Brain tumors in the mesial temporal lobe: long-term oncological outcome

Object. Surgical treatment of brain tumors in the mesial temporal lobe (MTL) is a highly demanding procedure. Only a few studies describing the surgery of MTL tumors have been reported, and they have been focused on the operative techniques and immediate results of the surgery. The authors have analyzed the long-term oncological outcome in patients with MTL tumors. Methods. Thirty-six patients with an MTL tumor were studied. The mean patient age at surgery was 32 years (range 13-62 years). The tumors were confined to the MTL (Schramm Type A) in 25 patients (69%). Extension of the tumor into the fusiform gyrus (Schramm Type C) and temporal stem (Schramm Type D) was observed in 4 and 7 patients (11 and 19%),respectively. There was a significant difference in the tumor size according to Schramm types (p = 0.001). Complete tumor resection was achieved in 26 patients (72%). All tumors were low-grade lesions except for 1 anaplastic astrocytoma. Results. After a median follow-up period of 50.5 months, 7 patients showed progression of the disease. The actuarial progression-free survival rates were 97% in the 1st year, 84% in the 2nd year, and 80% in the 5th year. The degree of tumor resection was significantly related to the tumor control failure (p = 50 years (p = 0.007, RR 8.312); and 4) short duration of epilepsy (< 6 months; p = 0.001, RR 21.54). Conclusions. Surgery is the principal treatment for MTL tumors, despite its technical difficulty. Complete tumor resection is strongly recommended for long-term tumor control. The MTL tumors are heterogeneous in their prognosis. Older age, short duration of epilepsy, and tumor size are all associated with poor outcome. Patients with these characteristics may have a more aggressive form of the disease than those with MTL tumors associated with chronic epilepsy. (DOI: 10.3171/2009.5.FOCUS09106)Uribe JS, 2009, J NEUROSURG, V110, P137, DOI 10.3171/2008.4.17508PHI JH, 2009, CANCER IN PRESSPichlmeier U, 2008, NEURO-ONCOLOGY, V10, P1025, DOI 10.1215/15228517-2008-052McGirt MJ, 2008, NEUROSURGERY, V63, P700, DOI 10.1227/01.NEU.0000325729.41085.73Schramm J, 2008, ACTA NEUROCHIR, V150, P857, DOI 10.1007/s00701-008-0013-7Smith JS, 2008, J CLIN ONCOL, V26, P1338, DOI 10.1200/JCO.2007.13.9337van Breemen MSM, 2007, LANCET NEUROL, V6, P421Schramm J, 2007, NEUROSURGERY, V60, P285, DOI 10.1227/01.NEU.0000249281.69384.D7Cataltepe O, 2005, J NEUROSURG, V102, P280Clusmann H, 2004, J NEUROL NEUROSUR PS, V75, P1589, DOI 10.1136/jnnp.2003.024208Schramm J, 2004, NEUROSURGERY, V55, P340, DOI 10.1227/01.NEU.0000129546.38675.1BDoetsch F, 2003, NAT NEUROSCI, V6, P1127, DOI 10.1038/nn1144Luyken C, 2003, EPILEPSIA, V44, P822Bauman G, 1999, INT J RADIAT ONCOL, V45, P923Lote K, 1997, J CLIN ONCOL, V15, P3129Piepmeier J, 1996, NEUROSURGERY, V38, P872Duffner PK, 1996, J NEURO-ONCOL, V28, P245Campbell JW, 1996, NEUROSURGERY, V38, P258PRAYSON RA, 1993, EPILEPSIA, V34, P609YASARGIL MG, 1992, ACTA NEUROCHIR, V118, P40YASARGIL MG, 1992, ACTA NEUROCHIR, V116, P147

Functional Characterization of Siberian Wild Rye Grass \u3cem\u3eEsHSP 16.9\u3c/em\u3e Gene Conferring Diverse Stress Tolerance in Prokaryotic Cells

Siberian wild rye (Elymus sibiricus L.) is a perennial, caespitose, and self-pollinating grass indigenous to Northern Asia and also is widely distributed from Northern Europe to Japan. The plant shows strong environmental adaptability with tolerance to drought and cold; thus, it is often used as forage resources (Yan et al., 2007). Environmental stresses caused by global warming are acknowledged to be as a serious issue in agriculture due to reductions of crop productivity (Ahuja et al., 2010). Genetic natural breeding of Siberian wild rye would potentially increase the productivity of forage crops; however, genetic studies on this grass have yet to be conducted. Heat shock proteins (Hsps) are the well characterized stress inducible proteins playing as molecular chaperones in prokaryotes and eukaryotes. We have also identified two differently localized small Hsps: rice chloroplastic and alfalfa mitochondrial Hsps confer tolerance to oxidative and heat stresses in tall fescue and to salinity and arsenic stresses in E. coli, tobacco, and tall fescue, respectively (Lee et al., 2012a; Lee et al., 2012b). Here, we cloned the small Hsp16.9 gene from various heat stress-induced fragments in Siberian wild rye using differentially expressed gene (DEG) analysis. We examined the mRNA expression of EsHsp16.9, in vitro molecular chaperone activity and in vivo stress tolerance by using a prokaryotic system against diverse environmental stresse

Dental stem cell therapy with calcium hydroxide in dental pulp capping

Calcium hydroxide has been extensively and steadily used for direct pulp capping in modern clinical dentistry. As it was known to have potential to induce hard tissue repair, this chemical has been applied to the exposed dental pulp and the hard tissue is expected to be regenerated above the pulp. During the reparative process of exposed pulp, primary odontoblasts that were lost as a result of extensive damage are replaced with newly differentiated odontoblast-like cells. This process is known to follow the sequential steps of proliferation, migration, and differentiation of progenitor cells. This research will examine the relationship between calcium hydroxide and the recruitment, proliferation, and mineralization of postnatal dental stem cells, obtained from an immature dental tissue of beagle dogs. Immunocytochemical staining and reverse transcriptase-polymerase chain reaction were used to identify the putative stem cell markers. Immunoblot analysis, wound healing assay, cell migration assay, and alizarin red staining were used to evaluate proliferation, migration, and mineralization capacity of the calcium hydroxide-treated stem cells. As an in vivo study, a combination of calcium hydroxide and autologous dental pulp stem cells (DPSCs) was applied for the treatment of intentionally created tooth defects on the premolars and the molars in beagle dogs to observe dentin regeneration. Ex vivo expanded DPSCs and periodontal ligament stem cells expressed STRO-1 and CD146, the mesenchymal stem cell markers. It was evident that calcium hydroxide increased recruitment, migration, proliferation, and mineralization of the DPSCs and periodontal ligament stem cells. Such results are valuable for future availability of DPSCs, which are recently focused as the stem cell reservoir for regeneration of dentin upon tooth injury, as well as for elucidation of the role of calcium hydroxide in pulp capping therapy.This work was supported by grants from the National Research Foundation of Korea (NRF) grant funded by the Korean government (MEST) (No. 2009-0066366) to Pill-Hoon Choung and by the Ministry of Health and Welfare, the Republic of Korea, through the Musculoskeletal Bioorgans Center Program (no. 0405-BO01-0204-0006)

Mouse Homologue of the Schizophrenia Susceptibility Gene ZNF804A as a Target of Hoxc8

Using a ChIP-cloning technique, we identified a Zinc finger protein 804a (Zfp804a) as one of the putative Hoxc8 downstream target genes. We confirmed binding of Hoxc8 to an intronic region of Zfp804a by ChIP-PCR in F9 cells as well as in mouse embryos. Hoxc8 upregulated Zfp804a mRNA levels and augmented minimal promoter activity in vitro. In E11.5 mouse embryos, Zfp804a and Hoxc8 were coexpressed. Recent genome-wide studies identified Zfp804a (or ZNF804A in humans) as a plausible marker for schizophrenia, leading us to hypothesize that this embryogenic regulatory control might also exert influence in development of complex traits such as psychosis

Recurred pneumocephalus in a head trauma patient following positive pressure mask ventilation during induction of anesthesia -A case report-

Pneumocephalus is a condition which usually results from head trauma. It has been known that iatrogenic pneumocephalus can occur as a complication of positive pressure mask ventilation during induction of anesthesia or ventilatory care for head trauma patients. We report a case of mask ventilation during anesthesia induction in a 50-year-old male patient with head trauma. Initial pneumocephalus associated with cerebrospinal fluid leakage was diagnosed immediate following head injury involving facial sinuses. He was managed with emergent lumbar drainage and supportive care. Pneumocephalus recurred following positive pressure mask ventilation (PPMV) during anesthesia induction for surgery on the right arm. Recurred pneumocephalus was managed with high flow oxygen and supportive care. Anesthesiologists should be aware of pneumocephalus as a potential complication of PPMV in head trauma patients, even after resolution of previous pneumocephalus

Growth characteristics and productivity of cold-tolerant “Kowinearly” Italian ryegrass in the northern part of South Korea

The objective of this research is to evaluate differences in growth characteristics and productivity between Kowinearly and Florida 80 Italian ryegrass varieties in regions with severely cold winters. This research was carried out in Suwon (in central South Korea) and Yonchun (in northern South Korea) during the 2002 2006 growing seasons. Kowinearly is a diploid variety with green leaf colour and a semi prostrate growth habit in autumn and a semi-erect one in spring. There were differences among the varieties in terms of cold tolerance, heading date, and forage yield in Yonchun. The winter field survival of Kowinearly was 85%, while that of Florida 80 was 43%. The dry matter yield of Kowinearly in Yonchun was 9,662 kg/ha, which was 31% more than that of Florida 80. In Suwon, the heading date of Kowinearly was May 7, which was 2 days later than that of Florida 80. In Yonchun, Kowinearly’s heading date was May 12, 1 day earlier than that of Florida 80. These results indicate that Kowinearly has good cold tolerance, and that in spring, it starts growth earlier than Florida 80, because of its higher cold tolerance.Keywords: Italian ryegrass, Kowinearly, cold tolerance, new variety, forage cro

A Case of More Abundant and Dysplastic Adenomas in the Interposed Colon than in the Native Colon

We report a 60-year-old woman with intramucosal adenocarcinoma arising in the interposed colon, 40 years after the esophageal reconstruction for lye induced esophageal stricture. Although synchronous adenomas were also found in the native colon where the graft was taken, the number of adenomas was greater in the interposed colon and more dysplastic, even progressed to adenocarcinoma, than that of the native colon. The microsatellite instability-testing performed in the intramucosal carcinoma from interposed colon showed absence of microsatellite instability. Changing of location and functional deman]d of colonic segment, and the exposure to different intraluminal contents might have facilitated the adenomacarcinoma transformation in the interposed colon

Efficacy and Safety of a Dexamethasone Implant in Patients with Diabetic Macular Edema at Tertiary Centers in Korea

Purpose. To evaluate the real-world efficacy and safety of the dexamethasone implant (DEX implant) in patients with diabetic macular edema (DME). Methods. Retrospective, multicenter, and noncomparative study of DME patients who were treated with at least one DEX implant. A total of 186 eyes from 165 patients were included. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), complications, and number of retreatments were collected. Data at baseline and monthly for 6 months were analyzed. Results. The average baseline BCVA and CRT were 0.60 LogMAR and 491.6 μm, respectively. The mean BCVA improved until 3 months and then decreased up to 6 months of follow-up (0.53, 0.49, and 0.55 LogMAR at 1, 3, and 6 months; p=0.001, <0.001, and 0.044, resp.). The change of mean CRT was similar to BCVA (345.0, 357.7, and 412.5 μm at 1, 3, and 6 months, p<0.001, <0.001, and <0.001, resp.). 91 eyes (48.9%) received additional treatment with anti-VEGF or DEX implant. The average treatment-free interval was 4.4 months. In group analyses, the DEX implant was more effective in pseudophakic eyes, DME with subretinal fluid (SRF), or diffuse type. Conclusions. Intravitreal dexamethasone implants are an effective treatment for patients with DME, most notably in pseudophakic eyes, DME with SRF, or diffuse type. A half of these patients require additional treatment within 6 months

Natural Course of Allergic and Nonallergic Rhinitis After 2 Years in Korean Children

Objectives. Allergic and nonallergic rhinitis are very common disease for children, however, little is known about their natural courses in the general population. The purpose is to evaluate the natural course of allergic and nonallergic rhinitis in children. Methods. We analyzed data from Snoring Child Cohort of 178 children (107 boys and 71 girls). All children entered the study at the age of 7 years (range, 6.5 to 7.4 years). Questionnaires regarding chronic rhinitis, a skin prick test (SPT) for 5 inhalent allergens, and specific IgE for 2 dust mites were administered. Children were classified into 4 groups: allergic rhinitis (rhinitis, positive SPT), nonallergic rhinitis (rhinitis, negative SPT), sensitization only (no rhinitis, positive SPT), and control (no rhinitis, negative SPT). We repeated follow them annually, and analyzed the data of first and third year for this study. Results. Finally, the data of 122 children were analyzed. Among 18 children with allergic rhinitis at 7 years, 13 (72%) became sensitization only after 2 years and 5 (28%) were remained having allergic rhinitis. Five out of 19 children (26%) with nonallergic rhinitis developed into allergic rhinitis and 7 (37%) into control at 9 years. Twenty-four out of 28 children (86%) with sensitization only at 7 years remained the same at 9 years. Among 57 control children at 7 years, 2 (4%) developed into allergic rhinitis, 7 (12%) with nonallergic rhinitis, and 16 (28%) with sensitization only at 9 years. Conclusion. The status of chronic rhinitis and allergen sensitization is ever-changing in children

Development of Bullous Acrodermatitis Enteropathica during the Course of Chemotherapy for Acute Lymphocytic Leukemia

Acrodermatitis enteropathica (AE) is an uncommon autosomal recessive genetic disorder of zinc malabsorption. The acquired form may be associated with inadequate intake, impaired absorption, and increased excretion of zinc. Those afflicted present with diarrhea, stomatitis, psychiatric symptoms, non-scarring alopecia, and nail dystrophy accompanied by erythematous which appears as scaly patches with erosion vesicles and pustules mostly affecting the extremities, perineal, and periorificial areas. Due to the variable findings of most case reports, the clinical and histopathological features of AE are often regarded as non-specific. We report an unusual case of bullous AE secondary to total parenteral nutrition for the treatment of acute pancreatitis occurring in a six-year-old male with acute lymphocytic leukemia who underwent chemotherapy. He presented with periorificial, reddish, eroded bullae with multiple vesicles and blisters on his fingers, toes, and buttock, showing necrotic keratinocytes with multiple intraepidermal vesicles and perivascular infiltration with predominant lymphocytes and few neutrophils within the dermis. To the best of our knowledge, this is the first case report of bullous AE in the Korean dermatologic literature