCS score recorded was 11.2±3.5 points, and the GCS score at discharge was 13.7±2.9 points. The factors significantly influencing the GCS score at the initial admission included respiration rate, saturation, white blood cell count, and pH (P=0.037, P=0.005, P=0.021, and P=0.001, respectively). Factors affecting the worst GCS score included age, diastolic blood pressure, platelet count, blood urea nitrogen (BUN), and pH (P=0.001, P=0.016, P=0.015, P=0.002, and P<0.001, respectively). The GCS score at discharge exhibited significant correlations with age, BUN, and pH (P<0.001, P<0.001, and P=0.011, respectively). The average age of the patients who experienced seizures after GLA poisoning was significantly higher at 75.1±12.9 years compared to that of patients without seizures (mean age, 65.0±15.2 years; P=0.006). Additionally, the average bicarbonate level was lower in patients with seizures, measuring 19.0±4.7 mmol/L, when compared with that of patients without seizures (average, 21.4±4.3 mmol/L; P=0.045). Conclusion The elderly, metabolic acidosis, and elevated BUN could serve as good indicators for adverse neurological outcomes in GLA-poisoned patients.

Alcoholic celiac plexus blocks have been used to relieve intractable upper abdominal cancer pain. Various techniques have been proposed including the use of the X-ray and CT scanner to improve results and to avoid complications. We used the CT scanner and the X-ray fluroscope for 36 cases of alcoholic celiac plexus blocks to determine the depth and position of the needle without previous diagnostic blocks. Good to excellent pain relief occurred in more than 72% of the patients and the advantages of the use of the CT scanner showed that 1) placement of the needle tip is easily established according to the surrounding anatomical structures. 2) the operator can introduce the needle without anxiety. 3) the time required for block are saved.
Alcoholics ; Anxiety ; Celiac Plexus* ; Humans ; Needles

No abstract available.
Lymphedema*

No Abstract Available.
Chondrocytes* ; Phenotype*