Anthocyanidins, the aglycones of anthocyanins, are natural colorants belonging to the flavonoid family. Cyanidin is one of the anthocyanidins, used for their antioxidant properties. Furthermore, previous studies have shown anthocyanidin-rich material extracts or aglycone form inhibit growth and induce apoptosis of cancer cells. But, Tumor metastasis is the most important cause of cancer death, and various treatment strategies have targeted on preventing the occurrence of metastasis. This study investigated the effects of cyanidin on metastasis processes, including motility, invasion and activity of MMP-2 and MMP-9 in MDA-MB-231 human breast cancer cell lines. We cultured MDA-MB-231 cells in presence of various concentrations 0, 5, 10 and 20 micrometer of cyanidin. The cell motility was significantly decreased dosedependently in cells treated with cyanidin (p < 0.05) and cyanidin treatment caused the significant suppression of the invasion (p < 0.05). MMP-2 and MMP-9 activities, and MMP-9 mRNA express were not affected by anthocyanin treatment. In conclusion, cyanidin inhibits cell motility, invasion in MDA-MB-231 human breast cancer cell lines.
Anthocyanins ; Apoptosis ; Breast ; Breast Neoplasms ; Cell Line ; Cell Movement ; Humans ; Neoplasm Metastasis ; RNA, Messenger

In Korea, cases of direct insertion of foreign bodies into the rectum are rare in the literature. Most cases of rectal insertion of foreign bodies are associated with sexual acts and psychiatric disorder such as schizophrenia. Objects inserted into the anus are usually blunt and shaped like the male genitalia. The removal method can be varied depending on the size and shape of the foreign object, its anatomical location, and the accompanying complications. In cases wherein attempts to remove the object fail or there are rectal perforation and peritonitis complications, immediate laparotomy may be required in order to prevent serious complications such as sepsis. Here, we report on a case of rectal perforation and peritonitis due to insertion of a foreign body in a middle-aged patient, with a literature review. He inserted a sharp pig backbone in his rectum and he only had depression. The patient underwent a Hartmann's operation as well as psychiatric counseling and treatment. Thus, after removal of foreign bodies, psychiatric counseling and treatment should be carried out in order to prevent similar accidents and to minimize the need for trauma medicine.
Anal Canal ; Counseling ; Depression* ; Foreign Bodies ; Genitalia, Male ; Humans ; Korea ; Laparotomy ; Male ; Peritonitis ; Rectum ; Schizophrenia ; Sepsis

Hemangioma in the renal pelvis is a very rare benign tumor that may be mistaken for renal cell carcinoma. We present a case of a 59-year-old woman with a renal mass, that was diagnosed as a cavernous hemangioma in the renal pelvis.
Carcinoma, Renal Cell ; Female ; Hemangioma* ; Hemangioma, Cavernous ; Humans ; Kidney Pelvis* ; Middle Aged

BACKGROUND: Philadephia chromosome negative chronic myeloproliferative disease (CMPD) is a clonal disorder which includes polycythemia vera (PV), essential thrombocythemia (ET) and idiopathic myelofibrosis (IMF). CMPD has chronic course and different clinical features with low rate of conversion to leukemia. We evaluated the clinical features of CMPD. METHODS: Since 1990, 57 cases of CMPD (18 PV, 35 ET and 4 IMF) were analysed and their clinical characteristics, survival and manner of evolution were evaluated retrospectively. RESULTS: Median age of 57 CMPD patients was 61 (range, 14~90) years and male to female ratio was 1:0.8. Most common clinical manifestations were dizziness/weakness (38.6%), headache (21.2%), cardiovascular events (19.3%) and other symptoms. Treatment with hydroxyurea was most frequent during clinical course of CMPD. Anagrelide was introduced in 12 patients recently. Complication of disease itself and treatment was not frequent except bleeding (3 cases) and thrombotic event (10 cases). Conversion to acute lekemia was none. Ten year overall survival was 83.3% in PV, 60.1% in ET and 4 cases of IMF were all alive at the 6 year follow up. CONCLUSION: CMPD is a chronic disease and long term control is much improved but definitive treatment without complication should be further investigated.
Chronic Disease ; Female ; Follow-Up Studies ; Headache ; Hemorrhage ; Humans ; Hydroxyurea ; Leukemia ; Male ; Polycythemia Vera ; Primary Myelofibrosis ; Retrospective Studies ; Thrombocythemia, Essential

A 44-year-old man treated with azathioprine, cyclosporine and prednisolone for 7.5 years after allogeneic renal transplantation was admitted because of exertional dyspnea, fatigue and pancytopenia which were found 3 months ago. He had been on hemodialysis for renal failure of unknown cause for 8 months before the renal transplantation. Bone marrow examination showed hypercellularity, erythroid hyperplasia and 7% of myeloblast, consistent with the diagnosis of myelodysplastic syndrome. Cytogenetic study showed chromosomal abnormalities:deletion of chromosome 5, monosomy 7, trisomy 8, monosomy 14 and deletion of chromosome 17. Immunosuppressive agents were discontinued and he was treated with transfusion, G-CSF, and combination chemotherapy including topotecan and Ara-C. Graft kidney function was normal before and after the treatment, but the clinical course was fatal because of leukemic transformation and eventually sepsis. Although therapy induced myelodysplastic syndrome was rare in renal allograft recipients, thorough evaluations including bone marrow biopsy and cytogenetic study are recommended in patients with anemia of unknown etiology.
Adult ; Allografts ; Anemia ; Azathioprine ; Biopsy ; Bone Marrow ; Bone Marrow Examination ; Chromosome Aberrations ; Chromosomes, Human, Pair 17 ; Chromosomes, Human, Pair 5 ; Cyclosporine ; Cytarabine ; Cytogenetics ; Diagnosis ; Drug Therapy, Combination ; Dyspnea ; Fatigue ; Granulocyte Colony-Stimulating Factor ; Granulocyte Precursor Cells ; Humans ; Hyperplasia ; Immunosuppressive Agents ; Kidney ; Kidney Transplantation ; Monosomy ; Myelodysplastic Syndromes* ; Pancytopenia ; Prednisolone ; Renal Dialysis ; Renal Insufficiency ; Sepsis ; Topotecan ; Transplantation* ; Transplants ; Trisomy

PURPOSE: Anterolateral thigh(ALT) perforator free flap is commonly used because of its various benefits. The author reports important factors of preoperative and perioperative ALT perforator free flap and causes of failure. METHODS: 84 patients who were treated with ALT perforator free flap from December 2004 to 2008, and February 2010 to April 2010 were studied. 61 patients were male and 23 were female. The mean age of patients was 51.1. The main cause was neoplasm and the main reconstructive areas were head and neck area. The size of flap was various from 3 x 4 to 12 x 18cm. 6 patients received split thickness skin graft at donor site. Preoperative angiography was checked to all patients. RESULTS: Among the 84 patients, partial necrosis of flaps occurred in 4 patients because of atherosclerosis, varicose vein, or inattention of patient, etc. And total flap necrosis in 5 patients because of abnormal vessels of recipient area or delay of operation, etc. One case of serous cyst was found as the complication of donor area. Two cases of skin graft on donor site were done because of suspected muscle compartment syndrome, 4 cases of that because of large flap. Septocutaneous perforators were found in 7 cases. The author couldn't find reliable perforator in 3 cases, ipsilateral anteromedial thigh perforator and contralateral ALT perforator and latissimus dorsi musculocutaneous free flap were done instead of ALT. There was no case which needed reoperation because of the impairment of blood supply, and 3 cases were revised by leech because of the burn injury by a lamp or venous congestion. CONCLUSION: Although ALT perforator free flap is widely used with its various merits, many factors such as preoperative condition of donor or recipient area, morphology of defect and operating time need to consider to prevent flap necrosis. And operators should need careful technique because septocutaneous perforator is uncommon, and musculocutaneous perforator is common but difficult to dissect.
Angiography ; Atherosclerosis ; Burns ; Compartment Syndromes ; Female ; Free Tissue Flaps ; Head ; Humans ; Male ; Muscles ; Neck ; Necrosis ; Reoperation ; Skin ; Thigh ; Tissue Donors ; Transplants ; Varicose Veins

BACKGROUND AND PURPOSE: New-onset headache in elderly patients is generally suggestive of a high probability of secondary headache, and the subtypes of primary headache diagnoses are still unclear in the elderly. This study investigated the characteristics of headache with an older age at onset (≥65 years) and compared the characteristics between younger and older age groups. METHODS: We prospectively collected demographic and clinical data of 1,627 patients who first visited 11 tertiary hospitals in Korea due to headache between August 2014 and February 2015. Headache subtype was categorized according to the International Classification of Headache Disorders, Third Edition Beta Version. RESULTS: In total, 152 patients (9.3%, 106 women and 46 men) experienced headache that began from 65 years of age [elderly-onset group (EOG)], while the remaining 1,475 patients who first experienced headache before the age of 65 years were classified as the younger-age-at-onset group (YOG). Among the primary headache types, tension-type headache (55.6% vs. 28.8%) and other primary headache disorders (OPH, 31.0% vs. 17.3%) were more common in the EOG than in the YOG, while migraine was less frequent (13.5% vs. 52.2%) (p=0.001) in the EOG. Among OPH, primary stabbing headache (87.2%) was more frequent in the EOG than in the YOG (p=0.032). The pain was significantly less severe (p=0.026) and the frequency of medication overuse headache was higher in EOG than in YOG (23.5% vs. 7.6%, p=0.040). CONCLUSIONS: Tension-type headache and OPH headaches, primarily stabbing headache, were more common in EOG patients than in YOG patients. The pain intensity, distribution of headache diagnoses, and frequency of medication overuse differed according to the age at headache onset.
Age of Onset ; Aged ; Classification* ; Diagnosis ; Electrooculography ; Female ; Headache Disorders* ; Headache Disorders, Primary ; Headache Disorders, Secondary ; Headache* ; Humans ; Korea ; Migraine Disorders ; Prescription Drug Overuse ; Prospective Studies ; Tension-Type Headache ; Tertiary Care Centers

The purpose of this study was to test the feasibility and usefulness of the International Classification of Headache Disorders, third edition, beta version (ICHD-3beta), and compare the differences with the International Classification of Headache Disorders, second edition (ICHD-2). Consecutive first-visit patients were recruited from 11 headache clinics in Korea. Headache classification was performed in accordance with ICHD-3beta. The characteristics of headaches were analyzed and the feasibility and usefulness of this version was assessed by the proportion of unclassified headache disorders compared with ICHD-2. A total of 1,627 patients were enrolled (mean age, 47.4±14.7 yr; 62.8% female). Classification by ICHD-3beta was achieved in 97.8% of headache patients, whereas 90.0% could be classified by ICHD-2. Primary headaches (n=1,429, 87.8%) were classified as follows: 697 migraines, 445 tension-type headaches, 22 cluster headaches, and 265 other primary headache disorders. Secondary headache or painful cranial neuropathies/other facial pains were diagnosed in 163 patients (10.0%). Only 2.2% were not classified by ICHD-3beta. The main reasons for missing classifications were insufficient information (1.6%) or absence of suitable classification (0.6%). The diagnoses differed from those using ICHD-2 in 243 patients (14.9%). Among them, 165 patients were newly classified from unclassified with ICHD-2 because of the relaxation of the previous strict criteria or the introduction of a new diagnostic category. ICHD-3beta would yield a higher classification rate than its previous version, ICHD-2. ICHD-3beta is applicable in clinical practice for first-visit headache patients of a referral hospital.
Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Guidelines as Topic ; Headache Disorders/classification/*diagnosis ; Humans ; Male ; Middle Aged ; Migraine Disorders/classification/diagnosis/epidemiology ; Registries ; Republic of Korea ; Tension-Type Headache/classification/diagnosis/epidemiology ; Young Adult

A hemorrhoid is the most common cause of acute lower gastrointestinal (LGI) bleeding. Diverticulosis, angiodysplasia and ischemic colitis can also cause LGI bleeding. Acute LGI bleeding from the appendix is very rare. We experienced a case of a 33-year-old woman with acute LGI bleeding from the appendix. Colonoscopy demonstrated an active hemorrhage from the orifice of the appendix. The patient was treated with a appendectomy, and a histological examination showed the presence of a small ulcer with inflamed granulation tissue in the mucosa and submucosa.
Adult ; Angiodysplasia ; Appendectomy ; Appendix ; Colitis, Ischemic ; Colonoscopy ; Diverticulum ; Female ; Granulation Tissue ; Hemorrhage ; Hemorrhoids ; Humans ; Mucous Membrane ; Ulcer

BACKGROUND: Neuroimaging can play a crucial role in discovering potential abnormalities to cause secondary headache. There has been a progress in the fields of headache diagnosis and neuroimaging in the past two decades. We sought to investigate neuroimaging findings according to headache disorders, age, sex, and imaging modalities in first-visit headache patients. METHODS: We used data of consecutive first-visit headache patients from 9 university and 2 general referral hospitals. The International Classification of Headache Disorders, third edition, beta version was used in headache diagnosis. We finally enrolled 1,080 patients undertook neuroimaging in this study. RESULTS: Among 1,080 patients (mean age: 47.7±14.3, female: 60.8%), proportions of headache diagnosis were as follows: primary headaches, n=926 (85.7%); secondary headaches, n=110 (10.2%); and cranial neuropathies and other headaches, n=43 (4.1%). Of them, 591 patients (54.7%) received magnetic resonance imaging (MRI). Neuroimaging abnormalities were found in 232 patients (21.5%), and their proportions were higher in older age groups and male sex. Chronic cerebral ischemia was the most common finding (n=88, 8.1%), whereas 76 patients (7.0%) were found to have clinically significant abnormalities such as primary brain tumor, cancer metastasis, and headache-relevant cerebrovascular disease. Patients underwent MRI were four times more likely to have neuroimaging abnormalities than those underwent computed tomography (33.3% vs. 7.2%, p <0.001). CONCLUSIONS: In this study, the findings of neuroimaging differed according to headache disorders, age, sex, and imaging modalities. MRI can be a preferable neuroimaging modality to identify potential causes of headache.
Brain Ischemia ; Brain Neoplasms ; Cerebrovascular Disorders ; Classification ; Cranial Nerve Diseases ; Diagnosis ; Female ; Headache Disorders ; Headache ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Neuroimaging ; Referral and Consultation