Metabolomics has been used as a powerful tool for the analysis and quality assessment of the natural product (NP)-derived medicines. It is increasingly being used in the quality control and standardization of NP-derived medicines because they are composed of hundreds of natural compounds. The most common techniques that are used in metabolomics consist of NMR, GC-MS, and LC-MS in combination with multivariate statistical analyses including principal components analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Currently, the quality control of the NP-derived medicines is usually conducted using HPLC and is specified by one or two indicators. To create a superior quality control framework and avoid adulterated drugs, it is necessary to be able to determine and establish standards based on multiple ingredients using metabolic profiling and fingerprinting. Therefore, the application of various analytical tools in the quality control of NP-derived medicines forms the major part of this review. Veregen® (Medigene AG, Planegg/Martinsried, Germany), which is the first botanical prescription drug approved by US Food and Drug Administration, is reviewed as an example that will hopefully provide future directions and perspectives on metabolomics technologies available for the quality control of NP-derived medicines.
Chromatography, High Pressure Liquid ; Dermatoglyphics ; Metabolomics* ; Prescriptions ; Quality Control* ; United States Food and Drug Administration

PURPOSE: We compared neovascularity with needle biopsies and definitive prostatectomy specimens to examine whether the measurement of microvessel density(MVD) has an ability to predict extracapsular extension with limited tissue sample. MATERIALS AND METHODS: We evaluated total 11 pathologically proven stage T3 lesions. The paraffin embedded tissues from needle biopsies and definitive prostatectomy specimens were sectioned serially. Of the serial sections obtained from prostatectomy specimens 2 showing a relatively uniform histology grade; one identical grade with biopsy sample, another the worst grade within the tumor or different grade from biopsy, and 2 from specific sites of the tumor; center and periphery, selected for examination. MVD determinations were performed immunohistochemically using monoclonal antibodies directed at the CD34 antigens. RESULTS: MVD of total 11 needle biopsies with grade 2-5 (score 4-8) ranged from 73.7 to 170.8 (median 106.7 +/- 10.6). The grade (score 5-9) distributions of prostatectomy specimens were different from those of needle biopsies and the MVD obtained from definitive prostatectomy specimens exhibited a heterogeneity within the individual tumor. The variation in densities between different grade group proved statistically different (p< 0.01, paired t-test). Also, the MVD count in the center of the tumor was higher than that in the periphery of the tumor and the difference between two group of the specific sites was statistically significant (p = 0.015, paired t-test). Finally, although MVD of biopsy sample did not correlated exclusively to that of definitive prostatectomy specimen, there would be a significant correlation of MVD between two groups if their distribution of histological grade were identical (p< 0.01, r2 = 0.889). CONCLUSIONS: Prior to surgical extirpation in the patients of clinically localized prostatic carcinomas, MVD determination of needle biopsies of the prostate would not correlate with that of definitive prostatectomy specimen. Given the limited tissue sampling from a biopsy, understanding of the site specificity of vasculature and analyzing the relationship of angiogenesis and other biologic factors of which histologic grade seems to be involved most importantly, are critical to developing a consistent and effective methodology of microvessel quantification.
Antibodies, Monoclonal ; Antigens, CD34 ; Biological Factors ; Biopsy ; Biopsy, Needle* ; Humans ; Microvessels* ; Needles* ; Paraffin ; Population Characteristics ; Prostate* ; Prostatectomy* ; Sensitivity and Specificity

No abstract available.
Female ; Fertilization* ; Humans ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, Twin*

BACKGROUND: Although a magnetic resonance imaging (MRI) is highly sensitive for changes associated with ischemic stroke, the detection of an acute ischemic lesion is usually impossible within 6 hours of the stroke onset on a conventional MRI. The perfusion MRI is a new imaging technique for diagnosing acute ischemic stroke. We evaluate the clinical usefulness of the perfusion MRI in predicting the final infarct extent in 18 patients with acute middle cerebral artery (MCA) territory ischemic stroke. METHOD: The perfusion MRI was performed within 6 hours after the stroke onset in all patients with a single-section dynamic contrast-enhanced T2*-weighted imaging in conjunction with a conventional routine MRI and MR angiography. Time-concentration curves and cerebral blood volume (CBV) maps were calculated from the dynamic MR imaging data by using numerical integration techniques. We compared findings of CBV maps with infarction on a follow-up CT or MRI. RESULTS: In 14 of 18 patients, the CBV in the occluded MCA territory were decreased. In the remaining 4 patients with a reversible ischemic neurologic deficit (RIND) or transient ischemic attack (TIA), the CBV were increased in 3 and normal in 1. Out of 14 patients with a decreased CBV, two had focal regions of increased CBV within the affected territory, indicating reperfusion hyperemia. The regions of increased or decreased CBV were eventually converted to infarction on follow-up images in all 14 patients. Out of 4 patients with RIND or TIA, one showed focal infarction in centrum semiovale on a follow-up image. CONCLUSIONS: The perfusion MRI was useful for the assessment of hemodynamic change about cerebral perfusion and may predict the extent of final infarction in acute MCA territory ischemic stroke. These results suggest that the perfusion MRI may play an important role in the diagnosis and management of acute ischemic stroke.
Angiography ; Blood Volume ; Diagnosis ; Follow-Up Studies ; Hemodynamics ; Humans ; Hyperemia ; Infarction ; Ischemic Attack, Transient ; Magnetic Resonance Imaging* ; Middle Cerebral Artery* ; Neurologic Manifestations ; Perfusion* ; Reperfusion ; Stroke*

Pigmented villonodular synovitis (PVNS) is a rare, benign, soft tissue neoplasm affecting the synovium of joints, classified as localized and diffused type. Localized type is more common, arising from synovium of joints, bursae, and tendon sheaths. Diffused type is relatively rare, frequently arising from an extra-articular lesion, and sometimes from an intramuscular or subcutaneous lesion. Although the cause of occurrence is not yet clear, recently it has been known as a benign neoplasm rather than an inflammatory or reactive process. We performed a total excision of the PVNS in a pretibial lesion and achieved a good result. We report on the case with a review of the literature.
Giant Cell Tumors* ; Giant Cells* ; Joints ; Soft Tissue Neoplasms ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons ; Tenosynovitis* ; Tibia

Heterotopic pancreas is a tissue histologically similar to normal pancreatic tissue found in a location other than the usual place, and having no anatomic or vascular connection with the pancreas itself. Heterotopic pancreas is usually asymptomatic and found incidentally. However, it can cause problems such as abdominal pain, melena, anemia, and severe bleeding. We report a case of a 29-year-old woman with obscure gastrointestinal bleeding caused by heterotopic pancreas located in Meckel's diverticulum. Gastroduodenoscopy and colonoscopy showed no bleeding focus. By capsule endoscopy and double balloon enteroscopy, a bleeding focus was suspected in the ileum. The patient received a laparoscopic resection of the Meckel's diverticulum. Pathologic examination revealed heterotopic pancreatic tissue within the muscular layer of the diverticulum. The patient recovered well without further bleeding.
Abdominal Pain ; Adult ; Anemia ; Capsule Endoscopy ; Colonoscopy ; Diverticulum ; Double-Balloon Enteroscopy ; Female ; Hemorrhage ; Humans ; Hypogonadism ; Ileum ; Meckel Diverticulum ; Melena ; Mitochondrial Diseases ; Ophthalmoplegia ; Pancreas

PURPOSE: Patients with work related burns suffer from anxiety, depression, insomnia and suicide ideation etc. Psychiatric symptoms could be reduced by treatment. Almost all patients are referred to psychiatric intervention in our hospital. However, a number of patients show non-adherence. The aim of this study is to figure out the reason of non-adherence and psychiatric symptoms of work related burns patients. METHODS: 123 patients participated in this study. Startle, Physiological arousal, Anger, and Numbness (SPAN), Feeling Suicide, Patient Health Questionnaire-2 (PHQ-2) were administered as screening tool. Questions about psychiatric intervention and reasons to refuse psychiatric intervention were asked. RESULTS: 32% patients were depressed, 34% patients had suicide ideation and 59% had PTSD after work related burns. However, 46% of burn patients had not been treated. Stigma of psychiatric intervention and concerns about dependency were major reasons for non-adherence. CONCLUSION: There are gap between necessity and reality of psychiatric intervention on work related burn patients.
Anger ; Anxiety ; Arousal ; Burns ; Dependency (Psychology) ; Depression ; Humans ; Hypesthesia ; Mass Screening ; Occupational Injuries ; Referral and Consultation ; Sleep Initiation and Maintenance Disorders ; Stress Disorders, Post-Traumatic ; Suicide

Choroid plexus cysts (CPCs) are the most commom neuroepithelial cysts, occuring in more than 50% of some autopsy series. They are typically small and asymptomatic and are discovered incidentally in older patients, usually in the trigone of the lateral ventricle. Symptomatic CPCs (usually exceptionally large, 2-8 cm) are rare. The authors report a case of large symptomatic choroid plexus cyst, located in the trigone of the right lateral ventricle in a 26-yr-old man who presented with headache and vomiting. The patient underwent endoscopic removal through a burr hole placed 3 cm from the midline and just behind the hair line. The histological examination of the cyst wall was consistent with choroid epithelium. Despite of postoperative intraventricular hemorrhage and catheter infection, he discharged home without neurologic deficits. The endoscopic fenestration rather than excision should be considered as the first surgical procedure because the goal of treatment is shrinkage of the cyst until normal cerebrospinal fluid flow is restored.
Adult ; Brain Diseases/diagnosis/pathology/*surgery ; *Choroid Plexus ; Cysts/diagnosis/pathology/*surgery ; Endoscopy ; Humans ; Male

Bovine viral diarrhea virus (BVDV) of the genus Pestivirus is known as a common contaminant of cell culture-derived vaccines. Hog cholera virus (HCV), which is also of the genus Pestivirus and an important livestock disease in Korea, is recognized as a potential contaminant of vaccines produced in porcine cells. However, it is difficult for the National Biological Assays of korea to adequately detect contamination of these agents in biological products. For these reasons, we established rapid and sensitive methods for the detection of BVDV and HCV contamination in cell cultures and veterinary biologicals by using RT-PCR and nested PCR assays. We designed a Pestivirus primer amplifying 152 bp to detect both BVDV and HCV and a common primer amplifying 237 bp to detect only BVDV. Also, for the differentiation between BVDV type 1 and type 2, nested PCR was conducted using the amplified 237 bp PCR product, to amplify 179 bp in BVDV type 2 genome. The sensitivity of the PCR using common primer for the detection of BVDV was 400 TCID50/ml. All 6 strains of Korean BVDV isolates, 5 vaccines strains and the standard strain NADL could be detected. No reactions were observed when testing 5 types of viruses infecting pigs (HCV, TGEV, PEDV, JEV, PRRSV), 4 types infecting cattle (Akabane virus, BEFV, BCV, BRV) and 4 types infecting cats (FIP, FPL, FCV, FVR). Using this RT-PCR assay, commercial vaccines were tested and, 55 lots from 12 vaccine companies, were negative for BVDV contaminations. Same results were obtained by the immunoflourescence assay. The newly developed PCR or RT-PCR assays can be used as rapid, reliable, sensitive, and simple methods for the detection of BVDV (Pestivirus) in cell cultures, master seeds, and live viral vaccines.
Animals* ; Biological Assay ; Biological Products ; Cats ; Cattle ; Cell Culture Techniques ; Classical swine fever virus ; Diarrhea Virus 1, Bovine Viral ; Diarrhea Virus 2, Bovine Viral ; Diarrhea* ; Genome ; Korea ; Livestock ; Pestivirus ; Polymerase Chain Reaction* ; Swine ; Vaccines ; Viral Vaccines*