Current Barriers of Obesity Management of Children Using Community Child Care Centers and Potential Possibility of Utilizing Mobile Phones: A Qualitative Study for Children and Caregivers / 대한지역사회영양학회지

Objectives@#This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management. @*Methods@#The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts. @*Results@#The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints. @*Conclusions@#The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.

A Qualitative Study on the Potential Utilization of a Mobile Phone for Obesity Management in Elementary-School Children : Parents Perspective / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS: The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS: The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS: The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.

A Qualitative Study on the Potential Utilization of a Mobile Phone for Obesity Management in Elementary-School Children : Parents Perspective / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS: The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS: The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS: The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.

Effects of Sodium Intake on the Association between the Salt-Sensitive Gene, Alpha-Adducin 1 (ADD1), and Inflammatory Cytokines in the Prevalence of Children Obesity

OBJECTIVE: To examine the effects of sodium intake on the correlations between the salt-sensitive gene α-adducin 1 (ADD1) and inflammatory cytokines in Korean childhood obesity. METHODS: A total of 2,070 students aged 8–9 years old participated in this study. The anthropometrics, serum biochemistry profile, inflammatory cytokines, and three-day dietary assessment were analyzed according to sex, obesity degree, and ADD1 polymorphism. RESULTS: The obesity prevalence was higher in boys (15.6%) than in girls (11.9%). Boys also showed higher values in anthropometrics; lipid, glucose, and insulin profiles; total calorie intakes, as well as those of sodium and calcium compared with those of the girls. The more obese were boys and girls, the higher were the anthropometrics and the blood levels (total cholesterol, triglyceride, low-density lipoprotein cholesterol, fasting blood sugar, and insulin), but the lower was high-density lipoprotein cholesterol. The obese boys had significantly higher sodium and Na/K intakes, while the obese girls had higher visfatin level and Na/K intake. In addition, an increase in the risk factors for blood pressure and obesity in ADD1 variants was identified. Serum tumor necrosis factor-α(TNF-α) significantly increased with increasing sodium intake in the ADD1 W allele carriers, regardless of sex. The presence of obesity with the ADD1 W allele induced inflammatory accelerators such as TNF-α or C-reactive protein(CRP) with higher sodium intake. CONCLUSION: Obese children with an ADD1w allele can experience a more complex form of obesity than non-obese when exposed to an obesity-inducing environment and need to be controlled sodium intake in the diet.

Leveraging Multimodal Supports using Mobile Phones for Obesity Management in Elementary-School Children: Program Providers' Perspective from a Qualitative Study / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate providers' perspectives on current challenges in implementing a program for prevention and management of childhood obesity and adoption of mobile phone as a potential solution of leveraging multimodal delivery and support in a school setting. METHODS: The qualitative data were collected through face-to-face in-depth interviews with 23 elementary-school teachers, 6 pediatricians, and 6 dieticians from community health centers and analyzed using a qualitative research methodology. RESULTS: Current challenges and potential solutions of obesity-prevention and -management program for obesity program for elementary school children were deduced as two themes each. Lack of tailored intervention due to limited recipient motivation, lack of individualized behavioral intervention, and different environmental conditions can be solvable by mobile technology-based personalized intervention which brings about interactive recipient participation, customized behavioral intervention, and ubiquitous accessibility. Lack of sustainable management due to stigmatization, limited interactions between program providers and inconsistent administrative support can be handled by multimodal support based on school setting using mobile platform providing education of health promoting behaviors toward larger scale and interactive networking between program participants, and minimizing administrative burden. CONCLUSIONS: Adoption of mobile-based health management program may overcome current limitations of child obesity program such as lack of tailored intervention and sustainable management via personalized intervention and multimodal supports although some concerns such as increased screen time need to be carefully considered in a further study.

High-fat Diet Accelerates Intestinal Tumorigenesis Through Disrupting Intestinal Cell Membrane Integrity

BACKGROUND: Excess energy supply induces chronic low-grade inflammation in association with oxidative stress in various tissues including intestinal epithelium. The objective of this study was to investigate the effect of high-fat diet (HFD) on intestinal cell membrane integrity and intestinal tumorigenesis in ApcMin/+ mice. METHODS: Mice were fed with either normal diet (ND) or HFD for 12 weeks. The number of intestinal tumors were counted and biomarkers of endotoxemia, oxidative stress, and inflammation were determined. Changes in intestinal integrity was measured by fluorescein isothiocyanate (FITC)-dextran penetration and membrane gap junction protein expression. RESULTS: HFD group had significantly higher number of tumors compared to ND group (P < 0.05). Blood total antioxidant capacity was lower in HFD group, while colonic 8-hydroxy-2'-deoxyguanosine level, a marker of oxidative damage, was higher in HFD group compared to that of ND group (P < 0.05). The penetration of FITC-dextran was substantially increased in HFD group (P < 0.05) while the expressions of membrane gap junction proteins including zonula occludens-1, claudin-1, and occludin were lower in HFD group (P < 0.05) compared to those in ND group. Serum concentration of lipopolysaccharide (LPS) receptor (CD14) and colonic toll-like receptor 4 (a LPS receptor) mRNA expression were significantly higher in HFD group than in ND group (P < 0.05), suggesting that significant endotoxemia may occur in HFD group due to the increased membrane permeability. Serum interleukin-6 concentration and myeloperoxidase activity were also higher in HFD group compared to those of ND group (P < 0.05). CONCLUSIONS: HFD increases oxidative stress disrupting intestinal gap junction proteins, thereby accelerating membrane permeability endotoxemia, inflammation, and intestinal tumorigenesis.

Aloe-emodin inhibits Pam₃CSK₄-induced MAPK and NF-κB signaling through TLR2 in macrophages / 한국영양학회지

PURPOSE: Aloe-emodin (AE), an ingredient of aloe, is known to exhibit anti-inflammatory activities. However, little is known about the underlying molecular mechanisms of its inflammatory modulatory activity in vitro. In the present study, we investigated the anti-inflammatory potential of AE using Pam₃CSK₄-stimulated macrophages. METHODS: RAW 264.7 macrophages were treated with AE (0~20 mM) for 1 h, followed by treatment with Pam₃CSK₄ for 1 h. After incubation, mRNA expression levels of cytokines were measured. The effect of AE on TLR2-related molecules was also investigated in Pam₃CSK₄-stimulated RAW 264.7 macrophages. RESULTS: AE attenuated Pam₃CSK₄-stimulated expression of proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1β (IL-1β) in RAW 264.7 macrophages. Two concentrations of AE (10 µM and 20 µM) effectively reduced mRNA expression of TLR2 by 41.18% and 54.43%, respectively, compared to that in control cells (p < 0.05). AE also decreased nuclear factor-kappa B (NF-κB) activation and mitogen-activated protein kinase (MAPK) phosphorylation. Phosphorylation levels of ERK1/2, p38, and JNK were markedly reduced by 20 µM AE. In particular, AE decreased phosphorylation of ERK in a dose-dependent manner in Pam₃CSK₄-stimulated RAW 264.7 macrophages. CONCLUSION: Our data indicate that AE exerts its anti-inflammatory effect by suppressing TLR2-mediated activation of NF-κB and MAPK signaling pathways in macrophages.

Analysis of Recent Four Years' Cross-Matching Tests of One Commercial Laboratory

The cross-matching test, an essential pre-transfusion test, is usually performed using only a segment of a blood bag and a recipient's blood sample at a commercial laboratory. We analyzed cross-matching test results obtained at LabGenomics laboratory, client of which were mainly small- and medium-sized medical clinics. Data for a total of 12,902 cross-matching tests referred from January 2012 to December 2015 were analyzed for incompatibility in the results and trends based on the distribution of medical clinics. Medical clinics were categorized as nursing home, obstetrics and gynecology, plastic surgery, dental clinic, orthopedic surgery, and others. Incompatible results were observed for 35 cases (1.09%) in 2012, 22 cases (0.68%) in 2013, 31 cases (1.02%) in 2014, and 41 cases (1.20%) in 2015. Overall, 55.4% of referrals came from a nursing home, 6.4% from obstetrics and gynecology, 4.4% from plastic surgery, 20.0% from dental clinic, 5.9 % from orthopedic surgery, and 7.9% from others. Further studies are required to evaluate the efficacy of cross-matching test results and its relationship with transfusion requirements.

Genome-wide association study for the interaction between BMR and BMI in obese Korean women including overweight

BACKGROUND/OBJECTIVES: This is the first study to identify common genetic factors associated with the basal metabolic rate (BMR) and body mass index (BMI) in obese Korean women including overweight. This will be a basic study for future research of obese gene-BMR interaction. SUBJECTS/METHODS: The experimental design was 2 by 2 with variables of BMR and BMI. A genome-wide association study (GWAS) of single nucleotide polymorphisms (SNPs) was conducted in the overweight and obesity (BMI > 23 kg/m2) compared to the normality, and in women with low BMR (< 1426.3 kcal/day) compared to high BMR. A total of 140 SNPs reached formal genome-wide statistical significance in this study (P < 1 x 10(-4)). Surveys to estimate energy intake using 24-h recall method for three days and questionnaires for family history, a medical examination, and physical activities were conducted. RESULTS: We found that two NRG3 gene SNPs in the 10q23.1 chromosomal region were highly associated with BMR (rs10786764; P = 8.0 x 10(-7), rs1040675; 2.3 x 10(-6)) and BMI (rs10786764; P = 2.5 x 10(-5), rs10786764; 6.57 x 10(-5)). The other genes related to BMI (HSD52, TMA16, MARCH1, NRG1, NRXN3, and STK4) yielded P <10 x 10-4. Five new loci associated with BMR and BMI, including NRG3, OR8U8, BCL2L2-PABPN1, PABPN1, and SLC22A17 were identified in obese Korean women (P < 1 x 10(-4)). In the questionnaire investigation, significant differences were found in the number of starvation periods per week, family history of stomach cancer, coffee intake, and trial of weight control in each group. CONCLUSION: We discovered several common BMR- and BMI-related genes using GWAS. Although most of these newly established loci were not previously associated with obesity, they may provide new insights into body weight regulation. Our findings of five common genes associated with BMR and BMI in Koreans will serve as a reference for replication and validation of future studies on the metabolic rate.

High-fat Diet Accelerates Intestinal Tumorigenesis Through Disruption Intestinal Cell Membrane Integrity

There is an error in a grant number in Acknowledgements.

The Impact of CDH13 Polymorphism and Statin Administration on TG/HDL Ratio in Cardiovascular Patients

PURPOSE: Adiponectin is expressed in adipose tissue, and is affected by smoking, obesity, and genetic factors, such as CDH13 polymorphism, contributing to the development of coronary vascular diseases (CVDs). MATERIALS AND METHODS: We investigated the effect of genetic variations of CDH13 (rs3865188) on blood chemistry and adiponectin levels in 345 CVD patients undergoing statin-free or statin treatment. RESULTS: Genetic variation in CDH13 was significantly correlated with several clinical factors, including adiponectin, diastolic blood pressure, triglyceride (TG), and insulin levels. Subjects with the T allele (mutant form) had significantly lower adiponectin levels than those with the A allele. Total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), TG/high-density lipoprotein cho-lesterol (HDLc) ratio, and HDL3b subtype were markedly decreased in statin treated subjects regardless of having the A or T allele. TG and TG/HDL in the statin-free group with TT genotype of the rs3865188 was higher than in the others but they were not different in the statin-treated subjects. We observed a significant difference in adiponectin levels between patients with the A and T alleles in the statin-free group; meanwhile, no difference in adiponectin levels was noted in the statin group. Plasma levels of other cytokines, leptin, visfatin, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha), were not different among the CDH13 genotypes according to statin administration. Body mass index (BMI), TG, insulin, HDL3b, and TG/HDL ratio showed negative correlations with adiponectin levels. CONCLUSION: Plasma adiponectin levels and TG/HDL ratio were significantly different according to variants of CDH13 and statin administration in Korean patients with CVD.

Chemopreventive Action of Anthocyanin-rich Black Soybean Fraction in APC(Min/+) Intestinal Polyposis Model

BACKGROUND: Anthocyanins have been shown to inhibit cancer cell growth by suppressing oxidative stress and inflammatory responses. The purpose of this study was to investigate the effects of an anthocyanin-rich extract (AE) from black soybean coat on intestinal carcinogenesis. METHODS: APC(Min/+) mice were fed a diet of 0.2% or 0.5% AE for 7 weeks. We analyzed the number of intestinal tumors, oxidative stress and inflammatory markers associated with beta-catenin and cytosolic phospholipase A2 (cPLA2) signals. The number of intestinal tumors, and cellular expression of beta-catenin were determined. RESULTS: The number of intestinal tumors was significantly lower in mice fed a 0.5% AE diet compared to those of the other groups. Cytosolic beta-catenin expression was significantly decreased in the AE supplemented groups compared to that of the control animals. In addition, mucosa expression of cyclooxygenase-2 and cPLA2 were also significantly decreased in the 0.5% AE group, by 32% and 62%, respectively, compared to the control group. CONCLUSIONS: These results suggest that dietary AE reduced the development of intestinal tumors, possibly through the ability to suppress oxidative stresses, decreasing inflammatory responses mediated by beta-catenin associated signals.

Carnosic Acid Inhibits Lipid Accumulation in 3T3-L1 Adipocytes Through Attenuation of Fatty Acid Desaturation

BACKGROUND: Excess body fat accumulation contributes to the development of metabolic disorders that can cause adverse health effects. Carnosic acid (CA), a major bioactive component of rosemary (Rosemarinus officinalis), has been suggested to possess anti-adipogenic properties. The present study was conducted to elucidate the mechanism underlying the anti-adipogenic effects of CA. METHODS: 3T3-L1 pre-adipocytes were treated with CA (0.1, 1, and 10 muM) from day 0 to day 8 of differentiation. On day 8, biochemical markers of lipid accumulation and the degree of fatty acid desaturation were measured. RESULTS: Oil Red O staining results, triglyceride (TG) accumulation, and glycerol 3-phosphate dehydrogenase activity suggested that CA significantly inhibited lipid accumulation in 3T3-L1 adipocytes. CA significantly decreased mRNA expression of peroxisome proliferator-activated receptor-gamma, sterol regulatory element-binding protein 1, and CCAAT/enhancer binding protein-alpha in a dose-dependent manner. Moreover, it decreased the ratio of both C16:1/C16:0 and C18:1/C18:0, with reduced expression of stearoyl CoA desaturase 1 mRNA and protein. CONCLUSIONS: These results suggest that CA efficiently suppressed adipogenesis in 3T3-L1 adipocytes and its action, at least in part, is associated with the downregulation of adipogenesis-related genes and the fatty acid composition of TG accumulated in adipocytes.

Design of service delivery for a child obesity prevention and management program using technology convergence / 한국영양학회지

PURPOSE: Health professionals and policy makers confront the failure of provider-administered, conventional behavioral interventions in the fight against obesity epidemic. The aim of this study was to develop a tailored, cost-effective delivery system for a child obesity prevention and management program through technology convergence using Web-enabled smart cellular phones. METHODS: Assessment of service needs and development of a delivery system for the program were based on a comprehensive literature review and expert reviews, and results from in-depth interviews and a need-assessment survey. RESULTS: The user- and site- centered service delivery system using Web-enabled cellular telephones as the hardware platform for obesity prevention and management has been developed. A tailored informational service and intervention will be provided interactively between stakeholders through the platform. The potential legal issues associated with the service design have also been considered. CONCLUSION: The user-centered convergence design and platform based on principles of Transtheoretical Model and Stages of Change using the Health Promoting School framework could enable effective intervention and promote acceptance in the long-run.

Carnosic acid inhibits TLR4-MyD88 signaling pathway in LPS-stimulated 3T3-L1 adipocytes

BACKGROUND/OBJECTIVES: Carnosic acid (CA), found in rosemary (Rosemarinus officinalis) leaves, is known to exhibit anti-obesity and anti-inflammatory activities. However, whether its anti-inflammatory potency can contribute to the amelioration of obesity has not been elucidated. The aim of the current study was to investigate the effect of CA on Toll-like receptor 4 (TLR4) pathways in the presence of lipopolysaccharide (LPS) in 3T3-L1 adipocytes. MATERIALS/METHODS: 3T3-L1 adipocytes were treated with CA (0-20 microM) for 1 h, followed by treatment with LPS for 30 min; mRNA expression of adipokines and protein expression of TLR4-related molecules were then measured. RESULTS: LPS-stimulated 3T3-L1 adipocytes showed elevated mRNA expression of tumor necrosis factor (TNF)-alpha, interleukin-6, and monocyte chemoattractant protein-1, and CA significantly inhibited the expression of these adipokine genes. LPS-induced up regulation of TLR4, myeloid differentiation factor 88, TNF receptor-associated factor 6, and nuclear factor-kappaB, as well as phosphorylated extracellular receptor-activated kinase were also suppressed by pre-treatment of 3T3-L1 adipocytes with CA. CONCLUSIONS: Results of this study suggest that CA directly inhibits TLR4-MyD88-dependent signaling pathways and decreases the inflammatory response in adipocytes.

Association of Leisure Time Physical Activity and Metabolic Syndrome over 40 Years / 가정의학회지

BACKGROUND: This study aimed to investigate the relationship between leisure time physical activities (LTPA) and metabolic syndrome (MS). METHODS: Five thousand seven hundred and thirty two adults 40 years old or older were enrolled in the study from April 2009 to December 2010. National Cholesterol Education Program's Adult Treatment Panel III was used for the criteria of MS, and Minnesota Leisure Time Physical Activity Questionnaire was used to measure LTPA. After adjusted covariates (age, hypertension, smoking, drinking, education level, household income level, work time physical activities, and menopause for females), the relationship between LTPA and MS was analyzed using logistic regression analysis. RESULTS: The prevalence of MS was 22.8% in men, and 14.1% in women. Average LTPA was 1,498 kcal/wk in men, and 1,308 kcal/wk in women. After adjustment for covariates, the odds ratios of middle and low LTPA compared with high LTPA were 1.06 (0.87-1.34), 1.54 (1.08-1.75), for women, this same association was not seen in men. The prevalence of MS was 22.8% in men and 14.1% in women, and their LTPA burned 1,498 and 1,308 kcal/wk, respectively. When the odds ratio of MS for the high LTPA group was set at 1.0, the odds ratio of MS was 1.06 (0.87-1.34) in the middle LTPA group and 1.54 (1.08-1.75) in the low LTPA group in women, which showed that the MS risk increased when the LTPA was lower. This same association was not seen in men. CONCLUSION: LTPA was independently associated with metabolic syndrome, but only for women.

The Analysis of Risk Factor Management Programs for Patients with Coronary Artery Disease / 재활간호학회지

PURPOSE: This study was performed to analyse the trends of risk factor management programs for patients with coronary artery disease. METHODS: Using PubMed, 35 intervention studies related to risk factor management programs among randomized controlled trials searched with the key words of coronary artery disease and coronary heart disease. Collected studies were analysed according to the characteristics of studies and participants, method and content of intervention, and outcome indicator and its effects. RESULTS: The mean period of intervention was 28.7+/-26.8 weeks, the mean frequency was 3.0+/-2.0 times per week, and the duration of one session was below 60 minuets in 65.8% of the reviewed studies. The interventions were counselling, exercise, education, and cognitive behavior therapy. Counselling was applied most frequently in previous studies. The outcomes of intervention had been measured with anthropometric, physical, physiological, psychological, behavioral, and cognitive aspects, but the effect of the intervention was inconsistent among the studies. CONCLUSION: Based on the results of this study, systematic and comprehensive cardiac rehabilitation program consisted of counselling, exercise, and education should be developed and performed for health management and relapse prevention of patients with coronary artery disease.

Factors Affecting the Perception of Importance and Practice of Patient Safety Management among Hospital Employees in Korea

PURPOSE: The study was undertaken to identify factors affecting perception of the importance and practice of patient safety management (PSM) among hospital employees in Korea. METHODS: This study was conducted using a descriptive design and a self-report questionnaire. Two hundred and eighty employees were recruited from three hospitals using a convenience sampling method. Measures were perception of the importance, practice, and characteristics of PSM. Data were analyzed using descriptive statistics including t test, one-way analysis of variance, Pearson's correlation analysis, and multiple regression. RESULTS: Factors affecting perception of the importance of PSM were whether hospital employees were in contact with patients while on duty, weekly working hours, education on PSM, and perceived adequacy of PSM system construction. Factors affecting the practice of PSM were perceived adequacy of work load, perceived adequacy of PSM system construction and perception of its importance. CONCLUSION: The findings of this study indicate a need for developing strategies to improve perception of the importance and practice of PSM among all hospital employees, and provide a reference for future experimental studies.

Dietary carnosic acid suppresses hepatic steatosis formation via regulation of hepatic fatty acid metabolism in high-fat diet-fed mice

In this study, we examined the hepatic anti-steatosis activity of carnosic acid (CA), a phenolic compound of rosemary (Rosmarinus officinalis) leaves, as well as its possible mechanism of action, in a high-fat diet (HFD)-fed mice model. Mice were fed a HFD, or a HFD supplemented with 0.01% (w/w) CA or 0.02% (w/w) CA, for a period of 12 weeks, after which changes in body weight, blood lipid profiles, and fatty acid mechanism markers were evaluated. The 0.02% (w/w) CA diet resulted in a marked decline in steatosis grade, as well as in homeostasis model assessment of insulin resistance (HOMA-IR) index values, intraperitoneal glucose tolerance test (IGTT) results, body weight gain, liver weight, and blood lipid levels (P < 0.05). The expression level of hepatic lipogenic genes, such as sterol regulating element binding protein-1c (SREBP-1c), liver-fatty acid binding protein (L-FABP), stearoyl-CoA desaturase 1 (SCD1), and fatty acid synthase (FAS), was significantly lower in mice fed 0.01% (w/w) CA and 0.02% (w/w) CA diets than that in the HFD group; on the other hand, the expression level of beta-oxidation-related genes, such as peroxisome proliferator-activated receptor alpha (PPAR-alpha), carnitine palmitoyltransferase 1 (CPT-1), and acyl-CoA oxidase (ACO), was higher in mice fed a 0.02% (w/w) CA diet, than that in the HFD group (P < 0.05). In addition, the hepatic content of palmitic acid (C16:0), palmitoleic acid (C16:1), and oleic acid (C18:1) was significantly lower in mice fed the 0.02% (w/w) CA diet than that in the HFD group (P < 0.05). These results suggest that orally administered CA suppressed HFD-induced hepatic steatosis and fatty liver-related metabolic disorders through decrease of de novo lipogenesis and fatty acid elongation and increase of fatty acid beta-oxidation in mice.

A Rare Case of Transformation of Childhood Myelodysplastic Syndrome to Acute Lymphoblastic Leukemia

Transformation of MDS into ALL during childhood is extremely rare. We report a rare case of an 8-yr-old girl who presented with refractory cytopenia of childhood (RCC) that transformed into ALL only 3 months after the diagnosis of childhood MDS. Although no cytogenetic abnormalities were observed in conventional karyotype and FISH analysis, we found several deletions on chromosomes 5q, 12q, 13q, and 22q. Partial homozygous deletion of the RB1 gene was observed on microarray analysis, with the bone marrow specimen diagnosed as ALL. This is the first case report of transformation of ALL from childhood MDS in Korea. We also compared the clinical, cytological, and cytogenetic features of 4 previously reported childhood MDS cases that transformed into ALL.