A dysfunction of endoplasmic reticulum (ER) stress response can result in various diseases, including cancer, inflammation, diabetes and neurodegenerative disorders. To investigate whether ER stress response can play an essential role in the induction and treatment of chronic constipation, alterations in the key parameters for ER stress were measured in loperamide (Lop) induced constipation Sprague Dawley (SD) rats treated with aqueous extracts of Liriope platyphylla (AEtLP), which has been shown to have a laxative effect. Symptoms of chronic constipation including alteration of stool parameters and the transverse colon's structure were successfully induced by Lop treatment. Laxative effects such as enhancement of stools parameters, recovery of the mucosa thickness, increased muscle thickness and recovery of flat luminal surface were also observed in the Lop+AEtLP treated group. Furthermore, enhancement of eukaryotic initiation factor 2 alpha (eIF2α) phosphorylation and inositol-requiring enzyme 1 beta (IRE1β) expression, key indicators for ER stress, that were observed in the Lop+vehicle treated group were significantly recovered in the Lop+AEtLP treated group, although the phosphorylation level of c-Jun N-terminal protein kinase (JNK) remained constant. Moreover, alterations in the transcription level of the marker genes X-box binding protein 1 (XBP-1) and growth arrest and DNA damage-inducible protein (GADD34) were similar to those of eIF2α and IRE1β. However, their level was slightly or completely recovered after AEtLP treatment. Overall, this study provides the first evidence that ER stress response may be tightly correlated with chronic constipation induced by Lop treatment, as well as the laxative effects of AEtLP.
Animals ; Carrier Proteins ; Constipation* ; DNA ; Endoplasmic Reticulum Stress* ; Endoplasmic Reticulum* ; Eukaryotic Initiation Factor-2 ; Inflammation ; Loperamide ; Mucous Membrane ; Neurodegenerative Diseases ; Phenobarbital ; Phosphorylation ; Protein Kinases ; Rats*

We report a case of increased values of entropy parameters Response Entropy (RE) and State Entropy (SE) during intravenous general anesthesia in a sleepwalking patient. An ASA class II, 64-year-old woman with stress incontinence underwent mid-urethral sling surgery. Prior to surgery, the patient had been administered paroxetine, valproic acid and clonazepam for the treatment of sleepwalking disorder. After 10 min of target-controlled infusion of propofol and remifentanil, entropy values increased up to 94 (RE) and 88 (SE) for 10 min. The target effect-site concentrations of anesthetics increased from 4 to 7 microg/ml propofol and 4 ng/ml remifentanil, at which point values fell back to adequate anesthesia levels. Episodes of recall or of explicit memories did not occur during the anesthesia. In conclusion, sleepwalking patients with long-term use medications may need increment of anesthetic dose caused by the anesthetic drug metabolism activation or impairment or immaturity of inhibitory circuits in brain.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Brain ; Clonazepam ; Entropy* ; Female ; Humans ; Metabolism ; Middle Aged ; Paroxetine ; Propofol* ; Somnambulism* ; Suburethral Slings ; Valproic Acid

We report a case of increased values of entropy parameters Response Entropy (RE) and State Entropy (SE) during intravenous general anesthesia in a sleepwalking patient. An ASA class II, 64-year-old woman with stress incontinence underwent mid-urethral sling surgery. Prior to surgery, the patient had been administered paroxetine, valproic acid and clonazepam for the treatment of sleepwalking disorder. After 10 min of target-controlled infusion of propofol and remifentanil, entropy values increased up to 94 (RE) and 88 (SE) for 10 min. The target effect-site concentrations of anesthetics increased from 4 to 7 microg/ml propofol and 4 ng/ml remifentanil, at which point values fell back to adequate anesthesia levels. Episodes of recall or of explicit memories did not occur during the anesthesia. In conclusion, sleepwalking patients with long-term use medications may need increment of anesthetic dose caused by the anesthetic drug metabolism activation or impairment or immaturity of inhibitory circuits in brain.
Anesthesia* ; Anesthesia, General ; Anesthetics ; Brain ; Clonazepam ; Entropy* ; Female ; Humans ; Metabolism ; Middle Aged ; Paroxetine ; Propofol* ; Somnambulism* ; Suburethral Slings ; Valproic Acid

Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease characterized by fever and lymphadenitis. The etiology and pathogenesis of KFD is unclear. However, two hypotheses have been suggested: a viral infection hypothesis and an autoimmune hypothesis. Several KFD patients with various types of autoimmune diseases have been reported, and these reports support the hypothesis for autoimmune pathogenesis of KFD. Here, we report the case of a 17-year-old female patient diagnosed with KFD and autoimmune thyroiditis. This case serves as additional evidence that the etiology of KFD is autoimmune origin.
Adolescent ; Autoimmune Diseases ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphadenitis ; Thyroiditis, Autoimmune

The ethical statement was omitted unintentionally.

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.
Adult ; Aged ; Body Weight ; Child ; Diet ; Energy Intake ; Energy Metabolism ; Female ; Hand ; Humans ; Male ; Methods ; Population Groups ; Water

OBJECTIVES: This study assessed the accuracy of the 24-hour diet recall method for estimating the energy intake of elderly men using the doubly labeled water as a reference method. METHODS: Seventeen subjects (mean age 72.5 ± 3.9 years), who maintained the same body weight during the two weeks study period, were included in this study. Three 24-hour diet recalls (two weekdays and one weekend) were obtained over a 14 day period to estimate the mean energy intake. The total energy expenditure was measured over the same 14 days using the doubly labeled water method. The total energy intake and total energy expenditure were compared by paired t-test. RESULTS: The total energy intake from the 24-hour diet recalls method was 2536.7 ± 350.6 kcal/day, and the total energy expenditure from the doubly labeled water method was 2659.8 ± 306.8 kcal/day. The total energy intake was slightly under-reported by −123.2 ± 260.8 kcal/day (−4.4%). On the other hand, no significant difference was observed between the total energy intake and total energy expenditure of the subjects (p=0.069). The percentage of accurate predictions was 64.7%. The correlation between the total energy intake and total energy expenditure was statistically significant (r=0.697, p < 0.005). CONCLUSIONS: The present study supports the use of the 24-hour diet recall method to estimate the mean energy intake in elderly men group. More studies are needed to assess the validity of 24-hour diet recall method in other population groups, including elderly women, adults and children.
Adult ; Aged ; Body Weight ; Child ; Diet ; Energy Intake ; Energy Metabolism ; Female ; Hand ; Humans ; Male ; Methods ; Population Groups ; Water

BACKGROUND: Nasopharyngeal bacterial flora can cause respiratory tract diseases as well as invasive bacterial diseases. Moraxella catarrhalis colonizing in the nasopharynx is considered an important potential pathogen with an increasing production of beta-lactamase. This study examined the nasopharyngeal colonization rate of M. catarrhalis and the antibiotic susceptibility of M. catarrhalis. MATERIALS AND METHODS: Healthy children who visited one of the three University hospitals in the Republic of Korea or attended a day-care center around the participating hospitals were enrolled in this study. The nasopharyngeal samples were obtained by nasopharyngeal washing with normal saline and M. catarrhalis was isolated. The nasopharyngeal colonization rate of M. catarrhalis was investigated and the minimal inhibitory concentrations (MICs) were measured for commonly used oral antibiotics (amoxicillin, amoxicillin/clavulanate, cefaclor, cefixime, cefdinir, cefditoren, erythromycin and trimethoprim). RESULTS: Three hundred and seventy-nine children aged between 6 months and 5 years were enrolled, and the nasopharyngeal colonization rate of M. catarrhalis was 33% (124 children). All isolated M. catarrhalis produced beta-lactamase. The MIC90 of the antibiotics were as follows: amoxicillin, >16 mg/L; amoxicillin/clavulanate, 0.5 mg/L; cefaclor, 8 mg/L ; cefixime, 0.125 mg/L; cefdinir, 0.25 mg/L; cefditoren, 0.25 mg/L; erythromycin, 0.5 mg/L; and trimethoprim, >16 mg/L. CONCLUSIONS: M. catarrhalis was colonized in 33% of the children aged 6 months to 5 years, and showed low MICs for amoxicillin/clavulanate and oral 2nd and 3rd generation cephalosporins.
Aged ; Amoxicillin ; Anti-Bacterial Agents ; beta-Lactamases ; Cefaclor ; Cefixime ; Cephalosporins ; Child ; Colon ; Drug Resistance ; Erythromycin ; Hospitals, University ; Humans ; Moraxella ; Moraxella (Branhamella) catarrhalis ; Nasopharynx ; Republic of Korea ; Respiratory Tract Diseases ; Trimethoprim

OBJECTIVE: To identify the optimal site for piriformis muscle injection, using easily detectable sacroiliac joint as a landmark, under fluoroscopic guidance. METHOD: We examined the anatomic relationships of the sciatic nerve, piriformis muscle and sacroiliac joint in 18 buttocks from 9 cadavers. The distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve, and the width of the sciatic nerve at that point were measured. We assessed the depth of the piriformis muscle and the sciatic nerve using ultrasonography in asymptomatic controls. RESULTS: The mean distance from the inferior margin of the sacroiliac joint to the piriformis muscle at the crossing point with the sciatic nerve was 15.7+/-3.4 (12~22) mm laterally and 16.5+/-4.1 (10~25) mm caudally. The mean width of the sciatic nerve at that point was 15.4+/-3.7 (12~22) mm. Ultrasonographic findings revealed the mean distance as 4.48+/-0.49 cm from the skin to the surface of the piriformis muscle and as 5.68+/-0.62 from the skin to the surface of the sciatic nerve. CONCLUSION: The most optimal injection site for piriformis syndrome was located 15.6+/-3.4 (12~22) mm laterally and 16.5+/-4.1 (10~25) mm caudally from the inferior margin of the sacroiliac joint.
Buttocks ; Cadaver ; Muscles ; Piriformis Muscle Syndrome ; Sacroiliac Joint ; Sciatic Nerve ; Skin

BACKGROUND: Immune thrombocytopenic purpura (ITP) is an autoimmune disorder presenting low platelet count in peripheral blood without any other abnormalities in other blood cell lineage. There were many studies that investigated the mechanism of ITP and the factors related to its chronicity, but much remains controversial. Neutrophil to lymphocyte ratio (NLR) is considered an indicator representing the severity of acute or chronic inflammation. The aim of this study was to assess whether NLR can predict the outcome of ITP and its chronicity.METHODS: Patients who were diagnosed as ITP at Dong-A University Hospital between March 2000 and March 2016 were analyzed retrospectively. NLR results and other medical records at diagnosis and after treatment were analyzed and compared between two groups; patients with single episode and chronic ITP group.RESULTS: Of a total of 67 patients, 39 patients (58.21%) were chronic ITP. Patients with single episode showed low NLR at diagnosis than patients with chronic ITP (1.23±1.38 vs. 1.54±1.15, P=0.42), but NLR after recovery were significantly high (1.58±1.71 vs. 1.31±0.76, P=0.21). However, patients with chronic ITP showed a trend of high NLR at the time of relapse.CONCLUSION: Chronic ITP patients showed higher NLR at the time of diagnosis compared with the patients with single episode. Also, the NLR at the time of relapse showed higher level compared to those at diagnosis. Relationship between NLR and chronic ITP need to be further studied.
Blood Cells ; Diagnosis ; Humans ; Inflammation ; Lymphocytes ; Medical Records ; Neutrophils ; Platelet Count ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic ; Recurrence ; Retrospective Studies