OBJECTIVE: Catechol-O-methyltransferase(COMT) is an important enzyme that inactivates biologically active or toxic catechols. Abnormal catecholamine transmission has been implicated in the pathogenesis of schizophrenia and bipolar disorder. Polymorphism(Val/Met) of the COMT gene was shown to determine high-and low-activity alleles of the enzyme. This study was designed to investigate the association between COMT gene polymorphism and schizophrenia and bipolar disorder in a Korean population. METHOD: COMT gene were genotyped with polymerase chain reaction and restriction enzyme NlaIII in 128 patients with schizophrenia, 110 with bipolar disorder, and 176 controls. RESULTS: 1) The distribution of the COMT genotype in schizophrenic patients with Val/Val, Val/Met, Met/Met were 76(59.4%), 43(33.6%), 9(7.0%), in bipolar disorder patients were 63(57.3%), 35(31.8%), 12(10.9%), and in the controls were 83(47.2%), 79(44.9%), 14(8.0%). The allele frequencies of the COMT gene in schizophrenic patients with Val and Met were 195(76.2%), 61(23.8%), in bipolar disoreder patients were 161(73.2%), 59(26.8%), and in the controls were 245(69.6%), 107(30.4%). 2) There were no differences in genotype distribution and allele frequencies of COMT gene polymorphism among the 3 groups. Neither patients with schizophrenia nor bipolar disorder differed in the genotype and allelic frequencies from the controls. CONCLUSION: These results suggest COMT gene polymorphism is not causally related to the development of schizophrenia and bipolar disorder in a Korean Population.
Alleles ; Bipolar Disorder* ; Catechol O-Methyltransferase* ; Catechols ; Gene Frequency ; Genotype ; Humans ; Polymerase Chain Reaction ; Schizophrenia*

No abstract available.
Hand*

BACKGROUND: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a severe reduction in the number of circulating platelets. Corticosteroid therapy, which has been used in ITP for many years, has produced a complete or partial response rate of 65% to 75%, although sustained remissions have been reported in only 18% to 32% of the patients. The purpose of the present study is to define response to each treatment and ultimate outcome of adults with ITP. METHOD: A clinical study was done on 35 cases of ITP who had admitted to the department of Internal Medicine, Yeungnam University Hospital from June 1983 to July 1996. The response of each treatment modalities was based on criteria of Defino and Cooperative Latin American Group on Hemostasis and Thrombosis. RESULTS: The mean age of patients was 41.9 years old and female to male ratio was 1:0.6 (female:22 cases, male:13 cases). The complete response rate to intravenous gamma-globulin as early therapy was obtained in 72% of the patients and the duration to platelet count above 50,000/ microliter was 3 days after intravenous gamma-globulin therapy. Duration of response was 15 days. The CCR (continuing complete response) to corticosteroid was obtained in 16% of the patients, and no CCR to reinduction with corticosteroid was observed. The CR to splenectomy was obtained in 85% of the patients. The overall results of all therapeutic modalities were CCR 43%, TCR (temporary complete response) 20%, PR (partial response) 31%, and NR (no response) 6%. CONCLUSION: This analysis of ITP in adults suggests that splenectomy remains as the most effective treatment and intravenous gamma-globulin is effective for rapid elevation of platelet count.
Adult* ; Female ; gamma-Globulins ; Hemostasis ; Humans ; Internal Medicine ; Male ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic* ; Secondary Prevention ; Splenectomy ; Thrombosis

Syphilitic aortitis, passing out of our mind, is the most common systemic manifestation of late syphilis and is more typically manifestated 10 to 30 years afterward. This diagnosis has been made less frequently in recent decades than in the past, because of public awareness of syphilis and screening program. Treponema pallidum lodge within vasa vasorum, especially ascending aorta cause the histologic changes, which are responsible for the three major forms of symptomatic cardiovascular syphilis, including aortic insufficiency, coronary ostial stenosis, and aortic aneurysm. We experienced a case of syphilitic aortitis with aortic insufficiency and aortic aneurysm in a 48-year-old man presented with progressive dyspnea. Echocardiography, chest CT, and later surgical correction were performed and surgical specimen revealed the histologic finding consistent with syphilitic aortitis. We report this case with a review of the literature.
Aorta ; Aortic Aneurysm* ; Aortitis ; Constriction, Pathologic ; Diagnosis ; Dyspnea ; Echocardiography ; Humans ; Mass Screening ; Middle Aged ; Syphilis ; Syphilis, Cardiovascular* ; Tomography, X-Ray Computed ; Treponema pallidum ; Vasa Vasorum

Right sided aortic arch is an uncommon congenital anomaly. It can be classified into three types, depending on the left aortic arch's degenerating pattern and the branching pattern of the great vessels. It can be associated with major congenital heart disease, depending on the type of right sided aortic arch. We report a case of an 18-years-old female who has right sided aortic arch with atrial septal defect (ASD). In our case, the patient had a right sided aortic arch and aberrant left subclavian artery, also she had ASD (ostium secundum) and moderate tricuspid regurgitation with pulmonary hypertension. The patient was successfully performed patch closure of ASD and tricuspid valve annuloplasty via midline sternotomy. The patient had uneventful postoperative course.
Aneurysm ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Deglutition Disorders ; Female ; Heart Diseases ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Sternotomy ; Subclavian Artery ; Tricuspid Valve ; Tricuspid Valve Insufficiency

BACKGROUND: We examined global gene expression profiles of peripheral blood mononuclear cells (PBMCs) in patients with ulcerative colitis (UC), and tested whether the identified genes with the altered expression might be associated with susceptibility to UC. METHODS: PBMCs from 8 UC and 8 normal healthy (NH) volunteers were collected, and total RNAs were subjected to the human 8.0K cDNA chip for the microarray analysis. Real time-PCR (RT-PCR) was performed to verify the results of microarray. One hundred forty UC patients and 300 NH controls were recruited for single nucleotide polymorphism (SNP) analysis. RESULTS: Twenty-five immune function-related genes with over 2-fold expression were identified. Of these genes, two chemokines, namely, CXCL1 and CCL20, were selected because of their potential importance in the evocation of host innate and adaptive immunity. Four SNPs were identified in the promoter and coding regions of CXCL1, while there was no significant difference between all patients with UC and controls in their polymorphisms, except minor association at g.57A< G (rs2071425, p=0.02). On the other hand, among three novel and one known SNPs identified in the promoter region of CCL20, g.-1,706 G< A (p=0.000000055), g.-1,458 G< A (p=0.0048), and g.-962C< A (p=0.0006) were found to be significantly associated with the susceptibility of UC. CONCLUSION: Altered gene expression in mononuclear cells may contribute to IBD pathogenesis. Although the findings need to be confirmed in other populations with larger numbers of patients, the current results demonstrated that polymorphisms in the promoter region of CCL20 are positively associated with the development of UC.
Adaptive Immunity ; Chemokines ; Clinical Coding ; Colitis, Ulcerative* ; Crohn Disease ; DNA, Complementary ; Gene Expression ; Hand ; Humans ; Inflammatory Bowel Diseases ; Microarray Analysis ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic* ; RNA ; Transcriptome ; Ulcer* ; Volunteers

Hyponatremia resulting from ingestion of large volumes of bowel preparation solution has been reported in patients with alternated renal water handling like renal failure or old age. Colonoscopy-induced hyponatremia was known to be related with an increase in serum arginine vasopressin concentration. Ingestion of bowel preparation solution can lead to diarrhea associated with nausea, vomiting and dehydration, often resulting in raised plasma concentrations of antidiuretic hormone. Besides, non- osmotic stimuli for arginine vasopressin concentrations can be provoked by nausea, vomiting, and intestinal hyperactivity during bowel preparation and colonoscopic procedure. We have experienced three cases of hyponatremia resulting from ingestion of bowel preparation solution for colonoscopy. The factors leading to increased arginine vasopressin secretion seem to be nausea, vomiting and intestinal hyperactivity during bowel preparation for colonoscopy.
Arginine Vasopressin ; Colonoscopy* ; Dehydration ; Diarrhea ; Eating* ; Humans ; Hyponatremia* ; Nausea ; Plasma ; Renal Insufficiency ; Vomiting

Osteoclasts are cells of hemopoietic origin that play an critical role in bone resorption and responsible for bone diseases, including osteoporosis, periodontal disease, and rheumatoid arthritis. In this study, we examined the effect of AG490, a Jak2-specific inhibitor on osteoclast differentiation. AG490 significantly inhibited receptor activator of NF-kappaB ligand (RANKL)-mediated osteoclast differentiation in a dose-dependent manner. RANKL stimulated the phosphorylation of p38, ERK, and JNK and promoted I-kappaB degradation. However, AG490 suppressed the phosphorylation of p38 induced by RANKL treatment. AG490 suppressed the mRNA expression of TRAP, c-Fos, NFATc1, and OSCAR in bone marrow-derived macrophages (BMMs) treated with RANKL. Also, AG490 significantly inhibited the protein expression of c-Fos and NFATc1 in response to RANKL. These results suggest that AG490 inhibited osteoclast differentiation by suppressing the expression of c-Fos and NFATc1.
Arthritis, Rheumatoid ; Bone Diseases ; Bone Resorption ; Macrophages ; Osteoclasts ; Osteoporosis ; Periodontal Diseases ; Phosphorylation ; Receptor Activator of Nuclear Factor-kappa B ; RNA, Messenger ; Tyrphostins

Although a pathogenic mechanism of hemolytic anemia complicated with viral hepatitis is unknown, it is suggested that there are four mechanisms; 1) In the individual who has predisposition to hemolytic anemia, viral infection accelerates the red cell destruction & hemolysis become obvious. 2) Directly, virus itself injures to the red cell membrane. 3) The serious liver failure & hypersplenism induce the hemolysis. 4) Autoimmune hemolytic anemia because of immunological abnormality caused by viral infection. We experienced a case of autoimmune hemolytic anemia in 33-year-old male patient who was diagnosed as chronic lobular hepatitis B with biopsy. Diagnosis was estabilished by clinical features, blood cell count, routine urinalysis, direct & indirect Coombs test, liver function test, immunoglobulin quantitations, hepatitis B marker, bone marrow aspiration, and liver biopsy. This case was treated with corticosteroid and transfusion. During follow-up, he has been well tolerated.
Adult ; Anemia, Hemolytic ; Anemia, Hemolytic, Autoimmune* ; Biopsy ; Blood Cell Count ; Bone Marrow ; Cell Membrane ; Coombs Test ; Diagnosis ; Follow-Up Studies ; Hemolysis ; Hepatitis B* ; Hepatitis* ; Humans ; Hypersplenism ; Immunoglobulins ; Liver ; Liver Failure ; Liver Function Tests ; Male ; Urinalysis

BACKGROUND/AIMS: To determine the efficacy and safety of low-dose tacrolimus in Korean rheumatoid arthritis (RA) subjects with an inadequate response to methotrexate (MTX). METHODS: This was a multicenter, open-label study conducted at five Korean sites. Fifty-six patients with active RA, despite treatment for ≥ 1 month with a stable, maximally tolerated dosage of oral MTX (median dosage, 15 mg/wk), were enrolled and received 1.5 mg/day of tacrolimus as a single oral dose once per day for 16 weeks while continuing to receive MTX. All other disease-modifying anti-rheumatic drugs were discontinued, whereas stable dosages of nonsteroidal anti-inflammatory drugs and oral corticosteroids (≤ 10 mg/day of prednisone or an equivalent corticosteroid) were allowed. The primary clinical response criterion was the American College of Rheumatology's definition of 20% improvement (ACR20) at the end of treatment. RESULTS: The ACR20 response rate was 42.9% (24 of 56 patients) in patients who had received tacrolimus at least once. The overall ACR50 and ACR70 responses at the end of treatment for all patients were 30.4% and 10.7%, respectively. Throughout the treatment period, 37 patients experienced 71 adverse events (AEs) in total, and four patients left the study because of AEs. In addition, 15 patients in total experienced treatment-related AEs. Throughout the treatment period, two patients were reported to experience two serious AEs, and one patient left the study because of a serious AE. CONCLUSIONS: In patients whose active RA persists despite treatment with MTX, low-dose tacrolimus in combination with MTX appears to be safe and well tolerated, and provides clinical benefit.
Adrenal Cortex Hormones ; Antirheumatic Agents ; Arthritis, Rheumatoid* ; Humans ; Methotrexate* ; Prednisone ; Tacrolimus*