Adipokines, adipocyte-derived protein, have important roles in various kinds of physiology including energy homeostasis. Chemerin, one of adipocyte-derived adipokines, is highly expressed in differentiated adipocytes and is known to induce macrophage chemotaxis and glucose intolerance. The objective of the present study was to investigate the changes of chemerin and the chemokine-like-receptor 1 (CMKLR1) gene expression levels during differentiation of the bovine adipocyte and in differentiated adipocytes treated with tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), adiponectin, leptin, and chemerin (peptide analog). The expression levels of the chemerin gene increased at d 6 and 12 of the differentiation period accompanied by increased cytoplasm lipid droplets. From d 6 onward, peroxisome proliferator-activated receptor-${\gamma}2$ (PPAR-${\gamma}2$) gene expression levels were significantly higher than that of d 0 and 3. In contrast, CMKLR1 expression levels decreased at the end of the differentiation period. In fully differentiated adipocytes (i.e. at d 12), the treatment of TNF-${\alpha}$ and adiponectin upregulated both chemerin and CMKLR1 gene expression levels, although leptin did not show such effects. Moreover, chemerin analog treatment was shown to upregulate chemerin gene expression levels regardless of doses. These results suggest that the expression of chemerin in bovine adipocyte might be regulated by chemerin itself and other adipokines, which indicates its possible role in modulating the adipokine secretions in adipose tissues.
The aim of this study was to evaluate the association between obesity and periodontal diseases in Korea adults. The date from the 2015 Korean National Health and Nutrition Survey were used, and 4,827 subjects over 19 years were included in the analysis. Periodontal disease was assessed using the Community Periodontal Index. Obesity was measured according to body mass index. Odd ratios (ORs) were estimated using binary logistic regression analysis model. The stratification variables were smoking and diabetes, and also adjusted for sex, age, and education level. The adjusting variables included sex, age, and education level. The ORs of obesity for periodontal disease were 0.78 (95% CI = 0.51-1.22) for the category of <18.5 of BMI and 1.29 (95% CI = 1.11-1.49) for the ${\geq}25$ BMI category (both compared to the 18.5 to 24.9 category). In a subgroup analysis, the OR of BMI among those who were both non-smoking and no diabetes was 1.20 (95% CI = 1.02-1.48) for those with BMI levels ${\geq}25$. This study implies that obesity intolerance may be an independent risk factor for periodontal diseases. Obesity should also be considered when managing periodontal disease to improve oral health.
Purpose : The problems of late deterioration of sensation and a double sensibility phenomenon are a known deficiency of the original neurovascular island flap. To eliminate this problems, the authors was performed to assess the results of Thumb-pulp loss reconstruction with a heterodigital neurovascular island Flap Using a Nerve Disconnecting-Reconnecting Technique Material and Methods : Between July. 1987 and November. 2000, we have used a disconnecting-reconnecting technique for heterodigital island flaps in which divided nerve of the transferred island flap is sutured to original nerve of the thumb in 9 patients. 9 patients with a mean follow-up period of 3.6 years were examined, while 7 patients were follow-up for 2years or more. Evaluation of results was based on flap quality, donor site quality, classic two-point sensory discrimination(2PD), and location of sensation(double sensibility), donor site cold intolerance, neuroma formation, scar contractures, total active movement(TAM) of the thumb and donor digit and subjective results and objective results. Results : The two-point discrimination was average 6.7 mm. Donor site paresthesia was observed more frequently in a short postoperative period. Sensation was referred to the thumb in all cases and the recovery occurred over a period of a two months. There were no flap complication or failures and the length of the thumb tip was preserved in all cases. Conclusion : This technique was found to provide well-vascularized pulp of the thumb with proper cortical representation in one operative stage.
Purpose: This retrospective study was to determine the functional results of patients who were amputated of their fingertip between patients who were treated with replantation and patients who were treated with thenar flap. Materials and Methods: From 2004 to 2007, we identified and operated 159 patients who were diagnosed with fingertip amputations. Of 159 patients, Eighty-two patients were treated by replantation (67 in men and 14 in women) and the mean age at the operation was 41 years (range, 15-68 years). Seventy-nine patients was treated with thenar flap(54 in men and 25 in women) and the mean age at the operation was 43 years(range, 21-70 years). We compared variables between two groups including, age, gender, diagnosis, duration of hospital admission, grip strength, two-point discrimination, Semmes Weinstein monofilament test, active range of motion (ROM) of the proximal and distal interphalangeal (PIP and DIP) joint, pain (or tenderness), paresthesia, cold intolerance, the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and finger for activities of daily living (ADLs). Results: The duration of admission was longer in Replantation group than in Thenar flap group(p=0.001). However, the grip strength (p=0.003) and Semmes Weinstein monofilament test (p=0.029) in the Replanation group were statistically superior to the Thenar flap group. The average DASH disability (p=0.003)/symptom score (p=0.007) and ADLs (p<0.001) in the Replantation group was statistically better. In addition, cold intoleranace test of Thenar flap group is worse than the Replantation group. Conclusion: This study demonstrate that fingertip replantation have demonstrated not only to obtain the best appearance but also to gain better functional outcome. However, it is impossible to perform replatation, the thenar flap can be limited alternative method for fingertip amputation in aspect of preservation of range of motion and hospitalization time.
Objective: Graves' disease, the most common cause of primary hyperthyroidism, is a thyroid specific autoimmune disorder. When resistance to medication is shown in spite of long term therapy with anti-thyroid drugs, radioactive iodine therapy would be chosen in Western medicine. However, this therapy has often been reported to cause patients have hypothyroidism, thus requiring them to take levothyroxine for the rest of their lives. In this study, we evaluate the clinical efficacy and safety of Ahnjeonbaekho-tang (AJBHT) on patients with Graves' disease. Methods: We prescribed AJBHT for 3 months to two groups: patients who had been taking antithyroid drugs were administered AJBHT after discontinuing the antithyroid drugs ($Com-Tx{\rightarrow}Single-Tx$), and patients who had not been taking antithyroid drugs were started with AJBHT (Single-Tx) immediately. We evaluated the thyroidal function test (TFT) and visual analogue scale (VAS) for clinical symptoms for 3 months. Results: Serum T3 and fT4 were significantly decreased in both groups and remission rate of thyroidal hormones were significantly improved in the Single-Tx group. The clinical symptoms of palpitation, fatigue, and heat intolerance were significantly improved in both groups. In the safety analysis, all patients were in normal range of liver, renal function blood test and common blood count. Conclusion: From these results, we suggested that AJBHT was effective on TFT and clinical symptoms of Graves' disease. The study supports that AJBHT may be a useful agent for patients with Graves' disease who are resistant to antithyroid medication or radioactive iodine therapy, and for patients at first diagnosis.
An 8 month old female Maltese (body weight 3.6 kg) was referred with primary complaints of dyspnea and exercise intolerance. Diagnostic imaging studies revealed marked cardiomegaly and prominent main pulmonary trunk dilation on thoracic radiography, abnormally arisen aortic roots (toward right ventricle) with left-to right shunted perimembraneous ventricular septal defect located underneath of aortic root, aortic root was located to predominantly to the right ventricle and pulmonary regurgitation (peak velocity 4.7 m/s, pressure gradient ~88 mmHg) from pulmonary over-circulation and hypertension on echocardiography, indicating double outlet right ventricle (DORV). The dog was treated with furosemide (1 mg/kg, BID) for reducing volume overload at right ventricle, spironolatcone (1 mg/kg) and enalapril (0.5 mg/kg) for minimizing deleterious cardiac remodeling, and sildenafil (1 mg/kg) for lessening pulmonary over-circulation and hypertension. The clinical condition of this dog was improved after 1 week of medical treatment. The dog is currently survived and regularly monitored.
A 2-month-old intact male Pitbull terrier (weighing 1.01 kg) were referred with primary complaints of severe abdominal distension, exercise intolerance, retarded growth, yellow nasal discharge and anorexia. Diagnostic imaging studies found enlarged right atrium partitioned by abnormal membrane, severe pulmonic systolic jets (5.66 m/s of peak velocity) and right-to-left blood shunt at the inter-atrial septum. Based on clinical and diagnostic findings, the case was diagnosed as cor triatriatum dexter complicated with severe pulmonic stenosis and right-to-left shunted patent foramen ovale. Either surgical or interventional therapy has not been attempted, because of unstable patient's condition. Using blood transfusion, oxygen supply and cardiac medications (i.e., sildenafil, spironolactone, enalapril), the dog was recovered.
In middle-aged men, abdominal obesity has been an important risk factor of coronary artery disease (CAD) as well as a predictor of hypertension, dyslipidemia, insulin resistance and glucose intolerance. Particularly, risks from abdominal obesity increase when adipose tissue accumulates in visceral compartment. Many studies showed that weight reduction by caloric restriction improves abdominal obesity and reduces lots of cardiovascular risk factors. Testosterone treatment also results in a significant decrease in visceral fat area and normalizes endocrine metabolism. However there is no study that compare the effect of caloric restriction with that of testosterone treatment. The purpose of this study is to investigate the effect of caloric restriction and that of testosterone treatment on body fat distribution, serum lipids and glucose metabolism in male patients with CAD. Forty five middle-aged overweight-obese men with CAD participated in 12 weeks' program. They were matched with age, body weight, body mass index (BMI) and divided into three groups : control group (n = 15) , caloric restriction group (-300 kcal/day, n = 15) and testosterone treatment group (testosterone undecanoate tablets, n = 15) . After 12 weeks, control group did not have any changes in anthropometries, lipid profile, body fat distribution, glucose metabolism and hormonal status. Expectedly, caloric restriction group showed decreases in body weight, BMI, waist to hip ratio, % body fat. Ten percentage of total cholesterol and 23% of triglyceride in serum were also decreased. In body fat distribution, total fat areas at both L1 and L4 levels were significantly reduced in this group without reduction in muscle of thigh and calf. However, testosterone treatment group did not have any significant changes in body weight, % body fat, serum lipid profile and abdominal fat distribution. In conclusion, weight reduction by caloric restriction is more beneficial in body fat distribution and serum lipid level than testosterone treatment in overweight male patients with CAD. This result suggests that modest weight reduction is possible to help decrease risk factors of CAD.
Kim, Jung Hyun;Kim, Jin Soo;Lee, Dong Chul;Ki, Sae Hwi;Roh, Si Young;Yang, Jae Won
Archives of Plastic Surgery
/
v.32
no.4
/
pp.485-490
/
2005
Fingertip is the end of tactile organ and the part of hand most frequently injured. Fingertip injuries should be evaluated on an individual basis considering patient's overall physical condition, medical history, etiology, time of injury, and anticipated future hand use, and accordingly one of various methods of reconstruction should be selected. Complications after the reconstruction of fingertip injuries have been reported as pain, hypersensitivity, numbness, distal paresthesia, cold intolerance, and atrophy. From January to December 2002, dermofat grafts were performed on 15 patients to correct painful fingertips after injury. The thickness of the soft tissue of fingertip was measured both preoperatively and postoperatively with simple X-ray. To evaluate the improvement of pain, visual analogue scale(VAS) was used through the direct interview with patients. The average of postoperative follow-up period was 10.9 months. The average of increased soft tissue thickness ratio was 88.4%(2.3mm to 3.8mm). The average of preoperative VAS was 7.6, and postoperative VAS was 3. Dermofat graft on fingertip needs a further long-term follow-up study for the absorption ratio of dermofat, however, this procedure is simple and could be done under local anesthesia, and would be a useful alternative procedure to correct painful fingertips with the soft tissue atrophy after injury.
The clustering of insulin resistance with hypertension, glucose intolerance, hyperinsulinemia, increased triglyceride and decreased HDL cholesterol levels, and central and overall obesity has been called syndrome X, or the insulin resistance syndrome(IRS). To develop a nutrition service for IRS, this study was performed to evaluate the prevalence of each component of the metabolic abnormalities of IRS and analyze the clustering pattern of IRS among subjects living in the Taegu community. Participants in this study were 9234(mean age ; M/F 48/40yrs);63.5% were men, 24.4% were obese, 13.3% had hypertension. 3.7% had hyperglycemia, and 32.4% had hyperlipidemia. The IRS was defined as the coexistence of two or more components among metabolic abnormalities; obesity, hypertension. hyperglucemia and hyperlipidemia. The prevalence of IRS in Taegu was 19.2%(M/F:20.8%/16.4%), the clustering of these fisk variables was higher in advanced age group. Among the subjects of IRS having two of more diseases, 75.6% were obese, the pattern were similar in men and women. The younger, the higher the prevalence of obesity associated clustering patterns. The prevalence of obesity associated patterns among the hyperglycemia associated clustering patterns was 44.5%. The samples of the representative clustering patterns were obesity and hyperlipidemia (8.0%), hypertension and hyperlipidemia(3.2%), hypertension, obesity and hyperlipiemia(3.1%), hypertension and obesity(2.3%), and hyperglycemia and hyperlipidemia(0.8%). The clustering of obesity and hyperlipidemia until 50 year old groups, and the clustering of hypertension and hyperlipidemia in the 60 and 70 age groups were the most prevalent. We concluded that insulin resistance syndrome was a relatively common disorder in the Taegu community, and prevalence and the characteristics of the intervention strategies for IRS are desired, an effective improvement will be achieved.
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