Polyherbal formula SC-E3 inhibits rheumatoid arthritis activity in a mouse model of type-II collagen-induced arthritis / 中西医结合学报

OBJECTIVE@#SC-E3 is a polyherbal formula that contains five medicinal herbs used frequently in traditional herbal medicine. In our previous study, we demonstrated the antioxidant and anti-inflammatory effects of SC-E3. The present study examined the effects of SC-E3 in a mouse model of type-II collagen-induced arthritis (CIA).@*METHODS@#In vivo, male DBA/1J mice were immunized by intradermal injection of bovine type-II collagen and complete or incomplete Freund's adjuvant, to induce arthritis. SC-E3 was orally administered daily for 23 days. In vitro, bone marrow-derived macrophages (BMMs) were treated with macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor-κB ligand (RANKL) in the absence or presence of SC-E3.@*RESULTS@#Administrations of SC-E3 were found to have anti-arthritic effects in the joints of CIA mice, as evidenced by reduced paw swelling, bone erosion and deformation, inflammatory cell infiltration, and inflammation in synovial membrane. SC-E3 also reduced serum levels of tumor necrosis factor-α, interleukin-1β, aspartate aminotransferase and alanine aminotransferase. Furthermore, tartrate-resistant acid phosphatase-positive osteoclast numbers in the joints were significantly lower in SC-E3-treated CIA mice than in CIA mice. In addition, the differentiations of BMMs to multinucleated osteoclasts induced by M-CSF and RANKL stimulation were dose-dependently reduced by SC-E3.@*CONCLUSION@#These results suggest that SC-E3 possesses substantial anti-arthritic activity because it inhibits pro-inflammatory cytokines and osteoclastogenesis, and that SC-E3 has potential therapeutic use for the treatment of rheumatoid arthritis.

Alterations of Gefitinib Pharmacokinetics by Co-administration of Herbal Medications in Rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the potential pharmacokinetic interactions of the anticancer agent gefitinib (Iressa®) and the oriental medications Guipi Decoction (, GPD, Guibi-tang in Korean) and Bawu Decoction (, BWD, Palmul-tang in Korean).</p><p><b>METHODS</b>Methylcellulose (MC, control), GPD (1,200 mg/kg), or BWD (6,000 mg/kg) was orally administered to rats either as a single dose or multiple doses prior to gefitinib administration. To examine the effects of a single dose of the herbal medicines, gefitinib (10 mg/kg) was orally administered after 5 min or 1 h of MC or the herbal medicine pretreatments. To examine the effects of the multiple doses of the herbal medicines, gefitinib (10 mg/kg) was orally administered following 7 consecutive days of the administration of MC or each herbal medicine. The plasma concentrations of gefitinib were determined with liquid chromatography-tandem mass spectrometry assay. The plasma concentration-time profiles of gefitinib were analyzed with a noncompartmental analysis.</p><p><b>RESULTS</b>Gefitinib was rapidly absorbed and showed a monoexponential decline with an elimination half-life of 3.7-4.1 h. The pharmacokinetics of gefitinib was not affected by GPD pretreatment. However, a significantly lower maximum plasma concentration (C, P<0.05) and area under the curve (P<0.05), and a delayed time to reach C (T, P<0.01) were observed in both single- and multipledose BWD-pretreated rats compared with the control rats.</p><p><b>CONCLUSIONS</b>BWD and not GPD might delay and interfere with gefitinib absorption. Further evaluations of the clinical significance of these findings are needed.</p>

Ethanol Extract of Lycopodium serratum Thunb. Attenuates Lipopolysaccharide-Induced C6 Glioma Cells Migration via Matrix Metalloproteinase-9 Expression / 中国结合医学杂志

<p><b>OBJECTIVE</b>To elucidate how ethanol extract of L. serratum (ELS) could exert anti-migratory effects on glioma with the suppression of nuclear factor kappa B (NF-κB) downstream pathway.</p><p><b>METHODS</b>Cell viability of ELS on C6 glioma was detected by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Nitric oxide (NO) assay and 2',7'-dichlorofluorescin diacetate (DCFH-DA) assay were applied to measure NO production and reactive oxygen species (ROS) generation on lipopolysaccharide (LPS)-induced C6 glioma cells. NF-κB, mitogen-activated protein kinase (MAPK), inducible nictric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) protein were determined by Western blot. Wound healing assay was used to investigate the inhibitory effect of ELS on fetal bovine serum (FBS)-induced migration and matrix metalloproteinase (MMP)-9 and -2 activity was examined by zymography.</p><p><b>RESULTS</b>ELS suppressed LPS-induced phosphorylation of extracellular signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 through inhibiting the expression of chemokine CCL2 (or monocyte chemoattractant protein-1, MCP-1). In addition, ELS inhibited the expression of iNOS, COX-2, and the production of NO by LPS in C6 glioma cells. ELS also significantly decreased serum-induced migration of C6 glioma cells in scratch wound healing in a dose-dependent manner (P<0.01). The activity of MMP-9 and -2 were also significantly attenuated by ELS with LPS treatment (P<0.01).</p><p><b>CONCLUSIONS</b>Our results suggest that downregulation of MMP-9 gene expression might be involved in the anti-migration effect of ELS against LPS-induced C6 glioma cells.</p>

Fruits extracts of Hovenia dulcis Thunb. suppresses lipopolysaccharide-stimulated inflammatory responses through nuclear factor-kappaB pathway in Raw 264.7 cells

Objective: To investigate the anti-inflammatory effects and the action mechanism of the fruits of Hovenia dulcis (H. dulcis) in lipopolysaccharide (LPS)-induced mouse macrophage Raw 264.7 cells. Methods: The extract of H. dulcis fruits (EHDF) were extracted with 70% ethanol. Mouse macrophages were treated with different concentrations of EHDF in the presence and absence of LPS (1 μg/mL). To demonstrate the inflammatory mediators including nitric oxide, inducible nitric oxide synthase and cyclooxygenase (COX)-2 expression levels were analyzed by using in vitro assay systems. COX-derived pro-inflammatory cytokines including interleukin-1β, tumor necrosis factor-α and prostaglandin E

Saeng-Kankunbi-Tang () protects liver against oxidative damage through activation of ERK/Nrf2 pathway / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the cytoprotective effects of Saeng-kankunbi-tang (, SKT), a herbal prescription consisting of Artemisia capillaris and Alisma canaliculatum, and its underlying mechanism involved.</p><p><b>METHODS</b>In mice, blood biochemistry and histopathology were assessed in carbon tetrachloride (CCl4)-induced oxidative hepatic injury in vivo. The animal groups included vehicle-treated control, CCl4, SKT 500 mg/(kg day) CCl4+SKT 200 or 500 mg/(kg day). In HepG2 cell, tert-butyl hydroperoxide (tBHP) induced severe oxidative stress and mitochondrial dysfunction in vitro. The cyto-protective effects of SKT were determined by 3-(4,5-dimethylthiazol)-2,5-diphenyltetrazolium bromide (MTT) assay, flfluorescence activated cell sorting analysis and western blotting.</p><p><b>RESULTS</b>The administration of SKT prevented liver damage induced by CCl4 in mice, by inhibition of hepatocyte degeneration and inflflammatory cell infifiltration as well as plasma parameters such as alanine aminotransferase (P<0.01). Moreover, treatment with tBHP induced hepatocyte death and cellular reactive oxygen species production in hepatocyte cell line. However, SKT pretreatment (30-300 μg/mL) reduced this cell death and oxidative stress (P<0.01). More importantly, SKT inhibited the ability of tBHP to induce changes in mitochondrial membrane transition in cell stained with rhodamine 123 P<0.01). Furthermore, treatment with SKT induced extracellular signal-regulated kinases-mediated nuclear factor erythroid-2-related factor 2 (Nrf2) activation as well as the expressions of heme oxygenase 1 and glutamate- cystein ligase catalytic, Nrf2 target genes.</p><p><b>CONCLUSIONS</b>SKT has the ability to protect hepatocyte against oxidative stress and mitochondrial damage mediated by Nrf2 activation.</p>

Fruits extracts of Hovenia dulcis Thunb. suppresses lipopolysaccharide-stimulated inflammatory responses through nuclear factor-kappaB pathway in Raw 264.7 cells

OBJECTIVE@#To investigate the anti-inflammatory effects and the action mechanism of the fruits of Hovenia dulcis (H. dulcis) in lipopolysaccharide (LPS)-induced mouse macrophage Raw 264.7 cells.@*METHODS@#The extract of H. dulcis fruits (EHDF) were extracted with 70% ethanol. Mouse macrophages were treated with different concentrations of EHDF in the presence and absence of LPS (1 μg/mL). To demonstrate the inflammatory mediators including nitric oxide, inducible nitric oxide synthase and cyclooxygenase (COX)-2 expression levels were analyzed by using in vitro assay systems. COX-derived pro-inflammatory cytokines including interleukin-1β, tumor necrosis factor-α and prostaglandin E2 were determined using ELISA kits. Cell viability, heme oxygenase-1 expression, nuclear factor-kappaB and nuclear factor E2-related factors 2 translocation were also investigated.@*RESULTS@#EHDF potently inhibited the LPS-stimulated nitric oxide, inducible nitric oxide synthase, COX-2, interleukin-1β and tumor necrosis factor-α expression in a dose-dependent manner. EHDF suppressed the phosphorylation of inhibited kappaB-alpha and p65 nuclear translocation. Treatment of macrophage cells with EHDF alone induced the heme oxygenase-1 and nuclear translocation of nuclear factor E2-related factor 2.@*CONCLUSIONS@#These results suggest that the ethanol extract of H. dulcis fruit exerts its anti-inflammatory effects by inhibiting inhibited kappaB-alpha phorylation and nuclear translocation of nuclear factor-kappaB.

Association between Physical Activity and Hypertension in Chronic Obstructive Pulmonary Disease

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have increased likelihood of hypertension, which may lead to increased mortality rates. This study investigated the incidence of hypertension in patients with COPD according to the levels of their physical activities. METHODS: This study used data from the fifth Korean National Health and Nutrition Examination Survey, conducted from 2010 to 2012, including 1,243 people aged 40 years or older with COPD who were cross-classified according to their levels of physical activity. The relevance of morbidity associated with high blood pressure was also evaluated through cross and logistic regression analyses. RESULTS: Among patients with COPD who performed moderate-intensity physical activities, the group without hypertension had 4.3% higher compared to the group with hypertension (P=0.012). Adjusted analysis for patient age, sex, body mass index, smoking, drinking habit, income, diabetes mellitus, hyperlipidemia, and energy intake performed to determine the relationship between physical activity level and hypertension revealed that patients with moderate-intensity physical activity had 53.6% lower (95% confidence interval: 0.288-0.997) incidence of hypertension. CONCLUSIONS: The results of the current study suggest that patients with COPD who perform moderate-intensity physical activity have a lower incidence of hypertension.

The Association between Sleep Duration and Hypertension in Non-obese Premenopausal Women in Korea / 가정의학회지

BACKGROUND: Previous studies have revealed that sleep duration is linked to both obesity and hypertension. Here, we evaluated the association between sleep duration and hypertension in obese and non-obese premenopausal women using representative national survey data from the Korean population. METHODS: A total of 4,748 subjects over 20 years of age from the Korean National Health and Nutrition Examination Survey from 2010 to 2012 were included. To control for risk factors, multivariable logistic regression was used to calculate the adjusted odds ratios and 95% confidence intervals of hypertension across the following sleep duration categories: 8 h/d. RESULTS: Among the participants, 367 subjects (7.7%) had hypertension. Their mean sleep duration was 7 hours. In the non-obese subjects, after controlling for potential confounding variables, the odds ratio for hypertension was 1.86 fold greater in those with a sleep duration of <6 hours (odds ratio, 1.79; 95% confidence interval, 1.05 to 3.03) as compared to those who slept for 6.8 hours. However, there was no association between sleep duration and the risk of hypertension in obese subjects. Long sleep duration (over 8 h/d) was not associated with hypertension in either the non-obese or the obese subjects in this study. CONCLUSION: Short sleep duration (less than 6 h/d) may be a significant risk factor for hypertension in non-obese premenopausal women. However, there is no association between sleep duration and the risk of hypertension in obese women.

Compound K attenuates stromal cell-derived growth factor 1 (SDF-1)-induced migration of C6 glioma cells

BACKGROUND/OBJECTIVES: Stromal cell-derived growth factor 1 (SDF-1), also known as chemokine ligand 12, and chemokine receptor type 4 are involved in cancer cell migration. Compound K (CK), a metabolite of protopanaxadiol-type ginsenoside by gut microbiota, is reported to have therapeutic potential in cancer therapy. However, the inhibitory effect of CK on SDF-1 pathway-induced migration of glioma has not yet been established. MATERIALS/METHODS: Cytotoxicity of CK in C6 glioma cells was determined using an EZ-Cytox cell viability assay kit. Cell migration was tested using the wound healing and Boyden chamber assay. Phosphorylation levels of protein kinase C (PKC)α and extracellular signal-regulated kinase (ERK) were measured by western blot assay, and matrix metallopeptidases (MMP) were measured by gelatin-zymography analysis. RESULTS: CK significantly reduced the phosphorylation of PKCα and ERK1/2, expression of MMP9 and MMP2, and inhibited the migration of C6 glioma cells under SDF-1-stimulated conditions. CONCLUSIONS: CK is a cell migration inhibitor that inhibits C6 glioma cell migration by regulating its downstream signaling molecules including PKCα, ERK1/2, and MMPs.

Compound K attenuates stromal cell-derived growth factor 1 (SDF-1)-induced migration of C6 glioma cells

BACKGROUND/OBJECTIVES: Stromal cell-derived growth factor 1 (SDF-1), also known as chemokine ligand 12, and chemokine receptor type 4 are involved in cancer cell migration. Compound K (CK), a metabolite of protopanaxadiol-type ginsenoside by gut microbiota, is reported to have therapeutic potential in cancer therapy. However, the inhibitory effect of CK on SDF-1 pathway-induced migration of glioma has not yet been established. MATERIALS/METHODS: Cytotoxicity of CK in C6 glioma cells was determined using an EZ-Cytox cell viability assay kit. Cell migration was tested using the wound healing and Boyden chamber assay. Phosphorylation levels of protein kinase C (PKC)α and extracellular signal-regulated kinase (ERK) were measured by western blot assay, and matrix metallopeptidases (MMP) were measured by gelatin-zymography analysis. RESULTS: CK significantly reduced the phosphorylation of PKCα and ERK1/2, expression of MMP9 and MMP2, and inhibited the migration of C6 glioma cells under SDF-1-stimulated conditions. CONCLUSIONS: CK is a cell migration inhibitor that inhibits C6 glioma cell migration by regulating its downstream signaling molecules including PKCα, ERK1/2, and MMPs.

Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients

OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5) underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months). The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018) and an improvement in lower extremity function (p = 0.025) in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery. .

Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection. .

Inhibition of CYP3A4 and CYP2C9 by podophyllotoxin: Implication for clinical drug–drug interactions.

Podophyllotoxin (PPT) and its derivatives exert significant anti-cancer activities, and one derivative etoposide is often utilized to treat various cancers in the clinic. The aim of the present study is to investigate the inhibitory effects of PPT on major cytochrome P450 (CYP) isoforms in human livers. Inhibition of CYP3A4, CYP2C9, CYP2C8, CYP2D6, CYP2E1 and CYP2A6 by PPT was investigated in the human liver microsomal system. Time-dependent inhibition of CYP3A4 by PPT was also evaluated. The results showed that PPT strongly exhibited inhibitory effects on CYP3A4 and CYP2C9 in a concentration-dependent manner. Half inhibition concentration (IC50) was 1.1±0.3 and 4.6±0.3 μM for CYP3A4 and CYP2C9, respectively. Inhibition kinetic analysis showed that PPT exhibited competitive inhibition towards CYP3A4 and CYP2C9 with Ki of 1.6 and 2.0 μM, respectively. Additionally, PPT exerted time-dependent inhibition towards CYP3A4 and the kinetic parameters were 4.4±2.1 μM and 0.06±0.01 min–1 for KI and kinact, respectively. Our experimental data indicate that potential drug–drug interaction (DDI) might exist when PPT is co-administered with the substrates which mainly undergo CYP3A4- or CYP2C9-mediated metabolism.

Review of the clinical features of skin cancer: a study of 1, 048 cases from a hospital in West China

Skin cancer [SC] is a group of malignancies which include primary and metastatic tumors which involve the skin and its appendages. Up to the present, only a few studies on the clinical features and the trend of S have been reported but the status in West China is still undetermined. The S cases were from a major hospital in West China. A total of 1048 cases from 1981 to 2006 were included in our study. The clinical features of S including age, gender, lesion location and pathological diagnosis were analyzed. In order to illustrate the trend of S incidence, the patients from 1981-1993 and 1994- 2006 were assigned to group A and B respectively. The percentage of S in all malignancies [Ms], including all kinds of internal carcinomas and skin cancers, and the percentage of S in inpatients and outpatients [IOPs] between group A and B were separately compared to illustrate the trend in S incidence in this area. [1] Of the 1048 S s included, 308 [29.4%] were squamous cell carcinoma [S C], 293 [28.0%] basal cell carcinoma [B] and 168 [16.0%] cutaneous malignant melanoma [MM] .Ratio of male to female was 1.5:1.0.Median age was 54.0 +/- 23.0 years.40.8%of the S s occurred on the head, 35.0%on the trunk and 24.2%on the extremities. Median age of MM [53.0 +/- 22.5] was less than those of B [58.0 +/- 18.3 years] and S [57.0 +/- 20.0 years] .83.6%of the B s, 49.8%of the S s and 13.5% of the CMMs occurred on the head. [2] Of the 168 MMs, 106 [63.1%] occurred on the acral, 23 [13.7%] on the head, 24 [14.3%] on the trunk and 15 [8.9%] on the limbs. Of the 106 acral melanoma [AM], 41 [38.7%] occurred on the plantar skin, 19 [17.9%] on the heel, 15 [14.2%] on the subungual skin of thumbs, 13 [12.3%] on the subungual skin of big toes and 18 [17.0%] on other acra. [3] The percentages of S in IOPs [S s/IOPs] in Group A and B were 0.0038% [325/8, 457, 672], 0.0066% [723/11, 037, 720], an increase of by 74%.The percentages of S in all Ms [S /Ms] were 2.1% [325/15, 363] and 3.1% [723/23, 364], an increase of 48%.During the same period, the percentages of Ms in IOPs [Ms/IOPs] were 0.18% [15, 363/8, 457, 672] and 0.21% [23, 364/11, 037, 720], increased only by 17%. In our study, S C, B and MM were major S types. The head and trunk are the main sites for S occurring. AM is the most common MM. In past 26 years, the percentages of S in all malignancies and in inpatients and outpatients have increased in this hospital. The finding in our study provides a clue for understanding of the trend of S in West China

The Value of Laparoscopic Assistance in Total Vaginal Hysterectomy / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to evaluate value of laparoscopic assistance during total vaginal hysterectomy, and its implications for hysterectomy method. METHODS: Between January 2001 and December 2001, 236 patients underwent transvaginal hysterectomy (TVH) or Laparoscopic assisted vaginal hysterectomies (LAVH) for benign disease. We compared the results of the two methods, taking account of age, parity, past history of abdominal surgery, surgical indication, operation time, blood loss, presence of pelvic adhesion, weight of uterus, and intra- and post- operative complications and hospital stays. RESULTS: There was no difference in patients' mean age, parity, or menopausal status. Previous operation history was similar between the two groups, except previous cesarean section history. Indications for surgery were similar between the two group. There was no statistical difference on preoperative hemoglobin, postoperative hemoglobin, and 1st day hemoglobin drop. However, mean blood loss checked in operation room was greater for the LAVH group (TVH:113.7+/-83.9 cc, LAVH:146.1+/-113.3 (p<0.05). Uterine weight was heavier in the laparoscopic (249.6 gm) than the vaginal group (214.8 gm) (p<0.05). Mean operating time was shorter in the vaginal (46.5 min) than the laparoscopic group (84.9 min). In laparoscopic group, 15 patients had pelvic adhesions. Four of the 15 patients had adhesions between the posterior surface of the uterus and the bowel, and successful laparoscopic adhesiolysis was achieved in all four cases. CONCLUSION: LAVH have longer operation times and hopital stays than vaginal hysterectomies, but can be safer procedures in patients with possible pelvic adhesions.

Large cell Neuroendocrine Carcinoma Associated with Invasive Mucinous Adenocarcinoma of the Uterine Cervix / 대한산부인과학회잡지

Cervical large cell neuroendocrine carcinoma is rare. We experienced one case of cervical large cell neuroendocrine carcinoma with invasive mucinous adenocarcinoma in 49 years old woman. So we report the case and brief review of literature.

The Clinical Usefulness of Cervicovaginal Fetal Fibronectin as a Prediction of the Time of Induction / 대한산부인과학회잡지

OBJECTIVES: Fibronectin is a high-molecular-weight glycoprotein found in the plasma and extracellular matrix. The presence of fetal fibronectin in cervicovaginal secretion of pregnant women during the second and the third trimester has been suggested as a means of identifying women in preterm labor who be delivered prematurely. Therefore, our purpose was to determine the clinical efficacy of the presence of fetal fibronectin in cervicovaginal secretion of patient in full term as biochemical predictor of Time of Induction. METHODS: Fetal fibronectin was obtained at external os and posterior vaginal fornix in 30 women in full term who had no uterine contraction with intact membrane. The cervix was assessed by digital vaginal examination and scored with a modified Bishop score. RESULTS: There was a good correlation in delivery time after induction between the fetal fibronectin and the modified Bishop score (r=0.695,P<0.005) CONCLUSION: The presence of fetal fibronectin is better than Bishop score that is dependent on clinical experience as biochemical predictor of Time of Induction.

Antenatal Screening for Gestational Diabetes by 50-g, 1-hour Glucose Screening Test / 대한산부인과학회잡지

OBJECTIVE: Gestational diabetes mellitus is defined as carbohydrate intolerance of variable severity first diagnosed during pregnancy. It is associated with adverse outcomes of pregnancy including obstetrical complications such as increased rate of cesarean sections, preeclampsia, and birth trauma, and perinatal morbidities, such as macrosomia, hypoglycemia, hypocalcemia, and hyperbilirubinemia. Therefore, screening for gestational diabetes mellitus and early diagnosis of this condition allows intervention to be carried out, thereby, the reduction of the untoward effects mentioned above can be minimized. METHODS: Screening for abnormal glucose metabolism was carried out in 489 pregnant women. A 50-g oral glucose load without regard to time of day or last meal, and a 1-hour plasma glucose determination with a threshold of 140mg/dl were used as a glucose screening test(GST). Patients with an abnormal GST underwent an oral glucose tolerance test(GTT). RESULTS: The overall incidence of gestational diabetes was 2.7%. The occurrence of this disorder was significantly related to the age of pregnant women, parity, or the presence of risk factors for gestational diabetes and obesity(Body Mass Index> or =26kg/m2). CONCLUSION: This study suggests that Korean pregnant women should be screened for gestational diabetes.

Donor Specific Transfusion 24 Hours Prior to(-24h DST) Living Donor Renal Transplantation / 대한신장학회잡지

The goal of the immunologic maneuvering for organ transplantation may be the donor specific immune tolerance rather than non-specific immunosuppression. Although DST is one of the most extensively studied methods for donor specific immune hyporesponsiveness, it is not widely used in recent years because of possible sensitization and overall improvement of graft survival without DST. Several human and animal studies showed that -24h DST with concomitant cyclosporine administration improved graft survival. -24 DST may not induce adverse sensitization that preclude subsequent transplantation and the procedure is simple and does not delay the operation in living donor transplantation. Between Feb. 1994 and Jan. 1997, 33 patients received 100-200ml of fresh whole blood from the kidney donor 1 day before transplantation. Twenty donors were living related and 13 donors were non- related. Mean age was 40(22-52). Two patients was diabetic. All but one received primary allograft. Cyclosporine and prednisolone were the primary immunosuppressants that started 2-3 days before transplantation. Acute rejection occurred in 11 recipients(33.3%). Acute rejection tended to occur earlier. Eight of 11 first episodes were within 3 days post- transplant, which were all recovered by either steroid pulse or OKT3. Mean follow up was 35 months. Two patients died with functioning graft. Three-year graft survival rate was 93.9%. There was no immunologic graft loss. We conclude that -24h DST may be a valuable option of immune modulation for renal transplantation with no demonstrable adverse reaction. It's beneficial effect needs to be confirmed by a larger controlled study.

A Case of Granulocytic Sarcoma causing Spinal Cord Compression in Chronic Myelogenous Leukemia / 대한혈액학회지

Granulocytic sarcoma is a localized tumor mass composed of immature cells of the granulocytic series. It can develope in patients with acute myelogenous leukemia or impending blast crisis of chronic myelogenous leukemia. Granulocytic sarcoma during the course of chronic myelogenous leukemia has beeen noted to occur in lymph node, bone, skin, breast, peritoneum, testis, ovary, gastrointestinal tract, kidney, brain. We reported a case of granulocytic sarcoma causing spinal cord compression in chronic myelogenous leukemia with a brief review of literature.