BACKGROUND AND PURPOSE: Valproic acid (2-propylpentanoic acid) which enhances GABA synthesis and blocks it's degradation has been useful treatment of migraine and may activate GABA receptors to modulate trigeminal nociceptive neurons innervating the meninges. But the mechanism and action of sodium valproate in headache is not clear. To investigate the mechanism of valproic acid action in headache model, we compared the change of dural plasma protein extravasation in both substance-P neurogenic inflammation rats with valproic acid pretreatment and without valproic acid pretreatment. METHOD: Sprague-Dawely rats were pretreated with valproate 30 minutes prior to substance-P administration in order to test the effects of sodium valproate on dural plasma protein extravasation by detecting the amount of extravasated Evans blue in the dura matter. To examine the abilities of either bicuculine (GABAA antagonist) and phaclofen (GABAB antagonist) to reverse the effect of valproate, they were administered 5 min before valproate administration. After then we also test the effect of muscimol (GABAA agonist) and bicuculine (GABAA antagonist) in substance-P induced neurogenic inflammation rats. RESULTS: Intraperitoneal injection of sodium valproate and muscimol reduced dural plasma protein extravasation after intravenous substance-P administration. The GABAA antagonist bicuculine completely reversed the effect of valproate and muscimol on plasma extravasation following substance-P administration, whereas the GABAB receptor antagonist, phaclofen, did not. CONCLUSION: We concluded that the attenuation of dural plasma protein extravasation by valproate and muscimol is mediated by via GABAA receptors within the meninges. Agonists and modulators at the GABAA receptor may become useful for the development of selective therapeutic agents for migraine headache.
Animals ; Evans Blue ; gamma-Aminobutyric Acid ; Headache* ; Injections, Intraperitoneal ; Meninges ; Migraine Disorders ; Muscimol ; Neurogenic Inflammation ; Nociceptors ; Plasma ; Rats* ; Receptors, GABA ; Sodium* ; Valproic Acid*

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of cauda equina syndrome due to lumbar ossification of the posterior longitudinal ligament (OPLL). SUMMARY OF LITERATURE REVIEW: Lumbar OPLL with neurologic symptoms is very rare. MATERIALS AND METHODS: A 49-year-old female had experienced weakness in both lower extremities and radiating pain for 1 day prior to presentation. Simple radiography and CT showed OPLL at the L1-L2 level. We performed a total laminectomy and posterolateral fusion at the L1-L2 level using a posterior approach. RESULTS: After treatment, the patient showed improvement of symptoms and is currently living without discomfort. CONCLUSIONS: Cauda equina syndrome due to lumbar OPLL is rare; however, rapid neurologic recovery can be achieved through early diagnosis and surgery.
Cauda Equina* ; Early Diagnosis ; Female ; Humans ; Laminectomy ; Longitudinal Ligaments* ; Lower Extremity ; Middle Aged ; Neurologic Manifestations ; Ossification of Posterior Longitudinal Ligament ; Polyradiculopathy* ; Radiography

Uterine sarcoma whieh is originated from uterine muscle and/or connective tissues, is very rare malignant tumor and is the most lethel of all primary uterine tumors. This study was undertaken to correlate the clinieal findings, diagnoses, managements and ultimate outcome of each particluar grouy of uterine sarcoma at Depart,ment of Obstetrics and Gynecology in Korea University Hospital. The reaults were as follows, 1. The distribution of uterinesarcomaby histologic type was 5 cases (35.7%) for leiomyosarcoma, 5 cases (35.7%) for endometrial strornal sarcoma and 4 eases (28.6%) for mixed Mullerian tumor, 2. The mean age and yarity were 50.8 years and 3.1. 3. The most common syrrlptorn was irregular vaginal bleeding (64.3%), and lower abdominal pain (21.4%), abdominal palpable mass (14.3%) in order of frequency. 4. The distribution by YIGO clinical atage was 35.7% for stage I, 35.7% for stage II, 7.2% for stage IE and 21.4% for stage lV. The average survival time of each stage of disease was decreased with increasing stage. 5. The mean survival time was decreased with inereasing numbers of mitotic figure per 10 high power fields. 6. The mean survival time according to histologc type was 14.5 months for leiomyoaarcoma, 21.5 months for endometrial stromal marcoma, 5.8 months for malignant mixed Mullerian tumor, respectively.
Abdominal Pain ; Animals ; Connective Tissue ; Diagnosis ; Female ; Gynecology ; Korea ; Leiomyosarcoma ; Mice ; Myometrium ; Obstetrics ; Sarcoma* ; Survival Rate ; Uterine Hemorrhage ; Uterus*

No abstract available.
Aged* ; Female ; Humans ; Sarcoma, Kaposi*

No abstract available.
Aged* ; Female ; Humans ; Sarcoma, Kaposi*

PURPOSE: Since the discovery of estrogen receptor-beta(ER-beta, five C-terminal variants of ER-beta were identified. We designed this study to investigate the pattern and clinical implications of ER-betaand its splicing variants expression in normal and malignant mammary tissues. METHODS: Using reverse transcription polymerase chain reaction (RT-PCR), we examined the expression levels of ER-alpha and ER-betaand its five splicing variants (beta1, beta2, beta3, beta4, beta5) in 50 paired normal and cancer tissues. We measured the densities of RT-PCR products using Tina version 2.10 (Raytest, Germany). Firstly, the incidence and intensity of ER-alpha and ER-beta and its five splicing variants were compared. Then the expression of ER-betamRNA splicing variants was also analyzed with regard to the ER-alphaprotein expression measured by immuno-histochemical staining and the menopausal status of the patients. Chi-square test and paired samples t-test were used for statistical analysis. Differences were considered to be significant with a p-value of less than 0.05. RESULTS: The expression of ER-betamRNA variants in normal breast and cancer tissues were as follows: ER-beta2 (100%/100%), ER-beta4 (76%/74%), ER-beta5 (32%/58%), and ER-beta1 (14%/16%). ER-beta3 was not detected at all. In terms of intensity, we observed a significant decrease of ER-beta2 (P<0.001) and an increase of ER-beta5 (P=0.004) in the mRNA expression levels among breast cancers compared to the corresponding normal breast tissues. Compared to the corresponding normal tissues, a significant decrease of ER-beta2 in cancer tissues was observed in patients with ER-alpha-positive (P<0.001), with age over 50 (P=0.01), and under 50 (P=0.04) as well, but not in patients with ER-alpha-negative (P=0.48). ER-beta4 also significantly decreased in patients with ER-alpha-positive (P=0.004) and with age over 50 (P=0.07). ER-beta5 showed a significant increment only in patient aged over 50 (P=0.04). CONCLUSION: ER-alpha mRNA expression significantly increases but ER-beta mRNA expression decreases in the cancer tissues compared to the corresponding normal tissues. Among ER-beta variant forms, ER-beta2 is predominant in both normal and malignant mammary tissues and ER-beta4, ER-beta5, and ER-beta1 in descending order but ER-beta3 does not express in mammary tissues. The decrease of ER-beta2 and ER-beta4 expression is prominent in cancer tissue especially in ER-alpha-positive cancers, which suggests that ER-beta2 and ER-beta4 may possess a regulatory function in mammary carcinogenesis. Further investigations to verify the roles of ER-beta variants are mandatory.
Breast ; Breast Neoplasms ; Carcinogenesis ; Estrogens* ; Humans ; Incidence ; Polymerase Chain Reaction ; Receptors, Estrogen ; Reverse Transcription ; RNA, Messenger

Ferroptosis is a newly recognized type of cell death that results from iron-dependent lipid peroxidation and is different from other types of cell death, such as apoptosis, necrosis, and autophagic cell death. This type of cell death is characterized by mitochondrial shrinkage with an increased mitochondrial membrane density and outer mitochondrial membrane rupture. Ferroptosis can be induced by a loss of activity of system Xc− and the inhibition of glutathione peroxidase 4, followed by the accumulation of lipid reactive oxygen species (ROS). In addition, inactivation of the mevalonate and transsulfuration pathways is involved in the induction of ferroptosis. Moreover, nicotinamide adenine dinucleotide phosphate oxidase and p53 promote ferroptosis by increasing ROS production, while heat shock protein beta-1 and nuclear factor erythroid 2-related factor 2 inhibit ferroptosis by reducing iron uptake. This article outlines the molecular mechanisms and signaling pathways of ferroptosis regulation, and explains the roles of ferroptosis in human disease.
Apoptosis ; Autophagy ; Cell Death* ; Glutathione Peroxidase ; HSP27 Heat-Shock Proteins ; Humans ; Iron ; Lipid Peroxidation ; Mevalonic Acid ; Mitochondrial Membranes ; NADP ; Necrosis ; Oxidoreductases ; Reactive Oxygen Species ; Rupture

As the productive activities have vastly increased following industrialization and urbanization in the modem society, the resulting high mobility of people and goods have caused a sharp increase in the accidents in the work places as well as traffic accidents. In particular, deaths caused by injuries are generally concentrated in the economically active young peoples, producing incalculable losses to the society and nation as a whole. Advanced nations with superior medical care systems have succeeded in reducing incidents of such deaths by operating trauma centers. Especially noteworthy is the case of the United States where such specialized trauma centers have greatly contributed to reducing deaths from injuries in the non-urban areas with less access to medical facilities. At present Korea has no medical centers specializing in injuries. In large cities, the injuries are being treated tertiary medical facilities while in the provinces they are referred to small and medium-sized hospitals that constitute secondary medical facilities. Currently in Korea the Trauma patients are treated at general hospitals that consist of 726 secondary medical facilities and 40 tertiary medical centers nationwide. The secondary medical facilities which tend to take most responsibility for the treatment of trauma are generally deficient in medical staff and facilities (including operating and intensive care facilities). Despite such deficiency and limitations, no regulations exist regarding treatment or transportation of trauma patients. This article reports the outcome of a comparative analysis of the results of trauma treatments among different types of medical facilities based on objective data in the hope that such study would facilitate a comparison with the treatment systems of advanced countries and thereby contribute to a precise formulation of problems that must be addressed in this area.
Accidents, Traffic ; Hope ; Hospitals, General ; Humans ; Critical Care ; Korea ; Medical Staff ; Modems ; Social Control, Formal ; Transportation ; Trauma Centers ; United States ; Urbanization ; Workplace ; Industrial Development

Eosinophilia is a common finding in premature babies during the neonatal period. Serial eosinophil counts were determined in 94 hospitalized, appropriately grown premature in fants whose gestational ages ranged form 28 to 36 weeks. The incidence, severity and etiologic factors of eosinophilia were retrospectively studied in premature infants, who were divided into three groups according to their gestational age. The results were as follows: 1) Absolute eosinophilia (>700/mm3)was documented in 46.8%(44/94). 2) The duration of TRN and antibiotics was cignificantly higher in infants with eosinophilia than withour eosinophilia (p<0.05). The gestational age of the infants with eosinophilia was significantly shorter than that of the infants without eosinophilia (p<0.05). The infants with eosinophilia started with bottle feeding significantly earlier than the infants without eosinophilia (p<0.05). 3) The infants younger than 30 weeks of gestational age have greater incidence of eosinophilia (75%) than the infant with the gestational age between 34 and 36 weeks (34.3%)(p<0.05). 4) The incidence of mild eosinophilia was higher in the group with gewtational age 30 weeks or below(37.5%)than in the group with gestational age between 34 and 36 weeks(17.1%)(p<0.05).Also, the incidence of severe eosinophilia was significantly higher in the group with gestational age 30 weeks or below(37.5%)than in the group with gestational age between 34 and 36 weeks(17.1%)(p<0.05). 5) Eosinophilia was more prevalent in the infants who received parenteral nutrition composed of glucose, amino acid and lipid(77.8%) than the infants who received only glucose(34.1%)(p<0.05). 6) Gestational age and birth weight were significantly lower in infants with severe eosinopilia than those of mild or moderate eosinophilia. The duration of TRN and antibiotics were significantly longer in infants with severe eosinophilia than those of mild or moderate eosinophilia (p<0.05). 7) The peak eosinophil count was observed significantly later in severe eosinophilic group (26.5 13.1 days)than in non-eosinophilic group(14.4 9.0 days)(p<0.05). The above results suggest that eosinophilia in premature infants may be the effecto of immature immunologic responses to the intravenous administration of extemal antigens like amino acid, lipid and antibiotics.
Administration, Intravenous ; Anti-Bacterial Agents ; Birth Weight ; Bottle Feeding ; Eosinophilia* ; Eosinophils ; Gestational Age ; Glucose ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Parenteral Nutrition ; Retrospective Studies

BACKGROUND: In anemic patients, it has been usually traditional practice to correct the anemic state with preoperative blood transfusion. But now, there is an increasing tendency of refusing blood transfusion due to the transfusional complications, especially AIDS etc. The purpose of this study is to survey the effects of anesthesia in anemic patients with normal cardiopulmonary function compared to non-anemics. METHOD: 40 patients with uterine myoma were divided into two groups, an experimental group of 20 patients with hemoglobin concentration of 8~10 gm% and a control group of 20 patients with hemoglobin concentration higher than 10 gm%, and their blood pressure, pulse rate and arterial oxygen saturation were monitored and compared. RESULTS: There were no significant differences between two groups in blood pressure, pulse rate and arterial oxygen saturation. CONCLUSION: Preoperative blood transfusion, in patients with moderate anemia, does not seem to be a mandatory practice.
Anemia ; Anesthesia ; Blood Pressure ; Blood Transfusion* ; Heart Rate ; Humans ; Leiomyoma* ; Oxygen