The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).
Anxiety ; Depression ; Gastrointestinal Diseases ; Humans ; Irritable Bowel Syndrome ; Thiophenes

OBJECTIVE: To evaluate the results of second-trimester maternal serum triple-marker screening test for Down syndrome and open neural tube defects in singleton pregnancies conceived from in vitro fertilization, the screen positive rates and triple-marker level of patients conceiving singleton pregnancies by IVF were compared to those of pregnancies conceived naturally. METHODS: Two hundred singleton pregnancies conceived by IVF and naturally conceived pregnancies who had done maternal serum screening test during the second trimester were analyzed from January 1995 to April 1998. RESULTS: One (0.5%) of the 200 cases of IVF singleton pregnancies had a positive result for Down syndrome compared with 1% of screen positive rate in the 200 cases of naturally conceived pregnancies. The median level of the triple markers were 0.92 multiples of the median(MoM) for alpha-fetoprotein(AFP), 1.44 MoM for unconjugated estriol(E3) and 0.87 MoM for human chorionic gonadotropin(hCG) respectively. CONCLUSION: The positive rate of triple test for Down syndrome and open neural tube defect in the two groups were significantly not different. As additional data are collected, corrected standards should be determined.
Chorion ; Down Syndrome ; Female ; Fertilization in Vitro* ; Humans ; Mass Screening* ; Neural Tube Defects ; Pregnancy Trimester, Second ; Pregnancy*

Chin ; Female ; Humans ; Lip ; Male ; Osteotomy ; Prognathism ; Recurrence ; Witchcraft

Contact urticaria designates a local immediate and/or delayed urticaria reaction, with swelling and redness at the sites of contact with certain agents. Fruits are the frequently causative agent for immunologically mediated contact urticaria. We report herein a contact urticaria occurring in a 20-year-old male immediately aftar contact with peach and plum, and after ingestion of plum, peach and apple. Swelling and itching sensation of lips and oral cavity, and tightness of chest were also developed ofter ingestion of plum, peach and apple.
Eating ; Fruit ; Humans ; Lip ; Male ; Mouth ; Prunus persica* ; Prunus domestica ; Pruritus ; Sensation ; Thorax ; Urticaria* ; Young Adult

54-year-old male patient with acute lymphocytic leukemia was consulted to our department. He had had a few painful erythematous necrotic plaques on the chest, which suggested initslly vasculitis or pyoderma. On histological examination, characterisitic histological findings of non-septated large hyphae were observed in the dermis and subcutaneoustissue, Although organism was not isolated on Sabouraud agar media containing cycloheximide, the diagnosis of cutaneous mucormycosis was made by the characteristic histological nattlre. He died after 2 weeks with amphotericin B intravenous injections so that additional fungus culture was not performed.
Agar ; Amphotericin B ; Cycloheximide ; Dermis ; Diagnosis ; Fungi ; Humans ; Hyphae ; Injections, Intravenous ; Male ; Middle Aged ; Mucormycosis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Pyoderma ; Thorax ; Vasculitis

No abstract available.
Aluminum Oxide* ; Dental Porcelain*

A clinical observation of tattoos was made during physical exarnination for conscription in Choongchengnarndo and northern area of Seoul from April to August, 1988. The result were as follows : 1. The most common educational level of tattoo pstient was in the middle school graduated group (55.9%). 2. The average age when first tattoo was made was 17.3% years. 3. Left arm was the most favorite site (44.45b). 4. Most of motivation for being tattooed was curiosity, heroism, for fun(51.2%). 5. Girl friends name, heart or heart and arrow, rose and one-mind were the most common contents of tattoos. 6. The average number of tattoo was 2.5. 7. More Tattoos were tattooed by themselves than by others (55.9%). 8. Most common tattoo material was chinese ink. 9. The complications of tattoo were found in 23 case (5.2%); hypertropic scar, keloid, post inflammatory hyper/hypo pigmentation and pyoderma. 10. The removal of tattoos were tried in 95 case (21.6%). The most frequent methods used were cigarette burning and scratching with a knife.
Adolescent* ; Arm ; Asian Continental Ancestry Group ; Burns ; Cicatrix ; Exploratory Behavior ; Female ; Friends ; Heart ; Humans ; Ink ; Keloid ; Motivation ; Pigmentation ; Pyoderma ; Seoul ; Tobacco Products

Autograft using suction hlistered epidermis is one of the surgical therapeutic mod- alities of vitiligo, and has been successfully used by several authors. The maintenance of grafting pigment is belieued to be more important than repigmentation itself. To examine the maintenance of pigment, 22 vitiligo patients were treated by autograft using suction blistered epidermis and followed for 16.8 months. Repigmentation developed in 20 patients, Two patients were lost to follow up. Out of 20 patients, grafting pigment was maintained in 17 patients(85% ) and disappeared in three patients(15% ). By clinical subtype, the rates of maintenance were 100% in segmental type, 80% in localized type and 66% in generalized type. The best results were observed in a head and neck location and the worst rates and maintenance were in the hand. However, these differences were not statistically significant. likewise, age and sex were not factors in maintenance and repigrnentation. Based on this study, autograft using suction blistered epidermis appears to be a good therapeutic modality for stable vitiligo, particularly segmental vitiligo.
Autografts* ; Blister* ; Epidermis* ; Follow-Up Studies* ; Hand ; Head ; Humans ; Lost to Follow-Up ; Neck ; Suction* ; Transplants ; Vitiligo

Itching is a rare symptom in neurological disease. Paroxysmal symptom is uncommon in neuromyelitis optica (NMO) or multiple sclerosis. We describe a 45-year-old woman who presented with paroxysmal pruritus in association with relapse of NMO on two separate occasions. Cervical MRI showed a lesion at a level corresponding to the dermatomal site of the itching. Paroxysmal pruritus could be a predictive symptom of relapse in NMO unless there are other comorbid causes such as systemic diseases, allergy, drug reaction, or emotional stress responsible for the itching.

Rheumatoid arthritis is considered to be a collagen disease which mainly involves articular structures, sometimes has extraarticular manifestations. It is generally accepted now that periarticular osteoporosis develops in early phase of rheumatoid arthritis and generalized osteoporosis in late period. Of several methods of non-invasive measurement of bone mass, single photon absorptiometry was introduced by Cameron and Sorenson(1963) and it has been used for measuring bone mass by many authors with its precision, reproducibility and objective quantification. We tried to observe the quantitative changes of bone mass in rheumatoid arthritis patients with single photon absorptiometry technique. Through the study of bone densitometry in 30 rheumatoid arthritic women compared with age-matched 60 healthy controls, we obtained follow results. 1. Bone mineral density of the rheumatoid arthritis group was lower than that of the control group, but had no significant statistical difference. 2. Bone mineral density of the 40–49-year-old group and 50–59-year-old group was considerablely different in the rheumatoid arthritis group and control group. 3. Bone mineral density of the group whose rheumatoid arthritis history was over 2 year was lower than that of the group below 2 year.
Absorptiometry, Photon ; Arthritis, Rheumatoid ; Bone Density ; Collagen Diseases ; Densitometry ; Female ; Humans ; Osteoporosis