BACKGROUND: Neocortical temporal lobe epilepsy (NTLE) appears to have different characteristics in clinical and electrophysiological aspects from mesial temporal lobe epilepsy (MTLE). Many semiological studies on TLE have been performed. We investigated ictal EEG patterns to differentiate NTLE from MTLE. METHODS: One hundred twenty nine scalp ictal EEG recordings came from 27 pathologically proven TLE patients were analyzed by 1) frequency of ictal discharge at EEG seizure onset (alpha, beta, theta & delta), 2) distribution patterns of ictal EEG onset (diffuse, lateralized & regionalized), 3) electrode of maximum amplitude at initial regionalized portion of ictal EEG, and 4) mesial to lateral and anterior to posterior amplitude ratio of ictal discharges in temporal electrodes. RESULTS: One hundred seven seizures came from MTLE (23 patients) and twenty-two seizures from NTLE (4 patients). Ictal EEG onset with delta wave was observed more frequently in MTLE (42.7%) than in NTLE (14.3%), but beta wave onset was noted more frequently in NTLE (14.3%) than MTLE (0%). Initial ictal EEG discharges were lateralized on ipsilateral hemisphere in 22.0% of MTLE and in 28.6% of NTLE, regionalized over ipsilateral temporal region in 36.6% and 23.8% respectively, and showed diffuse nonlateralized onset in 41.5% of MTLE and 47.6% of NTLE. Both TLE groups revealed most often their maximum negativity of ictal EEG onset at sphenoidal electrode (MTLE: 59.3%, NTLE: 42.8%). Mesial to lateral amplitude ratio of ictal EEG was significantly larger in MTLE group than NTLE group. The amplitude ratio of anterior to posterior temporal electrodes was greater in NTLE group than in MTLE group. CONCLUSION: Delta frequency of ictal onset EEG is more suggestive of MTLE while beta frequency may suggest NTLE. Initial ictal EEG patterns with their maximum on sphenoidal electrode do not differentiate MTLE from NTLE. NTLE has wide vertical and narrow horizontal electrical field, but MTLE has wide horizontal and narrow vertical electrical field.
Electrodes ; Electroencephalography* ; Epilepsy, Temporal Lobe* ; Humans ; Scalp ; Seizures ; Temporal Lobe*

PURPOSE: The goal of this study was to determine the risk of malignancy of thyroid nodules with minimal cystic changes. METHODS: A total of consecutive 1,000 thyroid nodules (≥1 cm) with final diagnoses from twoinstitutions were included in this study. The risk of malignancy of thyroid nodules was analyzed according to the internal content, which was categorized as purely solid, minimally cystic (cystic changes ≤10%), and partially cystic (cystic changes >10%). We also assessed the risk of malignancy of nodules with minimal cystic changes depending on echogenicity and presence of any suspicious ultrasonografic (US) features. RESULTS: The overall frequency of purely solid, minimally cystic, and partially cystic noduleswas 730/1,000 (73%), 61/1,000 (6.1%), and 209/1,000 (20.9%), respectively, with risks ofmalignancy of 14.8% (108/730), 3.3% (2/61), and 3.3% (7/209), respectively. The risk ofmalignancy of nodules with minimal cystic changes was significantly lower than that of purelysolid nodules (P=0.013). The risk of malignancy of nodules with minimal cystic changes was also lower than that of purely solid nodules in the group of hypoechoic nodules (P=0.063) and in the group of nodules with suspicious US features (P=0.028), but was not significantly different from that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features (P≥0.652). CONCLUSION: Thyroid nodules with minimal cystic changes have a low risk of malignancy, similar to that of partially cystic nodules regardless of echogenicity or the presence of suspicious US features. The US lexicon could define solid nodules as nodules with purely solid internal content in order to enhance the accuracy of estimated risks of malignancy.
Diagnosis ; Thyroid Gland* ; Thyroid Nodule* ; Ultrasonography

Nasal dermoid sinus cyst (NDSC) is a rare congenital malformation which results from anomalous embryological development and occurs in the midline of the nose. An accurate diagnosis using CT or MRI is essential for an appropriate surgical treatment, which in some cases entails cooperation between the neurosurgeon and the oromaxillofacial surgeon. Surgical extirpation is the treatment of choice, and various surgical approaches like vertical-dorsal rhinotomy, lateral rhinotomy, transverse rhinotomy, external rhinotomy, and bicoronal flap approach have been advocated. Rut in the case of intracranial extension, the craniofacial approach is required. We report a 5-year-old girl with NDSC who was successfully managed using the external rhinoplasty approach.
Child, Preschool ; Dermoid Cyst* ; Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging ; Nose ; Rhinoplasty

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.
Aged* ; Blood Pressure ; Compliance* ; Drinking ; Friends ; Humans ; Hypertension* ; Logistic Models ; Surveys and Questionnaires ; Spouses

BACKGROUND: The purpose of the research was to find significant factors that were related to the therapeutic compliance of hyper- tension(HT). METHODS: Hypertensive 354 patients from 932 rural elderly were measured blood pressure and administered the questionnaire during August 2003. Operational definition of therapeutic compliance was the state of care and management of HT. The data were analysed by univariate analysis and multivariate regression model. RESULTS: Results of univariate analysis, the seriousness, the barriers, the benefits, and the patients who have family members or friends suffering from HT, the motive of the behavior were significant variables for acceptance rate of the caring HT(p<0.01). Result of multiple logistic regression on participating caring process in HT, significant prediction variable were the subjects who had spouses, long ongoing caring process, no drinking habits, mind set that considers the high blood pressure as a serious disease, families and friends who had complications, didn't feel that taking the medication is not uncomfortable if they haven't experienced the side effect during the caring process. CONCLUSION: According to this result, we should consider major prediction variables to increasing the therapeutic compliance of hypertensive patients and developing the program for controlling hypertensive patients.
Aged* ; Blood Pressure ; Compliance* ; Drinking ; Friends ; Humans ; Hypertension* ; Logistic Models ; Surveys and Questionnaires ; Spouses

BACKGROUND/OBJECTIVES: One of the mechanisms considered to be prevalent in the development of Alzheimer's disease (AD) is hyper-stimulation of microglia. Black chokeberry (Aronia melanocapa L.) is widely used to treat diabetes and atherosclerosis, and is known to exert anti-oxidant and anti-inflammatory effects; however, its neuroprotective effects have not been elucidated thus far. MATERIALS/METHODS: We undertook to assess the anti-inflammatory effect of the ethanolic extract of black chokeberry friut (BCE) in BV2 cells, and evaluate its neuroprotective effect in the lipopolysaccharide (LPS)-induced mouse model of AD. RESULTS: Following stimulation of BV2 cells by LPS, exposure to BCE significantly reduced the generation of nitric oxide as well as mRNA levels of numerous inflammatory factors such as inducible nitric oxide synthase (iNOS), cyclooxygenase 2 (COX-2), interleukin 1 beta (IL-1β), and tumor necrosis factor alpha (TNF-α). In addition, AD was induced in a mouse model by intraperitoneal injection of LPS (250 µg/kg), subsequent to which we investigated the neuroprotective effects of BCE (50 mg/kg) on brain damage. We observed that BCE significantly reduced tissue damage in the hippocampus by downregulating iNOS, COX-2, and TNF-α levels. We further identified the quinic acids in BCE using liquid chromatography-mass spectrometry (LCMS). Furthermore, we confirmed the neuroprotective effect of BCE and quinic acid on amyloid beta-induced cell death in rat hippocampal primary neurons. CONCLUSIONS: Our findings suggest that black chokeberry has protective effects against the development of AD.
Alzheimer Disease ; Amyloid ; Animals ; Atherosclerosis ; Brain ; Cell Death ; Cyclooxygenase 2 ; Ethanol ; Hippocampus ; Inflammation ; Injections, Intraperitoneal ; Interleukin-1beta ; Mice ; Mice, Inbred ICR ; Microglia ; Neurons ; Neuroprotective Agents ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Phytochemicals ; Quinic Acid ; Rats ; RNA, Messenger ; Spectrum Analysis ; Tumor Necrosis Factor-alpha

Various factors such as senescence, stress, neurodegenerative diseases including Alzheimer's disease (AD) contribute to the impairments of organs, especially brain. Also, they should be negative factors on normal brain function, like as memory and cognition. In this study, the neuroprotective role of BF-7, extracted from Bombyx mori, was examined agaist scopolamine-induced neurotoxicity in SK-N-SH cells. In order to know if the BF-7 has positive role on the cognition and memory, we examined using SD rat model and human. Scopolamine-induced memory impairments were observed, as measured by the passive avoidance and water maze tests, but treatment with BF-7 significantly improved memory and cognitive function. Moreover, the memory index and memory preservation of clinical experiments using MMSE-K tests were significantly improved memory and cognitive function. This results strongly represent that the BF-7 play effectively positive role in the improvement of brain function including learning and memory. Taken together, our results suggested that the BF-7 should be useful for developing strategies protecting nervous system and improving brain function.
Aging ; Alzheimer Disease ; Bombyx ; Brain ; Cognition ; Humans ; Learning ; Memory* ; Models, Animal ; Nervous System ; Neurodegenerative Diseases ; Scopolamine Hydrobromide

PURPOSE: Sphincter preservation is one of the main goals in the treatment of rectal cancer. The aim of this study was to evaluate the oncologic safety of a sphincter-saving resection with a distal resection margin of less than 1 cm. METHODS: Two hundred forty-eight patients who underwent a sphincter-saving resection between June 1989 and December 2002 and who had a confirmed distal resection margin of less than 1 cm on pathologic examination were included. All patients were evaluated for local and systemic recurrences. RESULTS: The median follow-up period was 45 (6~144) months. The mean length of distal resection margin was 0.79+/-0.26 cm. Lower rectalcancer was most common (56.5%). Forty patients (16.1%) experienced recurrence. The local recurrence rate was 3.6%, systemic recurrence rate was 11.7%, and the combined local and systemic recurrence rate was 0.4%. In systemic recurrence, the liver was the most common site, followed by the lung. Among stage II & III groups, patients who underwent adjuvant chemoradiotherapy experienced significantly lower local recurrence compared to patients in the chemotherapy-only or the no-adjuvant group (2.6%, 12.9%, 8.7%, P=0.05). The length of distal resection margin, the total mesorectal excision, the location of tumor, sex, histology, and stage were not associated with local recurrence. CONCLUSIONS: A distal resection margin of less than 1 cm in a sphincter-saving resection showed acceptableoncologic outcomes. Adjuvant chemoradiotherapy were beneficial to reduce local recurrence in the stage II and the stage III groups.
Chemoradiotherapy, Adjuvant ; Follow-Up Studies ; Humans ; Liver ; Lung ; Rectal Neoplasms* ; Recurrence