BACKGROUND: The clinical and electroencephalographic differentiation of the mesial temporal lobe epilepsy (MTLE) and neocortical temporal lobe epilepsy (NTLE) may have a practical value. Until now, a few comparative studies reported some relatively minor differences between the two groups. We investigated the clinical history, interictal and ictal electroencephalographic (EEG) patterns to differentiate NTLE from MTLE. METHODS: Twenty two patients with medically refractory MTLE and fourteen patients with isolated neocortical lesions were recruited. The interictal and ictal scalp EEG patterns were compared in terms of the interictal EEG distribution patterns of epileptiform discharges, focal slow waves (ipsilateral/contralateral refers to side of pathology), and the frequencies of ictal discharges on EEG at seizure onset. RESULTS: Interictal EEG patterns of epileptiform discharges and focal slow waves were recorded most often at the ipsilateral or bilateral sphenoidal electrodes in both groups without significant differences. Ictal EEG onset with rhythmic theta waves was significantly more frequent in MTLE (72.3%) than in NTLE (36.7%), but ictal EEG onset with rhythmic alpha waves and those with rhythmic beta waves were significantly more frequent in NTLE (33.3%, 20.0%, respectively) than in MTLE (10.8%, 1.2%, respectively). Initial ictal EEG patterns appeared more frequently at the sphenoidal electrodes in both groups (MTLE:73.5%, NTLE:60.0%). Initial ictal EEG patterns of the bilateral hemisphere, ipsilateral hemisphere or ipsilateral diffuse temporal area were seen only in NTLE (16.7%, 3.3%, 10% respectively), but not in MTLE. CONCLUSIONS: This study showed that the initial ictal patterns and the frequency of ictal onset were significantly different in MTLE and NTLE. These differences could give a practical help in diagnosing MTLE and NTLE.
Electrodes ; Electroencephalography ; Epilepsy, Temporal Lobe* ; Humans ; Scalp* ; Seizures ; Temporal Lobe*

Uterine sarcoma whieh is originated from uterine muscle and/or connective tissues, is very rare malignant tumor and is the most lethel of all primary uterine tumors. This study was undertaken to correlate the clinieal findings, diagnoses, managements and ultimate outcome of each particluar grouy of uterine sarcoma at Depart,ment of Obstetrics and Gynecology in Korea University Hospital. The reaults were as follows, 1. The distribution of uterinesarcomaby histologic type was 5 cases (35.7%) for leiomyosarcoma, 5 cases (35.7%) for endometrial strornal sarcoma and 4 eases (28.6%) for mixed Mullerian tumor, 2. The mean age and yarity were 50.8 years and 3.1. 3. The most common syrrlptorn was irregular vaginal bleeding (64.3%), and lower abdominal pain (21.4%), abdominal palpable mass (14.3%) in order of frequency. 4. The distribution by YIGO clinical atage was 35.7% for stage I, 35.7% for stage II, 7.2% for stage IE and 21.4% for stage lV. The average survival time of each stage of disease was decreased with increasing stage. 5. The mean survival time was decreased with inereasing numbers of mitotic figure per 10 high power fields. 6. The mean survival time according to histologc type was 14.5 months for leiomyoaarcoma, 21.5 months for endometrial stromal marcoma, 5.8 months for malignant mixed Mullerian tumor, respectively.
Abdominal Pain ; Animals ; Connective Tissue ; Diagnosis ; Female ; Gynecology ; Korea ; Leiomyosarcoma ; Mice ; Myometrium ; Obstetrics ; Sarcoma* ; Survival Rate ; Uterine Hemorrhage ; Uterus*

No abstract available.
Actinomycosis*

Valproic acid is a commonly prescribed medication approved for epilepsy, migraine and bipolar disorder. The common adverse effects associated with valproic acid include nausea, vomiting, tremor and weight gain. Less common but more serious adverse effects can occur. These include irreversible hepatotoxicity and pancreatitis. We report one case of pancreatitis, an uncommon disorder in children, in an 11-year-old boy treated with valproic acid for simple partial seizure.
Bipolar Disorder ; Child ; Epilepsy ; Humans ; Male ; Migraine Disorders ; Nausea ; Pancreatitis* ; Seizures ; Tremor ; Valproic Acid* ; Vomiting ; Weight Gain

BACKGROUND: The Wada test is not yet standardized among epilepsy surgery centers, which makes it difficult to dis-cern the differences between its results. The objectives of this study were to examine the effects of memory stimulus types in the Wada test and the methods of score measurement of results. METHODS: We examined the Wada test in 59 patients with temporal lobe epilepsy who had language dominancy in left hemispheres. They underwent surgical treat-ment and were seizure-free for at least until the 1-year follow up. The Wada test was done on the patients using three different protocols during the presurgical evaluations: 1) protocol A; sixteen cards displaying eight line drawings of common objects and eight words, 13 patients, 2) protocol B; eight line drawings of abstract figures, 14 patients, and 3) protocol C; four line drawings of common objects and four line drawings of abstract figures, 32 patients. RESULTS: Thirty-three patients with RTL (right temporal lobectomy) and 26 patients with LTL (left temporal lobectomy) were not significantly different in demographic and disease characteristics such as age and sex, age at onset, risk factors before 2 years old, epilepsy duration, and Korean Wechsler Adult Intelligence Scale- IQ scores. Patients with RTL rec-ognized significantly more words and line drawings of common objects with a right injection than those with a left injection. Patients with LTL recognized significantly more line drawings of abstract figures and common objects fol-lowing a left injection versus a right injection. Correct rates obtained through discriminant function analysis (100% (A), 64% (B) and 84% (C) were higher than that obtained through cutoff criteria (memory asymmetry scores (3)25%: 82% (A), 62% (B) and 56% (C) ). CONCLUSIONS: Our study shows that line drawings of common objects as Wada memory stimuli are more useful for the lateralization of the epileptogenic hemisphere than line drawings of abstract figures and words. Discriminant function analysis is also a more effective score measurement than cutoff criteria.
Adult ; Child, Preschool ; Epilepsy ; Epilepsy, Temporal Lobe* ; Follow-Up Studies ; Humans ; Intelligence ; Memory* ; Risk Factors ; Temporal Lobe*

BACKGROUND/AIMS: Multiple myeloma (MM)–associated cardiac damage, particularly according to the type of monoclonal (M) protein has not been elucidated. We sought to investigate relationship between elevated serum M protein levels and echocardiographic indices of cardiac structure and function in patients with MM. METHODS: We evaluated a total of 184 consecutive MM patients who underwent echocardiography for bone marrow pre-transplant screening. Serum levels of intact immunoglobulin M protein and free light chain kappa/lambda (FLC-κ/-λ) were measured. RESULTS: One hundred thirty-nine patients were non-light chain MM (non-LCMM) and 45 patients belonged to LCMM. In patients with non-LCMM, significant correlations were found between serum M protein and left atrial volume index (LAVi; r = 0.720, p < 0.0001), E/e’ (r = 0.511, p < 0.0001), and systolic pulmonary arterial pressure (r = 0.485, p < 0.0001). In patients with LCMM, log-transformed FLC-λ (log-λ) was correlated with left ventricular ejection fraction (LVEF, r = –0.536, p = 0.010), left ventricular (LV) end-systolic dimension (r = 0.500, p = 0.018), and LV end-systolic volume (r = 0.444, p = 0.038). On multivariate analyses, hematocrit and serum M protein were independent predictors of LAVi in patients with non-LCMM. In patient with LCMM, FLC-λ isotype was only found to be an independent determinant of LVEF. CONCLUSIONS: An increase in serum M protein was associated with LV diastolic dysfunction, whereas an increase in serum FLC-λ concentration showed a negative correlation with the echocardiographic parameters of LV systolic function. These findings also suggest that serum M protein has different effects on LV function according to the type of paraproteins in patients with MM.
Arterial Pressure ; Bone Marrow ; Echocardiography ; Hematocrit ; Humans ; Immunoglobulin M ; Mass Screening ; Multiple Myeloma* ; Multivariate Analysis ; Paraproteins ; Stroke Volume ; Ventricular Function, Left*

BACKGROUND/AIMS: Multiple myeloma (MM)–associated cardiac damage, particularly according to the type of monoclonal (M) protein has not been elucidated. We sought to investigate relationship between elevated serum M protein levels and echocardiographic indices of cardiac structure and function in patients with MM. METHODS: We evaluated a total of 184 consecutive MM patients who underwent echocardiography for bone marrow pre-transplant screening. Serum levels of intact immunoglobulin M protein and free light chain kappa/lambda (FLC-κ/-λ) were measured. RESULTS: One hundred thirty-nine patients were non-light chain MM (non-LCMM) and 45 patients belonged to LCMM. In patients with non-LCMM, significant correlations were found between serum M protein and left atrial volume index (LAVi; r = 0.720, p < 0.0001), E/e’ (r = 0.511, p < 0.0001), and systolic pulmonary arterial pressure (r = 0.485, p < 0.0001). In patients with LCMM, log-transformed FLC-λ (log-λ) was correlated with left ventricular ejection fraction (LVEF, r = –0.536, p = 0.010), left ventricular (LV) end-systolic dimension (r = 0.500, p = 0.018), and LV end-systolic volume (r = 0.444, p = 0.038). On multivariate analyses, hematocrit and serum M protein were independent predictors of LAVi in patients with non-LCMM. In patient with LCMM, FLC-λ isotype was only found to be an independent determinant of LVEF. CONCLUSIONS: An increase in serum M protein was associated with LV diastolic dysfunction, whereas an increase in serum FLC-λ concentration showed a negative correlation with the echocardiographic parameters of LV systolic function. These findings also suggest that serum M protein has different effects on LV function according to the type of paraproteins in patients with MM.
Arterial Pressure ; Bone Marrow ; Echocardiography ; Hematocrit ; Humans ; Immunoglobulin M ; Mass Screening ; Multiple Myeloma* ; Multivariate Analysis ; Paraproteins ; Stroke Volume ; Ventricular Function, Left*

BACKGROUND: We hypothesized that intermittent pneumatic compression device (IPCD) compression system might induce more decreases on the core temperature by increasing the lower extremity blood flow. This study investigated the effects of IPCD compression system on the body temperature in patients undergoing minor surgery under propofol-remifentanil anesthesia. METHODS: Forty female patients were randomly assigned to treat with either elastic stockings (ES group, n = 20) or IPCD (IPCD group, n = 20). Anesthesia was induced and maintained with propofol and remifentanil. The core temperature and arteriovenous shunt in the lower leg were measured using esophageal temperature and the calf to toe skin-surface temperature gradient, respectively. The measurements were taken at 15-minute intervals immediately after anesthesia induction (baseline values, T0) until the end of the surgery. RESULTS: During the study period, the core temperature and skin temperature gradient were comparable between the two groups. The core temperature decreased from 60 min in both groups. And, skin-surface temperature gradient decreased from 15 min in the IPCD group and 30 min in the ES group after anesthesia induction, without intergroup differences across time. CONCLUSIONS: This study demonstrated that the IPCD system did not affect the change in the core temperature when compared to the ES, in patients undergoing minor surgery during propofolremifentanil anesthesia. Thus, the IPCD system could be safely used during propofol-remifentanil anesthesia, without increasing the risk of the intraoperative hypothermia.
Anesthesia ; Body Temperature ; Female ; Humans ; Hypothermia ; Leg ; Lower Extremity ; Piperidines ; Propofol ; Skin Temperature ; Stockings, Compression ; Surgical Procedures, Minor ; Toes

OBJECTIVES: Schizophrenic patients have been reported to be associated with abnormal performance on a broad range of neuropsychological tests. But it has been a persistent controversy in the neuropsychology of schizophrenia whether this disorder is characterized by generalized deficits or specific deficits. The purpose of this study was to investigate, using standardized Benton Neuropsychological Assessment(BNA), whether the specific pattern of neurocognitive deficits is found in schizophrenics. METHODS: The subjects were composed of (1) 30 schizophrenic inpatients who were diagnosed as paranoid subtype according to DSM-IV diagnostic criterior and (2) 30 normal subjects with matching demographic variables(i.e. age, sex, educational level). All tests of BNA were given to schizophrenic patients and normal subjects, and the performances of schizophrenic patients and normal subjects were compared on all aspects of BNA. Schizophrenic symptoms were assessed via Positive and Negative Syndrome Scale(PANSS) to determine the relationship between clinical symptoms and schizophrenic cognitive deficits. RESULTS: Of 12 tests of BNA, schizophrenic patients' performances on Serial Digit Learning(SDL), Facial Recognition Test(FR), Tactile Form Perception(TFP), Finger Localization(FL) were significantly lower than those of normal subjects. In addition, schizophrenic patients showed significantly lower performances than those of normal subjects on Right Hand, Left Hand, Identification of two simultaneously touched fingers of FL, and more Peripheral Error on Visual Form Perception Test(VFPT). Finally, no significant correlation was found with respect to the relationships between total scores, positive symptom scores, negative symptom scores of PANSS, and all scores of BNA tests in schizophrenic patients. CONCLUSION: These results suggest that schizophrenic patients may have a specific pattern of neurocognitive deficits in verbal working memory, learning, attention, and complex sensory information processing in visual and haptic modality such as facial perception skills, tactile information processing, independent of psychotic symptoms. The pattern of deifcits is at least in partial, in agreement with many previous study results. On the tests of linguistic functions, visuospatial perception, and constructional abilities, schizophrenic patients' performances were not significantly different from those of normal subjects. The findings on visuospatial perception and constructional abilities imply that some posterior cortical zones may be relatively uncompromised in schizophrenia. Both poor performances on object recognition tests relative to normal performances on object location tests and verbal working memory dysfunction may be associated with the putative dysfunction of the reciprocal connections either (1) between the prefrontal and parietal cortex or (2) between the prefrontal cortex and hippocampal formation. This tentative explanation remains to be confirmed.
Automatic Data Processing ; Diagnostic and Statistical Manual of Mental Disorders ; Fingers ; Form Perception ; Hand ; Hippocampus ; Humans ; Inpatients ; Learning ; Linguistics ; Memory, Short-Term ; Neuropsychological Tests ; Neuropsychology ; Prefrontal Cortex ; Rabeprazole ; Schizophrenia*

BACKGROUND: Cryosurgery was recently introduced as a treatment for varicose veins in the lower extremities. Cryosurgery with freezing probes can be used to remove the great saphenous vein (GSV) via an inguinal incision alone. The aim of this study was to assess early outcomes and the feasibility of cryosurgery for varicose veins. MATERIALS AND METHODS: Forty patients were enrolled in the present study from March 2009 to July 2010. All patients underwent careful physical examinations, and their GSV reflux was demonstrated by duplex ultrasonography. Clinical severity was measured according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification. The impaired GSVs were removed with rigid cryoprobes after freezing. Patients had follow-up appointments at 1 week, 1 month, 3 months, and 6 months after surgery. Sclerotherapy was performed during follow-up on an outpatient basis as needed. RESULTS: A total of 19 men and 21 women were enrolled. The mean follow-up duration was 3.4 months (range, 1 to 12 months). The clinical severity ranged from CEAP 2 to CEAP 6a. Thirty-eight patients underwent concomitant phlebectomy during surgery. No recurrences were reported during follow-up. There were three cases of minor complications. Two patients had paresthesia, and one had thrombophlebitis. CONCLUSION: Using cryosurgery techniques to treat varicose veins, the complication rates were minimal and outcomes were comparable to those of previous reports. This procedure is a safe and feasible treatment modality for varicose veins.
Appointments and Schedules ; Cryosurgery ; Female ; Follow-Up Studies ; Freezing ; Humans ; Lower Extremity ; Male ; Outpatients ; Paresthesia ; Physical Examination ; Recurrence ; Saphenous Vein ; Sclerotherapy ; Varicose Veins