OBJECTIVE: There are four possible explanations for the sexual dysfunction of schizophrenics. The first is the possibility or a real structural aspect. The second possibility is that sexual function changes secondary to the illness. The third possibility is that there are medical and sociocultural barriers to sexual expression for chronic schizophrenics. The fourth possibility is that sexual dysfunction due to antipsychotic medication. However, we didn't know the precise cause of sexual dysfunction in schizophrenics. Therefore, the purpose of this study was to explore the mechanism of illness itself and antipsychotics on sexual dysfunction in male schizophrenics. METHODS: The serum prolactin(PRL), testosterone(TST), and the plasma serotonin(5-HT) concentrations were measured by radioimmunoassay and high performance liquid chromatography method for 100 healthy male schizophrenics according to the DSM-IV. Concomitantly, the severity of psychotic symptoms using Clinical Global Impression(CGI), Brief Psychiatric Rating Scale(BPRS), Positive and Negative Syndrome Scale(PANSS), and the severity of side effects for antipsychotics using Extrapyramidal Side Effects Scale(EPSE), Anticholinergic Side Effects Scale(ACSE), the cognitive function using PANSS-Cognitive Function(PANSS-CF), Mini Mental State Exam-Korean(MMSE-K), and sexual dysfunction using Sexual Functioning Questionnaire(SFQ), Questionnaire for Sexual Dysfunction in Men were assessed. The PRL, TST and 5-HT levels of 50 healthy male controls who had no medical, neurological, and psychiatric illnesses were evaluated The sexual function using SFQ(items FGa, FNa) were also assessed. Furthermore, the correlation with age, education, religion economic status, age at onset, duration of illnesses, duration of admission. levels of PRL, TST, 5-HT, antipsychotic dosages, potency, benztropine total duration of medication, EPSE, ACSE, CGI BPRS, PANSS, PANSS-CF MMSE-K and sexual dysfunctions were identified in male schizophrenics. RESULTS: 1) The frequencies of sexual dysfunctions for schizophrenics(80%) were significantly(p<0.001) higher than those for controls(42%). The sexual dysfunctions according to sexual response cycle were low sexual desire '76% 'impairment of achieving erection '75%, 'impairment of maintaining erection'75%, 'impairment of obtaining orgasm'32%, 'impairment in the quality of orgasm'61%, 'impairment of quantity of ejaculate'44%, premature ejaculation'15%, and 'delayed ejaculation'50%. 2) The PRL, 5-HT levels of schizophrenics(28.5+/-20.6ng/ml, 298.5+/-89.1ng/ml) were significantly(p<0.001) higher than those of controls(10+/-5.6ng/ml, 169.2+/-37.8ng/ml), while the TST levels of schizophrenics(4.3+/-1.5ng/ml) and controls(4.5+/-1.2ng/ml) were not significantly different. The sexual dysfunctions of schizophrenics who had abnormal 5-HT levels(4.7+/-1.3 scores) were significantly(p<0.05) higher than those of who had normal 5-HT levels(3.8+/-1.6 scores) on item D7. 3) The sexual dysfunctions of unmarried schizophrenics were significantly(p<0.01 : p<0.05) higher than those of married schizophrenics(6.1+/-2.8 scores, 4.7+/-1.3 scores on item FGa : beta=-0.211 on item FNa). The sexual dysfunctions we positively correlated with the rise of 5-HT levels (r=0.209, p<0.05 on item D4 and r=0.241, p<0.05 on item D7), the higher age at onset(r=0.275, p<0.01 on item FNa : r=-0.202, p<0.05 on item FDa), the longer duration of illesses(r=0.237, p<0.05 on item D6), the longer duration of admission(r=0.234, p<0.05 on item D4 : r=0.328, p<0.05 on item D6), the longer total duration of medication(r=0.237, p<0.05 in item D6). However, age, education, religion, economic status, PRL, TST levels, antipsychotics dosage, potency, benztropine, ACSE, CGI, BPRS, PANSS, PANSS-CF, MMSE-K scores were not correlated with increased sexual dysfunctions. CONCLUSIONS: Male schizophrenics have significantly more sexual dysfunction to compare with controls. The high frequencies of sexual dysfunctions were low sexual desire and erectile disorder. The unmarried, higher age at onset, are longer duration of diseases were positively correlated with increased sexual dysfunctions. Also high 5-HT levels were positively correlated with increased sexual dysfunctions. This means that studies of plasma 5-HT levels, albeit questionable indicators of central 5-HT function, offer some additional support for the association of sexual dysfunction with excess 5-HT activity as primary pathology of schizophrenia. Our findings suggest that excess 5-HT activity seems to affect the patient's sexual function.
Antipsychotic Agents ; Benztropine ; Chromatography, Liquid ; Diagnostic and Statistical Manual of Mental Disorders ; Education ; Humans ; Male* ; Pathology ; Plasma ; Prolactin ; Surveys and Questionnaires ; Radioimmunoassay ; Schizophrenia ; Serotonin ; Single Person ; Testosterone

We experienced a case of adenocarcinoma arising in sacrococcygeal teratoma. The patient was a 52-year-old woman. She was admitted due to one month of sacral pain. She had a sacral mass since birth. On physical examination, anal fistula was present at the perianal area and pus drainage was noted. MR image showed multiple variable-sized cysts with inhomogeneous density. Resected specimen, mesuring 12.5 7.0 cm in diameter, showed multiple variable-sized cystic lesions admixed with grayish solid portion. The cysts contained mucoid material. The microscopic examination showed mature teratoma composed of cysts lined by pseudostratified ciliated columnar epithelium, intestinal mucosa, mature cartilage, bone, and fat tissue. A moderately differentiated adenocarcinoma developed from the cystic area in the mass.
Adenocarcinoma* ; Adult ; Cartilage ; Drainage ; Female ; Humans ; Intestinal Mucosa ; Middle Aged ; Mucous Membrane ; Parturition ; Physical Examination ; Rectal Fistula ; Suppuration ; Teratoma*

No abstract available.
Antibodies, Antineutrophil Cytoplasmic* ; Incidence*

Tumorlet is a rare lesion of disputed origin that was first described by whitwell in 1955, and about one-third of the reported cases have been associated with underlying lung disease. Patient was a 60-year-old female who was admitted with a histroy of chest discomfort and dyspnea. Right lower lobe was partially resected under the clinical diagnosis of the bronchogenic cyst. Grossly, lung tissue around round cystic lesion appeared brown firm and somewhat fibrotic, and showed several scattered ill-defined whitish gray nodules. Microscopically, lung tissue around bronchogenic cyst was partially obliterated by dense fibrous scar tissue. Within this areas of fibrosis, and in the wall of alveolar ducts and respiratory bronchioles, innumerable microscopic tumorlets were found and argyrophilic granules were also demonstrated in scattered tumorlets with Grimelius stain.
Female ; Humans ; Cysts

OBJECTIVES: Hemophilia B has been known to result from more than 500 kinds of mutations. And it is difficult to find out a mutation specific for each family. Therefore, linkage analysis of DNA polymorphism within or near the factor IX gene has been frequently used in the clinical practice for molecular genetic diagnosis of hemophilia B. But the ethnic variation makes more difficult to apply useful markers in Caucasian population. To investigate the usefulness of the MseI and HhaI polymorphism in Korean population, we analysed the MseI and HhaI polymorphism. METHODS: Forty-five normal Korean and thirteen parents of the hemophilia B patients, using PCR and restriction enzyme analysis. RESULTS: The heterozygosity rate of MseI polymorphism was 49.7% and that of HhaI polymorphism was 25.5%. CONCLUSION: These data indicated that PCR-based analysis of MseI and HhaI polymorphism of factor IX was useful in molecular genetic diagnosis of hemophilia B in Korean population.
Diagnosis* ; DNA* ; Factor IX* ; Hemophilia A* ; Hemophilia B* ; Humans ; Molecular Biology* ; Parents ; Polymerase Chain Reaction ; Prenatal Diagnosis ; Restriction Mapping

Porphyromonas gingivalis is strongly implicated in the pathogenesis of adult periodontitis, the major cause of tooth loss in adults. Use of an antibacterial agent controlling P. gingivalis as a periodontal therapeutic agent has been rationalized. The present study was performed to observe the antibacterial effect of inorganic polyphosphates (polyP) on P. gingivalis. P. gingivalis 2561 was grown in half-strength brain-heart infusion broth containing hemin and vitamin K with or without polyP. Minimal inhibitory concentration (MIC) of polyP with various chain lengths was determined by measuring the absorbance of the grown cells at 540 nm. MIC of polyP for the bacterium was determined to be 0.05%. The effect of polyP with a chain length of 75 (polyP 75) was further examined. PolyP 75 added to the growing culture of P. gingivalis at its exponential phase was as effective in inhibiting the growth of P. gingivalis as polyP 75 added at the very beginning of the culture. More than 99% of the cells lost their viability determined by viable cell count when polyP 75 was added to the culture of growing P. gingivalis at the concentration of 0.06%, suggesting that polyP 75 has a bactericidal effect on the bacterium. Intracellular nucleotide release from the cells was increased by approx. 20% in the presence of polyP 75 but was not reversed by the addition of divalent cations like Ca++ and Mg++. Under the transmission electron microscope, only a small number of the growing P. gingivalis cells were actually lysed. However, the majority of the cells appeared to be atypical in their shape, demonstrating accumulation of highly electron-dense granules and bodies of condensed nucleic acid-like material in the cytoplasm. In the presence of polyP 75, the protein profile of P. gingivalis was changed as determined by SDS-polyacrylamide gel electrophoresis and immunoblot, and the proteolytic activity of the bacterium demostrated on the zymograms was decreased. The overall results suggest that polyP have a strong bactericidal activity against P. gingivalis in which lysis in relation to chelation may not play the major role but unknown mechanism that possibly affects the viability of the bacterium may be involved. PolyP may be used as an agent for prevention and treatment of periodontitis.
Adult ; Cations, Divalent ; Cell Count ; Chronic Periodontitis ; Cytoplasm ; Electrophoresis ; Hemin ; Humans ; Periodontitis ; Polyphosphates* ; Polyps ; Porphyromonas gingivalis* ; Porphyromonas* ; Tooth Loss ; Vitamin K

Pigmented squamous cell carcinoma is a very rare malignant, pigmented, epidermal tumor. The rarity of pigmented squamous cell carcinomas may reflect in part their misdiagnosis as other pigmented neoplasms, particularly malignant melanoma. To our knowledge, only five cases have been reported in literature. We recently experienced a case of pigmented squamous cell carcinoma arising from pigmented actinic keratosis in a 77 years old female. Physical examination showed a 0.8 0.6 cm, smooth, dark brown pigmented patch with irregular but sharply defined borders located on the upper left chest. The biopsy specimen showed histologic findings of pigmented actinic keratosis with abundant melanin pigments, which became pigmented squamous cell carcinoma. Most of pigments in the squamous cell carcinoma were contained within the melanocytes along with the neoplastic squamous cells.
Actins* ; Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnostic Errors ; Female ; Humans ; Keratosis, Actinic* ; Melanins ; Melanocytes ; Melanoma ; Physical Examination ; Skin ; Thorax

Adenocarcinoma of the ciliary epithelium is a rare tumor, usually occuring in elderly patients who have a history of severe ocular trauma or chronic inflammation. We report an adenocarcinoma of the nonpigmented ciliary epithelium found within the phthisical globe of a 36-year-old female whose eye had been loss of vision since infancy. The mass, measured 4.0 x 4.0 cm, was relatively limited by sclera but had invasion to posterior portion. Histologically, the tumor was a compact mass which consisted of tubular and papillary structures with foci of the pleomorphic area. Strands of cells and individual cells were invested with thick basement membrane that have positivity for periodic acid-Schiff stain. Immunohistochemical staining showed strong reactivity for cytokeratin and epithelial membrane antigen, and focal for neuron-specific enolase and S-100 protein.
Adenocarcinoma ; Adenocarcinoma, Papillary* ; Adult ; Aged ; Basement Membrane ; Epithelium* ; Female ; Humans ; Inflammation ; Keratins ; Mucin-1 ; Phosphopyruvate Hydratase ; S100 Proteins ; Sclera

Twenty three patients with locally invasive transitional cell carcinoma of the bladder(stage T2-T4N0M0) who refused to undergo radical cystectomy or were poor surgical candidates were included in this study. All patients received transurethral resection(TUR) of the tumor initially for the pathologic staging and debulking of tumor mass. Then, patients were treated with either one of the following two bladder preservation protocols. First trials consisted of initial 2 courses of MVAC(methotrexate, vinblastin, adriamycin and cisplatin) chemotherapy and followed by radiotherapy( 6480cGy) plus 2 courses of cisplatin. The other protocol was initial radiotherapy ( 6480cGy) with 2 courses of cisplatin and additional 2 courses of MCV(methotrexate, cisplatin and vinblastin) chemotherapy. There were 8 patients in T2, 13 in T3 and 2 in T4. Repeat biopsies were conducted 1 to 6 months after initiation of therapy. With a mean follow up of 17.1 months, other than two patients who underwent cystectomies, the survival rate without local recurrence or distant metastasis was 66.6% (14/21)-87.5 % ( 7/8) in T2. 63.6 % ( 7/11) in T3 and 0%(0/2) in T4. Bladder tumor recurrence and metastasis was observed in 3 patients respectively. One patient in stage T4 died at 20 months with multiple metastasis. The survival rate is closely correlated to initial stage. Patients with no residual mass after TUR seemed to be better in response than patients with residual mass. Side reactions such as neutropenia ( <2000/ mm3) were observed in 6(26.2% ) patients, radiation cystitis in 2(8.7% ) and radiation proctitis in 1(4.3%) The bladder preservation protocol in locally invasive bladder tumor has relatively satisfactory results but longer follow-up is necessary to determine the efficacy of current protocol in long term survival.
Biopsy ; Carcinoma, Transitional Cell ; Cisplatin ; Cystectomy ; Cystitis ; Doxorubicin ; Drug Therapy ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Neutropenia ; Proctitis ; Radiotherapy ; Recurrence ; Survival Rate ; Urinary Bladder Neoplasms* ; Urinary Bladder*

Postpartum hemorrhage is a common cause of maternal mortality; its main cause is placenta accreta. Therapeutic hypothermia is a generally accepted means of improving clinical signs in postcardiopulmonary resuscitation patients. A 41-year-old pregnant woman underwent a cesarean section under general anesthesia at 37 weeks of gestation. After the cesarean section, the patient experienced massive postpartum bleeding, which led to cardiac arrest. Once spontaneous circulation returned, the patient underwent an emergency hysterectomy and was placed under therapeutic hypothermia management. The patient recovered without neurological complications.
Adult ; Anesthesia, General ; Cesarean Section ; Emergencies ; Female ; Heart Arrest* ; Hemorrhage ; Humans ; Hypothermia ; Hypothermia, Induced* ; Hysterectomy* ; Maternal Mortality ; Placenta Accreta ; Postpartum Hemorrhage* ; Postpartum Period* ; Pregnancy ; Pregnant Women ; Resuscitation