Objective: To investigate the effects of long-acting injectable 3-monthly paliperidone palmitate on the clinical and social functioning of patients with schizophrenia. Methods: This study enrolled patients with schizophrenia receiving long-acting injectable 1-monthly paliperidone palmitate for at least 4 months and who subsequently received 3-monthly paliperidone palmitate. Accordingly, 418 patients were followed up for 24 weeks. Their clinical symptoms and social functioning were measured using the Clinical Global Impression-Severity of Illness and Personal and Social Performance scales. Results: The Personal and Social Performance total score was significantly higher after 3-monthly paliperidone palmitate treatment than at baseline (baseline vs. week 24: 54.3 ± 18.0 vs. 61.0 ± 14.5 [mean ± standard deviation]; p ＜ 0.001; Wilcoxon signed-rank test); the proportion of patients in the mildly ill group (scores 71−100) also increased significantly (baseline vs. week 24: 16.5% vs. 20.6%; p＜ 0.001; McNemar-Bowker test). The mean Clinical Global Impression-Severity of Illness score decreased significantly (baseline vs. week 24: 3.7 ± 1.0 vs. 3.4 ± 0.9; p＜ 0.001; Wilcoxon signed-rank test), as did the proportion of patients in the severely ill group (baseline vs. week 24: 4.1% vs. 2.1%; p ＜ 0.001; McNemar-Bowker test). Conclusion Continuous 3-monthly paliperidone palmitate treatment significantly enhances the personal and social performance of patients with schizophrenia and reduces the proportion of those with severe illness. These findings suggest that long-acting injectable antipsychotic administration at intervals longer than 1 month might improve the social functioning of and promote return to activities of daily living in patients with schizophrenia.

Background/Aims: Little is known about the clinical course of hepatitis B virus (HBV)-infected patients undergoing anti-tumor necrosis factor α (TNF-α) therapy for inflammatory bowel disease (IBD). We aimed to investigate the clinical course of HBV infection and IBD and to analyze liver dysfunction risks in patients undergoing anti-TNF-α therapy. Methods: This retrospective multinational study involved multiple centers in Korea, China, Tai-wan, and Japan. We enrolled IBD patients with chronic or resolved HBV infection, who received anti-TNF-α therapy. The patients’ medical records were reviewed, and data were collected using a web-based case report form. Results: Overall, 191 patients (77 ulcerative colitis and 114 Crohn’s disease) were included, 28.3% of whom received prophylactic antivirals. During a median follow-up duration of 32.4 months, 7.3% of patients experienced liver dysfunction due to HBV reactivation. Among patients with chronic HBV infection, the proportion experiencing liver dysfunction was significantly higher in the non-prophylaxis group (26% vs 8%, p=0.02). Liver dysfunction occurred in one patient with resolved HBV infection. Antiviral prophylaxis was independently associated with an 84% reduction in liver dysfunction risk in patients with chronic HBV infection (odds ratio, 0.16; 95% confidence interval, 0.04 to 0.66; p=0.01). The clinical course of IBD was not associated with liver dysfunction or the administration of antiviral prophylaxis. Conclusions Liver dysfunction due to HBV reactivation can occur in HBV-infected IBD patients treated with anti-TNF-α agents. Careful monitoring is needed in these patients, and antivirals should be administered, especially to those with chronic HBV infection.

Lemierre's syndrome is very rare and is characterized by previous oropharyngeal infections, such as pharyngitis or peritonsillar abscess, leading to high fever, internal jugular venous thrombosis, and metastatic infections to multiple internal organs. Prompt and accurate diagnosis followed by early treatment with antibiotics is very important because its mortality is high if treatment is delayed. We report on the case of a 23-year-old female who was transferred to our hospital with a left peritonsillar abscess combined with left jugular venous thrombosis, complaining of a sore throat and left submandibular swelling, and diagnosed as Lemierre's syndrome. Finally, she was treated successfully without anticoagulants.
Anti-Bacterial Agents ; Anticoagulants ; Diagnosis ; Female ; Fever ; Humans ; Lemierre Syndrome* ; Mortality ; Peritonsillar Abscess* ; Pharyngitis ; Venous Thrombosis ; Young Adult

Development of a therapy providing protection from, or reversing gentamicin-sulfate (GS)-induced oxidative stress and nephrotoxicity would be of great clinical significance. The present study was designed to investigate the protective effects of Houttuynia cordata Thunb. (HC) against gentamicin sulfate-induced renal damage in rats. Twenty-eight Sprague-Dawley rats were divided into 4 equal groups as follows: group 1, control; group 2, GS 100 mg/kg/d, intraperitoneal (i.p.) injection; group 3, GS 100 mg/kg/d, i.p. + HC 500 mg/kg/d, oral; and group 4, GS 100 mg/kg/d i.p. + HC 1000 mg/kg/d, oral administration). Treatments were administered once daily for 12 d. After 12 d, biochemical and histopathological analyses were conducted to evaluate oxidative stress and renal nephrotoxicity. Serum levels of creatinine, malondialdehyde (MDA), and blood urea nitrogen (BUN), together with renal levels of MDA, glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) were quantified to evaluate antioxidant activity. Animals treated with GS alone showed a significant increase in serum levels of creatinine, BUN, and MDA, with decreased renal levels of GSH, SOD, and CAT. Treatment of rats with HC showed significant improvement in renal function, presumably as a result of decreased biochemical indices and oxidative stress parameters associated with GS-induced nephrotoxicity. Histopathological examination of the rat kidneys confirmed these observations. Therefore, the novel natural antioxidant HC may protect against GS-induced nephrotoxicity and oxidative stress in rats.
Animals ; Blood Urea Nitrogen ; Catalase ; Cats ; Creatinine ; Drug Combinations ; Gentamicins ; Glutathione ; Glycerides ; Houttuynia ; Kidney ; Malondialdehyde ; Monoterpenes ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase

Superior mesenteric artery (SMA) syndrome is an uncommon cause of a proximal intestinal obstruction. The most characteristic symptoms are postprandial fullness, nausea, and vomiting. The diagnosis is established by ultrasonography and contrast-enhanced computed tomography. Almost all patients respond well to conservative management. However, if conservative management fails, surgical options should be applied. In this article, we report a case of SMA syndrome with Nutcracker syndrome in a patient with diabetes mellitus. Establishing the diagnosis of Nutcracker syndrome is usually based on clinical suspicion and radiological findings. Several complications that have been reported to result from SMA syndrome include peptic ulcer disease, pancreatitis, metabolic alkalosis, and uremic syndrome. However, Nutcracker syndrome accompanied by SMA syndrome is extremely uncommon, as described in this case. To our knowledge, this association has not been reported previously.
Alkalosis ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Humans ; Intestinal Obstruction ; Mesenteric Artery, Superior ; Nausea ; Pancreatitis ; Peptic Ulcer ; Superior Mesenteric Artery Syndrome ; Vomiting

No abstract available.

OBJECTIVE: We analyzed the diffusion and perfusion characteristics of acute MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episode) lesions in a large series to investigate the controversial changes of the apparent diffusion coefficient (ADC) that were reported in prior studies. MATERIALS AND METHODS: We analyzed 44 newly appearing lesions during 28 stroke-like episodes in 13 patients with MELAS. We performed a visual assessment of the MR images including the ADC and perfusion maps, comparison of the ADC between the normal and abnormal areas, comparison of % ADC between the 44 MELAS lesions and the 30 acute ischemic infarcts. In addition, the patterns of evolution on follow-up MR images were analyzed. RESULTS: Decreased, increased, and normal ADCs were noted in 16 (36%), 16 (36%), and 12 (27%) lesions, respectively. The mean % ADC was 102 +/- 40.9% in the MELAS and 64 +/- 17.8% in the acute vascular infarcts (p < 0.001), while perfusion imaging demonstrated hyper-perfusion in six acute MELAS lesions. On follow-up images, resolution, progression, and tissue loss were noted in 10, 4, and 17 lesions, respectively. CONCLUSION: The cytotoxic edema gradually evolves following an acute stroke-like episode in patients with MELAS, and this may overlap with hyper-perfusion and vasogenic edema. The edematous swelling may be reversible or it may evolve to encephalomalacia, suggesting irreversible damage.
Adolescent ; Adult ; Brain/*pathology ; Brain Edema/pathology ; Child ; *Diffusion Magnetic Resonance Imaging ; Female ; Humans ; MELAS Syndrome/*pathology ; *Magnetic Resonance Angiography ; Male ; Middle Aged ; Stroke/pathology ; Young Adult

OBJECTIVE: We determined whether the expression of GRIM-19 is correlated with pathologic types and malignant grades in gliomas, and determined the function of GRIM-19 in human gliomas. METHODS: Tumor tissues were isolated and frozen at -80degrees C just after surgery. The tissues consisted of normal brain tissue (4), astrocytomas (2), anaplastic astrocytomas (2), oligodendrogliomas (13), anaplastic oligodendrogliomas (11), and glioblastomas (16). To profile tumor-related genes, we applied RNA differential display using a Genefishing(TM) DEG kit, and validated the tumor-related genes by reverse transcription polymerase chain reaction (RT-PCR). A human glioblastoma cell line (U343MG-A) was used for the GRIM-19 functional studies. The morphologic and cytoskeletal changes were examined via light and confocal microscopy. The migratory and invasive abilities were investigated by the simple scratch technique and Matrigel assay. The antiproliferative activity was determined by thiazolyl blue Tetrazolium bromide (MTT) assay and FACS analysis. RESULTS: Based on RT-PCR analysis, the expression of GRIM-19 was higher in astrocytic tumors than oligodendroglial tumors. The expression of GRIM-19 was higher in high-grade tumors than low-grade tumors or normal brain tissue; glioblastomas showed the highest expression. After transfection of GRIM-19 into U343MG-A, the morphology of the sense-transfection cells became larger and more spindly. The antisense-transfection cells became smaller and rounder compared with wild type U343MG-A. The MTT assay showed that the sense-transfection cells were more sensitive to the combination of interferon-beta and retinoic acid than U343MG-A cells or antisense-transfection cells; the anti-proliferative activity was related to apoptosis. CONCLUSION: GRIM-19 may be one of the gene profiles which regulate cell death via apoptosis in human gliomas.
Apoptosis ; Astrocytoma ; Brain ; Cell Death ; Cell Line ; Collagen ; Drug Combinations ; Glioblastoma ; Glioma ; Humans ; Interferon-beta ; Laminin ; Light ; Microscopy, Confocal ; Oligodendroglioma ; Polymerase Chain Reaction ; Proteoglycans ; Reverse Transcription ; RNA ; Tetrazolium Salts ; Thiazoles ; Transfection ; Tretinoin

BACKGROUND/AIMS: The lifestyle changes that have accompanied economic growth have influenced disease patterns in Korea. Changing patterns of gastrointestinal (GI) diseases over the past two decades were investigated in the present study. METHODS: Data from inpatients with specific GI diseases, as defined by the International Classification of Diseases code, were extracted from the database at a tertiary medical facility for 1990, 1996, and 2006. RESULTS: Admission rates for GI diseases increased between 1990 and 2006. The most prevalent disease in 1990 was gastric cancer, followed by appendicitis and colorectal cancer. However, by 2006, gastric cancer, colon cancer, and colon adenoma or polyps had become the most prevalent diseases. Although gastric cancer showed a decreasing trend, the rate of colon cancer doubled over two decades. Furthermore, rates of detection and endoscopic treatment of early gastric cancer and adenoma of the stomach and colon have increased noticeably. Newly emerging diseases include inflammatory bowel disease and gastroesophageal reflux. There was no change in the incidence of peptic ulcer, but ulcer-related complications and the numbers treated surgically decreased. CONCLUSIONS: The findings of this study indicate that the clinical trends of GI diseases in Korea have changed in a similar way to those in the West. Early detection of a GI neoplasm will continue to increase with the establishment of cancer-screening programs, resulting in a rising need for minimally invasive treatments.
Adenoma ; Appendicitis ; Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Economic Development ; Gastroesophageal Reflux ; Gastrointestinal Diseases ; Humans ; Incidence ; Inflammatory Bowel Diseases ; Inpatients ; International Classification of Diseases ; Korea ; Life Style ; Peptic Ulcer ; Polyps ; Stomach ; Stomach Neoplasms

Gankyrin is an oncoprotein containing seven ankyrin repeats that is overexpressed in hepatocellular carcinoma (HCC). Gankyrin binds to Mdm2, which results in accelerated ubiquitylation via degradation of p53, and it also plays an important role in cell proliferation. However, little is known about the relationships between p53 levels, cell proliferation, and gankyrin over-expression. In order to investigate the influence of gankyrin protein on p53 and Mdm2 in a zebrafish model, we injected human gankyrin (hgankyrin) containing expression vectors (pCS2-hgankyrin, pCS2-hgankyrin-EGFP) into zebrafish embryos. To measure p53 and Mdm2 expression in hgankyrin-injected embryos, RT-PCR, Northern blot and in-situ hybridization and BrdU immunostaining were used. In addition, to know the effect of hgankyrin on cell proliferation in vitro, cell viability assays such as MTT, trypan blue staining and RT-PCR following transfection of hgankyrin-containing vector into HEK 293 cell line were performed. In vivo results indicated that p53 mRNA levels decreased but those of Mdm2 were not decreased in the presence of hgankyrin. These results suggest that gankyrin downregulates p53 expression and not Mdm2 expression. In the study of cell proliferation, BrdU-positive cells were predominantly increased in the head and tail regions in hgankyrin-injected zebrafish. Additional in vitro studies using trypan blue staining and MTT assay showed that gankyrin-expressing HEK 293 cells proliferated at a faster rate, indicating that gankyrin promotes cell proliferation. Our results demonstrate that hgankyrin overexpression downregulates p53 expression and promotes cell proliferation in zebrafish. Gankyrin may play an important role in tumorigenesis via its effects on p53 and cell proliferation.
Animals ; Cell Line ; Cell Proliferation ; Cell Survival ; Gene Expression ; Humans ; In Situ Hybridization ; Models, Animal ; Proteasome Endopeptidase Complex/*genetics/*metabolism ; Proto-Oncogene Proteins/*genetics/*metabolism ; Proto-Oncogene Proteins c-mdm2/genetics/metabolism ; Tumor Suppressor Protein p53/genetics/*metabolism ; Zebrafish