Increased Reactive Oxygen Species Production by Peripheral Blood Mononuclear Leukocytes, not by Polymorphonuclear Leukocytes, in Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Reactive oxygen species (ROS) are known as a potential mediators that sustain chronic inflammation in atopic dermatitis (AD). To determine the role of peripheral blood mononuclear leukocytes (MO) and polymorphonuclear leukocytes (PMN) in prolonged inflammation, ROS generation of those cells in AD was examined. METHODS: Seventeen AD patients and 10 healthy controls were enrolled. MO and PMN were stimulated with the reagents: phobol ester (PMA), adenosine triphosphate (ATP), and chemotactic peptide (f-MLP). ROS levels were measured using chemiluminescence assay. RESULTS: In AD, chemiluminescence response of unstimulated MO was higher than that of normal controls. MO from AD patients produced 1.58-1.80 higher ROS for up to 30 minutes than the controls. When the cells were treated with the reagents (PMA, ATP, f-MLP), all the stimuli enhanced chemiluminescence activity of MO. When MO were treated with PMA, the ratio of ROS produced by MO of patients to that of the controls decreased. When the cells were treated with either ATP or f-MLP, the quantity of ROS generated by MO from the controls was greater than the controls. PMN from both AD patients and the controls generated ROS for 30 min similarly. As treated with the reagents, PMN from AD patients produced a smaller ROS than the controls. CONCLUSION: These results indicate MO but not PMN from AD patients were primed and ready for activation in vivo, and a reduced function of PMN from AD patients was observed. In conclusion, enhanced respiratory burst activity of MO is implicated in the prolonged inflammation of AD.

Vacuum-Assisted Closure in Treatment of Poststernotomy Wound Infection and Mediastinitis: Three cases report / 대한흉부외과학회지

Poststernotomy mediastinitis is a rare but potentially life-threatening complication of cardiac surgery. Up to present, poststernotomy wound infection has been treated by closure of wound directly or by use of myocutaneous flaps after irrigation and debridement of wound. We describe a new treatment of poststernotomy wound infection by using the vacuum- assisted closure technique. This technique was successfully applied in 3 patients with poststernotomy wound infection and mediastinitis, and a healed sternotomy wound could be achieved using this new technique.

A Case of Acute Viral Myositis

Diffuse myalgia is common in transient systemic viral infections but overt myositis, with weakness and signs of muscle inflammation, rarely accompanies viral infection in chidren. We describe a 8-year-old boy with severe myalgia and tenderness in both lower extremities, whose unusual skeletal muscle uptake on Technetium-methylene diphosphate bone scan helped to diagnosis of myositis. Clinical course, muscle-derived enzyme studies(AST, ALT, LD, CK), electromyogram findings, histopathologic findings obtained from left gastrocnemius muscle biopsy and serologic studies for enteroviral antibodies (enterovirus type 71 and Coxsackie B4 neutralization antibody titer 1:128 respectively) were all compatible with acute viral myositis.

A Case of Limbic Encephalitis Associated with Small Cell Lung Cancer: About Diagnostic MRI Findings

Limbic encephalitis is a rare paraneoplastic syndrome characterized by prominent memory impairment, affective and behavioral disturbances, and progressive intellectual deterioration. Among many different neoplasm known to cause limbic encephalitis, a small cell lung cancer is certainly the most frequently reported. We experienced a 64-years old male patient presented with clinical features consistent with limbic encephalitis. He was subsequently found to have small cell lung cancer and showed characteristic evolutional MRI features ; increased signal intensity on T2 weighted image in the bilateral medial temporal regions during early stage and progressive severe atrophy in the late stage.

Surgical Management of Medically Intractable Epilepsy

Since October, 1989, the authors underwent operations for 20 patients of medically intractable epilepsy. Eight patients with temporal lobe epilepsy were treated by temporal lobectomy. Four patients with extratemporal focus of seizure were treated with extratemporal cortisectomy, Eight patients with multiple types of seizure were treated with callosotomy. The presurgical evaluations of epileptic seizures were very important. The presurgical evaluations were standard EEG, CCTV-EEC morning, neuroimaging, neuropsychological test, Wade test and invasive study with intracranial electrodes. There were no serious complications after operation. The authors concluded that epilepsy surgery seemed to be safe and helpful method for the treatment of medically intractable epilepsy.

Presurgical Invasive Study in Intractable Epilepsy: Intracranial Electrode and Brain Mapping

Improved diagnostic tools, patient selections, and operative techniques have brought a resurgence of the surgical management of intractable epilepsy recently. And the most remarkable developments of epilepsy surgery are various kinds of intensive presurgical evaluation. The aims of presurgical evaluation for intractable epilepsy are : 1) The diagnosis of exact types of epilepsy for appropriate medical treatment as well as for surgical intervention. 2) The exact localization of epileptogenic region responsible for the patient's habitual seizures and testing for functional safety of the focal resection of epileptogenic region. Theoretically the presurgical evaluations can be classified as noninvasive and invasive studies. The noninvasive presurgical studies include various kinds of EEG investigations, neuroimaging, neuropsychological studies and other laboratory studies. The invasive presurgical evaluations include various kinds of intracranial electrode recording and functional brain mapping, The authors analysed the invasive presurgical evaluation of Yonsei epilepsy program since Oct. 1989 and review the literatures.

Wada test for evaluation of language and memory function inmedically intractable epilepsy

The Wada test was performed for lateralization of language and memory function, using intracarotid injection of Sodium Amytal. But, the internal carotid artery(ICA) Wada test has some limitations for testing memory function. The posterior cerebral artery(PCA) Wade test has been designed to modify to modify the ICA Wada test for testing memory function selectively. In our study, 10 patients out of 12 patients with intractable seizure underwent only the ICA Wada test and the other 2 patients underwent both are ICA and the selective PCA Wada test In all 12 patients undergoing the ICA Wada test, we succesfully localized speech and language dominace. Four of 12 patients who underwent the ICA Wada test for evaluation of memory function displayed superior memory functions in one hemisphere, but the other hemisphere also significantly contributed to memory. The selective PCA Wada test, performed in 2 patients, showed successful results of memory function test in both patients. Four of 12 patients underwent temporal lobectomy and there was no major post-operative language or memory deficits. We conclude that the ICA and PCA Wada tests are useful for preoperative evaluation of medically intractable epilepsy, and the PCA Wada test is valuable in memory evaluation in some patients who have hight risk of postoperative global amnesia after temporal lobectomy following equivocal results of memory function by the ICA Wada test.

99mTc-HMPAO brain SPECT in medically intractable epilepsy; ictal study / 대한핵의학회잡지

No abstract available.

A case of rapid cycling affective disorder after the damage of temporal lobe / 신경정신의학

No abstract available.

A case of rapid cycling affective disorder after the damage of temporal lobe / 신경정신의학

No abstract available.

Seizure Disorder Associated with Focal Low Density on Computed Tomography

During last 3 years, we experienced 24 cases of acute seizure disorder, showing localized low density on computed tomographic (C-T) scan and having the clinical characteristics, and have analyzed clinically. The results were followings: 1. It was commoner in men, with a ratio of 2:1, and their ages ranged from 4 to 54 years (mean 20.9 years), with the peak incidence in 2nd & 3rd decades. 2. It occurred in any season, but commoner in summer and autumn. 3. This disorder was characterized by sudden onset of convulsion, focal or generalized, in health man, and had no other associated symptoms. 4. C-T brain scan showed decreased density without mass effect on parietal or frontal area, which had usually constrast enhancement such as small ring or nodular type, and disappeared between 3 to 5 months. 5. Other laboratory tests were normal except leukocytosis (11 of 18 cases) and abnormal EEG (9 of 24 cases). 6. This disorder was self limited. The cause was unknown, but it had the possibility of viral infection.