Recently various types of dopamine receptors have been proved to exist in human central nervous system. And the understanding of the of specific function is expected to improve therapeutic effect as well as to reduce undesirable side-effect of current antipsychotic and antiparkinson treatment. Since the dopamine autoreceptor is known to be more sensitive to dopaminergic drugs, there is a growing concern about its functional role in neuropsyhiatric disease. Besides ligand binding studies, recent advances in molecular biology make it possible to quantitate mRNA coding for specific receptors which gives more direct information about its rate of synthesis at the gene level. It is documented that chronic antipsychotics treatment enhances the sensitivity of dopamine autoreceptor, but changes in its mRNA expression have never been investigated yet. Using male Sprague-Dawley rats, 6-hydroxydopamine was injected into left median forebrain bumdle to test whether D2 receptoe mRNA found in midbrain is coding for autoreceptors. And antipsychotic drugs, haloperidol, sulpiride, and clozapine, were administered daily for 2 weeks in order to evaluate their effect on dopamine autoreceptor mRNA, expression. The quantitation of mRNA expression was performed using ribonuclease protection assay. After 6-hydroxydopamine injection, significant reduction in D2, both D2L and D2S, receptor mRNA expression was observed in left midbrain compared with right side. The ratios of D2L/beta-actin and D2S/beta-actin- mRNA in left midbrain were 23.3% and 21.6% of that in right side respectively. Significant expression was demonstrated after repetitive haloperidol and sulpiride, but not after clozapine treatment ; D2S mRNA was increased after haloperidol treatment, while sulpiride enhanced D2L mRNA expression. However, the relative ratio of D2L and D2S mRNA expression in rat midbrain was not changed after repetitive administration of antipsychotic drugs used in this study. These result suggest ; first, the major proportion of mesencephalic D2 receptor mRNA is coding for autoreceptor ; second, the D2 receptor mRNA expression is increases after chronic haloperidol and sulpiride, ut not after clozapine treatment, which may be related to development of extrapyramidal side to alter the relative ratio of D2L and D2S mRNA expression in rat midbrain.
Animals ; Antipsychotic Agents* ; Autoreceptors ; Central Nervous System ; Clinical Coding ; Clozapine ; Dopamine ; Dopamine Agents ; Haloperidol ; Humans ; Male ; Mesencephalon ; Molecular Biology ; Oxidopamine ; Prosencephalon ; Rats* ; Rats, Sprague-Dawley ; Receptors, Dopamine ; Ribonucleases ; RNA, Messenger* ; Sulpiride

Rheumatoid patients have poor bone quality and also have an increased incidence of sepsis, delayed wound healing, and general overall complications. It is the purpose of this paper to assess the clinical and roentgenographic results of ABG total hip replacement in rheumatoid arthritis. Twenty-six total hip arthroplasties done in seventeen patients with rheumatoid arthritis were studied prospectively. The average follow-up was 3 years and 4 months, with a minimum follow-up of 2 years and 7 months. The average age of the patients was 49.7 years (range 36-63) and there were sixteen females and one male. All patients fulfilled the 1987 revised criteria and there were eleven cases of protrusio acetabuli. All patients except two were taking oral steroids, nineteen cases were classed as Singhs index 1, five cases as Singhs index 2, and two cases as Singhs index 3. The Charnley approach with a trochanteric osteotomy was employed in all patients. Cup fixation was achieved with two spikes in twenty-one cases, two spikes and one screw in five cases, and in all cases the acetabular cup was angled at less than 45 from the horizontal. There was a gap between the acetabular cup and the acetabulum at DeLee and Charnley zone 1 in three cases, and at zone 2 in six cases. At 2 years, there was no radiolucency, reactive line or any sign of bone resorption. The development of cancellous and cortical densification was seen in Gruen's zone 2 and 6 for the first time in the 1 year radiographs. It became more prominent in the 2 year radiographs. The reactive bone line first became visible at the 6 month follow-up in the Gruen's zone 3 and 5. These lines extended more proximally, but it did not involve the proximal HA coated portion. Cortical hypertrophy of diaphysis was seen at Gruen's zone 3 and 5 in five cases. Rounding off of calcar was visible at zone 7 in six cases. There were no radiological changes of the femoral side in fourteen cases and the acetabular side in seven cases. There was one case of wire breakage, one case of trochanteric separation, and one case of intraoperative splitting of calcar. The result of the study indicated that the development of osseointegration in rheumatoid arthritis might be slow, but the clinical and radiological results were satisfactory. Further prospective follow up is necessary to determine whether the favorable early result of HA coated implant are maintained over longer periods.
Acetabulum ; Arthritis, Rheumatoid* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Bone Resorption ; Diaphyses ; Durapatite* ; Female ; Femur ; Follow-Up Studies ; Hip ; Humans ; Hypertrophy ; Incidence ; Male ; Osseointegration ; Osteotomy ; Prospective Studies ; Sepsis ; Steroids ; Wound Healing

No abstract available.
Bone Marrow Transplantation* ; Bone Marrow*

No abstract available.
Animals ; Embryonic Structures* ; Mice*

Four children, with histopathologically confirmed posterior fossa primitive neuroectoderrnal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are and other tumors. when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.
Angiography ; Cerebral Angiography ; Child ; Humans ; Hydrocephalus ; Medulloblastoma* ; Neuroectodermal Tumors, Primitive* ; Pathology* ; Radiography ; Tomography, X-Ray Computed

PURPOSE: Elevated-rim acetabular liner enhances stability in total hip arthroplasty and has been widely accepted. But it has potential adverse effects. So, we assessed the effects of the elevated-rim acetabular liner clinically and radiologically. MATERIALS AND METHODS: We reviewed the results of 74 total hip arthroplasties of 64 patients that had been performed from January 1993 to March 1995. Thirty-six cases of the 74 cases used elevated rim acetabular liner and 38 cases did standard liner. Dislocation rate, Harris hips score, osteolysis and revision rate were compared between two groups. RESULTS: There were no significant differences in mean anteversion, abduction angles of the cup and femoral offsets between two groups. Four of the 38 cases with the standard liner had a dislocation, compared with one of 36 cases with the elevated-rim liner (P=0.358) . Femoral osteolysis was observed 7 cases (18.4%) in the standard liner group and 14 cases (38.8%) in the elevated-rim liner group. Acetabular osteolysis was observed 17 cases (44.7%) in the standard group and 21 cases (58.3%) in the elevated-rim group. Nine cases (23.6%) had been revised in the standard group and 6 cases (16.6%) in the elevated group. CONCLUSION: Excessive wear and breakage of the polyethylene by impingement was developed in the elevated-rim polyethylene liner.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Dislocations ; Hip ; Humans ; Osteolysis ; Polyethylene

PURPOSE: We reviewed the clinical and radiological outcomes of total hip arthroplasty and bipolar hemiarthroplasty for avascular necrosis of the femoral head. MATERIALS AND METHODS: From January 1986 to December 1989, 24 cases were treated with total hip arthroplasty and 27 cases with bipolar hemiarthroplasty for avascular necrosis of the femoral head. Clinical outcomes were assessed using Harris Hip Score. Serial radiographs of the hip were used to assess stability of the femoral component, change of the acetabular cup angle, osteolysis of acetabulum or femur, wear of polyliner and erosion of the acetabular cartilage. RESULTS: The average Harris Hip Score was 93.1 in bipolar hemiarthroplasty group and 86.8 in total hip arthroplasty group at last follow up. Femoral osteolysis was observed in 17 patients of 24 total hip arthroplasties and in 14 patients of 27 bipolar hemiarthroplasties. Acetabular osteolysis was observed in 8 cases of 24 total hip arthroplasties. Revision was undertaken 8 cases (33.3%) in the total hip arthroplasty group and 6 cases (22.2%) in the bipolar hemiarthroplasty group. The main causes of revision were wear of polyliner and severe osteolysis in the total hip arthroplasty group and erosion of the acetabular cartilage in the bipolar arthroplasty group. CONCLUSION: The main cause of failure after total hip arthroplasty for avascular necrosis of the femoral head was using a 32 mm femoral head and a polyliner less than 8mm thickness.
Acetabulum ; Arthroplasty* ; Arthroplasty, Replacement, Hip ; Cartilage ; Femur ; Follow-Up Studies ; Head* ; Hemiarthroplasty ; Hip* ; Humans ; Necrosis* ; Osteolysis

Median sternotomy incision is world-widely used for open heart surgery, especially in valvular heart disease. But recently, minimally invasive approach by the right parasternal incision for valvular heart disease was introduced with the many merits by small incision. We experienced 1 case of mitral valve repalcement by right parasternal incision and extended transseptal approach. This technique has no specific complications or problems compared with the median sternotomy and was proven by the excellent exposure. Cosmetically, the patient was satisfied with the incision.
Heart Valve Diseases ; Humans ; Mitral Valve* ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery

PURPOSE: To compare clinical outcomes of the plate and threaded K-wire for fixation of midshaft clavicular fractures. MATERIALS AND METHODS: From 2005 Jan to 2009 May, medical records of 18 patients who underwent open reduction and internal fixation with plate (group 1) and 13 others who underwent intramedullary fixation with threaded K-wire (group 2) were reviewed. The mean follow up periods were 21.9 and 18.9months. The Functional results were evaluated with The Disabilities of the Arm, Shoulder and Hand (DASH) score and Constant shoulder score. The statistical evaluation was assessed with Paired T-test, Chi-square test. RESULTS: The DASH score were 11.5+/-2.7 in group 1 and 12.4+/-4.3 in group 2. The constant shoulder score were 92.0+/-3.1 in group 1 and 87.1+/-2.8 in group 2. Length of surgical wound (cm) were 10.6+/-3.4 in group 1 and 4.8+/-1.5 in group 2. Postoperative pain and range of motion change were superior in group 1. CONCLUSION: There was no significant difference between the two groups in functional and radiological results. But, there were patient's complaints about length of surgical wound in group 1 and hardware irritation in group 2.
Arm ; Clavicle ; Follow-Up Studies ; Hand ; Humans ; Medical Records ; Pain, Postoperative ; Range of Motion, Articular ; Shoulder

PURPOSE: The purpose of this clinical study was to compare the outcomes of anteromedial and anterolateral trans-tibial approachs in arthroscopic PCL reconstruction. MATERIALS AND METHODS: Between January 2004 and December 2007, 40 patients (40 knees, which underwent PCL reconstruction, with a follow-up of more than 1.6 years) were surveyed in the areas of clinical and radiographic results and individual satisfaction. Forty knees with isolated PCL rupture were reviewed retrospectively. They were divided into two groups of equal size according to the transtibial approach used: anteromedial or anterolateral. The evaluation parameters included activities and functional outcomes using the Lysholm and Tegner score, single leg hop test and individual satisfaction using the IKDC score. Radiographic results were analyzed using the posterior drawer radiography with manual methods and the Telos device, and the changes in the tibial tunnel diameter were measured. RESULTS: Both groups showed improvements in the Lysholm and Tegner score. Both groups showed improvements in the single leg hop test. As far as individual satisfaction evaluation using the IKDC score was concerned, 85% of cases in both groups improved to nearly normal. Both groups showed improvements on the posterior drawer radiography. Tibial tunnel enlargement was also seen. The results of both groups demonstrated no statistically significant difference. CONCLUSION: Both groups showed improvements in the clinical and radiographic results and in the individual satisfaction score. However, results of both groups demonstrated no statistically significant difference. Therefore, the long term results need to be studied.
Follow-Up Studies ; Humans ; Humulus ; Knee ; Leg ; Retrospective Studies ; Rupture