BACKGROUND: Dopamine receptors have been regarded as a strong candidate involved in etiology of schizophrenia and a target for various antipsychotic drugs. The purpose of our study was to investigate whether dopamine D1 receptor(DRD1) gene polymorphisms would predict the treatment response to antipsychotics in schizophrenia. METHOD: One hundred thirty-four schizophrenic patients, who met DSM-IV criteria for schizophrenia were entered into a 48-week study. The psychopathology of the patients was assessed at baseline, 12th, 24th, 48th weeks of treatment by PANSS. Responders were defined by a 20% of the reduction in total PAnSS score at end point. The genomic DNA fragment corresponding to nucleotides of dopamine D1 receptor gene was amplified by polymerase chain reaction(PCR). RESULT: Neither allelic frequencies nor genotypes for dopamine D1 receptor differed significantly between responders and non-responders. Also, there was no difference of changes of PANSS scores among three genotype groups of the dopamine D1 receptor. CONCLUSION: Allelic variation in the dopamine D1 gene is not associated with individual differences in antipsychotic response.
Antipsychotic Agents ; Diagnostic and Statistical Manual of Mental Disorders ; DNA ; Dopamine* ; Genotype* ; Humans ; Individuality ; Nucleotides ; Psychopathology ; Receptors, Dopamine ; Receptors, Dopamine D1* ; Schizophrenia

No abstract available.

Multifocal fibrosclerosis, a rare disorder, has no known etiology and is considered to be a systemic illness manifested by combinations of fibrosing process of multiple areas such as mediastinal fibrosis, retroperitoneal fibrosis, orbital pseudotumor, sclerosing cholangitis, and Reidel's thyroiditis. We have experienced a 49-year-old man with pseudotumor of the orbit, sclerosing cholangitis, and CNS involvements included unrecognized meningitis and suspicious CNS vasculitis. The patient showed clinical improvement with corticosteroid therapy.
Cholangitis, Sclerosing ; Fibrosis ; Humans ; Meningitis ; Middle Aged ; Orbit ; Orbital Pseudotumor ; Retroperitoneal Fibrosis ; Thyroid Gland ; Thyroiditis ; Vasculitis, Central Nervous System

No abstract available.
Anemia ; Gaucher Disease* ; Humans ; Siblings* ; Thrombocytopenia

We have experienced three unusual cases of dorsal extradural lumbar disc sequestration, manifesting as severe low back pain, radiating leg pain and motor weakness. Magnetic resonance imaging suggested sequestrated disk fragment located in epidural space had compressed the dural sac from lateral to dorsal sides. With the help of adequate early surgery by open procedure, these symptoms were relieved without any complications.
Epidural Space ; Leg ; Low Back Pain ; Magnetic Resonance Imaging

OBJECTIVE: To determine whether the use of contrast enhancement (especially its extent) predicts malignant brain edema after intra-arterial thrombectomy (IAT) in patients with acute ischemic stroke. METHODS: We reviewed the records of patients with acute ischemic stroke who underwent IAT for occlusion of the internal carotid artery or the middle cerebral artery between January 2012 and March 2015. To estimate the extent of contrast enhancement (CE), we used the contrast enhancement area ratio (CEAR)-i.e., the ratio of the CE to the area of the hemisphere, as noted on immediate non-enhanced brain computed tomography (NECT) post-IAT. Patients were categorized into two groups based on the CEAR values being either greater than or less than 0.2. RESULTS: A total of 39 patients were included. Contrast enhancement was found in 26 patients (66.7%). In this subgroup, the CEAR was greater than 0.2 in 7 patients (18%) and less than 0.2 in the other 19 patients (48.7%). On univariate analysis, both CEAR > or =0.2 and the presence of subarachnoid hemorrhage were significantly associated with progression to malignant brain edema (p<0.001 and p=0.004), but on multivariate analysis, only CEAR > or =0.2 showed a statistically significant association (p=0.019). In the group with CEAR > or =0.2, the time to malignant brain edema was shorter (p=0.039) than in the group with CEAR <0.2. Clinical functional outcomes, based on the modified Rankin scale, were also significantly worse in patients with CEAR > or =0.2 (p=0.003) CONCLUSION: The extent of contrast enhancement as noted on NECT scans obtained immediately after IAT could be predictive of malignant brain edema and a poor clinical outcome.
Brain Edema* ; Brain* ; Carotid Artery, Internal ; Humans ; Infarction* ; Middle Cerebral Artery ; Multivariate Analysis ; Stroke ; Subarachnoid Hemorrhage ; Thrombectomy*

PURPOSE: The application of laparoscopic surgery in children has expanded tremendously in recent years. However, the feasibility of the technique is somewhat controversial. We summarize our experience of laparoscopy in children and describe the surgical techniques used in these cases. METHODS: Between June 2001 and May 2004, 58 children (33 male, 25 female) underwent laparoscopic surgery at the Department of Surgery, Daegu Fatima hospital. All the clinical data was collected retrospectively. RESULTS: The laparoscopic procedures for each indications were a laparoscopic reduction for a barium reduction failed intussuception (n=15), laparoscopic appendectomy for acute appendicitis (n=30), laparoscopic splenectomy for symptomatic hereditary spherocytosis (n=4), laparoscopic salphin-go-ophorectomy for torsion of parovarian cyst and ovarian tumor (n=2), laparoscopic diverticulectomy for symptomatic Meckel's diverticulum (n=2), laparoscopic Hellor myotomy and Dor fundoplication for achalasia (n=1), diagnostic purpose for peritoneal tuberculosis (n=2) and the laparoscopic removal of a foreign body in the peritoneal cavity (n=2). The mean age was 7.9 years (range from 4 months to 14 years). In intussusception, the laparoscopic reduction was successful in 12 patients (80%), with a conversion to an open procedure occurring in 3 cases (20%). There were no other open con-versions. There were no postoperative wound complications except for two wound problems in patients with acute perforated appendicitis. The operative time and duration of the hospital stay was suitable. CONCLUSION: The laparoscopic procedure in various disorders of infants and children is safe and avoids the necessity of open surgery under the appropriate indication.
Appendectomy ; Appendicitis ; Barium ; Child* ; Conversion to Open Surgery ; Daegu ; Esophageal Achalasia ; Female ; Foreign Bodies ; Fundoplication ; Humans ; Infant ; Intussusception ; Laparoscopy* ; Length of Stay ; Male ; Meckel Diverticulum ; Operative Time ; Parovarian Cyst ; Peritoneal Cavity ; Peritonitis, Tuberculous ; Retrospective Studies ; Splenectomy ; Wounds and Injuries

BACKGROUND: Although much progress has been made in the management of hilar cholangiocarcinoma, long-term survival for most patients remains poor. The reasons of poor prognosis are due to mainly the difficulty of curative resection of the tumor, frequent postoperative recurrence and also the concomitant cholangitis, hyperbilirubinemia and impaired hepatic function resulted from progressive bile duct obstruction. In spite of many obstacles to surgical treatment for hilar cholangiocarcinoma, recent reports support that the surgical resection is the only promising way of treatment for better long-term survival. But there are still many problems and risks of high morbidity and mortality associated with the operation. AIMS: The appropriate selection of the patient for operation and the operation method by careful evaluation of the clinical status of the patient and the disease is very important for both improving the long-term survival and decreasing the postoperative complication. METHODS: This study was investigated to evaluate the prognostic factors in the surgical treatment of hilar cholagiocarcinoma which influence the postoperative morbidity and survival rate. RESULTS: 1) The postoperative complications were developed in 4 cases(11%) and 1 case of them was dead due to acute respiratory distress syndrome. The postoperative recurrence was observed in 6 cases(25%) and the recurred sites were local recurrences in 5 cases and bone metastasis in 1 case. Ten patients(41.7%) were dead and the causes of deaths were recurrence in 5 cases. Postoperative mean survival time was 16.46 months and 3, 7, 12 month cumulative survival rates were 84%, 67%, 51% respectively. 2) The clinicopathological factors including clinical findings, laboratory results and microscopic findings were not related significantly to the postoperative prognosis. 3) The mean survival time was 5.54 months in bile duct resection group and 26.2 months in bile duct resection with hepatic resection group. Ten month cumulative survival rate was 40% in bile duct resection group and 92.8% in bile duct resection with hepatc resection group, which means that the extent of resection is significantly related to survival rate(p=0.012). CONCLUSION: Clinicopathological factors were not associated with the postoperative prognosis and the difference of operation type(extent of resection) was significantly related to the postoperative survival rate in the surgical treatment of hilar cholangiocarcinoma. The result suggests that more wide surgical resection including hepatic resection increases the possibility of curative resection and improve the long-term survival of the patient.
Bile Ducts ; Cause of Death ; Cholangiocarcinoma* ; Cholangitis ; Cholestasis ; Humans ; Hyperbilirubinemia ; Mortality ; Neoplasm Metastasis ; Postoperative Complications ; Prognosis ; Recurrence ; Respiratory Distress Syndrome, Adult ; Survival Rate

A sarcomatoid carcinoma of the gastrointestinal tract is a very rare tumor. Only limited cases have been reported in the literature. The tumor is more malignant than the usual adenocarcinoma of the gastrointestinal tract. Typically, when discovered, a sarcomatoid carcinoma of the small intestine is already in a late stage of disease with a rapidly progressive course. The survival rate is markedly lower than for adenocarcinomas. Here, we report the case of a 63-year-old male patient who was referred from the Gastroenterology Department of Chonnam University Hospital. He had been suffering from a sudden onset of painless jaundice, and from weight loss for one month. The operation at our hospital was performed under a diagnosis of periampullary cancer. Whipple's operation was carried out on Dec. 14, 1998. Pathology confirmed the diagnosis of a sarcomatoid carcinoma of the duodenum. This article presents that case of a sarcomatoid carcinoma of the duodenum with a brief review of the literature.
Adenocarcinoma ; Diagnosis ; Duodenum* ; Gastroenterology ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Jaundice ; Jeollanam-do ; Male ; Middle Aged ; Pathology ; Survival Rate ; Weight Loss

The objective of this study was to find out whether the unilateral distraction of mandible has an influence on temporomandibular joint and if it does, how significant the influence is. Four beagle dogs were used in this study. Each dog had two implants placed into the left mandible. The mandible was distracted for 14days with an distraction device as an amount of 0.75mm, twice per day after osteotomy between two implants. Each animals were sacrificed at the second, fourth, sixth and eighth week after the total distraction amount of 10.5mm were gotten. Upon embedding and staining, the specimens were evaluated with a light microscope. The results were as follows. 1. For the second week group, the articular cartilage and osteoid seam of temporal bone and condyle were relatively well maintained. There were not any significant differences between distraction side and non distraction side. 2. For the fourth week group, the periosteal reaction was activated and the articular cartilage and osteoid seam of temporal bone and condyle were severely thickened-especially at posterior portion of distraction side. This findings revealed that the unilateral distraction forces has more influence on distraction side than on non distraction side, and on posterior portion than on anterior portion. 3. For the sixth and eighth week group, the thickness of meniscus in distraction side gradually recovered to the initial level. The thickened articular cartilage and osteoid seam of temporal bone and condyle were decreased in distraction side and showed relatively stable in non distraction side. From this results, we suggest that several considerations are required such as using an occlusal splint, maintaining the stability of bone distraction device and evaluating bone distraction rate to minimize the damages of temporomandibular joint tissues in early stage of distraction side.
Animals ; Cartilage, Articular ; Dogs ; Mandible* ; Occlusal Splints ; Osteotomy ; Temporal Bone ; Temporomandibular Joint*