Short-chain Fatty Acids Inhibit Staphylococcal Lipoprotein-induced Nitric Oxide Production in Murine Macrophages

Staphylococcus aureus, a Gram-positive pathogen, can cause severe inflammation in humans, leading to various life-threatening diseases. The lipoprotein is a major virulence factor in S. aureus-induced infectious diseases and is responsible for excessive inflammatory mediators such as nitric oxide (NO). Short-chain fatty acids (SCFAs) including butyrate, propionate, and acetate are microbial metabolites in the gut that are known to have anti-inflammatory effects in the host. In this study, we investigated the effects of SCFAs on S. aureus lipoprotein (Sa.LPP)-induced NO production in mouse macrophages. Butyrate and propionate, but not acetate, inhibited Sa.LPP-induced production of NO in RAW 264.7 cells and bone marrow-derived macrophages. Butyrate and propionate inhibited Sa.LPP-induced expression of inducible NO synthase (iNOS). However, acetate did not show such effects under the same conditions. Furthermore, butyrate and propionate, but not acetate, inhibited Sa.LPP-induced activation of NF-κB, expression of IFN-β, and phosphorylation of STAT1, which are essential for inducing transcription of iNOS in macrophages. In addition, butyrate and propionate induced histone acetylation at lysine residues in the presence of Sa.LPP in RAW 264.7 cells. Moreover, Sa.LPP-induced NO production was decreased by histone deacetylase (HDAC) inhibitors. Collectively, these results suggest that butyrate and propionate ameliorate the inflammatory responses caused by S. aureus through the inhibition of NF-κB, IFN-β/STAT1, and HDAC, resulting in attenuated NO production in macrophages.

A Case of Duodenal Amyloidosis Accompanied with Candidiasis that was Diagnosed by Endoscopy / 대한소화기내시경학회지

This report describes a case of a 63-year-old female who suffered from gastrointestinal amyloidosis. The patient presented with abdominal pain, nausea, vomiting and watery diarrhea for a week. Previously, the patient had been treated for rheumatoid arthritis. Endoscopy showed the presence of erythematous mucosa and yellowish exudates in the bulb, a finding that was compatible with duodenal candidiasis. Colonoscopy showed diffuse erythematous and easy friability in the entire colon, a finding suggestive of infectious colitis. The pathology report indicated that the lesion had amyloid, which was stained by Congo red. Endoscopic findings of amyloidosis are non-specific, such as friable mucosa, granulation, polyp, erosion and ulceration. Therefore, it is difficult to diagnose amyloidosis with endoscopic findings. However, if the patient has risk factors of secondary amyloidosis such as rheumatoid arthritis, gastrointestinal amyloidosis based on the endoscopic finding should be considered. We report a case of duodenal amyloidosis accompanied with candidiasis, which has not been previously reported.

Diagnostic Accuracy of Computed Tomography for the Lymph Node Staging of Endoscopically Resectable Early Gastric Cancer / 대한소화기내시경학회지

BACKGROUND/AIMS: Accurate staging of the lymph nodes (LNs) before endoscopic mucosal resection (EMR) is important. We evaluated the accuracy of CT for LN staging in patients the endoscopically resectable early gastric cancer (EGC). METHODS: The medical records of 155 EGCs patients who had undergone an operation were analyzed. The pre-operatively performed multidetector CT scans and the post-operative histopathologic findings were reviewed for comparing the LN staging with that using the Japanese classification system. Endoscopically resectable EGC was defined as EGC without LN metastasis and also the EGC that satisfied the EMR criteria according to the Japanese guideline. RESULTS: The diagnostic efficacy of CT for LN staging of all the enrolled EGC patients was as follow: accuracy 65.2%, overstaging rate 29.7%, understaging rate 5.2%. The overall accuracy and the overstaging rate of CT for LN staging of endoscopically resectable EGC were as follows: EGC without LN metastasis [69.8% (97/139), 30.2% (42/139)], EGC satisfying extended criteria [72.5% (58/80), 27.5% (22/80)] and EGC satisfying limited criteria [79.2% (19/24), 20.8% (5/24)]. The accuracy of the EMR criteria for predicting node negative EGC were as follows: the extended criteria 98.8% (79/80), the limited criteria 100% (24/24). CONCLUSIONS: Our study showed that prediction of LN metastasis before EMR according to CT staging had limited value due to the tendency of overestimation. Therefore, we should preferentially consider the treatment strategy according to the EMR criteria.

Clinical evaluation of hemochromatosis with end-stage renal disease / 대한내과학회지

Hemochromatosis is almost always a consequence of treatment for anemia in long term hemodialysis patients who have undergone frequent blood transfusions and iron therapy. Clinically, iron overload may be a serious problem for some maintenance hemodialysis patients and it may be manifested as organ dysfunctions. So, it is important to diagnose iron overload early and restrict blood transfusions and the administration of iron agents in these patients. We recently experienced one case of suspected primary hemochromatosis in a long term hemodialysis patient, and we evaluated the patient by checking the serum ferritin level and performing liver biopsy. Treatment with desferrioxamine was started with recombinant erythropoietin. We report on this case with a brief review of the literature.

Differential Diagnosis of Diabetes Mellitus caused by Liver Cirrhosis and Other Type 2 Diabetes Mellitus / 대한간학회지

<0.05). PP2h, fasting C-peptide and ratio of fasting insulin/C-peptide tend to be higher in hepatogenous DM than those of controls, but which were not statistically significant. CONCLUSIONS: The ratio of PP2h/FPG and fasting plasma insulin differentiated hepatogenous DM from the other type 2 DM. Insulin resistance in liver cirrhosis was higher than the other type 2 DM, and impaired hepatic insulin degradation might be an important mechanism of hyperinsulinemia in liver cirrhosis.