Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.
Adult ; Carcinoid Tumor* ; Frameshift Mutation ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Incidental Findings ; Multiple Endocrine Neoplasia Type 1 ; Pancreas ; Recurrence ; Siblings ; Thorax ; Thymectomy

The direct differentiation of hepatocytes from bone marrow cells remains controversial. Several mechanisms, including transdifferentiation and cell fusion, have been proposed for this phenomenon, although direct visualization of the process and the underlying mechanisms have not been reported. In this study, we established an efficient in vitro culture method for differentiation of functioning hepatocytes from murine lineage-negative bone marrow cells. These cells reduced liver damage and incorporated into hepatic parenchyma in two independent hepatic injury models. Our simple and efficient in vitro protocol for endodermal precursor cell survival and expansion enabled us to identify these cells as existing in Sca1+ subpopulations of lineage-negative bone marrow cells. The endodermal precursor cells followed a sequential developmental pathway that included endodermal cells and hepatocyte precursor cells, which indicates that lineage-negative bone marrow cells contain more diverse multipotent stem cells than considered previously. The presence of equivalent endodermal precursor populations in human bone marrow would facilitate the development of these cells into an effective treatment modality for chronic liver diseases.
Animals ; Ataxin-1/*analysis ; Bone Marrow Cells/*cytology ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Female ; Hepatocytes/*cytology ; Mice ; Mice, Inbred BALB C

The laryngeal mask airway (LMA) has several advantages over endotracheal intubation for the airway management in tracheal stenosis patients. Endotracheal tubes are narrower than the natural trachea and can induce reflex airway constriction resulting in more resistance to ventilation. Furthermore, an endotracheal tube can injure the trachea, and cause airway edema, and further tracheal constriction. In contrast, the increase in airway resistance that occurs when using the laryngeal mask is relatively low, because the diameter of the laryngeal mask airway is larger than that of the endotracheal tube and the laryngeal mask airway is not intubated. However, patients with a mechanically obstructed trachea, those with tracheomalacia or an external compression of the trachea, cannot be managed with a laryngeal mask airway, because it cannot prevent tracheal collapse. Thus it is important that the causes of tracheal obstruction are differentiated. This report suggests that the laryngeal mask airway can be used as a route for mechanical ventilation and as a conduit for tracheal evaluation and endotracheal intubation using fiberoptic bronchoscope during tracheal reconstruction surgery in patients with tracheal stenosis.
Airway Management ; Airway Resistance ; Bronchoscopes ; Constriction ; Edema ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngeal Masks* ; Reflex ; Respiration, Artificial ; Trachea ; Tracheal Stenosis ; Tracheomalacia ; Ventilation

Graft-versus-host disease (GVHD), a life-threatening complication after bone marrow transplantation (BMT), is induced by activation of alloreactive donor T cells. Our previous study demonstrated that transplantation of myeloid differentiation factor 88 (MyD88)-deficient knockout (KO) bone marrow (BM) resulted in aggravation of GVHD. Here, to understand the cellular mechanism, we performed longitudinal in vivo imaging and flow cytometric analyses followed by transcriptome and functional examination of donor MyD88-KO BM progenies in GVHD hosts, using a major histocompatibility complex-matched but minor histocompatibility antigen-mismatched C57BL/6→BALB.B model. In GVHD hosts with MyD88-KO BMT, donor BM-derived CD11b+Gr-1+ cells were found to undergo cell death, a fate significantly different from the explosive expansion shown by the wild type (WT) counterparts, and also from the moderate expansion of the WT or MyD88-KO BM-derived cells in non-GVHD hosts. It was also revealed that MyD88-KO CD11b+Gr-1+ cells preferred differentiation into CD11c+ dendritic cells (DCs) to expansion as myeloid-derived suppressor cells in GVHD hosts or in high inflammatory in vitro conditions. These CD11c+ DCs comprised the majority of MyD88-KO CD11b+Gr-1+ apoptotic cells in GVHD hosts. Their ability to cross-present alloantigens of host origin contributed to the enhancement of T cell alloreactivity, causing GVHD aggravation and eventually death through the killing function of activated T cells. These results provide insights into the roles of MyD88 in myelopoiesis of donor BM and the protective effects in GVHD hosts, helpful information for development of a strategy to control GVHD.
Bone Marrow Cells* ; Bone Marrow Transplantation ; Bone Marrow* ; Cell Death ; Dendritic Cells* ; Graft vs Host Disease ; Histocompatibility ; Homicide ; Humans ; In Vitro Techniques ; Isoantigens ; Myeloid Differentiation Factor 88 ; Myelopoiesis ; T-Lymphocytes ; Tissue Donors* ; Transcriptome

Classical swine fever (CSF), previously known as hog cholera, remains one of the most important swine-related contagious diseases worldwide. In order to eradicate classical swine fever virus (CSFV), it is commonly used in LOM-850 strain as a live attenuated CSF vaccine. However, there are symptoms of vaccination, such as the depression of feed intake, and difficulty of differentiation between infected and vaccinated hosts is impossible based on the antibodies induced. Nicotiana benthamiana were considered as an alternative to the production of recombinant vaccines on account of higher yields and levels of soluble protein than other models and crops in protein recombinant products. This study was conducted to evaluate histopathological validation of the plant-produced E2 fusion protein (ppE2) in piglets. The piglets were challenged by an injection of YC11WB strain in 7 days, 11 days and 14 days after one shot of the vaccination. The histopathological examination indicated that ppE2 can protect against lethal CSFV challenge at least 11 days of vaccination in piglets. These data suggest that the ppE2 can be an effective vaccine against CSFV in piglets.
Animals ; Antibodies ; Classical swine fever virus ; Classical Swine Fever ; Depression ; Swine ; Tobacco ; Vaccination ; Vaccines, Synthetic

This study was conducted to investigate the effects of powdered young barley leaf and its water extract on body weight and lipid metabolism in high-fat fed mice. Male mice were divided into normal group, high-fat (HF) group, highfat group supplemented with powdered young barley leaf (HF-YBL) and high-fat group supplemented with water extract of the powdered young barley leaf (HF-WYBL). The powdered young barley leaf or its water extract was added to a standard diet based on 1% dried young barley leaf (1 g YBL/100 diet and 0.28 g WYBL/100 g diet) for 8 weeks. Supplementation of YBL and WYBL significantly reduced body weight and epididymal adipose tissue weight in highfat fed mice. Food intake and daily energy intake were significantly lower in the YBL group than in the HF group. After 8 weeks, plasma triglyceride and cholesterol concentrations were significantly higher in the HF group than in the Normal group; however, both YBL and WYBL significantly lowered those of the high-fat fed mice. The ratio of HDL-cholesterol/ total cholesterol of the YBL and WYBL groups were significantly elevated compared to that of HF group. Both YBL and WYBL significantly increased fecal excretion of triglyceride in high-fat fed mice, whereas they did not affect fecal cholesterol concentration. The triglyceride levels of liver, adipose tissue and heart were significantly lower in the YBL and WYBL groups than in the HF group. Supplementation of WYBL also lowered the kidney triglyceride and heart cholesterol concentrations compared to those of HF group. Hepatic lipid regulating enzyme activities, fatty acid synthase, HMG-CoA reductase and acyl-coenzyme A: cholesterol acyltransferase, were significantly lower in the YBL and WYBL groups than in the HF group. Accordingly, these results suggest that YBL and WYBL improve plasma and organ lipid levels partly by increasing fecal lipid excretion and inhibiting fatty acid and cholesterol biosynthesis in the liver.
Acyl Coenzyme A ; Adipose Tissue ; Animals ; Body Weight ; Cholesterol ; Diet ; Diet, High-Fat ; Eating ; Energy Intake ; Fatty Acid Synthetase Complex ; Heart ; Hordeum ; Humans ; Kidney ; Lipid Metabolism ; Liver ; Male ; Mice ; Oxidoreductases ; Plasma ; Sterol O-Acyltransferase ; Water

Background: Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM). Methods: From March 2014 to December 2018, data of patients with T2DM, who were treated with quadruple hypoglycemic medications for over 12 months in 11 hospitals in South Korea, were reviewed retrospectively. We compared glycosylated hemoglobin (HbA1c) levels before and 12 months after quadruple treatment with OHAs. The safety, maintenance rate, and therapeutic patterns after failure of the quadruple therapy were also evaluated. Results: In total, 357 patients were enrolled for quadruple OHA therapy, and the baseline HbA1c level was 9.0%±1.3% (74.9± 14.1 mmol/mol). After 12 months, 270 patients (75.6%) adhered to the quadruple therapy and HbA1c was significantly reduced from 8.9%±1.2% to 7.8%±1.3% (mean change, –1.1%±1.2%; P<0.001). The number of patients with HbA1c <7% increased significantly from 5 to 68 (P<0.005). In addition, lipid profiles and liver enzyme levels were also improved whereas no changes in body weight. There was no significant safety issue in patients treated with quadruple OHA therapy. Conclusion This study shows the therapeutic efficacy of the quadruple OHA regimen T2DM and demonstrates that it can be an option for the management of T2DM patients who cannot use insulin or reject injectable therapy.

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).

Only few studies have shown the efficacy and safety of glucose-control strategies using the quadruple drug combination. Therefore, the aim of the present study was to investigate the usefulness of the quadruple combination therapy with oral hypoglycemic agents (OHAs) in patients with uncontrolled type 2 diabetes mellitus (T2DM).