Vestibular schwannoma (VS) is a benign tumor typically originated in the schwann cell of vestibular nerve and usually accompany hearing symptom. Microsurgical removal and radiosurgery have a great role for the treatment of VS. Recently radiosurgery has been considered as an alternative or primary treatment for VS with the tremendous increase of patients who were treated with gamma knife radiosurgery (GKS) though microsurgery still takes the premier. By many published results, it is proved that GKS is a effective and noninvasive technique for VS, especially small sized tumors with satisfactory tumor control rate. The authors assumed that GKS can be expected to achieve satisfactory tumor control rate for small VS under 5 cc in volume. A major interest regarding radiosurgery nowadays is to determine the optimal radiation dose for hearing preservation to improve the quality of life of patients. The more high radiation dose are used for effective tumor growth control, the more radiation-related complications like as hearing deficit, the impairment of other cranial nerve function are increased. Since 1990's the mean radiation dose for tumor margin was more than 18 Gy, but there were high complication rate in spite of good tumor growth control. After the year of 2000, under the influence of advanced neuro-imaging techniques and radiosurgical planning system which enable clinicians to do more precise planning, marginal dose for VS has been decreased to 12-13 Gy and the radiation-related complications has been reduced. But because there may be a unexpected radiationinduced complications as time goes by after the latency period, optimal radiation dose for VS should be established on the basis of more long term follow-up observation.
Cranial Nerves ; Follow-Up Studies ; Hearing ; Humans ; Latency Period (Psychology) ; Microsurgery ; Neuroma, Acoustic* ; Quality of Life ; Radiosurgery* ; Vestibular Nerve

Vestibular schwannoma (VS) is a benign tumor typically originated in the schwann cell of vestibular nerve and usually accompany hearing symptom. Microsurgical removal and radiosurgery have a great role for the treatment of VS. Recently radiosurgery has been considered as an alternative or primary treatment for VS with the tremendous increase of patients who were treated with gamma knife radiosurgery (GKS) though microsurgery still takes the premier. By many published results, it is proved that GKS is a effective and noninvasive technique for VS, especially small sized tumors with satisfactory tumor control rate. The authors assumed that GKS can be expected to achieve satisfactory tumor control rate for small VS under 5 cc in volume. A major interest regarding radiosurgery nowadays is to determine the optimal radiation dose for hearing preservation to improve the quality of life of patients. The more high radiation dose are used for effective tumor growth control, the more radiation-related complications like as hearing deficit, the impairment of other cranial nerve function are increased. Since 1990's the mean radiation dose for tumor margin was more than 18 Gy, but there were high complication rate in spite of good tumor growth control. After the year of 2000, under the influence of advanced neuro-imaging techniques and radiosurgical planning system which enable clinicians to do more precise planning, marginal dose for VS has been decreased to 12-13 Gy and the radiation-related complications has been reduced. But because there may be a unexpected radiationinduced complications as time goes by after the latency period, optimal radiation dose for VS should be established on the basis of more long term follow-up observation.
Cranial Nerves ; Follow-Up Studies ; Hearing ; Humans ; Latency Period (Psychology) ; Microsurgery ; Neuroma, Acoustic* ; Quality of Life ; Radiosurgery* ; Vestibular Nerve

Motivational interviewing is a directive, collaborative conversation style for strengthening a person's own motivation and commitment to change. Motivational interviewing provides diabetes educators with appropriate tools to interview patients with diabetes who are resistant to change and can help with lifestyle change and health behavior. Motivational interviewing has been incorporated into health care settings to treat a variety of health conditions. The purpose of this article is to provide diabetes educators with ways to actually use motivational interviewing in diabetes self-management education.
Delivery of Health Care ; Diabetes Mellitus ; Education* ; Health Behavior ; Humans ; Life Style ; Motivation ; Motivational Interviewing* ; Self Care*

Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.

Cigarette smoke (CS) induces oxidative and nitrosative stress to the respiratory tract (RT) via both oxidants contained in CS and by CS-induced activation of RT inflammatory-immune pro-oxidant processes. CS exposure has been associated with reduced levels of plasma micronutrient antioxidants, in part due to an increased utilization and turnover of alpha-tocopherol (AT). It has been suggested that gamma-tocopherol (GT) may have an expanded spectrum of antioxidant activation compared to alpha-tocopherol (AT). In order to investigate effects of high GT supplementation as compared to AT, C57 BL/6 mice were fed control AT (35 mg/kg diet) or high GT (1,000 mg/kg diet) diet for 8-10 weeks and then exposed to 60 mg/m3 CS, 6 hr/day for 3 days. AT and GT levels and their metabolites were measured at endpoints. High GT supplementation significantly reduced AT levels in plasma, liver and lung compared to AT. CS increased levels of AT and GT in plasma and lung of control AT group but decreased GT levels in lung of high GT supplemented group. Moreover, CS significantly decreased GT metabolite, gamma-CEHC. The results suggest that high GT supplementation have selective modulation of concentrations of vitamin E and its metabolite in plasma and lung but not in liver against in vivo CS exposure.
alpha-Tocopherol ; Animals ; Antioxidants ; Chromans ; Diet ; gamma-Tocopherol ; Liver ; Lung ; Mice ; Micronutrients ; Oxidants ; Plasma ; Propionates ; Respiratory System ; Smoke ; Tobacco Products ; Vitamin E ; Vitamins

Pericardial effusion is a common disease seen by echocardiography, and it is found in 3–9% of annual echocardiograms. Although moderate pericardial effusion has been reported in some cases, it is usually asymptomatic and is rarely accompanied by cardiac tamponade. A large pericardial effusion may be due to various causes, including idiopathic causes, tuberculosis, cancer, connective tissue disease, infection, and hypothyroidism. Recent advances in analytic and imaging techniques have increased our ability to diagnose the cause of pericardial effusion accurately. This information is important for determining the proper treatment based on each case’s clinical characteristics. We report a case of large, recurrent pericardial effusion accompanied by hypothyroidism with initial increased levels of tumor markers, including cancer antigen 125, carcinoembryonic antigen, and alpha-fetoprotein. The patient was treated with thyroid hormone only. In follow-up images, the pericardial effusion was resolved and all of the tumor markers were normalized.

Lymphocytic hypophysitis is a clinically rare disease, and it has been known to be an autoimmune disease which mainly affects pregnant women at the end of gestation or right after delivery. The authors experienced a case of lymphocytic hypophysitis in a 29-year-old pregnant woman with rapid progressing visual disturbance. Sella MRI showed a mass-like lesion of hypophysis and hypertrophy of pituitary stalk with evidences of hypopituitarism. Cesarean section was done and then TSA was performed. The pathologic diagnosis was lymphocytic hypophysitis. After TSA, visual acuity was improved and visual field defect was recovered. She was given thyroid hormone replacement therapy because of transient partial hypopituitarism for 6 months after surgery. One must consider the probability of lymphocytic hypophysitis, if there are alteration of visual acuity and visual field defect which aggravate rapidly during pregnancy due to mass effect, decreased serum hormonal levels shown in hypopituitarism and sella MRI findings of hypertrophy of pituitary stalk and enlargement of pituitary gland.
Adult ; Autoimmune Diseases ; Cesarean Section ; Diagnosis ; Female ; Hormone Replacement Therapy ; Humans ; Hypertrophy ; Hypopituitarism ; Magnetic Resonance Imaging ; Pituitary Gland ; Pituitary Gland, Posterior ; Pregnancy ; Pregnant Women ; Rare Diseases ; Thyroid Gland ; Visual Acuity ; Visual Fields

The earliest reports of the use of electrical energy to directly stimulate bone healing seem to be in 1853 from England, the techniques involved the introduction of direct current into the non-united fracture site percutaneously via metallic needles, with subsequent healing of the defect. One endpoint of the periodontal therapy is to generate structure lost by periodontal diseases. Several procedural advances may support regeneration of attachment, however, regeneration of alveolar bone does not occur consistently. Therefore, factors which stimulate bone repair are areas for research in periodontal reconstructive therapy. Effects of cytokines or growth factors on bone repair are examples of such areas. Another one is electrical current which occurs in bone naturally, so that such bone may be particularly susceptible to electrical therapy. The purposes of this study were to observe the effects of electrical stimulation on the normal periodontium, to determine whether the electricity is the useful means for periodontal regeneration or not. Forty rats weighted about 100 gram were used and divided into 4 groups, the first group, there was no electrical stimulation with the connection of electrodes only. In the second group, there was stimulated by the 10 mA during 10 minutes per a day, in the third group was stimulated by the 25 mA , and the fourth by the 50 mA. At 3, 5, 10 and 15 days post-appliance , two rats in each group were serially sacrificed. and the maxillae and the mandible processed to paraffin, and the specimens were prepared with Hematoxylin-Eosin stain for the light microscopic evaluation. The results of this study were as follows : 1. There was the distinct reversal line on the lingual alveolar crest, whereas a little changes in the labial alveolar crest to the duration and amount of currents. 2. In 50 mA group, the cells were highly concentrated at the apex of anterior teeth, and was observed the necrotic tissue. In posterior root apex, the hypercementosis was appeared, and newly formed cementum layer has been increased continuously with the time. 3. The periodontal ligament fiber and Sharpey's fiber were arranged in order, and the bone trabeculae were increased as the experiment proceeded by, relatively the bone marrows were decreased. 4. In the pulp tissue, the blood vessels were increased with blood congestion in the experimetal specimens remarkably, and the dentinal tubules were obstructed . 5. The osteoblasts in alveolar bone proper had been showed highly activity, and also observed the formation of bone trabeculea. In the conclusion, it was suggested that the electrical stimulation has influence on the periodontium and the pulp tissue. However, there might be the injurious effects.
Animals ; Blood Vessels ; Bone Marrow ; Cytokines ; Dental Cementum ; Dentin ; Electric Stimulation* ; Electricity ; Electrodes ; England ; Estrogens, Conjugated (USP) ; Hypercementosis ; Intercellular Signaling Peptides and Proteins ; Mandible ; Maxilla ; Needles ; Osteoblasts ; Osteogenesis ; Paraffin ; Periodontal Diseases ; Periodontal Ligament ; Periodontium* ; Rats ; Regeneration ; Tooth

OBJECTIVE: The aim of this study was to evaluate Topotecan-, Cisplatin- and Taxol-induced apoptosis in five human ovarian cell lines as a measure of chemosensitiviy and relationship between apoptosis and p53 and bcl-2 gene expression. METHODS: In this study, the author is presenting data on apoptosis induced by Topotecan, Cisplatin and Taxol in five ovarian cancer cell lines, and represent different levels of sensitivities to Topotecan, Cisplatin and Taxol. This study also includes the interaction of these chemotherapeutic agents on ovarian cancer cell lines with respect to the apoptosis and cytotoxicity assay as a quantitative measure of the efficiency of killing. Presence of the p53 and bcl-2 gene product were examined by western blotting. RESULTS: The five cell lines represent various sensitivities to Topotecan, Cisplatin, Taxol (LD50 range of Topotecan, 30~1000 ng/ml; Cisplatin, 3~10 microgram/ml, Taxol 5~1000 nm). SKOV-3 represent a resistant cell line which was 2~30 times resistant to Topotecan, 3 times resistant to Cisplatin, and 2~200 times resistant to Taxol when compared to others. Demonstration of apoptosis correlated with the sensitivity of the cell lines to Topotecan, Cisplatin and Taxol for SNU-840 and OVCAR-3. DNA fragmentation of OVCAR-3 was uniformly present when treated with Topotecan, Cisplatin and Taxol, 24 or 48 hours. When sequencing experimetns were performed with correlated with cytotoxicity assays, except in SNU-251 cells where no signigicant difference was observed in different interactions of Topotecan, Cisplatin and Taxol. Pretreatment with Topotecan, Cisplatin at a 24 hour interval resulted in enhanced cytotoxicity. Quantitation of the fragmented DNA correlated with that seen on gel electrophoresis. CONCLUSION: The study indicate that the ability to achieve significant cytotoxicity by Topotecan, Cisplatin and Taxol may be related to the induction of apoptosis rather than necrosis. However, outcome of these treatments depend on cellular and genetic characheristics.
Apoptosis* ; Blotting, Western ; Cell Line* ; Cisplatin* ; DNA ; DNA Fragmentation ; Electrophoresis ; Genes, bcl-2 ; Homicide ; Humans ; Necrosis ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan*

BACKGROUND: Nerve growth factor(NGF) is a neurotrophic polypeptide necessary for the survival and growth of some central neurons, as well as sensory afferent and sympathetic neurons. In addition to its actions on the nervous system, it also has significant biologic effects on cells of the immune-inflammatory compartment. NGF can variably induce melanocyte mitosis, increase melanogenesis, enhance dendricity and prevent apoptotic cell death following the UV injury. OBJECTIVE: The purpose of this study is to evaluate the effects of NGF on proliferation of cultured human melanocytes. METHODS: The effects of NGF on proliferation of cultured human melanocytes were evaluated. To specify the NGF effect on proliferation of human melanocytes, excess of anti-NGF neutralizing polyclonal antibody was added. RESULTS: 1) In 1% of melanocyte growth supplement(MGS) medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. 2) In 0.2% of MGS medium, all experimental groups showed no significant increase of cell number. The addition of anti-NGF polyclonal antibody did not influence the proliferation of melanocytes. CONCLUSION: These results suggest that, even though NGF has many biological influencse on melanocytes, it does not play a significant role in the proliferation of melanocyts.
Cell Count ; Cell Death ; Humans* ; Melanocytes* ; Mitosis ; Nerve Growth Factor* ; Nervous System ; Neurons