Assessment of collagen antibody-induced arthritis in BALB/c mice using bioimaging analysis and histopathological examination / 한국실험동물학회지

The aim of this study was to examine the therapeutic potential of sulfasalazine and prednisolone in a mouse collagen antibody-induced arthritis (CAIA) model. Twenty-five male BALB/c mice were randomly divided into five groups: group 1 (G1): control, group 2 (G2): probe control, group 3 (G3): CAIA, group 4 (G4): CAIA+sulfasalazine (10 mg/kg, oral), and group 5 (G5): CAIA+prednisolone (100 mg/kg, oral). Fluorescence bioimaging was performed in vivo 24 and 48 h after treatment with a fluorescence probe (OsteoSense® 680 EX), and all mice were sacrificed. The hind knee joints were fixed in 10% neutral phosphate-buffered formalin, and micro-computed tomography (micro-CT) and histopathological analyses were performed. The paw thickness increased in a time-dependent manner in G3 mice, but trended toward a decrease in both G4 and G5 mice. Fluorescence intensity increased in G3 mice at 24 and 48 h after fluorescence probe treatment, but the fluorescence intensity in G4 and G5 mice was lower than that in G3. Micro-CT analyses showed that the joint surfaces of G3 mice had a rough and irregular articular appearance, but the occurrence of these irregularities was lower in G4 and G5. Hematoxylin and eosin and Safranin O-fast green staining confirmed that destruction of the cartilage and bony structures, synovial hyperplasia, and inflammatory cell infiltration all occurred in G3, and that the occurrence of these phenomena was lower in G4 and G5 than in G3. Taken together, these results suggest that sulfasalazine and prednisolone can reduce acute rheumatoid arthritis in mice.

Repetitive Colonoscopic Decompression as a Bridge Therapy before Surgery in a Pregnant Patient with Chronic Intestinal Pseudo-Obstruction

Chronic intestinal pseudo-obstruction is a rare clinical syndrome which is characterized by intestinal obstruction without occluding lesions in the intestinal lumen and pregnancy is one of the important aggravating factors. Here, we report a case of a woman with intractable intestinal pseudo-obstruction that was precipitated by pregnancy. She could not make any stool passage for more than 4 weeks until a fetal gestational age of 17 weeks was reached. However, the patient could be maintained by repetitive colonoscopic decompressions and finally total colectomy could be performed successfully at a fetal gestational age of 21 weeks.

Efficacy of Early Infliximab Treatment for Pediatric Crohn's Disease: A Three-year Follow-up / 대한소아소화기영양학회지

PURPOSE: To investigate the efficacy of early infliximab use and to follow the progress of pediatric cases of Crohn's disease for 3 years. METHODS: We reviewed the medical records of 28 pediatric patients who had been treated with infliximab for Crohn's disease. Eighteen patients (the 'top-down' group) received infliximab and azathioprine for induction and maintenance therapy for the first year, and then were treated with azathioprine for 2 additional years. Ten patients who were refractory to conventional therapy were categorized in the 'step-up' group. All patients were followed for at least 36 months. Treatment efficacy was assessed by the relapse rate using the pediatric Crohn's disease activity index (PCDAI) score in each group at 12, 24, and 36 months. Blood samples were available from 10 patients, and were used to assess antibody to infliximab (ATI). RESULTS: The relapse rate in 'top-down' group was lower than that in 'step-up' group at 1, 2, and 3 years. But, just the relapse rate at the 2 years was significantly different. At 3 years, the relapse rate according to different characteristic variables (sex, age at diagnosis, involvement, PCDAI at diagnosis) was not significantly different. Only one patient treated with infliximab had an adverse event, consisting of dyspnea and tachycardia. ATI was not detected in the blood samples from 10 patients. CONCLUSION: Early induction with infliximab at diagnosis ('top-down' therapy) is effective for reducing the relapse rate compared to conventional therapies in pediatric Crohn's disease possibly for up to 3 years.

Benign Recurrent Intrahepatic Cholestasis with a Single Heterozygote Mutation in the ATP8B1 Gene / 대한소아소화기영양학회지

Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive inherited disorder characterized by multiple recurrent episodes of severe cholestatic jaundice without obstruction of extrahepatic bile duct. We present the case of a 7-year-old boy with BRIC confirmed by mutation analysis in the ATP8B1 gene and typical clinical manifestation. Despite inheritance of BRIC, we detected a mutation on only one allele. To our knowledge, this is the first report of BRIC with a confirmed single heterozygote novel mutation in the ATP8B1 gene in Korea.

Expression of Exogenous Human Hepatic Nuclear Factor-1alpha by a Lentiviral Vector and Its Interactions with Plasmodium falciparum Subtilisin-Like Protease 2

The onset, severity, and ultimate outcome of malaria infection are influenced by parasite-expressed virulence factors as well as by individual host responses to these determinants. In both humans and mice, liver injury follows parasite entry, persisting to the erythrocytic stage in the case of infection with the fatal strain of Plasmodium falciparum. Hepatic nuclear factor (HNF)-1alpha is a master regulator of not only the liver damage and adaptive responses but also diverse metabolic functions. In this study, we analyzed the expression of host HNF-1alpha in relation to malaria infection and evaluated its interaction with the 5'-untranslated region of subtilisin-like protease 2 (subtilase, Sub2). Recombinant human HNF-1alpha expressed by a lentiviral vector (LV HNF-1alpha) was introduced into mice. Interestingly, differences in the activity of the 5'-untranslated region of the Pf-Sub2 promoter were detected in 293T cells, and LV HNF-1alpha was observed to influence promoter activity, suggesting that host HNF-1alpha interacts with the Sub2 gene.

Short-Term Outcome of Curative One-Stage Laparoscopic Resection for Obstructive Left-Sided Colon Cancers Followed by Stent Insertion: Comparative Study with Non-Obstructive Left-Sided Colon Cancers

PURPOSE: Laparoscopic surgery has been considered to be contraindicated for treating malignant colorectal obstruction. Stent insertion for obstructive colorectal cancer has recently allowed laparoscopic surgery to be performed by means of preoperative bowel decompression and bowel preparation. The aim of this study is to evaluate the safety and the feasibility of a one-stage laparoscopic resection for obstructive left-sided colon cancer after stent insertion by comparing the results to those for non-obstructive left-sided colon cancer. METHODS: Between May 2006 and January 2009, a laparoscopic colorectal operation was performed on 18 consecutive patients with obstructive left-sided colon cancer after placement of a self-expandable stent by one colorectal surgeon, and the results were compared retrospectively to those for 43 patients with non-obstructive left-sided colon cancer who had undergone a laparoscopic procedure with the same surgeon. The collected data were the clinicopathologic characteristics, the perioperative complications, the oncologic outcomes, the postoperative recovery results, and the survival rate. RESULTS: The obstructive left-sided colon cancer group had significant benefits in retrieved lymph nodes (18.8+/-5.3 vs. 14.0+/-8.7, P=0.036), and distal resection margin (5.5+/-3.0 cm vs. 3.6+/-2.4 cm, P=0.011). There were no significant differences in other clinicopathological characteristics and oncologic outcomes, including the overall 3-yr survival rate, between the two groups. CONCLUSION: Preoperative stent decompression followed by a laparoscopic colorectal resection is a safe and feasible option for treating obstructive left-sided colon cancer. A further large-scale prospective study should be performed to evaluate the long-term outcome of a one-stage laparoscopic resection using stent insertion in cases of obstructive left-sided colon cancer.

Elective Laparoscopic Repair after Colonoscopic Decompression for Incarcerated Morgagni Hernia

Plain radiographs of an 88-year-old woman who had experienced vomiting and abdominal distention for 3 days revealed a severely obstructed ileus, and abdominopelvic computed tomography revealed an incarcerated Morgagni hernia. The endoscope was passed through the constrictions from the diaphragmatic indentations and a thin catheter was placed for decompression. The obstructive ileus regressed markedly after the procedure; the patient underwent elective laparoscopic repair of the hernia 1 week later. This is believed to be the first case of endoscopic preoperative decompression for an incarcerated Morgagni hernia.

Comparison of Radiologic and Clinical Results between Locking Compression Plate and Unlocked Plate in Proximal Humerus Fractures

PURPOSE: The purpose of this study is to compare the results of using a locking compression plate and an unlocked plate for treating proximal humeral fractures. MATERIALS AND METHODS: This study was based on 20 patients who underwent plate fixation for proximal humeral fractures out of the 87 patients with proximal humeral fractures and who were admitted from 2003 to 2007 in our hospital. Of the 20 patients, 10 were treated with a locking compression plate and the other 10 were treated with an unlocked plate. Each group was evaluated according to the humeral neck shaft angle, the period until bony union, the complications and the Constant score. The humeral neck shaft angle was based on plain x-rays taken immediately after the operation and at 6 months postoperatively. The Constant score was evaluated on the last visit to our clinic. RESULTS: There was no significant statistical difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. Yet, there were three cases of screw migration in the unlocked plate group. CONCLUSION: There was no significant difference between the two groups in terms of the neck shaft angle, the period until bony union and the Constant score. The locking compression plate is considered to achieve more effective fixation for proximal humerus fractures because there were less complications such as screw migration.

Nineteen Types of WNT Genes Mediate The Differentiation of C3H10T1/2 Cell Lines / 대한정형외과연구학회지

PURPOSE: In humans, nineteen types of WNT genes (WNTs) have been hightlighted up to date. The canonical Wnt cascade has recently emerged as a critical regulator of stem cells. To obtain new insights how nineteen WNTs affect mesenchymal stem cells differentiation, we analyzed the transcriptional activity, osteogenic and adipogenic activity of WNTs in mesenchymal stem cells. MATERIALS AND METHODS: Recombinant adenoviruses expressing nineteen WNTs were constructed to infect pluripotent mesenchymal progenitor C3H10T1/2 cells. Transcriptional activity was determined by using the luciferase reporter assay. Osteogenic activity was determined by measuring the induction of alkaline phosphatase upon Wnt stimulation. Adipogenic activity was measured by histochemical Oil red-O staining. RESULTS: WNT1, 2, 3, 3A and 10B significantly induced transcriptional activity in C3H10T1/2 cells. WNT1, 2, 3, 3A and 10B significantly induced alkaline phosphatase activity, but inhibited adipogenic activity in C3H10T1/2 cells. The results of qualitative and quantitative assay of alkaline phosphatase activity were consistent with those of luciferase assay for transcriptional activity and Oil red-O staining for adipogenic activity. CONCLUSION: We could expect that WNT1, 2, 3, 3A and 10B may play a crucial role in inducing osteoblast differentiation of mesenchymal stem cells.

Arthrographic Evaluation in Developmental Dislocation of the Hip: Comparison Between Hip Arthrogram and Operative Findings / 영남의대학술지

One of the main purposes in the treatment of developmental dislocation of the hip is to achieve and maintain concentric, congruent, and stable reduction. The arthrogram perform an important role in the diagnosis and treatment of developmental dislocation of the hip. The arthrogram provides much information about the soft tissue status of the hip joint. Limbus and ligamentum teres is exactly evaluated so we can plan the reduction and treatment before operation. 18 preoperative hip arthrograms of 17 children treated for developmental dislocation of the hip from 1992 to 1998 were reviewed. The limbus, ligamentum teres and transverse acetabular ligament were compared with the pathoanatomy seen at the time of open reduction. Arthrography proved reliable in identifying the limbus and ligamentum teres. So we recommend that arthrography must be performed before closed or open reduction. Also, we recorded the radiographic parameters: acetabular index, acetabular floor thickness, center edge(CE) angle of Wiberg, and Y-coordinate. The center edge(CE) angle of Wiberg obtained from arthrography was measured more accurately than from simple roentgenograms because the ossification of the femoral head was frequently located eccentrically in the developmental dislocation of the hip.