TonEBP suppresses adipocyte differentiation via modulation of early signaling in 3T3-L1 cells

TonEBP belongs to the Rel family of transcription factors and plays important roles in inflammation as well as kidney homeostasis. Recent studies suggest that TonEBP expression is also involved in differentiation of several cell types such as myocytes, chondrocytes, and osteocytes. In this study, we investigated the roles of TonEBP during adipocyte differentiation in 3T3-L1 cells. TonEBP mRNA and protein expression was dramatically reduced during adipocyte differentiation. Sustained expression of TonEBP using an adenovirus suppressed the formation of lipid droplets as well as the expression of FABP4, a marker of differentiated adipocytes. TonEBP also inhibited the expression of PPARγ, a known master regulator of adipocytes. RNAi-mediated knock down of TonEBP promoted adipocyte differentiation. However, overexpression of TonEBP did not affect adipogenesis after the initiation of differentiation. Furthermore, TonEBP expression suppressed mitotic clonal expansion and insulin signaling, which are required early for adipocyte differentiation of 3T3-L1 cells. These results suggest that TonEBP may be an important regulatory factor in the early phase of adipocyte differentiation.

Efficacy of prolonged entecavir monotherapy in treatment-naive chronic hepatitis B patients exhibiting a partial virologic response to entecavir

BACKGROUND/AIMS: The optimal management of patients exhibiting a partial virologic response (PVR) to entecavir (ETV) has not been determined . The aim of this study was to determine the long-term efficacy of prolonged ETV monotherapy in treatment-naive chronic hepatitis B (CHB) patients exhibiting a PVR to ETV therapy. METHODS: This study included 364 treatment-naive CHB patients treated with ETV for > or =48 weeks and who received continuous ETV monotherapy for > or =96 weeks. PVR was defined as a decrease in serum hepatitis B virus (HBV) DNA of more than 2 log10 IU/mL from baseline but with detectable HBV DNA by real-time PCR assay at week 48. RESULTS: Fifty-two of the 364 patients (14.3%) showed a PVR. Among them, 41 patients received continuous ETV monotherapy for > or =96 weeks (median duration 144 weeks, range 96-312 weeks), and 40 of these patients (95%) achieved a virologic response (VR, HBV DNA <20 IU/mL) during prolonged ETV monotherapy (median duration 78 weeks, range 60-288 weeks). The cumulative probabilities of a VR at weeks 96, 144, and 192 from treatment initiation were 78.0%, 92.7%, and 95.1%, respectively. The VR rate was 97.2% (35/36) in HBeAg-positive patients and 100% (5/5) in HBeAg-negative patients. In multivariate analysis, HBeAg positivity (odds ratio [OR], 9.231; 95% confidence interval [CI], 1.03-82.91; P=0.047) and a high baseline HBV DNA level (OR, 0.170; 95% CI, 0.08-0.37; P=0.000) were independently associated with a delayed virologic response. No patient developed genotypic resistance to ETV during follow-up. CONCLUSIONS: Long-term ETV monotherapy is effective for achieving a VR in treatment-naive CHB patients exhibiting a PVR to ETV. HBeAg positivity and high baseline HBV DNA level were independently associated with a delayed virologic response.

Association between Respiratory Function and Albuminuria among Korean Male according to Smoking Status: The 2011 Korea National Health and Nutrition Examination Survey (KNHANES)

BACKGROUND: Several studies have found an association between decreased respiratory function and renal impairment in those with chronic kidney disease. The relationship has not been investigated for healthy smokers. The aim of this study was to examine the association between respiratory function and renal function according to smoking status in Korean male population. METHODS: From the 5th Korean National Health and Nutrition Examination Survey (KNHANES), we enrolled 1246 male participants who were 40 years or older. As a cross-sectional study, the association between respiratory function and renal function were analysed depending on the' smoking status. Pearson correlation analysis was used to find the association between respiratory function and renal impairment. Covariance Analysis allowed to compare renal function (albuminuria, eGFR) with respiratory function (FEV1, FVC) according to smoking status. RESULTS: Regardless of smoking status, there was a negative correlation between respiratory function (FEV1 and FVC) and urinary albumin to creatinine ratio (LogUACR), and positive correlation between respiratory function (FEV1 and FVC) and estimated glomerular filtration rate (eGFR). Smokers have lower FEV1 and FVC in case they have albuminuria, after adjusting for covariant (P=0.012, P=0.010, respectively). CONCLUSIONS: Respiratory function was significantly lower in male smokers with albuminuria. Primary care physicians need to recognize that albuminuria may accompany with decreased respiratory function and to detect renal function impairment earlier in male smokers.

Factors Influencing the Miss Rate of Polyps in a Tandem Colonoscopy Study / 대한소화기학회지

BACKGROUND/AIMS: The miss rate of colon polyps and its related factors have not been clearly identified yet. This study aims to review the miss rate of polyps both on the patient-level and on the polyp-level and to analyze the factors affecting the miss rate such as those related to the endoscopist, procedure, patient, and polyp. METHODS: From August 2011 to August 2013, patients who underwent elective second colonoscopy for resection of polyps, the sizes of which were not small enough to be resected by biopsy forceps alone at first colonoscopy, were enrolled retrospectively. RESULTS: The miss rate on the patient-level was 59.2% (234/395) and on the polyp-level was 27.9% (578/2,068). There was no significant difference in the miss rate depending on the experience of the endoscopists or characteristics of the patients. In terms of the procedure, the miss rate was higher when the colonoscopy was performed in the afternoon (OR 1.632, p=0.046). It was found that the miss rate of polyps increased when the polyps were small (OR 4.595, p<0.001 in <5 mm/OR 3.447, p<0.001 in 5-10 mm), flat or sessile (OR 2.406, p<0.001 in flat/OR 1.768, p=0.002 in sessile), and located in the left colon (OR 1.391, p=0.007). CONCLUSIONS: The experience of endoscopists did not have influence on the accuracy of polyp detection. However, the fatigue of endoscopists in the afternoon is considered to render polyp detection less accurate. Also, the large curves and folds of the sigmoid colon are regarded as a reason for the higher miss rate of polyps in the left colon.

Prognostic Factors of the RA Patients with ILD

OBJECTIVE: Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA), and an important cause of morbidity and mortality in RA. We compared demographic and clinical characteristics of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) patterns in RA patients and determined the prognostic factors that influence the survival of RA-ILD patients. METHODS: 51 enrolled RA patients (male n=21, female n=30) with ILD underwent HRCT. We categorized ILD into two groups, as the UIP pattern and the NSIP pattern, using HRCT. HRCT scans were scored to investigate the extent of the ILD. We divided the extent of the interstitial lung disease into 4 groups 1~14%, 15~19%, 20~24%, >25%. RESULTS: There were no significant differences between the UIP and NSIP pattern in the clinical characteristics, except for age at the time of the study (RA-NSIP pattern vs RA-UIP pattern 62.3+/-11.7 vs 68.2+/-8.4, p=0.042). There were no significant differences in survival time between the RA-UIP and RA-NSIP pattern (Log rank p=0.985). The extent of ILD on chest HRCT was significantly associated with mortality (HR=1.044, 95% CI 1.019~1.069) and patients that were diagnosed with ILD at an older age (HR=1.109, 95% CI 1.024~1.200) were associated with a worse prognosis. Comparing four groups divided by the extent of the lung disease, there were significant differences in survival estimates (Log-rank p-value<0.001) based on an ILD extent of 15%. CONCLUSION: Our study reveals that the extent of ILD on chest HRCT was found to be significantly associated with poor prognosis of RA-ILD patients.

Prognostic Factors of the RA Patients with ILD

OBJECTIVE: Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA), and an important cause of morbidity and mortality in RA. We compared demographic and clinical characteristics of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) patterns in RA patients and determined the prognostic factors that influence the survival of RA-ILD patients. METHODS: 51 enrolled RA patients (male n=21, female n=30) with ILD underwent HRCT. We categorized ILD into two groups, as the UIP pattern and the NSIP pattern, using HRCT. HRCT scans were scored to investigate the extent of the ILD. We divided the extent of the interstitial lung disease into 4 groups 1~14%, 15~19%, 20~24%, >25%. RESULTS: There were no significant differences between the UIP and NSIP pattern in the clinical characteristics, except for age at the time of the study (RA-NSIP pattern vs RA-UIP pattern 62.3+/-11.7 vs 68.2+/-8.4, p=0.042). There were no significant differences in survival time between the RA-UIP and RA-NSIP pattern (Log rank p=0.985). The extent of ILD on chest HRCT was significantly associated with mortality (HR=1.044, 95% CI 1.019~1.069) and patients that were diagnosed with ILD at an older age (HR=1.109, 95% CI 1.024~1.200) were associated with a worse prognosis. Comparing four groups divided by the extent of the lung disease, there were significant differences in survival estimates (Log-rank p-value<0.001) based on an ILD extent of 15%. CONCLUSION: Our study reveals that the extent of ILD on chest HRCT was found to be significantly associated with poor prognosis of RA-ILD patients.

A Case of Postural Orthostatic Tachycardia Syndrome Associated with Migraine and Fibromyalgia

Postural orthostatic tachycardia syndrome (POTS) refers to the presence of orthostatic intolerance with a heart rate (HR) increment of 30 beats per minute (bpm) or an absolute HR of 120 bpm or more. There are sporadic reports of the autonomic nervous system dysfunction in migraine and fibromyalgia. We report a case of POTS associated with migraine and fibromyalgia. The patient was managed with multidisciplinary therapies involving medication, education, and exercise which resulted in symptomatic improvement. We also review the literature on the association between POTS, migraine, and fibromyalgia.

Pandemic H1N1 Influenza Vaccination Responses in Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients

OBJECTIVE: We investigated the efficacy and safety of pandemic H1N1 vaccine in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) patients, and evaluated its correlation with serum cytokine level. METHODS: A total of 43 RA patients and 31 SLE patients were enrolled in the study and were compared with age, sex-matched 40 healthy controls (HC). The blood samples drawn from selected patients before vaccination and in post-vaccination at week 4 were assayed in one session to measure the titers of antibodies against haemagglutinin specific for influenza virus strains: A/California/7/2009 NYMC X-179A (H1N1). Serum IL17 and CXCL13 levels were measured in the same session by enzyme-linked immunosorbent assay. The association of serum cytokine level with anti-influenza antibody titer and mean fold increase (MFI) was investigated. Each specific side effect after vaccination was monitored in both the patients and control groups. RESULTS: The geometric mean antibody titer (GMT) for pre- and post-vaccination at week 4 was not significantly different between RA and HC, SLE and HC. The seroconversion rate in HC and RA was not significantly different, whereas the seroprotection rate is significantly higher in HC (82.5%) than RA (55.8%) (p<0.05). MFI in HC, RA, SLE were 19.65, 6.00 and 6.06, which were significantly higher in HC. Serum IL17 level was 6.28+/-2.89 pg/mL and 7.56+/-3.34 pg/mL in pre-, post-vaccination SLE patients, 33.85+/-15.62 pg/mL and 38.04+/-18.60 pg/mL in RA patients and was significantly lower in SLE patients. Serum CXCL13 level was 518.73+/-720.29 pg/mL and 431.53+/-601.23 pg/mL in pre-, post-vaccination SLE patients, which was significantly higher than HC (149.64+/-248.81 pg/mL and 147.36+/-213.92 pg/mL in each pre-, post-vaccination) and was not significantly different with the level of RA patients. In SLE patients, significant correlations were detected between cytokine level and post-vaccination antibody titer (r=0.22 p=0.026 between IL 17 and GMT; r=0.44, p<0.05 between CXCL13 and GMT). CONCLUSION: The increase in post-vaccination antibody titer is weaker in both RA and SLE patients group than the HC group. Post-vaccination antibody titer was positively correlated with B lymphocyte chemoattractant and CXCL13 in SLE patients, but not in RA patients.

Remission of Lymphocytic Interstitial Pneumonia in Sjogren's Syndrome after Autologous Peripheral Blood Stem Cell Transplantation

Interstitial pneumonia occurs in approximately 25% of patients with primary Sjogren's syndrome. Interstitial pneumonia combined with primary Sjogren's syndrome usually responds well to systemic steroids, and fatal cases are rare. Lymphocytic interstitial pneumonia shows diffuse infiltration of polyclonal B and T cells. Autologous stem cell transplantation is performed in cases of primary Sjogren's syndrome as an optional treatment when the condition responds poorly to conventional treatment. The hypothesis that primary Sjogren's syndrome improves after transplantation relies on the role of B-cell abnormalities in pathogenesis or the strong effects of immunosuppressive therapy. We experienced the case of a patient diagnosed with primary Sjogren's syndrome and lymphocytic interstitial pneumonia progression refractory to conventional treatment (steroid and immunosuppressive drugs) and cyclophosphamide pulse therapy. Our patient demonstrated improvement of lung manifestations and autoimmune disease activity after autologous stem cell transplantation.

Moraxella Meningoencephalitis: Case Report and Review of the Literature

Moraxella is an aerobic, Gram-negative coccobacillus, which is rarely associated with serious and invasive infections. Because of its rarity, the clinical significance and appropriate therapy for infections due to Moraxella are not well understood. We report a case of meningoencephalitis caused by Moraxella. The patient presented with fever and confusion and was successfully treated with beta-lactam and aminoglycoside antibiotics. We also review 8 previously published cases of Moraxella meningitis or meningoencephalitis.

Intracranial Vasculopathy in a Patient with Systemic Sclerosis: Atherosclerotic or Moyamoya-Like Disease?

No abstract available.

Clinical observation of the diabetes mellitus control and tuberculosis treatment

No abstract available.

Analysis of medical care content in a family physician clinic

No abstract available.