OBJECTIVES: Phencyclidine(PCP) or PCP-like substances such as ketamine have been know to rekindle the cognitive dysfunction in schizophrenia. The aims of this study were to identify whether PCP-like substances can produce cognitive deficit in schizophrenia, to discuss relation with aging process, and finally to speculate underlying neurochemical mecha-nisms by various drug responses. METHODS: In experiment I, radial maze tests were done in 24 Sprague-Dawley rats for 3 days to get baseline data. Being divided into 4 groups(6 rats respectively) of normal aged, normal adult controls, atropine-treated and ketamine-treated, the radial maze tests were repeated on every week for 6 weeks, and then the rats were sacrificed by intracardiac perfusion with phosphate-buffered 10% formaldehyde solution for histology. The brain specimen was stained with hematoxylin-eosin to count cells in the prefrontal cortex and hippocampus. In experiment II, radial maze tests were done for 48 rats before any drug treatment and only after ketamine administration. Thereafter, haloperidol, bromocriptine, clonidine, nimodipine, tacrine, valproic acid, naloxone and fluoxetine were intramuscularly injected on every other day in addition to ketamine. Radial maze tests were repeated on every week for 6 weeks, and then rats were prepared by the same procedure for histology. RESULTS: 1) Reaction times of radial maze tests of atropine-treated rats were significantly prolonged than those of normal aged(p<0.05) or normal adult controls(p<0.05). Cell numbers of prefrontal cortex & hippocampus in ketamine-treated rats were significantly reduced than those in normal aged(p<0.05) or normal adult controls(p<0.005). 2) Reduced cell numbers by ketamine became significantly raised by tacrine administration in prefrontal cortex $ hippocampus(p<0.05), while there were no significant changes on radial maze test. Cell numbers also tended to be raised by nimodipine, fluoxetine and haloperidol administration. CONCLUSIONS: In conclusion, the visuospatial memory disorders in ketamine-induced psychotic rats might be partly associated with aging process. Furthermore, the responses to the various drugs suggested cholinergic system might have an important role in the neurochemical mechanism of the cognitive dysfunction in ketamine-induced psychosis. Otherwise, calcium metabolism as well as serotonergic and dopaminergic systems seemed to be possibly related.
Acetylcholine ; Adult ; Aging* ; Animals* ; Brain ; Bromocriptine ; Calcium ; Cell Count ; Clonidine ; Fluoxetine ; Formaldehyde ; Haloperidol ; Hippocampus ; Humans ; Ketamine ; Memory Disorders ; Metabolism ; Models, Animal* ; Naloxone ; Nimodipine ; Perfusion ; Prefrontal Cortex ; Psychotic Disorders ; Rats ; Rats, Sprague-Dawley ; Reaction Time ; Schizophrenia* ; Tacrine ; Valproic Acid

Acute tubular necrosis has been rarely reported as a complication of typhoid fever in the literature. We experienced four cases of acute tubular necrosis associated with typhoid fever in children. Patients showed significant titer of widal reaction associated with acute renal failure and one of them rised in 2 months after onset of clinical symptoms. Renal biopsy findings were compatible with acute tubular necrosis and immune complexes were not deposited in the glomeruli. Clinical and urinary findings were normalized by hemodialysis and antibiotic therapies. In conclusion, close longterm follow up of widal titer is mandatory in acute tubular necrosis, especially when associated with high fever.
Acute Kidney Injury ; Antigen-Antibody Complex ; Biopsy ; Child ; Fever ; Follow-Up Studies ; Humans ; Necrosis* ; Renal Dialysis ; Typhoid Fever*

Scapholunate advanced collapse (SLAC) deformity most often occurs with chronic rotary scaphoid instability from scaphoiunate ligament tear and scaphoid fracture. Prior to 1984 when Watson HK reported his concept on SLAC wrist deformity, the most popular procedure for this pathology was scaphoid implant arthroplasty with or without midcarpal fusion. We have reviewed 15 cases of SLAC deformity treated with scaphoid excision and midcarpal fusion from 1984 to 1993. Among them, scaphoid implants made of silicone were inserted in 4 cases. Scaphoid implant arthroplsty without carpal fusion has been excluded. The mean period of follow-up was 8.8 years and the mean age of patients was 47.5 years. Males and right wrists were predominant. Wrist motion was 56% and grip power was 71% of the normal opposite side. On the average overall, 8 patients had no pain and 7 patients had mild pain. The grade of pain was minimal, 0.5 in grade (Rating system: no pain-0, mild- 1, moderate-2, severe-3). However, all of the 4 cases of limited carpal fusion with a scaphoid implant developed silicone particulate induced synovitis and pain. The procedure appears to be effective in maintaining function of the hand with minimal pain up to 5.8 years. However, silicone scaphoid implant appears not to be necessary and is not recommended with a limited carpal fusion for this pathology.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Male ; Pathology ; Silicones ; Synovitis ; Wrist

In 1947, Liver described adenoid squamous cell carcinoma under the title of "adenoacanthoma of sweat gland". This tumor is not rare, but reported cases in literatures were relatively few. The tumor were frequently found in the sun-exposed skin; such as face, ear, neck etc.. The cases involving non-sun-exposed area, such as oral and labial mucosa, nosopharynx and vulva etc., were also reported. Therefore, the relation between the pathogenesis of adenoid squamous cell carcinoma and sun damage has been still debated. Immunohistochemical studies have recently suggested that this tumor is squamous cell carcinoma undergoing acantholysis. The authors experienced a case of adenoid squamous cell carcinoma of the vulva in a seventy-one year old female patient. She had suffered from itching sensation on vulva for 10 years, and palpable mass on vulva for 1 month. On gross examination, a pale gray pigmentation and erosion, was noted at the right labia major, the minor extending left labia major and minor. On microscopic examination, nests of atypical epithelial cells extending into the cornium showed an adenoid architecture. These were composed of a peripheral layers of cuboidal cell in a lacy pattern. And the glandular spaces contained dyskeratotic acantholytic tumor cells in central portion. Therefore we diagnosed this case as adenoid squamous cell carcinoma of the vulva.
Female ; Humans

Pulmonary artery sling is a rare congenital cardiovascular anomaly which presents clinical obstructive symptoms and signs of trachea, right main bronchus and esophagus due to left pulmonary artery abnormaly arises from proximal part of right pulmonary artery. Aberrant left pulmonary artery courses to the right above right main bronchus and then turns to the left, and courses to between the anterior of the esophagus and the posterior aspect of trachea. One of important clinical significances of the pulmonary artery sling is associated with intracardiac anomalies, and with tracheal stenosis and bronchomalacia due to press tracheobronchial tree by the aberrant pulmonary artery. It has been thought that embryological malconnection between the pulmonary artery bud from left sixth arch and the pulmonary posterior branchial plexus in the left lung bud. We had experienced 21 months old male infant with left pulmonary artery sling associated with persistent left superior vena cava and dextropostioned heart. The heart seems to move to right hemithorax due to hypoplasia or segmental atelectasis of right lung.
Bronchi ; Bronchomalacia ; Esophagus ; Heart* ; Humans ; Infant ; Lung ; Male ; Pulmonary Artery* ; Pulmonary Atelectasis ; Trachea ; Tracheal Stenosis ; Vena Cava, Superior*

Leser-Trelat sign is characterized by the sudden appearance and rapid increase in number and size of seborrheic keratoses associated with an internal malignancy. A 78-year-old woman showed multiple pea to bean sized dark brownish papules and plsques on the trunk. Skin lesions had appeared suddenly since 5 months ago and then rapidly increased in number and size. The histopathologic exsmination of the skin lesions revealed seborrheic keratoses. The chest roentgenogram revealed the mass shadow on the right hilar region and transbronchial lung biopsy revealed small cell carcinoma.
Aged ; Biopsy ; Carcinoma, Small Cell* ; Female ; Humans ; Keratosis, Seborrheic ; Lung* ; Peas ; Skin ; Thorax

PURPOSE: The purpose of this study was to evaluate the utility of two-phase dynamic CT, early and equilibrium pahse, in the preoperative staging of rectal cancers. MATERIALS AND METHODS: We performed incremental dynamic CT after rectal infusion of water in 34 patients with pathologically proved rectal cancers. Two-phase dynamic CT findings were prospectively analyzed and correlated with surgical and histopathologic findings. A total of 150ml of nonionic contrast medium was intravenously administered with a power injector at a flow rate of 5ml/sec for 30 sec, and two-phase images were obtained at 30 sec(early phase) and 2 min (equilibrium phase) after bolus injection. Local tumor staging and regional lymph node were classified by TNM staging. RESULTS: All 34 rectal cancers showed a moderate to marked enhancement in the early phase and a homogeneous and prolonged enhancement of the entire lesion in the equilibrium phase. T-staging of primary tumors were 85.3%(29/34) in early phase and 70.6%(24/34) in equilibrium phase. The accuracy in determining the perirectal fat invasion of rectal cancer was 92%(23/25) in early phase, and 72%(18/25) in equilibrium phase. The sensitivity & specificity of the regional lymph node metastasis were 63.6% and 79.1% in early phase, and 54.5% and 65.2% in equilibrium phase, respectively. CONCLUSION: Early phase dynamic CT was more accurate for the preoperative staging of rectal cancer than that at equilibrium phase.
Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Staging ; Prospective Studies ; Rectal Neoplasms* ; Sensitivity and Specificity ; Water

Infectious mononucleosis is a common systemic illness primarily invloving children and young adults and due apparently to the Epstein-Barr virus (EBV). Although the typical case is easily recogniged, unusual manifestations or serious complications occur frequently enough to pose problems in diagnosis and management. Neurologic complications are rare(1%). These nerologic complications may actually precede the full clinical picture or present as the sole manifestation of the illness, thereby causing a confusing clinical picture and delay in diagnosis. We have experienced a case of infectious mononucleosis associated with facial nerve palsy in a 22-months old female. She was admitted to the hospital with the fever, right facial nerve palsy and hepatosplenomegaly. The diagnosis was made on the clinical findings, immunologic findings and the typical findings of peripheral blood smear. On peripheral blood smear, atypical lympocytes with relative lympocytosis were seen. On Immunologic study EBV anti-VCA IgM titer was 1:20 and the IgG titer was 1:40. To our knowledge, this is the first report in Korea. So, we report this case and the brief literatures of infectious mononucleosis associated with neurologic complications and other viral diseases which caused facial nerve palsy.
Child ; Diagnosis ; Facial Nerve* ; Female ; Fever ; Herpesvirus 4, Human ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Infectious Mononucleosis* ; Korea ; Paralysis* ; Virus Diseases ; Young Adult

No abstract available.
Nephrotic Syndrome* ; Venous Thrombosis*

Primary extracranial and extraspinal meningiomas are rare. Cases involving the orbit, skin, nasal cavity, paranasal sinuses, oral cavity and parotid gland have been reported. The histogenesis of primary extracranial meningioma is still nucertain, but it has been thought that this tumor originates from arachnoid cell rests in displaced during embryonal development. The authors observed a case of primary meningioma of the nasal cavity and paranasal sinuses occurring in a thirty-eight year old male patient in Feb. 1989. He suffered from bulging in the medio-superior portion of left orbit for 15 years, and left nasal obstruction and headache for 5 years, A head CT scan revealed numberous polypoid masses filling the left frontal sinus left ethmoidal sinus, left maxillary sinus and left nasal cavity. During the operation, a connection to the dura was not found. Microscopically, there were discrete lobules or netst of meningothelial cells, beneath the nasal mucosa. They showed an occasional whorling pattern and psammoma bodies. Therefore, this case was diagnosed as primary meningioma, meningotheliomatous type involving the left nasal cavity and paranasal sinuses.
Male ; Humans ; Meningioma