Efficacy and local irritation evaluation of Eriobotrya japonica leaf ethanol extract / 한국실험동물학회지

BACKGROUND: Although Eriobotrya japonica leaves have been studied as a raw material for various cosmetic products, little is known about the anti-oxidant, anti-inflammatory, and anti-melanogenic activities of Eriobotrya japonica leaf ethanol extract (EJEE). METHODS: This study was conducted to evaluate the anti-oxidant, anti-inflammatory, and anti-melanogenic activities of EJEE using different in vitro models. In addition, we investigated the potential irritation of EJEE to skin and eye using animal alternative tests. RESULTS: The total content of polyphenols, one of the active constituents of EJEE, was analyzed by high-performance liquid chromatography and found to contain 88.68 mg tannic acid equivalent/g. EJEE showed a concentration-dependent 1,1-diphenyl-2-picrylhydrazyl radical scavenging activity, 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) radical scavenging activity, and a superoxide dismutase-like activity. The anti-inflammatory effect of 0.5% (w/v) EJEE was demonstrated by a reduction in lipopolysaccharide-induced nitric oxide and tumor necrosis factor-alpha levels in RAW 264.7 cells. EJEE also significantly inhibited melanogenesis in melanocyte stimulating hormone-induced B16F1 cells. EJEE did not show any irritation in skin and eye in animal alternative test. CONCLUSIONS: These results indicate that the EJEE possesses anti-oxidant, anti-inflammatory, and anti-melanogenic activities, while it did not induce toxicity or irritation in neither skin nor eye. Therefore, EJEE can be used as a cosmetic ingredient for skin improvement.

Chlorfenapyr Intoxication Manifested by Extensive Leukoencephalomyelopathy

No abstract available.

Hypersexuality Induced by Rasagiline Monotherapy in a Patinet with Parkinson's Disease

Impulse control disorders including hypersexuality occur occasionally in Parkinson's disease, especially when treated with dopamine agonist. A 62-year-old male with Parkinson's disease was initially treated with rasagiline monotherapy and presented hypersexuality. After 8 weeks of discontinuation of the drug, his hypersexual behavior was significantly improved. To our knowledge, this is the first reported Asian case of a hypersexuality caused by rasagiline. Our observation emphasizes that patients and caregivers need to be educated on the possibility of hypersexuality resulting from rasagiline.

Quantitative Gait Analysis in Patients with Huntington's Disease

OBJECTIVE: Gait disturbance is the main factor contributing to a negative impact on quality of life in patients with Huntington’s disease (HD). Understanding gait features in patients with HD is essential for planning a successful gait strategy. The aim of this study was to investigate temporospatial gait parameters in patients with HD compared with healthy controls. METHODS: We investigated 7 patients with HD. Diagnosis was confirmed by genetic analysis, and patients were evaluated with the Unified Huntington’s Disease Rating Scale (UHDRS). Gait features were assessed with a gait analyzer. We compared the results of patients with HD to those of 7 age- and sex-matched normal controls. RESULTS: Step length and stride length were decreased and base of support was increased in the HD group compared to the control group. In addition, coefficients of variability for step and stride length were increased in the HD group. The HD group showed slower walking velocity, an increased stance/swing phase in the gait cycle and a decreased proportion of single support time compared to the control group. Cadence did not differ significantly between groups. Among the UHDRS subscores, total motor score and total behavior score were positively correlated with step length, and total behavior score was positively correlated with walking velocity in patients with HD. CONCLUSION: Increased variability in step and stride length, slower walking velocity, increased stance phase, and decreased swing phase and single support time with preserved cadence suggest that HD gait patterns are slow, ataxic and ineffective. This study suggests that quantitative gait analysis is needed to assess gait problems in HD.

Gallstone Ileus in 83-Year-Old Woman

Gallstone ileus is a rare complication of the biliary stone, occurring in 0.3-0.5% of patients with cholelithiasis. The mortality rate is high at 12-27% and early diagnosis and prompt management can improve its prognosis. An 83-year-old woman was admitted to the hospital with abdominal pain. The patient previously had a hysterectomy and had received radiation therapy for uterine cancer. Plain abdominal x-ray showed typical findings of small bowel ileus with step ladder patterns. Computed tomography (CT) scan revealed biliary-enteric fistula with a 3-cm-sized gallstone in the jejunal loop. Surgical treatment was planned but due to the patient's wish, conservative treatment was provided for 10 days. In the follow-up CT scan, the stone had moved to the distal ileum but intestinal perforation was suspected. Ileocecectomy and adhesiolysis were performed and the patient recovered fully. Here we report a case of gallstone ileus that was treated by surgical removal after 10 days of conservative treatment.

No Association between PAWR Gene Polymorphisms and Tardive Dyskinesia in Schizophrenia Patients

Tardive dyskinesia (TD) is a hyperkinetic movement disorder associated with the prolonged use of antipsychotic drugs. Since prostate apoptosis response 4 (Par-4) is a key ligand of the dopamine D2 receptor, the Par-4 gene (PAWR) is a good candidate gene to study in the context of TD susceptibility. We examined the association between PAWR gene polymorphisms and TD. Three single nucleotide polymorphisms of PAWR were selected for the analysis: rs7979987, rs4842318, and rs17005769. Two hundred and eighty unrelated Korean schizophrenic patients participated in this study (105 TD and 175 non-TD patients). Genotype/allele-wise and haplotype-wise analyses were performed. There were no significant differences in genotype and allele frequencies between the two groups. Haplotype analysis also did not reveal a difference between the two groups. Within the limitations imposed by the size of the clinical sample, these findings suggest that PAWR gene variants do not significantly contribute to an increased risk of TD.

Inpatient Course and Length of Hospital Stay in Patients with Brain Disorders in South Korea: A Population-based Registry Study

OBJECTIVE: To describe inpatient course and length of hospital stay (LOS) for people who sustain brain disorders nationwide. METHOD: We interviewed 1,903 randomly selected community-dwelling patients registered as 'disabled by brain disorders' in 28 regions of South Korea. RESULTS: Seventy-seven percent were initially admitted to a Western medicine hospital, and 18% were admitted to a traditional Oriental medicine hospital. Forty-three percent were admitted to two or more hospitals. Mean LOS was 192 days. Most patients stayed in one hospital for more than 4 weeks. The transfer rate to other hospitals was 30-40%. Repeated admissions and increased LOS were related to younger onset age, higher education, non-family caregiver employment, smaller families, and more severe disability. CONCLUSION: Korean patients with brain disorders showed significantly prolonged LOS and repeated admissions. Factors increasing burden of care influenced LOS significantly.

Surgical Removal of Endovascular Stent after Migration to the Right Ventricle Following Right Subclavian Vein Deployment for Treatment of Central Venous Stenosis

Central venous stenosis or occlusion occurs in 11-50% of hemodialysis patients with prior subclavian vein cannulation and ipsilateral fistula or shunt. Most patients are asymptomatic but some require treatment to reduce the risk of thrombosis and improve inadequate hemodialysis pressure. In these cases, endovascular intervention, including ballooning and stenting, is a feasible strategy for selected patents. We report an unusual case of a 40-year-old man on hemodialysis that underwent endovascular stenting to treat right subclavian vein stenosis and experienced stent migration to the right ventricle, requiring surgical removal.

The Change in Family Structure and Income for Community-dwelling Patients with Brain Disorders

OBJECTIVE: To find out the changes of the family structure and familial total income of Korean patients with the brain disorders and associated factors. METHOD: A total of 1,903 patients with brain disorders in Korea were enrolled and drew up the questionnaires about their socioeconomic state and family supports, including pre- and post-disorder family structure, compositions of their family income, and employment of caregivers. RESULTS: A 38.2% of subjects experienced the change in numbers of cohabiting family, decrement in 30.3% and increment in 7.9%. Prior to brain disorders, 48.6% of patients earned their living by themselves, but only 2.8% did after brain disorders. Separation and divorce increased, especially three times more in male patients than in females. A 16.6% of patients employed caregivers, and used them 6.2 days per week, 18 hours a day on average. CONCLUSION: This study reemphasized the worsening socioeconomic state of patients with brain disorders and their families. Increasing tendency of social isolation was also noted.

Utilization and Satisfaction of Rehabilitation Service in Patients with Brain Disorders in Korea

OBJECTIVE: To investigate the utilization of medical rehabilitation services and the degree of satisfaction about rehabilitation services in patients with brain disorders. METHOD: A total of 1903 patients agreed to participate in this study and were interviewed from September 2005 to May 2006. The subjects completed the questionnaires about the utilization of medical rehabilitation services and the degree of satisfaction with those treatments. Pearson's chi-square test, Student t-test and frequency analysis were used for statistical analysis. RESULTS: A 78.0 percent of patients received inpatient rehabilitation treatment. A 66.9 percent of all patients were served of only physical therapy and 31.6 percent received both physical and occupational therapy. The main reason why patients could not have a chance to experience rehabilitation treatment was associated with environmental problems, such as the ignorance of the need about rehabilitation treatment, or the insufficient communication between doctors and patients. Most patients (54.6%) were satisfied with the rehabilitation treatment. However, as the number of admission was increased, patients tended to be less satisfied with the rehabilitation treatment. CONCLUSION: The inpatient rehabilitation treatment was limitedly served to patients with brain disorders mostly when the patients required rehabilitation services. It is necessary to provide more effective and various rehabilitation services to patients under the comprehensive guideline of the process of rehabilitation services.

Delayed Pleural Effusion after Right Subclavian Vein Catheterization: A Case Report / 대한구급학회지

Central venous catheterization is commonly used for supplying large amounts of fluids, total parenteral nutrition and for monitoring central venous pressure. Numerous complications exist with the technique, including pneumothorax, arterial puncture with vessel injury, catheter embolus, mediastinal hematoma, hydrothorax, and the thrombus of the vein. We reported an uncommon case of pleural effusion, due to catheter tip migration and penetration, which occurred 4 days after central venous catheterization.

The Cost of Brain Disorder: Individual and Social Cost

OBJECTIVE: To estimate the cost of brain disorders from individual and social aspects. METHOD: This study employed two complementary methodologies for the estimation: individual survey and collective statistics. The survey recruited 1903 disabled persons, staying at home, registered at public health center as brain disorders. They were asked about epidemiologic, clinical variables, medical cost, employment status and pre-/post-morbid incomes. Collective statistics included mortality data from the national statistical office, report on wage structure report from the ministry of labor and national health insurance statistical yearbook from the national health insurance corporation. Individual cost of brain disorders was estimated by summing direct medical cost and indirect cost from productivity loss (job loss or decreased income). Social cost also comprised direct medical cost and indirect cost; indirect cost corresponded to productivity loss due to healthcare utilization, job loss, decreased income and premature death. RESULTS: Individual cost of brain disorders was 164,041,000 Korean Won (KRW) per patient. 93.3% of the subjects of the survey who were pre-morbidly employed lost their job and the income of those who maintained employment decreased to 51.5% of original income on average. Social cost of brain disorder in 2005 was 9,901,057,327,000 KRW. Major part of social cost was due to job loss. CONCLUSION: Brain disorder imposes substantial amount of economic cost, individually and socially. Especially job loss from disability after brain disorder takes up the largest portion. The results of the study are expected to serve as a foundation for future research and healthcare policy.

Stroke Rehabilitation Report using the Brain Rehabilitation Registration Online Database System in the Years 2006 to 2008

OBJECTIVE: We report here on analyzing 3,128 subjects with stroke and who were discharged from the Departments of Rehabilitation Medicine of secondary or tertiary hospitals, and all the hospitals subscribed to the Online Database System developed by the Korean Society of Neurorehabilitation. METHOD: This is a retrospective analysis of the brain rehabilitation registry database for outcome of stroke outcome in the year 2006 to 2008. RESULTS: The male stroke subjects and cerebral infarction were 58.4% and 66.3%, respectively. Cerebral infarction in the middle cerebral artery territory was the most common, and the basal ganglia and cerebral cortex were the common areas for the cases of intracranial hemorrhage. The mean age of the patients was 61.7 years, and the most common ages were 45~64 years for all the stroke subjects. The subjects with cerebral hemorrhage (56.1 years) were younger than those with cerebral infarction (63.9 years). Seasonal variation was observed in the occurrence of stroke; spring (34.1%), winter (27.4%), summer (21.6%) and autumn (16.8%) in this order. There was no significant difference of the changes on the Korean version of the modified Barthel index between the patients with cerebral infarction and cerebral hemorrhage after rehabilitation. On analyzing the two groups of stroke subjects admitted before and after 100 days from stroke onset, the changes on the Korean version of the modified Barthel index and the Brunnstrom stage scores of the early admission group were higher that those of the late rehabilitation group. CONCLUSION: The above findings suggest that 1) the incidence, lesion sites and seasonality of stroke in this database system are similar to those of the worldwide data, 2) the length of hospital stay for the subjects with stroke is about 46 days and 3) early rehabilitation is more effective in improving the outcome of stroke subjects.

Pharyngoesophageal Diverticulum in a Dermatomyositis Patient with Dysphagia : A case report

There have been few reports on a pharyngoesophageal diverticulum in dermatomyositis patients. This report concerns a young woman suffered from dermatomyositis, and resulting in dysphagia. Although dysphagia is a common manifestation of inflammatory myopathy, it was associated with a pharyngoesophageal (Zenker's) diverticulum in this case. The videoflouroscopic study showed a diverticulum of the pharyngoesophageal junction. Esophagography confirmed a complicated Zenker's diverticulum that was a tubular mucosal pouch with poor distensibility and mucosal irregularity on left posterolateral aspect of the pharyngoesophageal junction. After 4 months, dysphagia improved and pharyngoesophageal diverticulum disappeared on esophagography and neck computed tomography. To our knowledge, there has been no report of a pharyngoesophageal diverticulum in a dermatomyositis patient with dysphagia in Korea. We report clinical and laboratory findings of our case and review association with a pharyngoesophageal diverticulum and dermatomyositis.

A Case of Accelerated Idioventricular Rhythm Lasted for 5 Days after Reperfusion in a Patient with Spasm-induce Myocardial Infaction: A Case Report / 대한구급학회지

A 56-year-old man presented with right coronary arterial spasm accompanied by ST segment elevation in the inferior leads. A reperfusion arrhythmia, accelerated idioventricular rhythm (AIVR), developed 1 hour after a nitroglycerin infusion. The AIVR was sustained for 5 days without hemodynamic instability, and resolved spontaneously during hemodynamic monitoring in the coronary intensive care unit.

Gastric Mucosal Injury after Ingestion of a Hot Liquid Diet via Gastric Feeding Tube / 대한소화기내시경학회지

When a patient complains of gastrointestinal symptoms such as nausea, vomiting, and upper abdominal pain after ingestion of a substance such as a corrosive agent and certain drugs which can cause mucosal injury to the esophagus and stomach, we always keep in mind gastrointestinal injury and should perform an endoscopic procedure promptly and use the appropriate treatment. It is well known that common corrosive agents which can cause gastrointestinal injury are acidic and alkaline chemicals, and the common causative drug for gastrointestinal injury is NSAID. However, it is not well known that consuming hot food and drinks can cause gastrointestinal injury also. Up to now, there have only been a few case reports of esophageal mucosal injury due to the consumption of hot food and drinks. Gastric mucosal injury after ingesting hot food and drinks is rare and has not been reported often. So here, we report a case of gastric mucosal injury after ingesting a hot liquid diet via gastric feeding tube.

Clinical Practice Guideline for Stroke Rehabilitation in Korea

The clinical practice guideline for the stroke rehabilitation was formulated through both extensive review of published literature and consensus meeting of the specialists. The purposes of this study were to provide optimum practical guideline for acute and subacute stroke rehabilitation and to enhance the quality of stroke rehabilitation team in Korea. This guideline contains evidences and recommendations on the organization of post-stroke rehabilitation team, timing, evaluation, and intensity of rehabilitation, detailed management of dysphagia, neurogenic bladder and bowel, movement, shoulder problem, cognition, neglect, language, mood and complications commonly encountered in the acute and subacute period of stroke rehabilitation. Clinicians who are working in the field of stroke rehabilitation can adopt this guideline for their practice and give the feedback for further revision.

A Case of Intracardiac Metastasis of Hepatocellular Carcinoma Presenting with Functional Tricuspid Valve Stenosis Accompanied with Hepatopulmonary Syndrome

Intracardiac metastasis of hepatocellular carcinoma with functional tricuspid valve stenosis is not common. Furthermore, hepatopulmonary syndrome associated with hepatocellular carcinoma is rarely encountered. We present a case of intracardiac metastasis of hepatocellular carcinoma presenting with functional tricuspid valve stenosis accompanied with hepatopulmonary syndrome.

New Scoring System for Jebsen Hand Function Test

OBJECTIVE: To develop a new scoring system for Jebsen Hand Function Test (JHFT) and test validity of the new score scale in stroke patients. METHOD: JHFT and the modified Barthel index upper extremity subtest (MBI-U) were performed on a total of 210 stroke patients at a tertiary university hospital. Based on JHFT raw data, scores were calculated from the existing scoring system and the new one. Validity of scores from each system was evaluated by comparing each score with the MBI-U score. Floor effects of both scoring system were compared. RESULTS: In all the seven subtest items of JHFT, the floor effect of the new scoring system was far lower than that of the existing one. Pearson correlation coefficient between the score from the new scoring system and the MBI-U score was 0.4880 (p<0.0001, n=210). CONCLUSION: 'New score scale' -a scoring system for JHFT based upon new criteria- was presented. New score scale for JHFT has reduced floor effect and is valid in stroke patients.

Characteristics of Old Aged Stroke: Rehabilitation Perspectives

Background: To compare the risk factors, stroke features, and functional outcomes of old aged stroke patients (> or =75yr) admitted for rehabilitation with those of younger age group of patients ( or =75 years old) admitted to a rehabilitation facility were analyzed. Measures include stroke features, risk factors, comorbidities, length of rehabilitation stay and Mini-mental status examination (MMSE), Modified Barthel Index (MBI), Modified Rankin Scale (MRS), and Functional Ambulation Category Scale (FAS). The functional outcomes were measured at admission and at discharge. Results: On admission, elderly patients showed lower body mass index (21.9 vs. 23.9), higher rates of cerebral infarction (71% vs. 54%), and lower MBI (31 vs. 46) than younger patients (p0.05). However, on discharge, MMSE (16 vs. 21), MBI (42 vs. 59), the ratio of 0, 1 by MRS (no significant disability; 18% vs 46%), and the ratio of 4, 5 by FAS (can walk independently on level ground; 29% vs 52%) were lower in elderly patients as compared to younger patients (p<0.05). The percentage of home discharge tended to be lower in elderly patients as compared with younger patients (55% vs 74%, p=0.051). Conclusion: The elderly stroke patients had poorer rehabilitation outcome as compared to younger age stroke patients within same rehabilitation stay. Therefore, setting the rehabilitation goal lower or allowing longer rehabilitation stay should be considered for old aged stroke patients.