OBJECTIVES: The purpose of this study was to investigate whether longitudinal changes in positive and negative symptoms affect cognitive functioning in chronic schizophrenia. METHODS: Sixty-eight patients diagnosed with DSM-IV schizophrenia were examined on two occasions over 6 months for symptoms and cognitive changes. Symptoms were measured by PANSS. Cognitive functions were examined for sustained attention, executive function, concentration and attention, and verbal memory and learning using Degraded Stimulus Continuous Performance Test, Wisconsin Card Sorting Test, Digit Span, and Rey Auditory Verbal Learning Test, respectively. Twenty control subjects were assessed to compare the cognitive scores of remitted schizophrenic patients. RESULTS: Patients showed significant improvement in symptoms and all cognitive tests after 6 months treatments. Significant improvements in positive and negative symptoms did not predict improvements in any aspect of cognitive functioning measured. Normal controls performed significantly better than remitted schizophrenic patients on all cognitive tests. The results show no relationship between change in symptoms and change in cognition in chronic schizophrenia. CONCLUSION: We suggest that symptomatic and cognitive impairment may be a distinct construct. These findings highlight the importance of treating cognitive impairment in addition to the clinical symptoms of schizophrenia.
Cognition ; Diagnostic and Statistical Manual of Mental Disorders ; Executive Function ; Follow-Up Studies* ; Humans ; Learning ; Memory ; Schizophrenia* ; Verbal Learning ; Wisconsin

No abstract available.
Animals ; Calcitonin* ; Female ; Osteoporosis* ; Ovariectomy* ; Rats* ; Tamoxifen*

The aseptic loosening has emerged as one of the most common and serious long term complications, which requires the revision of total hip replacement arthroplasty. We studied the radiologic finding of the aseptic loosening in 79 patients of uncemented total hip replacement arthroplasty which had been performed in our hospital from March 1991 to December 1994. We evaluated the white reaction lines, osteolysis state, translation and migration in postoperative and last follow-up radiographies. The white reactive lines around the femoral stem and the acetabular cup were most frequent in zone IV and zone II. But it was not progressive and need more long term follow-up evaluations to confirm whether these lines are related to loosening or not. In assessment for stable state, the more stable at initial fixations, the better state of long term stability. Some patients have pain without loosening but all patients with loosening have pain. Press fit is the most important factor of the late stability. The osteolysis is not directly proportional to femoral loosening in this study, but it might be due to short follow up time.
Acetabulum ; Arthroplasty* ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Osteolysis

The incidence of herniated lumbar disc under the age of 19 years is increasing due to increased sports activity of teenager and development of diagnostic methods. 33 cases of herniated lumbar disc of the teenager was analyzed at Department of Orthopaedic Surgery, Dong-A College of Medicine from March 1990 to May 1994. The results were obtained as follows: 1) Among 413 patients, 33 patients(7.9%) were teenagers and the sex ratio was 2.3:1 in male to female. 2) Average intervals between the onset of clinical symptoms and the admission were 13.2 months. 3) 20 cases(60.6%) had a definite trauma history, and among these cases, 14 cases(70.0%) were associated with sports activity. 4) The most common level of herniation was L4-5 in 29 cases(64.4%), straight leg raising test was positive in 32 cases(97.0%), sensory change in 13 cases(39.4%), motor weakness in 10 cases(30.3%). 5) Among positive MRI findings(32 cases), 17 cases(53.1%) were the protruded type. 6) Among 23 operative cases, 21 cases had excellent or good results.
Adolescent ; Female ; Humans ; Incidence ; Intervertebral Disc ; Leg ; Magnetic Resonance Imaging ; Male ; Sex Ratio ; Spine ; Sports

Intracellular pH regulation of osteoblasts is of a great importance in the process of bone formation and resorption, and has been suggested to be mediated via intracellular Ca2+ and cAMP messenger systems. To elucidate the mechanism of modulation of intracellular pH by parathyroid hormone and PMA(Phorbo1-12-myristate-13-acetate), effects of these agonists on the individual transporter system, Na+-H+ antiporter and Cl−-HCO3-(−OH−) exchanger, were investigated. Intracellular pH and Ca2+ were measured by using the fluorescent dye BCECF and fura-2, respectively, in UMR-106 cell monolayer grown on glass coverslip. Addition of tumor promotor, PMA(luM) caused 0.14 unit pH rise of resting intracellular pH(pHi) and 38% increase of the initial rate of pHi recovery after cytosolic acid load. Perfusion of Cl−-free solution resulted in rapid cytosolic alkalinization of which the rate was increased 26% by preincubation of PMA. Ca2+ ionophore, ionomycin (1uM) decreased resting pHi by 0.17 unit, but had no effect on the initial rate of pHi recovery after cytosolic acid load. However, the addition of ionomycin augmented the initial rate of pHi increase after Cl−-depletion outside the cells by 34% over the control. Stimulation of cells with parathyroid hormone(10-8M) caused an initial acidification (0.27 unit) followed by cytosolic alkalinization, with inhibiting effect on the initial rate of pHi recovery after acid load (42%). But parathyroid hormone did not have any significant effect on the rate of pHi increase after Cl−-depletion. PMA caused a sustained increase of intracellular Ca2+, of which the peak depended on the concentration of Ca2+ in extracellular medium. Ionomycin caused a transient increase of Ca2+ but PTH had no significant increase of intracellular Ca2+ in the concentration range of 10-6M to 10-12M tested. 10-8M PTH increased cAMP levels by about 10-fold and 10-10M PTH did by 1.6-fold. PMA, which increased cytosolic Ca2+ concentration, also had an stimulatory effect on cAMP production in the concentration range of 10-5M to 10-6M by 2-fold. These findings suggest that in UMR-106 cells Ca2+ and cAMP can influence pHi by altering the activity of pHi regulatory transporter system, and parathyroid hormones modulate pHi by inhibiting Na+-H+ antiporter via intracellular increase of cAMP, which is probably accounts for the inhibitory effect of parathyroid hormone on the proliferation of osteoblasts.
Cytosol ; Fura-2 ; Glass ; Hydrogen-Ion Concentration ; Ion Transport ; Ionomycin ; Osteoblasts ; Osteogenesis ; Parathyroid Hormone ; Perfusion

The 17 patients with 22 resistant clubfeet were treated with modified Turco's operation with or without combining release of calcaneocuboid joint at Department of Orthopaedic Surgery, Hanyang University School of Medicine between 1896 and 1991. They were analysed preoperatively and postoperatively with chinical and radiological methods. In patients who were treated with combined procedures, the latetal talocalcaneal angle and anteroposterior talo-first metatarsal angle in radiological findings were showed better improvement(p < 0.05), and anteroposterior talocalcaneal angle was also showed better improvement but not significant statistically, than those who were treated with modified Turco's operation alone. The final results of combined procedures were better than that of modified Turco's operation. And the most common characteristic physical findings in resistant clubfoot were small heel, deep longitudinal crease on the medial aspect of midfoot area and a single transverse crease on the posterior heel just proximal to the insertion of the tendocalcaneus. So we suggest these physical findings may be expectance for the resistance of the congenital clubfoot to conservative treatment, but it need further comparative study.
Clubfoot ; Heel ; Humans ; Joints ; Metatarsal Bones

PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals ; Cytoskeleton ; Desmin ; Intermediate Filament Proteins* ; Intermediate Filaments* ; Laminin ; Leg* ; Mammals ; Muscle Fibers, Skeletal ; Muscle, Striated ; Muscles* ; Myoblasts ; Nerve Crush ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Rats* ; Regeneration* ; Sciatic Nerve* ; Vimentin

PURPOSE: The intermediate filament proteins, desmin and vimentin, are specific components of the cytoskeleton of striated muscle fibers and of mononuclear cells of mesenchymal origin including myoblasts, respectively. Desmin has also been found in presumptive myoblasts of mammals. The aim of this experiment was attempted to observe the phenotypic changes of intermediate filaments in skeletal muscle fibers during early stages of sciatic nerve crushing injury. MATERIALS AND METHODS: The sciatic nerves of rats were surgically crushed by hemostat and serial cryosections of soleus and extensor digitorum longus(EDL) muscles were prepared at 2, 4, 6, 8, 10, 15, 20 and 27 days after nerve injury. Serial cryosections were immunolabelled with desmin, vimentin and laminin and were histochemically reacted with NADH-TR. RESULTS: 1) Firstly, desmin positive fibers were appeared in fast-twitch type C fibers of both muscles at 6 days after nerve crushing, but were not reacted for vimentin. 2) Co-expressions of desmin and vimentin were firstly detected in fast-twitch type A fibers of EDL muscles at 8 days after nerve injury. In soleus muscles, co-expressions of desmin and vimentin were firstly seen in slow-twitch type B fibers at 10 days after nerve injury. Many atrophic fibers, that contained several central nuclei like myotubes and co-expressed desmin and vimentin, were appeared in EDL muscles at 10 days after nerve injury. Although whole regions of fibers were regenerated in EDL muscles, only peripheral regions of fibers were regenerated in soleus muscles at 15 days after nerve injury. Many atrophic fibers, co-expressed of desmin and vimentin, were appeared in EDL muscles at 20 days after nerve injury. These whole fibers represented various degrees of regenerating stages. Most of mature fibers containing several central nuclei, only expressed vimentin slightly, were seen in soleus muscles at 20 days after nerve injury. Most fibers of both muscles were matured at 27 days after nerve injury, but some fibers in EDL muscles were still in processing of degeneration and regeneration. No expressions of desmin and vimentin indicated that muscle fibers were almostly matured in soleus muscles at 27 days after nerve injury. 3) Targetoid or target fibers which informed reinnervation, were appeared firstly in soleus muscles at 20 days and were seen in both muscles at 27 days after nerve injury. All targetoid and target fibers were type B fibers. CONCLUSION: Desmin was revealed in processes of degeneration and regeneration and vimentin was appealed in regeneration process. At the same time, positive immunoreactivity of desmin and vimentin showed specific differences in degree of degeneration and regeneration according to different muscles and muscle fibers.
Animals ; Cytoskeleton ; Desmin ; Intermediate Filament Proteins* ; Intermediate Filaments* ; Laminin ; Leg* ; Mammals ; Muscle Fibers, Skeletal ; Muscle, Striated ; Muscles* ; Myoblasts ; Nerve Crush ; Nerve Fibers, Myelinated ; Nerve Fibers, Unmyelinated ; Rats* ; Regeneration* ; Sciatic Nerve* ; Vimentin

This is a clinical study of 129 cases of colorectal cancer who were treated in the department of surgery, Inchon Christian Hospital from January 1989 to December 1996. The results were as follows; 1) The peak age incidence was 7th decade and the ratio between male and female was 1.87 : 1 2) The most frequent site of the tumor was the rectum(59.7%). 3) In the right and left colon cancer the most frequent symptom was abdominal pain and in the rectal cancer the most frequent symptom was bloody stool. 4) The duration of symptoms prior to admission was within 3months(58%). 5) The diagnostic methods were digital examination, sigmoidoscopy colonofiberscopy, barium enema and abdominal CT scanning. 6) The most frequently performed operation was Abdominoperineal resection(27%). 7) The staging of tumors was performed according to modified Dukes' classification and Dukes C was most frequent(55.1%). 8) The most common histopathologic type was adenocarcinoma(98%). 9) The most common macroscopic finding was ulcerative pattern. 10) The most common distant metastatic site was pelvic organ(12%). 11) The most common post-operative complication was wound infection(10.1%). 12) The 5year survival rate was analyzed by Kaplan-Meier's method : the overall 5year survival rate was 60.7%.
Abdominal Pain ; Barium ; Classification ; Colonic Neoplasms ; Colorectal Neoplasms* ; Enema ; Female ; Humans ; Incheon ; Incidence ; Male ; Rectal Neoplasms ; Sigmoidoscopy ; Survival Rate ; Tomography, X-Ray Computed ; Ulcer ; Wounds and Injuries

We examined the rates of postoperative neurologic complications, as recorded in the medical record department in Severance Hospital from 1989 through 1991 for patients who had had operations on the spine. There were 538 hospitalizations for procedures on the spine; 327(60.78%) of herniated disc, 120(22.30%) of spondylolisthesis, 64(11.90%) of infection, 27(5.02%) of spinal stenosis were included. Neurologic complications oecurred in 12(2.23%) patients; 3 cases in herniated disc, 4 in spinal stenosis, 4 in spondylolisthesis, and 1 in infection. Regarding techniques of the operation, 8 complications occurred in arthrodesis, among these, 2 were in anterior approach and 6 in posterior approach. Four cases of the complications occurred in laminectomy and discectomy procedure. Complications were more frequent in the patients who had had spinal stenosis when arthrodesis was performed than decompression procedure only. Possible causes of neurologic complication were postoperative hematoma formation, translation of the vertebral column due to instability after anterior debridement and forceful traction of the nerve root during the operation.
Arthrodesis ; Debridement ; Decompression ; Diskectomy ; Hematoma ; Hospitalization ; Humans ; Intervertebral Disc Displacement ; Laminectomy ; Medical Records ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Traction