Capecitabine, a precursor of 5-fluorouracil (5-FU), is a well-tolerated and safe chemotherapy that has been used to treat breast, pancreatic, and colorectal cancers. Albeit rare, both 5-FU and capecitbine have been reported to be associated with acute central nervous system toxicity, including cerebellar dysfunction, posterior reversible encephalopathy syndrome, and transient leukoencephalopathies. Here we present a case of 32-year-old female, demonstrating transient mutism related to capecitabine induced acute toxic leukoencephalopathy.

BACKGROUND/AIMS: Glycated hemoglobin (HbA1c) is widely used as a marker of glycemic control. Translation of the HbA1c level to an average blood glucose level is useful because the latter figure is easily understood by patients. We studied the association between blood glucose levels revealed by the oral glucose tolerance test (OGTT) and HbA1c levels in a Korean population. METHODS: A total of 1,000 subjects aged 30 to 64 years from the Cardiovascular and Metabolic Diseases Etiology Research Center cohort were included. Fasting glucose levels, post-load glucose levels at 30, 60, and 120 minutes into the OGTT, and HbA1c levels were measured. RESULTS: Linear regression of HbA1c with mean blood glucose levels derived using the OGTT revealed a significant correlation between these measures (predicted mean glucose [mg/dL] = 49.4 × HbA1c [%] - 149.6; R2 = 0.54, p < 0.001). Our linear regression equation was quite different from that of the Alc-Derived Average Glucose (ADAG) study and Diabetes Control and Complications Trial (DCCT) cohort. CONCLUSIONS: Discrepancies between our results and those of the ADAG study and DCCT cohort may be attributable to differences in the test methods used and the extent of insulin secretion. More studies are needed to evaluate the association between HbA1c and self monitoring blood glucose levels.
Blood Glucose* ; Cohort Studies ; Diabetes Mellitus ; Fasting ; Glucose ; Glucose Tolerance Test* ; Hemoglobin A, Glycosylated ; Humans ; Insulin ; Linear Models ; Metabolic Diseases

Oxidative stress is induced by an imbalanced redox states, involving either excessive generation of reactive oxygen species (ROS) or dysfunction of the antioxidant system. The brain is one of organs especially vulnerable to the effects of ROS because of its high oxygen demand and its abundance of peroxidation-susceptible lipid cells. Previous studies have demonstrated that oxidative stress plays a central role in a common pathophysiology of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease. Antioxidant therapy has been suggested for the prevention and treatment of neurodegenerative diseases, although the results with regard to their efficacy of treating neurodegenerative disease have been inconsistent. In this review, we will discuss the role of oxidative stress in the pathophysiology of neurodegenerative diseases and in vivo measurement of an index of damage by oxidative stress. Moreover, the present knowledge on antioxidant in the treatment of neurodegenerative diseases and future directions will be outlined.
Alzheimer Disease ; Brain ; Neurodegenerative Diseases* ; Oxidation-Reduction ; Oxidative Stress* ; Oxygen ; Parkinson Disease ; Reactive Oxygen Species

In addition to identifying genetic differences between target populations, it is also important to determine the impact of genetic differences with regard to the respective target populations. In recent years, there has been an increasing number of cases where this approach is needed, and thus various statistical methods must be considered. In this study, genetic data from populations of Southeast and Southwest Asia were collected, and several statistical approaches were evaluated on the Y-chromosome short tandem repeat data. In order to develop a more accurate and practical classification model, we applied gradient boosting and ensemble techniques. To infer between the Southeast and Southwest Asian populations, the overall performance of the classification models was better than that of the decision trees and regression models used in the past. In conclusion, this study suggests that additional statistical approaches, such as data mining techniques, could provide more useful interpretations for forensic analyses. These trials are expected to be the basis for further studies extending from target regions to the entire continent of Asia as well as the use of additional genes such as mitochondrial genes.
Asia ; Asian Continental Ancestry Group* ; Classification* ; Data Mining* ; Decision Trees ; Ethnic Groups* ; Genes, Mitochondrial ; Health Services Needs and Demand ; Humans ; Microsatellite Repeats ; Models, Statistical

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly due to M llerian duct malformation. The most common clinical presentation is pelvic pain and dysmenorrhea shortly after menarche, in associated with the finding of a vaginal or pelvic mass. An accurate and prompt diagnosis is of importance to permit treatment and to assure the future fertility of the patient. The simple and adequate treatment of the condition is incision of the obstructed vaginal septum providing adequate drainage of the retained blood. We report a case of uterus didelphys with obstructed hemivagina with brief review of the literature.
Diagnosis ; Drainage ; Dysmenorrhea ; Female ; Fertility ; Humans ; Menarche ; Pelvic Pain ; Uterus*

During revascularization after ischemia, oxygen free radicals and cytotoxic enzymes are released and they have a role in pathogenesis of ischemia-reperfusion injury. Glucocorticoid decreases oxygen free radical formation by inhibition of arachidonic acid metabolism, and alpha-lipoic acid scavenges nitric oxide(NO) with inhibition of hydroxy radical formation. Author investigated the role of glucocorticoid and alpha-lipoic acid to decrease ischemia reperfusion injury in 24 anesthetized rats (normal saline-injected, n= 8; dexamethasone-injected, n=8; alpha-lipoic acid-injected, n= 8), subjecting a soleus muscle to 4 hours of tourniquet ischemia followed by 2 hours of reperfusion, and evaluated the concentration of NO, tissue edema, and neutrophil count of rat skeletal muscle as a indicator of tissue damage by ischemia- reperfusion injury. We obtained the results that glucocorticoid and alpha-lipoic acid treatment decreased the increase of NO concentration, tissue edema, and neutrophil count significantly. These results support that pretreatment with glucocorticoid or alpha-lipoic acid has a beneficial effect on the preventive management of ischemia-reperfusion injury.
Animals ; Arachidonic Acid ; Edema ; Free Radicals ; Ischemia ; Metabolism ; Muscle, Skeletal ; Neutrophils ; Oxygen ; Rats ; Reperfusion ; Reperfusion Injury* ; Thioctic Acid* ; Tourniquets

No abstract available.
Thrombocytopenia*

PURPOSE: The purpose of this study was to evaluate the overall rate and risk factors for the development of an incisional hernia and a parastomal hernia after colorectal surgery. METHODS: The study cohort consisted of 795 consecutive patients who underwent open colorectal surgery between 2005 and 2007 by a single surgeon. A retrospective analysis of prospectively collected data was performed. RESULTS: The overall incidence of incisional hernias was 2% (14/690). This study revealed that the cumulative incidences of incisional hernia were 1% at 12 months and 3% after 36 months. Eighty-six percent of all incisional hernias developed within 3 years after a colectomy. The overall rate of parastomal hernias in patients with a stoma was 6.7% (7/105). The incidence of parastomal hernias was significantly higher in the colostomy group than in the ileostomy group (11.9% vs. 0%; P = 0.007). Obesity, abdominal aortic aneurysm, American Society of Anesthesiologists score, serum albumin level, emergency surgery and postoperative ileus did not influence the incidence of incisional or parastomal hernias. However, the multivariate analysis revealed that female gender and wound infection were significant risk factors for the development of incisional hernias female: P = 0.009, wound infection: P = 0.041). There were no significant factors related to the development of parastomal hernias. CONCLUSION: Our results indicate that most incisional hernias develop within 3 years after a colectomy. Female gender and wound infection were risk factors for the development of an incisional hernia after colorectal surgery. In contrast, no significant factors were found to be associated with the development of a parastomal hernia.
Aortic Aneurysm ; Cohort Studies ; Colectomy ; Colorectal Surgery ; Colostomy ; Emergencies ; Female ; Hernia ; Hernia, Ventral ; Humans ; Ileostomy ; Ileus ; Incidence ; Multivariate Analysis ; Obesity, Abdominal ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Serum Albumin ; Surgical Stomas ; Wound Infection

We investigated the effect of lysophosphatidic acid (LPA) in experimental acetaminophen (APAP)-induced acute liver injury. LPA administration significantly reduced APAP-challenged acute liver injury, showing attenuated liver damage, liver cell death and aspartate aminotransferase and alanine aminotransferase levels. APAP overdose-induced mortality was also significantly decreased by LPA administration. Regarding the mechanism involved in LPA-induced protection against acute liver injury, LPA administration significantly increased the glutathione level, which was markedly decreased in APAP challenge-induced acute liver injury. LPA administration also strongly blocked the APAP challenge-elicited phosphorylation of JNK, ERK and GSK3β, which are involved in the pathogenesis of acute liver injury. Furthermore, LPA administration decreased the production of TNF-α and IL-1β in an experimental drug-induced liver injury animal model. Mouse primary hepatocytes express LPA₁(,)₃–₆, and injection of the LPA receptor antagonist KI16425 (an LPA₁(,)₃-selective inhibitor) or H2L 5765834 (an LPA₁(,)₃(,)₅-selective inhibitor) did not reverse the LPA-induced protective effects against acute liver injury. The therapeutic administration of LPA also blocked APAP-induced liver damage, leading to an increased survival rate. Collectively, these results indicate that the well-known bioactive lipid LPA can block the pathogenesis of APAP-induced acute liver injury by increasing the glutathione level but decreasing inflammatory cytokines in an LPA₁(,)₃(,)₅-independent manner. Our results suggest that LPA might be an important therapeutic agent for drug-induced liver injury.

Malignant triton tumor is a rare and usually aggressive sarcoma consisting of a malignant schwannoma with rhabdomyoblastic differentiation. Although this tumor is usually found at the extremities, 20% of cases are located in the head and neck region. This unusual tumor has not yet been described in the Korean Journal of Otolaryngology-Head and Neck Surgery. Malignant triton tumor is histologically high-grade, with large numbers of mitoses, prominent necrosis, and cellular pleomorphism. The clinical course for malignant triton tumor is usually one of rapid growth, early metastasis, and poor outcome in spite of therapy. Recently we experienced a case of malignant triton tumor, which involved the nasal cavity, maxillary and ethmoid sinus. The malignant tumor was treated with wide surgical excision followed by radiation therapy.
Ethmoid Sinus ; Extremities ; Head ; Mitosis ; Nasal Cavity* ; Neck ; Necrosis ; Neoplasm Metastasis ; Neptune* ; Neurilemmoma ; Sarcoma