No abstract available.
Animals ; Mice* ; Oocytes*

PURPOSE: Conventional MRI may not visualize the structural abnoramlity in large proportion of patients with intractable extratemporal lobe epilepsy. METHODS: Five patients with intractable extratemporal lobe epilepsy underwent resective surgery. Preoperatively, all patients underwent video-EEG monitoring using extracranial electrodes and MRI. Three had PET scans and four had MRS. 3D-reconstruction of the MRI was performed in all patients. Then, subdural grid electrodes were implanted on the suspected lesion in 3D-reconstructed brain; One had bitemporal depth electrodes insertion, and subdural grid electrodes implantation on bilateral frontal lobe. Two had frontal resection and including supplementary sensorimotor area in one. Parietal and parieto-temporal resection was performed in each. One had partial occipital lobe resection. RESULTS: All had complex partial seizures and four of them had lateralizing signs. Standard surface EEG recordings were not reliable in lateralizing or localizing the epileptogenic zone in any of patients. Conventional MRI revealed subtle abnormality in the superior parietal lobule, and atrophic changes in parietal lobe and posterior portion of the superior temporal gyrus, in each. Three did not show any structural abnormalities. MRS showed abnormal NAA/Ch: Cr ratio in two; one in the lesion and one in the bilateral hipocampus. PET showed hypometabolism in the extensive area in three with limitation in localizing the epileptogenic zone. All had abnormal gyral and sulcal paterns in 3D-reconstructed brain; two in the frontal lobe, superior parietal lobule, and inferior parietal and posterior portion of the superior temporal gyrus, in each, and one in the occipital lobe. Histopathologic findings revealed cortical dysplasia in all. Three were seizure free and two were class I in Engel's classification during follow-up between 4 to 24 months. CONCLUSIONS: This study suggests that in the surgical treatment of the extratemporal lobe epilepsy without prominent abnormalities in conventional MRI, 3D-reconstruction of the MRI may be of value in localizing the epileptogenic zone.
Brain ; Classification ; Electrodes ; Electroencephalography ; Epilepsy ; Follow-Up Studies ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging* ; Malformations of Cortical Development ; Occipital Lobe ; Parietal Lobe ; Positron-Emission Tomography ; Rabeprazole ; Seizures

OBJECTIVE: The present study was undertaken to examine the effects of magnesium ion in the culture medium on the development of mouse fertilized oocytes either before or after pronuclear formation, and to investigate whether the effect of magnesium ion is related with the redistributional change of mitochondria. METHODS: Fertilized oocytes obtained from the oviducts of mice at 15 hr after hCG injection before pronuclear formation (pre-PN) or 21 hr after hCG injection after pronuclear formation (post-PN) were used. The embryos were cultured for 3 days with basic T6 medium-magnesium free and various concentrations of magnesium ion, 0.0, 0.5, 1.0, 2.0, 4.0 or 8.0 mM, respectively. After culture, the developmental stages of embryos and the number of nuclei were evaluated. To observe the effects of magnesium ion on the mitochondrial distribution, fertilized oocytes were collected at 21 hr after hCG injection and cultured for 6 hr with various concentration of magnesium ion. As a control, fertilized oocytes with pronuclei at 27 hr after hCG injection were used. RESULTS: The concentration of magnesium ion to accelerate the in vitro development of mouse fertilized oocytes appeared to be at 2.0 mM for the pre-PN and the post-PN stage embryos. In the mitochondrial redistribution patterns, the embryos cultured in 2.0 mM concentration of magnesium ion showed the highest percentage (22.6%) of distinct perinuclear clustering pattern comparing to other experimental group. CONCLUSION: The effect of magnesium ion may be related to the cytoplasmic redistribution of mitochondria. This relationship seems to connect the developmental competence of preimplantation mouse embryos in vitro. These results can suggest that higher concentration of magnesium ion (2.0 mM) than those of conventional culture medium (0.2~1.2 mM) is more suitable for in vitro culture of preimplantation mouse embryos.
Animals ; Cytoplasm ; Embryonic Structures* ; Magnesium* ; Mental Competency ; Mice* ; Mitochondria ; Oocytes ; Oviducts

PURPOSE: To analyze the optical coherence tomographic patterns and clinical courses of patients with diabetic macular edema (DME) after treatment. METHODS: The charts of 65 patients with DME were retrospectively reviewed. Baseline optical coherence tomographic patterns of DME were categorized into the 4 groups: group 1 (9 eyes, 13.8%) showed diffuse retinal thickening, group 2 (21 eyes, 32.3%) had cystoid macular edema (CME), group 3 (13 eyes, 20.0%) demonstrated serous retinal detachment (SRD) and group 4 (22 eyes, 33.9%) had combined CME and SRD. Treatments for DME included intravitreal bevacizumab/triamcinolone injection, focal laser photocoagulation and vitrectomy. During 12 months of follow-up, changes in the patterns of DME were assessed. Additionally, the central retinal thickness (CRT) and best-corrected visual acuity (BCVA) were measured at baseline, 6 and 12 months. RESULTS: During 12 months of follow-up, 21 eyes (32.3%) showed changes in the DME pattern: 2 eyes (22.2%) in group 1, 3 (14.3%) in group 2, 4 (30.8%) in group 3 and 12 (54.5%) in group 4. A significantly greater proportion of eyes with changes in DME pattern underwent vitrectomy compared with those without changes in DME pattern (p = 0.012). There was a significant difference in CRT among the 4 groups; group 4 demonstrated the largest CRT at baseline, 6 and 12 months (p < 0.001, 0.002 and 0.029, respectively). However, there were no significant differences in BCVA among the 4 groups at baseline, 6 or 12 months (p = 0.879, 0.375 and 0.246, respectively). CONCLUSIONS: Clinical courses varied according to the tomographic patterns of DME after treatment, and the poorest anatomic outcome was found in group 4. Change in tomographic pattern of DME was correlated with the treatment of DME, which might suggest a poorer outcome in those patients than in the patients who maintained their DME patterns.
Follow-Up Studies ; Humans ; Light Coagulation ; Macular Edema* ; Prognosis ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy

Speech lateralization by Wada is a necessary step in the presurgical evaluation of patients with intractable epilepsy. It, however, is invasive. We studied the usefulness of a noninvasive technique: MRI-based volumetric and anatomical analysis of the anterior speech area as compared to Wada test. Thirty nine patients with intractable epilepsy under presurgical evaluation includding Wada test for hemispheric lateralization for language, were studied: patients with left language dominance(n=20) and right language dominance (n=19). Sagittal and coronal T1-weighted turbo FLASH scans were acquired. Every image in each patient was reconstructed and inferior frontal gyrus was identified on the 3D-surface rendered brain. Then cortical gray matter of inferior frontal gyrus in each image was segmented and reconstructed using a 3D software(Allegro, ISG, Toronto, Canada). Sulcal and gyral patterns of the inferior frontal gyrus were evaluated and classified comparing with the normotive data of Steinmetz. Total volume of inferior frontal gyrus(ifg), regional volumes of pars triangularis(tr) and pars opercularis(op) were obtained. Asymmetry Quotient(AQ) of inferior frontal gyrus, (right-left)/0.5(right+left), between left and right were calculated in each patient. AQ from both groups of patients were compared and data was analysed. Complicated gyral pattern and presentation of a diagonal sulcus in the pars opercularis were prominent in the left side in patients with the left hemispheric dominance for language(p<0.006, p<0.02), and in the right side in patients with the right hemispheric dominance(p<0.002, p<0.03). In patients with language dominance in the left hemisphere, AQ of each portion of anterior speech area showed significant leftward asymmetry(M: Mean, SEM: Standard Error of Mean, Mifg=-.24; SEMifg=0.04, Mtr=-.19; SEMtr=0.09, Mop=-.26; SEMop=0.06). In patients with language dominance in the right hemisphere, AQ showed mild rightward asymmetry or no asymmetry(Masa=0.21; SEMifg=0.06, Mtr=0.15; SEMtr=0.08, Mop=0.24; SEMop=0.09). Fisher's Exact test demonstrated significant value of AQ in each portion of inferior frontal gyrus correlated with hemispheric dominance for language with confidence index(CI)in 95%. Interestingly, AQ of pars triangularis plus pars opercularis showed the highest value(p=0.00001) in predicting the language dominant hemisphere. MRI-based sulcal, gyral patterns and volumetric asymmetry of inferior frontal gyrus correlate with speech lateralization on Wada test. This is a promising noninvasive technique in hemispheric lateralization for language.
Brain ; Epilepsy ; Humans

A schwannoma is a benign neoplasm that is composed of a relative pure proliferation of Schwann cell and constitutes 1% of orbital tumors. Most series report patient age between 20 and 50 year. There was no case report with the schwannoma of nenonate in the domestic and the abroad except two cases in the childhood age group. We experienced a schwannoma which diagnosed by microscopic and immunohistochemical S-100 protein stain in neonate who does not open his eye and present a case with a review of the literature.
Humans ; Infant, Newborn* ; Neurilemmoma* ; Orbit* ; S100 Proteins

Paragonimus westermani can cause extrapulmonary parasitism in various sites such as abdominal organ, brain, eye, periorbital tissue, heart and pericardium, mediastinum, and subcutaneous tissue. We experienced a case of subcutaneous paragonimiasis involving the breast. The lesion exhibited chronic granuloma with scattered eggs of paragonimus westermani. The adult worm was not found within the lesion which should be disintegrated a year ago by praziquantel treatment. This relatively rare involvement of ectopic paragonimiasis should be differentiated from breast malignancy.
Adult ; Male ; Female ; Humans

No abstract available.
Adult* ; Hernia* ; Humans

Purpose: This study evaluated the short-term safety of resident-performed intravitreal injections. Methods: We retrospectively reviewed the medical records of 503 patients (503 eyes) treated for the first time in our hospital from January 2018 to October 2020 via intravitreal bevacizumab, ranibizumab, aflibercept, or triamcinolone acetonide injections by residents or retina specialists. In terms of short-term ophthalmic complications, patients were followed-up 1 day, 1 week, and 1 month after injection. Results: A total of 503 eyes of 503 patients were included. Intravitreal injections were given to 211 and 292 eyes by residents (the resident group) and retina specialists (the retina specialist group), respectively. There were no between-group differences in baseline characteristics except in terms of the indications for injection. Intraocular pressure elevation >5 mmHg occurred in two eyes (0.95%) in the resident group and five (1.71%) in the retina specialist group, but the difference was not statistically significant. Subconjunctival hemorrhage occurred in 29 eyes (13.74%) of the resident group and 32 eyes (10.96%) of the retina specialist group; again, the difference was not statistically significant. No case of noninfectious endophthalmitis occurred in the resident group but two (0.68%) cases occurred in the retina specialist group; again, the difference was not significant. There were two (0.95%) cases of infectious endophthalmitis in the resident group and one (0.34%) case in the retina specialist group; again, the difference was not significant. No corneal erosion, traumatic lens damage, vitreous hemorrhage, or retinal tearing or detachment were noted in either group. Conclusions Resident-performed intravitreal injections appear to be safe.