No abstract available.
Diabetes Insipidus* ; Diagnosis*

BACKGROUND: It is well known that non-rapid eye movement(NREM) sleep activates the occurrence of interictal epileptiform discharges(IED) in many epileptic syndromes. We performed this study to assess the effect of NREM sleep on IED in epileptic patients with organic brain lesions. MATERIALS AND METHODS: We analyzed awake and sleep electroencephalopathy(EEG) recorded simultaneously after partial sleep deprivation in 50 patients. We calculated the awake and sleep spike index (ASI and SSI, spikes/epoch), and the percentage increase of ASI and SSI during sleep. RESULTS: In the 50 patients, the IEDs were recorded exclusively during the awake state in 1 (2%) patient, and during the sleep state in 13(26%) patients. The SSI was higher in 44 (88%) patients, and the ASI was higher in 5 (10%) patients. The mean ASI and the SSI in patients with organic brain lesions were 0.058+/-0.121 and 0.148+/-0.187, and it was 0.081+/-0.150 and 0.174 +/-0.226 in patients without organic brain lesions. There were significant increases in the spike index (P<0.05) during NREM sleep in both groups (n=36), but no significant difference in the percent increase of spike index (P>0.05). CONCLUSION: The IEDs were activated significantly during NREM sleep both in patients with and without organic brain lesions, but there were no differences in the degree of activation in both groups. The activating effect of NREM sleep was not correlated with clinical factors such as, frequent nocturnal seizures, frequent generalized tonic clonic seizures, type of epilepsy and taking anticonvulsants. We conclude that the routine EEG used to evaluate epileptiform discharges in epileptic patients should include sleep recordings after partial sleep deprivation.
Anticonvulsants ; Brain ; Electroencephalography* ; Epilepsy ; Humans ; Seizures ; Sleep Deprivation

No abstract available.
Hallermann's Syndrome*

We report a case of pyelocalyceal diverticulum. The patient was a 25-year-old woman and admitted to the Dept. of Urology B.N.U.H. because of mild left flank pain. The tentative diagnosis was made by IVP and confirmed by operation and histological examination. The roentgenogram of IVP revealed round cystic mass at lateral site of middle calyx, right.
Adult ; Diagnosis ; Diverticulum* ; Female ; Flank Pain ; Humans ; Urology

BACKGROUND: Anemia is still the most common nutrient deficiency worldwide, especially in adolescence because of an insufficient supply of iron, an increased iron requirement due to accelerated physical growth and blood loss due to menstruation in girls. This study was designed to assess the anemia and serum iron status of middle school girls. METHODS: Hematologic examinations, physical examinations and questionnaires were performed for middle school girls in 1990, 1997, 1999 and 2000. Anemia was defined as a serum hemoglobin level of less than 11.5 g/dL. Iron deficiency was defined as a serum ferritin level of less than 10 ng/mL. Iron deficiency anemia was defined as anemia plus one of the following; MCV less than 78 fL, Ferritin level less than 10 ng/mL or Transferrin saturation rate less than 10%. RESULTS: There was no significant difference in mean Hb between urban and rural areas and decreases in mean Hb as with age. The prevalence of anemia decreased by year; 13.5% in 1990, 6.9 % in 1997, 6.0% in 1999, and 5.7% in 2000. It was high in high school girls(10.1% in 1997 and 12.6% in 2000). The prevalence of iron deficiency decreased by year; 36.1% in 1990, 13.9% in 1997, 13.3% in 1999, and 23.2% in 2000. It was 21.3% in 1997 high school girls and 37.8% in 2000. The prevalence of iron deficiency anemia(IDA) decreased by year; 10.0% in 1990, 4.6% in 1997, 8.3% in 1999, and 6.1% in 2000. It was 11.6% in 1997 high school girls and 18.6% in 2000. CONCLUSION: Although the prevalence of iron deficiency decreased during this period, the prevalence of anemia in the elder adolescence girls was high. Two things are recommended; first, it is necessary to screen for anemia in middle school girls and high risk groups, second, it is important to evaluate the knowledge of nutrition and to enforce effective nutritional education, leading to subjects receiving adequate nutrition.
Adolescent* ; Anemia* ; Anemia, Iron-Deficiency ; Education ; Female* ; Ferritins ; Humans ; Iron* ; Menstruation ; Physical Examination ; Prevalence ; Surveys and Questionnaires ; Transferrin

H-reflex is a kind of late respons which can be used for the proximal nerve conduction study. Also it is a useful and widely used nerve conduction technique es to look electrically at the monosynaptic reflex. Although recordable from all muscles theoretically, H-reflexes are most commonly recorded from the calf muscles following stimulation of the tibial nerve in the popliteal fossa. But in this study, We tried to establish the normal data and to evaluate the significance of the H-reflex study in cervical radiculopathy. H-reflexes were recorded from flexor carpi radialis (FCR) muscle, extensor carpi radialis (ECR) muscle, brachioradialis (BR) muscle, and abductor digiti minimi (ADM) muscle in 31 normal adults (62 cases) and 12 patients with cervical radiculopathy. The mean values of H-reflex latency in normal control group were 16.16+/- 1.65 msec in FCR; 15.99+/- 1.25 msec in ECR; 16.47+/- 1.59 msec in BR; 24.46+/- 1.42 msec in ADM. And the mean values of side to side difference of H-reflex latency were 0.47+/- 0.48 msec in FCR; 0.68+/- 0.72 msec in ECR; 0.63+/- 0.43 msec in BR; 22.31+/- 1.24 msec in ADM. Mean values of side to side differences of interlatency time were 0.49+/-0.47 msec in FCR; 0.73+/- 0.62 msec in ECR; 0.79+/- 0.71 msec in BR; 0.69+/- 0.44 msec in ADM. Also, there were no significant differences in H-reflex latency between right and left side. H-reflex tests in patient group with cervical radiculopathy revealed abnormal findings in 11 out of 12 patients. These results suggest that H-reflex in the upper extremity would be helpful in the diagnosis of the cervical radiculopathy.
Adult ; Male ; Female ; Humans

BACKGROUND AND OBJECTIVES: Regional recurrence of head and neck squamous cell carcinoma (HNSCC) is the most common single type of treatment failure, and thus a challenging problem for the clinician. When planning management of regional recurrence, the grave outcome of the recurrence itself, and benefits and morbidity owing to the intervention must be taken into account. We analyzed the factors affecting salvage treatment outcomes of regional recurrence in head & neck squamous cell carcinoma. SUBJECTS AND METHOD: A retrospective analysis of medical records over a 10 year period (1994-2003) was conducted. Sixty-two patients with regional and locoregional recurrence were identified. Patients with local recurrence or distant metastasis were excluded. RESULTS: The median age of the population was 62 years. Sixty percent of the cases were regional, and the remainders were locoregional recurrences. The median time of recurrence was 16 months with an overall survival rate of 46.1%. Recurrence in a surgically virginal neck was associated with a favorable outcome. Factors associated with poor outcomes were node positive at initial presentation, neck dissection at initial treatment, recurrence at contralateral neck, incorporation of chemotherapy for salvage treatment, and subsequent recurrence after salvage treatment. CONCLUSION: In the management of patients with regional recurrence of HNSCC, the factors mentioned above should be taken into consideration regarding patient selection, salvage management plan, and patient counseling.
Carcinoma, Squamous Cell* ; Counseling ; Drug Therapy ; Head and Neck Neoplasms ; Head* ; Humans ; Medical Records ; Neck Dissection ; Neck* ; Neoplasm Metastasis ; Patient Selection ; Recurrence* ; Retrospective Studies ; Survival Rate ; Treatment Failure ; Treatment Outcome

The extraaxial presentation of a medulloblastoma is rare. This article describes the case of a 12-year-old boy who presented with severe headache, nausea, and vomiting. The tumor developed in the left tentorium; it was misdiagnosed as a meningioma based on the radiology examination. We review the literature and discuss the atypical presentation of medulloblastoma.
Child ; Headache ; Humans ; Male ; Medulloblastoma* ; Meningioma ; Nausea ; Vomiting

PURPOSE: Enolase is a cytoplasmic enzyme that catalyzes the conversion of 2-phosphoglycerate to phosphoenolpyruvate in the glycolytic pathway. The aim of this study was to investigate whether the overexpression of neuron-specific enolase (NSE) can serve as a prognostic factor in patients with gastric cancer (GC). MATERIALS AND METHODS: To assess its prognostic value in GC, NSE expression was measured by immunohistochemistry in a clinically annotated tissue microarray comprising of 327 human GC specimens. Cytoplasmic NSE expression was scored from 0 to 4, reflecting the percentage of NSE-positive cells. RESULTS: In terms of histology as per the World Health Organization criteria (P=0.340), there were no differences between the NSE overexpression (NSE-OE) and NSE underexpression (NSE-UE) groups. The NSE-OE group showed a significantly lower rate of advanced GC (P<0.010), lymph node metastasis (P=0.010), advanced stage group (P<0.010), cancer-related death (P<0.010), and cancer recurrence (P<0.010). Additionally, a Kaplan-Meier survival analysis revealed that the NSE-OE group had longer cumulative survival times than the NSE-UE group (log-rank test, P<0.010). However, there were no significant differences in the serum levels of NSE expression in patients with GC and healthy volunteers (P=0.280). CONCLUSIONS: Patients with NSE overexpressing GC tissues showed better prognostic results, implying that NSE could be a candidate biomarker of GC.
Cytoplasm ; Healthy Volunteers ; Humans ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Phosphoenolpyruvate ; Phosphopyruvate Hydratase* ; Prognosis ; Recurrence ; Stomach Neoplasms* ; World Health Organization

BACKGROUND: Since the 1980s, early ambulation and cardiac rehabilitation have been emphasized in clincal practice after myocardial infarction. This is based on the belief that cardiac rehabilitation can reduce cardiovascular mortality, improve functional capacity and reduce the risk of further coronary events. In this study, we investigate the effect of aerobic exercise-based cardiac rehabilitation on functiona capacity and cardiopulmonary response in patiets with myocardial infarction. METHODS: 19 patients were divided into two group(9 patients for training group and 10 patients for control group) at 4-6 weeks after acute myocardial infarction. Training group performed aerobic exercise for 8 weeks(3 sessions per week, mean 53mins per session) at 40-60% of heart rate(HR) reserve, while control group did not. Before and after 8 weeks, all patients performed symptom-limited exercise test using modified Bruce protocol. Also, breath by breath respiratory gas analysis was carried out throughout exercise test. RESULTS: For body composition, body weight(-2.7%, p<0.001), body mass index(-2.5%, p<0.001) and %body fat(-2.6%, p<0.05) were decrease significantly in training group after 8 week cardiac rehabilitation. Resting HR(-13%, p<0.05) was reduced significantly in training group, but no significant change occured in resting blood pressure between the two groups. Maximal oxygen uptake(18%, p<0.01) and anaerobic threshold(21%, p<0.05) were increased significantly in training group after 8 week cardiac rehabilitation as compared with the control group. There was no significant change in maximal O(2)pulse between the two groups. Submaximal rate-pressure product(-17%, p<0.05) and submaximal rate of perceived exertion (-2.6, p<0.001) were decreased significantly in training group after 8 week cardiac rehabilitation as compared with the control group. CONCLUSIONS: Our findings indicate that cardiac rehabilitation results in the significant improvement of functional capacity and cardiopulmonary response in patients with myocardial infarction. Cardiac rehabilitation for patients with myocardial infarction can contribute early return and readaptation to normal life, because myocardial oxygen consumption(or rate-pressure product) is decreased at the same exercise level after exercise training.
Blood Pressure ; Body Composition ; Early Ambulation ; Exercise ; Exercise Test ; Heart ; Humans ; Mortality ; Myocardial Infarction* ; Oxygen ; Rehabilitation*