Recent basic and clinical studies demonstrate a major role for neural plasticity in the etiology and treatment of depression and stress-related illness. The neural plasticity is reflected both in the birth of new cell in the adult brain (neurogenesis) and the death of genetically healthy cells(apoptosis) in the response to the individual's interaction with the environment. The neural plasticity includes adaptations of intracellular signal transduction pathway and gene expression, as well as alterations in neuronal morphology and cell survival. At the cellular level, repeated stress causes shortening and debranching of dendrite in the CA3 region of hippocampus and suppress neurogenesis of dentate gyrus granule neurons. At the molecular level, both form of structural remodeling appear to be mediated by glucocorticoed hormone working in concert with glutamate and N-methyl-D-aspartate(NMDA) receptor, along with transmitters such as serotonin and GABA-benzodiazepine system. In addition, the decreased expression and reduced level of brain-derived neurotrophic factor(BDNF) could contribute the atrophy and decreased function of stress-vulnerable hippocampal neurons. It is also suggested that atrophy and death of neurons in the hippocampus, as well as prefrontal cortex and possibly other regions, could contribute to the pathophysiology of depression. Antidepressant treatment could oppose these adverse cellular effects, which may be regarded as a loss of neural plasticity, by blocking or reversing the atrophy of hippocampal neurons and by increasing cell survival and function via up-regulation of cyclic adenosine monophosphate response element-binding proteins(CREB) and BDNF. In this article, the molecular and cellular mechanisms that underlie stress, depression, and action of antidepressant are precisely discussed.
Adenosine Monophosphate ; Adult ; Apoptosis ; Atrophy ; Brain ; Brain-Derived Neurotrophic Factor ; Cell Survival ; Dendrites ; Dentate Gyrus ; Depression* ; Gene Expression ; Glutamic Acid ; Hippocampus ; Humans ; Neurobiology* ; Neurogenesis ; Neurons ; Parturition ; Plastics ; Prefrontal Cortex ; Serotonin ; Signal Transduction ; Up-Regulation

The PCL is one of the most important structure, providing 95% of the total retraint to posterior displacement of the tibia. Insufficieny of the PCL has received increased attension in recent literature, perhaps because of the apparent increase in its incidence due to the increased in motor-vehicle accident and to more accurate evaluation of knee injuries. But there is still so much controvercy cercerning the treatment for individuals with insufficiency of the PCL because the results of operative treatment have been inconsistent. The purpose of this study were to analyze the the results of arthroscopic PCL reconstruction using autogenous bone-patellar tendon-bone and then, we suggest the ideal method of treatment for patients with insufficiency of the PCL. We studied the functional and static results of 14 patients who were followed up more than 1 year out of 16 cases after reconstruction of the PCL using autogenous patellar tendon under arthroscopy from l993 to l995 at the department of orthopedic surgery of Inchon Christian Hospital and Inha university Hospital. The results were as follows: 1. The causes of injury were slip and fall (50%) and traffic accident (50%), and there were 6 acute and 8 chronic knee injuries. 2. Average Lysholm knee evaiuation score were preoperative 61.3, postoperative 93, average posterior tibial displacement of injuried side as compared with normal side in posterior stress x-ray, preoperative 18.2mm(range 10-24mm), postoperative 5.0mm(range 2-11 mm) and average postoperative range of motion was 2.1-127.9 degree. lll conclusion, the reconstruction of PCL with autogenous patellar tendon under arthroscopy is a recommendable treatment method in patients who have insufficiency of PCL, because of small incision, rninimum loss of knee function, rnimimum postoperative pain, and eary motion and rehabilitation. But we think that more cases, long-term follow-up, study of the comparion with patients who treated conservatively are needed.
Accidents, Traffic ; Arthroscopy* ; Follow-Up Studies ; Humans ; Incheon ; Incidence ; Knee ; Knee Injuries ; Orthopedics ; Pain, Postoperative ; Patellar Ligament* ; Posterior Cruciate Ligament* ; Range of Motion, Articular ; Rehabilitation ; Tibia

The antiarrhythmic effect of oral Mexiletine was evaluated by Holter monitoring on 10 subjects with chronic high-frequency ventricular premature complexes and ventricular tachycardia referred to our cardiology clinic of Severance Hospital from June, 1982 through September, 1983. The frequency of the ventricular premature complexes and the ventricular tachycardia was measured by 24-hour ambulatory electrocardiography on each patient before and during the administration of Mexiletine(450-600 mg/day). The results were as follows : 1) In 10 patients with ventricular tachycardia total suppression of ventricular tachycardial was demonstrated in 8 patients during the administration of oral Mexilletine. 2) The number of the ventricular premature complexes was reduced markedly in 6 out of the 10 patients. 3) Side effects occurred in 5 out of 10 patients. These include tremor, weakness, dry mouth, indigestion, anorexia, chest discomfort, and dizziness but were tolerated except in one.
Anorexia ; Arrhythmias, Cardiac* ; Cardiology ; Dizziness ; Dyspepsia ; Electrocardiography, Ambulatory* ; Humans ; Mexiletine* ; Mouth ; Tachycardia, Ventricular ; Thorax ; Tremor ; Ventricular Premature Complexes

Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.
Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Hypothyroidism* ; Thyroid Function Tests ; Thyroid Gland ; Quetiapine Fumarate

Hypertrophic cardiomyopathy has been a well-known genetical transmitted disease entity with the advance of echocardiography. We have recently experienced a family with hypertrophic cardiomyopathy proved by noninvasive methods including chest x-ray,, electrocardiography and echocardiography. The propositus of this family was a 21 year-old solier who was admitted because of exertional dyspnea during military exercise. Both he and his sister had severely affected hearts with typical echocardiographic findings, asymmetrical septal hypertrophy(ASH) and systolic anterior motion of the anterior mitral leaflet(SAM). The clinical study is reported with the concerned literatures.
Cardiomyopathy, Hypertrophic* ; Dyspnea ; Echocardiography ; Electrocardiography ; Heart ; Humans ; Military Personnel ; Siblings ; Thorax ; Young Adult

No abstract available.
Semen*

No abstract available.
Fertilization* ; Humans* ; Oocytes*

No abstract available.
Endometriosis* ; Female ; Nafarelin*

PURPOSE: Factors affecting the response to surfactant replacement therapy are considered as types of surfactant, and strategies of treatment including prophylactic vs rescue therapy, single vs multiple doses, methods of mechanical ventilation, and modes of surfactant delivery. Among those factors, response to surfactant replacement therapy according to the modes of surfactant delivery was rarely studied in the world. In preterm infants with RDS, we studied the efficacy and adverse effects of surfactant replacernent therapy according to the differences in the modes of surfactant delivery. METHOD: Preterm infant weighing 500-2,500g with RDS who required assisted ventilation were divided into two groups. One group is as follows five fractional doses with five positional changes after removal from ventilator by feeding tube technique. The other group is as follows; two fractional doses with two positional changes by side-port adaptor technique. Of the 30 infants enrolled, 15 were randomly assigned to each group. We compared the respiratory indices, chest radiologic response, clinical outcome after surfactant replacement, and adverse effects during dosing procedure. RESULT: There were no diffrences of patient profile between two groups. There were significant improvernent in FiO2, a/APO2, MAP, OI, and chest radiologic response following surfactant replacement therapy in both groups. No significant differences were noted in the adverse effects during dosing procedure and incidence of complication. CONCLUSION: In initial phase of RDS treatment with surfactant replacement therapy, two fractional doses with two positional changes by side-port adaptor technique improve respiratory indices, radiologic response without dernonstrable harmful effects as five fractional doses with five positional changes after removal from ventilator by feeding tube technique, however two fractional dosing procedure is more recommendable because of #more simple and convenient procedure.
Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial ; Thorax ; Ventilation ; Ventilators, Mechanical

Delayed emergence of speech or language are frequent causes for concern about development during early childhood. Delay in evaluation and proper management until school entry in more likely to result in frustration, anxiety and school failure. Many language disturbances and their attendant behavior disorders respond to intensive language therapy. Authors analyzed the medical records of 52 children with delayed language development evaluated during 30 months from January 1986 through June 1988. The results were as follows: 1. The majority of cases were evaluated at the age of 2-2.9 year old (16 cases, 30.8%) and 3-3.9 year old (11 cases, 21.2%) 2. Male to female ratio was 3:1 3. The most common cause was mental retardation (53.8%), followed by developmental language disorder (23.1%) and autism (13.5%) 4. The most common associated condition was dysarticulation (17.3%), followed by strabismus (9.6%) and seizures (7.7%) 5. Special education was recommended in cases of 23 (44.2%), speech therapy in 12 cases (23.1%) and consultation to child psychiatry in 7 cases (13.5%) Making diagnosis of underlying disorders in not simple because assessment of intelligence in young children in difficult and only a few tests are standardized. More detailed study on children with delayed language development and development of psychometric tests for handicapped children are necessary, especially in Korea.
Anxiety ; Autistic Disorder ; Child Psychiatry ; Child* ; Clinical Study* ; Diagnosis ; Disabled Children ; Education, Special ; Female ; Frustration ; Humans ; Intellectual Disability ; Intelligence ; Korea ; Language Development Disorders ; Language Development* ; Language Therapy ; Male ; Medical Records ; Mental Disorders ; Psychometrics ; Seizures ; Speech Therapy ; Strabismus