OBJECTIVES: The purpose of this study is to compare the postoperative stability of conventional orthognathic surgery to a surgery-first orthognathic approach after bilateral sagittal split ramus osteotomy (BSSRO). MATERIALS AND METHODS: The study included 20 patients who underwent BSSRO for skeletal class III conventional orthognathic surgery and 20 patients who underwent a surgery-first orthognathic approach. Serial lateral cephalograms were analyzed to identify skeletal changes before surgery (T0), immediately after surgery (T1), and after surgery (T2, after 1 year or at debonding). RESULTS: The amount of relapse of the mandible in the conventional orthognathic surgery group from T1 to T2 was 2.23±0.92 mm (P<0.01) forward movement and −0.87±0.57 mm (non-significant, NS) upward movement on the basis of point B and 2.54±1.37 mm (P<0.01) forward movement and −1.18±0.79 mm (NS) upward movement on the basis of the pogonion (Pog) point. The relapse amount of the mandible in the surgery-first orthognathic approach group from T1 to T2 was 3.49±1.71 mm (P<0.01) forward movement and −1.78±0.81 mm (P<0.01) upward movement on the basis of the point B and 4.11±1.93 mm (P<0.01) forward movement and −2.40±0.98 mm (P<0.01) upward movement on the basis of the Pog. CONCLUSION: The greater horizontal and vertical relapse may appear because of counter-clockwise rotation of the mandible in surgery-first orthognathic approach. Therefore, careful planning and skeletal stability should be considered in orthognathic surgery.
Congenital Abnormalities ; Humans ; Mandible ; Orthognathic Surgery* ; Osteotomy, Sagittal Split Ramus* ; Prognathism ; Recurrence

Cross-talk between the thalamus and cortex has been implicated in attention but its pathogenic role in attention-deficit/hyperactivity disorder (ADHD) remains unknown. Here, I demonstrate that Git1-/- mice, previously proposed as an animal model for ADHD, show abnormal theta oscillation in the thalamus. Multi-electrode recordings revealed that Git1-/- mice have hyper-synchrony of neural activities between the thalamus and cortex. The abnormal thalamic oscillation and thalamocortical synchrony in Git1-/- mice were markedly reduced by amphetamine. In addition, ethosuximide ameliorates abnormal thalamic oscillation and ADHD-like hyperactivity shown in Git1-/- mice. My study suggests critical roles of GIT1 and thalamocortical neural circuitry in ADHD.
Amphetamine ; Animals ; Ethosuximide ; Mice* ; Models, Animal ; Thalamus

GIT1, a multifunctional signaling adaptor protein, is implicated in the development of dendritic spines and neuronal synapses. GIT1 forms a signaling complex with PIX, RAC, and PAK proteins that is known to play important roles in brain development. Here we found that Git1-knockout (Git1-/-) mice show a microcephaly-like small brain phenotype, which appears to be caused by reduced neuronal size rather than number. Git1-/- mice also show decreased dendritic spine number without morphological alterations in the hippocampus. Behaviorally, Git1-/- mice show impaired motor coordination and learning and memory. In addition, adult dGit Drosophila mutants show decreased brain size and abnormal morphology of the mushroom body. These results suggest that GIT1 is important for brain development in both rodents and flies.
Adult ; Animals ; Brain* ; Dendritic Spines ; Diptera ; Drosophila ; Hippocampus ; Humans ; Invertebrates* ; Learning ; Memory ; Mice ; Microcephaly ; Mushroom Bodies ; Neurons ; Phenotype ; Rodentia ; Synapses ; Vertebrates*

PURPOSE: To compare duloxetine with placebo for the treatment of Korean women with stress urinary incontinence (SUI). MATERIALS AND METHODS: This was a phase 3, double-blind, stratified, randomized, parallel, placebo-controlled, multi-center study investigating efficacy and safety of a of duloxetine compared with placebo in the treatment of SUI. After a 2-week no-drug screening period, women ages 29-69 were randomly assigned to placebo (n=60) or duloxetine (n=61) as 40mg twice daily for 8 weeks followed by a 2 week no-drug period. Women were seen at 4-week intervals. The primary efficacy variable was percent change in incontinence episodes frequency (IEF)/week. Secondary variables included percent change in, changes in Incontinence Quality of Life (I-QoL) total and 3 sub-scale scores, and Patient Global Impression of Improvement (PGI-I) ratings. Safety was evaluated by treatment emergent adverse events (TEAE), discontinuations due to adverse events, vital signs measurements, and clinical laboratory tests. RESULTS: There were statistically significant improvements with duloxetine compared with placebo in IEF (duloxetine baseline 16.4IEF/wk, endpoint 7.7IEF/wk, median percent reduction=50.0% vs placebo baseline 13.3IEF/ wk, endpoint 8.8IEF/wk, median percent reduction=37.1%, p=0.033), and avoidance and limiting behavior subscale (p=0.006) in I-QoL. TEAEs were reported significantly more often in the duloxetine group compared with the placebo group (82.0% vs 31.7%; p<0.001); common AEs (>or=5% in duloxetine-treated subjects and p<0.05) were nausea, dizziness, anorexia, fatigue, lethargy, abdominal discomfort, and constipation. Discontinuation rates because of AEs were 34.4% for duloxetine and 8.3% for placebo. CONCLUSIONS: These data provide evidence for the safety and efficacy of duloxetine for the treatment for Korean women with SUI.
Anorexia ; Constipation ; Dizziness ; Fatigue ; Female ; Humans ; Lethargy ; Mass Screening ; Nausea ; Quality of Life ; Urinary Incontinence* ; Vital Signs ; Duloxetine Hydrochloride

OBJECTIVE: To classify complete spinal cord injury (SCI) patients based on the preservation of desire to void and to make clear the difference between each group METHOD: This study was performed retrospectively on 117 complete SCI patients with lesions above T11 who were referred to the urodynamic laboratory. Patients were classified according to the preservation of desire to void during conventional urodynamic study. The clinical and urodynamic characteristics of each group were analyzed. RESULTS: There were 37 patients (31.6%) with the preservation of desire to void. There were significantly lower compliance of bladder and longer duration from onset to examination in the sensory preservation group than the nonpreservation group (p<0.05). There were no significant difference in clinical features such as voiding method, the presence of autonomic dysreflexia between each group. CONCLUSION: The presence of desire to void was noted in 31.6% of complete SCI patients observed.
Autonomic Dysreflexia ; Compliance ; Humans ; Retrospective Studies ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics

PURPOSE: To evaluate the results of serial prostate biopsy in men with elevated prostate-specific antigen (PSA) levels, where the initial biopsies were negative for cancer. MATERIALS AND METHODS: Between January 2000 and December 2003, 750 men with a serum PSA level of 4.0ng/ml or greater underwent transrectal ultrasound guided needle biopsy of the prostate, with 218 (29.1%) diagnosed as having prostate cancer. Of the other 532 men, 104 (19.5%), whose follow-up PSA level was persistently elevated beyond the normal range, underwent a second biopsy, with 26 (4.9%) undergoing third and subsequent biopsies for the same reason. The cancer detection rates after each biopsy session, and reliable predictors for prostate cancer after the 2nd biopsy in those whose PSA level was in the gray zone, were evaluated. RESULTS: The cancer detection rates of the 1st, 2nd and 3rd biopsies were 29.1, 16.3 and 30.7%, respectively, with 10.3% of the prostate cancers detected in this study missed on the initial biopsy. The detection rate of the second biopsy in gray zone patients was 13.1%, which was comparable to the first biopsy result (12.7%) for the same range group. The median PSA, % free PSA and PSA density were significantly different between the prostate cancer and non-cancer groups after the second biopsy in gray zone patients (p<0.05). CONCLUSIONS: 10.3% of the prostate cancers detected in this study were missed on the initial biopsy. The median PSA, % free PSA and PSA density are reliable predictors of prostate cancer after the second biopsy in gray zone patients.
Biopsy* ; Biopsy, Needle ; Follow-Up Studies ; Humans ; Male ; Prostate* ; Prostate-Specific Antigen ; Prostatic Neoplasms* ; Reference Values ; Ultrasonography

No abstract available.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory* ; Male

PURPOSE: Patients with neurogenic bladder ultimately undergo morphometric and functional changes of their bladder and urethra. As a result, voiding symptoms such as frequency, nocturia, urgency and incontinence appear Propiverine hydrochloride(BUP-4) is a benzylic acid derivative with musculotropic antispamodic activity and moderate anticholinergic effect. We evaluated the clinical and urodynamic effects of BUP-4 for patients with neurogenic urinary frequency and incontinence MATERIALS AND METHODS: Twenty six patients with neurogenic bladder suffering from urinary frequency and incontinence(including 5 placebo) were given 20mg of BUP-4 orally a day and its clinical and urodynamic effect were evaluated. RESULTS: In the group treated with BUP-4 for four weeks, 57.9% in 19 patients with frequency, 53.3% in 15 nocturia, 50.0% in 14 weak stream, 55.6% in 9 intermittency, 50.0% in 10 dribbling, 64.3% in 14 urgency, 55.6% in 9 hesitancy, 73.7% in 19 incontinence showed improvement of their symptom. Urodynamic study performed after treatment with BUP-4 for 4 weeks or more revealed greater than 10% increase in bladder capacity compared to pretreatment study in 11 patients out of 21(52.4%) and their maximum bladder capacity increased significantly from 181.7+/-101.3 to 249.4+/- 184.7mL(p=0.012). Maximum detrusor pressure decreased from 52.5+/-35.6 to 50.9+/- 26.8cmH2O(p=0.010). Changes in compliance and volume on the first urge sense were statistically insignificant. In placebo group, no significant symptomatic and urodynamic improvement were reported. Side effects of the drug had appeared in 7 patients(33.3%) out of 21 after 4 weeks of treatment -5 cases of dry mouth and 2 cases of nausea - but they were not severe enough to stop the treatment. CONCLUSIONS: The use of BUP-4 in patients with neurogenic bladder results in improvement of symptoms and urodynamic profile(bladder capacity and maximum detrusor pressure). Thus, BUP-4 could be used as one of the first line drugs in the treatment of patients with neurogenic bladder.
Compliance ; Humans ; Mouth ; Nausea ; Nocturia ; Rivers ; Urethra ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Urodynamics*

The spinal motonucleus of the genitofemoral nerve regulating scrotal temperature can also be related to prenatal and neonatal testicular descent by gubernacular change in rats, and a sexually dimorphic-like bulbocavernosus/dorsolateral motonucleus. There is a hypothesis that neonatal androgen affects these motonuclei, and induces development of sexual organs through neural stimulation. Until now, the accumulation of isotope-labelled androgen and the immuno-reactivity of androgen receptor protein in each sexually-dimorphic spinal motonucleus have been revealed in adult rats but they have not been established in rats during neonatal periods. To investigate the presence of the androgen receptor in spinal sexually-dimorphic motonuclei in the neonatal period, we evaluated the androgen receptor immunoreactivity of these motonuclei. In Sprague-Dawley male rats, the lumbar spinal cords were resected at postnatal days 3, 10 and 30, and stained immunohistochemically using polyclonal antibody of androgen receptor protein. The immunoreactivity of androgen receptor protein was observed in the cells of the genitofemoral motonucleus from the 13th thoracic to the 2nd lumbar spinal cord and the bulbocavernosus/dorsolateral motonucleus was observed from the 4th to 5th lumbar spinal cord in all age groups. The proportional areas of both motonuclei at days 3 and 10 on cross-section were larger than at day 30. The motonuclei at days 3 and 10 were similar in all age groups. With the above results, the presence of androgen receptor protein was confirmed in the genitofemoral and bulbocavernosus/dorsolateral motonucleus from neonate to day 30. The larger proportional area of these motonuclei in neonates may indicate an active role for these motonuclei during the neonatal period. Although the immunoreactivity does not directly imply the presence of a functional receptor, neonatal androgen could be responsible for the development of sexual organs through the spinal motonucleus.
Animal ; Animals, Newborn ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Androgen/immunology ; Receptors, Androgen/analysis* ; Sex Characteristics* ; Spinal Cord/chemistry*

Prostate-specific antigen(PSA) in serum exists in several molecular forms that can be measured by immunodetectable assays; free PSA, PSA complexed to alpha1-antichymotripsin and total PSA, which represents the sum of the free and complexed forms. We have determined the amount and ratio of these forms may be seful for increasing the ability of PSA to be used in distinguishing prostate cancer(PCa) from benign prostatic hyperplasia(BPH). We evaluated 117 asymptomatic healthy male controls(mean age 55.8, range 50-71) with no clinical evidence of PCa, 125 men with symptomatic BPH(mean age 67.6, range 52-89) who underwent prostatic surgery(open prostatectomy or TLRP) and 14 men with biopsy-proven, untreated PCa(mean age 71.3 range 54-86). Using ACS-PSA2 assay(Ciba-Corning). we measured the free PSA(F), total PSA(T) and free/total(F/T) ratio. The method utilized was monoclonal-polyclonal immunometric, chemiluminescent assay, using a standardized calibrator 90:10. We also performed total PSA measurement with Tandem-R PSA assay(Hybritech). Correlation between ACS-PSA2 assay and Tandem-RPSA assay was excellent (r2=0.93). Receivr operating characteristics(ROC) analyses between them showed very similar performances. ROC analysis of free to total PSA ratio was more superior than that of free form PSA only. When all subjects were included, the ratio of free to total PSA in controls, BPH and PCa were 0.27, 0.24 and 0.07, respectively. which significantly differentiated between PCa and benign conditions(p<0.01). When the cut-off value (Fr) was set into 0.12, its diagnostic sensitivity and specificity were 86% and 84%, respectively. These findings suggest that free to total PSA ratio may enhance the ability to distinguish benign histologic conditions from cancer.
Humans ; Luminescent Measurements ; Male ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostate-Specific Antigen* ; Prostatectomy ; ROC Curve ; Sensitivity and Specificity