Résumé
Rumex acetosa is a folk medicine for gastritis and gastric ulcers. In our previous study, the ethanol extract of R. acetosa inhibited gastric ulcers and protected gastric tissue in mice induced with HCl/ethanol from gastric ulcers. Moreover, we isolated six anthraquinone compounds from this plant and evaluated their antiHelicobacter pylori activity. Therefore, this study was conducted to identify further the related antioxidant and anti-inflammatory activities and the bioactive constituents. Five fractions of n-hexane, methylene chloride, ethyl acetate, n-butanol, and aqueous fractions were obtained from the total ethanolic extract from whole parts of R. acetosa that had exhibited antioxidant and anti-inflammatory activities. The ethyl acetate fraction contained the highest total phenol and flavonoid contents among the five fractions and exhibited the most potent antioxidant effect on 2,2-diphenyl-1-picrylhydrazyl radical scavenging assay. Among the six compounds, emodin showed the most potent antioxidant activity. Next, we induced inflammation in the LPS-induced RAW 264.7 cell line. The methylene chloride fraction showed the strongest reducing nitric oxide production activity among the fractions. In addition, the methylene chloride fraction suppressed the phosphorylation of ERK and JNK, and the expression of cyclooxygenase-2 in a dose-dependent manner. These physiological activities of the fraction and the compounds could be involved in the anti-gastric ulcer activity of R. acetosa
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Helicobacter pylori is a well-known pathogen that is responsible for gastric disorders. Overcoming of the antibiotic-resistance is a main barrier to treat H. pylori infection. In our search for anti-H. pylori compounds from natural resources, bioactivity-guided isolation on the ethyl acetate fraction of Fraxinus mandshurica bark that had shown anti-H. pylori activity gave twelve compounds (1 - 12) of six coumarins, three phenylethanoids, two secoiridoids, and a lignan using silica gel column chromatography, Sephadex-LH 20, and recrystallization.The chemical structures were identified by spectroscopic data analysis, including 1D, 2D NMR, and mass spectrometry. Among them, compounds 2, 10, and 11 showed moderate growth inhibitory activity against three strains ofH. pylori, compared with positive controls of quercetin and metronidazole. Compounds 5, 6, 8, and 12 exhibited the inhibitory activity against strains 26695 or 43504. This is the first report on the anti-H. pylori activity of this plant and the isolated compounds.
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BACKGROUND AND OBJECTIVES: This study was performed to evaluate the long-term effect of adenotonsillectomy on childhood growth by examining preoperative growth status and presenting symptoms. SUBJECTS AND METHOD: One hundred and four patients who underwent adenotonsillectomy from January to December 2009 were enrolled in this study. Clinical data were collected from medical record reviews and through the administered questionnaire. We investigated symptoms and growth changes during 5 years following the surgery. RESULTS: The mean age of patients was 6.0±1.94 years (range, 3–10), with the male to female ratio of 62:42. Pre-operative symptoms were significantly improved after the surgery. The mean pre-operative height and weight percentiles were 53.6±27.4 and 59.6±29.2 at initial evaluation, and 67.1±26.4 and 59.6±28.6 at 5 years post adenotonsillectomy (p < 0.001, p=0.989), respectively. An increase in height percentile was more prominent in patients whose pre-operative height percentile was less than 50 compared to those with a percentile of 50 or more (p < 0.001). Weight percentile was significantly increased in those with the pre-operative weight percentile of less than 50 and decreased in patients with a percentile of 50 or more. CONCLUSION: Adenotonsillectomy has a positive effect on height growth in children with adenotonsillar hypertrophy, especially in patients whose height percentile is less than 50. Weight gain also can be expected in preoperative low-weight children.
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Enfant , Femelle , Humains , Mâle , Adénoïdectomie , Hypertrophie , Dossiers médicaux , Méthodes , Amygdalectomie , Prise de poidsRésumé
Mucosa associated lymphoid tissue (MALT) lymphoma refers to a type of marginal zone lymphomas, which represent a group of non-Hodgkin lymphomas originated from B lymphocytes of marginal zone. They are classified as extranodal MALT type (MALT lymphoma), splenic marginal zone B-cell lymphoma and nodal marginal zone B-cell lymphoma according to clinical and therapeutic implications of the tumor. MALT lymphoma is the most common type of marginal zone lymphoma, and about 5–8% of all B-cell lymphomas are diagnosed as MALT lymphoma. MALT lymphomas are usually found in the gastrointestinal tract, mostly in the stomach associated with H pylori infection; the non-gastric MALT lymphoma can also be found in the salivary gland, lung, head and neck, ocular adnexa, skin, thyroid, or breast. However, the involvement of nasal cavity and nasopharynx is rare. Based on our recent experience and a review of related literature, we report a case of MALT lymphoma that occurred in the nasopharynx and thyroid gland, which were treated with localized radiotherapy.
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Lymphocytes B , Région mammaire , Tube digestif , Tête , Poumon , Tissu lymphoïde , Lymphomes , Lymphome B , Lymphome B de la zone marginale , Lymphome malin non hodgkinien , Muqueuse , Fosse nasale , Partie nasale du pharynx , Cou , Radiothérapie , Glandes salivaires , Peau , Estomac , Glande thyroideRésumé
BACKGROUND AND OBJECTIVES: Nasopharyngeal carcinoma is an uncommon disease that is usually found in the advanced stage becuase its anatomical location makes early detection difficult. Radiation therapy or concurrent chemoradiation therapy is mainstay for treatment of nasopharyngeal carcinoma. We evaluated clinical characteristics and treatment outcomes of nasopharyngeal carcinoma and assessed prognostic factors related to survival. SUBJECTS AND METHOD: We retrospectively reviewed medical records of 87 patients who were treated for nasopharyngeal carcinoma from 1994 to 2013. Clinical characteristics, pathologic type, stage, treatment modality, recurrence and survival were investigated. RESULTS: The mean follow-up period was 66.7 (12-232) months. Recurrence rates were not significantly different between the radiation therapy group and combined chemoradiation groups in the early stage (27.3% vs. 21.6%, p=0.644) and the advanced stage (21.4% vs. 31.3%, p=0.496). Five-year overall survival and disease free survival rate was 74.0% and 58.9%, respectively. Five-year overall survival rate of the combined chemoradiation therapy group was significantly lower than that of the radiation therapy group (64.4% vs. 94.1%, p=0.001). Distant metastasis was significantly correlated with survival in multivariate analysis. CONCLUSION: In this study, the five-year overall survival rate was better in the radiation therapy group than in the combined chemoradiation group. This might be related to the fact that advanced stage disease was more common in the combined chemoradiation group. Further studies with larger study samples and longer follow-up are necessary to verify these results and determine optimal modalities for the treatment of nasopharyngeal carcinoma.
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Humains , Survie sans rechute , Traitement médicamenteux , Études de suivi , Dossiers médicaux , Analyse multifactorielle , Métastase tumorale , Pronostic , Récidive , Études rétrospectives , Taux de survieRésumé
Anti-Helicobacter pylori activity guided fractionation led to the isolation of five anthraquinones, two stilbenes and one naphthoquinone from the EtOAc fraction of Polygonum cuspidatum, using silica gel column chromatography, Sephadex-LH20, MPLC and recrystallization. The chemical structures were identified to be physcion (1), emodin (2), anthraglycoside B (3), trans-resveratrol (4), anthraglycoside A (5), polydatin (6), 2-methoxy-6-acetyl-7-methyljuglone (7) and citreorosein (8) by UV, ¹H-NMR, ¹³C-NMR and mass spectrometry. Anti-Helicobacter pylori activity including MIC values of each compound was evaluated. All of the isolates exhibited anti-H. pylori activity of which MIC values were lower than that of a positive control, quercetin. Compounds 2 and 7 showed potent growth inhibitory activity. Especially, a naphthoquinone, compound 7 displayed most potent antibacterial activity with MIC₅₀ value of 0.30 µM and MIC₉₀ value of 0.39 µM. Although anti-H. pylori activity of this plant was previously reported, this is the first report on that of compounds isolated from this species. From these findings, P. cuspidatum roots or its isolates may be useful for H. pylori infection and further study is needed to elucidate mechanism of action.
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Anthraquinones , Chromatographie , Émodine , Polygonum cuspidatum , Spectrométrie de masse , Plantes , Polygonum , Quercétine , Gel de silice , StilbènesRésumé
Plasmacytoma refers to malignant plasma cell tumor, which consists of abnormal proliferation of plasma cells. It can be classified into several types, multiple myeloma, solitary medullary plasmacytoma and extramedullary plasmacytoma according to clinical and histological aspects of the tumor. Multiple myeloma is the most common plasmacytoma and its main feature is the infiltration of plasma cells into the bone marrow. Over 10% of plasma cell count among the nuclear cells in the bone marrow biopsy allows diagnosis of multiple myeloma. This involves multiple organs and extramedullary sites including the spleen, liver, lymph nodes and kidney; however, the involvement of nasal cavity and paranasal sinus is rare. Recently, we experienced a case of multiple myeloma, which was present in both nasal cavities and paranasal sinuses. The case was treated with chemotherapy and radiotherapy followed by autologous bone marrow transplantation. We report on it with literature review.
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Biopsie , Moelle osseuse , Transplantation de moelle osseuse , Diagnostic , Traitement médicamenteux , Rein , Foie , Noeuds lymphatiques , Myélome multiple , Fosse nasale , Sinus de la face , Plasmocytes , Plasmocytome , Radiothérapie , RateRésumé
Immunoglobulin G4 (IgG4)-related sclerosing disease is characterized by a systemic involvement of tumor-like lesions with IgG4-positive plasma cell. This disease can occur in the salivary, lacrimal and pituitary gland in the head and neck region. The involvement of IgG4-related sclerosing disease at nasopharynx is extremely rare, so it is hard to make an accurate diagnosis. Recently, we have experienced two cases of IgG4-related sclerosing disease arising from the nasopharynx. Diffusely enhancing mass with surrounding bony erosion and increased 18-F fludeoxyglucose uptake was found at the nasopharynx, suggesting malignancy. But the cases were finally confirmed as IgG4-related sclerosig disease by punch biopsy and the symtoms improved with glucocorticoid therapy. We report our experiences with a literature review.
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Biopsie , Diagnostic , Tête , Immunoglobuline G , Immunoglobulines , Partie nasale du pharynx , Cou , Hypophyse , PlasmocytesRésumé
Eight isoflavonoid compounds were isolated from the EtOAc fraction of Maackia amurensis which had shown the highest anti-Helicobacter pylori activity among the fractions, using medium pressure liquid chromatography and recrystallization. Based on the spectroscopic data including 1H-NMR, 13C-NMR, HMBC and MS data, the chemical structures of the isolates were determined to be (-)-medicarpin (1), afromosin (2), formononetin (3), tectorigenin (4), prunetin (5), wistin (6), tectoridin (7) and ononin (8). Anti-H. pylori activity of each compound was evaluated with broth dilution assay. As a result, (-)-medicarpin (1), tectorigenin (4) and wistin (6) showed anti-H. pylori activity. (-)-Medicarpin (1) exhibited the most potent growth inhibitory activity against H. pylori with the minimal inhibitory concentration (MIC)90 of 25 microM, and tectorigenin (4) with MIC90 of 100 microM ranked the second. This is the first study to show the anti-H. pylori activity of M. amurensis, and it is suggested that the stem bark of M. amurensis or the EtOAc fraction or the isolated compounds can be a new natural source for the treatment of H. pylori infection.
Sujets)
Chromatographie en phase liquide , MaackiaRésumé
Paraphilia is a psychiatric disease that has been difficult to cure. However, recently developed therapeutic methods hold promise. The patient was a 20-yr-old male with chief complaints of continuous masturbation, genital exposure, and aggressive behavior that started 2 yr ago. We administered leuprorelin 3.6 mg intramuscular injection per month, a depot gonadotrophin-releasing hormone analogue, to this patient who a severe mentally retardation with paraphilia. The clinical global impression (CGI)-severity, CGI-improvement and aberrant behavior checklist were performed. After one month, we observed significant improvement in symptoms, such as decreases of abnormal sexual behavior and sexual desire. The GnRH analogues are suggested to be used as an alternative or supplementary therapeutic method for sexual offenders after clinical studies.
Sujets)
Humains , Mâle , Jeune adulte , Leuprolide/pharmacologie , Troubles mentaux/complications , Paraphilies/complications , Infractions sexuelles/prévention et contrôle , Comportement sexuel/effets des médicaments et des substances chimiquesRésumé
The current study evaluated DSM-IV psychiatric diagnoses and investigated the psychological characteristics of sexual offenders by using the Hypersexual Behavior Inventory(HBI), Sexual Addiction Screening Test (SAST), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Fifty male sexual offenders and 36 male healthy controls completed the psychiatric diagnosis and 30 of the 50 male sexual offenders completed the psychological tests listed above. Thirty-two of the 50 sexual offenders were patients with paraphilias, these sexual offenders had been admitted by the Ministry of Justice to the Institute for Forensic Psychiatry in Gongjui-si due to sexual violence. Participants displayed high lifetime rates of psychiatric disorders: 32 (64%) had paraphilias, 16 (32%) had depressive disorders, 10 (20%) had anxiety disorders, 9 (18%) had impulse control disorders, 6 (12%) had schizophrenia, 2 (4%) had bipolar disorders, and 16 (32%) had personality disorders or some other Axis II disorder. Scores for the sexual offenders were significantly higher both on the HBI and the SAST than the comparison group. Scores for the sexual offenders were also higher for the BDI and the BAI as compared to the control group, but this difference was not statistically significant. Results indicate that sexual offenders may have sexual addictions and be hypersexual. In addition to depressive and anxious psychopathologies, they also seem to have sexual psychopathologies. These results suggested that the psychopathology of sexual offenders may be different than that of a control group.
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Humains , Mâle , Anxiété , Troubles anxieux , Axis , Trouble bipolaire , Criminels , Dépression , Trouble dépressif , Diagnostic and stastistical manual of mental disorders (USA) , Psychiatrie légale , Troubles du contrôle des impulsions , Dépistage de masse , Troubles mentaux , Paraphilies , Troubles de la personnalité , Tests psychologiques , Psychopathologie , Schizophrénie , Infractions sexuelles , Justice socialeRésumé
OBJECTIVE: Recently the relationship between alleles frequency distribution, drug response and the attention deficit hyperactivity disorder (ADHD), has been actively researched. We investigated the association between the genetic type, alleles and drug response for the dopamine receptor D4 (DRD4) gene in ADHD patients in Korea. METHODS: One hundred fourteen patients diagnosed with ADHD according to the the Diagnostic and Statistical Manual of Mental Disorders version IV (DSM-IV) diagnostic criteria were selected for the study. The clinical features of patients were confirmed by Korean version of Conners' parent rating scale, Attention deficit Diagnostic System, Korean version of Spielberger state-trait anxiety scale. Blood samples were taken from the 198 subjects. DNA was extracted from blood lymphocytes, PCR was performed for DRD4 Polymorphism. Alleles, genotype frequencies, the Clinical Global Impression (CGI) improvement score were compared using the chi-square test. Korean ADHD Rating Scale (K-ARS) and CGI severity scores were compared using the t-test. RESULTS: In comparing the ADHD with 4/4 repeats group and without the ADHD with 4/4 repeats group, no significant difference was seen between the DRD4 genetic type, alleles distribution, and CGI drug response. CONCLUSION: As a result, it is viewed that there is no relationship between ADHD and DRD4, but final decision is indefinite. Follow up studies with larger patient or pure subgroups are expected.
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Humains , Allèles , Anxiété , Trouble déficitaire de l'attention avec hyperactivité , Études cas-témoins , Diagnostic and stastistical manual of mental disorders (USA) , ADN , Génotype , Lymphocytes , Méthylphénidate , Parents , Réaction de polymérisation en chaîne , Récepteurs dopaminergiquesRésumé
Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the vicious cycle of chronic diarrhea and is one of the main one thing among treatments. We should know the exact concept of chronic diarrhea and provide appropriate treatments according to etiologies of chronic diarrhea.
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Enfant , Humains , DiarrhéeRésumé
Paraphilia was a very treatment resistant psychiatric disorder. But new treatment strategies to paraphilia have been introduced recently. We report and review the effect of depot analogue (goserelin) administration in a 18 year-old adolescent with paraphilia. We administered goserelin 3.6 mg/month to him for 3 months, there were changes of scores in Clinical Global Improvement, Sex Addiction Screening Test, Freund Paraphilia Scales.
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Adolescent , Humains , Hormone de libération des gonadotrophines , Goséréline , Dépistage de masse , Paraphilies , Poids et mesuresRésumé
OBJECTIVES: As a baseline study to aid in the development of proper policy, we investigated the current condition of unpreparedness of documents required when issuing copies of medical records and related factors. METHODS: The study was comprised of 7,203 cases in which copies of medical records were issued from July 1st, 2007 through June 30th, 2008 to 5 tertiary referral hospitals. Data from these hospitals was collected using their established electronic databases and included study variables such as unpreparedness of the required documents as a dependent variable and putative covariates. RESULTS: The rate of unpreparedness of required documents was 14.9%. Multiple logistic regression analysis revealed the following factors as being related to the high rate of unpreparedness: patient age (older patients had a higher rate), issuance channels (on admission > via out-patient clinic), type of applicant (others such as family members > for oneself > insurers), type of original medical record (utilization records on admission > other records), issuance purpose (for providing insurer > medical use), residential area of applicant (Seoul > Honam province and Jeju), and number of copied documents (more documents gave a lower rate). The rate of unpreparedness differed significantly among the hospitals; suggesting that they may have followed their own conventional protocols rather than legal procedures in some cases. CONCLUSIONS: The study results showed that the level of compliance to the required legal procedure was high, but that problems occurred in assuring the safety of the medical information. A proper legislative approach is therefore required to balance the security of and access to medical information.
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Humains , Complexe I de protéines de revêtement , Compliance , Électronique , Électrons , Compagnies d'assurance , Modèles logistiques , Dossiers médicaux , Patients en consultation externe , Centres de soins tertiairesRésumé
OBJECTIVES: The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. METHODS: The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital's current system. RESULTS: With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. CONCLUSIONS: The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.
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Humains , Commerce , Compliance , Saccharose alimentaire , Hôpitaux , Dossiers médicaux , Corps médical , Vie privéeRésumé
OBJECTIVES: To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems. METHODS: To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security. RESULTS: The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals. CONCLUSIONS: This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.
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Prestations des soins de santé , Dossiers médicaux électroniques , Électronique , Électrons , Systèmes d'information , CoréeRésumé
OBJECTIVE: To supplement a previous study on the management of medical records with a view to preparing a system capable of ensuring basic patient rights regarding the protection of confidential medical information. The study objectives are to provide detailed guidelines to regulate the access and protection of medical information by analyzing patients' understanding and views regarding the dissemination of medical records. METHODS: A self-administered questionnaire was administered to 781 patients who visited five University hospitals located in Seoul, Busan, Gyeonggi, Chungnam and Jeonnam from July to September, 2008 and asked for copies of medical records to be issued. Data were analyzed by using the statistical program SPSS 13.0. RESULTS: More than 70% of respondents wanted to access their medical records after confirming the required documents. The highest distribution in the range of persons able to receive copies of medical records without the individual patient's consent or required documents was 'only personally' in each variable. Copies of medical records were issued mostly within 1 hour, while the appropriate time of issuing the copies was within one day. Half of respondents approved of a subscription system that did not require a doctor consultation. The results regarding changes in the ways to request/issue copies of medical records to improve the convenience for applicants differed significantly according to age. CONCLUSION: Considering the sensitivity of personal health information, medical records should only be issued with the patient's consent and by confirming the identity of the designated person with required documents. Furthermore, people should be aware of the importance of protecting personal health information, and medical institutes should inform the requirements for bringing the relevant documents. Medical institutes play an important role in protecting personal records, which necessitates generalized guidelines.
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Humains , Académies et instituts , Complexe I de protéines de revêtement , Enquêtes et questionnaires , Hôpitaux universitaires , Dossiers médicaux , Droits des patientsRésumé
PURPOSE: A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. METHODS: We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. RESULTS: Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9+/-5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/mm3). There was a statistically significant relation between vaccine being received and development of complications (P=0.033). CONCLUSION: We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.
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Adolescent , Adulte , Enfant , Humains , Bordetella pertussis , Toux , Vaccins diphtérique tétanique coquelucheux acellulaires , Fièvre , Incidence , Corée , Numération des leucocytes , Emphysème médiastinal , Réaction de polymérisation en chaine multiplex , Composés organothiophosphorés , Pneumopathie infectieuse , Réaction de polymérisation en chaîne , Prévalence , Atélectasie pulmonaire , République de Corée , Vomissement , CoquelucheRésumé
A low grade fibromyxoid sarcoma is a rare soft tissue tumor that has a tendency to develop in the deep soft tissue of young adults and the potential for local recurrence or distant metastasis. There have been several case reports and sporadic reports in the literature. However, only 1 case has been reported in Korea but without a follow-up result. We describe a 54-year-old female patient with a low-grade fibromyxoid sarcoma of the thigh that had been growing slowly for 34 years. A marginal resection of this tumor was performed. Currently, the patient is doing well without evidence of local recurrence or distant metastasis at 5 years after surgery.