Kainic acid[KA], a glutamic acid analogue, has been widely used as a excitotoxin in the study of neurotoxicity due to its ability to induce strong excitation and to increase intracellular calcium concentration of the mature central nervous system[CNS] neurons. However, it is not well known whether KA is also strongly cytotoxic to the neurons of the postnatal brain. We have injected KA into rats at different developmental stages and have investigated the changes in the expression of c-fos[transcriptional factor and a marker of neuronal activity], heat shock proetin 72[hsp 72, a neuronal injury marker], and glial fibrillary acidic protein[GFAP, a neuronal injury marker] mRNAs, which are known to be increased in KA-induced neurotoxicity, and glyceraldehyde 3-phosphate dehydrogenase [GAPDH, a house keeping gene] mRNAs with in situ hybridization histochemistry using specific riboprobes. The expression of c-fos mRNA was first identified in the CA3 area of hippocampus from 6hr after KA treatment in P7 rats. The c-fos mRNA-expressing area and the level of expression was gradually increased from P7 to adult. Hsp 72 mRNA was first expressed in the dentate gyrus and hippocampus from 6hr after KA treatment in P2l rats. In the adult rats, hsp 72 mRNA was broadly expressed in the brain at 2hr after KA treatment. The increase of GFAP mRNA expression was first identified in Pl4 rat brain from 6hrs after KA treatment, and by the development of brain it tends to appear earlier. The expression of GAPDH mRNA, however, did not show changes after KA treatment except for the adult rats showing a slight decrease at 12hr after KA treatment. These results suggest that KA may offer different level of cytotoxicity to the developing neurons by their developmental status and the difference may be correlated with the completion of synaptogenesis and increase of KA receptor.
Adult ; Animals ; Brain* ; Calcium ; Dentate Gyrus ; Glial Fibrillary Acidic Protein ; Glutamic Acid ; Glyceraldehyde 3-Phosphate ; Hippocampus ; Hot Temperature ; HSP70 Heat-Shock Proteins ; Humans ; In Situ Hybridization ; Kainic Acid* ; Neurons ; Neurotoxins ; Oxidoreductases ; Rats* ; RNA, Messenger ; Shock

OBJECTIVES: This study was performed to study the way of thinking and satisfaction level of North Korean defectors in South Korea on various topics and their relationship with each other. METHODS: Direct interview was performed for 553 North Korean defectors in South Korea. 44 items of life satisfaction were rated. Satisfaction level was rated on a 5 point scale (1-unsatisfactory and 5-fully satisfied). Factor analysis and correlation of the factors were performed. RESULTS: The average level of satisfaction was 3.39. Relatively high satisfaction items were adjustment of their children, family life, and residence area. But relatively low satisfaction items were psychological and mental area, leisure, and income. In governmental support systems, medical support was the most satisfactorily rated item, but financial support for settlement and support for employment or job training were the most dissatisfied. In the factor analysis, 44 items of satisfaction were grouped into 13 factors. The correlation of these factors showed that general satisfaction is significantly correlated with satisfaction with housing, economic status, governmental support and lower degree of confusion on the sense of value. Confusion on the sense of value was high when defectors do not have close friends, have difficulties in understanding South Korean people, and are not satisfied with their economic status. Religion did not have significant correlation with the their sense of value. And self and social consciousness of the defectors were strongly correlated with the their employment status. CONCLUSION: This result showed that the satisfaction of North Korean defectors is correlated not only with material aspects, but also psychological and mental aspects. The results of study should be considered in helping defector to adjust to living in South Korea.
Child ; Consciousness ; Employment ; Financial Support ; Friends ; Housing ; Humans ; Korea* ; Leisure Activities ; Thinking*

BACKGROUND/AIMS: Pancreaticoduodenectomy is the procedure of choice in patients with periampullary cancers. Marked improvements in morbidity and mortality rates following pancreaticoduodenectomy have been reported in recent years. However, pancreatic leakage still occurs in 5% to 25% of patients and is a major cause of morbidity and mortality. METHODS: Between January 1990 to June 1999, eighty-two patients underwent pancreaticoduodenectomy. We compared preoperative, intraoperative characteristics as well as postoperative sandostatin usage in those patients who experienced (n=21) versus those who did not experience pancreatic leakage (n=61). Information was retrospectively collected from hospital record. RESULTS: The clinical leakage rate in this series was 25.6% (n=21). There were no significant differences in preoperative characteristics comparing those with versus those without pancreatic leakage. Among intraoperative characteristics, duct stenting and transfusions were significantly associated with the pancreatic leakage. Finally, postopeative sandostatin usage was able to reduce significantly the incidence of pancreatic leakage. CONCLUSION: Although consensus among surgeons does not exist as to opeative tenchnique and postoperative management, stenting and less bleeding as well as sandostatin usage had better results in this study.
Consensus ; Hemorrhage ; Hospital Records ; Humans ; Incidence ; Mortality ; Octreotide ; Pancreatic Fistula ; Pancreaticoduodenectomy* ; Retrospective Studies ; Stents

BACKGROUND: Due to its anatomical location and vague symptom, early diagnosis of traumatic pacreatic injury is difficult. Furthermore it is very difficult to carry out appropriate management for the injury, so morbidity and mortality rates of traumatic pancreatic injuries remain high. Patients and METHODS: We reviewed medical records of 35 cases of patients who had been diagnosed as pancreatic injury and operated at Department of Surgery, Busan National University College of Medicine between January 1995 and December 2000. RESULT: 1) The male to female ratio was 2.5:1 and the highest incidence occurred in the 4th decade(31.3%). 2) Thirty two cases(91.4%) were injured by blunt trauma and 3 cases(8.6%) were injured by penetrating trauma. 3) The most common clinical manifestation was abdominal pain. 4) Twenty two patients(62.9%) were operated within 24hours after injury, and the mean time interval between injury and operation was 26.4 hours. 5) The serum amylase levels higher than 150 somogi unit were recorded in 20 cases(57.1%) of the patients. 6) Twenty seven patients(77.1%) had another associated injury with an average of 2 associated intraabdominal injuries. The most frequently injured intraabdominal organ was mesentery. 7) Complications occurred in 20 of 35 patients(57.1%) and the most common complication was pancreas-related complications, such as fistula, pseudocyst, abscess, pancreatitis. 8) Six patients(17.1%) were died due to hypovolemic shock, sepsis, respiratory failure and renal failure. CONCLUSION: Early diagnosis and appropriate operative methods may reduce morbidity and mortality from traumatic pancreatic injury
Abdominal Pain ; Abscess ; Amylases ; Busan ; Early Diagnosis ; Female ; Fistula ; Humans ; Incidence ; Male ; Medical Records ; Mesentery ; Mortality ; Pancreatitis ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis ; Shock

No abstract available.
Osteogenesis Imperfecta* ; Osteogenesis* ; Pseudarthrosis* ; Tibia*

The subepidermal calcified nodule, also known as a form of calcinosis cutis, is characterized by solitary circumscribed deposits of insoluble calcium within the subepidermis. The disease is not associated with any systemic or cutaneous diseases, or any biochemical abnormalities. The pathogenesis is still unknown. A 55-year-old female presented with a 4-month history of solitary skin-colored, hyperkeratotic papule on the left upper eyelid. The lesion was asymptomatic and had increased slowly in size. It is interesting that excisional biopsy showed typical histopathologic features of the subepidermal calcified nodule and the clear cell syringoma.
Biopsy ; Calcinosis ; Calcium ; Eyelids ; Female ; Humans ; Middle Aged ; Syringoma*

BACKGROUNDING AND AIM: Recent reports have suggested that preoperative biliary drainage increases the perioperative morbidity and mortality rates of pancreaticoduodenectomy. We reviewed retrospectively 150 patients who underwent pancreaticoduodenectomy to examine the relationship between preoperative biliarydrainage and the morbidity and mortality associated with pancreaticoduodenectomy. METHODS: Peri-operative morbidity and mortality were evaluated in 150 consecutive patients who underwent pancreaticoduodenectomy at Pusan National University Hospital for 10 years. Univariate and multivariate logistic regression analysis were done to evaluate the relationship between preoperative biliary decompression and the following end points: any complication, any major complication, infectious complications, intraabdominal abscess, pancreaticojejunal anastomotic leak, wound infection, and postoperative death. RESULTS: Preoperative prosthetic biliary drainage was performed in 86 patients (57.3%) (stent group), 17 patients (11.3%) underwent surgical biliary bypass performed during prereferral laparotomy, and the remaining 47 patients(31.3%) (no-stent group) did not undergo any form of preoperative biliary decompression. The overall surgical death rate was 1.3% (two patients); the number of deaths was too small for multivariate analysis. By multivariate logistic regression, no differences were found between the stent and no-stent groups in the incidence of all complications, major complications, infectious complications, intraabdominal abscess, or pancreaticojejunal anastomotic leak. Wound infections were more common in the stent group than the no-stent group. CONCLUSIONS: Preoperative biliary decompression increases the risk for postoperative wound infections after pancreaticoduodenectomy. However, there was no increase in the risk of major postoperative complications or death associated with preoperative stent placement. Patients with extrahepatic biliary obstruction do not necessarily require immediate laparotomy to undergo pancreaticoduodenectomy with acceptable morbidity and mortality rates; such patients can be treated by endoscopic biliary drainage without concern for increased major complications and death associated with subsequent pancreaticoduodenectomy.
Abscess ; Anastomotic Leak ; Busan ; Decompression ; Drainage ; Humans ; Incidence ; Laparotomy ; Logistic Models ; Mortality ; Multivariate Analysis ; Pancreaticoduodenectomy* ; Postoperative Complications ; Retrospective Studies ; Stents ; Surgical Wound Infection ; Wound Infection

Choledochal cyst may be defined as cystic dilatation of biliary tree, and prone to complications such as recurrent cholangitis, pancreatitis, choledocholithiasis, biliary cirrhosis, portal hypertension, cystic rupture and carcinoma. It is found usually in childhood(more than 60%). The clinical symptoms are characterized by abdominal pain, jaundice and a palpable abdominal mass. It can be diagnosed with abdominal US, abdominal CT, ERCP but the usefullness of ERCP is limited by its invasiveness. In 1977, Todani classified choledochal cyst to 5 types and many clinicians use this classification in these days. Principle of treatment is surgical excision due to its complication, so excision of the cyst with Roux-en- Y hepaticojejunostomy is common procedure. We retrospectivly reviewed 18 patients who were finally diagnosed as choledochal cyst from Jan, 1993 to June, 1998 at PNUH(Pusan National University Hospital). The ratio of female to male was 5 : 1, and their age distribution range from 3-day to 77-year old(less than 10-year old in 61.1%). Their chief complaints were abdominal pain(50.0%), jaundice( 38.9%), fever & chill(33.3%), palpable abdominal mass(22.2%) and symptomatic duration was less than 1 month in 72.2%. In laboratory findings; serum ALT level was elevated in 61.1%, ALP in 50.5%, Bilirubin in 38.9%. Almost all patients were diagnosed with US & CT, and preoperative diagnostic rate was 83.3%. According to Todani's classification; Type I was found in 11 patients(61.1%), Type II in 1(5.6%), Type IVa in 6(33.3%). Associated disease with choledochal cyst was found in nine patients; choledocholithiasis in four patients, cholangitis in two patients, pancreatitis in two patients, hepatitis in one patient. All patients were managed by operation; Cyst excision with Roux-en-Y hepaticojejunostomy in sixteen patients(88.8%), Cyst excision with Roux-en-Y choledochojejunostomy in one case(5.6%), Cyst excision with Roux-en-Y hepaticojejunostomy & T-tube choledochostomy in one case(5.6%). There was no anastomotic leakage and operative mortality, but pancreatitis(16.7%), cholangitis(11.1%), wound infection(5.6%) were complicated in the postoperative period. It is significant to have early diagnosis and early management such that we can expect better prognosis.
Abdominal Pain ; Age Distribution ; Anastomotic Leak ; Biliary Tract ; Bilirubin ; Child ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis ; Choledochal Cyst* ; Choledocholithiasis ; Choledochostomy ; Classification ; Dilatation ; Early Diagnosis ; Female ; Fever ; Hepatitis ; Humans ; Hypertension, Portal ; Jaundice ; Liver Cirrhosis, Biliary ; Male ; Mortality ; Pancreatitis ; Postoperative Period ; Prognosis ; Rupture ; Tomography, X-Ray Computed ; Wounds and Injuries

Angiosarcoma is a rare and highly malignant vascular tumor of endothelial cell origin. Cutaneous angiosarcoma usually occurs on the scalp and face of the elderly person, frequently in the sixth and seventh decade. Unusually, we experienced a case of angiosarcoma of the scalp in a 12-year-old girl. The patient had a solitary, well-demarcated 0.7X0.7cm sized, non-tender, blue-violaceous to gray-black colored, crusted papule on the vertex for 2 months. She was treated by wide surgical excision only but no recurrence in the last eight years after excision.
Aged ; Child ; Endothelial Cells ; Female* ; Hemangiosarcoma* ; Humans ; Recurrence ; Scalp*

OBJECTIVE: The purpose of this study is to investigate the effect of ipsilateral subthalamic nucleus(STN) lesioning on the spontaneous behavioral changes and the alteration of neuronal activities of deep cerebral nuclei in the rat parkinsonian model with 6-hydroxydopamine(6-OHDA). METHODS: To identify the spontaneous behavioral changes, apomorphine-induced rotational test and forepaw adjusting step were performed. We subsequently investigated the alteration of neuronal activities in the substantia nigra pars reticulata(SNpr) and globus pallidus(GP), in order to compare them with the behavioral changes in rat parkinsonian models. RESULTS: The STN lesioning in the rat parkinsonian model clearly improved behavioral changes. Compared to the normal control rats, rat PD models exhibited a significant increase in mean firing rates and the percentage of bursting neurons in the STN and SNpr. In the STN-lesioned rat PD models, mean firing rates and the percentage of bursting neurons in the SNpr were reduced and those in the GP increased. CONCLUSION: STN lesioning induced behavior improvement in rat parkinsonian models seems to be consistent with the surgical outcomes of the STN stimulation therapy in advanced Parkinsonn's disease(PD). The alteration of the neuronal activities in the SNpr and GP suggests that these sites are responsible for the improvement of parkinsonian motor symptoms observed following STN lesioning in rat parkinsonian models. The significance of bursting activity in the SNpr and GP remains obscure. Further study is necessary to elucidate the pathophysiological mechanism of PD.
Animals ; Fires ; Globus Pallidus ; Kainic Acid* ; Neurons* ; Oxidopamine* ; Parkinson Disease ; Rats* ; Substantia Nigra ; Subthalamic Nucleus