A 74-year old woman presented with partial and secondarily generalized status epilepticus lasted for 11 days. Initially her seizures consisted of only unformed visual hallucination, which progressed to formed hallucinations, and then memory disturbance and GTCs. During the period of recurrent formed visual hallucinations, T2-weighted brain MRI revealed high signal intensities in the left occipital lobe. After intravenous phenytoin loading, she did not develop any further GTCs but visual hallucinations persisted. Follow-up MRI performed after complete recovery of seizures showed complete recovery of the previous focal lesions, however, 1H-MRS showed a significant decrease of NAA in the recovered area. These features suggested the neuronal loss in the area of seizure focus, despite the complete recovery of transient focal abnormalities in MRI. This case provides a supportive evidence of neuronal damage even in focal status epilepticus, which stress the importance of early treatment and EEG confirmation of the complete seizure control after the disappearance of clinically obvious seizures.
Aged ; Brain ; Electroencephalography ; Female ; Follow-Up Studies ; Hallucinations ; Humans ; Magnetic Resonance Imaging ; Memory ; Neurons* ; Occipital Lobe* ; Phenytoin ; Seizures ; Status Epilepticus*

OBJECTIVE: This present study was conducted to examine the effects on in vitro growth of pre-antral mouse follicles by thecal-stromal cells attached to around the follicular membrane in culture medium without hormones. METHODS: Pre-antral follicles (100-130 micro meter) used in our studies were isolated mechanically by fine 30 G needles attached to 1 ml insulin syringe from mice ovaries of 20-25 days old female ICR strain. Isolated pre-antral follicles were divided into three groups by attached status of thecal-stromal cell layers to follicular membrane. Follicular Initial diameters of group I was 112.5 (mean) +/- 6.2 (SD) micro meter (n=31), group II was 112.8 +/- 7.8 micro meter (n=23), and group III was 115.1 +/- 6.5 micro meter (n=27). Divided pre-antral follicles were washed in fresh Ham's F-10 medium and cultured in 20 micro liter droplets of DMEM with glutamine, glucose and pyruvate under mineral oil on the 60 mm culture dish. All experimental media were supplemented with 10% FBS without hormones. Media were exchanged wholly by fresh media every 2 days in culture. Diameters of intrafollicular oocytes and cultured pre-antral follicles were measured using an precalibrated cross ocular micrometer at X200 every day during 6 days in vitro culture. Results were considered statistically significant when p value was less than 0.05 using Student's t-test. RESULTS: The mean and standard deviation (SD) of initial diameters of pre-antral follicles was 113.5 +/- 2.2 micro meter in three groups. Follicular growth rate of group III was significantly (p<0.05) higher in whole culture periods than group I and group II. Rate of follicular growth between group I and group II were not significant difference in culture for 1 to 3 days. However, group II was significantly higher than group I in culture for 4 days. Diameters of grown follicles for 6 days was 155.2 +/- 18.7 micro meter, 196.9 +/- 24.1 micro meter and 284.2 +/- 47.6 micro meter in group I, group II and group III, respectively. Growth rate of intrafollicular oocytes between three groups were not difference and revealed to continuous growth patterns in whole culture periods. Follicular diameter after culture for 7 days were not measured because of disruption of follicular structure or outgrowth of granulosa cells. CONCLUSION: Pre-antral follicles were grown very well in DMEM medium without hormones. Thecal- stromal cells attached to the surface of follicular membrane has acted effectively in vitro growth of follicles.
Animals ; Female ; Glucose ; Glutamine ; Granulosa Cells ; Humans ; Insulin ; Membranes ; Mice* ; Mineral Oil ; Needles ; Oocytes ; Ovary ; Pyruvic Acid ; Stromal Cells ; Syringes

Natural isoflavones and flavones are important dietary factors for prostate cancer prevention. We investigated the molecular mechanism of these compounds (genistein, biochanin-A and apigenin) in PC-3 (hormone-independent/p53 mutant type) and LNCaP (hormone-dependent/p53 wild type) prostate cancer cells. A cell growth rate and apoptotic activities were analyzed in different concentrations and exposure time to evaluate the antitumor activities of genistein, biochanin-A and apigenin. The real time PCR and Western blot analysis were performed to investigate whether the molecular mechanism of these compounds are involving the p21 and PLK-1 pathway. Apoptosis of prostate cancer cells was associated with p21 up-regulation and PLK-1 suppression. Exposure of genistein, biochanin-A and apigenin on LNCaP and PC-3 prostate cancer cells resulted in same pattern of cell cycle arrest and apoptosis. The inhibition effect for cell proliferation was slightly greater in LNCaP than PC-3 cells. In conclusion, flavonoids treatment induces up-regulation of p21 expression, and p21 inhibits transcription of PLK-1, which promotes apoptosis of cancer cells.
Antineoplastic Agents/*pharmacology ; Apigenin/pharmacology ; *Apoptosis ; Cell Cycle/drug effects ; Cell Cycle Proteins/biosynthesis/*genetics/metabolism ; Cell Line, Tumor ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21/biosynthesis/*metabolism ; Flavonoids/*pharmacology ; Gene Expression Regulation, Neoplastic/drug effects ; Genistein/pharmacology ; Humans ; Male ; Prostatic Neoplasms/genetics/metabolism/*pathology ; Protein Kinase Inhibitors/pharmacology ; Protein-Serine-Threonine Kinases/biosynthesis/*genetics/metabolism ; Proto-Oncogene Proteins/biosynthesis/*genetics/metabolism ; Transcription, Genetic/drug effects

BACKGROUND AND OBJECTIVES: Increasing evidence supports that psychological factors may be related to development of coronary artery disease (CAD). Although psychological well-being, ill-being, and control strategy factors may play a significant role in CAD, rarely have these factors been simultaneously examined previously. We assessed comprehensive psychological factors in patients with acute coronary syndrome (ACS). SUBJECTS AND METHODS: A total of 85 ACS patients (56 unstable angina, 29 acute myocardial infarction; 52.6+/-10.2 years; M/F=68/17) and 63 healthy controls (48.7+/-6.7 years, M/F=43/20) were included. Socio-demographic information, levels of psychological maladjustment, such as anxiety, hostility, and job stress, health-related quality of life (HRQoL), and primary and secondary control strategy use were collected through self-report questionnaires. RESULTS: There was no significant difference between the ACS group and control group in levels of anxiety, hostility, and job stress. However, ACS patients had significantly lower scores on the general health perception and bodily pain subscales of HRQoL than the control group. The ACS group, as compared with the controls, tended to use primary control strategies more, although not reaching statistical significance by univariate analysis. Multivariate logistic regression analysis after adjusting age and gender identified the physical domain of HRQoL {odds ratio (OR)=0.40}, primary control strategy (OR=1.92), and secondary control strategy (OR=0.53) as independent predictors of ACS. CONCLUSION: Poor HRQoL and primary control strategy, proactive behaviors in achieving ones' goal, may act as risk factors for ACS, while secondary control strategy to conform to current situation may act as a protective factor for ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Anxiety ; Coronary Artery Disease ; Hostility ; Humans ; Logistic Models ; Myocardial Infarction ; Psychology ; Quality of Life* ; Risk Factors* ; Stress, Psychological ; Surveys and Questionnaires

OBJECTIVE: The objective of this study was to examine the effect on development of mouse preimplantation embryos in culture media with different composition of energy sources in vitro culture. METHODS: Two hundred and seventy one two-cell embryos were cultured in four different culture system for 96 hours. Group I (n=61) was cultured in DMEM-G (DMEM with glutamine) only, groupII (n=64) was cultured in DMEM-GGP (DMEM with glutamine, glucose and pyruvate) only, group III (n=72) was cultured for 48 hours in DMEM-G and then transferred to DMEM-GGP and group IV (n=74) was cultured for 48 hours in DMEM-GGP and then transferred to DMEM-G. Development of embryos in each group was observed every 24 hours. RESULTS: After 24 hours, the rate of development > or = 3-cell was significantly higher in groupII (87.5%) and IV (86.5%) compared with group I (59.0%) and III (62.5%). After 48 hours, the rate of development into > or = morula stage was significantly higher in GroupII (79.7%) and IV (86.5%) compared with group I (34.4%) and III (37.5%). After 72 hours, the rate of development into blastocyst was significantly higher in group IV (74.3%) compared with group I (49.2%) and III (45.8%). After 96 hours, the rate of development into > or = expanded blastocyst was significantly higher in group IV (70.3%) compared with group I (32.8%),II (53.1%), and group III (40.3%). CONCLUSION: Mouse preimplantation embryos development was the most effective in culture system with DMEM-GGP for 48 hours and then transferred to DMEM-G.
Animals ; Blastocyst* ; Culture Media* ; Embryonic Structures ; Glucose ; Glutamine ; Mice* ; Morula ; Pyruvic Acid

Patients of choriocarcinoma with brain metastases are considered to have a very poor prognosis due to chemo-refractoriness and recurrence. So, selection and individualization of patients then followed by multimodality therapy are very important. We present a case of a patient who experienced twice of craniotomies due to intracranial hemorrhage and an emergent explorative laparotomy due to intestinal perforation of the metastatic sites of choriocarcinoma. She was treated with 12 cycles of high-dose MTX/EMA-CO, intrathecal MTX and WBRT. Eventually she has obtained a complete remission that ongoing for 2 years. So, we report this case with a brief review of the literatures.
Brain* ; Choriocarcinoma* ; Craniotomy ; Female ; Humans ; Intestinal Perforation ; Intracranial Hemorrhages ; Laparotomy ; Neoplasm Metastasis* ; Pregnancy ; Prognosis ; Recurrence

BACKGROUND: Facioscapulohumeral muscular dystrophy (FSHD) is associated with contractions of the polymorphic D4Z4-repeat array in 4q35 and has the distinctive clinical presentation of an initial involvement of the facial, shoulder-girdle, and upper-arm muscles. The aim of the present study was to determine clinical characteristics in Korean patients with FSHD and potential relationships between contracted D4Z4-repeat size and the FSHD phenotype. METHODS: We studied 34 genetically confirmed patients who had repeat sizes less than 38 kb, and analyzed their clinical manifestations with a structured protocol. The expressed phenotypes were scored according to the Clinical Severity Score formulated by Ricci and van Overveld. RESULTS: The clinical spectrum ranged widely, from asymptomatic individuals with minimal signs to wheelchair- bound patients. The initial affects were mainly in the facial muscles (68.8%), followed by the shoulder-girdle muscle (28.1%). Asymmetric features of the face and shoulder girdle were also important findings (71.9% and 90.0%, respectively). Winging scapular (87.5%), transverse smile (84.4%), Beevor's sign (68.8%), and sleeping with eyes opened (59.4%) were clinically important signs. There was a significant negative correlation between repeat size and clinical severity (r=-0.38, p=0.03). CONCLUSIONS: Distinctive clinical characteristics of FSHD are descending progression and asymmetric distribution of the muscle weakness. Our results also confirmed that the severity of FSHD increases with decreasing D4Z4-repeat size.
Contracts ; Eye ; Facial Muscles ; Genotype ; Humans ; Muscle Weakness ; Muscles ; Muscular Dystrophies ; Muscular Dystrophy, Facioscapulohumeral ; Phenotype ; Shoulder

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is the most common form of inherited motor and sensory neuropathy. Neurofilament light chain polypeptide (NEFL) is one of the most abundant cytoskeletal components of the neuron. The NEFL gene encoding the neurofilament light chain plays an important role in the axonal structure that includes an extensive fibrous network in the cytoplasm of the neuron. Mutations in the NEFL gene are also present in CMT2E, CMT type 1 and Dejerine-Sottas syndrome. However, there have been no reports to investigate the NEFL genes in Korean CMT patients. Therefore, we investigated to find the clinical characteristics in patients with the NEFL gene mutation. METHODS: We examined mutations of the NEFL gene in 125 Korean CMT families. Mutations were confirmed by the sequencing of both strands. Nerve conduction studies were carried out on CMT patients having each mutation. RESULTS: Three pathogenic mutations were found in 3 families, and 2 polymorphisms in 2 families. Two mutations (Leu334Pro, Pro22Arg) were determined too novel, and those were not detected in 105 healthy controls. A de novo missense mutation was found in a CMT family with the NEFL mutation. The frequency of the NEFL mutation was 2.4%, which was similar in Europeans, and lower than those found in Japanese. Pro22Arg and Glu397Lys mutations showed demyelinating neuropathy and Leu334pro mutation showed axonal neuropathy. CONCLUSIONS: We found NEFL mutations in patients with sporadic or dominantly inherited CMT. NEFL mutations should be considered in the evaluation of CMT or related neuropathies with various clinical features.
Asian Continental Ancestry Group ; Axons ; Charcot-Marie-Tooth Disease* ; Cytoplasm ; Hereditary Sensory and Motor Neuropathy ; Humans ; Mutation, Missense ; Neural Conduction ; Neurons

Pancreatic tumor has a wide range of differential diagnosis, from the benign inflammatory diseases, to the malignant disease such as pancreatic cancer. Here, we report a case of extrapulmonary paragonimiasis involving pancreas which was difficult to differentiate from primary neoplasm of pancreas. A 44 year old man was presented with a pancreatic tumor having inhomogenous enhancement and cystic nature in part, and conglomerated mass with rim enhancement and central hypodensity along both anterior and posterior side of pancreas on CT. No diagnostic clue was obtained from those conventional procedures and then the surgical exploration was perfomed to confirm the histology. The pathologic finding revealed the Paragonimus eggs in the granulomatous inflammation with necrosis.
Adult ; Diagnosis, Differential ; Eggs ; Humans ; Inflammation ; Necrosis ; Ovum ; Pancreas ; Pancreatic Neoplasms ; Paragonimiasis* ; Paragonimus

OBJECTIVE: The study was designed to find out current state of conservative treatment modalities for cervical pregnancies in korean. METHOD: 64 cases of cervical pregnancies reported by the joining of The Korean Society of Obstetrics & Gynecology from 1960 to 2000 and the 10 cases at Chungnam National University Hospital were analyzed retrospectively. RESULTS: The average age of the 74 cases was 31.7+/-6.6 years, and the average gestational age at the time of diagnosis was 8.3+/-3.4 weeks. The average duration of hospitalization was 8.2+/-4.8 days. Most (67/74) of the patients had previously experienced delivery or abortion. Out of the 74 cases, 36 had total hysterectomy; 4 cases had curettage; 12 were used only methotrexate; 11 had combined curettage and methotrexate; 10 cases had Foley catheter ballooning after curettage. From the 1960's to the end of 1980's, 33 (84.6%) cases out of 39 were performed hysterectomy. Whereas mainly conservative methods, in particular methotrexate treatment, were performed in the 1990's. Among the conservative modalities, Foley catheter ballooning after curettage had the shortest length of hospitalization with 4.3 days. CONCLUSION: After comparing the conservative methods for treating cervical pregnancies, it was found that methotrexate treatment was performed the most; however, Foley catheter ballooning after curettage seems to be an excellent treatment option.
Catheters ; Chungcheongnam-do ; Curettage ; Diagnosis ; Gestational Age ; Gynecology ; Hospitalization ; Humans ; Hysterectomy ; Methotrexate ; Obstetrics ; Pregnancy* ; Retrospective Studies