Surgical Treatment for a Broken Acupuncture Needle in the Retroperitoneal Space: A Case Report / 대한신경손상학회지

Acupuncture is a well-known traditional medical procedure in Korea and is being increasingly used to treat various conditions including pain control, especially among the older generation. However, several problems related to acupuncture have been reported. A 27-year-old woman expressed that she had back pain occurring despite her posture. She received acupuncture therapy 2 months prior. We discovered a needle-shaped foreign material near the T12 vertebra body in the retroperitoneum. We extracted 2 pieces of deteriorated broken needles by laparoscopy. Postoperatively, the woman was discharged within 5 days with no complications.We report a patient that received laparoscopy with a full recovery after having severe back pain caused by a broken needle which was stuck in the retroperitoneum.

Classification, bacteriological findings, and analysis of sex hormone receptors and cytokine expression in mammary lesions of abattoir sows

Mammary lesions in sows can prevent suckling piglets from consuming colostrum that provides fundamental nutrients and protective immunity. Although mammary gross lesions are frequently found in sows at farms or slaughterhouses, with the exception of mastitis, they have received little research attention. In this study, we investigated mammary lesions observed in South Korean sows between 2015 and 2016. Mammary tissue samples of 82 sows showing gross lesions during meat inspection were histologically classified and immunohistochemical analysis was conducted to assess the expression of estrogen receptor (ER)-α, ER-β, and progesterone receptor (PR) for mammary hyperplastic lesions as well as that of cluster of differentiation (CD) 3, CD79a, interleukin (IL)-1α, IL-1β, IL-6, and IL-8 for mastitis. Furthermore, 20 swab samples were cultured, and the isolated bacteria were identified using polymerase chain reactions for 16S ribosomal RNA genes. The lesions were classified as hyperplasia, mastitis, or hyperplasia with mastitis. Immunohistochemistry results revealed that there was neither expression of ER-α nor of ER-β, but all examined hyperplastic samples expressed PR. In addition, there was a significant correlation between CD3 and IL-1β expressions, as well as between IL-1β and IL-6 expressions. Regarding the identity of the isolated bacteria, Pseudomonas spp. were most frequently detected. The results of this study have revealed the incidence and characteristics of porcine mammary lesions.

Ganglioglioma in Brainstem : Case Report and a Review of Literatures

Ganglioglioma is an infrequent tumor of the central nervous system (CNS); mostly supratentorial region. But, they can occur anywhere in the central nervous system such as brainstem, cerebellopontine angle (CPA), thalamus, optic nerve and spinal cord. Although it occurs rarely, ganglioglioma should be included in the differential diagnosis of a posterior fossa mass because early recognition is important for treatment and patient counseling.

Gastroprotective Effects of Glutinous Rice Extract against Ethanol-, Indomethacin-, and Stress-induced Ulcers in Rats / 전남의대학술지

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.

Gastroprotective Effects of Glutinous Rice Extract against Ethanol-, Indomethacin-, and Stress-induced Ulcers in Rats / 전남의대학술지

This study was designed to evaluate the efficacy of an orally administered aqueous extract of glutinous rice (GRE) to protect against acute gastric mucosal lesions induced by ethanol, indomethacin, and water immersion restraint stress in rats and to characterize the active substances responsible for the protection. GRE was shown to dose-dependently prevent the gastric lesions induced by the above ulcerogenic treatments at doses of 30 to 300 mg/kg. GRE treatment increased the gastric mucin content and partially blocked the ethanol-induced depletion of the gastric mucus layer. Also, it increased the nonprotein sulfhydryl concentration in the gastric mucosa. The gastroprotective action of GRE was markedly enhanced by co-treatment with 4-8 mg/kg tea extracts. The activity of GRE was completely lost by heat treatment at 80degrees C for 3 min or treatment with 0.01% pepsin at 37degrees C for 1 h. Protein extraction studies indicated that prolamins are involved in the gastroprotective activity of GRE. Our results suggest that glutinous rice proteins are useful for the prevention and treatment of gastritis and peptic ulcer.

The Effect of 5-alpha Reductase Inhibitors on the Efficacy of Photoselective Vaporization of the Prostate with 120 W GreenLight HPS Laser / 대한남성과학회지

PURPOSE: To evaluate the effect of preoperative 5-alpha reductase inhibitor (ARI) administration on the operative results of photoselective vaporization of prostate with 120W GreenLight HPS laser. MATERIALS AND METHODS: Data were collected from 98 benign prostatic hyperplasia (BPH) patients who underwent transurethral electrovaporization of prostate by 120W Greenlight HPS laser between Jan. 2010 and Dec. 2010. We compared the time of operation, the energy required in lasering, postoperative maximum uroflow velocity, change in residual urine volume and complications between 5-ARI administrating group and control group. RESULTS: 56 patients administrated 5-ARI at least 3 months before surgery. 30 and 26 patients administrated finasteride and dutasteride, respectively. Mean follow up period was 4.1+/-1.8 months. Mean age of the subjects and mean prostate volume were not different. Mean change of postoperative hemoglobin, lasing time and energy required in lasering were greater in 5-ARI administrating group. There were 3 and 1 cases of acute urinary retension in 5-ARI administrating group and control group, respectively. CONCLUSIONS: The mean change of hemoglobin and mean energy required in lasering were greater and mean lasing time was longer in the patients who administrated 5-ARI before photoselective vaporization of prostate by 120W Greenlight HPS laser. Further investigation and extensive study will be needed to confirm these results.

Apoptotic Effects of 6-Gingerol in LNCaP Human Prostate Cancer Cells

OBJECTIVE: 6-Gingerol, one component of ginger (Zingiber officinale) compound, has been known to possess anti-inflammatory, analgesic, anti-emetic, and anti-cancer effects. In this study, the apoptotic ability of 6-gingerol was investigated in human prostate cancer cells. METHODS: 3-(4,5-Dimethylthiazol-2-yl)- 2,5-diphenyl-tetrazolium bromide (MTT) assay, flow cytometry, and western blot analysis were done in LNCaP human prostate cancer cell lines treated with the various doses of 6-gingerol for the different durations of drug exposure. RESULTS: 6-Gingerol in doses ranging from 100 to 300 microM induced dose- and time-dependent inhibition of cell viability in prostate cancer cells by using MTT assay. Maximal inhibition of cell viability was observed at 300 microM of 6-gingerol for 48 hours treatment in LNCaP cells. 6-Gingerol at the dose of 100 microM did not produce any significant change in apoptotic cells in flow cytometry analysis. However, significant increase in sub-G0/G1 phase was observed in cells treated with 200 and 300 microM of 6-gingerol. Any significant cell cycle arrest was not induced by 6-gingerol. In western blotting analysis, expression of caspase-3 was not evident in cells treated with 6-gingerol for 24 hours. However, 48 hours treatment with 6-gingerol altered the expression of caspase-3 in LNCaP cells. Expression of cleaved poly showed the dose-dependent fashion in both 24 hours and 48 hours treatment of 6-gingerol. CONCLUSION: These observations suggest that 6-gingerol may induce apoptosis in LNCaP human prostate cancer cells.

Leptin Enhances Nitric Oxide-Dependent Relaxation of the Clitoral Corpus Cavernosum

PURPOSE: The effects of leptin on female sexual behaviors are controversial, and studies on this topic are limited. The objectives of this study were to evaluate the direct effects of leptin on clitoral vasoreactivity in vitro and to determine the mechanism of action. MATERIALS AND METHODS: Isometric tension studies were conducted to determine the effects of pretreatment with leptin (10(-8) M) on the contractile responses of rabbit clitoral corpus cavernosal smooth muscle strips. The effects of leptin were assessed on precontraction induced by phenylephrine (PE; 10(-9)-10(-4) M) and KCl (35-140 mM). We also examined the effect of leptin on relaxation induced by acetylcholine (ACh; 10(-9)-10(-4) M), verapamil (10(-10)-10(-6) M), and sodium nitroprusside (10(-9)-10(-4) M) in PE-precontracted (10(-5) M) strips. RESULTS: Leptin enhanced ACh-induced relaxation in PE-precontracted strips. L-NAME pretreatment significantly reduced the effect of leptin on ACh-induced relaxation, whereas L-arginine potentiated the effect of leptin. Leptin decreased the KCl-induced contractile responses. Leptin increased verapamil-induced relaxation responses. The relaxation effects of leptin on KCl-induced contraction were inhibited by 10(-5) M methylene blue and L-NAME pretreatment. CONCLUSIONS: A high concentration of leptin enhances ACh-dependent relaxation in clitoral cavernosal smooth muscles. These relaxation effects of leptin may occur through an NO-dependent mechanism and voltage-dependent calcium channel blockade.

The Use of Phytotherapy in Male Patients with a Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: Single Center Study / 대한남성과학회지

PURPOSE: Recently, the use of complementary and alternative medicine (CAM) is increasing among patients with low urinary tract symtoms (LUTS) caused by benign prostate hyperplasia (BPH). We assessed current usage and awareness of phytotherapy, the most ubiquitous CAM, in BPH/LUTS patients. MATERIALS AND METHODS: A total of 204 patients with BPH who completed a questionnaire between January 2009 and December 2010 were enrolled. The questionnaire was composed of questions about age, education level, accompanying disease, type of phytotherapy, route of purchase, reason of taking medicine and whether the patient is using phytotherapy in combination with conventional medicine. RESULTS: The mean age was 55.5+/-8.7 years. 56 of the total patients (27.5%) were using phytotherapy. The patients who were accompanied with erectile dysfunction used phytotherapy the most. The most commonly used phytotherapy for prescription and health functional food was Saw palmetto. The most common route of purchase was by clinician's prescription (46.4%). Most patients answered the dissatisfaction of present treatment's effect as the main reason for using phytotherapy. The number of patients who were taking combination therapy of BPH medication and phytotherapy was much more than using phytotherapy alone. CONCLUSIONS: 27.5% of patients who had BPH/LUTS were using phytotherapy. This is the point of time for many urologists to acquire the knowledge of studies and latest research of phytotherapy and use it in treating patients with BPH/LUTS.

Panax Ginseng Extract in a Boy with Attention Deficit Hyperactivity Disorder / 대한정신약물학회지

New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of Panax ginseng extract administration in a 7 year-old boy with drug naive ADHD. We administered Panax ginseng extract 1,800 mg/day to him for 8 weeks. There were improvement of scores in Attention Diagnostic System, Clinical Global Improvement, Conner's ADHD Rating scale and Dupaul ADHD Rating scale.

Is intramuscular stimulation a safe procedure in unpracticed hands?: a case of cervical epidural hematoma resulting in hemiparesis: A case report

Intramuscular Stimulation (IMS) is a refined technique of traditional oriental acupuncture, and IMS has proved effective for relieving chronic pain of a neuropathic origin. IMS is currently seen to be quite a safe procedure with minimal complications having been reported to date. Various complications have been documented for acupuncture, but few complications or adverse effects have been reported in relation to the relatively new technique of IMS. We report here on a case of cervical spinal epidural hematoma that manifested as a cause of delayed hemiparesis. The safety of this procedure in unpracticed hands seems to be questionable.

Iron Supplementation in a Girl with Attention-Deficit Hyperactivity Disorder / 대한정신약물학회지

New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of oral ferrous sulfate administration in a 14 year old girl with ADHD, who has decreased serum iron, ferritin levels. We administered oral ferrous sulfate 120 mg to her for 8 weeks. There were improvements of scores in Attention Diagnostic System (ADS), Clinical Global Improvement (CGI), Conner's ADHD Rating scale and Dupaul ADHD Rating scale

Iron Supplementation in a Girl with Attention-Deficit Hyperactivity Disorder / 대한정신약물학회지

New treatment strategies to attention deficit hyperactivity disorder (ADHD) have been introduced recently. We report and review the effect of oral ferrous sulfate administration in a 14 year old girl with ADHD, who has decreased serum iron, ferritin levels. We administered oral ferrous sulfate 120 mg to her for 8 weeks. There were improvements of scores in Attention Diagnostic System (ADS), Clinical Global Improvement (CGI), Conner's ADHD Rating scale and Dupaul ADHD Rating scale

Effects of Subclinical Prostatitis on Benign Prostatic Hyperplasia

PURPOSE: Subclinical prostatitis is a very frequent histologic finding in pathological examinations of prostate surgery specimens. We evaluated the correlation between the symptoms of benign prostatic hyperplasia (BPH) and the grades of inflammation in surgical specimens of patients who had undergone operation for BPH without any evidence of clinical prostatitis. MATERIALS AND METHODS: Seventy five patients with BPH, who had gone through transurethral resection of the prostate (TURP) at our department from March 2004 to May 2007, were retrospectively studied. Of the 75 patients, 57 patients were pathologically diagnosed as having a BPH with prostatitis and 18 patients had the only BPH (group G0). Chronic inflammation was graded as I (group G1: scattered inflammatory cell infiltrate within the stroma without lymphoid nodules), II (group G2: nonconfluent lymphoid nodules) or III (group G3: large inflammatory areas with confluence of infiltrate). The serum prostate-specific antigen (PSA) level, PSA density (PSAD), International Prostate Symptom Score (IPSS) and maximum urinary flow rate were compared among the grades of inflammation. RESULTS: In the patients had undergone TURP, prostatic inflammation was found in 76% (57/75). The storage symptoms of IPSS and PSAD were significantly correlated to the extent of inflammation in each groups (p<0.05). No significant correlations were observed between PSA, size of prostate, voiding symptoms, quality of life (QoL) of IPSS, and maximum urinary flow rate. CONCLUSIONS: The extent of chronic inflammation had considerably more relationship with storage symptoms than voiding symptoms and with the increased PSAD. These findings suggest that the subclinical prostatitis may be one of the factors of storage symptoms of BPH patients and postoperative maintained lower urinary tract symptoms.

Efficacy of Renal Artery Embolization using a Mixture of Histoacryl(R) and Lipiodol in a Rabbit Model / 대한비뇨기과학회지

PURPOSE: We wanted to evaluate the efficacy and computed tomography(CT) findings of renal artery embolization with using a mixture of Histoacryl(R) and lipiodol in rabbit depending on the mixture proportions and the temporal course. MATERIALS AND METHODS: Eighteen rabbits were equally divided into two groups: group A received a 1:3 mixture and group B received a 1:5 mixture of Histoacryl(R) and lipiodol. We subdivided each group as follows: the 1-day group, the 10-day group and the 20-day group according to the elapsed days after embolization, respectively. As a result, the experimental groups were composed of six subgroups. Afterright renal artery embolizations, plain abdominal radiographs were obtained from all the rabbits. On the first day, the 10th day and the 20th day after embolization, abdominal CT was performed in each subgroup. RESULTS: On the post-embolization radiographs, the embolic casts were formed only at the main or segmental renal arteries in 7 cases of group A. On the other hand, the embolic casts were formed at the entire arterial trees in two cases of group A and all the cases of group B. On the pre- contrast-enhanced CT scans, there were radiopaque densities of embolic casts, residual lipiodol flecks and calcifications in the embolized kidneys. On the contrast-enhanced CT scans, global perfusion defects of the kidneys were noted in 17 rabbits. The cortical rim signs were noted in all rabbits of the 10-day and 20-day groups, except for one rabbit. CONCLUSIONS: The mixture of Histoacryl(R) and lipiodol is effective for renal artery embolization. The CT findings of the embolized kidneys are characteristic depending on the mixture proportions of the embolic agents and the temporal courses.

Clinical characteristics of constipation associated with diabetes mellitus / 대한내과학회지

BACKGROUND: Constipation occurs frequently in diabetes mellitus (DM). However, there are few reports that investigated the characteristics of constipation associated with DM. The purpose of this study was to evaluate the clinical features of constipation associated with DM. METHODS: Among constipated patients who visited Asan Medical Center from January 2000 to December 2004, 45 patients with DM (DM group) and 104 patients without DM (non-DM group) were included in this study. We reviewed the clinical presentation, results of anorectal manometry, colon transit time study, and defecogram. We also analyzed the response to biofeedback therapy. RESULTS: The severity of constipation symptoms before treatment was not different between DM and non-DM group. Patients with colon transit time over 56 hours were more frequent in DM group than in non-DM group (21/45, 46.7% vs. 31/104, 29.8% ; p=0.047). Among DM group, colon transit time and the duration of DM showed positive correlation (r=0.431, p=0.003). The resting anal sphincter pressure was significantly lower in DM group than in non-DM group (43.5+/-21.5 mmHg vs. 51.7+/-22.6 mmHg ; p=0.048). The results of defecography were similar between DM and non-DM group. Successful responses to biofeedback therapy were not different between DM and non-DM group (19/34, 55.9% vs. 43/79, 54.4% ; p=0.887). CONCLUSIONS: Slow transit constipation was more frequent in DM group than in non-DM group. The successful responses to biofeedback therapy appear to be similar between DM and non-DM group.

A review of lead poisoning cases reported for recent 30 years in Korea / 대한내과학회지

BACKGROUND: Because of widespread and long-term use of lead, many lead poisoning cases were reported. Especially, in Korea including Southeast Asia, we observed non-occupational lead poisoning cases by herbal medication. METHODS: We identified total 45 cases of lead poisoning through Medric search, from 1973 to 2002. Bibliographies of relevant articles were reviewed. We arranged cases by attributes following 1) reported year, 2) age, 3) sex, 4) exposure sources, 5) exposure duration, 6) clinical manifestation, 7) treatments. RESULTS: The average age of the patients was 41.4 +/- 15.7 year-old. The distribution by sex did not have difference each other. The non-occupational lead poisoning cases were mostly caused by Chinese herbal medication. On the cases of the herbal lead poisoning, average exposure duration was 7.3 +/- 3.8 months and the various dosages were taken from 5 mg to 3 g. The major clinical symptoms were abdominal pain, headache, and constipation. The typical laboratory finding was anemia. Major treatment agent was oral penicillamine. CONCLUSION: To differential diagnose of the lead poisoning from many diseases with similar symptoms is very difficult solely on the clinical aspect. Especially, in non-occupational cases it is more difficult. In Korea, non-occupational lead poisoning cases by herbal medication have been discovered more than in western countries. We reviewed about the lead poisoning cases since 1973, so we want to make an aware of scientific and rational making and management of lead in the health supplementary food and herbal medicine.

The Antinociceptive and Anti-inflammatory Effect of Ethylacetate Extracts from Bang-Poong (Radix ledebouriellae) on the Freund's Adjuvant-Induced Arthritis in Rats

In this study, we aimed to determine the antinociceptive and/or anti-inflammatory effect of Bang-Poong (BP, Radix Ledebouriellae) on Freund's adjuvant-induced arthritis in rats. Traditionally, BP has been used to treat several inflammatory diseases such as arthritis. Whole BP is extracted into two fractions that were ethylacetate and hexane-soluble fractions. Adult Sprague-Dawley rats (n=30, 130-150 g) were subcutaneously administered by the Freund's complete adjuvant (FCA) into the plantar surface of right hindpaw. Twelve days after the injection of FCA, the rats initially showed typical inflammatory edema and arthritis-related symptoms on the contralateral side (i.e. left hindpaw). Both antinociceptive (evaluation of mechanical, thermal pain threshold and analysis of spinal Fos expression) and anti- inflammatory (evaluation of paw edema, serum interleukin-6 level and x-ray analysis) effect of BP extracts were examined. The ethylacetate fraction of BP (BPE) significantly suppressed the FCA-induced paw edema as well as the serum level of interleukin-6 and it alleviated the radiological changes. Moreover, both mechanical and thermal hyperalgesia were attenuated by the treatment of BPE. In addition, spinal Fos expression that was increased by FCA- injection was suppressed in BPE group. Therefore, this study showed that BPE produced significant both antinociceptive and anti-inflammatory effects on FCA- induced arthritis in rats, while hexane fraction of BP did not show these effects. In conclusion, it is suggested that the ethylacetate fraction of BP is recommended to alleviate the arthritis-related symptoms in human according to the results of this study.

Relaxation Response of the Rabbit Clitoral Corpus Cavernosal Smooth Muscle in Chronic Estrogen-Deficiency State / 대한비뇨기과학회지

PURPOSE: To investigate involvement of chronic estrogen deficiency in impairment of relaxation response of the clitoral cavernous smooth muscle. MATERIALS AND METHODS: New Zealand white female rabbits were randomly divided control (sham operation, n=6) and experimental groups; 1) bilateral oophorectomy (n=8), 2) oophorectomy with estradiol replacement (n=7), 3) oophorectomy with flutamide treatment (n=6). All the rabbits were sacrificed 12 weeks after the operations. Blood levels of estradiol and lipid fractions were measured just before the operations and sacrifice. Clitoral cavernous strips were obtained to observe relaxation responses to endothelium-dependent and -independent vasodilators, and electrical field stimulation (ESF). RESULTS: The uterus weight and serum estradiol level decreased significantly (p<0.01) in the oophorectomy group compared with the baseline data. The serum levels of total cholesterol, triglyceride, and low density lipoprotein increased significantly (p<0.01) in the oophorectomy group. The relaxations of the clitoral strips to acetylcholine were significantly attenuated in the oophorectomy group compared with those of the control and estrogen replacement groups. However, sodium nitroprusside- and nonadrenergic noncholinergic-induced relaxations were not significantly different among the 4 groups. No significant histologic changes were noted in the clitoral tissues of the oophorectomy group. CONCLUSIONS: Chronic estrogen deficiency in the rabbits may cause impairment of endothelium-dependent relaxation of clitoral corpus cavernosal smooth muscles. Further studies are needed to determine whether the hypoesterogenemia itself and/or secondary hypercholesterolemia due to the chronic estrogen deficiency may result in the impairment.

A Case of Mania Associated with Hypericum Perforatum in a Patient with Major Depression / 대한정신약물학회지

Recently Korean Food and Drug Administration approved Hypericum perforatum preparations (St. John's wort) as an over-the-counter drug. The authors reported a case of Hypericum perforatum induced mania in a patient with major depressive disorder and reviewed. A seventy-five years old female patient was diagnosed as major depression 5 years ago, and had been admitted in the psychiatric ward twice and had received regular outpatient treatment. Since October 1998, she took paroxetine 20 mg, and bromazepam 1.5 mg constantly. But all of a sudden, she stopped taking the drugs on June 20th 2000, and took Hypericum perforatum 300 mg three times daily. Ten days after, she became abruptly talkative, irritable, hyperactive, and euphoric. She was diagnosed as Hypericum perforatum-induced mania. Manic symptoms came down after several days by discontinuation of taking Hypericum perforatum. Since then she has been got a continuous treatment with paroxetine 20 mg, and she is in full remission state now. Hypericum perforatum is one of herb extracts, which is known to have the antidepressant effect like traditional and newer antidepressants. The side effects of Hypericum perforatum are gastrointestinal disturbance, allergy reaction, fatigue, photosensitivity. And more serious side effect is drug-drug interaction due to it's inducing effect of cytochrome P450 and P-glycoprotein. It is possible to switch from depression to manic episode as was in this case. Although it was approved as an over-the-counter drug in Korea, the use of Hypericum perforatum need to be thoroughly examined to prevent misused if not fully understood.