The authors report a surgically treated patient with very unusual combination of a giant posterior fossa cyst in cerebellopontine area, Chiari I malformation and syringomyelia in cervico-thoracic area. Ventricles were not dilated. He complained weakness and clumsiness on the right upper extremity. His symptom was attributable to the syringomyelia of cervical spinal cord. The authors managed this patient by removing the arachnoid cyst and cystoperitoneal shunt on the assumption that this cyst has an influence on the formation of Chiari malformation and syringomyelia. After operation there was marked improvement in the motor power in the arm, and a follow-up MRI one month later showed a disappearance of syringomyelia. The authors believe that this very unusual condition is of interest in making the pathogenesis of syringomyelia clear.
Arachnoid* ; Arm ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Spinal Cord ; Syringomyelia* ; Upper Extremity

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

PURPOSE: To evaluate accuracy of magnetic resonance(MR) imaging for staging of lung cancer and to compare the accuracies of CT and MRI. MATERIALS AND METHODS: We retrospectively analyzed 25 cases of lung cancer, which were confirmed surgically and pathologically. Five experienced radiologists participated in the receiver operating characteristic (ROC) analysis to evaluate and compare accuracies of the CT and MR imaging in preoperative staging of non small cell lung cancer by assessing tumor invasion of bronchus, mediastinum, chest wall, and hilar or mediastinal lymph node metastasis. Imaging results were evaluated against "truth" data based on both surgery and pathologic examination. RESULTS: Sensitivity of CT in distinguishing T3-T4 tumors was 60% ;specificity was 76%. These values for MR imaging were not significantly different(53% and 72%). With ROC analysis, no difference existed between accuracies of CT and MR imaging in diagnosis of bronchial involvement, but MR imaging was significantly more accurate than CT(p<0.05) in diagnosis of mediastinal invasion. There was no significant difference between accuracies of CT and MR imaging in detecting mediastinal node metastasis(N2 or N3); sensitivities were 64% and 78%, respectively, and specificities were 64% and 66%. CONCLUSION: There was no significant difference in accuracies of CT and MR imaging in preoperative tumor classification and assessment of mediastinal node metastasis, but MR imaging was more accurate than CT in assessment of mediastinal invasion.
Bronchi ; Carcinoma, Bronchogenic* ; Classification ; Diagnosis ; Lung Neoplasms ; Lymph Nodes ; Magnetic Resonance Imaging* ; Mediastinum ; Neoplasm Metastasis ; Retrospective Studies ; ROC Curve ; Sensitivity and Specificity ; Small Cell Lung Carcinoma ; Thoracic Wall

Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months(range:31~133 months). Of the 96 patients, 60(63%) were males and 36(37%) were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headache(67%) followed by cerebral motor and sensory discrepancy(54%), nausea and vomiting(34%), seizure (19%), mental change(10%) and memory and calculation impairment(8%). Eighty five(88.5%) patients all, except 11(11.5%) brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas(75%), 4 mixed oligoastrocytomas(5%), and 17 oligodendrogliomas(20%). Fourty nine patients (58%) were grade I,II histology and 36 (42%) patients were grade III, IV histology. Of the 96 patients, 64(67%) recieved postoperative RT and 32(33%) were treated with primary radiotherapy. Gross total resection was performed in 14(16%) patients, subtotal resection in 29(34%), partial resection in 21(25%), and biopsy only in 21(25%). Median survival time was 53 months(range 2~133 months), and 2- and, 5-year survival rate were 69%, 49% respectively. 5-year survival rate by histologic grade was gradeI, 70%, gradeII, 58%, grade III, 28%, and grade IV, 15%. Multivariated analysis demonstrate that age at diagnosis (p=0.121), Karnofsky performance Status(KPS)(p=0.0002), histologic grade(p=0.0001), postoperative radiation therapy(p=0.0278), surgical extent(p=0.024), cerebellar location of tumor(p=0.0095) were significant prognostic factors influencing on survival.
Biopsy ; Brain Stem ; Diagnosis ; Female ; Follow-Up Studies ; Glioma* ; Humans ; Male ; Memory ; Nausea ; Radiation Oncology ; Radiotherapy ; Retrospective Studies* ; Seizures ; Survival Rate

The JNK inhibitor SP600125 strongly inhibits cell proliferation in many human cancer cells by blocking cell-cycle progression and inducing apoptosis. Despite extensive study, the mechanism by which SP600125 inhibits mitosis-related effects in human leukemia cells remains unclear. We investigated the effects of SP600125 on the inhibition of cell proliferation and the cell cycle, and on microtubule dynamics in vivo and in vitro. Treatment of synchronized leukemia cells with varying concentrations of SP600125 results in significant G2/M cell cycle arrest with elevated p21 levels, phosphorylation of histone H3 within 24 h, and endoreduplication with elevated Cdk2 protein levels after 48 h. SP600125 also induces significant abnormal microtubule dynamics in vivo. High concentrations of SP600125 (200 microMeter) were required to disorganize microtubule polymerization in vitro. Additionally, SP600125-induced delayed apoptosis and cell death was accompanied by significant poly ADP-ribose polymerase (PARP) cleavage and caspase-3 activity in the late phase (at 72 h). Endoreduplication showed a greater increase in ectopic Bcl-2-expressing U937 cells at 72 h than in wild-type U937 cells without delayed apoptosis. These results indicate that Bcl-2 suppresses apoptosis and SP600125-induced G2/M arrest and endoreduplication. Therefore, we suggest that SP600125 induces mitotic arrest by inducing abnormal spindle microtubule dynamics.
Anthracenes/*therapeutic use ; Antineoplastic Agents/*therapeutic use ; Apoptosis/*drug effects ; Cell Cycle/drug effects ; Enzyme Inhibitors/therapeutic use ; Humans ; JNK Mitogen-Activated Protein Kinases/*antagonists & inhibitors/*metabolism ; Leukemia/drug therapy ; Tubulin/*metabolism

OBJECTIVE: The aim of this study was to assess the gender differences in the clinical presentation and treatment patterns between Korean women and men with ankylosing spondylitis (AS). METHODS: We retrospectively analyzed the data from extensive clinical assessments of 721 patients (162 women and 559 men) with AS, who were diagnosed at Seoul St. Mary's Hospital, between January 2000 and September 2009. Clinical data, regarding the disease onset, disease duration, clinical presentations, status of human leukocyte antigen (HLA)-B27, and bone mineral density, were determined using a dual-energy X-ray absorptiometry (DEXA). Finally, we analyzed the medical treatments prescribed for these patients. RESULTS: The ratio of men to women was 3.45:1. Compared to men, women were older at the time of diagnosis, had shorter disease durations, and were diagnosed in earlier stages of the disease. More women had a history of uveitis at diagnosis than men. Back pain was the main presenting symptom, and its prevalence was the same in both genders. Fewer women showed cervical and thoracic axial involvement than men. Initially, more women had wrist and hand pain than men; however, at some point, peripheral arthritis development was equally likely in both genders. Women experienced shoulder pain, during the disease course, more often thanmen. On the other hand, men presented with knee and hip pain more often than women. Sulfasalazine and anti-TNF agents were more often prescribed to women. CONCLUSION: The presentation and progression of AS showed a difference between women and men. Because of these differences, AS should be considered when a women presents with peripheral arthritis or uveitis in the early stage of the disease.
Absorptiometry, Photon ; Arthritis ; Back Pain ; Bone Density ; Female ; Hand ; Hip ; Humans ; Knee ; Leukocytes ; Male ; Prevalence ; Retrospective Studies ; Shoulder Pain ; Spondylitis, Ankylosing ; Sulfasalazine ; Uveitis ; Wrist

A beneficial radioprotective agent has been used to treat the radiation-induced lung injury. This study was performed to investigate whether curcumin, which is known to have anti-inflammatory and antioxidant properties, could ameliorate radiation-induced pulmonary inflammation and fibrosis in irradiated lungs. Rats were given daily doses of intragastric curcumin (200 mg/kg) prior to a single irradiation and for 8 weeks after radiation. Histopathologic findings demonstrated that macrophage accumulation, interstitial edema, alveolar septal thickness, perivascular fibrosis, and collapse in radiation-treated lungs were inhibited by curcumin administration. Radiation-induced transforming growth factor-beta1 (TGF-beta1), connective tissue growth factor (CTGF) expression, and collagen accumulation were also inhibited by curcumin. Moreover, western blot analysis revealed that curcumin lowered radiation-induced increases of tumor necrosis factor-alpha (TNF-alpha), TNF receptor 1 (TNFR1), and cyclooxygenase-2 (COX-2). Curcumin also inhibited the nuclear translocation of nuclear factor-kappa B (NF-kappaB) p65 in radiation-treated lungs. These results indicate that long-term curcumin administration may reduce lung inflammation and fibrosis caused by radiation treatment.
Animals ; Blotting, Western ; Collagen ; Connective Tissue Growth Factor ; Curcumin ; Cyclooxygenase 2 ; Edema ; Fibrosis ; Inflammation ; Lung ; Lung Injury ; Macrophages ; Pneumonia ; Rats ; Receptors, Tumor Necrosis Factor ; Tumor Necrosis Factor-alpha

OBJECTIVES: This study was conducted to implement Health Plus Happiness Plus projects in Gyeongsangnam-Do and assess the policy implications of initiatives to address regional health inequalities. METHODS: Health Plus Happiness Plus projects were started as strategies to address regional health inequalities in Gyeongsangnam-Do. The principles of these projects are taken from the Health Action Zones initiatives in England: participation, partnership, resource concentration in project areas. The time period for these projects is from 2010 to 2017, and the total budget is 5.6 billion won. In 2010, a 6.8 hundred million won total budget was invested in 17 project areas. Such investments fell into four broad categories: establishment of the means and local framework; survey development to analyze the health determinants; development of an education and training center; and establishment of a technical support center. RESULTS: Education and training programs for practitioners and coordinators were provided, and project teams and project promotion committees were established in project areas. Health survey result briefing meetings were held, and 17 health committees were established in project areas. CONCLUSIONS: Health Plus Happiness Plus projects have some problems in relation to participation and partnerships, however, if these principled projects are performed continuously, they will contribute to a reduction of standardized mortality rate and regional health inequalities in Gyeongsangnam-Do and the improvement of residents' well-being in project areas.
Budgets ; Happiness ; Health Surveys ; Investments ; Socioeconomic Factors

PURPOSE: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. MATERIALS AND METHODS: During 1998~1999, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. RESULTS: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered 3~4 times. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). CONCLUSION: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.
Brachytherapy ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Cisplatin ; Drug Therapy ; Endoscopy ; Esophageal Neoplasms* ; Esophagitis ; Female ; Fluorouracil ; Humans ; Korea* ; Male ; Photons ; Radiotherapy ; Republic of Korea ; Tomography, X-Ray Computed

Objective: To investigate the antibacterial activity of SHH extracted with either water or ethanol against methicillin-resistant Staphylococcus aureus (MRSA) and combinatory antimicrobial effect with ciprofloxacin (CIP) by time kill assay and checkerboard dilution test. Methods: The antibacterial activity determined by broth dilution method indicated that the antibacterial activity of Sami-Hyanglyun-Hwan (SHH) water extract (SHHW) and SHH ethanol extract (SHHE) ranged from 250 to 2. 000 μg/mL and 125 to 1. 000 μg/mL against MRSA, respectively. Results: In the checkerboard method, the combinations of SHHE with CIP had a partial synergistic or synergistic effect against MRSA. The time-kill curves showed that a combined SHHE and CIP treatment reduced the bacterial counts dramatically after 24 h. Conclusions: The present study demonstrates the therapeutic ability of SHHE against MRSA infections.