Iatrogenic Sacral Root Entrapment after Iliosacral Screw Fixation in a Patient with Pelvic Ring Fracture - A Case Report -

Objectives@#Despite precise iliosacral (IS) screw placement, we encountered a case of a neurological deficit due to a bony fragment that remained around the nerve root after reduction of the fracture gap in a patient with a pelvic ring injury.Summary of Literature Review: Percutaneous IS screw fixation is a commonly used procedure because it enables an adequate fixation force to be secured through a minimally invasive method in patients with pelvic ring fractures. Percutaneous IS screw fixation using C-arm fluoroscopy has been well described. In addition, several studies have investigated methods to prevent neurological damage. @*Materials and Methods@#A 48-year-old man was diagnosed with a lateral compression type 1 pelvic ring fracture. Bilateral IS screw fixation was performed in the patient, who had no preoperative neurological abnormalities. He complained of pain around the sacroiliac joint that radiated to the lower leg after percutaneous IS screw fixation, and he was diagnosed with S1 radiculopathy on electromyography. @*Results@#While reviewing the patient’s preoperative computed tomography images, a bony fragment in the fracture gap on the left S1 root was noted. After confirming S1 root entrapment, decompressive laminectomy was performed. @*Conclusions@#Surgeons should be aware that postoperative neurological symptoms may be caused by a bony fragment resulting from the fracture, regardless of screw malposition in percutaneous IS screw fixation. Preoperative planning with meticulous image review and intraoperative neurological monitoring, as well as using full-threaded screws, may help to prevent this problem.

Triamcinolone Acetonide Injections for Lateral Malleolar Bursitis of the Ankle / 대한족부족관절학회지

PURPOSE: This study examined the clinical outcomes and usefulness of triamcinolone acetonide (TA) injections as an option in the conservative treatment of patients with lateral malleolar bursitis of the ankle. MATERIALS AND METHODS: A total of 27 patients (27 ankles), in whom TA injection had been performed between March 2016 and June 2017, were reviewed retrospectively. After the aspiration of fluid in the lateral malleolar bursal sac, 1 mL (40 mg) of TA was injected into the malleolar bursal sac. After the injection, the ankle was compressed with an elastic cohesive bandage for 2 to 4 weeks. The clinical outcomes and side effects were evaluated at the following time points: 2 weeks, 4 weeks, 3 months, 6 months, and 1 year after TA injection therapy. The responses to treatment were assessed according to the degree of fluctuation, shrinkage of the bursal sac, and soft tissue swelling. RESULTS: The mean age was 62.1 years (range, 41~81 years); there were 19 males and 8 females. Complete resolution was observed in 26 patients (96.3%) after the first or second application of a TA injection, and a partial response was observed in 1 patient (3.7%) after the first TA injection. The physical component scores of Medical Outcomes Study 36-item Short-Form Health Survey improved from 71.1 to 76.0 at the last follow-up (p=0.001). Associated complications were 1 patient (3.7%) with skin atrophy and 3 patients (11.1%) with transient hyperglycemia in diabetes mellitus. CONCLUSION: TA injection is a useful and safe procedure for patients not responding to the usual conservative treatment of lateral malleolar bursitis of the ankle.

Relationships of Plasma Homocysteine Concentration and Oxidative Stress Markers in Korean Collage Students

Elevated plasma concentration of total homocysteine (ptHcy) is known as an independent risk factor of cardiovascular disease (CVD) and oxidative stress is also commonly implicated in CVD. An association between ptHcy and oxidative stress has recently been suggested. The study objective is to examine the relationship between ptHcy and oxidative stress markers in 103 healthy college students (62 males and 41 females). Plasma levels of ptHcy, oxidative stress markers (conjugated diene, erythrocyte catalase, TRAP, lymphocyte DNA damage), antioxidant vitamins (alpha-tocopherol, gamma-tocopherol, carotenoids), and lipid parameters (total cholesterol, triglyceride, HDL cholesterol) were determined. The results show that the concentration of ptHcy was significantly higher in male subjects (22.17 +/- 2.14 micromole/L) than in female subjects (12.28 +/- 0.45 micromole/L). There was a negative association between ptHcy and plasma beta-carotene in male subjects (p or = 15 micromol/L), as compared to those with lower plasma homocysteine. These study results confirmed the views on the association between plasma homocysteine and oxidative stress markers in humans and support the hypothesis that homocysteine promotes the oxidative environment by counteracting the antioxidant defense mechanism.

The Improvement of Chaga Mushroom (Inonotus Obliquus) Extract Supplementation on the Blood Glucose and Cellular DNA Damage in Streptozotocin-Induced Diabetic Rats

Mushrooms have become a largely untapped source of powerful new pharmaceutical products that poses anti-inflammatory, and antimutagenic, and antioxidant activities. The antioxidant effects of the mushroom may be partly explained by protecting cellular components against free radical. The aim of this study was to investigate the protective effect of chaga mushroom against diabetes, via the mitigation of oxidative stress and reduction of blood glucose, in streptozotocininduced diabetic rats. Rats were rendered diabetic by intravenous administration of STZ through tail at a dose of 50 mg/kg. Animals were allocated into four groups with 8 rats each. The control and diabetic control group were fed withstandard rat feed. The other diabeic groups, the low chaga extract group and the high chaga extract group were fed ad libitum using 0.5 g/kg and 5 g/kg of chaga mushroom extract, respectively, for 4 weeks. The blood glucose levels in the two chaga extract groups showed a tendency to decrease but did not reach statistical significance after the supplementation. Leukocyte DNA damage, expressed as tail length, was found to be significantly lower in the high chaga extract group than in the diabetic control group (p > 0.05). Plasma level of total radical-trapping antioxidant potential (TRAP) was tend to be higher in the high chaga extract group compared with the diabetic control group. Erythrocyte antioxidant enzyme activities of two groups did not differ. Although we did not obtain beneficial effect on lowering blood glucose levels in the STZ-induced diabetic rats, this results suggest that the chaga mushroom extracts may initially act on protecting endogenous DNA damage in the short-term experiment.

The Effects of Purple Grape Juice Supplementation on Improvement of Antioxidant Status and Lymphocyte DNA Damage in Korean Smokers

The purpose of this project was to evaluate whether daily fruit juice consumption could reduce the DNA damage in healthy subjects. The study was performed using 67 healthy volunteers (29 smokers, 38 nonsmokers) who were supplemented with 480 ml of grape juice for 8 weeks. Eight weeks of grape juice consumption did not change any anthropometric parameters. Lymphocyte DNA damage before the study was significantly greater (p < 0.05) in smoker than nonsmoker, but, grape juice consumption significantly reduced DNA damage in both smoker (26%) and nonsmoker (17%) to the level where there was no difference remained between the two groups after the intervention trial. This preventive effect of grape juice against DNA damage was not affected by sex of the subjects in non-smokers. Plasma alpha-carotene, lycopene and gamma-totopherol was significantly increased after the trial in smokers, while erythrocyte catalase was significantly increased in both smokers and nonsmokers. Total radical-trapping antioxidant potential (TRAP) level in all subjects was significantly reduced after the intervention, while GSH-Px activity was increased only in nonsmokers. These results suggests that daily consumption of grape juice may protect DNA damage in peripheral lymphocytes, and supports the hypothesis that grape juice might exert their effect partially via a decrease in oxidative damage to DNA in humans partly by improving their antioxidative defense system.

Comparison of the Protective Effect of Antioxidant Vitamins and Fruits or Vegetable Juices on DNA Damage in Human Lymphocyte Cells Using the Comet Assay

In this study the in vitro protective effects of several antioxidant vitamins (vitamin C, alpha-tocopherol, beta-carotene), fruits and vegetables (strawberry, tangerine, orange and 100% orange juice, carrot juice), on the levels of isolated human lymphocyte DNA damage was measured using Comet assay. Comet assay has been used widely to assess the level of the DNA damage in the individual cells. Lymphocytes were pre-treated for 30 minutes with antioxidant vitamins (10, 50, 100, 500 micrometer) or fruits. vegetables (10, 100, 500, 1000 microgram/ml), an4 then oxidatively challenged with 100 micrometer H2O2 for 5 min at 4degrees C. The protective effect of antioxidant vitamins against DNA damage at a concentration of 50 micrometer were 50% in vitamin C, 32% in alpha-tocopherol, whereas, beta-carotene showed a 55% protection at a dose as low as 10micrometer. The inhibitory effects of DNA damage by strawberry, tangerine, orange, orange juices, carrot juices were 50 - 60% with wide ranges of doses. The results of the present study indicate that most the antioxidant vitamins and fruits.vegetables juices produced a significant reduction in oxidative DNA damage.

The Effects of Purple Grape Juice Supplementation on Blood Pressure, Plasma Lipid Profile and Free Radical Levels in Korean Smokers

Flavonoids contained in grapes are potent antioxidants that may protect against oxidative stress and reduce the risk of chronic diseases related with free radical damage. In this study we investigated the effect of daily grape juice supplementation on blood pressure (BP), plasma lipid profiles and the generation of free radicals in 67 healthy volunteers (29 smoker, 38 nonsmokers). The daily 480 ml of grape juice supplementation for 8 weeks resulted in a significant decrease in diastolic BP by 6.5% in smokers and systolic and diastolic BP by 11.2 and 3.7% in non-smokers. Plasma total cholesterol, HDL- and LDL-cholesterol levels in smokers and total cholesterol in non-smokers were significantly increased after the intervention. Plasma triglycerides and conjugated dienes were not affected by grape juice supplementation. Levels of free radical determined by reading the lucigenin-perborate ROS generating sources, decreased significantly by 18% compared to the beginning of the study. The results indicated that the consumption of grape juice may reduce BP and free radical generation in smokers, which was possibly exerted by flavonoids. Our findings suggested that the grape juice has protective effect on chronic disease due to the overproduction of free radical in smokers.

The Effects of Green Vegetable Juice (Angelica Keiskei) Supplementation on Plasma Lipids and Antioxidant Status in Smokers

It has been suggested that green juice supplementation may have some health promoting benefits. We evaluated the effects of green juice (Angelica keiskei) consumption on parameters of lipid profiles and plasma antioxidant status in healthy male smokers. Fifty-four smokers were supplemented with 300 ml of green juice for 6 weeks while maintaining their normal diet. Blood samples were collected on week 0 and week 6 in order to evaluate plasma lipid profiles (total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol) , plasma antioxidant vitamin levels (ascorbic acid, alpha-tocopherol, gamma-tocopherol, alpha-carotene, beta-carotene, cryptoxanthin and lycopene) , the degree of LDL oxidation and GOT, GPT levels for liver function. Plasma ascorbic acid level remained at the same level. However, alpha-tocopherol and gamma-tocopherol normalized by total cholesterol (p<0.05) and beta-carotene (p<0.001) level were all significantly increased after green juice supplementation. Plasma cholesterol was reduced for 12%, LDL-cholesterol was reduced for 9.3% after green juice consumption, while plasma triglyceride and HDL-cholesterol was not changed. Oxidized LDL assessed by conjugated diene (CD) , was decreased (p<0.0001) after green juice consumption. These results further support a role for green juice supplementation in the improvement of lipid status, prevention of lipid peroxidation, and thereby reducing risk factors of numerous diseases associated with elevated oxidative stress in smokers.

Protective Effect of Yellow-Green Vegetable Juices on DNA Damage in Chinese Hamster Lung Cell Using Comet Assay

The present study was attempted to investigate the antioxidant capacity of popular yellow-green vegetable juices (kale, Angelica keishei, carrot, small water dropwort) and to investigate the effect of vegetable juices on protecting oxidative damage to DNA in cultured Chinese hamster lung (CHL) cells. Antioxidant capacity was analyzed by TRAP assay (Total radical-trapping antioxidant potential). Cellular DNA dmamage was measured by SCGE (single-cell gel electrophoresis, also known as comet assay. Cells incubated in medium with PBS (negative control) or with various concentration of the freeze dried green juices (25, 50, 100, 250 ug/mL) resuspended in PBS were treated with H2O2 (200 micrometer) as an oxidative stimulus for 5 min at 4 degrees C. The physiological function of each vegetable juice on oxidative DNA damage was analyzed and expressed as tail moment (tail length X percentage migrated DNA in tail). Kale juice had the highest TRAP value suggesting that kale has the highest antioxidant capacity followed by Angelica keishei, small water dropwort and carrot. Cells treated with H2O2 had extensive DNA damage compared with cells treated with PBS or pre-treated with vegetable juice extracts. All green juices inhibited H2O2-induced DNA damage with kale being the most effective juice among the tested juices. These results indicate that green juice supplementation to CHL cells followed by oxidative stimulus inhibited damage to cellular DNA, supporting a protective effect against oxidative damage induced by reactive oxygen species.