Tumor Necrosis Factor-Associated Protein 1 (TRAP1) is Released from the Mitochondria Following 6-hydroxydopamine Treatment

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta. Most cases are sporadic and its etiology is incompletely understood. However, increasing evidence suggests that oxidative stress and mitochondrial dysfunction may be involved in the pathogenesis of Parkinson's disease. The aim of this study was to investigate changes in mitochondrial protein profiles during dopaminergic neuronal cell death using two-dimensional gel electrophoresis in conjunction with mass spectrometry. Several protein spots were found to be significantly altered following treatment of MN9D dopaminergic neuronal cells with 6-hydroxydopamine (6-OHDA). Among several identified candidates, TNF receptor-associated protein 1 (TRAP1), a mitochondrial molecular chaperone, was released from the mitochondria into the cytosol in MN9D cells as well as primary cultures of dopaminergic neurons following 6-OHDA treatment. This event was drug-specific in that such apoptotic inducers as staurosporine and etoposide did not cause translocation of TRAP1 into the cytosol. To our knowledge, the present study is the first to demonstrate the drug-induced subcellular translocation of TRAP1 during neurodegeneration. Further studies delineating cellular mechanism associated with this phenomenon and its functional consequence may provide better understanding of dopaminergic neurodegeneration that underlies PD pathogenesis.

Statistical 3D Distribution Analysis of Prostate Cancers in Korean Using Digital Processing Techniques / 대한의료정보학회지

OBJECTIVES: Several researchers have shown that three dimensional (3D) distribution analysis of prostate cancer is helpful when initiating needle biopsy procedures. Knowledge regarding the distribution of prostate cancer could enhance understanding of the pathophysiology involved and improve detection of these malignancies. We propose utilizing digital processing techniques to analyze prostate cancer distribution in a 3D setting. METHODS: Pre-made radical prostatectomy sample slices were digitized with a resolution of 76 dpi. Slices of each sample were aligned and registered by deformation algorithm and interpolated for analysis of relative distribution statistics. We analyzed 80 samples saved in electronic medical record and compared the detection rate of preoperative needle biopsies and radical prostatectomies using our 3D analysis technique. RESULTS: The statistical 3D distribution of prostate cancer was evaluated using a 36-sector process. Results were represented in the following two ways: distribution of a single patient, and statistical distribution of prostate cancers of multiple patients. The overall concordance rate was 62.7% between the two methods; therefore a technique is needed which can raise this percentage. CONCLUSIONS: We suggest using the normalization method to develop a software tool which permits reconstruction of the 3D distribution of prostate cancer from 2D legacy images and reduces the loss of image quality as well. This application will facilitate detection of prostate cancer by aiding in the determination of the most effective clinical position via partial sampling with decreased patient inconvenience.

Sequential Tongue Pressure and Laryngeal Movement during Swallowing

OBJECTIVE: To test the repeatability and the reproducibility of a newly developed device which measures tongue pressure and laryngeal movement, to identify the range of tongue pressure and to reveal the relationships between tongue pressure and age, gender and diet formula. METHOD: One hundred five healthy subjects (50 males, 55 females, range 20 to 74 years) were recruited for the study. They had examinations of tongue pressure and laryngeal movement. The pressure was measured with two air-filled bulbs connected to a transducer. Laryngeal movement was measured with a strain gauge. The test was repeated three times with a two minute rest interval and monitored twice by the same investigator and once by another investigator. All subjects performed 10 times of swallowing: 5 times each of 3 ml liquid and dry swallowing. RESULTS: Intraclass correlation coefficient (ICC) for both the repeatability and the reproducibility revealed good to moderate reliability for tongue pressure measurement and the time of maximum tongue pressure (ICC, 0.60~0.84). However, it was poor for measurement of laryngeal movement. There were no significant differences between gender and age groups in tongue pressure, the time to maximum tongue pressure and laryngeal movement. The tongue pressure was higher in dry swallowing than in wet swallowing. Also, the time to maximum tongue pressure and overall laryngeal movement were prolonged in dry swallowing. CONCLUSION: The newly developed tongue pressure measurement system is a reliable apparatus and there are no significant age and gender differences in tongue and laryngeal movement in healthy subjects.

A Case of Streptococcus salivarius Meningitis in a Patient with Cerebrospinal Fluid Rhinorrhea after Skull Base Fracture / 대한임상미생물학회지

Streptococcus salivarius meningitis is very uncommon, and most cases are iatrogenic, occurring after invasive procedures such as spinal anesthesia or lumbar puncture etc.. Post-traumatic occurrence of this infection is especially rare. A 20-year-old man with a previous history of skull base fracture was seen at the emergency department with signs of acute bacterial meningitis. The CSF had a few gram positive cocci with neutrophilic pleocytosis, which were identified as S. salivarius by the Vitek system (bioMerioux, Inc., Hazelwood, MO, USA), rapid ID 32 Strep (bioMerieux, Marcy-l'Etoile, France) and 16S rRNA sequencing. The microorganism showed intermediate resistance to penicillin (MIC=0.25 microg/mL) but was susceptible to cefotaxime (MIC=0.25 microg/mL) and vancomycin (MIC= 0.75 microg/mL). The patient was treated with ceftriaxone and vancomycin. He also had his CSF leakage repaired by an endoscopic approach. To our knowledge, this is the first case of S. salivarius meningitis reported in Korea.

Activity and Sleep Apnea Monitoring of Aged-Person using Image Processing / 대한의료정보학회지

OBJECTIVE: As the rapid progress of aged society, there must be solutions of preparation against unpredicted accidents for aged solitary people. The most important thing that we must consider is the unconstraint of daily life. So, we are to develop a system and algorithm which meet our objectives. METHODS: We have monitored the degree of activity of the aged solitary person. The CCD camera was used not to disturb the daily activity and we evaluated the degree of activity using image processing on personal computer. The activity monitoring during night was assumed by sleeping on the bed, so the major method was breath monitoring during sleeping. On the other hand, daily activity was monitored by wide viewing camera in the living room. To prevent the privacy trouble, the acquired image was converted to binary form and the degree of breath and moving factor was estimated. RESULTS: In this paper we propose a new processing algorithm to accurately measure breathing characteristics in sleep apnea sufferers. We improved the conventional center-of-mass method and further applied the projection-profile method. As a result, we have improved breath measurement accuracy. In a comparison with conventional polysomnography, our method was 92% effective in detecting apnea cases. CONCLUSION: As a result of this study, we can monitor sleep apnea more simply and with no sleep interference. In measuring the activity of daily life, these improved algorithms were applied. So, we established a monitoring method of no-constrained, quantitative measurement for the aged solitary people during the whole day.

The Anatomic Distribution and Pathological Characteristics of Prostate Cancer: A Mapping Analysis / 대한비뇨기과학회지

PURPOSE: We mapped the location of prostate cancer in Korean men, and investigated the volume and tumor distribution in relation to clinicopathological variables. MATERIALS AND METHODS: The volume of cancer and the anatomic location of each tumor foci were determined from 186 radical prostatectomy specimens, which were digitized to fit into a prototype prostate model. Using the computer-based digital images, the zonal cancer volume and distributional frequency were analyzed with respect to the clinical and pathological parameters, which were demonstrated in gray scales. RESULTS: The preoperative serum prostate-specific antigen (PSA) level ranged from 2.0 to 38.9ng/ml. The mean cancer volume of the 186 specimens was 4.5ml (median 1.9ml, range 0.01-37.7). The impalpable cancers were located more anteriorly and in the transition zone, and were also were smaller in volume (2.7ml vs. 5.5ml, p=0.004) than the palpable cancers. Cancers with seminal vesicle invasion were located more medially in the peripheral zone, and were larger in volume than organ-confined cancers or cancers with extracapsular extension (13.2ml vs. 3.0ml, p<0.001). For Gleason scores of 2-6, 7, and 8-10, the mean cancer volumes were 2.2, 3.7 and 8.2ml, respectively (p<0.001). High grade cancers were located more medially in the peripheral zone, especially when approaching the apex. CONCLUSIONS: T1c cancers are located more anteriorly and in the transition zone; therefore, inclusion of these areas for targeted biopsy may help to improve the detection of cancer in patients with elevated PSA levels and impalpable prostate cancer. A medial location of seminal vesicle invasive cancers may imply an ejaculatory ducts route of invasion rather than a direct extracapsular extension.

A Study on a Low Power Telemetry System for Infant Incubators / 대한의료정보학회지

As wireless network technology and various mobile communication equipments have widely used and rapidly developed, many research workers are studying about a measurable system for several medical data or bio-signals, such as electrocardiogram, pulse-oximetry and so forth, by wireless. And, even generic people who are in a good state of health as well as patients in the hospital, whose concern and care about healthcare has increased greatly, so many research workers are studying about Ubiquitous Healthcare of new technology. This technology will offer natural medical services freely in anywhere and in a quiet way, even if people can not go to hospital. Our research made a possibility to measure environment data in each infant incubator by using temperature and humidity sensor, prior to measure directly bio-signals of patients. Each sensor was composed of wireless network based on TinyOS, and that wireless network connected to Personal Digital Assistants(PDA). So we were studied about telemetry system by using wireless sensor network. It was researches about telemetry system to measure environment data in infant incubator before, by web-based RF modules. But they has problems that incubator's movement restriction by wire, wire net's limitation. We solved these problems by organizing wireless sensor network that connected together sensors and measurement devices. This wireless sensor network organization, based on TinyOS, is possible to receive sensor's data of long distance by a relay station and to save power. In future, this network will be basic of Ubiquitous Healthcare as well as medical information system in hospital.

A Study on the ROI Optimizing Technique for Accurate Breath Measurements in Sleep Apnea / 대한의료정보학회지

OBJECTIVE: A sleep apnea is the most frequent symptom among sleep disorders. As the number of aged people are increasing, research activities are also increasing to monitor sleeping disorders of the elderly who lives alone. We proposed a new processing algorithm to measure the quantity of breaths accurately. METHODS: We improved the conventional center-of-mass method and further apply the projection profile method. RESULTS: In this study a system that can monitors respiration non-invasively and automatically, by identifying the movement of the chest and abdomen using image processing technique during sleep, was implemented. We can see breathing status in real time based on the acquired breathing waves. To verify the designed system, the values from the polysomnography were compared and analyzed to validate the system accuracy. As a result, the mean accuracy is 96%. CONCLUSION: We can simply monitor the sleep apnea with no sleep interferences.

Retroperitoneal Ganglioneuroma: Case Report

The authors report a rare case of retroperitoneal ganglioneuroma discovered incidentally in a 47-year-old male during abdominal computed tomogaphy(CT) evaluation. The clinical features and findings of the complementary examinations, which included radiological assessment, abdomen CT and lumbar spine magnetic resonance image with contrast enhancement are presented, as well as the pathology findings. The tumor, 10x10x6cm in size, was well encapsulated and total removal was made. Histopathological diagnosis of retroperitoneal ganglioneuroma was confirmed.

Alteration of Interleukin-6 Levels in Serum and Cerebrospinal Fluid after Head Injury in Adults

OBJECTIVE: The cytokine interleukin-6(IL-6) plays a major role in initiating the acute phase response, especially in the production of acute phase reactants. The objective of this study is to determine whether serum IL-6 and cerebrospinal fluid(CSF) IL-6 levels were elevated at time of admission after head injury, serum IL-6 and CSF IL-6 levels related temporally to clinical improvement, severity of head injury with Glasgow Coma Scale(GCS) score and increased intracranial pressure(IICP). METHODS: All 21 patients(19 males and 2 females) with brain injury, managed in our institute between Aug 1996 and Jun 1998 were included in this study. Serum samples from all the 21 patients and CSF samples from 12 patients with low GCS score were analyzed for IL-6. IL-6 determination with enzyme-linked ELISA kits obtained from Quantikine(r). RESULTS: The values of IL-6 in serum and CSF in 21 patients with GCS score between 4 and 14(mean=9) were observed for 3-5 days after head injury. Peak elevation of serum IL-6 was observed on first day(8.2+/-4.9pg/ml) and then decreased to 4.0+/-3.6pg/ml on fifth day. Serum IL-6 levels decreased significantly faster in patients with GCS score of 8 through 11, compared with those of GCS score below 8. The patients showed markedly elevated and variable CSF IL-6 levels on admission(46.6+/-4.2pg/ml;normal, below 20.6+/-5.8pg/ml). CONCLUSION: This study demonstrates that the IL-6 level is related to the severity of traumatic brain injury.

Alteration of Interleukin-6 Levels in Serum and Cerebrospinal Fluid after Head Injury in Adults

OBJECTIVE: The cytokine interleukin-6(IL-6) plays a major role in initiating the acute phase response, especially in the production of acute phase reactants. The objective of this study is to determine whether serum IL-6 and cerebrospinal fluid(CSF) IL-6 levels were elevated at time of admission after head injury, serum IL-6 and CSF IL-6 levels related temporally to clinical improvement, severity of head injury with Glasgow Coma Scale(GCS) score and increased intracranial pressure(IICP). METHODS: All 21 patients(19 males and 2 females) with brain injury, managed in our institute between Aug 1996 and Jun 1998 were included in this study. Serum samples from all the 21 patients and CSF samples from 12 patients with low GCS score were analyzed for IL-6. IL-6 determination with enzyme-linked ELISA kits obtained from Quantikine(r). RESULTS: The values of IL-6 in serum and CSF in 21 patients with GCS score between 4 and 14(mean=9) were observed for 3-5 days after head injury. Peak elevation of serum IL-6 was observed on first day(8.2+/-4.9pg/ml) and then decreased to 4.0+/-3.6pg/ml on fifth day. Serum IL-6 levels decreased significantly faster in patients with GCS score of 8 through 11, compared with those of GCS score below 8. The patients showed markedly elevated and variable CSF IL-6 levels on admission(46.6+/-4.2pg/ml;normal, below 20.6+/-5.8pg/ml). CONCLUSION: This study demonstrates that the IL-6 level is related to the severity of traumatic brain injury.

Development of an Abdominal Aortic Aneurysm Model for Stent-graft Insertion

PURPOSE: To determine the efficacy of an abdominal aortic aneurysm model for stent-graft placement. MATERIALS AND METHODS: The model consists of two parts, the heart and the vascular system. A peristaltic pump and a solenoid valve were used to simulate a pulsatile flow from the heart. A ball-shaped piece of clay was placed inside a square box and liquid silicone was poured. After the silicone was formed, the clay was removed and a silicone tube was used to connect the heart model and the aneurysm model. The silicone tube was also used to simulate the iliac arteries and one end of the artery was clamped and the other one was extended to a water bath. Water at 37 degrees was circulated through the model, and the pressure at the thoracic aorta, aneurysm and iliac artery was measured with the outlet valve opening at 25, 50, and 100% before and after stent-graft placement. RESULTS: The liquid pressure measurements were 253/252, 271/162 and 264/166 mmHg at the thoracic aorta, aneurysm and iliac artery, respectively, when the outlet was 100% open. They were 173/121, 145/99, 145/106 mmHg when the outlet was 50% open, and 35/28, 61/44, 24/22 mmHg when it was 25% open. After placement f the stent-graft, the pressure measurements were 170/132, 174/128, and 167/128 mmHg, respectively. CONCLUSION: Since it was easy to produce, the model was useful for in-vitro stent-graft testing, and a wide range of pressure could be applied.

Recurrent Extraventricular Neurocytoma with Malignant Glial Differentiation

We present a case of recurrent extraventricular neurocytoma with malignant glial differentiation in left temporoparietal area. A 37-year-old man with presentation of generalized seizure had undergone biopsy of brain tumor in left parietal area in 1987, which revealed extraventricular neurocytoma and radiotherapy was followed. Postoperative course was uneventful until eleven years after biopsy, when he became gradually aphasic and right hemiplegic. Brain CT and MRI revealed enlargement of tumor with peritumoral edema and calcifications. He underwent subtotal tumor removal in 1998. Microscopic examination of second biopsy specimen revealed presence of large areas composed of anaplastic glial cells with frequent mitosis, nuclear pleomorphism, large eosinophilic cytoplasm and eccentric nuclei, resembling gemistocytes, which were strongly immunoreactive to glial fibrillary acidic protein(GFAP) but not to synaptophysin(SNP). Also focal areas of neuronal cells were found, which were immunoreactive to SNP but not to GFAP. These histologic findings imply that this recurred tumor was a high grade, mixed tumor with divergent differentiation of neuronal and astrocyte lineage. We report a rare case of extraventricular cerebral neurocytoma with malignant glial differentiation with review of the literature.

Expression of Vascular Endothelial Growth Factor Protein in Astrocytic Tumors

OBJECTIVE: Angiogenesis, the proliferation of capillary endothelial cells, is a vital component in the development, progression, and metastasis of many human tumors. Vascular endothelial growth factor(VEGF) is an endothelial cell-specific mitogen and induces angiogenesis and vascular permeability. The features of glioblastoma, distinct from low grade astrocytomas, are the presence of necroses and vascular endothelial proliferation. In this study, we investigated VEGF expression in the different grades of astrocytomas and determined whether VEGF expression correlates with development of glioblastoma and progression of astrocytomas. PATIENTS AND METHODS: Forty seven patients with astrocytic tumors(24 males and 23 females), aged 3 to 65 years, were evaluated. Immunohistochemical staining was carried out using labelled streptavidin biotin method and primary antibody was a antirabbit polyclonal Ab against N-terminus region of VEGF165(Oncogene research product, MA, USA). Immunoreactivity(IR) was classified into no IR(absent or a trace of stain), moderate IR and intense IR by level of staining amount and intensity. RESULTS: Six pilocytic astrocytomas showed 3 no IR and 3 moderate IR, 10 astrocytomas showed 2 no IR, 6 moderate IR and 2 intense IR, 12 anaplastic astrocytomas showed I no IR, 7 moderate IR and 4 intense IR and 19 glioblastomas showed 1 no IR, 11 moderate IR and 7 intense IR. Immunoreactivity was significantly different between low and high grade of tumors but there was no significant difference between anaplastic astrocytomas and glioblastomas. Gemistocytic tumor cells represented the predominent VEGF-immunoreactive cell types, as compared with compactly-arranged small tumor cells. In glioblastomas VEGF IR was observed in both perinecrotic and vital tumor areas. CONCLUSION: VEGF seems to be a important angiogenic factor in anaplastic astrocytomas and glioblastomas and VEGF expression may contribute to neovascularization of human astrocytomas.

Risk of Seizures after Operative Treatment of Ruptured Cerebral Aneurysms

OBJECTIVE: Postoperative seizure is a well documented complication of aneurysm surgery. The purpose of the present study was to analyze risk factors for postoperative seizure. METHODS: Between January 1990 and December 1996, we performed craniotomy for ruptured cerebral aneurysms in 321 patients. Among them 206 patients who could be followed up for more than 1 year(range, 1 to 4.6 years) were enrolled to present study. All patients were treated with anticonvulsants for 3 to 18 months postoperatively. We analyze the incidence of postoperative seizure in different sex and age groups, and risk factors associated with postoperative seizures following aneurysm rupture. For statistical processing chi-square test and Fisher's exact test were used. RESULTS: In the follow-up period of 1 to 4.6 years(mean, 1.8 years) postoperative seizure appeared in 18 out of 206 patients(8.7%). Mean latency between the operation and the first seizure was 6 months(range, 3 weeks to 18 months). The age of the patients has significant influence on the risk of seizure, it occurred more often in younger patients(p =0.0014). Aneurysm location in the MCA was associated with a significantly a higher risk of seizure(p =0.042). Eight patients(19%) out of 42 patients who suffered delayed ischemic neurologic deficit(DID) developed seizure. Delayed ischemic neurologic deficit was associated with significantly a higher risk of seizure(p =0.019). Infarct and hypertension were associated with significantly a higher risk of seizure(p < 0.05). pre- or postoperative intracranial hematoma(intracerebral or epidural hematoma) was associated with significantly a higher risk of seizure(p < 0.0001). H-H grade, Fisher grade, Glasgow Outcome Scale of patients and timing of operation after subarachnoid hemorrhage had no significant relation with the risk of seizure. CONCLUSION: Factors associated with the development of postoperative seizure were middle cerebral artery aneurysm, delayed ischemic neurologic deficit, infarct on late postoperative CT scan, hypertension, pre or postoperative intracranial hematoma(intracerebral or epidural hematoma). Identification of the risk factors may be help to focus the antiepileptic drug threapy in cases prone to develop seizures. Prospective evaluation is indicated.

Web-based Monitoring of Infant Incubators / 대한의료정보학회지

Infant Incubator is the most important equipment in a infant ICU. This maintain adequate temperature and humidity for survival of infants. The final object of this research is Web-based monitoring of several infant incubators in ICU. To realize these objects, we developed a temperature/humidity sensing module which is interfaced to Web server board via RS485 port. We used a small micro controller in each sensing module. So the size of this module is small enough to be attached to incubator. We can access each sensing module with RS485 port on Web server board via network. As a first trial, we networked 4 infant incubators. The operator can send alarms to each incubator and these alarms are indicated with sounds and lights on measurement module. Our system can increase the convenience by a intensive central monitoring, so instant handling to some kinds of accident is possible.

Outcome Analysis of the Patients with and without Anterior Plating in Multi-Level Degenerative Cervical Diseases

OBJECTIVES: The rates of pseudarthrosis for two- and three level fusion have been reported to be 17-63 and 50% without anterior cervical plating. The purpose of this study is to assess the effects of anterior cervical plating in the treatment of multilevel degenerative cervical disease such mostly the additional risks associated with hardware implants and its benefits, fusion rate and radiographic results, and clinical outcomes. METHODS: Forty-seven patients who underwent operations between 1993 and 1997 were retrospectively reviewed. The technique for operation was same for both groups(Smith Robinson with autologous iliac bone graft). Group I consisted of 35 consecutive patients treated with anterior cervical decompression and fusion with anterior cervical plate fixation. Group II consisted of 12 consecutive patients treated without plate fixation. We compared clinical outcomes by Prolo score, radiographic results in the rate of fusion, cervical lordosis by Gore angle, disc height by Farfan method, and surgical complications between two groups. RESULTS: The favorable clinical outcomes(excellent and good) by Prolo score were observed with the use of anterior cervical plate fixation(89% vs 75%). The successful fusion rate of multilevel cervical fusion was as seen with anterior cervical plate fixation(97% vs 75%). The overall graft complication rate in multilevel fusions was decreased, with anterior cervical plate fixation, and the hardware related complications were relatively minimal without serious consequences. CONCLUSION: Anterior cervical plate fixation in the treatment of multilevel cervical disorders is an effective stabilizing method which provides increased bony fusion rate, decreased graft complications, maintained cervical lordosis, early mobilization of the these patients without serious hardware related complications.

A Case of Intraorbital Pseudotumor: Case Report

Intraorbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. The authors report a case of intraorbital pseudotumor presenting with painful exophthalmos. A 45-year-old male patient had a two-week history of acute progressive exophthalmos and diplopia. Right orbit was explored through transcranial route and the mass was biopsied, which revealed dense inflammatory cells and fibrosis. He subsequently underwent corticosteroid therapy and symptoms improved gradually. The literatures were reviewed.

The Magnetic Resonance Images and Clinical Features of the Asymptomatic Pineal Cysts

No abstract available.

Symptomatic Tarlov's Cyst(Sacral Meningeal Cyst): Case Report

No abstract available.