Hypoglycemic effects of Welsh onion in an animal model of diabetes mellitus

Tight control of blood glucose is the most important strategy for the treatment of diabetes mellitus. Here, we investigated the beneficial effects of Welsh onion on fasting and postprandial hyperglycemia. Inhibitory activities of hot water extracts from the green stalk and white bulb, which are the edible portions of the Welsh onion, and the fibrous root extract against yeast alpha-glucosidase were measured in vitro. To study the effects of Welsh onion on postprandial hyperglycemia, a starch solution (1 g/kg) with and without Welsh onion fibrous root extract (500 mg/kg) or acarbose (50 mg/kg) was administered to streptozotocin-induced diabetic rats after an overnight fast. Postprandial plasma glucose levels were measured and incremental areas under the response curve were calculated. To study the hypoglycemic effects of chronic feeding of Welsh onion, five-week-old db/db mice were fed an AIN-93G diet or a diet containing either Welsh onion fibrous root extract at 0.5% or acarbose at 0.05% for 7 weeks after 1 week of adaptation. Fasting plasma glucose and blood glycated hemoglobin were measured. Compared to the extract from the edible portions of Welsh onion, the fibrous root extract showed stronger inhibition against yeast alpha-glucosidase, with an IC50 of 239 microg/mL. Oral administration of Welsh onion fibrous root extract (500 mg/kg) and acarbose (50 mg/kg) significantly decreased incremental plasma glucose levels 30-120 min after oral ingestion of starch as well as the area under the postprandial glucose response curve, compared to the control group (P < 0.01). The plasma glucose and blood glycated hemoglobin levels of the Welsh onion group were significantly lower than those of the control group (P < 0.01), and were not significantly different from those fed acarbose. Thus, we conclude that the fibrous root of Welsh onion is effective in controlling hyperglycemia in animal models of diabetes mellitus.

When should Videourodynamic Study be Performed after Correcting the Defect in Patients with Myelodysplasia? / 대한비뇨기과학회지

PURPOSE: Because vesicourethral dysfunction in myelodysplasia patients is a major cause of upper urinary deterioration and urinary incontinence, urodynamic evaluation should be performed as early as possible. We attempted to establish the proper time when videourodynamic study should be performed and which patients require early interventional therapy. MATERIALS AND METHODS: Out of the 222 patients seen in the pediatric urology department, 22 patients underwent correction of myeloplasia defect from January 2001 to September 2004. Preoperatively, the patients were assessed with videourodynamic study, and the postoperative videourodynamic studies were repeated at 2 to 6 months intervals. Four urodynamic parameters (bladder volume, compliance, detrusor activity and detrusor sphincteric synergy) were identified, graded and then added to obtain the urodynamic score. RESULTS: There was no statically significant difference in all urodynamic parameters between the preoperative and postoperative 2 month videourodynamic studies, but a statistically significant difference was noted in compliance between the preoperative and postoperative 6 month videourodynamic studies. The compliance was more decreased in the patients who had received surgical correction in their older age and high detrusor activity was observed for these patients on the preoperative videourodynamic study. CONCLUSIONS: Postoperative videourodynamic study and early treatment are recommended for the patients who are at high risk for upper urinary tract deterioration. However, for the low risk patients, postoperative 2 month videourodynamic study can prevent unnecessary treatment.

Intravesical Electrical Stimulation in Infrequent Voider Syndrome / 대한비뇨기과학회지

PURPOSE: Intravesical electrical stimulation (IVES) has been performed at the Severance Hospital for various purposes in children with voiding difficulty due to neurogenic or non-neurogenic causes. The effect of IVES in children with infrequent voider syndrome is controversial. The aim of this study was to investigate the effect of IVES in children with infrequent voider syndrome. MATERIALS AND METHODS: Between September 1999 and August 2001, 12 children diagnosed with infrequent voider syndrome, who received IVES at the Severance Hospital, were retrospectively analyzed. We investigated the changes in abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence after IVES. We also compared the uroflowmetry curve, maximal urine flow rate, maximal detrusor contraction pressure and residual urine volume after IVES. RESULTS: Abdominal straining voiding, a voiding interval more than 8 hours, urgency and overflow incontinence were decreased from 83.3 to 25.0%, 50.0 to 16.7%, 25.0 to 0% and 58.3 to 25.0%, respectively. After IVES, fractionated voiding and flat-shape voiding were decreased from 66.7 to 16.7% and 33.3 to 8.3%, respectively. Whereas, bell-shape voiding was increased from 0 to 75.0%. The maximal urine flow rate was increased significantly, from 5.6 3.7 to 11.2 4.2m/s (p=0.002), but the residual urine volume was decreased significantly, from 71.7 47.5 to 9.2 13.8ml (p=0.0001). The maximal detrusor contraction pressure was increased in some children. CONCLUSIONS: The maximal urine flow rate was significantly increased after IVES in children with infrequent voider syndrome, but the residual urine volume was decreased significantly. There was a significant treatment effect in flat-voiding children, leading to the conclusion that IVES can be particularly effective in this specific group of children with infrequent voider syndrome.

Three Cases with Cutaneous Polyarteritis Nodosa / 대한류마티스학회지

Systemic polyarteritis nodosa is a necrotizing vasculitis that involves small and medium-sized muscular arteries in the multiple organ systems, whereas cutaneous polyarteritis nodosa (CPAN) is a localized disease characterized by necrotizing vasculitis of small and medium-sized arteries in the skin without life-threatening organ involvement. CPAN is usually limited to skin, muscle, and joints. It is chronic but takes a benign course. The most common cutaneous manifestations include nodules, ulcers and a livedo reticularis pattern on the extremities. We describe three cases with CPAN showing necrotizing vasculitis on the skin without systemic symptoms or visceral involvement. In Korea, most previously published cases with CPAN have shown a good response to a short term of corticosteroids or colchicine administration. However, two of our three patients required another immunosuppressive agent in addition to corticosteroids to manage their intractable skin lesions, and the remaining one showed a good response to a short course of prednisolone. In addition, there was one patient with CPAN having hepatitis B surface antigen, which might be associated with his refractory skin disease.

Adjunctive facial contouring surgery in combination with orthognathic surgery

Autoimmune Pancreatitis with Effective Steroid Therapy

Autoimmune pancreatitis has recently been described as a clinical entity that causes chronic pancreatitis. This unique form of chronic pancreatitis is characterized by minimal attacks of abdominal pain, irregular narrowing of the pancreatic duct, and a diffuse enlargement of the pancreas. Autoimmune pancreatitis is associated with hypergammaglobulinemia. In addition, there is histological evidence of lymphoplasmacytic inflammation, the occasional coexistence of other autoimmune diseases, and has a favorable response to glucocorticoid treatment. Recently autoimmune pancreatitis has been increasingly reported particularly in Japan. We report two patients with autoimmune pancreatitis who were treated successfully with corticosteroid therapy.