Effects of Action Observation Training and Mirror Therapy on the Electroencephalograms of Stroke Patients

Purpose@#This study examined the effectiveness of action observation training (AOT) and mirror therapy in improving the electroencephalograms (EEG) of stroke patients. @*Methods@#Patients were allocated randomly to three groups: an action observation training with activity (AOTA) group (n=12), a mirror therapy with activity (MTA) group (n=11), and an AOT-only group (n=12). All groups received conventional physiotherapy in five 60-minute sessions over six weeks. The AOTA, MTA, and AOT groups practiced AOTA, MTA, and AOT, respectively, in three 30-minute sessions over six weeks. The differences between the pre- and post-treatment EEGs were assessed using a paired t-test. Comparisons between the groups were performed using one-way ANOVA. @*Results@#The participants in the AOTA and MTA groups showed significant improvement in the EEG. AOTA improved the alpha waves of the prefrontal, temporal, and parietal lobes significantly (p<0.05). MTA improved the alpha waves of the temporal lobe significantly (p<0.05). AOT did not result in significant improvement @*Conclusion@#AOTA and MTA improve stroke patients’ EEGs. Mirror neuron activation combined with conventional stroke physiotherapy promotes motor recovery and functioning. The effect is enhanced when the actions are executed after observation. Further research into mirror neuron activation will be needed to develop methods to improve the EEGs of stroke patients.

Effects of Action Observation Training and Mirror Therapy on the Electroencephalograms of Stroke Patients

Purpose@#This study examined the effectiveness of action observation training (AOT) and mirror therapy in improving the electroencephalograms (EEG) of stroke patients. @*Methods@#Patients were allocated randomly to three groups: an action observation training with activity (AOTA) group (n=12), a mirror therapy with activity (MTA) group (n=11), and an AOT-only group (n=12). All groups received conventional physiotherapy in five 60-minute sessions over six weeks. The AOTA, MTA, and AOT groups practiced AOTA, MTA, and AOT, respectively, in three 30-minute sessions over six weeks. The differences between the pre- and post-treatment EEGs were assessed using a paired t-test. Comparisons between the groups were performed using one-way ANOVA. @*Results@#The participants in the AOTA and MTA groups showed significant improvement in the EEG. AOTA improved the alpha waves of the prefrontal, temporal, and parietal lobes significantly (p<0.05). MTA improved the alpha waves of the temporal lobe significantly (p<0.05). AOT did not result in significant improvement @*Conclusion@#AOTA and MTA improve stroke patients’ EEGs. Mirror neuron activation combined with conventional stroke physiotherapy promotes motor recovery and functioning. The effect is enhanced when the actions are executed after observation. Further research into mirror neuron activation will be needed to develop methods to improve the EEGs of stroke patients.

The Two Cases of Multifocal Fixed Drug Eruption Caused by Diclofenac / 대한피부과학회지

Fixed drug eruption (FDE) is a drug-induced disorder that may appear as patches or bullae. It recurs at the same sites as those involved in exposure to the same drug (causative drug). We encountered two cases of generalized FDE, and both patients had a history of diclofenac exposure before the onset of skin lesions. In the first case, an 82-year-old female patient presented with multiple erythematous patches on the trunk and lower extremities. In the second case, a 71-year-old male patient developed multiple bullae on violaceous patches on the trunk and extremities. The findings of histopathologic examinations were indicative of the diagnosis of FDEs. Although diclofenac is commonly used as a non-steroidal inflammatory drug, diclofenac-induced generalized FDE occurs rarely and has not been reported in Korea. With reuse of causative drugs, the size and number of lesions tend to increase. Therefore, early diagnosis of FDE is important, and avoidance of repeated exposure to drugs should be educated.

A Rare Case of Juvenile Pemphigus Vulgaris Treated with Intravenous Immunoglobulin / 대한피부과학회지

Juvenile pemphigus vulgaris (JPV) is a rare variant of pemphigus vulgaris (PV) occurring in childhood and adolescence that has similar symptoms and the same histological and immunopathological features as classic adult PV. Although rare, advanced cases of JPV can be fatal due to secondary sepsis. Many patients with JPV are misdiagnosed and therefore not properly treated in the early stages of the disease. Although systemic corticosteroids are the therapeutic mainstay, long-term corticosteroid use has various adverse effects. Intravenous immunoglobulin (IVIG) was recently reported to reduce the side effects of corticosteroids. Here, we report a case of JPV in a 14-year-old boy treated with IVIG.

A Case Report of Hailey–Hailey Disease Treated with Alitretinoin

No abstract available.

Experimental Investigation on the Tissue Response Induced by Face-Lifting Mesh Suspension Thread in Rats

BACKGROUND: Face-lifting procedures are often performed to hide the effects of aging. Thread-lifting, a minimally invasive technique for the correction of facial aging, has become increasingly popular, and various materials for the procedure have been developed. OBJECTIVE: This study compared tissue responses to two types of threading sutures placed under rat skin: polypropylene (PP) monofilament mesh suspension thread (a novel face-lifting material) and polydioxanone (PDO) barbed thread. METHODS: Eight rats each were assigned to the PP monofilament mesh suspension, PDO barbed thread, and control groups. Tissue reactions were evaluated 28 days after subcutaneous loading of the materials. RESULTS: Significant increases in tensile strength and the mean area occupied by collagen fibers were evident in skin loaded with PDO barbed thread and PP monofilament mesh suspension thread compared to control skin (p<0.05). Compared to sites loaded with PDO barbed thread, those loaded with PP monofilament mesh suspension thread showed a significant increase in the number of collagen fibers and a lower grade of inflammation (p<0.05). CONCLUSION: PP monofilament mesh suspension thread has skin-rejuvenating effects comparable to those of PDO barbed thread, but induces a less severe inflammatory response. This indicates that it is a safe and effective material for use in thread-lifting procedures on aging skin.

Association between Homocysteine Levels and Psoriasis: A Meta-Analysis

BACKGROUND: Psoriasis is a multifactorial disease associated with an increased risk for metabolic syndrome and cardiovascular diseases. Elevated levels of homocysteine (Hcy) are a marker of cardiovascular risk. Several studies have evaluated the associations between psoriasis and Hcy levels; however, the results remain inconclusive. OBJECTIVE: We performed a systematic review of the literature and a meta-analysis to better understand the relationship between psoriasis and Hcy. METHODS: Five scientific databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) were searched to identify relevant studies. A review of 307 publications identified 16 studies that directly assessed plasma levels of Hcy in psoriasis patients. RESULTS: A total of 16 studies including 2,091 subjects were included in the meta-analysis. Hcy levels were significantly higher in psoriasis patients relative to healthy controls (weighted mean difference [WMD], 3.30; 95% confidence interval [CI], 1.58∼5.02; I²=82.1%). Subgroup analyses revealed that patients with higher mean psoriasis area severity index (PASI) scores (PASI>10) had significantly higher Hcy levels compared to healthy controls (WMD, 4.17; 95% CI, 1.18∼7.16; I²=88.3%), whereas patients with lower mean PASI scores (PASI ≤10) had not (WMD, 0.76; 95% CI, −1.84∼3.35; I²=72.2%). CONCLUSION: This meta-analysis found that psoriasis patients, in particular those with PASI >10, had significantly higher Hcy levels compared to healthy controls. Further research is needed to determine the association between Hcy levels and psoriasis severity.

Treatment of Hidradenitis Suppurativa Patient with Klinefelter Syndrome by Adalimumab

Hidradenitis suppurativa (HS) is a chronic, inflammatory and painful skin disease with recurrent nodules and tracts involving the intertriginous regions. It is known that the patient with HS shows an increased risk of metabolic disorders such as diabetes, metabolic syndrome and autoimmune diseases. Klinefelter syndrome (KS) is a sex chromosomal disorder occurring in males due to an abnormality of sexual differentiation, characterized by 47, XXY karyotype. Also, KS is related with somatic comorbidities such as metabolic syndrome, autoimmune and rheumatologic disorders as HS is. We report a HS patient with KS who shows a big improvement while on tumor necrosis factor-alpha inhibitor treatment.

Primary Squamous Cell Carcinoma of the Remnant Stomach after Subtotal Gastrectomy

Primary squamous cell carcinoma (SCC) of the stomach is a very rare disease. However, the pathogenesis, clinical characteristics, and prognosis of gastric SCC are controversial and remain to be elucidated. Herein, we report a case of primary gastric SCC of the remnant stomach after subtotal gastrectomy. A 65-year-old man was admitted to our hospital due to epigastric discomfort and dizziness. He had undergone subtotal gastrectomy 40 years previously for gastric ulcer perforation. Endoscopy revealed a normal esophagus and a large mass in the remnant stomach. Abdominal computed tomography revealed enhanced wall thickening of the anastomotic site and suspected metachronous gastric cancer. Endoscopic biopsy revealed SCC. Total gastrectomy was performed with Roux-en-Y esophagojejunostomy. A 10-cm tumor was located at the remnant stomach just proximal to the previous area of anastomosis. Pathologic examination showed well-differentiated SCC extended into the subserosa without lymph node involvement (T3N0M0). The patient received adjuvant systemic chemotherapy with 6 cycles of 5-FU and cisplatin regimen, and he is still alive at the 54-month follow-up. According to the treatment principles of gastric cancer, early detection and radical surgical resection can improve the prognosis.

Characteristics of Cutaneous Lymphomas in Korea According to the New WHO-EORTC Classification: Report of a Nationwide Study

BACKGROUND: Previously, cutaneous lymphomas were classified according to either the European Organization for the Research and Treatment of Cancer (EORTC) or the World Health Organization (WHO) classification paradigms. The aim of this study was to determine the relative frequency of Korean cutaneous lymphoma according to the new WHO-EORTC classification system. METHODS: A total of 517 patients were recruited during a recent 5 year-period (2006-2010) from 21 institutes and classified according to the WHO-EORTC criteria. RESULTS: The patients included 298 males and 219 females, and the mean age at diagnosis was 49 years. The lesions preferentially affected the trunk area (40.2%). The most frequent subtypes in order of decreasing prevalence were mycosis fungoides (22.2%), peripheral T-cell lymphoma (17.2%), CD30+ T-cell lymphoproliferative disorder (13.7%), and extranodal natural killer/T (NK/T) cell lymphoma, nasal type (12.0%). Diffuse large B-cell lymphoma accounted for 11.2% of cases, half of which were secondary cutaneous involvement; other types of B-cell lymphoma accounted for less than 1% of cases. CONCLUSIONS: In comparison with data from Western countries, this study revealed relatively lower rates of mycosis fungoides and B-cell lymphoma in Korean patients, as well as higher rates of subcutaneous panniculitis-like T-cell lymphoma and NK/T cell lymphoma.

Spindle Cell Rhabdomyosacoma of Uterus: A Case Study

Uterine rhabdomyosarcoma (RMS) typically presents as a mixed epithelial and mesenchymal tumors. Pure RMSs of the female genital tract are uncommon. Spindle cell variant of RMS is a rare morphologic subtype of embryonal RMS and mostly occurs in the paratesticular region of children. Here, we present a case of uterine spindle cell RMS in a 76-year-old woman. The tumor, 20x15x7 cm in size, was highly necrotic and adherent to the colon and rectum. Tumor cells were mostly spindle-shaped, and isolated rhabdomyoblasts were scattered. Immunohistochemical stains for myoglobin and myo-D1 showed diffuse positivity for tumor cells. The patient died only of disease three months after diagnosis.

Concurrence of Torus Mandibularis with Multiple Buccal Exostoses

No abstract available.

Enterobius vermicularis Ova in a Vaginal Smear

Enterobius vermicularis is one of the most common parasites found in the intestine of humans. The gravid female worms migrate outside the anus to release eggs on the perianal skin. Rarely, they migrate to the genitourinary tract in female patients. We present a case in which pinworm eggs were found in a cervicovaginal smear of a 37-year-old woman. The eggs were elongated oval shaped and flattened on one side. The thick, double contoured birefringent shell stained bright yellow or orange. Some coarsely granular embryos or curved larvae were enclosed in the refractile shell. Empty eggs or wrinkled shells with clumped granular material were also present. Although pinworm eggs are easily identified because of their characteristic morphologic appearance, careful screening is needed due to the frequent masking by inflammatory cells.

Clusterin Expression and Apoptosis in Transitional Cell Carcinoma of the Bladder / 대한비뇨기과학회지

PURPOSE: The clusterin expression has been associated with tumorigenesis of various malignancies, including tumors of the prostate, colon and breast. Furthermore, the expression of clusterin is modulated by many factors that are believed to regulate tumor growth and apoptosis. We studied the clusterin expression in transitional cell carcinoma (TCC) of the bladder and we investigated its correlation with apoptosis. MATERIALS AND METHODS: Eighty five bladder tumor specimens from radical cystectomy or transurethral resection were subjected to immunohistochemical clusterin staining with Ig G clusterin Ab. We examined the immunohistochemical localization of clusterin, and this was followed by TUNEL staining to detect the apoptotic cells. After double-staining with Hoechst 33258, we detected the apoptotic cells under a fluorescence microscope and we calculated the apoptotic index. RESULTS: Invasive TCC showed a stronger positive expression of clusterin as compared with superficial TCC, but the positivity of the clusterin expression was not in proportion to the tumor grade. The apoptotic indices of cancer were 0.52+/-0.28%, 0.30+/-0.16% and 0.17+/-0.11% in Grade I, Grade II and Grade III superficial TCC, respectively, and it was 0.23+/-0.13% in Grade III invasive TCC. Apoptotic cells were not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis. CONCLUSIONS: These results suggest that clusterin could be used as a marker to provide prognostic information for the TCC patients. The apoptotic index revealed that apoptosis and the clusterin expression have correlation with transitional cell cancer. Further study will be needed to clarify the role of clusterin as a therapeutic target for cancer treatment.

Submandibular Soft Tissue Actinomycosis Diagnosed by Fine Needle Aspiration Cytology: A Case Report / 대한세포병리학회지

A patient with actinomyces infection of the submandibular soft tissue was diagnosed by fine needle aspiration cytology (FNAC). A 38-year-old woman presented with a right submandibular mass which slowly grew in size over one month. Clinically and radiologically, the lesion was considered as tuberculous lymphadenitis or cellulitis. The polymerase chain reaction for tuberculosis was done by aspirated specimen but the result was negative. The smears of aspiration cytology showed characteristic colonies(sulfur granules) of actinomyces in inflammatory background. After antibiotic therapy for eight months, the patient has been well, showing no detectable mass. This patient was simply and rapidly diagnosed by FNAC and can avoid unnecessary surgical biopsy.

Expression of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53 in Human Breast Cancers

BACKGROUND: Cell cycle progression is governed by cell cycle regulators and inhibitors such as the cyclin dependent kinases (CDK), p27(Kip1), p21(WAF1/Cip1) and p53. The purpose of this study was to correlate expressions of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53 with the various clinicopathologic prognostic parameters of human breast cancers. METHODS: The paraffin-embedded tissue sections from 102 patients with human breast carcinomas were examined by performing immunohistochemical staining. The primary antibodies used for immunohistochemical staining were mouse monoclonal antibody to human p34(cdc2), p27(Kip1), p21(WAF1/Cip1), p53, ER and PR. RESULTS: The expression rates of p34(cdc2), p21(WAF1/Cip1) and p53 were 29.3%, 40.2% and 49.1% in breast carcinomas, respectively. In normal breast tissues, p34(cdc2), p21(WAF1/Cip1) and p53 were not expressed. The p34(cdc2) was expressed in the cytoplasm of cancer cells. The expression rate of p27(Kip1) was 29.3% in breast carcinomas and 100% in normal breast tissues, so the loss of p27(Kip1) expression in breast cancer was noted. The high expression of p21(WAF1/Cip1) in neoplastic cells was associated with the p53 expression (p=0.03). The expression of p27(Kip1) was correlated with that of the progesterone receptor (PR) (p=0.04) and the expression of p21(WAF1/Cip1) was correlated with that of positivity for estrogen receptor (ER) (p=0.04) and PR (p=0.04). No correlation was demonstrated between the mean patient survival and the expression rate of p34(cdc2), p27(Kip1), p21(WAF1/Cip1) and p53. CONCLUSIONS: The loss of the normal cell growth cycle by the abnormal expression of cyclin dependent kinases and their inhibitors and the steroid hormones may play an important role in human breast carcinogenesis. The p53 dependent p21(WAF1/Cip1) pathway, the p27(Kip1) protein loss and the cdc2 overexpression were important in development and progression of human breast cancer.

Correlation of Clusterin Expression and Apoptosis in Prostate Cancer and Benign Hyperplastic Tissues / 대한비뇨기과학회지

PURPOSE: We studied the apoptotic index in prostate cancer tissues and investigated the relationship of apoptosis and clusterin expression. MATERIALS AND METHODS: Forty-two archival prostatectomy specimens of varying grades of prostate cancer and 10 of benign prostatic hyperplasia were subjected to immunohistochemical clusterin staining with anti- clusterin antibody. Staining intensities were classified from 0 to 3. Apoptotic index was calculated with TUNEL positive cells under fluorescence microscope. We performed double staining for clusterin and TUNEL using immunofluorescence technique to determine the relationship between apoptosis and clusterin expression. RESULTS: Immunohistochemistry of clusterin showed a weak intensity in all benign tissues. Clusterin was localized mainly in the epithelial cells. Staining intensity was increased according to Gleason grade of cancer. Apoptotic indices of cancer were 0.86+/-0.8%, 0.76+/-1.0%, 0.39+/-0.4% and 0.14+/-0.09% in grades 2, 3, 4 and 5, respectively. In immunofluorescence localization study, apoptosis was not detected in the cancer cells stained with clusterin. Conversely, clusterin was not expressed in the cells showing apoptosis. CONCLUSIONS: These results more clearly show that clusterin acts as a survival protein protecting from apoptosis in prostate cancer. In addition, our findings revealed that the apoptotic index is lower in high grade prostate cancer. These findings have significant clinical implications for identifying the value of apoptotic index and clusterin expression in prostate cancer. Further study is needed to define the role of clusterin in the development and progression of prostate cancer.

The Regulators of VEGF Expression in Mouse Ovaries

The objectives of this study were to explore whether ovarian vascular endothelial growth factor (VEGF) expression in mice can be regulated by IL-6 (interleukin-6), angiotensin II, FSH, and hCG; and to test whether the mouse ovarian VEGF expression can result in angiogenesis. The ICR mice were sacrificed, and their ovaries were recovered. Recovered ovaries were treated with IL-6, angiotensin II, FSH, and hCG separately and incubated for 24 hours in alpha-MEM. Expression of mRNA and protein of VEGF were assessed by RT-PCR and immunohistochemistry. The resulting angiogenesis was evaluated through immunohistochemical analysis for CD34. Treatment of mice ovaries with IL-6, FSH, and hCG resulted in a significant increase of VEGF mRNA, and IL-6 was the most potent inducer of VEGF. IL-6 and FSH resulted in increased neovascularization in the follicular phase of mouse ovaries. In contrast, angiotensin II could not increase VEGF expression or neovascularization. We documented an in vitro increase in VEGF expression by IL-6, FSH, and hCG; and reaffirmed that the proliferative response of murine ovarian endothelial cells paralleled an increase of VEGF expression.

Resection of Peritoneal Implantation of Hepatocellular Carcinoma after Hepatic Resection: A Case Report / 한국간담췌외과학회지

Recent advances in the early diagnosis and curative resection of hepatocellular carcinoma (HCC) have improved its prognosis. However, there is controversy concerning aggressive surgical treatment of tumor recurrence after surgical resection for prolonging survival in some patients, and especially for the extrahepatic peritoneal implantation of tumor. We report here on one patient with hepatocellular carcinoma who experienced an implanted metastases in the abdominal cavity after hepatectomy. A 57-year-old man who had previously had a left lateral segmentectomy for a huge HCC with liver cirrhosis 14 months ago revisited the hospital due to the occurrence of a lower abdominal mass. On the initial work up, the alphafetoprotein (AFP) levels were increased and the abdominal tumor was visible at the ileocecal area, but intrahepatic recurrence was not visible in the remnant liver on abdominal computed tomography (CT). Therefore, peritoneal metastatic tumor resection with exploration of the other abdominal organs, and especially the remnant liver, were performed. After the second operation, the patient's postoperative course was uneventful and his serum AFP levels returned to the normal range at that time. Generally, surgical resection for intraabdominal implanted tumors is not indicated for improving survival, but resection of a local peritoneal implanted tumor arising from HCC may be of value for improving patient survival.

Localized Amyloidosis of the Ureter: A Report of Two Cases

We report on two cases of localized amyloidosis involving the ureter. The patients were a 64-year-old woman with right upper quadrant pain (case 1) and a 36-year-old woman suffering from left flank pain and intermittent gross hematuria (case 2). An intravenous pyelography of case 1 revealed multiple filling defects in the entire right ureter, whereas retrograde pyelography in case 2 showed diffuse narrowing in the mid and lower portions of the left ureter. Localized amyloidosis of the ureter was diagnosed in the two cases, and both had amyloid deposit in the renal pelvis and the urinary bladder in case 1, and in the contralateral ureter and the renal pelvis in case 2. Right nephroureterectomy was performed in case 1, but a segmental resection of the ureter with preservation of the kidney was administered in case 2. These two cases demonstrate that ureteral amyloidosis can be associated with amyloid deposition in the renal pelvis and the urinary bladder. Although ureteral amyloidosis is a rare occurrence, it should be considered in the differential diagnosis of ureteral obstruction to avoid unnecessary radical surgery.