No abstract available.
Anterior Temporal Lobectomy* ; Seizures*

No abstract available.
Hemispherectomy*

PURPOSE: This study evaluates and compares the surgical outcomes of pediatric intractable epilepsy from various surgical modalities. METHODS: Among the patients who underwent epileptic surgery from March 1996 to February 2001, only the children, who had at least one year follow-up, were included in this study. The mean age with first seizure attacks was 3.5 years. The interval between first seizure attacks and surgical treatment was 4.8 years on average, and the mean age at surgical management was 7.4 years. The possible etiology was observed in 75.4% of total patients. Brain tumor and cortical dysplasia were main causes. The surgical treatment was done with various modalities, including resective surgeries (49.2%), corpus callosotomy of disconnection methods (41.5%), combined surgeries (7.7%), and gamma knife radiosurgery (one case). RESULTS: Surgical outcomes were evaluated based on the Engel's classification. After resective surgery, 90.6% of the patients showed class I. The majority of corpus callosotomy (59.3%) had class III. The outcomes after combined surgeries ranged from class I to III. The result of gamma knife radiosurgery was class III. The pathologic findings from resected tissue showed cortical dysplasia, tumor, nonspecific gliosis, etc. The complications after surgery were transient or permanent hemiparesis, visual field defect, hydrocephalus, subdural effusion, etc. CONCLUSION: We performed the various surgical methods in children with medically intractable epilepsy and obtained different results by surgical modalities. The surgical outcome will be improved if there is an appropriate selection among surgical modalities through the various preoperative assessments.
Brain Neoplasms ; Child ; Classification ; Epilepsy* ; Follow-Up Studies ; Gliosis ; Humans ; Hydrocephalus ; Malformations of Cortical Development ; Paresis ; Radiosurgery ; Seizures ; Subdural Effusion ; Visual Fields

No abstract available.
Chickens* ; Yolk Sac*

Heterotopic brain tissue is a very rare developmental anomaly in which isolated brain tissue is found outside the cranial cavity. In the majority of cases, the nasal cavity is the most common site of involvement, and only 10 cases which were developed in the palate have been reported in the international literature. Recently, we experienced a case in which heterotropic brain tissue, a congenital tumor-like mass, was observed in the soft palate. This was considered initially as hemangioma under MRI study, and under this impression, we observed this lesion to regress spontaneously for two years. Surgical excisoin was performed for diagnostic and therapeutic purpose since the mass have had no interval change. Histopathological diagnosis of positive immunohistochemical reaction was performed for the heterotropic brain tissue using S-100 protein and glial fibrillary acidic protein (GFAP). At the present time, the patient has no evidence of the disease, recurrence nor complication. We present this case with a review of literature.
Brain* ; Diagnosis ; Glial Fibrillary Acidic Protein ; Hemangioma ; Humans ; Magnetic Resonance Imaging ; Nasal Cavity ; Palate ; Palate, Soft* ; Recurrence ; S100 Proteins

The diagnosis of acute inflammation of the placenta, represented as acute chorioamnionitis, is important in that it is associated with a poor clinical outcome for both the mother and the fetus, including major perinatal morbidities such as sepsis, respiratory distress syndrome, and CNS damage. However, current medical trends in Korea seem to overlook the significance of a histopathological diagnosis of acute placental inflammation, mainly due to the indifferences of clinicians and pathologists. Since late 1993, histopathological examinations have been performed on preterm placentas at Seoul National University. These examinations have demonstrated acute placental inflammation in a significant number of cases. In the present study the incidence of acute placental inflammation was analyzed in 521 placentas which were submitted for pathological examinations in 1995. Examinations were performed to provide basic information on the incidence and profile of acute placental inflammation in this hospital and, thereby, to emphasize the significance of histopathological examinations of the placenta in the routine surgical pathology service. Among the 521 placentas, acute inflammation was found in 194 cases (37.2%). In preterm placentas acute inflammation was found in 39.6% of the cases (67/169), while 36.1% (127/352) of term placentas showed acute inflammation. Taking the delivery mode into account, 26.3% (49/186) of the placentas delivered by cesarean section showed acute inflammation, while 43.3% (145/335) of the transvaginally delivered placentas showed inflammation. The present analysis demonstrates the existence of acute inflammation in a significant proportion of placentas with different clinical settings. The importance of a histopathological examination in routine hospital practice should be emphasized.
Incidence

Pulmonary epithelioid hemangioendothelioma (PEH), originally termed an intravacular bronchioloalveolar tumor, is a rare pulmonary neoplasm with a vascular origin and slow rate of malignancy. It affects various organs such as the liver, the central nervous system, lung, etc. Clinically, pulmonary epithelioid hemangioendothelioma has been considered to be a borderline malignancy, a generally indolent and nonaggressive tumor that displaes the pulomonary parenchyma over a number of years by slowly enlarging the tumor nodule. The clinical course of PEH is known to be usually benign. Here we report an unusual case of PEH that was highly malignant and was eventually fatal. The PEH was confirmed by microscopic analysis and hmmunohistochemical staining of CD31+(a membrane receptor and a sensitive and specific marker for vascular lesions) from an open lung biopsy specimen.
Biopsy ; Central Nervous System ; Hemangioendothelioma, Epithelioid* ; Liver ; Lung ; Lung Neoplasms ; Membranes

PURPOSE: We want to validate the use of the silver-enhanced in situ hybridization (SISH) technique as comparised with fluorescence in situ hybridization (FISH) technique for assessing the HER2 gene amplification of breast carcinoma. METHODS: Tissue microarray (TMA) blocks from 58 breast cancer specimens were prepared and the concordance between HER2 gene amplification in breast cancer was determined by the FISH (PathVysion(R), Abbott/Vysis) technique and the automated silver in situ hybridization (SISH, INFORMtrade mark, Ventana) technique. For comparison, all the specimens were stained by immunohistochemistry (Ventana-PATHWAY(R)4B5). Evaluation was performed by two pathologists and with following the instructions of the manufacturers and the guidelines of the American Society of Clinical Oncology/College of American Pathologists. RESULTS: The results of SISH and FISH were identical in all 58 cases; 17 cases showed HER2 amplification, and on the other hand, 41 cases didn't show HER2 amplification. Five weakly positive (2+) cases in immunohistochemistry staining revealed one HER2 amplification and four no HER2 amplification on both SISH and FISH. The SISH results of the HER2/CEP17 ratio were well correlated with the FISH results of the HER2/CEP17 ratio (correlation coefficient r=0.745, Linear regression r2=0.555, p<0.001). CONCLUSION: The results of the SISH technique for assessing the HER2 status of excised breast carcinoma is comparable to the result obtained by FISH. However, SISH has the advantage of having permanent end result that can be visualized by an ordinary light microscope and less laborious preparation and time is needed than is required by FISH. SISH seems to be more feasible than FISH for assessing HER2 amplification of breast cancer.
Breast ; Breast Neoplasms ; Fluorescence ; Genes, erbB-2 ; Hand ; Imidazoles ; Immunohistochemistry ; In Situ Hybridization ; Light ; Linear Models ; Nitro Compounds ; Silver

OBJECTIVES: Though gastric cancer is one of the most common cancer in Korea, there have been few studies to explore psychological distress in gastric cancer. The purpose of this study was to investigate the prevalence and associated risk factors of psychological distress among patients with gastric cancer. METHODS: With consecutive sampling, a total of 274 patients with gastric cancer who admitted to a cancer center in a general hospital were recruited and assessed on psychological distress using the Hospital Anxiety and Depression Scale(HADS). Sociodemographic and cancer-related clinical variables were also evaluated. RESULTS: One hundred fifty-three(55.8%) patients with gastric cancer showed psychological distress. Logistic regression models revealed that having alcohol drinking experience[odds ratio(OR)=2.10, p=0,034] and low performance status(OR=2.40 p=0.002) were significantly associated with psychological distress in patients with gastric cancer. CONCLUSIONS: These findings indicate that approximately half of patients with gastric cancer suffered from psychological distress and having alcohol drinking experience and low performance status would be associated risk factors, suggesting the need for distress screening and psychosocial supportive care in patients with gastric cancer.
Alcohol Drinking ; Anxiety ; Depression ; Hospitals, General ; Humans ; Korea ; Logistic Models ; Mass Screening ; Prevalence ; Risk Factors ; Stomach Neoplasms

PURPOSE: We intended to evaluate the efficacy, safety, and effects on quality of life of vagus nerve stimulation(VNS) in children with intractable epilepsy. METHODS: We retrospectively studied the medical records of 7 pediatric patients who underwent VNS implantation between December 2001 and April 2003. RESULTS: The ages at operation ranged from 6 years and 5 months to 11 years and 9 months. The duration of follow-ups ranged from 12 months to 44 months. All the patients had intractable seizures, in four of whom the epilepsy was symptomatic. Of the 4 patients, three had history of meningoencephalitis and one had pachygyria. 5 patients(71 %) had 50% or more reduction in seizure frequency and the onset of seizure reduction occurred within 3 months after VNS implantation. Seizure reduction of more than 50% was observed in head drop and atypical absence seizure(1/1, 100%, one with callosotomy), generalized tonic clonic seizure(3/4, 75%) and complex partial seizure(1/2, 50%). In 4 patients there were improvements in quality of life such as alertness, mood, verbal communication and motor function. Side effects were transient hoarseness in four patients and wound infection in one patient, but these were not too severe to lerate. CONCLUSION: VNS is an effective and safe adjunctive therapy in intractable pediatric epilepsy as wall as in improving quality of life.
Child ; Epilepsy* ; Follow-Up Studies ; Head ; Hoarseness ; Humans ; Lissencephaly ; Medical Records ; Meningoencephalitis ; Quality of Life ; Retrospective Studies ; Seizures ; Vagus Nerve Stimulation* ; Vagus Nerve* ; Wound Infection