One case of bezafibrate-induced myopathy was experienced and presente with a brief review of literatures. A 80-year-old woman with diabetes mellitus developed generalized myalgia and chest tightness 2 days before admission. The patient was treated with bezafibrate (800mg/day) for the previous 3 months. Serum creatine kinase, LDH and AST were markedly increased. Muscle biopsy revealed type 2 fiber atrophy. Withdrawal of the drug under the impression of bezafibrate-induced myopathy was followed by rapid clinical improvement.
Aged, 80 and over ; Atrophy ; Bezafibrate ; Biopsy ; Creatine Kinase ; Diabetes Mellitus ; Female ; Humans ; Muscular Diseases* ; Myalgia ; Thorax

BACKGROUND: Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. METHODS: The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation tines by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic and with the pulmonary function of the patients. RESULTS: The Tei indices of the patients with COPD were significantly higher than those of normal subjects (0.45±0.17 vs. 0.27±0.03, p<0.01). The isovolumetric contraction time/ejection time(0.32±0.08 vs. 0.25±0.05, p<0.05), the isovolumetric relaxation time/ejection time(0.29±0.16 vs. 0.15±0.08, p<0.05) and the preejection period/ejection time (0.46±0.10 vs. 0.38±0.06, p<0.05) were prolonged and the ejection time (255.2±32.6 vs. 314.2±16.5 msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the FEV1(r=-0.46, p=<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted FEV1) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). CONCLUSION: The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.
Echocardiography* ; Heart ; Humans ; Hypertension, Pulmonary ; Pulmonary Disease, Chronic Obstructive* ; Relaxation ; Ventricular Function, Right*

BACKGROUND AND OBJECTIVES: To evaluate the brain MR angiography(MRA) as a tool of diagnosis and follow up study in acute ischemic stroke. METHODS: We reviewed 90 patients of acute ischemic stroke who received thrombolytic therapy and underwent brain MRI with MRA from September 1994 to July 1995. They were divided into two groups according to carotid system and vertebrobasilar system and then positive MRA findings were defined as stenosis or occlusion of vessels in relation with MRI lesions. RESULTS: The positive MRA was shown more than 80% in large arteries and lower than 23% in small arteries. And also the MRA was shown the degree stenosis and underlying vessel abnormalities but could not precisely analyze the degree of improvement of vascular patency in this study. CONCLUSIONS: The MRA as a routine method addition to the MRI provides relatively reliable and noninvasive screening test and provides information that can be more complete evaluation and prognosis in patients of acute ischemic stroke.
Angiography* ; Arteries ; Brain ; Constriction, Pathologic ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Prognosis* ; Stroke* ; Thrombolytic Therapy ; Vascular Patency

Fifteen cases of the primary duodenal malignancies were radically resected from July 1989 to September 1996. These cases were analysed retrospectively with the literature review. The male to female ratio was 8:7. The mean age was 49 years. Histopatholgically, adenocarcinomas were 10 cases, sarcomas were 4 cases and malignant lymphoma was 1 case. The symptoms and signs were abdominal pain and discomfort, weight loss, nausea and vomiting, jaundice, melena and diarrhea in the order of the frequency. We performed Whipple's operations in 11 cases, regional pancretectomy in 1 case, Whipple's operation with Right hemicolectomy in 2 cases and local resection in 3 cases. There was no operative mortality. The perioperative morbidity was 33%. The post operative complications were abscess in abdomen in 3 cases and wound infections in 2 cases. 1 year and 2 years survival rate were 93.3% and 33.3%. Aggressive and radical treatment with curative intention even in the presence of locally advanced disease, could be performed with acceptable mortality and morbidity and expect a better outcome.
Abdomen ; Abdominal Pain ; Abscess ; Adenocarcinoma ; Diarrhea ; Female ; Humans ; Intention ; Jaundice ; Lymphoma ; Male ; Melena ; Mortality ; Nausea ; Retrospective Studies ; Sarcoma ; Survival Rate ; Vomiting ; Weight Loss ; Wound Infection

A 35-year-old man presented with simultaneous multiple intracranial hematomas in the right cerebellar dentate nucleus and left basal ganglia. The hematomas were visible by computed tomography performed within two hours of the patient's arrival. The initial computed tomography showed acute hemorrhage in the left basal ganglia and dentate nucleus in cerebellum. The patient then experienced a change of consciousness due to newly developed hydrocephalus, and emergent extra-ventricular drainage was performed. By discharge, fortunately, the patient was fully recovered.
Adult ; Basal Ganglia* ; Cerebellar Nuclei ; Cerebellum ; Consciousness ; Drainage ; Hematoma ; Hemorrhage* ; Humans ; Hydrocephalus ; Hypercholesterolemia ; Hypertension

Despite the increasing prevalence of metabolic disorders, the potential effects of metabolic factors on hepatocellular carcinoma (HCC) development in individuals with chronic liver diseases (CLDs) are not well understood. For a metabolic factor to be identified as a risk factor for HCC in patients with CLDs, such as hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, there should be a strong synergistic interaction between the carcinogenic mechanisms of the metabolic factor and the CLD itself. This review aims to comprehensively summarize the published data on the relationship between metabolic factors such as diabetes mellitus (DM), obesity, and blood lipids and the risk of HCC in patients with CLDs. DM consistently increases the risk of HCC in patients with CLD. When associated with DM, the risk of HCC seems to be highest in HCV and non-alcoholic fatty liver disease (NAFLD), followed by alcoholic liver disease (ALD) and HBV. Obesity may increase the risk of HCC. Among CLDs, the evidence is relatively consistent and clear for ALD, while clear evidence is limited in other CLDs including HBV, HCV, and NAFLD. Total cholesterol, potentially low-density lipoprotein cholesterol and triglyceride, seems to have strong inverse associations with HCC in individuals with CLDs. Despite evidence from observational studies, statins had no effect in preventing HCC in randomized controlled trials. Whether statins have a preventive effect against HCC is unclear. A better understanding and management of metabolic factors may be beneficial to reduce the risk of HCC in patients with CLDs.

Purpose: Foot alignment affects the overall balance and alignment of the body. This study examined the relationship between the foot parameters and scoliosis in children and adolescents through simple radiographs. Materials and Methods: Two hundred and forty-one outpatients under 15 years old from 2013 to 2022 were evaluated. Patients with an abnormal leg length discrepancy or pelvic tilt were screened. The patients included were divided into four groups. Each group was tested to determine if they had scoliosis. The foot anterior-posterior/lateral X-rays were selected for the foot parameters, and the EOS system was used for the spline and pelvis parameters. Results: A t-test of all groups showed no statistically significant difference as the p-value exceeded 0.05. An analysis of variance (ANOVA) comparing the Cobb’s angle and foot parameters did not show a significant correlation. On the other hand, female and older patients had a higher Cobb’s angle. Conclusion No direct relationship was noted between scoliosis and the foot parameters that could be measured radiographically among children and adolescents. In addition, no correction between the Cobb’s angle and foot parameters was found.

Choi JH et al. Effects of Streptozotocin-Induced Type 1 Diabetes on Cell Proliferation and Neuronal Differentiation in the Dentate Gyrus; Correlation with Memory Impairment. Korean J Anat (2009) 42(1): 41-48. Please note that there is error in the above article:On page 47 (ACKNOWLEDGEMENTS) on lines 39-40 in the right column, "(MOEHRD) (KRF-2007-8R07- 0301-064-S000100)" should be "(MOEHRD, Basic Research Promotion Fund) (KRF-2007-412-J00502)"

We examined the effects of steptozotocin (STZ)-induced type 1 diabetes on cell proliferation and neuroblasts in the subgranular zone of the hippocampal dentate gyrus (SZDG) of male Wistar rats. Change in memory function was also investigated using the passive avoidance test. In the SZDG, Ki67 (a marker for cell proliferation) positive nuclei were significantly decreased at 2 and 3 weeks and slightly decreased at 4 weeks after STZ treatment. Doublecortin (DCX, a marker for neuronal differentiation)-immunoreactive (+) neuroblasts with tertiary dendrites were significantly decreased in the STZ-treated group compared to those in the vehicle-treated group. However, DCX+ neuroblasts without tertiary dendrites were abundant at 4 weeks after STZ treatment. In addition, retention latency time in STZ-treated group was similar to that of vehicle-treated group at 2 and 3 weeks after STZ treatment. However, the retention latency time was significantly decreased at 4 weeks after STZ treatment. These results suggest that STZ significantly reduced cell proliferation and neuroblasts at 2~3 weeks after STZ treatment, but not at 4 weeks after STZ treatment although memory impairment was detected at 4 weeks after STZ treatment. The gradual reduction of DCX+ neuroblasts with tertiary dendrites may be associated with the impairment of hippocampus-related memory function.
Cell Proliferation ; Dendrites ; Dentate Gyrus ; Humans ; Male ; Memory ; Neurons ; Rats, Wistar ; Retention (Psychology) ; Streptozocin

In this study, we investigated the effects of treadmill exercise on hippocampal levels of calcium-binding proteins - calbindin D-28k (CB), calretinin (CR) and parvalbumin (PV) - using immunohistochemistry and Western blot analysis. At 6 weeks of age, male Wistar rats were put on a treadmill with or without running for 1 h/day/5 consecutive days at a pace of 22 m/min for a period of 5 weeks. In sedentary and exercise groups, CB immunoreaction was detected in granule cells of the dentate gyrus, mossy fibers, and CA1 pyramidal cells. In addition, CB immunoreaction was observed in interneurons of the CA1-3 region. Exercise significantly increased CB immunoreactivity in dentate granule cells, CA1 pyramidal cells and CA1-3 interneurons. CR immunoreaction was mainly observed in interneurons of the dentate gyrus and CA1-3 regions. Similar number of CR-immunoreactive neurons was observed in the exercise and sedentary groups. PV immunoreaction was detected in interneurons of the dentate gyrus and CA1-3 regions. PVimmunoreactive fibers were significantly increased in all regions of the hippocampus in the exercise group, as compared to the sedentary group. Similar to the immunohistochemical findings, protein levels of CB and PV were also increased in the exercise group compared to the sedentary group. These increases in CB and PV in the hippocampus may induce neuronal plasticity after treadmill exercise and may be related to the enhancement of synaptic plasticity in the hippocampus by exercise.
Animals ; Blotting, Western ; Calcium-Binding Protein, Vitamin D-Dependent ; Calcium-Binding Proteins ; Dentate Gyrus ; Hippocampus ; Humans ; Immunohistochemistry ; Interneurons ; Male ; Neuronal Plasticity ; Neurons ; Plastics ; Pyramidal Cells ; Rats ; Rats, Wistar ; Running