OBJECTIVE: Diurnal preference is an attribute reflecting whether people are alert and preferring to be active either early or late in the day. It also referred to as chronotype or morningness-eveningness trait. The PER3 genes have been known to influence diurnal preference. In this study, we have investigated the associations between the PER3 gene polymorphisms and diurnal preference in a healthy young population, controlling for the social and environmental confounding factors. METHODS: The participants in this experiment included 299 unrelated medical college students (M=191, F=108), with a mean age of 22.9 years. Diurnal preference was measured by a single administration of the 13-item Composite Scale for Morningness (CSM). Genotyping of the PER3 VNTR (rs57875989) was performed using polymerase chain reaction. A two-tailed alpha of 0.05 was chosen. RESULTS: The mean+/-SD score on the CSM scale for all subjects was 31.90+/-6.39. There was no significant difference in total CSM score between gender groups, although females showed a trend towards higher morningness score. Although PER3 5R/5R showed the tendency towards high CSM scores, there were no significant differences on CSM scores among genotypes and allele status of PER3 VNTR (rs57875989). CONCLUSIONS: We could not confirm that the PER3 VNTR is associated with diurnal preference in a Korean healthy young population. The future studies need to investigate the association between diurnal preference and other polymorphisms of PER3 gene in larger sample of Korean young healthy population.
Alleles ; Female ; Genotype ; Humans ; Polymerase Chain Reaction

Duloxetine is a balanced serotonin-norepinephrine reuptake inhibitor. Duloxetine-induced liver injury in patients with preexisting liver disease or chronic alcohol use is known. However, we have found that duloxetine can also induce liver injury in cases without those risk factors. We recommend that clinicians should monitor liver function carefully following duloxetine treatment.
Depressive Disorder, Major ; Humans ; Liver ; Liver Diseases ; Organothiophosphorus Compounds ; Risk Factors ; Thiophenes ; Duloxetine Hydrochloride

OBJECTIVES: The previous studies have suggested genetic vulnerability to restless legs syndrome (RLS) development. The occurrence of antipsychotic-related RLS could also be attributable to differences in genetic susceptibility. This study aimed to investigate whether Retinoid-related orphan receptor A (RORA) gene polymorphism is associated with antipsychotic-related RLS in schizophrenia. METHODS: We assessed symptoms of antipsychotic-induced RLS in 190 Korean schizophrenic patients and divided the subjects into two groups according to the International Restless Legs Syndrome Study Group diagnostic criteria : 1) subjects that met all of the criteria (n=44) and 2) the remaining subjects who were not considered to be RLS patients (n=146). Single-nucleotide polymorphism in the RORA gene was genotyped by PCR in 190 individuals. The chi2-test was conducted to compare differences between two groups. RESULTS: The frequencies of genotype (chi2=0.066, p=0.968) of the RORA gene (rs11071547) did not differ significantly between schizophrenic patients with and without RLS. The difference of allele frequencies (chi2=0.008, p=0.927) of the RORA gene (rs 11071547) between the schizophrenic patients with and without RLS were not significant. CONCLUSION: These results suggest that RORA gene polymorphism does not play a major role in susceptibility to antipsychotic-related RLS in schizophrenia.
Child ; Child, Orphaned ; Circadian Rhythm ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Restless Legs Syndrome* ; Schizophrenia*

OBJECTIVES: There are emerging evidences suggest that the development of tardive dyskinesia (TD) is related to the oxidative stress, excitotoxicity, and immune activation. The purpose of this study is to investigate whether single-nucleotide polymorphisms (SNPs) of tumor necrosis factor (TNF)-alpha genes are associated with the susceptibility of TD and schizophrenia. METHODS: We investigated two hundred and eighty Korean schizophrenic patients. The schizophrenic participants consisted of patients with (n=105) and without (n=175) TD who were matched for antipsychotic drug exposure and other relevant variables. The TNF-alpha gene -308G/A SNPs were analyzed by polymerase chain reaction (PCR)-based methods. RESULTS: The frequencies of genotype (chi2=0.33, p=0.848) of the TNF-alpha gene -308 G/A SNP did not differ significantly between schizophrenic patients with and without TD. The difference of allele frequencies (chi2=0.28, p=0.594) of the TNF-alpha gene between the schizophrenic patients with and without TD were not significant. CONCLUSION: These results suggest that the TNF-alpha gene -308 G/A SNPs are not associated with TD and schizophrenia in a Korean population. Further association studies of TD with other candidate genes for cytokines would help us understand the pathophysiological mechanisms of TD.
Cytokines ; Gene Frequency ; Genotype ; Humans ; Movement Disorders ; Oxidative Stress ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide ; Schizophrenia ; Tumor Necrosis Factor-alpha

To investigate the perceptions and attitudes of dental hygienists toward radiation safety management in Korea. A total of 800 dental hygienists were randomly selected for an anonymous survey, and 203 of them participated. The questionnaire items included the following: sex, career period, type of installed radiographic equipment, recognition of the diagnostic reference level (DRL), participation in radiation safety education, and attitudes toward radiation protection for both patients and dental hygienists. The participants were divided into two groups according to their years of experience (< 10 years versus ≥ 10 years). The difference between the groups was investigated according to frequency distribution. Fisher’s exact test or Pearson’s chi-square (χ2 ) test was used as appropriate. A regression analysis was performed to investigate the impact of wearing a thyroid collar for personnel protection during patient radiation exposure. The types of installed radiographic equipment included panoramic radiography (96.1%), cephalometric radiography (76.9%), intraoral radiography (72.9%), and cone-beam computed tomography (69.5%). Significant differences were observed in the learning pathway for the DRL (Fisher’s exact test, p < 0.05), satisfaction with radiation safety education (Pearson’s χ2 test = 5.3975, Pr = 0.02), and use of personnel radiation monitoring systems (Pearson’s χ 2 test = 18.1233, Pr = 0.000) between the groups. Significant differences were also observed in personnel protection using a thyroid collar and patient protection during panoramic radiography (odds ratio = 14.2). Dental hygienists with more than 10 years of experience were more satisfied with radiation safety education and more interested in radiation monitoring. Considering career experience, customized, continuous, and effective radiation safety management education should be provided.

Primary pancreatic lymphoma is rare, comprising 0.2~4.9% of all pancreatic malignancies and less than 1% of cases of non-Hodgkin's lymphoma. Many patients are diagnosed with lymphoma after radical resection. We report a rare presentation of diffuse large B cell lymphoma, appearing as a primary tumor of the pancreas. A 61-year old female was admitted to the hospital with the complaint of right upper abdominal pain. Computed tomography of the abdomen showed a well defined mass located at the head of the pancreas. A frozen section of pancreas, during laparotomy, revealed lymphoma. The patient received 6 cycles of chemotherapy and is currently in complete remission. This case underscores the importance of differentiating primary lymphoma from the more common adenocarcinoma of the pancreas as treatment and prognosis differ significantly. Primary pancreatic lymphoma should be considered in the differential diagnosis of pancreatic tumors and an attempt to obtain a tissue diagnosis is always necessary before proceeding to radical surgery, especially on young patients.
Pancreatic Neoplasms/diagnosis/pathology/*therapy ; Middle Aged ; Lymphoma, Large-Cell, Diffuse/diagnosis/pathology/*therapy ; Lymphoma, B-Cell/diagnosis/pathology/*therapy ; Humans ; Female

OBJECTIVES: The purpose of present study was to determine the validity of MMSE-K and its items in a group of urban patients with dementia of Alzheimer type and investigate the frequency of psychiatric symptoms and the correlation between the severity of cognitive impairment and that of psychopathology in them. METHODS: The subjects were 107 residents, aged over 55, of an urban community, who participated voluntarily in a free medical service for dementic patients. At first, MMSE-K were administered to all the participients to screen for the cognitive impairment. They were diagnosed mainly by the criteria of DSM-IV for dementia of Alzheimer type. Other diagnostic procedures were performed at that time and these included: a history taking for the past and present medical and psychiatric illnesses of the subject and its family members, physical and neurological examinations, clinical evaluations using several psychiatric symptom rating scales such as BPRS, HDRS, HARS and Overt Aggression Scale, Hachinski's Ishcemic Scale, evaluations for sleep disturbances and behavioral problems in daily living. The majority, of total 72 subjects who were evaluated as having cognitive dysfunctions, were the patients with dementia of Alzheimer type: 52 dementia of Alzheimer type, 12 vascular dementia, one mixed type of the two, and 7 others. We determined the validity of MMSE-K and its items in 52 subjects with dementia of Alzheimer type except the two, who could not respond well to the instructions of MMSE-K due to severe cognitive impairments, and 34 non-dementic subjects with only mild psychiatric symptoms. In 42 subjects with dementia of Alzheimer type who completed all the clinical rating scales with confidence, we investigated the frequency of psychiatric symptoms and the correlation between the severity of cognitive impairment and psychopathology. RESULTS: 1) The percent of false positive in diagnosing dementia of Alzheimer type using MMSE-K was 8.0%, and the sensitivity of MMSE-K was 82% in our 107 urban subjects. 2) There were statistically significant differences in the the mean scores of all items except the item, judgement, between the patients with dementia of Alzheimer type and non-dementic subjects(p<0.05). The two items, orientation for time and place, and the item, copy two pentagons, had the sensitivity and specificity over 70%. 3) The frequencies of behavioral and psychiatric symptoms in 42 patients with dementia of Alzheimer type were as follows: verbal aggression(50.0%), depression(46.2%), insomnia(30.8%), ...... , hallucination(21.2%) and delusion(15.4%). 4) The more cognitive dysfunctions had the patient with dementia of Alzheimer type, the more higher scores in the thinking disturbance subscale of BPRS they showed(p<0.01). CONCLUSION: MMSE-K was proved to be a valid instrument to evaluate the cognitive impairments in patients with dementia of Alzheimer type, but the item, judgement, newly admitted to MMSE-K instead of a language item in MMSE, was proved to be lack of power to discriminate the dementic patient from non-dementic subjects. Our subjects with dementia of Alzheimer type had revealed several behavioral and psychiatric symptoms other than cognitive dysfunctions, and those included depression, anxiety, insommnia, aggression, delusion and hallucination which needed intensive pharmacological interventions.
Aggression ; Anxiety ; Delusions ; Dementia* ; Dementia, Vascular ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Hallucinations ; Humans ; Neurologic Examination ; Psychopathology* ; Sensitivity and Specificity ; Thinking ; Weights and Measures

Background: Chronic use of glucocorticoid is known to result in osteoporosis. Deflazacort (DFZ), a synthetic glucocorticoid, has been reported to have bone sparing properties in vivo eompared to dexamethasone(DEX). Not only the direct effect of DFZ on human osteoblast but the mechanism by which the drug spares bone remains unclear. This study, therefore, is aimed to investigate the direct effect of DFZ on the proliferation and differentiation of human osteoblast as well as on the gene expression of osteocalcin and osteoblast as well as on the gene expression of osteocalcin and growth factor produced in osteoblast. Methods: Human osteoblast-like cells were cultured from a piece of the tibia removed during selective orthopedic surgery for patients without metabolic bone diseases. The morphological iden- tification of osteoblast-like cell was performed under the light microscope after alkaline phosphatase staining. Cell proliferation rate was determined by [3H] thymidine incorporation into DNA. Cell differentiation was determined by alkaline phophatase activity. mRNA expression was quanti- tatively measured by the competitive reverse transcription-polymerase ehain reaction(RT-PCR). Results: The cultured cells demonstrated 1,25-dihydroxyvitamin D3-induced increases in alkaline phophatase activity and osteocalcin mRNA expression which are the properties of osteoblast. Twenty six percent of the cultured cells were identified as osteoblast-like cells by alkaline phophatase staining. After 24hr incubation with DEX or DFZ, the [3H) thymidine incorporation was significantly inhibited by 100nM DEX or DFL Alkaine phophatase activity was significantly increased by 100nM DEX. Osteocalcin mRNA was significantly decreased by both glueocorticoids. While DEX significantly suppressed expression of asteocalcin mRNA at 10nM and 100nM, DFZ did so only at 100nM. IGF-I mRNA was significantly decreased by 100nM DEX. Conclusion: These results suggest that the inhibitory effect of DFZ on the cell proliferation and protein synthesis is less than that of DEX, which might be responsible for the bone sparing effect of DFZ in vivo.
Alkaline Phosphatase ; Bone Diseases, Metabolic ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Dexamethasone ; DNA ; Gene Expression ; Humans ; Insulin-Like Growth Factor I ; Orthopedics ; Osteoblasts ; Osteocalcin ; Osteoporosis ; RNA, Messenger ; Thymidine ; Tibia

OBJECTIVES: Several evidence has been suggested that the circadian gene variants contribute to the pathogenesis of seasonal affective disorder. In this study, we aimed to investigate the polymorphism in RORA (Retinoid-related orphan receptor A) gene in relation to seasonal variations among healthy young adults in Seoul, Korea. METHODS: A total of 507 young healthy adult subjects were recruited by advertisement. Seasonal variations were assessed by the Seasonality Pattern Assessment Questionnaire (SPAQ). Single-nucleotide polymorphism in the RORA rs11071547 gene was genotyped by PCR in 507 individuals. Considering summer type as confounding factor, we conducted analysis 478 subjects except 29 subjects of summer type. The Chi-square test was conducted to compare differences between groups of seasonals and non-seasonals. Association between genotypes and Global Seasonality Score (GSS) were tested using ANCOVA (Analysis of covariance). RESULTS: In this sample, the prevalence of SAD was 12.1% (winter type 9.3%, summer type 2.8%). There is no significant difference in genotyping distribution of RORA rs11071547 between groups of seasonals and non-seasonals. Global seasonality score (GSS) and scores of all subscales except body weight and appetite were not significantly different between the group with C allele homozygote and the group with T allele homozygote and heterozygote (p-value 0.138). Scores of body weight and appetite were significantly higher in group with C allele homozygotes. CONCLUSION: These results suggest that RORA gene polymorphism play a role in seasonal variations in appetite and body weight and is associated with susceptibility to seasonal affective disorder in some degree in the population studied.
Adult ; Alleles ; Appetite ; Body Weight ; Child ; Child, Orphaned ; Genotype ; Heterozygote ; Homozygote ; Humans ; Korea ; Polymerase Chain Reaction ; Prevalence ; Surveys and Questionnaires ; Seasonal Affective Disorder ; Seasons* ; Seoul ; Young Adult

Emphysematous cholecystitis is an uncommon form of acute cholecystitis characterized by the presence of gas within the wall, lumen of the gall bladder or biliary ducts. Clinically it is very similar to ordinary farm. But since the risk of perforation is five times that expected from ordinary cholecystitis, early diagnosis and appropriate surgical treatment are important. We could diagnose these cases by the simple abdomen, abdominal ultrasound and abdominal CT by the presence of air in the lumen and the wall of the gall bladder. Percutaneous trans hepatic gall bladder drainage (PTGBD) for decompression was used because poor general condition of patients and later, we could successfully perform the cholecystectomy without any complication. We presented two cases of emphysematous cholecystitis with review of the relevant literature on the subject.
Abdomen ; Cholecystectomy ; Cholecystitis ; Cholecystitis, Acute ; Decompression ; Drainage ; Early Diagnosis ; Emphysematous Cholecystitis* ; Humans ; Tomography, X-Ray Computed ; Ultrasonography ; Urinary Bladder