Previous studies have shown disrupted synaptic plasticity and neural activity in depression. Such alteration is strongly associated with disrupted synaptic structures. Chronic stress has been known to induce changes in dendritic structure in the basolateral amygdala (BLA) and medial prefrontal cortex (mPFC), but antidepressant effect on structure of these brain areas has been unclear. Here, the effects of imipramine on dendritic spine density and morphology in BLA and mPFC subregions of stressed mice were examined. Chronic restraint stress caused depressive-like behaviors such as enhanced social avoidance and despair level coincident with differential changes in dendritic spine structure. Chronic stress enhanced dendritic spine density in the lateral nucleus of BLA with no significant change in the basal nucleus of BLA, and altered the proportion of stubby or mushroom spines in both subregions. Conversely, in the apical and basal mPFC, chronic stress caused a significant reduction in spine density. The proportion of stubby or mushroom spines in these subregions overall reduced while the proportion of thin spines increased after repeated stress. Interestingly, most of these structural alterations by chronic stress were reversed by imipramine. In addition, structural changes caused by stress and blocking the changes by imipramine were corelated well with altered activation and expression of synaptic plasticity-promoting molecules such as phospho-CREB, phospho-CAMKII, and PSD-95. Collectively, our data suggest that imipramine modulates stress-induced changes in synaptic structure and synaptic plasticity-promoting molecules in a coordinated manner although structural and molecular alterations induced by stress are distinct in the BLA and mPFC.

PURPOSE: To determine whether there is a discrepancy between the medical professions perception of what patients should know and that of the patients themselves, we studied patients need to be informed about different aspects of epilepsy and compared findings with medical personnels perceptions of the issue. METHODS: Our study population consisted of 39 patients with epilepsy from the inpatient epilepsy unit, and 51patients from the outpatients clinic of the S. University Hospital between July and November 1997. However, the patients who declined to participate or who were not able to understand the directions and content of the questionnaire were excluded. The medical personnel participated in this study were 56 residents or nurses who were working in either Neurology or Neuro surgery Units. The questionnaire consisted of 6 categories with a total of 79 questions. The responses were indicated on a 5point Likert scale with 5 indicating the highest need . The data were analyzed with descriptive statistics, students t-tests, and chi-square. RESULTS: Of the 90 patients and 56 medical personnel studied, the need for lifestyle information such as smoking, drinking, sleep, driving, employment, and marriage was significantly higher from medical personnel than that of the patients(p=0.00). Regarding medical knowledge about epilepsy, the patients group had higher scores in the need for information on the structure of the brain (p=0.00), whereas medical personnel had higher scores on the symptoms of epilepsy. There was no correlation between the length of epilepsy and the need for information on every item on the questionnaire. The patients had higher rank regarding diet, although it was not significantly different from the medical personnel. Regarding antiepileptic drugs and what to do when there is an attack, medical personnel scored higher. The items on which the patients group scored higher than 4.5 were the possibility of inheritance, the factors that might reduce the number of attacks, the period of usage of AED, and the food they have to avoid or the food they have to take to reduce seizure attacks. CONCLUSIONS: Our study indicates that the patients group requires higher educational need in the structure of the brain, diet, and surgical treatment, but less in lifestyles and what to do when there is an attack. The educational program for the patients with epilepsy should emphasize medical knowledge with regard to brain anatomy, what to eat and what to avoid, and details of surgical treatment.
Anticonvulsants ; Brain ; Diet ; Drinking ; Employment ; Epilepsy* ; Humans ; Inpatients ; Life Style ; Marriage ; Neurology ; Outpatients ; Surveys and Questionnaires ; Seizures ; Smoke ; Smoking ; Wills

Aberrant expression of BORIS/CTCFL (Brother of the Regulator of Imprinted Sites/CTCF-like protein) is reported in different malignancies. In this study, we characterized the entire promoter region of BORIS/CTCFL, including the CpG islands, to assess the relationship between BORIS expression and lung cancer. To simplify the construction of luciferase reporter cassettes with various-sized portions of the upstream region, genomic copies of BORIS were isolated using TAR cloning technology. We analyzed three promoter blocks: the GATA/CCAAT box, the CpG islands and the minisatellite region BORIS-MS2. Polymorphic minisatellite sequences were isolated from genomic DNA prepared from the blood of controls and cases. Of the three promoter blocks, the GATA/CCAAT box was determined to be a critical element of the core promoter, while the CpG islands and the BORIS-MS2 minisatellite region were found to act as regulators. Interestingly, the polymorphic minisatellite region BORIS-MS2 was identified as a negative regulator that repressed the expression levels of luciferase reporter cassettes less effectively in cancer cells compared with normal cells. We also examined the association between the size of BORIS-MS2 and lung cancer in a case–control study with 590 controls and 206 lung cancer cases. Rare alleles of BORIS-MS2 were associated with a statistically significantly increased risk of lung cancer (odds ratio, 2.04; 95% confidence interval, 1.02–4.08; and P=0.039). To conclude, our data provide information on the organization of the BORIS promoter region and gene regulation in normal and cancer cells. In addition, we propose that specific alleles of the BORIS-MS2 region could be used to identify the risk for lung cancer.
Alleles ; Clone Cells ; Cloning, Organism ; CpG Islands ; DNA ; Gene Expression* ; Luciferases ; Lung Neoplasms* ; Lung* ; Minisatellite Repeats* ; Promoter Regions, Genetic

BACKGROUND AND OBJECTIVES: The objective of this study was to assess the short- and long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital. SUBJECTS AND METHOD: Four hundred sixty-seven patients received PMV (Ed-already defined above) using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model. RESULTS: After PMV, mitral valve area increased from 0.94+/-0.21 cm2 to 1.76+/-0.37 cm2 and the success rate (MVA>1.5 cm2 or increased by at least 50% without the development of moderate to severe mitral regurgitation) was 78.9%. Age (< or =50 years, p=0.018), echo score (< or =9, p=0.05) and pre-procedural mitral valve area (MVA, > or =1.1 cm2, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (< or =1.0 cm2, p=0.031) and echo score (>9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9% at 3 years post-PMV, 48.1% at 6 years and 29.6% at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD< or =60 mm, p=0.015). In addition, echo score (< or =8, p=0.412), pre-procedural MVA (> or =1.0 cm2, p=0.24) and ejection fraction (EF> or =55%, p=0.146) had an effect on the good long-term results of PMV from multivariate analysis. CONCLUSION: PMV was a very successful treatment method for mitral stenosis. Pre-procedural MVA was a representative predictive factor for short and long-term outcomes and the development of mitral regurgitation.
Balloon Valvuloplasty ; Echocardiography ; Humans ; Life Tables ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Multivariate Analysis ; Proportional Hazards Models ; Survival Rate

We report our experience with a case of performing laparoscopy-assisted total gastrectomy along with pancreas-preserving splenectomy for treating early gastric cancer. Laparoscopy-assisted total gastrectomy was planned for a 62-year-old male patient with a double early gastric cancer located in the upper and lower third of the stomach. Five trocars were placed and we used a harmonic scalpel to dissect the greater curvature. Enlarged splenic hilar lymph node was encountered and they were proved to be metastasis by frozen section biopsy. We then performed total gastrectomy with pancreas-preserving splenectomy for the purpose of completely dissecting the lymph nodes along the splenic artery and splenic hilum. We created a 4 cm sized longitudinal mini-laparotomy below the xiphoid process to remove the specimen, and anastomosis was done via the Roux-en-Y method. The patient was discharged on the 9th postoperative days after an uneventful recovery. Our experience shows that laparoscopy-assisted total gastrectomy with pancreas-preserving splenectomy is a relatively safe procedure for treating upper third early gastric cancer with metastatic splenic hilar lymph nodes.
Biopsy ; Frozen Sections ; Gastrectomy* ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Metastasis ; Splenectomy* ; Splenic Artery ; Stomach ; Stomach Neoplasms* ; Surgical Instruments

Ifosfamide-induced Fanconi syndrome is a rare complication that typically occurs in young patients due to a cumulative dose of ifosfamide > 40-60 g/m2, a reduction in kidney mass, or concurrent cisplatin treatment. It is usually characterized by severe and fatal progression accompanied by type II proximal renal tubular dysfunction, as evidenced by glycosuria, proteinuria, electrolyte loss, and metabolic acidosis. Diabetes insipidus is also a rare complication of ifosfamide-induced renal disease. We herein describe a case involving a 61-year-old man who developed ifosfamide-induced Fanconi syndrome accompanied by diabetes insipidus only a few days after the first round of chemotherapy. He had no known risk factors. In addition, we briefly review the mechanisms and possible therapeutic options for this condition based on other cases in the literature. Patients who receive ifosfamide must be closely monitored for renal impairment to avoid this rare but fatal complication.
Acidosis/chemically induced ; Antineoplastic Agents, Alkylating/*adverse effects ; Chemotherapy, Adjuvant ; Diabetes Insipidus/*chemically induced/diagnosis/therapy ; Fanconi Syndrome/*chemically induced/diagnosis/therapy ; Fatal Outcome ; Histiocytoma, Malignant Fibrous/*drug therapy/pathology ; Humans ; Ifosfamide/*adverse effects ; Male ; Middle Aged ; Neoadjuvant Therapy/*adverse effects ; Time Factors

Anti-tumor activity of the proteins from Gecko (GP) on cervical cancer cells, and its signaling mechanisms were assessed by viable cell counting, propidium iodide (PI) staining, and Western blot analysis. GP induced the cell death of HeLa cells in a dose-dependent manner while it did not affect the viability of normal cells. Western blot analysis showed that GP decreased the activation of Akt, and co-administration of GP and Akt inhibitors synergistically exerted anti-tumor activities on HeLa cells, suggesting the involvement of PI3-kinase/Akt pathway in GP-induced cell death of the cancer cells. Indeed, the cytotoxic effect of GP against HeLa cells was inhibited by overexpression of constituvely active form of Akt in HeLa cells. The candidates of the functional proteins in GP were analyzed by Mass-spectrum. Taken together, our results suggest that GP elicits anti-tumor activity against HeLa cells by inhibition of PI3-kinase/Akt pathway.
Blotting, Western ; Cell Count ; Cell Death ; HeLa Cells ; Humans ; Lizards ; Phosphatidylinositol 3-Kinases ; Propidium ; Proteins ; Uterine Cervical Neoplasms

Parachute mitral valve is a rare congenital cardiac anomaly in which the chordae tendineae of both leaflets of the mitral valve insert into a single papillary muscle. We diagnosed a 54-year-old adult with dyspnea after upper respiratory infection, who was proven to have the parachute mitral valve. To the best of our knowledge, this is the oldest patient reported with this congenital anomaly. The clinical, echocardiographic and MRI findings are described. We recommended surgery for anomalous lesion, but the patient refused. After medical treatment, the patient recovered uneventfully and remained asymptomatic during a follow-up of 13 months.
Adult* ; Chordae Tendineae ; Dyspnea ; Echocardiography ; Follow-Up Studies ; Heart Defects, Congenital ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Mitral Valve* ; Papillary Muscles