We have investigated the neural cell damage and the change in the expression of NOS in the rat hippocampus, one of the brain structures most vulnerable to seizures. Rats were injected with kainic acid (KA) and sacrificed 6 h, 1 d, 3 d and 6 d after KA administration. The neural cell damage and the expression pattern of NOS was studied using silver impregnation, NADPH-diaphorase (NADPH-d) histochemistry and reverse transcription-polymerase chain reaction (RT-PCR) analysis. Silver impregnation revealed that kainic acid caused pyramical cell damage which was most severe in the CA1/CA2 subfield and hilus and to a lesser degree in the CA3 region. The optical densities of NADPH-d-positive neurons in the CA1, CA3 and dentate gyrus (DG) regions of the hippocampus were shown to have increased in samples obtained 1 d and 3 d after injection of KA. The number of NADPH-d-positive neurons in the CA1 and CA3 regions of the hippocampus was shown to have decreased in samples obtained 3 d and 6 d after injection of KA. However, the number of NADPH-d-positive neurons in the DG region did not change significantly. The increase in the levels of nNOS, iNOS and eNOS mRNA reached maximal values in samples obtained 1 d after KA treatment. Our findings indicate that the KA-induced seizures induce neural cell damage, increase NOS activity and upregulate the expression of NOS mRNA, which suggests the possibility of a functional role of NOS in bringing about changes in the cells in the hippocampus following seizures.
Animals ; Brain ; Dentate Gyrus ; Hippocampus* ; Kainic Acid ; Neurons ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; RNA, Messenger ; Seizures* ; Silver

Current anatomy education in Korea has been dependent upon foreign textbooks and atlas. Various models and medical devices from overseas were imported and commonly used in Korea, Now, we need to provide our own literatures and graphic data based on Korean population for student education. It is necessary to design, produce and supply medical education, operative tools and treatment supportive devices customized to Korean human body and constitution. Accordingly, this is the time to assemble and deliver medical data to Korean population. In this study, we primarily focused on building musculoskeletal system of Korea population and set our goal as utilizing its graphic data for medical education in Korea. It is first study preparing theoretical foundations of Korean skeletal graphic system based on Korean body shape by comparison with other ethnic groups and foreign graphical models. Simultaneously, we conducted practical construction of the skeletal atlas by employing Korean standard measures. Parameters from the measurement for various types of bones were calculated, and the results were compared with data from foreign atlas and pictures. Individual drawings of bones from skull, upper extremity was made by using parameters we calculated, thus the atlas of Korean skeleton was constructed from artistic anatomical point of view. As a result, there were significant differences between Korean skeletons and the medical drawings from the oversea edition. Because many foreign drawings used data from Caucasians only and there were numerous exaggerated and false dimensions without actual measurement. In conclusion, the result of the study is expected to provide fundamental data for building anatomical atlas about Korean human body structure.
Constitution and Bylaws ; Education ; Education, Medical ; Ethnic Groups ; Foundations ; Human Body ; Humans ; Korea ; Musculoskeletal System ; Skeleton* ; Skull ; Upper Extremity*

PURPOSE: The purpose of this study was to determine the efficacy of sonography in the evaluation of normal pseudocapsular morphology and the detection of complications after total hip arthroplasty. MATERIALS AND METHODS: Between Janvary 1997 and June 2000, 47 patients [35 men and 12 women aged 24 to 84 (mean, 61) years] using real-time linear-array, convex US units with 3.5-MHz and 10-MHz transducers. Normal capsular morphology in 30 with total hip replacements, who had been asymptomatic for at least one year, was studied, and the prosthetic joint infection demonstrated in six of 17 who had experienced was confirmed at surgery or by US-guided aspiration. RESULTS: Sonograms indicated that a normal pseudocapsule lay straight over the neck of the prosthesis or was slightly convex toward the neck, and that the mean bone-to-pseudocapsule distance was 2.9 mm. However, in the 11 symptomatic patients in whom no evidence of infection was revealed by cultures, th mean distance was 4.7 mm; in the remaining six patients, whose joints were infected (a condition strongly suggested by the presence of extracapsular fluid), the mean distance was 5.5 mm, with no significant difference between the two groups. CONCLUSION: Sonography can be used to evaluate normal caspular morphology after total hip replacement and to diagnose infection around hip prostheses. In all patients in whom sonography revealed the presence of extra-articular fiuid, infection had occurred.
Arthroplasty, Replacement, Hip* ; Female ; Hip Prosthesis ; Humans ; Joints ; Male ; Neck ; Prostheses and Implants ; Transducers ; Ultrasonography*

PURPOSE: To measure the normal size of the styloid process using 3D (three-dimensional) reconstruction CT. MATERIALS AND METHODS: We retrospectively analyzed 3D reconstruction images obtained after coronal and axial CT scanning of the temporal bone or neck of 115 patients. The length and shape of both sides of the styloid process, the location of its tip, and calcification of the stylohyoid ligament were retrospectively analysed. RESULTS: The mean length of the styloid process was 26.6 (+/-7.9)mm on the right side, and 26.4(+/-8.3)mm on the left, a statistically insignificant difference (p=0.694). Its mean length was 26.2 (+/-8.5)mm in men and 26.7 (+/-7.2)mm in women, a statically in significant difference (p=0.733). As for variation with age, mean length tended to increase until the third decade, but not beyond. Segmental type (104/230, 45.2%) and fragmental type (73/230, 31.7%) were more commonly seen in shape of styloid process, and tapering tip of styloid process (156/230, 67.9%) is more commonly seen than clubbing tip of it (74/230, 32.1%). The process was angulated in six cases (2.6%); its tip was more frequently located between the internal and external carotid artery (211 cases, 91.7%) than more medially (19 cases, 8.3%). In the former location, the length of the process was 26.2(+/- 7.2)mm, and in the latter, 37.0(+/-6.0)mm. The difference was statistically significant (p=0.000). Calcification had occurred in 33 cases (14.3%). CONCLUSION: The length of a normal styloid process was 18-32 mm. There were no statistically significant differences between its two sides, or between the sexes. Length tended to increase until the third decade, but not beyond. Predominantly the tip was located between the internal and external carotid artery, though the process was longer when its tip was located medially.
Carotid Artery, External ; Female ; Humans ; Ligaments ; Male ; Neck ; Retrospective Studies ; Temporal Bone ; Tomography, X-Ray Computed

PURPOSE: To evaluate the relative image qualities obtained at magnetic resonance cholangiopancreatography (MRCP) turbo spin-echo (SSTSE) sequence and the three-dimensional turbo spin-echo (3D TSE) sequence with the sensitivity encoding (SENSE) technique. MATERIALS AND METHODS: Forty patients with suspected hepatic and extrahepatic diseases underwent MRCP using the SSTSE sequence and the 3D TSE sequence with the SENSE technique. Three radiologists scored and compared the quality of images of anatomic structures in the hepatopancreatic biliary system, and then directly compared the quality of the images obtained using the two sequences in each set of cases. RESULTS: For visualization of the intrahepatic bile duct, the cystic duct, the common bile duct, and the pancreatic duct, MRCP images obtained using the 3D TSE sequence with the SENSE technique were better than those obtained using the SSTSE sequence, though for the intrahepatic bile duct and common bile duct only, were these differences statistically significant (p<0.05). Quality was best for images of the common bile duct (87.5% for SSTSE and 97.5 % for 3D TSE with the SENSE technique). For the pancreatic and cystic duct, however, 52.5% and 10% of SSTSE images, respectively, and 57.5% and 32.5% of 3D TSE images, respectively, provided optimal image quality. In direct comparison, 3D TSE images obtained using the SENSE technique were better in 27 cases (67.5%), both images were equivocal in five cases (12.5%), and SSTSE images were better in eight cases (20%). These differences were statistically significant (p<0.05). CONCLUSION: For the visualization of anatomic structures in the hepatopancreatic biliary system, the 3D TSE sequence with the SENSE technique was better than the SSTSE sequence. For evaluation of the pancreatic and cystic duct, however, both techniques have their limitations and require further development.
Bile Ducts ; Bile Ducts, Intrahepatic ; Biliary Tract ; Cholangiopancreatography, Magnetic Resonance ; Common Bile Duct ; Cystic Duct ; Humans ; Pancreatic Ducts

Nitric oxide (NO) is a gaseous messenger that plays a role in neurotransmission, long term potentiation, depression and cerebral blood flow. Increases in intracellular calcium levels activate the enzyme NOS, and the NO released then diffuse to adjacent cells and activate guanylate cyclase. NO mediates the increase in cerebral blood flow during seizure activity. Therefore, the present study was aimed to investigate the change of NOS and calcium binding proteins in the rat cerebral cortex following seizure. Rats were injected with kainate (KA) and killed at 6 hours, 1, 3, 5 and 10 days after seizure. Expressional change of nNOS, calbindin D28k and parvalbumin was assessed by histochemistry, immunohistochemistry and microdensitometry in the rat brain. The intensity of the NADPH -d staining in rat cortical neurons showed a marked susceptibility to KA administration. At 6 hours and 3 days after seizure, the optical density of the NADPH -d staining was increased relative to the signal in saline treated control rats. At 5 and 10 days after seizure, the optical density of NADPH -d staining was not significantly different in most cortical regions compared to controls. In the hippocampus, the optical density of NADPH -d staining was highest at 5 days after seizure. The optical densities of calbindin D28k and parvalbumin positive neurons were various in the cerebral cortex, hippocampus and caudatoputamen during postseizure period. These results indicate that the calcium binding proteins investigated here are not essential for determining the activation of nNOS/NADPH -d positive neurons in the cerebral cortex and striatum.
Animals ; Brain* ; Calbindin 1 ; Calbindins ; Calcium* ; Calcium-Binding Proteins ; Carrier Proteins* ; Cerebral Cortex ; Depression ; Guanylate Cyclase ; Hippocampus ; Immunohistochemistry ; Kainic Acid ; Long-Term Potentiation ; NADP* ; Neurons* ; Nitric Oxide ; Rats* ; Seizures* ; Synaptic Transmission

Multiple lymphomatous polyposis (MLP) is a distinctive type of primary gastrointestinal lymphoma, characterized by multiple polyps involving long segments of the gastrointestinal tract. Because MLP has a high tendency toward extraintestinal involvement such as bone marrow, lymph node, spleen and liver, MLP can cause various clinical manifestations and has a poor prognosis. We report a case of gastrointestinal MLP, who had an unusual conjunctival involvement during the course of anti-cancer chemotherapy.
Bone Marrow ; Drug Therapy ; Gastrointestinal Tract ; Liver ; Lymph Nodes ; Lymphoma ; Polyps ; Prognosis ; Spleen

Breast cancer is the second most common malignancy among Korean women. The 2002 National Cancer Center screening guideline breast cancer was revised via an evidence-based approach to provide medical personnel with a standard protocol of screening breast cancer. There is moderate-level evidence that biennial screening mammography in asymptomatic women aged 40 to 69 reduces breast cancer mortality, while low-level evidence suggests that screening mammography in women 70 years or older does not reduce breast cancer mortality. The committee concluded that the current evidence is insufficient to assess the benefits and harms of either ultrasonography or clinical breast examination as screening modalities for breast cancer. Future researches about the benefits and harms of the National Breast Cancer Screening Program in Korea are strongly required because the characteristics of breast cancer in Korea are different from those in the West, especially regarding dense breast. In conclusion, the committee recommends biennial screening mammography in asymptomatic women aged 40 to 69 years (grade B recommendation). The committee recommends selective screening mammography in women 70 years or older according to individual risk and preference (grade C recommendation). The committee neither recommends nor opposes ultrasonography and clinical breast examination as screening modalities (grade I recommendation). Symptomatic and high-risk women, however, should be offered complementary measures including ultrasonography and clinical breast examination under clinical supervision.
Breast ; Breast Neoplasms* ; Female ; Humans ; Korea ; Mammography ; Mass Screening* ; Mortality ; Organization and Administration ; Ultrasonography

BACKGROUND AND OBJECTIVES: Recent studies showed that, in addition to parasympathetic nerves, cervical vagal nerves contained significant sympathetic nerves. We hypothesized that cervical vagal nerve stimulation (VNS) may capture the sympathetic nerves within the vagal nerve and activate the stellate ganglion. MATERIALS AND METHODS: We recorded left stellate ganglion nerve activity (SGNA), left thoracic vagal nerve activity (VNA), and subcutaneous electrocardiogram in seven dogs during left cervical VNS with 30 seconds on-time and 30 seconds off time. We then compared the SGNA between VNS on and off times. RESULTS: Cervical VNS at moderate (0.75 mA) output induced large SGNA, elevated heart rate (HR), and reduced HR variability, suggesting sympathetic activation. Further increase of the VNS output to >1.5 mA increased SGNA but did not significantly increase the HR, suggesting simultaneous sympathetic and parasympathetic activation. The differences of integrated SGNA and integrated VNA between VNS on and off times (DeltaSGNA) increased progressively from 5.2 mV-s {95% confidence interval (CI): 1.25-9.06, p=0.018, n=7} at 1.0 mA to 13.7 mV-s (CI: 5.97-21.43, p=0.005, n=7) at 1.5 mA. The difference in HR (DeltaHR, bpm) between on and off times was 5.8 bpm (CI: 0.28-11.29, p=0.042, n=7) at 1.0 mA and 5.3 bpm (CI 1.92 to 12.61, p=0.122, n=7) at 1.5 mA. CONCLUSION: Intermittent cervical VNS may selectively capture the sympathetic components of the vagal nerve and excite the stellate ganglion at moderate output. Increasing the output may result in simultaneously sympathetic and parasympathetic capture.
Animals ; Autonomic Nervous System ; Dogs* ; Electrocardiography ; Heart Rate ; Stellate Ganglion* ; Vagus Nerve Stimulation*

OBJECTIVE: We investigated the impact of depressed mood (dysphoria) and loss of interest or pleasure (anhedonia)on the risk of dementia in cognitively-normal elderly individuals. METHODS: This study included 2,685 cognitively-normal elderly individuals who completed the baseline and 4-year follow-up assessments of the Korean Longitudinal Study on Cognitive Aging and Dementia. We ascertained the presence of dysphoria and anhedonia using the Mini International Neuropsychiatric Inventory. We defined subjective cognitive decline as the presence of subjective cognitive complaints without objective cognitive impairments. We analyzed the association of dysphoria and anhedonia with the risk of cognitive disorders using multinomial logistic regression analysis adjusted for age, sex, education, Cumulative Illness Rating Scale score, Apolipoprotein E genotype, and neuropsychological test performance. RESULTS: During the 4-year follow-up period, anhedonia was associated with an approximately twofold higher risk of mild cognitive impairment (OR=2.09, 95% CI=1.20–3.64, p=0.008) and fivefold higher risk of dementia (OR=5.07, 95% CI=1.44–17.92, p=0.012) but was not associated with the risk of subjective cognitive decline. In contrast, dysphoria was associated with an approximately twofold higher risk of subjective cognitive decline (OR=2.06, 95% CI=1.33–3.19, p=0.001) and 1.7-fold higher risk of mild cognitive impairment (OR=1.75, 95% CI=1.00–3.05, p=0.048) but was not associated with the risk of dementia. CONCLUSION: Anhedonia, but not dysphoria, is a risk factor of dementia in cognitively-normal elderly individuals.
Aged ; Anhedonia ; Apolipoproteins ; Cognition Disorders ; Cognitive Aging ; Cohort Studies ; Dementia ; Depression ; Education ; Follow-Up Studies ; Genotype ; Humans ; Logistic Models ; Longitudinal Studies ; Mild Cognitive Impairment ; Neuropsychological Tests ; Pleasure ; Prospective Studies ; Risk Factors