Cryptococcus is native to the environment and thrives in any type of environment inhabited by birds. Cryptococcal genito-urinary infection has been reported in immunnocompromised patients and can involve the adrenal gland, kidney, prostate, or penis. To our knowledge, there have been no reports of cases where cryptococcal epididymo-orchitis infects an uncompromised healthy host. Here, we report a case of primary cryptococcal epididymo-orchitis in a healthy male.
Adrenal Glands ; Birds ; Cryptococcus ; Humans ; Kidney ; Male ; Orchitis ; Penis ; Prostate

Objectives: The objective of the present study was to examine whether patients with severe depression and/or anxiety show a difference in the level of body awareness compared with that of healthy controls. Methods: Outpatients (n=100) with a diagnosis of moderate to severe depression and/or anxiety and 42 healthy controls were included in the study. Body awareness was assessed with the Multidimensional Assessment of Interoceptive Awareness (MAIA) scale, and other clinical characteristics like anxiety and depression were measured using the State-Trait Anxiety Inventory and Patient Health Questionnaire, respectively. The data were analyzed using ANCOVA, and statistically significant differences between the two groups in both the overall MAIA score and subscale scores were documented. Results: The overall MAIA scores of patients with depression and/or anxiety were significantly lower than that of healthy subjects. Specifically, the differences found in the subscales of trust, acceptance, attention-regulation, and return-to-body were significant, whereas the differences found in the subscales of notice and mind-to-body awareness were not. Conclusion These findings imply that the ability to monitor one’s own bodily sensations and to be aware of their connection with emotional states cannot serve as a marker for psychological well-being. Rather, it may be the aspects of attentional styles and attitudes toward bodily states that play a critical role in mental health. Further analyses examining the relationships between the subscales of body awareness and other psychological variables are deemed necessary.

BACKGROUND: A pathogenesis of skin-homing lymphoid cells in primary cutaneous T-eell lymphoma(CTCL) has not been elucidated, CLA(cutaneous lymphocyte-associated antigen) defined by HECA-452 monoclonal anfibody has been proposed as the novel skin-homing receptors of infiltrative lymphocytes in atopic dermatitis and graft-versus-host disease. Accordingly, CLA may be a determinant explaining about the skin-homing properties of lymphoid tumor cells in CTCL. OBJECTIVE: This study was conducted to investigate the immunohistochemical expression of CLA in the lesional tissue specimens of cutaneous lymphomas. METHODS: Immunohistochemicslly, we examined the expression of CLA, E-selectin, ICAM-1 and LFA-1 antigens in the tissue specimens taken from the skin lesions and lymph nodes of the 22 patients with cutaneous lymphomas and the 20 control subjects with non-cutaneous lymphomas. Results : 1. The expression rate of CLA was 40.9% in the skin specimens of cutaneous lymphomas. We could not fad any expression of CLA in non-cutaneous lymphomas. 2. CTCL showed a more frequent expression of CLA(80%) than cutaneous B-cell lymphomas (CBCL)(8.3%). We found more frequently CLA+ high endothelial venules in non-cutaneous lymphomas(40%) than in cutaneous lymphomas(9.1%). 3. CLA and E-selectin were more frequently expressed in primary CTCL(100%, 83.3%) than in secondary CTCL(50%, 0%). 4. The positivity to ICAM-1 and LFA-1 antigens was higher in primary cutaneous lymphomas (72.7%, 81.8%) than in secondary forms(9.1%, 9.1%). Conclusion : CLA and E-selectin may represent the pivotal skin-homing receptor of infiltrative tumor cells and vascular counter-receptor in primary CTCL, respectively. Also, ICAM-1 and LFA-1 may have a role in the primary cutaneous infiltration of lymphoma cells as the additional cofactors.
Dermatitis, Atopic ; E-Selectin ; Flavin-Adenine Dinucleotide ; Graft vs Host Disease ; Humans ; Intercellular Adhesion Molecule-1 ; Lymph Nodes ; Lymphocyte Function-Associated Antigen-1 ; Lymphocytes ; Lymphoma* ; Lymphoma, B-Cell ; Skin ; Venules

Kallmann's syndrome is characterized by hypogonadotrophic hypogonadism resulting from insufficient release of GnRH and associated with anosmia or hyposmia, which has been related to agenesis of olfactory bulbs. We experienced a case of 17 year-old Kallmann's syndrome woman and a case of successful pregnancy of 29 year-old Kallmann's syndrome woman with hMG and hCG treatment and present two cases with a review of literatures.
Adolescent ; Adult ; Female ; Gonadotropin-Releasing Hormone ; Humans ; Hypogonadism ; Kallmann Syndrome* ; Olfaction Disorders ; Olfactory Bulb ; Pregnancy*

OBJECTIVE: Recently, the incidence of elderly primipara is increasing. Thus, impact of old age on pregnancy outcomes became important. Our purpose was to assess the effect of maternal age on pregnancy outcomes. METHODS: 73 cases of the elderly primipara over 35 years at the department of obstetrics and gynecology, Chon-ju presbyterian medical center, from Jan. 1, 1995 to Dec. 31, 1998, were compared with 73 cases randomly chosen young primiparas during same period. RESULTS: Elderly primipara had higher rate of infertility and spontaneous abortion history, antenatal complications, cesarean section, poorer neonatal outcome than young primipara. CONCLUSION: The pregnancy outcome of elderly primipara is considered to be less favorable than those of young primipara. Careful antenatal and intrapartal care should be performed for the elderly primipara. We think that many clinical study of congenital anomaly in elderly primipara will be necessary.
Abortion, Spontaneous ; Aged* ; Cesarean Section ; Female ; Gynecology ; Humans ; Incidence ; Infertility ; Jeollabuk-do ; Maternal Age ; Obstetrics ; Pregnancy Outcome ; Pregnancy* ; Protestantism ; Statistics as Topic*

Naive CD4 T cells activated by antigen-presenting cells (APCs) undergo terminal differentiation in the periphery. Multiple mechanisms determine their fates, that is, whether they differentiate into conventional T (Tconv) cells or regulatory T (Treg) cells. The key event during Treg generation is expression of the transcription factor Foxp3, which is the lineage-determining regulator for Treg differentiation and function. Here we show that the transcription factor Batf3 acts as a fate-decision factor with respect to Tconv versus Tregs by restraining Treg differentiation. Batf3 was preferentially expressed in effector CD4 T cells but not in Treg cells, and ectopic expression of Batf3 inhibited Foxp3 induction. Batf3-deficient CD4 T cells favorably differentiated into Treg cells in vitro and in colonic lamina propria. Batf3 KO mice also showed enhanced Treg function in gut-associated immune disease models (for example, ovalbumin tolerance and inflammatory bowel disease models). Batf3 bound to the CNS1 region of the Foxp3 locus and reduced expression of the gene. Thus, Batf3 is a transcriptional suppressor of Treg differentiation.
Animals ; Antigen-Presenting Cells ; Colon ; Ectopic Gene Expression ; Immune System Diseases ; In Vitro Techniques ; Inflammatory Bowel Diseases ; Mice ; Mucous Membrane ; Ovalbumin ; T-Lymphocytes ; T-Lymphocytes, Regulatory* ; Transcription Factors*

Patients with central serous chorioretinopathy complain of decreased vision, micropsia, metamorphopsia, and central scotoma due to sensory retinal detachment. Morphologic characteristics of the sensory retinal detachment were described using Heidelberg retina tomograph. We inspected the changes in morphology according to certain time interval in 28 eyes and correlated them with the changes in visual acuity and symptoms. The mean width,length, height, area and volume of the detached sensory retina at initial examina- tion were 2.86 +/-1.08 mm, 2.60 +/-0.97mm, 0.30 +/-0.10mm, 6.82 +/-4.70mm2 and 0.77 +/-0.68mm3, respectively. Of the 7 eyes that had been followed, improvement of vision preceded improvement of other symptoms but, this was not statistically significant. The extent of sensory retinal detachment reduced with time and the maximal reduction occurred during the first month from the initial visit. The volume reduction (87.4%) was greater than the area reduction (52.3%) at the time of visual improvement
Central Serous Chorioretinopathy ; Humans ; Retina ; Retinal Detachment* ; Retinaldehyde* ; Scotoma ; Vision Disorders ; Visual Acuity

BACKGROUND: Intrathecal gabapentin is effective on nociceptive states evoked by tissue injury. In addition, gabapentin interacts synergistically with clonidine at the spinal level, suggesting that a mechanism of gabapentin may be related to spinal adrenoceptors. However, it has not been established whether this drug is associated with cholinergic receptors. The aim of this study was to examine the role of spinal adrenergic and cholinergic receptors on the antinociceptive action of intrathecal gabapentin. METHODS: Rats were implanted with lumbar intrathecal catheters. For a nociceptive test, 50nl of 5% formalin solution was injected into the hindpaw. The effect of intrathecal gabapentin, administered 10 min before the formalin injection, was assessed. Next, antagonistic effects of intrathecal prazosin, yohimbine, atropine and mecamylamine for the action of intrathecal gabapentin were evaluated. RESULTS: Formalin injection caused a biphasic incidence of flinching of the injected paw. Intrathecal gabapentin produced a dose-dependent suppression of only the phase 2 flinching response in the formalin test. Intrathecal atropine, but not prazosin, yohimbine nor mecamylamine, reversed the antinociception of intrathecal gabapentin. CONCLUSIONS: The antinociceptive effect of intrathecal gabapentin on facilitated states may be mediated through the muscarinic receptor but by neither the nicotinic receptor nor the adrenergic receptor at the spinal level.
Animals ; Atropine ; Catheters ; Cholinergic Antagonists* ; Clonidine ; Formaldehyde ; Incidence ; Mecamylamine ; Nociception ; Pain Measurement ; Prazosin ; Rats ; Receptors, Adrenergic ; Receptors, Cholinergic ; Receptors, Muscarinic ; Receptors, Nicotinic ; Spinal Cord ; Yohimbine

The purpose of this study is to present the importance of work-related cerebrovascular and heart disease from the viewpoint of expenses. Using the insurance benefit paid for the 4,300 cases, this study estimated the burden of insurance benefits spent on work-related cerebrovascular and heart disease. The number of cases with work-related cerebrovascular and heart disease per 100,000 insured workers were 3.36 in 1995; they were increased to 13.16 in 2000. By the days of occurrence, the estimated number of cases were 1,336 in 2001 (95% CI: 1,211-1,460 cases) and 1,769 in 2005 (CI: 1,610-1,931 cases). The estimated average insurance benefits paid per person with work-related cerebrovascular and heart disease was 75-19 million won for medical care benefit and 56 million won for other benefits except medical care. By considering the increase in insurance payment and average pay, the predicted insurance benefits for work-related cerebrovascular and heart disease was 107.9 billion won for the 2001 cohort and 192.4 billion won for the 2005 cohort. From an economic perspective, the results will be used as important evidence for the prevention and management of work-related cerebrovascular and heart disease.
*Accidents ; *Accidents, Occupational ; Brain Diseases/epidemiology ; Cohort Studies ; Compensation and Redress ; Costs and Cost Analysis ; Heart Diseases/epidemiology ; Human ; *Insurance Benefits ; Insurance Coverage ; Korea ; Linear Models ; Models, Statistical ; *Occupational Health ; Sensitivity and Specificity ; Time Factors ; *Workers' Compensation

This study shows a case of neoadjuvant chemotherapy application for the management of a 34-year-old male patient diagnosed with invasive intraductal papillary mucinous neoplasm (IPMN), for which curative margin-negative resection initially seemed challenging. Five cycles of the FOLFIRINOX regimen (5-fluorouracil, leucovorin, irinotecan, and oxaliplatin) were administered preoperatively, resulting in a significant reduction of the intraductal mass size and deformity of the main vessels. The patient subsequently underwent a successful robotic pylorus-preserving pancreatoduodenectomy. Postoperatively, the patient received adjuvant chemotherapy with FOLFIRINOX, and after 5 months, showed no signs of tumor recurrence or specific complications. These findings suggest that neoadjuvant therapy can be a potentially effective strategy even in advanced invasive IPMN. Further research is necessary to establish guidelines for its application.