No abstract available.
Carbon Dioxide* ; Carbon* ; Lasers, Gas*

BACKGROUND: A small but significant proportion of patients with brain tumors continued to have seizures postoperatively. All of them could not be explained simply by the failure to adequately resect the tumor mass. We investigated factors influencing seizure recurrence in primary brain tumors. METHODS: We analyzed 435 patients treated with tumor surgery and examined the differences between epileptic seizure group (ESG) and non-epileptic seizure group (NESG). Among ESG, we selected 99 patients confirmed by pathology. We divided patients into chronic epileptic seizure group (CESG; duration of seizure attack >or=1 year) and acute epileptic seizure group (AESG; < 1 year). We also investigated the differences between two groups. RESULTS: Of 435 patients, 104 were ESG and 331 NESG. Among various factors, male, favorable neurological state, fronto-temporal lobe origin, astrocytoma, oligodendroglioma were statistically significant in ESG compared with NESG (p<0.05). Of 99 patients, 43 were CESG and 56 AESG. Among various factors, seizure recurrence rate without residual tumor or tumor recurrences was significantly higher in CESG than in AESG (p<0.05). On the other hand, the laboratory abnormalities, and the rate of residual tumor or tumor recurrences on follow-up MRI were significantly higher in AESG than in CESG (p<0.05). CONCLUSIONS: Among many factors, sex, neurological state, location and pathology of tumors were significantly related to seizure attacks in brain tumor. There were the differences of epileptogenesis between AESG and CESG. We suggest that patients with brain tumor and chronic epilepsy have to be investigated with extensive work-up including invasive electrophyosiologic studies.
Astrocytoma ; Brain Neoplasms* ; Epilepsy* ; Follow-Up Studies ; Hand ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm, Residual ; Oligodendroglioma ; Pathology ; Recurrence* ; Seizures ; Sex Factors

PURPOSE: We performed this study to assess the suitability of conventional angiography (CA) vs. multi-detector row helical CT angiogram (MD-CTA) as a method of preoperative diagnostic imaging for low extremity arterial surgery. METHODS: From February 2004 to September 2006, 23 patients (4 claudicants, 19 limb-threatening ischemia) were studied with CA and MD-CTA preoperatively. The site and degree of stenotic or occlusive lesions in arterial segments from the renal artery to the dorsalis pedis artery were compared with both methods. We also compared the surgical inflow and outflow site changes in preoperative planning based on CA and MD-CTA and the final outcome. Additional diagnostic value and test-related complications were also analyzed. RESULTS: The median age of patients was 68 years old (range: 43~89 years), with a male to female ratio of 1.3:1. Twenty-three patients had CA after an MD-CTA scan. One hundred fifty lesions were detected in these patients. The total ratio of consistency for occlusion in CA vs. MD-CTA was 69.6%. Three patients received amputation treatment and eleven patients received a bypass operation. The agreement between the preoperative plan based on MD-CTA and the final operation was 100%, even in critical limb ischemia. There were no serious complications related to the tests. CONCLUSION: These findings suggest that MD-CTA is an adequate preoperative imaging study of infrainguinal arterial surgery and may be substituted for conventional angiography without any serious complications.
Amputation ; Angiography ; Arteries ; Diagnostic Imaging ; Extremities ; Female ; Humans ; Ischemia ; Male ; Renal Artery ; Tomography, Spiral Computed

BACKGROUND: Seizure evoked by a variety of simple and complex sensory stimuli are called reflex epilepsy. Among the various sensory stimuli, musicogenic epilepsy is provoked exclusively by listening to music. Musicogenic epilepsy is typically of a complex partial type, with or without secondary generalization. EEG abnormalities are usually recorded from the temporal lobe and show a right-side preponderance. CASE: A 34-year-old male patient was admitted due to mental change. He was treated under the diagnosis of encephalitis and improved after several days. But complex partial and generalized tonic-clonic seizure was developed. His seizure was occurred spontaneously, but more often provoked when talking about by telephone. Brain MRI revealed no gross abnormality. Ictal brain SPECT (HMPAO) showed hyperperfusion in the right temporal region. EEG showed focal slowing in the right temporal region and no provocation by click sound through the BAEP and photic stimuli. CONCLUSION: This case is musicogenic epilepsy provoked by conversation through the telephone. Presumably, the primary auditory area of the temporal lobe was activated by encephalitis and these hyperexcitable cortical areas stimulated by only distorted voice through the telephone, but not by usual conversation, induce seizure.
Adult ; Brain ; Diagnosis ; Electroencephalography ; Encephalitis* ; Epilepsy, Reflex* ; Generalization (Psychology) ; Humans ; Magnetic Resonance Imaging ; Male ; Music ; Seizures ; Telephone* ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon ; Voice

PURPOSE: Hyperhomocysteinemia was observed in epileptic patients receiving anticonvulsants, especially homozygotes for mtehylenetetrahydrofolate reductase (MTHFR) gene 677C->T mutation. Hyperhomocysteinemia induce atherosclerosis, fetal anticonvulsant syndrome, etc. Therefore, we examined any other factors that might affect the level of homocysteine in epileptic patients. METHODS: We investigated the plasma total homocysteine level in 145 patients with epilepsy. And then we analyzed various factors (clinical findings, neuro-image finding, drugs, MTHFR gene, serum folate and vitamin B12 level) affecting the level of homocysteine. RESULTS: Among the various factors, male, present neurological deficits, frequent seizure attacks, MTHFR gene 677 TT genotype, polypharmacy, and conventional drug (phenytoin, carbamazepine, valproic acid, phenobarbital, primidone, benzodiazpines) than new drug (lamotrigine, vigabatrin, topiramate, oxcarbazepine zonisamide) were related with elevated homocysteine levels. CONCLUSION: We recommend monotherapy with new drugs and higher vitamin requirement in the male epileptic patients of MTHFR TT genotype with neurological deficits and frequent seizure attacks.
Anticonvulsants ; Atherosclerosis ; Carbamazepine ; Epilepsy ; Folic Acid ; Genotype ; Homocysteine* ; Homozygote ; Humans ; Hyperhomocysteinemia ; Male ; Oxidoreductases ; Phenobarbital ; Plasma ; Polypharmacy ; Primidone ; Seizures ; Valproic Acid ; Vigabatrin ; Vitamin B 12 ; Vitamins

PURPOSE: RUNX3, a novel tumor suppressor, is frequently inactivated in gastric cancer. In the present study, we examined the pattern of RUNX3 expression in gastric cancer cells from gastric cancer specimens and the impact of its alteration on clinical outcome. MATERIALS AND METHODS: A total of 124 samples of both gastric cancer and normal tissue were obtained from 124 patients who underwent curative gastrectomy at the Seoul Medical Center from January 2001 to December 2005. RUNX3 expression was determined by immunohistochemical staining, and the results were analyzed. Statistical analysis wabased on clinicopathological findings and differences in survival rates. RESULTS: The mean age of the patients was 61 years, and the male:female ratio was 1.9:1. The expression rate of RUNX3 was 59.7% (74/124). The expression rate was higher in differentiated gastric cancers (nucleus: 9.1%, cytoplasm: 57.6%) than in the undifferentiated types (nucleus: 5.2%, cytoplasm: 46.6%) (P=0.133). The 5-year survival rates according to RUNX3 expression determined from cancer tissue were 88.9% for the nucleus +/- cytoplasm(+) group of patients, 76.1% for the cytoplasm only (+) group of patients, and 65.3% for the RUNX3 negative expression group of patients (P=0.626). Only UICC TNM staging showed statistical significance related to the survival rate, as determined by multivariate analysis. CONCLUSION: The RUNX3 expression rate was higher in differentiated gastric cancer than in the undifferentiated types without significance. Although RUNX3 expression predicted better survival, based on multivariate analysis, the finding was not statistically significant. More cases should be further evaluated.
Cytoplasm ; Gastrectomy ; Humans* ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Seoul ; Stomach Neoplasms* ; Survival Rate

Background: Recent studies suggest that acanthosis nigricans (AN) is associated with insulin resistance in obese children. However, very few studies have assessed insulin resistance and obesity according to the degree of AN. Therefore, this study aimed to investigate the correlation between the degree of obesity and insulin resistance according to the severity of AN. Methods: A total of 141 participants (83 boys and 58 girls) aged 6−17 years were recruited for the Intervention for Childhood and Adolescents obesity via Activity and Nutrition study between 2016 and 2017. The participants were categorized into four groups according to the severity of AN: grade 0 (n=69), grade 1 (n=19), grade 2–3 (n=35), and grade 4 (n=18). All participants underwent physical examination and blood tests. We compared the mean homeostatic model assessment (HOMA-IR) and body mass index Z score (BMI Z-score) in each group using ANCOVA and linear regression model. Results: The HOMA-IR, which represents insulin resistance, increased with increasing AN severity (grade 0 group: 3.25±0.070; grade 1 group: 3.97±0.103; grade 2–3 group: 4.76±0.079; AN grade 4: 6.40±0.107; P for trend<0.001). Similarly, the BMI Z-score, which represents the degree of obesity, increased with increasing AN severity (grade 0 group: 2.29±0.052; grade 1 group: 2.42±0.080; grade 2–3 group: 2.44±0.062, grade 4: 2.67±0.089; P for trend<0.001). Conclusion Insulin resistance and the degree of obesity increase with the severity of AN in Korean obese children.

Background: Malnutrition is a well-known risk factor of falls, although studies examining the association between nutritional status and falls are rare. We aimed to investigate the association between nutritional status and falls according to gender among Korean older adults. Methods: The study included 10,675 participants (4,605 men and 6,070 women) aged 65 years and older and used data from the 2011 Survey of Living Conditions and Welfare Needs of Korean Older Persons. Nutritional status of the participants was assessed using the Nutritional Screening Initiative checklist, and the participants were categorized into the following groups: “good,” “moderate nutritional risk,” and “high nutritional risk.” Odds ratios (OR) of fall risk in the above groups based on gender were evaluated using multivariate logistic regression analyses. Results: Fallers in both genders showed significant association with older age, lower household income, inadequate exercise, and poor nutritional status compared with non-fallers. Considering the good nutritional status group as the reference group, the high nutritional risk group showed a higher risk of falls in men (OR, 1.59; 95% confidence interval [CI], 1.26–1.99); both moderate and high nutritional risk groups showed a higher risk of falls after adjusting for confounding factors in women (OR, 1.39; 95% CI, 1.19–1.62 and OR, 1.90; 95% CI, 1.61–2.24, respectively). Conclusion The risk of falls was associated with poor nutritional status, and statistical significance of the association between nutritional status and falls was stronger in women than in men.

No abstract available.
Hypertrophy ; Obesity ; Obesity, Abdominal

BACKGROUND: Hyperhomocysteinemia is an independent risk factor for cerebrovascular disease. MTHFR 677TT genotype can induce hyperhomocysteinemia. However, the association between this 677TT genotype and ischemic stroke still remains controversial. This study was undertaken to determine whether MTHFR 677TT genotype was associated with certain subtype of ischemic stroke. METHODS: The case group consisted of 129 patients with ischemic stroke and the control group consisted of 157 healthy individuals. We checked their fasting plasma homocysteine levels and analyzed the C677T mutation in the MTHFR gene. The relative risk of MTHFR 677TT genotype was assessed by odds ratios using multivariate logistic regression. RESULTS: Homocysteine levels in plasma were significantly higher in ischemic stroke patients (10.386.44 mol/L) than in controls (8.002.40) (P<0.05). In small-artery disease (11.366.01), the same result was found (P<0.05). On the other hand, the prevalence of the homozygote mutation was not significantly higher in ischemic stroke patients (20.2%) than in controls (13.4%) (adjusted OR 1.39, 95% CI 0.65 to 2.96). The adjusted OR and 95% CI was 2.59 (1.08 to 6.25) for the TT genotype in patients with small-artery disease compared to controls. The 677TT genotype was increased in small-artery disease compared to large-artery disease (adjusted OR 7.60, 95% CI 1.66 to 34.77). CONCLUSIONS: Our findings suggest that the homozygous C677T mutation in the MTHFR gene is a risk predictor in the subtype of ischemic stroke, such as small-artery disease.
Fasting ; Genotype ; Hand ; Homocysteine ; Homozygote ; Humans ; Hyperhomocysteinemia* ; Logistic Models ; Odds Ratio ; Plasma ; Prevalence ; Risk Factors ; Stroke*