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

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

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

BACKGROUNDS: The inflammatory reaction after cerebral ischemia involving adhesion molecules aggravates neurologic deficit. This study aimed to study the change of plasma level of the adhesion molecules after acute cerebral ischemia. METHODS: Nineteen patients with acute cerebral infarction and ten control subjects without a history of cerebrovascular disease were included in this study. The patient groups were subgrouped into large artery atherosclerosis and small artery occlusion groups according to TOAST classification. Plasma levels of sP-selectin, sE-selectin, sICAM-1 and sVCAM-1 were measured within 24 hours and in 6 to 8 days after acute ischemic infarction. RESULTS: The plasma level of sP-selectin was elevated in acute stroke patients within 24 hours and in 6 to 8 days after stroke onset compared with control group(p<0.05). But plasma levels of sE-selectin, sICAM-1 and sVCAM-1 were not different from those of control group. The plasma level of sP-selectin was significantly elevated in large artery artherosclerosis group compared with control group. CONCLUSION: This study suggest that P-selectin actively involves in inflammatory process after acute ischemic stroke, especially associated with atherosclerosis.
Arteries ; Atherosclerosis ; Brain Ischemia ; Cerebral Infarction ; Classification ; Humans ; Infarction ; Neurologic Manifestations ; P-Selectin ; Plasma* ; Stroke*

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*

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

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

BACKGROUND: Domestic violence once considered an infrequently occurring event existing only in deviant relationships, it has been more recently recognized as a widely distributed phenomenon resulting from multiple cultural, social, psycological factors. According to declining world economics, family violence rises with a simultaneous curtailment of agencies available to assist battered persons and there is increasing pressure on emergency departments to serve those who might otherwise have sought help from public agency. In Korea, we don't have any clinical data about domestic violence, and authors analysed clinical pictures of domestic violence victims who came to the emergency department of Korean University medical center. METHOD: We reviewed the victims of the domestic violence retrospectively, who visited in ED, Korean Univ. Hospital from Jan. 1996 to the Dec. 1996. We Analysed data to Age, sex, Injury severity score, location of injury, mechanism, perpetrator. RESULTS: During the study period, total 134 domestic violence victims were identified. The young, females were predominantly victimized. And married women were more commonly violated. (about 70%). ISS was relatively mild (2.491), face and head were mainly injured by punching and objects throwing. The Prevalence of domestic violence victims almost presented at Emergency department between 6:00/P.M. and 8:00 A.M.. CONCLUSION: Emergency physicians suspect domestic violence victims who injured at face and head by punching or hitted would. In these patients, we need more detail history and physical exam. And in case of repeated domestic violence, refer to neuropychatry dept and social workers with perpetratrs, and need mere concerte social programs for domestic violence.
Academic Medical Centers ; Domestic Violence* ; Emergencies* ; Emergency Service, Hospital* ; Female ; Head ; Humans ; Injury Severity Score ; Korea ; Prevalence ; Retrospective Studies ; Social Workers

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