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The Eosinophil Count Tends to Be Negatively Associated with Levels of Serum Glucose in Patients with Adrenal Cushing Syndrome

  • Lee, Younghak;Yi, Hyon-Seung;Kim, Hae Ri;Joung, Kyong Hye;Kang, Yea Eun;Lee, Ju Hee;Kim, Koon Soon;Kim, Hyun Jin;Ku, Bon Jeong;Shong, Minho
    • Endocrinology and Metabolism
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    • v.32 no.3
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    • pp.353-359
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    • 2017
  • Background: Cushing syndrome is characterized by glucose intolerance, cardiovascular disease, and an enhanced systemic inflammatory response caused by chronic exposure to excess cortisol. Eosinopenia is frequently observed in patients with adrenal Cushing syndrome, but the relationship between the eosinophil count in peripheral blood and indicators of glucose level in patients with adrenal Cushing syndrome has not been determined. Methods: A retrospective study was undertaken of the clinical and laboratory findings of 40 patients diagnosed with adrenal Cushing syndrome at Chungnam National University Hospital from January 2006 to December 2016. Clinical characteristics, complete blood cell counts with white blood cell differential, measures of their endocrine function, description of imaging studies, and pathologic findings were obtained from their medical records. Results: Eosinophil composition and count were restored by surgical treatment of all of the patients with adrenal Cushing disease. The eosinophil count was inversely correlated with serum and urine cortisol, glycated hemoglobin, and inflammatory markers in the patients with adrenal Cushing syndrome. Conclusion: Smaller eosinophil populations in patients with adrenal Cushing syndrome tend to be correlated with higher levels of blood sugar and glycated hemoglobin. This study suggests that peripheral blood eosinophil composition or count may be associated with serum glucose levels in patients with adrenal Cushing syndrome.

Screening, Diagnosis, and Treatment of Familial Hypercholesterolemia: Symposium of the Education Committee, Korean Society of Lipid and Atherosclerosis (가족성 고콜레스테롤혈증의 스크린, 진단, 치료: 한국지질동맥경화학회 교육위원회 심포지엄)

  • Lee, Chan Joo;Lee, Ji Hyun;Choi, Seonghoon;Kim, Shin-Hye;Kang, Hyun-Jae;Lee, Sang-Hak;Park, Kyong Soo
    • Journal of Lipid and Atherosclerosis
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    • v.7 no.2
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    • pp.122-154
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    • 2018
  • Familial hypercholesterolemia (FH) is typically associated with single gene mutation that is inherited by autosomal dominant manner. Due to high cardiovascular risk, aggressive discovery, diagnosis, and treatment of FH are critical. Although FH is being increasingly spotlighted, we do not have sufficient data on Korean patients with FH. Here, we present the content of symposium of the Education Committee, Korean Society of Lipid and Atherosclerosis held in May 2018: 1) epidemiology, clinical diagnosis, Korean FH data, and regulation in Korea; 2) genes associated with FH, sequencing process in suspicious proband, cascade screening, and difficulty in genetic diagnosis in FH; 3) the importance of lipid-lowering therapy in FH, conventional and novel therapeutics for FH; 4) diagnosis of FH in children and adolescence, screening, and treatment of FH in children and adolescence; 5) history of FH studies in Korea, the structure and current status of FH registry of Korean Society of Lipid and Atherosclerosis; and 6) difficulty in diagnosis of heterozygous and homozygous FH, drug intolerance and achievement of treatment target. Discussion between speakers and panels were also added. We hope that this article is helpful for understanding FH and future studies performed in Korea.

Statin Intolerance: an Overview of the Current Status and Possible Treatment Options

  • Suh, Sunghwan;Jung, Chang Hee;Hong, Soon-Jun;Kim, Jung-Sun;Choi, Sung Hee
    • Journal of Lipid and Atherosclerosis
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    • v.7 no.2
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    • pp.77-87
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    • 2018
  • Lowering serum low-density lipoprotein cholesterol (LDL-C) is the mainstay for reduction of risk of cardiovascular disease (CVD), the second most common cause of death in Korea. The 2015 Korean guidelines for management of dyslipidemia strongly recommend the use of statins in patients at risk of CVD. Statin therapy, which is the gold standard for CVD, reduces LDL-C level by 40% to 60% and is generally well tolerated. However, many patients are intolerant to statins and discontinue therapy or become nonadherent to therapy because of actual/perceived side effects. The most common of these side effects is the statin-associated muscle symptom (SAMS). Discontinuation and repetitive re-challenge with statins can help identify SAMS. If serum creatinine kinase level is more than 10 times the upper limit of normal, statin therapy must be stopped immediately, and the physician should identify possible causes including rhabdomyolysis and treat appropriately. In other patients, it might help to switch to a less potent statin or to use statins at intermittent non-daily dosing. To achieve target LDL-C level, non-statin lipid-lowering therapies such as dietary modifications, ezetimibe, and bile acid sequestrants may be added. Several new drugs have recently been approved for lowering LDL-C level. Alirocumab and evolocumab are monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9, and both drugs cause large reductions in LDL-C, similar to statins. Lomitapide and mipomersen are orphan drugs used as adjuncts to other lipid-lowering therapies in patients with homozygous familial hypercholesterolemia.

Studies on the Oral Disease Improvement Effects of Probiotics : A Review (프로바이오틱스의 구강질병 개선에 관한 연구 고찰)

  • Chung, Sung-Kyun
    • Journal of Digital Convergence
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    • v.17 no.6
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    • pp.315-326
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    • 2019
  • This study is a review of research articles on the characteristics of probiotics. Probiotics are effective at ameliorating immune disease, alleviating glucose intolerance, and improving constipation and diarrhea. Furthermore, they have anticancer and antitumor effects, preventive effects against cardiovascular disease, antidiabetic effects, antioxidant effects, antibacterial effects, and they produce useful metabolites. It has been demonstrated that oral probiotics are effective in eliminating halitosis and forming a favorable oral ecosystem, by creating an environment that is not readily inhabited by harmful bacteria, such as Streptococcus mutans, which produces lactic acid and causes tooth decay, or Porphyromonas gingivalis, which causes gum disease.As a result, oral probiotics are being considered not only as therapeutics against diseases, but also as preventive agents for the maintenance of a healthy oral balance. In spite of some limitations, clinical trials are currently underway, and this study can provide evidence to support the use of probiotics to improve oral health conditions, including dental caries, periodontal disease, and Candida colonization.

Growth Patterns of Indonesian Infants with Cow's Milk Allergy and Fed with Soy-Based Infant Formula

  • Setiabudiawan, Budi;Sitaresmi, Mei Neni;Sapartini, Gartika;Sumadiono, Sumadiono;Citraresmi, Endah;Sekartini, Rini;Putra, Azwin Mengindra;Jo, Juandy
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.316-324
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    • 2021
  • Purpose: The use of soy-based infant formula has increased widely in infants with cow's milk allergy (CMA). This study aimed to provide evidence on the growth pattern of CMA infants fed with soy-based infant formula in an Indonesian setting. Methods: A multi-site, intervention study was conducted among full-term and normal birth weight CMA infants. Within six months, the subjects were provided with a soy-based infant formula. Weight, height, and head circumference were measured at baseline, weeks 4, 8, 12, 16, 20, and 24. Adverse events were recorded by scoring atopic dermatitis and symptom-based clinical scores. Results: Based on the World Health Organization growth chart, we found that most of subjects had normal nutritional status for weight-for-age, length-for-age, weight-for-length, and head-circumference-for-age. There were statistically significant differences between baseline and end-line for weight-for-age, length-for-age, weight-for-length, and head circumference-for-age nutritional status. No allergic symptoms or intolerance toward soy formula were observed at the end of the intervention period. Conclusion: These results show that infants fed with soy-based infant formula have a normal pattern of growth.

Effects of the Combination of Evogliptin and Leucine on Insulin Resistance and Hepatic Steatosis in High-Fat Diet-Fed Mice

  • Shin, Chang Yell;Lee, Hak Yeong;Kim, Gil Hyung;Park, Sun Young;Choi, Won Seok;Sohn, Uy Dong
    • Biomolecules & Therapeutics
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    • v.29 no.4
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    • pp.419-426
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    • 2021
  • In this study, we aimed to investigate the effects of 8 weeks of treatment with a combination of evogliptin and leucine, a branched-chain amino acid, in mice with high-fat diet (HFD)-induced diabetes. Treatment with evogliptin alone or in combination with leucine reduced the body weight of the mice, compared to the case for those from the HFD control group. Long-term treatment with evogliptin alone or in combination with leucine resulted in a significant reduction in glucose intolerance; however, leucine alone did not affect postprandial glucose control, compared to the case for the mice from the HFD control group. Furthermore, the combination of evogliptin and leucine prevented HFD-induced insulin resistance, which was associated with improved homeostasis model assessment for insulin resistance, accompanied by markedly reduced liver fat deposition, hepatic triglyceride content, and plasma alanine aminotransferase levels. The combination of evogliptin and leucine increased the gene expression levels of hepatic peroxisome proliferator-activated receptor alpha, whereas those of the sterol regulatory element-binding protein 1 and stearoyl-CoA desaturase 1 were not altered, compared to the case in the HFD-fed mice (p<0.05). Thus, our results suggest that the combination of evogliptin and leucine may be beneficial for treating patients with type 2 diabetes and hepatic steatosis; however, further studies are needed to delineate the molecular mechanisms underlying the action of this combination.

Nutritional Status Indicators Affecting the Tolerability of Postoperative Chemotherapy After Total Gastrectomy in Patients With Gastric Cancer

  • Toyota, Kazuhiro;Mori, Masayuki;Hirahara, Satoshi;Yoshioka, Shoko;Kubota, Haruna;Yano, Raita;Kobayashi, Hironori;Hashimoto, Yasushi;Sakashita, Yoshihiro;Yokoyama, Yujiro;Murakami, Yoshiaki;Miyamoto, Katsunari
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.56-66
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    • 2022
  • Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.

Effects of Probiotic Fermented Fruit Juice-Based Biotransformation by Lactic Acid Bacteria and Saccharomyces boulardii CNCM I-745 on Anti-Salmonella and Antioxidative Properties

  • Laosee, Wanida;Kantachote, Duangporn;Chansuwan, Worrapanit;Sirinupong, Nualpun
    • Journal of Microbiology and Biotechnology
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    • v.32 no.10
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    • pp.1315-1324
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    • 2022
  • Fermentation is an effective process for providing various beneficial effects in functional beverages. Lactic acid bacteria and yeast fermentation-based biotransformation contribute to enhancement of nutritional value and digestibility, including lactose intolerance reduction and control of infections. In this study, the probiotic fermented fruit juice (PFJ) was produced by Lactobacillus plantarum TISTR 1465, Lactobacillus salivarius TISTR 1112, and Saccharomyces boulardii CNCM I-745 while mixed fruit juice (MFJ) was used as the basic medium for microorganism growth. The potential function, the anti-salmonella activity of PFJ, was found to be effective at 250 mg/ml of MIC and 500 mg/ml of MBC. Biofilm inhibition was performed using the PFJ samples and showed at least 70% reduction in cell attachment at the MIC concentration of Salmonella Typhi DMST 22842. The antioxidant activities of PFJ were determined and the results revealed that FSB.25 exhibited 78.40 ± 0.51 mM TE/ml by FRAP assay, while FPSB.25 exhibited 3.44 ± 0.10 mM TE/ml by DPPH assay. The volatile compounds of PFJ were characterized by GC-MS, which identified alcohol, aldehyde, acid, ester, ketone, phenol, and terpene. The most abundant organic acid and alcohol detected in PFJ were acetic acid and 2-phenylethanol, and the most represented terpene was β-damascenone. The sensory attributes showed scores higher than 7 on a 9-point hedonic scale for the FPB.25, illustrating that it was well accepted by panelists. Taken together, our results showed that PFJ could meet current consumer demand regarding natural and functional, fruit-based fermented beverages.

A Study for the Establishment of the Diagnostic Definition of Sanhupung (U32.7) using the Delphi Method (산후풍의 진단적 정의 확립을 위한 전문가 델파이 조사 연구)

  • Oh, Su-Kyoung;Noh, Eun-Ji;Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.16-30
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    • 2021
  • Objectives: The aim of this study was to establish a clear diagnostic definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 21 experts of Korean medicine, particularly in of gynecologic medicine, participated in the Delphi examination that included answering the 4th round survey. The Delphi examination was carried out through evaluating and correcting the questionnaire by e-mail. Results: Through the Delphi survey, we have reached on an agreement regarding the basic concepts, time, cause, essential symptoms, and accessory symptoms of Sanhupung. They are as follows: 1) Sanhupung is a culture bound syndrome reflecting Korea's cultural specificity. 2) Sanhupung can be diagnosed even after the miscarriage. 3) For the diagnosis of Sanhupung, the main cause of symptoms should not be classified as other disease. 4) Sanhupung can be diagnosed based on essential symptoms and accessory symptoms. 5) Essential symptoms include local symptoms such as joint pain at specific areas, partial sensory impairment and general symptoms including pain of all the joints, whole body sensory impairment, increased sweating, feeling of wind coming into the body, worsened symptoms with the cold, intolerance to cold, and pain of all the muscles. Conclusions: The basic concepts and diagnostic definition of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve reliability and validity of diagnostic definition of Sanhupung in clinical trials.

Oblique Axis Hypothenar Free Flaps: Tips for Harvesting Larger Flaps with Minimal Donor Site Morbidity

  • Sang Ho Oh;Jae In Chung
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.279-287
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    • 2023
  • Background Hypothenar free flaps (HTFFs) have been widely used for reconstructing palmar defects. Although previous anatomical and clinical studies of HTFF have been conducted, this technique still has some limitations. In this study, we describe some tips for large flap design that allows for easy harvesting of HTFFs with minimal donor site morbidity. Methods A total of 14 HTFF for hand defect reconstruction were recorded. The oblique flap was designed in the proximal HT area following relaxed skin tension line along the axis between fourth web space and 10 mm ulnar side of pisiform. A flap pedicle includes one or two perforators with ulnar digital artery and HT branch of basilic vein. In addition, innervated HTFF can be harvested with a branch of ulnar digital nerve. Electronic medical records were reviewed to obtain data on patients' information, operative details, and follow-up period. In addition, surgical outcome score was obtained from the patient, up to 10 points, at the last follow-up. Results Mean harvest time was 46 minutes, and two perforators were included in 10 cases. The mean flap area was 10.84 cm2. There were no problems such as donor site depression, scar contracture, keloids, wound dehiscence, numbness or neuroma pain at donor sites, and hypersensitivity or cold intolerance at flap site, either functionally or aesthetically. Conclusion Palmar defect reconstruction is challenging for hand surgeons. However, large HTFF can be harvested without complications using the oblique axis HTFF technique. We believe our surgical tips increase utility of HTFF for palmar defect reconstruction.