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*

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

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

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

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

Toxicity in kidney and urinary tract after using Chinese herb medicine in general people could be a problem in Korea. However, reported cases of Chinese herb toxicity in the literature are unexpectedly rare compared to the actual clinical experiences. It is assumed that this low incidence is due to the difficulty of the user to know the rescription or exact name of herb medicine. Ignorance about the nature of Chinese herb medicine might result in fatal effect for the health of general people. To prevent the possible organ toxicity of Chinese herb medicine, we need to consider three requirements. First, enough cases showing toxicity of herb medicine should be collected. Second, comparative analysis of the collected cases should be carried out. Third, public relations (P.R.) to the general people and the governmental regulation should be performed. That is, Information collection Data analysis P.R. and Regulation. I have been personally experienced some cases of typical Chinese herb induced nephropathy in the patients with past history using chines herb medicine. All of them showed clinical progression to chronic renal failure. The common problem in these patients were the ignorance about the prescribed herb medicine. These are actual reality in Korea and it means that the resolution of the problem and further prevention for the other people is impossible in this country. Rapidly progressive renal fibrosis after a slimming regimen including Chinese herbs containing aristolochic acid has been identified as Chinese-herb nephropathy. Chinese herb nephropathy have been reported in the literature world-widely (Toxicology 2002; 181-2: 577-80; Clin Nephrol 2000; 53(4): 301-6; Intern Med 2001; 40(4): 296-300; Am J Nephrol 2001; 21(6): 441-8; Nephrology 2004; 9(3): 126-9) since an outbreak of rapidly progressive renal failure observed in Belgium in 1992~1993, related to a slimming regimen involving Chinese herbs (Bull Mem Acad R Med Belg 1994; 149: 128-35). Seventy one cases were registered and renal failure has been progressed in most cases despite the withdrawal of the Chinese herbs. Renal biopsies showed an extensive interstitial fibrosis with loss of tubules. Chinese herb nephropathy contains a variety of clinical features of progressive renal failure to Fanconi's syndrome. Fanconi's syndrome has mostly been reported in Asian countries, and is characterized by proximal tubular dysfunction and slower progression to end-stage renal disease. It has been reported that Aristolochic acid componant in chinese herb induce the toxicity in kiney and urinary tract in humans and animals (J Pharm Belg 1997; 52(1): 7-27; J Am Soc Nephrol 2002; 13: 431-6). It has also been reported that the prevalence of urothelial carcinoma among patients with end-stage Chinese-herb nephropathy (caused by aristolochia species) is high (N Engl J Med 2000; 342(23): 1686-92). Chinese herb, Aristolochia Fang-chi, has been proved nephrotoxic and does not provide enough safety for common health care. The overview shows that attention is caught to the danger of Chinese herbs of unknown origin and these observations indicate the need of intensive search of nephrotoxins in cases of interstitial nephritis of unknown origin.
Animals ; Aristolochia ; Asian Continental Ancestry Group* ; Belgium ; Biopsy ; Delivery of Health Care ; Fibrosis ; Humans ; Incidence ; Kidney Failure, Chronic ; Kidney* ; Korea ; Nephritis, Interstitial ; Nephrology ; Prevalence ; Public Relations ; Renal Insufficiency ; Statistics as Topic ; Urinary Tract*