Chorea in the both lower limbs associated with nonketotic hyperglycemia

Hemichorea-hemiballism (HC-HB) is a complication of non-ketotic hyperglycemia (NKH); in NKH patients, the frequency of occurrence of HC-HB is greater than that of bilateral chorea. We report the case of a hyperglycemic patient who showed chorea in both the lower limbs. Magnetic resonance imaging (MRI) of the brain revealed high signal intensity on T1-weighted images of the bilateral dorsolateral putamen. The abnormal involuntary movements disappeared after oral administration of haloperidol. Our case report that chorea associated with NKH is correlated with the topography of the basal ganglia.

Novel compound heterozygous mutations in the pantothenate kinase 2 gene in a korean patient with atypical pantothenate kinase associated neurodegeneration

Pantothenate kinase-associated neurodegeneration (PKAN) is an autosomal recessive disorder that is characterized by mutations in the pantothenate kinase 2 gene (PANK2) and typical magnetic resonance imaging findings. We report a case of atypical PKAN presenting with generalized dystonia. Our patient had compound heterozygous mutations in the PANK2 gene, including mutation in exon 3 (p.D268G) and exon 4 (p.R330P). To our knowledge, this patient is the first to have the p.R330P mutation and the second to have the p.D268G mutation.

Extension of the Helmholtz-Smoluchowski velocity to the hydrophobic microchannels with velocity slip

Electrokinetic flows through hydrophobic microchannels experience velocity slip at the microchannel wall, which affects volumetric flow rate and solute retention time. The usual method of predicting the volumetric flow rate and velocity profile for hydrophobic microchannels is to solve the Navier-Stokes equation and the Poisson-Boltzmann equation for the electric potential with the boundary condition of velocity slip expressed by the Navier slip coefficient, which is computationally demanding and defies analytic solutions. In the present investigation, we have devised a simple method of predicting the velocity profiles and volumetric flow rates of electrokinetic flows by extending the concept of the Helmholtz-Smoluchowski velocity to microchannels with Navier slip. The extended Helmholtz-Smoluchowski velocity is simple to use and yields accurate results as compared to the exact solutions. Employing the extended Helmholtz-Smoluchowski velocity, the analytical expressions for volumetric flow rate and velocity profile for electrokinetic flows through rectangular microchannels with Navier slip have been obtained at high values of zeta potential. The range of validity of the extended Helmholtz-Smoluchowski velocity is also investigated.

Recursive estimation of transient inhomogeneous zeta potential in microchannel turns using velocity measurements

In the various biomedical microfluidic devices the target biomolecules are delivered by activating electroosmotic flows. The zeta potential of a microchannel wall, which determines the strength of the electroosmotic flow, is apt to change due to the adhesion of biomolecules such as DNA or protein especially around the microchannel turns. The resulting transient inhomogeneous profile of zeta potential alters flow pattern, volumetric flow rate and the band broading of solutes. In the present work, we have developed a method for the recursive estimation of transient inhomogeneous zeta potential in microchannel turns using velocity measurements. For the real time implementation of the present method, a compact and accurate reduced-order model is derived using the Karhunen-Loève Galerkin method and the Helmholtz-Smoluchowski slip velocity. The present scheme of recursive estimation is an important prerequisite to the real time control of microfluidic devices.

Effect of viscoelasticity on the flow pattern and the volumetric flow rate in electroosmotic flows through a microchannel

Many lab-on-a-chip based microsystems process biofluids such as blood and DNA solutions. These fluids are viscoelastic and show extraordinary flow behaviors, not existing in Newtonian fluids. Adopting appropriate constitutive equations these exotic flow behaviors can be modeled and predicted reasonably using various numerical methods. In the present paper, we investigate viscoelastic electroosmotic flows through a rectangular straight microchannel with and without pressure gradient. It is shown that the volumetric flow rates of viscoelastic fluids are significantly different from those of Newtonian fluids under the same external electric field and pressure gradient. Moreover, when pressure gradient is imposed on the microchannel there appear appreciable secondary flows in the viscoelastic fluids, which is never possible for Newtonian laminar flows through straight microchannels. The retarded or enhanced volumetric flow rates and secondary flows affect dispersion of solutes in the microchannel nontrivially.

ACE I/D polymorphism in Korean patients with ischemic stroke and silent brain infarction

OBJECTIVES

Angiotensin-converting enzyme (ACE) polymorphism may play a role in stroke and silent brain infarction (SBI) susceptibility, but the results among the populations studied to date have not been consistent. Thus, we investigated the association between ACE genotypes and ischemic stroke and SBI in Korean patients.

SUBJECTS AND METHODS

DNA samples from 237 stroke patients, 264 SBI patients and 234 age-matched controls were amplified using polymerase chain reaction to detect the ACE ins/del (I/D) polymorphism. Genotype was determined by the presence of a 490-bp band (I allele) or a 190-bp band (D allele) in agarose gel electrophoresis.

RESULTS

Odds ratios of the I/D and D/D genotypes and the overall (I/D + D/D) for the I/I genotype were significantly different between stroke patients and normal controls. However, there was no significant difference between patients with SBI and controls.

CONCLUSIONS

This study is the first report of a significant association between ACE polymorphism and ischemic stroke in the Asian population. Although no consistent associations have been found between ACE polymorphism and stroke in the populations studied to date, the ACE polymorphism may be a genetic determinant of ischemic stroke, at least in Korean patients.

Comparison of the Nernst–Planck model and the Poisson–Boltzmann model for electroosmotic flows in microchannels

In the analysis of electroosmotic flows, the internal electric potential is usually modeled by the Poisson-Boltzmann equation. The Poisson-Boltzmann equation is derived from the assumption of thermodynamic equilibrium where the ionic distributions are not affected by fluid flows. Although this is a reasonable assumption for steady electroosmotic flows through straight microchannels, there are some important cases where convective transport of ions has nontrivial effects. In these cases, it is necessary to adopt the Nernst-Planck equation instead of the Poisson-Boltzmann equation to model the internal electric field. In the present work, the predictions of the Nernst-Planck equation are compared with those of the Poisson-Boltzmann equation for electroosmotic flows in various microchannels where the convective transport of ions is not negligible.

Helmholtz-Smoluchowski velocity for viscoelastic electroosmotic flows

Many biofluids such as blood and DNA solutions are viscoelastic and exhibit extraordinary flow behaviors, not existing in Newtonian fluids. Adopting appropriate constitutive equations these exotic flow behaviors can be modeled and predicted reasonably using various numerical methods. However, the governing equations for viscoelastic flows are not easily solvable, especially for electroosmotic flows where the streamwise velocity varies rapidly from zero at the wall to a nearly uniform velocity at the outside of the very thin electric double layer. In the present investigation, we have devised a simple method to find the volumetric flow rate of viscoelastic electroosmotic flows through microchannels. It is based on the concept of the Helmholtz-Smoluchowski velocity which is widely adopted in the electroosmotic flows of Newtonian fluids. It is shown that the Helmholtz-Smoluchowski velocity for viscoelastic fluids can be found by solving a simple cubic algebraic equation. The volumetric flow rate obtained using this Helmholtz-Smoluchowski velocity is found to be almost the same as that obtained by solving the governing partial differential equations for various viscoelastic fluids.

Efficacy and tolerability of estradiol 1mg and drospirenone 2mg in postmenopausal korean women: A double-blind, randomized, placebo-controlled, multicenter study

OBJECTIVES

The aim of this study was to demonstrate that the therapeutic efficacy of an estradiol 1mg/drospirenone 2mg (E2/DRSP) preparation is superior to a placebo in postmenopausal Korean women with hot flushes and other climacteric symptoms, and to demonstrate that this treatment is both safe and tolerable.

METHODS

This was a double-blind, randomized, placebo-controlled, multicenter study over four 28-day treatment cycles. A total of 158 subjects were screened and 90 women were randomized into two treatment groups (E2/DRSP group, n=45; placebo group, n=45). The primary efficacy parameter was the individual relative change of hot flushes. The secondary efficacy parameters such as other climacteric, urogenital symptoms and vaginal bleeding patterns were also evaluated, and the occurrence of any adverse events was noted. In addition, physical, gynecological examinations and laboratory analyses were performed at the beginning and end of the study.

RESULTS

The mean number of hot flushes per week during treatment weeks 3-16 decreased by 48.1% during treatment with placebo, and by 84.4% during treatment with E2/DRSP (p<0.001). The E2/DRSP combination also reduced the incidence and intensity of menopausal symptoms in postmenopausal women. Most of adverse events was mild or moderate degree of intensity. None of the parameters measured in the study, including laboratory analyses, physical and gynecological examinations, vital signs, and weight, led to any concerns of safety.

CONCLUSIONS

The E2 1mg/DRSP 2mg combination tested in the study was efficacious and safe in the treatment of hot flushes and other climacteric symptoms in postmenopausal Korean women.

Estimation of zeta potential of electroosmotic flow in a microchannel using a reduced-order model

A reduced-order model is derived for electroosmotic flow in a microchannel of nonuniform cross section using the Karhunen-Loève Galerkin (KLG) procedure. The resulting reduced-order model is shown to predict electroosmotic flows accurately with minimal consumption of computer time for a wide range of zeta potential zeta and dielectric constant epsilon. Using the reduced-order model, a practical method is devised to estimate zeta from the velocity measurements of the electroosmotic flow in the microchannel. The proposed method is found to estimate zeta with reasonable accuracy even with noisy velocity measurements.

Simultaneous estimation of zeta potential and slip coefficient in hydrophobic microchannels

Electroosmotic flows through hydrophobic microchannels experience velocity slip at the channel wall, which increases the volumetric flow rate at a given electric potential gradient. The conventional method of zeta potential estimation using the volumetric flow rate may yield quite inaccurate zeta potential unless the velocity slip is appropriately taken care of. In the present investigation we develop a method for simultaneous estimation of zeta potential and velocity slip coefficient in the electroosmotic flow through a hydrophobic microchannel using velocity measurements. The relevant inverse problem is solved through the minimization of a performance function utilizing a conjugate gradient method. The present method is found to estimate the zeta potential and slip coefficient accurately even with noisy velocity measurements.

Eikenella corrodens cervical spinal epidural abscess induced by a fish bone

Cervical spinal epidural abscess, caused by fish bone injury and a secondary infection by Eikenella corrodens which is part of the normal flora, has not been reported. A 72-yr-old man came to the hospital with pain in his posterior neck and both shoulders for 2 months. He also was experiencing weakness on his right side for 3 days. A fish bone had been stuck in his throat for about 2 months. Neurological examination revealed right hemiparesis, hypesthesia on the left extremities and neck stiffness. Laboratory findings showed an elevated ESR/CRP and leukocytosis, and magnetic resonance imaging revealed a retropharyngeal abscess and cervical myelitis. The patient was treated with emergency surgical decompression and antibiotics. A fish bone was removed from the C3-C4 intervertebral disc space. In the culture of chocolate blood agar and 5% sheep blood agar plate, E. corrodens was detected as a causative organism.

Estimation of the zeta potential and the dielectric constant using velocity measurements in the electroosmotic flows

In this paper we develop a method for the determination of the zeta potential zeta and the dielectric constant epsilon by exploiting velocity measurements of the electroosmotic flow in microchannels. The inverse problem is solved through the minimization of a performance function utilizing the conjugate gradient method. The present method is found to estimate zeta and epsilon with reasonable accuracy even with noisy velocity measurements.

Supplementation of whole persimmon leaf improves lipid profiles and suppresses body weight gain in rats fed high-fat diet

The objective of this study was to investigate the hypolipidemic effects of powdered whole persimmon leaf supplement in rats fed high-fat diet. Three groups of male Sprague-Dawley rats during 6 weeks were fed different diet: normal control (NC), high-fat (HF), and high-fat supplemented with powdered whole persimmon leaf (PL; 5%, wt/wt) groups. Body weight and relative weight of interscapular brown adipose tissue were significantly lower in the PL group than in the HF group, while plasma leptin concentration was higher. The supplementation of persimmon leaf significantly lowered the plasma total cholesterol and triglyceride concentrations, whereas elevated the ratio of HDL-C/total-C and improved the atherogenic index. Persimmon leaf supplementation led the hepatic cholesterol and triglyceride values to similar levels to the NC group. Accumulation of hepatic lipid droplets and the epididymal white adipocyte size of PL group were diminished comparing to the HF group. Hepatic HMG-CoA and ACAT activities were significantly higher in the PL group than in other groups. Contents of fecal triglyceride, cholesterol and acidic sterol were significantly higher in the PL group than in the HF group. Accordingly, we suggest that supplementation of the powdered whole persimmon leaf improves plasma and hepatic lipid levels profile partly via the increased fecal lipids in high-fat fed rats. These beneficial effects may be due to the properties of its phenolic compounds (1.15 g/100g) and high fiber (63.48 g/100g) content in the powdered persimmon leaf.

Mullerian adenosarcoma with sarcomatous overgrowth of the cervix presenting as cervical polyp: a case report and review of the literature

An aggressive variant of adenosarcoma, mullerian adenosarcoma with sarcomatous overgrowth (MASO) in the cervix is extremely rare. This variant contains obvious, high-grade sarcoma in addition to a low-grade form. In this report, we describe a case of MASO of the uterine cervix and review the clinical and pathological features of these tumors. The patient was a 37-year-old woman with a cervical polypoid mass, which was morphologically considered as a benign endocervical polyp. Microscopically, polypoid cervical mass showed diffuse and dense malignant spindle cell proliferation around the benign endocervical glands and also an area of markedly anaplastic and pleomorphic spindle cell proliferation, so called, sarcomatous overgrowth. Total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection were performed. The patient has been followed-up and neither chemotherapy nor other adjuvant therapies have been administered. At present, she has been clinically free of disease for 9 months since she received surgery. It is extremely rare that MASO of the uterine cervix is presented in premenopausal woman. Gynecologists and pathologists should be aware of the difficulties associated with a delay in the diagnosis of MASO when the tumor is present as a benign looking cervical polyp.

Comparison of Magnetoencephalographic Spikes with and without Concurrent Electroencephalographic Spikes in Extratemporal Epilepsy

Interictal spikes in patients with epilepsy may be detected by either electroencephalography (EEG) (E-spikes) or magnetoencephalography (MEG) (M-spikes), or both MEG and EEG (E/M-spikes). Localization and amplitude were compared between E/M-spikes and M-spikes in 7 adult patients with extratemporal epilepsy to evaluate the clinical significance of MEG spikes. MEG and EEG were simultaneously measured using a helmet-shaped MEG system with planar-type gradiometers and scalp electrodes of the international 10-20 system. Sources of E/M-spikes and M-spikes were estimated by an equivalent current dipole (ECD) model for MEG at peak latency. Each subject showed 9 to 20 (mean 13.4) E/M-spikes and 9 to 31 (mean 16.3) M-spikes. No subjects showed significant differences in the ECD locations between E/M- and M-spikes. ECD moments of the E/M-spikes were significantly larger in 2 patients and not significantly different in the other 5 patients. The similar localizations of E/M-spikes and M-spikes suggest that combination of MEG and EEG is useful to detect more interictal spikes in patients with extratemporal epilepsy. The smaller tendency of ECD amplitude of the M-spikes than E/M-spikes suggests that scalp EEG may overlook small tangential spikes due to background brain noise. Localization value of M-spikes is clinically equivalent to that of E/M-spikes.

Korean experience with the OSTA risk index for osteoporosis: a validation study

The Osteoporosis Self-assessment Tool for Asians (OSTA) was developed to help physicians focus their efforts on patients at increased risk, and encourage appropriate use of bone mineral density (BMD) measurements. Previously, OSTA performed well in a sample of women from eight countries in Asia, and in a validation group of Japanese women. In this study, we evaluate the performance of OSTA using a sample of 1101 postmenopausal women from a clinic in Korea who had femoral neck BMD measurements by dual-energy X-ray absorptiometry (DXA). The OSTA had a high sensitivity (87%), and good specificity (67%) for identifying osteoporosis (BMD T-scores <or= -2.5); the corresponding values were 80% and 72% for identifying T-scores <or= -2.0. The prevalence of osteoporosis ranged from 2% among women classified as low risk (OSTA > -1) to 64% among those classified as high risk (OSTA < -4); these results were almost identical to those reported earlier for a sample of women from eight Asian countries. We conclude that the OSTA risk tool performed well in this sample of postmenopausal Korean women, similar to previous results in other Asian women. The OSTA tool is free and very easy to use; risk can be tabulated by age and weight, so that calculations are not necessary. Using OSTA could encourage patients and clinicians to actively assess osteoporosis, and measure BMD when appropriate, before fractures occur.

Vestibular diagnosis as prognostic indicator in sudden hearing loss with vertigo

The majority of episodes of sudden hearing loss are caused by inner ear disorders, often accompanied by vertigo. The patterns of hearing loss usually influence the prognosis. The purpose of this study was to analyze vestibular diagnoses in sudden hearing loss with vertigo, and to correlate them with the recovery of hearing loss. The clinical records of 125 patients with sudden hearing loss were reviewed. Various vestibular evaluations were performed in 36 patients with vertigo. The vertigo in these patients was classified as normal, unilateral hypofunction, directional preponderance, benign paroxysmal positional vertigo (BPPV), non-specific or irritative. The initial and final pure-tone audiograms of these patients were compared. The distribution of vestibular diagnoses was unilateral hypofunction in 30.6% of patients, BPPV in 25.7%, normal in 19.4%, non-specific in 11.1%, directional preponderance in 8.3% and irritative in 8.3%. The recovery of hearing in patients with vertigo was significantly worse than in those without vertigo. The recovery of hearing in patients with spinning vertigo did not differ from that of patients with non-spinning vertigo. The recovery of hearing was worst in the BPPV group, especially in the high frequency range, followed by the unilateral hypofunction group, who showed hearing thresholds between those in the BPPV group and those in the normal vestibular function test group. This study suggests that the diagnostic classification of vestibulopathy is a useful prognostic indicator of hearing recovery in sudden hearing loss with vertigo. We conclude that otolithic and semicircular canal involvement may cause poor hearing results, especially in the high frequency range.

Negative regulation of filamentous growth and flocculation by Lkh1, a fission yeast LAMMER kinase homolog

We have isolated a full-length cDNA clone that encodes for a Schizosaccharomyces pombe homolog of the dual-specificity protein kinase of the LAMMER family, lkh1 (lammer kinase homolog). The proposed Lkh1 protein contains 575 amino acids. The lkh1(+) null mutant is viable, but exhibits flocculation upon reaching stationary phase in liquid media and filamentous adhesion growth on solid media. Analysis of the flocculation activity of the lkh1(+) null mutant indicates that asexual aggregation of S. pombe cells into floccules is divalent cation-dependent and galactose-specific. We also demonstrate that the Saccharomyces cerevisiae LAMMER kinase homolog, Kns1, can substitute for the Lkh1 function in S. pombe.

Observation of a (6)(LambdaLambda)He double hypernucleus

A double-hyperfragment event has been found in a hybrid-emulsion experiment. It is identified uniquely as the sequential decay of ( 6)(LambdaLambda)He emitted from a Xi(-) hyperon nuclear capture at rest. The mass of ( 6)(LambdaLambda)He and the Lambda-Lambda interaction energy DeltaB(LambdaLambda) have been measured for the first time devoid of the ambiguities due to the possibilities of excited states. The value of DeltaB(LambdaLambda) is 1.01+/-0.20(+0.18)(-0.11) MeV. This demonstrates that the Lambda-Lambda interaction is weakly attractive.

Elevated gastrin secretion by in vivo gene electroporation in skeletal muscle

Whether or not in vivo gene transfer of gastrin gene into skeletal muscle by electroporation could modify gastrin secretion was examined. The expression plasmid vector, either pMEPrGaspA encoding the rat gastrin gene or pEGFP-N1 encoding the GFP reporter gene was injected into M. rectus abdominis of rats or M. biceps formis of mice. Subsequently, square electric pulses of direct current were applied six times at 25 V with a loading period of 100 msec per pulse. Clear foreign gene expression in the skeletal muscle was demonstrated by both GFP fluorescence and immunostaining of rat gastrin. Time course changes in plasma gastrin levels after transfection revealed that in rats, gastrin gene transfer significantly increased the plasma gastrin level for 4 weeks post-transfection (P<0.05), but the difference diminished at the end of the 10-week period. In mice, plasma gastrin level elevated similarly for 3 weeks, and pH of gastric contents decreased in the gastrin gene transfected group compared with the control counterpart (P<0.05). These findings suggest that localized in vivo gene transfer by electroporation allows skeletal muscle to become an artificial endocrine tissue for hormonal manipulation of animals.