Effect of Cultivation Stages of Hericium erinaceus on the Contents of Major Components and α-Glucosidase Inhibitory Activity

Hericium erinaceus, also known as lion’s mane mushroom, is an edible and medicinal mushroom that belongs to the family Hericiaceae. We previously reported hericene A as an anti-diabetic constituent of H. erinaceus and the effect of cultivation substrates on its content was investigated. As the continuation, the contents of five major compounds such as hericenes A-D, which exerted α-glucosidase inhibitory activity, together with ergosterol were investigated depending on cultivation stages. H. erinaceus was cultured for 25 days (5 stages) to induce fruiting bodies, and the contents of the compounds at each stage were quantified. All the five compounds were detected in fruiting body by HPLC analysis. Among the hericene derivatives in the mushroom, the content of hericene A was the highest, followed by hericene C and the content of hericenes B and D was relative low. All four hericene derivatives present in the highest content at stage 4 whereas the content of ergosterol was highest at stage 5. The highest α-glucosidase inhibitory activity of H. erinaceus was measured at stage 4, which correlates with the contents of hericene derivatives. Conclusively, H. erinaceus with better efficacy and high content of active constituents can be secured by the optimization of cultivation conditions.

Percutaneous Cholecystostomy Is Appropriate as Definitive Treatment for Acute Cholecystitis in Critically Ill Patients: A Single Center, Cross-sectional Study / 대한소화기학회지

BACKGROUND/AIMS: Percutaneous cholecystostomy (PC) is an effective treatment for cholecystitis in high-risk surgical patients. However, there is no definitive agreement on the need for additional cholecystectomy in these patients. METHODS: All patients who were admitted to Cheju Halla General Hospital (Jeju, Korea) for acute cholecystitis and who underwent ultrasonography-guided PC between 2007 and 2012 were consecutively enrolled in this study. Among 82 total patients enrolled, 35 underwent laparoscopic cholecystectomy after recovery and 47 received the best supportive care (BSC) without additional surgery. RESULTS: The technical and clinical success rates for PC were 100% and 97.5%, respectively. The overall mean survival was 12.8 months. In the BSC group, mean survival was 5.4 months, and in the cholecystectomy group, mean survival was 22.4 months (p<0.01). However, there was no significant difference between these groups in multivariate analysis (relative risk [RR]=1.92; 95% CI, 0.77-4.77; p=0.16). However, advanced age (RR=1.05; 95% CI, 1.02-1.08; p=0.001) and higher class in the American Society of Anesthesiologists' physical status (RR=3.06; 95% CI, 1.37-6.83, p=0.006) were significantly associated with survival in the multivariate analysis. Among the 47 patients in the BSC group, the cholecystostomy tube was removed in 31 patients per protocol. Recurrent cholecystitis was not observed in either group of patients during the follow-up period. CONCLUSIONS: In high-risk surgical patients, PC without additional cholecystectomy might be the best definitive management. Furthermore, the cholecystostomy drainage catheter can be safely removed in certain patients.

A case of fulminant community-acquired Acinetobacter baumannii pneumonia in Korea

Acinetobacter baumannii (AB) is a common pathogen found in patients with hospital-acquired pneumonia all over the world. Community-acquired AB pneumonia, however, is very rare and has seldom been reported in Asia-Pacific countries. Community-acquired AB pneumonia has a fulminant course and is associated with a higher mortality than hospital-acquired AB pneumonia. In Korea, no case of fatal community-acquired AB pneumonia has been reported to date. Here, we describe the first fatal case of fulminant community-acquired AB pneumonia in Korea.

Isolated Spontaneous Dissection of the Proximal Superior Mesenteric Artery / 대한내과학회지

No abstract available.

A Case of Synchronous Triple Primary Cancers Occurring in the Stomach, Colon and Liver

Multiple primary cancers are defined as more than two primary cancers occuring in one patient, synchronously or metachronously. Detection of multiple primary cancers have been increased gradually, because of the improvement of diagnostic and therapeutic tools. Nevertheless, synchronous triple primary cancers have been regarded as rare disease. Here, we report a case of synchronous triple primary cancers occurring in the stomach, colon and liver. The patient was a 68-year-old man who complained intermittent dyspepsia. All of these cancers were diagnosed by upper and lower GI endoscopy, and abdominal CT scans in early stages. The patient was managed successfully with endoscopic submucosal dissection and radiofrequency ablation.

A Case of Anomalous Systemic Arterial Supply to the Left Lower Lobe without Sequestration / 대한내과학회지

No abstract available.

Three cases of premature coronary artery disease in systemic lupus erythematosus / 대한내과학회지

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a potential for multisystem organ dysfunction. Systemic lupus erythematosus patients have more frequent and earlier manifested atherosclerosis including coronary artery disease than the general population. We report three patients having SLE that have experienced acute coronary syndrome with onset at a relatively young age. The patients have premature atherosclerosis in a coronary artery as determined by coronary angiography and intravascular ultrasonography (IVUS). We suggest that systemic lupus erythematosus is a significant risk factor for coronary atherosclerosis.

Leptin expression in adenocarcinomas and adenomatous polyps in patients with colon cancer / 대한내과학회지

BACKGROUND: Though leptin, the adipocytes-derived hormone, plays an important role in obesity, it can act as a growth factor for several cancers including gastrointestinal malignancies. Based on this background, we investigated whether leptin expression correlated with the clinicopathological characteristics or disease outcome in patients with colon cancer. We immunohistochemically analyzed the expression of leptin in a "colon adenoma-carcinoma sequence" in the normal colon mucosa, an adenomatous polyp and adenocarcinoma tissue, from a surgical resection for each patient. METHODS: We collected samples from 24 patients with a colorectal adenocarcinoma that was removed in either a total colectomy or hemicolectomy, and who presented with an adenomoatous polyp and an adenocarcinoma in the same surgical specimen. Leptin expression was assessed using immunohistochemical methods and was evaluated by grading the staining intensity as 0, +1, +2, +3. RESULTS: Whereas leptin expression was observed in 4.2% (1/24) of the normal colon mucosa, adenomatous polyps and adenocarcinomas showed 33.3% (8/24) and 50.0% (12/24) expression of leptin, respectively (p<0.05), suggesting that leptin expression in the adenomatous polyps and adenocarcinomas was higher than in the normal colon mucosa (p<0.05). There was no significant difference in leptin expression between the adenomatous polyps and adenocarcinomas, statistically. There was no relationship between leptin expression and patients age, sex, BMI (body mass index), cancer stage, and lymph node metastasis. However, the tumor size in the positive leptin expression group was larger than in the negative leptin expression group (5.6+/-2.2 cm vs 3.9+/-1.4 cm; p<0.05) CONCLUSIONS: Since leptin expression in adenomatous polyps and adenocarcinomas was higher than in the normal colon mucosa and leptin expression significantly correlated with the tumor size, leptin might play a role in the development of an adenomatous polyp and an adenocarcinoma in the colon. However, leptin does not contribute to the progression of colon adenoma, and further evaluation studies will be required.

A Case of Steroid Refractory Acute GVHD Treated with IL-2 & TNF-alpha Blocker in a Myelodysplastic Syndrome Patient who Underwent Unrelated Allogeneic Stem Cell Transplantation

Hematopoietic stem cell transplantation has evolved as a central treatment modality for the management of various hematologic malignancies. Despite adequate posttransplantation immunosuppressive therapy, acute GVHD remains a major cause of morbidity and mortality, even for the patients who have received HLA identical sibling grafts. Once established, acute GVHD is difficult to treat, and the best primary treatments such as corticosteroid have shown responses of approximately 50%. Once GVHD becomes steroid-refractory, the chances of survival are slim at best, and the possibility of long-term complications from chronic GVHD is almost always the rule. Many agents are currently being evaluated to treat this malady, including ATG, monoclonal antibodies, pentostatin, denileukin diftitox, etc. We reported here on a case of steroid refractory acute GVHD that was treated with IL-2 and TNF-alpha blocker in myelodysplastic syndrome patient who underwent unrelated allogeneic stem cell transplantation.

Tumor Lysis Syndrome in Lymphoblastic Crisis of CML

Tumor lysis syndrome (TLS) defines the metabolic derangements that occur with tumor breakdown following the initiation of cytotoxic therapy. TLS results from the rapid destruction of malignant cells and the abrupt release of intracellular materials and their metabolites into the extracellular space. The syndrome causes hyperuricemia, hyperkalemia, hyperphosphatemia, secondary hypocalcemia and uremia. It can result in acute renal failure and be fatal. Early recognition of patient at risk and preventive measures are important. There is a high incidence of TLS in tumors with high proliferative rates and large burden such as acute lymphoblastic leukemia and Burkitt's lymphoma. It less commonly occurs in solid tumors such as testicular cancer, breast cancer and small cell lung cancer. There are only a few reports on TLS complicated in CML in blast crisis. So we report a 45-yr-old woman presenting with TLS associated with CML in lymphoblastic crisis after the initiation of cytotoxic chemotherapy.

Infliximab Therapy in Korean Patients with Ankylosing Spondylitis / 대한류마티스학회지

OBJECTIVE: Infliximab, a monoclonal antibody to tumor necrosis factor-alpha, is effective in patients with ankylosing spondylitis (AS), who have not responded to conventional therapy. There were no data on the efficacy and side effect of infliximab in patients with AS in Korea. The objective of this study is to observe the efficacy and adverse effect of infliximab retrospectively in Korean patients with AS. METHODS: We reviewed the medical records of thirty-three AS patients. The patients were enrolled to fulfill the modified New York criteria of AS and be in active disease state and resist to conventional therapy. Patients were given 3~5 mg/kg of infliximab infusions at weeks 0, 2, 8 and 16. Information on C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and antinuclear antibody (ANA) test was collected at each infusion. The paired t-test was used for comparison between the visits. RESULTS: There were 29 male and 4 female patients. The mean age at first infliximab treatment was 34.6+/-9.8 years. All patients were HLA-B27 positive. ESR and CRP decreased significantly from baseline to 16 weeks after treatment (p<0.001, respectively). The mean ESR was 76.1+/-36.5 mm/h at baseline and 21.3+/-31.6 mm/h at 16 weeks. The mean CRP was 6.4+/-4.8 mg/dL at baseline and 1.3+/-2.1 mg/dL at 16 weeks. Only 1 out of 33 patients got worse. All patients were tested negative for ANA at baseline. After 16 weeks of therapy, the induction of ANA was observed in 8 patients, but no patients have lupus-like symptoms. CONCLUSION: Infliximab is an effective therapy with non-specific adverse effect in AS non-responsive to conventional therapy in Korea.

A Case of Intramuscular Abscess Caused by Nocardia farcinica in a Patient with Lupus Nephritis Concurrent with Pulmonary Tuberculosis / 대한류마티스학회지

Nocardiosis is usually a subacute infection, which can occur as an opportunistic infections in patients with systemic lupus erythematosus. There are rare cases of nocardiosis concurrent with Mycobacterium tuberculosis. We report a case of intramuscular nocardial abscess concurrent with pulmonary tuberculosis in a patient with lupus nephritis. She has received cyclophosphamide pulse therapies and is receiving oral steroid therapy 3 months ago. After Nocardia farcinica and Mycobacterium tuberculosis were confirmed by PCR and PCR-RFLP, we initiated trimethoprim/ sulfamethoxazole and antituberculous agents. After then, patient was improved and discharged, maintaining the medications.

Outbreak of Hepatitis by Orientia tsutsugamushi in the Early Years of the New Millenium / 대한간학회지

BACKGROUND/AIMS: Orientia -tsutsugamushi infection is an acute febrile disease due to the accidental transmission through human skin of forest dwelling vector Leptotrombidium larva. The authors observed liver dysfunctions in patients diagnosed with tsutsugamushi disease (Scrub typhus) in the past 3 years and report the data in the hope of bringing attention to this disease in the differential diagnosis of autumn-season hepatitis, especially of non-A, non-B and non-C hepatitis. METHODS: Medical records of 22 patients diagnosed with tsutsugamushi disease by the hemagglutinin method between October 2000 and November 2002 were reviewed. RESULTS: Female gender was dominant in the ratio of 3.4:1. Mean age was 56.4 +/- 2.6. Admission was between 23rd September and 15th November with the peak between mid October and early November. Fever, being the most common symptom, was observed in 21 cases, myalgia in 13, arthralgia in 12, chills in 6, and skin rash in 6. An incubation period of 7-9 days was most common (10 cases), 13-15 days (4), 10-12 days (3), within 3 days (3), and 4-6 days (2). Average ALT, AST and GGTP were increased to 93.2 +/- 17.3 IU/L (18 +/- 345 IU/L), 92.5 +/- 11.7 IU/L (34-255 IU/L) and 132.2 +/- 14.5 IU/L (19-251 IU/L), respectively, but total bilirubin was normal. All the patients improved with doxycycline therapy. CONCLUSIONS: Since it usually shows liver dysfunction, it is important to take Orientia tsutsugamushi into consideration in differential diagnosis of autumn-season, febrile hepatic disease.