Effect of medicinal plant extract for hangover relief / 대한수의학회지

The present study was performed to evaluate the effect of medicinal plant extract on relieving hangovers in mice administered alcohol. The animals were divided into three groups. Each group was treated with fermented plant extract, non-fermented plant extract, or water 30 min after consuming ethanol (2 mL/kg). A locomotor activity test showed that all groups had decreased motor activity until 40 min after plant extract administration. The mice treated with water had lower motor activity until 100 min post-administration. However, the group treated with non-fermented plant extract showed increased motor activity 40 min post-administration, and the higher activity level was maintained until 120 min post-administration. The animals treated with fermented plant extract had a level of motor activity between those of the groups treated with water or non-fermented plant extract. Blood was collected from each mouse 120 min post-administration and aldehyde concentration was measured. The group treated with non-fermented plant extract had a significantly higher (p < 0.05) aldehyde concentration than the other groups. These results demonstrate that the non-fermented medicinal plant extract helped alleviate hangovers 40 min after administration by reducing aldehyde concentrations in the blood.

Congenital Ocular Motor Apraxia: Clinico-Radiological Analyses

BACKGROUND: Congenital ocular motor apraxia (COMA) is characterized by impaired voluntary saccades and abnormal head thrusts. However, mechanism of this disorder remains to be elucidated. METHODS: This study analyzed the eye movements and imaging findings in 16 patients with COMA, who had been recruited from 2003 to 2009 at the Neuro-Ophthalmology Clinic of Seoul National University Bundang Hospital. RESULTS: All the children showed impaired saccades and smooth pursuit in the horizontal direction. One of them also exhibited impaired vertical saccades and smooth pursuit. Eight children showed excessive blinks in association with an attempt to generate saccades. The typical head thrust usually developed around the age of eight months and had resolved by the age of 6-7 years. History of spasmus nutans was confirmed in seven children. Fourteen children showed cerebellar vermian hypoplasia, mostly in the inferior portion, and five of them also had dysgenesis of the corpus callosum. The severity of cerebellar vermian hypoplasia was correlated with developmental delay, as determined by the age of independent walking. CONCLUSION: Cerebellar vermian hypoplasia is a frequent finding in COMA. Dysfunction of the oculomotor vermis may responsible for the impaired saccades and smooth pursuit in COMA. The occasional association of COMA with spasmus nutans indicates a common pathophysiology of these benign developmental disorders.

Vestibular Evoked Myogenic Potential in Meniere's Syndrome

BACKGROUND: Acoustic stimulation of the saccule can evoke the vestibulocolic reflex and the inhibitory potential can be measured in the ipsilateral sternocleidomastoideus as a vestibular evoked myogenic potential (VEMP). We investigated the saccular dysfunction in patients with Meniere's syndrome by using VEMP, and correlated the findings with those of other vestibular function tests. METHODS: Thirty-six patients, 29 with Meniere's disease and 7 with delayed endolymphatic hydrops, underwent interictal VEMP. Eight patients reported Tumarkins otolithic crisis. The patients also had a bithermal caloric test, testing of the subjective visual vertical (SVV), and brainstem auditory evoked potentials (BAEP) in addition to pure tone and speech audiometry. RESULTS: Abnormal VEMP was observed in 21 (58.3%) patients. All the patients with abnormal VEMP showed decreased amplitude or absence of VEMP in the lesion side. Three of them also exhibited delayed p13 or n23 latency. The VEMP was abnormal in four of the 13 patients with normal calorics, 13 of the 21 with normal SVV, and 11 of the 21 with normal BAEP. The abnormal VEMP was more common in patients with delayed endolymphatic hydrops (71.4%) and Tumarkins otolithic crisis (75.0%), but without statistical significance. CONCLUSIONS: VEMP detects saccular dysfunction in Meniere's syndrome. The abnormal VEMP in some patients with normal calorics, SVV or BAEP suggests differential involvement of the vestibular subsystem in Menieres syndrome especially in the early stage.

Periodic Alternating Nystagmus from Focal Cerebellar Lesion

Periodic alternating nystagmus (PAN) is characterized by a periodical reversal in the direction of the nystagmus. PAN has rarely been reported in discrete cerebellar lesions. We report a patient with PAN from a focal cerebellar lesion, which developed after removal of an ependymoma in the fourth ventricle. The nystagmus decreased upon tilting the head in the direction of the nystagmus. The positional modulation of the nystagmus supports that PAN occurs from an abnormal velocity storage mechanism.

Reflex Epilepsy Induced by Tooth Brushing: A Case Report / 대한간질학회지

Reflex epilepsy describes seizures which are precipitated by clearly recognized stimuli. Reflex epileptic seizures triggered by tooth brushing are rare. We report a case with reflex epilepsy occurring exclusively during tooth brushing. He began having seizures at age 28. Neurological examinations and brain magnetic resonance images were found normal. On long term video-EEG monitoring, he presented two episodes of simple partial seizure induced by brushing molar and premolar teeth, which was right facial clonic movement persisting 3-5 seconds. He was unresponsive during the event, but had no postictal confusion. Ictal EEG showed 6 Hz rhythmic theta activity in the left frontocentral area. Interictal EEG was normal. The findings of EEG suggest that this reflex epilepsy might have epileptic focus in the left frontocentral area. Reasonable precaution such as gargling or less vigorous brushing of his teeth with fingers effectively prevented seizure recurrence.

Reflex Epilepsy Provoked by Mental Activities Mainly Associated with Use of the Hands / 대한간질학회지

There have been very few reports on reflex seizures induced by writing. Complex precipitating behaviors such as calculation, writing, copying of complicated figure, and spatial construction have been recognized as triggering factor of epileptic seizures. We report a case of a patient with a very unusual form of complex reflex epilepsy in which seizures are usually induced by writing or spatial construction. Neurological examination was normal and brain magnetic resonance imaging showed mild brain atrophy without focal lesion. During long-term video-EEG monitoring, she was instructed to write a letter with the right hand. About 20 minutes after writing, she experienced similar aura and motion arrest and then showed an elevation of bilateral upper extremities like myoclonic jerk followed by generalized tonic clonic seizure. On ictal EEG, spike and wave complexes appeared from both centroparietal region followed by 10 Hz rhythmic activities for 20 seconds. Interictal EEG was normal. Ictal-interictal subtraction image of brain SPECT (99mTc-HMPAO) showed hyperperfusion in the middle frontal gyrus and precentral gyrus of left frontal lobe and superior and inferior frontal gyrus of right frontal lobe. We suggest that this reflex epilepsy might be originated from both central areas with maximum on the left side. Oxcarbazepine was effective in controlling this reflex epileptic seizure.

Prognostic Influence of Plasma C-reactive Protein and Platelet P-selectin Expression in Patients with Ischemic Stroke

BACKGROUND: Inflammation and platelet activation are important pathological processes in ischemic stroke. However, little is known about their prognostic values in ischemic stroke. In this study, we investigated the 90 days prognostic influences of plasma C-reactive protein (CRP) and platelet P-selectin expression on the outcomes of ischemic stroke. METHODS: Between May 2001 and March 2002, Plasma CRP concentration and platelet P-selectin expression were evaluated for 24 hrs in 93 patients with first-ever ischemic stroke. Clinical outcomes were measured at 90 days by the Barthel index (BI). We examined the association between their values and the clinical outcomes and we adjusted the possible confounding factors using multiple logistic regression analysis. RESULTS: Of 93 patients, 31 patients showed poor clinical outcomes (BI<85). The poor clinical outcome was related with the initial CRP level (p<0.0001), platelet P-selectin expression (p=0.0004), neurologic deficit (p<0.0001), and leukocytes counts (0.0003). In multiple linear regression analysis, the CRP level (odds ratio, 2.833; 95 % CI, 1.216 to 6.317; p=0.012), and initial neurologic deficit (odds ratio, 1.8; 95 % CI, 1.136 to 2.818: p=0.012) were independently related with clinical outcome after 90 days of ischemic stroke onset. CONCLUSIONS: CRP is an important predictable marker for poor clinical outcome in ischemic stroke. These findings are consistent with the hypothesis that inflammatory processes may be a critical factor for the progressing deterioration of ischemic stroke.

Clinical Experience with Leuprorelin Acetate in the Treatment of Endometriosis / 대한산부인과학회잡지

OBJECTIVE: To evaluate the clinical efficacy and safety of Lorelin(R), a depot form of leuprorelin acetate made in Korea, in the treatment of endometriosis. MATERIALS AND METHODS: Twenty patients with surgically proven endometriosis were recruited and followed during about 21 weeks of treatment. Lorelin(R) 3.75 mg was injected every 4 weeks after the first injection following initial operation and a total of six doses were injected to a patient. Symptom severity score, chemical battery, lipid battery, and serum levels of follicule stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and CA-l25 were assayed before Lorelin(R) treatment, after 3 doses, and after 6 doses. Statistical analysis was performed utilizing repeated analysis of variance (ANOVA) and results with P-value less than 0.05 were considered significant. RESULTS: The age range at initial operation was 25 to 48 and the mean age was 36.5+/-6.1 (mean+/-SD) years. Symptom severity score and serum levels of LH, FSH, E2, and CA-125 were significantly lower after 3 and 6 doses of Lorelin(R) than before treatment. Transient elevation of liver enzyme was observed in 2 patients after 3 doses of Lorelin(R). Side effects were mainly due to treatment-induced hypoestrogenism and the most frequent symptom was hot flush (55%), vaginal dryness (30%), transient nausea sense (25%), and arthralgia (25%). All patients were able to tolerate these symptoms and no one discontinued Lorelin(R) therapy. CONCLUSION: This study suggests that Lorelin(R) could be an effective and safe regimen in the treatment of endometriosis.

Influence of Activin and Follistatin on Expression of Insulin-like Growth Factor (IGF)-I, II, Insulin-like Growth Factor Binding Protein (IGFBP)-1, 2, and 3 mRNA in Cultured Mouse Granulosa Cells / 대한산부인과학회잡지

OBJECTIVE: To investigate the influence of activin and follistatin on the expression of IGF (insulin-like growth factor)-I, II, IGFBP (insulin-like growth factor binding protein)-1, 2, and 3 mRNA in cultured mouse granulosa cells MATERIALS AND METHODS: The granulosa cells were obtained from the mouse and cultured for 6 days with 10 ng/ml of activin, 10 ng/ml of follistatin, and 10 ng/ml of activin with 10 ng/m of follistatin, respectively. The cells not treated with activin or follistatin served as control. Reverse transcription-polymerase chain reaction (RT-PCR) has been used to examine the expression of IGF-I, II, IGFBP-1, 2, and 3 mRNA. Results were analyzed with Kolmogorov-Smirnov test and analysis of variance (ANOVA) and statistical significance was defined as p<0.05. RESULTS: The expression of IGF-I and II mRNA were not different significantly. However, the expression of IGFBP-3 mRNA was significantly increased in the follistatin group compared to the control group (p<0.05) and significantly decreased in the activin with follistatin group compared to the control group (p<0.05). The expression of IGFBP-1 mRNA was seemed to be increased in the activin group and decreased in the follistatin group compared to the control group, respectively (p=0.07, p=0.07). The expression of IGFBP-2 and 3 mRNA were seemed to be decreased in the activin group compared to the control group (p=0.06, p=0.07, respectively). CONCLUSION: Activin and follistatin might play a role as regulators of mouse ovarian physiology by modulating the IGF system, especially IGFBPs.

The Serial Change of Platelet Activation for 90 Days in Patients with Atherosclerotic Ischemic Stroke

BACKGROUND: Platelet activation is an important process of atherothrombosis. However, there are few studies demonstrating the serial changes of platelet activation and the influences of the kinds of therapeutic strategies in atherosclerotic ischemic stroke from acute onset to the subacute phase. METHODS: We serially measured the expressions of CD63 on platelets in patients with atherosclerotic ischemic stroke (n=29) and compared them with normal subjects (n=52) and analyzed the effects to reduce the platelet activation according to the therapeutic strategies. RESULTS: The platelet CD63 expression (p<0.001) in atherosclerotic ischemic stroke significantly increased at 24 hours of ischemic stroke onset compared to normal subjects and their increment continually remained until 90 days after the ischemic events. Among the 29 patients, 12 patients treated with clopidogrel and aspirin showed significant decreases of the platelet CD63 expression (p=0.01) at 7 days compared to that at 24 hours. However, the reducing effect of this combination regimen disappeared after 90 days. CONCLUSIONS: These results suggest that the hyperexpression of CD63 on platelets in atherosclerotic ischemic stroke is not easily suppressed by regular anti-platelet medications.

GnRH Antagonist Multiple Dose Protocol in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer Compared with GnRH Agonist Long Protocol / 대한산부인과학회잡지

OBJECTIVE: To evaluate the efficacy of GnRH antagonist multiple dose protocol (MDP) in controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET) comparing with the standard GnRH agonist long protocol (GnRH-a LP). METHODS: From January 2000 to September 2002, 57 infertile women with tubal factor alone who had undergone IVF-ET were enrolled in the present study. Study group consisted of 28 patients in 28 cycles in which GnRH antagonist Cetrorelix 0.25 mg was given daily when the leading follicle reached 14 mm in mean diameter until the human chorionic gonadotropin (hCG) injection. Control group consisted of 29 patients in 29 cycles in which COH was performed using standard GnRH-a luteal LP. RESULTS: Patient's characteristics were comparable in both groups. Premature luteinization was not developed in all patients in each group. The number of ampules and duration of exogenous gonadotropins required were significantly lower in the study group than those in the control group (por=14 mm diameter on the day of hCG injection, the number of oocytes retrieved, fertilization rate, and the number of grade I, II embryos between the two groups, but the numbers of mature oocytes retrieved and fertilized oocytes were significantly lower in the study group than in the control group (p<0.01, p<0.01). The clinical pregnancy rate seemed to be lower in the study group, but the difference did not achieve significance (28.6% vs 34.5%). There were also no differences in the miscarriage rate and multiple pregnancy rate between the two groups. CONCLUSION: This study demonstrates that GnRH antagonist Cetrorelix MDP can result in the comparable pregnancy outcome as the GnRH-a LP and furthermore reduce the total dose of gonadotropins and duration of stimulation.

Panhypopituitarism in a Pregnant Woman with Ovarian Hyperstimulation Syndrome and Residual Pituitary Adenoma / 대한산부인과학회잡지

Ovarian hyperstimulation syndrome (OHSS) is one of the most serious complication of controlled ovarian hyperstimulation (COH) and ovulation induction. High serum estradiol concentration can induce the increase of capillary permeability and fluid shift, and it can results in hypovolemia, hemoconcetration, thromboembolism, oliguria, ascites and even death. This physiologic changes of OHSS and/or pregnancy might induce the deterioration of pituitary function in patients with abnormal pituitary conditions such as low pituitary reserve or tumor. However, all this while, panhypopituitarism or pituitary apoplexy in a pregnant woman with OHSS and/or pituitary adenoma has not been reported. We have experienced a case of panhypopituitarism developed in a pregnant woman with severe OHSS and residual pituitary adenoma. She had residual prolactinoma, despite a transsphenoidal adenoidectomy, and had suffered from uncontrolled hyperprolactinemia (HPRL) and chronic anovulation. Therefore, she had taken ovulation induction for getting a pregnancy and conceived, but, in the conception cycle, she was hospitalized for management of severe OHSS and hyperemesis gravidarum. During the period of hospitalization, abrupt panhypopituitarism was developed unexpectedly. Therefore, we present this case with the brief review of literature.

The Predictive Value of a Single Serum Beta Human Chorionic Gonadotropin Level in Pregnancies Achieved by Intrauterine Insemination and In Vitro Fertilization-Embryo Transfer Program / 대한산부인과학회잡지

OBJECTIVE: To clarify specific serum beta-human chorionic gonadotropin (beta-hCG) levels on 11 days after intrauterine insemination (IUI) and in vitro fertilization-embryo transfer (IVF-ET) that could predict live birth. METHODS: Three hundred ninety-two pregnancies resulting from IUI and IVF-ET procedures between January 1, 1997 and December 31, 2000 were evaluated. Serum quantitative beta-hCG levels were measured 11 days after IUI or ET using standard immunoradiometric assays. Pregnancy outcomes were categorized as spontaneous abortion, biochemical pregnancy, ectopic pregnancy, singleton live birth, or multiple live birth. Statistical analyses were performed by analysis of variances, and Student's t-test. The sensitivity and specificity of serum beta-hCG level for predicting live birth were plotted using receiver-operator-characteristic (ROC) curve. RESULTS: The multiple live birth group has significantly higher serum beta-hCG level among the different pregnancy outcome groups. The beta-hCG level on the eleventh day after IUI and IVF-ET was significantly higher in the live birth group than the non viable pregnancy group. At a threshold level of 65 mIU/ml, the serum beta-hCG level on the eleventh day after IUI had a positive predictive value of 78.9% in predicting live birth with 95% specificity. At a threshold level of 115 mIU/ml, the serum beta human chorionic gonadotropin level on the eleventh day after ET had a positive predictive value of 92.1% with 95% specificity. CONCLUSION: These data suggest that serum beta-hCG level on 11 days after IVF-ET could be a reliable indicator predicting pregnancy outcome.

A Case Report of Vertebral Artery Aneurysm and Preeclampsia Complicating a Pregnancy with Neurofibromatosis / 대한산부인과학회잡지

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."

The relationship between clinical response and urinary MHPG and plasma cortisol level in major depressives treated with tricyclics / 신경정신의학

No abstract available.