BACKGROUND AND OBJECTIVES: Although pain resulting from thalamic stroke was described by D jerine & Roussy in 1906, its pathomechanism & anatomical substrate have not been defined yet. Several clinical & experimental studies suggest that laterality of lesion for generation of central pain is as important as location of lesion. We performed this study to evaluate clinical features of thalamic pain syndrome, including incidence, onset interval from stroke, nature, distribution, accompaniments, and to assess the relationships between laterality & location of lesion and occurrence of pain. METHODS: We reviewed the medical records and brain imaging of all patients with thalamic stroke from 1990 to 1997. Patients with thalamic pain syndrome due to a single well-demarcated thalamic stroke were included, and excluded tumoral, non-vascular etilogy, and patients with sensory deficit without pain and excluded patients who had multiple cerebral lesions even they have thalamic pain syndrome. RESULTS: One-hundred one cases were selected under the inclusion criteria, and twenty-four patients(24%) with thalamic pain syndrome were identified from 101 thalamic stroke. Pain onset within the first week poststroke was 17(71%). The patients with allodynia were 8(33%), increased by movement, stress, and thermal contact. The painful area distributed mainly limbs(50%), especially arm(35%), face plus hemibody(34%), and hemibody below face(8%). Thalamic pain syndrome accompanied with the pain and temperature loss was 17(71%). Thirteen patients had a right-sided lesion, 11 left-sided lesion. The lesion causing thalamic pain syndrome mainly located in the posterolateral areas(75%). CONCLUSIONS: We conclude that the thalamic pain syndrome resulting from mainly posterolateral thalamic lesion cause the spontaneous pain on the contralateral body, especially upper extrimity, and accompanied with pain & tempterature loss. The laterality of lesion is not represent for generation of thalamic pain syndrome. Key word : thalamic stroke, central pain.
Humans ; Hyperalgesia ; Incidence ; Medical Records ; Neuroimaging ; Stroke*

No abstract available.
Polycystic Kidney Diseases* ; Tuberous Sclerosis*

BACKGROUND: Aberrant expression of c-myb gene is often detected in transformed leukemic cells. Inhibition of c-myb expression by antisense oligos was shown to inhibit growth of normal as well as leukemic cells. C-myb antisense oligo for inhibition of tumor cell growth was, however, not decisive enough to be an effective anti-cancer agent. Thus, we set out to devise a systematic approach to find effective target sites for c-myb antisense oligos and to compare cellular uptake of antisense oligos complexed with different liposomes. METHODS: A computer simulation program for RNA secondary structures was employed to choose 8 potential target sites free of secondary structures along the entire c-myb mRNA sequence. Linear phosphorothioate-capped antisense oligos complementary to the selected target sites were synthesized and delivered into HL-60 and K562 cancer cell lines as liposomes complexes. RESULTS: Three of the 8 target sites were found to be relatively effective for reducing c-myb message. The three oliogs, MIJ-4, -17 and -18 were able to reduce c-myb message by more than 70% and suppressed tumor cell growth by about 70%. When three different cationic liposomes were used to facilitate the cellular uptake of antisense c-myb oligos, distinct liposome formulations were found to be comparably effective for reduction of c-myb message and inhibition of tumor cell growth. CONCLUSION: These results show that simulation of RNA secondary structure can be used to search effective target sites for antisense oligos and oligo uptake can be significantly enhanced by liposomes. However, cellular uptake of antisense oligos by liposomes needs further improvement.
Cell Line ; Computer Simulation ; Genes, myb ; Liposomes* ; RNA ; RNA, Messenger

The simultaneous occurrence of a renal cell carcinoma and a urothelial carcinoma in the same kidney is uncommon. Here we report the case of a 79-year-old woman with ipsilateral synchronous renal cell carcinoma and urothelial carcinoma. She was referred to our hospital for gross hematuria and right flank pain. A computed tomography scan showed a 15x20 mm enhanced lesion on the upper calyx and a 12x15 mm mass on the lateral aspect of the right kidney. We thus suspected a renal pelvis tumor and performed right hand assisted laparoscopic nephroureterectomy with bladder cuff excision (HALSNU). Gross findings were multiple, pale yellowish papillary masses on the upper and lower major calices, of which the largest one measured 16x20 mm. A separated solid mass measuring 12x16 mm was also noted on the anterior midportion of the kidney. The former was a urothelial carcinoma and the latter was a chromophobe renal cell carcinoma. We present a rare case of a chromophobe renal cell carcinoma and a urothelial carcinoma in the same kidney.
Aged ; Carcinoma, Renal Cell ; Female ; Flank Pain ; Hand ; Hematuria ; Humans ; Kidney ; Kidney Pelvis ; Urinary Bladder

No abstract available.
Humans ; Kidney* ; Living Donors* ; Transplants*

PURPOSE: This study was undertaken to correlate the CT and histopathologic findings of abscess wall. MATERIALS AND METHODS: The CT findings of 12 patients with pathologically proven brain abscess were retrospectively analyzed with particular attention to the thickness, smoothness and uniformity of enhancing abscess wall, and the results were correlated with histopathologic findings. RESULTS: Two patients with acute cerebritis showed an isodense ring on non-contrast CT(NCCT), but a true capsule formation could not be identified at pathologic examination. Six other patients with isodense ring on NCCT consisted of early to late cerebritis(3 cases), late cerebritis to early capsule(1 case), early capsule(1 case), and late capsule(1 case). These 6 cases showed ring enhancement on contrast enhanced CT(CECT) and true capsule formation pathologically. There was no isodense ring on NCCT in the remaining four patients. They consisted of early to late cerebritis(2 cases), late cerebritis(1 case), and late cerebritis to early capsule formation(1 case). These also showed ring enhancement on CECT and true capsule formation pathologically. CONCLUSION: We found that it is difficult to predict the exact stage of brain abscess on preoperative CT findings. It is suggested that clinical findings and sequential dynamic CT may provide more detailed informations for evaluation of abscess staging.
Abscess ; Brain Abscess* ; Brain* ; Humans ; Retrospective Studies

Duchenne muscular dystrophy(DMD) is an X-linked recessive disease, caused by the mutation of dystrophin gene at Xp21. The dystrophin produced by this gene is therefore absent on the membrane of muscular fiber in the patie nts with DMD. Recently, it is known that the dystrophin has also been located on the myoepithelial layer of sweat gland in the mice. We studied the sympathetic skin response(SSR) in a group of DMD patients and a control group to evaluate the function sympathetic nerve and sweat gland in DMD patients. Significant prolongation of latency of SSR in the palm and sole was noted in the group of DMD patients compared to the control group. However, there was no significant difference in the amplitude of SSR between two group. In the patient group, the rise in latency of SSR was closely correlated with the duration of symptoms and weakly associated with the stage of the illness. Therefore the latency of SSR may be a useful index in assessing the function of sympathetic nerve and sweat gland in DMD patients. These results could be a consequence of a lack of dvstrophin at myoepithelium of sweat gland in DMD patients.
Animals ; Dystrophin ; Humans ; Membranes ; Mice ; Muscular Dystrophy, Duchenne* ; Skin* ; Sweat Glands

OBJECTIVE: To identify and evaluate the outcome of consultation base rehabilitatiion program and the site of primary lesions of the hospitalized cancer patients. METHOD: Medical records of 119 hospitalized patients with cancer who received the consultation base rehabilitation program from January 1999 to December 2000, were reviewed. Karnofsky Performance Status scale (KPSS) was used as a functional measurement. RESULT: The most common primary cancer referred for the consultation base rehabilitation program was a lung cancer (16.8%), followed by brain cancer (10.9%) and hepatic cancer (9.2%). Spine was the most common metastatic site (72.7%). Strengthening (47.2%) and range of motion exercises (39.6%) were commonly prescribed rehabilitative procedures in the cancer patients with no metastasis and bracing (45.5%) was the most common cause for consultation in the cancer patients with metastasis. A significant functional improvement was observed between the initial (mean=58.4%) and final assessments (mean=65.2%) on KPSS (p<0.01) in the cancer patients with no metastasis. However, the cancer patients with metastasis did not show a significant functional improvement. CONCLUSION: Significant functional gains were observed in cancer patients who received the consultation base rehabilitation program.
Braces ; Brain Neoplasms ; Exercise ; Humans ; Karnofsky Performance Status ; Liver Neoplasms ; Lung Neoplasms ; Medical Records ; Neoplasm Metastasis ; Range of Motion, Articular ; Rehabilitation* ; Spine

Purpose: This study aimed to report on a pancreas-preserving strategy consisting of the conversion to pancreaticogastrostomy (PG) for the salvage of disrupted pancreaticojejunostomy (PJ) following pancreaticoduodenectomy (PD). Methods: This single-center retrospective study included 188 patients who underwent PD between March 2000 and June 2021. Conversion to PG was performed by placing the pancreatic stump with an internal stent in the stomach through the posterior gastrostomy and suturing the wound in 2 layers through the anterior gastrostomy. Results: A total of 181 patients underwent PJ, while 7 underwent PG. Of all patients, 6 had International Study Group on Pancreatic Fistula grade C postoperative pancreatic fistulae (POPF; 3.3%) and 23 had grade B POPF (12.7%). Two of the 6 grade C patients underwent completion pancreatectomy and died of liver failure after common hepatic artery embolization due to pseudoaneurysm. Conversion to PG was performed in 4, all of whom survived and experienced no long-term pancreatic fistulae, remnant pancreatic atrophy, or newly developed diabetes after a median follow-up period of 11.5 months. Conclusion Conversion to PG for the salvage of disrupted PJ following PD is safe and effective in selected patients that can lower mortality rates while maintaining pancreatic function.

BACKGROUND: Transient myocardial ischemia that is recorded on Holter monitoring after a myocardial infarction is known to be a risk factor of myocardial reinfarction or death. However, it is still uncertain whether transient myocardial ischemia is a cause of ventricular arrhythmias or is simply an indicator of severe coronary artery disease. Therefore, we have studied the relation of ventricular arrhythmias to transient myocardial ischemia detected on Holter monitoring after a myocardial infarction. METHOD: We studied 40 patients with acute myocardial infarction who were performed Holter monitoring, 7 to 14 days after an attack. On Holter monitoring, we analyzed the prevalence, characteristics of transient myocardial ischemia and its relation to ventricular arrhythmias. RESULTS: 1) Among 40 patients(32 men, 8 women, mean age 53+/-13), transient myocardial ischemia was recorded in 13 patients(33%). ST elevation was observed in 2 patients, and ST depression, in 11 patients. Total episodes of transient myocardial ischemia were 65, of which only one episode was accompanied by chest pain, and total daily episodes were 4.8+/-1.4. Total daily duration of transient myocardial ischemia was 61.4+/-15.5 minutes and the duration of each transient myocardial ischemia was 15.8+/-2.1 minutes. 2) There were no significant differences in frequencies of single ventricular premature beast, bigeminy, trigeminy, ventricular couplets, and ventricular tachycardias between two groups with and without transient myocardial ischemia. CONCLUSION: It is concluded that transient myocardial ischemia on Holter monitoring after myocardial infarction is not a cause of ventricular arrhythmias.
Arrhythmias, Cardiac* ; Chest Pain ; Coronary Artery Disease ; Depression ; Electrocardiography, Ambulatory* ; Female ; Humans ; Male ; Myocardial Infarction* ; Myocardial Ischemia* ; Prevalence ; Risk Factors ; Tachycardia, Ventricular