To evaluate the intractability of partial epileptic patients by variables, the author studied 113 patients (uncontrolled: 45, controlled: 68) who were admitted to the Department of Neurology, College of Medicine, Yeungnam University from January, 1991 to August, 1993. The results were as follows. The items related to complex partial seizures, multiple seizure types and a histories of status epilepticus or clusters of seizures were significantly associated with drug-refractoriness (p<0.01). A high frequency of seizures before evaluation was associated with a poor outcome(p<0.01). The presences of known etiology of seizures, neurologic abnormalities and psychiatric disturbance were associated with limited treatment responses(p<0.01, p<0.05, p<0.01). An abnormal EEG findings such as background slowing, focal slowing, epileptiform discharges or secondarily bilateral synchrony were statistically significant (p<0.01). Age at onset, sex, distribution of epileptic foci, duration of seizure before evaluation, family history and abnormal neuroradiologic findings were not statistically significant. By these results, it was suggested that having at least four factors of the above variables were associated with limited treatment response.
Electroencephalography ; Epilepsies, Partial* ; Humans ; Neurology ; Risk Factors ; Seizures ; Status Epilepticus

We investigated the role of the tumor suppressor genes in the germ cell tumor. Immunohistochemistry (IHC) and polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) for p53 mutation were done in 46 cases of the germ cell tumor with paraffin embedded tissue. The immunohistochemical staining for Rb protein was also performed in the same specimens. The following results were obtained. The overexpression of the p53 protein was detected in 7 of 46 cases (15%). p53 mutation by PCR-SSCP was detected in 1 of 46 cases (2.2%). Expression of Rb protein was negative in 19 cases (41%). These results suggest that p53 mutation does not play an important role in the initiation and progression of germ cell tumors.
Genes, Tumor Suppressor ; Germ Cells* ; Immunohistochemistry ; Neoplasms, Germ Cell and Embryonal* ; Paraffin ; Retinoblastoma Protein*

We have studied the vasodilating effect of bolus doses of sodium nitroprusside (SNP), nitro- glycerin (NTG), and isosorbide dinitrate (ISDN) in 40 patients during cardiopulmonary bypass with a constant pump flow. Blood volume of the venous reservoir and mean arterial pressure were recorded for 10 minutes after drug administration to detect changes in venous capacitance and arteriolar resistance. SNP 500 ug decreased mean blood pressure significantly more than NTG and ISDN compared with placebo. NTG 500 ug decreased mean blood pressure transiently at 1-4 min but significantly reduced reservoir blood volume. ISDN 500 ug increased mean blood pressure after drug administration, decreased reservoir blood volume less than NTG. We could conclude that SNP was more effective arteriolar vasodilator than NTG and ISDN, but NTG and ISDN were effective as a venodilator during cardiopulmonary bypass.
Arterial Pressure ; Blood Pressure ; Blood Volume ; Cardiopulmonary Bypass* ; Glycerol ; Humans ; Isosorbide Dinitrate* ; Isosorbide* ; Nitroglycerin* ; Nitroprusside* ; Sodium* ; Vascular Access Devices

We experienced an autopsy case of esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies in a 4 days old male infant. Esophageal atresia with tracheoesophageal fistula was type C by Gross Classification. Combined anomalies were malrotation of left kidney, one left accessory renal artery form right renal artery and one left accessory renal vein from right renal vein, duodenal atresia and annular pancreas. Until now, the esophageal atresia with tracheoesophageal fistula and other multiple congenital anomalies (7 congenital anomalies) are not reported in the korean literature, except our case. Our autopsy case, it suggests that esophageal atresia with tracheoesophageal fistula has often close relation-ship with other multiple congenital anomalies.
Infant ; Male ; Female ; Humans

Transforming growth factor (TGF)-beta1 plays an important role in hepatocarcinogenesis and has been described as a useful tumor marker and one of the poor prognostic indicators in patients with hepatocellular carcinoma (HCC). To investigate the role and cellular localization of TGF-beta1 during multistep hepatocarcinogenesis we performed a quantitative analysis of TGF-beta1 mRNA and immunohistochemical expression of TGF-beta1 and TGF-beta receptor II (TGF-betarII) in female Sprague-Dawley rats. The experimental groups included neoplastic lesions produced by Solt-Farber's protocol, regenerating liver after partial hepatectomy, and normal control. Quantitative change of TGF-beta1 mRNA was analysed by competitive reverse-transcription polymerase chain reaction (RT-PCR). TGF-beta1 protein and TGF-betarII expression were evaluated by immunohistochemical stain. The discrete tumor nodules were detected on 14th day and then increased in number and size. Three HCCs were induced on 8th or 9th month. RT-PCR demonstrated TGF-beta1 mRNA band in all examples of the normal and regenerating liver, nodules and HCCs. Competitive RT-PCR displayed higher TGF-beta1 mRNA in nodules, HCCs and regenerating liver than in normal controls. Hepatocytes from control and regenerating livers showed weak immunoreactivity for TGF-beta1. In contrast, the cytoplasm of hepatocytes of nodules in 7th, 8th and 9th month and HCCs were intensely stained for TGF-beta1. Some sinusoidal cells showed immunoreactivity for TGF-beta1 in all experimental groups. In early phase of carcinogenesis, the cytoplasm of hepatocytes in liver of 12h, 1d and 3d showed transiently increased immunoreactivity for TGF-beta1 and The immunoreactivity decreased thereafter. TGF-beta1 mRNA was also detected in the neoplastic hepatocytes by in-situ hybridization. Although TGF-betarII expression was correlated with TGF-beta1 immunoreactivity during early phase of carcinogenesis, hepatocytes in most nodules in 7th, 8th, 9th month and carcinomas showed decreased or little immunoreactivity for TGF-betarII. Based on the above results, it is concluded that TGF-beta1 expression increases not only in precancerous nodules but also in HCCs and its increase seems to be correlated with decrease or loss of TGF-betarII expression although its mechanism remains unclear. Hepatocytes may be a major cellular source of TGF-beta1 during hepatocarcinogenesis.
Carcinogenesis ; Carcinoma, Hepatocellular ; Cytoplasm ; Diethylnitrosamine* ; Female ; Hepatectomy ; Hepatocytes ; Humans ; Liver ; Polymerase Chain Reaction ; Rats, Sprague-Dawley* ; Receptors, Transforming Growth Factor beta* ; RNA, Messenger* ; Transforming Growth Factor beta* ; Transforming Growth Factor beta1* ; Transforming Growth Factors*

No abstract available.
Female ; Hydatidiform Mole* ; Pregnancy

No abstract available.
Busan* ; Eclampsia* ; Female ; Pregnancy ; Singing*

OBJECTIVES: Despite the importance of human immunodefi-ciency virus(HIV) transmission through heterosexual contact, the features of heterosexual transmission has not been well studied in Korea. So we conducted a cross sectional study to determine the transmission rates in married couples and assess risk factors for male to female heterosexual transmission of HIV. METHODS: 169 HIV-infected males and their female sex partners were recruited from 1985 to June 1998. We examined female sex partners HIV infection status and interviewed male index partners and their female sex partners about demographic characteristics and sexual practices. We analysed heterosexual transmission rate by epidemiologic characteristics, disease status and sexual practices. And we assessed risk factors for HIV infection by univariate and multivariate analysis. RESULTS: 30 female sex partners were infected at enrollment, yielding an transmission rate of 17.8%. Among couples who had used condoms consistently, none of the female sex partners was infected with HIV. In univariate analysis the significant risk factors were full blown AIDS status (OR=4.1, 95% CI: 1.49-11.43) and low CD4 T cell count of index partners at enrollment (OR=7.8, 95% CI: 2.19-27.80). In multivariate analysis HIV-1 RNA levels was significant risk factor when adjusted by CD4 T cell counts and mean sexual contacts per month (OR=19.2, 95% CI: 1.03-357.59) CONCLUSION: The risk of male to female heterosexual transmission increased with advanced stages of HIV infection in the index male partners.
Cell Count ; Condoms ; Family Characteristics ; Female* ; Heterosexuality* ; HIV Infections ; HIV* ; HIV-1 ; Humans ; Korea* ; Male* ; Multivariate Analysis ; Risk Factors* ; RNA

Airway hyperresponsiveness is a consistent feature of asthma. Since the airway smooth muscle is hyperresponsive to a number of different stimuli operating through many different mechanisms, it is attractive to speculate that the abnormality may reside in the airway smooth muscle itself. Animal model of asthma is needed to unravel possible mechanisms underlying airway hyperresponsiveness and also to develop new therapeutic approaches. However, there are few reports showing that airway smooth muscle from animal asthma model is indeed hyperresponsive. In addition, sensitizing and provoking doses of allergen were different each other ambng the studies on animal asthma model. The aim of this study was to determine an appropriate sensitizing and provoking dose of allergen to induce a maximum airway hyperresponsiveness. Eighty-four male Sprague-Dawley rats were actively sensitized with a subcutaneous injection of 0, 10, or 1000/gg ovalbumin(OA) and 14 days later they were provoked with 0, 1, or 5 % OA aerosols. One day after the provocation, serum levels of OA-specific IgE, cell numbers in bronchoalveolar lavage fluid (BALF), and in vitro isometric contractile responses of the isolated tracheal smooth muscle(TSM) to 120 mM KC1, acetylcholine(ACh, 0.1~ 1000/micro meter), electrical field stimulation (EFS, 0.5~100Hz), serotonin(5-HT, 0.014 100/micro meter), and OA(10, 50, or 250 micro gram/ml) were measured. The results were as follows; 1) When 38 OA-sensitized rats were exposed to OA aerosols in vivo early asthmatic responses(EAR) were observed in 20(52.6%) rats. In vitro isometric contractile forces of TSM from rats with EAR were stronger than those from rats without EAR. 2) The maximal contractile responses to KC1 and EFS were significantly higher in rats only sensitized with OA compared with those in controls. The maximal response to ACh was significantly related to OA-specific serum IgE level(r=0.40, p%0.05), and the latter was in turn significantly related to the BALF eosinophil count(r=0.67, p<0.01). 3) When 10 microgram OA-sensitized rats were analyzed, the maximal response to KC1, ACh, EFS, and 250 micro gram/ml OA were lower in OA-provoked rats compared to those in saline-provoked control rats, in which 5% OA-provoked rats had a lower response than 1% OA-provoked rats. 4) The sensitivity of TSM to ACh was significantly higher in 10/micro gram OA-sensitized & OA-provoked rats, and the sensitivity to EFS was also significantly higher in 10/~g OA-sensitized & 5% OA-provoked rats compared to that in controls(p<0.05). 5) There was a significant correlation between the sensitivity of TSM to EFS and the counts of eosinophil or of lymphocytes in BALF(for eosinophil, r=-0.30; p<0.05, for lymphocyte, r=-0.35; p<0.05), or OA-specific serum IgE level(r=-0.46, p<0.01) in OA-sensitized & OA-provoked rats. This relationship was maintained in the data obtained only from 10 micro gram OA-sensitized & 5% OA-provoked rats. 6) The ratio of EFS-sensitivity to ACh-sensitivity was significantly lower in OA-sensitized & OA-provoked rats compared to that in controls or rats only sensitized with OA(p%0.05). 7) The Schultz-Dale phenomenon occurred in an in vitro dose-dependent manner. However, the inhaled provocation with OA in vivo resulted in a decrease in the contractile response to OA in vitro. There was a significant correlation between OA-specific serum IgE level and isometric response to 250 micro gram/ml OA(r=0.36, p<0.01). These results suggest that sensitization and provocation in vivo with OA in rats induces hypersensitivity of airway smooth muscle to cholinergic stimuli through an allergic inflammatory mechanism. The sensitivity was highest when sensitized to 10 micro gram OA and exposed to 5% OA aerosols.
Aerosols ; Animals ; Asthma* ; Bronchoalveolar Lavage Fluid ; Cell Count ; Ear ; Eosinophils ; Humans ; Hypersensitivity ; Immunoglobulin E ; Injections, Subcutaneous ; Lymphocytes ; Male ; Models, Animal ; Muscle, Smooth* ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Fractures should be actively prevented in the elderly because recovery from the damage of fractures is slow and fractures can cause both physical and psychological pain in the elderly. Previous studies have reported that depression is related to falls or low bone mineral density (BMD). This study aimed to evaluate the risk of fracture according to the depression status among the elderly.METHODS: This study used the National Health Insurance Corporation cohort data to examine 96,188 elderly people aged >65 years who were examined in 2007 and 2008. The chi-square test was used to determine the general characteristics and fracture incidence in patients with depression and healthy controls, and the hazard ratio was calculated using the Cox proportional hazards model corrected for general characteristics. The Kaplan-Meier method predicted the risk of fracture in two groups during the observation period.RESULTS: In the depressed group, 23.2% (441 of 1,904) of the patients had a fracture during the 5-year follow-up period; however, in the control group, only 17.5% (16,470 of 94,284) had a fracture (P < 0.001). In addition, multivariate analysis of the adjusted variables showed that the risk of fracture in the depressed group was 1.34 times higher than that in the control group. The risk of fracture in women was 1.71 times higher than that in men, and the risk of fracture increased with age.CONCLUSION: The risk of fracture in the elderly who were depressed was significantly higher than that in the elderly who were not depressed.
Accidental Falls ; Aged ; Bone Density ; Cohort Studies ; Depression ; Depressive Disorder ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Methods ; Multivariate Analysis ; National Health Programs ; Proportional Hazards Models