Ubiquitin-positive neuritic threads (UNTS) in the hippocampal CA 2-3 region are reported to occur exclusively in association with so-called diffuse Lewy body disease (DLBD). hi order to assess the association between the occurrence of Lewy bodies (LBs) and that of the UNTs, an immunohistochemical study on the hippocampus including the parahippocampal gyrus with antiubiquitin antibody (Chemicon Co., California, U.S.A.) was perfon-ned in four groups of patient's brains. All brains were selected from the large pool of brains referred to the Neuropadiology Laboratory of the University of Minnesota for studies of Alzheimer's disease. Group 1 consisted of 34 cases (20 male and 14 female) with LBs widespread in the frontal and temporal cortex and the brain stem nuclei (basal nucleus, substantia nigra, locus ceruleus and dorsal vagal nucleus) associated with varying degrees of degeneration of the substantia nigra; 21 (11 male and 10 female) combined with and 13 (9 male and 4 female) without Alzheimer's disease (AD) pathology. Group 2 included 12 cases (9 male and 3 female) in which LBs were observed only in the brain stem nuclei; 7 with and 4 without AD pathology. Group 3 consisted of 30 cases (9 male and 21 female) without LBs but with AD pathology and degeneration of the substantia nigra. Group 4 included 23 cases (11 male and 12 female) with neither LBs nor AD pathology but with degeneration of the substantia nigra. Ages of the patients varied among the groups. In the 46 cases in the first two groups with LBs. The mean age in the 28 cases with AD pathology was 77.3+/-8.9 and in the 18 cases without AD pathology it was 71.6+/-8.8 (P<0.05). In the 53 cases in groups 3 and 4 without LBs, which served as the controls, the mean ages were 80.8+/-7.7 and 74.0+/-9.7 respectively. UNTs were encountered in all (100%) of 34 cases of group I with widespread LBs which met the histological criteria of DLBD regardless of combined AD pathology. In 12 cases of group 2 with LBs confined to the brain stem, UNTs occurred in 3 (25%), 1 with and 2 without AD pathology. hi the group 3 cases with only AD pathology, UNTs occurred in 4 (13%) of 30 cases, while no UNTs were encountered in the 23 cases of group 4 without AD pathology or LBs. In conclusion, UNTs in the hippocampal CA 2-3 region occur invariably but not exclusively in association with widespread LBs, frequently when LBs are confined to the brain stem, and infrequently with AD pathology. It seems, therefore, that the UNTs are closely related to LBs and increase in ftequency as LBs spread beyond the brain stem with time, but the pathogenesis of the UNTs is little understood.
Female ; Male ; Humans

Varying types of polyps could occur in the vermiform appendix. However, it is very unusual. Collins found 57 cases (0.08%) of benign mucosal polyps in the 71,000 cases of appendectomy specimens. There has been no reported case of appendiceal polyp in the literature in Korea. The authors experienced two cases of polyp in the vermiform appendix. The first case was a 51 year-old male patient who received a left hemicolectomy due to colonic polyposis. The second case was a 71 year-old male patient who was treated by appendectomy under the clinical diagnosis of acute appendicitis. The microscopic type of both cases were hyperplastic polyp.
Male ; Humans

PURPOSE: In the past, laymen or beauty parlor employees commonly injected people with unproven foreign material such as paraffin, silicone, and cooking oil. We have treated a patient who injected foreign material into her face and neck. METHODS: For the last 20 years, a 43-year-old woman has been injecting herself in the face and neck with foreign material. There was no tenderness, erythema, pain, ulceration, or necrosis. However many visible, touchable subcutaneous masses were found. Her face was extremely ugly and disfigured by the foreign material. We could not recognize the boundary between her neck and mandible. The occipital scalp drooped extremely. Over the past 3 years, from February 2005 to October 2007, we performed 15 operations. RESULTS: We conducted a cephalometric facial analysis to compare preoperative and postoperative facial diameter. The patient's upper face diameter decreased from 67cm to 60 cm, the mid face diameter from 82cm to 59cm, the lower face diameter from 63 cm to 50cm, and the neck circumference diameter from 53cm to 44cm, respectively. The mid sagittal diameter decreased from 26 cm to 23cm. The total excised tissue weight was 4023.7 gram after 15 operations. CONCLUSION: Serial excision of face and neck masses in a patient who injected herself with foreign material resulted in a satisfactory outcome.
Adult ; Beauty ; Cooking ; Erythema ; Female ; Foreign Bodies ; Humans ; Mandible ; Neck ; Necrosis ; Paraffin ; Scalp ; Silicones ; Ulcer

PURPOSE: Langerhans cell histiocytosis is a heterogenous group of Langerhans cell proliferative disorders and includeseosinophilic granuloma, Letterer-Siwe diseases, and Hand- Schuller Christian disease. We report a case of eosinophilic granuloma on frontal area. METHODS: A 17-year-old male presented with swelling and tenderness on Lt. frontal and periorbital area. CT and MRI showed a 33 x 25 mm sized mass that involved Lt. frontal calvarium, frontotemporal meninges, and orbital roof. RESULTS: Total excision of the mass and adjacent soft tissue, calvarium, and orbital roof was performed. Orbital roof defect was reconstructed with absorbable plate and calvarial defect was done with outer cortex of temporal bone flap. The histology revealed proliferation of histiocytes and eosinophils. Immunologically, these histiocytic cells expressed S-100 protein and CD1a. The patient is currently taking conservative treatment. CONCLUSION: The severity of these disease and their prognosis and treatments are various. For unifocal cranial Langerhans cell histiocytosis, complete excision is the treatment of choice. We report this case with review of literature.
Adolescent ; Eosinophilic Granuloma ; Eosinophils ; Frontal Bone ; Granuloma ; Histiocytes ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Male ; Meninges ; Orbit ; Prognosis ; S100 Proteins ; Skull ; Temporal Bone

PURPOSE: The goals of cranioplasty are to protect the brain from trauma and restore normal cranial contour with as few complication as possible. In patient who suffered from cranial defect, the most satisfactory form of cranioplasty may be archived with autogenous bone grafts. We report on the treatment of large frontal bone defect using pericranial flap and split-rib graft. METHODS: A 29-year-old male was referred to our department. He was involved in an automobile accident resulting in large frontal bone and sinus defect and skull basal defect. The reconstruction was undertaken using galeal frontalis myofascial flap and split-rib cranioplasty using bicoronal incision. RESULTS: The postoperative course was successful. For 9 months follow up period, there was no complication about hematoma, infection, CSF leakage and washboard deformity. He was pleased with the results even when absolute symmetry was not achieved. CONCLUSION: We experienced large frontal bone and sinus defect and skull basal defect patient and successfully treated with split-rib graft and galeal frontalis myofascial flap.
Adult ; Automobiles ; Brain ; Congenital Abnormalities ; Follow-Up Studies ; Frontal Bone ; Hematoma ; Humans ; Male ; Skull ; Transplants

Gynecomastia is an abnormal increase in the volume of the male breast. Surgical techniques include a variety of incisions, excisions, suction-assisted lipopectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods. The purpose of this article is to introduce the authors' method of using power-assisted liposuction and periareolar pull-out technique. Six men were treated from June 2005 through August 2008 for gynecomastia. Fatty breast tissue is removed by power-assisted liposuction. The periareolar pull-out technique is then performed to glandular enlargement. A mean of 120cc of breast tissue was aspirated, and 18.3g of glandular tissue were excised per breast. There were no complications such as skin flap necrosis or hematoma. The cosmetic outcome was good in all and the patients' satisfaction was high. Power-assisted liposuction in combination with periareolar pull-out technique effectively corrects gynecomatia. This combination has little morbidity, minimize scars, and leads to good cosmetic results.
Male ; Humans

Nitric oxide (NO) modulates the activities of various channels and receptors to participate in the regulation of neuronal intracellular Ca2+ levels. Ca2+ binding protein (CaBP) expression may also be altered by NO. Accordingly, we examined expression changes in calbindin-D28k, calretinin, and parvalbumin in the cerebral cortex and hippocampal region of neuronal NO synthase knockout(-/-) (nNOS-/-) mice using immunohistochemistry. For the first time, we demonstrate that the expression of CaBPs is specifically altered in the cerebral cortex and hippocampal region of nNOS-/- mice and that their expression changed according to neuronal type. As changes in CaBP expression can influence temporal and spatial intracellular Ca2+ levels, it appears that NO may be involved in various functions, such as modulating neuronal Ca2+ homeostasis, regulating synaptic transmission, and neuroprotection, by influencing the expression of CaBPs. Therefore, these results suggest another mechanism by which NO participates in the regulation of neuronal Ca2+ homeostasis. However, the exact mechanisms of this regulation and its functional significance require further investigation.
Animals ; Calcium ; Calcium-Binding Protein, Vitamin D-Dependent ; Calcium-Binding Proteins ; Carrier Proteins ; Cerebral Cortex ; Homeostasis ; Immunohistochemistry ; Mice ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Synaptic Transmission

OBJECTIVE: Quantitative electroencephalography (qEEG) has been increasingly used to evaluate patients with attention deficit hyperactivity disorder (ADHD). The aim of this study was to assess the correlation between qEEG data and symptom severity in patients with ADHD. METHODS: Fifteen patients with ADHD and 20 healthy controls (HCs) were recruited. Electroencephalography was assessed in the resting-state, and qEEG data were obtained in the eyes-closed state. The Korean version of the ADHD Rating Scale (K-ARS) and continuous performance tests (CPTs) were used to assess all participants. RESULTS: Theta-band (4-7 Hz) power across the brain was significantly positively correlated with inattention scores on the K-ARS, reaction times and commission errors on the CPTs in ADHD patients. Gamma-band (31-50 Hz) power was significantly positively correlated with the results of the auditory CPTs in ADHD patients. The theta/alpha (8-12 Hz) and theta/beta (13-30 Hz) ratios were significantly negatively correlated with commission and omission errors on auditory CPTs in ADHD patients. No significant correlations between qEEG relative power and K-ARS and CPT scores were observed in HCs. CONCLUSION: Our results suggest that qEEG may be a useful adjunctive tool in patients with ADHD.
Attention Deficit Disorder with Hyperactivity* ; Brain ; Electroencephalography* ; Humans ; Male* ; Reaction Time*

PURPOSE: Diabetes mellitus is a chronic disorder and strict glycemic control, which cannot be successfully obtained without behavior modification, is the most important factor in prevention and management of complications. The purpose of this study was to investigate the short-term effects and associated factors of the diabetes education program and to assess the necessity of regular and structured education and support in diabetic children and adolescents. METHODS: Thirty patients (10.0-18.9 years) with type 1 diabetes mellitus (T1DM), attending the diabetes clinic in Seoul National University Children's Hospital, were included in the diabetes education program with intensified treatment. A six-day-course program was provided by a diabetes care team with doctors, a specialist diabetes nurse, a clinical dietitian, and a social worker. Patient data of disease duration and complication studies at the time of enrollment were reviewed and changes in HbA1c levels before and after the education program were analyzed. RESULTS: In 28 of 30 patients, significant decrease of average HbA1c levels (average 0.9%, median 0.8%, P < 0.001) was observed after education. The changes in average HbA1c levels were prominent in patients who were educated for the first time. On follow-up, HbA1c level at 3 months was significantly decreased (P = 0.009) but after 9 months, it tended to increase again. The decrease of average HbA1c levels after education was negatively correlated with disease duration (r = -0.60, P = 0.001). CONCLUSION: The short-term effect of the diabetes education program with intensified treatment in diabetic children and adolescents was optimistic but regular education and support in these patients should be sustained.
Adolescent ; Behavior Therapy ; Child ; Diabetes Mellitus ; Diabetes Mellitus, Type 1 ; Follow-Up Studies ; Humans ; Social Workers ; Specialization

OBJECTIVES: To determine the yield of bronchoscopy for evaluating tracheobronchial spread in esophageal carcinoma and to identify the conditions for bronchoscopy in patients with newly diagnosed esophageal carcinoma, who planned to be operated. METHODS: From March 1989 to June 1997, 115 patients with esophageal carcinoma had received bronchoscopy. Bronchoscopic findings were classified into three types: Type I: no definitive endobronchial lesion, Type II: indirect effects(hyperemia and compression), Type III: invasion. CT findings were classified into three classes: Class A: tumor separated from tracheobronchial tree, Class B: abutting tree, Class C: compressing tree. We investigated the correlations of clinical presentation and non-invasive tests (including esophagogram) with bronchoscopic findings. RESULTS: 1) Among 115 patients, bronchoscopic findings were Type I in 67(58.3%), Type II in 34(29.6%), Type III in 14(12.2%). 2) Abnormal bronchoscopic findings are related with length of lesion by esophagogram.(p < 0.05) 3) Class C lesion by chest CT scan were closely correlated with abnormal bronchoscopic findings. 4) Chest symptoms were frequently associated with type III lesion of bronchoscopy CONCLUSION: We could recommend preoperative bronchoscopy in recently diagnosed as esophageal carcinoma who got more than 2 of 3 variables listed below: 1) patients who had chest symptoms, such as cough with sputum, hemoptysis, and dyspnea 2) length of tumor is long in esophagogram(above 5 cm in length), 3) tracheobronchial compressed lesion by chest CT scan. Bronchoscopy is not needed in cases with no chest symptom, short lesion length(below 5 cm) and normal chest CT finding for preoperative evaluation of esophageal carcinoma.
Bronchoscopy* ; Cough ; Dyspnea ; Hemoptysis ; Humans ; Sputum ; Thorax ; Tomography, X-Ray Computed