Moringa oleifera Prolongs Lifespan via DAF-16/FOXO Transcriptional Factor in Caenorhabditis elegans

Here in this study, we investigated the lifespan-extending effect and underlying mechanism of methanolic extract of Moringa olelifa leaves (MML) using Caenorhabditis elegans (C. elegans) model system. To define the longevity properties of MML we conducted lifespan assay and MML showed significant increase in lifespan under normal culture condition. In addition, MML elevated stress tolerance of C. elegans to endure against thermal, oxidative and osmotic stress conditions. Our data also revealed that increased activities of antioxidant enzymes and expressions of stress resistance proteins were attributed to MML-mediated enhanced stress resistance. We further investigated the involvement of MML on the aging-related factors such as growth, food intake, fertility, and motility. Interestingly, MML significantly reduced growth and egg-laying, suggesting these factors were closely linked with MML-mediated longevity. We also observed the movement of aged worms to estimate the effects of MML on the health span. Herein, MML efficiently elevated motility of aged worms, indicating MML may affect health span as well as lifespan. Our genetic analysis using knockout mutants showed that lifespan-extension activity of MML was interconnected with several genes such as skn-1, sir-2.1, daf-2, age-1 and daf-16. Based on these results, we could conclude that MML prolongs the lifespan of worms via activation of SKN-1 and SIR-2.1 and inhibition of insulin/IGF pathway, followed by DAF-16 activation.

Lindera obtusiloba Extends Lifespan of Caenorhabditis elegans

Lindera obtusiloba has been widely used as a traditional medicine for the treatment of lots of diseases, including abdominal pain, bruise, and hepatocirrhosis. Here in this study, we elucidated the lifespan-extending effect of methanolic extract of Lindera obtusiloba (MLO) using Caenorhabditis elegans model system. We found that MLO has potent lifespan extension activities under normal culture condition. Then, we determined the protective effects of MLO on the stress conditions such as osmotic, thermal and oxidative stress. To reveal possible mechanism of MLO-mediated lifespan, we further investigated the effect of MLO on the antioxidant enzyme activities and intracellular ROS levels. Our results demonstrated that superoxide dismutase and catalase activities were significantly up-regulated by MLO treatment, resulted in reduced intracellular ROS levels. In this work, we also tested whether MLO-mediated longevity activity was associated with aging-related factors such as food intake and growth. Our data revealed that both of pharyngeal pumping rate and body length were significantly shifted by MLO treatment, indicating these factors were involved in MLO's lifespan-extension effects. Although MLO induces reduction in food intake, the body movement of MLO-fed aged worms was not decreased, compared to untreated control worms, indicating MLO might extend lifespan without affecting healthspan.

A Case of Pseudomembranous Colitis in Old Age which was Misdiagnosed as Acute Appendicitis with Perforation

Pseudomembranous colitis is mostly related to antibiotics and it presents symptoms of diarrhea, abdominal pain, fever, hypoalbuminemia and hypovolemia. Diarrhea is the most common manifestation, but in geriatric patients, symptoms of pseudomembranous colitis can be different from those of usual cases and the course of disease can be more aggressive. For these reasons, it can be misdiagnosed. So physicians must take pseudomembranous colitis into consideration in older patients with acute abdominal pain, who have been treated with antibiotics. We reported a case of an older patient with pseudomembranous colitis which was misdiagnosed as acute appendicitis with perforation.

Staphylococcus aureus Pericardial Abscess Presenting as Severe Sepsis and Septic Shock After Acupuncture Therapy

Pericardial abscess is an extremely rare complication of Staphylococcus aureus bacteremia. We report a case of a 72-year-old woman with multiple acupuncture scars on both knees who presented with shortness of breath and general weakness. Transthoracic echocardiography and pericardiocentesis confirmed the presence of pericardial fluid collection. Staphylococcus aureus grew in both pericardial fluid and blood. Although an aggressive medical treatment including intravenous antibiotics and percutaneous drainage, the patient died 2 days after admission.

A Case of Acute Cerebral Infarction in Adult Cor Triatriatum Sinistrum / 대한내과학회지

Cor triatriatum is a rare congenital malformation of the heart characterized by a fibromuscular membrane dividing the atrium into two distinct chambers. In the majority of cases, it is diagnosed in early childhood, whereas adult cases are extremely rare [1,2]. The hemodynamics of cor triatriatum are similar to those of mitral stenosis, which sometimes cause embolic infarction. We describe an unusual case of cor triatriatum sinistrum in a 48-year-old man who presented with relapsed embolic infarction.

Successful Treatment of an Iatrogenic Giant Femoral Artery Pseudoaneurysm With Percutaneous Thrombin Injection

A femoral artery pseudoaneurysm (FAP) is one of the most troublesome complications following invasive procedures related to the femoral arterial access. Post-procedure FAP rarely occurs; however, its occurrence tends to increase with the more frequently antiplatelet agents, anticoagulants, and larger-sized catheter used for interventional procedures. Traditionally, surgical repair has been considered as the standard treatment modality for FAP; however, less invasive methods currently exist such as blind manual or ultrasound-guided compression repair (UGCR) as well as percutaneous thrombin injection, both of which have replaced the need for surgery. We report a case of a giant pseudoaneurysm in a femoral artery, which had developed as a complication of stenting in a patient with carotid artery stenosis and ischemic heart disease, and was subsequently successfully treated using percutaneous thrombin injection.

Retroperitoneal Fibrosis with Duodenal Stenosis

Retroperitoneal fibrosis is a rare disease characterized by the formation of dense plaque of fibrous tissue covering the retroperitoneal structures. This disease is commonly presented as ureteral obstruction, but the involvement of duodenum is rare. We report a case of retroperitoneal fibrosis which was complicated with duodenal stenosis and was successfully treated with corticosteroids. A 58-yr-old man, who had history of aorto-iliac bypass graft due to arteriosclerosis obliterans with infrarenal aortic occlusion was admitted to the hospital with abdominal pain and a mass. Abdominal CT scan revealed the periaortic soft tissue mass encircling grafted aorta and stenosis of duodenal third portion. Retroperitoneal fibrosis with duodenal stenosis was diagnosed and prednisolone therapy was initiated. Follow-up CT scan showed that the patient responded to prednisolone therapy with eased pain, shrinking periaortic mass, and reduced duodenal stenosis.

A Villous Adenoma with Foci of Adenocarcinoma Arising in the Common Hepatic Duct / 대한소화기내시경학회지

Villous adenoma of the extrahepatic duct is a rare disease. Even though it is benign, it has malignant potential and is considered a premalignant lesion. We here report one case of villous adenoma with foci of adenocarcinoma arising in the common hepatic duct. A 60-year-old male was admitted to our hospital because of epigastric pain. The cholangiogram revealed a large filling defect in the right intrahepatic and common hepatic duct with intrahepatic bile duct dilatation. The patient underwent right lobectomy. Grossly, stalked papillay tumor originated in the common hepatic duct was overriding the right intrahepatic duct. Microscopically, the tumor was composed of stratified tall columnar cells with various dysplasia and there were foci of invasive adenocarcinoma.

An Incidentally Found Emphysematous Cystitis / 대한신장학회잡지

Emphysematous cystitis is rare disease associated with gas in the bladder wall and lumen. Presentation is varied and sequelae may be minor, severe or fatal. Treatment consists of administration of appropriate antibiotics, control of blood glucose, and adequate bladder drainage. We present a case of emphysematous cystitis with diabetic woman, who did not present symptoms of cystitis but abdominal pain, nausea and vomiting. In our case, it was detected incidentally on simple radiography. After administration of susceptible parenteral antibiobcs and control of blood glucose level, her symptoms were improved.

Recent trends and clinical outcomes of infective endocarditis / 대한내과학회지

BACKGROUND: We sought to analyze the recent trends and clinical outcomes of infective endocarditis in Korea using newly proposed diagnostic criteria, Duke criteria, for this potentially life-threatening disease. METHODS: Retrospective analysis of medical records including echocardiographic data, blood culture and operation records was done for 156 patients (male 103) with clinical diagnosis of infective endocarditis at Asan Medical Center from 1989 to January 1998. RESULTS: One hundred eighteen patients (75%) fulfilled the criteria for definite group (Group I) in Duke criteria, whereas 38 patients (25%) for possible group (Group II). Mean age was 48+/-16 years. Although valvular heart disease was the most common underlying heart disease (49/156, 31%), in more than half (84/156, 54%) infective endocarditis was the first clinical presentation without previous medical history of any cardiac disease. Surgical intervention was required in 69 patients (44%), and the frequency of surgery during hospital course did not show any difference in Group I versus Group II (44% vs. 45%). Overall mortality was 17%, and did not show any difference in Group I versus Group II. Surgical mortality was 12% (8/69), which was not significantly different form mortality with medical treatment (21%, 18/87). Among 98 survivors in Group I, 84 patients (86%) were followed for average 34+/-24 months (0.5-98 months). Five-year survival and event-free survival rate were 85+/-7 % and 57+/-8 % respectively. CONCLUSION: Recently the mean age of patients with infective endocarditis increased dramatically, and infective endocarditis could be an initial clinical presentation without any previous medical history of cardiac disease in many patients. Surgical intervention was needed in considerable numbers of patients and infective endocarditis still shows relatively high mortality. There were no significant different clinical features in Group I and II.

A Case of Anomalous Origin of Left Coronary Artery from the Pulmonary Artery with Severe Mitral Regurgitation

We report a case of an anomalous origin of left coronary artery from the pulmonary artery with severe mitral regurgitation. A 20-year-old female was admitted to hospital for recurrent syncope and dyspnea on exertion. Cardiac ausculatation revealed systolic murmur radiating to left axilla and blood pressure of 90/70 mmHg. Electrocardiography showed a nonspecific ST-T wave change on V1, V2, V6, I, & aVL leads. Holter monitering showed no significant abnormality except occasional premature ventricular complexes. Chest radiography showed mild cardiomegaly with mitral valvular heart configuration and no pulmonary abnormality. Echocardiography showed normal left ventricular dimension and systolic function with marked dilated left atrium, severe mitral regurgitation, & severe resting pulmonary hypertension. Aortogram didn't show left coronary artery ostium. Right coronary angiogram showed normal right coronary artery which supplied major left epicardial coronary arteries via good collaterals (Rentrop grade III). Pulmonary angiogram showed anomalous origin of left coronary artery from main pulmonary trunk. She underwent mitral valvuloplasty and coronary artery bypass graft.