OBJECTIVES: The purpose of this study was to investigate the differences between potential neuroanatomical sites of action of(1) a typical antipsychotic drug (haloperidol), (2) an atypical antipsychotic drug (clozapine), and (3) three combinations of both haloperidol and serotonergic agents (haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine) by comparing their effects on c-fos expression in the rat brain. METHODS: Twenty-four Wistar rats of male sex, weighing 300-450 g, were divided into 6 groups according to the type of the agents tested [vehicle (0.14 M acetic acid 1 ml/kg), haloperidol (1.0 mg/kg), clozapine (20 mg/kg), haloperidol+buspirone (1.0 mg/kg+1.0 mg/kg), haloperidol+cyproheptadine (1.0 mg/kg+1.0 mg/kg), haloperidol+fluoxetine (1.0 mg/kg+0.25 mg/kg)]. The brain of variously treated rat was examined 2 hours after subcutaneousely injection in the neck. The brain was removed immediately after perfusion with 4% paraformaldehyde and placed in a fresh fixative of the same solution. After 12-hr fixation, brain sections (30 mum) of the areas including the medial prefrontal cortex, nucleus accumbens, and lateral striatum were stained by Fos immunohistochemistry, and subjected to light microscopic analytical observations. RESULTS: 1) The number of Fos-positive neurons in the medial prefrontal cortex was significantly increased in the clozapine, haloperidol+buspirone, haloperidol+cyproheptadine, and haloperidol+fluoxetine treated groups than in the control group (p<0.05). But, the haloperidol treated group shows no significant difference. 2) The number of Fos-positive neurons in the nucleus accumbens was significantly increased in the haloperidol clozapine, haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine treated groups than in the control group (p<0.05). 3) The number of Fos-positive neurons in the lateral striatum was significantly increased in the haloperidol, haloperidol+buspirone, haloperidol+cyproheptadine, haloperidol+fluoxetine treated groups than in the control group (p<0.05). But, the clozapine treated group shows no significant difference. CONCLUSION: These results suggest that differential expression of c-fos in rat brain induced by haloperidol, clozapine, and haloperidol combined serotonergic agents is associated with their clinical and pharmacological differences.
Acetic Acid ; Animals ; Brain* ; Clozapine* ; Haloperidol* ; Humans ; Immunohistochemistry ; Male ; Neck ; Neurons ; Nucleus Accumbens ; Perfusion ; Prefrontal Cortex ; Rats* ; Rats, Wistar ; Serotonin Agents*

PURPOSE: This study was conducted to evaluate the roughness and surface alternations of three differently blasted titanium discs treated by Nd: YVO4 Laser irradiation in different conditions. MATERIALS AND METHODS: Thirty commercially pure titanium discs were prepared and divided into three groups. Each group was consisted of 10 samples and blasted by ZrO2 (zirconium dioxide), Al2O3 (aluminum oxide), and RBM (resorbable blasted media). All the samples were degreased by ultrasonic cleaner afterward. Nine different conditions were established by changing scanning speed (100, 300, 500 mm/s) and repetition rate (5, 15, 35 kHz) of Nd: YVO4 Laser (Laser Pro D-20, Laserval Korea(R) Seoul, South Korea). After laser irradiation, a scanning electron microscope, X-ray diffraction analysis, energy dispersive X-ray spectroscopic analysis, and surface roughness analysis were used to assess the roughness and surface alternations of the samples. RESULTS: According to a scanning electron microscope (SEM), titanium discs treated with laser irradiation showed characteristic patterns in contrast to the control which showed irregular patterns. According to the X-ray diffraction analysis, only Al2O3 group showed its own peak. The oxidation tendency and surface roughness of titanium were similar to the control in the energy dispersive X-ray spectroscopic analysis. The surface roughness was inversely proportional to the scanning speed, whereas proportional to the repetition rate of Nd: YVO4. CONCLUSION: The surface microstructures and roughness of the test discs were modified by the radiation of Nd: YVO4 laser. Therefore, laser irradiation could be considered one of the methods to modify implant surfaces for the enhancement of osseointegration.
Electrons ; Osseointegration ; Pilot Projects ; Surface Properties ; Titanium ; Ultrasonics ; X-Ray Diffraction

PURPOSE: This study was undertaken to learn the usefulness, cost-effectiveness and safety of intraoperative transesophageal echocardiography(ITEE) during open heart surgery for congenital heart diseases. METHODS: The usefulness and safety of ITEE were assessed in 254 patients who underwent open heart surgery for congenital heart diseases from January 1, 2001 to June 30, 2003, with retrospective chart reviews and a simple relative cost analysis. RESULTS: Among 254 open heart surgery patients, ITEE was not performed in 47 cases. The majority of cases were atrial septal defect(15 cases, 32%), ventricular septal defect(16 cases, 34%), ASD and VSD(three cases, 6.4%). In the other five smaller babies(weight range 2.7-3.1 kg), the ITEE probes couldn't pass the patient's esophagus. In 207 cases, ITEE were performed without any major complications. Residual abnormalities were identified by ITEE in six cases(2.9%), requiring surgical revisions : four cases with right ventricular outflow tract pressure gradient, one case of residual mitral regurgitation and one case of residual aortic stenosis and supravalvular pulmonary stenosis. If these six cases had not directly returned to bypass for surgical revision of the initial repair at the same operation, the additional fee of reoperation after leaving operation room were estimated to be won47,496,346(won7,916.057 per patient). In contrast, the costs of performing ITEE in all open heart surgical patients(207 patients) stood to total won82,800,000(won400,000 per patient). CONCLUSION: ITEE was not considered to be a beneficial diagnostic modality in terms of cost effectiveness in this study. But, the routine use of ITEE during most open heart surgery for congenial heart defects may be warranted as it produces no major complication, improves postoperative care, and comforts surgeon's feelings.
Aortic Valve Stenosis ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Echocardiography, Transesophageal* ; Esophagus ; Fees and Charges ; Heart ; Heart Defects, Congenital ; Heart Diseases ; Humans ; Mitral Valve Insufficiency ; Postoperative Care ; Pulmonary Valve Stenosis ; Reoperation ; Retrospective Studies ; Thoracic Surgery

Epithelioid hemangioendothelioma(EH) is a rare vascular tumor of low-grade malignancy. It was previously described as intravascular bronchioloalveolar tumor (IVBAT). But electron microscopic study and immunohistochemical staining results have proved endothelial origin. Patients are usually asymptomatic and the tumors are found incidentally on routine chest X-rays. Most patients show a slowly progressive clinical course, even though some patients occasionally die as results of respiratory failure or extrathoracic complications. Confirmative diagnosis is made through thoracoscopic or open-lung biopsy. There is still no effective therapeutic modality for pulmonary EH. We have experienced a 55-year-old woman whose simple chest x-ray film revealed bilateral multiple small nodules. The nodules were histopathologically and immunohistochemically diagnosed as primary epithelioid hemangioendothelioma of the lung. The possibility of metastatic disease was excluded thorough clinical, laboratory and radiological studies. Comparison of radiographic chest film taken 3 years ago showed no significant progression of the pulmonary nodular lesions. Conservative management was instituted and careful 4 months follow-up showed no significant changes.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Lung ; Middle Aged ; Respiratory Insufficiency ; Thorax ; X-Ray Film

PURPOSE: This study was designed to demonstrate the potential therapeutic advantage of 3-dimensional (3-D) treatment planning over the conventional 2-dimensional (2-D) approach in patients with carcinoma of the nasopharynx. MATERIAL AND METHODS: The two techniques were compared both qualitatively and quantitatively for the boost portion of the treatment (19.8 Gy of a total 70.2 Gy treatment schedule) in patient with T4. The comparisons between 2-D and 3-D plans were made using dose statistics, dose-volume histogram, tumor control probabilities, and normal tissue complication probabilities. RESULTS: The 3-D treatment planning improved the dose homogeneity in the planning target volume. In addition, it caused the mean dose of the planning target volume to increase by 15.2% over 2-D planning. The mean dose to normal structures such as the temporal lobe, brain stem, parotid gland, and temporomandibular joint was reduced with the 3-D plan. The probability of tumor control was increased by 6% with 3-D treatment planning compared to the 2-D planning, while the probability of normal tissue complication was reduced. CONCLUSION: This study demonstrated the potential advantage of increasing the tumor control by using 3-D planning, but prospective studies are required to define the true clinical benefit.
Brain Stem ; Humans ; Nasopharynx* ; Parotid Gland ; Temporal Lobe ; Temporomandibular Joint

The purpose of this study is to review the validity of quantitative indices on the Evaluation of Korean Medical Schools in 1996. The data required for the indices were obtained from the 1996's edition of the Directory of Korea Medical Education and compared to the results of the evaluation. Among the quantitative indices of the evaluation the number of professors and assistants of basic medical science was the most valuable index to differentiate the better group from lesser groups of medical schools in Korea.
Education, Medical ; Korea ; Schools, Medical*

In order to ascertain the status of health damage among Korean farmers who spray pesticides regularly in summer, blood and urine samples were collected for 88 volunteers during July to Septembei in 1990. Serum cholinesterase activity, parent compounds of pesticides in blood and urine, SGOT, SGPT, blood pressure, pulse rate were measured. The results were as follows ; 1. Mean cholinesterase activity after spraying pesticides was significantly lower than that before splaying. While proportion of abnormal cholinesterase activity (<1900U/L) group was 2.3% before spraying pesticides, tHe proportion of the group after spraying was 22.8% 2. Cholinesterase activity were decreased over 50% in 14.7% of the suhjects who can be classified into poisoning group 3. While pulse rate and blood pressure were slightly increased in poisoning group, those were significantly decreased in non-poisoning group. 4. Consecutive splaying of pesticide caused further reduction of cholinesterase activity, 5. Five parent compounds of pesticides frequently used during summer farming were analyzed using 106 blood samples. IBP in one sample and Isoprothiolane in four samples were detected. No parent compounds were detected in urine samples.
Alanine Transaminase ; Aspartate Aminotransferases ; Blood Pressure ; Cholinesterases* ; Heart Rate ; Humans ; Parents ; Pesticides ; Poisoning ; Volunteers

Radiation therapy has been known to have a prophylactic effect for heterotopic ossification (HO), but until now it has not been known to have a therapeutic effect for established HO. We report a case of established HO compounded with a sudden increase in activity, that was improved with radiation therapy. A patient with traumatic brain injury had HO in both hips and thighs two months after the initial trauma. The existing level of HO activity suddenly increased seven months after the initial trauma, and was accompanied by severe pain that was refractory to indomethacin. We assumed that the pain was caused by the increased activity of HO on the basis of clinical symptoms and laboratory results. Initially, the patient received radiation therapy to the left lower extremity, with a total dose of 20 Gy in ten fractions. Next, the patient received radiation therapy at the same dosage to the right lower extremity, after which the pain and level of serum alkaline phosphatase significantly decreased. The patient experienced a mild pancytopenia as a side effect of the radiation therapy, but it was not severe enough to stop the radiation therapy, given the patient's suffering from the increased HO activity.
Adult ; Brain Injuries/complications* ; Case Report ; Human ; Male ; Ossification, Heterotopic/radiotherapy*

Primary retroperitoneal mucinous cystadenocarinoma is extremely rare with only five case reported in the literature.Primary mucinous adenocarcinoma is apparent that a primary retroperitoneal process in development results in tissue susceptible to malignants degeneration. It is impossible to clarify the precise defect in embryologic growth that allows these tumors to develop. The theory of coelomic metaplasia has gained increasing support in recent years for origin of the epithelial neoplasms of the ovary, and an invagination of the same coelomic or pertioneal epithelial layer with concurrent or subsqeunt metaplasia account for retroperitoneal mucinous neoplasmsThe preoperative course of these cysts appears indolent, yet the eoveall prognosis is poor. The role of chemotherapy in the treatment of these tumors remains undrfined. colse follow-up and aggressive management based on histologic appearance are indicated to improve the outcome of the patients with retroperitoneal mucinous cystadenocarinoam.Recently, We repoorted one case of primary retroperitoneal nucinous cytadeno -carcioma. The patient was a 32 year-old female complaing a palpable mass and discomfort in the left flank. Laparotomy revealed a huge retroperitoneal mass in the presence of bilateral normal ovaries. Histologically, it was a mucinous cystic neoplasm with flankly malignat area. No ovarian issue was found din the mass.
Adenocarcinoma, Mucinous ; Adult ; Cystadenocarcinoma, Mucinous* ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Laparotomy ; Metaplasia ; Mucins* ; Neoplasms, Glandular and Epithelial ; Ovary ; Prognosis

PURPOSE: Most epidemiological and clinical studies on BRCA1/ 2 mutations and the risk of breast cancer have been based on Western cohorts. There have been few such studies for Korean populations. The primary aim of this paper is to report the protocol of a Korean Hereditary Breast Cancer (KOHBRA) study. METHODS: The multi-centers registered in the Korean Breast Cancer Society are participating in the KOHBRA study. The objectives of the KOHBRA study till 2010 is to examine the prevalence of BRCA1/2 mutation and the prevalence of ovarian cancer among the high risk group of hereditary breast cancer patients and their families. This study is a prospective cohort study that recruited 2,250 subjects: 1) who were breast cancer patients with a family history of breast or ovarian cancers, 2) who were patients with a high risk of BRCA1/2 mutations (i.e. early onset, bilateral, male, multiple primary cancers), and 3) who had family members that were BRCA1/2 mutation carriers. The recruiting period will cover the 25th of May 2007 to the 24th of May 2010. Written informed consent is obtained at the time of enrollment. The family history and epidemiological data are obtained by a baseline questionnaire, the anthropometric data is measured and the clinical information is collected by chart-reviews by doctors. BRCA1/2 mutation testing and ovarian cancer screening are done. Blood samples are stored. Follow-up data are collected at 1, 3 and 5 yr after enrollment. RESULTS: Until now, 36 centers have joined the KOHBRA study and they are in the process of Institutional Review Board (IRB) approval. We expect to find the Korean founder mutation and to establish the Korean BRCA risk prediction model. Furthermore, the BRCA carrier cohort established from the KOHBRA study will be the groundwork to participate in an international study. CONCLUSION: The KOHBRA study will provide unique, important data to prove the etiology and natural history of Korean hereditary breast cancer. This study will be continued as genomic and proteomic epidemiological studies and future intervention studies for the prevention of hereditary breast cancer among Koreans.
Breast Neoplasms* ; Breast* ; Cohort Studies ; Epidemiologic Studies ; Ethics Committees, Research ; Follow-Up Studies ; Humans ; Informed Consent ; Male ; Mass Screening ; Natural History ; Ovarian Neoplasms ; Prevalence ; Prospective Studies ; Surveys and Questionnaires