Analgesic and anti-inflammatory effects of UP1304, a botanical composite containing standardized extracts of Curcuma longa and Morus alba / 中西医结合学报

<p><b>OBJECTIVE</b>Though the initial etiologies of arthritis are multifactorial, clinically, patients share the prime complaints of the disease, pain. Here the authors assessed the analgesic and anti-inflammatory effects of UP1304, a composite that contains a standardized blend of extracts from the rhizome of Curcuma longa and the root bark of Morus alba, on rats with carrageenan-induced paw edema.</p><p><b>METHODS</b>A plant library was screened for bradykinin receptor antagonists. In vivo, the anti-inflammatory and analgesic effects of the standardized composite, UP1304, were evaluated in rats with carrageenan-induced paw edema using oral dose ranges of 100-400 mg/kg. Ibuprofen, at a dose of 200 mg/kg, was used as a reference compound. In vitro, cyclooxygenase (COX) and lipoxygenase (LOX) inhibition assays were performed to evaluate the degree of inflammation.</p><p><b>RESULTS</b>Statistically significant improvements in pain resistance and paw edema suppression were observed in animals treated with UP1304, when compared to vehicle-treated rats. Results from the highest dose of UP1304 (400 mg/kg) were similar to those achieved by ibuprofen treatment at 200 mg/kg. In vitro, UP1304 showed dose-dependent inhibition of the enzymatic activities of COX and LOX. A half-maximal inhibitory concentration of 9.6 μg/mL for bradykinin B1 inhibition was calculated for the organic extract of C. longa. Curcumin showed Ki values of 2.73 and 58 μg/mL for bradykinin receptors B1 and B2, respectively.</p><p><b>CONCLUSION</b>Data presented here suggest that UP1304, analgesic and anti-inflammatory agent of botanical origin, acted as a bradykinin receptor B1 and B2 antagonist, and inhibited COX and LOX enzyme activities. This compound should be considered for the management of symptoms associated with arthritis.</p>

Evaluation of the genotoxicity of ginseng leaf extract UG0712 / 한국실험동물학회지

Although ginseng (genus Panax) leaf extract contains high concentrations of bioactive constituents, its effects have been reported in few preclinical studies, and information regarding its toxicity is not sufficient to allow for its clinical use. We evaluated the genotoxicity of UG0712, which is a powdered extract of ginseng leaves. UG0712 did not increase the number of revertant colonies in 4 histidine auxotrophic strains of Salmonella typhimurium (TA100, TA1535, TA98, and TA1537) or in a tryptophan auxotrophic strain of Escherichia coli (WP2uvrA(pKM101)) at any concentration evaluated, either in the absence or presence of the metabolic activation system. There was no significant increase in the number of metaphase cells with structural or numerical aberrations in the UG0712-treated groups compared to the concurrent vehicle control at any dose, regardless of the presence of the metabolic activation system. Oral administration of the extract at doses up to 2,000 mg/kg in male mice did not increase the frequency of micronucleated polychromatic erythrocytes in the bone marrow, and did not result in any significant clinical signs, body weight loss, gross findings, or mortality. These results suggest that UG0712 does not act as a mutagenic or genotoxic material at the concentrations evaluated.

13-week subchronic toxicity study of a novel ginsenoside composition from ginseng leaves in rats / 한국실험동물학회지

UG0712 is a new ginsenoside extract processed from ginseng leaves. A subchronic toxicity study of UG0712 was conducted in male and female SD rats. Rats were treated with UG0712 at doses of 100, 400 and 1,600 mg/kg/day for 13 weeks, and observed followed by 4-week recovery period at a highest dose. No-treatment-related effects were observed regarding the mortality, ophthalmic examination, urinalysis and histopathology. Although the changes in clinical sign, body weight, organ weight, hematology, and serum biochemistry were observed, they were temporal and pharmacological effects. Based on the present experiment conditions, the no observed adverse effect level was considered to be more than 1,600 mg/kg/day in both sexes of rats.

A standardized bamboo leaf extract inhibits monocyte adhesion to endothelial cells by modulating vascular cell adhesion protein-1

Bamboo leaves (Phyllostachys pubescens Mazel ex J. Houz (Poacea)) have a long history of food and medical applications in Asia, including Japan and Korea. They have been used as a traditional medicine for centuries. We investigated the mechanism of anti-inflammatory activity of a bamboo leaf extract (BLE) on tumor necrosis factor-alpha (TNF-alpha)-induced monocyte adhesion in human umbilical vein endothelial cells (HUVECs). Exposure of HUVECs to BLE did not inhibit cell viability or cause morphological changes at concentrations ranging from 1 microg/ml to 1 mg/ml. Treatment with 0.1 mg/ml BLE caused 63% inhibition of monocyte adhesion in TNF-alpha-activated HUVECs, which was associated with 38.4% suppression of vascular cell adhesion molecule-1 expression. Furthermore, TNF-alpha-induced reactive oxygen species generation was decreased to 47.9% in BLE treated TNF-alpha-activated HUVECs. BLE (0.05 mg/ml) also caused about 50% inhibition of interleukin-6 secretion from lipopolysaccharide-stimulated monocyte. The results indicate that BLE may be clinically useful as an anti-inflammatory or anti-oxidant for human cardiovascular disease including atherosclerosis.

Clinical Characteristics of Idiopathic Pulmonary Fibrosis Patients with Diabetes Mellitus: the National Survey in Korea from 2003 to 2007

Evidence suggests that diabetes mellitus (DM) is associated with idiopathic pulmonary fibrosis (IPF). According to the new IPF guidelines, high-resolution computed tomography (HRCT) is an essential means of diagnosing IPF. We investigated the relationship between IPF and DM in patients treated between 2003 and 2007. Newly diagnosed IPF patients in large university teaching hospitals in Korea were enrolled from January 2003 to December 2007. We retrospectively analyzed 1,685 patients using the interstitial lung disease (ILD) registry. In total, 299 IPF patients (17.8%) also had DM. The mean age of our subjects was 68.0 +/- 9.4 yr. HRCT showed significantly more reticular and honeycomb patterns in IPF patients with DM than in IPF patients without DM (P = 0.014, P = 0.028, respectively). Furthermore, significantly higher incidences of hypertension, cardiovascular diseases, and other malignancies (except lung cancer) were found in IPF patients with DM than in IPF patients without DM. In conclusion, IPF patients with DM are more likely to have the usual interstitial pneumonia (UIP) pattern, including reticular and honeycomb patterns, on HRCT than are those without DM.

Effects of Dialysate Calcium Concentration and Calcitriol on Bone Metabolism in Hemodialysis Patients / 대한내과학회지

BACKGROUND/AIMS: Whereas higher dialysate calcium (Ca) levels may pose a risk of hypercalcemia, lower levels may induce a negative Ca balance. We evaluated the effect of lowering dialysate Ca levels from 1.75 to 1.5 mmol/L and explored the appropriate use of calcitriol to regulate bone metabolism in hemodialysis patients. METHODS: The dialysate Ca levels of 36 patients were reduced from 1.75 to 1.5 mmol/L. They were divided into three groups according to basal intact parathyroid hormone (iPTH) level (group 1, iPTH 300 pg/mL, n = 8). Data were collected at 3-month intervals for 1 year. RESULTS: Throughout the study period, no significant difference in phosphate binders, serum Ca, phosphorus (P), or Ca x P products was observed among groups. However, iPTH, alkaline phosphatase (AP), and calcitriol dosage patterns differed among groups. In group 1, iPTH and AP increased significantly over 12 months (p = 0.01). In group 2, iPTH and AP showed no significant changes. In group 3, iPTH and AP declined significantly over 12 months (p = 0.02). Calcitriol dosage did not change in groups 1 and 2, but increased significantly in group 3 (p = 0.001). CONCLUSIONS: After converting hemodialysate Ca levels from 1.75 to 1.5 mmol/L, the initially different iPTH concentrations converged to a modestly elevated level. The use of 1.5 mmol/L hemodialysate Ca may thus be appropriate for both high- and low-turnover bone disease if phosphate binders and calcitriol are combined appropriately.

Effects of Dialysate Calcium Concentration and Calcitriol on Bone Metabolism in Hemodialysis Patients / 대한내과학회지

BACKGROUND/AIMS: Whereas higher dialysate calcium (Ca) levels may pose a risk of hypercalcemia, lower levels may induce a negative Ca balance. We evaluated the effect of lowering dialysate Ca levels from 1.75 to 1.5 mmol/L and explored the appropriate use of calcitriol to regulate bone metabolism in hemodialysis patients. METHODS: The dialysate Ca levels of 36 patients were reduced from 1.75 to 1.5 mmol/L. They were divided into three groups according to basal intact parathyroid hormone (iPTH) level (group 1, iPTH 300 pg/mL, n = 8). Data were collected at 3-month intervals for 1 year. RESULTS: Throughout the study period, no significant difference in phosphate binders, serum Ca, phosphorus (P), or Ca x P products was observed among groups. However, iPTH, alkaline phosphatase (AP), and calcitriol dosage patterns differed among groups. In group 1, iPTH and AP increased significantly over 12 months (p = 0.01). In group 2, iPTH and AP showed no significant changes. In group 3, iPTH and AP declined significantly over 12 months (p = 0.02). Calcitriol dosage did not change in groups 1 and 2, but increased significantly in group 3 (p = 0.001). CONCLUSIONS: After converting hemodialysate Ca levels from 1.75 to 1.5 mmol/L, the initially different iPTH concentrations converged to a modestly elevated level. The use of 1.5 mmol/L hemodialysate Ca may thus be appropriate for both high- and low-turnover bone disease if phosphate binders and calcitriol are combined appropriately.

Green urine in a patient who received a continuous infusion of propofol: A case report / 대한마취과학회지

The color of urine in patients who receive anesthetic gives much medical information to a medical team. So, we must check the urine color and know the cause of discoloration of the urine from anesthetic patients. Green urine is rare indeed and it is a benign potential side effect of propofol; this phenomenon is related to the metabolism of propofol. We experienced green urine from a long-term anesthetized patient who received a continuous infusion of propofol. We report here on this unusual case and we review the relevant literature.

Comparison of time to awareness between obese patients and non-obese patients after total intravenous anesthesia with propofol and remifentanil

BACKGROUND: The rate of obesity has reached epidemic proportions and is on the rise.There have not been adequate studies on the differences in anesthesiology in obese patient. For this reason, we designed this study to determine the effect of obesity on time to awareness, comparing the use of propofol and remifentanil in general anesthesia. METHODS: We enrolled 55 patients into the study, between ages 16 and 45 years, who had an ASA physical status 1, 2 and who were undergoing general anesthesia for an elective obstetric operation. According to the Asia-Pacific obesity criteria, we divided the patients into 2 groups, the obesity group (BMI > or = 25), and the non-obesity group (BMI < 25). Propofol and remifentanil were infused using TCI for general anesthesia. The bispectral index score (BIS) was used for monitoring depth of anesthesia.During each operation, we tried to keep the BIS between 40 and 55 by controling the target concentration of TCI.We compared the time-to- awareness between the obese patient group and the non-obese patient group. RESULTS: The obesity and the non-obesity group did not show significant difference in awareness times between the obesity group, 412.4 +/- 102.5 s and the non-obesity group, 434.1 +/- 49.1 s. CONCLUSIONS: There was no evidence of a significant difference in time-to-awareness between the obese patient group and the non-obese patient group.The use of remifentanil and propofol work equally well in obese and in non-obese patients anesthesized for elective surgery.

Renal manifestation in patients with rheumatoid arthritis / 대한내과학회지

BACKGROUND/AIMS: Although renal manifestations are often involved in patients with rheumatoid arthritis (RA), the causal relationship between RA and renal manifestations has not been clearly defined. The prevalence and causes of renal manifestations in patients with RA were investigated in this study. METHODS: The clinical data from 457 patients with RA and who were admitted to Hanyang University Hospital between 2001 and 2005 were retrospectively analyzed. Renal manifestations were defined as proteinuria (> or =300 mg/day) or azotemia (serum creatinine > or =1.7 mg/dL), with or without hematuria. RESULTS: Renal manifestation was present in 82 (17.9%) out of 457 RA patients. Among them, proteinuria was observed in 81 (17.7%), azotemia in 37 (8.1%) and hematuria with either proteinuria or azotemia in 35 (7.7%). For the cases with proteinuria, the amount of preteinuria was 1353+/-207 (mean+/-SD) mg/day. There was no significant correlation between the degree of proteinuria and the duration of RA. For the cases with azotemia, the serum creatinine was 3.98+/-0.35 mg/dL. The presence of azotemia had no significant association with the duration of RA (14.4+/-1.5 vs. 11.6+/-1.2 years, respectively). When the etiology of the renal manifestation was classified into primary and secondary renal disease, the latter included diabetic nephropathy in 13 (15.9%), hypertensive nephrosclerosis in 8 (9.8%), drug induced chronic tubulointerstitial disease in 11 (13.4%) and AA amyloidosis in 2. Renal biopsy revealed 10 cases of primary glomerulopathy, including IgA nephropathy in 3, membranous nephropathy in 2, mesangial proliferative glomerulonephritis in 1, focal segmental glomerulosclerosis in 1 and chronic sclerosing glomerulonephritis in 3. CONCLUSIONS: The prevalence of chronic kidney disease in patients with RA is high, although direct renal invasion by RA is very rarely encountered. Renal biopsy would be of great help to identify the various causes of renal manifestations in patients with RA.

A Case of Multiple Opportunistic Gastrointestinal Infections in a Korean AIDS Patient / 대한소화기내시경학회지

The number of AIDS patients is currently increasing in Korea, and multiple opportunistic infections, which are due to their immunocompromised state, have become a significant clinical problem. These opportunistic diseases may vary according to the severity of immunosuppression, the mode of transmission, the risk factors, the living environment and treatment; rectal syphilis, perianal condyloma lata and amoebic liver abscess are known to rarely develop in AIDS patients. We report here on a case of a homosexual man who simultaneously presented with an amebic liver abscess, esophageal candidiasis, chronic hepatitis B, rectal syphilis, perianal condyloma lata and asymptomatic neurosyphilis. He was treated with highly active antiretroviral therapy (HARRT) and the appropriate antiviral and antibiotic agents.

Successful Empirical Treatment of Intravenous Immune Globulin in Recent-Onset Idiopathic Dilated Cardiomyopathy: A Case Report / 대한구급학회지

Intravenous immunoglobulin (IVIG) therapy has been introduced to idiopathic dilated cardiomyopathy due to their antiviral and anti-inflammatory effects. But each study reported conflicting result and treatment regimen has not been clearly established. We experienced a case of 28-year-old woman with idiopathic dilated cardiomyopathy with severely depressed cardiac function. Its onset time was obvious within 1 month. Despite of conservative treatment of heart failure, sudden cardiac arrest was developed. We tried IVIG therapy, and her symptoms and cardiac function were improved after IVIG treatment.

A Case of Renal Infarction with Arterial Thromboembolism / 대한이식학회지

Renal infarction in transplant kidney is an very uncommon post-transplant complication, and usually occurs in the early postoperative period. Thromboemboli to the renal arteries usually originate from the heart, e.g. atrial fibrillation. This paper reports a 64-year-old man who had total occlusion of transplanted renal artery after 9 years from transplantation. His medicines included cyclosporine, prednisolone, aspirin, clopidogrel, and propranlol. Our patient presented with fever, oliguria, and left costovertebral angle tenderness, three days ago. Abdominal computed tomography (CT) revealed total occlusion of transplanted renal artery and right common iliac artery. Preservation of renal function is inversely proportional to the period of renal ischemia. Our patient was treated with heparinization. Remnant renal function was lost, he has been treated with hemodialysis.

A Case of Acute Appendicitis due to Intestinal Stricture after Intestinal Tuberculosis Treatment / 대한소화기학회지

Intestinal hemorrhage, perforation, obstruction, and fistula formation are the common complications associated with intestinal tuberculosis. However, these complications usually occurr in active stage of intestinal tuberculosis. A 45-year-old man was diagnosed as intestinal tuberculosis and received anti-tuberculosis medications for 9 months. After the end of treatment, intestinal lesion was cured. However a deformed appendiceal orifice due to hypertrophic sear resulting in symptomatic appendictis was noted. We report a case of acute appendicitis due to intestinal stricture after the successful treatment of intestinal tuberculosis.

A Comparative Study of Recovery Characteristics between Propofol-Remifentanil and Sevoflurane-Nitrous Oxide Anesthesia in Children / 대한마취과학회지

BACKGROUND: Remifentanil and sevoflurane are characterized by rapid emergence from anesthesia. Therefore, propofol-remifentanil anesthesia (PR) and sevoflurane-nitrous oxide anesthesia (SN) were compared with regard to the recovery characteristics in children. METHODS: Sixty children scheduled for tonsillectomy were randomly assigned to receive PR (n = 30) or SN (n = 30). The PR group was induced by remifentanil, propofol and vecuronium, maintained with infusion of remifentanil and propofol. The SN group was induced by sevoflurane, nitrous oxide, vecuronium maintained with sevoflurane in 50% nitrous oxide. At the end of operation, all anesthetics were discontinued and 100% oxygen was inspirated in both groups. The times to spontaneous breathing, extubation, eye opening, PACU discharge were assessed and postoperative nausea/vomiting, agitation were noted. RESULTS: Spontaneous breathing occurred after 9.29 +/- 1.02 minutes (PR) versus 6.85 +/- 0.60 minutes (SN) (P < 0.05), extubation after 9.19 +/- 0.91 minutes versus 8.87 +/- 0.67 minutes, eye opening after 9.47 +/- 1.01 minutes versus 14.85 +/- 0.80 minutes (P < 0.05) and PACU discharge after 21.32 +/- 2.01 minutes versus 27.55 +/- 1.72 minutes (P < 0.05). The occurrence of postoperative nausea/vomiting was 7% (PR) versus 13% (SN), and the incidence of agitation was 60% (PR) versus 83% (SN). CONCLUSIONS: It was observed that the recovery of propofol-remifentanil anesthesia was faster than that of sevoflurane-nitrous oxide anesthesia, except spontaneous breathing. The incidences of postoperative nausea/vomiting were low in both groups, and the incidences of agitation were higher in SN group than in PR group.

Appropriate Dose of Remifentanil for the Prevention of Emergence Agitation after Total Intravenous Anesthesia (TIVA) in Pediatric Patients Undergoing Tonsillectomy

BACKGROUND: Pediatric tonsillectomy may be associated with a high incidence of emergence agitation. The aim of this study was to determine the appropriate dose of remifentanil continuously administered in the postanesthetic care unit (PACU) to reduce the incidence of emergence agitation and side effects after total intravenous anesthesia (TIVA). METHODS: Sixty children aged from 4 to 12 years undergoing tonsillectomy were randomly assigned to 3 groups. Anesthesia was induced with 1.5 mg/kg of propofol, 1microg/kg of remifentanil and was maintained with continuous infusion of propofol 100microg/kg/min, remifentanil 0.25microg/kg/min. At the end of surgery, each group received 0.025 (group 1), 0.05 (group 2), or 0.1 (group 3)microg/kg/min of remifentanil, respectively and the infusion was discontinued at 10 min before PACU discharge. Duration of anesthesia and emergence time were evaluated at the operating room. Agitation score, the time of stay in PACU and postoperative side effects were evaluated at the PACU. RESULTS: The emergence time and the time of stay in PACU were prolonged in the group 3 compared to the other groups (P < 0.05). The Group 2 and 3 had lower agitation score in comparison with that of the group 1 in the PACU (P < 0.05). CONCLUSIONS: For reducing emergence agitation after TIVA, we recommend infusion dose of remifentanil 0.05microg/kg/min.

The Usefulness of Percutaneous Transluminal Angioplasty of the Middle Cerebral Artery Stenosis in Patients with Transient Ischemic Attack

PURPOSE: To determine the effectiveness of percutaneous transluminal angioplasty(PTA) of atherosclerotic middle cerebral artery(MCA) stenosis in patients with transient ischemic attack(TIA). MATERIALS AND METHODS: Ten patients with TIA who had undergone PTA were retrospectively investigated. In all ten, angiography revealed stenosis of the MCA. Mechanical dilatation was performed at the stenotic portion, and the angiographic findings after PTA, as well as peri/post-angioplastic complications, were evaluated. Four to 64 (mean, 23.5) months later, neurologic symptoms and the nature and timing of recurrent attacks were also assessed. RESULTS: The degree of stenosis before PTA was 50-75% in six patients and greater than 75% in four. Complete or partial angiographic recanalization of the stenotic segment occurred in nine patients (90%). During follow-up, seven patients recovered without recurrent TIA or cerebral stroke; one reported a tingling sensation and one experienced vertebrobasilar insufficiency. Motor aphasia developed in one patient after PTA, but after systemic heparinization, improved within 24 hours. One patient who suffered intracranial hemorrhage due to vascular rupture during PTA did three days later. CONCLUSION: PTA for atherosclerotic MCA stenosis in patients with TIA is an effective therapeutic method.

Action Mechanisms of Hormone Binding to Nuclear Receptors: Transcriptional Coregulators of the Nuclear Receptor Superfamily / 대한내분비학회지

No Abstract Available.

Association of castration-dependent early induction of c-myc expression with a cell proliferation of the ventral prostate gland in rat

The protooncogene c-myc is known to be associated with both cell proliferation and apoptosis. The possible cellular affects of castration on the ventral prostate gland of rat as well as the relationship to a castration induced c-myc expression were examined. Levels of c-myc mRNA in the ventral prostate gland peaked at 6 h (early induction) and 48 h (late induction) after castration, respectively. Castration-induced DNA fragmentation was not observed at an early induction of c-myc mRNA. DNA fragmentation appeared to be testosterone-dependent. On the other hand, cellular DNA synthesis measured by [3H]thymidine uptake in the ventral prostate gland was increased to maximum at 6 h after castration. These results suggest that an early induction of c-myc mRNA in ventral prostate gland after castration is closely associated with cell proliferation of the gland.

Superselective Embolization with Microcoil in Acute Gastrointestinal Hemorrhage

PURPOSE: To evaluate the efficacy and safety of superselective arterial embolization using the microcoil in acute gastrointestinal hemorrhage. MATERIALS AND METHODS: We evaluated 11 of 42 patients who had undergone diagnostic angiography and tran-scatheter arterial embolization due to acute gastrointestinal hemorrhage and subsequently underwent superselective arterial embolization using the microcoil. Nine were males and two were females, and their age ranged from 33 to 70 (mean, 51) years. The etiologies were bleeding ulcer (n=5), pseudoaneurysm from pancreatitis (n=3), and postoperative bleeding (n=3). The symptoms were melena, hematemesis, and hematochezia, and the critical signs were decreased hemoglobin and worsening of vital signs. All patients underwent superselective embolization using the microcatheter and microcoil. RESULTS: Bleeding occurred in the gastroduodenal artery (n=5), inferior pancreaticoduodenal artery (n=2), left gastric artery (n=2), right hepatic artery (n=1), and ileal branch of the superior mesenteric artery (n=1). All cases were treated succesfully, without complications. In one case in which there was bleeding in the right he-patic artery, reembolization with a microcoil was needed because of persistent melena. During follow up, three patients died from complications arising underlying diseases, namely disseminated intravascular coagulopathy, chronic renal failure, and adult respiratory distress syndrome. Procedural complications, such as ischemia or infarction were not noted. CONCLUSION: Superselective arterial embolization using the microcoil is a safe and effective method for the treatment of acute gastrointestinal bleeding, and does not lead to complications.