The Effects of Phlomis umbrosa Turcz on Osteoclast Differentiation / 체질인류학회지

Many bone-related diseases such as osteoporosis, rheumatoid arthritis are occurred by excessive bone resorbing activity of osteoclasts. Recently, many studies have been proceeded to find out the new therapeutic materials from natural products of plants. Phlomis umbrosa Turcz, one of the natural products of plants has been known to improve bone health. However, the precise effects and treatment mechanisms of Phlomis umbrosa Turcz about bone diseases has been unknown. So, we examined the effects of Phlomis umbrosa Turcz on expression of receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclast differentiation in bone marrow-derived macrophages (BMMs) and bone resorption. Also, we investigated the treatment mechanisms of Phlomis umbrosa Turcz relating to osteoclast differentiation. Here, we showed that Phlomis umbrosa Turcz significantly suppressed RANKL-induced osteoclast differentiation and bone resportion. Furthermore, Phlomis umbrosa Turcz suppressed the activation of NF-kappaB in bone marrow macrophage treated RANKL and M-CSF. The mRNA expression of c-Fos, nuclear factor of activated T-cells (NFAT)c1, osteoclast-associated receptor (OSCAR), tartrate-resistant acid phosphatase (TRAP) in BMMs was inhibited by Phlomis umbrosa Turcz. Integrin alphanu, beta3 relating to cell adhesion and dendritic cell-specific transmembrane protein (DC-STAMP) relating to the structure of filamentous actin (F-actin) ring and cathepsin K relating to bone resorbing activity are disrupted too. These results suggest that Phlomis umbrosa Turcz will be a good materials to treat bone diseases like osteoporosis.

Right Thalamic Hemorrhage Resulting from Low-voltage Electrical Injury: A Case Report

We report on a case of right thalamic hemorrhage resulting from low-voltage electrical injury caused by contact between a wet hand and an electronic scale. The patient was treated with clopidogrel for control of a previous cerebral infarction. The patient complained of numbness of the left upper extremity. On neurological examination, decreased motor power of her left side, grade IV, was observed. Findings on computerized tomography of the brain revealed a right thalamic hemorrhage. To the best of our knowledge, cerebral hemorrhage resulting from low-voltage electrical injury has not been previously reported in the literature.

Emergency Microsurgical Embolectomy for the Treatment of Acute Intracranial Artery Occlusion: Report of Two Cases

BACKGROUND: The main treatment for acute arterial ischemic stroke is intravenous or intra-arterial thrombolysis within a particular time window. Endovascular mechanical embolectomy is another treatment option in the case of major artery occlusion. Endovascular mechanical embolectomy is a useful technique for restoring blood flow in patients with large-vessel occlusion, and especially in those who are contraindicated for thrombolytics or in whom thrombolytic therapy has failed. CASE REPORT: We report herein two cases of emergency microsurgical embolectomy for the treatment of acute middle cerebral artery and internal carotid artery occlusion as an alternative treatment for major artery occlusion. CONCLUSIONS: Emergency microsurgical mechanical embolectomy may be an alternative treatment option for restoring blood flow in selected patients with large-vessel acute ischemic stroke.

A Case of Recurrent Bowel Perforation in a Patient with Churg-Strauss Syndrome / 대한류마티스학회지

Churg-Strauss syndrome is a rare systemic disorder characterized by asthma, eosionphilia and necrotizing vasculitis affecting small-to-medium-sized vessels. Although it is frequently associated with gastrointestinal mucosal lesions, recurrent bowel perforation is rare and potentially life threatening. We report a case of a 66-year-old man with Churg-Strauss syndrome, who presented with recurrent small bowel perforation. He was admitted with abdominal pain developed previous night, who had a previous small bowel perforation history treated with laparoscopic closure 5 months ago. Laboratory data showed remarkable eosinophilia. Physical examination indicated positive signs of peritoneal irritation in the entire abdomen, and abdominal computed tomography scanning showed edematous small bowel with intra-abdominal free air, suggesting intestinal perforation. He underwent laparoscopic small bowel closure and was treated with steroid.

Recanalization of Completely Thrombosed Non-Giant Saccular Aneurysm Mimicking as De Novo Aneurysm

Partial thrombosis of giant aneurysms is not uncommon however, complete angiographic occlusion occurs less frequently. In the case of non-giant aneurysms, complete thrombosis and recanalization has been rarely reported. A 31-year-old man presented to the emergency department with sudden bursting headache. Brain computed tomography (CT) revealed diffuse subarachnoid hemorrhage on the left side. Both CT angiography (CTA) and digital subtraction angiography showed suspicion of small left anterior choroidal artery aneurysm. We performed surgical exploration. In the operation field, anterior choroidal artery aneurysm of 2 x 2 mm with broad neck and friable appearance was observed. Because we could not clip without sacrificing the anterior choroidal artery, we performed wrapping only. Follow up CTA after 7 months demonstrated 4 mm right internal carotid artery bifurcation aneurysm. The patient underwent aneurismal neck clipping. During the operation, 9 x 13 mm sized thrombosed aneurysm was detected and completely clipped. We initially thought this aneurysm to be a de novo aneurysm however, it was an aneurysm that had recanalized from a completely thrombosed aneurysm. This case report provides an insight into the potential for complete thrombosis and recanalization of non-giant aneurysms.

A Case of Fatal DRESS Syndrome Caused by Dapsone in a Patient with Behcet's Syndrome / 대한류마티스학회지

Dapsone has been used for several dermatological conditions such as immunobullous disease and ulticarial vasculitis. Dapsone is very useful drug for treating the mucocutaneous manifestations of Behcet's disease. The widely recognized side effects of dapsone are headache, methemoglobinemia and hemolysis. The severer, but rarer side effect of dapsone is known as dapsone hypersensitivity syndrome, which consists of exfoliative dermatitis, hepatitis, lymphadenopathy and hemolytic anemia. When this is associated with eosinophilia, we can diagnose and treat this drug reaction with eosinophilia and systemic symptoms (DRESS). DRESS is a syndrome of fever, rash, and internal organ involvement that's secondary to administering the offending medication. We describe here a 47-year-old woman who was hospitalized with fever, skin rash, hemolytic anemia, lymphadenopathy, eosinophilia, pleural effusion and life threatening hepatitis, which could lead to hepatic failure, within three weeks of starting of dapsone therapy for controlling her oral and genital ulcers. We diagnosed the woman as suffering with DRESS syndrome and we started treatment with corticosteroid. Three weeks after starting therapy, her symptoms almost completely resolved and she was discharged.

Roles of Sphingosine-1 Phosaphate During Pathogenesis of Bone Destruction and Inflammation in Rheumatoid Arthritis Mice Model / 대한해부학회지

Sphingosine 1-phosphate (S1P) is a bioactive lipid molecule that mediates cell proliferation, differentiation, migration, and angiogenesis in vivo. However, the roles of S1P on pathogenesis of arthritis have been not completely understood. This study was designed to determine the effects of S1P modulation on collageninduced arthritis (CIA) model. DBA/1J mice were injected with collagen into the tail for induction of CIA model. S1P was administered into the peritoneal cavity every other days from day 1 to day 42 after collagen injection. To determine the degree of damage in CIA, we examined macroscopic findings of CIA. The inflammation and bone destruction of CIA mice were evaluated by histo-patholigy and radiography (CT and microradiography). The expressions of TNF-alpha, IL-6, and RANKL which have important roles in pathogenesis of rheumatoid arthritis and bone destruction were observed by immuno-histochemical staining. After injection with collagen in the DBA/1J mice, CIA was induced by swelling in the knee and ankle joint. Administration of S1P suppressed damages and incidence of arthritis elicited by collagen. In histologic and radiographic studies, S1P strongly suppressed the infiltration of inflammatory cells, the swelling of synovial membrane, erosion, and the destruction of bone on CIA mice. Injection of S1P resulted in down-regulation of the expression of the pro-inflammatory and bone destruction mediators such as TNF-alpha, IL-6, and RANKL on CIA mice. Furthermore, S1P suppressed the differentiation of bone marrow cells into osteoclasts by RANKL. In conclusion, this study suggest that S1P has protective effects on inflammation and bone destruction during pathogenesis of CIA, which indicates S1P can be a new possible therapeutic strategy for rheumatoid arthritis

Ruptured Aneurysm of Distal Posterior Inferior Cerebellar Artery: Report of Two Cases / 대한뇌혈관외과학회지

Aneurysms arising from the distal posterior inferior cerebellar artery (PICA) are rare. We present two cases of ruptured distal PICA aneurysms. A 48-year-old woman was admitted to our hospital because of sudden onset of severe headache and vomiting. A radiological examination revealed intraventricular hemorrhage (IVH) caused by rupture of a right distal PICA aneurysm. The aneurysm was clipped completely through a midline suboccipital approach. A 74-year-old woman was admitted to our hospital because of sudden onset of severe headache and vomiting, which was followed by unconsciousness. A radiological examination showed a hematoma in the cerebellar vermis and IVH from the fourth ventricle to the lateral ventricle with severe hydrocephalus caused by rupture of a left distal PICA aneurysm. After emergency extraventricular drainage was performed, the aneurysm was obliterated by the use of proximal parent artery clipping and coagulation. Aneurysms of the distal PICA are frequently associated with structural vascular anomalies and a high incidence of bleeding when these aneurysms are small. Thus, distal PICA aneurysms should be obliterated in almost all instances whenever they are encountered and these aneurysms should be managed immediately because of the high risk of rebleeding.

HO-1 Mediates Intracellular Calcium Modulation and Inhibits TNF-alpha-induced NF-kappaB Activity in Human Colonic Epithelial Cell Line / 대한해부학회지

Heme oxygenage-1 (HO-1) is the rate-limiting enzyme in heme catabolism, which leads to the generation of carbon monoxide (CO), biliverdin, and free iron. HO-1 has been known to show strong immunosuppressive properties although its mechanisms are not completely understood. In this study, it was therefore investigated anti-inflammatory properties of HO-1 in HT-29 cell, human colonic epithelial cell line. CoPPIX, HO-1 inducer, induced HO-1 expression without NF-kappa B activation and significantly blocked the I kappa B-alpha degradation by TNF-alpha in HT-29. Inhibition of HO-1 activity by ZnPPIX reversed the suppressive effects of CoPPIX on I kappa B-alpha degradation by TNF-alpha. Calcium chelating agent BAPTA/AM and calcium channel blockers, Verapamil and Flunarizine suppressed I kappa B-alpha degradation by TNF-alpha in HT-29 cells like CoPPIX while calcium ionophore A23187 also dose-dependently reversed the suppressive effects of CoPPIX on I kappa B-alpha degradation by TNF-alpha like a ZnPPIX. Interestingly, treatment of ZnPPIX increased basal intracellular calcium in HT-29 cells. Collectively, these results suggest that HO-1 exerts anti-inflammatory effects by down-regulation of NF-kappa B activity via suppression of intracellular calcium during pathogenesis of colitis in colonic epithelium.

The Effects of Heme Oxygenase-1 on Collagen Induced Arthritis Model / 대한해부학회지

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to inflammatory stresses. It has been known to show strong immunosuppressive properties although its mechanisms are not completely understood. This study was designed to determine the effects of HO-1 modulation on collagen induced arthritis (CIA) model. CIA model was induced by subcutaneous injection of collagen on tail of DBA/1J mice. For evaluation of HO-1 effects, an inducer of HO-1, cobalt protoporphyrin IX (CoPPIX), or an inhibitor of HO-1, tin protoporphyrin IX (SnPPIX), were administered every other days into peritoneal cavity from day 1 to day 42 after CIA induction. The macrocopic clinical findings of CIA were evaluated and histo-pathologic findings and radiographic analysis were carried out. The expressions of TNF-alpha, IL-6, and VEGF which have important roles in pathogenesis of rheumatoid arthritis were observed by immuno-histochemical staining. Collagen on DBA/1J mice induced arthritis at knee joint and ankle joint. Administration of CoPPIX significantly aggravated the severity of arthritis while SnPPIX protected collagen induced arthritis. SnPPIX strongly suppressed inflammatory cell infiltration, swelling of synovial membrane, and erosion and destruction of bone on CIA mice. Furthermore subcutaneous injection of collagen also increased expression of TNF-alpha, IL-6, and VEGF which are important pro-inflammatory mediators in rheumatoid arthritis. SnPPIX suppressed expression of the pro-inflammatory mediators on CIA mice. Finally, we suggest that HO-1 mediates the expression of pro-inflammatory mediators and bone destruction during pathogenesis of CIA, which indicates modulation of HO-1 can be a new therapeutic target of rheumatoid arthritis.

HO-1 Reduces the Severity of Trinitrobenzene Sulfonic Acid-induced Colitis through Suppression of NF-kappaB Activation / 대한해부학회지

Heme oxygenage-1 (HO-1), rate-limiting enzyme in heme catabolism, has been known to show strong immune-suppressive properties although its mechanisms are not completely understood. In this study, the authors investigated the mechanism whereby HO-1 has anti-inflammatory properties in trinitrobenzene sulfonic acid (TNBS)-induced colitis. Body weight was evaluated and tumor necrosis factor (TNF-alpha), interleukin (IL)-1beta and intercellular adhesion molecule-1 (ICAM-1) were detected by immunohistochemical staining. Heme oxygenase-1 (HO-1) expression was analyzed by Western blot and immunohistochemical staining. In a mouse model, HO-1 inducer, cobalt-protoporphyrin IX (CoPPIX) administration significantly improved the clinical symptoms and histopathologic changes of trinitrobenzene sulfonic acid (TNBS) colitis as well as significantly suppressed the expression of several inflammatory mediators such as TNF-alpha, IL-1beta and ICAM-1 induced by TNBS. Furthermore CoPPIX suppressed NF-kappaB activation that is an important transcription factor for expression of proinflammatory mediators in TNBS colitis while HO-1 activity inhibitor, zinc protoporphyrin IX (ZnPPIX) reversed the protective effects of CoPPIX in TNBS colitis. Collectively, these results suggest that HO-1 exerts anti-inflammatory effects by down-regulation of NF-kappaB activity via induction of HO-1 during pathogenesis of TNBS-induced colitis.

Cervical Spondylolysis in Child with Four Levels of Simultaneous Involvement: A Case Report

Cervical spondylolysis is a rare condition, and less than 100 cases have been reported in the world literature. Cervical spondylolysis is defined as a well corticated defect in the posterior element of a cervical vertebra. Although the etiology of cervical spondylolysis is unknown, its association with dysplastic changes and spina bifida occulta suggest that the lesion is congenital. Here, we describe the radiographs and CT images of cervical spondylolysis involving four levels in a 9 year old boy.

Systemic Administration of the Potassium Channel Activator in the Polystyrene Latex Bead-Induced Cerebral Vasospasm

No abstract available.