Vitamin D regulation of adipogenesis and adipose tissue functions

Vitamin D insufficiency is associated with obesity and its related metabolic diseases. Adipose tissues store and metabolize vitamin D and expression levels of vitamin D metabolizing enzymes are known to be altered in obesity. Sequestration of vitamin D in large amount of adipose tissues and low vitamin D metabolism may contribute to the vitamin D inadequacy in obesity. Vitamin D receptor is expressed in adipose tissues and vitamin D regulates multiple aspects of adipose biology including adipogenesis as well as metabolic and endocrine function of adipose tissues that can contribute to the high risk of metabolic diseases in vitamin D insufficiency. We will review current understanding of vitamin D regulation of adipose biology focusing on vitamin D modulation of adiposity and adipose tissue functions as well as the molecular mechanisms through which vitamin D regulates adipose biology. The effects of supplementation or maintenance of vitamin D on obesity and metabolic diseases are also discussed.

Factors Influencing the Experience of Depression among School-aged Children from Multicultural Families

PURPOSE: The purpose of this study was to investigate factors affecting the experience of depression in school-aged children from multicultural families. METHODS: Data from 1,812 school-aged children of multicultural families were collected from the 2015 National Multicultural Family Survey. Logistic regression was conducted based on complex sample analysis using SAS 9.4. RESULTS: Significant predictors for experiencing depression were lower self-esteem, lower Korean proficiency, less time spent conversing with the father, lower degree of parental interest, poorer school adjustment, greater difficulties with schoolwork, and experiencing violence at school. CONCLUSION: This study showed that factors related to the individual, family, and school environment influenced the experience of depression. Based on a consideration of these factors, it is necessary to develop an effective program to prevent depression by establishing high-risk criteria for depression.

Ectopic Pancreas Bleeding in the Jejunum Revealed by Capsule Endoscopy

Ectopic pancreas is defined as pancreatic tissue found outside the usual anatomic location. It is often found incidentally at different sites in the gastrointestinal (GI) tract. The incidence of ectopic pancreatic tissue in autopsy series is 1% to 2%, with 70% of the ectopic lesions found in the stomach, duodenum and jejunum. Although it is usually a silent anomaly, an ectopic pancreas may become clinically evident when complicated by inflammation, bleeding, obstruction or malignant transformation. We report a case of ectopic pancreas located in the jejunum and presenting as an obscure GI bleeding, which was diagnosed by capsule endoscopy.

A Case of Abdominal Actinomycosis Presenting as Ileocecal Ulcers and Recurrent Lower Gastrointestinal Bleeding

Abdominal actinomycosis is a rare chronic suppurative infection that is difficult to diagnose precisely without an operation. It also tends to be misdiagnosed as a malignancy, intestinal tuberculosis, diverticular disease, or Crohn's disease. A 54-year-old man presented with loose stools, hematochezia, and vague abdominal pain in the right lower quadrant. He had had a history of hematochezia and recurrent colon ulcers on colonoscopy seven times within the past 3 years. A colonoscopy at admission revealed multiple, variably sized and shaped ulcerations in the terminal ileum, cecum, and ascending and transverse colons. Biopsies from the cecal ulcer demonstrated sulfur granules. This is the first cases of abdominal actinomycosis presenting as a recurrent lower gastrointestinal hemorrhage due to ileocolic ulcerations in Korea.

Simvastatin inhibits sphingosylphosphorylcholine-induced differentiation of human mesenchymal stem cells into smooth muscle cells

Sphingosylphosphorylcholine (SPC) induces differentiation of human adipose tissue-derived mesenchymal stem cells (hASCs) into smooth muscle-like cells expressing alpha-smooth muscle actin (alpha-SMA) via transforming growth factor-beta1/Smad2- and RhoA/Rho kinase-dependent mechanisms. 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) have been known to have beneficial effects in the treatment of cardiovascular diseases. In the present study, we examined the effects of simvastatin on the SPC-induced alpha-SMA expression and Smad2 phosphorylation in hASCs. Simvastatin inhibited the SPC-induced alpha-SMA expression and sustained phosphorylation of Smad2 in hASCs. SPC treatment caused RhoA activation via a simvastatin-sensitive mechanism. The SPC-induced alpha-SMA expression and Smad2 phosphorylation were abrogated by pretreatment of the cells with the Rho kinase inhibitor Y27632 or overexpression of a dominant negative RhoA mutant. Furthermore, SPC induced secretion of TGF-beta1 and pretreatment with either Y27632 or simvastatin inhibited the SPC-induced TGF-beta1 secretion. These results suggest that simvastatin inhibits SPC-induced differentiation of hASCs into smooth muscle cells by attenuating the RhoA/Rho kinase-dependent activation of autocrine TGF-beta1/Smad2 signaling pathway.

Expressional Difference of RHEB, HDAC1, and WEE1 Proteins in the Stromal Tumors of the Breast and Their Significance in Tumorigenesis

BACKGROUND: Fibroadenoma (FA) and phyllodes tumor (PT) are stromal tumors of breast and are histologically similar. There are no established differences in tumorigenesis and oncogene expression among them. Ras homolog enriched in brain (RHEB) plays an important role in cell growth and cell-cycle control, histone deacetylase 1 (HDAC1) is an important factor in breast tumor progression and prognosis, and WEE1 homolog (WEE1) functions as a tumor suppressor. No studies on the expressional differences of these proteins in FA and PT have been reported to date. METHODS: The expression of these proteins in FA, PT, and normal breast was compared. We used 102 cases of FA and 25 cases of benign PT. RESULTS: In epithelial cells, the expression of RHEB, HDAC1, and WEE1 was lowest in PT, higher in FA, and most enhanced in normal breast. In addition, the expression of RHEB and HDAC1 was higher in the stromal cells of PT than in FA and normal breast. CONCLUSIONS: Both epithelial and stromal cells of FA and PT express these proteins, which indicates that epithelial cells play an important role in the development of stromal tumors. In addition, the expressional differences of these proteins may be associated with the tumorigenesis of breast stromal tumors.

Ipsilateral Tilt and Contralateral Sensory Change of Neck in Cortical Infarction

BACKGROUND: Numerous neck muscles are involved in neck movements, and so isolated neck weakness is extremely uncommon in cerebral infarction. CASE REPORT: We report herein the case of a 65-year-old woman with hypertension and acute cortical infarction, presenting with ipsilateral head tilt and contralateral sensory changes in the neck and shoulder area, which has never been described before. CONCLUSIONS: Transient neck weakness and sensory deficits can occur in acute cortical infarction. The motor representation of the neck muscles can be at the same level of the cortical sensory representation, near to the level of the trunk representation, which is in contrast to Penfield's findings. Several possible mechanisms for the ipsilateral tilt are described.

Association between Genetic Polymorphisms of CYP2D6 and Outcomes in Breast Cancer Patients with Tamoxifen Treatment

The aim of the study was to evaluate the association between genetic polymorphisms of CYP2D6 and outcomes in breast cancer patients with tamoxifen treatment. We evaluated the CYP2D6 genetic polymorphisms in 766 breast cancer patients. Among them, 110 patients whose samples were prospectively collected before surgery and treated with tamoxifen were included to evaluate the association between CYP2D6 and outcomes. The genotypes of CYP2D6 were categorized as extensive metabolizer (EM), intermediate metabolizer (IM), and poor metabolizer (PM) according to the activity score. The clinicopathologic features of 110 patients were not significantly different among the three groups except for the T-stage and nodal status. The high T-stage and axillary metastasis were more frequent in the PM group. While recurrence-free and overall survival in the PM group was poorer than the other groups, there was no significant difference between the EM and the IM group. The difference between the PM and the other groups on univariate analysis disappeared on multivariate analysis. These conflicting results suggest that the clinical value of CYP2D6 polymorphisms is still unclear and more large-sized and comprehensively designed trials are necessary.

Spontaneous Visceral Artery Hemorrhage in a Patient with Systemic Lupus Erythematosus Combined with Antiphospholipid Syndrome: A Case Report / 대한류마티스학회지

Spontaneous visceral hemorrhage is a rare complication of systemic lupus erythematosus (SLE). We report here on a 55-year old male with SLE and who presented with acute abdominal pain due to bleeding of the hepatic artery and the splenic artery. Angiography revealed a spontaneous hemorrhage from branches of the hepatic artery and the splenic artery. We report here on a case of spontaneous recurrent non-traumatic hemorrhage of a visceral artery in a patient with secondary antiphospholipid syndrome (APS), and such a condition has not been previously described in a Korean patient with SLE.

Early MRI Findings in a Patient With Klebsiella Pneumoniae Cerebritis

No abstract available.

Thromboxane A2 modulates migration, proliferation, and differentiation of adipose tissue-derived mesenchymal stem cells

Prostanoid metabolites are key mediators in inflammatory responses, and accumulating evidence suggests that mesenchymal stem cells (MSCs) can be recruited to injured or inflamed tissues. In the present study, we investigated whether prostanoid metabolites can regulate migration, proliferation, and differentiation potentials of MSCs. We demonstrated herein that the stable thromboxane A2 (TxA2) mimetic U46619 strongly stimulated migration and proliferation of human adipose tissue-derived MSCs (hADSCs). Furthermore, U46619 treatment increased expression of alpha-smooth muscle actin (alpha-SMA), a smooth muscle marker, in hADSCs, suggesting differentiation of hADSCs into smooth muscle-like cells. U46619 activated ERK and p38 MAPK, and pretreatment of the cells with the MEK inhibitor U0126 or the p38 MAPK inhibitor SB202190 abrogated the U46619-induced migration, proliferation, and alpha-SMA expression. These results suggest that TxA2 plays a key role in the migration, proliferation, and differentiation of hADSCs into smooth muscle-like cells through signaling mechanisms involving ERK and p38 MAPK.

A case of CMV-induced gastric ulcer / 대한내과학회지

A 59-year-old female with breast cancer, who had been treated with cancer chemotherapy and radiotherapy, visited the hospital with a 2-week history of epigastric pain. Upper gastrointestinal endoscopy showed multiple ulcers with gastric hypertrophy. In the biopsy specimen, no malignant cells were observed, but some cells were positive on immunochemistry examination for cytomegalovirus (CMV). Ganciclovir was administered for 2 weeks. Her symptoms improved and the immunochemistry finding of a subsequent gastric mucosal specimen was negative. However, the lumen of the gastric antrum was too narrow for the endoscope to pass the pylorus easily. A gastric perforation resulted and was treated with total gastrectomy and esophagojejunostomy, while an endoscopic stent was inserted to allow oral intake. Here, we report a case of gastric ulcer resulting from CMV infection and stenosis as a complication in an immunosuppressant patient.

The Prognostic Significance of Survivin Expression in Breast Cancer / 한국유방암학회지

PURPOSE: Survivin is a member of the inhibitors of apoptosis family. It has recently comes into the limelight as a promising tumor marker, but many previous reports have shown controversial results regarding the significance and prognostic value of a survivin expression. In this study we determined the correlation between the survivin expression and the conventional prognostic markers and we also investigated the outcomes according to the localization of the survivin expression. METHODS: Tissue microarray (TMA) blocks were made with formalin-fixed paraffin-embedded tissues from 185 breast cancer patients and the immunohistochemical staining was done using an anti-survivin antibody. Among these, 157 patients were available for a survivin expression. The conventional clinicopathologic features and overall survival were correlated with the localization of the survivin expression. RESULTS: Survivin was expressed in 101 breast cancers (64.3%). A higher cytoplasmic survivin expression were noted in the older group (p=0.003), in the node-negative cancers (p=0.012), in the earlier tumor stages (p=0.012) and in the cancers that had not been treated with adjuvant chemotherapy (p=0.014). On the contrary, a higher nuclear survivin expression was inversely correlated with an estrogen expression (p=0.006) and a progesterone receptor (p=0.043) expression. In terms of survival, a cytoplasmic expression was associated with improved overall survival (p=0.01) but a nuclear survivin expression was correlated with unfavorable overall survival (p=0.002). A high cytoplasmic to nuclear ratio of survivin was associated with improved overall survival (p=0.001) conversely, increased nuclear to cytoplasmic survivin ratio was correlated with unfavorable overall survival (p<0.0001). Multivariate analysis revealed that nuclear survivin expression (p=0.001) and high nuclear to cytoplasmic survivin ratio (p=0.012) were independent predictor of overall survival. CONCLUSION: Survivin is frequently expressed in primary breast cancer. A cytoplasmic survivin expression is a good prognostic predictor for patients with axillary node negative early breast cancers and a nuclear survivin expression is a worse independent predictor of overall survival for patients with axillary node positive breast cancers.

Analysis of Recognized Changes in Performance and Organizational Environment by Dietitians Transposed to Nutrition Teachers in Gyeonggi Province

This study was conducted to gather basic data on the tasks and roles of nutrition teachers by analyzing the changes inwork importance, performance frequency, and organizational environment after dietitians were transposed to nutrition teachers. E-mail surveys were sent to 100 newly assigned nutrition teachers who previously served as dietitians in Gyeonggi province. A total of 72 teachers responded to the survey. The respondents were asked the importance and frequency of 9 work-related duties performed as a dietitian and nutrition teacher, respectively. They were also surveyed regarding their satisfaction perceptions for 5 organizational changes. The majority of respondents were 36 to 40 years old (48.6%) and had 10~20 years of work experience (58.3%). Significant differences were found for work importance after changing to the role of nutrition teacher (p<0.001). In addition, work performance frequency differences were found for the categories of nutrition education, nutrition counseling, and dietary guidance. These results were attributable to the differences in work importance and performance frequency by now being a nutrition teacher rather than a dietitian. The respondents had increased satisfaction levels after changing from dietitian to nutrition teacher (p<0.001) in terms of 'pride for change in work', 'satisfaction level for pay', and 'satisfaction level for change in the organizational environment'. In order for nutrition teachers to have effective work performance, 'personal capabilities' and 'school manager support' should be coordinated. Overall, the results of this study suggest that effective training programs should be developed for nutrition teachers they can effectively complete newly assigned work tasks.

Function and Environmental Factors Analysis using ICF (International Classification of Functioning, Disability and Health) for People with Disabilities

OBJECTIVE: To evaluate the clinical usefulness of ICF (International Classification of Functioning, Disability and Health) through correlation among existing functional evaluation tools and examined environmental factors affecting its function. METHOD: One hundred eight persons with disabilities living in Seoul were randomly selected according to disability severity categories. Functional Independence Measure (FIM), modified Barthel index (MBI) and ICF were examined and subjects were interviewed by trained rehabilitation doctors and occupational therapists. We compared correlation between these three functional measurements. We coded environmental factors affecting function. That was used in second level of 74 ICF items. RESULTS: The average of FIM, modified Barthel index, capacity and performance scores of ICF was 112.76, 92.97, 5.74 and 3.19. There was a statistical correlation among FIM, Barthel index, and ICF. The facilitator chapters among ICF's environmental factors were support and relationships (51.9%), attitudes (45.8%) in order. Most facilitated second level domains among the 68 items were immediate family (66.77%) and health professionals (52.8%). The most barrier chapters in ICF were product and a technology (19.5%), environment changes (15.5%) in order. Most barrier second level domains were design, construction and technology of buildings for public use (37%) and assets (37.0%). CONCLUSION: ICF correlates with the existing functional evaluation tool and can facilitate management of activity and participation by linking the result with the environmental factors, which may exacerbate or minimize them

Changes of Coregulators, MAP Kinase Activity and p27/kip1 with Estrogen or Antiestrogen Treatment in Breast Cancer Cell Line / 한국유방암학회지

PURPOSE: Estrogen, various polypeptide hormones and growth factors are associated with the development and progression of breast cancer. Coregulatory proteins are also associated with estrogen receptor (ER) transcriptional activity and tamoxifen resistance. Therefore, it is necessary to investigate the change of coregulator mRNAs and various cell proliferation proteins and cell cycle-related proteins after treatment with estrogen or antiestrogen. METHODS: MCF-7 cells were maintained in dextran-coated charcoal stripped 10% Dulbecco's Modified Eagle Medium (DMEM). To measure the change of the coactivators' (src-1, P/CAF, CBP, AIB1) mRNAs and corepressors' (SMRT, N-coR) mRNAs, multiple PCR was carried out using specific primers. In addition, intracellular proteins related to cell proliferation and cell cycle regulation were measured by performing Western blotting after treatment with estrogen or tamoxifen. The change of mitogen activated protein kinases was also measured by performing Western after tamoxifen treatment for 4 weeks. RESULTS: Coactivator mRNAs expression rapidly decreased in 15 min after estrogen treatment but this recovered to the initial level in 3 hr. The pattern was similar for the case of tamoxifen treatment. Corepressor mRNAs expression rapidly decreased in 15 min after estrogen treatment and it remained at a lower level until 24 hr after estrogen treatment. With tamoxifen treatment, the initial response was similar to the cases of estrogen treatment, but the xpression gradually increased 3 hr after tamoxifen treatment. Treatment of estrogen induced intracellular concentrations of c-myc and Ki-67 and it increased nuclear translocation of NF-kappaB and phosphor-ERK and it decreased the intracellular cell cycle suppressor p27/kip1. Tamoxifen treatment increased nuclear p27/kip1 but it decreased c-myc, NF-kappaB and phosphor-ERK. Long-term (4 weeks) treatment of tamoxifen was associated with decrease of activated ERK and p38 but there was no change in phospho-Akt level. CONCLUSION: Estrogen induced cell proliferation and the survival pathway-related factors, but it decreased the cell cycle suppressor p27/kip1. Long-term treatment with antiestrogen tamoxifen might decrease the MAPK activities in ERalpha-expressing tumor cells.

Comparative Analysis of Dietitians' and Cooks' Performance for Equipment Sanitation Management at School Foodservices in Gyeonggi Province

The purpose of this study was to compare dietitians' with cooks' actual sterilization performance for improving points of sanitation practices of cooking instruments and facilities in Kyonggi Province school foodservices. A total of 400 questionnaires were mailed to the dietitians and the cooks at elementary and middle schools in Kyonggi Province. Finally, 140 dietitians and 140 cooks replied by making a total of 280 replies(70%). The results of this study found that the cooks' attitudes toward the sterilization of the vegetable cutter body, multiple shelf, and distributing cart showed higher frequencies than the dietitians'. Cooks disinfected the vegetable cutter blade, multiple shelf, distributing cart, cook's aprons, and 'L' transporting cart better than dietitians' guides expected. In the sterilization method, cooks performed better than indicated when cooking with rubber gloves. The most difficult thing in dietitians' managing sterilization was the lack of cooking facilities and instruments. They strongly demanded the detailed explanatory notes according to their own Cities and Provinces and the circumstantial manual of disinfection parts in School Foodservice Sanitary Management Guide. There were possibilities of food-poisoning, infection and safety incidents due to the budgetary shortage of cooking facilities and instruments.

Nutritional Assessment of Geriatric Stroke Patients in a Rehabilitation Hospital

OBJECTIVE: It was aimed to evaluate the nutritional status of geriatric stroke patients admitted to a convalescent and rehabilitation hospital and the clinical usefulness of the mini-nutritional assessment (MNA) to identify malnutrition in elderly stroke patients. METHOD: We performed a nutritional evaluation using the MNA questionnaire, anthropometric, haematological, and biochemical parameters in 30 stroke patients. Malnutrition was defined if there were abnormalities in at least one of the following parameters: serum values of albumin and transferrin, hemoglobin and total lymphocytes in blood, and body mass index. The sensitivity, specificity, and predictive values of MNA for malnutrition were assessed. RESULTS: The mean age of patients was 69.5 years and mean body mass index was 22.8 kg/m2. The prevalence of malnutrition was 46.7% while malnutrition or risk of malnutrition by MNA was 80%. The sensitivity, specificity, and positive/negative predictive values of MNA for malnutrition were respectively 92.9%, 31.3%, 54.2%, and 83.3% with a cutoff point lower than 23.5. There was a significant difference of hemoglobin value between malnourished and nourished group (p<0.05). CONCLUSION: Malnutrition was common in geriatric stroke patients. MNA was a useful screening tool to exclude nourished geriatric patients.

Surface roughness and microleakage of class V composite restorations : Effect of surface sealing / 대한치과보존학회지

The purpose of this study was to compare the effect of surface sealing materials on microleakage and surface roughness in Class V composite restorations. Twenty five standardized Class V cavity preparations were made on the facial surface of human premolars and were randomly assigned to 5 groups. The teeth were restored with Z-250 after applying Single Bond. Following 7 days storage in distilled water at 37degrees C, the restorations were sealed as following systems : No sealing ; Single Bond Adhesive ; Biscover ; Fortify ; Optiguard. Then, toothbrush abrasion test was conducted using a wear testing machine. Surface roughness was measured by means of profilometer before and after toothbrushing and the results were statistically analysed by using a paired t-test and ANOVA. The bonded interfaces and the changes of surface roughness were examined by SEM. For microleakage test, specimens were stained in a 2% methylene blue solution, then longitudinally sectioned and analyzed for leakage at occlusal and cervical interfaces using stereomicroscope. The results were statistically analysed by using a Kruskal-Wallis and Mann-Whitney U test. Surface roughness was increasing in all groups after toothbrushing, but no statistically significant differences. In SEM observation, surface sealant was partially retained and partially detached in bonded interfaces. Especially, microgap was identified in cervical margins. In microleakage test, there was better seal in the enamel region and a significant difference between groups at occlusal margin. Control group and Single Bond group had significantly better marginal seal at enamel margin than cervical margin.

An in-vitro evaluation of sealer placement methods in simulated root canal extensions / 대한치과보존학회지

The aim of this study was to evaluate the effectiveness of sealer placement in simulated root canal extensions. Forty resin blocks were attained from the Endo-training Bloc. In each block, the simulated root canal was made with #20, 08taper GT file. After each block was longitudinally split into two halves, a standardized groove was prepared on one canal wall of two halves to simulate the canal extensions with various irregularities. The two halves of each block were assembled and all simulated root canals were obturated by single cone method with AH26 sealer. Four different methods of sealer placement were used: group A, #20 K-file; group B, ultrasonic file; group C, lentulo spiral; group D, EZ-Fill bi-directional spiral. All obturated blocks were stored in 100% humidity at 37degrees C for 1 week. Using a low speed saw, each block was sectioned horizontally. Images of the sections were taken using a stereomicroscope at x 30 magnification and a digital camera. The amount of the sealer in the groove was evaluated using a scoring system, a higher score indicated better sealing effectiveness. The data was statistically analysed by Fisher's Exact Test. The sealing score was the lowest, specially at the middle area of canal extensions in group A, and that was statistically significant difference from other groups. In conclusion, the ultrasonic file, lentulo spiral and EZ-Fill bi-directional spiral were effective methods of sealer placement in simulated canal extensions. The K file was the least effective method, specially at the middle area of canal extensions.