Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.
Adult ; Animals ; Autografts ; Humans ; Methods ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Nerve Regeneration ; Neural Conduction ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Tissue Donors ; Transplants

No abstract available.

OBJECTIVES: Haloperidol has been widely used for treating schizophrenia with somewhat limitation due to the side effects. Some of these side effects are anticholinergic side effects such as dry mouth, constipation, urinary difficulty, blurred vision, sexual dysfunction, etc. Some kinds strategies to minimize these side effects are tried, one of which is the use of bethanechol. The authors studied the effects of bethanechol on the anticholinergic side effects of typical antipsychotics. METHODS: The subjects of this study consisted of 60 chronic schizophrenics who had used haloperidol since 4 weeks before the study and whose score of 'Askers side effects rating scale' was above 7. They were assigned evenly to three groups (placebo group, bethanechol 40mg group, bethanechol 80mg group). Benztropin had been washed out for 2 weeks before the study. The authors measured ASRS for evaluating the anticholinergic side effect and BPRS for evaluating the effects of bethanechol on the psychopathology, at baseline, the 2nd week and the 4th week from baseline, respectively. RESULTS: At baseline, the mean age of patients was 38.00(+/- 10.55) years, the mean duration of illness was 11.12(+/- 8.09) years, and the mean dosage of the haloperidol was 15.07(+/- 6.03)mg. At baseline, mean score of BFRS was 50.25(+/- 5.24), and mean score of ASRS was 9.27 (+/- 3.04). There were no significant differences of ages, duration of illness, dosage of haloperidol, scores of BPRS and ASRS among 3 groups at baseline. There were no significant changes in BPRS at the 2nd week and the 4th week as compared with baseline, and also there were no changes among groups. The total sums of ASRS showed the statistically significant changes in the 80mg group at the 2nd week and the 4th week. The 80mg group showed statistically significant changes in dry mouth, constipation and urinary difficulty dom the 2nd week, and orthostatic symptoms from the 4th week. CONCLUSION: The authors found that the use of bethanechol for the chronic schizophrenics treating with haloperidol greatly improved the anticholinergic side effects with no change in psychopathology. The 80mg group showed more significant results than the placebo group and the 40mg group, especially in dry mouth, constipation, urinary diffculty and orthostatic symptoms. The authors suggest that high doses of bethanechol decrease the anticholinergic side effects and increase the drug compliance of chronic schizophrenics with anticholinergic side effects.
2,5-Dimethoxy-4-Methylamphetamine ; Antipsychotic Agents ; Bethanechol* ; Compliance ; Constipation ; Haloperidol* ; Humans ; Mouth ; Psychopathology ; Schizophrenia

Uterine papillary serous carcinoma (UPSC) behave more aggressively than other endometrial carcinomas and have a propensity for intraabdominal spread, simulating the behavior of ovarian carcinoma. Because of high relapsing rate, and high mortality rate of UPSC, many gynecologist studied about its treatment regimen and recommended many treatment method. Many investigators recommended that patients with UPSC should undergo a staging laparotomy and they suggested the surgery should include at least total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic lymphadenectomy, paraaortic lymphadenectomy, peritoneal washing and peritoneal cytology, By and large, adjuvant systemic Platinum based chemotherapy or, paclitaxel based chemotherapy and adjuvant whole abdominal irradiation or pelvic irradiation was prescribed. We experienced two cases of the UPSC stage IIIc and stage IV diagnosed after explolaparotomy. We present these cases and review the literatures about the optimal treatment regimen of UPSC.
Drug Therapy ; Endometrial Neoplasms ; Female ; Humans ; Hysterectomy ; Laparotomy ; Lymph Node Excision ; Mortality ; Paclitaxel ; Platinum ; Research Personnel

No abstract available.
Animals ; Apomorphine* ; Dopamine* ; Parkinsonian Disorders* ; Rats* ; Receptors, Dopamine D2*

PURPOSE: In the WHO classification of breast carcinoma, invasive ductal carcinoma with predominant intraductal component (IDC with PIC) has been defined as carcinomas in which the component of ductal carcinoma in situ amounts to four times more than the invasive element in area. This study was designed to evaluate the clinicopathological significance of IDC with PIC. METHODS: Five hundred and seventy nine patients with breast cancer (154 IDC with PIC and 425 with T1 invasive ductal carcinomas) treated with mastectomy or breast conserving surgery between 1989 and 1998 at the Asan Medical Center were divided into two study groups (IDC with PIC and T1 IDC) and compared the clinicopathological characteristics and survival of both groups. RESULTS: By comparison with the T1 IDC, the IDC with PIC has several distinct features including younger mean age of occurrence (45.3 years vs 48.3 years, P=0.002), larger mean tumor size (3.5 cm vs 1.6 cm, P<0.001), lower incidence of axillary lymph node metastasis (15.7% vs 31.3%, P<0.001) and estrogen receptor positivity (45.7% vs 59.2%, P=0.03), higher incidence of low histologic grade (78.7% vs 61.7%, P=0.002) and cancer detection rate by screening without symptom (21.6% vs 11.5%, P=0.003) or clinical manifestation of nipple discharge (17.3% vs 4.3%, P<0.001) and microcalcification with or without mass on mammography (58.7% vs 30.2%, P<0.001). There were no significant difference in the cumulative 5-year overall and disease-free survival rates (93.1% vs 90.1%, P=0.78; 89.5% vs 86%, P=0.23). In the IDC with PIC group, tumors larger than 2 cm in size were more frequently metastasized to axillary lymph nodes than tumors smaller than 2 cm, but this finding was not significant (P=0.07). CONCLUSION: Invasive ductal carcinoma with predominant intraductal component showed less invasive and more low-grade malignant characteristics than T1 invasive ductal carcinoma. Survival was not statistically different.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating ; Chungcheongnam-do ; Classification ; Disease-Free Survival ; Estrogens ; Humans ; Incidence ; Lymph Nodes ; Mammography ; Mass Screening ; Mastectomy ; Mastectomy, Segmental ; Neoplasm Metastasis ; Nipples

BACKGROUND: Acute renal failure (ARF) due to acute pyelonephritis (APN) in patients in the absence of obstructive uropathy, diabetes, or chronic renal failure was reported rarely (12 cases in the last 25 yrs in Clin Inf Dis, 1992; 243-6 by SR Jones)2). Acute renal failure is a rare complication of acute pyelonephritis in patients who do not have urinary obstruction. Although urinary tract infections are common in adults, pyelonephritis is rarely considered in the differential diagnosis of acute renal failure, and when clinicians weigh the possible consequences of bacteriuria, renal failure is not considered to be a reasonable possibility. METHODS: We observed 6 patients of acute pyelonephritis associated with acute renal failure as an initial manifestation on admission in the past 6 months. The analysis of clinical features of these 6 patients (APN+) compared to 7 patients of APN without ARF (APN-) revealed following data. RESULTS: All were female in both groups. The mean age was 331.7 years in APN+ and 48+6 years in APN-, respectively (p, ns). All in both APN- and APN+ were caused by E. coli. But, none in both groups except 1 in APN- had bacteremia. The previous history of UTI was present in 5 in APN-, but none in APN+. Duration of clinical symptoms before admission (8.4+/-0.5 vs. 4.4+/-1.0 days, P<0.05) and admission days (24.2+/-1.8 vs. 11.1+/-1.5 days, p=0.000) were significantly longer in APN+. On admission, HUN and serum creatinine was 45+/-2.7mg/dL and 3.5+/-0.2mg/dL in APN+, respectively. No one in APN+ required dialysis, and subsequently recovered renal function with prompt antibiotic therapy resulting in no significant difference compared to that of APN on discharge (serum creatinine, 1.0+/-0.1 vs. 0.9+/-0.1mg/dL). No differences in leukocytosis and serum electrolyte levels on admission were present. However, significant anemia was noted in APN+ (hemoglobin, 9.0+/-0.7 vs. 11.9+/-0.2gm/dL). The days of fever and leukocytosis before disappearance were not different in both groups, but those of flank pain (12.8+/-1.5 vs. 5.7+/-0.7 days, P=0.001) and pyuria (16+/-1.9 vs. 6.4+/-0.6 days, P=0.000) significantly longer in APN+. Upon ultrasonography, all in APN+ showed enhanced echogenicity, but I in APN . (P=P value, NS=not significant) CONCLUSION: Upon these data, we concluded that ARF associated with APN as an initial manifestation was accompanied by several distinct clinical characteristics, which could be used for the early recognition of its unusual occurrence and subsequent appropriate management including antibiotics leading to a favorable outcome.
Acute Kidney Injury* ; Adult ; Anemia ; Anti-Bacterial Agents ; Bacteremia ; Bacteriuria ; Creatinine ; Diagnosis, Differential ; Dialysis ; Female ; Fever ; Flank Pain ; Humans ; Kidney Failure, Chronic ; Leukocytosis ; Pyelonephritis* ; Pyuria ; Renal Insufficiency ; Ultrasonography ; Urinary Tract Infections

No abstract available.
Meningioma* ; Radiosurgery*

PURPOSE: The purpose of this study was to examine whether recombinant human endostatin (rhEndostatin), an antiangiogenic agent, is effective against a human neuroblastoma cell line (designated TNB9). We employed a human neuroblastoma xenograft model, and we investigated whether continuous infusion is more effective than an intermittent administration. METHODS: In the first experiment, when the tumors on the backs of nude mice reached a weight of 90 mg, rhEndostatin was administered subcutaneously to the mice (n=5) every day for 10 consecutive days. In the second experiment, the same daily dose of rhEndostatin was administered continuously to the TNB9- bearing mice (n=6) via subcutaneous infusion pumps for 3 consecutive days with the total dose being 30% of the dose given in the first experiment. Nestin and factor VIII expression levels were assessed immunohistochemically to elucidate whether the effects of rhEndostatin was present according to the histologic evidence at day 4 in the second experiment. RESULTS: In the first experiment, the relative tumor weight in treated mice (n=5) was significantly less than that in the controls (n=12) on day 2 after treatment initiation only (P<.05). The maximum inhibition rate (MIR) of TNB9 xenograft growth by rhEndostatin was 46.4%, indicating the lack of efficacy. In the second experiment, the effects of rhEndostatin were much more marked than those noted in the first experiment, with the MIR being 60.7%. The mean relative tumor weight in the treated group (n=6) in the second experiment was significantly less than that in the controls (n=10) on days 2, 4 and 6 (P<.01), as well as on days 8 and 10 (P<.05). The nestin staining in the endothelium of the control tumors (n=2) was remarkable, whereas the nestin staining showed as a loss of fibrillar structure in the rhEndostatin-treated tumors (n=2). The number of vessels immunostained with antifactor VIII antibody was markedly reduced in the tumors (n=2) from the rhEndostatin-treated mice compared with that from the control mice (n=2). CONCLUSION: Continuous administration of rhEndostatin resulted in more significant tumor regression than an intermittent administration of the agent. This result suggests that the continuous infusion of rhEndostatin is an effective agent and administration method for treating patients with neuroblastoma in the future.
Animals ; Cell Line ; Endostatins* ; Endothelium ; Factor VIII ; Heterografts* ; Humans* ; Infusions, Subcutaneous ; Mice ; Mice, Nude ; Nestin ; Neuroblastoma* ; Tumor Burden

PURPOSE: The purpose of this study is to develop three-dimensional computerized anthropometry(3DCA) and to compare its reliability and accuracy 3DCA with manual anthropometry(MA) for measurement of lips and nasal deformities in unilateral cleft lips and palate(UCLP) patients. METHODS: Samples were consisted of six UCLP patients whose facial plaster models were available immediately before and 3 months after the cleft lip surgery. MA of the facial plaster models was carried out using an electronic caliper. In 3DCA, three-dimensional auto- measuring program was used to digitize landmarks and to measure three-dimensional virtual facial models (3DVFM), which was generated with a laser scanner and 3D virtual modeling program. Intraclass correlation coefficients(ICC) were calculated to evaluate reliability and reproducibility of the variables in both methods, and Wilcoxon's signed rank test was done to investigate the difference in values of the same variables of facial models of each patient between two methods. RESULTS: All ICC values were higher than 0.8, so both methods could be considered reliable. Although most variables showed statistical differences between two methods(p<0.05), differences between mean values were very small and could be considered not significant in clinical situation. CONCLUSION: In clinical situation, 3DCA can be an objective, reliable and accurate tool for evaluation of lips and nasal deformities in the cleft patients.
Cleft Lip ; Congenital Abnormalities ; Electronics ; Electrons ; Humans ; Lip