Pharmacologic therapy is still the primary management for epilpsy; however, surgical treatment is a reasonable therapeutic option for patients suffering from medically intractable seizures, especially temporal lobe epilepsy having a documented unilateral epileptogenic area. Thirty nine patients with pharmaco-resistant complex partial seizures underwent anterior temporal lobectomy and hippocampectomy in 38 cases and frontal cortisectomy in one case. On pathological examination, hippocampal sclerosis was a predominent pathologic finding and was identified in 18 cases. Other non-neoplastic lesions consisted of 5 cases of vascular lesions(2 cavernous angiomas, 2 arteriovenous malformations and 1 angiomatosis), 3 cases of fibrous nodule, 2 cases of cicatrical changes of cerebral cortex, and 1 case of parasitic infection. Neoplasms including two cases of oligodendroglioma and one case of anaplastic astrocytoma were also noted. In seven cases, there was no detectable lesion on gross and microscopic examination. On post-operative follow-up, seizures were completely terminated in most cases(31 cases, 79%). The rest of the patients also displayed marked alleviation of symptoms. The seizures tended to recur more aften among the patients with neoplasm or no pathologically detectable lesion. In order to detect any minute pathological lesion, thorough gross and microcsopic examinations are considered to be essential.

We report 4 cases of malignant thymoma which were composed of 2 cases of invasive thymoma and 2 cases of thymic carcinoma. The cytologic findings of invasive thymoma were similar to those of benign thymoma. The distinctive cytologic features of thymic carcinoma were necrotic background, irregular clusters and individually scattered arrangement of anaplastic epithelial cells, and some scattered mature small lymphocytes. These findings may be found in the Hodgkin'slymphoma, seminoma, and metastatic squamous cell carcinoma, undifferentiated carcinoma, and large cell carcinoma of the. lung. But, the feature of irregular clustering of anaplastic epithelial cell having scanty cytoplasm was different from Hodgkin'slymphoma and seminoma. Clinical and radiologic findings as well as cytologic finding were helpful in differential diagnosis of thymic carcinoma from metastatic carcinoma.
Biopsy, Fine-Needle* ; Carcinoma ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Cytoplasm ; Diagnosis, Differential ; Epithelial Cells ; Lung ; Lymphocytes ; Seminoma ; Thymoma*

Pheochromocytoma is originated from chromaffin cell of sympathetic nervous system and associated with other disease, such as neurofibromatosis, duodenal carcinoid, medullary thyroid cancer and parathyroid adenoma. Especially, pheochromocytoma is developed more than 50% in neurofibromatosis associated with hypertension. In such cases, several clinical features documented as more frequent bilateral phochromocytoma, more associated with other neuroendocrine tumors and thus more poor prognosis. We can observe the sustained hypertension despite of surgical resection of tumors in pheochromocytoma cases. One of the possible reason of post operative sustained hypertension is the pheochromocytoma originated from minor organ of Zukerkandl that was not resected during operation. Untreated or delayed treated cases with pheochromocytoma were often expired by complication of hypertension such as cerebrovascular hemorrhage, myocardial infarction, etc. Thus, in neurofibromatosis with hypertension, screening of pheochromocytorna is very important for the early detection of tumor and more favorable prognosis. Recently, We experienced a case of neurofibromatosis associated with bilateral pheochromocy-toma expired by cerebral hemorrhage during operation, so we report the case with literature review.
Carcinoid Tumor ; Cerebral Hemorrhage ; Chromaffin Cells ; Hemorrhage ; Hypertension ; Mass Screening ; Myocardial Infarction ; Neuroendocrine Tumors ; Neurofibromatoses* ; Parathyroid Neoplasms ; Pheochromocytoma* ; Prognosis ; Sympathetic Nervous System ; Thyroid Neoplasms

Pathologists and others have been calling the serous cystadenoma of the pancreas "microcystic cystadenoma", following Compagno and Oertel's proposal in l978 because it usually consists of innumerable small cysts (less than 2cm). However, unilocular or predominantly macrocystic types of serous cystadenoma have been occasionally reported. Therefore, they present a difficulty in precise preoperative and intraoperative diagnosis for their simi1ar gross appearance to other cystic lesions of the pancreas. We discovered two cases of macrocystic and unilocular serous cystadenomas of the pancreas which were lined by cuboidal to flattened epithelial cells. They contained PAS positive and D-PAS negative intracytoplasmic glycogen granules. The unilocular, macrocystic and microcystic patterns may represent a morphologic spectrum of a pancreatic neoplasm. So we propose to use the term "serous cystadenoma" rather than microcystic cystadenoma.
Cysts

The most important prognostic factor of breast cancer is the status of lymph node or distant metastasis, which is resisted by basement membrane and stromal matrix. MMP (matrix metalloproteinase)-2 is a 72-kilodalton type IV collagenase/ gelatinase and degrades the type IV collagen which is a main component of the basement membrane. Therefore, MMP-2 is believed to be one of the key molecule for cancer invasion and metastasis. Enzymatic activity of MMP is inhibited by TIMPs (tissue inhibitors of metalloproteinase). TIMP-2 forms a complex with latent pro-MMP-2 and inhibits the active forms of MMP-2. The balance of MMPs and TIMPs is suspected as the important factor of invasion and metastasis of the tumor cells. We studied the association between the expression of MMP-2/TIMP-2 and growth pattern of tumor border, lymph node metastasis, and estrogen receptor expression in the 57 cases of invasive ductal carcinoma of the breast using immunohistochemical staining methods. The results revealed increased expression of MMP-2 in the infiltrating tumor border and tumors with positive lymph node metastasis and negative estrogen receptor with no statistical significance (p>0.05). But the expression of TIMP-2 was increased in expanding tumor border and tumors with positive lymph node metastasis and negative estrogen receptor without statistical significance (p>0.05).
Basement Membrane ; Breast Neoplasms ; Breast* ; Carcinoma, Ductal* ; Collagen Type IV ; Estrogens* ; Gelatinases ; Lymph Nodes* ; Matrix Metalloproteinases ; Neoplasm Metastasis* ; Tissue Inhibitor of Metalloproteinase-2*

BACKGROUND: This study aimed to evaluate regional cerebral blood flow (rCBF) changes using 99mTC-ECD SPECT (Ethylene Cysteine Diethylester Single Photon Emission Computed Tomography) and contemporary clinical responses such as cognitive and psychiatric symptoms and activities of daily living (ADL) after cholinesterase inhibitors (ChEI) treatment. METHODS: The subjects were eight probable Alzheimer's disease (AD) patients (four males and four females, mean age 69.63 years) who were recruited from the department of Neurology, at Yeungnam University Medical Center, between August 2000 and April 2002. The clinical diagnosis of AD was based on the DSM-IV and NINCDS-ADRDA criteria. Hachinski ischemic scores of all the patients were below 1. The mean treatment duration was 30.38 weeks which ranged from 24 to 44 weeks. Four patients received Rivastigmine (Exelon(r)) 12 mg after titration, and three patients received Donepezil (Aricept(r)) 10 mg during the whole period and only one patient had Donepezil 10 mg after the initial 5 mg for three weeks. The base line and follow up 99mTC-ECD SPECT studies were done on an average 6 days before the ChEI treatment and 4 days after finishing the study. RESULTS: The most significant increase in blood flow occurred in the bilateral parietal lobes (p<0.05). Reduction in the rCBF is more profound on the left hemisphere in the base line (p<0.05) and it achieved significant increase of rCBF after ChEI treatment compared with the right hemisphere (p<0.05). CONCLUSIONS: Treatment with ChEI for 30.38 weeks increased rCBF and overall increased in global cognitive functions including K-MMSE, ADAS-cog, CDR, CDR-SB, GDS, and NPI and ADCS-ADL scores.
Academic Medical Centers ; Activities of Daily Living ; Alzheimer Disease* ; Cholinesterase Inhibitors* ; Cholinesterases* ; Cysteine ; Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Follow-Up Studies ; Humans ; Male ; Neurology ; Parietal Lobe ; Tomography, Emission-Computed, Single-Photon* ; Rivastigmine

No abstract available.
Health Promotion*

PURPOSE: To classify the cavernous sinus lesions, to describe their radiological findings, and to assess the usefulness of MR compared to CT. METHODS AND MATERIALS: Fourty-five patients with lesions involving the cavernous sinus proved by histological and/or clinical and imaging methods were studied retrospectively and classified into neoplastic, vascular, and inflammatory lesions. CT and MR findings were compared in 21 patients evaluated by both modalities simultaneously according to these 4 categories. RESULTS: Pitiutary macroadenoma was the most common cavernous sinus lesion(42%). Diffuse convex bulging of the lateral wall of cavernous sinus was the most frequent radiological finding(84%), and the others were encasement of the cavernous carotid artery(49%), remodelling of the surrounding bones(44%), and complete obliteration of Meckel's cave(38%), in descending order of frequency. Bulging of the lateral wall of cavernous sinus was equally well demonstrated on both modalities, but encasement or displacement of the cavernous carotid artery and complete or partial obliteration of Meckel's cave were much better delineated on MR than on CT with the ratio of 3.8:1 and 4.6: 1, respectively. Only bone changes were much better demonstrated on CTthan on MR with the ratio of 3.8: 1. CONCLUSION: MR issuperior to CTin demonstrating thecavernouscarotid artery encasement and obliteration of Meckel's cave, but CT is much better than MR in demonstrating bone changes.
Arteries ; Carotid Arteries ; Cavernous Sinus* ; Humans ; Retrospective Studies

The purpose of this study was to evaluate the abrasion resistance of surface penetrating sealant which was applied on a composite resin restoration and to provide proper time to reapply sealant on composite resin surface. Two hundred rectangular specimens, sized 8 x 3 x 2 mm, were made of Micronew (Bisco, Inc., Schaumburg, IL, U.S.A) and divided into two groups; F group (n = 10) was finished with coarse and medium grit of Sof-Lex discs and BisCoverwas applied B group (n = 190) after finishing with discs. B group was again subdivided into nineteen subgroups. From B-1 group to B-18 group were subjected to toothbrush abrasion test using a distilled water-dentifrice slurry and toothbrush heads. B-IM group was not subjected to toothbrush abrasion test. Average surface roughness (Ra) of each group was calculated using a surface roughness tester (Surfcorder MSE-1700: Kosaka Laboratory Ltd., Tokyo, Japan). A representative specimen of each group was examined by FE-SEM (S-4700: Hitachi High Technologies Co., Tokyo, Japan). The data were analysed using cluster analysis, paired t-test, and repeated measure ANOVA. The results of this study were as follows; 1. Ra of F group was 0.898 +/- 0.145 microm and B-IM group was 0.289 +/- 0.142 microm. Ra became higher from B-1 group (0.299 +/- 0.48 microm) to B-18 group (0.642 +/- 0.313 microm). 2. Final cluster center of Ra was 0.361 microm in cluster 1 (B-IM ~ B-7), 0.511 microm in cluster 2 (B-8 ~ B-14) and 0.624 microm in cluster 3 (B-15 ~ B-18). There were significant difference among Ra of three clusters. 3. Ra of B-IM group was decreased 210.72% than Ra of F group. Ra of B-8 group and B-15 group was increased 35.49% and 51.35% respectively than Ra of B-IM group. 4. On FE-SEM, B-IM group showed the smoothest resin surface. B-8 group and B-15 group showed vertically shallow scratches, and wide and irregular vertical scratches on composite resin surface respectively. Within a limitation of this study, finished resin surface will be again smooth and glazy if BisCover would be reapplied within 8 to 14 months after applying to resin surface.
Head

The purpose of this study was to evaluate the abrasion resistance of surface penetrating sealant which was applied on a composite resin restoration and to provide proper time to reapply sealant on composite resin surface. Two hundred rectangular specimens, sized 8 x 3 x 2 mm, were made of Micronew (Bisco, Inc., Schaumburg, IL, U.S.A) and divided into two groups; F group (n = 10) was finished with coarse and medium grit of Sof-Lex discs and BisCoverwas applied B group (n = 190) after finishing with discs. B group was again subdivided into nineteen subgroups. From B-1 group to B-18 group were subjected to toothbrush abrasion test using a distilled water-dentifrice slurry and toothbrush heads. B-IM group was not subjected to toothbrush abrasion test. Average surface roughness (Ra) of each group was calculated using a surface roughness tester (Surfcorder MSE-1700: Kosaka Laboratory Ltd., Tokyo, Japan). A representative specimen of each group was examined by FE-SEM (S-4700: Hitachi High Technologies Co., Tokyo, Japan). The data were analysed using cluster analysis, paired t-test, and repeated measure ANOVA. The results of this study were as follows; 1. Ra of F group was 0.898 +/- 0.145 microm and B-IM group was 0.289 +/- 0.142 microm. Ra became higher from B-1 group (0.299 +/- 0.48 microm) to B-18 group (0.642 +/- 0.313 microm). 2. Final cluster center of Ra was 0.361 microm in cluster 1 (B-IM ~ B-7), 0.511 microm in cluster 2 (B-8 ~ B-14) and 0.624 microm in cluster 3 (B-15 ~ B-18). There were significant difference among Ra of three clusters. 3. Ra of B-IM group was decreased 210.72% than Ra of F group. Ra of B-8 group and B-15 group was increased 35.49% and 51.35% respectively than Ra of B-IM group. 4. On FE-SEM, B-IM group showed the smoothest resin surface. B-8 group and B-15 group showed vertically shallow scratches, and wide and irregular vertical scratches on composite resin surface respectively. Within a limitation of this study, finished resin surface will be again smooth and glazy if BisCover would be reapplied within 8 to 14 months after applying to resin surface.
Head