Female phenotype of a 46,XY male may originates from male pseudohermaphroditism due to $17{\alpha}$-hydroxylase deficiency. Lack of cortisol increases adrenocorticotropic hormone (ACTH) and mineralocorticoid production, leading to low renin hypertention and hypokalemia. A 41-year-old phenotypic female presented primary amenorrhea and hypertension. In the hormonal profile, the levels of serum estradiol, testosterone, rennin, and cortisol were decreased and ACTH and deoxycorticosterone were increased. Laparoscopic bilateral gonadectomy was performed, and corticosteroid, antihypertensive drugs, and estrogen were administered. We report this case with a brief review of the literatures.
Objective : The objective of this study was to research depression with acupuncture & moxibustion treatment. Methods : We searched Chinese Medical Literature(published from 1985~2002) related to depression and acupuncture. Results : 1) PC6(內關), HT7(神門), ST36(足三里), GV20(百會), LR3(太衝), SP6(三陰交) are much used for the treatment depression. 2. LR3(太衝), CV17(전중), GB34(陽陵泉), ST40(豊隆), PC6(內關) are much used for the excess type of depression and PC6(內關), SP6(三陰交), HT7(神門), BL15(心兪) are much used for deficiency type of depression. 3. ST36(足三里), SP6(三稜交), HT7(神門), PC6(內關), HT5(通里), KI1(通泉) are used for the treatment depression in electroacupuncture therapy. BL15(心兪), BL20(脾兪),ST36(足三里) are used for the treatment depression in acupoint injection therapy. 4. In dermal needle therapy, it is used to tap slightly until the skin becomes congested in the region of Bladder meridian and nape, back of Governor Vessel. 5. It seems that psychotherapy, music therapy and light therapy will be applied for the treatment of depression. Conclusion : We expect that acupuncture treatment of depression will be applied practically in clinical medicine due to further study on depression with acupuncture.
This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis and to evaluate the embolized kidney using B-mode ultrasonography and selective angiography. Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. Ultrasonographic findings revealed that size of the kidney was significantly increased at 9 days and 17 days and the length of renal cortex was significantly decreased at 17 days after ligation of the unilateral ureter and it was in accordance with dilation of ipsilateral renal pelvis. No significant change of BUN, creatinine, ALT, calcium, and phosphorus was found immediately after unilateral experimental hydronephrosis. Therefore, it was concluded that unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$, body temperature, pulse, and respiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. Average ethanol dose for renal artery embolization was $1.94{\pm}1.24ml/kg$. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. Revascularization of renal artery was not found in angiography in dogs treated by TAE-RA at immediately after TAE-RA and 14 days after TAE-RA. Ultrasonographically, the mean longitudinal length of the embolized kidney decreased significantly at 2 and 3 months after TAE-RA compared to that of contralateral normal kidney. In summary, marked shrinkage of the embolized kidney was observed in dogs with unilateral experimental hydronephrosis treated by TAE-RA with iohexol-ethanol and no adverse effects were observed throughout the observation period. It is concluded that TAE-RA with iohexol-ethanol solution is a viable alternative to nephrectomy in dogs with unilateral hydronephrosis.
Song, Kum Ho;Huh, Kwon Hoe;Cho, Ok Yeon;Sim, Jae Hoon;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang;Lee, Kwan Seop
Clinical and Experimental Pediatrics
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v.46
no.4
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pp.351-357
/
2003
Purpose : To raise awareness of the clinical importance of, and the need for proper management of acute focal bacterial nephritis(AFBN), we analyzed 22 AFBN patients and 22 other upper urinary tract infection patients by use of comparative studies. Methods : From January 2000 to May 2002, 22 AFBN patients aged from 1 month to 12 months were selected. As a control group, 22 UTI patients with no radiologic abnormalities were selected and matched by age and sex. Results : The incidence of AFBN was more common in boys than in girls. Since both groups had similar symptoms, it was difficult to diagnose AFBN by clinical presentations alone. ESR and CRP were significantly higher in AFBN patients. The most common causative organism was E. coli in both groups. On the sonographic findings, the most lesions were seen on the upper lobe of the kidney; more frequently, on left kidney. The lesions showed globular or wedge-shaped increased echogenecity. $^{99m}Tc-DMSA$ scan showed the complete coincidence of the location, size and shape in all cases compared to the findings of renal sonography. Conclusion : The roles of renal sonography and DMSA scan were very important, and ultrasonography was an excellent initial tool in diagnosing AFBN. Since the degree of infection in AFBN is more severe than other urinary tract infections and evollution into a renal abscess is possible, early diagnosis and appropriate antibiotics therapy is essential.
Purpose: To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Materials and Methods: Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. Results: The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Conclusion: Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.
The effect of vanadate on the optimum pH of Na-K-ATPase was investigated. The results were as follows: 1) The optimum PH of Na-K-ATPase was shifted from PH 7.4 to 6.8 at 10 mM K by $5{\times}10^{-6}M$ vanadate. 2) The ratio of Na-K-ATPase activity at pH 6.8 and 7.4 increased with increasing vanadate concentration. 3) Inspite of the presence of $5{\times}10^{-6}M$ vanadate Na-K-ATPase activity at pH 7.4 was higher than that at pH 6.8 below 50 mM $Na^+$, and the ratio of Na-K-ATPase activity at pH 7,4 and 6.8 was higher than that of the control. 4) Na-K-ATPase activity at pH 7.4 was higher than that at pH 6.8 below 7mM $K^+$. 5) Optimum pH of Na-K-ATPase activity was shifted from pH 7.4 to 6.8 by $10^{-5}M$ vanadate at 5 mM $K^+$. 6) $K^+$-pNPPase activity increased with lowering of pH, and the degree of inhibition of $K^+$-pNPPase activity by $10^{-7}$M vanadate was decreased with lowering of pH. These results suggest that vanadate shifts the optimum pH of Na-K-ATPase activity to more acidic PH than PH 7.4. This effect may not be caused by the decrease in the inhibitory potency of vanadate itself to Na-K-ATPase by the change of medium pH, but mainly by the alteration of Na-and K-binding site, which appears in the presence of vanadate only.
Lee, Sue Young;Cho, Sung Hee;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yeon;Lee, Kyung Yil;Kang, Jin Han
Pediatric Infection and Vaccine
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v.11
no.1
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pp.90-100
/
2004
Objective : Urinary tract infection(UTI) is a frequent serious bacterial infection in young infants. The clinical presentation may be non-specific and variable, depends on factors such as the age and the level of infection. Children with renal involvement may be at risk of permanent renal damage. Experimental studies have shown that renal lesions caused by acute febrile UTI may be prevented or diminished by early diagnosis and treatment. Therefore, it is important to find a method that can permit early diagnosis and identification of patients who are at risk for progressive renal damage. We designed this study to identify related factors in culture positive UTI infants, and also to identify related factors in culture negative UTI infants, who are febrile with pyuria, by using renal imaging and functional studies including renal sonography, DMSA scan and VCUG. Methods : Retrospectively analyzed the medical records of 136 febrile infants with pyuria over 2 years(from January 2001 to February 2003). Urine culture was done in all cases, and regardless of urine culture findings, renal imaging study was done if symptomatic UTI suspected. Results : Total 57 organisms were isolated in 53 patients. E. coli was the most common organism(86%), followed by E. faecalis, M. morganii, Proteus species, P. aeruginosa, S. aureus and E. fergusonii. Most of the isolates had high sensitivity on cephalosporins or amikacin and had low sensitivities on aminopenicillins. Abnormal acute phase DMSA scan or VCUG findings were seen in both urine culture positive and negative group without statistical differences(P>0.05). In febrile infants with pyuria, fever over 48 hours, older age and high CRP related to abnormal acute phase DMSA scan findings regardless urine culture results. Conclusion : 1st or 3rd generation cephalosporins with amikacin could be the first choice of treatment for UTI. Febrile infants with positive urine culture dose mean urinary tract infection but not acute pyelonephritis which directly relates to cortical damage which could be confirmed by acute phase DMSA scan. Even cases with negative urine culture findings, acute pyelonephritis should be concerned in febrile infants with pyuria who are older than 3 months of age, has fever over 48 hours or high CRP level. And in such cases, acute phase DMSA scan and VCUG should be evaluated for early treatment and long term prognosis.
Purpose : Acute pyelonephritis in children may result in permanant renal damage which later in life may lead to hypertension and renal failure. The purpose of this study was to evaluate the factors that might be useful for predicting the development of renal scar in children with urinary tract infection(UTI). Methods : We retrospectively reviewed 442 patients with UTI who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, during the period from April 1992 to March 2002. The patients were divided into two groups according to the presence of renal scar on the follow-up DMSA renal scan, and we compared the factors associated with renal scarring between the two groups. Results : There were no significant differences in sex, causative organism and acute phase reactants between the groups with and without renal scar. The age at diagnosis was significantly higher in the renal scar group compared to that without scar. Of the 60 patients with renal scar, 78% had vesicoureteral reflux(VUR), but 13% of patients without scar had VUR. Furthermore, the severity of VUR was significantly correlated with renal scar formation. 53% showed multiple cortical defects on the initial DMSA renal scan, compared to 32% in the non-scar group. In addition, 76% of patients showing multiple cortical defects on the initial DMSA renal scan with VUR had renal scar. Conclusion : The presence and grade of VUR, and findings on the initial DMSA renal scan would contribute to predict risk of renal scar formation in children with UTI.
The studies were carried out to obtain the basic data for maximizing the protoplast yields from the mycelia of P. ostreatus and P. sajor-caju. Some factors affecting the regeneration of the protoplast of both species and the productivity of their reversion were also examined. The maximum yields of protoplasts were obtained from four days cultured mycelia of both species on cellophan membrane placed on the surface of PSA or MCM media in a petri dish. The optimal concentration of lytic enzyme Novozym 234 for protoplast releasing was 5 mg per ml of 0.5 M phosphate buffer solution with 0.6 M sucrose or 0.6 M $MgSO_4$ at pH 6.0. The greatest number of protoplasts was released 3 hours after incubation of the mycelia of P. ostreatus and after 4 hours for the P. sajor-caju in the lytic enzyme solution. Among the osmotic stabilizer solutions tested 0.6 M sucrose and 0.6 M KCl showed the best regeneration rates of the protoplasts of both species. When 0.75 % agar solution was over-layed on the regeneration media immediately after inoculation of the protoplast the regeneration rates were greatly enhanced. The ampicillin added to the agar solution prevented bacteria from infection. The reverted isolates produced the sporophores and basidial spores just like their parents without any mutations when they were cultivated in a broad mouth bottle with sawdust substrates.
Lee, Jin Han;Shin, Hong-Beom;Kim, Jong Won;Suh, Ho-Suk;Lee, Young Jin
Sleep Medicine and Psychophysiology
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v.26
no.1
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pp.44-48
/
2019
Objectives: Insomnia is one of the most prevalent sleep disorders. Recent studies suggest that cognitive and physical arousal play an important role in the generation of primary insomnia. Studies have also shown that information processing disorders due to cortical hyperactivity might interfere with normal sleep onset and sleep continuity. Therefore, focusing on central nervous system arousal and normalizing the information process have become current topics of interest. It has been well known that neurofeedback can reduce the brain hyperarousal by modulating patients' brain waves during a sequence of behavior therapy. The purpose of this study was to investigate effects of neurofeedback therapy on electroencephalography (EEG) characteristics in patients with primary insomnia. Methods: Thirteen subjects who met the criteria for an insomnia diagnosis and 14 control subjects who were matched on sex and age were included. Neurofeedback and sham treatments were performed in a random order for 30 minutes, respectively. EEG spectral power analyses were performed to quantify effects of the neurofeedback therapy on brain wave forms. Results: In patients with primary insomnia, relative spectral theta and sigma power during a therapeutic neurofeedback session were significantly lower than during a sham session ($13.9{\pm}2.6$ vs. $12.2{\pm}3.8$ and $3.6{\pm}0.9$ vs. $3.2{\pm}1.0$ in %, respectively; p < 0.05). There were no statistically significant changes in other EEG spectral bands. Conclusion: For the first time in Korea, EEG spectral power in the theta band was found to increase when a neurofeedback session was applied to patients with insomnia. This outcome might provide some insight into new interventions for improving sleep onset. However, the treatment response of insomniacs was not precisely evaluated due to limitations of the current pilot study, which requires follow-up studies with larger samples in the future.
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