Age-related Changes in the Sirtuin1-NFE2-related Factor 2 Signaling System in the Kidney / 대한내과학회지

BACKGROUND/AIMS: Renal aging-related changes are characterized by oxidative stress. SIRT1 regulates cellular conditions by activating Nrf2. The present study investigated the processes of renal changes by antioxidant enzymes and the relationship between SIRT1 and Nrf2. METHODS: We used male 2-, 12-, and 24-month-old C57BL/6 mice. We measured renal function, histological changes, oxidative stress, and expression of SIRT1–Nrf2 signaling in the kidneys. RESULTS: 24-month-old mice exhibited increased albuminuria and serum creatinine. Creatinine clearance was decreased in 24-month-old mice compared with 12-month-old mice. There were increases in mesangial volume and tubulointerstitial fibrosis in 24-month-old mice. Moreover, oxidative stress marker, 3-Nitrotyrosine, expression and apoptosis were increased in 24-month-old mice. The 24 h urinary 8-isoprostane and 8-hydroxy-deoxyguanosine excretion increased with aging. The levels of expression of SIRT1 and nuclear Nrf2 were decreased in 24-month-old mice. The antioxidant enzymes HO-1 and NQO-1 were down-regulated in 24-month-old mice. Another antioxidant enzyme, SOD2, was decreased in 24-month-old mice. CONCLUSIONS: Our results demonstrated that SIRT1 was down-regulated with aging, and this may be related to changes in the expression of target molecules including Nrf2. As a result, oxidative stress was induced. The pharmacological targeting of these signaling molecules may reduce the pathological changes associated with aging in the kidney.

Erratum: Age-related Changes in the Sirtuin1-NFE2-related Factor 2 Signaling System in the Kidney / 대한내과학회지

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Findings of Cardiac Magnetic Resonance Imaging in Hypertrophic Cardiomyopathy after 16 Years

A 58-year-old man had been diagnosed with non-obstructive hypertrophic cardiomyopathy (HCMP) according to echocardiography findings 16 years ago. Echocardiography showed ischemic cardiomyopathy (CMP)-like features with decreased systolic function but a non-dilated chamber. Coronary angiography was performed but showed a normal coronary artery. Cardiac magnetic resonance imaging (MRI) revealed multifocal transmural and subepicardial delayed-enhancing areas at the anteroseptal, septal, and inferoseptal left ventricular (LV) wall, and wall thinning and decreased motion of the anteroseptal LV wall. Findings of ischemic CMP-like features by echocardiography suggested microvascular dysfunction. This late stage of HCMP carries a high risk of sudden death. Cardiac MRI evaluation may be necessary in cases of ischemic CMP-like features in HCMP. In this case, the diagnosis of end-stage HCMP with microvascular dysfunction was confirmed by using cardiac MRI after a follow-up period of more than 16 years.

Prevalence and Clinical Characteristics of Noncardiac Chest Pain with Reflux Esophagitis in Korea

BACKGROUND/AIMS: Noncardiac chest pain (NCCP) is substernal, squeezing chest pain, unrelated to the cardiac problem. Our study aimed to define the prevalence and clinical characteristics of reflux esophagitis in NCCP patients in Korea. MATERIALS AND METHODS: We reviewed medical records of patients who visited Department of Cardiology, St. Paul's Hospital due to chest pain and had normal coronary arteriography and who had received endoscopy within 6 months. Patients diagnosed with peptic ulcer or gastric cancer were excluded. The patients were classified into two groups according to their endoscopic results; the reflux esophagitis group and the control group. RESULTS: Two hundred seventeen NCCP patients were enrolled and 96 patients (44.2%) were diagnosed with reflux esophagitis: 68 patients (31.3%) with minimal change esophagitis; 26 patients (12.0%) with Los Angeles (LA) grade A; 2 patients (0.9%) with LA grade B. There were no patients with severe erosive reflux disease. There were no significantly different characteristics in the reflux esophagitis group and the control group. CONCLUSIONS: The prevalence of reflux esophagitis in NCCP patients in Korea was 44.2%. Most patients had mild reflux esophagitis.

Common Bile Duct Angiosarcoma / 대한췌담도학회지

Angiosarcoma is a very rare form of neoplasm derived from soft tissue. It is reported even more rarely in hepatobiliary system. Because of its nonspecific symptoms and difficulty in diagnosis, angiosarcoma is often presented in a progressed state and often results in poor prognosis. To our best knowledge, there has been no report regarding angiosarcoma in common bile duct worldwide. We report a case of 77-year-old-woman presented with right upper abdominal pain diagnosed as angiosarcoma in common bile duct.

Choroidal Metastasis from Colon Cancer Treated with Palliative Radiotherapy / 대한내과학회지

Choroidal metastasis from colorectal cancer is very rare and has not been reported before in Korea. We report a case of eye hyperemia and discomfort in a patient with advanced colon cancer. Orbit magnetic resonance imaging and positron emission tomography revealed an enhancing mass within the temporal side of the left orbit, suggestive of choroidal metastasis from the colorectal adenocarcinoma. The condition's rarity may be due to the long and distant pathway from the colon to the orbit. The presentation usually suggests extensive hematogeneous cancer dissemination and a poor prognosis. However, palliative radiotherapy may be an effective treatment for choroidal metastasis.