Objective: To investigate the effects of a herb complex extract (HCE) prepared from Cornus officinalis Sieb. Et Zucc., Eriobotrya japonica Lindley, and olive leaves on immune response of mouse spleen NK cells in vitro and in vivo analysis. Methods: The activity of natural killer (NK) cells was measured in splenocytes and YAC-1 cells. Mice were immunosuppressed using cyclophosphamide (5 mg/kg body weight). Three different doses of HCE (200, 400, and 800 mg/kg body weight) and red ginseng extract (800 mg/kg body weight) which was used as standard immunomodulatory herb were administered orally for 4 weeks. The body weight, dietary, water intake, organs (liver, thymus, and spleen) weight, completed blood count, and cytokines (tumor necrosis factor alpha, interferon gamma, and interleukin-2) production was measured. Results: At the maximum concentration of HCE, the activity of NK cells was increased by 48.5%. HCE increased liver, spleen, and thymus weights without altering numbers of white blood cells, lymphocytes, and neutrophils in a cyclophosphamide-induced immunosuppression rat model. However, HCE recovered the inhibited cytokine expression; HCE (800 mg/kg) increased cytokines levels. The results indicate the immune enhancement potential of this HCE. Conclusion: The HCE enhances immunity by increasing NK cell activity, regulating cytokine levels, and maintaining spleen weight. Therefore, it may be used as a potential immunity enhancer.

PURPOSE: Although anaphylaxis is recognized as an important, life-threatening condition, data are limited regarding its triggers in different age groups. We aimed to identify anaphylaxis triggers by age in Korean children. METHODS: We performed a retrospective review of medical records for children diagnosed with anaphylaxis between 2009 and 2013 in 23 secondary or tertiary hospitals in South Korea. RESULTS: A total of 991 cases (mean age=5.89±5.24) were reported, with 63.9% involving patients younger than 6 years of age and 66% involving male children. Food was the most common anaphylaxis trigger (74.7%), followed by drugs and radiocontrast media (10.7%), idiopathic factors (9.2%), and exercise (3.6%). The most common food allergen was milk (28.4%), followed by egg white (13.6%), walnut (8.0%), wheat (7.2%), buckwheat (6.5%), and peanut (6.2%). Milk and seafood were the most common anaphylaxis triggers in young and older children, respectively. Drug-triggered anaphylaxis was observed more frequently with increasing age, with antibiotics (34.9%) and nonsteroidal anti-inflammatory drugs (17.9%) being the most common causes. CONCLUSIONS: The most common anaphylaxis trigger in Korean children was food. Data on these triggers show that their relative frequency may vary by age.
Anaphylaxis* ; Anti-Bacterial Agents ; Arachis ; Child* ; Contrast Media ; Egg White ; Epidemiology ; Fagopyrum ; Humans ; Juglans ; Korea ; Male ; Medical Records ; Milk ; Retrospective Studies* ; Seafood ; Tertiary Care Centers ; Triticum

Autophagy has been investigated for its involvement in inflammatory diseases, but its role in asthma has been little studied. This study aimed to explore the possible role of autophagy and its therapeutic potential in severe allergic asthma. BALB/c mice were sensitized with ovalbumin (OVA) on days 0 and 14, followed by primary OVA challenge on days 28–30. The mice received a secondary 1 or 2% OVA challenge on days 44–46. After the final OVA challenge, the mice were assessed for airway responsiveness (AHR), cell composition and cytokine levels in bronchoalveolar lavage fluid (BALF). LC3 expression in lung tissue was measured by western blot and immunofluorescence staining. Autophagosomes were detected by electron microscopy. 3-Methyladenine (3-MA) treatment and Atg5 knockdown were applied to investigate the potential role of autophagy in allergic asthma mice. AHR, inflammation in BALF and LC3 expression in lung tissue were significantly increased in the 2% OVA-challenged mice compared with the 1% OVA-challenged mice (P<0.05). In addition, eosinophils showed prominent formation of autophagosomes and increased LC3 expression compared with other inflammatory cells in BALF and lung tissue. After autophagy was inhibited by 3-MA and Atg5 shRNA treatment, AHR, eosinophilia, interleukin (IL)-5 levels in BALF and histological inflammatory findings were much improved. Finally, treatment with an anti-IL-5 antibody considerably reduced LC3 II expression in lung homogenates. Our findings suggest that autophagy is closely correlated with the severity of asthma through eosinophilic inflammation, and its modulation may provide novel therapeutic approaches for severe allergic asthma.
Animals ; Asthma* ; Autophagy* ; Blotting, Western ; Bronchoalveolar Lavage Fluid ; Eosinophilia ; Eosinophils ; Fluorescent Antibody Technique ; Inflammation* ; Interleukins ; Lung ; Mice ; Microscopy, Electron ; Ovalbumin ; Ovum ; RNA, Small Interfering

Thyroid antibodies are frequently observed in urticaria patients, but their roles in urticaria are not clearly elucidated. We investigated the role of serum specific IgE to thyroid peroxidase (TPO) in patients with aspirin intolerant acute urticaria (AIAU) and aspirin intolerant chronic urticaria (AICU). We recruited 59 AIAU and 96 AICU patients with 69 normal controls (NC). Serum specific IgE to TPO was measured by manual direct ELISA, and CD203c expressions on basophil with additions of TPO were measured to prove a direct role of TPO in effector cells. The prevalences of serum specific IgE to TPO were significantly higher in AIAU (15.2%) and AICU groups (7.5%) compared to NC (0%, P=0.018: P=0.013, respectively). Flow cytometry showed CD203c induction in a dose dependent manner with serial additions of TPO in some AIAU and AICU patients having high specific IgE to TPO. Our findings show that the prevalence of serum specific IgE to TPO was significantly higher in both AIAU and AICU patients than in NC. It is suggested that specific IgE to TPO play a pathogenic role in AIAU and AICU.
Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Aspirin/*adverse effects ; Autoantibodies/immunology ; Basophils/drug effects/*immunology ; Humans ; Immunoglobulin E/blood/*immunology ; Iodide Peroxidase/blood/*immunology ; Urticaria/*chemically induced/*immunology/pathology

Although some studies have explained the immunomodulatory effects of statins, the exact mechanisms and the therapeutic significance of these molecules remain to be elucidated. This study not only evaluated the therapeutic potential and inhibitory mechanism of simvastatin in an ovalbumin (OVA)-specific asthma model in mice but also sought to clarify the future directions indicated by previous studies through a thorough review of the literature. BALB/c mice were sensitized to OVA and then administered three OVA challenges. On each challenge day, 40 mg kg-1 simvastatin was injected before the challenge. The airway responsiveness, inflammatory cell composition, and cytokine levels in bronchoalveolar lavage (BAL) fluid were assessed after the final challenge, and the T cell composition and adhesion molecule expression in lung homogenates were determined. The administration of simvastatin decreased the airway responsiveness, the number of airway inflammatory cells, and the interleukin (IL)-4, IL-5 and IL-13 concentrations in BAL fluid compared with vehicle-treated mice (P<0.05). Histologically, the number of inflammatory cells and mucus-containing goblet cells in lung tissues also decreased in the simvastatin-treated mice. Flow cytometry showed that simvastatin treatment significantly reduced the percentage of pulmonary CD4+ cells and the CD4+/CD8+ T-cell ratio (P<0.05). Simvastatin treatment also decreased the expression of the vascular cell adhesion molecule 1 and intercellular adhesion molecule 1 proteins, as measured in homogenized lung tissues (P<0.05) and human epithelial cells. The reduction in the T cell influx as a result of the decreased expression of cell adhesion molecules is one of the mechanisms by which simvastatin attenuates airway responsiveness and allergic inflammation. Rigorous review of the literature together with our findings suggested that simvastatin should be further developed as a potential therapeutic strategy for allergic asthma.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Asthma/*drug therapy/immunology ; Bronchoalveolar Lavage Fluid/immunology ; CD4-Positive T-Lymphocytes/drug effects/immunology ; CD8-Positive T-Lymphocytes/drug effects/immunology ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use ; Inflammation/*drug therapy/immunology ; Interleukins/analysis/immunology ; Lung/*drug effects/immunology ; Mice, Inbred BALB C ; Simvastatin/*therapeutic use

Two or more procedures maybe combined into a single surgical event using an abdominal laparoscopic surgery technique. Synchronous operations can provide patients with the advantage of a single hospital stay, single anesthetic exposure and single recovery period. Cholecystectomy and totally extraperitoneal (TEP) herniorrhaphy should be performed in both extremities and in different spaces of the abdomen. As described in this report, laparoendoscopic single site surgery (LESS), synchronous cholecystectomy and TEP herniorrhaphy were successfully performed using an umbilical incision in a single surgical event.
Abdomen ; Cholecystectomy ; Extremities ; Hernia ; Herniorrhaphy ; Humans ; Imidazoles ; Laparoscopy ; Length of Stay ; Nitro Compounds ; Pyrazines

A choriocarcinoma of the rectum is extremely rare and has a very poor prognosis. Its rarity and the obscurity of its histogenesis make the entity of disease hard to define. We report a case of a choriocarcinoma of the rectum which showed synchronous liver and lung metastasis. A 52-year- old male patient presented with tenesmus, hematochezia and pain on defecation for 4 months. The preoperative colonoscopy revealed a mass at the rectum, 3 cm proximal to the anal verge. The biopsy revealed a poorly differentiated adenocarcinoma. An abdominoperineal resection was performed, and the pathologic examination confirmed a choriocarcinoma arising from an adenocarcinoma. Immunostain for beta-human chorionic gonadotropin (hCG) was strongly positive for the choriocarcinoma component. Serum hCG checked postoperatively was as high as 4,222 IU/L, but the serum carcinoembryonic antigen (CEA) was normal. Although chemotherapy was begun at the 5th week after the operation, the patient died on the 47th day after the operation. A choriocarcinoma of the colon or the rectum is very rare and is aggressive. Although radical resection and chemotherapy are performed, the clinical outcome is very disappointing. Even though a choriocarcinoma of the colon or the rectum is very rare, it should be included on the list for differential diagnosis of a colorectal carcinoma.
Adenocarcinoma* ; Biopsy ; Carcinoembryonic Antigen ; Choriocarcinoma ; Chorionic Gonadotropin ; Colon ; Colonoscopy ; Colorectal Neoplasms ; Defecation ; Diagnosis, Differential ; Drug Therapy ; Female ; Gastrointestinal Hemorrhage ; Humans ; Liver ; Lung ; Male ; Neoplasm Metastasis ; Pregnancy ; Prognosis ; Rectal Neoplasms ; Rectum*

We present a case of 44-year-old male with spontaneous right vertebral arteriovenous fistula associated with neurofibromatosis type 1. The symptom of this patient was myeloradiculopathy of which was due to compressed cervical spinal cord by enlarged epidural vein. Complete occlusion of the fistula using coils resulted in relief of the patient symptom and complete disappearance of enlarged epidural vein on follow-up MR image one month later.
Adult ; Arteriovenous Fistula* ; Embolization, Therapeutic* ; Fistula ; Follow-Up Studies ; Humans ; Male ; Neurofibromatoses* ; Neurofibromatosis 1* ; Spinal Cord ; Veins

PURPOSE: Wilms tumor is the most common malignant renal tumor in children. We investigated the epidemiology, clinical features and treatment outcome of the children with Wilms tumor in Korea during the recent 10 years. METHODS: Two hundred forty six patients were enrolled between January 1991 and December 2000 from 26 major hospitals in Korea. The data regarding the clinical features including sex, age, pathologic type, prognostic factor and treatment outcome of patients were analyzed retrospectively by review of patient's medical records. Kaplan-Meier survival curves were constructed, The differences between groups were analyzed by log-rank test. RESULTS: There were 130 males and 116 females. The incidence between the age of 1~4 years was the highest with 66.2%. The annual incidence rate per 1, 000, 000 population varied from 1.9 to 2.1. The 10 years overall survival rate according to sex, clinical stage, pathologic type and relapse were as follows: 88.6% in male, 90.9% in female, 100% in stage I, 94.7% in stage II, 92.1% in stage III, 63.4% in stage IV, 85.7% in stage V, 95.3% in favorable histology, 64.1% in unfavorable histology, 94.8% in non-relapse, and 40.9% in relapse. The relapse rate was 12%. The 10 years overall survival rate of 246 patients were 89.1%. CONCLUSION: Our results could provide the most recent and important clinical information on Wilms tumor of children in Korea.
Child ; Epidemiology* ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Korea* ; Male ; Medical Records ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Wilms Tumor*

PURPOSE: Ligasure(TM) is a feedback-controlled bipolar diathermy originally devised to seal vessels and developed to weld tissue bundles. The tissue fusion mechanism consists of melting collagen and elastin, and the tissue welding property of Ligasure(TM) can be used in a hemorrhoidectomy. To confirm the efficacy of Ligasure(TM) in hemorrhoidectomies, I compared it with the conventional semi-open method. METHODS: One hundred patients with grade III or IV hemorrhoids were randomly assigned to the Ligasure(TM) (n=50) or the conventional semi-open (n=50) hemorrhoidectomy group. The operation time, the postoperative analgesic requirement, the hospital stay, the time to return to normal life, and complications were prospectively recorded and analyzed. RESULTS: There was no difference in sex and age between the two groups. The operation time was markedly shorter in the Ligasure(TM) group than semi-open group (10.8+/-4.0 versus 23.7+/-5.2 min; P<0.001). Although the hospital stay was not statistically different, the time to return to the normal life was shorter in the Ligasure(TM) group (9.5+/-3.8 versus 12.7+/-4.0 days; P<0.05). The requirement for postoperative analgesics within 48 hours (nalbuphine, 5mg) was not significantly different. In each group, an urinary retention was noted and treated with urinary catheterization. In Ligasure(TM) group, an anal stenosis was developed and was successfully treated with advancement flap surgery. In each group a secondary bleeding and a skin tag were noted. There was no wound infection or incontinence. CONCLUSIONS: Ligasure(TM) hemorrhoidectomy reduces the operation time and the time to return to the normal life. If anal stenosis is to be prevented, careful attention is required to preserve the anal skin and mucosa. Ligasure(TM) is simple to use and is useful in the treatment of patients with grade III or IV hemorrhoids.
Analgesics ; Collagen ; Constriction, Pathologic ; Diathermy ; Elastin ; Freezing ; Hemorrhage ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Length of Stay ; Mucous Membrane ; Prospective Studies ; Skin ; Treatment Outcome ; Urinary Catheterization ; Urinary Catheters ; Urinary Retention ; Welding ; Wound Infection