OBJECTIVES: Considering large diversity of clinical presentation of schizophrenia, it is important to identify valid clinical subtypes or dimensions that might have homogeneous biological underpinning. The current study aimed to explore lifetime symptom-based dimensional phenotypes in patients with chronic schizophrenia, and to investigate their correlation with cognitive functions and other clinical characteristics. METHODS: Lifetime-based symptoms and additional clinical variables were measured using the Diagnostic Interview for Genetic Studies and the Schedule for the Deficit Syndrome in 315 clinically stable patients with chronic schizophrenia. Through principal components factor analysis, eight dimensional phenotypes were obtained. Comprehensive neuropsychological tests were administered for 103 out of 315 patients, and domain scores were calculated for cognitive domains defined in the MATRICS consensus battery. RESULTS: 'Non-paranoid delusion factor' including delusions of grandiose or religious nature, showed significant negative correlation with processing speed, working memory, attention/vigilance, and general cognitive ability, and positive correlation with intra-individual variability. 'Negative symptom factor' showed significant negative correlation only with general cognitive ability. Those two factors were also negatively correlated with function levels measured by Global Assessment Scale (GAS), and associated with poor treatment responses. CONCLUSION: Symptom-based dimensional phenotypes of schizophrenia measured on a lifetime basis showed discriminative correlation with cognitive function domains, global functioning level, and overall treatment responses, indicating their possibility as valid phenotype axes of schizophrenia having homogeneous biologic basis.
Appointments and Schedules ; Cognition ; Consensus ; Delusions ; Humans ; Memory, Short-Term ; Neuropsychological Tests ; Phenotype ; Schizophrenia*

We evaluated the effect of the pregnane X receptor agonist, pregnenolone 16 alpha-carbonitrile (PCN) on the expression levels of plasma monoamine transporter (PMAT) in the intestine. Male C57/BL6 mice were divided into two 2 groups: mice in the PCN group (n=3) were administered PCN once a day for 4 days, while those in the control group (n=3) received the same volume of vehicle once a day for 4 days. After the mice were killed 24 h after administration of the last dose of PCN or vehicle, and the expression levels of PMAT in the intestine tissues were isolated and measured the expression level of PMAT using immunohistochemical and western blotting analyses. The expression level of PMAT expression levels in the small intestine increased after PCN treatment. These results suggest that the induction of PMAT may play a clinically significant role by increasing intestinal absorption of PMAT substrates such as metformin.
Animals ; Blotting, Western ; Cell Membrane* ; Humans ; Intestinal Absorption ; Intestine, Small ; Intestines ; Male ; Metformin ; Mice ; Plasma ; Pregnenolone Carbonitrile

The use of artificial skins for full thickness wounds is an accepted technique, but unfortunately the take rate is low and the aesthetical result is not acceptable. The freeze-drying treatment of allogenic tissues can destroy cells with preserving the structural organization of extracellular matrices, permitting allogenic transplantation. In this study we investigated a new method to process the allogenic skin for transplantable allogenic dermis and this dermis was evaluated in a full thickness wound model. The results are as followings; 1. After treatment with NaCl and SDS solution and then with freeze-drying method, the allogenic dermis shows acellular dermal matrix with preserved normal extracellular matrix. 2. This allogenic dermis became completely incorporated into the wound without evidence of rejection or replacement by scar tissue. 3. The take rate of thin autografts overlying the allogenic dermis that were applied simultaneously was comparable to take rate of autograft alone. 4. The reduction in secondary contraction by allogenic dermis treated wounds was significant. 5. After grafting with cultured keratinocytes, the degree of epithelial coverage was 70% at 2 weeks. In conclusion, the allogenic dermis processed with our method displayed lack of antigenicity, and rapid revascularization. This allogenic dermis can permit simultaneous engraftment of an overlying STSG or cultured kerationocytes, reduce secondary contraction and improve cosmesis of full thickness wounds.
Acellular Dermis ; Autografts ; Cicatrix ; Dermis* ; Extracellular Matrix ; Keratinocytes ; Skin ; Skin, Artificial ; Transplants ; Wounds and Injuries*

This study examined within- and between-person variation in nutrient intakes in order to estimate the degree of precision in dietary assessment among 37 males and 46 females whose mean age was 70.4 years old. To collect dietary data, each subject was interviewed 5 or 6 times using a 24-hour recall method during a 3 month period. Within-person variation ranged from 23.5% to 101.2%. Lower values of within-person variation were observed in energy, carbohydrated, protein and phosphorous while higher value was observed in vitamin A. Between person variations of nutrient intakes ranged 12.6-23.5% in most nutrients. With 1 day dietary data, observed nutrient intakes were estimated to within 6-25% of the group's usual9true) intakes and 52-198% of the individuals' usual intakes. The values of these maximum percentage deviations became smaller when the number of dietary recalls increased. The results of this study suggest that the Korean elderly subjects appear to have a slightly less diverse diet compared to young Korean women. Within persons, intakes of nutrients largely from animal sources were more variable for the Korean elderly than for their counterparts in Western countries. This study also implies that commonly used 1 day dietary study may be appropriate for assessing group means of nutrient intakes, but clearly not appropriate for assessing individual's nutrient intakes.
Aged* ; Animals ; Diet ; Female ; Humans ; Male ; Vitamin A

The objective of this study was to investigate the relationship between insomnia severity, depression, anxiety, and anxiety sensitivity and to find out the explanatory variables that account for the insomnia severity among depression, anxiety, and anxiety sensitivity in general population. 95 mentally healthy volunteers who visit health promotion center of Kangbuk Samsung hospital for their regular medical examination were requested to complete Athens Insomnia Scale, Beck Depression Inventory, State-Trait Anxiety Inventory, and Anxiety Sensitivity Index. Association between total scores of Athens Insomnia scale and other variables (total scores of Beck Depression Inventory excluded item 16, total scores of State Anxiety, total scores of Trait Anxiety, and total scores of Anxiety Sensitivity Scale) was assessed individually with partial correlations adjusted by age and then together using multiple regression analysis. The total scores of Athens Insomnia Scale were significantly associated with total scores of Beck Depression Inventory excluded item 16(r = 0.541, p<0.001), total scores of Trait Anxiety(r = 0.642, p<0.001), total scores of State Anxiety(r = 0.267, p<0.05), and total scores of Anxiety Sensitivity Index(r = 0.312, p<0.01). Total scores of trait anxiety showed the highest correlation with the total scores of Athens Insomnia Scale and was the significant predictor to total scores of Athens Insomnia Scale among the other predictor variables (p<0.001). These results show that insomnia severity is positively correlated with depression, anxiety, and anxiety sensitivity. The correlation was strongest with trait anxiety. In addition, our results suggest that trait anxiety is associated with insomnia severity in general populations.
Anxiety* ; Depression* ; Health Promotion ; Healthy Volunteers ; Sleep Initiation and Maintenance Disorders*

In many cases the breast reconstruction surpasses the goal of a normal breast mound appearance in clothing and achieves a result that, in time, may look almost normal in the unclothe state. Breast reconstructions with autologous transverse rectus abdominis myocutaneous (TRAM) flaps are well known to produce the most aesthetically excellent results. the pedicled to TRAM flap cannot be used in high risk patient such as obese or smoking patients due to partial flap necrosis. But, the free TRAM flap have more robust blood supply and less donor site morbidity than the pedicled TRAM flap and is therefore the currently preferred technique in western. However, the free TRAM flaps has a problem related to the anastomotic failure which has been reported as high as 6% to 10%. Moreover many Korean women have smaller sized breast than western women and have no risk factors compromising flap circulation. So the single pedicled TRAM flap can be safely used for breast reconstruction without any flap necrosis. 60% of the elevated flap area has a sufficient volume to mold a new breast that matches with the contralateral breast and the unneccessary distal portion of the flap that has the marginal circulation can be resected. In this study we review our 20 consecutive cases of breast reconstruction using the pedicled TRAM flap and have a conclusion that the pedicled TRAM flap produce an aesthetically acceptable new breast in Korean mastecotmy patients without any flap necrosis or donor site morbidity.
Breast* ; Clothing ; Female ; Fungi ; Humans ; Mammaplasty* ; Necrosis ; Rectus Abdominis* ; Risk Factors ; Smoke ; Smoking ; Tissue Donors

In 1868 Charcot described the join in tabes dorsalis, which since then has been designated as Charcot neuroarthropathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthropathy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indfference to pain, leprosy, and intra-articular use of steroid, etc. Authors present a case of Charcot joint which involved the left knee joint associated with pathologic fracture of the left tibia and fibula.
Arthropathy, Neurogenic ; Diabetes Mellitus ; Fibula ; Fractures, Spontaneous ; Joints ; Knee Joint ; Knee ; Leprosy ; Syringomyelia ; Tabes Dorsalis ; Tibia

One hundred and seventy-two cases of tuberculosis of the bones and joints were treated at the department of orthopedic surgery, Inchon Christian Hospital during the 3 years and 10 months from March, 1979, to December, 1982. The results obtained were as followings: 1. The incidence was decreased progressively 1.92% in 1980 to 1.18 in 1982. 2. Tuberculous lesions involved spine(50.58%), knee(16.28%), hip(13.37%), ankle(2.33%) and greater trochanter(2.33%) in order. 3. Age and sex distribution were not remarkable. 4. The main associated tuberculous lesions were pulmonary tuberculosis and tuberculous pleurisy (20.65%). Therefore, pulmonary problems should be always carefully investigated in every case of skeletal tuberculosis. 5. Average duration of disease was one year and 3.5 months, average hospital days was one month. 6. Initial miss diagnosis of lesions ultimately proved to be tuberculosis. Rheumatoid arthritis:13 cases, Osteoarthritis : 3 cases, Herniated lumbar disc: 3 cases, Cellulitis :2 cases, Neoplasm :2 cases. Early diagnosis is essential since proper therapy is available and far advanced destruction, long suffering and disability can be avoided. 7. Post operative complication was mainly due to failure of bone graft in tuberculous spondylitis and was draining sinus formation and wound disruption in other skeletal tuberculosis. 8. The result of treatment of skeletal tuberculosis from conservative methods were relatively poor. The corroboratory care of skeletal tuberculosis can be obtained by extensive surgery.
Cellulitis ; Diagnosis ; Early Diagnosis ; Incheon ; Incidence ; Joints ; Orthopedics ; Osteoarthritis ; Sex Distribution ; Spondylitis ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary ; Wounds and Injuries

The most common problem in pterygium operation is the recurrence. Therefore radiation therapy or instillation of mitomycin-C after pterygium operation have used to prevent the recurrence of pterygium. We evaluated recurrence rate and complication rate with mitomycin-C and without mitomycin-C after the operation of pterygium in 113 eyes. The 112 patients(113 eyes) underwent simple surgical excision, whose mean age was 50.7 tears, and whose follow-up period was 6 to 12 months. 0.04% solution of mitomycin-C was instilled to 61 eyes and not to 52 eyes. Recurrence was noticed in 12 out of 61 eyes(19.6%) among the group not using mitomycin-D and in 2 out of 52 eyes(3.8%) among the group using mitomycin-C after pterygium operation. One eye in patients using mitomycin-C showed severe corneal edema due to endothelial decompensation by the toxicity of mitomycin-C. It is concluded that mitomycin-C ws effective to prevent recurrence after pterygium operation, but we should be aware of the severe complications by the toxicity of mitomycin-C.
Corneal Edema ; Follow-Up Studies ; Humans ; Mitomycin* ; Pterygium* ; Recurrence*

BACKGROUND: Intestinal ischemia remains a devastating event despite improvements in clinical recognition and in diagnostic and therapeutic modalities. The ischemic bowel diseases encompass a wide clinical spectrum from mild, reversible disease to severe, irreversible injury. The clinical picture is characterized initially by poorly localized whether an increased serum lactate level is a recognized danger signal marker for intestinal ischemia in patients who present at the emergency department because of abdominal complaints. METHODS: Patients who came to our emergency department with abdominal pain and the risk factors of intestinal ischemia between Apr. 1999 and Nov. 1999 were included in this study. The data analysis included age, sex, final diagnosis, pathogenesis of bowel ischemia, and serum lactate level. RESULTS: The serum lactate level in the intestinal ischemia group was 28.54+/-22.51mg/dl; in non-ischemia group, it was 15.49+/-22.52mg/dl. This difference between the two groups was significatn(p<0.05). An increased serum lactate level had a sensitivity of 88.2% and specificity of 59.2%, a positive likelihood ratio of 4.92, and a negative likelihood ratio of 0.47 as a marker of bowel ischemia. These results do not represent a very meaningful revision of bowel ischemic provability, but may make a small contribution to management of the disease, depending upon their magnitude and the clinical context in which they are applied. CONCLUSION: In patients with abdominal complaints, an increased serum lactate level is usually a useful aid as a diagnostic marker of bowel ischemia.
Abdominal Pain ; Diagnosis ; Early Diagnosis* ; Emergency Service, Hospital ; Humans ; Ischemia* ; Lactic Acid* ; Risk Factors ; Sensitivity and Specificity ; Statistics as Topic