Adiponectin secretion-promoting compounds have therapeutic potentials in human metabolic diseases. Diallyl biphenyl-type neolignan compounds, magnolol, honokiol, and 4-O-methylhonokiol, from a Magnolia officinalis extract were screened as adiponectin-secretion promoting compounds in the adipogenic differentiation model of human bone marrow mesenchymal stem cells (hBM-MSCs). In a target identification study, magnolol, honokiol, and 4-O-methylhonokiol were elucidated as PPARα and PPARγ dual modulators. Diallyl biphenyl-type neolignans affected the transcription of lipid metabolism-associated genes in a different way compared to those of specific PPAR ligands. The diallyl biphenyl-type neolignan structure provides a novel pharmacophore of PPARα/γ dual modulators, which may have unique therapeutic potentials in diverse metabolic diseases.

Neurilemmomas are relatively uncommon, slowly growing tumors which originate from Schwann cells. Intrathoracic neurilemmomas often occur in the chest wall and posterior mediastinum, but endobronchial neurilemmomas are exceedingly rare. These tumors in trachea or bronchus are usually detected by radiologic examinations, mostly computed tomography scan of chest. An 88-year-old man was admitted for management of pneumonia in left lower lobe and parapneumonic effusion. On bronchoscopic examination, there was a small polypoid nodule less than 1 cm in diameter mimicking an endobronchial inflammatory polyp at the bifurcation of the right anterior segmental bronchus and lateral segmental bronchus and under auto-fluorescence imaging, the nodule showed reddish brown area with defined margin. The bronchoscopic biopsy revealed that the bronchial nodule was endobronchial neurilemmoma. This is an interesting case of endobronchial neurilemmoma mimicking a bronchial polyp that is detected incidentally via bronchoscopy.
Aged, 80 and over ; Biopsy ; Bronchi ; Bronchoscopy ; Humans ; Mediastinum ; Neurilemmoma* ; Optical Imaging ; Pneumonia ; Polyps* ; Schwann Cells ; Thoracic Wall ; Thorax ; Trachea

Eosinophilic gastroenteritis is a rare, benign condition, characterized by various gastrointestinal symptoms associated with eosinophilic infiltration of the wall of the any part of the digestive tract, most commonly the stomach and small intestine. Eosinophilic gastroenteritis is generally classified according to the involved layer of the gastrointestinal tract. Serosal type is the rarest form of eosinophilic gastroenteritis that is characteristically accompanied with eosinophilic ascites and responds well to steroid treatment. We have experienced a typical case of serosal type eosinophilic gastroenteritis in a women who complained of abdominal pain. She had peripheral eosinophilia, gastric and small bowel wall thickening with eosionophilic ascites. Her symptom relieved rapidly after starting corticosteroid treatment and she had long been in clinical remission after discontinuation of corticosteroid administration.
Abdominal Pain ; Ascites ; Eosinophilia ; Eosinophils* ; Female ; Gastroenteritis* ; Gastrointestinal Tract ; Humans ; Intestine, Small ; Stomach

BACKGROUND: Perioperative respiratory adverse events remain a major cause of postoperative morbidity and mortality during pediatric anesthesia. This multicenter study was designed to evaluate the incidence of perioperative respiratory adverse events during elective pediatric surgery and to identify the risk factors for these events. METHODS: Pediatric patients undergoing elective surgery under general anesthesia in 11 hospitals were randomly selected for this prospective, multicenter study. Preanesthetic assessments, anesthetic and surgical conditions were recorded by anesthesiologists in charge. Adverse respiratory events were registered. RESULTS: Eight hundred and twenty-three patients were included. The overall incidence of any perioperative respiratory adverse respiratory event was 15.1%. The incidences of perioperative bronchospasm, laryngospasm, coughing, desaturatioin (oxygen saturation <95%), and airway obstruction were 0.1, 0.5, 10.2, 4.1, and 1.6% respectively. According to the multivariate analysis, five risk factors were identified: multiple attempts for airway device insertion, odds ratio (OR) 2.88; recent URI (< or =2 weeks), OR 1.96; induction with intravenous anesthetics, OR 1.95; airway related surgery, OR 1.88; ASA class > or =2, OR 1.62. CONCLUSIONS: Multiple attempts for airway device insertion, recent URI, induction with intravenous anesthetics, airway related surgery and ASA class > or =2 were associated with increased risk for perioperative respiratory adverse events.
Airway Obstruction ; Anesthesia ; Anesthesia, General ; Anesthetics, Intravenous ; Bronchial Spasm ; Child ; Cough ; Fees and Charges ; Humans ; Incidence ; Laryngismus ; Multivariate Analysis ; Odds Ratio ; Prospective Studies ; Risk Factors

BACKGROUND: Optiscope(TM) is a newly developed video stylet device. This study evaluated and compared the hemodynamic changes observed after endotracheal intubation with video stylet and after conventional laryngoscopic endotracheal intubation. METHODS: Fifty-eight adult patients with American Society of Anesthesiologists (ASA) physical status class 1 or 2, undergoing general anesthesia, were randomized into two groups: one group of patients were intubated using video stylet (n = 29) and the other group were intubated using direct laryngoscope (n = 29). Systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), heart rate (HR), POGO (percentage of glottic opening) score, time for intubation and degree of sore throat were recorded. RESULTS: There were no significant differences in the SBP, MAP, DBP, HR, and the sore throat incidence between the two groups. Optiscope(TM) produced better POGO scores, but time for intubation was longer than with conventional laryngoscope. CONCLUSIONS: Optiscope(TM), when compared with conventional laryngoscope for intubation, does not modify the hemodynamic response, but it provides a better view of the vocal cords.
Adult ; Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Bronchoscopes ; Heart Rate ; Hemodynamics ; Humans ; Incidence ; Intubation ; Intubation, Intratracheal ; Laryngoscopes ; Pharyngitis ; Video Recording ; Vocal Cords

BACKGROUND/AIMS: The meaning of specialized intestinal metaplasia (SIM) in the diagnosis of Barrett's esophagus (BE) is not clear. This study was designed to determine the clinical significance of SIM in the diagnosis of Barrett's esophagus. MATERIALS AND METHODS: Biopsies were taken from 601 subjects with endoscopically suspected columnar-lined esophagus. Under light microscopy with Alcian-blue stain, SIM was identified. Demographic characteristics, gastroesophageal (GE) reflux symptoms and endoscopic findings were compared between the SIM-present group and the SIM-absent group. RESULTS: Among 601 subjects, 184 (30.6%) were confirmed by pathology to have SIM. Age over 40 years (P<0.001) and a medication history of proton pump inhibitor or H2 blocker were found more frequently in the SIM-present group (P=0.01) than in the SIM-absent group. Any of 7 GE reflux symptoms (heartburn, acid regurgitation, chest pain, hoarseness, globus sensation, cough and epigastric soreness) were more frequent in the SIM-present group than SIM-absent group (P<0.001). Specifically, heartburn, chest pain and cough were significantly more common in the SIM-present group. There was no clinically significant difference associated with endoscopic findings or other clinical characteristics. CONCLUSIONS: When subjects with endoscopically suspected BE are analyzed based on the presence or absence of SIM, the SIM-present group was significantly associated with GE reflux symptoms suggestive of frequent GE reflux. However, the presence of SIM did not correlate with endoscopic findings.
Barrett Esophagus ; Biopsy ; Chest Pain ; Cough ; Esophagus ; Gastroesophageal Reflux ; Heartburn ; Hoarseness ; Light ; Metaplasia ; Microscopy ; Prospective Studies ; Proton Pumps ; Sensation

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

BACKGROUND/AIMS: Chronic gastritis is a common finding during endoscopy and it is very important to describe it correctly. This study was designed to evaluate the distribution of endoscopic gastritis and the differences according to age, sex or area. MATERIALS AND METHODS: A clinical analysis was conducted on 25,536 subjects who had undergone an upper endoscopy for routine health check-up. Endoscopic gastritis was classified into four types, superficial gastritis, erosive gastritis, atrophic gastritis and intestinal metaplasia. The distribution of the four types of gastritis was evaluated according to sex, age and area. RESULTS: 51.6% of the patients had experienced at least one of the symptoms (epigastric pain or discomfort, soarness, dyspepsia, abdominal pain) on at least a few occasions during the previous year. The incidence of normal gastric finding was 3,593 (14.1%). 21,943 (85.9%) subjects have at least more than one of endoscopic gastritis. The number of cases with superficial gastritis was 7,983 (31.3%), erosive gastritis 6,054 (23.7%), atrophic gastritis 6,918 (27.1%), and intestinal metaplasia 1,181 (7.1%). Erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men than women (P<0.001) and in the older age group (> or =60 years) than younger age group (P<0.001). CONCLUSIONS: The prevalence of endoscopic gastritis was very common, 85.9%. In addition, erosive gastritis, atrophic gastritis and intestinal metaplasia were more frequent in men and in the older age group, which is similar to gastric cancer or peptic ulcer. Cautious regular endoscopic follow-up might be necessary regardless of gastrointestinal symptoms in Korea.
Dyspepsia ; Endoscopy ; Female ; Gastritis ; Gastritis, Atrophic ; Helicobacter pylori ; Humans ; Incidence ; Korea ; Male ; Metaplasia ; Peptic Ulcer ; Prevalence ; Stomach Neoplasms

BACKGROUND: The greater occipital nerve (GON) block has been frequently used for different types of headache, but performed with rough estimates of anatomic landmarks. Our study presents the values of the anatomic parameters and estimates the effectiveness of the ultrasound-guided GON blockade. METHODS: The GON was detected using ultrasound technique and distance from external occipital protuberance (EOP) to GON, from GON to occipital artery and depth from skin to GON was measured in volunteers. Patients with occipital headache were divided into two groups (ultrasound-guided block: group S, conventional blind block: group B) and GON block was performed. The same parameters were measured on group S and VAS scores were assessed at pretreatment, 1 week and 4 weeks after treatment on both groups. RESULTS: The GON had distance of 23.1 +/- 3.4 mm (right) and 20.5 +/- 2.8 mm (left) from EOP to GON. Its depth below the skin was 6.8 +/- 1.5 mm (right) and 7.0 +/- 1.3 mm (left). The distance from GON to occipital artery was 1.5 +/- 0.6 mm (right) and 1.2 +/- 0.6 mm (left) in volunteers. Initial VAS score of group S and group B patients were 6.4 +/- 0.2 and 6.5 +/- 0.2. VAS score of 4 weeks after injection were 2.3 +/- 0.2 on group S and 3.8 +/- 0.3 on group B (P = 0.0003). CONCLUSIONS: The parameters measured in this study should be useful for GON block and ultrasound-guided blockade is likely to be a more effective technique than blind blockade in occipital headache treatment.
Anatomic Landmarks ; Arteries ; Follow-Up Studies ; Headache ; Humans ; Nerve Block ; Skin

The Shikani Optical Stylet(TM) (SOS, Clarus Medical, USA) is another tool to facilitate tracheal intubation. It combines the benefits of a lightwand and a fiberoptic bronchoscope. We report the application of SOS in facilitating the tracheal intubation of two-person with history of difficult airway management. A 25-year-old woman with micrognathia was scheduled to undergo an exploratory laparotomy. Intubation attemps failed with a direct laryngoscope because of difficulty in her mouth opening. Although airway management was re-attempted by a laryngeal mask airway, it also failed for the same reason. Airway management was successfully performed using the SOS instead of a laryngeal mask airway. The second case was a 38-year-old woman with ankylosing spondylitis, scheduled for spinal fusion. She had difficulty in extending her neck. Intubation was successfully performed via the SOS. We believe that intubation by the SOS is a useful and readily available alternative technique for patients with difficult airways.
Adult ; Airway Management ; Bronchoscopes ; Female ; Humans ; Intubation ; Laparotomy ; Laryngeal Masks ; Laryngoscopes ; Mouth ; Neck ; Spinal Fusion ; Spondylitis, Ankylosing