Ginseng root, as a folk medicine, has been used in for eastern countries for thousands of years. Ginseng extract has been shown to have a variety of effects on the activity of the central nervous system, promoting simulation as well as inhibition of the cortical activity. A survey of the relevant literatures has indicated that the putative anxiolytic activity of red ginseng has not been scientifically investigated. Therefore, the present study was designed to assess anxiolytic effect of ginseng total saponinis(GTS). The putative anxiolytic effects of several fractions of GTS were investigated in mice using an elevated plus maze paradigm. Single dose administration of TS Fr.- I showed anxiolytic action in mice. Anxiolytic effect induced by TS Fr.-I was similar to that induced by diazepam. TS Fr.-II, TS Fr.-III and TS Fr.-IV did not show the anxiolytic action compared with that of TS Fr.-I. It was suggested that regulation of GABAergic neurotransmission may be important in the action of GTS. The Interaction of GTS fractions with benzodiazepine receptor was performed using rat cortical membranes. GTS inhibited the binding of [3H] Rp 15-1788 on the benzodiazepine receptor. Among from TS fractions, the binding activity of GTS in the TS Fr.-IV was highest, which did not show the anxiolytic activity. From these results, we conclude that GTS has anxiolytic action, and the is not related to benzodiazepine receptor binding activity.
Animals ; Anti-Anxiety Agents* ; Central Nervous System ; Diazepam ; Medicine, Traditional ; Membranes ; Mice ; Panax* ; Rats ; Receptors, GABA-A ; Saponins* ; Synaptic Transmission

C1q nephropathy is a rare glomerular disease, defined by characteristic mesangial C1q immune deposition seen in immunofluorescence microscopy with no serological evidence of systemic lupus erythematosus. C1q nephropathy can be diagnosed with a subsequent biopsy, as with IgA nephropathy. There are some cases with an initial diagnosis of hematuria and proteinuria with minimal disease changes, focal segmental glomerulonephritis, and mesangial proliferative glomerulonephritis, but lacking C1q nephropathy, in which C1q deposition on immunofluorescence subsequently develops. We report a case that was diagnosed as diffuse mesangial proliferative glomerulonephritis, but a subsequent biopsy showed C1q nephropathy, with C1q deposition in both immunohistochemistry and electron microscopy (EM). We treated the C1q nephropathy with methylprednisolone and confirmed the disappearance of C1q depositions by both immunohistochemistry and EM in a follow-up biopsy.
Biopsy ; Complement C1q ; Diagnosis ; Fluorescent Antibody Technique ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA ; Hematuria ; Immunohistochemistry ; Lupus Erythematosus, Systemic ; Methylprednisolone ; Microscopy, Electron ; Microscopy, Fluorescence ; Proteinuria

Therapeutic management of brain tumors is based on accurate knowledge of their size, location and histologic type. Stereotaxic cytology under CT guidance has been applied to the investigation of brain tumors, especially in the sellar turcica, third ventricle, and pineal regions. In the present case, the tumor protruded into the nasal cavity, so we were able to get cytologic material via fine needle aspiration.
Biopsy, Fine-Needle* ; Brain Neoplasms ; Nasal Cavity ; Pituitary Neoplasms* ; Third Ventricle

PURPOSE: Although eosinophilia is a common laboratory finding in many neonatal intensive care units (ICUs), its causative mechanisms remain obscure. We aimed to determine the causes of eosinophilia in the neonatal ICU environment. METHODS: Serial eosinophil counts were determined weekly for 288 hospitalized, appropriately grown neonates. Infants were divided into four groups according to gestational age, and the incidence and etiologic factors of eosinophilia were retrospectively studied. RESULTS: Absolute eosinophilia (>700/mm3) was documented in 18% (52/288) of neonates. Twenty-two infants (42.3%) exhibited mild eosinophilia (700-999 cells/mm3), 27 (51.9%) exhibited moderate eosinophilia (1,000-2,999 cells/mm3), and 3 (5.8%) exhibited severe eosinophilia (>3,000 cells/mm3). Of the 288 infants studied, 54 suffered sepsis. Thirty of these 54 infants (55.6%) showed eosinophilia, and 22 out of the remaining 234 infants (9%) without sepsis showed eosinophilia, indicating that eosinophilia was more prevalent in the sepsis group (P <0.05). All 5 infants suffering from bronchopulmonary dysplasia showed eosinophilia, and 47 out of the remaining 283 infants (16.7%) without bronchopulmonary dysplasia showed eosinophilia. Thus, eosinophilia was more prevalent in the bronchopulmonary dysplasia group (P <0.05). Furthermore, increased prevalence of eosinophilia was associated with respiratory distress syndrome, ventilator use, blood transfusion, and total parenteral nutrition (P <0.05). CONCLUSION: Our results suggest that eosinophilia is influenced by sepsis and bronchopulmonary dysplasia, although it can also occur idiopathically at birth. Moreover, the potential role of eosinophils in conditions such as wound healing and fibrosis in sepsis or chronic lung disease may be a cause of eosinophilia.
Blood Transfusion ; Bronchopulmonary Dysplasia ; Eosinophilia ; Eosinophils ; Fibrosis ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Lung Diseases ; Parenteral Nutrition, Total ; Parturition ; Prevalence ; Retrospective Studies ; Sepsis ; Stress, Psychological ; Ventilators, Mechanical ; Wound Healing

BACKGROUND: In diagnoses of iron deficiency anemia(IDA) and anemia of chronic disease(ACD), bone marrow examinations, the gold standard, are too invasive. Iron parameters such as serum ferritin, iron, and total iron binding capacity(TIBC), may be altered by perturbations as varied as infection, inflammation, and malignancy. Clinically, IDA may be the initial manifestation of an occult carcinoma of the gastrointestinal tract, thus noninvasive methods with high sensitivity are now required in detecting tissue iron deficiency. In this study, we investigated the diagnostic availability of the soluble transferrin receptor(sTfR) in differential diagnosis of IDA and ACD. SUBJECTS AND METHODS: Thirty eight patients with uncomplicated IDA(ferritin <12.0 microgram/L), 22 patients with uncomplicated anemia of chronic disease(ferritin > or =60.0 microgram/L), 7 patients with combined anemia(IDA+ACD, 12.0 microgram/L< OR = ferritin <60.0 microgram/L), and 20 normal controls were included in the study. The blood levels of sTfR, hemoglobin(Hb), RBC indices, serum ferritin, serum iron, and TIBC were measured and the transferrin saturation was calculated. The sTfR levels were compared with each other group. The correlations between iron parameters and the sTfR levels were investigated in each group. RESULTS: The sTfR receptor levels were significantly higher in uncomplicated IDA patients(56.2+/-19.8 nmol/L) than in normal controls(17.9+/-3.9 nmol/L) and uncomplicated ACD patients(15.3+/-7.5 nmol/L). No difference of the sTfR concentrations was observed between ACD patients and normal controls. In combined group, four of the 7 cases showed higher sTfR values than that of normal controls. Good inverse correlation was observed between Hb and sTfR levels in uncomplicated IDA group. There were no correlations between iron parameters and sTfR levels in the other groups. CONCLUSION: Because the sTfR level was not elevated in ACD and was significantly higher in IDA, blood determination of the sTfR levels may be a useful method in differential diagnosis of IDA and ACD. The sTfR is the most useful marker expressing the functional iron deficiency without being affected by chronic diseases. Because the sTfR levels were inversely correlated with Hb in IDA patients, the combined use of two parameters, ferritin and sTfR which are the indices of storage iron and functional iron respectively, may allow accurate definition of the entire range of body iron status.
Anemia* ; Anemia, Iron-Deficiency* ; Bone Marrow Examination ; Chronic Disease* ; Diagnosis ; Diagnosis, Differential ; Ferritins ; Gastrointestinal Tract ; Humans ; Inflammation ; Iron* ; Receptors, Transferrin* ; Transferrin*

PURPOSE: Spinal cord injuries can lead to varying degrees and patterns of neurologic deficits, which depend on the level of the injury, duration, completeness. So we analyzed the relationship between the types of neurogenic bladder and the level of injury in the spinal cord injury. MATERIALS AND METHODS: From June 1997 to August 2002, one-hundred twenty seven spinal cord injury patients were studied by neurological and urological examination and video-urodynamic evaluation. The neurogenic bladder in spinal cord injury were analyzed into five types according to the injured level. RESULTS: The 94 males and 33 females had a mean age of 45.7+/-15.1 years (range 15 to 92). Mean follow up interval after injury was 33.9+/-48.4 months. Injured level was classified into five levels; cervical, thoracic, lumbar, and sacral. Of the 127 patients 37 (29.1%) was cervical, 18 (14.2%) was thoracic, 33 (26.0%) was lumbar, and 39 (30.7%) was sacral. When all patients were divided suprasacral and infrasacral lesion. Typically, suprasacral lesions show detrusor hyperreflexia, and infrasacral lesions have detrusor areflexia. 30 (37.5%) of 88 suprasacral lesions and 12 (30.8%) of 39 infrasacral lesions were presented to atypical. 35.7% of patients have combine spinal lesion, but 47.6% of patients have no causes for atypical patterns. 3 (27.3%) of 11 patients were followed up, they changed neurogenic pattern. CONCLUSIONS: In our results, video urodynamic findings showed that about 30 percent patients had atypical patterns of neurogenic bladder, and they have underlying disease about 52.4%. And 27% of followed patients changed neurogenic pattern of bladder. So, urodynamic study have an important role in the spinal cord injury for diagnosis of neurogenic pattern and selection proper treatment, catching out the interval change and correction of treatment method, and evaluation of prognosis.
Diagnosis ; Female ; Follow-Up Studies ; Humans ; Male ; Neurologic Manifestations ; Prognosis ; Reflex, Abnormal ; Spinal Cord Injuries* ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics

This study was carried out to evaluate the factors influencing the outcome of an operation for adrenal hypertension. 35 patients with adrenal hypertension who were operated on between Jan. 1989 and Dec. 1996 at the Department of surgery, Korea University Hospital, underwent an adrenalectomy for pheochromocytoma, Cushing's syndrome and primary aldosteronism. Out of 20 clinicopathologic factors, only 3 were showen through univariate analysis to be associated with postoperative persistent hypertension. Fifteen of the 16 patients with pheochromocytoma (93.8%), 4 of the 7 patients with Cushing's syndrome (57.8%), and 5 of the 12 patients with primary aldosteronism became normotensive following surgery. Persistent hypertension correlated with a kind of adrenal hypertension, especially Cushing's syndrome or primary aldosteronism (p=0.012). In primary aldosteronism, none of the patients with fundoscopic arterial grade of more than III were in the complete response group but 5 of the 7 patients in the incomplete response group (p=0.004). For primary aldosteronism the mean serum renin level for the complete response group was 0.058+/-0.025 ng/ml/hr and that of incomplete response group was 0.51+/-0.87 ng/ml/hr (p=0.03). This study suggests that or adrenalectomy for hypertension with Cushing's syndrome or primary aldosteronism results in a more unfavorable outcome than one for hypertension with pheochromocytoma. The presence of fundoscopic arterial grade of more than III or a depressed serum renin level in primary aldosteronism was a cautious predictor of persistent hypertension after the adrenalectomy.
Adrenal Glands ; Adrenalectomy ; Cushing Syndrome ; Humans ; Hyperaldosteronism ; Hypertension ; Korea ; Pheochromocytoma ; Renin

BACKGROUND: In Korea, more than 20 cases of beta-thalassemia have been reported up to date. To detect -thalassemia. Hemoglobin (Hb) fractions were measured in patients with hypochromic microcytosis, and we analyzed the hematological characteristics of these patients. METHODS: Among 359, 369 CBCs performed at Asan Medical Center, 229 patients (0.064%) showed hypochromic microcytosis with less than 75 fL of mean corpuscular volume (MCV), less than 24 pg of mean corpuscular hemoglobin (MCH), and less than 18% of red cell distribution width (RDW). We analysed Hb fractions using high performance liquid chromatography (VARIANT(TM) Hemoglobin Testing System). Iron, total iron binding capacity (TIBC), ferritin, and reticulocyte counts were measured and medical history was searched on cases with Hb A2 and F fractions more than 3.5% and 2.0%, respectively. RESULTS: Among the 229 patients with hypochromic microcysis, 44 (19.2%) showed an increased level of Hb A2 and/or F fractions. With the exclusion of 28 patients (23 children <2 years old and 5 pregnant women), 16 (7.0%) showed a significantly increased level of Hb A2 and/or F. However, all 16 patients were diagnosed as having iron deficiency anemia based on their iron status and clinical findings. Three patients who had an increased level of Hb F at more than 5% needed a further study and follow-up to rule out the diagnosis of the hereditary persistence of the fetal hemoglobin. CONCLUSIONS: No thalassemia cases were found in the study. Incidence of beta-thalassemia should be very low, less than 1/359, 369 (0.00027%), in South Korea; a larger population should be screened to detect beta-thalassemia.
Anemia, Iron-Deficiency ; beta-Thalassemia* ; Child ; Chromatography, Liquid ; Chungcheongnam-do ; Diagnosis ; Erythrocyte Indices ; Ferritins ; Fetal Hemoglobin ; Follow-Up Studies ; Humans ; Incidence ; Iron ; Korea ; Reticulocyte Count ; Thalassemia

PURPOSE: Generally, young age onset malignancies show worse prognosis. But is "young age onset" a single prognostic factor for breast cancer, has been controversial. The incidence of breast cancer according to age is different by region and races. This study purposed to know the incidence of breast cancer in younger or 35 year old (below Young age group) and its clinical characteristics, prognosis, and difference with older age onset breast cancer. METHODS: A retrospective study of consecutive 545 breast cancer patients who had been treated by our hospital from 1990 to 1999, was carried out. We investigated the ratio of 35 year old or younger breast cancer patients, age of menarche, TNM stage, histologic grades, hormone receptor status, survival rates. And compared it with counter age (>35) group's. The significances of differences were evaluated using Student's-t test or chi-square test by variable type. Analysis were performed using SPSS software. RESULTS: Younger age group patients were 62 (11.3%) among them, showed earlier menarche, worse histologic differentiation, and lower mammographic detection rate than counter group (p<0.05). There were no difference in TNM stage distribution, hormone receptor expression status according to age group (p>0.05). Young age group's 5 year overall and disease free survival rates were 83+/-5% and 58+/-8%, both were lower than counter group's 89+/-2% and 74+/-3% (p<0.05). Also age adjusted overall and disease free survival rates were worse than counter age group's. CONCLUSION:Younger age group shows worse survival rates, have poor prognostic factors and show early relapsing rate than older age group. So we can consider "young age onset" as a poor prognostic factor in breast cancer.
Adult ; Breast Neoplasms* ; Breast* ; Continental Population Groups ; Disease-Free Survival ; Female ; Humans ; Incidence ; Menarche ; Prognosis* ; Retrospective Studies ; Survival Rate

PURPOSE: In 2012, a revised guideline for acute acetaminophen overdose was proposed in the UK, recommending that the treatment threshold should be lowered to 100 mcg/ml at 4 hours after ingestion without risk stratification of hepatotoxicity. However, the poison centers in some developing countries do not have laboratory resources to provide serum drug levels in time. The primary aim of the study is to evaluate the cut-off value of reported dose per kilogram to determine when N-acetylcysteine treatment is warranted under the revised guideline. METHODS: Data were collected retrospectively from the toxicology registry of an urban emergency medical center between 1st January 2010 and 30th June 2017. Inclusion criteria were single acute overdose of more than 75 mg/kg in 15 hours from ingestion and over 14 years of age. Subgroups were created by 25 mg/kg increments of reported dose, then sensitivity, specificity, positive predictive value and negative predictive value were calculated for the cutoff values of 100 mg/kg, 125 mg/kg, 150 mg/kg and 175 mg/kg for toxic serum level over ‘100-treatment line’. RESULTS: A total of 99 patients were enrolled in the study; 24 patients showed toxic serum levels (24.2%). Zero of 17 patients with an ingestion dose under 100 mg/kg showed toxic level (0%), and 0 of 15 under 125 mg/kg (0%), 2 of 14 under 150 mg/kg (14.3%), and 4 of 12 under 175 mg/kg (33.3%) had toxic levels. The higher the ingested dose per kilogram of weight, the higher the frequency of the toxic serum concentration on the first test (χ² test for trend, χ²=22.66, p-value < 0.001) and the sensitivity of each value was 100%, 100%, 92% and 76%. CONCLUSION: In acute single acetaminophen intoxication, the ingestion dose of 100 mg/kg of weight will be useful in determining the need for the N-acetylcysteine antidote in the indigent laboratory environment.
Acetaminophen* ; Acetylcysteine ; Developing Countries ; Eating ; Emergencies ; Great Britain* ; Humans ; Nomograms ; Poverty ; Retrospective Studies ; Sensitivity and Specificity ; Toxicology