Blood-brain barrier dysfunction in ischemic stroke and diabetes: the underlying link, mechanisms and future possible therapeutic targets / 대한해부학회지

Ischemic stroke caused by occlusion of cerebral artery is responsible for the majority of stroke that increases the morbidity and mortality worldwide. Diabetes mellitus (DM) is a crucial risk factor for ischemic stroke. Prolonged DM causes various microvascular and macrovascular changes, and blood-brain barrier (BBB) permeability that facilitates inflammatory response following stroke. In the acute phase following stroke, BBB disruption has been considered the initial step that induces neurological deficit and functional disabilities. Stroke outcomes are significantly worse among DM. In this article, we review stroke with diabetes-induce BBB damage, as well as underlying mechanism and possible therapeutic targets for stroke with diabetes.

Blood-brain barrier dysfunction in ischemic stroke and diabetes: the underlying link, mechanisms and future possible therapeutic targets / 대한해부학회지

Ischemic stroke caused by occlusion of cerebral artery is responsible for the majority of stroke that increases the morbidity and mortality worldwide. Diabetes mellitus (DM) is a crucial risk factor for ischemic stroke. Prolonged DM causes various microvascular and macrovascular changes, and blood-brain barrier (BBB) permeability that facilitates inflammatory response following stroke. In the acute phase following stroke, BBB disruption has been considered the initial step that induces neurological deficit and functional disabilities. Stroke outcomes are significantly worse among DM. In this article, we review stroke with diabetes-induce BBB damage, as well as underlying mechanism and possible therapeutic targets for stroke with diabetes.

Morphology of the human aorta and age-related changes: anatomical facts / 대한해부학회지

Aorta is the largest artery in the human body. Its starting point is the aortic orifice of the aortic valve and it terminates at the level of the fourth lumbar vertebra. The main function of the aorta is to transport oxygenated blood to supply all the organs and cells. With advancing age, the structure and hence the function show progressive changes. Various changes in the aortic morphology include the luminal diameter of aorta, whole length of the aorta, thickness, the microstructural components also change, and these include collagen, elastin and smooth muscle cells. In addition, the dimensions of all segments of the aorta increase with age in both sexes. Since age is a major risk factor for degenerative change and diseases affecting the aorta, understanding the detailed anatomy of the aorta may provide essential information concerning the age-associated process of the aorta. Knowledge of the morphological changes in the aorta is also important for future clinical therapies pertaining to aortic disease. Additionally, the information regarding the structural changes with age may be applied for age determination. This review describes the overview of the anatomy of the aorta, age related changes in the morphology of the aorta and aortic diseases.

Erratum: Study of sexual dimorphism of Malaysian crania: an important step in identification of the skeletal remains / 대한해부학회지

In the article, two co-authors were missing in the author list.

Concomitant Anomalous Branching of Facial Nerve and Double Parotid Duct: A Case Report

The facial nerve divides within the parotid gland into upper temporozygomatic and lower cervicofacial branches. The two branches further subdivide and emerge from the parotid gland as five main branches. We observed a rare anomalous branching pattern of the facial nerve along with double parotid duct on the right side of a 50-year-old male cadaver. The two parotid ducts emerged at the level of the anterior border of parotid gland then united to form one single duct thereby opened into the oral cavity. The first duct (D1) emerged from the upper one third of the anterior border of the parotid gland and traversed horizontally for 9 mm to join the second duct. Knowledge of anomalous branching pattern of facial nerve and double parotid ducts may be beneficial for maxillofacial surgeons.

A new method for sex estimation from maxillary suture length in a Thai population / 대한해부학회지

Sex estimation is one of the crucial procedures in the biological profile identification of human skeletal remains. Knowing sex of unknown case can lead to accurate and appropriate methods for predicting age, stature, ancestry, or even personal identification. Skull is one of the most reliable one among other skeletons and it is usually retained for both archaeological and forensic contexts. Although many morphological features and metric measurements of skull have been studied for sexing, but to the best of our knowledge is no study on maxillary suture length for sex estimation. Therefore, this study aims to develop a new sex estimation method for a Thai population by determining three maxillary suture lengths: anterior, transverse, and posterior maxillary suture, by computerizing amount of pixel obtained from photographs of these sutures. The present study was conducted on 190 Thai bone samples of which 96 were males and 94 were females. Independent t test revealed statistically significant difference (P < 0.01) between males and females in all maxillary suture measurements. Equations derived from prediction model, which required three maxillary suture lengths gave 76.8421% accuracy from the leave-one-out cross validation in estimating sex percentage accuracies in predicting sex from these equations, which were relatively moderate. This study provides a novel and objective sex estimation method for Thais. It suggests that maxillary suture length can be applied for sex estimation. The new computerized technique will contribute basis knowledge and method for sex estimation, especially when only base of skull is available in forensic circumstance.

Study of sexual dimorphism of Malaysian crania: an important step in identification of the skeletal remains / 대한해부학회지

Sex determination is one of the main steps in the identification of human skeletal remains. It constitutes an initial step in personal identification from the skeletal remains. The aim of the present study was to provide the population-specific sex discriminating osteometric standards to aid human identification. The present study was conducted on 87 (174 sides) slices of crania using postmortem computed tomography in 45 males and 42 females, aged between 18 and 75 years. About 22 parameters of crania were measured using Osirix software 3-D Volume Rendering. Results showed that all parameters were significantly higher in males than in females except for orbital height of the left eye by independent t test (P<0.01). By discriminant analysis, the classification accuracy was 85.1%, and by regression, the classification accuracy ranged from 78.2% to 86.2%. In conclusion, cranium can be used to distinguish between males and females in the Malaysian population. The results of the present study can be used as a forensic tool for identification of unknown crania.

Anatomical variants of the superficial temporal artery in patients with microtia: a pilot descriptive study / 대한해부학회지

Superficial temporal artery (STA) based pedicled fascial flap plays a pivotal role in ear reconstruction for microtia patients. There is paucity of literature on the anatomy of the STA in microtia patients. The present study aimed to describe any possible anatomical variations seen in the STA of patients afflicted with microtia. Pre-operative carotid computer tomographic angiography images of patients under the microtia database of Plastic and Reconstructive Surgery Unit at a tertiary medical centre were selected and 3-dimensionally reconstructed. Measurements were made on the 3D reconstructed computed tomographic angiography images of the STA on both the sides of the microtic ear and the non-microtic ear to assess its various anatomical parameters. We managed to obtain a total of 39 computed tomographic angiography images of STAs for analysis. There was a significant difference in the number of main branches of STA between the two groups (P=0.006). The proportion of ears with 2 main branches was higher in the non-microtia group (89.5%) compared to the microtia group (45.0%). A significant difference was found in the STA diameter between the two groups (P=0.012). The mean diameter of STA in the non-microtia group was larger by 0.4 mm. Furthermore, the median angle of STA was larger on the side of the non-microtic ears compared to that of microtic ears by 24.5°, with a P-value of 0.011. The results of the study may be of clinical importance while planning and performing ear reconstructive surgeries using STA based pedicled fascial flaps.

Letter to the Editor: Patients' Knowledge and Decisional Conflict Regarding Tamoxifen Use: Scientific Views

No abstract available.

Diabetes Mellitus and Diet: Few Important Facts to Ponder / Jurnal Sains Kesihatan Malaysia

Diabetes mellitus (DM) is a metabolic disease which is characterized by hyperglycemia. There is either disturbance in insulin secretion or defective insulin action or even a combination of both. Usually, there are few confounding factors like genetic, obesity, sedentary life style, atherosclerosis, and even faulty dietary habits which lead or aggravate DM. Usually, the individual does not care and often the complications resulting from hyperglycaemia are fatal. Complications in DM involve the cardiovascular, musculoskeletal, endocrine, renal and neurological systems in the body. Treatment of diabetic complications is not only costly but it is also a burden on the affected families. The present review discusses the challenges faced in DM with special concern on diet and food habits. Knowledge of proper food consumption may also help an individual combat complication in DM and reduce the mortality and morbidity.

Letter to the editor: Knowledge and Attitude of Nursing Personnel towards Depression in General Hospitals: The Korean Perspective

No abstract available.

Immature reticulocyte fraction is an early predictor of bone marrow recovery post chemotherapy in patients with acute leukemia

To establish the benefits of immature reticulocyte fraction [IRF] measurement using an automated hematology cells analyzer over absolute neutrophil count [ANC] in predicting bone marrow recovery post induction chemotherapy. A prospective observational study was carried out in the Departments of Pathology, Medicine, and Pediatrics, Universiti Kebangsaan Malaysia, Medical Center [UKMMC], Kuala Lumpur, Malaysia during a period of 19 months from April 2009 to December 2010 to assess the bone marrow recovery in patients with acute leukemia. A total of 22 patients in remission induction phases were enrolled in this study. The blood specimens were collected from day zero after chemotherapy, and every 3 days until patients recovered hematologically. All blood samples were measured for ANC and IRF using an automated hematology analyzer [Beckman-Coulter LH750]. The percentage of patients showing IRF recovery earlier than ANC recovery was 63.6% [14 out of 22 patients]. There was a significant difference in the mean number of days for IRF recovery as compared with ANC recovery [14.05 and 17.18 days], p=0.005. This study proved that IRF was more useful in predicting bone marrow recovery in a patient with acute leukemia post induction chemotherapy compared with ANC. The IRF is not affected by infection, is easily measured, and inexpensive; thus, it is a reliable parameter to evaluate bone marrow reconstitution

Letter to the Editor: Vienna Nomogram-Based Prostate Biopsy: Can It Be a Much Better Diagnostic Tool Than Other Conventional Prostate Biopsies?

No abstract available.

High C reactive protein associated with increased pulse wave velocity among urban men with metabolic syndrome in Malaysia

To determine the association between carotid femoral pulse wave velocity [PWV[CF]]; augmentation index [AI]; and high-sensitivity C reactive protein [hs-CRP] with metabolic syndrome [MetS], and to determine the influence of ethnicity on PWV[CF] and AI, and the association between high hs-CRP and increased PWV, and AI in MetS. A cross-sectional study was conducted at Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia from September 2009 to September 2011. Three hundred and eighty men [Chinese and Malays] were recruited from the study. The PWV[CF] and AI were measured by Vicorder [SMT Medical, Wuerzburg, Germany]. The hs-CRP level was also determined. We defined MetS using the International Diabetes Federation [IDF] and harmonized criteria. Malays had higher AI compared to the Malaysian Chinese. Patients with MetS had higher PWV[CF] [IDF criteria: 8.5 [8.3-8.7] versus 8.2 [8.0-8.4] m/s, p=0.03; harmonized criteria: 8.5 [8.4-8.7] versus 8.2 [8.0-8.4] m/s, p=0.007] and hs-CRP [IDF criteria: 0.9 +/- 2.0 versus 0.4 +/- 1.1 mg/L, p=0.0007; harmonized criteria: 0.8 +/- 1.9 versus 0.4 +/- 1.1 mg/L, p=0.002] compared to non-MetS. In subjects with MetS, those with high hs-CRP [>3mg/L] had higher PWV[CF]. Augmentation index values were significantly higher in Malays compared with Malaysian Chinese. Metabolic syndrome was associated with increased PWV[CF] and hs-CRP. Patients with MetS and high hs-CRP were associated with higher PWV[CF]. The measurement of hs-CRP reflects the degree of subclinical vascular damage in MetS

Acute myocardial infarction in an adolescent

Myocardial infarction [MI] is known to be common in adults. Interestingly, we report a case of a 15-year-old boy who presented with typical chest pain secondary to myocardial infarct attributable to a combination of familial hyperlipidemia and possible episode of Kawasaki disease in the past. The patient failed treatment and follow-up care, and died 2 years later. Although rare, this case demonstrates that MI should be considered as a diagnosis in adolescents presenting with typical chest pain as early detection, and management is vital for survival

rare case of intussusception associated with metastasize small cell carcinoma of lung

Intussusception is common cause of bowel obstruction in the paediatric age group compared to the elderly population. Many times, The diagnosis may be difficult because of asymptomatic nature of this bowel disorder. We hereby describe the case of a 75-year-old male who presented with lethargy, weakness, loss of movement in the joints and was found to be anemic. The haemoglobin level was low so he was transfused with packed cells. On gastrointestinal [GI] endoscopy, upper GI bleed was observed. A mass was observed beyond ampulla at the 2[nd] and 3[rd] part of the duodenal junction. Computerized tomography [CT] scan also showed a mass at the head of pancreas and the lesion at the left lung. In view of persistent bleed, 'Whipple's procedure' was performed. Histopathological examination showed small cell carcinoma of the lungs with metastasis to the pancreas and the jejunum. We here discuss the case of intussusception with intestinal metastasis which presented with gastrointestinal bleeding

Nodular melanoma mimicking keratoacanthoma: lessons to learn

A 67-year-old man of Chinese descent presented with a painless nodular lesion that had been present on his right forearm for the previous 3 months. A single, well-defined, dome-shaped, firm nodule with a central keratin plug surrounded by erythema was noted. Keratoacanthoma with secondary bacterial infection was suspected and the patient underwent an excision biopsy. Biopsy of the nodule and immunohistochemical staining supported a diagnosis of nodular malignant melanoma. It should be noted both that nodular malignant melanoma may present with a wide variety of clinical appearances, and that the lack of melanin pigment in nodular malignant melanoma may hinder the diagnosis of this aggressive tumour