The surgical treatment of epilepsy patients can be divided into various resection methods such as simple excision, lesionectomy, and lesionectomy plus cortisectomy. Recently, radiosurgery is included in the armamentarium. Several authors suggest that the radiosurgery is an alternative treatment to open respective surgery for intractable epilepsy, especially for mesial temporal lobe epilepsy. The optimal indication and effi cacy of radiosurgery for epilepsy patients are still controversial. In our study, 153 patients with seizure/epilepsy and MRI visible lesion from 1993 to 2006, were included (157 operations). We reviewed the cases of the patients with epileptogenic lesions of neoplasm and vasculopathy who had been treated surgically to determine surgical outcome in relation with types of surgical treatment, pathology, and location of lesion.

No abstract available.
Anterior Temporal Lobectomy* ; Seizures*

BACKGROUND: The catalytic subunit of telomerase, hTERT (telomerase reverse transcriptase), is one of the most important components of telomerase, and performs a pivotal role in the mechanism underlying the regulation of telomerase activity in cellular immortalization and carcinogenesis. The principal objective of this study was to investigate hTERT expression in patients with non-small cell lung carcinomas (NSCLCs), and to evaluate its clinical significance and association with the expression of p16 and p53. METHODS: Using tissue microarray, the protein expression profiles of hTERT, p16 and p53 were investigated via immunohistochemistry in 167 samples of NSCLCs. RESULTS: Expression was observed in 54.5% (91/167) of the tumors, which were predominantly squamous cell carcinomas. Patients evidencing hTERT expression in their tumors exhibited significantly poorer survival rates than did patients without hTERT expression in early-stage NSCLCs (p=0.0125). According to the results of our Cox regression analysis, hTERT expression proved to be an independent prognostic factor (p=0.006), particularly for squamous cell carcinomas (p=0.019). hTERT expression was not correlated with p16 expression, but was rather associated with the expression of p53 (p=0.002). CONCLUSIONS: Our results show that hTERT may perform a function in the progression of NSCLC, and that its detection may be useful in predicting the prognosis of NSCLC patients in the early stages of the disease, as well as in the development of a targeted therapy in these tumors.
Carcinogenesis ; Carcinoma, Non-Small-Cell Lung ; Carcinoma, Squamous Cell ; Catalytic Domain ; Humans ; Immunohistochemistry ; Lung* ; Prognosis ; Survival Rate ; Telomerase*

Nucleolar organizer regions (NORs) are loops of DNA which occur in the nucleoli of cells which possess ribosomal RNA genes. The numbers and areas of NORs have been thought to be related to cellular activities. We aimed to investigate the direct relationship between the parameters of AgNORs and cellular proliferative activity using immunohistochemical method with the monoclonal antibody Ki-67, which demonstrates proliferating nuclei. The sequential technique for the simultaneous Ki-67 immunostaining and NOR staining was applied to the same slides of a series of non-Hodgkin's lymphomas (NHL) of the low, intermediate, and high grade type. The number of AgNOR per cell was counted and mean NOR percentage nuclear area (NPNA) was measured by morphometry in both the Ki-67 positive and Ki-67 negative nuclei. The increased immunoreactivity for Ki-67 was found in the high grade than in the low grade non-Hodgkin's lymphoma. This was reflected in the two areas of the palatine tonsils and lymph nodes, the positive cell counts being higher in the follicle center nuclei than in those in the interfollicular compartment. In general the numbers and NPNA of AgNORs were higher in the Ki-67 positive nuclei than in those lacking the antigen in malignant lymphomas as well as in control. The AgNORs numbers and NPNA in controls were the highest in the Ki-67 positive cells in the follicular area and the lowest in the Ki-67 negative cells in the perifollicular area. In malignant lymphomas the numbers and NPNA of AgNORs tended to increase in proportion to their grade in both the Ki-67 positive and negative cells. The numbers of AgNORs of the high grade and the NPNA of the intermediate and the high grade were significantly higher in Ki-67 positive cells than in Ki-67 negative ones. With this double staining method it was now possible to confirm that numbers and NPNA of AgNORs were directly related to the cellular proliferative activity. In maligant lymphoma, among the several parameters of the AgNORs, NPNA in Ki-67 positive cells is proposed to be the most useful marker in determining the prognosis of the patient.
Cell Count ; DNA ; Genes, rRNA ; Humans ; Lymph Nodes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Nucleolus Organizer Region* ; Palatine Tonsil ; Prognosis

Hysterosalpingography and Hysteroscopy have been used for the detection of intraute-rine pathology such as polyps, submucous myomas, intrauterine adhesion and endometrial hyperplasia or cancer. Recently the ultrasound has also been utilized for the detection of uterine pathology. Therefore the purpose of this study was to evaluate the diagnostic efficacy of SonoHysterography in detection of intrauterine pathology compared with HSG and Hysteroscopy. 32 patients underwent Sono-Hysterography and Hysteroscopy for the evaluation of the uterine pathology from september 1995 to January 1996. Nine of 32 patients had infertility problem and HSG performed prior to Sono-Hysterography and Hysteroscopy. The results are as follows : 1. The patients' ages ranged from 20 to 50 years(median 37.9). 2. All 9 patients with infertility who had positive HSG findings in uterine cavity showed the intrauterine pathology in Sono-Hysterography as well as Hysteroscopy. The detail findings are as follows :septated uterus(n=2), intrauterine adhesion :IUA(n=3), endometrial polyp(n=3), and IUA combined endmetrial hyperplasia(n=1). 3. Twenty two of 23 patients with abnormal uterine bleeding showed the intrauterne pathology and one patient had negative finding in Sono-Hysterography. However, Hysteroscopy revealed positive intrauterine pathology in 22 patients who had abnormal uterine bleeding. One patients who had positive finding in Sono-Hysterograply showed negative by Hysterography. In contrast, one patient who had negative finding in Sono-Hysterography had positive uterine pathology with polyp in Hysteroscopy. The histologic pathology in all 23 patients reported endometrial polyp(n=12), placental polyp(n=2), submucous myoma(n=1), endometrial hyperplasia(n=5), endometrial cancer(n=1), normal endometrial finding(n=2). 4. Sono-Hysterography, therefore, has a sensitivity and positive predictive value of 96.6%, 93.5% respectively. Our study showed a positive Sono-Hysterography is very predictive of the intrauterine pathology. Sono-Hysterography is safe, quick and minimal invasive procedure. So it is an invaluable technique in the evaluation of uterine cavity.
Endometrial Hyperplasia ; Female ; Humans ; Hysterosalpingography ; Hysteroscopy* ; Infertility ; Myoma ; Pathology* ; Polyps ; Ultrasonography ; Uterine Hemorrhage

No abstract available.
Agaricales* ; Anemia, Aplastic* ; Humans

No abstract available in English.

Mesenteric fibromatoses occur as sporadic lesions or as parts of familial adenomatous polyposis, are clonal lesions prone to locally aggressive behavior, but lack metastatic capacity. Fibromatoses harbor somatic beta-catenin or adenomatous polyposis coli (APC) mutations, leading to intranuclear accumulation of b-catenin. We report a case of mesenteric fibromatosis presenting as a 5.4x4.8 cm submucosal tumor of the jejunum in a 42-year-old woman. Histologically, the tumor consisted of proliferation of bland, elongated-spindle fibroblasts with collagen deposition and a characteristic prominent vasculature. Immunohistochemically, the tumor cells showed nuclear staining for beta-catenin. Mesenteric fibromatosis should be included in the differential diagnosis of submucosal spindle cell tumors of the gastrointestinal tract, and nuclear immunoreactivity for beta-catenin may help distinguish these tumors form histological mimics.
Adenomatous Polyposis Coli ; Adult ; beta Catenin ; Collagen ; Diagnosis, Differential ; Female ; Fibroblasts ; Fibroma ; Gastrointestinal Tract ; Humans ; Immunohistochemistry ; Intestine, Small ; Jejunum

Myofibrosarcoma of the breast is a rare malignant mesenchymal tumor that has been reported in only four well documented cases so far. We report a case of myofibrosarcoma of the breast in an 88-year-old man who complained of a palpable mass for 1 year. Microscopically, the tumor consisted mainly of spindled cells, arranged in irregular fascicles and embedded in broad bands of dense hyalinized collagen. It showed ill-defined border infiltrating the adjacent adipose tissue, moderate cellular pleomorphism, and high mitotic rate (8~9/10 HPF). Immunohistochemical study confirmed myofibroblastic differentiation of the tumor cells with diffuse strong reaction for vimentin, smooth muscle actin, and fibronectin.
Actins ; Adipose Tissue ; Aged, 80 and over ; Breast* ; Collagen ; Fibronectins ; Humans ; Hyalin ; Muscle, Smooth ; Myofibroblasts ; Vimentin

The lumbar discectomy has steadily improved since its introduction by Mixter and Barr in 1934. The results of standard discectomy are good, but surgeons must still contend with the "failed disc" syndrome. This is most likely caused by excessive damage to the contents of the epidural space during surgery. The application of microsurgical techniques to lumbar discectomy greatly minimizes disruption of the integrity of normal anatomy. Meticulous hemostasis may help to speed the process of convalescene, and the retention of epidural fat around the nerve root may help to prevent adhesions, which is a common cause of late, "failed disc" syndrome. High resolution computerized tomography of the lumbar spine provides an accurate means of preoperatively assessing both bony and soft tissue pathology of the spine, including nerve roots and the thecal sac. The author reviewed 84 cases of microsurgery of herniated lumbar discs at Yonsei University, Severance hospital and Young Dong hospital from April, 1982 to August, 1982 to August, 1983. Conclusions: 1) Among 84 patients, the ratio of male to female was 1.63:1(52pts:32pts) and cases in the 3rd and 4th decades were 60.7% of the total. 2) The most frequent level of herniation was L4-5 intervertebral space(73%), left side. 3) In preoperative studies, a spinal CT scan was taken in 78pts(93%), and in 31pts(37%), a spinal CT scan alone was taken. The accuracy of spinal CT scan was 100%. 4) Of operative findings, 50 lesions(60%) were identified as protruding discs and 34 lesions(18.1%) as ruptured ones. 5) Among 84 cases, 31pts(37%) received flavotomy and 53pts(63%) received flavectomy or small partial hemilaminectomy. 6) The advantages of microsurgery of herniated lumbar discs were magnified vision and brilliant illumination, precise identification of structures in deep fields(including nerve root and its related structures), a marked advantage to dissect the adhered nerve root to its surrounding structures, its capacity to preserve the integrity of normal tissue, and meticulous hemostasis. This resulted in marked reduction in immediate postoperative pain, early ambulation and early discharge. 7) 100% of microsurgery for herniated lumbar disc disclosed from good to excellent results. 8) After microsurgery, no cases needed re-operation and there were no recurrent disc herniations.
Diskectomy ; Early Ambulation ; Epidural Space ; Female ; Hemostasis ; Humans ; Lighting ; Male ; Microsurgery* ; Pain, Postoperative ; Pathology ; Spine ; Tomography, X-Ray Computed