No abstract available.
Breast Neoplasms* ; Breast* ; Estrogens*

Transient ischemic attack (TIA) often precede cerebral infarcts as a warning symptom. But the studies revealing the frequency and the correlation between preceding TIAs and following infarcts are rare. According to the western data, about one-quarter of the patients with cerebral infarct have been supposed to have the previous history of TIAs. We prospectively studied the exact frequency, clinical presentation, and presumed causes of TIAs preceding cerebral infarct. Ninety five patients diagnosed as acute cerebral infarction were interviewed whether they had had previous episodes of TIA. 4 check-list using ordinary language was used, and NINDS diagnostic criteria was applied on the consensus between several neurologists. Seventeen patients (18%) had history of preceding TIAs. Carotid territory was affected in 11 patients (65%), while vertebrobasilar in 4(24%) and undetermined in 2. Duration was less than an hour in 10 patients(59%), and attacks were multiple in about half. Time interval between the last attack and infarction was less than one week in 10 cases(59%). Incidence of recent TIA ((1 month) was 22% in large artery disease(LAD), 11% In cardioembolism(CE), 9% in small-artery disease(SAD), and 7% in mixed etiology. Conclusion, TIAs preceding cerebral infarcts are not rare, but seems to be less common in Koreans than in Caucasians. As expected, atherothrombosis of large artery is supposed to be the leading cause of TIAs.
Arteries ; Cerebral Infarction ; Consensus ; Humans ; Incidence ; Infarction ; Ischemic Attack, Transient* ; National Institute of Neurological Disorders and Stroke ; Prospective Studies

BACKGROUND AND PURPOSE: Current therapy for acute ischemic stroke is highly focused on neuroprotective agents, and many ion channel blockers have been challenged for experimental models. In this study, we tried to reveal the neuroprotective effect of lamotrigine, a voltage-sensitive sodium channel blocker, for transient global ischemia of Mogolian gerbil. METHODS: Lamotrigine (50mg/kg) was administered via gastric tube 30 minutes before and after global ischemia (for 10 min) under body temperature monitoring. Sham-operated and non-treated ischemia group were compared. Seven days after reperfusion, gerbils were killed with perfusion/fixation technique and representative sections were cut through the hippocampus. Hematoxylin-Eosin staining was done for microscopic examination and number of viable neurons in CA1 area was counted. RESULTS: Neuronal density was different between sham-operated (n=11), non-treated ischemic (n=11), and lamotrigine-treated (n=26) group (107.8+13.1/mm vs. 21.5+23.0/mm vs. 82.0+13.1/mm, p<0.01). Both pre-(n=17) and post-treated group (n=9) showed significant neuroprotective effect compared with non-treated group. Neuronal density of pre-treated group was slightly higher than in post-treated group, though statistically not significant (84.6+13.0/mm vs. 77.3+12.7/mm, p=0.13). CONCLUSION: These results show that lamotrigine may have some effects reducing the delayed neuronal death in transient global ischemia. Considering the mechanism of action, we suggest that activation of voltage-sensitive sodium channel and release of glutamate at early phase of ischemia may be related to the delayed neuronal death.
Body Temperature ; Cerebral Infarction ; Gerbillinae ; Glutamic Acid ; Hippocampus ; Ion Channels ; Ischemia* ; Models, Theoretical ; Neurons ; Neuroprotective Agents* ; Reperfusion ; Sodium Channels ; Stroke

No abstract available.
Chorionic Gonadotropin* ; Gonadotropin-Releasing Hormone* ; Gonadotropins* ; Humans* ; Progesterone* ; Superovulation*

BACKGROUND: Transient global ischemia causes delayed neuronal death (DND) in the CA1 area, of which the mecha-nism is controversial. Induction of apoptosis-regulating proteins during the process of DND has been reported, howev-er ,the exact role of Bcl-2/Bax is not well understood. We tried to reveal the pattern of the Bax/Bcl-2 expression modi-fied by the duration of ischemia and hypothermia. METHODS: Global ischemia was induced in Mongolian gerbils for 2, 5, and 10 minutes under the temperature of 36 degrees C and 32 degrees C. Hippocampal sections were evaluated 48 hours after ischemia with H&E and immunohistochemical staining to Bcl-2/Bax. Viable neuronal density and semi-quantitative grading were compared. RESULTS: In the CA1 area, neurons were intact in 2 min ischemia, while partial or significant ischemic changes were observed in 5-10 min ischemia of 36 degrees C setting, which were less severe in 32 degrees C . Bcl-2 was posi-tive in 2 min ischemia, while negative in 5~10 min ischemia of 36 degrees C . Bax was negative in 2 and 10 min ischemia, while positive in 5 min ischemia. In 32 degrees C setting, Bcl-2 was also positive in 2 min ischemia and partially positive in 5- 10 min ischemia, although Bax expression was not different from 36 degrees C. CONCLUSIONS: The complex mechanism of DND, which is in the spectrum of apoptosis and necrosis, seems to be determined by the severity of ischemia. The bal-ance between Bcl-2 and Bax may determine the survival of neurons in mild to moderate ischemia. Further evidence remains to be determined by morphological and molecular biological methods.
Apoptosis ; Body Temperature* ; Gerbillinae ; Hypothermia ; Ischemia* ; Necrosis ; Neurons

PURPOSE: To assess quality of life and depressive status in Korean patients with Graves' ophthalmopathy. METHODS: A cross-sectional study of 49 patients (mean age, 41 years; sex ratio, M:F=11:38) with Graves' ophthalmopathy (referred to as the Graves' group) and 48 age-matched and sex-matched controls (mean age, 40.2 years; sex ratio, M:F=11:37) was performed using the Korean version of the 36-item Short-Form General Health Survey (SF-36) questionnaire and the Beck Depression Inventory (BDI). Survey data was compared among patients with mild, moderately severe, and sight-threatening Graves' ophthalmopathy and between patients with low (0 or 1) or high (2 or 3) Gorman scores. RESULTS: Those in the Graves' group scored significantly lower on all categories of the SF-36, as compared to the control group (p<0.05). The 4 patients with sight-threatening Graves' had significantly lower scores for physical functioning, role limitations due to physical health, and the physical component summary of the SF-36, when compared with the 28 patients with mild Graves' and the 17 patients with moderately severe Graves' (p<0.05). The 17 patients in the high Gorman score group had lower physical component summary scores than the 32 patients in the low Gorman score group (p=0.03). The 16 patients with BDI scores > or =16 had significantly lower scores on the SF-36 and higher clinical activity scores, as compared to the 33 patients with BDI scores <16 (p<0.05). CONCLUSIONS: Patients with Graves' ophthalmopathy had reduced health-related quality of life and were more likely to be depressed, especially those with a sight threatening condition or significant diplopia. It is important to identify these patients to provide the necessary psychological support.
Adult ; Analysis of Variance ; Cross-Sectional Studies ; Depression/*epidemiology ; Female ; Graves Ophthalmopathy/*psychology ; Humans ; Korea/epidemiology ; Male ; *Quality of Life ; Questionnaires

Workplace violence is related to various health effects including mental illness such as anxiety or depression. In this study, the relationship between the experience of workplace violence and depression in substitute drivers in Korea, namely, daeri drivers, was investigated. To assess workplace violence, questions regarding types and frequency of the experience of violence over the past year were asked to the daeri drivers. In order to assess the risk of depression, the Center for Epidemiological Studies Depression Scale was used. Odds ratios with 95% confidence intervals of depression were estimated using multiple logistic regression analysis. All of the daeri drivers had experienced instance of verbal violence while driving and 66 of the drivers (34.1%) had been in such a situation more than once in the past quarter of a year. Sixty-eight daeri drivers (42.2%) had experienced certain type of physical violence over the past year. Compared to daeri drivers who had experienced workplace verbal violence less than 4 times and who had not experienced workplace physical violence over the past year, higher odds ratio was observed in daeri drivers who had experienced workplace verbal violence or physical violence, more than 4 times and more than one time respectively, after adjustment. Experience of verbal or physical type of workplace violence over the past year increased the risk of depression in the daeri drivers. Because violence against drivers can compromise the safety of the driver, the customer, and all the passengers, it is imperative that the safety and health of daeri drivers be highlighted.
Adult ; Aged ; *Automobile Driving/psychology ; Depression/epidemiology/*etiology ; Driving Under the Influence/prevention & control/psychology ; Humans ; Male ; Middle Aged ; Occupational Health ; Odds Ratio ; Republic of Korea/epidemiology ; Surveys and Questionnaires ; *Workplace Violence

PURPOSE: To compare the clinical manifestations between patients with ocular myasthenia gravis and those with generalized myasthenia gravis (MG). METHODS: The medical records of 71 patients diagnosed with MG between January 1995 and December 2007 were reviewed. Demographics, sensitivities of diagnostic methods, the presence of systemic autoimmune diseases, ophthalmic complications caused by MG, and treatments were evaluated and compared. RESULTS: Fourteen patients (20%) were diagnosed with ocular MG and 57 patients (80%) with generalized MG. Sensitivities of anti-acetylcholine receptor antibody and repetitive nerve stimulation tests were significantly higher in the generalized MG group (84%, 89%) compared to those in the ocular MG group (50%, 54%) (p = 0.011, p = 0.008). The sensitivity of the neostigmine test was the highest in both groups (98% of generalized MG, 79% of ocular MG), and the difference between the two groups was borderline significant (p = 0.058). The most common symptoms were ptosis and diplopia, and both groups presented with pain, blurred vision, and tearing. Systemic autoimmune disease was more prominent in the generalized MG group (21%) than in the ocular MG group (14%), and steroid therapy was used more frequently in the generalized MG group (82%) than in the ocular MG group (57%). Ophthalmic complications associated with long-term steroid treatment were more profound in the generalized MG (30%) compared to those of the ocular MG (21%). CONCLUSIONS: The generalized MG group was associated with higher sensitivities to diagnostic tests, more systemic steroid use, higher ophthalmic complications caused by systemic autoimmune disease, and long-term steroid treatment compared to those of the ocular MG group.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases/complications ; Child ; Drug Administration Schedule ; Eye Diseases/chemically induced/immunology ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis/complications/*diagnosis/*drug therapy ; Steroids/*administration & dosage/adverse effects ; Young Adult

BACKGROUND: Although steroid is one of the most widely used therapeutic measures for brain edema, its effect on brain edema after intracerebral hemorrhage (ICH) remains to be clarified. We performed this study to evaluate the efficacy of high dose methylprednisolone and conventional dose dexamethasone on the development of brain edema after experimental ICH. METHODS: Fifty-four male Sprague-Dawley rats, weighing 350-450 g, were used. ICH was made by stereotaxic injection of autologous arterial blood (0.13ml) into the right caudatoputamen. The animals were divided into three groups (n = 18 each). Group A received intraperitoneal(IP) injection of normal saline at 8-hour interval. Group B received dexamethasone (0.2mg/kg IP 30minutes after blood injection and 0.1mg/kg IP every 8h thereafter). Group C received methylprednisolone (30 mg/kg IP 30 minutes after ICH, 15mg/kg IP at 2 h after initial dose, and every 8h thereafter). We sacrificed the rat after 3 days and the development of brain edema was determined by measuring brain water content. We compared brain water content in each group. RESULTS: Water content of the right hemisphere was slightly lower in the methylprednisolone-treated rats than other groups; mean + S.D. in group A, B, and C was 80.94 + 0.66%, 80.56 + 0.70%, and 80.42 + 0.91%, respectively. However, there was no statistical significance ( p > 0.1) by the ANOVA test. The difference of the mean water contents between the two hemispheres was slightly higher in the saline-treated group than other groups, but without statistical significance ( p > 0.1). CONCLUSION: We could not find any significant reduction of the brain water content in the groups treated with steroid regardless of the doses. Our results do not warrant the popular steroid therapy in patients with ICH.
Animals ; Brain ; Brain Edema* ; Cerebral Hemorrhage* ; Dexamethasone ; Humans ; Male ; Methylprednisolone ; Rats ; Rats, Sprague-Dawley

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate. Thirty patients, classified as ASA ps 2 or 3, were selected randomly and divided them into two groups as follows: Group l(N=15); Not-administrated furosemide(control group) Group 2(N=15); Administrated furosemide(Experimental group) All patients were premedicated with hydroxyzine(1 mg/kg, IM) and were performed continuous epidural anesthesia with 2/ lidocaine(1-1.5 mg/segment). 5% D-sorbitols were used for irrigating solution, and Hartmans solutions were given for maintenance fluid. And fixed the irrigating container to 60 cm in height from symphysis pubis. With the starting of operation, 20 mg furosemide was administrated to experimental group. The blood samples for serum Na+, K+, glucose and BUN were obtained at preoperation, 10 min, 20 min, 30 min after the stating of operation and immediate postoperative period, and serum osmolality and effective osmolality were calculated. The results were as follows: l) The values of sodium concentration of control group were decreased significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimental group were not changed significantly. 2) The values of serum osmolality and effective osmolality were decreased significantly at 30 min after the starting of operation and immediate postoperative period as compared with the preoperative value(p<0.05). But those of experimenta1 group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. So we would like to recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.
Absorption ; Anesthesia, Epidural ; Electrolytes* ; Furosemide* ; Glucose ; Heart Failure ; Humans ; Osmolar Concentration* ; Postoperative Period ; Prostate* ; Renal Insufficiency ; Sodium ; Transurethral Resection of Prostate