OBJECTIVES: The analysis of heart rate variability (HRV) is a useful non-invasive tool to investigate the autonomic nerve function. Previous studies on the relationship between HRV and depression have been reported controversial results. Similarly, the correlation between the serum lipids and depression is debatable. The purpose of this study is to examine the relationship between heart rate variability, lipid profile and depression. METHODS: A total of 42 patients with major depressive disorder (MDD) and 32 age and sex-matched normal subjects who had no previous history of major medical and mental illnesses were recruited for this study. A structured-interview was used to assess the general characteristics and psychiatric illness. HRV measures were assessed by time-domain and frequency-domain analyses. Psychological symptoms were measured using the Hamilton rating scale for anxiety (HAM-A), Hamilton rating scale for depression (HAM-D). In addition, the evaluation for lipid profile was performed by blood test. RESULTS: In serum lipid profile test, MDD group showed higher cholesterol (197.68+/-42.94 mg/dL vs. 176.85+/-34.68 mg/dL, p=0.044), TG (139.45+/-92.54 mg/dL vs. 91.4+/-65.68 mg/dL, p=0.018), LDL (130.03+/-33.18 vs. 106.62+/-27.08, p=0.004) level than normal control group. In HRV time domain analyses, the standard deviation of the NN interval (SDNN) was decreased in MDD group than normal control group, but was not significant (32.82+/-14.33 ms vs. 40.36+/-21.40ms, p=0.078). ApEn (Approximate Entrophy) was significantly increased in MDD group than normal control group (1.13+/-0.11 vs. 0.91+/-0.18, p<0.001). ApEn was correlated with LDL level (r=0.277, p=0.028), HAM-D scores (r=0.534, p<0.001) and HAM-A scores (r=0.470, p<0.001). CONCLUSION: MDD patients showed increased ApEn, one of the HRV measurement. And this ApEn was correlated with LDL, HAM-D and HAM-A scores. In this study, the analysis of ApEn would be a useful test of MDD.
Anxiety ; Autonomic Pathways ; Cholesterol ; Depression ; Depressive Disorder, Major ; Heart ; Heart Rate ; Humans

The epidermal cell-derived thymocyte activating factor (ETAF) produced by keratinocytes and endowed with IL-1 like activities, can potentiate or stimulate a variety of immune reactionsl. In addition to stimulating thymocyte proliferation, it enhanced IL-2 production by mitogen-stimulated lymphocytes. In this study, IL-2 activity stimulated by ETAF was investigated by using peripheral lymphocytes (PBL)and LBRM33 1A5 cell lines. The expression of HLA-DR antigen and the effect of r-IFN-gamma on IL-1 production by keratinocytes were also evaluated : 1. The HLA-DR positive cultured keratinocytes were obser ved in interferon (IFN), interferon-phorbol myristic acid (IFN-PMA) and interferon-lipopolysaccharide (IFN-LPS) groups. There was no HLA-DR expression in the control. PMA. and LPS group. 2. Il-1alpha from supernatants of cultured keratinocytes were produced by all groups including control group. The amounts of IL-1alpha produced by IFN, IFN-PMA and IFN-LPS groups were higher than the other groups. 3. There were no statistical differences between total IL-1alpha from cultured keratinocytes and control or other experimental groups. 4. In experiment for positivie control, the anrounts of IL-2 production by PBL and LBRM33 1A5 cell line were increased proportional to the concentration of added rIL-1. But there was no difference between groups above 1.0 U/ml and 0.5 fmol in LBRM33 1A5 cell line. 5. the production of IL-2 by PBL were increased by phytohemagglutinin (PHA), PHAPMA and PHA-LPS groups. There were no production of IL-2 in control, IFN, LPS, only LPS added group, and IL-1alpha. The IL-2 induced by PHA-PMA group was much higher than the other groups. The production of IL-2 was stimulated by IL-1 of supernatarnts and cell lysates from the cultured keratinocytes, but here was no correlation between IL-2 production and added IL-1. 6. The production of IL-2 by LBRM33 IA5 were increased by PHA, PHA-PMA and PHA-LPS groups. There were no production of IL-2 in the other groups. In summary, the results suggest that supernatants and cell lysates from cultured keratinocytes can stimulate the IL-2 production by human PBL and LBRM33 1A5 cell line. Therefore the ETAF can potentiate or stimulate the immune reactions and enhance IL-2 production by mitogen-stimulated lymphocytes.
Cell Line ; HLA-DR Antigens ; Humans ; Interferons ; Interleukin-1* ; Interleukin-2* ; Keratinocytes* ; Lymphocytes* ; Myristic Acid ; Thymocytes

Crohns disease is a granulomatous isease of the gastrointetin 1 tract, especially terminal ileum, but may involve the lip, mouth, anus, skin, liver and bone. The skin is a common site of extraintestinal involvement in Crohns disease, with the perianil, perineal, and peristomal areas most frequently affected. Vulvar involvement, however, is an uncommon extraintestinal manifestantion of Crohns disease. We report a case of a 16-year-old girl with Crohns disease of the vulva and perianal region. A histopathologic study of the descending colon and vulvar skin showed noncaseating granulomatous reactions composed of lymphocytes, epithelioidell and giant cells. We were able to make the diagnosis of Crohns disease of the vulvar and the patient was treated with prednisolone and metronidazole.
Adolescent ; Anal Canal ; Colon, Descending ; Crohn Disease* ; Diagnosis ; Female ; Giant Cells ; Humans ; Ileum ; Lip ; Liver ; Lymphocytes ; Metronidazole ; Mouth ; Prednisolone ; Skin ; Vulva*

We present a case of malignant melanoma associated wi h itiligo in the 49 year-old female patient. Skin lesions showed that centrally located dark black nodile surrounded with brownish colored plaque on the upper half and depigmented patch on the lower half on the left upper thigh and depigmented patch on the right forehead. In western countries, patients with melanoma have been obscrved to develop vitiligo or depigmented spots on the skin, while in korea, rarely observed. We reports that malignant melanoma associated with vitiligo.
Female ; Forehead ; Humans ; Korea ; Melanoma* ; Middle Aged ; Skin ; Thigh ; Vitiligo*

Candida granuloma is a variant of chronic mucocutaneous candidasis associated with chronic infection mainly by Candida albicans in which the skin lesions are rather granulomatous and hyperkeratotic. To date a variety of defects of cell mediated immunity have been shown to be important. We describe a 2-year-old boy with cutaneous candida granuloma and immunologic dysfunction.
Candida albicans ; Candida* ; Child, Preschool ; Granuloma* ; Humans ; Immunity, Cellular ; Male ; Skin

Ramsay Hunt syndrome (RHS) might cause serious complications, such as facial paralysis and hearing loss if diagnosis and treatments are delayed. Early diagnosis is therefore very important to avoid such serious complications. We report a case of RHS that was occurred during the treatment of postherpetic neuralgia resulted from zoster sine herpete. The patient showed severe segmental intercostal neuralgia at the right 11 and 12th thoracic level. There were no history of the trauma, operation and skin rash and vesicle on the lesion site. Varicellar-zoster virus (VZV) IgG Antibody was positive but VZV IgM antibody was negative. Pain nature was severe sharp, electrical shock like pain, but no paresthesia and dysesthesia was not existed. About two month later, small painful vesicular eruptions were occurred around the ipsilateral auricle. At this time, VZV IgM antibody was positive. Acyclovir, prednisolone, fexofenadine were immediately prescribed. The patient relieved from RHS without any complications. Clinician should be suspect the possibility of zoster sine herpete if the patient showed severe atypical chest wall pain.
Acyclovir ; Diagnosis ; Early Diagnosis ; Exanthema ; Facial Paralysis ; Hearing Loss ; Herpes Zoster Oticus* ; Herpes Zoster* ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Neuralgia ; Neuralgia, Postherpetic ; Paresthesia ; Prednisolone ; Shock ; Thoracic Wall ; Zoster Sine Herpete*

Syringoid eccrine carcinoma (SEC) is a rare cutaneous malignant tumor thought to be derived from eccrine sweat apparatus. It is usually present in the head, neck and trunk region, and often occurs in the fourth to seventh decades of life. A 94-year-old male patient visited our department with an 80-year history of a lesion showing a 2×2 cm sized well-demarcated round shaped erythematous to pinkish colored nodule with ulcer on his left thigh. Histological findings revealed a tumor consisted mainly of numerous small cords and nests forming luminal or tubular structures and tumor cells showing variable atypia. Some ductal structures showed tadpole appearance. On immunohistochemical staining, epithelial membrane antigen, S-100, cytokeratin 7 and carcinoembryonic antigen were reactive and Ki-67 showed less than 10% positivity. Based on these findings, the final diagnosis was made as SEC. The patient was treated with local wide excision and didn't show any recurrence during the follow-up period of 12 months. Herein, we report a very rare case of SEC which occurred on the left thigh and discuss 10 cases of SEC presented on the extremities, including our case.
Carcinoembryonic Antigen ; Diagnosis ; Extremities ; Follow-Up Studies ; Head ; Humans ; Keratin-7 ; Larva ; Male ; Mucin-1 ; Neck ; Phenobarbital ; Recurrence ; Sweat ; Sweat Gland Neoplasms ; Thigh* ; Ulcer

Ganglioneuromas commonly arise from sympathetic ganglia. These neoplasm may be located wherever ganglion cells are normally found from skull base to pelvis including adrenal gland. Ganglioneuromas in spinal cord are very rare. We report a case of dumbbell-shaped extradural spinal ganglioneuroma. A 7-year-old boy was admitted to our hospital with a 20 day-history of both leg pain and a 10 day-history of progressive paraparesis. On magnetic resonance image, there was a dumbbell-shaped extradural spinal cord tumor in T11-L4 level. Two stage operation(First : Laminoplastic laminotomy of T11-L4 to remove the extradural portion of the tumor in the spinal canal, Second : Right retroperitoneal approach for the removal of paraspinal tumor located in L2-3 level) was performed. Pathologic diagnosis was a ganglioneuroma and paraparesis improved postoperatively.
Adrenal Glands ; Child ; Diagnosis ; Ganglia, Sympathetic ; Ganglion Cysts ; Ganglioneuroma* ; Humans ; Laminectomy ; Leg ; Male ; Paraparesis ; Pelvis ; Skull Base ; Spinal Canal ; Spinal Cord ; Spinal Cord Neoplasms

OBJECTIVES: Domestic violence is related to many psychiatric diseases, such as depression, anxiety disorder, and PTSD. Heart rate variability (HRV) is an index of autonomic control of the heart and is related to cardiovascular and emotional disorders. Although there have been some studies on the effects of domestic violence on women's mental health, relatively little information is available on HRV in this population. The aim of this study is to investigate demographic data, psychological features, and HRV in female victims of domestic violence and difference between Korean and foreign female victims. METHODS: A total of 210 female victims of domestic violence (166 Korean women and 44 foreign women) were recruited for this study. Psychological symptoms were measured using the Hamilton Rating Scale for Anxiety (HAM-A), Hamilton Rating Scale for Depression (HAM-D), and Impact of Event Scale-Revised (IES-R). HRV measures were assessed by time-domain and frequency-domain analyses. RESULTS: The mean score of HAM-A was 13.81, that of HAM-D was 12.92, and that of IES-R was 33.61 ; there were no significant differences between Korean and foreign women in these measures. In HRV time domain analyses, approximate entropy (ApEn) was significantly increased in foreign women compared to the Korean women. The square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) was significantly decreased in foreign women compared to Korean women. There were no significant differences in the other HRV variables between Korean and foreign women. CONCLUSION: Female victims of domestic violence in Korea are associated with depression, anxiety, and PTSD symptoms. The physiologic factors of a female victim's nationality could be related to higher ApEn and lower RMSSD in foreign female victims. These findings have important implications for future study to study the relationships among ethnic and environmental factors and HRV variables.
Anxiety ; Anxiety Disorders ; Depression ; Domestic Violence* ; Emigrants and Immigrants ; Entropy ; Ethnic Groups ; Female ; Heart Rate* ; Heart* ; Humans ; Korea* ; Mental Health ; Stress Disorders, Post-Traumatic

Post-traumatic seizure is a known consequence of head trauma and a major public problem. But the surveillance study of this problem in our country is very rate. The purpose of the current study was to determine the incidence, clinical patterns and the outcome of the post-traumatic seizure in our institute. A retrospective review of management in 5053 patients with head injury was performed in our department between 1983 and 1992. In our series, the frequency of post-traumatic epilepsy was 254 patients, giving 1 5.0% incidence rate(early seizure occurred in 2.2% and late seizure occurred in 2.8% of patients). Of these, the records of 203 patients who received follow-up care for at least 2 years was reviewed. The first early epileptic attack occurred within 24 hours of injury in one third of the cases(33.3%), and the first late epileptic attack occurred within 1 year was about two thirds of the cases(64.6%). On CT scan findings, the early epilepsy had a higher incidence in scans that showed diffuse brain swelli ng and the late epilepsy had a higher incidence in subdural and intracerebral hematoma. 57.5% of early seizure were focal type, and 55.2% of late seizure were generalized convulsive seizure. The outcome of severe head injury patients with early seizure was better than that of late seizure group. The severity of head injury was related to the occurrence of late post-traumatic seizure.Development of new antiepileptic drugs, increasing knowledge of preventing post-traumatic sequelae and demand for surgical treatments have allowed the reduction of the incidence of the post-traumatic seizures. But further survey or study is recommanded in order to achieve more improvement in the management of post-traumatic seizures.
Anticonvulsants ; Brain ; Craniocerebral Trauma* ; Electroencephalography ; Epilepsy ; Epilepsy, Post-Traumatic ; Follow-Up Studies ; Head* ; Hematoma ; Humans ; Incidence* ; Retrospective Studies ; Seizures* ; Tomography, X-Ray Computed