PURPOSE: To identify the relationship between hemoglobin (Hgb) or hematocrit (Hct) level and dural sinus density using unenhanced computed tomography (UECT). MATERIALS AND METHODS: Patients who were performed UECT and had records of a complete blood count within 24 hours from UECT were included (n=122). We measured the Hounsfield unit (HU) of the dural sinus at the right sigmoid sinus, left sigmoid sinus and 2 points of the superior sagittal sinus. Quantitative measurement of dural sinus density using the circle regions of interest (ROI) method was calculated as average ROI values at 3 or 4 points. Simple regression analysis was used to evaluate the correlation between mean HU and Hgb or mean HU and Hct. RESULTS: The mean densities of the dural sinuses ranged from 24.67 to 53.67 HU (mean, 43.28 HU). There was a strong correlation between mean density and Hgb level (r=0.832) and between mean density and Hct level (r=0.840). CONCLUSION: Dural sinus density on UECT is closely related to Hgb and Hct levels. Therefore, the Hgb or Hct levels can be used to determine whether the dural sinus density is within the normal range or pathological conditions such as venous thrombosis.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cranial Sinuses/pathology/*radiography ; Female ; *Hematocrit ; Hemoglobins/*analysis ; Hepatolenticular Degeneration/complications ; Humans ; Male ; Middle Aged ; Pregnancy ; Pregnancy Complications ; Radiographic Image Interpretation, Computer-Assisted ; Reference Values ; Regression Analysis ; Superior Sagittal Sinus/pathology/*radiography ; Tomography, X-Ray Computed/*methods ; Young Adult

Bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome has not been previously reported. Williams syndrome is a genetic disorder characterized by infantile hypercalcemia, elfi n facial features, an outgoing personality, and cardiovascular abnormalities. It has been found to be related to elastin gene defect. Cerebrovascular abnormalities with associated strokes in Williams syndrome have been described only recently and rarely. Moyamoya disease is a cerebrovascular disorder characterized by progressive occlusion of the supraclinoid internal carotid artery. The pathogenesis of Moyamoya disease is unclear. Only a single report of Moyamoya disease associated with Williams syndrome manifesting as an intracerebral hemorrhage has been published. We report the fi rst case of bilateral Moyamoya disease manifesting as ischemic stroke in a patient with Williams syndrome. We propose that inherited moyamoya disease is also related to elastin gene defect.

BACKGROUND: Spinal stroke is unusual, accounting for 1% of all cases of stroke in general hospital. The clinical features of anterior spinal artery syndromes due to Adamkiewicz artery obstruction are dissociative sensory disturbances, motor weakness, and autonomic dysfunctions. There have been several reports of using magnetic resonance imaging(MRI) in ischemic spinal cord infarctions. However, angiographic and MRI finding of the obstruction of Adamkiewicz artery has never been reported in Korea. CASE: A previously healthy 60-year-old woman presented an acute onset of paralysis of both lower limbs. On admission she showed paralysis and anesthesia of both lower limbs, and loss of bladder function. Routine hematological and CSF studies revealed no abnormalities. MRI disclosed T11-L2 level spinal cord infarction on T1- and T2-weighted images. Posterior tibial somatosensory evoked potential study revealed prolongation of cortical waves. Spinal angiographic findings were compatible with spinal cord infarction due to the obstruction of Adamkiewicz artery. COMMENT: To our knowledge, this is believed to be the first case of spinal stroke due to the obstruction of Adamkiewicz artery confirmed both by MRI and by angiography in Korean literature.
Anesthesia ; Angiography ; Arteries* ; Evoked Potentials, Somatosensory ; Female ; Hospitals, General ; Humans ; Infarction ; Korea ; Lower Extremity ; Magnetic Resonance Imaging ; Middle Aged ; Paralysis ; Spinal Cord ; Stroke* ; Urinary Bladder

No abstract available.
Adenocarcinoma* ; Endometrial Hyperplasia* ; Female

OBJECTIVES: Gamma-aminobutyric acid (GABA) has potential benefits in counteracting the sleep disruption and potential therapeutic effects on blood pressure, stress, cancer, and inflammatory diseases. Recently, High-dose GABA can be extracted from fermented rice germ using lactic acid bacteria. This study aimed to evaluate the effects of GABA natural extracts from fermented rice-germ on sleep latency, subjective sleep quality and insomnia symptoms. METHODS: This was a prospective randomized double-blind placebo-controlled trial performed at Kyung-Hee University hospital at Gangdong from June 2013 to October 2013. Adult (age≥30) patients who was diagnosed of insomnia according to DSM-IV criteria was enrolled. They were randomized into three groups: high dose treatment group 300 mg; low-dose treatment group, 100 mg; and placebo group. Questionnaires including Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), WHO-5 Well-Being Index were performed, and 1-week actigraphy was recorded before and 1 week after the treatment. RESULTS: Total of 114 patients were randomized into 3 groups: high-dose treatment (n=37), low-dose treatment (n=38), and placebo treatment group (n=39). At 1 week after the treatment, PSQI total score and C2 (sleep latency) score significantly decreased in low-dose and high-dose treatment group than the placebo groups [Repeated measures analysis of variance (ANOVA), p=0.017, 0.004 respectively]. ISI score also decreased in the two groups in dose-dependent manner (Repeated measures ANOVA, p=0.037). There were five (4.4%) patients who reported medication adverse events. CONCLUSIONS: This study suggests that treatment of low and high-dose GABA from unpolished rice-germ decreases sleep latency and improve insomnia severity without severe adverse events.
Actigraphy ; Adult ; Bacteria ; Blood Pressure ; Diagnostic and Statistical Manual of Mental Disorders ; gamma-Aminobutyric Acid* ; Humans ; Lactic Acid ; Prospective Studies ; Sleep Initiation and Maintenance Disorders ; Therapeutic Uses

Depression is well-known to comorbid with several psychiatric disorders. Many schizophrenics also suffer from depression in the course of their illness. Combined therapy of SSRI and tricyclic antidepressants were reported to have benefits in some depressed patients. Paroxetine, a potent CYP2D6 inhibitor, increases the blood levels of tricyclic antidepressant markedly, Using paroxetine, we tried this combined therapy in the treatment of depressive symptoms in 10 chronic schizophrenic inpatients and evaluated its efficacy and drug interactions between paroxetine and tricyclic antidepressants. The following results were obtained: 1) The mean score of Hamilton's Depression Rating Scale(HDRS) was reduced significantly after 6 weeks-trials of this combined therapy for the mild depressive symptoms in 10 chronic schizophrenics. In four patients, 50% or more reductions in the scores of HDRS were noticed at final evaluation. 2) Two among our 10 subjects experienced severe toxic behavioral problems. Anticholinergic crisis with toxic confusion due to high blood levels of tricyclics was fecund in one patient and the other showed rapid clinical deterioration in his psychotic symptoms such as delusion and hallucination without any consciousness alternation. 3) Baseline plasma levels of tricyclics before adding paroxetine were higher or than expected in our chronic schizophrenic subjects maintained with their antipsychotic medications. Several antipsychotics were also known as a potent CYF2D6 inhibitors and to increase the blood levels of tricyclics. Because the blood levels of tricyclics had already increased significantly by the use of antipsychotics, adding paroxetine to antipsychotics and tricyclic antidepressant In our subjects could increase the blood levels of tricyclics not so much as previously reported in the literatures.
Antidepressive Agents, Tricyclic ; Antipsychotic Agents ; Consciousness ; Cytochrome P-450 CYP2D6 ; Delusions ; Depression* ; Drug Interactions ; Hallucinations ; Humans ; Inpatients ; Paroxetine* ; Plasma ; Schizophrenia

OBJECTIVE: To investigate the distribution of BCL-2, BAX proteins and DNA fragmented cells in the normal human endometrium during at each menstrual cycle in order to find out whether apoptosis regulates cyclic endometrial change. METHODS: Normal endometrial tissues wee obtained from 40 patients, 32~45 year of age, all with regular menstrual cycle, who were undergoing abdominal hysterectomy for myoma of uterus or cervical intraepithelial neoplasia for period from 1992 through 1997. Immunohistochemical staining was used to determine the expression of BCL-2 and BAX protein with paraffin-embedded tissues. RESULTS: BCL-2 was expressed on the glandular epithelial cells and stromal cells during the proliferative phase. The intensity of BCL-2 was increased predominantly on the basal layer than the functional layer in late proliferative phase. However, BCL-2 immunoreactivity was decreased in the secretory phase. BAX wes expressed predominantly during the secretory phase. the intensity was increased in late secretory phase rather than early secretory phase. DNA fragmented cells were detected in a few cells at each phase. However, it was increased during the late secretory phase. CONCLUSION: Apoptosis-related genes, BCL-2 and BAX, may play a role in the regulation of cyclic endometrial change.
Apoptosis ; bcl-2-Associated X Protein ; Cervical Intraepithelial Neoplasia ; DNA ; Endometrium* ; Epithelial Cells ; Female ; Genes, bcl-2 ; Humans* ; Hysterectomy ; Menstrual Cycle ; Myoma ; Stromal Cells ; Uterus

BACKGROUND: Drowning represents the third most common cause of all accidental deaths worldwide. Although few studies of submersion injury were done in Korea, the subjects were mainly pediatric patients. The purpose of this study is to describe the clinical feature of submersion injury in adults. METHODS: The medical records of 31 patients with submersion injury who were >15 years of age and admitted to Kyungpook National University Hospital from July 1990 to March 2003 were retrospectively examined. RESULTS: The most common age-group, cause, and site of submersion accidents in adults were 15-24 years of age, inability to swim, and river followed by more than 65 years of age, drinking, and public bath respectively. The initial chest radiographs showed bilaterally and centrally predominant distribution of pulmonary edema at lung base in about 90% of patients with pulmonary edema represented by submersion injury but at only upper lung zone in 10%. Eventually, 25 patients (80.6%) survived without any neurologic deficit and 2 patients (6.5%) with significant neurologic deficit, and 4 patients (12.9%) died. Age, arterial gas oxygenation, and mental status among baseline variables showed significant difference for prognosis. CONCLUSIONS: More than 65 years of age, drinking, and occurrence in public bath were relatively important in submersion injury of adults, and the successful survival of 80.6% of patients suggests that cardiopulmonary resuscitation should be intensively done in even adults.
Adult* ; Baths ; Cardiopulmonary Resuscitation ; Drinking ; Drowning ; Gyeongsangbuk-do ; Humans ; Immersion* ; Korea ; Lung ; Medical Records ; Near Drowning ; Neurologic Manifestations ; Oxygen ; Prognosis ; Pulmonary Edema ; Radiography, Thoracic ; Retrospective Studies ; Rivers

No abstract available.
Lung Neoplasms* ; Lung* ; Peroxidase*

A fusion gene between echinoderm microtubule-associated protein-like 4 (EML4) and the anaplastic lymphoma kinase (ALK) has been identified in non-small cell lung cancers (NSCLCs). Although a few studies have evaluated EML4-ALK fusion genes in Korean NSCLCs, the prevalence of different EML4-ALK fusion variants has yet to be clearly assessed. Herein, we have examined the profiles of EML4-ALK fusion gene variants in Korean patients of NSCLCs. EML4-ALK fusion genes have been detected in 10 (6.0%) of 167 patients of NSCLCs and in 9 (7.4%) of 121 patients of adenocarcinoma. Of the 10 patients with fusion genes identified, 8 (80%) were E13;A20 (variant 1) and 2 (20%) were E6;A20, with an additional 33-bp sequence derived from intron 6 of EML4 (variant 3b). These results indicate that the profiles of EML4-ALK fusion gene variants in Korean patients of NSCLC may differ from those in other ethnic populations. Herein, we describe for the first time the profiles of EML4-ALK fusion variants of Korean patients with NSCLCs.
Adenocarcinoma/diagnosis/genetics ; Aged ; Asian Continental Ancestry Group/*genetics ; Base Sequence ; Carcinoma, Non-Small-Cell Lung/diagnosis/*genetics ; Exons ; Female ; Humans ; Introns ; Lung Neoplasms/diagnosis/*genetics ; Male ; Middle Aged ; Oncogene Proteins, Fusion/chemistry/*genetics ; Republic of Korea ; Sequence Analysis, RNA ; Smoking