Recent advances of neuroimaging and electrophysiological monitoring technique have contributed in improving the surgical outcome of frontal lobe epilepsy. The authors have analysed 36 consecutive cases of intractable frontal lobe epilepsy that were treated at our institute between September, 1992 and December, 1995 to determine the clinical, electrophysiological, and neuroimaging characteristics as well as to delineate the efficacy of surgical treatment in improving the seizure outcome. The patients consisted of 19 males and 17 females. The mean age of the seizure onset and the mean duration of epilepsy were 14.9 and 11.6 years, respectively. Magnetic resonance imaging(MRI) showed no lesion in 9 patients and pathological lesions in 27 patients. The types of the lesions observed included primary brain tumor, mostly low-grade glioma in 10 patients, cortical dysplasia in 4, post-traumatic scar in 4, neocortical gliosis in 3, cyst in 3, and postencephalitic atrophy in 3. Intracranial recordings were performed in 23 cases to determine the epileptogenic zone. The surgical outcome was graded according to Engle's Classification as Class A in 20 patients, Class B in 2, Class C in 9, and Class D in 5. The surgical outcome was promising regardless of the presence or the absence of the lesion on MRI, invasive recording, age of seizure onset, and duration of epilepsy.
Atrophy ; Brain Neoplasms ; Cicatrix ; Classification ; Epilepsy ; Epilepsy, Frontal Lobe* ; Female ; Frontal Lobe* ; Glioma ; Gliosis ; Humans ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development ; Neuroimaging ; Seizures

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*

Regional left ventricular dysfunction is common in patients with coronary artery disease and accurate analysis of regional dysfunction is of particular interest. For the quantitative assessment of regional dysfunction, we measured regional ejection fraction by radial sector division method in 19 patients with acute myocardial infarction and 13 normal controls who had multigated blood pool scan. And two independent observer analyzed regional wall motion using 5 point grading system in 18 patients undergoing radionuclide ventricular cineangiography. The results obtained were as follows : 1) Regional wall motion scores for the gated blood pool study agreed completely in 72 of 108 segments (66.7%) and agreed within 1 grade in 88 of 108 segments(81.5%) and agreement rate is lowest in the septal area. 2) Global left ventricular ejection fraction was 63.2+/-4.2% in normal controls, 36.6+/-6.8% in extensive anterior wall infarction group and 52.6+/-9.7% in inferior wall infarction group. The value of extensive anterior wall infarction group was significantly lower than that of inferior wall infarction group(p<0.005). 3) Regional left ventricular ejection fraction by radial sector division method in normal control group were as follows : area 1 ; 56.5+/-6.7%, area 2 : 77.9+/-4.8%, area 3 ;84.3+/-5.5%, area 4 : 76.8+/-6.6%, area 5 ; 84.7+/-7.6%, area 6 ; 85.9+/-11.2%, area 7 ; 75.5+/-12.3%, area 8 ; 74.9+/-14.0%, area 9 ; 75.5+/-8.8%, area 10 ; 54.2+/-11.0%, 11 ; 34.5+/-16.3, area 12 ; 37.1+/-18.0%. 4) Mean regional ejection fraction in 7 patients with anterior wall infarction showed significantly lower values in area 4 to area 8, and in area 2 to area 5 in case of inferior wall infarction group. 5) We thought that regional ejection fraction obtained by radial sector division method is valuable index for the management and evaluation of patients with coronary artery disease.
Cineangiography ; Coronary Artery Disease ; Humans ; Infarction ; Myocardial Infarction* ; Septum of Brain ; Stroke Volume ; Ventricular Dysfunction, Left

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.
Adult ; Breast ; Epididymis ; Humans ; Male ; Myoepithelioma ; S100 Proteins ; Salivary Glands ; Skin ; Testis

We have experienced two patients who had hypokalemic metabolic alkalosis as well as hypomagnesemia and hypocalciuria with elevated plasma renin activity. We have performed renal clearance study after water loading, administration of furosemide and thiazide in two patients and two normal controls. Maximal free water clearance per 100 mL glomerular filtration rate(CH2O) and distal fractional chloride reabsorption[CH2O/(CH2O+CCl)] in our patients were reduced than the controls. Chloride clearance(CCl) was increased after furosemide administration but not after thiazide administration. Distal fractional chloride reabsorption[CH2O/(CH2O+CCl)] was dramatically decreased by furosemide administration in our patients, whereas thiazide had little effect on it. Fractional excretion of sodium, chloride, magnesium, calcium was increased by furosemide administration, whereas thiazide administration had little effect on this parameters. These findings suggested the presence of a defect in the distal convoluted tubule rather than in the thick ascending loop of Henle. Herein, we report two cases of Gitelman's syndrome diagnosed by renal clearace study after water loading, administration of furosemide and thiazide.
Alkalosis ; Calcium ; Filtration ; Furosemide ; Gitelman Syndrome* ; Humans ; Loop of Henle ; Magnesium Chloride ; Plasma ; Renin ; Sodium ; Water

The purposes of this study were to determine phenolic compounds and to evaluate antioxidant activities of plums (Soldam, Oishiwase and Formosa). Soldam contains the highest amount of total phenolics among cultivars (Formosa: 4.0%, Oishiwase: 3.3%, Soldam: 6.4% for total phenolic) as well as the total flavonoids of which constituents were mainly myricetin and anthocyanidin. The antioxidant activities were measured by DPPH, ABTS radical scavenging, and SOD-like activities. The DPPH radical scavenging activity of Korean plum extracts (200 microg/mL) showed more than 43%, and the Soldam turned out to be the highest : ID50 value: 160-177 microg/mL for Formosa and Oishiwase; 58-64 microg/mL for Soldam. The ABTS radical scavenging activity of Korean plum extracts (200 microg/mL) was found to be more than 50%. The SOD-like activity of Korean plum extracts (200 microg/mL) showed more than 70%. Among three kinds of cultivars, Soldam had the highest antioxidant activity. The nitrite scavenging activity of Soldam was 61.5%, which is the highest, compared with that of the other cultivars, about 50%. From these results, Korean plums turned out to be phytochemical rich fruit as well as to show high antioxidant activities.
Anthocyanins ; Benzothiazoles ; Flavonoids ; Fruit ; Phenol ; Prunus domestica ; Sulfonic Acids ; Taiwan

PURPOSE: The wild-type p53 protein participates in suppressing cell transformations while its mutant forms has tumorigenic potential. Alterations in the structure of the p53 protein are one of the most common changes associated with human cancers. CREB-binding protein (CBP) and its homologue, p300, are transcriptional co-activators of various sequence-specific DNA-binding transcription factors and are involved in a wide range of cellular activities, such as DNA repair, cell growth, differentiation, and apoptosis. Several studies suggested that an association between p53 and p300 might account for the p53-responsible negative regulation. This study examined the relationship between p53 and CBP expression in terms of the clinicopathological factors and significance. METHODS: The level of p53 protein and CBP expression was measured in 150 gastric adenocarcinoma patients, who had undergone a gastrectomy, and the relationship between p53 and CBP was examined. Immunohistochemical stain was performed on formalin-fixed paraffin-embedded sections using monoclonal anti-p53 and anti-CBP antibody. RESULTS: 1. p53 protein was expressed in 46.3% (31/67) of early gastric cancers (EGC), 69.9% (58/83) of advanced gastric cancers (AGC)(P<0.05), 69.1% (65/94) of the intestinal type, 42.9% (24/56) of the diffuse type (P<0.05), 78.5% (55/70) of patients with a lymph node metastasis and 42.5% (34/80) of patients without a lymph node metastasis (P<0.01). 2. CBP expression was observed in 65% (61/94) of intestinal type, 51% (29/56) of the diffuse type (P>0.05), 47.8% (32/67) of EGC, 69.8% (58/83) of AGC (P<0.05), 68.6% (48/70) of patients with a lymph node metastasis and 52.5% (42/80) of patients without a lymph node metastasis (P>0.05). 3. p53 protein and CBP expression was coincidentally observed in 66.7% of gastric adenocarcinomas, and there was a significant correlation between the expression of both (P<0.05). CONCLUSION: That the expression of the p53 protein and CBP indirectly indicate the malignant potential of a cell, and may play an indirect role in the CBP and p53-mediated tumorigenic potential.
Adenocarcinoma* ; Apoptosis ; CREB-Binding Protein* ; DNA Repair ; Gastrectomy ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Stomach ; Stomach Neoplasms ; Transcription Factors

PURPOSE: We examined the expressions of claudin-4 and E-cadherin, which are known as cell adhesion-associated proteins, in stomach cancer. The relationship of their expression with the clinicopathologic factors was examined to investigate the roles of these proteins in the invasion or metastasis of stomach adenocarcinoma. METHODS: The expressions of claudin-4 and E-cadherin were examined in 73 cases of adenocarcinoma of the stomach by performing immunohistochemical staining. RESULTS: The expressions of claudin-4 and E-cadherin in the stomach adenocarcinoma were both correlated with the histologic grade, the T-stage and nodal metastasis, respectively (P<0.05). The expression of claudin-4 was significantly associated with the expression of E-cadherin. CONCLUSION: Our data suggests that claudin-4 and E-cadherin are involved in the processes of histologic differentiation, invasion and metastasis of stomach adenocarcinoma.
Adenocarcinoma ; Cadherins* ; Claudin-4* ; Neoplasm Metastasis ; Stomach Neoplasms* ; Stomach*

BACKGROUND/AIMS: Patient-controlled sedation (PCS) allows the patients to titrate the dosages of sedative drug according to their needs. The objective of this study was to compare the safety and the efficacy of nurse-administered propofol sedation (NAPS) with those of PCS. METHODS: Eighty one patients were randomly assigned to two groups. All patients received meperidine 25 mg and propofol 40 mg as an initial dose for sedation. Patients in PCS group were subsequently infused with propofol 15 mg over 80 seconds through infusion pump whenever they required. Patients in NAPS group were injected with 10~20 mg propofol by nurse with supervision by endoscopist. The dosage of propofol, cardiopulmonary parameters, procedure time, sedation score, pain score, the patients' and endoscopists' satisfaction scores were assessed. RESULTS: With regard to blood pressure, pulse rate and oxygen saturation, serious complications were not observed. Especially, there was no significant difference of mean total dose between two groups (NAPS group and PCS group received 76.7+/-24.7 mg and 82.5+/-26.6 mg respectively). Pain score was higher in woman than in man (p=0.03). CONCLUSIONS: 1.2~1.5 mg/kg of propofol with small dose of opioid during colonoscopy was effective and safe. NAPS was more practical and useful method of sedation than PCS during colonoscopy.
Blood Pressure ; Colonoscopy* ; Female ; Heart Rate ; Humans ; Infusion Pumps ; Meperidine ; Organization and Administration ; Oxygen ; Propofol*

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Although advances have been made in the treatment of MS, such as the use of IFN-β, glucocorticoids and stem cells, the therapeutic effects of these treatments are not sufficient. In the present study, we evaluated whether the combination of methylprednisolone (MP) and human bone marrow-derived mesenchymal stem cells (BM-MSCs) could enhance the therapeutic effectiveness in experimental autoimmune encephalomyelitis (EAE), a model for MS. EAE was induced by immunizing C57BL/6 mice with myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55). The immunized mice received an intraperitoneal injection of MP (20 mg/kg), an intravenous injection of BM-MSCs (1 × 10⁶ cells) or both on day 14 after immunization. Combination treatment significantly ameliorated the clinical symptoms, along with attenuating inflammatory infiltration and demyelination, compared to either treatment alone. Secretion of pro-inflammatory cytokines (IFN-γ, TNF-α, IL-17) was significantly reduced, and anti-inflammatory cytokines (IL-4, IL-10) was significantly increased by the combination treatment as compared to either treatment alone. Flow cytometry analysis of MOG-reactivated T cells in spleen showed that combination treatment reduced the number of CD4⁺CD45⁺ and CD8⁺ T cells, and increased the number of CD4⁺CD25⁺Foxp3⁺ regulatory T cells. Furthermore, combination treatment enhanced apoptosis in MOG-reactivated CD4⁺ T cells, a key cellular subset in MS pathogenesis. Combination treatment with MP and BM-MSCs provides a novel treatment protocol for enhancing therapeutic effects in MS.
Animals ; Apoptosis ; Central Nervous System ; Clinical Protocols ; Cytokines ; Demyelinating Diseases ; Encephalomyelitis, Autoimmune, Experimental* ; Flow Cytometry ; Glucocorticoids ; Humans* ; Immunization ; Injections, Intraperitoneal ; Injections, Intravenous ; Mesenchymal Stromal Cells* ; Methylprednisolone* ; Mice ; Multiple Sclerosis ; Myelin-Oligodendrocyte Glycoprotein ; Spleen ; Stem Cells ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Therapeutic Uses