Bilateral ischemic lumbosacral plexopathy from chronic aortoiliac occlusion presenting with progressive paraplegia

Spinal cord ischemia is rare but causes significant morbidity and mortality. Spinal cord ischemia has been reported after open and endovascular interventions of the thoracic and abdominal aorta, and, rarely, acute occlusion of aorta from in situ thrombosis or acute embolic occlusion. Acute interruption of the critical blood supply to the spinal cord or root contributes to this devastating neurologic deficit. However, gradually worsening lumbosacral plexopathy and consequent paraplegia related to chronic aortic occlusion is extremely rare. We present a case of a 58-year-old man with progressive lower limb paralysis from atherosclerotic aortoiliac occlusion without history of aortic surgery or evidence of thromboembolism

Weather and its effects on RSV A and B infections in infants and children in Korea

BackgroundThe epidemic patterns of respiratory syncytial virus (RSV) infection and the factors determining its seasonality are not well studied in the local society of South Korea.AimsThis study aims to investigate the prevalence of RSV infection in hospitalized children and its relationship with climate change in Cheonan, Korea.Methods This retrospective study included 2,484 children (aged 0–14 years) who were hospitalized for respiratory tract infections documented RSV test at a tertiary hospital in Cheonan between December 2006 and February 2014. Daily temperature and humidity data during the period were obtained from the Korea Meteorological Administration.Results In total, 752 (30 per cent) showed tested positive for RSV infection, and the prevalence was noted to be higher during November and December. RSV A and RSV B were less likely to be detected simultaneously (0.4 per cent). RSV A was more likely to be detected during lower temperatures, lower wind speeds, and shorter daylight hours, and RSV B during lower daily precipitation and higher humidity. RSV infection was predominantly prevalent between November and April. The infection rate of RSV peaked every other year in Korea. Air temperature was associated with the epidemics of RSV infection.ConclusionFurther understanding of the effect of climate on RSV infection will help in timely prevention using immunoprophylaxis or future vaccines

Prevalence of sarcopenia and sarcopenic obesity in Korean adults: The Korean Sarcopenic Obesity Study (KSOS)

*Context:* Sarcopenic obesity (SO), a combination of excess weight and reduced muscle mass and/or strength, is suggested to be associated with an increased risk of adverse health outcomes. 
*Objectives:* To examine the prevalence and characteristics of Sarcopenic and SO defined by using different indices such as Appendicular Skeletal muscle Mass (ASM)/height^2^ and Skeletal Muscle Index (SMI (%): skeletal muscle mass (kg)/weight (kg) × 100) for Korean adults. 
*Methods:* 591 participants were recruited from the Korean Sarcopenic Obesity Study (KSOS) which is an ongoing prospective observational cohort study. Analysis was conducted in 526 participants (328 women, 198 men) who had complete data on body composition using Dual X-ray absorptiometry and computed tomography. 
*Results:* The prevalence of sarcopenia and SO increases with aging. Using two or more standard deviations (SD) of ASM/height^2^ below reference values from young, healthy adults as a definition of sarcopenia, the prevalence of sarcopenia and SO was 6.3% and 1.3% in men and 4.1% and 1.7% in women over 60 years of age. However, using two or more SD of SMI, the prevalence of sarcopenia and SO was 5.1% and 5.1% respectively in men and 14.2% and 12.5% respectively in women. As defined by SMI, subjects with SO had 3 times the risk of metabolic syndrome (OR = 3.03, 95% confidence interval (CI) = 1.26-7.26) and subjects with non-sarcopenic obesity had approximately 2 times the risk of metabolic syndrome (OR = 1.89, 95% CI = 1.18-3.02) compared with normal subjects. 
*Conclusion:* Obese subjects with relative sarcopenia were associated with a greater likelihood for metabolic syndrome. As Koreans were more obese and aging, the prevalence of SO and its impact on health outcomes are estimated to be rapidly grow. Further research is requested to establish the definition, cause and consequences of SO.
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Design of Safety Assurance System of Specific Vehicle Information using ABPRE in the Fog Computing Environment

There would be high demand for technology that monitors illegal activity and detects risk with respect to vehicles on the road in a future urban traffic system, for accident prevention. However, there may be substantial overheads from the massive amount of data that would be required for the surveillance system as it would be automatically operated and used, as further advancements are made in sensor network technology and IoT (Internet of Things). In the transportation field, systems were mainly studied to measure the driver\u27s drowsiness or mobile phone use. These systems will collect information from several mobile devices at the same time, resulting in overhead of data. Fog computing reduces the overhead of data because it uses distributed proxy servers. However, security aspects were not considered. Encryption can be done to ensure the privacy of the information on the moving vehicles. However, in order to track a specific vehicle the data of the moving vehicles should be provided decrypted or decrypted by the secondary user. In this paper, to solve security aspects, we provide a new DSS model that utilizes ABPRE (Attribute Based Proxy Re-Encryption). The proposed system encrypts data sensed from moving vehicles. The cipher is configured to re-encrypt quickly at the proxy. The proposed method allows only users with access authority via secondary user\u27s properties to access data with attribute-based re-encryption. Therefore, safety is secured

Korean Ginseng-Induced Occupational Asthma and Determination of IgE Binding Components

A number of case reports on occupational asthma caused by herbal medicines have been issued, for example, on Sanyak, Chunkung, Banha, and Brazilian ginseng. Recently, cases of occupational asthma induced by Sanyak and Korean ginseng have been reported, but the pathogenic mechanisms involved are unknown. This study was carried out to evaluate the immunologic mechanism underlying Korean ginseng-induced occupational asthma. A patient engaged in Korean ginseng wholesale was referred for recurrent dyspnea, wheezing, and nasal symptoms, which were aggravated at work. Allergen bronchial provocation testing to Korean ginseng extract showed a typical immediate response, and skin prick testing to Korean ginseng extract also showed a strong positive response. Moreover, serum-specific IgE levels to Korean ginseng extract were significantly higher than in controls. Enzyme-linked immunosorbent assay (ELISA) inhibition tests showed a dose-dependent inhibition by Korean ginseng, but not by Dermatophagoides farinae, wheat flour, or Chinese balloon flower. Sodium dodecylsulfate-poly-acrylamide gel electrophoresis (SDS-PAGE) and immunoblotting revealed four specific Immunoglobulin E (IgE) binding components at 26, 30, 47, and 60 kDa, which were not bound by control sera. These results strongly suggest that occupation asthma induced by Korean ginseng is induced via an IgE-mediated mechanism

Hypereosinophilia Presenting as Eosinophilic Vasculitis and Multiple Peripheral Artery Occlusions without Organ Involvement

We report here a case with hypereosinophilia and peripheral artery occlusion. A 32-yr-old Korean woman presented to us with lower extremity swelling and pain. Angiography revealed that multiple lower extremity arteries were occlusive. The biopsy specimen showed perivascular and periadnexal dense eosinophilic infiltration in dermis and subcutaneous adipose tissue. Laboratory investigations revealed a persistent hypereosinophilia. She was prescribed prednisolone 60 mg daily. Her skin lesion and pain were improved and the eosinophil count was dramatically decreased. After discharge, eosinophil count gradually increased again. Cyanosis and pain of her fingers recurred. She had been treated with cyclophosphamide pulse therapy. Her eosinophilia was decreased, but the cyanosis and tingling sense were progressive. The extremity arterial stenoses were slightly progressed. Skin biopsy showed perivascular eosinophilic infiltration in the dermis and CD40 ligand (CD40L) positive eosinophilic infiltration. The serum TNF-α was markedly increased. These results suggest that CD40L (a member of TNF-α superfamily) could play a role in the inflammatory processes when eosinophil infiltration and activation are observed. We prescribed prednisolone, cyclophosphamide, clopidogrel, cilostazol, beraprost and nifedipine, and she was discharged

Usefulness of Videofluoroscopic Swallow Study with Mixed Consistency Food for Patients with Stroke or Other Brain Injuries

This study evaluated the feasibility of mixed consistency foods test in patients with dysphagia which developed after stroke or other brain injuries. The findings of a videofluoroscopic swallow study (VFSS) were compared using single versus mixed consistency foods. Forty-nine patients with stroke or other brain injuries who had no significant abnormal findings in the single consistency food VFSS and started regular hospital diet were recruited for this study. Twenty-five (51%) of the 49 patients showed normal findings whereas 24 (49%) patients showed abnormal findings in the mixed consistency food VFSS. Abnormal findings included posterior spillage of liquid prematurely to pyriform sinus (n = 23), laryngeal penetration (n = 6), subglottic aspiration in the oral preparatory phase of swallowing (chewing), solid components (n = 2), and significant (more than 10%) residue in valleculae or pyriform sinus (n = 2). There was an increased risk of abnormal findings in mixed consistency food VFSS such as aspiration and penetration when a patient showed delayed pharyngeal delay time in single consistency food using liquids. In conclusion, VFSS protocols using mixed consistency foods would be useful before starting regular diet for patients after stroke or other brain injuries

The potent protective effect of wild ginseng (Panax ginseng C.A. Meyer) against benzo[alpha]pyrene-induced toxicity through metabolic regulation of CYP1A1 and GSTs

Wild Panax ginseng C.A. Meyer (WG) is a well-known medicinal herb. In this study, the protective effects of a water extract from the root of WG on benzo[alpha]pyrene (BP)-induced hepatotoxicity and the mechanism of these effects were investigated for the first time. The effects of WG on liver toxicities induced by BP were assessed by blood biochemical and histopathological analyses. BP caused severe liver injury in rats, as indicated by elevated plasma ALT, AST and LPO levels. Pretreatment with WG for 4 weeks completely abrogated increases in the ALT, AST and LPO levels when challenged with BP. Reductions in GSH content and GST activity by BP were reversed by WG. These protective effects of WG against BP-induced toxicity were consistent with the results of histopathological examinations. We next examined the effects of WG on the gene expression of the enzymes that metabolize BP in H4IIE cells. CYP1A1 mRNA and protein expression were increased by BP. WG moderately inhibited BP-induced CYP1A1 gene expression. Moreover, GSTA2, GSTA3 and GSTM2 gene expressions were significantly increased by WG through the Nrf2/antioxidant responsive element pathway for enzyme induction. In summary, WG is efficacious in protecting against BP-induced hepatotoxicity as results of metabolic regulations through both the inhibition of metabolic enzyme activation and the enhancement of electrophilic detoxification, implying that WG should be considered a potential chemopreventive agent