Dioscorea Extract (DA-9801) Modulates Markers of Peripheral Neuropathy in Type 2 Diabetic db/db Mice

The purpose of this study was to investigate the therapeutic effects of DA-9801, an optimized extract of Dioscorea species, on diabetic peripheral neuropathy in a type 2 diabetic animal model. In this study, db/db mice were treated with DA-9801 (30 and 100 mg/kg, daily, p.o.) for 12 weeks. DA-9801 reduced the blood glucose levels and increased the withdrawal latencies in hot plate tests. Moreover, it prevented nerve damage based on increased nerve conduction velocity and ultrastructural changes. Decrease of nerve growth factor (NGF) may have a detrimental effect on diabetic neuropathy. We previously reported NGF regulatory properties of the Dioscorea genus. In this study, DA-9801 induced NGF production in rat primary astrocytes. In addition, it increased NGF levels in the sciatic nerve and the plasma of type 2 diabetic animals. DA-9801 also increased neurite outgrowth and mRNA expression of Tieg1/Klf10, an NGF target gene, in PC12 cells. These results demonstrated the attenuation of diabetic peripheral neuropathy by oral treatment with DA-9801 via NGF regulation. DA-9801 is currently being evaluated in a phase II clinical study.

A Successful Reconstruction of Superior Mesenteric Artery Aneurysm

Superior mesenteric artery (SMA) aneurysm is rare but shows high risk of rupture. Mycotic aneurysm is the most common cause of SMA aneurysm, followed by atherosclerosis. Diagnosis is usually made by ultrasonography or abdominal CT scanning. Because of its particular anatomy, surgical treatment is often challenging for the surgeons. We present a successful reconstruction of the SMA after ligation of SMA aneurysm in a 43-year-old man who suffering from epigastric and back pain for 5 months.

Complications after Renal Transplantation

PURPOSE: The medical records of 524 renal recipients who have been transplanted until December 2000 in our hospital were reviewed in order to compare the incidence of the surgical and medical complications according to their different treatment protocols. METHODS: To compare the surgical complications, the recipients were divided according to their ureter reconstruction method and donor type. Group 1; living donor and modified Politano method are done. Group 2; living donor but an extravesical ureteroneocystostomy. Group 3; cadaver donor and an extravesical anastomosis. Regarding the medical complications, recipients who received Sandimmun based immunosuppression (with steroid and/or azathioprine) were grouped as 1, those recipients with Neoral based immunosuppression (with steroid and/or cellcept) were grouped as 2, and re-cipients immunosuppressed by prograf based immunosuppression (with steroid and/or cellcept) were grouped as 3. The incidence of complications and adverse effects in each group and per recipient were described as the percentage of the total incidence. RESULTS: Most of the surgical complications including an allograft rupture, ureteral fistula, lymphocele and reoperation due to bleeding were developed during the first month after transplantation but decreasing in group 2 and 3. An ureter stricture and renal artery stenosis developed after 6 months. Infectious complications were developed in 60.7% of recipients and among them, a viral infection occurred in 41.9% which was followed by bacterial and fungal infection. However, the incidence of infection also decreased in group 3. Herpes infections were the most common in viral infection and their incidence showed a dual peak (within 6 months and after 1 year). The recurrence of the original disease, mostly a focal sclerosing glomerulosclerosis, and de novo cancer showed lower incidence in group 3 but the follow up duration should be considered. Tremor and hirsutism are two of the most common adverse effects but showed a different incidence in group 3. Some side effects such as diarrhea, post-transplant diabetes were more common in group 3 than in group 1 and 2. CONCLUSION: The decreasing incidence of complications and the drug side effects in recent days might be due to a better understand of the surgical procedures and the development of new immunosuppressants. However, new side effects or toxicity by new immunosuppressant must be considered seriously.

A Case of Duodenal Bulb Carcinoid Tumor Causing a Carcinoid Syndrome without Liver Metastasis / 대한소화기내시경학회지

A primary duodenal carcinoid tumor causing carcinoid syndrome is rare. In case of accompanying carcinoid syndrome in a primary duodenal carcinoid tumor, it mostly suggests massive liver metastasis. In rare case, venous drainage of carcinoid tumor and systemic venous drainage are directly connected without passing through the portal system. Therefore, it is rare and interesting case which a primary duodenal carcinoid tumor accompanies carcinoid syndrome without liver metastasis. We experienced an occasion of a primary carcinoid tumor located in duodenal bulb in a 56 year-old woman. This patient came to our hospital because of intermittent diarrhea, epigastric pain and facial flushing. And it was surely diagnosed as carcinoid tumor by gastrointestinal endoscopic biopsy. She was hospitalized for surgery and we were able to confirm that carcinoid syndrome was accompanied through biochemical test. However, metastatic lesion was not found at liver, small and large intestine. We report this case with reference to documents due to rarity.

Cytokeratin Expressions in Normal Nasal Mucosa, Nasal Polyps, Inverted Papilloma, and Squamous Cell Carcinoma Tissues / 대한이비인후과학회지

All epithelial cells express more than 2 cytokeratins, and their tissue distribution is determined by cellular types, location, and degree of differentiation. It is known that changes in cytokeratin expression accompany squamous metaplasia of the human nasal epithelium. We analysed cytokeratin expression patterns and their significance in normal nasal mucosae, nasal polyps, inverted papillomas, and maxillary squamous cell carcinomas using immunohistochemical staining with anti-CK4, CK8, CK10, CK13, CK17, CK18, and CK19. Nasal polyp showed the same pattern of cytokeratin expression as that of nasal mucosa. While CK10 expression was present only in the tissue of squamous cell carcinoma, CK18 and CK19 were not expressed. Specimens of Inverted papilloma expressed CK4 and CK13 only in the suprabasal layer, and CK17 in the basal and suprabasal layers. In contrast, normal epithelium expressed CK13 and CK17 only in the basal layer, and CK4 in the basal and suprabasal layers. CK8 and CK18 were less expressed in the specimen of inverted papilloma than in the normal nasal mucosa. The expression patterns of CK10 and CK19 suggest that they may play a role in determinating the malignant change of inverted papilloma and in investigating the pathogenesis of inverted papilloma and maxillary cancer.