Four children, with histopathologically confirmed posterior fossa primitive neuroectoderrnal tumors, were examined by plain radiography, computed tomography (CT) and cerebral angiography. The homogeneously well enhanced solid mass in the midline of the posterior fossa and hydrocephalus of various degree were seen on all CT scans. One case had calcifications and another case had low density areas in the tumor mass. Three cerebral angiograms showed vascular displacement without tumor vascularities. Unfortunately, these CT and angiography findings are and other tumors. when a well enhanced solid mass in the midline posterior fossa is seen on CT scan in children.
Angiography ; Cerebral Angiography ; Child ; Humans ; Hydrocephalus ; Medulloblastoma* ; Neuroectodermal Tumors, Primitive* ; Pathology* ; Radiography ; Tomography, X-Ray Computed

PURPOSE: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. MATERALS AND METHODS: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. RESULTS: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. CONCLUSION: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.
Cardiomyopathies* ; Chest Pain ; Coronary Artery Bypass ; Dyspnea ; Humans ; Male ; Myocardium ; Positron-Emission Tomography ; Stroke Volume ; Tomography, Emission-Computed, Single-Photon

PURPOSE: Hydroxyapatite (HA) has been widely used due to its chemical similarity to bone and good biocompatibility. HA is composed of macropores and micropores. Too much irregularities of the micropores are ineffective against the adhesion and proliferation of osteoblast. Many efforts have been tried to overcome these drawbacks. HA crystal coating on the irregular surface of HA scaffold, crystallized HA, is one of the method to improve cell adhesion. Meanwhile, the collagen has been incorporated with HA to create composite scaffold that chemically resembles the natural extracellular matrix components of bone. The authors proposed to examine the effect of collagen-coated crystallized HA on the adhesion and proliferation of osteoblast. METHODS: HA powder containing 10 microM pore size was manufactured as 1 cm pellet size. In order to make crystallized HA, 0.1 M EDTA solution was used to dissolve HA powder and heated 100degreesC for 48 hours. Next, the crystallized HA pellets were coated with collagen (0.1, 0.5, and 1%). The osteoblasts were seeded into HA pellets and incubated for the various times (1, 5, and 9 days). After the indicating days, methylthiazol tetrazolium (MTT) assay was performed for cell proliferation and alkaline phosphatase (ALP) activity was measured for bone formation. RESULTS: In SEM study, the surface of crystallized HA pellet was more regular than HA pellet. MTT assay showed that the proliferation of osteoblasts increased in a collagen dose-dependent and time-dependent manner and had a maximum effect at 1% collagen concentration. ALP activity also increased in a collagen dose-dependent manner and had a highest effect at 1% collagen concentration. CONCLUSION: These data showed that crystallization and collagen coating of HA was effective for osteoblast proliferation and ALP activity. Therefore, our results suggest that crystallized-HA scaffold with collagen coating is may be a good strategy for tissue engineering application for bone formation
Alkaline Phosphatase ; Cell Adhesion ; Cell Proliferation ; Collagen ; Crystallization ; Durapatite ; Edetic Acid ; Extracellular Matrix ; Hot Temperature ; Osteoblasts ; Osteogenesis ; Seeds ; Tissue Engineering

OBJECTIVE: To investigate the influence of associated medical diseases and complications on functional improvement after in-patient through stroke rehabilitation. METHOD: We performed a retrospective analysis on medical records of 183 stroke patients who had admitted to the department of rehabilitation medicine. Functional Independence Measure (FIM), Modified Barthel Index (MBI) at admission and discharge were used to assess the functional status. We investigated medical diseases, such as hypertension, diabetes, myocardial infarct, atrial fibrillation osteoarthritis, rheumatoid arthritis, previous history of stroke and complications such as dementia, post-stroke depression, central post-stroke pain, complex regional pain syndrome, neglect and aphasia. RESULTS: Post-stroke patients with myocardial infarct, atrial fibrillation, osteoarthritis, dementia, aphasia and neglect significantly showed lower gain of FIM and MBI, lower FIM and MBI efficacy during inpatient rehabilitation compared to without those (p<0.05). However, hypertension, diabetes, previous history of stroke, post-stroke depression, rheumatoid arthritis, central post-stroke pain and complex regional pain syndrome did not significantly influence on gain and efficacy of FIM and MBI (p>0.05). Total numbers of associated medical diseases and complications negatively affect on FIM and MBI efficacy (p<0.05). CONCLUSION: Therefore, it may be important to early detect and manage associated medical diseases and complications in post-stroke patients during rehabilitation, which improve the overall functional recovery of the patients.

OBJECTIVES: A great deal of attention has been paid to comorbid personality disorders in obsessive-compulsive disorder not only from the theoretical perspectives but also from the clinical aspects related to the prediction of the treatment response. The purpose of the current study was to investigate the relations of the symptoms dimensions in OCD to the comorbid personality pathology. METHODS: One-hundred thirty subjects with OCD completed Yale-Brown Obsessive Compulsive Scale (YBOCS) and Personality Disorder Questionnaire-4+ (PDQ-4+). Factor scores of symptom dimensions yielded from a factor analysis of 13 categories in YBOCS symptom checklist were inspected how to be related with the presence of any personality disorder and the PDQ scores for cluster A, B, and C personality pathology. RESULTS: The PDQ total score was significantly correlated with aggressive/sexual/religious obsessions, hoarding, and symmetry/ordering dimensions. The hoarding and repeating/counting dimensions were correlated with cluter A pathology, the symmetry/ordering dimension was with cluster B pathology, while the obsessions dimension was globally related to personality disorders of all the clusters. CONCLUSION: These findings add the evidence of the heterogeneity of OCD. The presence of pure obsessions, hoarding, and symmetry/ordering dimensions may need a close screening for comorbid personality disorders and individualized therapeutic strategies.
Checklist ; Mass Screening ; Obsessive Behavior ; Obsessive Hoarding ; Obsessive-Compulsive Disorder* ; Pathology* ; Personality Disorders ; Population Characteristics

BACKGROUND: The diagnosis of hepatitis C virus (HCV) infection is screened by anti-HCV enzymelinked immunosorbant assay (ELISA) and confirmed by recombinant immunoblotting assay (RIBA) or HCV RT-PCR. We attempted to evaluate the results between anti-HCV ELISA and a qualitative HCV RT-PCR. METHODS: Four hundred and twenty patients who were tested with anti-HCV ELISA and HCV RTPCR, simultaneously, from January 2002 to June 2005 were enrolled in this study. Anti-HCV ELISA was performed by AxSYM HCV version 3.0 (Abbott Laboratories, USA). HCV RT-PCR was performed using in-house RT-nested PCR methods from January 2002 to October 2004 and HCV Genotype Amplification Kit (LiPA) (Bayer Healthcare, USA) from November 2004 to June 2005. RESULTS: Of the 420 patients tested, 321 were positive for anti-HCV ELISA, and 204 were positive for RT-PCR. The positive predictability of anti-HCV ELISA was 63.6%. Among anti-HCV positive patients, RT-PCR was positive in 7.3% of the patients with sample/cut-off (S/CO)<6, compared with 82.8% of the patients with S/CO> or =6. Among the 117 patients with positive anti-HCV, but with negative HCV RT-PCR, 64 had liver diseases such as chronic hepatitis C, chronic hepatitis B, or hepatocellular carcinoma. Twelve patients showed positive HCV RT-PCR, but negative anti-HCV results; of these 9 had hepatic dysfunction. CONCLUSIONS: In the patients who were positive for anti-HCV ELISA with a low S/CO, HCV RT-PCR positivity was shown in a low proportion. Therefore, in such cases, the results should be confirmed by RIBA or HCV RT-PCR. The liver function test showed increased levels of hepatic enzymes in patients with positive HCV RT-PCR, but negative anti-HCV. Such findings correlate to an early phase of chronic hepatitis C, suggesting the necessity of continuous follow up.
Carcinoma, Hepatocellular ; Delivery of Health Care ; Diagnosis* ; Enzyme-Linked Immunosorbent Assay* ; Follow-Up Studies ; Genotype ; Hepacivirus ; Hepatitis B, Chronic ; Hepatitis C ; Hepatitis C, Chronic ; Humans ; Immunoblotting ; Liver Diseases ; Liver Function Tests ; Polymerase Chain Reaction

OBJECTIVE: To determine the effects of the voluntary contraction of muscles and magnetic stimulation intensity on the motor evoked potential (MEP) and the silent period (SP). METHOD: We studied MEPs and SPs in opponens pollicis muscle in 30 healthy adults (male: 16, female: 14) while varying the amount of the voluntary contraction and the stimulation intensity. We analyzed MEPs and SPs in relation to sex, recording site, opposition power and height. RESULTS: 1) During the contraction, the latencies of MEP were significantly shorter than during the relaxation. 2) The amplitudes of MEP reached plateau at 30% of maximal voluntary contraction and increased with increment of stimulation intensity without limitation. The amplitudes of MEP of right hand were bigger than left hand. There were no significant differences according to sex and recording site. 3) The durations of SP were directly proportional to the degrees of voluntary contraction and the stimulation intensity. CONCLUSION: Transcranial magnetic stimulation should be performed under the same voluntary contraction and magnetic stimulation intensity.
Adult ; Evoked Potentials, Motor* ; Female ; Hand ; Humans ; Muscles ; Relaxation ; Transcranial Magnetic Stimulation*

STUDY DESIGN: A prospective study. PURPOSE: To identify associations between psychiatric factors and patient-reported outcomes after corrective surgery in patients with lumbar degenerative kyphosis (LDK). OVERVIEW OF LITERATURE: Thus far, to the best of our knowledge, patient factors that may help predict patient-reported outcomes after corrective surgery for LDK have not been studied. METHODS: We prospectively investigated 46 patients with LDK who underwent surgical correction with a minimum follow-up of 2 years. Demographic data were collected. Short form-36, mental component scores (MCS), physical component scores (PCS), Scoliosis Research Society-22 (SRS-22) scores, and Roland-Morris Disability Questionnaire (RMDQ) scores were determined before the surgery and after 2 years of follow-up. Psychiatric conditions were preoperatively evaluated using the Zung depression scale (ZDS) and Zung anxiety scale (ZAS). Patients were divided into two groups (with or without psychiatric issues), according to baseline ZDS and ZAS scores. RESULTS: Patients included 43 women and 3 men. Twelve patients were deemed to have psychiatric problems (P group) and 34 patients had no psychiatric problems (NP group). No significant intergroup differences were found in MCS, PCS, SRS-22, and RMDQ scores preoperatively. However, at the 2-year follow-up, a significant intergroup difference was observed between PCS and RMDQ scores. Multiple regression analysis revealed that only the presence of a preoperative psychiatric problem can predict PCS and RMDQ scores. Other factors, such as, gender, age, body mass index, bone mineral density, osteotomy site, number of fusion segments, and instrumented levels did not affect PCS or RMDQ scores. CONCLUSIONS: The presence of a psychiatric factor may be an important risk factor underlying poor physical and pain scores after corrective surgery in patients with LDK. The findings presented here suggest that psychiatric factors should be evaluated prior to surgery for determining the risk of a poor outcome.
Anxiety ; Body Mass Index ; Bone Density ; Depression ; Female ; Follow-Up Studies ; Humans ; Kyphosis ; Lumbar Vertebrae ; Male ; Mental Disorders ; Osteotomy ; Prospective Studies ; Risk Factors ; Scoliosis

BACKGROUND AND OBJECTIVES: A number of studies have found that anatomic and physiological changes of the larynx with advancing age result in reduced control of the phonatory mechanism in elderly individuals. Although vocal signs of senescence are a small reflection of involution, it is important to understand the effects of normal aging on voice by differentiating changes precipitated by aging from those precipitated by physical abnormalities. The purposes of this study are to investigate the characteristics and examine the normative reference of the acoustic parameters with aging in Koreans. MATERIALS AND METHODS: The acoustic measurements in 300 normal persons of all age groups without laryngeal and audiological problems were assessed by multi-dimensional voice program (MDVP) 4305, KAY Elemetrics Corp., NJ, USA), and the changes due to advancing age were analysed. RESULTS: Fundamental frequency in women decreased with advanced age but it was noted with stability in men as they aged. Frequency stability decreased with advanced age in Koreans; amplitude stability decreased in men but not in woman. The normative reference of acoustic parameters in all age groups was also discussed. CONCLUSION: It may be suggested that the different normal thresholds for evaluating acoustic parameter in normal voice should be adjusted in different age groups in Korean.
Acoustics* ; Aged ; Aging* ; Female ; Humans ; Larynx ; Male ; Voice

Schwannoma or neurilemmoma is a benign peripheral nerve sheath tumor that arises from Schwann cells. Approximately 25–45% of all schwannomas occur in the head and neck regions, and the intraoral presentation of these is only 1%. We report a rare case of a patient presenting tongue base schwannoma with characteristic imaging features on computed tomography and magnetic resonance imaging.
Diagnosis, Differential ; Head ; Humans ; Magnetic Resonance Imaging ; Neck ; Nerve Sheath Neoplasms ; Neurilemmoma ; Peripheral Nerves ; Schwann Cells ; Tongue