OBJECTIVES: Significant progress has been made in understanding psychosocial, psychological, and environmental factors associated with suicide. However it is only recently that attention has been paid to the understanding of the neurobiology of suicide. The aim of this study was to examine the relationship between platelet serotonin level and suicidal behavior and psychological features of the suicidal attempters. METHODS: After a suicidal attempt platelet serotonin level was measured from 21 patients and compared it with those from depression patients and normal controls. Also MMPI, HAM-D, Barratt impulsiveness scale(BIS) were done to evaluate their psychological features. RESULTS: 1) There was no significant difference in sex ratio of the suicidal attempters. 2) There was no significant difference in platelet serotonin levels among three groups. 3) The analysis of MMPI revealed that the scores of D, Hs, Pt in clinical scales were significantly higher in suicide patients and scores of D, Pa, Si were in depression patients. 4)The HAM-D score was significantly higher in depression and suicide patients, especially in depression patients. 5) The analysis of Barratt impulsiveness scale revealed that the scores of nonplanning, motor and cognitive impulsiveness scale were significantly higher in suicide patients. CONCLUSIONS: There was no significant difference in platelet serotonin levels among three groups. However the analysis of psychological features revealed significant differences. Therefore we concluded that psychological examinations are benefit to evaluate the suicidal tendency.
Blood Platelets* ; Depression ; Humans ; MMPI ; Neurobiology ; Serotonin* ; Sex Ratio ; Suicide ; Weights and Measures

OBJECTIVES: This study is designed to evaluate the fusion rate of anterior cervical discectomy and fusion (ACDF) using prefilled cage, and clinical features in patients with traumatic cervical injury. METHODS: Sixteen trauma patients at a single institute who underwent ACDF with prefilled cage and rigid plate fixation were evaluated for radiographic fusion status postoperatively every 1 month, 3 month, and 6 month after the surgery. ACDFs were done in 9 patients at one level, 3 patients at two levels, 3 patients at three levels, and 1 patient at four levels. Fourteen patients had fracture and instability, and 2 patients had traumatic herniated cervical discs without fracture and instability. Plain radiographs and CT scan were done for evaluation of bone fusion in all patients. RESULTS: Bone fusion was recognized in all patients. Intervertebral disc height was well maintained during follow-up period. There was no patient with graft failure and instability. Even though the patients with fracture and instability, there was no patient who needed posterior stabilization. There was one case of subsidence without clinical symptom which was needed additional surgical treatment. CONCLUSION: In the treatment of the patients with traumatic cervical diseases, prefilled cage is very effective to achieve cervical spinal stability after ACDF, and to maintain intervertebral disc height. We can achieve immediate postoperative stability and prevent graft displacement by reinforcement with cervical plate and screws.
Diskectomy ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Reinforcement (Psychology) ; Transplants

Several cases of pulmonary air embolisms during surgery have been reported. However, such incidences are very rare during endoscopic surgeries. A 5-year-old boy with third ventricular arachnoid cyst and hydrocephalus underwent endoscopic third ventriculostomy under the general anesthesia, during which continuous intraventricular irrigation was maintained with normal saline. During the procedure, arterial and transcutaneous oxygen tension and end-tidal carbon dioxide tension became suddenly decreased while arterial carbon dioxide tension increased. Within 3 minutes after the inspired gas mixture was changed to 100% oxygen, the patient's respiratory variables returned to near base line. The second attack occured about 10 minutes later and decreased arterial oxygen tension with increased arterial carbon dioxide tension continued for about 5 minutes. After waking up from anesthesia, the patient suffered a generalized seizure attacks that was managed with anticonvusant therapy. We believe that we are the first to report an attack of pulmonary air emblism during brain endoscopic procedure. It was reported with the review of literatures.
Anesthesia ; Anesthesia, General ; Arachnoid ; Brain ; Carbon Dioxide ; Child, Preschool ; Embolism, Air* ; Humans ; Hydrocephalus ; Incidence ; Male ; Oxygen ; Pulmonary Embolism ; Seizures ; Ventriculostomy*

Retinoic acid has been used as a trial of chemotherapeutic agent in the field of cancer therapy and resulted some success in leukemia and breast cancer. Recently, it is being tried on the malignant astrocytoma. We evaluated the effect of all-trans and 13 cis-retinoic acid on C6 cell line cultures(14 day incubation) using MTT assay and counting of cell numbers for establishing the basis of clinical trial. The cell number counting showed 51.6% and 43.1% of control in the cell number at 10 -6M concentration of all-trans and 13 cis-retinoic acid. MTT assay showed 56.4% and 46.1% of control in the optical absorbance at 10 -6M concentration of all-trans and 13 cis-retinoic acid. These results indicate the possiblity of both drug as effective chemotherapeutic agents for glial cell tumors but in-vivo study will be needed for clinical trial.
Astrocytoma ; Brain Neoplasms ; Breast Neoplasms ; Cell Count ; Cell Culture Techniques ; Cell Line* ; Glioma ; Leukemia ; Tretinoin*

Colonoscopy is frequently used for lower GI tract screening tests. Although rare, splenic injury may develop in the high-risk patients on anticoagulants or antiplatelet agents. A 78-year-old female visited our hospital complaining of chest pain. She had taken antihyperlipidemic and antiplatelet agent with hyperlipidemia and 20%-stenosis in the left anterior descending artery. She was taken polypectomy after colonoscopy 4 years ago. The next day, after a follow-up colonoscopy for polypectomy, she complained epigastric and left upper abdominal discomfort. Pain intensity was not high, but next day, epigastric pain was increased, so coronary angiography was performed 2 days later using anticoagulants. Coronary angiography showed 40~50%-stenosis in the left anterior descending artery. Another antiplatelet agent was added. After 72 hours on colonoscopy, her pain was localized upper left abdominal area. Abdominal CT showed intracapsular bleeding in the spleen with a small amount of hemoperitoneum in the pelvis. Since her vital signs were stable, she was treated with conservative management. Her pain improved and discharged. One month later, she was taken Abdominal CT. CT showed the size of intracapsular fluid collection in the spleen was increased, but the whole fluid collection was liquidized. 2 weeks later, follow-up sonography showed the size of fluid collection conspicuously was reduced. The case reported herein is a splenic Injury after Colonoscopy in patient on antiplatelet agents.
Aged ; Anticoagulants ; Arteries ; Chest Pain ; Colonoscopy* ; Coronary Angiography ; Female ; Follow-Up Studies ; Hemoperitoneum ; Hemorrhage ; Humans ; Hyperlipidemias ; Lower Gastrointestinal Tract ; Mass Screening ; Pelvis ; Platelet Aggregation Inhibitors ; Spleen ; Tomography, X-Ray Computed ; Vital Signs

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
Arm ; Braces ; Dislocations* ; Elbow Joint ; Elbow* ; Hematoma* ; Humans ; Humerus ; Joint Capsule ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Radiography ; Range of Motion, Articular ; Reference Values ; Rupture ; Splints ; Young Adult

We studied thirty benign and twenty-one malignant brain tumors in order to investigate the relationship between p53, bcl-2, apoptosis and histologic grade of brain tumors. For the study of p53 and bcl-2 gene expression, we used immunohistochemical staining method using monoclonal antibodies to p53 and bcl-2; and, for apoptosis, In-situ end labeling technique was used. The malignant group showed significantly higher p53 and apoptosis positive index(PI) than the benign group(mean p53 PI, malignant: 16.0 benign: 0.9/mean apoptosis PI, malignant: 2.3 benign: 0.2)(p=0.003); but bcl-2 positive index was not significantly different between two groups (p=0.118). Correlation between p53 mutation and apoptosis PI was statistically significant(p=0.012, Pearson coefficient=0.349); but correlation between bcl-2 expression and apoptosis PI was not(p=0.318). Moreover, correlation between p53 mutation and bcl-2 expression was not statistically significant(p=0.583). These results suggest that higher p53 mutation tends to exist in the group of tumors with higher malignant histologic grades. Furthermore, it can be concluded that greater DNA damage reflected by higher frequency of apoptosis tends to exist in the group of higher malignant histologic grade.
Antibodies, Monoclonal ; Apoptosis* ; Brain Neoplasms* ; Brain* ; DNA Damage ; Genes, bcl-2

PURPOSE: It has been reported that retinoic acid, one of the most popular agents for chemoprevention could inhibit the proliferation of many cancer cells including neuroblastoma and glioblastoma. However, there is increasing demand reaccessing its in vitro inhibitory effect on the tumor proliferation because of the poor results from recent clinical trials of retinoic acid in the malignant brain tumor. Retinoicacid ptomoted the diffferentiation and apoptosis of tumor cell so that its effect might be obvious in the pediatric brain tumor. Therefore we are going to confirm the effectiveness of retinoic acid to inhibit the proliferation of the tumor cells; glioblastoma and medulloblastoma in childhood. METHODS: Medulloblastoma cells were derived from the primary culture of the patient's specimen, and glioblastoma cells were cell lines of 373-MG and 87-MG. We estimated growth inhibition rate of each tumor cells using MTT assay in the concentration from 10 M to 10((-5))M of all-trans and 13-cis retinoic acid. RESULTS: 13-cis retinoic acid in the concentration of 10 6M inhibited cell growth rate 10-22% on the 4th day of incubation, 10% on the 7th day, and 0-12% on the 14th day in the concentration from 10((-6))M to 10((-5))M. All-trans retinoic acid inhibited cell growth rate less than 5% in the concentration less than 10((-5))M though the whole incubation period, but 42% on the 4th day, 37% on the 7th day, and 0% on the 14th day in the concentration of 10((-5))M. 13-cis retinoic acid inhibited cell growth rate 30% on the 4th day, 20% on the 7th and 14th day in the concentration between 10((-6))M and 10((-5))M. Alltrans retinoic acid inhibited cell growth rate less than 5% on the 4th and 7th day. Medulloblastoma cells showed growth inhibition more than 25% by all-trans and 13-cis retinoic acid in the concentration less than 10((-6))M. 13-cis retinoic acid showed 25% growth inhibition in the concentration above 10((-6))M, but all-trans retinoic acid showed 40% growht inhibition in the same concentration. CONCLUSION: We could not find the effect of retinoic acid in the glioblastoma cells due to variable responses of the tumor cell growth inhibition in the concentration of maximum tolerable dose. However, there ia a significant inhibitory effect of medulloblastoma cell proliferation both in the 13-cis and all-trans retinoic acid.
Apoptosis ; Brain Neoplasms ; Cell Culture Techniques* ; Cell Line ; Cell Proliferation ; Chemoprevention ; Glioblastoma* ; Isotretinoin* ; Medulloblastoma* ; Neuroblastoma ; Tretinoin

OBJECTIVE: There is no acceptable indication and treatment of choice for infantile and child subdural hygroma and there are only a few reports about that in Korea. So the authors studied the clinical findings of infantile and child patients with subdural hygroma to improve the understanding and to suggest a standard treatment method. METHODS: The authors retrospectively evaluated the causes, preoperative symptoms, radiological thicknesses, and postoperative results of 25patients with subdural hygroma who received surgical therapy. RESULTS: There were 16boys and 9girls whose median age was 6months(range 2~120months). The main clinical manifestations were seizures, increased intracranial pressure, macrocrania and alteration of consciousness. Radiological thicknesses of the subdural hygroma varied from 7mm to 42mm and postoperative changes of thickness(y) could be expressed with the factor of month(x): y = -1.32 x +11.8 in subdural drainage, and y = -1.52 x +14.9 in subduroperitoneal shunts. Of the 25patients, 2 (50%) were successfully treated by aspiration, 13 (59%) by subdural drainage, and 9 (69%) by subduroperitoneal shunt. CONCLUSION: It is suggested that the diagnosis and treatment of subdural hygroma in infants and children should be carefully addressed because of its high prevalence in children, and especially in infants. It is also suggested that the subdural drainage could be primary initial treatment method because it is simpler than a shunt, and since our data show that there is no statistical difference in postoperative recovery duration between the two operative methods.
Child* ; Consciousness ; Diagnosis ; Drainage ; Hematoma, Subdural ; Humans ; Infant* ; Intracranial Pressure ; Korea ; Prevalence ; Retrospective Studies ; Seizures ; Subdural Effusion*

PURPOSE: To evaluate the incidence of urologic cancer in Korea. MATERIALS AND METHODS: Between January 1998 and December 2002 the Korean Urologic Oncology Society (KUOS) decided to evaluate the incidence of Korean urologic cancer. The URO-DMS data obtained by 86 training hospital was analyzed. First, the disease code was simplified; for example, renal cell carcinoma (C64), and thereafter, evaluated for incidence and prevalence, etc. RESULTS: A total of 35,480 patients were newly diagnosed over this period. Bladder cancer was the most common (42.9%) urologic cancer, followed by prostate (26.4%), kidney (22.4%), ureter (3.7%), renal pelvis (3.0%), testis (2.8%), penile (0.2%), urethral (0.1%) and scrotal cancers (0.1%). Male patients outnumbered the females by a ratio of 4.4:1. The incidence rates per 100,000 males for prostate and testicular cancers were 7.73 and 0.81, respectively. The incidence rates per 100,000 persons for bladder, renal, ureter and renal pelvis cancers were 6.36, 3.30, 0.55 and 0.44, respectively. Cancers of the prostate and kidney increased rapidly, but the others increased steadily. CONCLUSIONS: It is hoped that these results would contribute to cancer research and control of cancers in Korea.
Carcinoma, Renal Cell ; Epidemiologic Studies* ; Female ; Hope ; Humans ; Incidence ; Kidney ; Kidney Pelvis ; Korea* ; Male ; Prevalence ; Prostate ; Testicular Neoplasms ; Testis ; Ureter ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urologic Neoplasms*