We report the case of a 48-year-old man with schwannoma involving the orbit. Computerized tomography and magnetic resonance imaging revealed a 2X3X2cm-sized well-enhanced round lesion which mildly compressed the optic nerve. The patient underwent fronto-orbitotemporal craniotomy, with successful total removal of the tumor. To our knowledge, this is the first report of schwannoma involving the orbit : a review of the literature is also included.
Craniotomy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurilemmoma* ; Optic Nerve ; Orbit*

Hyponatremia is frequently seen in intracranial hemorrhagic patients and has been often attributed to inappropriate secretion of antidiuretic hormone. But in recent years, a number of studies have shown that hyponatremia in many patients with intracranial disease may actually be caused by cerebral salt wasting (CSW) syndrome and circulating Atrial natriuretic peptide (ANP) and Brain natriuretic peptide (BNP) are probably involved. This report describes a patient who developed bacterial meningites caused by pseudomonas aeruginosa and CSW syndrome after removal of pituitary adenoma. CSW syndrome resolved by fluid and salt replacement after 4 months.
Humans ; Hyponatremia ; Meningitis* ; Meningitis, Bacterial ; Natriuretic Peptide, Brain ; Pituitary Neoplasms* ; Pseudomonas aeruginosa ; Pseudomonas* ; Wasting Syndrome*

It hae been well established that, specifi alterations in members of the ras gene family, H-ras, K-ras and N-ras, can convert them into active oncogenes. These alterations are either point mutations occurirg in either codon 12, 13 or 61, or alternatively, a 5- to 50-fold amplification of the wfld-type gene. Activated ras oncogenes have been found in a significant proportion of all turnors, but the incidence varies considerably with the tumor type : it is frequent (20~40%) in colarectal eancer and acute myeloid leukemia, but absent or preaent rarely in breast and atomach cancer. But the role of c-K-ras point mutatio in the development of cancers in the female genital tract has not been extensively studied. Polymerase chain reaction followed by gel electrophoresis was performed respectively using wild-type normal and specific point mutation primers{GGT->GAT, GGT->AGT, GGT->TGT and GGT->GTT) to detect, point, mutation of codon 12 of c-K-ras oncogene. The c-K-ras oncogene point mutation was confirmed by Southern blot hybridization using synthetic oligonucleatide probe. 3'-end Iabelled with digoxigenin -dUTP. With this method, the frequency of point mutation on codon 12 of c-K-ras oncogene was examined the tissues in 37 casea of ovarian cancer, 7 cases of endometrial cancer, 36 cases of the gestational trophoblastic tumor, 60 cases of cervical cancer. The relationship between the presence of a c-K-ras point mutation and clinicopathological characteristics of the female genital tract cancers were also analysed. The results were as follows; 1. The incidence of four point mutations on codon 12 of c-K-ras oncogene in 37 ovarian cancers was 45.9% (17/37) and distribution were 43.2% (16/37), 2.7% (1/37) and 0% (0/37) in GGT-->GAT, GGT-->AGT, GGT-->TGT, and GGT-->GTT, respectively. According to histological type, in ovarian cancers, The point mutation of K-ras oncogene waspositive in 45 % (10/22) of serous cystadenocarcinomas. The incidence of four point mutations on codon 12 among 37 patients with ovarian cancer according to histological type was 45.5 % (10/22) with serous cystadenocarcinoma, 57.1% (4/7) of mucinous cystadenocarcinoma. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer with the clinical stage, point mutation was detected in 28.5% (2/7) of patients with stage I, 40.0% (2/5) with stage II, and 52.0% (13/25) with stage III/IV. There was no statistically significant increasement of point mutations with the advance of the clinical stage of ovarian cancer. Comparing the positive rate of point mutations of K-ras oncogen among 37 patients with ovarian cancer according to the histologic grade point mutation was detected in 50.0 % (2/4) 0f patients with grade I, 451.7 % (5/12) with grade II and 47.6 % (10/21) with grade III. 2. The incidence of point mutations of K-ras oncogen among 33 patients with ovarian cancer who were performed pelvic lymph node dissection was 57.1 % (12/21) of the patients with pelvic lymph node metastases and 16.7% (2/12) of the patients without pelvic lymph node metastases. There was statistically significant difference between the positive rate of c-K-ras point mutations and the pelvic lymph nodal status(P<0.05). 3. In 7 cases of endometrial cancer, positive rate of K-ras point was 42.8 % (3/7). Point mutations were also detected in 2 cases from 4 choriocarcinomas, but, the point mutation was only detected in 1 case from 60 cervical carcinomas. From these results, we may suggest that the point mutation on codon 12 c-K-ras oncogene are considered to be one of the important genetic change in the tumor formation and progression of ovarian of c-K-ras oncogene seems to be the one stop in the multistep process of tumor formation in ovarian cancer. Furthermore, the point mutation of c-k-ras gene could occur more frequently in the patients of ovarian cancer with pelvic lymph node metastases than in those without pelvic metastases, suggesting the orle in tumor progression. And we concluded that point mutation on codon 12 is comparable frequent in uterine endometrial carcinomas and have significance as an event that contributes to progrssion of endometrial cancers and choriocarcinoma, but cervical carcinoma do not appear to have c-K-ras point mutation in general. More studies will be necessary, but the detection of c-k-ras point mutation as the possibility of biological tumor marker to predict clinical outcome may be utilized in female malignancies.
Blotting, Southern ; Breast ; Choriocarcinoma ; Codon ; Cystadenocarcinoma, Mucinous ; Cystadenocarcinoma, Serous ; Digoxigenin ; Electrophoresis ; Endometrial Neoplasms ; Female* ; Genes, ras ; Humans ; Incidence ; Leukemia, Myeloid, Acute ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Oncogenes* ; Ovarian Neoplasms ; Point Mutation* ; Polymerase Chain Reaction ; Pregnancy ; Trophoblastic Neoplasms ; Biomarkers, Tumor ; Uterine Cervical Neoplasms

No abstract available.
Cerebral Hemorrhage ; Parkinson Disease

BACKGROUND: DNA methylation and histone modification are dynamically linked in the epigenetic control of gene silencing and they play an important role in tumorigenesis. METHODS: To evaluate the role of histone deacetylase 1 (HDAC1) in the development of lung cancer and the relationship between a HDAC1 overexpression and p16INK4a hypermethylation, we performed immunohistochemical staining for HDAC1 in 76 lung cancer specimens (39 squamous cell carcinomas and 37 adenocarcinomas) that had been previously evaluated for their p16INK4a methylation status by real-time quantitative polymerase chain reaction. RESULTS: A HDAC1 overexpression (>50% of HDAC1 immunoreactive cells) was detected in 65 (85.5%) out of the 76 cases and it was more frequently seen in the squamous cell carcinomas (97.4%) than in the adenocarcinomas (73.0%) (p=0.002). The incidence of HDAC1 overexpression tended to be higher in the heavy smokers with more than 20 pack-years (p=0.067). Although there was no statistical significance, the frequency of p16INK4a hypermethylation in the cases with a HDAC1 overexpression (27.7%) tended to be higher than that in the cases without a HDAC1 overexpression (9.0%) (p=0.175). CONCLUSIONS: A HDAC1 overexpression might be involved in lung carcinogenesis, and especially in a subgroup of smoking and squamous cell carcinoma patients, and a HDAC1 overexpression may be associated with p16INK4a hypermethylation.
Adenocarcinoma ; Carcinoma, Squamous Cell ; Cell Transformation, Neoplastic ; Cyclin-Dependent Kinase Inhibitor p16 ; DNA Methylation ; Epigenomics ; Gene Silencing ; Genes, p16 ; Histone Deacetylase 1 ; Histone Deacetylases ; Histones ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Methylation ; Polymerase Chain Reaction ; Smoke ; Smoking

BACKGROUND: Recently, the number of elderly patients with bacteremia has been increasing in the emergency room. Klebsiella pneumoniae is the second common agent of all gram negative bacteremia. We designed this study in order to describe the clinical characteristics and outcomes of elderly patients with K. pneumoniae bacteremia in the emergency room. METHODS: We retrospectively reviewed medical records of 109 patients infected with K. pneumoniae, who visited an emergency room of a tertiary hospital from March 2006 to October 2010. All patients were divided into two groups (83 survivors versus 26 nonsurvivors). We compared the outcomes and the clinical characteristics between the two groups. RESULTS: A total of 26 patients (23.9%) died in this study. There were no significant differences in age, sex, previous medical and surgical history between survivor and nonsurvivor groups. In the univariate logistic regression analysis, the significant favorable factors for survival associated with K. pneumoniae bacteremia were malignancy (odds ratio [OR], 0.311; p=0.018), Charlson comorbidity index (OR, 0.787; p=0.010), intensive care unit admission (OR, 0.260; p=0.032), mean arterial pressure (OR, 1.053; p=0.001), body temperature (OR, 2.250; p=0.001), blood urea nitrogen (OR, 0.969; p=0.002), albumin (OR, 6.739; p<0.001) and lactate (OR, 0.876; p=0.046). In a multiple logistic regression, the significant risk factors for predicting mortality were low body temperature (OR, 1.036; p=0.044) and low serum albumin (OR, 5.636; p=0.002) at the time of admission. CONCLUSION: Initial albumin level and body temperature were significant risk factors of mortality in elderly patients in the emergency room infected by K. pneumoniae bacteremia. Elderly patients with K. pneumoniae bacteremia in the emergency room should be carefully observed due to the high mortality rate.
Aged ; Arterial Pressure ; Bacteremia ; Blood Urea Nitrogen ; Body Temperature ; Comorbidity ; Emergencies ; Humans ; Intensive Care Units ; Klebsiella ; Klebsiella pneumoniae ; Lactic Acid ; Logistic Models ; Medical Records ; Pneumonia ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Survivors ; Tertiary Care Centers

STUDY DESIGN: A prospective study is to evaluate the cervical range of motion through the analysis of the plain films of the cer-vical spine. OBJECTIVE: To provide criteria validity for the cervical lordosis, range of motion and segmental motion of each segment using normal Korean adults, as guide lines for the radiographic diagnosis and treatment of cervical diseases. MATERIALS AND METHODS: One hundred and four healthy Korean adults were examined. Roentgenographic lateral views were taken in neutral, active flexion and extension positions. Measurement of the range of motion and segmental motion of the cer-vical spine, using the technique of Penning and Bakke, were independently made by two observers. RESULTS: The mean angle of the lordosis and the range of motion were 19.8degrees+/-8.4degrees and 63.1degrees+/-11.2degrees respectively, and the range of motion of each segment were 10.3degrees+/-2.9degrees, 9.2degrees+/-3.0degrees, 13.5degrees+/-7.2degrees 15.1degrees+/-4.3degrees, 15.6degrees+/-4.4degrees and 13.0degrees+/-5.0degrees and C1-2, C2-3, C3-4, C4-5, C5-6 and C6-7, respectively. There were no differences in the lordotic angle between the ages and genders. The range of motion decreased with increasing age, but there was no difference between genders. The segmental motion was no different between genders, but decreased significantly with increasing age on segments C1-2, C5-6 and C6-7. CONCLUSIONS: No significant differences were found in the range of cervical motion of each segment and the lordotic angle of the Korean population compared with those of other populations. The range of cervical motion also decreased with increasing age. These data provide guidelines in the dynamics of cervical spine and for the roentgenographic diagnosis and treatment of cervi-cal diseases.
Adult ; Animals ; Diagnosis ; Humans ; Lordosis ; Prospective Studies ; Range of Motion, Articular* ; Spine*

PURPOSE: Recently, public interest in obesity and earlier pubertal development has been increasing. The purpose of this study was to analyze the relationship between obesity and pubertal development in girls. METHODS: A total of 158 girls presenting with earlier pubertal development from July 2008 to June 2010 were included in the study. Their mean age was 8.27+/-1.3 years and the mean bone age advancement was 1.86+/-0.3 years. RESULTS: Based on weight-for-height percentiles, their obesity rate was 9.2% and overweight rate was 15.8%. However, for body mass index (BMI), the result was a bit different; with an obesity rate of 13.2% and overweight rate of 24.3%. About 40% of the girls had a family history of early maturation. Among them, 25.7% had a maternal history, 4.6% paternal and 7.2% both. However, 60% of them had no family history. We then classified these girls into families with one son and one daughter, and those with two daughters. In one-son/one-daughter families, 69.3% were the first children and 30.7% were second. In two-daughter families, 65.3% were the first and 34.7% were second. We found that 67.5% had a history of taking herbal medicine. CONCLUSION: The obesity and overweight rates in girls with earlier pubertal development were higher than those of normal girls, but with a small discrepancy between weight-for-height percentile and BMI-based results. Furthermore, taking herbal medicine seems to be a potential factor for earlier pubertal development in Korea.
Body Mass Index ; Child ; Herbal Medicine ; Humans ; Isothiocyanates ; Korea ; Nuclear Family ; Obesity ; Overweight

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.
Anal Canal ; Female ; Foreign Bodies ; Formaldehyde ; Humans* ; Lacrimal Apparatus Diseases ; Middle Aged ; Sensation ; Thelazioidea

The authors report a case of infection with Thelazia callipaeda in a Korean man. The patient was a 47 year-old man. He experienced epiphora and foreign body sensation of the right eye since 3 weeks ago. Total of 2 worms were removed from the conjunctival sac; one by himself 1 day prior to examination and the other by an ophthalmologist. The worm was slender creamy white in color which was fixed in a 10% formaline solution. The worm was 17.38 mm in length, 0.45 mm in body width, 0.026 mm in length of buccal cavity, 0.63 mm in length of anterior end to vaginal opening, 0.76 mm in length of anterior end to the esophagointestinal junction and 0.06 mm in length of posterior end to the anus. There were numerous striations on surface of worms and vaginal opening was located anterior to the esophagointestinal junction. Based on aforementioned findings, it was confirmed as a female worm of Thelazia callipaeda, and the authors report it with literature.
Anal Canal ; Female ; Foreign Bodies ; Formaldehyde ; Humans* ; Lacrimal Apparatus Diseases ; Middle Aged ; Sensation ; Thelazioidea