Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

Wilson's disease typically presents symptoms associated with liver damage or neuropsychiatric disturbances, while endocrinologic abnormalities are rare. We report an unprecedented case of hypopituitarism in a patient with Wilson's disease. A 40-year-old woman presented with depression, general weakness and anorexia. Laboratory tests and imaging studies were compatible with liver cirrhosis due to Wilson's disease. Basal hormone levels and pituitary function tests indicated secondary hypothyroidism and adrenal insufficiency due to hypopituitarism. Brain MRI showed T2 hyperintense signals in both basal ganglia and midbrain but the pituitary imaging was normal. She is currently receiving chelation therapy along with thyroid hormone and steroid replacement. There may be a relationship between Wilson's disease and hypopituitarism. Copper deposition or secondary neuronal damage in the pituitary may be a possible explanation for this theory.
Adrenal Insufficiency/diagnosis/etiology ; Adult ; Brain/diagnostic imaging ; Depression/etiology ; Female ; Hepatolenticular Degeneration/*complications ; Humans ; Hypopituitarism/complications/*diagnosis/drug therapy ; Hypothyroidism/diagnosis/etiology ; Liver Cirrhosis/complications/diagnostic imaging ; Magnetic Resonance Imaging ; Steroids/therapeutic use ; Thyrotropin-Releasing Hormone/therapeutic use

OBJECTIVETo explore the clinical effect of Shugan Jieyu Capsules (SJC) on type III B prostatitis complicated by sexual dysfunction.

METHODSA total of 98 patients with type III B prostatitis complicated by sexual dysfunction were equally randomized to a control and a trial group, the former treated with the combination of biofeedback/electrical stimulation and the α-blocker Tamsulosin Hydrochloride, and the latter with oral SJC in addition, both for 8 weeks. Before and after treatment, the severity of the symptoms was determined with NIH-CPSI, the patients'sexual function evaluated with CIPE-5 and IIEF-5, and their anxiety, depression and other psychological problems assessed with Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale ( HAMD). The results were subjected to statistical analysis and compared between the two groups.

RESULTSStatistically significant differences were found between the control and trial groups in the NIH-CPSI score (26.31 ± 7.91 vs 18.84 ± 6.63, P < 0.01), CIPE-5 premature ejaculation score (10. 41 ± 3.03 vs 14.37 ± 2.35, P < 0.05), IIEF-5 score (10.29 ± 3.97 vs 14.69 ± 4.19, P < 0.05), HAMA score (24.31 ± 1.78 vs 13.41 ± 4.21, P < 0.01), and HAMD score (25.24 ± 2.83 vs 14.49 ± 4.44, P < 0.01).

CONCLUSIONSJC can effectively relieve anxiety, depression and other psychological problems in type III B prostatitis patients with sexual dysfunction and improve their clinical symptoms as well.

Adrenergic alpha-1 Receptor Antagonists ; therapeutic use ; Adrenergic alpha-Antagonists ; Anxiety ; drug therapy ; Biofeedback, Psychology ; Capsules ; Depression ; diagnosis ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Electric Stimulation Therapy ; Humans ; Male ; Premature Ejaculation ; drug therapy ; etiology ; Prostatitis ; complications ; drug therapy ; Sulfonamides ; therapeutic use

We investigated the frequency of sleep disturbances and the association between sleep disturbances and glucoregulation in type 2 diabetic patients. The frequency of sleep disturbances in 614 type 2 diabetic patients was investigated using validated sleep questionnaires. There were 381 male and 233 female patients. The mean age was 59.7 +/- 11.1 yr; the mean body mass index was 24.9 +/- 4.4 kg/m2; the mean HbA1c was 7.8% +/- 1.5%; and the mean duration of diabetes was 10.3 +/- 8.4 yr. The questionnaires revealed insomnia in 48.2% of the patients while 8.5% reported excessive daytime sleepiness. A total of 49% of the patients was poor sleepers, while 28.5% had depression. Multivariate logistic regression analysis showed that there was no significant association between HbA1c and other sleep disturbances, such as poor sleep, insomnia, and short duration of sleep. Sleep disturbances were very common in patients with type 2 diabetes mellitus, whereas there was no association between poor or short sleep and glucoregulation. Awareness and identifying sleep complaints in such patients are necessary to improve their quality of daily life.
Adult ; Aged ; Body Mass Index ; Depression/epidemiology ; Diabetes Mellitus, Type 2/complications/*diagnosis/drug therapy ; Female ; Hemoglobin A, Glycosylated/analysis ; Humans ; Hypoglycemic Agents/therapeutic use ; Logistic Models ; Male ; Middle Aged ; Quality of Life ; Questionnaires ; Sleep Disorders/*complications ; Sleep Initiation and Maintenance Disorders/epidemiology

This paper aims to introduce, summarize, and emphasize the importance of the 'Evidence-Based, Pharmacological Treatment Guideline for Depression in Korea, Revised Edition'. The guideline broadly covers most aspects of the pharmacological treatment of patients in Korea diagnosed with moderate to severe major depression according to the DSM-IV TR. The guideline establishment process involved determining and answering a number of key questions, searching and selecting publications, evaluating recommendations, preparing guideline drafts, undergoing external expert reviews, and obtaining approval. A guideline adaptation process was conducted for the revised edition. The guideline strongly recommends pharmacological treatment considered appropriate to the current clinical situation in Korea, and should be considered helpful when selecting the appropriate pharmacological treatment of patients diagnosed with major depressive disorder. Therefore, the wide distribution of this guideline is recommended.
Antidepressive Agents/*therapeutic use ; Antipsychotic Agents/therapeutic use ; Databases, Factual ; Depression/complications/diagnosis/*drug therapy ; Drug Tolerance ; Evidence-Based Practice ; Humans ; Monoamine Oxidase Inhibitors/therapeutic use ; Neurotransmitter Uptake Inhibitors/therapeutic use ; Placebo Effect ; Psychotic Disorders/complications/drug therapy ; Republic of Korea ; Severity of Illness Index

Adolescent ; Depression ; complications ; diagnosis ; drug therapy ; Humans ; Male ; Tourette Syndrome ; complications ; diagnosis ; drug therapy ; Treatment Outcome