We have seen a primitive glioma which can be regarded as ependymoblastoma arising at the left frontal lobe of four-year-old boy. He has complained of excitement, hyperesthesia, mild incomplete paralysis of the left lower extremity for 1 1/2 months, and also incontinence of urine and stool was complained. The signs of increased intracranial pressure such as papilledema and separation of suture line were noted. Brain scanning showed tumor mass at the left frontal lobe, and which was revealed to be vascular tumor on carotid angiogram and delta wave was found at those area by electroencephalogram. Operative findings were that the tumor was hemorrhagic vascular mass showing partly cystic and necrotic in appearance, not bulged above outer surface and not connected with ventricle. The tumor mass measured 6x5x4cm which cut surface was pinkish white and focal necrotic areas were also seen. On microscopic examination the tumor was composed of relatively uniform primitive glial cells and the tumor cells arranged in perivascular area forming multiple layers while other region showed well formed tubules. Fibrillated cytoplasmic process between central vessel and glial cells that could be seen in matured ependymoma was not identified.
Brain ; Cytoplasm ; Electroencephalography ; Ependymoma ; Frontal Lobe ; Glioma ; Humans ; Hyperesthesia ; Intracranial Pressure ; Lower Extremity ; Male ; Neuroectodermal Tumors, Primitive* ; Neuroglia ; Papilledema ; Paralysis ; Sutures

We experienced a case of persistent left superior vena cava draining into the common atrium in a fetus of 26-year-old primigravida. Persistent left superior vena cava is derived from the left cardinal vein. This anomalous vessel usually drains into the right atrium via the coronary sinus and has no physiologic significance. Much less frequently, the left superior vena cava drains directly into the left atrium and it is associated with complex heart anomalies such as atrial septal defect, absence of coronary sinus, double outlet right ventricle, transposition of great arteries and asplenia syndrome. Fetal echocardiography showed an abnormal vessel draining into common atrium in a fetus with complex heart anomalies. It had a different direction from right superior vena cava or pulmonary veins in its traveling. We report a case with autosy findings.
Adult ; Coronary Sinus ; Double Outlet Right Ventricle ; Echocardiography* ; Fetus ; Heart ; Heart Atria ; Heart Septal Defects, Atrial ; Heterotaxy Syndrome ; Humans ; Pulmonary Veins ; Transposition of Great Vessels ; Veins ; Vena Cava, Superior*

No abstract available.
Prenatal Care*

In this article (J Korean Med Sci 2015; 30: 644-50), one author's name is misspelled. Correct Sung-Hun Im into Seong Hoon Lim.

The effects of subarachnoid administration of 0.5% bupivacaine in 5% and 10% glucosesolution were investigated in a randomized 30 cases undergoing a low limb and low abdominal surgery in the Department of Anesthesiology at the Hanyang University Hospital from October 1st, 1984 to March 31st, 1985. The results are as follows: 1) These were no significant differences between the patients of the three groups in relation to sex, age, weight, height and operation time. 2) The oneset time of the maximum segmental spread of analygesia in the control group was 5 to 10 minutes and 10 to 15 minutes in the experimental groups. 3) The spread of sensory blockade in the experimental groups was lowered 2~3 segment compared with control group. 4) The onset time of complete motor blockade in the control group was 5 minutes and 5~10 minutes in the experimental group. 5) Duration of complete motor blockade in experimental groups was shorter than the control group. 6) The cardiovascular changes were investigated with no significant differences between the patients of the three groups. 7) The minimal complications such as mild hypotension in three cases, micturition difficulty in one case, mild translent headache in one case were investigated in the three groups. According to our investigation of subarachnoid blockade with 0.5% bupivacain 2ml in 5% and 10% glocose solution, it considered that the spread was limited and produced intense sensory and motor block of long duration which was suitable of the low limbs and low abdominal surgery.
Anesthesiology ; Bupivacaine ; Extremities ; Headache ; Humans ; Hypotension ; Urination

The wild edible mushroom, Lentinus lepideus has recently been cultivated for commercial use in Korea. While the mushroom has been widely used for nutritional and medicinal purposes, the possible anti-hyperlipidemic action is unclear. The effects of dietary L. lepideus on plasma and feces biochemical and on the liver histological status were investigated in hypercholesterolemic rats. Six-wk-old female Sprague-Dawley albino rats were divided into three groups of 10 rats each. Biochemical and histological examinations were performed. A diet containing 5% L. lepideus fruiting bodies reduced plasma total cholesterol, triglyceride, low-density lipoprotein, total lipid, phospholipids, and the ratio of low-density to high-density lipoprotein. Body weight was reduced. The diet did not adversely affect plasma biochemical and enzyme profiles. L. lepideus reduced significantly plasma beta- and pre-beta-lipoprotein, while alpha-lipoprotein content was increased. A histological study of hepatic cells by conventional hematoxylin-eosin and oil red O staining revealed normal findings for mushroom-fed hypercholesterolemic rats. The present study suggests that a diet supplemented with L. lepideus can provide health benefits by acting on the atherogenic lipid profile in hypercholesterolemic rats.
Agaricales ; Animals ; Azo Compounds ; Body Weight ; Cholesterol ; Diet ; Electrophoresis, Agar Gel ; Feces ; Female ; Fruit ; Hepatocytes ; Humans ; Insurance Benefits ; Korea ; Lentinula ; Lipoproteins ; Liver ; Phospholipids ; Plasma ; Rats

OBJECTIVE: We report here on analyzing 3,128 subjects with stroke and who were discharged from the Departments of Rehabilitation Medicine of secondary or tertiary hospitals, and all the hospitals subscribed to the Online Database System developed by the Korean Society of Neurorehabilitation. METHOD: This is a retrospective analysis of the brain rehabilitation registry database for outcome of stroke outcome in the year 2006 to 2008. RESULTS: The male stroke subjects and cerebral infarction were 58.4% and 66.3%, respectively. Cerebral infarction in the middle cerebral artery territory was the most common, and the basal ganglia and cerebral cortex were the common areas for the cases of intracranial hemorrhage. The mean age of the patients was 61.7 years, and the most common ages were 45~64 years for all the stroke subjects. The subjects with cerebral hemorrhage (56.1 years) were younger than those with cerebral infarction (63.9 years). Seasonal variation was observed in the occurrence of stroke; spring (34.1%), winter (27.4%), summer (21.6%) and autumn (16.8%) in this order. There was no significant difference of the changes on the Korean version of the modified Barthel index between the patients with cerebral infarction and cerebral hemorrhage after rehabilitation. On analyzing the two groups of stroke subjects admitted before and after 100 days from stroke onset, the changes on the Korean version of the modified Barthel index and the Brunnstrom stage scores of the early admission group were higher that those of the late rehabilitation group. CONCLUSION: The above findings suggest that 1) the incidence, lesion sites and seasonality of stroke in this database system are similar to those of the worldwide data, 2) the length of hospital stay for the subjects with stroke is about 46 days and 3) early rehabilitation is more effective in improving the outcome of stroke subjects.

The purpose of this report was to provide information for patients receiving inpatient rehabilitation after stroke and to identify the possible factors influencing functional outcome after inpatient rehabilitation. Stroke patients (n = 5,212) who were discharged from the Departments of Rehabilitation Medicine (RM) of university hospitals and rehabilitation hospitals from 2007 through 2011 were participants. Prevalence, age, transfer time after onset, length of stay (LOS), functional status at admission and discharge were analyzed. In all stroke subjects, cerebral infarctions (67%) were more common than hemorrhages. Cerebral infarctions in the middle cerebral artery territory were most common, while the basal ganglia and cerebral cortex were the most common areas for hemorrhagic stroke. The LOS decreased from 45 to 28 days. Transfer time after onset decreased from 44 to 30 days. Shorter transfer time after onset was correlated with better discharge functional status and shorter LOS. Initial functional status was correlated with discharge functional status. In ischemic stroke subtypes, cerebellar and brainstem strokes predicted better outcomes, while strokes with more than one territory predicted poorer outcomes with more disabilities. In hemorrhagic stroke subtypes, initial and discharge functional status was the lowest for cortical hemorrhages and highest for brainstem hemorrhages. This report shows that LOS and transfer time after onset has been decreased over time and initial functional status and shorter transfer after onset are predictors of better functional outcome at discharge.
Aged ; Aged, 80 and over ; *Databases, Factual ; Demography ; Female ; Hemorrhage/complications ; Hospitals, University ; Humans ; Inpatients ; Ischemia/complications ; Length of Stay ; Male ; Middle Aged ; Rehabilitation Centers ; Stroke/etiology/*rehabilitation ; Treatment Outcome

BACKGROUND: Insulin resistance is a strong contributor to cardiovascular diseases. The increasing prevalence of diabetes and the subsequent complications confers a great importance to the early detection and intervention of diabetes. However, the exact roles of blood glucose and blood pressure in nondiabetic and normotensive range to vascular complications are not precisely defined. High-sensitivity C-reactive protein (hsCRP) levels have consistently been associated with various cardiovascular endpoints in a number of studies. The aim of this study was to find out whether the insulin resistance and hsCRP, a non-traditional cardiovascular risk factor, increase according to the fasting glucose and blood pressure levels in nondiabetic and normotensive individuals. METHODS: In 7,979 participants (4,847 males, 3,132 females, mean age 46 yrs) undergoing medical checkup program in Kangbuk Samsung Hospital, blood pressures, body mass index (BMI), fasting blood glucose, fasting insulin, lipid batteries and hsCRP levels were checked. All participants were subdivided into 5 groups according to fasting glucose level and into 4 groups according to the blood pressures. Homeostatic model assessment-insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI) were calculated. RESULTS: HOMA-IR and QUICKI increased according to the increment in fasting glucose and blood pressure in nondiabetic and normotensive range (p<0.01). Log (hsCRP) level significantly increased in proportion to the increment in fasting glucose and blood pressure in nondiabetic and normotensive range (p<0.01). CONCLUSION: Insulin resistance correlated with increment in the fasting glucose and blood pressure even in nondiabetic and normotensive range. Cardiovascular risk might be increased in proportion to the increment of fasting glucose and blood pressure even in the normal range. There may not be the glycemic and hypertensive threshold for the cardiovascular risk.
Blood Glucose* ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Fasting* ; Female ; Glucose ; Humans ; Insulin Resistance* ; Insulin* ; Male ; Prevalence ; Reference Values ; Risk Factors

BACKGROUND: Osteoprotegerin (OPG) is a soluble glycoprotein which inhibits osteoclastogenesis through binding to receptor activator of nuclear factor-kappaB ligand (RANKL). OPG-knockout mice develop early-onset osteoporosis and arterial calcification. Recent studies report that serum OPG levels are elevated in diabetic patients with cardiovascular disease and are associated with the presence and severity of coronary artery disease. We examined the relationships between serum OPG levels and insulin resistance, bone metabolism and cardiovascular risk factors in diabetic patients. METHODS: In 84 diabetic patients (33 men, 51 women, mean age 56.7 years old) were studied. Blood pressure, body mass index (BMI), fasting blood glucose, postprandial 2-hour blood glucose, fasting insulin and lipid profiles were measured. Serum OPG levels were measured with sandwich ELISA method. Bone mineral density (BMD)s were checked and serum osteocalcin and urine deoxypyridinoline levels were checked as bone turnover markers. 24-hour urine microalbumin were checked and left ventricular mass index (LVMI) were evaluated with echocardiography. From simple chest X-ray, the presence of aortic calcification were confirmed by a trained radiologist. Homeostatic model assessment (HOMA)-insulin resistance (IR), quantitative insulin sensitivity check index (QUICKI) were calculated as insulin resistance indices. RESULTS: Serum OPG levels were positively correlated with age, LVMI, HOMA and negatively correlated with lumbar spine BMD and QUICKI. After adjustment for age, only LVMI showed persistent correlation with serum OPG levels and when multiple regression analysis was performed with LVMI as the dependent variable, BMI and OPG were the significant predictors of LVMI (R2=0.054, p=0.012). Dividing the subjects into 3 groups according to 24-hour urine microalbumin levels, mean values for serum OPG levels increased as 24-hours urine microalbumin levels increased, but without statistical significance. Mean serum OPG levels were higher in patients with aortic calcification, without statistical significance. CONCLUSION: Serum OPG levels were positively correlated with insulin resistance indices and negatively correlated with lumbar spine BMD in diabetic patients, suggesting a compensatory mechanism to counteract bone loss progression. Serum OPG levels were independent predictor for LVMI in diabetic patients, warranting further research on OPG as the marker for future cardiovascular mortality in diabetic patients.
Animals ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Bone Density ; Cardiovascular Diseases ; Coronary Artery Disease ; Diabetes Mellitus ; Echocardiography ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Female ; Glycoproteins ; Humans ; Hypertrophy, Left Ventricular ; Insulin Resistance* ; Insulin* ; Male ; Metabolism* ; Mice ; Mortality ; Osteocalcin ; Osteoporosis ; Osteoprotegerin* ; RANK Ligand ; Risk Factors* ; Spine ; Thorax