No abstract available.
Sinusitis*

BACKGROUND/OBJECTIVES: Psidium guajava L. (guava) leaves have been shown to exhibit hypoglycemic and antidiabetic effects in rodents. This study investigated the effects of guava leaf extract on adipogenesis, glucose uptake, and lipolysis of adipocytes to examine whether the antidiabetic properties are mediated through direct effects on adipocytes.MATERIALS/METHODS: 3T3-L1 cells were treated with 25, 50, 100 µg/mL of methanol extract from guava leaf extract (GLE) or 0.1% dimethyl sulfoxide as a control. Lipid accumulation was evaluated with Oil Red O Staining and AdipoRed assay. Immunoblotting was performed to measure the expression of adipogenic transcription factors, fatty acid synthase (FAS), and AMP-activated protein kinase (AMPK). Glucose uptake under basal or insulin-stimulated condition was measured using a glucose analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy-D-glucose. Lipolysis from fully differentiated adipocytes was measured by free fatty acids release into the culture medium in the presence or absence of epinephrine. RESULTS: Oil Red O staining and AdipoRed assay have shown that GLE treatment reduced lipid accumulation during adipocyte differentiation. Mitotic clonal expansion, an early essential event for adipocyte differentiation, was inhibited by GLE treatment. GLE inhibited the expression of transcription factors involved in adipocyte differentiation, such as peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhancer-binding protein α (C/EBPα), and sterol regulatory element-binding protein-1c (SREBP-1c). FAS expression was also decreased while the phosphorylation of AMPK was increased by GLE treatment. In addition, GLE increased insulin-induced glucose uptake into adipocytes. In lipid-filled mature adipocytes, GLE enhanced epinephrine-induced lipolysis but reduced basal lipolysis dose-dependently. CONCLUSIONS The results show that GLE inhibits adipogenesis and improves adipocyte function by reducing basal lipolysis and increasing insulin-stimulated glucose uptake in adipocytes, which can be partly associated with antidiabetic effects of guava leaves.

BACKGROUND/OBJECTIVES: Psidium guajava L. (guava) leaves have been shown to exhibit hypoglycemic and antidiabetic effects in rodents. This study investigated the effects of guava leaf extract on adipogenesis, glucose uptake, and lipolysis of adipocytes to examine whether the antidiabetic properties are mediated through direct effects on adipocytes.MATERIALS/METHODS: 3T3-L1 cells were treated with 25, 50, 100 µg/mL of methanol extract from guava leaf extract (GLE) or 0.1% dimethyl sulfoxide as a control. Lipid accumulation was evaluated with Oil Red O Staining and AdipoRed assay. Immunoblotting was performed to measure the expression of adipogenic transcription factors, fatty acid synthase (FAS), and AMP-activated protein kinase (AMPK). Glucose uptake under basal or insulin-stimulated condition was measured using a glucose analog 2-[N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl) amino]-2-deoxy-D-glucose. Lipolysis from fully differentiated adipocytes was measured by free fatty acids release into the culture medium in the presence or absence of epinephrine. RESULTS: Oil Red O staining and AdipoRed assay have shown that GLE treatment reduced lipid accumulation during adipocyte differentiation. Mitotic clonal expansion, an early essential event for adipocyte differentiation, was inhibited by GLE treatment. GLE inhibited the expression of transcription factors involved in adipocyte differentiation, such as peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhancer-binding protein α (C/EBPα), and sterol regulatory element-binding protein-1c (SREBP-1c). FAS expression was also decreased while the phosphorylation of AMPK was increased by GLE treatment. In addition, GLE increased insulin-induced glucose uptake into adipocytes. In lipid-filled mature adipocytes, GLE enhanced epinephrine-induced lipolysis but reduced basal lipolysis dose-dependently. CONCLUSIONS The results show that GLE inhibits adipogenesis and improves adipocyte function by reducing basal lipolysis and increasing insulin-stimulated glucose uptake in adipocytes, which can be partly associated with antidiabetic effects of guava leaves.

Capillary hemangioma is the most common vascular tumor in childhood; however, its occurrence in the bronchus is extremely rare. We recently performed a sleeve resection of the left main bronchus on a four-month-old infant with a severe emphysema caused by bronchial capillary hemangioma.
Bronchi* ; Capillaries* ; Emphysema ; Hemangioma, Capillary* ; Humans ; Infant*

Background: Monitoring mortality trends can help design ways to improve survival, but observation of national mortality trends in critically ill children is lacking for the Korean population Methods: We analyzed the incidence and mortality trends of children younger than 18 years admitted to an intensive care unit (ICU) from 2012 to 2018 using the Korean National Health Insurance database. Neonates and neonatal ICU admissions were excluded. Multivariable logistic regression analyses were performed to estimate the odds ratio of in-hospital mortality according to admission year. Trends in incidence and in-hospital mortality of subgroups according to admission department, age, presence of intensivists, admissions to pediatric ICU, mechanical ventilation, and use of vasopressors were evaluated. Results: The overall mortality of critically ill children was 4.4%. There was a significant decrease in mortality from 5.5% in 2012 to 4.1% in 2018 (Pfor trend < 0.001). The incidence of ICU admission in children remained around 8.5/10,000 population years (Pfor trend = 0.069). In-hospital mortality decreased by 9.2% yearly in adjusted analysis (P < 0.001). The presence of dedicated intensivists (Pfor trend < 0.001, mortality decrease from 5.7% to 4.0%) and admission to pediatric ICU (Pfor trend < 0.001, mortality decrease from 5.0% to 3.2%) were associated with significant decreasing trends in mortality. Conclusion Mortality among critically ill children improved during the study period, and the improving trend was prominent in children with high treatment requirements. Varying mortality trends, according to ICU organizations, highlight that advances in medical knowledge should be supported structurally.

The Korean hemorrhagic fever is an acute febrile disease, which characteristically accompanies high fever, abdominal pain, headache, vomiting, bleeding tendency and renal failure. The Korean hemorrhagic fever displays various clinical manifestations and courses. Complication includes hypertension, intra-organ bleeding, respiratory problems including pulmonary edema, pituitary insufficiency, infection and anemia. In rare cases, cardiac complications, such as acute myocarditis and atrioventricular conduction block were reported. In addition, an acute pancreatitis, which accompanied serum amylase and lipase elevation, was rarely reported as one of the cause of abdominal pain in the patients with the Korean hemorrhagic fever. We report a patient, who were diagnosed with Korean hemorrhagic fever and displayed persistent abdominal pain, elevation of serum amylase and lipase, and detection of diffuse edema of the pancreas and fluid collection in the retroperitoneal space, especially around the pancreas and kidney, in the ultrasound and CT scan.
Abdominal Pain ; Amylases ; Anemia ; Atrioventricular Block ; Edema ; Fever ; Headache ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Hypertension ; Hypopituitarism ; Kidney ; Lipase ; Myocarditis ; Pancreas ; Pancreatitis* ; Pulmonary Edema ; Renal Insufficiency ; Retroperitoneal Space ; Tomography, X-Ray Computed ; Ultrasonography ; Vomiting

The pulmonic autograft as a replacement for the diseased aortic valve has become increasingly popular due to the potential to do away with anticoagulation and superior durability. There has not been any case of mitral valve replacement with pulmonic autograft reported in Korea. A 53-year-old female patient with rheumatic mitral steno-insufficiency, chronic atrial fibrillation, tricuspid insufficiency, and obstruction of the left circumflex artery, received mitral valve replacement using pulmonic autograft, maze procedure, tricuspid valvuloplasty and coronary artery bypass. The postoperative course was uneventful with a well functioning pulmonic autograft in the mitral position on echocardiogram. She is currently doing well without anticoagulation.
Aortic Valve ; Arteries ; Atrial Fibrillation ; Autografts* ; Coronary Artery Bypass ; Female ; Humans ; Korea ; Middle Aged ; Mitral Valve* ; Transplantation, Autologous

Anomalous origin of the right coronary artery from the pulmonary artery is a rare congenital anomaly that has generally been found incidentally during autopsy or surgery. Sudden death may occur without antecedent symptoms in apparently healthy, asymptomatic patients and hence operation is recommended when the lesion is recognized. As opposed to the more frequent anomalous origin of the left coronary artery from the pulmonary artery, only a few children with this anomaly have been reported to have undergone surgical treatment. This report describes a 2-year old patient whose diagnosis was made by echocardiography, confirmed by angiocardiography, and successfully corrected by reimplantation of the anomalous coronary artery into the aorta.
Angiocardiography ; Aorta ; Autopsy ; Child ; Child, Preschool ; Coronary Vessels* ; Death, Sudden ; Diagnosis ; Echocardiography ; Humans ; Pulmonary Artery* ; Replantation

Diabetic gastroparesis is a pathologic condition of delayed gastric emptying with gastrointestinal symptoms such as nausea, early satiety and vomiting in the absence of mechanical obstruction in patients with diabetes mellitus. We report a case of diabetic gastroparesis who had diabetes mellitus for 13 years and suffered from nausea and vomiting with marked gastric dilatation of acute onset. Blood glucose level of the patient was very high and any mechanical obstruction was not found by gastroduodenal endoscopy, hypotonic duodenography, celiac angiography, electrogastrography and CT scan. Acute gastric dilatation was resolved with conservative treatment of gastric drainage, glucose control and hydration. Gastrointestinal symptoms of nausea and vomiting improved and diet was well tolerated thereafter.
Angiography ; Blood Glucose ; Diabetes Mellitus ; Diet ; Drainage ; Endoscopy ; Gastric Dilatation* ; Gastric Emptying ; Gastroparesis* ; Glucose ; Humans ; Nausea ; Tomography, X-Ray Computed ; Vomiting