We performed immunohistochemical stain of p-glycoprotein using JSB-1 monoclonal antibody to study multidrug resistant(MDR) gene expression in 137 gastric tumor tissues obtained from 87gastric carcinoma patients. The incidence of p-glycoprotein expression was 60 of 87 cases(69%) and it was not correlated with age, sex, depth of tumor invasion, and lymph node metastasis, but was correlated with histologic type of gastric adenocarcinoma. The distribution of p-glycoprotein positive cells in the tumor tissue was diffuse in 34 cases(73.9%) and focal in 12 cases(26.1%), and the dominant staining patterns of p-glycoprotein in the tumor cells were cytoplasmic and golgi staining in 20 cases(43.5%) and 19 cases(41.3%), respectively, and 7 cases(15.2%) showed fine granules in the cytoplasm. The incidence of p-glyco-protein expression in the tumor tissue was higher in A and AB blood type patients who have A antigen than in 0 and B blood type patients. Cytoplasmic staining pattern was dominant in O and B blood types and golgi staining in A and AB blood type patients. Among 27 patients 'who received chemotherapy, partial remission was noted in 9 of 11 p-glyco-protein negative patients(81.8%) and no remission or progression of the tumor was seen in 9 of 16 p-glycoprotein positive patient(56.3%). The p-glycoprotein expression in gastric carcinoma had no direct correlation with known several prognostic factors of the gastric tumor except for histologic type, and it is supposed that p-glycoprotein detection in gastric tumor tissue by immunohisto-chemical stain is a good method for predicting the response of chemotherapy, especially in p-gly-coprotein negative cases.
Incidence

The prognosis of severe head injured patients (Glasgow coma scale 3 to 8) was assessed through clinical prognostic factors in 209 cases, retrospectively. Severe head injured patients were 9.1% of all head trauma and 55% of cases were diffuse brain injury. Mechanism of injury were motorvehicle accident, falls, bicycle, and others. The patients with normal pupillary reaction had a significantly higher percentage of good outcome (77%) than the patient with bilateral 3rd nerve palsy (14.2%)(p<0.0001), 79% of good motor responsive patients had a good outcome compared to none of patients with poor motor response(p<0.0001). The patients with short duration of unawareness(within 30days) significantly higher percentage of good outcome(98%) than the patients with long duration of unawaereness(24%)(p<0.0001). The patients with initial high GCS score(6-8 score) had a significantly higher good outcome(58%) than the patients with low GCS score(3-5 score)(p<0.0001), 87% of pediatric patients had a good outcome compared to 38% of adults(p<0.0001). The diffuse head injured patients without basal cistern compression had a significantly hgher percentage of good outcome(83%) than the patients with basal cistern compression(41%)(p<0.0001), 62% of patients with skull fracture had a good outcome compared to 39% of patients without skull fracture(39%)(p<0.0017). Individual prognostic factors affect to patient's outcome and utilize to be powerful tool for assessing the relative efficacy of alternative treatments as well as patient's prognosis.
Brain Injuries ; Coma ; Craniocerebral Trauma ; Head* ; Humans ; Paralysis ; Prognosis ; Retrospective Studies ; Skull ; Skull Fractures

Superficial siderosis is a rare condition characterized by hemosiderin deposition in leptomeninges, subpial tissue, brainstem, cerebellum, spinal cord, and cranial nerves. Slowly progressive hearing loss and gait ataxia are invariable clinical manifestations. We report three patients with their clinical and radiological features. All patients presented with hearing loss and cognitive dysfunction. Two showed gait ataxia and myelopathic symptoms and signs. Decreased visual acuity, hand tremor, limb ataxia, dysarthria, and nystagmus were also present. All patients showed typical MRI findings: marked linear hypointensities around the cerebellum, brainstem, and the surface of the cerebral cortex, especially in sylvian fissures. Two patients had brain tumors : pituitary adenoma and oligodendroglioma. Another patient had no definite bleeding source. Hemosiderin deposition is caused by chronic and recurrent subarachnoid hemorrhage derived from tumor, vascular malformation, aneurysm, posthemispherectomy, and unknown bleeding sources. Diagnosis is easily made by characteristic clinical manifestations and MRI findings. The selective vulnerability of the cerebellum and the 8th cranial nerve depends upon their own histological and biochemical characteristics. Benefits of the iron chelating agents are questionable. Removal of the possible bleeding sources is the most reliable strategy to prevent the disease progression.
Adenoma ; Aneurysm ; Ataxia ; Brain Neoplasms ; Brain Stem ; Cerebellum ; Cerebral Cortex ; Cranial Nerves ; Diagnosis ; Disease Progression ; Dysarthria ; Gait Ataxia ; Hand ; Hearing Loss ; Hemorrhage ; Hemosiderin ; Humans ; Iron Chelating Agents ; Magnetic Resonance Imaging ; Oligodendroglioma ; Pituitary Neoplasms ; Siderosis* ; Spinal Cord ; Subarachnoid Hemorrhage ; Tremor ; Vascular Malformations ; Visual Acuity

PURPOSE: The number of patients waiting for kidney transplantation is incessantly increasing, but the number of cadaveric kidney transplantations or ABO-compatible donors is so insufficient that ABO-incompatible kidney transplantation is being performed as an alternative. There are overseas studies and research showing that the 5-year survival rate and 5-year graft survival rate of ABO-incompatible kidney transplantation are not much different from those of ABO-compatible kidney transplantation. However, domestic research on the subject is rare. Therefore, we report the results of 22 ABO-incompatible kidney transplantation cases performed in our hospital. MATERIALS AND METHODS: This research was from 22 patients in our hospital who underwent ABO-incompatible kidney transplantation from 15 February 2007 to 20 May 2010. RESULTS: As yet, there have been no donor graft losses and no deaths after transplantation. The results of the two groups were analyzed by analysis of covariance of the creatinine value of the recipients at 6 months after the operation, corrected for the preoperative value in order to statistically identify whether there were differences in renal function after the operation between ABO-compatible and ABO-incompatible kidney transplantation. The results of the analysis of covariance showed no statistical difference in renal function after the operation between the two groups. CONCLUSIONS: Even though there were not many cases, our initial results for ABO-incompatible kidney transplantation were positive. Considering the increasing number of patients waiting for kidney transplantation, longer-term domestic research studies of ABO-incompatible kidney transplantation are necessary.
ABO Blood-Group System ; Cadaver ; Creatinine ; Graft Survival ; Humans ; Kidney ; Kidney Transplantation ; Living Donors ; Survival Rate ; Tissue Donors ; Transplants

No abstract available.
Ganglioglioma*

No abstract available.

BACKGROUND: Since prognosis of pontine hemorrhage (PH) is dependent on the initial consciousness level, prediction of outcome is not difficult in patients presenting deeply comatose mentality or mild neurologic deficits without altered consciousness. The outcome of PH accompanied by some degree of altered mentality is, however, so various and cannot be easily predicted. The aim of this study was to analyze the radiologic factors determining the prognosis in this subgroup of PH. We also tried to describe the common clinical and radiologic features in patients with benign clinical course, which have rarely been studied systematically. METHODS: Chiefly based on the initial level of consciousness, 42 patients were classified into benign (BH, n=14), non-benign (NBH, n=19), and fatal (FH, n=9) PH. We retrospectively reviewed their medical records and radiologic data. The modified Rankin score was used for evaluating long-term prognosis. In NBH group, transverse and vertical extension index of hematoma, hemorrhage volume, and presence of extrapontine extension were investigated on CT images. RESULTS: Hemiparesis with or without ocular disturbance was the most common manifestation in BH group (64%) and two patients showed neurologic signs identical to lacunar syndrome. The most common location of hemorrhage was unilateral tegmentum (64%). In NBH group, transverse extension index was significantly greater in the patients with worse prognosis, though vertical extension index and extrapontine extension did not seem to be important in predicting the prognosis. CONCLUSIONS: The clinical features simulating lacunar syndrome are frequently found in BH. The degree of transverse extension in the pons is important in predicting the prognosis of NBH subgroup.
Coma ; Consciousness ; Hematoma ; Hemorrhage* ; Humans ; Hydrogen-Ion Concentration ; Medical Records ; Neurologic Manifestations ; Paresis ; Pons ; Prognosis ; Retrospective Studies ; Stroke, Lacunar

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.
Fibrosarcoma ; Humans ; Positron-Emission Tomography ; Sensitivity and Specificity

No abstract available.
Incontinentia Pigmenti*

In spite of relatively common references as differential diagnosis in the cases of vertebrobasilar ischemia or infartion, there are only a few reports about dissections of the vertebrobasilar artery(VBA) in Korea. We reviewed medical records and radiographic findings of the 10 patients diagnosed as having dissections of the VBA at Seoul National University Hospital and Seoul City Borame Hospitall since 1994. The 10 patients, all men ranging from 15 to 58 years, did not have the usual risk factors for stroke. In 6 cases, temporally related trauma or exercise was noted. There were also 2 cases of delayed neurologic manifestations from preceeding trauma, developed 74 days and about I year later respectively. Most subjects(9 cases) showed the ischemic symptoms of posterior circulations. Subarachnold hemorrhage was manifested in 2 cases. Magnetic resonance imaging(MRD, magnetic resonance angiography(MRA) and transfemoral cerebral angiography(TFCA) showed irregular narrowing of proximal vertebral artery(VA) with non-visualization of its distal part, thrombosed VA, intramural high signal intensity in VBA, double lumen appearance or fusiform aneurysm. Until now(mean follow up period; 15 months), them are no recurrences with anticoagulation or antiplatelet therapy in the cases of vertebrobasilar ischemia. Dissections of the VBA should be included in the differential diagnosis of vertebrobasilar ischemia or infarction, especially in the young population or in the subjects without common risk factors. The diagnosis can be made on the bases of clinical features and the characteristic findings of MRI, MRA and TFCA.
Aneurysm ; Arteries* ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Korea ; Magnetic Resonance Imaging ; Male ; Medical Records ; Neurologic Manifestations ; Recurrence ; Risk Factors ; Seoul ; Stroke ; Vertebrobasilar Insufficiency