BACKGROUND: Depression and anxiety are common psychiatric symptoms in patients with epilepsy, exerting a profound negative effect on health-related quality of life. Several issues, however, pertaining to their association with psychosocial, seizure-related and medication factors, remain controversial. In the present study we have investigated the association of depression and anxiety with various demographic and seizure-related variables in patients with newly-diagnosed and chronic epilepsy. METHODS: We investigated 80 patients with epilepsy (46.3% males, mean age 36.1+/-11.4 years, range 18~64; mean disease duration, 13.4+/-12.2 years). Depression and anxiety were assessed in the interictal state with the Beck Depression Inventory, 21-item version (BDI-21) and the state and trait subscales of the State-Trait Anxiety Inventory (STAI-S and STAI-T), respectively. The association of depression and anxiety with various variables was investigated using univariate analyses and multiple linear regression analyses. RESULTS: Duration of epilepsy, the number of side effects and the number of GABAergic anti-epileptic drugs were correlated with depression, together accounting for 25.1% of the variation of the BDI-21. The STAI-S index was significantly associated with occupation status and the number of GABAergic anti-epileptic drugs accounting for 27.4% of the variation of the STAI-S. Finally, the number of side effects was correlated with trait anxiety. CONCLUSIONS: Our study shows that the duration of epilepsy, occupation status, GABAergic anti-epileptic drugs and the number of side effects are risk factors for the development of depression and/or anxiety.
Accounting ; Anxiety ; Depression ; Epilepsy ; Humans ; Linear Models ; Male ; Occupations ; Quality of Life ; Risk Factors

Duodenal intramural hematoma is mostly caused by blunt abdominal trauma. It is also less commonly reported as a complication of anticoagulation therapy or as a blood dyscrasia, and as a complication of diagnostic/ therapeutic endoscopy. The presentation of these patients is abdominal pain, vomiting, fever and hematochezia, and this is rarely accompanied with intestinal obstruction, severe pancreatitis and acute peritonitis as its complications. The diagnosis is made clear by performing abdominal ultrasonography and abdominal computed tomography. We reported here on one case of intramural duodenal hematoma and hemoperitoneum after performing endoscopic hemostasis in a chronic renal failure patient who was on maintenance hemodialysis.
Abdominal Pain ; Diagnosis ; Duodenum ; Endoscopy* ; Fever ; Gastrointestinal Hemorrhage ; Hematoma* ; Hemoperitoneum* ; Hemostasis, Endoscopic ; Humans ; Intestinal Obstruction ; Kidney Failure, Chronic* ; Pancreatitis ; Peritonitis ; Renal Dialysis ; Ultrasonography ; Vomiting

Pleomorphic adenoma is most frequently seen in the major salivary glands, but can also be found in oral mucosa, hard and soft palate, temporal bone, hypophyseal duct, limbs, skin, inguinal region as well as in the nasal cavity. The majority of intranasal pleomorphic adenomas originate from the mucosa of nasal septum and lateral nasal wall. The treatment of choice is local but adequate excision. The authors experienced a rare case of pleomorphic adenoma that arose from the nasal vestibule: it was treated with local excision. We report the case with a review of literatures.
Adenoma ; Adenoma, Pleomorphic* ; Extremities ; Mouth Mucosa ; Mucous Membrane ; Nasal Cavity ; Nasal Septum ; Nose ; Palate, Soft ; Salivary Glands ; Skin ; Temporal Bone

BACKGROUND AND OBJECTIVES: To determine the frequency of the histologic types of nasal polyp in Korea and their relationships with respect to age, laterality, asthma, allergic rhinitis (AR) and expression of vascular endothelial growth factor (VEGF). SUBJECTS AND METHOD: Tissue slides obtained from 282 patients with nasal polyps were examined; polyps were classified either as eosinophilic polyp or chronic inflammatory polyp. VEGF expression was determined using immunohistochemical staining. RESULTS: Of the 282 subjects, 169 (59.9%) had chronic inflammatory polyps, 113 (40.1%) had eosinophilic polyps, and 232 (82.3%) had bilateral polyps. Twenty-two subjects (7.8%) had asthma and 23 (8.2%) had AR. There was no statistical relationship between nasal polyp type and laterality or the presence of asthma or AR. Of 10 children, 9 (90%) had chronic inflammatory polyps. VEGF expression was significantly higher in eosinophilic polyps than in chronic inflammatory polyps, and significantly higher in the samples of each polyp type from the subjects with AR than those without AR. In subjects with asthma, however, the VEGF expression did not differ between eosinophilic polyps and chronic inflammatory polyp samples. CONCLUSION: In the Korean population, chronic inflammatory nasal polyps are more common than eosinophilic nasal polyps. VEGF expression was the highest in eosinophilic polyps of the subjects with AR, suggesting that VEGF might contribute to the polyp formation via local allergic action.
Asthma ; Child ; Eosinophils ; Humans ; Hypersensitivity ; Inflammation ; Korea ; Nasal Polyps ; Polyps ; Rhinitis ; Rhinitis, Allergic, Perennial ; Vascular Endothelial Growth Factor A

Both neoplasm and infections arising from the external auditory canal (EAC) can involve the temporomandibular joint (TMJ) but rarely the reverse. A benign TMJ mass that presents as an EAC mass is a rare otologic entity as only seven cases have been reported worldwide. The authors experienced a 72-year-old male patient presenting with EAC mass with fluctuation when opening the mouth, which turned out to be caused by venous malformation of the TMJ. Surgical excision of the mass via endaural approach was successful. We present this case with a review of the literature.

Both neoplasm and infections arising from the external auditory canal (EAC) can involve the temporomandibular joint (TMJ) but rarely the reverse. A benign TMJ mass that presents as an EAC mass is a rare otologic entity as only seven cases have been reported worldwide. The authors experienced a 72-year-old male patient presenting with EAC mass with fluctuation when opening the mouth, which turned out to be caused by venous malformation of the TMJ. Surgical excision of the mass via endaural approach was successful. We present this case with a review of the literature.
Aged ; Constriction, Pathologic ; Ear Canal ; Humans ; Male ; Mouth ; Temporomandibular Joint ; Vascular Malformations ; Veins

PURPOSE: Cow's milk protein is one of the most common and strongest food allergen. We investigated the effects of heat treatment on the distribution and antigenicities of major allergens from cow's milk. We also compared the protein distribution and antigenicities among cow's milk formula and its substitutes. METHODS: We heated alpha-casen, beta-lactoglobulin (BLG), alpha-lactalbumin (ALA), and crude extract of cow's milk in 100degrees C boiling water for 1 hour. We prepared crude extracts from cow's milk formula, partially hydrolyzed milk formula (pHF) and extensively hydrolyzed milk formula (eHF). The protein compositions of all the samples were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The antigenicities were determined by IgE immunoblotting with pooled serum collected from 11 patients with milk allergy. RESULTS: After heating, no significant alteration was found in casein, and the aggregates of ALA and BLG were detected with molecular weights of about 30 and 45 kDa, respectively. The antigenicities of newly detected aggregates were increased. The new aggregates of BLG with increased antigenicities were also found in heated milk total protein. Major milk allergens were not found in pHF, and residual components with a molecular weight below 10 KDa did not show IgE-binding activity. We failed to observe the residual components and antigenicities of eHF. CONCLUSION: Changes in protein distribution and antigenicity of milk total protein induced by heat treatment may not be significantly different from those of each major allergen. The residual components of pHF could have little IgE-binding capacity, and there may be few or no antigenic components in eHF.
Allergens ; Caseins ; Complex Mixtures ; Electrophoresis ; Heating ; Hot Temperature* ; Humans ; Hydrolysis* ; Immunoblotting ; Immunoglobulin E ; Lactalbumin ; Lactoglobulins ; Milk ; Milk Hypersensitivity ; Milk Proteins* ; Molecular Weight ; Sodium ; Water

Hepatobiliary involvement is a rare manifestation of Henoch-Schonlein purpura (HSP). HSP cases related to hepatitis A, B or C virus have been reported but little is known about HSP cases complicated by cholestatic hepatitis without underlying hepatobiliary disease. Here, we report a case of Henoch-Schonlein purpura presenting with cholestatic hepatitis. The patient presented with upper abdominal pain and cholestasis that developed characteristic purpura. The patient was treated conservatively by therapeutic fasting and nutritional support, and liver function recovered 7 weeks after admission.
Abdominal Pain ; Cholestasis ; Fasting ; Hepatitis ; Hepatitis A ; Humans ; Liver ; Nutritional Support ; Purpura ; Purpura, Schoenlein-Henoch ; Viruses

The inducible 70 kDa heat shock proteins (Hsp70) in mice are encoded by two almost identical genes, hsp70.1 and hsp70.3. Studies have found that only hsp70.1 is induced by hypertonic stress while both hsp70.1 and hsp70.3 genes are expressed in response to heat shock stress. It is unclear if the human counterparts, hsp70-2 and hsp70-1, are differentially regulated by heat shock and osmotic stress. This study found that only hsp70-2 was induced by hypertonic stress in human embryonic kidney epithelial cells and fibroblasts, while heat shock stress induced both hsp70-1 and hsp70-2. The human hsp70-2 promoter region contains three TonE (tonicity-responsive enhancer) sites, which were reported to play an important role in the response to hypertonicity. When the reporter plasmids containing different parts of the 5' flanking region of hsp70-2 were transfected into human embryonic kidney epithelial cells or fibroblasts, one TonE site at -135 was found to play a key role in the response to hypertonicity. The inactivation of the TonE site using site-directed mutagenesis led to the complete loss of induction by hypertonicity, which demonstrates the essential role of the TonE site. This suggests that the TonE site and the TonEBP (TonE binding protein) are the major regulators for the cellular response against high osmolarity in human kidney tissue.
Transcription, Genetic/drug effects/genetics ; Transcription Factors/genetics/*physiology ; Saline Solution, Hypertonic/*pharmacology ; Reverse Transcriptase Polymerase Chain Reaction ; Protein Binding ; Promoter Regions (Genetics)/genetics ; Point Mutation ; Mutagenesis, Site-Directed ; Humans ; HSP70 Heat-Shock Proteins/*genetics/metabolism ; Gene Expression Regulation/*drug effects ; DNA-Binding Proteins/genetics/metabolism ; Cell Line ; Binding Sites/genetics ; Base Sequence ; 5' Flanking Region/genetics

Autoimmune arthritis, such as rheumatoid arthritis (RA), is a chronic inflammatory disorder that primarily affects the joints and then results in their progressive destruction. Effector Th cells have been classified as Th1 and Th2 subsets based on their cytokine expression profiles and immune regulatory function. Another subset of T cells termed Th17 was recently discovered and known to selectively produce IL-17. Also, Th17 was shown to be generated by TGFbeta and IL-6 and maintained by IL-23. IL-17 is a proinflammatory cytokine that is considered to involve the development of various inflammatory autoimmune diseases such as RA, asthma, lupus, and allograft rejection. IL-17 is present in the sera, synovial fluids and synovial biopsies of most RA patient. IL-17 activates RA synovial fibroblasts to synthesize IL-6, IL-8 and VEGF via PI3K/Akt and NF-kappaB dependent pathway. IL-17 increases IL-6 production, collagen destruction and collagen synthesis. In addition, it not only causes bone resorption but also increases osteoclastogenesis and fetal cartilage destruction. Inhibition of the IL-17 production may contribute a novel therapeutic approach along with potent anti-inflammatory effect and with less immunosuppressive effect on host defenses.
Allografts ; Arthritis* ; Arthritis, Rheumatoid ; Asthma ; Autoimmune Diseases ; Biopsy ; Bone Resorption ; Cartilage ; Collagen ; Fibroblasts ; Humans ; Interleukin-17 ; Interleukin-23 ; Interleukin-6 ; Interleukin-8 ; Joints ; NF-kappa B ; Synovial Fluid ; T-Lymphocytes ; Transforming Growth Factor beta ; Vascular Endothelial Growth Factor A