Therapeutic Advantages of Treatment of High-Dose Curcumin in the Ovariectomized Rat

OBJECTIVE: Although curcumin has a protective effect on bone remodeling, appropriate therapeutic concentrations of curcumin are not well known as therapeutic drugs for osteoporosis. The purpose of this study was to compare the bone sparing effect of treatment of low-dose and high-dose curcumin after ovariectomy in rats. METHODS: Forty female Sprague-Dawley rats underwent either a sham operation (the sham group) or bilateral ovariectomy (OVX). The ovariectomized animals were randomly distributed among three groups; untreated OVX group, low-dose (10 mg/kg) curcumin administered group, and high-dose (50 mg/kg) curcumin group. At 4 and 8 weeks after surgery, serum biochemical markers of bone turnover were analyzed. Bone histomorphometric parameters of the 4th lumbar vertebrae were determined by micro-computed tomography (CT). In addition, mechanical strength was determined by a three-point bending test. RESULTS: High-dose curcumin group showed significantly lower osteocalcin, alkaline phosphatase, and the telopeptide fragment of type I collagen C-terminus concentration at 4 and 8 weeks compared with the untreated OVX group as well as low-dose curcumin group. In the analyses of micro-CT scans of 4th lumbar vertebrae, the high-dose curcumin treated group showed a significant increase in bone mineral densities (p=0.028) and cortical bone mineral densities (p=0.036) compared with the low-dose curcumin treated group. Only high-dose curcumin treated group had a significant increase of mechanical strength compared with the untreated OVX group (p=0.015). CONCLUSION: The present study results demonstrat that a high-dose curcumin has therapeutic advantages over a low-dose curcumin of an antiresorptive effect on bone remodeling and improving bone mechanical strength.

Perioperative risk factors for prolonged mechanical ventilation after liver transplantation due to acute liver failure / 대한마취과학회지

BACKGROUND: Acute liver failure (ALF) is a rapidly progressing and fatal disease for which liver transplantation (LT) is the only treatment. Posttransplant mechanical ventilation tends to be more prolonged in patients with ALF than in other LT patients. The present study examined the clinical effects of prolonged posttransplant mechanical ventilation (PMV), and identified risk factors for PMV following LT for ALF. METHODS: We reviewed data of patients undergoing LT for ALF between January 2005 and June 2011. After grouping patients according to administration of PMV (> or = 24 h), donor and recipient perioperative variables were compared between the groups with and without PMV. Potentially significant factors (P or = grade III), intraoperative blood pressure fluctuation, and oliguria (< 0.5 ml/kg/h) were independent risk factors for PMV. CONCLUSIONS: PMV was associated with deleterious outcomes. Besides care for known risk factors including hepatic encephalopathy, meticulous attention to managing intraoperative hemodynamic circulatory status is required to avoid PMV and improve the posttransplant prognosis in ALF patients.

A Kimura's disease developing during follow up period after remission of lymphoma / 대한내과학회지

The presented case is a 43-year-old male with a painless mass in the right neck for two weeks. Excisional biopsy was performed under the clinical impression of malignant lymphoma, because he experienced lymphoma 32 months ago. Histopathologically, it shows hyperplasia of small blood vessels and lymphoid cells with eosinophilic infiltration, so it was diagnosed as Kimura's disease. This seems to be the first reported case of Kimura's disease developed during follow up period after remission of lymphoma.

Adenocarcinoma of Unknown Primary Site

BACKGROUND: Metastatic cancer of unknown primary site occupies 0.5~10% of all diagnosed cancer patients and includes various tumors with diverse responses to systemic chemotherapy. Adenocarcinoma of unknown primary site (ACUPS), the most common subtype, has no standard treatment, rarely responds to conventional treatment and has a poor survival rate. METHODS: The retrospective study was performed to investigate the clinical characteristics and the treatment outcomes of ACUPS. RESULTS: Eighty-one patients with ACUPS diagnosed at Samsung Medical Center from May 1995 to July 1999 were included. The median age was 58 years (range, 29~77). The common sites of metastases were the lymph node, liver, lung and bone in order. In 49 of 81 patients (60.5%), the dominant tumor location was below the diaphragm. The majority of patients (76 of 81) were initially treated with systemic chemotherapy including cisplatin. Responses were evaluable in 70 of 76. Eighteen of 70 patients (25.7%) responded to chemotherapy and complete remission was observed in 6 patients. The overall median survival of 81 patients was 5.6 months. The median survival of the responding patients was 18.3 months but the median survival of the nonresponding patients was 4.6 months (p<0.01). In univariate and multivariate analysis, age, performance status and response to initial chemotherapy were significant prognostic factors for overall survival. CONCLUSION: We observed poor response to the treatment and survival rate in ACUPS, but complete remission and long-term survival were observed in a small number of patients.

Risk Factors in Patients with Rebleeding after CT-Guided Stereotactic Burr Hole Aspiration for Hypertensive Intracerebral Hematoma

This retrospective comparative study involved 282 hypertensive intracerebral hemorrhage patients admitted to Kyungpook University Hospital between January 1991 and January 1993 for the evaluation of clinical risk factors of rebleeding. For all patients, surgery involved CT-guided stereotactic burr-hole aspiration. In 39(13.8%), postoperative rebleeding occurred at the site of the hematoma. The mean age of both the rebleeding and non-rebleeding group was 58. In the rebleeding group, the male to female ratio was 19:20(1:1.1), and in the non-rebleeding group, the corresponding figure was 113:130(1:1.5). The amount of intracerebral hematoma appearing on brain CT during the 24 hours following surgery was measured and defined as rebleeding in cases where the amount was the same as or more than before surgery. In comparative analysis, the authors defined the following hypothetical clinical risk factors: age, location of hematoma, pre-op systolic blood pressure, volume of hematoma, pre-op consciousness, time interval from hemorrhage ictus to operation, past history and systemic disease. Through analysis of rebleeding cases, these risk factors were then compared: p-value was estimated by use of the chi-square test. In conclusion, clinical risk factors in rebleeding were found to be high systolic blood pressure prior to surgery, poor pre-op clinical grade, small amount of hematoma, short time interval from hemorrhage ictus to operation(6-24 hours), and a past history of cerebrovascular disease.

Anterior Cervical Fixation in Spine Injury Patients Requiring Tracheostomy

Because of the possibility of increased the risk of soft tissue or bone infection, surgeon have been somewhat reluctant to use the anterior cervical approach in spinal injury patients who had previously undergone tracheostomy. The authors investigated whether the use of a Caspar plate in such patients during anterior cervical fixation altered the risk of infection. We analyzed the mechanism and level of injury, operative procedures, post-operative course and infection in 12 cervical injury patients with previous tracheostomy. The procedure had been performed on the day of injury because of semicoma resulting from combined head injury in two cases, and because of multiple rib fracture with hemothorax, and old age with chronic obstructive lung disease in one case each; it had been performed between 1-6 days after injury because of high fever with pneumonia and atelectasis in eight cases. The interval between tracheostomy and anterior fixation was 5-20(average, 13) days. During clinical follow-up at 8-21 (average, 16) months, bone union without infection was observed in all patients. The authors concluded that in patients with cervical cord injury, tracheostomy did not increase the risk of infection in subsequent anterior cervical fixation using a Caspar plate.