BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.
Arteriosclerosis ; Blood Glucose ; Diabetes Complications ; Diabetes Mellitus* ; Diabetic Foot ; Edema ; Female ; Fingers ; Hospitals, General ; Humans ; Korea ; Male ; Onychomycosis ; Outpatients ; Skin

This report describes a very rare case of primary undifferentiated carcinoma of the endometrium with small cell and trophoblastic differentiation. The patient was 54-year-old woman with complaints of vaginal bleeding and palpable lower abdominal mass. The light microscopic findings revealed predominantly small cells with round nuclei, spindle cells, and large cells with hyperchromatic bizarre nuclei. Foci of syncytiotrophoblastic giant cells are scattered, especially in the hemorrhagic areas. Immunohistochemical stainging for neuron specific enolase and beta-hCG showed positive reactions to small cells and syncytiotrophoblastic giant cells, respectively. Argentaffin and argyrophil stains, however, showed negative reactions to small cells. The histogenesis of small cell undifferentiated carcinoma of the endometrium remains unclear; however, it may arise from epithelial precursors instead of neuroendocrine cells, and syncytiotrophoblastic cells may be differentiated or dedifferentiated from the undifferentiated carcinoma cells.
Female ; Humans

The loudness dependence of the auditory evoked potential (LDAEP) has been proposed as a valid biomarker of central serotoninergic activity in humans. The specificity and sensitivity of the LDAEP to changes in serotonergic neurotransmission have recently been explored in many studies about pharmacology and genetics. The majority of evidence for an association between the LDAEP and serotonin activity has come from animal studies. Genetic association studies with the LDAEP have provided conflicting reports with additional evidence outlining sensitivity to other neurotransmitter systems including the dopamine and glutamatergic systems. The LDAEP has been revealed to reflect the pathophysiology of various psychiatric illnesses. There is supporting evidence that major psychiatric disorders have differential LDAEP activities. Overall, the LDAEP shows strong evidence as a potential predictor of antidepressant treatment response. It need to be explored whether the LDAEP could be a biological marker of various psychiatric diseases and treatment prediction of antidepressants and serotonin related drugs.
Animals ; Antidepressive Agents ; Biomarkers ; Depression ; Dopamine ; Evoked Potentials, Auditory ; Genetic Association Studies ; Humans ; Neurotransmitter Agents ; Sensitivity and Specificity ; Serotonin ; Synaptic Transmission

OBJECTIVE: This study was carried out to investigate the clinical availability of event related potential (ERP) P300, N100 and QEEG as biological markers in schizophrenia (SPR) patients. METHODS: The 23 SPR patients who met Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria of SPR and age and sex matched 23 normal controls (NC) were recruited. Positive and Negative Syndrome Scale (PANSS) was used to evaluate the clinical symptoms. The three electrodes (Cz, CPz, Pz) were used to measure the amplitude and latency of each ERP components. The qEEG was analyzed by the ranges of Hz: delta (1-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13-30 Hz) and gamma (30-50 Hz). RESULTS:P300 amplitudes of SPR patients were reduced across Cz, CPz and Pz (F=5.81, p<0.05). There was no difference in P300 latency, N100 amplitude and N100 latency between SPR and NC. P300 amplitudes were not influenced by demographic characteristics and PANSS scores in SPR patients. The PANSS positive, negative, general subscale scores were positively correlated with N100 latency at Cz, CPz. SPR patients showed significantly decreased alpha activity (SPR vs. NC=24.44+/-6.98% vs. 29.55+/-6.74%, p<0.05) and increased gamma activity (SPR vs. NC=19.48+/-5.47% vs. 16.42+/-4.69%, p<0.05) compared with those of NC. CONCLUSION: The results suggest that the amplitude of P300 and alpha activity can be considered as a biological marker of SPR. And there is a possibility that the latency of N100 may reflect symptom severity of schizophrenia patients.
Biomarkers ; Diagnostic and Statistical Manual of Mental Disorders ; Electrodes ; Humans ; Schizophrenia

OBJECTIVE: Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. METHODS: Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. RESULTS: There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. CONCLUSION: Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.
Accidents, Traffic* ; Adjustment Disorders* ; Depression ; Diagnosis, Differential ; Hypochondriasis ; Hysteria ; Memory Disorders ; Memory* ; MMPI ; Paranoid Disorders ; Prognosis ; Schizophrenia ; Stress Disorders, Post-Traumatic*

OBJECTIVE: This study aimed to test the hypothesis that the loudness dependence of auditory evoked potentials (LDAEP) can be used to predict the presence of bipolarity in patients with major depressive episodes. METHODS: A cohort of 61 patients who met the criteria for major depressive disorder (MDD) following diagnosis using Axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision, and who had no history of hypomanic or manic episodes was included in this study. The patients were stratified into two subgroups based on whether or not they achieved a positive score for the Korean versions of the Mood Disorder Questionnaire (K-MDQ). The LDAEP was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. RESULTS: The Barratt Impulsiveness Scale (BIS) score was also higher for the positive screening group (81.24+/-11.87) than for the negative screening group (73.30+/-14.92; p=0.039, independent t-test). However, the LDAEP, Beck Depression Inventory, Hamilton Depression Rating Scale, Beck Hopelessness Scale (BHS), and Hamilton Anxiety Scale scores did not differ significantly between them. When binary logistic regression analysis was carried, the relationship between the positive or negative subgroups for K-MDQ and BIS or Beck Scale for Suicidal Ideation (BSS) score was also significant (respectively, p=0.017, p=0.038). CONCLUSION: We found that LDAEP was not significantly different between depressive patients with and without bipolarity. However, our study has revealed the difference between two subgroups based on whether or not they achieved a positive score for the K-MDQ in BIS or BSS score.
Anxiety ; Axis, Cervical Vertebra ; Cohort Studies ; Depression ; Depressive Disorder, Major ; Evoked Potentials ; Evoked Potentials, Auditory ; Humans ; Logistic Models ; Mass Screening ; Mood Disorders ; Surveys and Questionnaires ; Suicidal Ideation

While it has been reported previously that the loudness dependence of auditory evoked potentials (LDAEP) is a putative biological marker or a predictor of treatment response, there have been few studies of LDAEP in bipolar disorder. However, a recent study by Park and colleagues raised the possibility that the LDAEP could be useful as a biological marker of bipolar disorder. They found that the LDAEP was significantly higher in normal controls than in patients with either bipolar disorder or schizophrenia. Lee and colleagues also examined the LDAEP in bipolar disorder and normal controls, and found that it differed according to the bipolar phase, being significantly higher in cases of euthymic bipolar disorder, bipolar depression, and bipolar mania. With regard to treatment response, early clinical findings were that a higher LDAEP and a stronger intensity dependence of visual evoked potentials were related to a favorable response to lithium treatment. Juckel and colleagues recently demonstrated that the pretreatment LDAEP could be a predictor of successful prophylactic lithium treatment. The present article reviews the literature in order to determine whether the LDAEP can be used as a biological marker or a predictor of treatment response in patients with bipolar disorder and of manic switch or treatment resistance in patients with major depressive episode(s).
Biomarkers ; Bipolar Disorder* ; Evoked Potentials, Auditory* ; Evoked Potentials, Visual ; Humans ; Lithium

OBJECTIVES: Previous studies have suggested that information processing impairment is the main pathophysiology of post-traumatic stress disorder (PTSD). The P300 event-related potential (ERP) has been widely used, in diseases with cognitive dysfunction, such as schizophrenia and Alzheimer's disease, for detecting abnormality in information processing. This study examined P300 characteristics of PTSD patients. METHODS: We recruited 23 patients (mean age 44.35) who met DSM-IV criteria for PTSD and matched 24 normal control (NC) subjects by age and education level. The NC group had no personal history of psychiatric or neurological abnormality. We conducted the Korean version of the structured interview for PTSD (K-SIPS) and Davidson trauma scale (DTS) with the PTSD patients. Then we measured P300 amplitude and latency on 3 electrodes (Cz, CPz, Pz) in both PTSD patients and the NC group. RESULTS: Compared with the NC, the P300 amplitudes of PTSD patients were lower on Cz (PTSD: NC=5.51+/-2.82 uV : 11.80+/-5.18 uV, p<0.01), CPz (PTSD : NC=5.84+/-2.71 uV : 12.69+/-4.51 uV, p<0.01) and Pz (PTSD : NC=5.01+/-2.60 uV : 10.99+/-4.24 uV, p<0.01). We found increasing tendency toward P300 latency in PTSD group compared with NC. However, the BDI and DTS symptom severity scores were negatively correlated with the P300 amplitude of Pz. CONCLUSION: There was a significant reduction of P300 amplitudes in PTSD patients. Compared to NC group, PTSD patients showed a reduced P300 amplitude significantly correlated with symptom severity. The present findings suggest PTSD patients experience cognitive dysfunction and ERP P300 can be a useful surrogate marker of symptom severity in PTSD patients.
Alzheimer Disease ; Automatic Data Processing ; Biomarkers ; Diagnostic and Statistical Manual of Mental Disorders ; Electrodes ; Event-Related Potentials, P300 ; Humans ; Schizophrenia ; Stress Disorders, Post-Traumatic

Objective: The loudness dependence of the auditory evoked potential (LDAEP) is associated with central serotonergic neurotransmission. Recent studies have proposed that LDAEP is also influenced by dopaminergic activity. Evidence shows attention deficit hyperactivity disorder (ADHD) symptoms are associated with dopamine dysfunction. This study aimed to evaluate the relation between ADHD symptoms and LDAEP, as well as medication-mediated changes of LDAEP. Methods: A total of 38 male children (6−12 years old) with ADHD were analyzed in this study. Symptom severity was assessed using the ADHD rating scale (ARS) and the continuous performance test. To determine LDAEP, the auditory event-related potential was evaluated before medication. Changes in LDAEP were measured after 12 weeks of treatment with methylphenidate. Results: The subjects had a mean age of 9.24 ± 1.74 years with an average IQ of 109.4 ± 13.8. Before pharmacological treatment with methylphenidate, LDAEP was positively associated with the ARS score after adjusting for age and IQ (r = 0.592, p = 0.005). LDAEP was correlated with inattention (r = 0.522, p = 0.015) and hyperactivity-impulsivity (r = 0.6, p = 0.004). However, the LDAEP of 15 subjects decreased following methylphenidate treatment (Z = −1.988, p = 0.047). Conclusion In boys with ADHD, LDAEP appears to be associated with symptom severity. LDAEP showed a significant association with impulsivity and inattention. Importantly, LDAEP was shown to decrease after drug treatment. Our findings support the utility of LDAEP as a noninvasive and clinically useful method to assess symptom severity in children with ADHD.

OBJECTIVES: The current study investigated the putative relationship between chronotype and suicidality or bipolarity in patients with major depressive disorder (MDD). METHOD: Nineteen outpatients who met the criteria for MDD according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision were recruited for the current study. The subjects were divided into two subgroups based on their Basic Language Morningness (BALM) scores (dichotomized according to the median BALM score). The Loudness Dependence of Auditory Evoked Potentials (LDAEP) was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents. In addition, K-Mood Disorder Questionaire (K-MDQ), Beck Scale for Suicidal Ideation (BSS), Beck Hopelessness Scale (BHS), Barratt Impulsiveness Scale (BIS) were applied. RESULTS: The K-MDQ, BSS, BHS, BIS score was higher for the eveningness group than for the morningness group. However, the LDAEP, Hamilton Depression Rating Scale, Hamilton Anxiety Scale scores did not differ significantly between them. There were negative correlations between the total BALM score and the total K-MDQ, BSS, and BHS scores (r = -0.64 and p = 0.0033, r = -0.61 and p = 0.0055, and r = -0.72 and p = 0.00056, respectively). CONCLUSIONS: Depressed patients with eveningness are more vulnerable to the suicidality than those with morningness. Eveningness is also associated with bipolarity.
Anxiety ; Depression ; Depressive Disorder, Major* ; Evoked Potentials ; Evoked Potentials, Auditory* ; Humans ; Outpatients ; Serotonin Agents ; Suicidal Ideation*