BACKGROUND: Leptin, the product of ob gene, is an important circulating hormone for the regulation of homeostasis of body weight and enegy expenditure. There was a previous reports that thyroid hormone is one of regulating factors of leptin gene expression in vitro. The aim of this study was designed to evaluate the role of thyroid hormone levels in the regulation of circulating leptin concentrations in human. METHODS: A total 16S subjects were studied; 76 patients with Graves disease, 49 patients with Hashimoto disease and 43 control sujjects. The correlation between thryoid hormone and leptin levels were analyzed and serum leptin levels were compared among the groups which was classified by thyroid functional status. Serum leptin concentratios were measured by radioimmunoassay. RESULTS: There were no significant differences in serum leptin levels between the groups of control, Graves disease and Hashimoto disease. The hypothyroid groups of Graves disease which was induced by excessive antithyroid drug treatment showed significant low levels(5.6 +/-2.8 ng/mL) compared to control(9.6 +/- 5.2 ng/ml) and thyrotoxic groups(10.0 +/- 5,0 ng/mL) CONCLUSION: The hypothyroid patients showed low levels of serum leptin concentrations it may indicate that thyroid horrnone play a role in the appropriate secretion of leptin in human.
Body Weight ; Gene Expression ; Graves Disease ; Hashimoto Disease ; Health Expenditures ; Homeostasis ; Humans ; Leptin* ; Radioimmunoassay ; Thyroid Gland*

The Changes of soluble Fas levels in Patients with Autoimmune Thyroid Diseases BACKGROUD: Apoptosis was observed in thyroid tissue from Hashimoto disease but not those from Graves disease. Recently Fas and Fas ligand interactions among thyrocytes were suggested to development of clinical hypothyroidism in Hashimoto disease.Soluble Fas produced as the form lacking the tranmembrane domain due to alternative splicing, is supposed to inhibit Fas-Fas ligand interaction and blocks Fas mediated apoptosis. METHODS: In tbis study, we measured serum soluble Fas to determine the possible involvement of this molecule in the autoimmune thyroid disease by enzyme linked immunosorbant assay in 29 patients with Graves disease, 30 patients with Hashimotos disease and 19 normal controls. RESULTS: Compared with normal subjeets (4.26 +/- 1.00 U/mL), soluble Fas was not increased in patients with Graves disease (4.23 +/- 1.14 U/mL, p>0.05) but it was increased in throtoxic Graves patients (4.70 +/- 1.26 U/mL, p<0.05) compared to euthyroid Graves (3.72 +/- 0.73 U/mL, p<0.05) and normal subjects (4.26 +/- 1.00 U/mL, p<0.05). The euthyroid and hypothyroid patients with Hashimoto disease showed low soluble Fas levels, 2.94 +/- 0.54 U/mL and 2.74 U/mL, respectively compare to the patients with Graves disease and normal subjects. The thyroid hormone levels to (T3 T4 and free T4) showed positive correlation with the serum titers of antithyroid autoantibodies, antithyroglobuin antibodies, antiperoxidase antibodies and thyrotropin binding inhibitor immunoglobulins. CONCLUSION: We found that the patients with thyrotoxic Graves disease had increased level of serum soluble Fas and the patients with Hashimoto disease showed low levels of soluble Fas compared to normal controls. Increased soluble Fas in Graves disease suggests increased expression of alternatively spliced Fas mRNA variant and decreased soluble Fas in Hashimoto disease suggests decreased Fas mRNA variant and increased full length membrane Fas, so these findings are related to the promotion of apoptosis of thyroid cells during autoimmune reaction in Hashimotos disease.
Alternative Splicing ; Antibodies ; Apoptosis ; Autoantibodies ; Fas Ligand Protein ; Graves Disease ; Hashimoto Disease ; Humans ; Hypothyroidism ; Immunoglobulins ; Membranes ; RNA, Messenger ; Thyroid Diseases* ; Thyroid Gland* ; Thyrotropin

Studies on hepatic tuberculosis are rare in Korea except several case repots. This is the first report on hepatic tuberculosis confirmed by the peritoneoscopic liver biopsy in Korea. A 43-year-old man was admitted due to high fever and cough for l0 days. On physical examination moist rale was audible on the both lower lung fields and hepatomegaly was noted. Chest X-ray revealed multiple fine granularity scattered uniformly throughout the both lung fields compatible with miliary pulmonary tuberculosis. On blood chemistry, SGOT, SGPT and alkaline phosphatase were elevated. Peritoneascopy revealed multiple yellowish-white small nodules evenly acattered on the entire surface of the both lobes of the liver and the needle biopsy of the liver showed chronic granulomatous inflammation with multinucleated giant cells and caseous necrosis consistent with hepatic tuberculosis. The patient was treated with antituberculous medications. Chest X-ray 6 months after treatment revealed completely healed miliary pulmonary tuberculosis and on blood chemistry 200 days after therapy SGOT, SGPT and alkaline phosphatase were within normal limits.
Adult ; Alanine Transaminase ; Alkaline Phosphatase ; Aspartate Aminotransferases ; Biopsy* ; Biopsy, Needle ; Chemistry ; Cough ; Fever ; Giant Cells ; Hepatomegaly ; Humans ; Inflammation ; Korea ; Liver* ; Lung ; Necrosis ; Physical Examination ; Respiratory Sounds ; Thorax ; Tuberculosis, Hepatic* ; Tuberculosis, Pulmonary

PURPOSE: To evaluate the differential clinical & electroencephalographic characteristics between benign childhood epilepsy with occipital paroxysm (BCEOP) and symptomatic occipital lobe epilepsy (SOLE). METHODS: Nine patients of BCEOP and seven patients of SOLE diagnosed at the department of pediatrics and epilepsy center in Inje University Sang-gye Paik Hospital from March 1992 to June 1998, were studied for the determination of differential characteristics between the two groups. Clinical features, EEG characteristics, MRI findings, associated conditions, and prognosis were investigated and compared between these groups. RESULT: 1) Male : female ratio was 1 : 2 in BCEOP and 1 : 2.5 in SOLE. 2) Seizure onset age was older in SOLE as compared with BCEOP. 3) There was no significant difference in seizure types between two groups. 4) Visual aura could be elicited in 5 patients (55.6%) in BCEOP, and 3 patients (42.9%) in SOLE. 5) Ictus emeticus was only noted in 4 patients (44.4%) of BCEOP. 6) Migraine was associated only in 3 patients of BCEOP. 7) Background EEG abnormality was more frequently associated in SOLE than BCEOP. 8) Seizure control was inefficient only in 3 patients (42.9%) of SOLE, and all patients with BCEOP were successfully treated with antiepileptic drugs. CONCLUSION: SOLE showed higher seizure onset age, less frequent association of ictus emeticus and migraine, more frequent background EEG abnormalities and more medical intractability to antiepileptic drugs than BCEOP.
Age of Onset ; Anticonvulsants ; Child* ; Electroencephalography ; Epilepsies, Partial* ; Epilepsy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Migraine Disorders ; Occipital Lobe* ; Pediatrics ; Prognosis ; Seizures

PURPOSE: To evaluate the clinical and electrophysiological characteristics of malformation of cortical development (MCD) with epilepsy. METHOD: We studied clinical and electroencephalographic (EEG) features of 54 childhood epilepsy patients with MCD diagnosed by magnetic resonance imaging (MRI) and pathologic examinations. RESULTS: 1) Bilateral diffuse MCD's were in 5 patients, bilateral focal MCD's were in 8, unilateral diffuse MCD's in 7, and unilateral focal MCD's were noted in 34 patients. 2) Partial seizures were manifested in 35 patients, and 4 of them evolve to infantile spasm (IS), isolated IS was noted in 15 cases, and generalized seizures were noticed in 2 cases 3) Asymmetric EEG backgraound slowing was noted in 30 patients, and 29 patients (96.7%) had MCD's in abnormal side of brain. 4) Polymorphic slowing was noted in 36 patients, and 28 cases (77.8%) had MCD's in those area. 5) Sensitivity of partial epileptiform discharges (ED's) for MCD was 79.6%, but specificity was 68.5%. 6) Localized paroxysmal fast activity was noted in 16 cases (29.6%), and specificity for MCD was 90.7%. 7) Spindle shaped fast activity was noted in 8 patients (14.8%), and its specificity was 100%. 8) Thirty-one cases (57.4%) were intractable to antiepileptic drugs (AED's). Seventeen cases of them were treated by ketogenic diet, and 12 patients (66.7%) were completely controlled. Among 12 cases of surgical resection, 11 patients (91.7%) became seizure free for 6 months to 2 years. 9) In pathologically confirmed cases, EEG sensitivity for MCD lesion was 100%, but sensitivity of MRI was 69.2%. CONCLUSION: EEG is most sensitive diagnostic tool for MCD in childhood epilepsy. and many of intractable epilepsy could be controlled by ketogenic diet and surgery.
Anticonvulsants ; Brain ; Electroencephalography ; Epilepsy* ; Humans ; Infant ; Infant, Newborn ; Ketogenic Diet ; Magnetic Resonance Imaging ; Seizures ; Sensitivity and Specificity ; Spasms, Infantile

PURPOSE: To evaluate myocardial conductivity to understand cardiac involvement in patients with mitochondrial disease. METHODS: We performed retrospective study on fifty-seven nonspecific mitochondrial encephalopathy patients with no clinical cardiac manifestations. The patients were diagnosed with mitochondrial respiratory chain complex defects through biochemical enzyme assays of muscle tissue. We performed standard 12-lead electrocardiography (ECG) on all patients. RESULTS: ECG abnormalities were observed in 30 patients (52.6%). Prolongation of the QTc interval (>440 ms) was seen in 19 patients (33.3%), widening of the corrected QRS interval in 15 (26.3%), and bundle branch block in four (7.0%). Atrioventricular block, premature atrial contraction and premature ventricular contraction were seen in two patients each (3.5%) and Wolff-Parkinson-White syndrome in one patient (1.8%). CONCLUSION: Given this finding, we recommend active screening with ECG in patients with mitochondrial disease even in patients without obvious cardiac manifestation.
Atrial Premature Complexes ; Atrioventricular Block ; Bundle-Branch Block ; Child ; Electrocardiography ; Electron Transport ; Enzyme Assays ; Heart ; Humans ; Mass Screening ; Mitochondria ; Mitochondrial Diseases ; Mitochondrial Encephalomyopathies ; Muscles ; Retrospective Studies ; Ventricular Premature Complexes ; Wolff-Parkinson-White Syndrome

No abstract available.
Hepatitis B Surface Antigens* ; Kidney Failure, Chronic* ; Korea* ; Liver Diseases* ; Liver*

BACKGROUND: In the previous studies, we identified that the interferon-gamma activated sequence (GAS) in the 5-flanking region of rat ICAM-1 gene is major element for interferon-y-inducible expression of the gene in rat thyroid cells, FRTL-5. We here, investigated the role of transcriptional coactivators, CBP (CREB binding protein) and CIITA (class II transactivator) in the modulation of the activity of GAS which could interacts with signal transducers and activators of transcription-1 and 3 (STAT1 and STAT3). METHODS: The expression of CBP RNA and protein were quantitated in FRTL-5 after stimulation with interferon-y (IFN-gamma), thyroid stimulating hormone (TSH), forskolin and methimazole. Direct association of CBP with STAT were analyzed by irnmunoprecipitation. The transcriptional roles of CBP and CIITA in the regulation of GAS were assessed by the cotransfection with their expression vectors with reporters; 5-deletion constructs of rat ICAM-1 promoter or 8xGAS-luc constructs, into FRTL-5 thyroid cells. RESULTS: The level of CBP RNA and protein were not changed by the treatment with TSH, IFN-y, forskolin and methimazole in FRTL-5, FRT and BRL liver cells. The CBP could be directly associated with STAT1. Furthernmore, the overexpression of CBP significantly increases the both promoter activities; rat ICAM-1 gene promoter which has GAS element and 8xGAS-luc cassette constructs. However the cotransfection of CI1TA decreased the constitutive and CBP-mediated transactivation of rat ICAM-1 promoter and SxGAS-luc cassette constructs. CONCLUSION: We identified that the two transcriptional coactivators; CBP and CIITA has differential roles in the regulation of transcriptional activity of GAS drived promoter. CBP increases the GAS activity through the direct binding with STATl, but CIITA inhibited the CBP-mediated transactivation of GAS activity.
Animals ; Colforsin ; Intercellular Adhesion Molecule-1 ; Interferon-gamma ; Liver ; Methimazole ; Rats ; RNA ; Thyroid Gland* ; Thyrotropin ; Transcriptional Activation ; Transducers

OBJECTIVE: The purpose of our study is to examine the clinical significance of vertebrobasilar artery(VBA) fenestration and duplication. In addition, we review its incidence and pathogenesis. METHODS: Cerebral angiography was performed in 803 patients and magnetic resonance angiography(MRA) in 880; the patients had or were suspected to have cerebrovascular disease. We retrospectively reviewed angiography and MRA. RESULTS: Fifteen patients (eight men, seven women, 3 to 77 years of age, median age = 58 years) had a VBA fenestration and duplication. Seven (7/803 = 0.87%) of the patients undergoing cerebral angiography revealed fenestrations and one duplication of VBA. Ten patients (10/880 = 1.14%) among 880 patients that underwent MRA demonstrated fenestration of basilar artery(BA). Two of 66 patients that underwent both conventional cerebral angiography and cranial MRA showed a fenestration of BA. Twelve fenestrations were located in the proximal portion of the BA and one was in the mid portion of the BA. One vertebral artery(VA) fenestration was located in the intracranial portion of the right VA, and one VA duplication was at the level of C1-2 in the left VA. CONCLUSION: In addition to medial defects, flow phenomena at the proximal end of fenestrations, where hemodynamic stress and increased turbulence are present, may contribute to aneurysm formation. And arterial fenestration is a predisposing factor in vascular injury and cerebral ischemia.
Aneurysm ; Angiography* ; Arteries* ; Brain Ischemia ; Causality ; Cerebral Angiography ; Female ; Hemodynamics ; Humans ; Incidence ; Magnetic Resonance Angiography* ; Male ; Retrospective Studies ; Vascular System Injuries

OBJECTIVES: The aging process can influence sexual functions by physiological, pathological, behavioral and psychosocial changes. Studies on sex among elderly are scarce. However, sexual activities remain throughout life in different forms. The aim of this study was to identify sexual problems and dysfunctions among dementia patients and compare with healthy aged persons. METHODS: The sexual problems and affecting factors were evaluated by structured interview and sexual problem screening instruments for 46 dementia patients according to DSM-IV and 60 healthy Koreans aged over 60. RESULTS: 1) Frequency of erection was less than once a day in 68.0% of controls, while more than once a day in 47.6% of dementia. Trouble in attaining erection was found in 50.0% of dementia as compared with 65.4% of controls. Awake with erection was less than once a week in 37.8% of controls, while less than once a week in 22.2% and more than once a week in 10.0% of dementia. Maintaining erection was better in controls (92.0%) as compared with dementia (55.0%)(p<0.01). Number of sex partner was one in 75.0% and none in 25.0% of controls, while one in 80.0%, none in 16.0% and more than one in 4.0% of dementia. Pain during with intercourse was less in dementia (22.7%) than controls (73.2%)(p<0.001). Frequency of ejaculation and masturbation, frequency of intercourse, thoughts and dreams of sex, feeling of desire was higher in dementia than controls (p<0.05). In 41.7% of dementia patients, sexual activity cf. sexual desire was less(desired>activity). Satisfaction in sex life (41.7%), partner's satisfaction (31.8%), satisfaction with partner (45.5%) and men's interest in sex decline with age (54.5%) were higher in dementia (p<0.001, respectively). 2) The recognition of sexual problems was higher in healthy elderly (74.1%). Most of sexual dysfunctions except sexual desire disorder (83.3% in controls vs 40.0% in dementia) was higher in demetia, that is, erectile disorder (30.0%), premature ejaculation (20.0%), and orgasmic disorder (10.0%). The duration over 5 years of sexual problems was the most in both (46.7% in controls vs 53.3% in dementia). 3) Problematic sexual behaviors seen among dementia patients were obscene remarks/sexual hallucination (30.8%, respectively), public exposure (15.4%), inappropriate contact/physical contact with others/sexual seduction toward other patients (1.7%, respectively) in that order. Appea-rance time of sexual problems was over 1 year of dementia (50.0%), within 1 year of dementia (32.4%), and with the initiation of dementia (17.6%). The frequency was more than once a week in 60.0% and less than once a week in 40.0% of dementia. Place of sexual misbehavior was one's own room (68.6%), other place (22.9%), toilet (5.7%), activity therapy room (2.9%) in that order. Targets of sexual misbehavior were other patients (40.0%), caregivers (31.4%), medical personnel/others (14.3%, respectively) in that order. For the management of sexual misbehavior, most of the doctors chose non-pharmacological methods (83.9%). CONCLUSION: The sexual activity among Korean elderly with age over 60 was more active in healty controls than dementic patients, while sexual dysfunction except sexual desire disorder was more in dementic patients than healthy controls. Therefore, special interest and proper management was needed toward hypersexuality as well as sexual hypoactivity, and most of all, conceptual changes of doctors and caregivers toward sexual problems in the elderly must be preceded.
Aged* ; Aging ; Caregivers ; Dementia ; Diagnostic and Statistical Manual of Mental Disorders ; Dreams ; Ejaculation ; Hallucinations ; Humans ; Korea* ; Male ; Mass Screening ; Masturbation ; Premature Ejaculation ; Sexual Behavior ; Sexual Dysfunctions, Psychological