The current understanding of the neurobioloby of anxiety is generally based on experimental animal model, empirical effective psychopharmacological agents, chemical and naturalistic challenge paradigms, and psychoendocinological assessment. This article focuses on reviewing neuroanantomical, neuroendocinological and neurofunctional research of anxiety disorder. In the decade ahead, we anticipate that extension of current research and the new integrated approach promise novel insight into mechanism of anxiety.
Anxiety Disorders ; Anxiety* ; Models, Animal ; Neuroanatomy ; Neurobiology* ; Neuroendocrinology ; Neuroimaging

The anterior cruciate ligament(ACL) is one of the major stabilizers of knee motion. The ACL does not heal once torn, unlike many other biological tissues. Its absence can lead to severe joint instability which can lead to disruptions of secondary restraints around the knee and then progress to degenerative joint disease. Thus many authors advocate surgical intervention for a torn ACL in order to restore stability to the joint. Yet, there is still controversy as to best treatment for the ACL injuries. It is desirable to be considered for the patients age, the severity of the injury, and the future activity level of the patient to decide treatment. We analyzed thirty ACL acute injuries of twenty seven patients who had an ACL injury and treated surgically between Apr. 1986 and Dec. 1991 at St. Pauls Hospital. The results were as follows: 1. There were twenty five males and two females. The mean age was 33.4 years ranged, 15 to 52 years. 2. The anterior cruciate ligaments were torn at proximal portion in twenty two cases, at midportion and distal portion in four, respectively. 3. Two knees had isolated ACL injuries and twenty eight had combined injuries. 4. Twenty one out of twenty six cases treated with primary repair, and three out of four cases treated with reconstruction had good-excellent results.
Anterior Cruciate Ligament ; Female ; Humans ; Joint Diseases ; Joint Instability ; Joints ; Knee ; Male

Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

Cartilage is one of the most commonly manipulated tissue in esthetic and reconstructive surgery. Cartilage has an important role in longitudinal bone growth. Anabolic hormones and locally produced peptide growth factors are known to influence this process Matrix composition changes through proliferation, maturation, and differentiation of chondrocytes, and endochondral ossification thereafter. Defined cartilage matrix is synthesized during the maturation of chondrocytes where the major change is the increment of type II collagen. Variable sulfated mucololysaccharides and hyaluronic acid are also synthesized during this maturation. IGF-I(insulin like growth factor-I), so called somatomedin C, is a prominent growth factor in serum. IGF-I is known to be involved in long growth. IGF-I is affected by pituitary growth hormone. There are few studies done on IGF-I effect in cartilage matrix formation and possible changes of collagen subtypes. This experiment was designed to see the IGF-I effect on the colagen synthesis of cultured chondrocytes. Optimal concentration of IGF-I for the experiment was determined using H3-thymidine incorporation into DNA. The IGF-I effect on collagen synthesis was studied using H3-proline. The IGF-I effect on the synthesis of subtypes of collagen was studied using SDS-PAGE and immunocytochemical staining. Chondrocytes were isolated from the ears of New Zealand white rabbit and cultured in 2 X 10(5) cells/300 microgram density. IGF-I increased DNA synthesis, and optimal concentration of IGF-I was determined by dose-relationship curve as 10ng/ml. Collagen synthesis was increased by IGF-I. Type II collagen was increased on SDS-PAGE with IGF-I and this gel electrophoresis showed type X collagen, also. The increase in type II collagen was confirmed with immunocytochemical staining, the reaction becoming stronger with the addition of IGF-I. Type I collagen was not changed with IGF-I on immunocytochemistry. We conclude that IGE-I is an important modulator influencing not only proliferation and maturation but also terminal different-iation of chondrocytes.
Bone Development ; Cartilage ; Chondrocytes* ; Collagen Type I ; Collagen Type II ; Collagen Type X ; Collagen* ; DNA ; Ear ; Electrophoresis ; Electrophoresis, Polyacrylamide Gel ; Growth Hormone ; Hyaluronic Acid ; Immunohistochemistry ; Insulin-Like Growth Factor I* ; Intercellular Signaling Peptides and Proteins ; New Zealand

PURPOSE: As a treatment of giant cell tumors (GCT) of the long bone, anhydrous alcohol was used in our institution due to the potential complications associated with other previous adjuvants. Therefore, this study evaluated the feasibility and effectiveness of anhydrous alcohol as a new adjuvant in the treatment of a GCT. MATERIALS AND METHODS: One hundred and three GCT patients were treated and followed up for an average of 6 years (range, 1-29.3 years) with a mean age of 33 years (range, 16-67 years). Curettage, additional burring, and reconstruction with a bone graft or cementing were performed in 69 patients. Among them, anhydrous alcohol was used as an adjuvant in 38 patients. RESULTS: Four (10.5%) patients given the anhydrous alcohol treatment had a local recurrence, whereas 15 recurrences (48.4%) developed in 31 patients treated without the anhydrous alcohol (p=0.001). There were no anhydrous alcohol-related complications. According to Kaplan-Meier's analysis and the log rank test, the anhydrous alcohol adjuvant showed a significant effect (p=0.014) in preventing the recurrence of GCT. CONCLUSION: The data suggests that anhydrous alcohol can be used as an effective adjuvant without potential risks for the treatment of a GCT of the long bone.
Curettage ; Giant Cell Tumors* ; Giant Cells* ; Humans ; Recurrence ; Transplants

A persistent left superior vena cava is the most common anomaly of the superior caval system. Usually the persistent left superior vena cava is connected with the right atrium via the coronary sinus, resulting in no physiologic derangement : however in 7 to 8 percents of the patietns with a persistent left superior vena cava, the anomalous vessel communicates with the left atrim. In the absence of obstruction to the flow from the left atrium to the left ventricle. this anatomic situation usually results in right to left shunting of varying degress. We recently experienced a case of persistent left superior vena cava in a 52-year-old female who complained of chest discomfort, epigastric pain and dyspnea(NYHA functional class II). Cine-angiography showed that the contrast passed from the left SVC through the dilated coronary sinus into right atrium. And right sided SVC was not seen. The patient was treated with conservative measures and discharged with improved condition.
Coronary Sinus ; Female ; Heart Atria ; Heart Ventricles ; Humans ; Middle Aged ; Thorax ; Tricuspid Valve Insufficiency* ; Vena Cava, Superior

Animal experiment was carried out to measure the physiologic changes of thoracic or thoracolumbar spine that occurred as a result of electrical stimulation, and to evaluate the usefulness of electrical stimulation as a possible treatment for scoliosis. Unilateral electrical stimulations were applied to the back muscle of immature rabbits.They were subgrouped into medial, intermediate, and lateral muscle stimulated groups in order to observe the effects of various electrode placements. The radiograms were taken every other week to observe the changes of the spinal curvatures for the period of 12 weeks. The histological studies of the muscles, which were obtained from the stimulated(right) and the nonstimulated(left) sides at the same level, also were carried out to determine the response of the muscles to the electrical stimulation. The results were as follows. l. A significant scoliotic curvature was observed two weeks after electrical stimulation, and those curvatures did not change more for the next six weeks in spite of prolonged stimulation. 2. Scoliotic curvature induced by electrical stimulation for eight weeks remained unchanged for another four weeks after stopping stimulation. 3. There were no statistical differences in the induced scoliotic curvature among the three groups stimulated at different sites of the medial, intermediate, and lateral regions respectively. 4. A prolonged unilateral electrical stimulation could induce the scoliosis, and may be used as a method for treatment of scoliosis.
Animal Experimentation ; Back Muscles ; Electric Stimulation ; Electrodes ; Methods ; Muscles ; Scoliosis ; Spinal Curvatures ; Spine

OBJECTIVE: The purpose of this study was to describe the myocardial enhancement patterns in patients with myocardial infarction using two-phase contrast-enhanced multidetector-row computed tomography (MDCT). MATERIALS AND METHODS: Twenty-three patients with clinically proven myocardial infarction (17 acute myocardial infarction [AMI] and 6 chronic myocardial infarction [CMI]) were examined with two-phase contrast-enhanced ECG-gated MDCT. The presence, location, and patterns of myocardial enhancement on two-phase MDCT images were compared with infarcted myocardial territories determined by using electrocardiogram, echocardiography, thallium-201 single photon emission computed tomography, catheter and MDCT coronary angiography. RESULTS: After clinical assessment, the presence of myocardial infarctions were found in 27 territories (19 AMI and 8 CMI) of 23 patients. Early perfusion defects were observed in 30 territories of all 23 patients. Three territories not corresponding to a myocardial infarction were detected in three patients with AMI and were associated with artifacts. Fourteen of perfusion defects were in the left anterior descending artery territory, four in the left circumflex artery territory, and nine in the right coronary artery territory. Delayed enhancement was observed in 25 territories (17 AMI and 8 CMI) of 21 patients. Delayed enhancement patterns were variable. Transmural early perfusion defects (n =12) were closely associated with transmural late enhancement (n = 5) and subendocardial residual defect with subepicardial late enhancement (n = 5). CONCLUSION: Myocardial infarction showed early perfusion defects and variable delayed enhancement patterns on two-phase contrast-enhanced MDCT. Delayed enhancement technique of MDCT could provide additional information of the location and extent of infarcted myocardium, and could be useful to plan appropriate therapeutic strategies in patients with AMI.
Adult ; Aged ; Aged, 80 and over ; Contrast Media ; Coronary Angiography ; Echocardiography ; Electrocardiography ; Female ; Humans ; Iohexol/analogs & derivatives/diagnostic use ; Male ; Middle Aged ; Myocardial Infarction/*radiography ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed/*methods

The use of angiographic embolization gas been well described for the control of gynecologic bleeding. Recently, we have experienced the successful embolization in two case of serons bleeding related to giynecologic malignancy. Clinical evaluation revealed a gynecologic cancer with active bleeding. Becaause we judged that conservative management was unable to cuntrol the bleeding, we underwent an angiographic embolization. The result presented here indicates that angiographic embolization is a relatively safe, effective and rapid procedure that should be considered early in management of gynecohogic cancer bleeding that is unresponsive to conservative management.
Hemorrhage*

The authors studied the expression of proliferating cell nuclear antigen (PCNA) and the number of argyrophilic nucleolar organizer regions (AgNORs) in 94 cases of various brain tumors and in 5 cases of normal brains. PCN was recognized immunohistochemically in paraffin sections by the monoclonal antibody PC-10. AgNORs could be demonstrated using the silver impregnation method. The PCNA index was not significantly different from the histological grading of glioma(glioblastoma multiforme: 41.40+/-29.14%, anaplastic astrocytoma: 35.00+/-41.02%, and low grade astrocytoma: 22.37+/-30.85%) and there was a wide range of staining even in the same tissue section. However, the AgNORs count per cell correlated well with the pathologic grading of glioma (glioblastoma multiforme : 3.19+/-0.71, anaplastic astrocytoma : 2.06+/-0.16, and low grade astrocytoma : 1.27+/-0.29) with statistical significance. In meningiomas, AgNORs were useful to differentiate benign meningiomas(1.25+/-0.19) and malignant meningiomas(1.78+/-0.35) The authors suggest that the AgNORs count is a faster, less expensive, and a more predictive method in the malignancy of brain tumors than the PCNA immunochemistry expression.
Astrocytoma ; Brain Neoplasms* ; Brain* ; Glioma ; Immunochemistry ; Meningioma ; Nucleolus Organizer Region* ; Paraffin ; Pregnenolone Carbonitrile ; Proliferating Cell Nuclear Antigen ; Silver