No abstract available.

OBJECTIVE: Gout is one of the most common forms of inflammatory arthritides among men, which is caused primarily by chronic hyperuricemia. Although pharmacological therapy is the mainstay treatment to manage gout, limiting the consumption of dietary purine is also important. Several epidemiological studies have reported that alcohol consumption is closely related to hyperuricemia and gout. The objective of this study was to determine the purine content in common Korean alcoholic beverages using high performance liquid chromatography (HPLC) to provide a dietary guideline for those with hyperuricemia or gout. METHODS: Thirty-five alcoholic beverages were analyzed. Blindly labeled samples of each alcoholic beverage were degassed and frozen. The sample preparation prior to HPLC followed the methods of Japanese researchers. HPLC was performed to analyze adenine, guanine, hypoxanthine, and xanthine content in the alcoholic beverages. RESULTS: The standard curves were linear for all purines. Purine contents were as follows: beer (42.26~146.39 micromol/L, n=12), medicinal wine (8.2 and 40.41 micromol/L, n=2), rice wine (13.19 micromol/L), Makgeolri (11.71 and 24.72 micromol/L, n=2), red wine (0, 6.03, and 17.9 micromol/L, n=3). No purines were found in fruit wine (n=2), Kaoliang (n=1), white wine (n=1), or distilled alcoholic beverages, such as soju (n=10) or whiskey (n=1). CONCLUSION: Among popular Korean alcoholic beverages, beer contained a considerable amount of purines, whereas distilled alcoholic beverages did not. Patients with either gout or hyperuricemia should avoid alcoholic beverages, especially those containing large amounts of purines.
Adenine ; Alcohol Drinking ; Alcoholic Beverages ; Alcoholics ; Arthritis ; Asian Continental Ancestry Group ; Beer ; Chromatography, High Pressure Liquid ; Chromatography, Liquid ; Fruit ; Gout ; Guanine ; Humans ; Hyperuricemia ; Hypoxanthine ; Male ; Purines ; Wine ; Xanthine

Arterial blood gas analysis has become an integral part of the clinical evaluation of the patient with known or suspected pulmonary disease. However, when the results of the measurements show arterial hypoxemia which is out of proportion to the clinical and X-ray evidence of lung disease, we may consider potential errors in measurement involving the blood gas analyzer or methods of blood sample storage. We experienced spurious hypoxemia in a patient with extreme leukocytosis (220.0 X 10(3)/mm3) secondary to leukemia. The degree of PaO2 decay was blunted by placing the blood on ice.
Anoxia ; Blood Gas Analysis ; Humans ; Ice ; Leukemia ; Leukocytosis* ; Lung Diseases ; Oxygen*

OBJECTIVES: We review the sleep problems of the alcohol dependence patients. Especially we are interested in the prevalence, the severity of symptoms, anxiety, depression, and sleep quality of restless legs syndrome (RLS) in the alcohol dependence patients. METHODS: We recruit 86 alcohol dependence patients who were admitted from October 6th, 2008 to October 17th, 2008. We interviewed each patient and evaluated sleep questionnaires such as the Sleep Disorder Questionnaire (SDQ), the Pittsburgh Sleep Quality Index (PSQI) and the International Restless Legs Syndrome Study Group (IRLSSG) rating scale. The presence of RLS and its severity were assessed using the IRLSSG diagnostic criteria and the IRLSSG severity scale, respectively. Depression and anxiety were evaluated by the Beck Depression Inventory (BDI) and the Beck anxiety inventory (BAI). RESULTS: Of all 86 patients, 59 patients have insomnia, 33 patients have RLS, 30 patients have Periodic limb movement disorder (PLMD), 29 patients have nightmare. RLS patients have more high score in the BAI (21.70+/-10.36 vs 14.67+/-11.98), and their sleep quality was poor in the PSQI (11.09+/-4.08 vs 7.92+/-3.91) than non-RLS patients. CONCLUSION: This study shows that alcohol dependence patients show many sleep problems such as insomnia and RLS. So we should notice that the sleep problems of alcohol dependence patients are important in clinical approach and treatment.
Alcoholism ; Anxiety ; Depression ; Dreams ; Humans ; Nocturnal Myoclonus Syndrome ; Prevalence ; Surveys and Questionnaires ; Restless Legs Syndrome ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders

PURPOSE: To report a case of chronic central serous chorioretinopathy treated with an intravitreal injection of 2.5 mg of bevacizumab. CASE SUMMARY: A 38-year-old male complained of visual disturbance in the right eye. He had a history of central serous chorioretinopathy which improved without treatment. Since the patient did not feel any ocular discomfort, he did not visit our clinic for approximately 11 months. At the time of presentation, fundus examination revealed exudative retinal detachment involving the macular area. Additionally, fluorescein angiography revealed multiple early phase hyperfluorescent lesions. Neurosensory detachment around the macula and increased central macular thickness were also observed using optical coherence tomography. Under the diagnosis of chronic central serous chorioretinoapthy, the patient was treated with 2.5 mg of intravitreal bevacizumab. Visual acuity improved two months after treatment, with improvement in both neurosensory retinal detachment and fluorescein leakage. No changes were observed at the six-month follow-up.
Adult ; Antibodies, Monoclonal, Humanized ; Central Serous Chorioretinopathy ; Eye ; Fluorescein ; Fluorescein Angiography ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Retinal Detachment ; Retinaldehyde ; Tomography, Optical Coherence ; Visual Acuity ; Bevacizumab

Cervical pregnancy is a rare form of ectopic gestation and it can cause serious bleeding, shock and death. Although hysterectomies are still performed due to massive hemorrhages, there are some conservative approaches to cervical pregnancies to conserve fertility. Methotrexate is a very useful agent in the management of trophoblastic disease, and has been utilized recently for the successful management of tubal, interstitial, and cervical ectopic gestations. We report a case of viable cervical pregnancy treated successfully with intraamniotic injection of methotrexate guided by transabdominal ultrasonography.
Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate* ; Pregnancy* ; Shock ; Trophoblasts ; Ultrasonography*

OBJECTIVE: The authors examined the efficacy of citalopram, and its effect on the quality of life in patients with panic disorder. METHOD: Seventy three patients who had panic disorder were recruited for this study. They did not have major depression and other axis I diseases. They were scheduled to be examined 4 times (at baseline, 4, 12 and 24 weeks) and took citalopram for 24 weeks with a flexible dosing schedule. The primary efficacy variables were the response and remission rates (response: HAMA total score decreased by at least 50% from baseline; remission: HAMA total score < or = 7). Other variables included the Hamilton Rating Scale for Depression, Panic Disorder Severity Scale (PDSS), Acute Panic Inventory, Clinical Global Impression Scale and Sheehan Disabilities Scale (SDS). RESULTS: The number of patients who completed 24 weeks of treatment was 33 (45.2%). Forty patients who were dropped out consisted of 4 patients with symptom improvement and 36 patients with failure to return. Response/remission rates were 56.2/31.5% in the last-observation-carried-forward methods and 87.9/69.7% in the observed case data. Treatment with citalopram improved anxiety and depressive symptoms during 24 weeks on all efficacy measures. By a completed patient analysis, citalopram also significantly improved the disability scores on SDS. In this study, any serious adverse effects were not observed. CONCLUSION: Treatment with citalopram was effective and well-tolerated for the patients with panic disorder, and also improved quality of life in the patients.
Anxiety ; Appointments and Schedules ; Axis, Cervical Vertebra ; Citalopram* ; Depression ; Humans ; Panic Disorder* ; Panic* ; Prospective Studies* ; Quality of Life ; Treatment Outcome

PURPOSE: The objectives of this study are to identify the brain centers whose activity changes are related to sexually arousing visual stimuli and to identify the difference between young and middle-aged males by mapping the brain activity with using blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI). MATERIALS AND METHODS: Ten young heterosexual, right handed males with normal sexual function (mean age: 27 years, age range: 24 to 31) and ten middle-aged heterosexual, right handed males with normal sexual function (mean age: 52 years, age range: 46 to 55) were enrolled into this study. Real-time visual stimulation was performed with the subjects alternatively viewing erotic and non-erotic films to identify the activated brain regions associated with sexual response. Assessments with using a five-point scale were determined after visual stimulation to evaluate the subjective sexual arousal. Brain activity was mapped by performing BOLD-fMRI on a 1.5T MR scanner. After functional scanning, the high-resolution data was analyzed with the SPM analyzing program; the significance of activation was set at p<0.01 or p<0.001. RESULTS: The parietal lobe, frontal lobe, cingulate gyrus, caudate nucleus, thalamus and hypothalamus were noted as the areas of activation specifically associated with viewing the erotic film segments by the young males. For the middle-aged males, these areas were the parietal lobe, frontal lobe, right temporal lobe, cingulate gyrus and caudate nucleus. The thalamus and hypothalamus were activated in only the young males. CONCLUSIONS: We suggest that the non-activation of the hypothalamus and thalamus in middle-aged males may be associated with the lesser physiological arousal in response to the erotic visual stimuli. The non-invasive visualization of the central nervous system by functional MRI in healthy males has shown the possibility for evaluating the neuroanatomy of the brain that is associated with sexual arousal and its clinical application by comparing young and middle-aged males.
Arousal ; Brain* ; Caudate Nucleus ; Central Nervous System ; Frontal Lobe ; Gyrus Cinguli ; Hand ; Heterosexuality ; Humans ; Hypothalamus ; Magnetic Resonance Imaging ; Male* ; Neuroanatomy ; Oxygen ; Parietal Lobe ; Photic Stimulation ; Temporal Lobe ; Thalamus

PURPOSE: This study was conducted to identify the structures that can mimic aneurysm on CT angiography with using the 3-D volume rendering technique and a 16-row detector CT. MATERIALS AND METHODS: This study examined 206 patients who underwent CT angiography with a 16-row detector CT from May 2003 to July 2004. For the CT angiography, the contrast media was injected at a rate of 4 cc per second. The scanning was then done when 5 seconds delay time had elapsed after the CT number of the common carotid artery had reached 150. The baseline images were obtained by reconstructing the row data with a kernel value of H31f, a slice thickness of 1 mm and an increment of 0.5 mm. Finally, the 3-D images were constructed by using a volume rendering technique. The structures that were confused with aneurysm on CT angiography were further evaluated by MPR or MIP to ascertain whether they were aneurysms. For comparison, digital subtraction angiography was done in 86 patients and surgery was done in 5 patients. RESULTS: On CT angiography, 51 patients did not show any abnormalities, and 80 patients showed definitive aneurysms, as was ascertained by their sizes, shapes and locations, or by the aneurysm clips only. The remaining 75 patients showed 90 aneurysm mimicking structures that were 35 infundibular dilatations or preaneurysmal blebs, 24 focal dilatations of the branches of the deep middle cerebral veins, 6 focal dilatations of the sphenoparietal sinuses adjacent to the middle cerebral artery, 18 focal dilatations of the inferior sagittal sinuses adjacent to the pericallosal artery and 7 low density calcifications of the vessel walls that were adjacent to the aneurysm-prevalent arteries. CONCLUSION: CT angiography based on volume rendering technique was able to identify the structures that were confused with aneurysm. Accordingly, careful observation is required for interpreting the reconstructing 3-D images since a wide variety of structures can be confused with aneurysm on CT angiography.
Aneurysm* ; Angiography* ; Angiography, Digital Subtraction ; Arteries ; Blister ; Carotid Artery, Common ; Cerebral Veins ; Contrast Media ; Dilatation ; Humans ; Imaging, Three-Dimensional ; Middle Cerebral Artery

Neovascularization of the adventitial vasa vasorum with extension into the intima of atherosclerotic lesions is frequently observed, but its pathophysiological significance is still subject to debate. Recently, leptin, the product of the Ob gene, was identified. Leptin, via activation of the endothelial receptor (Ob-R), generates a growth signal involving a tyrosine kinase-dependent intracellular pathway and promotes angiogenic processes. We hypothesized that a high concentration of leptin within vasa vasorum and plaque itself, may influence inflammatory and vascular neovascularization coupling with functional upregulation of the vascular endothelial growth factor (VEGF). Microscopic computerized tomography was utilized for the spatial distribution of vasa vasorum and intimal neovascularization from atherosclerotic human coronary arteries. Atherosclerotic coronary arteries showed a dense plexus of microvessels in the adventitia and plaque itself. Microscopic analysis from human atherosclerotic aortas revealed an increase in the intimal thickness with neovascularization. The immunoreactivity for Ob-R, VEGF and matrix metalloproteinase (MMP) increased in atherosclerotic plaque, predominantly in the endothelial lining of the intimal neovessel and macrophages/foam cells. Our observation of a prominent colocalization between Ob-R, VEGF and MMP supports this hypothesis and these factors participate in the neovascularization of atherosclerotic lesions. The present study is the first report on vascular tissue and it opens a promising perspective concerning future investigations of leptin-dependent modulation of atherogenesis and vascular neovascularization under pathophysiolgical conditions.
Adult ; Arteriosclerosis/physiopathology ; Arteriosclerosis/pathology ; Arteriosclerosis/metabolism* ; Blood Vessels/pathology ; Blood Vessels/metabolism ; Carrier Proteins/physiology ; Carrier Proteins/metabolism* ; Human ; Middle Age ; Neovascularization, Pathologic/physiopathology