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1.  Ibuprofen Associated Acute Vanishing Bile Duct Syndrome and Toxic Epidermal Necrolysis in an Infant 
Yonsei Medical Journal  2014;55(3):834-837.
Acute vanishing bile duct syndrome, a rare but rapidly progressive destruction of the intrahepatic bile ducts with unknown pathogenesis, is most often a drug- or toxin-related. Toxic epidermal necrolysis is a serious dermatologic condition and a potentially life threatening disease, which is drug or infection induced. Ibuprofen associated acute vanishing bile duct syndrome and toxic epidermal necrolysis have not been reported previously in infants. We report a 7-month-old infant with ibuprofen associated toxic epidermal necrolysis, followed by severe and rapidly progressive vanishing bile duct syndrome. She recovered totally with supportive care.
doi:10.3349/ymj.2014.55.3.834
PMCID: PMC3990079  PMID: 24719156
Acute vanishing bile duct syndrome; toxic epidermal necrolysis; infant
2.  Clinical Characteristics of Failure to Thrive in Infant and Toddler: Organic vs. Nonorganic 
Purpose
To investigate the clinical characteristics and outcomes among infants and toddlers with failure to thrive (FTT).
Methods
This retrospective study was done with 123 patients who had visited Pusan National University Children's Hospital during their first two years of life and had received an FTT diagnosis. We compared the clinical characteristics of the patients based on the causes of their FTT and their ages at the time of first hospital visit. We investigated triggering factors, feeding practices, and outcomes in 25 patients with nonorganic FTT (NOFTT).
Results
Eighty cases (65.0%) were NOFTT. The gestational ages, birth weights, and weights at the first visits were significantly lower in patients with organic FTT (OFTT) (p<0.05). Infants who had first visited the clinic at age <6 months had the least z-score. The percentage of patients with severe weight decline was higher in OFTT than in NOFTT (60.0% vs. 17.3%). The z-scores at the follow-up visits were improved after treatment in both of the groups. Preceding infection was the most common triggering factor of NOFTT and persecutory feeding as abnormal behavior of caregiver was observed in 22 cases (88.0%). After treatment with feeding method modification, all patients with NOFTT showed normal growth.
Conclusion
Weight decline is more severe in OFTT patients and in younger patients at the first visit. Infants with FTT can attain normal weight gain growth by treating organic diseases and supplying proper nutrition in OFTT, and by correcting abnormal dietary behavior of caregiver in NOFTT.
doi:10.5223/pghn.2013.16.4.261
PMCID: PMC3915728  PMID: 24511523
Failure to thrive; Infant
3.  Juvenile Polyp and Colonoscopic Polypectomy in Childhood 
Purpose
This study aimed to evaluate the clinical features of juvenile polyp and the usefulness of polypectomy with entire colonoscopy in children.
Methods
We retrospectively reviewed the medical records of 83 children who were diagnosed with having juvenile polyps.
Results
The mean age of the patients was 6.5±3.7 (range 1.3-14.5 years) years. The male to female ratio was 2.1 : 1. Eighty one patients (97.6%) had hematochezia, of which the observed characteristics included red stool (74.1%), blood on wipe (13.6%). The time interval between the 1st episode of hematochezia and colonoscopy was 8.9±20.4 (ranged 0.1-48.0) months. The most proximal regions of colonoscopic approach were terminal ileum (96.4%). Sixty three patients (75.9%) had a solitary polyp and 20 patients (24.1%) had multiple polyps. The sites of the polyps were rectum (61.4%), sigmoid colon (23.5%). Eighteen polyps (15.1%) were found more proximal locations than rectosigmoid. The polyp size ranged from 0.3 to 5 cm. After the polypectomy, hematochezia recurred in 9 patients. Endoscopic hemostasis was performed in 2 patients due to severe bleeding. All procedures were carried out without using general anesthesia.
Conclusion
Juvenile polyp occurred in a wide range locations and had variable sizes and numbers, suggesting that colonoscopy on the entire colon is necessary. Colonoscopic polypectomy is a simple and useful therapeutic method in children with juvenile polyp.
doi:10.5223/pghn.2012.15.4.250
PMCID: PMC3746052  PMID: 24010095
Juvenile polyp; Colonoscopy; Polypectomy; Child
4.  Role of colonoscopy in the diagnosis and treatment of pediatric lower gastrointestinal disorders 
Korean Journal of Pediatrics  2010;53(9):824-829.
The safety and effectiveness of colonoscopy in the investigation of lower gastrointestinal tract pathology in children has been established for more than 2 decades in Korea. Skill and experience have since advanced to the point that both diagnostic and therapeutic colonoscopy are now routinely performed by most pediatric gastroenterologists. Pediatric colonoscopy differs significantly from its adult parallels in nearly every aspect including patient and parent management and preparation, selection criteria for sedation and general anesthetic, bowel preparation, expected diagnoses, instrument selection, imperative for terminal ileal intubation, and requirement for biopsies from macroscopically normal mucosa. Investigation of inflammatory bowel disease, whether for diagnosis or follow-up evaluation, and suspected colonic polyps are the most common indication for pediatric colonoscopy. The child who presents with signs and symptoms of lower gastrointestinal disorder should undergo colonoscopy with biopsy to make the diagnosis, as well as to help determine the appropriate therapy. This review introduces practical information on pediatric colonoscopy, the author's experiences, and the role of colonoscopic examination in the diagnosis and treatment of pediatric lower gastrointestinal disorders.
doi:10.3345/kjp.2010.53.9.824
PMCID: PMC3005213  PMID: 21189966
Colonoscopy; Children
5.  Association between Urinary Bisphenol A and Waist Circumference in Korean Adults 
Toxicological Research  2014;30(1):39-44.
Bisphenol A (BPA) is widely used in the production of polycarbonate plastics, epoxy resins, and food and beverage containers. In the present study, we aimed to investigate the relationship between urinary concentrations of BPA and waist circumference in Korean adults. A total of 1,030 Korean adults (mean age, 44.3 ± 14.6 years) were enrolled in the study on the integrated exposure to hazardous materials for safety control, conducted by the Ministry of Food and Drug Safety from 2010 to 2012. Abdominal obesity was defined as having a waist circumference of at least 90 cm and 85 cm for men and women, respectively. The participants were divided into 4 groups according to the urinary BPA concentration quartile. Waist circumference was significantly higher among subjects with a urinary BPA concentration in the highest quartile relative to those in the lowest quartile (p = 0.0071). Linear regression analysis revealed a significant positive association between urinary BPA concentrations and body mass index, body fat, after adjusting for potential confounders. Moreover, subjects with urinary BPA concentrations in the fourth quartile were more likely to be obese compared to those with urinary BPA concentrations in the first quartile (odds ratio, 1.938; 95% CI: 1.314~2.857; p for trend = 0.0106). These findings provide evidence for a positive association between urinary BPA concentration and waist circumference in Korean adults.
doi:10.5487/TR.2014.30.1.039
PMCID: PMC4007042  PMID: 24795798
Bisphenol A; Waist circumference; Korean adults
6.  Dietary Patterns in Children with Attention Deficit/Hyperactivity Disorder (ADHD) 
Nutrients  2014;6(4):1539-1553.
The role of diet in the behavior of children has been controversial, but the association of several nutritional factors with childhood behavioral disorders has been continually suggested. We conducted a case-control study to identify dietary patterns associated with attention deficit hyperactivity disorder (ADHD). The study included 192 elementary school students aged seven to 12 years. Three non-consecutive 24-h recall (HR) interviews were employed to assess dietary intake, and 32 predefined food groups were considered in a principal components analysis (PCA). PCA identified four major dietary patterns: the “traditional” pattern, the “seaweed-egg” pattern, the “traditional-healthy” pattern, and the “snack” pattern. The traditional-healthy pattern is characterized by a diet low in fat and high in carbohydrates as well as high intakes of fatty acids and minerals. The multivariate-adjusted odds ratio (OR) of ADHD for the highest tertile of the traditional-healthy pattern in comparison with the lowest tertile was 0.31 (95% CI: 0.12–0.79). The score of the snack pattern was positively associated with the risk of ADHD, but a significant association was observed only in the second tertile. A significant association between ADHD and the dietary pattern score was not found for the other two dietary patterns. In conclusion, the traditional-healthy dietary pattern was associated with lower odds having ADHD.
doi:10.3390/nu6041539
PMCID: PMC4011050  PMID: 24736898
dietary pattern; attention deficit/hyperactivity disorder (ADHD); school-aged children; Korean
7.  In Vitro Anti-Osteoporosis Properties of Diverse Korean Drynariae rhizoma Phenolic Extracts 
Nutrients  2014;6(4):1737-1751.
Drynariae rhizoma has been used to prevent bone loss that occurs with increasing age. However, the chemical compounds in extracts that act on bone metabolism in herbal medicine are poorly understood. This study aimed to investigate and compare the extraction efficacy of polyphenolic compounds, antioxidant activity, and in vitro anti-osteoporosis properties of water extract (DR-DW) and ethanol extract (DR-EtOH) from D. rhizoma. Total phenolics and flavonoids were better extracted with 70% EtOH, and this extraction method also resulted in higher antioxidant activity and in vitro anti-osteoporosis properties in these extracts. In particular, the contents of phloroglucinol, protocatechuic acid ethyl ester, 2-amino-3,4-dimethyl-benzoic acid, 3-(3,5-dimethyl-pyrazol-1-yl)-benzoic acid, chlorogenic acid, syringic acid, trans-ferulic acid, (−)-epigallocatechin, epigallocatechin gallate, quercetin dehydrate, luteolin and emodin in DR-EtOH were higher than those in DR-DW. These results indicated that DR-EtOH could be a good source of natural herbs with anti-osteoporosis properties.
doi:10.3390/nu6041737
PMCID: PMC4011064  PMID: 24763116
Drynariae rhizoma; extraction solvent; phenolic compounds; antioxidant; anti-osteoporosis
8.  Aggravation of Relapsing Polychondritis due to the Infection and Its Manifestation on a Nasal Tip Graft 
Relapsing polychondritis (RP) is an uncommon systemic disease that is characterized by episodic and progressive inflammation of the cartilaginous structures, which can be very debilitating and in some instances life-threatening. The pathogenic pathways of RP are largely unknown. However, several hypothesis have been suggested. We had an interesting case of aggravation of RP due to the infection. Graft cartilage on the nasal tip was affected by RP also. This case can give a clue of revealing the pathogenesis of RP. We introduce a case with a review of the literature.
doi:10.3342/ceo.2014.7.1.63
PMCID: PMC3932352  PMID: 24587884
Relapsing polychondritis; Nose; Cartilage; Antibody; Foreign-body reaction
9.  Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis 
Objectives
This study extended and updated a meta-analysis of the association between exposure to dichlorodiphenyltrichloroethane (DDT) and the risk of breast cancer.
Methods
We reviewed the published literature on exposure to DDE and breast cancer risk to update a meta-analysis from 2004. The total of 35 studies included 16 hospital-based case–control studies, 11 population-based case–control studies, and 10 nested case–control studies identified through keyword searches in the PubMed and EMBASE databases.
Results
The summary odds ratio (OR) for the identified studies was 1.03 (95% confidence interval 0.95–1.12) and the overall heterogeneity in the OR was observed (I2 = 40.9; p = 0.006). Subgroup meta-analyses indicated no significant association between exposure to DDE and breast cancer risk by the type of design, study years, biological specimen, and geographical region of the study, except from population-based case–control studies with estimated DDE levels in serum published in 1990s.
Conclusion
Existing studies do not support the view that DDE increases the risk of breast cancer in humans. However, further studies incorporating more detailed information on DDT exposure and other potential risk factors for breast cancer are needed.
doi:10.1016/j.phrp.2014.02.001
PMCID: PMC4064641  PMID: 24955316
breast cancer; dichlorodiphenyldichloroethylene; meta-analysis; pesticide exposure; systematic review
10.  Site-specific growth and density control of carbon nanotubes by direct deposition of catalytic nanoparticles generated by spark discharge 
Nanoscale Research Letters  2013;8(1):409.
Catalytic iron nanoparticles generated by spark discharge were used to site-selectively grow carbon nanotubes (CNTs) and control their density. The generated aerosol nanoparticles were deposited on a cooled substrate by thermophoresis. The shadow mask on top of the cooled substrate enabled patterning of the catalytic nanoparticles and, thereby, patterning of CNTs synthesized by chemical vapor deposition. The density of CNTs could be controlled by varying the catalytic nanoparticle deposition time. It was also demonstrated that the density could be adjusted by changing the gap between the shadow mask and the substrate, taking advantage of the blurring effect of the deposited nanoparticles, for an identical deposition time. As all the processing steps for the patterned growth and density control of CNTs can be performed under dry conditions, we also demonstrated the integration of CNTs on fully processed, movable silicon microelectromechanical system (MEMS) structures.
doi:10.1186/1556-276X-8-409
PMCID: PMC3850720  PMID: 24090218
Carbon nanotubes; Thermophoresis; Patterning; Spark discharge; Chemical vapor deposition
11.  Evaluation of Airborne Particle Emissions from Commercial Products Containing Carbon Nanotubes 
The emission of the airborne particles from epoxy resin test sticks with different CNT loadings and two commercial products were characterized while sanding with three grit sizes and three disc sander speeds. The total number concentrations, respirable mass concentrations, and particle size number/mass distributions of the emitted particles were measured using a condensation particle counter, an optical particle counter, and a scanning mobility particle sizer. The emitted particles were sampled on a polycarbonate filter and analyzed using electron microscopy. The highest number concentrations (arithmetic mean = 4670 particles/cm3) were produced with coarse sandpaper, 2% (by weight) CNT test sticks and medium disc sander speed, whereas the lowest number concentrations (arithmetic mean = 92 particles/cm3) were produced with medium sandpaper, 2% CNT test sticks and slow disc sander speed. Respirable mass concentrations were highest (arithmetic mean = 1.01 mg/m3) for fine sandpaper, 2% CNT test sticks and medium disc sander speed and lowest (arithmetic mean = 0.20 mg/m3) for medium sandpaper, 0% CNT test sticks and medium disc sander speed. For CNT-epoxy samples, airborne particles were primarily micrometer-sized epoxy cores with CNT protrusions. No free CNTs were observed in airborne samples, except for tests conducted with 4% CNT epoxy. The number concentration, mass concentration, and size distribution of airborne particles generated when products containing CNTs are sanded depends on the conditions of sanding and the characteristics of the material being sanded.
doi:10.1007/s11051-012-1231-8
PMCID: PMC3507461  PMID: 23204914
Airborne particles; Carbon nanotubes; Number concentration; Particle size distribution; Respirable mass concentration; Sanding
12.  Use of the i-gel™ supraglottic airway device in a patient with subglottic stenosis -a case report- 
Korean Journal of Anesthesiology  2013;65(3):254-256.
The airway management of patients with subglottic stenosis poses many challenges for the anesthesiologists. Many anesthesiologists use a narrow endotracheal tube for airway control. This, however, can lead to complications such as tracheal mucosal trauma, tracheal perforation or bleeding. The ASA difficult airway algorithm recommends the use of supraglottic airway devices in a failed intubation/ventilation scenario. In this report, we present a case of failed intubation in a patient with subglottic stenosis successfully managed during an i-gel™ supraglottic airway device. The device provided a good seal, and allowed for controlled mechanical ventilation with acceptable peak pressures while the patient was in the beach-chair position.
doi:10.4097/kjae.2013.65.3.254
PMCID: PMC3790038  PMID: 24101961
Airway management; Subglottic stenosis
13.  Congenital Internal Hernia Presented with Life Threatening Extensive Small Bowel Strangulation 
Internal hernia (IH) is a rare cause of small bowel obstruction occurs when there is protrusion of an internal organ into a retroperitoneal fossa or a foramen in the abdominal cavity. IH can be presented with acute or chronic abdominal symptom and discovered by accident in operation field. However, various kinds of imaging modalities often do not provide the assistance to diagnose IH preoperatively, but computed tomography (CT) scan has a high diagnostic accuracy. We report a case of congenital IH in a 6-year-old boy who experienced life threatening shock. CT scan showed large amount of ascites, bowel wall thickening with poor or absent enhancement of the strangulated bowel segment. Surgical exploration was performed immediately and had to undergo over two meters excision of strangulated small bowel. To prevent the delay in the diagnosis of IH, we should early use of the CT scan and take urgent operation.
doi:10.5223/pghn.2013.16.3.190
PMCID: PMC3819693  PMID: 24224153
Intestinal obstruction; Hernia; Child
14.  Mechanical Stretching for Tissue Engineering: Two-Dimensional and Three-Dimensional Constructs 
Mechanical cell stretching may be an attractive strategy for the tissue engineering of mechanically functional tissues. It has been demonstrated that cell growth and differentiation can be guided by cell stretch with minimal help from soluble factors and engineered tissues that are mechanically stretched in bioreactors may have superior organization, functionality, and strength compared with unstretched counterparts. This review explores recent studies on cell stretching in both two-dimensional (2D) and three-dimensional (3D) setups focusing on the applications of stretch stimulation as a tool for controlling cell orientation, growth, gene expression, lineage commitment, and differentiation and for achieving successful tissue engineering of mechanically functional tissues, including cardiac, muscle, vasculature, ligament, tendon, bone, and so on. Custom stretching devices and lab-specific mechanical bioreactors are described with a discussion on capabilities and limitations. While stretch mechanotransduction pathways have been examined using 2D stretch, studying such pathways in physiologically relevant 3D environments may be required to understand how cells direct tissue development under stretch. Cell stretch study using 3D milieus may also help to develop tissue-specific stretch regimens optimized with biochemical feedback, which once developed will provide optimal tissue engineering protocols.
doi:10.1089/ten.teb.2011.0465
PMCID: PMC3402846  PMID: 22335794
15.  Analysis of the association between necrotizing enterocolitis and transfusion of red blood cell in very low birth weight preterm infants 
Korean Journal of Pediatrics  2013;56(3):112-115.
Purpose
To investigate the association between necrotizing enterocolitis (NEC) and red blood cell transfusions in very low birth weight (VLBW) preterm infants.
Methods
We studied were 180 VLBW preterm infants who were admitted to the neonatal intensive care unit of CHA Gangnam Hospital from January of 2006 to December of 2009. The subjects were divided into 2 groups: an NEC group (greater than stage II on the modified Bell's criteria) and a control group (less than stage II on the modified Bell's critieria). We defined red blood cell transfusion before NEC diagnosis as the frequency of transfusion until NEC diagnosis (mean day at NEC diagnosis, day 18) in the NEC group and the frequency of transfusion until 18 days after birth in the control group.
Results
Of the 180 subjects, 18 (10%) belonged to the NEC group, and 14 (78%) of these 18 patients had a history of transfusion before NEC diagnosis. The NEC group received 3.1±2.9 transfusions, and the control group received 1.0±1.1 transfusions before the NEC diagnosis (P=0.005). In a multivariate logistic regression corrected for gestational age, Apgar score at 1 minute, the presence of respiratory distress syndrome, patent ductus arteriosus, premature rupture of membrane, disseminated intravascular coagulopathy and death were confounding factors. The risk of NEC increased 1.63 times (95% confidence interval, 1.145 to 2.305; P=0.007) with transfusion before the NEC diagnosis.
Conclusion
The risk for NEC increased significantly with increased transfusion frequency before the NEC diagnosis.
doi:10.3345/kjp.2013.56.3.112
PMCID: PMC3611044  PMID: 23559972
Necrotizing enterocolitis; Very low birth weight infants; Red blood cell transfusion
16.  Exercise-Induced Intranodal Atrioventricular Block 
Korean Circulation Journal  2012;42(10):698-701.
Exercise-induced atrioventricular (AV) block in patients with normal AV conduction at rest is rare. Herein, we describe the case of a 67-year-old woman with normal 1 : 1 AV conduction at rest, who developed complete AV block during a treadmill test. Our patient complained of effort-related dizziness and dyspnea, which had been ongoing for 3 months. The patient's physical examination was normal. The resting electrocardiogram showed left anterior fascicular block with a PR interval of 0.19 seconds. The echocardiogram was normal except for mild aortic valve regurgitation. During the treadmill test, the patient developed complete AV block at a sinus rate of 90 beats/min, which was followed by 2 : 1 AV block associated with dyspnea and dizziness. The patient's coronary angiogram was normal, and the ergonovine provocation test was negative. Electrophysiological studies demonstrated rate-dependent intranodal AV block. The patient received implantation of a permanent dual chamber (DDD) pacemaker and had no further symptoms during the follow-up period.
doi:10.4070/kcj.2012.42.10.698
PMCID: PMC3493807  PMID: 23170098
Atrioventricular block; Exercise test; Electrophysiologic techniques, cardiac
17.  The Effect of Doubling the Statin Dose on Pro-Inflammatory Cytokine in Patients With Triple-Vessel Coronary Artery Disease 
Korean Circulation Journal  2012;42(9):595-599.
Background and Objectives
Statin prevents atherosclerotic progression and helps to stabilize the plaque. According to a recent study, statin reduces inflammation in blood vessels. However, it has not been demonstrated to have any anti-inflammation reaction in patients who have been diagnosed as having a triple-vessel coronary artery disease (CAD).
Subjects and Methods
This study included a total of thirty (30) patients who had been diagnosed by coronary angiogram as having a triple-vessel CAD. Patients who already had been taking statin were given doubled dosage. An interview, physical examination and blood test were performed at the beginning of this study and three months later.
Results
After doubling the dose of statin, there was no statistically significant decrease in total cholesterol, low density lipoprotein-cholesterol, (increase in) high density lipoprotein-cholesterol and triglyceride in the blood test. C-reactive protein (CRP), an acute phase reactant, significantly decreased from 0.34 mg/dL at the beginning of the study to 0.12 mg/dL at the end of study (p<0.01). The interleukin-6 concentration also significantly decreased from 8.55 pg/dL to 4.81 pg/dL (p<0.001). No major cardiovascular events occurred and the dosage regimen was not modified during the close observation period. There was no difference in the symptoms of angina pectoris, established by World Health Organization Angina Questionnaires, before and after the dose increase. Liver enzymes remained within normal range with no significant increase before and after conducting this study.
Conclusion
Doubling the dose of statin alone significantly lowers pro-inflammatory cytokine concentration, which is closely related to the potential acute coronary syndrome, and CRP, a marker of vascular inflammation.
doi:10.4070/kcj.2012.42.9.595
PMCID: PMC3467442  PMID: 23091503
Statin; C-reactive protein; Interleukin-6
18.  Postoperative B-Type Natriuretic Peptide Levels Associated With Prolonged Hospitalization in Hypertensive Patients After Non-Cardiac Surgery 
Korean Circulation Journal  2012;42(8):521-527.
Background and Objectives
B-type natriuretic peptide (BNP) is an important marker for the diagnosis of heart failure and is useful towards predicting morbidity and mortality after non-cardiac surgery. Nevertheless, information on the relationship between postoperative BNP levels and perioperative prognosis after non-cardiac surgery is scarce. The purpose of the study was to assess whether postoperative BNP levels could be used as a predictor of prolonged hospitalization in elderly hypertensive patients after non-cardiac surgery.
Subjects and Methods
Ninety-seven (97) patients, aged 55 years or older (mean age: 73.12±10.05 years, M : F=24 : 73) were enrolled in a prospective study from May 2005 through August 2010. All patients underwent total knee or hip replacement. Postoperative BNP and other diagnostic data were recorded within 24 hours of surgery. Patients that required a prolonged hospital stay due to operative causes, such as wound infection and re-operation, were excluded.
Results
The length of hospital stay was significantly correlated with postoperative BNP levels (p=0.031). Receiver operating characteristic curves demonstrated postoperative BNP levels as predictors of hospital stay ≥30 days with areas under the curve of 0.774 (95% confidence interval: 0.679-0.87, p<0.0001). A BNP cut-off value above 217.5 pg/mL had a sensitivity of 80.6% and a specificity of 66.7% for predicting postoperative hospital stays of 30 days or more.
Conclusion
Postoperative BNP levels may predict the length of hospital stays after non-cardiac surgery in hypertensive patients. Elevated BNP levels were associated with prolonged hospitalization after elective orthopedic surgery.
doi:10.4070/kcj.2012.42.8.521
PMCID: PMC3438261  PMID: 22977447
Natriuretic peptin, brain; Hospitalization; Postoperative period; Hypertension
19.  A Case of Jugular Bulb Diverticulum Invading the Internal Auditory Canal 
Korean Journal of Audiology  2012;16(1):39-42.
Jugular bulb diverticulum (JBD) is a rarely reported vascular anomaly, which is an extraluminal outpouching from the jugular bulb. Especially, there exists a lack of reported cases involving JBD encroaching the internal auditory canal (IAC) in Korea. Subjects with JBD may be asymptomatic or have variable symptoms based on its location and size. In this article, we report a unique case of JBD eroding into the IAC that was presented as sudden sensorineural hearing loss with vertigo.
doi:10.7874/kja.2012.16.1.39
PMCID: PMC3936529  PMID: 24653869
Hearing loss; Vertigo; Jugular bulb diverticulum
20.  Long-term Study of Sialodochoplasty for Preventing Submandibular Sialolithiasis Recurrence 
Objectives
The transoral removal of stones by sialodochoplasty has been popularized in the treatment of submandibular sialolithiasis. However, the effectiveness of sialodochoplasty is controversial, and there are no reports on the long-term outcomes of this procedure. The purpose of this study was to assess the effectiveness and long-term outcomes of sialodochoplasty in patients with submandibular sialolithiasis.
Methods
We conducted a cross-sectional study that included retrospective chart reviews and prospective telephone or interview surveys of 150 patients treated for submandibular sialolithiasis from March 2001 to January 2008. The patients were treated with two different procedures by two different surgeons. One surgeon performed a transoral sialolithectomy without sialodochoplasty in 107 patients (SS group), and the other surgeon performed a transoral sialolithectomy with sialodochoplasty in 43 patients (SP group).
Results
The success rate of transoral sialolithectomy was 98.1% in the SS group and 93% in the SP group. The recurrence rates of symptoms or stones were 1.9% and 4.7% in the SS and SP groups, respectively. The incidence of postoperative transient hypoesthesia was 13.1% in the SS group and 34.9% in the SP group. The mean operating times were 29.79 and 47.44 minutes in the SS and SP groups, respectively. The mean percentage of general anesthesia was 42.1% in the SS group and 83.7% in the SP group.
Conclusion
Sialodochoplasty in addition to transoral sialolithectomy for submandibular sialolithiasis did not affect the rate of symptom or stone recurrence, but did increase the postoperative hypoesthesia incidence and general anesthesia percentage.
doi:10.3342/ceo.2012.5.1.34
PMCID: PMC3314803  PMID: 22468200
Stone; Sialolithiasis; Sialodochoplasty
21.  Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy 
The Korean Journal of Pain  2011;24(4):226-230.
Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.
doi:10.3344/kjp.2011.24.4.226
PMCID: PMC3248587  PMID: 22220245
fibromatosis; liposarcoma; neuropathic pain
22.  Magnetic resonance imaging evaluation of Yukatan minipig brains for neurotherapy applications 
Laboratory Animal Research  2011;27(4):309-316.
Magnetic resonance imaging (MRI) of six Yukatan minipig brains was performed. The animals were placed in stereotaxic conditions currently used in experiments. To allow for correctpositioning of the animal in the MRI instrument, landmarks were previously traced on the snout of the pig. To avoid movements, animal were anesthetized. The animals were placed in a prone position in a Siemens Magnetom Avanto 1.5 System with a head coil. Axial T2-weighted and sagittal T1-weighted MRI images were obtained from each pig. Afterwards, the brains of the pigs were fixed and cut into axial sections. Histologic and MR images were compared. The usefulness of this technique is discussed.
doi:10.5625/lar.2011.27.4.309
PMCID: PMC3251761  PMID: 22232639
Brain; Yukatan minipigs; magnetic resonance imaging; neurologic disorder
23.  Simvastatin inhibits osteoclast differentiation by scavenging reactive oxygen species 
Experimental & Molecular Medicine  2011;43(11):605-612.
Osteoclasts, together with osteoblasts, control the amount of bone tissue and regulate bone remodeling. Osteoclast differentiation is an important factor related to the pathogenesis of bone-loss related diseases. Reactive oxygen species (ROS) acts as a signal mediator in osteoclast differentiation. Simvastatin, which inhibits 3-hydroxy-3-methylglutaryl coenzyme A, is a hypolipidemic drug which is known to affect bone metabolism and suppresses osteoclastogenesis induced by receptor activator of nuclear factor-κB ligand (RANKL). In this study, we analyzed whether simvastatin can inhibit RANKL-induced osteoclastogenesis through suppression of the subsequently formed ROS and investigated whether simvastatin can inhibit H2O2-induced signaling pathways in osteoclast differentiation. We found that simvastatin decreased expression of tartrate-resistant acid phosphatase (TRAP), a genetic marker of osteoclast differentiation, and inhibited intracellular ROS generation in RAW 264.7 cell lines. ROS generation activated NF-κB, protein kinases B (AKT), mitogen-activated protein kinases signaling pathways such as c-JUN N-terminal kinases, p38 MAP kinases as well as extracellular signal-regulated kinase. Simvastatin was found to suppress these H2O2-induced signaling pathways in osteoclastogenesis. Together, these results indicate that simvastatin acts as an osteoclastogenesis inhibitor through suppression of ROS-mediated signaling pathways. This indicates that simvastatin has potential usefulness for osteoporosis and pathological bone resorption.
doi:10.3858/emm.2011.43.11.067
PMCID: PMC3249586  PMID: 21832867
bone resorption; mitogen-activated protein kinases; osteoclast; RANK ligand; reactive oxygen species; simvastatin
24.  Multidetector computed tomographic angiography evaluation of micropig major systemic vessels for xenotransplantation 
Journal of Veterinary Science  2011;12(3):209-214.
Due primarily to the increasing shortage of allogeneic donor organs, xenotransplantation has become the focus of a growing field of research. Currently, micropigs are the most suitable donor animal for humans. However, no standard method has been developed to evaluate the systemic vascular anatomy of micropigs and standard reference values to aid in the selection of normal healthy animals as potential organ donors are lacking. Using 64-channel multidetector row computed tomographic angiography (MDCTA), we evaluated morphological features of the major systemic vessels in micropigs and compared our results to published human data. The main vasculature of the animals was similar to that of humans, except for the iliac arterial system. However, diameters of the major systemic vessels were significantly different between micropigs and humans. Specifically, the diameter of the aortic arch, abdominal aorta, external iliac artery, and femoral artery, were measured as 1.50 ± 0.07 cm, 0.85 ± 0.06 cm, 0.52 ± 0.05 cm, and 0.48 ± 0.05 cm, respectively, in the micropigs. This MDCTA data for micropig major systemic vessels can be used as standard reference values for xenotransplantation studies. The use of 64-channel MDCTA enables accurate evaluation of the major systemic vasculature in micropigs.
doi:10.4142/jvs.2011.12.3.209
PMCID: PMC3165148  PMID: 21897092
MDCTA; micropig; vessel; xenotransplantation
25.  Antibacterial Action of Polyphosphate on Porphyromonas gingivalis▿  
Polyphosphate [poly(P)] has antibacterial activity against various Gram-positive bacteria. In contrast, Gram-negative bacteria are generally resistant to poly(P). Here, we describe the antibacterial characterization of poly(P) against a Gram-negative periodontopathogen, Porphyromonas gingivalis. The MICs of pyrophosphate (Na4P2O7) and all poly(P) (Nan + 2PnO3n + 1; n = 3 to 75) tested for the bacterium by the agar dilution method were 0.24% and 0.06%, respectively. Orthophosphate (Na2HPO4) failed to inhibit bacterial growth. Poly-P75 was chosen for further study. In liquid medium, 0.03% poly-P75 was bactericidal against P. gingivalis irrespective of the growth phase and inoculum size, ranging from 105 to109 cells/ml. UV-visible spectra of the pigments from P. gingivalis grown on blood agar with or without poly-P75 showed that poly-P75 reduced the formation of μ-oxo bisheme by the bacterium. Poly-P75 increased hemin accumulation on the P. gingivalis surface and decreased energy-driven uptake of hemin by the bacterium. The expression of the genes encoding hemagglutinins, gingipains, hemin uptake loci, chromosome replication, and energy production was downregulated, while that of the genes related to iron storage and oxidative stress was upregulated by poly-P75. The transmission electron microscope showed morphologically atypical cells with electron-dense granules and condensed nucleoid in the cytoplasm. Collectively, poly(P) is bactericidal against P. gingivalis, in which hemin/heme utilization is disturbed and oxidative stress is increased by poly(P).
doi:10.1128/AAC.01014-10
PMCID: PMC3028800  PMID: 21098243

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