Fibroblast growth factor 21 (FGF21) is an attractive target for treating metabolic disease due to its wide-ranging beneficial effects on glucose and lipid metabolism. Circulating FGF21 levels are increased in insulin-resistant states; however, endogenous FGF21 fails to improve glucose and lipid metabolism in obesity, suggesting that metabolic syndrome is an FGF21-resistant state. Therefore, transcription factors for FGF21 are potential drug targets that could increase FGF21 expression in obesity and reduce FGF21 resistance. Despite many studies on the metabolic effects of FGF21, the transcriptional regulation of FGF21 gene expression remains controversial and is not fully understood. As the FGF21 transcription factor pathway is one of the most promising targets for the treatment of metabolic syndrome, further investigation of FGF21 transcriptional regulation is required.
Diabetes Mellitus ; Fibroblast Growth Factors* ; Gene Expression ; Glucose ; Insulin Resistance ; Lipid Metabolism ; Metabolic Diseases ; Obesity ; Transcription Factors

PURPOSE: To evaluate the usefulness of computed tomography(CT) scanning in classification and selection of treatment method for distal radius fractures involving articular surfaces. MATERIALS AND METHODS: Plain radiographs and CT scans of 42 patients with intraarticular distal radius fractures was analysed for type of fractures and surgical indication and then the results were compared. RESULTS: Fracture types were changed in 15 of 42 patients. 10 patients with AO B1, B3, C1 or C2 type fractures were reclassified as C3 type, which suggested that CT scan revealed articular comminution more accurately. According to the assesment of plain radiographs, 16 patient needed surgical treatment. However additional 17(68%) patients were necessary operation on the bases CT scan evaluation. CONCLUSIONS: Evaluation of intraarticular fractures of distal radius using CT scan was useful for fracture classification and selection of treatment methods, which provided an accurate assessment of fracture patterns and reduction status.
Equidae ; Humans ; Intra-Articular Fractures ; Radius ; Radius Fractures

An ectopic pregnancy in the abdominal organs is very rare. Primary intestinal pregnancy is considered the rarest form of extrauterine pregnancy, and only a few well-documented cases have been reported. Herein, a case of an abdominal pregnancy in a 25-year-old woman, with massive lower gastrointestinal bleeding, is reported. The source of bleeding could not be identified, despite gastroscopy, ultrasonography and angiography investigations. A diagnostic laparotomy disclosed an abdominal pregnancy, causing an erosion of the jejunal wall at the site of the pregnancy, with massive lower gastrointestinal bleeding. An abdominal pregnancy is seldom included in the differential diagnosis of lower gastrointestinal bleeding. The possibility of intestinal erosion in an abdominal pregnancy should be borne in mind in cases of lower gastrointestinal bleeding.
Adult ; Angiography ; Diagnosis, Differential ; Female ; Gastroscopy ; Hemorrhage* ; Humans ; Laparotomy ; Pregnancy ; Pregnancy, Abdominal* ; Pregnancy, Ectopic ; Ultrasonography

Background and Objectives: Tonsillectomy is one of the most common operative procedures in otorhinolaryngology. Most patients following tonsillectomy suffer from postoperative pain and hemorrhage. This study was performed to investigate whether filmogen topical gel (PHARGELⓇ, Vitrobio SAS), applied to the tonsillectomy site after tonsillectomy reduced pain and hemorrhage.Subjects and Method A total of 40 patients over 15 years old scheduled for elective tonsillectomy were randomly divided into two groups. After tonsillectomy and postoperative day 0, 1, 2, and 7, one group was applied with the filmogen topical spray 3-5 times a day but the other group remained without applying it. Pain and postoperative hemorrhage were measured at the postoperative day 0, 1, 2, and 7 of the operation. Pain was measured by using a visual analogue scale. Results: Patients who applied the filmogen topical spray presented lower pain scores than patients who didn’t applied the spary. There was no difference for postoperative hemorrhage between two groups. Conclusion Filmogen topical spray is an effective postoperative control for pain but not for hemorrhage on the tonsillectomy site.

BACKGROUND: As our population in Korea ages, more postoperative pulmonary complications (PPCs) have recently developed. There have been several studies about the predictive factors for PPC, but any consensus has not been established. In this study, we reappraised the predictive factors for PPC after general anesthesia in a population from Gyeong-ju, which was composed of elderly people. METHODS: We retrospectively investigated the incidence and predictive factors for PPC in 84 patients who underwent general anesthesia. We investigated gender, age, height, weight, BMI, smoking, underlying disease, underlying respiratory disease, malignancy, the laboratory findings (hemoglobin, albumin, arterial O2 saturation) and the pulmonary function tests of the patients. RESULTS: 84 patients were initially enrolled into the study, and PPC developed in 31 (36%) patients. The mean age of the enrolled patients was 66.515.1 years-old, so it shows the trend of an aging society. Three predictive factors were revealed that are independently associated with the PPC: site of operation (OR, 8.3), underlying disease (OR, 9.9) and serum albumin (OR, 4.0). CONCLUSIONS: Among the statistically meaningful predictive factors, underlying disease and operation site are well known from previous studies, but the albumin level<3.5 g/dL is also meaningful, which is higher than the previous reference level. It implies that the patient with a albumin level 3.0~3.5 g/dL can be classified into the high risk group. Therefore, we should recognize that it is necessary to apply more strict reference levels in an aging population to reduce the incidence of PPC.
Aged ; Aging ; Albumins ; Anesthesia, General* ; Consensus ; Gyeongsangbuk-do ; Humans ; Incidence ; Korea ; Postoperative Complications ; Respiratory Function Tests ; Retrospective Studies ; Serum Albumin ; Smoke ; Smoking

BACKGROUND: Adrenal incidentaloma is an adrenal neoplasm frequently encountered in clinical practice for which detection rates have recently increased. We describe here the clinical characteristics of adrenal incidentalomas. METHODS: A retrospective study was performed examining the age, sex, location, size, function, and the histological findings for 348 patients with an adrenal mass discovered incidentally on computed tomography (CT) undertaken for health examination or nonadrenal disease from August 2005 to May 2012. RESULTS: Patients consisted of 156 males (44.8%) and 192 females (55.2%), aged between 20 and 86. Adrenal masses were most commonly found in patients in their sixth decade (32.5%). Regarding the location of the masses, 62.0% were found in the left adrenal gland, 30.2% were found in the right, and 7.8% were found bilaterally. Of all of the masses analyzed, 87.1% were 1 to 4 cm in size, and an adenoma-like appearance was the most common finding (75.3%) seen on CT scans. Hormonal analysis showed that 82.2% of the masses were nonfunctioning, 6.0% were diagnosed as subclinical Cushing's syndrome, 4.6% were aldosterone-producing adenomas, and 7.2% were pheochromocytomas. Adrenalectomy was performed in a total of 69 patients having adenoma (50.7%), pheochromocytoma (24.6%), and carcinoma (4.3%). CONCLUSION: The characteristics of benign, malignant, nonfunctional, and functional adrenal masses that were incidentally found at our hospital were similar to those presented in other studies.
Adenoma ; Adrenal Gland Neoplasms ; Adrenal Glands ; Adrenalectomy ; Aged ; Cushing Syndrome ; Female ; Humans ; Male ; Pheochromocytoma ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Cardiovascular disease (CVD) is a complex multigenic disorder, with significant inheritable elements having important roles relating to environmental factors. Recently, the alpha 2 adrenoceptor (alpha(2)-AR) gene has been reported to be involved in the development of coronary artery disease (CAD). The aim of this study was to investigate the relationships between an insertion/deletion (I/D) in alpha(2B)-AR and CAD in Korean subjects. SUBJECTS AND METHODS: The alpha(2B)-AR I/D polymorphism, which was located in the third intracellular loop of the receptor polypeptide, was examined in 292 patients (M:F=219:73) with CAD and 151 healthy control subjects (M:F=70:81) who visited the Cardiovascular Genome Center in Yonsei Cardiovascular Hospital. RESULTS: In the patient group, 77 men (35.1%) and 26 women (35.6%) had the I/I genotype; 105 men (47.9%) and 39 women (53.4%) a heterozygous genotype and 37 (17.0%) and 8 (11.0%) the D/D genotype. In the controls, 23 men (32.8%) and 29 women (35.8%) had the I/I genotype; 38 (54.3%) and 39 (48.1%) the I/D genotype and 9 (12.9%) and 13 (16.1%) the D/D genotype. There were no differences in the genotype frequencies between the patient and control groups, either in men or women. From a logistical regression analysis, the alpha(2B)-AR genotype was not significantly associated with CAD in our study group. CONCLUSION: The alpha(2B)-AR I/D polymorphism is not a risk factor for CAD in the Korean population.
Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Genome ; Genotype ; Humans ; Male ; Polymorphism, Genetic ; Risk Factors*

OBJECTIVES: Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. METHODS: We performed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we performed rectal swabs on the cattle raised by the household of the index patient. RESULTS: We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. CONCLUSIONS: We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
Animals ; Cattle ; Diarrhea ; Enterohemorrhagic Escherichia coli* ; Family Characteristics ; Grandparents ; Hemolytic-Uremic Syndrome ; Humans ; Korea* ; Mothers ; Shiga Toxin 2 ; Zoonoses

Fever of unknown origin (FUO) is not infrequently a diagnostic dilemma for clinicians. Common infectious causes include endocarditis and abscesses in adults, and noninfectious causes include neoplasms and certain collagen vascular diseases. Endocrine causes of FUO are rare. The only endocrine disorder likely to present as FUO is subacute thyroiditis. Subacute thyroiditis usually occurs in middle-aged women as viral prodrome, neck tenderness, classic symptoms of thyrotoxicosis, and an elevated erythrocyte sedimentation rate. The patient may have abrupt onset of fever and chills with complaints of thyroid pain, or only low-grade fever with poorly characterized anterior neck pain. We present a case of FUO in a 48-year-old female who had had fever and neck pain for more than one month. Despite an extensive evaluation, the patient had persistent fever and no cause was found, with the exception of subacute thyroiditis. The fever resolved from the second day of treatment with low-dose steroid (prednisolone, 10 mg per day). This case illustrates that subacute thyroiditis should be considered in cases of FUO.
Abscess ; Adult ; Blood Sedimentation ; Chills ; Collagen ; Endocarditis ; Female ; Fever ; Fever of Unknown Origin ; Humans ; Neck ; Neck Pain ; Thyroid Gland ; Thyroiditis, Subacute ; Thyrotoxicosis ; Vascular Diseases

Recent improvements have been made to the use of time-resolved, three-dimensional phase-contrast (PC) magnetic resonance imaging (MRI), which is also named four-dimensional (4D) PC-MRI or 4D flow MRI, in the investigation of spatial and temporal variations in hemodynamic features in cardiovascular blood flow. The present article reviews the principle and analytical procedures of 4D PC-MRI. Various fluid dynamic biomarkers for possible clinical usage are also described, including wall shear stress, turbulent kinetic energy, and relative pressure. Lastly, this article provides an overview of the clinical applications of 4D PC-MRI in various cardiovascular regions.
Biomarkers ; Hemodynamics* ; Hydrodynamics ; Magnetic Resonance Imaging*