Polydeoxyribonucleotide Ameliorates Inflammation and Apoptosis in Achilles Tendon-Injury Rats / 대한배뇨장애요실금학회지

Purpose@#Adenosine A2A receptor agonist polydeoxyribonucleotide (PDRN) possesses an anti-inflammatory effect and suppress apoptotic cell death in several disorders. In this current study, the effect of PDRN on inflammation and apoptosis in rats with Achilles tendon injury was investigated. @*Methods@#von Frey filament test and plantar test were conducted for the determination of pain threshold. Analysis of histological alterations was conducted by hematoxylin and eosin staining. Immunohistochemistry for cleaved caspase-3-positive cells and cleaved caspase-9-positive cells was done. Enzyme-linked immunoassay was used to detect the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and cyclic adenosine-3’,5’-monophosphate (cAMP). Western blot was conducted to detect the protein levels of cAMP response element-binding protein (CREB), protein kinase A (PKA), Bcl-2-associated X (Bax), and B-cell lymphoma 2 (Bcl-2). @*Results@#PDRN treatment relieved mechanical allodynia and alleviated thermal hyperalgesia after Achilles tendon injury. TNF-α and IL-6 concentrations were decreased by PDRN application. PDRN injection significantly enhanced cAMP concentration and phosphorylated CREB versus CREB ratio, showing cAMP-PKA-CREB pathway was activated by PDRN application. PDRN treatment inhibited percentages of cleaved caspase-3-positive cells and caspase-9-posiive cells and the suppressed Bax versus Bcl-2 ratio in Achilles tendon injury rats. @*Conclusions@#PDRN is probably believed to have a good effect on pain and inflammation in the urogenital organs. PDRN may be used as a new treatment for Achilles tendon injury.

Clinical Analysis of Recurrence Rate and Symptom Improvement in Gastro-esophageal Reflux Disease Patients / 대한소화기학회지

BACKGROUND/AIMS: Gastro-esophageal reflux disease (GERD) is a chronic condition, with 50-80% of patients experiencing recurrence within one year following completion of initial treatment. The present study aimed to estimate recurrence rate and treatment response in GERD patients treated with proton pump inhibitor. METHODS: A total of 207 symptomatic GERD patients, which were confirmed by endoscopy from July 2008 till January 2009, were enrolled. They were divided into non-erosive reflux disease (NERD) group and erosive reflux disease (ERD) group by endoscopic findings. Patients were treated with lansoprazole 15 mg (NERD group) or 30 mg (ERD group) once daily for 8 weeks. The presence of symptoms was assessed in each patient at baseline and post-treatment using a questionnaire. Subsequent symptomatic recurrence on the cessation of therapy in each improved patients was checked by telephone survey or outpatient interview. RESULTS: Ninety-four patients and 113 patients were first diagnosed with NERD and ERD, respectively. The mean post-treatment follow-up period was 24.4+/-8.5 weeks. Recurrence rate was 40.0% (NERD, 43.8%; ERD, 37.1% (p=0.224)). Recurrence time was 10.1+/-5.8 weeks (NERD 9.6 weeks; ERD, 10.6 weeks (p=0.444)). Regarding the symptom improvement after 8 week therapy with lansoprazole, 89.4% (NERD, 85.1%; ERD, 92.9% (p=0.056)) of total patients were symptomatically improved. CONCLUSIONS: Forty percentage of GERD patients recurred within 6 months following the completion of 8 week therapy with lansoprazole. Recurrence rate, recurrence time, and rate of symptom improvement were not significantly different between NERD group treated with half dose and ERD group treated with full dose lansoprazole.

The clinical characteristics of noncardiac chest pain and treatment response in non-erosive reflux disease (NERD) / 대한내과학회지

BACKGROUND/AIMS: Noncardiac chest pain (NCCP) is defined as recurring angina-like retrosternal chest pain of noncardiac origin. Gastroesophageal reflux disease (GERD) is by far the most common cause of NCCP. We evaluated the incidence of some esophageal abnormalities as a cause of NCCP and the treatment response to a proton pump inhibitor (PPI). METHODS: Forty seven NCCP cases were selected from 184 cases who underwent 24-hour ambulatory pH monitoring or esophageal manometry. Patients were excluded if they had a history of gastrointestinal surgery, pancreatobiliary disorder, coronary artery disease, valvular heart disease, depression or tuberculosis. In this study, all GERD patients had non-erosive reflux disease (NERD). RESULTS: Of the 47 NCCP cases, 30 (63.8%) were female and 17 (36.2%) were male. Only 7 (14.9%) cases had typical GERD symptoms such as acid regurgitation and heartburn. Of the 47 NCCP cases, 12 (25.5%) had GERD-related NCCP, and six (12.8%) had esophageal motility disorder. Of the 12 cases diagnosed as GERD-related NCCP, nine (75.0%) showed a satisfactory PPI response. The PPI was effective for GERD-related NCCP compared with non-GERD related NCCP (p=0.015). CONCLUSIONS: About 40% of NERD patients with NCCP had an esophageal disorder including GERD and esophageal motility disorder. A PPI was effective for GERD-related NCCP.

Comparison between Conventional 4 L Polyethylene Glycol and Combination of 2 L Polyethylene Glycol and Sodium Phosphate Solution as Colonoscopy Preparation / 대한소화기학회지

BACKGROUND/AIMS: Effective bowel preparation is essential for accurate diagnosis of colon disease. We investigated efficacy and safety of 2 L polyethylene glycol (PEG) solution with 90 mL sodium phosphate (NaP) solution compared with 4 L PEG method. METHODS: Between August 2009 and April 2010, 526 patients were enrolled who visited Seoul National University Bundang Hospital for colonoscopy. We allocated 249 patients to PEG 4 L group and 277 patients to PEG 2 L with NaP 90 mL group. Detailed questionnaires were performed to investigate compliance, satisfaction and preference of each method. Bowel preparation quality and segmental quality were evaluated. Success was defined as cecal intubation time less than 20 minutes without any help of supervisors. RESULTS: Both groups revealed almost the same baseline characteristics except the experience of operation. PEG 4 L group's compliance was lower than PEG 2 L with NaP 90 mL group. Success rate and cecal intubation time was not different between two groups. Overall bowel preparation quality of PEG 2 L with NaP 90 mL group was better than PEG 4 L group. Segmental bowel preparation quality of PEG 2 L with NaP 90 mL group was also better than PEG 4 L group in all segments, especially right side colon. Occurrence of hyperphosphatemia was higher in PEG 2 L with NaP 90 mL group than PEG 4 L group. However, significant adverse event was not reported. CONCLUSIONS: PEG 2 L with NaP 90 mL method seems to be more effective bowel preparation than PEG 4 L method.

Plasmodium vivax Infection Accompanied by Acute Renal Failure / 대한신장학회지

Malaria is one of the most important parasitic infection in the world. Four species of the genus Plasmodium cause nearly all malarial infections in humans, but the clinical features vary according to the causative species. Among them, Plasmodium falcifarum malaria is associated with numerous complications such as renal failure, cerebral malaria, and DIC, but Plasmodium vivax malaria usually has benign course. The proposed mechanism is blockage of microcirculation to vital organ by sequestration of parasitized erythrocytes. In Korea, for recent 20 years, there have been increasing numbers of malaria infection especially at North area of Geonggi-do. But serious complications in association with Plasmodium vivax malaria are rarely reported. Recently we experienced a case of Plasmodium vivax infection complicated by acute renal failure and report it with literature review.

A Case of Plasmodium vivax Malaria Associated with Autoimmune Hemolytic Anemia / 감염과화학요법

Anemia associated with Plasmodium vivax (P.vivax) malaria occurs as a result of the lysis of red cells by schizonts, bone marrow suppression, and splenic sequestration. A 20-year-old man presented with fever and anemia. He was diagnosed with P. vivax malaria with a positive direct antiglobulin test and treated with antimalarial medication for 2 weeks. He recovered without sequelae. we suggest that autoimmune hemolytic anemia should be considered as one of cause of anemia in P. vivax malaria.

A Case of Plasmodium vivax Malaria Associated with Autoimmune Hemolytic Anemia / 감염과화학요법

Anemia associated with Plasmodium vivax (P.vivax) malaria occurs as a result of the lysis of red cells by schizonts, bone marrow suppression, and splenic sequestration. A 20-year-old man presented with fever and anemia. He was diagnosed with P. vivax malaria with a positive direct antiglobulin test and treated with antimalarial medication for 2 weeks. He recovered without sequelae. we suggest that autoimmune hemolytic anemia should be considered as one of cause of anemia in P. vivax malaria.

A Case of IgA Nephropathy Associated with Leptospirosis / 대한신장학회지

Leptospirosis is a spirochaetal infectious disease caused by Leptospira interrogans. Multiple organ involvement may be encountered in leptospirosis. Early renal involvement is very common and characterized by tubulo-interstitial nephritis and tubular dysfunction. Rarely, diffuse mesangial proliferative glomerulonephritis may be seen. Immunoglobulin A nephropathy (IgA nephropathy) is defined by the predominant deposition of IgA in the glomerular mesangium. The secondary IgA nephropathy is thought to be caused by hepatobiliary disease, mucosal disease, infection, malignancy, some hematologic disease and systemic autoimmune or hypersensitivity disease. However, there are few reports about IgA nephropathy associated with leptospirosis. We herein report a case of IgA nephropathy in 21-year- old leptospirosis patient.

A Case of Broncholithiasis Caused by Aspergillus with Broncho-Obstructive Pneumonia and Massive Hemoptysis / 결핵및호흡기질환

A broncholith is a calcified mediastinal lymph node, which partially or completely erodes into the bronchial lumen, and is related to the late tissue response to healing of granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. However, there have been a few reports on broncholithiasis caused by Aspergillus. We experienced a case of broncholithiasis caused by Aspergillus, with broncho-obstructive pneumonia and massive hemoptysis. A 39 year-old woman was admitted to our hospital with right middle lobar pneumonia. On the fourth day following admission, massive hemoptysis developed, so an emergent bronchial artery embolization was performed. On the ninth day following admission, a broncholith on the lateral segmental bronchus of the right middle lobe was found by bronchoscopy, which was proved to be Aspergillus hypae with calcification on histological examination. After the simple bronchoscopic removal of the broncholith and empirical antibiotic therapy, the patient recovered without any complications.