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.

The anatomical structure of vermiform appendix was studied for 124 Korean adult cadavers and the articles were reviewed with special reference to its position and length. The results are as follows ; 1. On the frequency of positional types based on Wakeley (1933), postileal type was recorded most frequently (37.7%) and retrocecal type was found in 19.7% of cases, showing the difference from other ethnic groups whose most frequent position was retrocecal or pelvic type. 2. In the direction of appendix in relation to the clock, the direction between 1 and 3 o'clock was most frequently found. 3. Appendix of fixed form was found in 22.1% of cases, that of free form 77.9%. In free form, postileal type was found most frequently, but retrocecal type was met most frequently in fixed form. 4. The length of appendix was 5.95±1.64 cm (male ; 6.14±1.67 cm ; female 5.59±1.51 cm). Neither significant difference between sex nor positional type was noted. 5. Positions of appendix are seemed to be set up during fetal stage. The Ethnic variation in the positions of appendix is thought to be determined by inherited physical anthropological factor, not by postnatal one.
Adult* ; Appendix* ; Cadaver ; Ethnic Groups ; Female ; Humans

We describe a case metastatic alveolar soft part sarcoma of the brain in a 20-year old man. Alveolar soft part sarcoma is slowly growing tumor which almost shows conspicuous vascular invasion and have a high incidence of blood-borne metastasis. The principal metastatic sites are the lungs, followed by the skeleton and brain. Cerebral metastases may be the first manifestation of the disease and are more common with alveolar soft part sarcoma than with any other type of soft tissue sarcoma. The light-and electron-microscopic and immunohistochemical findings are described. Periodic acid-Schiff-positive, diastase resistant, intracytoplasmic crystals, pathognomonic for alveolar soft part sarcoma, are present. The cells expressed immunoreactivity for vimentin, desmin, neuron-specific enolase, S-100 protein and renin. The results of our own immunohistochemical examinations is suggestive of myoendocrine origin.
Incidence ; Neoplasm Metastasis

The melanotic neuroectodermal tumor of infancy(MNTl) is a rare, usually benign, pigmented lesion which most frequently involves the maxilla. Skull, brain, and mandible are other craniofacial sites; this anatomic region accounts for 87% of all cases. The vast majority of MNTl, nearly 95%, present in infants of both sexes within the first year of life. Most cases of MNTl follow a benign course, with a 15% propensity for local recurrence. MNTl is regarded as a primitive neuroectodermal tumor with polyphenotypic differentiation. We report a classical MNTl which occurred in left lower maxilla in 6-month old female infant. She developed an ill defined, firm swelling on the left alveolar ridge and gum during 3 weeks. Mass excision reveals ill defined, grayish-tan hard mass, measuring 2.0x1.6 cm. Microscopically, the tumor reveals irregular alveolar pattern of melanin-containing cuboidal cells and nests of small round cells. The immunohistochemical staining for melanoma-associated antigen, neuron-specific enolase and cytokeratin show positive reactions. Ultrastructural examination showed intracytoplasmic melanosome, tonofilament and desmosome.
Infant ; Male ; Female ; Humans

Mural nodules in ovarian mucinous tumors, whether benign, borderline, or malignant, have been described by several authors since Prat and Scully first described sarcoma or sarcoma-like mural nodules occurring in association with mucinous epithelial neoplasia in 1979. Three distinct types of the mural nodule have been identified; i. e., 1) sarcoma-like lesion, 2) true mesenchymal sarcome, and 3) anaplastic carcinoma simulating a sarcoma. Mural nodules of sarcomatous and carcinomatous foci associated with mucinous ovarian tumors should be separated from sarcoma-like nodules because of the poor prognosis of the former compared to the favorable prognosis of the latter. We experienced a case of ovarian mucinous cystadenocarcinoma with sarcoma-appearing mural nodule of anaplastic carcinoma occurred in a 59-year-old woman and reported with brief review of the literatures.
Carcinoma* ; Cystadenocarcinoma, Mucinous* ; Female ; Humans ; Middle Aged ; Mucins* ; Ovary ; Prognosis ; Sarcoma

Among the fifty-three clinical isolates of Haemophilus influenzae, nineteen isolates including eight isolates of each biotype I-VIII, six of serotype b (Hib) strains and five of nontypeable strains were characterized by SDS-PAGE about outer membrane protein (OMP), restriction enzyme analysis (REA) and rRNA gene restriction pattems. OMP patterns showed to common band patterns in each H. influenzae isolate. Based on the two major proteins, 31KDa-38KDa, isolated strains were classified into 7 subtypes. In the OMP patterns about biotype and serotype, the specific pattern of each biotype was not distinguishable, but all of the serotype b strains were shown identical unique pattern, therefore it made distinctive difference with nontypeable strains. The digested genomic DNAs with EcoRI were identical result with rRNA gene restriction. It was more subdivided into 10 ribotypes. The most common ribotype I and serotype 1 accounted for 6 strains (31.6%) and 7 strains (36.8%) of the 19 clinical isolates, respectively. Hib isolates that were both OMP subtype 1 and ribotype I accounted for 2 strains (10.5%). In the epidemiologically unrelated strains, the putative association between the subtypes could not be confirmed. According to these results, the three methods were discriminatory and appropriate techniques for epidemiological studies of H. influenzae.
DNA ; Electrophoresis, Polyacrylamide Gel* ; Genes, rRNA* ; Haemophilus influenzae type b ; Haemophilus influenzae* ; Haemophilus* ; Influenza, Human ; Membrane Proteins ; Restriction Mapping* ; Ribotyping

The activation of the insulin-like growth factor-I-receptor system (IGF-IR) has recently emerged as critical events in transformation and tumorigenicity of several human tumors. In this study we investigated the expression of IGF-IR in 33 colorectal adenomas, 88 primary colorectal carcinomas, and 30 normal colonic mucosa adjacent to the carcinoma. Immunohistochemical staining (IHC) for IGF-IR was performed on paraffin embedded sections using an anti-IGF-IR rabbit polyclonal antibody. IHC stains for IGF-IR were scored using a semiquantitative scoring system. The relationship of IGF-IR staining to clinicopathologic variables and proliferating cell nuclear antigen (PCNA) staining was also analysed. The mean IHC scores for IGF-IR of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 0.41 0.96, 0.76 1.23, 2.0 1.48, 2.83 2.0 and 5.93 1.58, respectively. These scores for each category were statistically significant except between normal glands and adenoma and between intramucosal carcinoma and node-negative carcinomas. The mean PCNA indexes of normal glands, adenoma, intramucosal carcinoma, node-negative carcinoma, and node-positive carcinoma were 2.48 2.60, 6.94 11.03, 27.21 11.42, 43.36 9.9 and 57.60 10.01, respectively. The PCNA index for each category was statistically significant except between normal and adenoma. IGF-IR scores and PCNA indexes were higher with tumor progression and also correlated each other (sr=0.65, p=0.0001). Higher IGF-IR scores and PCNA indexes were seen in tumors with advanced stage, infiltrative growth pattern, poor differentiation, nerve invasion, lymphovascular invasion, and moderate fibrosis. Our results suggest that IGF-IR plays an important role in tumorigenicity and tumor progression.
Adenoma* ; Colon ; Colorectal Neoplasms ; Coloring Agents ; Fibrosis ; Humans ; Immunohistochemistry ; Mucous Membrane ; Paraffin ; Proliferating Cell Nuclear Antigen

OBJECTIVES: The purpose of this study is to analyze the current status of nutrition education programs for multicultural families and to provide policy suggestions for improvement. METHODS: In-depth interviews of a total of 21 multicultural experts were conducted; 15 people were interviewed individually, while 6 people were interviewed in groups of three. RESULTS: In-depth interviews revealed various problems related to the operation of nutrition education programs. The causes of problems were analyzed and categorized as four factors: systemic, practical, environmental and cultural. As for the systematic factors, insufficient linkage between related organizations and duplicate performance of several projects were identified as concerns Establishment of a control tower and strengthening the linkage among the related organizations may be needed to address this concern. With regard to practical factors, the study identified that language barriers, and lack of nutritional education media and tools translated into multicultural languages were limiting factors. These limitations the development of nutrition education materials that aretranslated into multiple languages, implementation of education programs that are different from the Korean education, and by providing interpreters. As for the environmental factors, low educational level and poor nutritional knowledge of multicultural women made it difficult for them to understand the contents of the education. Demonstration, practical training and urgent education on pregnancy and childbirth nutrition were identified as needs to address these concerns. Withregard to cultural factors, food culture conflict with Korean families, and difficulties in home practices were detected as concerns. Participants in the study suggested that getting education with family and facilitation of weekend and nighttime programs health of this community. CONCLUSIONS: Further studies are needed to adopt more effective and efficient nutrition intervention to promote the healthy eating of the married immigrant women based on the study results.
Communication Barriers ; Eating ; Education* ; Emigrants and Immigrants* ; Female ; Humans ; Korea* ; Marriage* ; Parturition ; Pregnancy

BACKGROUND: Evaluation of clinical performance is an essential area for the students who are preparing their career as a medical doctor. However the clinical skills has neither been taught with balanced proportion nor adequately being assessed their abilities. Yet no significant studies on this issue has been reported in Korea so far. The present study was done as a part of preliminary study to seek a model that would be introduced clinical performance assessment in Korean Medical Licensure Examination system. Purpose: The objectives of this study is to develop items of clinical performance and the effective methods to carry out the clinical performance assessment in Korean Medical Licensure Examination system. METHODS: Primary list of clinical performances which was generated through discussion between researchers and medical experts has been distributed to the physicians of various levels. Six hundred ninety seven medical doctors including professors, family physicians, and public health doctors were asked to express their opinion by mail questionnaire. Final items were selected after the reaction of questionnaires and each item has been carefully studied its validity, achievability, and practicality. RESULTS: Thirty five items were selected among fifty one items presented according to the checked number of "essential" and "frequently useful". Seven items were added according to the higher rate of recommendation by open questionnaire. The forty two items were confirmed as a final list which the students should be expected to demonstrate prior to graduation from undergraduate medical school("exit objective"). The OSCE was performed without any serious logistic problems and both examinees and evaluators thought the experience positively. CONCLUSION: To look at the present environment and the readiness it is recommendable to apply the items of psychomotor skills at the beginning for Medical Licensure Examination. For that purpose various medical dolls, kits and subjects can be used.
Clinical Competence ; Humans ; Korea ; Licensure, Medical* ; Physicians, Family ; Postal Service ; Public Health ; Surveys and Questionnaires

PURPOSE: To determine the effect of polyurethane with sustained release dexamethasone in delayed adjustable strabismus surgery in rabbits. METHODS: After recession of the superior rectus muscle(SRM), balanced salt solution or polyurethane film with/without sustained release dexamethasone was applied beneath and over the SRM in the control group(group C), polyurethane-steroid group(group P-S) and polyurethane group(group P), respectively. Delayed adjustment was performed once on each SRM at four and six weeks postoperatively by a masked observer. The possible length to adjust and the necessary force required for the adjustment, as well as the degree of any adhesions, were also evaluated. RESULTS: In the control group, adjustment was impossible in all of the eyes at four and six weeks postoperatively. In group P-S, adjustment was possible in 11 out of 11(11/11) eyes four weeks postoperatively and in 10/11 eyes six weeks postoperatively. In group P, adjustment was possible in 9/11 eyes four weeks postoperatively and in 10/12 eyes six weeks postoperatively. In addition, the degree of adhesion was significantly less in group P and in group P-S compared to the control group. The degree of adhesion between the SRM and the sclera was marginally better(p=0.051) in group P-S four weeks postoperatively than in group P. CONCLUSIONS: Use of polyurethane film could delay adjustment in most of the rabbit eyes for up to six weeks postoperatively. Sustained release dexamethasone is helpful for delaying adjustment in rabbit eyes until six week postoperatively without the need for frequent topical instillation of steroids.
Dexamethasone* ; Masks ; Polyurethanes* ; Rabbits ; Sclera ; Steroids ; Strabismus*