OBJECTIVE: In the central nervous system, gamma-aminobutyric acid (GABA) is well known to act as an inhibitory neurotransmitter by hyperpolarizing postsynaptic neurons through gating GABA-activated Cl- channels. To date, however, the functional roles of GABA remain unclear in the autonomic nervous system. In the present study, we characterize GABA-activated Cl- currents in the neurons of major pelvic ganglia (MPG). METHODS: MPG neurons, located on the lateral surfaces of the prostate gland, from male rats were enzymatically dissociated. Ionic currents were recorded using whole-cell variant patch-clamp technique. Membrane potential was recorded under current clamp mode. Current traces were filterd at 2kHz by using 4-pole Bassel filter in the amplifier. RESULTS: Application of GABA (100micrometer) induced inward currents in the neurons, with holding potentials being maintained below the Cl- equilibrium potential (ECl). The GABA response was concentration-dependent and its reversal potential was close to the theoretical ECl. The GABA-induced Cl- currents were largely blocked by bicuculline (10micrometer, n=5), a GABAA receptor antagonist, but were not affected by 9-AC and niflumic acid, chloride channel blockers. GABA also produced significant membrane depolarization (19mV, n=28). As in the case of the Cl- currents, the GABA-induced depolarizations were largely blocked by bicuculline(10micrometer, n=6), but not by DIDS(50micrometer, n=4), another chloride channel blocker. CONCLUSION: The data suggest that GABAergic roles may be due to it's activation of excitatory GABAA receptors, which are expressed in MPG neurons.
Animals ; Autonomic Nervous System ; Bicuculline ; Central Nervous System ; Chloride Channels ; gamma-Aminobutyric Acid* ; Ganglia* ; Humans ; Male ; Membrane Potentials ; Membranes ; Neurons* ; Neurotransmitter Agents ; Niflumic Acid ; Patch-Clamp Techniques ; Prostate ; Rats

BACKGROUND: Clinical features of basal cell epithelioma(BCE) are known to be different according to social and environmental factors. Recently, there have been reports of an increase of BCE in the Chung-Nam area. OBJECTIVE: We evaluated the incidence of tumors, age and sex distribution, and tumor sites. METHODS: Clinical records were reviewed for 153 cases of BCE with a histologically confirmed diagnosis for patients who visited the Department of Dermatology, Chungnam National University Hospital during the 20 years from 1978 to 1997. Pathologic characteristics were also reviewed. RESULTS: The frequency of BCE expressed as a percentage of the total number of new patients increased from 0.10% in 1978 to 0.76% in 1997. The ratio of man to woman with BCE was 1 : 1.1 with a mean age of 61.8 years. Most cases of BCE were on the face (90.8%), especially on the nose (29%). The solid type (66.7%) was the most common pathologic pattern, followed by the adenoid type (9.7%), and the morpheic type (8.6%). The pigmented type of BCE accounted for 41.9%. CONCLUSION: The incidence of BCE has increased during the past 20 years. However, the age of occurrence, common site, and pathologic patterns did not show a significant difference from Caucasians, except for a higher frequency of pigmented type BCE, as can be expected in oriental people.
Adenoids ; Carcinoma, Basal Cell* ; Chungcheongnam-do ; Dermatology ; Diagnosis ; Female ; Humans ; Incidence ; Nose ; Sex Distribution

BACKGROUND AND OBJECTIVES:Conventional vestibular rotation testing with the head centered on the axis stimulates the semicircular canals evoking compensatory eye movements. By placing subjects off from the axis of rotation, the otolithic organ may also be simultaneously stimulated by additional linear acceleration forces. In the present study, we compared the rotation with subjects placed on axis to those placed in an eccentric position. MATERIALS AND METHOD:In the eccentric rotation, the head of subject was facing outward and placed eccentrically for 33cm on naso-occipital axis. Slow harmonic acceleration test and velocity step test were performed. RESULTS:The sinusoidal eccentric rotation at 0.32, 0.64 Hz produced a significantly higher vestibulo-ocular reflex gain than did on axis rotation. In velocity step test, initial slow component velocity was significantly higher in eccentric rotation than in centric rotation. CONCLUSION:These finding suggest that the gain enhancement due to eccentric rotation is a result of tangentiallinear acceleration, probably sensed by the otolithic organ. This study raises the possibility of using eccentric rotation for the diagnosis of the patients with otolithic dysfunction.
Acceleration ; Axis, Cervical Vertebra ; Diagnosis ; Exercise Test ; Eye Movements ; Head ; Humans ; Otolithic Membrane ; Reflex* ; Reflex, Vestibulo-Ocular ; Semicircular Canals

OBJECTIVE: The purpose of this study is to compare the outcomes of two methods for stabilization and fusion: Postero-Lateral Fusion (PLF, pedicle screw fixation with bone graft) and Posterior Lumbar Interbody Fusion (PLIF, cage insertion) for spinal stenosis and recurred disc herniation except degenerative spondylolisthesis. METHODS: Seventy one patients who underwent PLF (n=36) or PLIF (n=35) between 1997 and 2001 were evaluated prospectively. These two groups were compared for the change of interbody space, the range of segmental angle, the angle of lumbar motion, and clinical outcomes by Prolo scale. RESULTS: The mean follow-up period was 32.6 months. The PLIF group showed statistically significant increase of the interbody space after surgery. However, the difference in the change of interbody space between two groups was insignificant (P value= 0.05). The range of segmental angle was better in the PLIF group, but the difference in the change of segmental angle was not statistically significant (P value=0.017). Angle of lumbar motion was similar in the two groups. Changes of Prolo economic scale were not statistically significant (P value=0.193). The PLIF group showed statistically significant improvement in Prolo functional scale (P value=0.003). In Prolo economic and functional scale, there were statistically significant relationships between follow-up duration (P value<0.001), change of interbody space (P value<0.001), and range of segmental angle (P value<0.001). CONCLUSION: Results of this study indicate that PLIF is superior to PLF in interbody space augmentation and clinical outcomes by Prolo functional scale. Analysis of clinical outcomes showed significant relationships among various factors (fusion type, follow-up duration, change of interbody space, and range of segmental angle). Therefore, the authors recommend instrumented PLIF to offer better clinical outcomes in patients who needed instrumented lumbar fusion for spinal stenosis and recurred disc herniation.
Follow-Up Studies ; Humans ; Prospective Studies ; Spinal Stenosis ; Spondylolisthesis

PURPOSE: Intravenous immunoglobulin (IVIG) is the standard treatment for Kawasaki disease (KD). However, there is still no standard treatment for IVIG-resistant KD. This study aimed to evaluate the efficacy of low-dose methotrexate (MTX) as a treatment for IVIG-resistant KD. MATERIALS AND METHODS: We retrospectively analyzed 10-year data for patients with IVIG-resistant KD who were administered MTX at Severance Children's Hospital. RESULTS: The subjects included 75 patients with KD aged 5 months to 9.2 years who had been administered MTX. Their maximum body temperatures decreased significantly within 24 h of therapy. The patients' C-reactive protein levels were significantly lower 1 week after administering the first dose of MTX than those before treatment. No adverse effect for MTX was observed. CONCLUSION: MTX treatment of IVIG-resistant KD resulted in rapid defervescence, improvement of clinical symptoms, and normalization of acute-phase reactants in all patients. Thus, MTX could be a candidate treatment for IVIG-resistant KD.
C-Reactive Protein/analysis ; Child ; Child, Preschool ; Coronary Vessels/pathology ; Demography ; Dose-Response Relationship, Drug ; Drug Therapy, Combination ; Female ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Infant ; Male ; Methotrexate/administration & dosage ; Methotrexate/therapeutic use ; Mucocutaneous Lymph Node Syndrome/blood ; Mucocutaneous Lymph Node Syndrome/drug therapy ; Retrospective Studies ; Steroids/therapeutic use ; Treatment Outcome

BACKGROUND: Significant discrepancy exists between anatomical plate designs and the anatomy of the native distal radius, which may be attributable to considerable morphometric variations in the volar aspect of the distal radius. We aimed to evaluate the degree of variability in the morphometry of the distal radius and identify factors associated with this variability. METHODS: We measured the volar surface angle (VSA) of the intermediate and lateral columns and the volar surface width (VSW) in the distal radius from three-dimensional computed tomography scans acquired from 81 cadaveric forearms. These morphometric parameters were compared between the lateral and intermediate columns, between males and females, and between Koreans and Caucasians. Caucasian morphometric data were obtained and pooled from the previous studies. The coefficient of variation was used to assess the variability of the parameters and Cohen's d to estimate the effect size of the difference between groups. RESULTS: The average VSA of the lateral column was 22°± 6°, and that of the intermediate column was 29°± 8° in Koreans (p < 0.001). The variability was high for both VSAs. The VSA of the intermediate column was significantly larger in males than in females (p < 0.001) and in Caucasians than in Koreans (p < 0.001). The average VSW of distal radius was 30 ± 3 mm at the watershed line, and it became narrower proximally. The VSW was significantly larger in males than in females (p < 0.001) and in Koreans than in Caucasians (p < 0.001). The effect sizes of the difference for the VSA and VSW between sexes, races and columns were medium to large. CONCLUSIONS: Considerable variability exists in the morphometry of the volar distal radius, with sex, race, and column as contributing factors. These results suggest that surgeons should carefully choose an anatomical volar locking plate with appropriate angulation characteristics for each patient to achieve patient-specific alignment of the distal radius.
Bone Plates ; Cadaver ; Continental Population Groups ; Female ; Forearm ; Humans ; Male ; Radius* ; Surgeons

No abstract available.
Neurocysticercosis*

Primary thyroid lymphoma is a relatively rare thyroid tumor and usually a non-Hodgkin type. Its most common histologic type is the diffuse large B cell lymphoma followed by mucosa-associated lymphoid tissue (MALT). It is known to be frequently associated with autoimmune thyroiditis such as Hashimoto's thyroiditis. We report three cases of thyroid lymphoma at a single institution with a review of the literature.
Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell ; Thyroid Gland ; Thyroiditis ; Thyroiditis, Autoimmune

Acute myocardial infarction (AMI) is very rare in young adults. Nephrotic syndrome is an uncommon cause of AMI in young adults and is characterized by excessive proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema. The hypercoagulable state and accelerated atherosclerosis in patients with nephrotic syndrome may be associated with the development of AMI in young adults. We report herein a case of ST-segment elevation myocardial infarction with sudden cardiac arrest in a young patient with minimal change disease.
Atherosclerosis ; Death, Sudden, Cardiac ; Edema ; Humans ; Hyperlipidemias ; Hypoalbuminemia ; Myocardial Infarction* ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Proteinuria ; Shock, Cardiogenic* ; Young Adult*

Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient. Although Osborn wave is not pathognomonic of hypothermia, it is a well-known electrocardiogram finding of hypothermic patients. The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored. This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.
Electrocardiography ; Heart Arrest ; Humans ; Hypothermia* ; Individuality ; Tachycardia ; Tachycardia, Ventricular ; Ventricular Fibrillation*