Clinical and Radiological Features of Korean Patients With Anti-HMGCR Myopathy

Background@#and Purpose To understand the characteristics of Korean patients with anti-3-hydroxy-3-methylglutaryl-coenxyme A reductase (HMGCR) myopathy, we measured antiHMGCR antibodies and analyzed the clinical, radiological, and pathological features of patients with anti-HMGCR myopathy. @*Methods@#We measured titers of anti-HMGCR antibodies in the sera of 99 patients with inflammatory myopathy, 36 patients with genetic myopathy, and 63 healthy subjects using an enzyme-linked immunosorbent assay. We tested 16 myositis-specific autoantibodies (MSAs) in all patients with anti-HMGCR myopathy. @*Results@#Positivity for the anti-HMGCR antibody was observed in 17 (4 males and 13 females) of 99 patients with inflammatory myopathy. The median age at symptom onset was 60 years.Ten (59%) of the patients with anti-HMGCR positivity had taken statins. The titer of antiHMGCR antibodies was significantly higher in the statin-naïve group (median=230 U/mL, interquartile range=170–443 U/mL) than in the statin-exposed group (median=178 U/mL, interquartile range=105–210 U/mL, p=0.045). The most common symptom was proximal muscle weakness in 15 patients (88%), followed by myalgia in 9 (53%), neck weakness in 4 (24%), dysphagia in 3 (18%), and skin lesions in 2 (12%). The median titer of anti-HMGCR antibody was 202 U/mL. We found eight different MSAs in nine (53%) patients. The median disease duration from symptom onset to diagnosis was significantly shorter in the MSA-positive group than in the MSA-negative group (p=0.027). @*Conclusions@#Our study was the first to measure anti-HMGCR antibodies in inflammatory myopathy. It has provided new findings, including the suggestion of the coexistence of other MSAs in Korean patients.

Inhibitory effects of persimmon (Diospyros kaki Thumb.) against diet-induced hypertriglyceridemia/hypercholesterolemia in rats / 한국영양학회지

PURPOSE: This study aimed to investigate the potential of freeze-dried persimmon powder (Diospyros kaki Thumb.) to protect against dyslipidemia induced by a high-fat/cholesterol diet (HFD) in a rat model. METHODS: Fifty Wistar rats were randomly divided into five groups: normal control (NC), high-fat/cholesterol control (HC), tannin in HFD (HT, 1% of diet), immature persimmon in HFD (HI, 7% of diet), and mature persimmon in HFD (HM, 7% of diet). Tannin was used as a positive control. Biochemical, molecular, and histopathological changes were observed in the blood and liver. RESULTS: We confirmed that a high fat/cholesterol diet successfully induced dyslipidemia, which was characterized by significantly altered lipid profiles in the plasma and liver. However, oxidized low-density lipoprotein levels, histopathological damage in the liver, and hepatic triglyceride levels were significantly reduced in all HT, HI, and HM groups compared to those in the HF group. In contrast, plasma apolipoprotein B level was significantly reduced only in the HT and HM groups, whereas reduction of the LDL-C level was detected only in the HI group. Although HF-induced sterol regulatory element-binding protein (SREBP) gene expression was significantly reduced in all treated groups, downstream gene expression levels varied among the different groups; significant reduction of fatty acid synthase (FAS) and 3-hydroxy-3-methylglutaryl-CoA (HMGCR) gene expression was detected only in the HI group, whereas cholesterol 7α-hydroxylase (CYP7A1) gene expression was significantly elevated only in the HM group. CONCLUSION: Taken together, the data suggest that protection of LDL oxidation and hepatic lipogenesis might be, at least partly, attributed to tannin in persimmons. However, the identified mechanisms varied up to the maturation stage of persimmon. In the case of immature persimmon, modulation of FAS and HMGCR gene expression was prominent, whereas in the case of mature persimmon, modulation of CYP7A1 gene expression was prominent.

Evaluation of Azithromycin Prescriptions for Pediatric Patients

BACKGROUND: Azithromycin has broad spectrum and is effective to treat several bacterial respiratory tract infection. It is also relatively safe and tolerable to pediatric patient. Careful use of azithromycin is also required for the prescribers because it could cause cardiovascular toxicity (QTc prolongation) and ototoxicity. There has been no study on duration of azithromycin use in pediatric patients in Korea. METHODS: The outpatient sample data on the azithromycin prescription was obtained from Korean health insurance review and assessment service. The characteristics of azithromycin prescription were analyzed with two different years (2011 and 2014). RESULTS: Total 4,215 cases were analyzed. The azithromycin was prescribed the most frequently in the children (73.2% in 2011 and 62.5% in 2014) and for the condition of bronchopneumonia (28.7% in 2011 and 21.7% in 2014) in both years. The duration of prescribed for azithromycin has significantly different between 2011 and 2014. In 2014, 94.3% of prescription were indicated less than 5 days, but 86.6% were in 2011. Acute bronchiolitis and bronchopneumonia prescriptions more longer duration of treatment compared with acute bronchitis and others. CONCLUSION: The pattern of prescribing azithromycin has been changed for the treatment of several infectious diseases in pediatric patients. The rate of appropriate duration of azithromycin treatment has increased.