No abstract available.
Gingival Crevicular Fluid* ; Periodontal Diseases*

This study was carried out to identify synaptic reorganization by mossy fibers of epileptic dentate gyrus by Timm sulphide silver histochemistry and to investigate degree of synaptic reorganization according to both hippocampal sclerosis and epileptiform discharge in human temporal lobe epilepsy(TLE). The control group was composed of two hippocampal tissues obtained from autopsied brain without neurological abnormalities. TLE group was composed of thirteen hippocampal tissues obtained from surgically resected temporal lobe. Among thirteen hippocampal tissues, five specimens were obtained both of two areas of each hippocampus with or without prominent epileptiform discharges on electrocorticogram(ECoG) for tailored hippocampal resection. Hippocampal cell density was quantitatively analyzed in TLE group and compared with that of control group. A portion of hippocampal tissue was observed under light microscopic and transmission electron microscopes after development with Danscher method. The results were as follows : Hippocampal cell loss was noted in all TLE group. Hippocampal cell loss greater than 30% of control values was found in 12 cases and average hippocampal cell loss was 70%(range 39-88%). The remaining 1 case had 13% hippocampal cell loss. The supragranular Timm granules were noted in inner molecular layer of dentate gyrus and tended to significantly increase in proportion as severity of hippocampal sclerosis. Average of hippocampal cell loss in two areas of five hippocampal tissues with or without prominent epileptiform discharge on ECoG was 73.6%(range 53-90%) and 66.4%(range 50-86%), which showed statistically significant (p<0.05) difference between these two areas and the supragranular Timm granules also tended to increase in the hippocampal tissue with epileptiform discharge. On transmission electron microscope, there showed distinct supragranular Timm granules correspond to mossy fiber synaptic terminals. The results of this study demonstrated that mossy fiber synaptic reorganization seems to play a major role in pathogenesis of human TLE and the development of mossy fiber synaptic reorganization is closely related to severity of hippocampal sclerosis. The result also support the rationale for tailoring the extent of hippocampal resection by intraoperative acute recording(ECoG) according to individual pathophysiology.
Brain ; Cell Count ; Dentate Gyrus* ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Presynaptic Terminals ; Sclerosis* ; Silver ; Temporal Lobe*

In our previous study, we observed that hydrosalpingeal fluid (HSF) adversely effect mouswe embryo development and hatching. The aim of this study was to evaluate the effect of HSF as assessed by the blastocyst development rate (BDR) and by cell counting in vitro HSF was collected from nine patients undergoing salpingoneostomy to correct hydrosalpinx. Two-cell embryos were obtained from superovulated ICR mice. T6 medium and T6+/-0.4% bovine serum albumin were used as control media. T6 medium containing 10% or 50% HSF and 100% HSF from each patient were used as test media. Nine to 15 embryos were cultured in microdrops prepared from each of these media. To assess the total cell number within each blastocyst, the blastocysts were fixed and stained with Hoechst 33342 to facilitate cell counting. The mean BDR in two control media were 88.89% and 85.40%. The mean BDR in media containing 10%, 50%, 100% HSF were 85.87%, 89.58% and 75.57%, respectively (*: p<0.05). The overall mean cell count (+/-SEM) in control media were 87.6+/-9.65 and 90.12+/-11.38. The BDR was affected adversely only by 100% HSF and not in media containing 10% or 50% HSF. Mean cell counts were decreased significantly only in blastocysts cultured 100% HSF (63.8+/-13.66; p<0.01) but not in blastocysts cultured in 10% or 50% HSF (91.3+/-12.44 and 82.9+/-18.27, respectively). Thus, it is concluded that HSF has no embyotoxic effect but has a mildly negatively effect on embryonic growth and development.
Animals ; Blastocyst ; Cell Count ; Embryonic Development ; Embryonic Structures* ; Female ; Growth and Development ; Humans* ; Mice* ; Mice, Inbred ICR ; Pregnancy ; Serum Albumin, Bovine

Jugular bulb diverticulum (JBD) is a rarely reported vascular anomaly, which is an extraluminal outpouching from the jugular bulb. Especially, there exists a lack of reported cases involving JBD encroaching the internal auditory canal (IAC) in Korea. Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size. In this article, we report a unique case of JBD eroding into the IAC that was presented as sudden sensorineural hearing loss with vertigo.
Cytochrome P-450 CYP1A1 ; Diverticulum ; Hearing Loss ; Hearing Loss, Sensorineural ; Korea ; Vertigo

No abstract available.
Female* ; Humans ; Neck* ; Urinary Bladder* ; Urinary Incontinence*

The incidence of multiple primary cancers is low than that of single primary cancer. In gastric cancer, incidence of occurrence of multiple primary cancer is 3 to 11.3%. Because stomach and lung are unrelated organs, the combination of gastric cancer and lung cancer is rare. Its estimated incidence is about 10% of all multiple primary cancers. The histologic types of secondary lung cancer in one series, squamous cell carcinomas were 49%; adenocarcinomas were 28%; large cell carcinomas were 14%; small cell carcinomas were 9%; others were 6%. This patient had been diagnosed as early gastric cancer 3 years ago, but he refused operation for cancer and wasnt followed up. After 3 years, he revisited us for dry coughing and diagnosed as small cell lung cancer. At this time, previous gastric cancer was remained as well differentiated, early gastric adenocarcinoma. For its rarity, we report this case with review of literatures.
Adenocarcinoma ; Carcinoma, Large Cell ; Carcinoma, Small Cell ; Carcinoma, Squamous Cell ; Cough ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Small Cell Lung Carcinoma* ; Stomach ; Stomach Neoplasms*

PURPOSE: The purpose of this study is to investigate the trends and traits of moral sensitivity and reasoning over six years of medical school. METHODS: The participants in this study consisted of 217 first to sixth-year medical students of Sungkyunkwan University School of Medicine in Korea. Essay type questionnaire was used for evaluating moral sensitivity and the Korean-Defining Issues Test (KDIT) was used for evaluating moral reasoning. RESULTS: It was found that the medical students' sensitivity of 'public welfare', 'prospective result' and 'role-taking as a doctor' was significantly higher than that of the pre-medical students'. Moral sensitivity increased in the 3rd and the 4th years but decreased in the 5th and the 6th years. Moral reasoning decreased in the 3rd and the 4th years but increased in the 5th and the 6th years. No correlation was observed between moral sensitivity and reasoning(r=0.033). Developmental trends of moral sensitivity and reasoning showed a significant difference in terms of year of medical school. CONCLUSION: The results suggest that medical school curriculum tends to impct students' moral sensitivity. This school has implemented the problem-based learning curriculum into the 3rd and the 4th years. It is necessary to consider the developmental state of the student's morality when developing an effective medical ethics program.
Curriculum ; Ethics, Medical ; Humans ; Korea ; Morals ; Problem-Based Learning ; Schools, Medical ; Students, Medical* ; Surveys and Questionnaires

PURPOSE: Cyclosporin A (CsA) is widely used as a prophylactic and therapeutic agent against a graft- versus-host disease following bone marrow transplantation. Herein, a case of cyclosporin-induced optic neuropathy, after bone marrow transplantation, is reported, which to our knowledge has never previously been reported. METHODS: A 43-year-old man, with acute myelogenous leukemia, who was treated with bone marrow transplantation one month previously, also with immunosuppressive medication, presented with decreased visual acuity and nystagmus in both eyes. He had been administerd CsA for about one month, from one day before the bone marrow transplantation. A fundus examination, visual field, electroretinography, and brain MRI were performed. RESULTS: At the first ocular examination, his visual acuity was markedly decreased in both eyes. On fundus examination, an edematous optic nerve head, with superficial peripapillary hemorrhage, was noticed in both eyes. A large central scotoma was seen in both eyes on a visual field examination. The amplitude of the b-wave in the scotopic ERG was slightly decreased in both eyes. However, there were no abnormal findings in the other examinations. Cyclosporin-induced optic neuropathy was suspected as the cause of the decreased visual acuity, so the CsA was discontinued and replaced by FK506(tacrolimus). On the second day after the discontinuation of the CsA, the optic disc edema improved, and the visual acuity of both eyes recovered almost too normal. CONCLUSIONS: It is important to monitor the neuro-ophthalmologic and neurologic signs of bone marrow transplant closely in patients taking cyclosporin.
Adult ; Bone Marrow ; Bone Marrow Transplantation ; Brain ; Cyclosporine* ; Edema ; Electroretinography ; Hemorrhage ; Humans ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Optic Disk ; Optic Nerve Diseases* ; Scotoma ; Visual Acuity ; Visual Fields

PURPOSE: This study was aimed to examine whether tutor evaluation in the PBL course assesses different aspects of learning from what written examination assesses. METHODS: 89 medical students were assessed by Self-Directed Learning Readiness Scale (SDLRS) and Learning Orientation Scale (LOS) in March 2004. Their tutor evaluation and written examination scores in the 1st semester of 2004 PBL units were collected in August 2004. Data analyses were conducted using t-test, correlation analysis, and linear regression. RESULTS: SDLRS scores were significantly correlated with tutor evaluation scores, but not with written examination scores. Both schoolwork orientation and academic orientation scores on LOS were significantly associated with tutor evaluation and written examination scores. Tutor evaluation scores were explained significantly by all predictors, such as SDLRS, schoolwork orientation, and academic orientation scores. However, written examination scores were explained significantly by academic orientation only. CONCLUSIONS: Tutor evaluation in the PBL assessed student self-directed learning readiness and academic orientation, but written examination did not. The findings show a crucial possibility that tutor evaluation may overcome shortcomings of the written examination.
Education, Medical, Undergraduate ; Educational Measurement ; Humans ; Learning* ; Linear Models ; Problem-Based Learning ; Psychological Tests ; Regression Analysis ; Statistics as Topic ; Students, Medical

Uterine anomalies have been reported in 4% of women with infertility and in up to 15% of those with recurrent abortion. One of the major intrauterine disorder associated with infertility and recurrent abortions is intrauterine septum, The reproductive outcome of 41 patients of intrauterine septum (7 complete, 34 incomplete) with repeated abortions or infertility was assessed after the uterine septotomy. 5 of 7 patients with comlete uterine septum undergone uterine septotomy (3; hysteroscopic metroplasty, 2; abdominal metroplasty) had total 6 pregnancies and all of them had live biths. 28 patients with incomplete uterine septum got the hysteroscopic intrauterine septotomy and the viable pregnancy rate was 62% (3 ongoing pregnancies, 13 live biths of total 26 pregnancies). 6 patients with incomplete uterine septum had not the operation and 5 patients had 5 live births after total 6 pregnancies with 1 spontaneus abortion. Even though, the number of cases were small, the live birth rate in the group of septotomy of the patients of complete uterine septum (100%, 6/6) was higher than that in the group of not-done (50%, 1/2). The live birth rate in the group of not-done of the patients with incomplete uterine septum (83%, 5/6) was higher than that in the group of hysteroscopic uterine septotomy (62%, 16/26), but 5 of 6 had short uterine septal length (<1 cm), 1 had 1.5 cm septal length in the group of not-done. All the patients with successful pregnancy outcome had no other co-factors at the diagnostic laparoscopy, but the 5 primary infertility patients with no live birth even after treatment (all were with incomplete septum; 3 undergone hysteroscopic septotomy, 2 not-done with one abortion) had other co-factors such as endometriosis, peritoneal or tubal facor. In conclusion, hysteroscopic uterine septotomy would be useful for the patients with habitutal abortion or infertility and more advanced managemnet protocols should be applied to the patients having other co-factors if there was no pregnancy even after the uterine septotomy.
Abortion, Habitual* ; Endometriosis ; Female ; Humans ; Hysteroscopy* ; Infertility* ; Laparoscopy ; Live Birth ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate