The etiologies of alcohol dependence may be divided into three factors:biological, psychological, and social factors. Among these, many of the current articles deal with the genetic factors, due to rapid developments in methodology and so on. Because of these reasons, it is thought that it would be worthful to review the articles related to the genetic etiologies and other neurobiological etiologies of alcohol dependence at this point. Because alcohol dependence is a complicated and heterogenous disease, it is not likely to be associated with a single gene polymorphism. And as it is still early times in identifying its genetic etiology, I think it is not easy to make conclusion in this field now. However, I believe that many recent studies using endophenotype and haplotype will give us more promising results. The fact that unlike other substances, alcohol dose not act on only one or two neurotransmitter receptors makes neurobiological research to be not easy one. It is interesting that some of the articles reported in this fields recently dose not confined to brain reward system but extended to CRF or molecular biology.
Alcoholism* ; Brain ; Endophenotypes ; Haplotypes ; Molecular Biology ; Receptors, Neurotransmitter ; Reward

PURPOSE: To compare the accuracy of implantation by radiologic results between 3D Linker and navigation guided total knee arthroplasty. MATERIALS AND METHODS: Between February 2004 and April 2005, total knee arthroplasties were done in 25 knees with balanced gap-resection technique (group A) and 25 using kinematic navigation system(group B) by a single surgeon. All patients had standing long anteroposterior (AP) radiographs of the lower extremities and supine lateral radiographs of the knees at 6 weeks postoperatively. Mechanical axis deviation, alpha and beta, angles were measured on standing long leg AP views and alpha and beta angles on supine knee lateral views. Results were classified according to the deviation from the reference line and graded as excellent, good, and poor. The result was regarded as satisfactory when all five angles were excellent or good. RESULTS: The mean mechanical axis deviation was 1.11degrees in group A and 1.36degrees in group B and all were excellent in both groups. Regarding alpha.angles, 19 cases were excellent and, 6 good in group A and, 21 excellent and 4 good in group B. Regarding., angles, 22 cases were excellent and, 3 good in group A and, 23 excellent and 2 good in group B. Regarding.,, angles, 15 cases were excellent, 8 good and 2 poor in group A and, 15 excellent, 9 good, and 1 poor in group B. Regarding beta angles, 19 cases were excellent, 3 good and 3 poor in group A and, 23 excellent, and 2 poor in group B. There were no statistical differences between two groups in all five angles (p>0.05). An excellent implantation in all five angles was obtained in 28% in group A and 60% in group B (p<0.05). There were 80% of satisfactory cases in group A and 84% in group B with no statistical difference (p>0.05). CONCLUSION: Radiological results (mechanical axis and component angles) of total knee arthroplasty were satisfactory in 80% with balanced gap-resection technique and 84% with kinematic navigation system and showed no statistical difference.
Arthroplasty* ; Axis, Cervical Vertebra ; Humans ; Knee* ; Leg ; Lower Extremity

The 302 patients with head-injured military personnel who had admitted to the Department of neurosurgery, Capital Armed Forces General Hospital were clinicostatistically analysed and discussed with the review of the literatures. The results were as follows: The most common cause of head injury was traffic accident(38.4% of the total cases) and the next were, in order of incidence, simple fall(9.5%), exercise(3.9%), assault(13.5%) and gun shot wound or explosive injury(7.2%). 2) Skull fracture was identified in 214 cases;98 cases of linear, 87 cases of depressed, 4 cases of basal, 2 cases mixed skull fracture. 3) The 85.7% of epidural hematomas were associated with skull fracture and the most common site of hematoma was frontal area. 4) Of all cases of subdural hematoma, acute type was prevalent(67.9%) and its main involved wite was frontotemporoparietal areas. 5) The associated injuries were found in 35.7% of patients. 6) The minor head injury of which GCS is from 13 to 15 was 148 cases, the moderate head injury of which GCS is fromn 9 to 12 was 49 cases, the severe head injury of which GCS is form 3 to 8 was 105 cases. 7) Of 105 cases of severe head injured patients the mortality was 61.9% and good recovery was 7.6%. But outcome was different according not only to GCS but also the type of lesion. 8) The operative morality was 24.1% and the good recovery was achieved 55.2% of patients. The remaining 8.9% resulted in disabled or vegetative state. 9) In the accidents of gun shot wound or explosive injury, operation mortality rate was 31.8%, but 8 cases(36.3%) were seen good recovery.
Arm ; Craniocerebral Trauma ; Glasgow Coma Scale ; Head ; Hematoma ; Hematoma, Subdural, Acute ; Hospitals, General ; Humans ; Incidence ; Military Personnel* ; Morals ; Mortality ; Neurosurgery ; Persistent Vegetative State ; Skull Fractures ; Wounds and Injuries

Pseudotumor cerebri is a condition of obscure etiology characterized by headache, papilledema and raised intracranial pressure in the absence of a space-occupying lesion. We have experienced a case of pseudotumor cerebral complicated by acute frontal sinusitis associated with mild intracranial meningeal inflammation. We have checked the intracranial pressure through serial lumbar puncture before and after medication and conservative management. Symptom were resolved gradually upon lowering the intracranial pressure by serial lumbar puncture and conservative management. So we report a case with brief review of the literature.
Frontal Sinus* ; Frontal Sinusitis* ; Headache ; Inflammation ; Intracranial Pressure ; Papilledema ; Pseudotumor Cerebri* ; Spinal Puncture

The purpose of this study was to analyze the muscle activities and gait pattern in lower limb depending on the orthotic type. Using electromyography (EMG), we evaluated muscle activities in 12 healthy men volunteered for this experiment. Surface electrodes were used to record the level of muscle activities in the tibialis anterior (TA), gastrocnemius (GCM), rectus femoris (RF), vastus lateral (VF), biceps femoris (BF) muscles during the gait. These signals were compared with % reference voluntary contraction (%RVC) which was normalized by integrated EMG (IEMG). The Gait cycle were divided into seven phases: loading response (LR), mid stance, terminal stance, pre swing (PS), initial swing (IS), mid swing, terminal swing. The results can be summarized as follows; there were increase of TA and GCM muscle during loading response phase & mid stance phase. There were increase of TA and BF muscle during terminal stance phase, pre swing phase, initial swing phase, mid swing phase and terminal swing phase.
Contracts ; Electrodes ; Electromyography ; Foot ; Gait ; Humans ; Lower Extremity ; Male ; Muscles ; Quadriceps Muscle

Postoperative brain edema and/or hemorrhage is a serious problem especially arteriovenous malformations(AVM) in an eloquent area. It has ben a neurosurgical dilemma whether to surgically remove an unruptured AVM in an eloquent area. It is necessary to define the anatomic location, understand the hemodynamics, vasoreactivity of the adjacent brain parenchyma for safe removal of an AVM in an eloquent area. A successful removal of an AVM at an eloquent motor area without neurological deficit was made. We report method of localizating, angiographic anatomy, mechanism of possible hemodynamic insult related to operation.
Arteriovenous Malformations* ; Brain ; Brain Edema ; Hemodynamics ; Hemorrhage

The purpose of this study is to assess the usefulness of digital infrared thermographic image(DITI) in patients with surgically treated lumbar disc disease. A series of 480 patients with lumbar herniated disc was studied. The mean age of the patients was 37 years, with a range of 18 to 64 years. Of which 126 cases of chemonucleolysis. 18 cases of percutaneous endoscopic laser discectomy, and 336 cases of laminectomy with discectomy were performed. Among these patients, 336 cases of laminectomy were assessed by DITI preoperatively. The thermal differences(delta T) between the symptomatic and asymptomatic limbs were evaluated. We have categorized the types of herniations into 3 classes: 200 protruded, 99 extruded, and 37 sequestered. The thermal differences were classified into 3 groups: 177 patients had delta T < 0.5 degrees C, 74 patients had 0.5 degrees C < or = delta T < 0.8 degrees C and 85 patients had delta T > or = 0.8 degrees C. Among the group of patients with the sequestered disc, 30(i.e. 80%) had delta T > or = 0.8 degrees C. Among the surgically treated 336 patients, non-visualization of a part of the sciatic limb on preoperative DITI was the condition used to coin the term amputation sign by the authors. In the sequestered group, the "amputation sign" was observed in 28 cases(75%). We conclude that DITI can predict a sequestered disc disease, and it allows more precise indication regarding open surgery.
Amputation ; Diskectomy ; Extremities ; Humans ; Intervertebral Disc Chemolysis ; Intervertebral Disc Displacement ; Laminectomy ; Numismatics

It is clinically important to know the size of normal trachea for airway management and respiratory care. The knowledge is useful for avoiding many possible complications due to tracheal intubation by appropriate choice of endotracheal tube size. Therefore, we investigated antero-posterior(A-P) diameter, transverse diameter and cross- sectional area(CSA) of trachea at various level with MRI(magnetic resonance imaging) in 70 males and 79 females who were divided into three age groups(group 1: 16-39 year of age, group 2: 40-59 year of age, group 3: 60-83 year of age), and they had no abnormalities in cardiopulmonary system. The results were as follows; 1. A-P 2. Transverse 3. Narrowing portion 4. CSA 1. A-P diameter of trachea was 17.1+/-1.4 mm in male and 13.9+/-1.3 mm in female. Transverse diameter of trachea was 15.1+/-1.6 mm in male and 13.3+/-1.5 mm in female(Table 1). A-P and Transverse diameters were greater in male than in female (P<0.05). 2. C-7 was the narrowest portion of A-P diameter in both sex (P<0,05). C-5 was the narro- west portion of transverse diameter in both sex (P<0.05). 3. A-P diameters of trachea among male patients were 17.1+/-1.2 mm, 17.41.6 mm, and 16.6+/- 1.3 mm in group 1, 2 and 3 (Table 3, Fig. 4). A-P diameters of trachea in female age group 1, group 2 and group 3 were 13.7+/-1.2 mm, 14.3+/-1.3 mm, and 13.6+/-1.5 mm(Table 3, Fig. 4). Transverse diameters of trachea in male age group 1, group 2 and group 3 were 14.8+/-1.4 mm, 15.1+/-1.7 mm, and 15.4+/-1.6 mm(Table 3, Fig. 4). Transverse diameters of trachea in female age group 1, group 2 and group 3 were 13.0+/- 1.2 mm, 13.6+/-1.9 mm and 13.5+/-1.4 mm(Table 3, Fig. 4). 4. CSA(cross sectional area) of trachea were 201.1+/-31.3 mm(2) in male and 145.4+/-27.7(2) mm in female(Table 4). 5. CSA at C5, C6, C7 and Tl in male were 175.9+/-61.1 mm(2), 201.1+/-43.8 mm(2), 196.2+/-36.2 mm(2) and 230.9+/-463 mm(2) (Table 4, Fig. 5). CSA at C5, C6, C7 and Tl in female were 127.0+/- 33.4 mm(2), 138.434.6 mm(2), 140.734.7 mm(2) and 171.7+/-42.0 mm(2) (Table 4, Fig. 5). 6. CSA of trachea among male patients were 198.1+/-28,5 mm(2), 206.2+/-33.0 mm(2) and 198.3+/-33.1 mm(2) in group 1, 2 and 3 (Table 5, Fig. 6). CSA of trachea in female age group 1, group 2 and group. 3 were 140.2+/-25.0 mm(2), 152.8+/-32.4 mm(2) and 145.6+/-25.1 mm(2) (Table 5, Fig. 6). But there was no significant difference between groups according to the sex. 7. CSA of trachea in age groups were stastically insignificant for both sex.
Adult* ; Airway Management ; Female ; Humans ; Intubation ; Magnetic Resonance Imaging* ; Male ; Trachea*

PURPOSE: This study is to compare the rate and pattern of anastomotic leakage (AL) for rectal cancer after laparoscopic vs. conventional open surgery at high and low rectal anastomosis and to evaluate whether the number of linear staples used for distal rectal resection is related to AL in laparoscopic group. RESULTS: One hundred ninety-seven patients who underwent a curative resection for rectal cancer between March 2002 and February 2006 were studied retrospectively (107 laparoscopic, 90 open). The proportions of patients with anastomosis above vs. below 5 cm from AV were not different between the laparoscopic and the open groups; (above/below: 54/53 and 41/49, respectively, P=0.57). The protective stoma rate, the overall rate of AL, the rate of AL according to the height of the anastomosis, and the number of distal linear staples were evaluated for both groups. RESULTS: Clinical AL occurred in 11 of 107 patients (10.3%) for the laparoscopic group and in 5 of 90 patients (5.6%) for the open group. The rates of AL in patients without protective stoma were not significantly different for high rectal anastomosis (6.0% for laparoscopic vs. 2.6% for open, P= 0.63) and for low rectal anastomosis (25.8% for laparoscopic vs. 12.1% for open, P=0.21). The risk of AL was 4.9 times higher when 3 linear staples were used than when 2 linear staples were used in the laparoscopic group. CONCLUSIONS: There was no statistical difference in AL between the laparoscopic group and the open group. The rate of AL could be reduced by using fewer linear staples for distal rectal resection in the laparoscopic group.
Anastomotic Leak* ; Humans ; Rectal Neoplasms* ; Retrospective Studies*

Among the series of 272 cases of surgically treated anterior circulation aneurysms, we experienced 6 cases of central infarctions involving caudate nucleus, globus pallidus, putamen and genu of internal capsule respectively or in combination. These surgery related complications were caused by the injury to the perforators going to the anterior perforated substance during manipulation of the large aneurysm or the aneurysms ruptured prematurely. The clinical courses of these patients, however, were not so severe. The morbidities were minimal or none after the average follow-up periods of 17 months. Thorough knowledge of the anatomy of the perforators may help to minimize the severe morbidity in the management of large or difficult aneurysms.
Aneurysm* ; Caudate Nucleus ; Follow-Up Studies ; Globus Pallidus ; Humans ; Infarction* ; Internal Capsule ; Olfactory Pathways ; Putamen