Objective: Patients with panic disorder (PD) are approximately four times more likely to experience suicidal thoughts and attempts compared to healthy controls (HCs). Despite the elevated risk compared to HCs, the relationship between cortical thickness (CT) in PD and suicidality remains underexplored. Methods: We recruited 161 right-handed participants, including 82 PD patients and 79 HCs, and assessed them using a comprehensive battery of psychological scales, including the Scale for Suicidal Ideation (SSI), Early Trauma Inventory Self Report-Short Form, Neuroticism-Extraversion-Openness Personality Inventory-Neuroticism (NEO-N), State-Trait Anxiety Inventory-Trait Anxiety (STAI-T), Panic Disorder Severity Scale (PDSS), and Beck Depression Inventory. Results: In whole-brain vertex-wise group comparison, patients with PD demonstrated significantly lower CT values in the insula, lateral occipital sulcus, and precentral gyrus compared to HCs. Notably, paradoxical significant positive correlations were observed between SSI total scores and CT in the above-mentioned regions within the PD cohort.Pearson’s correlation analyses further indicated that CT in these regions may be linked to high levels of early trauma, trait anxiety (e.g., NEO-N, STAI-T), panic symptom severity (e.g., PDSS), and treatment response in patients with PD. Conclusion This study suggest that suicidality in PD may be associated with CT in specific EFN regions related to suicidal brain and that CT in these regions could play a critical role in anxiety symptomatology in PD.

BACKGROUND: Two genetic loci, PKD1 and PKD2, have been identified as being responsible for ADPKD, and PKD1 is known to be associated with poor prognosis. However, the presence of intrafamilial clinical diversity suggests the presence of disease-modifying loci. Because the mechanism of renal failure in ADPKD includes cystic growth and tubulointerstitial atrophy and fibrosis, we studied the associations between two cytokine gene polymorphisms in the TGF-beta gene, which are known to be related with chronic tubulointerstitial inflammation, and ADPKD progression in Korean patients. METHODS: 47 normal controls and 114 individuals with ADPKD were genotyped by PCR-RFLP, and the TGF-beta gene leader sequence of T869C(Leu10Pro) variant was compared with MspA1I and G915C (Arg25Pro) with BglI. Statistic significances were determined using the Chi-square test. RESULTS: The distribution of alleles for the TGF-beta Leu10Pro polymorphism in ADPKD was : T 52%, C 48%, which was similar to the Korean(56 : 44, p= 0.670) and Western controls(65 : 35), and in addition, no differences were found between the CRF and the non-CRF groups(p=0.571) or the early hypertension and the normotension groups(p=0.252). The distribution of alleles for the TGF-beta Arg25Pro polymorphism was all GG type, which was different from Western controls(90 : 10, p=0.000). CONCLUSION: Our results suggest that the polymorphism at Arg25Pro of TGF-beta in Korean population has different allele distribution from Western, and the polymorphism at Leu10Pro of TGF-beta has no association with the renal progression of Korean ADPKD patients.
Alleles ; Atrophy ; Fibrosis ; Genetic Loci ; Humans ; Hypertension ; Inflammation ; Polycystic Kidney, Autosomal Dominant* ; Prognosis ; Renal Insufficiency ; Transforming Growth Factor beta*

BACKGROUND: Autosomal dominant polycystic kidney disease(ADPKD) is the most common hereditary renal disease in adults, and its major complaints include pain and abdominal fullness due to cyst expansion. So far, for the control of these symptoms, cyst ablation with ethanol or tetracycline, laparoscopic manipulations and surgical marsupialization have been used. METHODS: We used conventional ethanol(n=9) or n-butyl cyanoacrylate(NBCA) plus lipiodol solution (n=18) or both(n=3) for separate cysts as the sclerosing agent in 24 adult Korean ADPKD patients. And their clinical courses after treatment were evaluated. RESULTS: The male to female ratio was 8 : 16 and the mean age at the treatment was 50 yrs(S.D. 13.1). Causes for aspiration were pain in 14 and abdominal fullness in 7 patients and the range for the cyst diameters aspirated were 5-16 cm. Flank pain or discomfort were decreased subjectively in most cases except two. Mean arterial pressures(S.D.) (mmHg) before and after procedure were as follows 112(11.1)(basal), 96(9.6)(1 month) and 98(9.7)(6 month)(p < 0.05, paired-t test). Blood urea nitrogen levels(mg/dL) were not changed 6 month later[24 (12.1) vs. 22(14.6)]. There was no major complication such as bleeding or infection and no death and associated with procedure. There was no difference of therapeutic effect according to sclerosing agent. CONCLUSION: NBCA was as effective as conventional ethanol for sclerotherapy in ADPKD and cyst ablation therapy showed a BP-lowering effect in short-term period.
Adult ; Blood Urea Nitrogen ; Ethanol ; Ethiodized Oil ; Female ; Flank Pain ; Hemorrhage ; Humans ; Male ; Polycystic Kidney, Autosomal Dominant* ; Sclerotherapy* ; Tetracycline

BACKGROUND: ADPKD is one of the most common hereditary renal disease in adult and is a systemic disorder with a variety of cardiovascular manifestations. To elucidate the clinical characteristics of cerebrovascular complications in Korean ADPKD patients, we reviewed the medical records of ADPKD patients who was registered in ADPKD clinic of Seoul National University Hospital. METHODS: A total of 18 adult patients were included and their sex ratio was 8:10. The median age of ADPKD diagnosis was 45.5 year (range 19-85), and age at cerebrovascular accident(CVA) was 52 years(22-82). The median duration from hypertension to CVA was 8 years(0-30). RESULTS: There were 5 cases of infarction, 4 cases of intracerebral hemorrhage, 4 cases of subarachnoid hemorrhage, and 4 cases of transient ischemic attack. Other clinical parameters of ADPKD were not different from patients who were not complicated with CVA. Intracranial aneurysms were detected in 6 patients and their median age at diagnosis was 47.5 years(33-66). Four cases were manifested as subarachnoid hemorrhage. Five cases were diagnosed through TFCA, and two of them were revealed as multiple aneurysms. Five cases received surgical treatment and five of six cases improved without any neurologic sequeale. MR angiography(MRA) were taken in 16 asymptomatic patients, and multiple aneurysms were newly detected in one of them. CONCLUSION: Cerebrovascular complications in Korean ADPKD patients were not significantly different from western patients. Intracranial aneurysms must be included in differential diagnosis in ADPKD patients who manifest an acute neurologic symptoms, and high-risk group need to be screened selectively with MRA.
Adult ; Aneurysm ; Cerebral Hemorrhage ; Diagnosis ; Diagnosis, Differential ; Humans ; Hypertension ; Infarction ; Intracranial Aneurysm ; Ischemic Attack, Transient ; Medical Records ; Neurologic Manifestations ; Polycystic Kidney, Autosomal Dominant* ; Seoul ; Sex Ratio ; Subarachnoid Hemorrhage

Intrathoracic kidney is a very rare congenital anomaly in development of the kidney. It was firstly described by Mikulics in 1922. More than 130 cases were reported in the world. Most of the patients have no clinical problem and discovered incidentally in chest X-ray. We have experienced a case of intrathoracic kidney in a 48-year-old female who was admitted due to recurrent calculous cholecystitis. Intrathoracic mass lesion was noted in the plain chest film and confirmed as intrathoracic kidney by chest computed tomography and intravenous pyleography. We report a case of intrathorcic kidney with brief review of literature.
Adult* ; Cholecystitis ; Female ; Humans ; Kidney* ; Middle Aged ; Thorax