OBJECTIVE: Repeated treatment with psychostimulants induces sensitization of the dopaminergic system in the brain. Dopaminergic sensitization has been proposed as a mechanism of psychosis. Although antipsychotics block the expression of sensitized behavior, they are ineffective for reversing the sensitized state. We investigated the effect of clozapine, haloperidol, and fluoxetine on the reversal of cocaine-induced behavioral sensitization. METHODS: Male ICR mice were sensitized to cocaine with repeated treatment. Animals were then split into four groups, and each group was treated with vehicle or one of the above drugs for 5 days. After a 3-day drug washout, locomotor activity was assessed before and after a cocaine challenge. RESULTS: Clozapine reversed the sensitized state, whereas haloperidol did not. Fluoxetine seemed to reverse the sensitization partially. CONCLUSION: We confirmed that D2 blockade was not effective for reversing sensitization. The reversal by clozapine is partially explained in terms of its strong 5-HT2 and weak D2 affinity. The partial reversal by fluoxetine seemed to be related to its serotonin-augmenting action.
Animals ; Antipsychotic Agents ; Brain ; Clozapine* ; Cocaine ; Fluoxetine* ; Haloperidol* ; Humans ; Male ; Mice ; Mice, Inbred ICR ; Motor Activity ; Psychotic Disorders

Air embolism is a rare complication of percutaneous nephrolithotomy. Patent foramen ovale, which is necessary in fetal circulation, is a potential route for emboli arising from the venous system to enter the systemic arterial circulation, resulting in paradoxical air embolism syndrome. A case of paradoxical air embolism during percutaneous nephrolithotomy is presented. To our knowledge, this is the first report of paradoxical air embolism associated with patent foramen ovale during percutaneous nephrolithotomy.
Adult ; Diverticulum/surgery ; Embolism, Air/*etiology ; Embolism, Paradoxical/*etiology ; Foramen Ovale, Patent/complications/surgery ; Humans ; Intraoperative Complications/*etiology ; Male ; Nephrostomy, Percutaneous/*adverse effects

Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal proliferation of Langerhans cells. The temporal bone is frequently involved in pediatric LCH cases, but there have been few reports of adult LCH with temporal bone involvement. We present a case of adult onset LCH affecting the temporal bone. The diagnosis was made by biopsy, based on histopathologic findings of Langerhans cells. Diagnostic and therapeutic considerations of LCH involving the temporal bone are discussed.
Adult ; Biopsy ; Ear Canal ; Histiocytosis, Langerhans-Cell ; Humans ; Langerhans Cells ; Rare Diseases ; Temporal Bone

Purpose: Infertility affects 10% to 15% of couples, and male factor accounts for 50% of the cases. The relevant male genetic factors, which account for at least 15% of male infertility, include Y-chromosome microdeletions. We investigated clinical data and patterns of Y-chromosome microdeletions in Korean infertile men. Materials and Methods: A total of 919 infertile men whose sperm concentration was ≤5 million/mL in two consecutive analyses were investigated for Y-chromosome microdeletion. Among them, 130 infertile men (14.1%) demonstrated Y-chromosome microdeletions. Medical records were retrospectively reviewed. Results: In 130 men with Y-chromosome microdeletions, 90 (69.2%) had azoospermia and 40 (30.8%) had severe oligozoospermia.The most frequent microdeletions were in the azoospermia factor (AZF) c region (77/130, 59.2%), followed by the AZFb+c (30/130, 23.1%), AZFa (8/130, 6.2%), AZFb (7/130, 5.4%), AZFa+b+c (7/130, 5.4%), and AZFa+c (1/130, 0.7%) regions. In men with oligozoospermia, 37 (92.5%) had AZFc microdeletion. Chromosomal abnormalities were detected in 30 patients (23.1%). Higher follicle-stimulating hormone level (23.2±13.5 IU/L vs. 15.1±9.0 IU/L, p<0.001), higher luteinizing hormone level (9.7±4.6 IU/L vs. 6.0±2.2 IU/L, p<0.001), and lower testis volume (10.6±4.8 mL vs. 13.3±3.8 mL, p<0.001) were observed in azoospermia patients compared to severe oligozoospermia patients. Conclusions Y-chromosome microdeletion is a common genetic cause of male infertility. Therefore, Y-chromosome microdeletion test is recommended for the accurate diagnosis of men with azoospermia or severe oligozoospermia. Appropriate genet

OBJECTIVES: This study was designed to investigate the association between the dopamine D2 receptor (DRD2) genetic polymorphism [TaqIB (rs17294542) and TaqID (rs1800498)] and patients with schizophrenia. METHODS: TaqIB (rs17294542) and TaqID (rs1800498) polymorphism of the DRD2 gene were typed in 100 patients with schizophrenia and 109 normal controls. RESULTS: There were no statistical differences in genotype and allele distribution of TaqIB (rs17294542) and TaqID (rs1800498) genetic polymorphism between patients with schizophrenia and normal controls. CONCLUSIONS: These results suggest that the TaqIB (rs17294542) and TaqID (rs1800498) polymorphisms of the DRD2 gene may not be associated with schizophrenia in the Korean population.
Alleles ; Genotype ; Humans ; Polymorphism, Genetic ; Receptors, Dopamine D2 ; Schizophrenia

A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.

OBJECTIVE: Previous studies have suggested that hyperhomocysteinemia and methylenetetrahydrofolate reductase (MTHFR C677T) mutations are associated with increased risk of recurrent spontaneous abortion (RSA). Recently, a second site polymorphism in MTHFR, 1298A-->C, which changes a glutamic acid into an alanine residue, was shown to be associated with a decreased enzyme activity. We tested whether the variant alleles of MTHFR C677T and A1298C are risk factor (biomarker) for RSA. MATERIALS AND METHODS: We analyzed DNA from a case-control study in the Korean DNA was extracted from blood samples of 118 patients with RSA and 123 healthy fertile patients as the controls. MTHFR variant alleles were determined by a PCR-restriction fragment length polymorphism assay. RESULTS: We found no evidence for an association between 677TT genotype and risk of RSA (OR=1.95, 95% CI=0.84~4.50, p=0.12). However, the MTHFR 1298AC (OR=0.36, 95% CI=0.20~ 0.63, p=0.0004) and 1298AC+CC (OR=0.35, 95% CI=0.20~0.61, p=0.0002) genotypes were lower among 118 RSA cases compared with 123 controls, conferring a 2.8-fold decrease in risk of RSA, respectively. Moreover, the combined genotypes of MTHFR 677CC/1298AC (OR=0.30, 95% CI= 0.10~0.88, p=0.029) and 677CT/1298AC (OR=0.77, 95% CI=0.60~0.99, p=0.043) also showed significantly lower risk than those with MTHFR 677CC/1298AA type. CONCLUSION: MTHFR 1298AC, MTHFR 677CC/1298AC and 677CT/1298AC genotypes may represent genetic markers for the protection of RSA at least in Korean women.
Abortion, Spontaneous* ; Alanine ; Alleles ; Case-Control Studies ; DNA ; Female ; Genetic Markers ; Genotype ; Glutamic Acid ; Humans ; Hyperhomocysteinemia ; Methylenetetrahydrofolate Reductase (NADPH2) ; Oxidoreductases* ; Pregnancy ; Risk Factors ; Vascular Diseases

BACKGROUND: The automated border detection(ABD) echocardiography has the ability of recognizing the endocardial-blood interface, and therefore, on-line estimation of the left ventricular(LV) volume every cardiac cycle. Compared with the off-line conventional 2-dimensional echocardiographic method that requires tracing the endocardial border manually, the ABDd system can be a convenient and objective method in the estimation of the LV volume and the ejection fraction(EF). The purpose of this study is to compare the LV volume and EF between the on-line ABD system and the convertional off-line echocardiographic method. METHODS: In two weeks, 83 adult patients older than 16 years of age were referred to our echocardiographic laboratory. Among these 83 patients, 64 patients who had a normal sinus rhythm were included to our study. Using the Hewlett-Packard SONOS 1500, a 2.5 MHz transducer was placed dat the cardiac apex. Patients with an apical 4 chamber view of the LV in which at least 75% of the endocardium was clearly seen were selected for study. On that view, the ABD system was turned on, and the reansmit power and the time-gain compensation controls were adjusted in order to approximate the automated border to the visually apparent endocardial surface. The LV end-diastolic volume(LVESV) and LV end-systolic volume(LVESV) were calculated by the method of disc. LVEDV, LVESV, and EF were displayed every cardiac cycle. Also the off-line estimation of the LV volume was performed by the method of disc, after manually tracing the endocardial border on the apical 4 chamber view. RESULTS: 44 patients(69%) of 64 patients had > or =75% of the LV endocardium visualized. LVEDV, LVESV, and Ef with the ABD system were highly correlated with those with the off-line, manually traced method(r=0.95, 0.8, respectively), but LVEDV and EF with toe ABD system were significantly less than those with the latter(p<0.01). The limits of agreement between tow methods(off-line, manually traced method-ABD system) were somewhat wide. Those of LVEDV, LVESV and EF were +22~-10ml(mean 6ml), +15~-14ml(mean 0.1ml), and +19~-12%(mean 3.8%), respectively. CONCLUSION: LVEDV,LVESV, and EF measurements by the ABD system and the off-line manually traced methods thve a strong correlation, The ABD system should habe clinical applications in setting, in which measurements of LV volume and Ef are important, But, the comparison with a more reliable method is necessary.
Adult ; Compensation and Redress ; Echocardiography* ; Endocardium ; Humans ; Toes ; Transducers

PURPOSE: This study is designed to explore the role of retrograde urethrography as a predictor of recovery of urinary continence after radical retropubic prostatectomy. MATERIALS AND METHODS: A total of 40 patients who underwent radical retropubic prostatectomy from January 2005 to April 2007 were investigated. Among them one neurogenic bladder patient and one follow up loss patient were excluded. Voiding pattern and urinary incontinence were investigated with voiding diary monthly after Foley catheter removal. Recovery of urinary continence was defined as usage of less than 1 diaper per day. Pericatheter urethrography was conducted 2 weeks after operation. If definite bladder-urethral extravasation was not detected, an retrograde urethrography was performed immediately. 30 patients with sufficient length of urethra, regular margin of urethra and beaky appearance were defined as Group A, and 8 patients without above mentioned characteristics were marked as Group B. Differences between two groups were compared in terms of age, prostate volume, prostate specific antigen, urodynamic parameters, and duration of urinary incontinence. RESULTS: No significant differences were found in age, prostate volume, PSA between two groups. In group A, recovery rates of urinary continence were 70% (21 persons), 100% (30 persons) at 1,3 months after removal of catheter, respectively. In group B, rates of urinary continence recovery were 16.6% (1 person), 37.5% (3 persons), 75% (6 persons) at 1,3,4 months, respectively and 1 person regained continence at 7 months. CONCLUSION: A catheter free retrograde urethrography can be easily added after confirmation of bladder urethra anastomosis site healing. It gives us some valuable informations about external sphincter. The characteristics of retrograde urethrography can be used as a predictor of early recovery of postoperative incontinence.
Catheters ; Follow-Up Studies ; Humans ; Prostate ; Prostate-Specific Antigen ; Prostatectomy* ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urinary Incontinence ; Urodynamics

PURPOSE: To evaluate the clinical and imaging findings of tubular carcinoma of the breast. MATERIALS AND METHODS: We retrospectively assessed the clinical and imaging findings of ten lesions of pathologically proven tubular carcinoma in nine patients, also evaluating the mammographic findings and categorizing the mass according to the ACR BI-RADS classification. The ultrasonographic findings were assessed in terms of shape, echogenicity, margin and posterior shadowing, and in four cases the size of nodules at physical examination was compared with the mammographic, ultrasonographic and pathologic findings. RESULTS: Nine lesions were palpable at physical examination. Bilateral tubular carcinoma of the breast was found in one patient, and unilateral single lesions in the others. There was no metastasis and no death within an average of 666 (range, 163) days of surgery. At mammography, masses were detected in six cases; the features, observed were a lobular or irregular shape (6/6), a spiculated margin (3/6) and high density (5/6). Ultrasonography showed that all unilateral lesions were hypoechoic (8/8), with a lesion height-to-width ratio of greater than 1.0 in seven of these, an ill-defined margin in sis, and posterior acoustic shadowing in seven. Mean nodule diameter was 1.17 cm at physical examination, 1.09 cm at mammography, 0.86 cm at ultrasonography and 0.80 cm at pathological evaluation. CONCLUSION: Most tubular carcinomas were palpable in spite of their small size, and their postoperative prognosis was good. Ultrasonography is useful in the detection of mammographically occult tubular carcinoma and for measuring the size of lesions.
Acoustics ; Adenocarcinoma* ; Breast* ; Classification ; Humans ; Mammography ; Neoplasm Metastasis ; Physical Examination ; Prognosis ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography