Nicotine alleviates alcohol-induced memory and long-term potentiation impairment.

Alcohol and nicotine are routinely abused together. There is one plausible explanation that comorbidity can alleviate alcohol-induced cognitive impairment. However, the mechanism involved is not known. The aim of this report was to evaluate the interactive effects of alcohol coadministration with nicotine on hippocampal memory and long-term potentiation (LTP). C57BL/6 mice were distributed into 4 treatment groups: control, alcohol, nicotine, and alcohol plus nicotine. All mice received tap water or alcohol solution and saline or nicotine. In water maze test, the alcohol group showed significant decreases in hippocampus function and acquisition training than control, nicotine, and combined treatment groups. The alcohol group also showed a significantly shorter latency in entering the foot-shock compartment than control, nicotine, and combined treatment groups in a passive avoidance test. Theta burst stimulation was adopted to induce concrete LTP in CA1 field recording using hippocampal slice. Alcohol alone administration failed to maintain LTP. Nicotine alone administration did not alter hippocampal LTP. There were no negative effects of alcohol on hippocampal LTP in mice administrated with nicotine. The current study successfully demonstrated beneficial effects of nicotine on alcohol induced memory impairment accompanied by hippocampal LTP impairment after one week of co-administration and one-day withdrawal.

[Rapunzel Syndrome Removed with Enteroscopy in a Child].

A trichobezoar is a type of bezoar that is composed of hair. In most cases, it is confined to the stomach, but in rare cases, it may extend to the small intestine. This condition is referred to as Rapunzel syndrome. The therapeutic method for bezoar removal depends on its type, location, and size. Generally, the treatment for Rapunzel syndrome involves surgical laparotomy. Endoscopic removal has also been effective in some cases. On the other hand, complications, such as respiratory difficulty and esophageal impaction may be encountered during endoscopic removal. Until now, the successful endoscopic removal of trichobezoars has been limited to the stomach or duodenum. This paper reports the case of a 4-year-old female patient with Rapunzel syndrome whose trichobezoar reached the proximal jejunum. The trichobezoar was removed without complications using an electrosurgical knife and snare through a single-balloon enteroscopy. The trichobezoar can be removed successfully using enteroscopy under general anesthesia without abdominal laparotomy in young children. Therefore, this method of removal can be considered preferentially for children with Rapunzel syndrome.

Propofol effects on cerebellar long-term depression.

Propofol is an intravenously administered anesthetic that induces γ-aminobutyric acid-mediated inhibition in the central nervous system. It has been implicated in prolonged movement disorders. Since the cerebellum is important for motor coordination and learning, we investigated the potential effects of propofol on cerebellar circuitry. Using the whole-cell patch-clamp technique in Wister rat cerebellar slices, we demonstrated that propofol administration impaired long-term depression from the parallel fiber (PF) to Purkinje cell (PC) synapses (PF-LTD). Also, propofol reduced metabotropic glutamate receptor 1 (mGluR1)-mediated and group I mGluR agonist-induced slow currents in PCs. These results suggest that the propofol-induced PF-LTD impairment may be related to an alteration in mGluR1 signaling, which is essential to motor learning.

Intestinal Malrotation With a Fixed Partial Volvulus in an Adult.

A 44-year-old man had been suffering from nausea, vomiting and watery diarrhea for 5 days and was then admitted to Dankook University Hospital. He had suffered from several episodes of mild symptoms, including abdominal distension, loss of appetite, easy satiety, nausea, vomiting, and diarrhea throughout his lifetime, but most episodes had been ignored by him or physicians. An upper gastrointestinal series and a computed tomography scan revealed an intestinal malrotation with a volvulus. In order to untwist the small bowel in a counterclockwise direction to about 180 degrees, we had to perform not only a dissection of Ladd's band, but also a dissection of other adhesions between the mesocolon and the mesenteric vessel trunk. Surgical intervention needs to be performed for an old intestinal malrotation with any symptoms because the structural or morphological change proceeds as time passes, which is caused by fibrosis due to tension being repetitively applied to Ladd's band, leading to its contraction. Furthermore, a severe contraction may even lead to a fixed partial volvulus.

Genipin induces cyclooxygenase-2 expression via NADPH oxidase, MAPKs, AP-1, and NF-κB in RAW 264.7 cells.

Genipin is a compound found in gardenia fruit extract with diverse pharmacological activities. However, the mechanism underlying genipin-induced cyclooxygenase-2 (COX-2) expression remains unknown. In this study, we investigated the effects of genipin on COX-2 expression and determined that exposure to genipin dose-dependently enhanced the production of prostaglandin E2 (PGE2), a major COX-2 metabolite, in RAW 264.7 cells. These effects were mediated by genipin-induced activation of the COX-2 promoter, as well as AP-1 and NF-κB luciferase constructs. Phosphatidylinositol-3-kinase/Akt and MAPKs were also significantly activated by genipin, and Akt and MAPKs inhibitors (PD98059, SB20358, SP600125, and LY294002) inhibited genipin-induced COX-2 expression. Moreover, genipin increased production of the ROS and the ROS-producing NAPDH-oxidase (NOX) family oxidases, NOX2 and NOX3. Inhibition of NADPH with diphenyleneiodonium attenuated ROS production, COX-2 expression and NF-κB and AP-1 activation. These results suggest that the molecular mechanism mediating ROS-dependent COX-2 up-regulation and PGE2 production by genipin involves activation of Akt, MAPKs and AP-1/NF-κB.

Bilateral adrenal pheochromocytoma with a germline L790F mutation in the RET oncogene.

About ten percent of pheochromocytomas are associated with familial syndrome. Hereditary pheochromocytoma has characteristics of early onset, multifocality and bilaterality. We experienced a case of 44-year-old man with bilateral pheochromocytoma without evidence of medullary thyroid cancer. Genetic test detected a L790F germline mutation of RET oncogene. The author found a necessity for genetic tests in cases of young-age, bilateral pheochromocytoma.

A case of unexpected regeneration of small intestinal mucosal necrosis.

If full-thickness mucosa, including the mucosal crypt, has been almost denuded, mucosa cannot regenerate as has been shown by animal models. The authors experienced an unusual mucosal regeneration exceed denuded bowel that occur in midgut volvulus of duration 2 days in a 6-day-old infant. Santulli's jejunostomy was performed using seriously denuded small bowel to prevent short bowel syndrome, despite the risks of leakage or stricture. Subsequently, stomal mucosa was fully regenerated when grossly identified 19 days after the second operation without any surgical complications.

Infantile vulvar abscess with a normal anus: a suspicious sign of rectovestibular fistula.

PURPOSE: We investigated whether infantile vulvar abscesses are predictable features of rectovestibular fistula with a normal anus. MATERIALS AND METHODS: A retrospective analysis of five infants with vulvar abscesses and rectovestibular fistulae with normal anuses was performed. RESULTS: Four cases had a left vulvar abscess, and in one case the vulvar abscess was on the right side. All caregivers reported passage of stool from the vagina. The fistulae were almost uniformly located from the vestibule to the rectum above the anal dentate line, observable by visual inspection and probing under anesthesia. The first two cases were treated with division and closure of the fistulae after a diverting loop colostomy, and the remaining three cases with fistulotomy and curettage. There was no recurrence during the median follow-up period of 38 months. CONCLUSION: This unique rectovestibular fistula should be suspected in female infants with vulvar abscesses, especially when parents report passage of stool from the vagina. Fistulotomy and curettage may be an initial treatment and effective as a temporary diverting colostomy and delayed repair of the fistula.

Hepatic fibrosis scan for liver stiffness score measurement: a useful preendoscopic screening test for the detection of varices in postoperative patients with biliary atresia.

OBJECTIVE: Even after successful Kasai portoenterostomy, progressive hepatic fibrosis in postoperative patients with biliary atresia (BA) can be associated with portal hypertension and esophageal or gastric varices. Therefore, early diagnosis and close follow-up of varices are important. We investigated the correlation between the liver stiffness scores measured by FibroScan and the presence of esophageal or gastric varices to examine the usefulness of FibroScan as a preendoscopic screening test for varices. PATIENTS AND METHODS: A total of 49 of 81 children with BA following successful Kasai operations were enrolled in this study. FibroScan and endoscopic examination were performed prospectively. RESULTS: There were 22 males (44.9%) and the mean age of the patients was 3.8 +/- 2.7 years. Esophageal or gastric varices were present in 30 patients (Vx group) and absent in 19 (nVx group). The mean liver stiffness score was significantly higher in the Vx group (21.35 +/- 10.31 kPa in the Vx group versus 9.75 +/- 8.61 kPa in the nVx group, P < 0.001). The optimal cutoff value of the liver stiffness score for the prediction of a varix was 9.7 kPa with a sensitivity of 0.97 and a specificity of 0.80. CONCLUSIONS: Liver stiffness scores measured by FibroScan correlate well with the presence of esophageal or gastric varices. FibroScan is a novel, noninvasive, and useful screening method for the preendoscopic detection of varices in postoperative patients with BA.

Gastric volvulus associated with agenesis of the left lobe of the liver in a child: a case treated by laparoscopic gastropexy.

Association of gastric volvulus with agenesis of the left lobe of the liver is very rare and mostly reported in adults. We report a case of gastric volvulus associated with agenesis of the left lobe of the liver in a child, which was successfully treated by laparoscopic gastropexy.

Prenatal diagnostic clue for fetus in fetu.

The purpose of this paper is to define a prenatal diagnostic clue for fetus in fetu (FIF) based on the characteristic findings of four FIF cases studied by the authors. A retrospective analyses of prenatal ultrasonography (US), postnatal US, computed tomography (CT) scans and operative findings were carried out on each of the four FIF cases collected from a multi-center. Prenatal US findings for each of the four cases showed a fluid-filled sac with a solid portion "floating" within it. In addition, bony structures were found in the solid portion. In each of the four cases, the postpartum imaging studies were consistent with the prenatal US findings. Operative findings revealed a solid mass within a fluid-filled sac surrounded by a transparent membrane. The solid mass was connected to the membrane by a stalk. Histopathologically, the cells making up the sac were of the same type as those of the amnion, while the solid mass had the general characteristics of FIF. In conclusion, FIF can be suspected when prenatal US shows a solid mass with bony structures within a fluid-filled sac in a newborn.