No abstract available.
Amitriptyline* ; Humans

There are many advantages in treating long bone fractures with interlocking intramedullary nail and its advantages are well known. Although it is used widely, many major and minor complication can develop in spite of meticulous operation techniques. Frist fifty consecutive interlooking intramedullary nail of two different surgeon, total of 100 cases that were operated in Seoul Paik Hospital from January, 1991 to July, 1994, were reviewed and the complications were analyzed with various factors. 1. Among the 100 cases, a total of 30(30%) major and minor complications had developed. But only 4 major complications which needed reoperation or poor result occurred. 2. Among the complications that had developed, angulation and rotation deformity being 10 cases were the most common, other complications were delayed union in 5 cases, nonunion in 2 cases, problem of screw in 4 cases, metal failure in 2 cases, misentry point in 2 cases and others in 5 cases. 3. There were no remarkable difference between surgeon A and surgeon B. The complications decreased abruptly after 30th case for each surgeon and only a few complications, probably due to complex fracture pattern, occurred. In conclusion, complications after interlocking intramedullary nailing can be reduced by meticulous preoperative planning and learning process of surgeon.
Congenital Abnormalities ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Learning ; Reoperation ; Seoul

PURPOSE: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral certex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. MATERIALS AND METHODS: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |CR-CL|/(CR-CL)x200, where CR and GL and the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean+2 SD of 20 control subjects. RESULTS: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68+/-8.94 vs 4.35+/-0.94, mean+/-SD), thalamus (31.91+/-10.61 vs 2.57+/-1.45), basal ganglia (35.94+/-16.15 vs 4.34+/-2.08), parietal (18.94+/-10.69 vs 3.24+/-0.87), frontal (13.60+/-10.8 vs 4.02+/-2.04) and temporal cortex (18.92+/-11.95 vs 5.13+/-1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). CONCLUSION: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.
Basal Ganglia Hemorrhage* ; Basal Ganglia* ; Brain ; Cerebellum ; Humans ; Rabeprazole ; Thalamus ; Tomography, Emission-Computed, Single-Photon

Malignant hyperthermia is a dramatic syndrome that rarely arises during anesthesia and which is still fatal in the majority of cases. It is a hypermetabolic muscle condition characterized by hyperpyrexia and skeletal muscle rigidity. Any potent inhalation anesthetic agent or any skeletal muscle relaxant can trigger this acute catast rophic reaction. A case is presented of a 28 year old femal with a family history of malignant hyperthermia in herrelatives. She sunderwent repair of a retinal detachment under N2O-O2-halothane withcinduction by thiopenthal and succinylcholine. One and half hours after induction, arrhythmia developed and was followed by unstable blood pressure, hyperpyrexia, muscular rigidity. Anesthesia was ended and vigorous emergency treatment was attempted. But she died postoperatively on the 4th day after anesthesia. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Incidence

A brief episode of ischemia and reperfusion termed 'ischemic preconditioning' has been established as rendering muscle tolerance to damage during a subsequent prolonged ischemia. The effects of ischemic preconditioning in the cardiac muscle is related to the stimulation of adenosine A1 receptor and the opening of KATP channel. The effect and mechanism of ischemic preconditioning in the skeletal muscle is not known clearly. The author performed the present study to investigate the effect and the mechanisms of ischemic preconditioning by measuring the SOD immunoreactivities on timely reperfused ischemic muscles. The healthy Sprague -Dawley rats weighing from 200 g to 250 g were used as experimental animals. Under pentobarbital (50 mg/kg) anesthesia, lower abdominal incision was done and left common iliac artery was ligated by using vascular clamp for 2 hours. Rectus femoris muscles were obtained at 0 hour, 1 hour, 2 hours, 6 hours, 12 hours, 24 hours, 48 hours and 72 hours of reperfusion. The group of ischemic preconditioning underwent three episodes of 5 minute occlusion and 5 minute reperfusion of common iliac artery followed by 2 hours of ischemia and timely reperfusion. Adenosine (50 microgram/kg) or pinacidil (1 mg/kg) were administered intravenously before ischemia and 2 hours of ischemia and timely reperfusion was done. 10 microM thick cryosections in all groups were obtained. The immunoreactivities of SOD were observed by use of antihuman Cu,Zn -and Mn -SOD antibodies. The results obtained were as follows. 1. The immunoreactivities of SOD in the rectus femoris muscles of rats increased after ischemic preconditioning. The patterns of the changes in immunoreactivities of Cu, Zn -and Mn -SOD were similar at the muscle fibers with large section area or small section area. 2. After the treatment of adenosine, the immunoreactivities of Cu, Zn -SOD in the group of 2 hours and 24 hours reperfusion and the immunoreactivities of Mn -SOD in the group of 24 hours reperfusion increased. After the treatment of pinacidil, the immunoreactivities of Mn - SOD increased and the immunoreactivities of Cu, Zn -SOD are similar to normal control rat. 3. After 2 hours of ischemia the immunoreactivities of SOD were similar to normal control rat. The immunoreactivities of Cu, Zn -SOD in the group of 1 hour, 2 hours and 24 hours reperfusion and those of Mn -SOD in all groups of reperfusion increased. 4. In the group of 2 hours ischemia and timely reperfusion with ischemic preconditioning, the immunoreactivities of SOD in the muscle fiber with large section area decreased and those of SOD in the muscle fibers with small section area increased in comparison with the group of 2 hours and timely reperfusion. The pattern of change between immunoreactivities of Cu,Zn -and Mn -SOD in each muscle fiber were similar. 5. After the treatment of adenosine, the immunoreactivities of SOD increased in the group of 1 hour, 2 hours, 6 hours and 12 hours reperfusion. After the treatment of pinacidil, the immunoreactivities of SOD increased in the group of 1 hour, 2 hours, 6 hours, 12 hours and 24 hours reperfusion. Consequently, these results suggest that the immunoreactivities of SOD increase after 2 hours of ischemia and timely reperfusion with ischemic preconditioning. The effect of ischemic preconditioning is related to opening of KATP channel partly.
Adenosine ; Anesthesia ; Animals ; Antibodies ; Iliac Artery ; Ischemia* ; Ischemic Preconditioning ; Muscle, Skeletal ; Muscles* ; Myocardium ; Pentobarbital ; Pinacidil* ; Quadriceps Muscle* ; Rats* ; Receptor, Adenosine A1 ; Reperfusion*

OBJECTIVE: This study was performed to assess the possible involvement of the dopamine D5 receptor gene(DRD5) in the etiology of schizophrenia. METHODS: We identified the distribution of the T978C varient of the dopamine D5 receptor gene in 100 schizophrenics and 100 normal controls in Korean population, and evaluated the association between two groups. RESULTS: There were no significant differences in genotype frequency of T978C variation and genotype prevalence of homozygotes between schizophrenic and control groups. There was no significant difference in T978C allele frequencies between schizophrenic and control groups. CONCLUSION: We present evidence of a lack of allelic association between the exonic common polymorphism of the dopamine D5 receptor gene and Korean schizophrenic patients. The assumption that the T978C varient of the dopamine D5 receptor gene has a genetic role in the development of schizophrenia was not examined by this case-control study. However, because it is considered that DRD5 may act as the expression factor for the symptoms of schizophrenia or affect the difference in an individual's susceptibility to the disease, future studies to investigate the influence of other variations of DRD5 are needed.
Case-Control Studies ; Dopamine* ; Exons ; Gene Frequency ; Genotype ; Homozygote ; Humans ; Prevalence ; Receptors, Dopamine D5* ; Schizophrenia

No abstract available.

Microform cleft lip is a mild form of incomplete cleft lip, also known as a minimal occult, abortive, forme fruste cleft lip. However, it has no definition and few methods have been reported for its correction. A microform cleft lip is characterized as the incomplete union of the superficial portion of the orbicularis oris muscle. It is more prominent during facial expression than in a resting state. We confined microform cleft lip in our study to the absence of philtral skin change and a contracted position on the top of cupid's bow. During the past 5 years, 17 patients of microform cleft lip were operated on. We corrected the defect of the upper vermilion border and nostril sill with minimal incision, and repaired the underlying lip musculature in superficial discontinuity. Reduction of the widened alar base was performed. Deformed alar cartilage was dissected via rim incision, and suspended in a medial and upper direction with pull-out sutures. The most important thing is precise repair of the superficial portion of the separated orbicularis oris muscle via minimal incision, and it is best to operate after 1-year of age for accurate repair. The results were satisfactory and the parents were also satisfied. The advantages of this procedure are as follows: 1. Less visible, minimal scar on upper lip 2. Simultaneous correction of vermillion notching, deformed cupid's bow and nasal deformity. 3. Eversion of philtral ridge due to tenting effect of horizontal mattress suture 4. Philtral elongation effect by reduction of alar base and Z-plasty of cupid's bow.
Cartilage ; Cicatrix ; Cleft Lip* ; Congenital Abnormalities ; Facial Expression ; Humans ; Lip ; Microfilming* ; Parents ; Skin ; Sutures

OBJECTIVES: The dopamine-blocking effects and the associated side effects(amenorrhea, lactation, sexual dysfunct of classical antipsychotics in schizophrenic patients have been studied for a long time. The purpose of this study to find out these effects of new antipsychotics(risperidone, olanzapine) in schizophrenic patients treated with clinical relevant doses. METHOD: Plasma levels of both prolactin and testosterone were measured in 91 schizophrenic patients(28 taking haloperidol, 4-20mg/day ; 31 taking risperidone, 2-6mg/day/ 32 taking olanzapine, 5-20mg/day). RESULTS: In male schizophrenic patients, the prolactin levels of risperidone group(76.44+/-38.85ng/ml) and haloperidol group(60.26+/-20.74ng/ml) had no significant difference, but were significantly higher than that of olanzapine(26.90+/-5.36ng/ml). In female, the prolactin level of olanzapine group(36.66+/-17.55) was significantly lower than those of risperidone(121.7+/-.33) and haloperidol group(161.66+/-37.53). And prolactin level of risperdone group was lower than that of haloperidol group. While the testosterone plasma level of risperidone, haloperidol and olanzapine in both male and female schizophrenic patients had no significant difference. CONCLUSIONS: At doses known to be effective in popular clinical setting, prolactin level in patients taking risperidone we higher than that of haloperidol, while olanzapine showed no significant difference in terms of prolactin plasma level haloperidol. New antipsychotics may not influence the testosterone plasma level.
Antipsychotic Agents* ; Female ; Haloperidol ; Humans ; Lactation ; Male ; Plasma ; Prolactin* ; Risperidone ; Testosterone*

Fractures of the tibial pilon are the severe injuries to the ankle joint resulted from axial compression, shear and/or rotational forces. The mangement has been notoriously difficult due to the comminution of the distal tibia, articular incongruity and soft tissue trauma. The advocated treatment sequence of fibular reconstruction, restoration of the articular suface, bone grafting of defects and the use of an anterior or medial neutralization plate, early movement and delayed weight bearing, were performed recently and the best results have been obtained. The results of treatment of 18 cases were analysed at the Department of Orthopedic Surgery, Chonbuk National University Hospital and Chong ju Lee Rha Hospital from Mar. 1982 to Aug. 1989. The results were as follows. 1. The most frequent type of fracture was type III according to Ruedi and Allgower's classification. 2. The operative treatment was performed with plates and screws in fourteen cases. 3. The overall good and fair results were 72%.
Ankle Joint ; Bone Transplantation ; Classification ; Clinical Study ; Jeollabuk-do ; Orthopedics ; Tibia ; Weight-Bearing