PURPOSE: The purpose of this study was to determine the effect of dehydroepiandrosterone (DHEA) on recovery of muscle atrophy induced by Parkinson's disease. METHODS: The rat model was established by direct injection of 6-hydroxydopamine (6-OHDA, 20 microg) into the left striatum using stereotaxic surgery. Rats were divided into two groups; the Parkinson's disease group with vehicle treatment (Vehicle; n=12) or DHEA treatment group (DHEA; n=22). DHEA or vehicle was administrated intraperitoneally daily at a dose of 0.34 mmol/kg for 21 days. At 22-days after DHEA treatment, soleus, plantaris, and striatum were dissected. RESULTS: The DHEA group showed significant increase (p<.01) in the number of tyrosine hydroxylase (TH) positive neurons in the lesioned side substantia nigra compared to the vehicle group. Weights and Type I fiber cross-sectional areas of the contralateral soleus of the DHEA group were significantly greater than those of the vehicle group (p=.02, p=.00). Moreover, extracellular signal-regulated kinase (ERK) phosphorylation significantly decreased in the lesioned striatum, but was recovered with DHEA and also in the contralateral soleus muscle, Akt and ERK phosphorylation recovered significantly and the expression level of myosin heavy chain also recovered by DHEA treatment. CONCLUSION: Our results suggest that DHEA treatment recovers Parkinson's disease induced contralateral soleus muscle atrophy through Akt and ERK phosphorylation.
Animals ; Corpus Striatum/drug effects/metabolism ; Dehydroepiandrosterone/*pharmacology/therapeutic use ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Male ; Muscle Fibers, Slow-Twitch/drug effects ; Muscle, Skeletal/drug effects/metabolism ; Muscular Atrophy/drug therapy/*etiology/*pathology ; Myosins/metabolism ; Neurons/drug effects/enzymology ; Oxidopamine/toxicity ; Parkinson Disease, Secondary/*chemically induced/*complications ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism ; Rats ; Rats, Sprague-Dawley ; Tyrosine 3-Monooxygenase/metabolism

OBJECTIVE: We developed a Clinical Document Architecture(CDA) Generator module based on CDA standard for the interchange of radiological reports. METHODS: This paper describes CDA standard, the template of radiological report, CDA Generator module, and the Web-form report using an Extensible Stylesheet Language(XSL) style-sheet. And the CDA Generator module is integrated into a existing Picture Archiving Communication System(PACS) Viewer. RESULTS: Radiological reports based on CDA standard are used to interchange between different health institutions, and also presented in an Extensible Markup Language (XML) compatible web browser. CONCLUSION: The proposed module and concept in this paper may be a utility in improving health care delivery and can also be used to integrate with other Digital Imaging and Communication in Medicine(DICOM) Structured Report (SR) compliant PACS systems.
Delivery of Health Care ; Web Browser

This study was to determine the effect of exercise on the recovery of dopaminergic neuron loss and muscle atrophy in 6-OHDA-induced hemi Parkinson's disease model. Exercise was loaded twice per day for 30 minutes each time, at 5 days after 6-OHDA lesioning and continued for 16 days using a treadmill. Exercise significantly increased the number of tyrosine hydroxylase positive neuron in the lesioned substantia nigra and the expression level of tyrosine hydroxylase in the striatum compared with the control group. To examine which signaling pathways may be involved in the exercise, the phosphorylation of GSK3beta and ERK were observed in the striatum. In the control group, basal level of GSK3beta phosphorylation was less than in both striatum, but exercise increased it. ERK phosphorylation decreased in the lesioned striatum, but exercise recovered it. These findings suggest that exercise inactivates GSK3beta by phosphorylation which may be involved in the neuroprotective effect of exercise on the 6-OHDA-induced cell death. In the exercise group, weight, and Type I and II fiber cross-sectional area of the contralateral soleus significantly recovered and expression of myosin heavy chain and Akt and ERK phosphorylation significantly increased by exercise. These results suggest that exercise recovers Parkinson's disease induced dopaminergic neuron loss and contralateral soleus muscle atrophy.
Animals ; Atrophy ; Cell Death ; Dopaminergic Neurons ; Glycogen Synthase Kinase 3 ; Muscle, Skeletal ; Muscles ; Muscular Atrophy ; Myosin Heavy Chains ; Neurons ; Neuroprotective Agents ; Oxidopamine ; Parkinson Disease ; Phosphorylation ; Rats ; Substantia Nigra ; Tyrosine 3-Monooxygenase

Here, we present a case of anaplastic giant cell ependymoma (GCE) occurring in a 15-year-old woman. Squash smear slides for intraoperative frozen section diagnosis revealed oval to round cell clusters with a papillary structure in a fibrillary background. This was occasionally accompanied by the presence of bizarre pleomorphic giant cells with hyperchromatic nuclei and prominent intranuclear inclusions. These intranuclear inclusions were a key clue to diagnosis of ependymoma. Histologic analysis revealed features of a high-grade tumor with perivascular pseudorosettes and bizarre pleomorphic giant cells, which established the diagnosis of GCE. We performed a review of literatures about the cytologic features of GCE, including our case, thus proposing that intraoperative frozen diagnosis of GCE would be established by squash smear preparations featuring the mitosis and necrosis, as well as the high cellularity, and the presence of giant cells showing hyperchromatic nuclei with eosinophilic cytoplasm and intranuclear inclusions/pseudoinclusions.
Adolescent ; Cytoplasm ; Eosinophils ; Ependymoma ; Female ; Frozen Sections ; Giant Cells ; Humans ; Intranuclear Inclusion Bodies ; Mitosis ; Necrosis

No abstract available.
Edema* ; Humans ; Hydrops Fetalis* ; Infant, Newborn*

A 66-year-old male was admitted to the department of surgery, at the Presbyterian Medical Center due to right upper quadrant pain. Tumor marker studies reported CEA and CA19-9 elevation. Liver function test was normal. Ultrasonography and computed tomography showed a single infiltrative tumor in the left lobe of liver, multiple lymphadenopathies around the common hepatic duct and intrahepatic bile duct dilatation of the left lobe. The gallbladder was nonspecific. During laparotomy, we found an ill-marginated and infiltrative tumor in the left lobe of liver, multiple enlarged lymph nodes around the common hepatic duct and cystic duct, and mild thickening of the gallbladder fundus wall. Left hepatic lobectomy and cholecystectomy were performed. Pathologic findings revealed that the liver tumor was a moderated differentiated adenocarcinoma with extension to the pericystic and pericommon hepatic lymph nodes and focal adenocarcinoma in situ of gallbladder mucosal wall with clear cystic duct resection margin. We therefore report a rare case of synchronous double primary cancer of the intrahepatic bile duct and gallbladder.
Adenocarcinoma ; Aged ; Bile Ducts, Intrahepatic* ; Cholecystectomy ; Cystic Duct ; Dilatation ; Gallbladder* ; Hepatic Duct, Common ; Humans ; Laparotomy ; Liver ; Liver Function Tests ; Lymph Nodes ; Male ; Protestantism ; Ultrasonography

BACKGROUND: Using long-term (more than 30 years) data from a single center, this retrospective study evaluated changes of independent risk factors affecting renal allograft survival by transplant era. METHODS: Of 3,000 cases of kidney transplantation, 2,708 (90.3%), including their follow-up observations, were reviewed. Transplant era was classified according to immunosuppressive regimens as either early group (transplant serial No. 1~1,500) or recent group (transplant serial No. 1,501~3,000). RESULTS: There was a significant difference observed in pre-transplant clinical manifestations between the early and recent groups. The number of elderly recipients and donors, number of deceased donors, and cases related to pre-transplant diabetes, pre-emptive transplantation, and retransplantation were differed relative to transplant era. The short- and long-term graft survival rate of the recent group improved significantly, and the effect of human leukocyte antigen mismatching and living donor type disappeared in the recent group. Moreover, pre-emptive transplantation and retransplantation were effective only in the recent group. However, non-immunological factors such as elderly recipients and donors, and immunologic factors such as episodes of acute rejection and types of immunosuppressive regimen were persistent independent risk factors affecting graft survival rate. CONCLUSIONS: According to the retrospective survival analysis of a large number of recipients in a single center, risk factors for kidney transplant patients differed by transplant era. However, the independent risk factors associated with elderly recipients and donors (non-immunologic), and episodes of acute rejection, and types of immunosuppressive regimen (immunologic) persisted regardless of transplant era.
Aged ; Follow-Up Studies ; Graft Survival ; Humans ; Immunologic Factors ; Kidney ; Kidney Transplantation ; Leukocytes ; Living Donors ; Rejection (Psychology) ; Retrospective Studies ; Risk Factors ; Tissue Donors ; Transplantation, Homologous ; Transplants

BACKGROUND/AIMS: Add on adefovir (ADV) to ongoing lamivudine (LAM) has been recommended as a standard therapy for the treatment of LAM resistance. In the past, switch to ADV monotherapy was suggested as an option for the treatment of LAM resistance, leading to frequent development of ADV resistance. However, ADV monotherapy has been still used in LAM-resistant patients because of low cost in Korea. The aims of this study were to evaluate the virologic response and virologic breakthrough during adding on LAM in LAM-resistant patients receiving ADV monotherapy. METHODS: The study population comprised 99 patients with LAM-resistance. We divided them into 3 groups (Group 1: switch to ADV monotherapy, N=58, Group 2: add on ADV to ongoing LAM, N=25, Group 3: add on LAM to ADV monotherapy, N=16). HBV DNA levels were assessed at baseline and every 3 months during therapy. Serum HBV DNA levels were measured by bDNA assay or the COBAS TaqMantrade mark HBV test. RESULTS: The median treatment duration for group 1, group 2, and group 3 was 42.0, 20.6, and 31.8 (18.7 mon. of ADV+13.1 mon. of LAM) months, respectively. Cumulative rate of virologic breakthrough in group 1 was 5.2%, 19.0%, and 25.9% at 12, 24, and 36 months of treatment, respectively. Virologic breakthrough was not detected in group 2 and group 3 (p=0.016, group 1 vs. group 2 or 3). In group 3, median serum HBV DNA levels were 4.22 log10 copies/mL prior to LAM administration. Median serum HBV DNA changes from baseline (log10 copies/mL) were -0.91, -1.93, -1.87 and -1.74 at week 12, 24, 36 and 48, respectively. CONCLUSIONS: Later add on LAM to ADV monotherapy prevented the development of ADV resistance in patients with LAM resistance effectively, comparable to ADV add on to continuing LAM therapy.
Adenine/*analogs & derivatives/therapeutic use ; Adult ; Antiviral Agents/*pharmacology ; DNA, Viral/blood ; Drug Resistance, Viral ; Drug Therapy, Combination ; Female ; Hepatitis B e Antigens/blood ; Hepatitis B, Chronic/*drug therapy ; Humans ; Lamivudine/*therapeutic use ; Male ; Middle Aged ; Phosphonic Acids/*therapeutic use

OBJECTIVE: Pallidotomy is known to improve the symptoms of idiopathic Parkinson, s disease (PD), motor fluctuations and dyskinesia related to levodopa therapy. Previous studies reported significantly higher complication rates associated with bilateral pallidotomy than unilateral pallidotomy. The authors assess the safety and clinical outcomes of bilateral pallidotomy for advanced PD. METHODS: Simultaneous bilateral pallidotomy was performed in eight patients with advanced PD between January 1, 2001 and December 31, 2001. All patients underwent lesion making in posteroventral site of internal globus pallidus. The target was localized using macroelectrode stimulation and MRI guided stereotactic technique. The lesions were made by radiofrequency currents. RESULTS: Among eight cases, seven had severe disabling dyskinesias. Compared with baseline scores, the values of dyskinesia after surgery was significantly decreased (P<0.05) for up to 1 year. The mean score changed from 4.4+/-2.1 to 0.3+/-0.5. According to Unified Parkinson's Disease Rating Scale (UPDRS), the mean motor score in off period, which was 38.3+/-13.8 was significantly decreased for 6 months (P<0.05). The ADL (on/off) scores and motor "on" scores of UPDRS were unchanged or deteriorated to 12 months after surgery. There was no apparent adverse effect after surgery in all patients. Only transient mild dysphagia happened in one patient. CONCLUSION: Simultaneous bilateral pallidotomy in advanced PD appears to be effective and safe, particularly in reducing the dyskinesia; in our experience, the side effects are not as high as reported by other groups.
Activities of Daily Living ; Deglutition Disorders ; Dyskinesias ; Globus Pallidus ; Humans ; Levodopa ; Magnetic Resonance Imaging ; Pallidotomy* ; Parkinson Disease* ; Stereotaxic Techniques

BACKGROUND/AIMS: Entecavir is a potent and selective guanosine analogue that has demonstrated a significant antiviral efficacy against hepatitis B virus (HBV). The aim of this study was to characterize the response to entecavir and to examine the factors affecting that response. METHODS: We administered 0.5 mg of entecavir once daily for more than 12 months to 114 naive chronic hepatitis B (CHB) patients. We measured the levels of liver enzymes, serological markers, and serum HBV DNA at 3-month interval. RESULTS: Normalization of serum alanine aminotransferase levels was observed in 68.5% (76/114), 74.6% (85/114), and 81.6% (62/76) of patients after 6, 12, and 24 months of therapy, respectively. HBV DNA levels of <50 copies/mL (as evaluated by polymerase chain reaction) were observed in 43.9% (50/114), 71.1% (81/114), and 85.5% (65/76) of patients after 6, 12, and 24 months, respectively. Viral breakthrough was not observed. The rates of HBeAg loss and seroconversion were 43.5% (27/62) and 14.5% (9/62), respectively, after 12 months of therapy, and 56.4% (22/39) and 15.4% (6/39) after 24 months. The independent factor associated with PCR negativity was early virologic response (EVR; HBV DNA <2,000 copies/mL after 3 months of therapy, P<0.001). The independent factors predicting HBeAg loss were found to be serum albumin levels (P=0.041) and EVR (P=0.005). CONCLUSIONS: Entecavir induced excellent biochemical and virologic responses in naive CHB patients. EVR was an independent factor for predicting HBV PCR negativity and HBeAg loss.
Adult ; Alanine Transaminase/blood ; Antiviral Agents/*therapeutic use ; Aspartate Aminotransferases/blood ; DNA, Viral/blood ; Female ; Guanine/*analogs & derivatives/therapeutic use ; Hepatitis B e Antigens/analysis ; Hepatitis B, Chronic/*drug therapy ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Retrospective Studies ; Time Factors