Immunosuppressive therapy can improve clinical, biochemical and histological features and considerably prolong survival in patients with autoimmune hepatitis. Although ethnicity may affect disease severity and presentation, the long-term outcome of immunosuppression in Korean populations is unknown. This study was aimed to assess the efficacy of immunosuppressive therapy and determine the prognosis of autoimmune hepatitis in Korean populations. We reviewed the medical records of 86 patients diagnosed as having autoimmune hepatitis at the Samsung Medical Center between 1994 and 2008. Seventy-two (83.7%) patients reached remission after a median treatment duration of 3.5 months (range 1 to 44 months). Attempts to withdraw medications were made in 24 cases after the median treatment duration of 36 months (median 6 to 125 months). Thirteen of 24 (54.1%) patients relapsed after treatment withdrawal. Of the 86 patients, 6 (7.2%) experienced disease progression and the overall 5-and 10-yr progression-free survival rates were 91.2% and 85.5%, respectively. In conclusion, immunosuppressive therapy for autoimmune hepatitis results in a favorable rate of remission and excellent progression-free survival, but the relapse rate after treatment withdrawal is high. This suggests that long-term immunosuppressive therapy may be particularly important for treatment of Korean patients.

Plantago asiatica is distributed widely in East Asia. Since ancient times it has been used as a diuretic to treat acute urinary infections, and as an antiinflammatory, antiasthmatic, antioxidant, antibacterial, antihyperlipidemic and antihepatitis drug. The major compound, plantamajoside from P. asiatica, which is used as a marker compound in chemotaxonomic studies, was reported to have antibacterial activity, inhibition activity against cAMP phosphodiesterase and 5-lipoxygenase and antioxidant activity. However, there are no reports on the safety of plantamajoside. This study assessed the toxic effects of plantamajoside concentrate (PC), the purity of which was above 80%, in rats following administration at dose levels of 0, 500, 1000 and 2000 mg/kg body weight/day for 13 weeks, as recommended by the OECD guidelines. The results showed that there were no differences in body weight, food intake, water consumption, relative organ weight or the hematological and serum biochemical values among the different dosage groups. No death or abnormal clinical signs were observed during the experimental period. Therefore, the results suggested that no observed adverse effect level (NOAEL) of the PC in rats after oral administration is considered to be greater than 2000 mg/kg in rats under the conditions employed in this study.

Ventricular perforation is a rare complication of permanent cardiac pacemaker implantation. We report here on a 68-year-old woman with a dual chamber permanent pacemaker that had been implanted one month earlier, and she suffered cardiac perforation from the pacemaker lead. Frequent follow-up via12-lead surface electrocardiography and chest radiography and the proper work-up for pacemaker implantation are needed for detecting rare complications after pacemaker implantation.

This study investigated anti-diabetic activity of Kocat-D1, which is a currently used traditional medicine for treatment of diabetes in Shandong, China. Insulin sensitizing activity was observed in a cell-based glucose uptake assay using 3T3-L1 adipocytes. The treatment of 0.2 mg/mL of hot water extract of Kocat-D1 with 0.2 nM insulin was associated with a significant increasing in glucose uptake (165.0±0.7%) over the treatment of 0.2 nM insulin. C57BL/KsJ-db/db mice (8 weeks of age) were separated into 3 groups: normal control (control, db/＋ mice untreated), diabetic control (DM control, db/db mice untreated), Kocat-D1 (db/db mice treated with Kocat-D1 extract 350 mg/kg/day). After 16 weeks of treatment, body weight and total diet intake of Kocat-D1 group were significantly lower than DM control groups. Blood glucose levels of the Kocat-D1 group (14.7±1.4 mmol/L) were significantly lower compared to the DM control group (27.1±0.2 mmol/L). Furthermore, insulin level was significantly increased in the Kocat-D1 group (0.17±0.02 ng/mL) compared with the DM control group (0.05±0.02 ng/mL). The glomeruli in kidney was stained using periodic acid-shiff base (PAS) for confirming collagen accumulation. The glomeruli in kidney of Kocat-D1 group had significantly reduced PAS-positive compared with that of DM control.