BACKGROUND: It is reported that many types of psychiatric disorders, including anxiety disorder, are related with abnormal brain wave activity, and neurofeedback is associated with clinical improvement in generalized anxiety, OCD, phobic disorder, and PTSD. But in panic disorder, previous studies with neurofeedback are very lacking. Therefore, in this study, the author applied neurofeedback to patients with panic disorder, refractory to cognitive-behavioral therapy and medication. METHODS: From March 2 to May 15 in 2005, six patients with a panic disorder had received 20 sessions of neurofeedback training. The author evaluated the treatment effect by using the alteration of K-APPQ score, the frequency of panic attack, medication and individual handicap. RESULTS: All 6 patients completed 20 sessions of neurofeedback training. At the end, the score of total APPQ, agoraphobia, and interoceptive fear was decreased (P= 0.028) and the frequency of panic attack, medication, and individual handicap was also decreased. CONCLUSION: Neurofeedback training was successful in reducing panic symptom severity, frequency and individual handicap. A controlled study on a larger population is strongly recommended.
Agoraphobia ; Anxiety ; Anxiety Disorders ; Brain Waves ; Humans ; Neurofeedback* ; Panic ; Panic Disorder* ; Phobic Disorders ; Stress Disorders, Post-Traumatic

No abstract available.
Lymphadenitis*

Gastric Teratomas are exetremely rare in infancy and childhood. About 50 cases of gastric teratomas are reported in the world's literature. Most of them were male. Few were dignosed prior to surgery. The mos thelpful diagnostic aid was of teeth or bone in radiologic examinations. Treatment is surgical excision and all of them were benign. Recently, we experienced a case of gastric teratoma combined with congental syphilis which was confirmed by explo-lapa and biopsy in 2month old male infant, who had large intraabdominal mass, vomiting, respiratory distress and skin lesions. The literature on this subject was reviewed briefly.
Biopsy ; Humans ; Infant ; Male ; Skin ; Syphilis ; Syphilis, Congenital* ; Teratoma* ; Tooth ; Vomiting

BACKGROUND: Genetic and environmental factors are known to affect the incidence and severity of asthma. Stimulation of beta2-Adrenergic Receptor (beta 2AR) results in smooth muscle relaxation, leading to decrease in resistance of airflow. The gene encoding the beta 2AR has recently been seguenced. The beta 2AR genotype at the polymorphic lociof codons 16, 27, 34, and 164 was known to cause changes in the amino acids. The relationships between the structure of the beta 2AR and its functions are being elucidated. PURPOSE: The gene encoding the beta 2AR was carried out to assess the frequency of polymorphisms in bronchial asthma, to determine wheather these polymorphisms have any relation to the severity, or nocturnal symptoms in bronchial asthma. METHOD: The subjects studied were 103 patients with bronchial asthma, which consisted of 30 mild episodic, 32 mild persistent, 17 moderate, and 24 severe asthma patients. The polymorphisms of the beta 2AR gene were detected by mutated allele specific amplification (MASA) method at the codons 16, 27, 34, and 164. RESULTS: The most frequent polymorphism was arginine 16 to glycine. The other two polymorphisms, valine 34 to methionine and glutamine 27 to glutamic acid occured in 11 and 6 patients respectively. The polymorphism of threonine 164 to isoleucine was not found in our enrolled patients. The homozygous polymorphism of beta 2AR gene was found in only arginine 16 to glycine (12.6%). The heterozygous polymorphisms of beta 2AR gene were in arginine 16 to glycine, valine 34 to methionine, and glutamine 27 to glutamic acid, as 65.1%, 10.7%, and 5.8% respectively in asthma patients. The presence of agrginine 16 to glycine heterozygous or/and homozygous polymorphism was associated in severe asthma (p=0.015), but there was no association between the other three polymorphisms and the severity of asthma. The frequency of the 182AR gene polymorphisms was no relation in nocturnal asthma as compared with non-nocturnal asthma. CONCLUSION: The arginine 16 to glycine polymorphism of the beta 2AR gene is the most frequently found in asthma patients and association with severe asthma. But there was no association between the polymorphism of the beta 2AR gene and nocturnal asthma.
Alleles ; Amino Acids ; Arginine ; Asthma* ; Codon ; Genotype ; Glutamic Acid ; Glutamine ; Glycine ; Humans ; Incidence ; Isoleucine ; Methionine ; Muscle, Smooth ; Polymorphism, Genetic* ; Relaxation ; Threonine ; Valine

Li-Fraumeni syndrome(LFS) is an autosomal dominant disorder that predisposes individuals to multiple forms of cancer including breast cancer, soft tissue sarcoma, brain tumor, osteosarcoma, leukemia, and adrenocortical carcinoma. Recently, germ-line mutation of the p53 tumor suppressor gene has been implicated in this familial disorder. We report a case of a 25-year old woman who presented with bilateral breast cancer and uterine leiomyoma. Her mother had died of early-onset bilateral breast cancer. And her younger sister had breast carcinoma as well, which was identified at the age of 22, indicating her strong familial history. To test for the presence of the p53 germ-line mutation, we analyzed the genomic DNA from the peripheral blood of the proband and her sister by PCR-SSCP analysis of exon 5 through exon 8 of the p53 gene. As a result, a p53 mutation in exon 7 was detected in an allele, and it was shared with her sister as the same pattern. Sequencing analysis determined the altered nucleotide at codon 248(CGG < TGG) which is one of the most frequent mutation sites related to LFS. Therefore, this patient has the most consistent characteristic features of LFS phenotype and it is believed that this case is the first report of a family with Li-Fraumeni syndrome carrying the p53 germ-line mutation in Korea.
Adult ; Base Sequence ; Breast Neoplasms/diagnosis/genetics ; Case Report ; Female ; Genes, p53 ; Germ-Line Mutation ; Human ; Korea ; Li-Fraumeni Syndrome/*diagnosis/genetics ; Molecular Sequence Data ; Pedigree ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Sequence Analysis, DNA ; Support, Non-U.S. Gov't

OBJECTIVES: Primary IgA nephropathy is the most common type of glomerulonephritis, which may progress to end stage renal failure in about 30-35% of the cases. The incidence of recurrence of IgA nephropathy in transplanted kidney is approximately 50-60% but IgA nephropathy which is recurred in graft has relatively benign clinical course so the rate of graft loss due to recurrent IgA nephropathy is about 10%. Overall graft survival rate of IgA nephropathy is higher than other glomerular disorders which cause end stage renal disease according to recent clinical studies. However accurate causative disorders of end stage renal failure had seldom been reported by pathologic examination and accurate graft survival rate and recurrence rate of original disease after renal transplantation couldn't be investigated. We performed analysis of clinical outcome and prognosis for IgA group. METHODS: 1259 cases of kidney transplantation were performed in the Severance hospital between Apr 1979 and Dec.1994. We selected 178 cases of those who got renal biopsy and excluded the cases of cadaveric transplants, hepatitis B antigen carrier, diabetes mellitus and not taking cyclosporine A. 178 cases of those were divided into two groups, IgA and nonIgA group. We performed analysis of 5 year graft and patient survival rate between two groups. The IgA group was divided into two group, recurrent and not-recurrent IgA group. We also performed analysis of recurrence rate and graft survival rate between two groups. RESULTS: 1) 62 cases(35.2M) were IgA group and 116 cases were non-IgA group. 2) Male to female ratio of IgA group was 2.9:1, whose age averaged 35 years old. 3) Among 6 cases of the IgA group, 3 cases lost their graft due to chronic rejection, 2 cases due to recurrence and 1 case due to acute rejection. 4) The 5 year graft survival rate of IgA and nonIgA group were 85%, 90% each without statistical significance(p>0.05). The 5 year patient survival rate of IgA and nonlgA group after renal allograft were 100%, 97% each without statistical significance(p>0.05). 5) 266 cases of posttransplant kidney biopsies were performed and 10 cases were diagnosed as recurrent IgA nephropathy with recurrence rate of 15%. 6) Renal insufficiency was noted in 4 cases of recurrent IgA nephropathy, 2 cases of those were chronic renal failure and the other 2 cases lost their graft. The histologic findings of these cases included mesangial widening and proliferation(4 cases), glomerulosclerosis(2 cases), crescent formation(1 cases). 7) The interval between transplantation and recurrence averaged 41 months. 24hr proteinuria and serum level of creatinine at the time of diagnosis averaged 2.6g and 2.2 mg/dl each. 8) Male to female ratio, age, HLA type and degree of HLA match showed no significant difference between nonrecurrent and recurrent IgA group in graft but 5 year graft survival rate of recurrent IgA group was lower than nonrecurrent group with statistical significance(71% vs 83%, p<0.05). CONCLUSION: Recurrent IgA nephropathy in transplanted kidney might be one of major cause of graft loss with chronic rejection. However precise pathologic examination of before k after transplantation on larger patient population and more long term follow-up are advised.
Adult ; Allografts ; Biopsy ; Cadaver ; Creatinine ; Cyclosporine ; Diabetes Mellitus ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Graft Survival ; Hepatitis B ; Humans ; Immunoglobulin A* ; Incidence ; Kidney ; Kidney Failure, Chronic ; Kidney Transplantation* ; Male ; Prognosis ; Proteinuria ; Recurrence ; Renal Insufficiency ; Survival Rate ; Transplants

PURPOSE: In the past 30 years, the chemotherapeutic approach to advanced colorectal cancer has remained major challenge. Fluorinated pyrimidine has been the main active drugs, and cisplatin was introduced under clinical conditions. Because of the renal and hematologic toxicity of cisplatin, oxaliplatin was developed. The purpose of this study was to assess the clinical response to and the side effects of oxaliplatin chemotherapy. METHODS: From January 1999, 11 patients who received oxaliplatin chemotherapy entered this study. There were 9 males and 2 females, and their ages varied from 40 to 71 years old. The mean ECOG scale was 1. According to TNM staging, 2 was stage 2 at diagnosis, 5 at stage 3, and 4 at stage 4. Totally, we performed 57 cycles of oxaliplatin chemotherapy. Labaratory data and toxicity were assessed for each cycle according to the WHO scale. Ten (10) patients have received follow-up CT since treatment. RESULTS: Grade 1 anemia occurred in 68% of the cycles, grade 2 in 20%, and grade 3 in 12%. Grade 1 thrombocytopenia occurred in 35% of the cycles and grade 2 in 14%. Grade 1 leukopenia and neutropenia occurred in 27% and 25% of the cycles, respectively. Grade 1 stomatitis occurred in 12% of the cycles and grade 2 in 2%. Grade 1 nausea occurred in 44% of the cycles. Grade 1 vomiting occurred in 14% of the cycles and grade 2 in 4%. Grade 1 diarrhea occurred in 10% of the cycles and grade 2 in 4%. Nephrotoxicity was absent, and typical oxaliplatin neurotoxicity was reported as grade 1 in 2% of the cycles. No complete response was observed, and oxaliplatin che motherapy induced one partial remission. CONCLUSION: There was a mild hematologic and alimentary side effect. There were no renal and few neurologic side effects, but the response to oxaliplatin was poor.
Aged ; Anemia ; Cisplatin ; Colorectal Neoplasms* ; Diagnosis ; Diarrhea ; Drug Therapy* ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; Male ; Nausea ; Neoplasm Staging ; Neutropenia ; Stomatitis ; Thrombocytopenia ; Vomiting

BACKGROUND/AIMS: Striking geographic differences have been noted in the etiology of fulminant hepatic failure (FHF). The prognosis of patients with FHF who do not receive liver transplantation in a timely manner is quite dismal. This study intended to identify the etiology and outcome of FHF in Korean adults and to examine the role of urgent living-donor liver transplantation (LDLT) for treating this unique situation. METHODS: We identified all the adult FHF patients who were referred to our unit between 1999 and 2004. FHF was defined as severe acute hepatitis complicated by the rapid development of hepatic encephalopathy within 8 weeks of the initial symptoms in the patients without a previous history of liver disease. RESULTS: One hundred fourteen patients (47 males and 67 females) were identified. The mean age was 39.5+/-15.3 years. Drugs were the most common cause (28.1%) of FHF (herbal medications, 9.6%), and acute viral infection accounted for 23.7% (HBV accounted for 15.8%). Indeterminate etiologies were noted in 34%. The 90-day survival rate of the nontransplant group was only 15%. Fourteen patients received liver transplants (13 right-lobe LDLT, 1 cadaveric whole liver), and 12 of these (85.7%) survived and showed good graft function during 22 months of median follow-up. CONCLUSIONS: Although the causes of FHF in Korea were diverse, HBV infection and herbal medications were responsible for a significant proportion of the cases. Since urgent LDLT improved the overall survival rate of patients with FHF, this should be considered as an important treatment option for patients suffering with FHF.
Survival Rate ; Middle Aged ; Male ; Living Donors ; *Liver Transplantation ; Liver Failure, Acute/etiology/mortality/*surgery ; Humans ; Female ; Child ; Aged ; Adult ; Adolescent

Nutcracker syndrome(renal vein entrapment syndrome) is probably more common than previously suspected. The nutcracker phenomenon refers to compression of left renal vein between aorta and superior mesenteric artery that results in elevation of pressure in left renal vein and develoment of collateral veins. This syndrome occurs in relatively young and previously healthy patients and is characterized by intermittent gross hematuria due to left renal vein hypertension, at times associated with flank pain, abdominal pain or varicocele. We report a 17 years-old male patient with this syndrome presented with flank pain, abdominal pain, and intermittent gross hematuria for 3 months. Urinalysis revealed protein(-), blood(+++), many RBC with only 1% of dysmorphic RBC. IVP and cystoscopy showed no remarkable finding but doppler ultrasonography and abdominal spiral CT revealed compression of left renal vein between aorta and superior mesenteric artery. Renal venography showed compression of left renal vein and collateral circulation to left gonadal vein and the pressure gradient between left renal vein and inferior vena cava was 11mmHg. The nutcracker syndrome should be considered as one of the causes of nonglomerular hematuria. All patients with unexplained severe left flank or abdominal pain, or unilateral hematuria from the left on cystoscopy, should be studied by selective renal venography and pressure measurement in inferior vena cava and renal veins. The patient with this typical syndrome could be treated surgically, by transposition of left renal vein and resection of collateral veins as the procedure of choice to correct the underlying pathologic process and eliminate these troublesome symptoms.
Abdominal Pain ; Adolescent ; Aorta ; Collateral Circulation ; Cystoscopy ; Flank Pain ; Gonads ; Hematuria ; Humans ; Hypertension ; Male ; Mesenteric Artery, Superior ; Phlebography ; Renal Veins ; Tomography, Spiral Computed ; Ultrasonography, Doppler ; Urinalysis ; Varicocele ; Veins ; Vena Cava, Inferior

Viral load and the duration of viral shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are important determinants of the transmission of coronavirus disease 2019.In this study, we examined the effects of viral doses on the lung and spleen of K18-hACE2 transgenic mice by temporal histological and transcriptional analyses. Approximately, 1×105 plaque-forming units (PFU) of SARS-CoV-2 induced strong host responses in the lungs from 2 days post inoculation (dpi) which did not recover until the mice died, whereas responses to the virus were obvious at 5 days, recovering to the basal state by 14 dpi at 1×102 PFU. Further, flow cytometry showed that number of CD8+ T cells continuously increased in 1×102 PFU-virusinfected lungs from 2 dpi, but not in 1×105 PFU-virus-infected lungs. In spleens, responses to the virus were prominent from 2 dpi, and number of B cells was significantly decreased at 1×105PFU; however, 1×102 PFU of virus induced very weak responses from 2 dpi which recovered by 10 dpi. Although the defense responses returned to normal and the mice survived, lung histology showed evidence of fibrosis, suggesting sequelae of SARS-CoV-2 infection. Our findings indicate that specific effectors of the immune response in the lung and spleen were either increased or depleted in response to doses of SARS-CoV-2. This study demonstrated that the response of local and systemic immune effectors to a viral infection varies with viral dose, which either exacerbates the severity of the infection or accelerates its elimination.