No abstract available.
Aged* ; Humans

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

No abstract available.
Acute Kidney Injury ; Mannitol* ; Renal Insufficiency*

STUDY DESIGN: Sixteen patients with congenital kyphoscoliosis were evaluated the clinical and radiological results according to the treatment method. OBJECTIVES: To provide a guideline for surgical treatment of congenital kyphoscoliosis SUMMARY OF LITERATURE REVIEW: Congenital kyphoscoliosis is an abnormal coronal and sagittal curvature of spine that is caused by the presence of vertebral anomalies, which causes a significant deformity and disability. Correction of the deformity is challenging and accompanied by high risk of complications. Many methods of operative treatment were recommended with various results. MATERIALS & METHODS: We reviewed 16 patients of congenital kyphoscoliosis who were operated from 1984 to 1997, and follow-up periods were over 12 months in all. The average age of surgery was 12 years (ranged from 4 to 20 years). Nine cases were operated by excision of quadrant hemivertebra through combined anterior & posterior approach and 6 cases were treated only by posterior instrumentation and one underwent posterior on bloc spondylectomy. RESULTS: The type of curves were thoracic in 5, thoracolumbar in 9, lumbar area in 2 patients. Average angle of kyphosis was 55 degree preoperatively, 25 degree postoperatively, and 39 degree at the follow up study. Average angle of scoliosis was 48 degree, 22 degree, and 27 degree, respectively. In 9 cases corrected by excision of quadrant hemivertebra; kyphotic angle was changed from 62degrees preoperatively, to 22degrees postoperatively and to 36 degree at the end of follow up study, while scoliotic angle was changed from 47degrees, to 12degrees and to 21degrees, respectively. In 6 cases corrected by posterior instrumentation kyphotic angle was changed from 52degrees preoperatively, to 33degrees postoperatively and to 48degrees degree at the follow up study, while scoliotic angle was changed from 53degrees, to 33degrees and to 37degrees, respectively. CONCLUSION: Excision of quadrant hemivertebra through combined anterior and posterior approach or posterior instrumentation were resulted in significant loss of correction during the remaining growth period due to the secondary change of adjacent vertebrae. So, to obtain better correction and to reduce the recurrence of deformity, more aggressive approach including the concept of three dimentional osteotomy involving the upper and lower adjacent curve may be considered.
Congenital Abnormalities ; Follow-Up Studies ; Humans ; Kyphosis ; Osteotomy ; Recurrence ; Scoliosis ; Spine

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

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

The authors dissected and examined a horseshoe kidney from the cadaver of a 54-year-old Korean female. The results were as follows. Other congenital anomalies or complications were not found, and no renal stones showed on plain radiography of the horseshoe kidney. The horseshoe kidney was located in the area between the 12 th thoracic vertebra and the 4th lumbar vertebra, with the superior extremity of the left kidney 10mm more inferior than that of the right. The isthmus connecting the bilateral kidneys was located at the level of the 3rd lumbar vertebra. The size of the kidney was 102mm × 52mm × 44mm (right) and 108mm × 62mm × 34mm (left), and the superoinferior and anteroposterior lengths of isthmus were 22mm and 10mm, respectively. The abdominal aorta and inferior vena cava passed posteriorly to the isthmus, with the inferior mesenteric artery and lumbar splanchnic nerve passing anteriorly. Some grooves were found on the anterior surface of the bilateral kidney. The hilum of the right kidney faced the anteromedial direction and that of the left kidney faced the anterolateral direction. At the hilar plane, the right renal arteries and veins passed anteriorly and posteriorly to the renal pelvis ; the left renal arteries passed posteriorly to the renal pelvis, with the left renal veins passing anteriorly and posteriorly. Three branches of the right renal arteries passed renal hilum, while two branches did not, and two branches of the left renal arteries passed renal hilum, while six branches did not. The two arteries arising from the aortic bifurcation were distributed to the isthmus. The number of renal veins passing the renal hilum were three in the right, and two in the left. The right and left ovarian veins drained to the renal veins. There were 12 minor calyces distributed normally in the right kidney, 13 minor calyces distributed radially in the left kidney, and 3 minor calyces in the isthmus, composed of parenchyme. The left portion of the horseshoe kidney was concluded to have developed poorly, on the basis of incomplete ascension and abnormal rotation during development, the imperfect configuration of the renal shape, and the abnormal distribution of the renal vessels and renal calyces.
Aorta, Abdominal ; Arteries ; Cadaver ; Extremities ; Female ; Fused Kidney* ; Humans ; Kidney ; Kidney Pelvis ; Mesenteric Artery, Inferior ; Middle Aged ; Radiography ; Renal Artery ; Renal Veins ; Spine ; Splanchnic Nerves ; Veins ; Vena Cava, Inferior

BACKGROUND: Insulin resistance syndrome shows extreme insulin resistance and is associated with acanthosis nigricans. We can differentiate it into type A insulin resistance that has insulin receptor defect, and type B insulin resistance due to insulin receptor autoantibody. Type B insulin resistance was firstly described by Kahn in 1976. It was often found in adult female and showed autoimmune characteristics. As clinical characteristics, there are hyperglycemia, hypoglycemia, hyperinsulinemia, extreme insulin resistance and acanthosis nigricans. METHODS: We investigated 17 insulin receptor autoantibody positive cases and 8 cases of normal control who had visited Wonju Christian Hospital from October 1994 to December 1995. Among insulin receptor autoantibody positive subject, male was 4 cases and female 13 cases. Their mean age was 42.2. We compared patients who had insulin receptor antibody positive acanthosis nigricans(IRA) with normal controls. IRA patients were 6 cases(35.3%) of nomal glucose tolerance, 11 cases(64.7%) of abnormal glucose tolerance including overt diabetes mellitus. RESULTS: The 11 cases(64.7%) among IRA patrents were obese and 13 cases(76.5%) had hyperininsulinemia. In IRA patients, mean serum insulin concentration during oral glucose tolerance test was 202.1mU/mL and it was greater than 46.3 of normal controls. Insulin sensitivity in 1.79mg/L * mM * xmU * min normal controls was higher than 0.74mg/L * mM * min of IRA patients. CONCLUSION: IRA patients showed abnormal glucose tolerance including overt diabetes millitus, severe insulin resistance, hyperinsulinemia and obesity.
Acanthosis Nigricans* ; Adult ; Diabetes Mellitus ; Female ; Gangwon-do ; Glucose ; Glucose Tolerance Test ; Humans ; Hyperglycemia ; Hyperinsulinism ; Hypoglycemia ; Insulin Resistance ; Insulin* ; Male ; Obesity ; Receptor, Insulin*

No abstract available.
Dysgerminoma*

PURPOSE: The aim of this study was to determine whether patients with recurrent stone formations have significant metabolic risk factors compared to patients with first-time stone formations. MATERIALS AND METHODS: 456 patients who participated in the stone metabolic study at Chung-Ang University Hospital between January 1, 2001 and June 30, 2002 were selected as subjects. 347 patients (211 males, 136 females) with first-time stone formations and 109 patients (77 males, 32 females) with recurrent stone formations were selected. The blood test and 24-hour urine test were categorized and grouped according to: 1) gender; 2) age brackets of 40 and under, 40-49, and 60 and over; 3) and gender-based age bracket distribution. RESULTS: Hypocitraturia was the most common metabolic abnormality in both males and females and in all age groups. Hypocitraturia, in particular, was shown to have more significant associations (p<0.05) in female patients in their 40s and 50s with recurrent stone formations (75%) compared to female patients of the same age range with first-time stone formations (38.6%). In addition, a small urine volume was found to have similar significant associations with these subject groups (p<0.05) with respect to patients with first-time stone formations and recurrent stone formations. Female Patients (especially those in their 40s and 50s) with recurrent stone formations (242.1+/-158.5) were found to have a higher probability (p<0.05) of hypocitraturia than patients with first-time stone formation (419.9+/-242.3). CONCLUSIONS: In women with recurrent stone formation, hypocitraturia and low urine volume are the risk factors that differentiate them from patients with first-time stone formation. The correction of hypocitraturia & low urine volume may significantly reduce the patients' chances for recurrent stone formation.
Female ; Hematologic Tests ; Humans ; Male ; Recurrence ; Risk Factors* ; Urolithiasis