BACKGROUND: To clarify the clinicoradiological correlation and prognosis of acute ischemic stroke involving para-median territory of pons. METHODS: We studied 37 patients with first-ever ischemic stroke involving paramedian terri-tory of pons and divided them based on the shape and level of lesion shown in their MRI. The clinical features, MRI findings, and prognosis were assessed. RESULTS: The paramedian infarctions extending to the basal surface were found in 28 patients (76%), and small infarctions separated from the basal surface were found in 9 patients (24%). In patients with infarction extending to the basal surface, 23 patients (82%) had progressive or fluctuating onset, whereas all patients with small infarction separated from the basal surface had non-progressive onset. In the group with upper pon-tine lesion (14 patients), dysarthria-clumsy hand syndrome was found in 4 patients, ataxic hemiparesis (AH) in 3, pure motor hemiparesis (PMH) in 2, and pure sensory stroke in 1. In the group with middle and lower pontine lesion (22 patients), PMH was found in 9, AH in 3, and sensory motor stroke in 2. The mean Modified Rankin Disability Scale scores on admission and after follow-up (mean 29 months) of the group with upper pontine lesion were 2.36 +/-0.50 and 1 . 0 0 +/-0.55, those with mid-lower pontine lesions, 3.48 +/-0.51 and 1.17 +/-0.49 (P<0.01 and P>0.05 respectively). CONCLUSIONS: Paramedian pontine infarction extending to the basal surface usually presents with progressive onset. Paramedian pontine infarction most often produces classic lacune syndrome of which PMH is the most common. In our study, patients with mid-lower paramedian pontine infarction had more severe initial neurological deficits than those with upper paramedian pontine infarction. However, a late outcome was found to be favorable in both groups.
Follow-Up Studies ; Hand ; Humans ; Infarction* ; Magnetic Resonance Imaging ; Paresis ; Pons ; Prognosis* ; Stroke

OBJECTIVE: The aim of this study was to test the psychometric properties of Korean version of 10 items of Drug Attitude Inventory (KDAI-10). METHODS: A total of 157 stabilized schizophrenic patients were entered into the study after completion of screening tests. They completed the KDAI-10. And then they were interviewed with various scales such as Subjective Response Scale (SRS), Positive and Negative Syndrome Scale (PANSS), Extrapyramidal Side Effects Rating Scale (ESRS), and Global Assessment of Functioning (GAF). Correlations of KDAI-10 with these scales were tested. RESULTS: The Cronbach's alpha used to measure the internal consistency of the scale, was high (0.83). Principal component analysis with varimax rotation produced 2 factors, which explained 50.37% of the total variances. The First factor including 6 items was the positive subjective feelings and the second factor including 4 items was the negative subjective feelings, which were identical to the original authors'. Individual item correlations with total scores were all statistically significant (r=0.48-0.72, p<.001). And correlations of KDAI-10 with SRS, PANSS, ESRS and GAF showed that they were significantly correlated. CONCLUSION: Although the results were not quite satisfactory, KDAI-10 was demonstrated to have good reliability and construct validity.
Humans ; Mass Screening ; Principal Component Analysis ; Psychometrics* ; Schizophrenia ; Weights and Measures

PURPOSE: Several studies suggest that tumor angiogenesis is a significant prognostic factor in carcinoma of the breast, lung, prostate, oral cavity, and colon. We assessed whether intensity of tumor angiogenesis, as measured by microvessel counts in histologic sections, correlates with prognosis in patients with stage III gastric cancer. MATERIALS AND METHODS: Paraffin-embedded sections from 49 patients (23 stage IIla, 26 stage IIIb) with primary gastric cancer that had been completely removed were analyzed for angiogenesis. Vessels were stained with anti-factor VIII polyclonal antibody, and areas with the most discrete microvessels were counted in a 200X field. RESULTS: Patients with stage IIIa gastric cancer had fewer microvessels than those with stage IIIb gastric cancer (32.8+-14.5 vs. 40.3+-16.1, P=0.106). The mean microvessel count from patients who were alive were significantly lower than that from patients who had died at the time of follow-up (24.8+-10.0 vs. 42.9+- 14.5, P=O.OOO). The 5-year survival rate of patients with count less than 33 microvessels was higher than that of patients with count more than 33 microvessels (59.9% vs. 11.6%, P= 0.000). On multivariate analysis by Cox proportional hazards model, the microvessel count was a significant prognostic factor of stage III gastric cancer. CONCLUSION: Tumor angiogenesis assessed by microvessel count may be a significant prognostic factor of stage III gastric cancer and may prove valuable in selecting patients with stage III gastric cancer for aggressive adjuvant therapy and closer postoperative follow-up.
Breast ; Colon ; Follow-Up Studies ; Humans ; Lung ; Microvessels ; Mouth ; Multivariate Analysis ; Prognosis* ; Proportional Hazards Models ; Prostate ; Stomach Neoplasms* ; Survival Rate

OBJECTIVE: The purpose of this study was to evaluate the physicochemical properties and cytocompatibility of microporous, spherical biphasic calcium phosphate(BCP) ceramics with a 60/40 hydroxyapatite/beta-tricalcium phosphate weight ratio for application as a bone graft substitute. MATERIALS AND METHODS: Microporous, spherical BCP granules(MGSB) were prepared and their basic characteristics were compared with commercially available BCP(MBCP; Biomatlante, France) and deproteinized bovine bone mineral(Bio-Oss; Geistlich-Pharma, Switzerland, BBP; Oscotec, Korea). Their physicochemical properties were evaluated by scanning electron microscopy, X-ray diffractometry, Fourier-transform infrared spectroscopy, inductively coupled plasma atomic emission spectrometer, and Brunauer-Emmett-Teller method. Cell viability and proliferation of MC3T3-E1 cells on different graft materials were evaluated. RESULTS: MGSB granules showed a chemical composition and crystallinity similar with those in MBCP, they showed surface structure characteristic of three dimensionally, well-interconnected micropores. The results of MTT assay showed increases in cell viablity with increasing incubation times. At 4d of incubation, MGSB, MBCP and BBP showed similar values in optical density, but Bio-Oss exhibited significantly lower optical density compared to other bone substitutes(p < 0.05). MGSB showed significantly greater cell number compared to other bone substitutes at 3, 5, and 7d of incubation(p < 0.05), which were similar with those in polystyrene culture plates. CONCLUSION: These results indicated the suitable physicochemical properties of MGSB granules for application as an effective bone graft substitute, which provided compatible environment for osteoblast cell growth. However, further detailed studies are needed to confirm its biological effects on bone formation in vivo.
Bone Substitutes ; Calcium* ; Cell Count ; Cell Survival ; Ceramics* ; Crystallins ; Microscopy, Electron, Scanning ; Osteoblasts ; Osteogenesis ; Plasma ; Polystyrenes ; Spectrum Analysis ; Switzerland ; Transplants*

Malignancy-related cerebral embolism, which is generally attributed to hypercoagulability, is an uncommon cause of ischemic stroke. However, ischemic stroke developed with intracardiac extension of lung cancer has rarely been reported. We report a case of acute embolic stroke caused by pulmonary adenocarcinoma that invaded the right inferior pulmonary vein and extended into the left atrium. Microembolism developing as a result of lung cancer may have been the cause of stroke in this case.
Adenocarcinoma ; Cerebral Infarction ; Heart Atria ; Intracranial Embolism ; Lung Neoplasms ; Pulmonary Veins ; Stroke ; Thrombophilia

BACKGROUND: The aim of gender verification test is to maintain impartiality among female competitors by excluding males in women's sports competitions. Some microscopic methods such as X-chromatin test and Y-chromatin test had been used for this purpose. Because of their known shortcomings, the methods were replaced with the polymerase chain reaction(PCR)-based test. In this report we describe the assay used in the gender verification during the '99 Kangwon Asian Winter Games. METHODS: Buccal smear samples of 126 female competitors were obtained. These samples underwent digestion with proteinase K, and were followed by boiling treatment with Chelex resin. PCR was performed to detect the sex determining region of Y chromosome(SRY) in order to confirm the femininity, and beta globin region was coamplified for confirming that the DNA was extracted from buccal cells. An X-Y homologous region encoded amelogenin was also amplified so that the femininity could be reconfirmed. RESULTS: No SRY and Y-amelogenin like sequences were amplified in any of samples of 126 female competitors analysed. CONCLUSIONS: Established gender verification method based on PCR amplification of Y chromosomal DNA seems to be superior to others. Sampling is simple. The procedure of extracting DNA is simple, rapid, and does not require multiple tube transfers. False positivity and/or false negativity appear to be less. It appear that this method is useful and reliable for gender verification in international sports events.
Amelogenin ; Asian Continental Ancestry Group* ; beta-Globins ; Digestion ; DNA* ; Endopeptidase K ; Female ; Femininity ; Gangwon-do* ; Humans ; Male ; Polymerase Chain Reaction* ; Sports

BACKGROUND AND PURPOSE: Sleep-disordered breathing (SDB) is suggested to be strongly associated with ischemic strokes. Risk factors, stroke subtypes, stroke lesion distribution, and the outcome of SDB in stroke patients remain unclear in Korea. METHODS: We prospectively studied 293 patients (159 men, 134 women; age 68.4+/-10.5) with acute ischemic stroke. Cardiovascular risk factors, stroke severity, sleep-related stroke onset, distribution of stroke lesions, and 3-month score on the modified Rankin Scale (mRS) were assessed. Stroke severity was assessed by the US National Institutes of Health Stroke Scale (NIHSS) and the mRS. The apnea-hypopnea index (AHI) was determined 6.3+/-2.2 days after stroke onset with the Apnea Link portable sleep apnea monitoring device. RESULTS: The prevalence of SDB (defined as an AHI of > or =10) was 63.1% (111 men, 74 women). Those in the SDB group were older, had higher NIHSS and mRS scores, greater bulbar weakness, and a higher incidence of sleep-associated stroke onset. Among risk-factor profiles, alcohol consumption and atrial fibrillation were significantly related to SDB. The stroke outcome was worse in patients with SDB than in those without SDB. The lesion location and specific stroke syndrome were not correlated with SDB. CONCLUSIONS: SDB is very common in acute cerebral infarction. Different risk-factor profiles and sleep-related stroke onsets suggest SDB as a cause of ischemic stroke. The higher NIHSS score and greater bulbar involvement in the SDB group seem to show the influence of ischemic stroke on the increased SDB prevalence.
Alcohol Drinking ; Aluminum Hydroxide ; Apnea ; Atrial Fibrillation ; Carbonates ; Cerebral Infarction ; Humans ; Incidence ; Male ; National Institutes of Health (U.S.) ; Prevalence ; Prospective Studies ; Risk Factors ; Sleep Apnea Syndromes ; Stroke

OBJECTIVE: Stenotrophomonas maltophilia has been emerging as an important nosocomial pathogen in recent years in patients with impaired host- defense mechanism or who has been exposed to large amount of inocula. This organism is usually resistant to multiple (commonly used) antimicrobial agents, particularly to those of the beta-lactam class. To evaluate the clinical feature of Stenotrophomonas maltophilia infection and in vitro anti- microbial susceptibility, we performed a retrospective study. METHODS: We analyzed the result of in vitro antimicrobial susceptibility test for 200 isolates of S. maltophilia and the annual isolation rate during the period between January 1990 and December 1994 in our institution, and performed a retrospective study for the available records of 165 cases among them. The data were obtained with only the first isolation of the organism for each patients. RESULTS: Total of 165 initial isolates, the isolates were from wounds in 50(30.3%), urine in 47(28.5%), the respiratory tract in 37(22.4%), blood in 9(5.5%), bile in 6(3.6%), and miscellaneous sources in 16(9.7%). The 84.2% of isolates were hospital-acquired isolate and 58.3% of these patients had received antecedent antibiotic therapy: polymicrobial growth was demonstrated in 61.9% of the cases. In vitro antimicrobial susceptibiiity test, ofloxacin was active against the isolates in 89.2%, moxalactam in 85.9%, ciprofloxacin in 83.9%, TMP-SMX(trimethoprim-sulfamethoxazole) in 64.2%, As expected, S. maltophilia isolates were, in general, not susceptible to cephalosporins, penicillins. The annual isolation rate at Kyung Hee University hospital was not increased significantly from 1990 to 1994, 19.53 per 10,000 patients dismissals in 1990, 13.56 in 1994. The major underlying diseases of patients were malignancy(17.6%), cerebrovascular disorder(17%), diabetic mellitus(13.3%). Mortality rate is 10.3%. CONCLUSION: S. maltophilia has been emerging as an important nosocomial pathogen in immunocompromised patients, especially those receiving broad-spectrum antimicrobial therapy. And this organism is resistant to multiple antimicrobial agents, particularly to those of the beta-lactam class. When antimicrobial treatment is necessary, the clinician should be guided by results of in vitro susceptibility testing because of the notable in vitro resistance of S. maltophilia to commonly used antibiotics. And when S. maltophilia has been recovered from a patient, wound and contact isolation is warranted.
Anti-Bacterial Agents ; Anti-Infective Agents ; Bile ; Cephalosporins ; Ciprofloxacin ; Humans ; Immunocompromised Host ; Mortality ; Moxalactam ; Ofloxacin ; Penicillins ; Respiratory System ; Retrospective Studies ; Stenotrophomonas maltophilia ; Stenotrophomonas* ; Wounds and Injuries

Intramuscular Stimulation (IMS) is a refined technique of traditional oriental acupuncture, and IMS has proved effective for relieving chronic pain of a neuropathic origin. IMS is currently seen to be quite a safe procedure with minimal complications having been reported to date. Various complications have been documented for acupuncture, but few complications or adverse effects have been reported in relation to the relatively new technique of IMS. We report here on a case of cervical spinal epidural hematoma that manifested as a cause of delayed hemiparesis. The safety of this procedure in unpracticed hands seems to be questionable.
Acupuncture ; Chronic Pain ; Hand ; Hematoma ; Hematoma, Epidural, Spinal ; Paresis

Background: The purpose of the study was to investigate the incidence, prevalence, and survival of malignant gliomas (MGs) using population-based Korean National Health Insurance Database (NHID) data. Methods: Using the Korean NHID, we identified patients with MG as C71 codes in KCD 5–7 according to ICD-10 from January 1, 2007 to December 31, 2017. Epidemiological characteristics of MG, including annual incidence, prevalence, mortality rates, and survival rates, were collected and analyzed according to socioeconomic state (SES) and treatments received. Results: We identified 45,066 newly diagnosed-MG patients from 2007 to 2017, for an age-adjusted incidence of 7.47 per 100,000 people. The mean age at diagnosis was 54 years. The male to female ratio was 1.11. Mortality and survival probability were analyzed among total subjects and in subgroups. The mortality rates were lower in female than that of male patients (hazard ratio, 0.69; 95% confidence interval, 0.67–0.71), and in younger age population and in higher income group. Patients operated had a slightly higher survival rate. The 1-, 3-, 5-, and 10-year survival rates were estimated at 63.4%, 46.2%, 39.4%, and 34.8%, respectively. This is the first population-based study to determine the incidence and prevalence of MG according to epidemiological characteristics in Korea using NHID. Conclusion Our study found that female sex and high SES were factors that significantly lowered the mortality rate in MG, and younger groups and operated patients showed significantly higher survival rates.