Pancreatic Endocrine Tumors: A Report on a Patient Treated with Sorafenib

A 31-yr-old man with abdominal pain was diagnosed with a pancreatic endocrine tumor and multiple hepatic metastases. Despite optimal treatment with interferon alpha, a somatostatin analog, local therapy with high-intensity focused ultrasound ablation for multiple hepatic metastases, and multiple lines of chemotherapy with etoposide/cisplatin combination chemotherapy and gemcitabine monotherapy, the tumor progressed. As few chemotherapeutic options were available for him, sorafenib (800 mg/day, daily) was administered as a salvage regimen. Sorafenib was continued despite two episodes of grade 3 skin toxicity; it delayed tumor progression compared to the previous immunotherapy and chemotherapy. Serial computed tomography scans showed that the primary and metastatic tumors were stable. Thirteen months after beginning targeted therapy, and up to the time of this report, the patient is well without disease progression. We suggest that sorafenib is effective against pancreatic endocrine tumors

Hepatic glycogenosis in type 1 diabetes mellitus mimicking Mauriac syndrome

Hepatic glycogenosis in type 1 diabetes mellitus (DM) can be caused by poor glycemic control due to insulin deficiency, excessive insulin treatment for diabetic ketoacidosis, or excessive glucose administration to control hypoglycemia. Mauriac syndrome, which is characterized by hepatomegaly due to hepatic glycogenosis, growth retardation, delayed puberty, and Cushingoid features, is a rare diabetic complication. We report a case of hepatic glycogenosis mimicking Mauriac syndrome. A 14-year-old girl with poorly controlled type 1 DM was admitted to The Catholic University of Korea, Seoul St. Mary's Hospital for abdominal pain and distension. Physical examination revealed hepatomegaly and a Cushingoid face. The growth rate of the patient had decreased, and she had not yet experienced menarche. Laboratory findings revealed elevated liver enzyme levels. A liver biopsy confirmed hepatic glycogenosis. Continuous glucose monitoring showed hyperglycemia after meals and frequent hypoglycemia before meals. To control hyperglycemia, we increased insulin dosage by using an insulin pump. In addition, we prescribed uncooked cornstarch to prevent hypoglycemia. After strict blood glucose control, the patient's liver functions and size normalized. The patient subsequently underwent menarche. Hepatic glycogenosis is a complication of type 1 DM that is reversible with appropriate glycemic control

Relationships between non-acoustic factors and subjective reactions to floor impact noise in apartment buildings

The aim of this study was to provide an understanding of how residents in apartment buildings perceive and react to impact sounds coming from the upstairs neighbours' dwellings. Based on existing theoretical and empirical studies on environmental noise, a conceptual model was developed to explain relationships among noise annoyance and non-acoustic factors. The model was then tested using structural equation modelling with survey data from residents living in apartment buildings (N = 487). The findings showed that the conceptual model was consistent with other models developed for environmental noises. The results indicated that annoyance induced by floor impact noise was associated with perceived disturbance, coping, and self-reported health complaints. Noise sensitivity had a direct impact on perceived disturbance and an indirect impact on annoyance, and moderating variables affected the non-acoustic factors. Exposure to footstep noises increased the impact size of noise sensitivity to disturbance. Predictability, marital status, and house ownership were found to influence the relationship between attitudes towards authorities and coping. In addition, a negative attitude towards neighbours (i.e., the noise source) moderated the positive relationship between annoyance and coping

Should HLA-B*5701 Screening Be Performed in Every Ethnic Group before Starting Abacavir?

Human leukocyte antigen allele (HLA)-B*5701 is associated with abacavir hypersensitivity. However, the carriage rate of HLA-B*5701 has rarely been studied in Asians. In 534 Korean patients with human immunodeficiency virus infection, HLA-B*5701 status was determined by polymerase chain reaction with HLA-B*5701-specific primers. No patients had the HLA-B*5701 allele (95% confidence interval, 0%-0.7%). This explains the paucity of immunologically confirmed cases of abacavir hypersensitivity in Koreans.Saag M, 2008, CLIN INFECT DIS, V46, P1111, DOI 10.1086/529382Mallal S, 2008, NEW ENGL J MED, V358, P568*PAN ANT GUID AD A, 2008, GUID US ANT AG HIV 1Waters LJ, 2007, AIDS, V21, P2533Sun HY, 2007, J ANTIMICROB CHEMOTH, V60, P599, DOI 10.1093/jac/dkm243Rauch A, 2006, CLIN INFECT DIS, V43, P99Phillips EJ, 2006, CLIN INFECT DIS, V43, P103Martin AM, 2005, TISSUE ANTIGENS, V65, P571, DOI 10.1111/j.1399-0039.2005.00401.xLee KW, 2005, TISSUE ANTIGENS, V65, P437, DOI 10.1111/j.1399-0039.2005.00386.xMiddleton D, 2004, TISSUE ANTIGENS, V63, P555Phillips EJ, 2002, AIDS, V16, P2223Saito S, 2000, TISSUE ANTIGENS, V56, P522Park MH, 1999, TISSUE ANTIGENS, V53, P3861

Rupture of endotracheal tube cuff during robot-assisted endoscopic thyroidectomy -A case report-

We encountered a case of a rupture of an endotracheal tube cuff during robot-assisted thyroid surgery in a 35-year-old male patient. Two hours after commencing surgery, the bellows of the ventilator were not filled and a rupture of the endotracheal tube cuff was suspected. Once the robot-manipulator is engaged, the position of the operating table cannot be altered without removing it from the patient. Reintubation with direct laryngoscopy was performed with difficulty in the narrow space between the patient's head and robot-manipulator without moving the robot away from the patient. The rupture of the endotracheal tube cuff was confirmed by observing air bubbles exiting from the balloon in water. The patient was discharged 3 days after surgery without complications. In robot-assisted thyroid surgery, a preoperative arrangement of the robot away from the patient's head to obtain easy access to the patient is essential for safe anesthetic care

Herb Mixture Inhibits Proinflammatory Mediators Through the Suppression of JNK and P38 Activation in LPS-Stimulated Raw 264.7 Macrophages

ABSTRACT Inflammation has been implicated as a pathophysiological feature underlying many chronic diseases. In the present study, we investigated the anti-inflammatory effect of new formulation of herb medicine, DG1102, composed by five different herbal ingredients such as Taraxaci Herba, Rhei Rhizoma, Houttuynia cordata Thunb. Houttuyniae Herba, Eriobotryae Folium which has been used for inflammatory diseases, in LPS-stimulated Raw 264.7 macrophages. DG1102 suppressed nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin (IL)-1α, IL-6, IL-10 and macrophage inflammatory protein production in the lipopolysaccharide (LPS)-stimulated RAW 264.7 macrophages, as well as inducible nitric oxide synthase and cyclooxygenase 2 expression. Furthermore, DG1102 suppressed the activation of p38 and c-Jun N-terminal kinase (JNK). Our results suggest that DG1102 has an immune-modulatory activity suppressing production of pro-inflammatory cytokines and chemokine via the suppression of JNK and p38 MAPK activation in LPS-stimulated RAW 264.7 macrophages. The present study provides the biological evidence of the efficacy of medicinal plants in the treatment of inflammatory diseases