The serotonin has been known to play important roles in pathology of the mood disorders. We summerize the evidences of serotonin in pathology of the mood disorders in a view of neuroanatomical and neurochemical aspects. Nowaday, the selective serotonin reuptake inhibitors(SSRIs)may be practically the first line of antidepressants with traditional tricyclic antidepressants(TCAs. Authors review the role of serotonin in the treatment of the mood disorders, in a view of the general considerations in selecting antidepressants, pharmacology, therapeutic, indications, side effects, doses of medication, drug-discontinuation syndrome, drug-to-drug interactions, and special therapeutic situations.
Antidepressive Agents ; Mood Disorders* ; Pathology* ; Pharmacology ; Serotonin*

The authors reviewed clinical data and 50 pathologic specimens from 41 patients of prostate adenocarcinoma filed in the Department of Pathology, Hanyang University school of Medicine, in order to evaluate correlation between clinical stages and histopathologic grades of prostate adenocarcinoma. Each of five currently used grading systems were compared with clinical stages of prostate adenocarcinomas. The followings results were obtained: All of the grading systems were relatively well correlated with clinical progression of the tumon. Histologic grading systems including Gleason's grading system, Gleasons scoring system and M.D. Anderson system showed better correlation than cytologic grading system of Mostofi. Gaeta gradings system regarding both histologic and cytologic aspects of the carcinoma showed good correlation to clinical stage with correlation coefficient of 0.654. Combined scoring system of cytologic and histologic grades (Mostofi-M.D. Anderson combined scoring system) showed better correlation to the clinical stage than single individual grading s system. The author conclued that Gleasons histologic grading system with cytologic characteristics of tumor cells would represent best parameter of clinical progression of the prostate adenocarcinoma.
Adenocarcinoma

BACKGROUND AND PURPOSE: This study was undertaken to compare the sensitivity of the Repetitive Nerve Stimulation Test (RNST) between the upper and lower extremity muscles in myasthenia gravis(MG) patients. MATERIALS AND METHODS: The study population consisted of 20 normal persons(control group) and 10 MG patients(MG group). Using Stalberg's method. RNST was systemically performed in orbicularis oculi muscle. upper extremity muscles(flexor carpi ulnaris. abductor digiti quinti), and lower extremity muscles(tibialis anterior. extensor digitorum brevis. vastus medialis). RESULTS: There were statistical differences of decremental response(mean+/-SD) in orbicularis oculi and upper extremity muscles between the control and MG groups(p<0.05 or p<0.01). However, there was no statistical difference of decremental response(mean+/-SD) to RNST in lower extremity muscles between the control and MG groups. There were highersensitivity in orbicularis oculi and upper extremity muscles than lower extremity muscles. Although positive reponse were detected in the lower extremity muscles, the positive response rates of lower extremity muscles were lower than o.oculi and upper extremity muscles. CONCLUSIONS: When the response rates of RNST in facial and upper extremity muscles are normal, may not be required RNST in lower extremity muscles.
Humans ; Lower Extremity* ; Muscles* ; Myasthenia Gravis* ; Upper Extremity

OBJECTIVE: This study was a open clinical trial aimed at exploring the effectiveness of combined treatment with estrogen and antipsychotics to the chronic female schizophrenics. METHOD: 40 female patients who met DSM-VI criteria for schizophrenia who were chronically ill were randomly assigned to estrogen group(EG) and control group(CG). EG patients were received estrogen 1.25mg for 8 weeks in addition to their routine antipsychotic regimens. CG patients were received their routine antipsychotic regimens only. Both groups were evaluated by PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) at 0, 4, 8 week during the trial period and compaired with each other. RESULTS: 40 female patients have completed the study during 8 weeks. EG was significantly improved in PANSS and CGI scores than CG during the 8 weeks. In EG patients, all symptom subtypes(positive symptoms, negative symptoms, general psychopathology symptoms) of PANSS were significantly improved and positive symptoms were most significantly improved at 8 weeks. CONCLUSIONS: This results support the clinical value of combined estrogen therapy among chronic female schizophrenics.
Antipsychotic Agents* ; Chronic Disease ; Estrogens* ; Female* ; Humans ; Psychopathology ; Schizophrenia*

Ureteral duplication is the most common developmental abnormality of the upper urinary tract. The upper pole ureter is often associated with a ureterocele and the lower pole ureter, the V-U reflux. A case of bilateral double collecting system associated with bilateral ureteroceles in a 6-month old Korean male is presented with review of literature.
Humans ; Infant ; Male ; Ureter ; Ureterocele* ; Urinary Tract

This is an autopsy case of a 6 month old girl who suddenly died of respiratory distress during sleep. She had suffered from mild but frequent episodes of common cold and was treated for eczema for several days. At autopsy, the heart was enlarged and weighed 100 gm. A firm and gray-white tumor, measuring 4.5 x 3.8 x 2.8 cm, was located in the interventricular septum and encroached upon the wall of left ventricle. The mass was well demarcated but was not encapsulated. Neither necrosis nor calcification was present. Microscopically the tumor was composed of haphazardly arranged bundles of collagen fibers and fibroblasts. Myocardial cells are intermingled with the fibroblasts at the margin of the tumor. Massive edema of the lung and congestion of the liver and spleen were pronounced.

BACKGROUND: Tracheal intubation for general anesthesia often leads to trauma of the airway mucosa, resulting in postoperative sore throat and hoarseness. Numerous studies have investigated the factors as contributing causes, but the influence of method of anesthesia induction and time for extubation of the endotracheal tube has not been systematically examined. The aim of this study was to establish the effects of the methods of anesthesia induction and timing of extubation on postoperative sore throat and hoarseness. METHODS: Eighty patients with ASA physical status 1 or 2 were randomly divided into four groups. Group 1 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and early extubated ; group 2 patients (n=20) recieved succinylcholine 1.0 mg/kg for intubation and lately extubated ; group 3 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and early extubated ; group 4 patients (n=20) recieved pancuronium 0.1 mg/kg for intubation and lately extubated. All patients were interviewed 6, 24, 48, and 72 hrs after operation by an anesthesiologist in a double-blind manner. RESULTS: The incidence of sore throat at postoperative 6 and 24 hrs were decreased in group 3 compaired with group 1, 2, and 4 (p<0.05), respectively. The severity of sore throat at postoperative 6 hrs were decreased in group 3 compared with group 1, 2 and 4 (p<0.05), and that of postoperative 24 hrs were decreased in group 3 compared with group 1 and 2 (p<0.05), respectively. The severity of hoarseness at postoperative 6 hrs were decreased in group 3 compared with group 2 (p<0.05). CONCLUSIONS: We suggest that postoperative sore throat and hoarseness may be developed more when extubation was perfomed lately than early. Therefore, early extubation provide advantage in terms of reducing sore throat and hoarseness in limited cases of anesthesia.
Anesthesia* ; Anesthesia, General ; Hoarseness* ; Humans ; Incidence ; Intubation ; Mucous Membrane ; Pancuronium ; Pharyngitis* ; Succinylcholine

A case of extrapulmonary silicosis involving abdominal lymph nodes in a 62-year-old man is presented. The patient underwent subtotal gastrectomy and regional lymph nodes dissection for gastric adenocarcinoma of clinical stage III. On gross examination, two separate gastric adenocarcinomas and multiple enlarged lymph nodes mimicking metastatic lesion were noted. Microscopic examination of the enlaged lymph nodes revealed characteristic sclerohyaline silicotic nodules without metastatic adenocarcinoma. Chest roentgenogram showed diffusely scattered multiple tiny nodular lesions in the entire lung fields, particularly the posterior side of both upper lung fields. He had worked in a mine for 18 years and had been exposed to silica for 5 of those years. We report incidentally found, unusual case of extrapulmonary silicosis.
Adenocarcinoma ; Gastrectomy ; Humans ; Lung ; Lymph Nodes ; Middle Aged ; Silicon Dioxide ; Silicosis* ; Thorax

BACKGROUND: To evaluate the clinical and functional outcomes of arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension, and investigate the radiologic and clinical benefits from the results. METHODS: We evaluated patients treated with arthroscopic-assisted reduction and percutaneous screw fixation for glenoid fractures with scapular extension from November 2008 to September 2015. Fractures with displacement exceeding one-fourth of the anterior-articular surface or more than one-third of the posterior-articular surface in radiographic images were treated by surgery. Clinical assessment was conducted based on range of motion, Rowe score, and Constant score of injured arm and uninjured arm at last follow-up. RESULTS: Fifteen patients with Ideberg classification grade III, IV, and V glenoid fracture who underwent arthroscopic-assisted reduction using percutaneous screw fixation were retrospectively enrolled. There were no differences in clinical outcomes at final follow-up compared to uninjured arm. Bone union was seen in all cases within five months, and the average time to bone union was 15.2 weeks. Ankylosis in one case was observed as a postoperative complication, but the symptoms improved in response to physical therapy for six months. There was no failure of fixation and neurovascular complication. CONCLUSIONS: We identified acceptable results upon radiological and clinical assessment for the arthroscopic-assisted reduction and percutaneous fixation. For this reason, we believe the method is favorable for the treatment of Ideberg type III, IV, and V glenoid fractures. Restoration of the articular surface is considered to be more important than reduction of fractures reduction of the scapula body.
Ankylosis ; Arm ; Arthroscopy ; Classification ; Follow-Up Studies ; Fracture Fixation ; Glenoid Cavity ; Humans ; Methods ; Postoperative Complications ; Range of Motion, Articular ; Retrospective Studies ; Scapula

BACKGROUND: Afterload as well as myocardial contractil ity is an important factor for the adequacy of circulation after cardiac surgery . To noninvasively assess alterations in afterload, we evaluated the changes in aortic blood velocity waveform. MATERIAL AND METHOD: Ascending aortic blood flow was measured by continuous wave Doppler echocardiography befo re and after afterload manipulation in eight open-chest dogs. Nitroprusside was administered singly and simultaneously with epinephrine in various combinations. Left atrial pressure as an index of preload was maintained by saline administra tion. RESULT: The infusion of nitrop russide produced dose-dependent decreases in blood pressure and index of systemi c vascular resistance(ISVR) (all p<0.05 vs baseline), which was associated with increases in peak velocity(PV), mean acceleration(MA) and minute distance, and w ith a decrease in acceleration time(all p<0.05 vs baseline). ISVR obtained durin g nitroprusside infusion had a better correlation with both PV(r=-0.60, p=0.001) and MA(r=-0.52, p=0.003) than with velocity time integral(VTI) or the Doppler t ime intervals. The combined infusion of nitroprusside and epinephrine, unless IS VR was elevated, produced synergistic effects on PV, MA and VTI, but these Doppl er indexes tended to diminish with an elevation in afterload. CONCLUSION: Doppler measuremen t of PV and MA in the ascending aorta may be used to noninvasively assess change s in afterload.
Acceleration ; Animals ; Aorta ; Atrial Pressure ; Blood Pressure ; Dogs ; Echocardiography, Doppler ; Epinephrine ; Nitroprusside ; Regional Blood Flow ; Thoracic Surgery