Alzheimer's disease(AD) is associated with a characteristic neuropathology. The major hallmarks of AD are senile plaques(SPs) and neurofibrillary tangles(NFTs). beta-amyloid protein(Abeta) is derived from the proteolysis of amyloid precursor protein(APP) and then converted to SPs. Mature SPs produce cytotoxicity through direct toxic effects and activation of microglia and complement. NFTs are composed of paired helical filaments(PHFs) including abnormally phosphorylated form of the microtubule-associated protein(MAP) tau and increased tau level in cerebrospinal fluid may be observed in most AD. The aggregation of Abeta and tau formation are thought to be a final common pathway of AD. Acetycholine, dopamine, serotonin, GABA and their receptors are associated with AD. Especially, decreased nicotinic acetylcholine receptors(nAChRs) in AD are reported. Genetic lesions associated with AD are mutations in the structural genes for the APP located on chromosome 21, presenilin(PSN)1 located on chromosome 14 and PSN2 located on chromosome 1. Also, trisomy 21, Apo-E gene located on chromosome 19, PMF locus, low density lipoprotein receptor-related protein and alpha-macroglobulin increase risk of AD. In this article, we will review about the neurobioloby of AD and some newly developed research areas.
Acetylcholine ; Alzheimer Disease* ; Amyloid ; Amyloid beta-Peptides ; Apolipoproteins E ; Cerebrospinal Fluid ; Chromosomes, Human, Pair 1 ; Chromosomes, Human, Pair 14 ; Chromosomes, Human, Pair 19 ; Chromosomes, Human, Pair 21 ; Complement System Proteins ; Dopamine ; Down Syndrome ; gamma-Aminobutyric Acid ; Genetics ; Lipoproteins ; Microglia ; Neurobiology* ; Proteolysis ; Serotonin

The mirtazapine is a relatively new antidepressant that has noradrenergic and specific serotonin antagonist action(NaSSAs). This has been known as one of the most safest drugs because of its few side effects. Until now, there have been only one case report that mirtazapine causes a EPS side effect(restless leg syndrome). But the peculiar mechanism of this drug makes it impossible to explain the exact reasons why the mirtazapine could induce EPS symptoms. Authors obseved three cases of mirtazapine indeced akathisia. We could not explain the phenomenon the other way except akathisia. So here we presents the three case of mirtazapine induced akathisia and a few possible hypothesis of this phenomenon.
Leg ; Psychomotor Agitation* ; Serotonin

Fracture of the coracoid process are rare and those associating with a complete acromioclavlcular separation is even more rare. The mechanism of injury may be attributed to either direct or indirect trauma. Most coracoid fractures are minimally displaced because It is by maintained by the coracoclavicular ligament and coracoacromial ligaments. Usually good result is obtained In the coracoid fracture by non-operative treatment. On the other hand open reduction Is rarely Indicated. The case we are reporting was treated by open reduction and Internal fixation of the acromloclavicular joint using two Kirschner wires, and screw fixation was done for the fracture of the base of the coracoid process. Review of the literature ls also done.
Bone Wires ; Dislocations ; Hand ; Joints ; Ligaments

The present study is an observation of 678 cases of children's fractures; which was treated in the Dept. of Orthopedic Surgery, inchon Christian Hospital, for the past ten years, from 1968 to 1978. The peak age was in from 5 years to 6 years. The sex ratio was 2.9 male to 1 female. The ratio between the right and left extremity was nearly equal. The frequency of fracture of the upper extermity was silghtly dominant then lower extremity. The cause of fracture was fall down Injury in nealy 70% of all cases. The epiphyseal Injury was noted as 16.8% of total orthapedic cases. The most common type of Salter & Harris Classiflcation was type II or 56.1%. Mostly all of children's fractures were treated by closed method, and others were treated by open reduction. Complication Included 29 cases of changed carring angle 18 cases of traumatic arthritis and 8 cases of malunlted supracondylar fracture and 3 cases of postoperative Infections and 2 cases of radial nerve palsy and 3 cases of delayed ulnar nerve palsy of the elbow. In fractures of the femur, 3 cases of the peroneal nerve palsy and 2 cases of leg longth discrepancy was noted. Brief discussion and review of Iiterature is presented.
Arthritis ; Elbow ; Extremities ; Female ; Femur ; Humans ; Incheon ; Leg ; Lower Extremity ; Male ; Methods ; Orthopedics ; Paralysis ; Peroneal Nerve ; Radial Nerve ; Sex Ratio ; Ulnar Neuropathies

Recently, the number of surgeries with age-related cataracts has increased remarkably high due to the safety of modern cataract surgery and reliable post-operative visual function has been widely recognized by patients. In spite of such an increase in the number of patients, the authors specualtes that there are still many cataract patients with highly deteriorated visual function who havehad no occasion to receive an ocular examinatio. In order to screen such patients during their general health examination, the authors` study group experienced and evaluated the simplified cataract screening system recently proposed by Sasaki et al, Kanazawa Medical University in Japan. The cataract screening system consists of two steps; primary screening system is 12-item questionnaires, and far vision. In order to evaluate the screening system in Korea, it was used to test 224 indivisual who had wanted to be examined ophthalmologically in two area, Yongsan, Seoul and Donghae, Gangwondo province. Initially, well-trained nurse did the screening system, and then the same patients were examined by one ophthalmologist. The agreement ratio between the screening test and the final judgement for cataract was 70.8% and the final cataract-screening rate was 95.1%. Based on these results, the authors propose the possibility of clinical use of this screening system in general health care units.
Cataract* ; Delivery of Health Care ; Gangwon-do ; Humans ; Japan ; Korea ; Mass Screening* ; Surveys and Questionnaires ; Seoul

No abstract available.
Suction* ; Tonsillectomy*

PURPOSE: As well as patient survival, the restoration of postoperative function such as ambulation is important in limb salvage operations for treatment of malignant bone tumors involving the proximal femur. The authors analyzed clinical outcomes of limb salvage operations using tumor prostheses for metastatic or primary malignant bone tumors in the proximal femur. MATERIALS AND METHODS: From February 2005 to January 2014, 20 cases (19 patients) with malignant bone tumor involving the proximal femur with pain or complicated pathologic fracture were treated with segmental resection and limb salvage operations with tumor prostheses. Mean age was 63.1 years (range 35-86). Fourteen patients were male and six ones were female. The mean follow-up period was 20 months (1-94 months). There were 15 cases of metastatic bone tumor, 4 cases of osteosarcoma, and 1 case of multiple myeloma. The primary tumors of the metastatic bone tumors included 4 lung cancers, 3 hepatocellular carcinomas, and 3 renal cell carcinomas. Other primary tumors were breast cancer, thyroid cancer, colon cancer, prostate cancer, and malignant spindle cell tumor, each in 1 case. Modular tumor prostheses were used in all cases; (Kotz's(R) Modular Tumor prosthesis (Howmedica, Rutherford, New Jersey) in 3 cases, MUTARS(R) proximal femur system (Implantcast, Munster, Germany) in 17 cases). Perioperative pain was assessed with Visual Analogue Scales (VAS). Postoperative functional outcome was assessed with Musculoskeletal Tumor Society (MSTS) grading system. RESULTS: Out of 20 cases (19 patients), 11 cases (10 patients) survived at the last follow-up. Average postoperative survival of the 9 deceased patients was 10.1 months (1-38 months). VAS score improved from pre-operative average of 8.40 (5-10) to 1.35 (0-3) after operation. Average postoperative MSTS function score was 19.65 (65.50%, 7-28). The associated complications were 2 local recurrences, 3 hematomas, 3 infections, 2 scrotal swellings, and 1 dislocation. There was no case of periprosthetic fracture or loosening. CONCLUSION: Limb salvage operation with tumor prosthesis is an appropriate treatment for early pain reduction and functional restoration in malignant bone tumors in the proximal femur with pain an/or complicated pathologic fractures.
Breast Neoplasms ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Colonic Neoplasms ; Dislocations ; Female ; Femur* ; Follow-Up Studies ; Fractures, Spontaneous ; Hematoma ; Humans ; Limb Salvage* ; Lung Neoplasms ; Male ; Multiple Myeloma ; Osteosarcoma ; Periprosthetic Fractures ; Prostatic Neoplasms ; Prostheses and Implants* ; Recurrence ; Thyroid Neoplasms ; Walking ; Weights and Measures

No abstract available.
Child* ; Humans

At the present time, lidocaine is commonly used in ophthalmic surgery as a local anesthetic. Although it is safer than general anesthesia, visionthreatening and even life-threatening side effect can occur rarely. We report one case of visual loss combined with severe neurologic damage after local injection of lidocaine. Fifty-year-old male patient underwent phacoemulsification and IOL transscleral implantation with unplanned anterior vitrectomy after Nadbath-Ellis akinesia and retrobulbar anesthesia with lidocaine with 1:100,000 epinephrine. After operation, the patient had visual loss, facial palsy, total ophthalmoplegia, severe proptosis and submandibular swelling. There were no evidences of eyeball perforation, retrobulbar hemorrhage, and direct nerve injury. Although the mechanism of nerve injury is not well explainable, we suggest lidocaine toxic reaction. To our knowledge, This is the first reported case in the literature. We report this case with available literature review.
Anesthesia ; Anesthesia, General ; Blindness* ; Cataract* ; Epinephrine ; Exophthalmos ; Facial Paralysis ; Humans ; Lidocaine* ; Male ; Ophthalmoplegia ; Phacoemulsification ; Retrobulbar Hemorrhage ; Vitrectomy

Cataract and refractive surgical procedures are now among the most common and successful in medicine. A clear understanding of the current situation and future trends in these fields has become increasingly important. Since 1995, we have annually surveyed the members of the Korean Society of Cataract and Refractive surgery(KSCRS) about cataract surgery technique, anesthesia, intraocular lens and refractive surgery. Third annual survey forms consisted of 71 multiple-choice questions were mailed in January 1998 to 180 ophthalmologist members of the KSCRS. Approximately 44% of the questionnaires mailed were returned by the February cutoff date. Current data were compared with data in previous annual survey. Over half of the respondents(52%) were in forties. Most of the cataract operation(83%) was carried out on hospitalized patients. Use of a retrobulbar with akinesia for cataract was 49%, and use of topical anesthesia increased from 5% in 1995 to 17% in 1996. Eight-one percent of surgeons used phacoemulsification for more than half of their patients. Selfsealing wound construction was main wound closure technique in phacoemulsification for 44%. The type of intraocular lens used for small incision cataract surgery included silicone(64%), small round PMMA(polymethyl methacrylate, 21%), and acrylic(11%). Sixty-three percent of surgery. From the answers to the survey, we found current trend and these results are valuable information to all ophthalmologists.
Anesthesia ; Cataract* ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Postal Service ; Refractive Surgical Procedures* ; Wound Closure Techniques ; Wounds and Injuries ; Surveys and Questionnaires