Red pepper seed water extract inhibits preadipocyte differentiation and induces mature adipocyte apoptosis in 3T3-L1 cells

BACKGROUND/OBJECTIVES: Reducing the number of adipocytes by inducing apoptosis of mature adipocytes as well as suppressing differentiation of preadipocytes plays an important role in preventing obesity. This study examines the anti-adipogenic and pro-apoptotic effect of red pepper seed water extract (RPS) prepared at 4℃ (RPS4) in 3T3-L1 cells. MATERIALS/METHODS: Effect of RPS4 or its fractions on lipid accumulation was determined in 3T3-L1 cells using oil red O (ORO) staining. The expressions of AMP-activated protein kinase (AMPK) and adipogenic associated proteins [peroxisome proliferator-activated receptor-γ (PPAR-γ), CCAAT/enhancer-binding proteins α (C/EBP α), sterol regulatory element binding protein-1c (SREBP-1c), fatty acid synthase (FAS), and acetyl-CoA carboxylase (ACC)] were measured in 3T3-L1 cells treated with RPS4. Apoptosis and the expression of Akt and Bcl-2 family proteins [B-cell lymphoma 2 (Bcl-2), Bcl-2-associated death promoter (Bad), Bcl-2 like protein 4 (Bax), Bal-2 homologous antagonist/killer (Bak)] were measured in mature 3T3-L1 cells treated with RPS4. RESULTS: Treatment of RPS4 (0–75 µg/mL) or its fractions (0–50 µg/mL) for 24 h did not have an apparent cytotoxicity on pre and mature 3T3-L1 cells. RPS4 significantly suppressed differentiation and cellular lipid accumulation by increasing the phosphorylation of AMPK and reducing the expression of PPAR-γ, C/EBP α, SREBP-1c, FAS, and ACC. In addition, all fractions except ethyl acetate fraction significantly suppressed cellular lipid accumulation. RPS4 induced the apoptosis of mature adipocytes by hypophosphorylating Akt, increasing the expression of the pro-apoptotic proteins, Bak, Bax, and Bad, and reducing the expression of the anti-apoptotic proteins, Bcl-2 and p-Bad. CONCLUSIONS: These finding suggest that RPS4 can reduce the numbers as well as the size of adipocytes and might useful for preventing and treating obesity.

Comparative Study of Nursing Students Consciousness of Biomedical Ethics and Attitudes toward Human Tissue Donation and Transplantation According to Participation in Anatomy Camp Program / 체질인류학회지

The purpose of this study was to identify the consciousness of biomedical ethics and attitudes toward human tissue donation and transplantation among participants and non-participants in the anatomy camp program. Data collection is made from one hundred and eighty-two students who were enrolled in one university nursing department, in B metropolitan city. Ninety-six students participated in the anatomy camp program, while eighty-six students did not participate in the anatomy camp program. The total mean scores of consciousness of biomedical ethics between participants (2.03/4) and non-participants (1.96/4) were significantly different (t=2.217, p≤.028). And the total mean scores of attitudes toward human tissue donation and transplantation between participants (3.49/5) and non-participants (3.31/5) were significantly different (t=4.579, p≤.000). There were statistically significant differences between two groups in sub-categories of consciousness of biomedical ethics: organ transplantation, artificial insemination.

Clinical Presentation and Outcomes of Middle East Respiratory Syndrome in the Republic of Korea / 감염과화학요법

BACKGROUND: From May to July 2015, the Republic of Korea experienced the largest outbreak of Middle East respiratory syndrome (MERS) outside the Arabian Peninsula. A total of 186 patients, including 36 deaths, had been diagnosed with MERS-coronavirus (MERS-CoV) infection as of September 30th, 2015. MATERIALS AND METHODS: We obtained information of patients who were confirmed to have MERS-CoV infection. MERS-CoV infection was diagnosed using real-time reverse-transcriptase polymerase chain reaction assay. RESULTS: The median age of the patients was 55 years (range, 16 to 86). A total of 55.4% of the patients had one or more coexisting medical conditions. The most common symptom was fever (95.2%). At admission, leukopenia (42.6%), thrombocytopenia (46.6%), and elevation of aspartate aminotransferase (42.7%) were observed. Pneumonia was detected in 68.3% of patients at admission and developed in 80.8% during the disease course. Antiviral agents were used for 74.7% of patients. Mechanical ventilation, extracorporeal membrane oxygenation, and convalescent serum were employed for 24.5%, 7.1%, and 3.8% of patients, respectively. Older age, presence of coexisting medical conditions including diabetes or chronic lung disease, presence of dyspnea, hypotension, and leukocytosis at admission, and the use of mechanical ventilation were revealed to be independent predictors of death. CONCLUSION: The clinical features of MERS-CoV infection in the Republic of Korea were similar to those of previous outbreaks in the Middle East. However, the overall mortality rate (20.4%) was lower than that in previous reports. Enhanced surveillance and active management of patients during the outbreak may have resulted in improved outcomes.

Chylous Ascites in a Patient with Sepsis Caused by Bilateral Pneumonia / 대한구급학회지

Chylous ascites is a rare form of ascites characterized by milky peritoneal fluid rich in triglycerides due to the accumulation of chyle in the peritoneal cavity. This affliction occurs as a result of a disruption of lymph flow associated with traumatic injury or obstruction of the lymphatic system. There are various causes of chylous ascites, such as lymphatic anomalies, malignancy, cirrhosis, infection, trauma, surgery, and nephrotic syndrome. We report a rare case of an 81-year-old male with sepsis caused by bilateral pneumonia who presented with chylous ascites.

A Unique Ultrasonographic Finding of Carotid Thrombus in a Patient with Acute Cardiogenic Cerebral Infarction / 대한뇌졸중학회지

In patients with acute ischemic stroke, carotid duplex ultrasonography has been used to assess atherosclerotic lesions at the extracranial carotid artery. We reported a unique sonographic finding of carotid artery thrombus in a patient with acute cardioembolic stroke and atrial fibrillation. An 81-year-old woman with atrial fibrillation was presented with dysarthria and left side hemiparesis. She had undergone surgical thrombectomy and angioplasty for her right brachial artery occlusion four days before the stroke onset. Diffusion-weighted MRI revealed multiple territorial infarctions suggestive of acute cardio-embolic stroke. CT angiography showed an occlusion of the right common carotid artery. On B-mode ultrasonography, longitudinal intraluminal tortuous cylinderic oscillating thrombus was observed on the right distal common carotid artery to the proximal internal carotid artery. This case illustrates a unique ultrasonographic finding of acute cardiogenic thrombus in the extracranial carotid artery.

Altered Consciousness After Acute Lacunar Infarction of the Corona Radiata in Patients With Severe White Matter Change

With an increasing proportion of the elderly, dementia due to severe cerebral white matter change is frequently observed. Because these patients cannot express their symptoms effectively, the recognition of stroke can be delayed. In addition, clinical characteristics of their stroke might be different. We reported on three patients with severe leukoaraiosis, who exhibited altered consciousness after acute lacunar infarction in the corona radiata. This clinico-radiological discrepancy may have resulted from different susceptibility to ischemia in patients with severe white matter change.

Crossed Cerebellar Diaschisis in Complex Partial Status Epilepticus

Crossed cerebellar diaschisis has been described mostly in hemispheric stroke and supratentorial tumors with positron-emission tomography (PET) and single photon emission computed tomography (SPECT). Rarely it has been described with brain diffusion-weighted MRI of status epilepticus. We report a patient with status epilepticus, who developed MRI abnormalities in the cerebral cortex and contralateral cerebellum. EEG abnormalities correlated anatomically with the cerebral cortex of image change. An aggressive medication resulted in seizure control, reversal of neurologic deficit, and improvement or resolution of the MRI and EEG abnormalities in 3 weeks. We concluded that both localization and resolution of lesions may be explained by reversible excitotoxic cell damage due to seizure-related excessive synaptic activity.

Crossed Cerebellar Diaschisis in Complex Partial Status Epilepticus / 대한간질학회지

Crossed cerebellar diaschisis has been described mostly in hemispheric stroke and supratentorial tumors with positron-emission tomography (PET) and single photon emission computed tomography (SPECT). Rarely it has been described with brain diffusion-weighted MRI of status epilepticus. We report a patient with status epilepticus, who developed MRI abnormalities in the cerebral cortex and contralateral cerebellum. EEG abnormalities correlated anatomically with the cerebral cortex of image change. An aggressive medication resulted in seizure control, reversal of neurologic deficit, and improvement or resolution of the MRI and EEG abnormalities in 3 weeks. We concluded that both localization and resolution of lesions may be explained by reversible excitotoxic cell damage due to seizure-related excessive synaptic activity.

A Case of Severe Strongyloidiasis in a Patient with Chronic Obstructive Pulmonary Disease Receiving Long-Term Steroid Therapy / 감염과화학요법

Strongyloides stercoralis is a soil-transmitted intestinal nematode that may cause long-lived auto-infection in the host. It is distributed worldwide, especially in the tropical and subtropical regions, but has been rarely reported in Korea. Chronic infections by S. stercoralis are mostly inapparent infections that carry nonspecific gastrointestinal and pulmonary symptoms. However, In immunocompromised patients such as those receiving long-term steroid therapy and patients with AIDS or malignant tumors, S. stercoralis can induce hyperinfection by autoinfection. This may lead to increased rate of complications such as resistance to chemotherapy and sepsis. In such cases mortality rate of up to 87% has been reported. We report a case of severe strongyloidiasis in a patient with chronic obstructive pulmonary disease who was receiving long-term steroid therapy. The chief complaint was repeated dyspnea and hematochezia, and strongyloidiasis was diagnosed by the presence of rhabditiform larvae of S. stercoralis in the fecal smear and isolation of filariform larvae from the stool culture. The patient developed septic shock during treatment with albendazole and showed clinical signs of hyperinfection of S. stercoralis. He eventually died despite aggressive treatment.

A Case of Severe Strongyloidiasis in a Patient with Chronic Obstructive Pulmonary Disease Receiving Long-Term Steroid Therapy / 감염과화학요법

Strongyloides stercoralis is a soil-transmitted intestinal nematode that may cause long-lived auto-infection in the host. It is distributed worldwide, especially in the tropical and subtropical regions, but has been rarely reported in Korea. Chronic infections by S. stercoralis are mostly inapparent infections that carry nonspecific gastrointestinal and pulmonary symptoms. However, In immunocompromised patients such as those receiving long-term steroid therapy and patients with AIDS or malignant tumors, S. stercoralis can induce hyperinfection by autoinfection. This may lead to increased rate of complications such as resistance to chemotherapy and sepsis. In such cases mortality rate of up to 87% has been reported. We report a case of severe strongyloidiasis in a patient with chronic obstructive pulmonary disease who was receiving long-term steroid therapy. The chief complaint was repeated dyspnea and hematochezia, and strongyloidiasis was diagnosed by the presence of rhabditiform larvae of S. stercoralis in the fecal smear and isolation of filariform larvae from the stool culture. The patient developed septic shock during treatment with albendazole and showed clinical signs of hyperinfection of S. stercoralis. He eventually died despite aggressive treatment.

Diagnostic Experience in the 3 Human Brucellosis Cases by the Microbiologic, Serologic and Gene Tests / 대한임상미생물학회지

Brucellosis is a zoonosis caused by Brucella species. B. melitensis, B. suis, B. abortus and B. canis can infect humans. Recently, as the cases of bovine brucellosis have increased every year in Korea, the cases of human brucellosis have also increased among livestock workers and veterinarians in rural areas, since the first human case was reported in 2003. Because clinical manifestations of the disease are nonspecific and may be very atypical, clinicians and laboratory persons need to be active in using diagnostic tools including polymerase chain reaction in addition to the ordinary culture and serologic tests, and taking an appropriate measure to prevent intralaboratory infection. We report herein our experience in three human brucellosis cases diagnosed by cultures, serologic tests and gene detection.

Reappraisal of the predictive factors for postoperative pulmonary complications after general anesthesia / 대한내과학회지

BACKGROUND: As our population in Korea ages, more postoperative pulmonary complications (PPCs) have recently developed. There have been several studies about the predictive factors for PPC, but any consensus has not been established. In this study, we reappraised the predictive factors for PPC after general anesthesia in a population from Gyeong-ju, which was composed of elderly people. METHODS: We retrospectively investigated the incidence and predictive factors for PPC in 84 patients who underwent general anesthesia. We investigated gender, age, height, weight, BMI, smoking, underlying disease, underlying respiratory disease, malignancy, the laboratory findings (hemoglobin, albumin, arterial O2 saturation) and the pulmonary function tests of the patients. RESULTS: 84 patients were initially enrolled into the study, and PPC developed in 31 (36%) patients. The mean age of the enrolled patients was 66.515.1 years-old, so it shows the trend of an aging society. Three predictive factors were revealed that are independently associated with the PPC: site of operation (OR, 8.3), underlying disease (OR, 9.9) and serum albumin (OR, 4.0). CONCLUSIONS: Among the statistically meaningful predictive factors, underlying disease and operation site are well known from previous studies, but the albumin level<3.5 g/dL is also meaningful, which is higher than the previous reference level. It implies that the patient with a albumin level 3.0~3.5 g/dL can be classified into the high risk group. Therefore, we should recognize that it is necessary to apply more strict reference levels in an aging population to reduce the incidence of PPC.

GOLD, update 2003: What are modified? / 대한내과학회지

No abstract availalble.

A case of syndrome of inappropriate antidiuretic hormone secretion (SIADH) in small cell cancer of lung combined with squamous cell cancer of lung / 대한내과학회지

Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the term applied to arginine vasopressin (AVP) excess associated with hyponatremia without edema in the absence of physiologic or pharmacologic stimuli to AVP secretion. SIADH is associated with various conditions such as malignant tumors, infection, central nervous system disorders, and different pharmacological agents. The patient was 73-year-old female. She was admitted to the hospital because of persistent cough, dizziness, general weakness and confusion. On admission, her serum osmolality was 253 mOsm/kg, urine osmolality was 416 mOm/kg, and urine Na concentration was 159 mEq/L. Her Chest X-ray and CT scan of lung showed about 4x3.5 cm sized mass at posterior basal segment of left lower lobe of the lung, and CT-guided percutaneous needle aspiration revealed small round cell with clusters of malignant squamous cells. She was treated by salt restriction, hypertonic saline infusion and demeclocycline. We planned chemotherapy for advanced combined lung cancer, but she was discharged because of poor general condition and associated pneumonia without cancer chemotherapy. We report a rare case of SIADH in small cell cancer of lung combined with squamous cell cancer of lung.

A Case of Pulmonary Trichomoniasis / 대한임상병리학회지

Man is host to three distinct trichomonad species such as Trichomonas vaginalis, T. hominis, and T. tenax. Although reports of trichomonads found outside their natural habitat are rare, sporadic case reports have appeared describing trichomonads in the respiratory tract. The route of infection is unknown, but possible mechanisms include invasion from mouth, oral sex, bronchopleural or pleuroenteral fistula. Pulmonary trichomoniasis is a kind of oppotunistic infection and is usually caused by aspirated T. tenax in male adult patientis with chronic purulent or necrotic pulmonary disease. A 63-year-old male patient with alcoholic liver cirrhosis and chronic bronchiectasis was admitted due to copious sputum, dyspnea, fever and severe weight loss. On the thoracentesis from his right pleural cavity, 1 L of foul-smelling, brownish-yellow exudate was withdrawn and showed a large number of neutrophil, bacteria and numerous flagellated, actively motile organisms with typical appearance of thrichomonads in wet preparation. This patient was expired due to sepsis and insufficiency of multiple organs inspite of chemotherapy with metronidazole, cefuroxime and gentamicin on day 35 of admission. So, we report the first case of pulmonary trichomoniasis diagnosed in wet preparation of pleural fluid in Korea.

Clinical Usefulness of Various Methods for the Diagnosis of Tuberculosis / 대한임상병리학회지

BACKGROUND: In the diagnosis of tuberculosis, methods that have high sensitivity and specificity such as polymerase chain reaction and serologic test of tuberculosis have been introduced recently. Thus, we performed AFB stain, culture, PCR-ybridization and serologic test of tuberculosis to determine the clinical usefulness of each method in patients who were diagnosed as having pulmonary and extrapulmonary tuberculosis. METHODS: With the study subjects of 72 patients (57 with pulmonary tuberculosis, 15 with extrapulmonary tuberculosis) and controls of 60 persons, we performed the AFB stain, culture, PCR-ybridization and serologic test using an ICT(R) tuberculosis kit (AMRAD, Australia). Then, we compared diagnostic results in each tests and the effect of multiple tests among various methods. RESULTS: In 57 pulmonary tuberculosis patients, 42 (73.7%) showed positive with AFB stain, 40 (70.2%) with culture, 53 (93.0%) with PCR-ybridization, 47 (82.5%) with serologic test. And in 15 extrapulmonary tuberculosis patients, 4 showed positive (26.7%) with AFB stain, 5 (33.3%) with culture, 7 (46.7%) with PCR-ybridization method, and 12 (80.0%) with serologic test. In 72 tuberculosis patients, 67 (93.1%) showed positive for any of more than 2 tests among the 4 testing methods; and among 3 testing methods combined in different ways, 53 (73.6%) to 60 (83.3%) showed positive of any of more than 2 tests. CONCLUSIONS: We think that using the traditional method of detecting bacteria together with PCR-ybridization or serologic test would be a fast and accurate method of diagnosing tuberculosis. Especially, in those cases with extrapulmonary tuberculosis or taking a specimen of sputum is difficult, we think that serologic test would help in the diagnosis.

Clinical Usefulness of Various Methods for the Diagnosis of Tuberculosis / 대한임상병리학회지

BACKGROUND: In the diagnosis of tuberculosis, methods that have high sensitivity and specificity such as polymerase chain reaction and serologic test of tuberculosis have been introduced recently. Thus, we performed AFB stain, culture, PCR-ybridization and serologic test of tuberculosis to determine the clinical usefulness of each method in patients who were diagnosed as having pulmonary and extrapulmonary tuberculosis. METHODS: With the study subjects of 72 patients (57 with pulmonary tuberculosis, 15 with extrapulmonary tuberculosis) and controls of 60 persons, we performed the AFB stain, culture, PCR-ybridization and serologic test using an ICT(R) tuberculosis kit (AMRAD, Australia). Then, we compared diagnostic results in each tests and the effect of multiple tests among various methods. RESULTS: In 57 pulmonary tuberculosis patients, 42 (73.7%) showed positive with AFB stain, 40 (70.2%) with culture, 53 (93.0%) with PCR-ybridization, 47 (82.5%) with serologic test. And in 15 extrapulmonary tuberculosis patients, 4 showed positive (26.7%) with AFB stain, 5 (33.3%) with culture, 7 (46.7%) with PCR-ybridization method, and 12 (80.0%) with serologic test. In 72 tuberculosis patients, 67 (93.1%) showed positive for any of more than 2 tests among the 4 testing methods; and among 3 testing methods combined in different ways, 53 (73.6%) to 60 (83.3%) showed positive of any of more than 2 tests. CONCLUSIONS: We think that using the traditional method of detecting bacteria together with PCR-ybridization or serologic test would be a fast and accurate method of diagnosing tuberculosis. Especially, in those cases with extrapulmonary tuberculosis or taking a specimen of sputum is difficult, we think that serologic test would help in the diagnosis.

Osteoporosis in Chronic Obstructive Pulmonary Disease / 결핵

BACKGROUND: Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. METHOD: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar, USA). RESULTS: Mean bone mineral density(BMD) of spine in COPD group was 0.683+/-.154 g/cm2 and 0.971 +/-.212g/cm2 in controls(p0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were -3.82+/-.94(SD) and -2.82+/-.97(SD) in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T-score(r=-0.457, p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls(0.71+/-.13 g/cm2 and 0.97+/-.21 g/cm2, p<0.01). CONCLUSION: Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

A Case of Occupational Asthma Associated with Chromium / 대한산업의학회지

Occupational asthma is an important occupation-related disease. We experienced a case of asthma induced by chromium. After discovery, chromium has been widely used in industry. Health effects of chromium and its compounds are contact dermatitis (allergic and irritant), mucosal irritation, basal septal perforation, asthma, and lung cancer. Their toxicity depends on valency, solubility, concentration, pH, exposure duration and route. The patient was a 47-year-old male and an ex-smoker. He complained of cough, sputum and dyspnea while working. Total eosinophil count was elevated but serum IgE value was normal. Bronchoprovocation test with 0.5 % (w/v) chromium solution revealed early and late asthmatic responses. Although his initial methacholine bronchial challenge test shoved a negative result, bronchial hyperresponsiveness developed after bronchoprovocation test with chromium solution. After discharge, he has complained of an intermittent dyspnea. It was suggested that chromium could induce occupational asthma in exposed workers. Further investigations are needed to clarify their pathogenetic mechanisms.

Choriocarcinoma in Posterior Mediastinum: A case Report / 대한흉부외과학회지

Primary mediastinal choriocarcinoma is characteristically seen in young males presenting with the symptomes of cough, chest pale, and gynccomastia. A 33-year-old woman was admitted to the hospital because of severe dyspnea and chest pain which was aggravated rapidly 2 or 3 days ago. Posterior mcdiastinal mass measuring about 1 cm in diameter was seen in Chest P-A, left lateral view of chest, and chest CT. Serum beta-HCG level was markedly elevated up to 200,000 mIxt. Whole body CT and other studies could not find any lesion on ovary and uterus. But, a single nodule nEeasuring about 1 cm in diameter was identified in the brain CT. The tumor cells (syncytiotrophoblastic cells) from resected mass revealed positivity on i histochemical staining for beta-HCG. She was treated with EMA-CO after resection of tumor, But, 7 months later, she was readmitted and showed cerebral hemorrhage due to metastatic choriocarcinoma. She was operated again for the brain tumor, and was doing well for further 7 months.