The silkworm extract powder contain 1-deoxynojirimycin (DNJ), a potent alpha-glycosidase inhibitor, has therapeutic potency against diabetes mellitus. Therefore, natural products containing DNJ from mulberry leaves and silkworm are consumed as health functional food. The present study was performed to evaluate the safety of the silkworm extract powder, a health food which containing the DNJ. The repeated toxicity studies and gentic toxicity studies of the silkworm extract powder were performed to obtain the data for new functional food approval in MFDS. The safety was evaluated by a single-dose oral toxicity study and a 90 day repeated-dose oral toxicity study in Sprague-Dawley rats. The silkworm extract powder was also evaluated for its mutagenic potential in a battery of genetic toxicity test: in vitro bacterial reverse mutation assay, in vitro chromosomal aberration test, and in vivo mouse bone marrow micronucleus assay. The results of the genetic toxicology assays were negative in all of the assays. The approximate lethal dose in single oral dose toxicity study was considered to be higher than 5000 mg/kg in rats. In the 90 day study, the dose levels were wet at 0, 500, 1000, 2000 mg/kg/day, and 10 animals/sex/dose were treated with oral gavage. The parameters that were monitored were clinical signs, body weights, food and water consumptions, ophthalmic examination, urinalysis, hematology, serum biochemistry, necropsy findings, organ weights, and histopathological examination. No adverse effects were observed after the 90 day administration of the silkworm extract powder. The No-Observed-Adverse-Effect-Level (NOAEL) of silkworm extract powder in the 90 day study was 2000 mg/kg/day in both sexes, and no target organ was identified.
1-Deoxynojirimycin ; Animals ; Biochemistry ; Biological Agents ; Body Weight ; Bombyx* ; Bone Marrow ; Chromosome Aberrations ; Diabetes Mellitus ; Functional Food ; Food, Organic ; Hematology ; Mice ; Micronucleus Tests ; Morus ; Mutagenicity Tests ; Organ Size ; Rats ; Rats, Sprague-Dawley ; Toxicology ; Urinalysis ; Drinking

PURPOSE: The shape of the acromion was analyzed radiologically to assess the effect on rotator cuff tears. MATERIALS AND METHODS: The rotator cuff tear group consisted of 91 patients with a mean age 55.6 years (range, 27-85 years) and the normal shoulder articular disease (control) group consisted of 100 subjects with a mean age of 42.9 years (range, 18-72 years). The lateral extension of the acromion and the lateral acromial angle were measured on an oblique coronal MRI, and the anterior covering of the acromionon was measured on a supraspinatus outlet view. RESULTS: The lateral extension of the acrominon of the rotator cuff tear group of patients and the control group of subjects was 0.70+/-0.07 and 0.64+/-0.10, respectively. The lateral acromial angle was 72.6+/-6.5degrees and 76.4+/-6.5degrees, respectively, and the anterior covering of the acromion was measured to be 0.55+/-0.13 and 0.51+/-0.14, respectively. In a comparison with the control group of subjects, the lateral extension of the acrominon of the rotator cuff tear group of patients was larger and the lateral acromial angle was smaller; these findings were statistically significant (p<0.001). In addition, the correlation coefficients of the lateral extension of the acromion to the lateral acromial angle in the rotator cuff tear group of patients and in the control group of subjects was -0.44 and -0.46, respectively; a statistically significant correlation was seeen (p<0.001). CONCLUSION: The results suggest that the measurement of the lateral extension of the acromion and the lateral acromial angle determines the shape of the acromion, and thus it may represent a useful marker to confirm the interrelationship of a rotator cuff tear.
Acromion ; Humans ; Rotator Cuff ; Shoulder

OBJECTIVES: This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease. METHODS: The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveillance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveillance program consists of simple chest x-ray, spirometry and medical questionnaire. RESULTS: Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT. HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea. CONCLUSIONS: In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.
Asbestos ; Cough ; Diagnosis* ; Dyspnea ; Lung Diseases* ; Lung* ; Questionnaires ; Sensitivity and Specificity ; Smoke ; Smoking ; Spirometry ; Thorax ; United States Occupational Safety and Health Administration

PURPOSE: The aim of this study is to determine the feasibility and effectiveness of performing an ultrasound-guided percutaneous cholecysto-cholangiogram (PCC) for excluding biliary atresia as the cause of neonatal jaundice. MATERIALS AND METHODS: Between Oct. 2003 and Feb. 2005, six ultrasound-guided PCC procedures were performed to five jaundiced infants (4 females and 1 male; mean age: 60 days old) for whom possibility of biliary atresia could not be ruled out by the DISIDA scan as the cause of their neonatal jaundice. Gallbladder puncture was performed under ultrasound guidance with a 23-gauge needle. Contrast material injection during fluoroscopic examination was performed after dilatation of the gallbladder lumen with normal saline under ultrasound guidance. The criteria used for excluding biliary atresia were complete visualization of the extrahepatic biliary trees and/or contrast excretion into the duodenum. The complications and final diagnosis was assessed according to the clinical and laboratory findings. RESULTS: The procedures were successful in all the patients without any complication. Biliary atresia could be ruled out in all the patients. The final diagnosis was neonatal cytomegalovirus hepatitis in two patients, total parenteral nutrition-associated cholestasis in two patients, and combined cytomegalovirus hepatitis and total parenteral nutrition-associated cholestasis in one patient. CONCLUSION: Ultrasound-guided PCC is a feasible and effective method for the early definitive exclusion of biliary atresia as the cause of neonatal jaundice. By the technique of injecting normal saline before contrast injection, PCC can be done even in a totally collapsed or very small gallbladder.
Biliary Atresia* ; Cholangiography ; Cholecystography ; Cholestasis ; Cytomegalovirus ; Diagnosis ; Dilatation ; Duodenum ; Female ; Gallbladder ; Gastrointestinal Tract ; Hepatitis ; Humans ; Infant* ; Infant, Newborn ; Jaundice, Neonatal ; Male ; Needles ; Punctures ; Ultrasonography

PURPOSE: To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. MATERIALS AND METHODS: Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. RESULTS: Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows:Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. CONCLUSION: These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.
Acinetobacter ; Acinetobacter Infections ; Catheters ; Ceftazidime ; Ceftriaxone ; Central Nervous System Infections ; Coagulase ; Coinfection ; Enterococcus ; Fever ; Gyeongsangbuk-do ; Humans ; Meningitis ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Muscle Rigidity ; Neurosurgical Procedures ; Retrospective Studies ; Staphylococcus ; Streptococcus pneumoniae ; Vancomycin

PURPOSE: To investigate the etiologic microorganisms of external ventricular drain (EVD)-related ventriculitis and the appropriateness of using ceftazidime and vancomycin as an empiric therapy in neurosurgical patients with EVD-related ventriculitis. MATERIALS AND METHODS: Retrospective analysis of 39 patients with EVD-related ventriculitis among 340 neurosurgical patients to whom EVD had been placed during December 2000 and October 2003 at Kyungpook National University Hospital. RESULTS: Thirty-nine EVD-related infections (39/340, 11.5%) occurred and the attributable mortality rate was 10.3% (4/39). The average duration from the ventricular catheter placement to the development of ventriculitis was 8.4 days. All patients with EVD infection had fever and 89.7% (35/39) of the patients showed nuchal rigidity. The positive culture rate in CSF was 87.1% (34/39) and the frequency of individual organism is as follows:Acinetobacter 45% (19 cases), methicillin-resistant coagulase negative Staphylococcus 22% (9 cases), methicillin-resistant Staphylococcus aureus 22% (9 cases), Enterococcus 5% (2 cases), Streptococcus pneumoniae 3% (1 case), non-fermenting gram-negative bacilli 3% (1 case). The polymicrobial infection rate was 15.4% (6/39). Among 19 cases of Acinetobacter infection, 42.1% (8/19) of the strains showed resistance to ceftriaxone and 15.7% (3/11) to ceftazidime. However, all cases were sensitive to meropenem. CONCLUSION: These findings show that the major etiologic organisms causing EVD-related ventriculitis have recently changed to Gram-negative non-fermenters, especially Acinetobacter. Because Gram-negative non-fermenting rods resistant to ceftazidime are increasing, an immediate change from ceftazidime plus vancomycin, the widely accepted empiric antibiotic therapy, to meropenem plus vancomycin should be considered when clinical symptoms and signs show no improvement or even deterioration.
Acinetobacter ; Acinetobacter Infections ; Catheters ; Ceftazidime ; Ceftriaxone ; Central Nervous System Infections ; Coagulase ; Coinfection ; Enterococcus ; Fever ; Gyeongsangbuk-do ; Humans ; Meningitis ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Muscle Rigidity ; Neurosurgical Procedures ; Retrospective Studies ; Staphylococcus ; Streptococcus pneumoniae ; Vancomycin

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the clinical and radiological results of different surgical methods in osteoporotic vertebral fracture patients, with neurologic deficits in the thoracolumbar junction. SUMMARY OF LITERATURE REVIEW: Various surgical methods have been reported for osteoporotic vertebral fractures, with neurologic deficits, in the thoracolumbar junction. These are: anterior decompression, anterior decompression and anterior or posterior reconstruction, and Egg shell procedure. However, it is controversial as to which method is better. MATERIALS AND METHODS: 13 patients that had undergone surgical treatment for osteoporotic vertebral fractures, with neurologic deficits, With a mean age of 68+/-8.4, ranging from 51 to 79 years. Six of the cases were male and seven were female. The mean follow up period was 18 months. The patients were divided into two groups. Group A (n=8): Anterior decompression, anterior interbody fusion, with cage or autologous strut iliac bone block, and instrumentation (anterior or posterior). Group B (n=5): Posterior decompression and posterior reconstruction (egg shell procedure). The kyphotic angles, neurologic improvements and complications in each group were analyzed preoperatively, postoperatively and at final follow up. RESULTS: In group A, the mean kyphotic angles were 29+/-5.9 degrees, 18+/-6.7 degrees and 23+/-7.7 degrees preoperatively, postoperatively and at the final follow up, respectively. In group B, the mean kyphotic angles were 31+/-1.1 degrees, 12+/-6.3 degrees and 18+/-5.5 degrees preoperatively, postoperatively and at the final follow up, respectively. In group A, 3 and 5 patients were graded as Frankel grades C and D, respectively. In group B, 1, 1 and 3 patients were graded as Frankel grades B, C and D, respectively. The neurological status improved in all the patients, by mean 1.1 grades in group A and 1.2 grades in group B. In group A, postoperative transient dyspnea and screw loosening occurred in one and two patients, respectively. In group B, postoperative paralytic ileus and screw loosening occurred in one two patients, respectively. CONCLUSIONS: Posterior decompression and posterior reconstruction (egg shell procedure) was an effective surgical method, equivalent to an anterior or anterior and posterior procedure, for osteoporotic vertebral fracture patients, with neurologic deficits.
Animals ; Decompression ; Dyspnea ; Egg Shell ; Female ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Neurologic Manifestations* ; Retrospective Studies

STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the clinical and radiological results of different surgical methods in osteoporotic vertebral fracture patients, with neurologic deficits in the thoracolumbar junction. SUMMARY OF LITERATURE REVIEW: Various surgical methods have been reported for osteoporotic vertebral fractures, with neurologic deficits, in the thoracolumbar junction. These are: anterior decompression, anterior decompression and anterior or posterior reconstruction, and Egg shell procedure. However, it is controversial as to which method is better. MATERIALS AND METHODS: 13 patients that had undergone surgical treatment for osteoporotic vertebral fractures, with neurologic deficits, With a mean age of 68+/-8.4, ranging from 51 to 79 years. Six of the cases were male and seven were female. The mean follow up period was 18 months. The patients were divided into two groups. Group A (n=8): Anterior decompression, anterior interbody fusion, with cage or autologous strut iliac bone block, and instrumentation (anterior or posterior). Group B (n=5): Posterior decompression and posterior reconstruction (egg shell procedure). The kyphotic angles, neurologic improvements and complications in each group were analyzed preoperatively, postoperatively and at final follow up. RESULTS: In group A, the mean kyphotic angles were 29+/-5.9 degrees, 18+/-6.7 degrees and 23+/-7.7 degrees preoperatively, postoperatively and at the final follow up, respectively. In group B, the mean kyphotic angles were 31+/-1.1 degrees, 12+/-6.3 degrees and 18+/-5.5 degrees preoperatively, postoperatively and at the final follow up, respectively. In group A, 3 and 5 patients were graded as Frankel grades C and D, respectively. In group B, 1, 1 and 3 patients were graded as Frankel grades B, C and D, respectively. The neurological status improved in all the patients, by mean 1.1 grades in group A and 1.2 grades in group B. In group A, postoperative transient dyspnea and screw loosening occurred in one and two patients, respectively. In group B, postoperative paralytic ileus and screw loosening occurred in one two patients, respectively. CONCLUSIONS: Posterior decompression and posterior reconstruction (egg shell procedure) was an effective surgical method, equivalent to an anterior or anterior and posterior procedure, for osteoporotic vertebral fracture patients, with neurologic deficits.
Animals ; Decompression ; Dyspnea ; Egg Shell ; Female ; Follow-Up Studies ; Humans ; Intestinal Pseudo-Obstruction ; Male ; Neurologic Manifestations* ; Retrospective Studies

Carboplatin intra-arterial chemotherapy(IAC) has an advantage of increased uptake during the first passage of the drugs through tumor capillaries. Although not common, this type of therapy is known to cause neurological complications, myelosuppression, and ototoxicity. However, the incidence of ocular toxicity is reported to be rare. Eleven of our patients with glioma(Grade II Astrocytoma: 3, Grade III Astrocytoma: 1, Grade IV Astrocytoma: 5, Gliofibroma: 1, Oligodendroglioma: 1) underwent IAC regimen with carboplatin(300mg/m2) which were administrated after blood-brain barrier disruption. Of there, 3 patients had ocular complications after supra-ophthalmic IAC injection of carboplatin but fully recovered following steroid therapy. Although our results from IAC seem to be favorable for these patients, we suggest that its complications, such as ocular toxicity, need to be carefully considered prior to treatment.
Astrocytoma ; Blood-Brain Barrier ; Capillaries ; Carboplatin* ; Glioblastoma ; Glioma* ; Humans ; Incidence ; Oligodendroglioma

PURPOSE: DNA ploidy pattern was shown to correlate with several clinicohistologic findings in several tumors. Aim of this study was to evaluate the correlation of the clinicohistologic findings in colorectal cancer and the failure pattern in rectosigmoid cancer with DNA ploidy. MATERIALS AND METHODS: DNA flow cytometry using the Hedley methods on paraffin embedded specimen from 117 patients with colorectal cancers after curative resection was performed. We tried to find the correlation between DNA ploidy and various clinicohistologic findings. And then the correlation DNA ploidy and the failure pattern in 75 patients of rectosigmoid cancer was analized. RESULTS: Forty samples (34.2%) from tumors gave aneuploidy histogram. There was no significant difference in the frequency of DNA aneuploidy in terms of age, sex, depth of invasion, location and Dukes stage. But there was a significant correlation between DNA ploidy and the failure rates in Dukes stage B rectosigmoid cancer ( p=0.048). CONCLUSIONS: These findings suggest that DNA ploidy pattern shows the correlation with the treatment failure rates in Dukes stage B rectosigmoid, but not with many other clinicohistologic findings. However, more patients will be needed to disclose these findings.
Aneuploidy ; Colorectal Neoplasms* ; DNA* ; Flow Cytometry ; Humans ; Paraffin ; Ploidies* ; Treatment Failure