Protective Effects of Chlorogenic Acid against Experimental Reflux Esophagitis in Rats

Esophageal reflux of gastric contents causes esophageal mucosal damage and inflammation. Recent studies show that oxygen-derived free radicals mediate mucosal damage in reflux esophagitis (RE). Chlorogenic acid (CGA), an ester of caffeic acid and quinic acid, is one of the most abundant polyphenols in the human diet and possesses anti-inflammatory, antibacterial and anti-oxidant activities. In this context, we investigated the effects of CGA against experimental RE in rats. RE was produced by ligating the transitional region between the forestomach and the glandular portion and covering the duodenum near the pylorus ring with a small piece of catheter. CGA (10, 30 and 100 mg/kg) and omeprazole (positive control, 10 mg/kg) were administered orally 48 h after the RE operation for 12 days. CGA reduced the severity of esophageal lesions, and this beneficial effect was confirmed by histopathological observations. CGA reduced esophageal lipid peroxidation and increased the reduced glutathione/oxidized glutathione ratio. CGA attenuated increases in the serum level of tumor necrosis factor-alpha, and expressions of inducible nitric oxide synthase and cyclooxygenase-2 protein. CGA alleviates RE-induced mucosal injury, and this protection is associated with reduced oxidative stress and the anti-inflammatory properties of CGA.

Comparative Study of Posterior Lumbar Interbody Fusion with Posterolateral Fusion in Degenerative Lumbar Spinal Disorders

STUDY DESIGN: A retrospective study. OBJECTIVES: The authors found that problems such as axial pain, donor site pain, loss of reduction, loosening or failure of fixation materials occurred relatively frequently after posterolateral fusion. For this, we had views on the ideas that the problems could be improved by an operation that fused vertebral bodies. Furthermore, we performed posterior lumbar interbody fusion and wanted to know the results. SUMMARY OF LITERATURE REVIEW: We performed posterior lumbar inter-body fusion as an alternative, due to complications of autoiliac bone graft that has complications, such as donor site pain. MATERIALS AND METHODS: Sixty patients with single segment degenerative lumbar disease were treated with decompression, pedicle screws fixation, and spinal fusion. The patients were followed-up for more than 2 years. Thirty patients, who had undergone posterolateral fusion with autologous iliac bone graft, were classified as the "group 1". The second 30 patients, who underwent posterior lumbar interbody fusion with cage and local bone graft, were classified as the "group 2". The operation time, blood loss, fusion rate, lumbar lordotic angle, segmental angle were compared between the 2 groups. The clinical outcomes were evaluated by Kim's functional evaluation scale. RESULTS: The operation time was shorter in group 2 (142.74 minutes vs 171.64 minutes), there was a statistical difference between the 2 groups. Intraoperative blood loss was more in group 2 (563.40 vs 551.78 mL), but total blood loss, including postoperative drained blood was less in group 2. The bony fusion rate was 90% in group 1, 97% in group 2. For the lumbar lordotic angle, the last outcome was less than the preoperative value. There was no statistical difference between the 2 groups. The segmental angle in group 1, the last outcome was less than the preoperative value. The segmental angle in group 2 was maintained the value through pre-operation to post-operation. Clinical outcomes were satisfactory in group 1 (96.67%) & in group 2 (100%). In group 1, 7 patients experienced pain at the iliac graft donor site. In group 2, there were 2 cases of retroposition of the cage. CONCLUSIONS: In the posterior lumbar interbody fusion group, operation time was shorter, total blood loss was less than in the posterolateral fusion group. Restoration and maintenance of the segmental angle in sagittal and coronal radiographs showed better outcomes, axial pain and iliac donor site pain were less. It is the authors' position that posterior lumbar interbody fusion is an alternative operation to supplement the faults of posterolateral fusion.

A Case of Synovial Hemangioma of the Knee

We report an unusual case of a 17-years-old male with complaints of pain and swelling of the left knee for the last 3 years with limitation of movement. He presented with spontaneous hemarthrosis of the knee joint. Magnetic resonance imaging revealed an intra articular mass. Arthroscopic excision was performed and the histology was characteristic of synovial hemangioma. After 1 year, the patient was completely asymptomatic and showed no signs of recurrence.

Atonic Seizure with Hypotonia in a Patient with Parietal Lobe Epilepsy / 대한간질학회지

Atonic seizure shows characteristic features such as head drop because postural muscle tone is suddenly lost. Atonia of the seizure means no muscle tone and loss of electromyographic activities were reported. We report a left parietal lobe epilepsy patient with atonic seizure showing hypotonia on electromyography. A 27 year-old woman had intractable head drop seizures since 6 years old. Her brain MRI demonstrated cortical dysplasia in the left parietal lobe. During the video-EEG monitoring, she had 21 epileptic seizures which were atonic seizures. During her atonic seizures, simultaneous EMG recordings showed decreased muscle activities during the head drop attacks, instead of no muscle tone. This is the first case showing transient hypotonia during the atonic seizure, instead of atonia.

Atonic Seizure with Hypotonia in a Patient with Parietal Lobe Epilepsy

Atonic seizure shows characteristic features such as head drop because postural muscle tone is suddenly lost. Atonia of the seizure means no muscle tone and loss of electromyographic activities were reported. We report a left parietal lobe epilepsy patient with atonic seizure showing hypotonia on electromyography. A 27 year-old woman had intractable head drop seizures since 6 years old. Her brain MRI demonstrated cortical dysplasia in the left parietal lobe. During the video-EEG monitoring, she had 21 epileptic seizures which were atonic seizures. During her atonic seizures, simultaneous EMG recordings showed decreased muscle activities during the head drop attacks, instead of no muscle tone. This is the first case showing transient hypotonia during the atonic seizure, instead of atonia.

Two Solitary Lesions of Fibrous Dysplasia in the Tibia (A Case Report) / 대한족부족관절학회지

Fibrous dysplasia is a benign disease that causes replacement of the medullary bone with fibrous tissue in one or more bones. Long bone like femur, tibia and fibular are often affected and occurring under 30 years old. We report a case of two solitary lesions of fibrous dysplasia with pathologic fracture treated with bone curettage, bone graft, plate fixation, who complains of lower leg pain.

New V-shaped Technique in SLAP Repair (Comparison of Cinical Results Between New V-shaped Repair and Conventional Rapair Technique in Arthroscopic Type II SLAP Surgery)

PURPOSE: The purpose of this study was to compare clinical outcomes between the new V-shaped repair method and conventional methods for the arthroscopic repair of Type II SLAP lesions. MATERIALS AND METHODS: Our study population consisted of 23 people treated with the new V-shaped repair method or conventional methods in the arthroscopic repair of Type II SLAP lesions at our institution between May 2006 and October 2008. Eleven shoulders were treated using the new V-shaped repair method. Twelve shoulders were treated using conventional methods. The average follow up period was 15 months. For evaluation of clinical results, we used UCLA and VAS pain scores. RESULTS: Comparing change scores (preoperative vs. postoperative states) there were no significant differences in UCLA score or VAS score between the two groups. CONCLUSION: The new V-shaped repair technique elicits similar clinical results with conventional arthroscopic repair techniques and thus can be considered a useful alternative when using an absorbable suture that is anchor linked with only one suture.

The Calcaneus Fracture of Joint Depression Type with Lateral Subtalar Dislocation (A Case Report) / 대한족부족관절학회지

Calcaneus fracture with a subtalar dislocation are extremely rare. A case of a joint depression type calcaneus fracture with a lateral dislocation of the calcaneal posterior facet and tuberosity is presented. We treated it with open reduction and internal fixation with Steinmann pins and K-wires through limited posterior approach and obtained satisfactory radiographic and clinical outcome.

Clinical Investigation of Children with Severe Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: We attempted to investigate clinical characteristics of children with severe atopic dermatitis. METHODS: A total of 204 children diagnosed with Atopic dermatitis at the Pediatric Allergy Respiratory Center in Busan St. Mary's Medical Center from June 2006 to June 2008 were enrolled in this study. Cases were divided into 3 groups according to SCORAD index: severe, moderate and mild groups. We collected birth, environment, and allergic family history, and tested serum IgE, total eosinophil count, specific IgE, ECP (Eosinophil Cationic Protein) and the SCORAD index between the 3 groups. RESULTS: Of the 204 patients, 100 (49.02%) were included in the severe group, 51 (25.0%) in the moderate group, and 53 (25.98%) in the mild group. There were no differences in serum total IgE, serum total eosinophil counts and ECP between the severe and moderate groups. Serum total IgE, serum total eosinophil counts and ECP were relatively higher in the severe group than mild group. Food allergen sensitization rate was relatively higher in the infantile severe group than in the childhood severe group, while inhalant allergen sensitization rate was relatively higher in the childhood severe group than in the infantile severe group. There was no correlation between serum total IgE, serum total eosinophil counts, ECP and the number of sensitized allergens relative to SCORAD index in the severe group. CONCLUSION: Serum IgE, total eosinophil count, specific IgE and ECP may be specific indicators of children with severe atopic dermatitis. Further studies are needed to determine a clear distinction between severe and moderate atopic dermatitis patients.

A Case of Lipoid Pneumonia Induced by Aspiration of Shark Liver Oil / 소아알레르기및호흡기학회지

Lipoid pneumonia, a rare disease entity, results from accumulation of lipids in the alveoli. It results from the aspiration of vegetable, animal oil or mineral oil. Squalene is a derivative of shark liver oil that is taken as a traditional remedy in some Asian counties and is used widely also in cosmetics. Although many cases with predisposing factors have been reported, lipoid pneumonia can occur in normal individuals without predisposing factors. A 2-year-old boy was admitted to the hospital with a history of fever and cough for during 2 weeks. On physical examination, his lung sound was decreased in the right lung field. He was found to have infiltrate in the right upper lobe, middle and lower lung field on a chest radiograph. His parents fed him with squalene. High resolution computed tomography scan of the chest showed 'Crazy-paving appearance' in the right upper, middle and lower lobes. Lipoid pneumonia is suggested when there is a history of oil- or lipid- based product use or consumption. The characteristic finding of lipid materials, 'Crazy-paving appearance' in chest Computed Tomography (CT) or chest Magnetic Resonance Image (MRI), may be useful in the diagnosis of lipoid pneumonia. We report the case of lipoid pneumonia of a 2-year-old healthy child with a history of squalene.

Usefulness of Short-term Follow-up Enzyme Immunoassay in Mycoplasma pneumoniae Infection / 소아알레르기및호흡기학회지

PURPOSE: The diagnosis of Mycoplasma pneumoniae (M. pneumoniae) infection is usually based on serology using complement fixation assay (CFA), particle agglutination test (PA), enzyme immunoassay (EIA) and polymerase chain reaction (PCR). The objective of this study is to compare the performance of EIA and PCR in diagnosis of M. pneumoniae infection. We also evaluated the usefulness of EIA which were checked on short-term follow-up (3-5 days). METHODS: We included 234 pneumonia children. We used serum specimens for EIA test, which were obtained on admission and 3-5 days after admission. We collected throat swabs or sputums for PCR test, which were obtained on admission or next morning after admission. RESULTS: Of 234 patients, 124 (53.0%) met the diagnostic criteria. The median age was 6 years (from 10 months to 12 years). On admission, the sensitivity and specificity of EIA-specific IgM were 46.1% and 72.8%, respectively. The rate of agreement between PCR and EIA was 64.1%.(kappa=0.187, P=0.004) On 3-5 days after admission, the sensitivity and specificity rates of EIA specific IgM were 85.5%, 69.6%, respectively. The rate of agreement between PCR and EIA was 74.8%.(kappa=0.490, P=0.000) Days after onset had no relation with sensitivity of EIA.(P>0.05) The sensitivity and specificity rates of PCR were 57.5% and 90.0%, respectively. CONCLUSION: This study suggests that PCR and EIA may be the useful diagnostic methods for detecting early phase of M. pneumoniae infection. And EIAs which checked on short-term follow up is also useful. PCR has shown a higher specificity but lower sensitivity. Therefore, PCR must be performed with serologic tests.

A Case of Leigh Syndrome with Typical MRI and MRS Findings

Leigh syndrome (LS) is a genetically and clinically heterogeneous disorder caused by metabolic defects affecting lactate/pyruvate metabolism. The consequence of the metabolic defects are decreased amounts of APT and basic cell energy productions of the nervous system. In LS, several mutations have been reported in both the nuclear and the mitochondrial genome. Here, we report a 26-year-old woman clinically diagnosed with LS having characteristic brain MR and MRS abnormalities but without known definite pathogenetic mitochondrial DNA mutations.

Three Cases of Delayed Onset Post-traumatic Segmental Spinal Myoclonus

Segmental myoclonus can be seen in variable lesions of the brainstem or spinal cord, but the pathophysiology of the segmental myoclonus is not fully defined yet. We describe three patients with delayed developed and chronically persisted involuntary movement restricted to one arm after mild cervical injury. Myoclonus developed 1 month later in 2 patients and the other 5 months later after the injury. They suffered from myoclonus for more than 2 months, 1 year, and 25 years, respectively. Clonazepam and phenytoin were tried, but not satisfactory.

Three Cases of Delayed Onset Post-traumatic Segmental Spinal Myoclonus

Segmental myoclonus can be seen in variable lesions of the brainstem or spinal cord, but the pathophysiology of the segmental myoclonus is not fully defined yet. We describe three patients with delayed developed and chronically persisted involuntary movement restricted to one arm after mild cervical injury. Myoclonus developed 1 month later in 2 patients and the other 5 months later after the injury. They suffered from myoclonus for more than 2 months, 1 year, and 25 years, respectively. Clonazepam and phenytoin were tried, but not satisfactory.

A Case of Human Rabies Confirmed by Polymerase Chain Reaction

The human rabies is a fatal infectious disease invading the central nervous system. There are many cases of clinically suspicious human rabies encephalitis in Korea since 1906. A 53-year old man was admitted to the Department of Neurology because of rapidly progressive dysphagia. His sputum was examined and the rabies virus was found by the polymerase chain reaction technique. So we report a case of human rabies encephalitis confirmed by detection of the rabies virus from his saliva.