A Randomized Clinical Trial of Synbiotics in Irritable Bowel Syndrome: Dose-Dependent Effects on Gastrointestinal Symptoms and Fatigue / 가정의학회지

BACKGROUND: This double-blind, randomized controlled design study aimed to assess the dose-dependent effects of synbiotics on gastrointestinal symptoms of and fatigue in irritable bowel syndrome (IBS). METHODS: Thirty subjects with IBS were randomly assigned into the following three groups and received 2 capsules a day for 8 weeks: (1) high-dose (2 capsules of synbiotics); (2) low-dose (1 capsule of synbiotics and 1 capsule of placebo); and (3) placebo (2 capsules of placebo). At baseline and 8 weeks, they completed the study questionnaires. RESULTS: Two subjects in the high-dose group were lost to follow-up, leaving a total of 28 patients for the analysis. After 8 weeks, abdominal discomfort, abdominal bloating, frequency of formed stool, fatigue Visual Analog Scale (VAS), and Multidimensional Fatigue Inventory were significantly different among the groups (P=0.002, 0.006, 0.007, 0.028, and 0.041, respectively, by Kruskal-Wallis test). However, only abdominal discomfort, abdominal bloating, frequency of formed stool, and fatigue VAS were significantly improved in the high-dose group compared with those in the placebo group (P=0.002, 0.003, 0.002, and 0.013, respectively) by Mann-Whitney test with Bonferroni correction. No adverse drug reactions were reported. CONCLUSION: High-dose synbiotics were superior to placebo in improving bowel symptoms and fatigue of IBS patients, suggesting that synbiotic dosage plays an important role in the treatment of IBS.

Milk Consumption and Framingham Risk Score: Analysis of the Korea National Health and Nutrition Examination Survey Data (2008-2011)

PURPOSE: The benefit of milk intake remains controversial. The association between milk consumption and Framingham Risk Score (FRS) in a population consuming relatively low amounts of dairy products is undetermined. MATERIALS AND METHODS: A total of 13736 adults (5718 male and 8018 female) aged 20-80 years from the Korea National Health and Nutrition Examination Survey (2008-2011) were divided into groups according to milk consumption (rarely, monthly, weekly, and daily) and compared according to FRS after relevant variable adjustments. RESULTS: The mean FRS in males and females were 6.53 and 5.74, respectively. Males who consumed milk daily (15.9%) had a significantly lower FRS than males having milk rarely (31.6%) or monthly (17.4%; p=0.007). Females who consumed milk daily (22.3%) also had significantly lower FRS than rarely (29.8%), monthly (13.8%), or weekly (34%; p=0.001) consumers. In particular, males > or =60 years old who consumed milk daily had a significantly lower FRS than males who consumed less milk (p<0.001). The odds ratio in this age group showed a significant and gradual increase in the weekly [OR=2.15; 95% confidence interval (CI) 1.14-4.03], monthly (OR=2.29; 95% CI 1.15-4.54), and rarely (OR=3.79; 95% CI 2.01-7.14) milk consumption groups when compared with the daily milk consumption group. CONCLUSION: Milk consumption was associated with a lower FRS in a low milk-consuming population. In particular, daily milk consumption in males over 60 years old may be beneficial for those at risk for cardiovascular disease.

Effectiveness of Combined Surgery Simultaneously Correcting 3 Main Causes of Involutional Entropion

PURPOSE: To evaluate the long-term effectiveness of inferior retractor tightening combined with lateral tarsal strip surgery and anterior lamellar resection for simultaneously correcting the 3 main causes of involutional entropion. METHODS: In this retrospective study we reviewed 80 patients diagnosed with involutional entropion between April 2004 and February 2014 at the Korea University Guro Hospital and Cheonan Chungmu Hospital. The patients were evaluated for the 3 major causes of involutional entropion and were confirmed to have all components. Lateral canthal tendon laxity test and anterior lamellar redundancy test were performed to grade the involutional entropion patients. The patients received inferior retractor tightening, lateral tarsal strip operation and anterior lamellar resection procedure simultaneously. RESULTS: Eighty involutional entropion patients were included in the present study. The patients consisted of 35 males and 45 females with an average age of 71.1 ± 9.3 years. In the lateral canthal tendon laxity test, 52 (61.2%) eyes were grade II, 33 (38.8%) eyes were grade III. In the anterior lamellar redundancy test, 17 (20%) eyes were grade I, 57 (67.1%) eyes were grade II and; 11 (12.9%) eyes were grade III. Among the 80 patients, 85 eyelids received combined surgery, 84 had successful outcomes and 1 case recurred at 5 months following the primary surgery with an average follow up of 26.5 ± 4.6 months. Lateral canthal deformity was observed in 2 eyelids which were corrected successfully. CONCLUSIONS: Simultaneous correction of the 3 main causes of involutional entropion through inferior retractor tightening, lateral tarsal strip surgery and anterior lamellar resection procedure is effective in correcting involutional entropion and safe in avoiding overcorrection.

Efficacy and Safety of "URSA Complex" in Subjects with Physical Fatigue: A Multicenter, Randomized, Double-blind, Placebo-controlled Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Fatigue is a common symptom both in diseases status and in healthy subjects. Various supplements and nutraceuticals for relieving of fatigue have been used. However, there are a few studies to evaluate the efficacy and the safety of the drug for fatigue alleviation, we conducted using URSA Complex to evaluate the efficacy on physical fatigue via score changes in the checklist individual strength (CIS).</p><p><b>METHODS</b>The study was designed as a multicenter, randomized, double-blind, placebo-controlled trial, with subjects randomized to one of the two arms, receiving either placebo or URSA Complex administered as identical capsules. The primary efficacy endpoints of this clinical trials are the ratio of improving CIS scores < 76 points in patients at the end (4 weeks). Secondary efficacy variables are as follows one is an improvement of fatigue and the other is an improvement of the liver enzyme.</p><p><b>RESULTS</b>The fatigue recovery rate in who had improved CIS scores of < 76 points were 70.0%, 50.9% in the therapy group and placebo group, respectively (P = 0.019). The fatigue recovery rate in CIS score was higher in URSA Complex therapy group than placebo group. The difference between therapy group and placebo group was statistically significant at 4 weeks later, but not 2 weeks.</p><p><b>CONCLUSIONS</b>Our results provided that the URSA Complex was effective in alleviating physical fatigue. The adverse event frequency in the therapy groups was similar to that in the placebo group.</p>

Septic arthritis of the temporomandibular joint: a case report

Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature.

A Clinical Analysis of 179 Cases of Centipede Bite Patients Who Visited the Emergency Department in Korea

PURPOSE: To investigate the epidemiology and clinical characteristics of centipede bite injuries. METHODS: We conducted a retrospective study of clinical manifestations in patients who were identified between April 2005 to April 2007 as having suffered from centipede bites. Factors evaluated included sex, age, location and time of bite, part of body affected, clinical signs and symptoms, treatment modalities and complications. RESULTS: A total of 179 cases of centipede bite were identified. Centipede bites occurred between spring and autumn. 69.3% of bites happened at night. All patients were bitten on an exposed body parts, and the digit of both the handsand feet were the sites most often involved. Pain, swelling, erythema were the most frequent symptoms and signs. Most cases showed minor manifestations but, three patients needed to be admitted because of anaphylaxis. CONCLUSION: Centipede bites are relatively common in the summer season in rural and island areas, especially at night. Though the clinical symptoms of centipede bites are generally minor symptoms, emergency physicians need to possess accurate knowledge of the clinical manifestations in order to properly identify severe cases.

A Case of Purtscher's Retinopathy Responsive to High-dose Steroid Therapy

PURPOSE: To report a case of high dose steroid-responsive Purtscher's retinopathy which was developed after operation for diaphragmatic laceration sustained in motorcycle accident. CASE SUMMARY: A 68-year-old man came to our hospital with complaining of decreased visual acuity in the right eye after diaphragmatic laceration operation. Best corrected visual acuity was 0.1 in the right eye. Anterior segment was nonspecific. However, afferent pupillary defect was observed. Superficial intraretinal hemorrhage, numerous cotton-wool spots, peripapillary hemorrhage, and macular edema were detected on fundus examination. Fluorescein angiography revealed capillary nonperfusion and fluorescein filling defect due to retinal hemorrhage in arteriovenous phase and fluorescein leakage from the macula and capillary nonperfusion area in the late venous phase. Accordingly, Purtscher's retinopathy was diagnosed and the patient was observed without specific treatment. After 2 weeks of observation, symptoms and fundus findings were not changed. High-dose steroid therapy was begun with injection of one gram of methylprednisone for three days, switched to oral prednisolone, and then slowly tapered in period of 3 weeks. 7 days after the treatment, visual acuity was improved to 0.2 in the right eye but afferent pupillary defect was still observed. Cotton-wool spots slightly decreased, peripapillary hemorrhage was absorbed but macular edema was remained. 14 days after the treatment, visual acuity greatly improved to 0.63 and afferent pupillary defect was not observed. Cotton-wool spots and macular edema were decreased but fluoroscein leakage from capillary nonperfusion area was remained. CONCLUSIONS: In the case of Purtscher's retinopathy, high-dose steroid therapy can be a useful management method for the improvement of visual acuity and other symptoms.

The Effects of the Cyanoacrylate Tissue Adhesive Mono-therapy for Corneal Perforation

PURPOSE: To report cases of corneal perforation among corneas treated with cyanoacrylate tissue adhesive. METHODS: We performed cyanoacrylate tissue adhesive application on 1 case of corneal perforation due to fungal keratitis, one case of corneal perforation due to neurotrophic keratitis, one case of corneal fistula due to foreign body and one case of corneal perforation due to corneal stromal dystrophy. After cyanoacrylate tissue adhesive removal, amniotic membrane transplantation was conducted in two cases, and keratoplaty was performed in another two cases. RESULTS: Postoperative follow-up period was 12 months on average. In all four cases, ocular integrity was successfully restored. There was no sign of recurrence, infection or inflammation. CONCLUSIONS: Cyanoacrylate tissue adhesive monotherpy can restore ocular integrity successfully in various type of corneal perforation and After cyanoacrylate tissue adhesive removal, amniotic membrane transplantation and keratoplaty can be performed additionally.

Study of Genetic Imprinting on 3 Cases of Insulin-Dependent Diabetes Mellitus Developed in Early Infantile Period / 대한소아내분비학회지

Infantile onset diabetes mellitus(especially, neonatal diabetes) is rare disorder and may be transient or permanent. Most patients are full-term but small-for-date infants and typical symptoms occur within the first 4-6 weeks of life, requiring insulin therapy. Neonatal diabetes differs from type 1 diabetes in many aspects and seems to form a distinct entity of inborn pancreatic malfunction. The transient cases often develop type 2 diabetes mellitus later in life. In recent reports, transient neonatal diabetes is associated with paternal uniparental isodisomy and unbalanced duplication of chromosome 6q22-23. In our study, clinical course of case 1 was compatible with transient neonatal diabetes, but chromosomal abnormalities such as above was not shown in DNA analysis. In case 2 and 3, we could not decide exactly on genetic basis.

Clinical Study on Chronic Granulomatous Disease(CGD) -Occurrence in Siblings-

To analyse the age of onset, etiologic microorganisms, clinical manifestations, managements and genetic variation of chromic granulomatous disease, the authors reviewed four patients who were diagnosed as CGD at Department of Pediatrics, Seoul National Univesity Children's Hospital. They were siblings in relationship-two of them were brothers, the others were brother-sister. @ES The results were as follows; 1) Initial manifestations developed within 1 year old, and lymphadenopathy associated with BCG vaccination was the most common. 2) In culture study of micro-organism, catalase positive microorganisms such as Staphylococcus aureus, Serratia marcescens, Coagulase (-) Staphylococcus, Enterococcus, Proleus vulgaris, Klebsiella pneumoniae, E. coli and fungus such as Candida albicans were isolated. In 2 cases, culture study revealed no growth. 3) Fever, lymphadenopathy, hepatomegaly, suppurative dermatitis and pneumonia were the most common manifestations. In most of cases, antituberculous medications were administered under the impression of tuberculosis without response. 4) Immunologic screening tests including B-cell system, T-cell system, and complement system were within normal limit except NBT test. 5) In spite of severe infections, NBT scores of all the cases were less than those of controls. Liver biopsies of 3 cases showed granuloma formation with characteristic yellow brown pigment-laden macrophages.

Twelve cases of nonimmune hydrops fetalis / 대한주산의학회잡지

No abstract available.