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

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

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.

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

BACKGROUND: Although cardiopulmonary resuscitation(CPR) is a very effective therapy in cardiac arrest, it is hard to prove the true effectiveness of CPR. Several studies about out-of-hospital and emergency department CPR exist, but only a few reports about in-hospital CPR are available. This study was designed to investigate in-hospital cardiac arrest, to analyze the result of CPR, and to evaluate the problems associated with in-hospital CPR. METHODS: A clinical analysis of 71 cases of in-hospital CPR announcement from January 2000 to August 2000 was performed. The initial rhythm on cardiac arrest, return of spontaneous circulation(ROSC), and the survivals were analyzed in the case of the 46 true cardiac arrest patients. RESULTS: During 8 months, there were 71 cases of in-hospital CPR announcement. Among them, there were 46 cases of true cardiac arrest and 25 cases of non-cardiac arrest. Of the 46 true cardiac-arrest cases, 27(58.7%) experienced ROSC, 15(32.6) survived for over 24 hours, and 7(15.2%) survived to be discharged. The initial rhythms on cardiac arrest were 30 cases(65.2%) of asystole, 14(30.4%) of PEA(pulseless electrical activity), and 2(4.3%) of ventricular fibrillation, with ROSC being 17 cases(56.7%), 9(64.3%) and 1(50.0%) cases and discharged survivors being 4 cases(13.3%), 3(21.4%) and 0(0.0%) cases, respectively. CONCLUSION: Extraordinarily high proportions of asystole and PEA were seen in the initial rhythm of cardiac arrest, and those were associated with high survival rates. Although further study is needed to evaluate the course leading to this high proportion of asystole and PEA, this result suggests that if the EMS system in the hospital is activated promptly and systematically, a better outcome will be achieved in case of cardiac arrest with asystole and PEA.
Cardiopulmonary Resuscitation* ; Emergency Service, Hospital ; Heart Arrest ; Humans ; Peas ; Survival Rate ; Survivors ; Tertiary Care Centers* ; Ventricular Fibrillation

Interleukin-23 (IL-23) is a novel pro-inflammatory cytokine which has been implicated to play a pathogenic role in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-23 inductive activity of the proinflammatory cytokine IL-17, IL-1 beta and tumor necrosis factor (TNF-alpha) in RA synovial fluid mononuclear cells (SFMC). Expression of IL-23p19, IL-17, IL-1 beta and TNF-alpha in joint was examined by immunohistochemistry (IHC) of patients with RA and osteoarthritis (OA). The effects of IL-17 and IL-1 beta on expression of IL-23p19 in human SFMC from RA patients were determined by reverse transcriptase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). IL-23p19 was expressed in the RA fibroblast like synoviocyte (FLS), but not from OA FLS. Similar to the protein expression, IL-23p19 mRNA could be detected by RT-PCR in RA SFMC. IL-17 and IL-1 beta could induce RA SFMC to produce the IL-23p19. The effects of IL-17 were much stronger than IL-1 beta or TNF-alpha. These responses were observed in a dose- responsive manner. In addition, IL-17 or IL-1 beta neutralizing antibody down-regulated the expression of IL-23p19 induced by LPS in RA-SFMC. Our results demonstrate that IL-23p19 is overexpressed in RA synovium and IL-17 and IL-1 beta appears to upregulate the expression of IL-23p19 in RA-SFMC.
Antibodies, Neutralizing ; Arthritis, Rheumatoid ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Humans ; Immunohistochemistry ; Interleukin-17 ; Interleukin-1beta ; Interleukin-23 ; Interleukin-23 Subunit p19 ; Joints ; Osteoarthritis ; RNA, Messenger ; RNA-Directed DNA Polymerase ; Synovial Fluid ; Synovial Membrane ; Tumor Necrosis Factor-alpha

Interleukin-23 (IL-23) is a novel pro-inflammatory cytokine which has been implicated to play a pathogenic role in rheumatoid arthritis (RA). This study was undertaken to investigate the IL-23 inductive activity of the proinflammatory cytokine IL-17, IL-1 beta and tumor necrosis factor (TNF-alpha) in RA synovial fluid mononuclear cells (SFMC). Expression of IL-23p19, IL-17, IL-1 beta and TNF-alpha in joint was examined by immunohistochemistry (IHC) of patients with RA and osteoarthritis (OA). The effects of IL-17 and IL-1 beta on expression of IL-23p19 in human SFMC from RA patients were determined by reverse transcriptase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). IL-23p19 was expressed in the RA fibroblast like synoviocyte (FLS), but not from OA FLS. Similar to the protein expression, IL-23p19 mRNA could be detected by RT-PCR in RA SFMC. IL-17 and IL-1 beta could induce RA SFMC to produce the IL-23p19. The effects of IL-17 were much stronger than IL-1 beta or TNF-alpha. These responses were observed in a dose- responsive manner. In addition, IL-17 or IL-1 beta neutralizing antibody down-regulated the expression of IL-23p19 induced by LPS in RA-SFMC. Our results demonstrate that IL-23p19 is overexpressed in RA synovium and IL-17 and IL-1 beta appears to upregulate the expression of IL-23p19 in RA-SFMC.
Antibodies, Neutralizing ; Arthritis, Rheumatoid ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Humans ; Immunohistochemistry ; Interleukin-17 ; Interleukin-1beta ; Interleukin-23 ; Interleukin-23 Subunit p19 ; Joints ; Osteoarthritis ; RNA, Messenger ; RNA-Directed DNA Polymerase ; Synovial Fluid ; Synovial Membrane ; Tumor Necrosis Factor-alpha