Rabies is a fetal viral encephalitis to which all mammals, including man are susceptible. This virus, the genus of Rhabdovirus, is usually present in the saliva of infected animals and is transmitted by their bite. As a rule the virus enter the CNS by ascending along peripheral nervous system and extremely variable in extent. Negri bodies are appear in about 75% of cases. These bodies are eosinophilic, usually rounded inclusions and is located in the cystoplasm of the neurons, most frequently in the pyramidal neurons of the Hippocampus and the Purkinje cells of the cerebellum. We have experienced a case of canine rabies that showed Negri bodies in the Purkinje cells along with diffuse degenerative encephalitis and perivascular mononuclear cells infiltration. The Negri bodies were best demonstrated by Negri body staining although routine H-E staind was also useful. There inclusion bodies were located exclusively in the cytoplasm, and were found occasionally. Electron microscopic findings of the Negri bodies showed aggregates of bulletshaped nucleocapsids. We report a Negri body found in the brain of rabid dog with the light and electron microscopic findings.
Male ; Humans ; Dogs ; Animals

OBJECTIVE: In this study, there was an investigation as to whether there is a functional difference in essential tremor (ET), according to responses to beta-blockers, by evaluating regional changes in cerebral glucose metabolism. MATERIALS AND METHODS: Seventeen male patients with ET were recruited and categorized into two groups: 8 that responded to medical therapy (group A); and 9 that did not respond to medical therapy (group B). Eleven age-sex matched healthy control male subjects were also included in this study. All subjects underwent F-18 fluorodeoxyglucose (FDG)-PET, and evaluated for their severity of tremor symptoms, which were measured as a score on the Fahn-Tolosa-Marin tremor rating scale (FTM). The FDG-PET images were analyzed using a statistical parametric mapping program. RESULTS: The mean FTM score 6 months after the initiation of propranolol therapy was significantly lower in group A (18.13 > 8.13), compared with group B (14.67 = 14.67). The glucose metabolism in group A in the left basal ganglia was seen to be decreased, compared with group B. The ET showed a more significantly decreased glucose metabolism in both the fronto-temporo-occipital lobes, precuneus of right parietal lobe, and both cerebellums compared with the healthy controls. CONCLUSION: Essential tremor is caused by electrophysiological disturbances within the cortical-cerebellar networks and degenerative process of the cerebellum. Furthermore, ET may have different pathophysiologies in terms of the origin of disease according to the response to first-line therapy.
Adrenergic beta-Antagonists/*pharmacology/therapeutic use ; Aged ; Brain/*drug effects/metabolism/radiography ; Brain Mapping ; Essential Tremor/*diagnosis/drug therapy/radiography ; Fluorodeoxyglucose F18/*chemistry ; Glucose/*metabolism ; Humans ; Male ; Middle Aged ; *Positron-Emission Tomography ; Propranolol/pharmacology/therapeutic use ; Radiopharmaceuticals/*chemistry

OBJECTIVES: This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems. METHODS: We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively. RESULTS: Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%. CONCLUSIONS: It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.
Delivery of Health Care ; Electronic Health Records ; Hospitals, Public ; Humans ; Outpatients

Surgical oncologist plays a pivotal role in treating patients with cancer in the era of precision medicine. In this article, we summarized traditional roles of surgical oncologists and suggested further additional ones for the modern day in the multidisciplinary approach to gastric cancer treatment.

PURPOSE: This study evaluated the difference between the modified subvastus approach in total knee arthroplasty (TKA) and the medial parapatellar approach in terms of the postoperative function of the knees. MATERIALS AND METHODS: From March to December 2002, 40 primary TKAs from 26 patients were divided into two groups by a prospective, randomized, blinded trial. The patients were followed up for more than 1 year. The modified subvastus approach was used in 21 knees, and the medial parapatellar approach was used in the remaining 19 knees. The time of postoperatively active straight-leg raise (SLR), and the range of flexion of the operated knee were assessed at postoperative 10 days, 6 weeks, 3, 6, and 12 months. The degree of the patellar tilt and subluxation was investigated at postoperative 12 months. The data collected was analyzed using a t-test. RESULTS: The patients with the modified subvastus approach performed active straight-leg raise sooner mean, 0.5 day) than the patients operated on using medial parapatellar approach (mean 2.2 days). Knee flexion was better at post-operative 10 days in the modified subvastus approach group than the medial parapatellar approach group. However, there was no statistical difference after 6 weeks, 3 months, 6 months, and 12 months after surgery. The level of patellar tilt and subluxation was similar in the two groups. CONCLUSION: The modified subvastus approach provided the advantage of early postoperative rehabilitation in terms of an earlier active SLR and greater knee flexion at 10 days compared with the medial parapatellar approach. The use of the modified subvastus approach in primary TKA is recommended.
Arthroplasty* ; Humans ; Knee* ; Prospective Studies ; Rehabilitation

PURPOSE: Previously, we reported that the expression of E-cadherin was significantly decreased according to the increase of the level of hepatocyte growth factor (HGF) in gastric cancer tissue. In this work, the effect of HGF on the cell-cell adhesion and intracellular distribution of E-cadherin in the gastric carcinoma cell lines were studied. MATERIALS AND METHODS: Western blot analysis was performed to confirm the presence or abscence of c-Met and E-cadherin in SNU-1, 5, and 16 cells. Tyrosine phosphorylation of c-Met, E-cadherin, alpha-, beta-, gamma-catenins was checked by immunoprecipitation. The morphologic changes induced by HGF were studied with immunocytochemical staining. Functional proportion of E-cadherin was estimated by cell fractionation. The effect of HGF on cell proliferation and invasion was also assessed. RESULTS: Among SNU-1, 5, and 16 cell lines, only SNU-16 cells expressed both E-cadherin and c-Met. A morphological change from epithelial shape to fibroblastic one was observed in the SNU-16 cells after treatment with HGF. In addition, E-cadherin expression of the SNU-16 cells was shifted from the membrane and to the cytoplasm, and the functional fraction of E-cadherin was decreased in the SNU-16 cells treated with HGF. On the other hand, HGF increased the proliferation and invasion of the SNU-16 cells. CONCLUSION: These results suggest that HGF may regulate cell adhesion in gastric carcinomas via the cellular redistribution and functional change of E-cadherin.
Blotting, Western ; Cadherins* ; Cell Adhesion ; Cell Fractionation ; Cell Line* ; Cell Proliferation ; Cytoplasm ; Fibroblasts ; gamma Catenin ; Hand ; Hepatocyte Growth Factor* ; Hepatocytes* ; Immunoprecipitation ; Membranes ; Phosphorylation ; Stomach Neoplasms ; Tyrosine

BACKGROUND: Alzheimer's disease (AD) and Parkinson's disease associated with dementia (PDD) are considered to be frequent types of cortical and subcortical dementia. Definitive diagnosis of neurodegenerative diseases is impossible without biopsy. Single photon emission computed tomography (SPECT) of the brain has long been used for years with cognitive disorders. Nevertheless, differential brain perfusion of patients with PDD and AD who exhibit mild dementia has not been reported. Therefore, we investigated the differences in the cerebral perfusional pattern using perfusion SPECT between mild AD and mild PDD to help clarify the diagnosis in the early stage of these dementias, since accurate diagnosis is crucial in decision regarding treatment, appropriate advice, management and prognosis. METHODS: Thirty-one patients with mild PDD and 32 patients with mild probable AD were enrolled in this study. All subjects underwent 99mTc-hexamethyl propylene amine oxime perfusion SPECT and general neuropsychological tests, and these data including perfusion images were analyzed. RESULTS: Perfusion SPECT showed hypoperfusion in frontal, parietal and temporal regions in both PDD and AD patients with mild dementia. Hypoperfusion in the occipital and cerebellar regions was significantly apparent in only PDD patients. CONCLUSION: Comparison of mild PDD with mild AD showed a significantly decreased perfusion in the occipital and cerebellar region in patients with mild PDD. Cerebral perfusion in the occipital region and the cerebellum could be a crucial differential diagnostic method of these diseases in the early phase. Further studies are needed for a definitive conclusion.
Alkenes ; Alzheimer Disease ; Biopsy ; Brain ; Cerebellum ; Dementia ; Humans ; Neurodegenerative Diseases ; Neuropsychological Tests ; Parkinson Disease ; Perfusion ; Tomography, Emission-Computed, Single-Photon

Basal cell carcinoma (BCC) is one of the most commonly diagnosed malignant skin tumors and develops characteristically on sun-exposed areas, such as the head and neck. Ultraviolet light exposure is an important etiologic factor in BCCs, and BCCs arising from non-sun- exposed areas are, therefore, very rare. In particular, the axilla, nipple, the genital and perianal areas are not likely to be exposed to ultraviolet light; thus, if BCC develops in these areas, other predisposing factors should be considered. Herein, we report a case of BCC arising on the pubic area in a 70-year-old man. We also performed a survey of the literature and discussed the 19 cases of BCC from non-sun-exposed areas reported to date in Korea.
Aged ; Axilla ; Carcinoma, Basal Cell ; Head ; Humans ; Korea ; Neck ; Nipples ; Skin ; Ultraviolet Rays

BACKGROUND AND PURPOSE: Although acetyl-L-carnitine (ALC) treatment may have beneficial effects on Alzheimer's disease (AD), its underlying neural correlates remain unclear. The purpose of this study was to investigate cerebral perfusion changes after ALC treatment in AD patients using technetium-99m hexamethylpropylene amine oxime single photon emission computed tomography (SPECT). METHODS: A total of 18 patients with early AD were prospectively recruited and treated with ALC at 1.5 g/day for 1.4±0.3 years. At baseline and follow-up, brain SPECT, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), and Neuropsychiatric Inventory (NPI) were used to assess participants. After ALC administration, changes in brain perfusion, severity of dementia, cognitive performance, and neuropsychiatric disturbances were examined. RESULTS: After ALC administration, changes in scores of MMSE, CDR, GDS, and NPI were not statistically significant (p>0.05). Voxel-wise whole-brain image analysis revealed that perfusion was significantly (p<0.001) increased in the right precuneus whereas perfusion was reduced in the left inferior temporal gyrus (p<0.001), the right middle frontal gyrus (p<0.001), and the right insular cortex (p=0.001) at follow-up. CONCLUSIONS: Although previous studies have suggested that AD patients generally demonstrate progressive deterioration in brain perfusion and clinical symptoms, this study reveals that the perfusion of the precuneus is increased in AD patients after ALC administration and their cognitive and neuropsychiatric symptoms are not aggravated. Further studies are warranted to determine the potential association between perfusion increase in the precuneus and clinical symptoms after ALC treatment in AD patients.
Acetylcarnitine* ; Alzheimer Disease* ; Brain ; Cerebral Cortex ; Cognition ; Dementia ; Follow-Up Studies ; Humans ; Parietal Lobe ; Perfusion* ; Prospective Studies ; Temporal Lobe ; Tomography, Emission-Computed, Single-Photon*

Halo nevus is a pigmented nevus surrounded by a round or oval depigmentation. Of patients with halo nevus, 18 to 26% patients have vitiligo, either involving the nevus or at a distant site. While the exact etiology of halo formation and vitiligo is unknown, several theories suggest that common immunologic mechanisms are involved in the destruction of melanocytes of both phenomena. Unlike common melanocytic nevus, congenital nevus associated with both halo formation and concurrent extralesional vitiligo is very uncommon and only one case has been reported in the Korean dermatological literature. A 19-year-old female presented with surrounding depigmentation around a congenital hairy nevus on the left forearm. Simultaneously, vitiligo appeared on the lowerabdomen and surrounding regions of both areola. The halo depigmented lesion around congenital nevus and the periareolar vitiliginous lesion shared some histological and immunohistochemical features. These findings further support common immunological mechanisms of pigment destruction in both phenomena.
Female ; Forearm ; Humans ; Melanocytes ; Nevus ; Nevus, Halo ; Nevus, Pigmented ; Vitiligo ; Young Adult