Quantitative Analysis of Flavonoid Glycosides in Sophora japonica and Sophora flavescens by HPLC-DAD

Recently, a phytoestrogenic functional food has been developed using the fruits of Sophora japonica. Phytochemical investigation of fruits of S. japonica led to the isolation of eight flavonoid glycosides using various chromatographic techniques. The isolated compounds were identified as genistin (1), sophoricoside (2), genistein 7,4'-di-O-β-D-glucopyransoide (3), sophorabioside (4), genistein-7-O-β-D-glucopyranoside-4'-O-[(α-Lrhamnopyranosyl)-(1→2)-β-D-glucopyranoside] (5), sophoraflavonoloside (6), nicotiflorin (7) and kaempferol-3-O-α-L-rhamnopyranosyl-(1→6)-β-D-glucopyranosyl-(1→3)-β-D-glucopyranoside (8), respectively, by comparison of their spectroscopic data with those reported in the literature. In addition, a new HPLC-DAD method for simultaneous determination of the isolated compounds was developed to quantitate the contents of flavonoids in S. japonica and S. flavescens. The method was validated in terms of limit of detection, limit of quantitation, specificity, linearity, precision and accuracy. The validated method was successfully applied to determine eight flavonoids in two Sophora species. The contents of eight flavonoids varied according to the parts and species. Particularly, it was found that only the fruits of S. japonica contained sophoricoside, a phytoestrogenic isoflavone.

The Effect of Pravastatin on Insulin Resistance in Hyperglycemic Patients / 임상당뇨병

BACKGROUND: The effect of pravastatin on insulin resistance (IR) is controversial and poorly studied in prediabetes. METHODS: This study was performed in hyperglycemic patients at Saint Carollo Hospital from January 1, 2013 to December 31, 2015. Among them, we selected 40 patients (24 prediabetes and 16 new onset diabetes [NOD]) who had been treated with pravastatin 20 mg daily for 2 or 4 months and in whom fasting insulin and fasting glucose had been measured before and after administration of pravastatin. IR was defined as a fasting insulin level ≥ 12.94 µU/mL, homeostasis model for IR (HOMA-IR) ≥ 3.04 or quantitative insulin sensitivity check index (QUICKI) ≤ 0.32. RESULTS: Pravastatin treatment decreased total cholesterol and low-density lipoprotein cholesterol levels by 25.2% and 32.3% respectively (P = 0.000 for all), but did not affect fasting insulin level, HOMA-IR, or QUICKI in total, prediabetes, and NOD groups. Prevalence of IR was significantly different between prediabetes and NOD groups both before and after pravastatin treatment (0% versus 37.5%, P = 0.001), but pravastatin treatment did not affect the prevalence of IR in the prediabetes or NOD group. Fasting glucose level was not significantly different before and after pravastatin treatment in prediabetes (106.8 ± 6.4 mg/dL versus 103.8 ± 8.4 mg/dL, P = 0.223) but was significantly different in the NOD group (171.5 ± 70.1 mg/dL versus 124.4 ± 26.7 mg/dL, P = 0.017). CONCLUSION: Pravastatin treatment did not affect IR or fasting glucose level in hyperglycemic patients. Therefore, we suggest pravastatin can be prescribed to hypercholesterolemic patients with hyperglycemia.

Vascular Endothelial Dysfunction in Cerebral Leukoaraiosis

BACKGROUND: Chronic subclinical ischemia has been considered as one of major causes of leukoaraiosis, although its trigger is unknown. The vascular endothelium plays a major role in maintaining cerebral perfusion through autoregulation. In this study we evaluated the endothelial bioavailability of nitric oxide (NO) in patients with leukoaraiosis. METHODS: We enrolled consecutive patients with lacunar syndrome or transient ischemic attack; the control group comprised age- and sex-matched patients with hypertension but with no neurological abnormality. All participants underwent flow-mediated dilatation of the brachial artery (FMD) to evaluate endothelial function. Leukoaraiosis was defined as ill-defined patches with high signal intensities on FLAIR and low signal intensities on T1-weighted images. Patients were defined as having ischemic leukoaraiosis if they presented with leukoaraiosis and lacunar infarction. Leukoaraiosis only was defined when patient had leukoaraiosis without lacunar infarction leukoaraiosis without lacunar infarction. RESULTS: In total, 75 patients (37 with leukoaraiosis and 38 controls) were enrolled in this study. The demographic and clinical characteristics were similar in the two groups. FMD was lower in patients with leukoaraiosis than in controls (p0.05). CONCLUSIONS: The bioavailability of NO in the vascular endothelium is decreased in patients with leukoaraiosis only and in those who also have ischemic leukoaraiosis compared to controls. These results are suggestive of a causative role of endothelial dysfunction in the pathomechanism of leukoaraiosis.

Long Spontaneous Remission in Neuromyelitis Optica

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system characterized by optic neuritis and longitudinal extensive transverse myelitis. The clinical course can be either polyphasic (relapsing-remitting) or monophasic. The relapsing-remitting course is observed in more than 80% of NMO cases, and relapse generally occurs within 1 year in 60% of patients, and within 3 years in 90%. We report a rare case of long spontaneous remission in untreated NMO.

Brachial Plexopathy Caused by Vertebral Artery Dissection

No abstract available.

Acute Cerebral Infarction, Deep Vein Thrombosis and Pulmonary Embolism in Kimura's Disease / 대한뇌졸중학회지

Kimura's disease is a chronic inflammatory disease producing subcutaneous tumor-like nodules chiefly in the head and neck region. It is characterized histologically by lymphoid follicles, intense aggregations of eosinophils, vascular proliferation and fibrosis combined with peripheral blood eosinophilia. We report a 56-year-old man who presented with dysarthria and right hemiparesis. On physical examination, a non-ender mass 5 x 6 cm was identified in the right submandibular area. He was diagnosed with Kimura's disease by biopsy. One month after admission, he complained of paresthesia in the left lower extremity. CT angiography revealed thromobosis in the left femoral vein and bilateral pulmonary embolism. To our knowledge, the concomitant occurrence of acute cerebral infarction, deep vein thrombosis and pulmonary embolism in patients with Kimura's disease has never been reported. Eosinophil-derived cytotoxic proteins are presumed to be fundamental to the pathogenesis of these disorders in Kimura's disease.

Spontaneous Pneumothorax as an Initial Manifestation of Metastatic Papillary Thyroid Carcinoma

Spontaneous pneumothorax occurs in a variety of lung diseases. Primary or metastatic lung cancers are rare, but important causes of pneumothorax. We report here on a case of pulmonary metastasis of thyroid papillary carcinoma that initially presented as spontaneous pneumothorax. A 32-year-old male with no history of thyroid disease underwent wedge resection of the lung due to recurrent pneumothorax. Histologically, the pleura and subpleural lung parenchyma revealed several micronodular lesions and randomly scattered glandular structures with mild cytological atypia. The cells were characterized by their overlapped hypochromatic nuclei with longitudinal grooves and inconspicuous nucleoli. On the additional sections, we found a few intranuclear inclusions and colloid-like material in the follicular structures. The glandular cells were immunoreactive for thyroglobulin, TTF-1, CK 7 and HMW-CK and they were focally immunoreactive for EMA, but they were negative for S100, chromogranin and CEA. The Ki-67 labelling index was 4%. Neck ultrasonography revealed an ill-defined hypoechoic nodule in the left lobe of the thyroid. The diagnosis of conventional, classical papillary carcinoma was made by both the cytology and the total thyroidectomy specimen. Pathologists should conduct a through histologic examination for the patients with recurrent spontaneous pneumothorax to search for the underlying causes.

Penetrating Chest Injuries Caused by the Sideview Mirror of the Patient's Car: Report of 2 cases

Penetrating chest trauma caused by the components of one's own car is rare in motor vehicle accidents. We experienced two cases of penetrating chest injury caused by the sideview mirror of the patient's vehicle. One was a 25-year-old man. The sideview mirror penetrated the left chest, went through the diaphragm, and ruptured the spleen. He was in shock upon arrival at the emergency room. An emergency thoracotomy and laparotomy were done. The ruptured spleen was resected, the lung and the diaphragm were debrided and repaired, and the chest wall was reconstructed. The other patient was a 57-year-old male, who was transported to our emergency room with the sideview mirror of his truck stuck into his right chest wall as the result of an accident. He also had a right Bennet's fracture and an open fracture of the right tibia. Air had been sucked into the right pleural cavity through the wound. Multiple rib fractures and lung lacerations had also occurred. Removal of the sideview mirror, repair of the lacerated lung, and reconstruction of chest wall were done immediately. Both patients recovered without complication and were discharged.

Significance of Bone Scan in Chest Trauma / 대한흉부외과학회지

BACKGROUND: Clinical analysis of the relation between the clinical data of chest trauma patients and bone scan results was done to investigate the sensitivity and specificity of bone scan for the diagnosis of rib or chondral fracture. MATERIALS AND METHOD: 445 patients treated due to chest trauma in Dongguk University Kyungju Hospital from July 1998 to December 2001 were studied.Age and sex distribution,causes of chest trauma,interval from the injury to arrival at hospital,final diagnosis,relationship between the chest pain and bone scan results,relationship between local tenderness and bone scan results,and sensitivity and specificity of bone scan were studied. RESULT: The male was 61.6%and the female was 38.4%.Age distribution was nearly even from the twenties to the sixties.The traffic accident was the most common cause of chest injury(60.4%).Most p at i e nt s (76.6%)were arrived to the hospital within 6 hours after chest trauma.Rib fracture was the most common final diagnosis(46.5%).The relationship between the duration of chest pain and tenderness and the bone scan results were significant,and the same in the relationship between the duration of local tenderness and the bone scan results,but the latter is more significant.The sensitivity of bone scan was 99.4%and the specificity was 90.4%. CONCLUSION: If the patient complains the chest pain continuously and the local tenderness around the chest is continued over 3 weeks,it is good to perform the bone scan.Further study including the MRI may be helpful for more evaluation in chest trauma patients.

A Case of Pulmonary Trichomoniasis / 대한임상병리학회지

Man is host to three distinct trichomonad species such as Trichomonas vaginalis, T. hominis, and T. tenax. Although reports of trichomonads found outside their natural habitat are rare, sporadic case reports have appeared describing trichomonads in the respiratory tract. The route of infection is unknown, but possible mechanisms include invasion from mouth, oral sex, bronchopleural or pleuroenteral fistula. Pulmonary trichomoniasis is a kind of oppotunistic infection and is usually caused by aspirated T. tenax in male adult patientis with chronic purulent or necrotic pulmonary disease. A 63-year-old male patient with alcoholic liver cirrhosis and chronic bronchiectasis was admitted due to copious sputum, dyspnea, fever and severe weight loss. On the thoracentesis from his right pleural cavity, 1 L of foul-smelling, brownish-yellow exudate was withdrawn and showed a large number of neutrophil, bacteria and numerous flagellated, actively motile organisms with typical appearance of thrichomonads in wet preparation. This patient was expired due to sepsis and insufficiency of multiple organs inspite of chemotherapy with metronidazole, cefuroxime and gentamicin on day 35 of admission. So, we report the first case of pulmonary trichomoniasis diagnosed in wet preparation of pleural fluid in Korea.

Mediastinitis Caused by Prevotella Intermedia/Nigrescens Occurred after Acupuncture: A case report / 대한흉부외과학회지

A 54-year-old male patient was admitted due to dyspnea with chest pain and reddish swelling in the right lteral neck and right upper which developed 2 or 3 days age. He was treated with acupuncture in the neck about one week ago prior to admission. CT scans of the chest showed density of air and abnormal soft tissue which suggested abscess of the anterior mediastinum and subcutaneous tissue. He underwent cervical and mediastinal drainage with closed thoracostomy and antibiotic therapy. Black-pigmente anaerobic nonspore-forming gram-negative bacilli were isolated from the mediastinal pus and were identified as Prevotella intermedia/nigrescens upon performing biochemical tests and API rapid ID 32A (bioMeriux, France) kit. He underwent decortication of the right side because of loculated empyema on 41st postoperative day. He was fully recovered and discharged on the 82nd hospital day. This was thought to be another case of descending necrotizing mediastinitis not caused by peritonsilar abscess but by cellulitis developed after acupuncture. Early deterction of mediastinits and aggressive drainage of mediastinal abscess are important.

A Case of Rh Negative Brother and Sister, Both of Whose Parents Were Rh Positive / 대한수혈학회지

The authors have experienced a case of Rh negative brother and sister, both of whose parents were Rh positive. On the testing by five major Rh antisera (anti D, anti C, anti E, anti c, and anti e), the phenotypes of his father and mother were each DccEe and DCCee, those of the brother and sister were ddCcee. Considering the possible genotypes, their genotype was only one Cde/cde in twenty-four combinations. The possibility of that Rh negative (Cde/cde) child could successively born by those parents was 0.00017, with reference to Rh haplotype frequency in Korea. So, this case is rare and showed that Rh negative child could be born by Rh positive parents.

Pulmonary Infarction Associated with Facture of Right Clavicle and Multiple Ribs / 대한흉부외과학회지

Pulmonary infarction is rarely diagnosed with certainty except at postmortem examination. Part of this uncertainty is because of the inability to distinguish between hemorrhage, congestive a electasis, and necrosis clinically and radiographically. The pathogenesis of pulmonary infarction is poorly understood. It is dif%cult to induce pulmonary infarction in animals by ligation of the arterial supply to the lung. Many factors seem to be important in its pathogenesis, in addition to congestive heart failure, malignant tumor, thrombophlebitis, chronic obstructive lung disease, nephrotic syndrome, and postopeiative state. However, pulmonary infarction have not been reported in association with chest trauma. We report a case of pulmonary infarction associated with fractures of right clavicle and multiple ribs. A 45-year-old male had admitted due to right chest pain and dyspnea, which developed after right chest trauma occurred at about 3 weeks ago. He was treated at local clinics under the diagnosis of fractures of right clavicle and ribs until the admission. Chest CT disclosed a huge mass with central low density in right upper lobe, and small masses were also seen on both lung fields. Open lung biopsy resulted in negativity for the malignancy. Clinical symptoms and radiological findings were not improved by conservative treatment. Right upper lobectomy was done eventually. The final diagnosis was pulmonary infarction. And, the patient has been well after operation.

Choriocarcinoma in Posterior Mediastinum: A case Report / 대한흉부외과학회지

Primary mediastinal choriocarcinoma is characteristically seen in young males presenting with the symptomes of cough, chest pale, and gynccomastia. A 33-year-old woman was admitted to the hospital because of severe dyspnea and chest pain which was aggravated rapidly 2 or 3 days ago. Posterior mcdiastinal mass measuring about 1 cm in diameter was seen in Chest P-A, left lateral view of chest, and chest CT. Serum beta-HCG level was markedly elevated up to 200,000 mIxt. Whole body CT and other studies could not find any lesion on ovary and uterus. But, a single nodule nEeasuring about 1 cm in diameter was identified in the brain CT. The tumor cells (syncytiotrophoblastic cells) from resected mass revealed positivity on i histochemical staining for beta-HCG. She was treated with EMA-CO after resection of tumor, But, 7 months later, she was readmitted and showed cerebral hemorrhage due to metastatic choriocarcinoma. She was operated again for the brain tumor, and was doing well for further 7 months.

Evaluation of DNA Ploidy of Bronchogenic Carcinomas by Image Analysis

In order to extract useful tumor cell-specific information. DNA contents and other morphological parameters were measured by image analysis. Single cell preparation was made from archived paraffin blocks of 14 cases of bronchogenic squamous cell carcinoma, poorly differentiated, by protease treatment. The cells were Feulgen stained, and DNA content, area, perimeter, and major axis of the tumor cell nuclei were measured. Inflammatory lymphocytes concurrent with the tumor cells were used as an internal standard. DNA ploidies of the lymphocytes and 2C tumor cells showed simple peaks with Gaussian distribution and mean coefficients of variation of 10% and 14% respectively. By the location and proportion of the tumor cells other than 2C cells, DNA ploidies could be classified into diploidy(1 case), polyploidy(2 cases), and aneuploidy(11 cases). The mean proportion of DNA aneuploidal tumor cells relative to the total tumor cells was 82.8%. In 8 cases, nuclear areas showed more or less overlapped distribution, whereas DNA contents showed discrete peaks. THes results suggest that many bronchogenic squamous cell carcinomas, poorly differentiated, have DNA aneuploidy and high proportion of aneuploidal cells, and that nuclear size and DNA content are more or less independent parameters.

Electron Microscopy on Activity and Localization of Glucose-6-phosphatase in Liver Cells

It is interesting and in important to study histochemical changes of glucose-6-phosphatase (G-6-Pase) activity by electron microscopy in order to promote the knowledge needed for diagnosis and prognosis in such liver diseases as von Gierke's disease, hepatoma and various other hepatocellular alterations of different origins. Since we had not accomplished the electron microscopic demonstration of G-6-Pase, although light microscopic studies on changes of the enzyme activity were done in this laboratory, this investigation was planned to obtain a satisfactory technique for ultrastructural demonstration of the enzyme activity. Unfixed frozen sections (80 micro thick) of mouse liver were washed for 2~3 minutes in a 0.4M sucrose solution (pH6.8) containing 4 mM lead nitrate and then incubated for 15~20 minutes at 32~37 degrees C in several different media to which 0.4M sucrose solution was added: A) a modification of the original Chiquoine medium, B) the first modification of the Wachstein-Meisel medium C (the second modification; the 2% lead nitrate solution was reduced in amount to 1.5 m1 instead of 3.0 ml in the medium-B). After incubation, these sections were fixed in 1% osmic acid containing sucrose, followed by embedding in Epon, ultrathin-section, mounting and staining with uranyl acetate and/or lead nitrate. By incubating the sections in the medium (B or C), satisfactory preparations were obtainable for its electron microscopic demonstration. The granular deposits of reaction products were found characteristically on the membranous component of the rough-and smooth-surfaced endoplasmic reticulum and unclear envelope. Occasional deposits were observed within cisternae or vesicles, in the nucleus, and immediate1y adjacent to the cisternal membrane and glycogen areas.

Prednisolone and Glucose-6-phosphatase Activity in Liver Cells

Prednisolone, a cortisol analogue, was given intraperitoneally to rats with 5, 10 or 15 doses of 5 mg. per kg. of body weight per day. Sacrificing the animals 24 hours after the last injection, unfixed frozen sections from small pieces of liver tissue were incubated and stained by a modification from the method of Wachstein and Meisel(1965) for glucose-6-phosphatase (G-6-Pase) activity. Some of the tissue blocks were processed for staining with hematoxylin and eosin for histopathological observation. Glucose-6-phosphatase activity, being represented histochemically by brownish-black deposits, was progressively increased after administrations 5 or 10 times. With 15 doses of prednisolone the general histochemical picture of G-6-Pase activity appeared to be similar to that of the control group, except for a different distribution of hepatocytes possessing strong activity. In prednisolone treated rats, the swollen hepatocytes showed a marked, cytoplasmic vacuolization and nuclear pyknosis, particularly in the periportal and midzonal areas of hepatic lobules. Some discussion of the G-6-Pase corticosteroids are presented in terms of their metabolic effects.

Glucose-6-phosphatase Activity and Ultrastructures in Hepatocytes of Thioacetamide-treated Mice

To investigate the earlier cellular alterations(Glucose-6-Pase activity and morphologic features) caused by a hepatotoxin, thioacetamide (TAA), a single dose of the agent (200mg per kg of body weight) was given intraperitoneally to mice, which were sacrificed at intervals of 4, 8 or 16 hours after corresponding treatments. For histochemical study of glucose-6-phosphatase (G6Pase) activity, unfixed frozen sections were incubation of the Wachstein and Meisel medium and stained. The smallest pieces of liver tissue were fixed in glutaraldehyde and osmic acid, and stained by the routine electron-microscopic techniques. Some pieces of liver were fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. There was a rapid and progressive loss of G6Pase activity, in an orderly time sequence, in the experimental group. There were also morphologic changes: loss of cytoplasmic basophilia, cell infiltration and necrosis in the centrilobular and intermediate zones, and an increase of sER, small vesicles and ribosomes in the cytoplasm of hepatocytes, the marked changes of nuclei and nucleoli, and a slight increase of lipid droplets in the cytoplasm at 16 hours after intoxication. The correlation between these cellular alterations was discussed in view of mechanisms in the hepatotoxic action.

Glucose-6-phosphatase Activity and Ultrastructures in Hepatocytes of Thioacetamide-treated Mice

To investigate the earlier cellular alterations(Glucose-6-Pase activity and morphologic features) caused by a hepatotoxin, thioacetamide (TAA), a single dose of the agent (200mg per kg of body weight) was given intraperitoneally to mice, which were sacrificed at intervals of 4, 8 or 16 hours after corresponding treatments. For histochemical study of glucose-6-phosphatase (G6Pase) activity, unfixed frozen sections were incubation of the Wachstein and Meisel medium and stained. The smallest pieces of liver tissue were fixed in glutaraldehyde and osmic acid, and stained by the routine electron-microscopic techniques. Some pieces of liver were fixed in 10% formalin, embedded in paraffin, and stained with hematoxylin and eosin. There was a rapid and progressive loss of G6Pase activity, in an orderly time sequence, in the experimental group. There were also morphologic changes: loss of cytoplasmic basophilia, cell infiltration and necrosis in the centrilobular and intermediate zones, and an increase of sER, small vesicles and ribosomes in the cytoplasm of hepatocytes, the marked changes of nuclei and nucleoli, and a slight increase of lipid droplets in the cytoplasm at 16 hours after intoxication. The correlation between these cellular alterations was discussed in view of mechanisms in the hepatotoxic action.