The development of drug-resistant influenza and new pathogenic virus strains underscores the need for antiviral therapeutics. Currently, neuraminidase (NA) inhibitors are commonly used antiviral drugs approved by the US Food and Drug Administration (FDA) for the prevention and treatment of influenza. Here, we show that vitisin B (VB) inhibits NA activity and suppresses H1N1 viral replication in MDCK and A549 cells. Reactive oxygen species (ROS), which frequently occur during viral infection, increase virus replication by activating the NF-κB signaling pathway, downmodulating glucose-6-phosphate dehydrogenase (G6PD) expression, and decreasing the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) antioxidant response activity. VB decreased virus-induced ROS generation by increasing G6PD expression and Nrf2 activity, and inhibiting NF-κB translocation to the nucleus through IKK dephosphorylation. In addition, VB reduced body weight loss, increased survival, decreased viral replication and the inflammatory response in the lungs of influenza A virus (IAV)-infected mice. Taken together, our results indicate that VB is a promising therapeutic candidate against IAV infection, complements existing drug limitations targeting viral NA. It modulated the intracellular ROS by G6PD, Nrf2 antioxidant response pathway, and NF-κB signaling pathway. These results demonstrate the feasibility of a multi-targeting drug strategy, providing new approaches for drug discovery against IAV infection.

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of remote cerebellar hemorrhage (RCH) as a complication of spinal surgery. SUMMARY OF LITERATURE REVIEW: Remote cerebellar hemorrhage is rare but lethal as a complication of spinal surgery. Interestingly, dural tears and cerebrospinal fluid (CSF) leakage are reported in all published cases of RCH. MATERIALS AND METHODS: A 67-year-old man had posterior lumbar decompression and posterolateral fusion for spinal stenosis at L4/5/S1. Intraoperatively, the dura was torn and there was a loss of CSF. The dural tear was sutured immediately in a water-tight manner. After surgery, the patient complained of headache and dizziness. On postoperative day 44, brain magnetic resonance imaging (MRI) showed meningeal enhancement suggesting meningitis. On postoperative day 54, brain computed tomography (CT) showed cerebellar edema and hemorrhage, and external ventricular derivation was performed. RESULTS: The patient died. CONCLUSIONS: Special attention should be paid to prevent dural damage during spinal surgery or minimize CSF leakage in the case of dural damage and tears during spinal surgery, and CT and MRI should be promptly performed for symptomatic patients.
Aged ; Brain ; Cerebrospinal Fluid* ; Decompression ; Dizziness ; Edema ; Headache ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Meningitis* ; Spinal Stenosis ; Tears

BACKGROUND: During the past two decades, laser treatments have been increasingly performed by various personnel in Korea. However, as a result, adverse events related to laser treatments have also increased. OBJECTIVE: This study aimed to characterize cutaneous adverse events associated with laser treatments in Korea and to consider feasible ways to minimize possible laser-associated adverse events. METHODS: Adverse event reports after laser treatments were collected from the members of the Korean Dermatological Association. A retrospective analysis of clinical data was performed regarding the pre-treatment lesion, specific laser type applied, personnel who performed the procedure, and consequences in terms of treatmentrelated complications. RESULTS: A total of 69 reported cases of adverse events associated with laser treatment were collected. The most frequently reported adverse event was postinflammatory dyspigmentation, followed by secondarily induced dermatological disease, treatment-inflicted burn, and residual scar. CONCLUSION: Both expected and unexpected adverse events occur after laser treatments. Most adverse events are not serious, but proper dermatological attention should be given to avoid complications. It should be noted that the safest and the most successful laser treatment can be provided only by qualified personnel.
Burns ; Cicatrix ; Hyperpigmentation ; Korea ; Laser Therapy ; Retrospective Studies

STUDY DESIGN: A case report. OBJECTIVES: To report a rare case of epidermoid cyst in the spinal canal. SUMMARY OF LITERATURE REVIEW: Epidermoid cyst in the spinal canal is rare. Idiopathic epidermoid cyst in the spinal canal not associated with a trauma or infection is even rarer. MATERIAL AND METHODS: A 73 year-old female presented with a 1 year history of progressive paresthesia and motor weakness of both lower extremeties. MRI showed a cystic mass on the 7th thoracic canal. We performed total laminectomy at the T6-T8 level. The cystic mass was excised after durotomy using a posterior approach. RESULTS: We confirmed the presence of an epidermoid cyst for histopathology. CONCLUSION: Idiopathic epidermoid cyst in the spine is very rare and requires accurate differential diagnosis. Preoperative MRI scans are necessary to differentiatie epidermoid cysts from other intradural masses. Confirmative diagnosis can be done by histopatholoty.
Diagnosis ; Diagnosis, Differential ; Epidermal Cyst* ; Female ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Paresthesia ; Spinal Canal ; Spine

OBJECTIVE: Cerebral edema develops in the brain tumors by loosening of the endothelial tight junction. Tight junction(TJ) proteins, such as occludin and claudin bind adjacent cells tightly. Authors examine the expression rate of occludin in human brain tumors to evaluate the effect of altered expression of occludin on cerebral edema. METHODS: Seventy surgical specimens stored at -70degrees C were used. It included 14 astrocytic tumors, 27 meningiomas, 12 scwannomas, 7 pituitary adenomas, 6 hemangioblastomas, and 4 craniopharyngiomas. After protein extraction, expression of occludin was investigated by Western blot analysis. The tumors were classified according to World Health Organization(WHO) classification. RESULTS: The expression rates of occludin in brain tumors were: glioma (8/14=57.1%), meningioma (16/27=59.3%), schwannoma (10/12=83.3%), pituitary adenoma (6/7=85.7%), hemangioblastoma (6/6=100%), and craniopharyngioma (3/4=75.0%). The expression rate in glioma and meningioma was lower than other brain tumors. In gliomas, high grade tumor (1/4=25.0%) exhibited lower expression rate of occludin than low grade one (7/10=70.0%). CONCLUSION: These results suggest that the expression of occludin is different among the various kinds of brain tumors. In gliomas, its expression is correlated with the histological grade. It may indicate that occludin plays a role in the development of edema in the brain tumors.
Blotting, Western ; Brain Edema ; Brain Neoplasms* ; Brain* ; Classification ; Craniopharyngioma ; Edema ; Glioma ; Hemangioblastoma ; Humans ; Meningioma ; Neurilemmoma ; Occludin* ; Pituitary Neoplasms ; Tight Junctions* ; World Health ; World Health Organization

OBJECTIVE: Telomerase, a ribonucleoprotein adds telomeric sequences repeatedly to the ends of telomeres to compensate for the progressive loss. A favorable prognosis might be associated with low or no telomerase activity in some tumors. We present the correlation of the telomerase activity and the prognosis of patients with brain neoplasms. METHODS: Between March 1998 and December 1999, 62 patients with brain tumors underwent surgery and their surgical specimens were studied. Telomerase activity was investigated by telomeric repeats amplification protocol assay and the survival time was analyzed, retrospectively. The significance and the correlation of data were also assessed statistically. RESULTS: There was no significant difference in the expression of telomerase activity among histological types. However, a significant difference was noted in the expression of telomerase activity between high-grade gliomas and low-grade gliomas(p=0.022). The overall mean survival time of telomerase-positive and telomerase-negative groups in 11 dead patients were 11.4+/-6.6 months and 15.0+/-8.4 months respectively, and its difference was statistically significant(p=0.038). CONCLUSION: Our data suggests that telomerase may play a role in biological malignancy of the gliomas and also can be used as a prognostic indicator for the survival time of brain tumors.
Brain Neoplasms* ; Brain* ; Glioma ; Humans ; Prognosis* ; Retrospective Studies ; Ribonucleoproteins ; Statistics as Topic ; Survival Rate ; Telomerase* ; Telomere

PURPOSE: A pancreaticoduodenectomy (PD) and pylorus-preserving pancreaticoduodenectomy (PPPD) are the two methods commonly used to treat periampullary neoplasms. This study was designed to compare these two methods in terms of the post-operative complications, the recurrence rate, and the post-operative weight change. METHODS: The medical records of 110 patients who underwent PD or PPPD from February 1986 through to June 2002 were retrospectively reviewed. The PD was performed on 54 patients and PPPD was performed on 56 patients, respectively. The mean follow-up periods were 25.33 months in the PD group and 25.39 months in the PPPD group, respectively. RESULTS: Diabetes mellitus occurred in 9 patients (16.7%) in the PD group and 8 patients (14.3%) in the PPPD group, and gastric emptying was delayed in 14 (25.9%) and 15 (26.8%) patients of each group after surgery. Procedure related deaths occurred in 2 (3.7%) and 4 (7.1%) patients from each group. There were no statistically significant differences in the post-operative complications between the two groups. The disease recurrence rate was significantly lower in the PPPD group than in the PD group (60.5% vs. 22.9%, p=0.001). Post-operative weight loss just after surgery at 3 months and 6 months after surgery was 3.56 kg, 3.68 kg, and 3.97 kg in the PD group and 2.78 kg, 1.77 kg, and 1.8 kg in the PPPD group, respectively, without showing a statistically significant difference. CONCLUSION: The clinical outcomes of the PPPD was not different from those of the PD in terms of the post-operative complications and weight loss. The disease recurrence rate was lower in the PPPD group. These results suggest that PPPD could be the treatment choice periampullary neoplasms.
Diabetes Mellitus ; Follow-Up Studies ; Gastric Emptying ; Humans ; Medical Records ; Pancreaticoduodenectomy* ; Pylorus* ; Recurrence ; Retrospective Studies ; Weight Loss

A cystic parathyroid adenoma is rare. A case of primary hyperparathyroidism, with the cystic formation of a parathyroid adenoma and a severe bony lesion, is reported. A 52-year-old male was admitted due to pain in both hips and for evaluation of hypercalcemia. The plasma level of the intact parathyroid hormone(iPTH) was elevated to 1424pg/mL. Ultrasonography and the computed tomography revealed a parathyroid cyst on the left thyroid lower pole. Parathyroid scintigraphy detected a parathyroid adenoma. A radiograph showed a subperiosteal bone resorption on the phalanges, and a brown tumor(osteitis fibrosa cystica) on the femur shaft was noted. A surgical excision of the parathyroid adenoma was performed. The PTH level in the cystic fluid was increased. A histological examination confirmed a cystic parathyroid adenoma. The PTH level was normalized after the operation.
Bone Resorption ; Femur ; Hip ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Male ; Middle Aged ; Osteitis Fibrosa Cystica ; Parathyroid Neoplasms* ; Plasma ; Radionuclide Imaging ; Thyroid Gland ; Ultrasonography

OBJECTIVE: Survivin is one of the inhibitor of apoptosis protein family proteins, which inhibits apoptosis through pathway different from that involving the Bcl-2 family. Overexpression of survivin has been reported in the most common human cancers. The purpose of this study is to investigate survivin expression and its relevance to histological malignancy and apoptosis of brain tumors. METHODS: Seventy-eight consecutive patients with brain tumor, who underwent operation, were included in this study. Pathological types of brain tumor were classified by World Health Organizaton classification. Survivin expression was detected by Western blot analysis and apoptosis was examined by DNA fragmentation. RESULTS: Survivin was expressed in 32(41.0%) of 78 patients with brain tumor and apoptosis was detected in 14(21.9%) patients. Histological malignancy of brain tumors was not correlated with survivin expression or apoptosis(p>0.05). However, survivin-positive tumors were strongly associated with anti-apoptosis(p=0.000) and apoptosis was significantly relevant to survivin-negative tumors(p=0.006). CONCLUSION: These results suggest that survivin expression is strongly related to the apoptosis of brain tumors, but not associated with biological malignancy. Therefore, survivin may be a potential target for brain tumor therapy based on apoptosis.
Apoptosis* ; Blotting, Western ; Brain Neoplasms* ; Brain* ; Classification ; DNA Fragmentation ; Humans ; Inhibitor of Apoptosis Proteins ; World Health

OBJECTIVE: The regulation of apoptosis is influenced by various gene products including Bcl-2, which has been known to be anti-apoptotic. In addition, telomerase, a ribonucleoprotein that synthesizes telomeres, has been detected in many human neoplasms. In the current study, we present the anti-apoptotic effect by Bcl-2 expression and telomerase activity in the human brain tumors. METHODS: A total of 76 cases of surgically resected brain tumors were studied. Telomerase activity was detected by the telomeric repeat amplification protocol assay and Bcl-2 protein was examined by the Western blot analysis. Apoptosis of the specimens was also detected by DNA fragmentation analysis. RESULTS: Telomerase activity and apoptosis were detected in 65.8%(50 of 76) and 21.1%(16 of 76) respectively. Telomerase activity was correlated to apoptosis inversely(p<0.05). Bcl-2 was also expressed in 23.7%(18 of 76) and apoptosis detected in 11.1%(2 of 18) with Bcl-2. In 18 cases with Bcl-2, telomerase activity was expressed in 77.8%(14 of 18) and apoptosis was not induced in 85.7%(12 of 14) with telomerase activity. However, apoptosis was not detected in 4 cases with Bcl-2 and negative telomerase activity. Their difference of anti-apoptotic numbers between two groups was significant(p<0.05). In 36 cases with negative Bcl-2 and positive telomerase activity, apoptosis was not detected in 72.2%(26 of 36). In 22 cases without Bcl-2 and telomerase activity, apoptosis was not detected in 81.8%(18 of 22). Their difference between two groups was not significant statistically. CONCLUSION: Our results suggest that apoptosis may be modulated by telomerase activity of the human brain tumors with Bcl-2. And also, we may expect that apoptosis can be induced effectively by the inhibition of telomerase activity and Bcl-2 in the brain tumors.
Apoptosis* ; Blotting, Western ; Brain Neoplasms* ; Brain* ; DNA Fragmentation ; Humans ; Ribonucleoproteins ; Telomerase* ; Telomere