Behcets syndrome is a multisystem disorder presenting with recurrent oral and genital ulcers as well as uveitis, Gastrointestinal involvement associated with ileal ulcer is rare, but its outcome may by fatal. We have recently experienced a 43-year-old man who had Behcets syndrome with ileal ulcer penetrated to 3rd portion of the duodenum. He had been updergone right hemicolectomy and ileocolostomy for ileal inflammation of unknown etiology 20 years ago. Thereafter he had had relapsing oral and genital ulcers, and abdominal pain intermittently. From 15 days ago before visiting our hospital, he had severe abdominal pain and dark blood-colored stool. The colonofiberscopic finding revealed a large, deep penetrating ulcer and multiple shallow ulcers on the ileum. Deal segmental resection, gastro-jejunostomy and jejunal patch at 3rd portion of the duodenum were performed with marked improvement.
Abdominal Pain ; Adult ; Behcet Syndrome ; Duodenum* ; Humans ; Ileum ; Inflammation ; Ulcer* ; Uveitis

Tumor necrosis factor alpha (TNFalpha) is a multifunctional inflammatory cytokine that regulates various cellular and biological processes. Increased levels of TNFalpha have been implicated in a number of human diseases including diabetes and arthritis. Sympathetic nervous system stimulation via the beta2-adrenergic receptor (beta2AR) in osteoblasts suppresses osteogenic activity. We previously reported that TNFalpha up-regulates beta2AR expression in murine osteoblastic cells and that this modulation is associated with TNFalpha inhibition of osteoblast differentiation. In our present study, we explored whether TNFalpha induces beta2AR expression in human osteoblasts and then identified the downstream signaling pathway. Our results indicated that beta2AR expression was increased in Saos-2 and C2C12 cells by TNFalpha treatment, and that this increase was blocked by the inhibition of NF-kappaB activation. Chromatin immunoprecipitation and luciferase reporter assay results indicated that NF-kappaB directly binds to its cognate elements on the beta2AR promoter and thereby stimulates beta2AR expression. These findings suggest that the activation of TNFalpha signaling in osteoblastic cells leads to an upregulation of beta2AR and also that TNFalpha induces beta2AR expression in an NF-kappaB-dependent manner.
Arthritis ; Biological Processes ; Chromatin Immunoprecipitation ; Durapatite ; Humans ; Luciferases ; NF-kappa B ; Osteoblasts ; Receptors, Adrenergic ; Sympathetic Nervous System ; Tumor Necrosis Factor-alpha ; Up-Regulation

Purpose: This study aimed to develop a four-hour food additive education program for elementary school students to provide them with accurate information on food additives. Methods: A survey was conducted among 133 elementary school students living in Gyeonggi Province to identify the level of food additive awareness. A four-hour food additive education program and educational materials (PPT, activity sheets, and teacher guidelines) were developed based on the results of the food additive awareness survey. The developed educational programs were based on the Theoretical Model of Stages of Behavior Change.An elementary school nutrition teacher conducted a pilot education for 83 elementary school students to evaluate the feasibility of the developed education program. A survey was conducted to evaluate the effectiveness and satisfaction of the pilot education program. Results: The results of the Food Additive Awareness Survey showed that only 42.1% of people were aware of food additives; 46.3% wanted to know more about food additives, and 54.3% required food additive education. Food coloring (44.7%) and artificial sweeteners (18.7%) were the most common food additives of interest. What they wanted to know about food additives was the safety of food additives (36.8%) and the role and function of food additives (20.3%). After the pilot training on food additives, the level of awareness of food additives was improved significantly, and the percentage of participants who recognized the need for food additive education and promotion increased. According to the satisfaction survey of the food additives education, the interest, understanding, real-life application, learning method, and content amount were approximately 90%. Conclusion The educational program developed through this study will change the negative perceptions of food additives in elementary school students to a positive one. It will do so by helping nutrition educators educate students on this important subject.

Purpose: This study aimed to develop a four-hour food additive education program for elementary school students to provide them with accurate information on food additives. Methods: A survey was conducted among 133 elementary school students living in Gyeonggi Province to identify the level of food additive awareness. A four-hour food additive education program and educational materials (PPT, activity sheets, and teacher guidelines) were developed based on the results of the food additive awareness survey. The developed educational programs were based on the Theoretical Model of Stages of Behavior Change.An elementary school nutrition teacher conducted a pilot education for 83 elementary school students to evaluate the feasibility of the developed education program. A survey was conducted to evaluate the effectiveness and satisfaction of the pilot education program. Results: The results of the Food Additive Awareness Survey showed that only 42.1% of people were aware of food additives; 46.3% wanted to know more about food additives, and 54.3% required food additive education. Food coloring (44.7%) and artificial sweeteners (18.7%) were the most common food additives of interest. What they wanted to know about food additives was the safety of food additives (36.8%) and the role and function of food additives (20.3%). After the pilot training on food additives, the level of awareness of food additives was improved significantly, and the percentage of participants who recognized the need for food additive education and promotion increased. According to the satisfaction survey of the food additives education, the interest, understanding, real-life application, learning method, and content amount were approximately 90%. Conclusion The educational program developed through this study will change the negative perceptions of food additives in elementary school students to a positive one. It will do so by helping nutrition educators educate students on this important subject.

Purpose: This study aimed to develop a four-hour food additive education program for elementary school students to provide them with accurate information on food additives. Methods: A survey was conducted among 133 elementary school students living in Gyeonggi Province to identify the level of food additive awareness. A four-hour food additive education program and educational materials (PPT, activity sheets, and teacher guidelines) were developed based on the results of the food additive awareness survey. The developed educational programs were based on the Theoretical Model of Stages of Behavior Change.An elementary school nutrition teacher conducted a pilot education for 83 elementary school students to evaluate the feasibility of the developed education program. A survey was conducted to evaluate the effectiveness and satisfaction of the pilot education program. Results: The results of the Food Additive Awareness Survey showed that only 42.1% of people were aware of food additives; 46.3% wanted to know more about food additives, and 54.3% required food additive education. Food coloring (44.7%) and artificial sweeteners (18.7%) were the most common food additives of interest. What they wanted to know about food additives was the safety of food additives (36.8%) and the role and function of food additives (20.3%). After the pilot training on food additives, the level of awareness of food additives was improved significantly, and the percentage of participants who recognized the need for food additive education and promotion increased. According to the satisfaction survey of the food additives education, the interest, understanding, real-life application, learning method, and content amount were approximately 90%. Conclusion The educational program developed through this study will change the negative perceptions of food additives in elementary school students to a positive one. It will do so by helping nutrition educators educate students on this important subject.

Purpose: This study aimed to develop a four-hour food additive education program for elementary school students to provide them with accurate information on food additives. Methods: A survey was conducted among 133 elementary school students living in Gyeonggi Province to identify the level of food additive awareness. A four-hour food additive education program and educational materials (PPT, activity sheets, and teacher guidelines) were developed based on the results of the food additive awareness survey. The developed educational programs were based on the Theoretical Model of Stages of Behavior Change.An elementary school nutrition teacher conducted a pilot education for 83 elementary school students to evaluate the feasibility of the developed education program. A survey was conducted to evaluate the effectiveness and satisfaction of the pilot education program. Results: The results of the Food Additive Awareness Survey showed that only 42.1% of people were aware of food additives; 46.3% wanted to know more about food additives, and 54.3% required food additive education. Food coloring (44.7%) and artificial sweeteners (18.7%) were the most common food additives of interest. What they wanted to know about food additives was the safety of food additives (36.8%) and the role and function of food additives (20.3%). After the pilot training on food additives, the level of awareness of food additives was improved significantly, and the percentage of participants who recognized the need for food additive education and promotion increased. According to the satisfaction survey of the food additives education, the interest, understanding, real-life application, learning method, and content amount were approximately 90%. Conclusion The educational program developed through this study will change the negative perceptions of food additives in elementary school students to a positive one. It will do so by helping nutrition educators educate students on this important subject.

Boerhaave's syndrome, spontaneous esophageal rupture, is lethal and associated with a 70% survival rate despite emergent surgical management in recent reports. Early diagnosis and management is critical for more favorable outcome. But, it is difficult to diagnose early because of the low incidence and lack of specific symptoms and signs. We experienced 37 year-old male patient with Boerhaave's syndrome who was heavy drinker, and suffered from chronic renal failure. He visited a hospital because of hematemesis and severe back pain. He was transferred to our hospital with a nasogastric tube insertion, which was penetrating the distal esophagus. A radiologic examination revealed that the distal tip was located in the left pleural cavity. It was assumed that the tube had passed through the preexisting perforation site. Operation was not performed emergently due to delay in diagnosis and severe hyperkalemia. The patient was in a septic condition, but had recovered slowly after systemic broad spectrum antibiotic therapy, pleural drainage and intrapleural antibiotic injections. An esophagography revealed no leakage of gastro-grafin on the 14th hospital day, and he later completely recovered from sepsis.
Adult ; Back Pain ; Diagnosis ; Drainage ; Early Diagnosis ; Esophageal Perforation ; Esophagus ; Hematemesis ; Humans ; Hyperkalemia ; Incidence ; Kidney Failure, Chronic ; Male ; Pleural Cavity* ; Rupture ; Sepsis ; Survival Rate

Tumor necrosis factor alpha (TNFalpha) is a multifunctional cytokine that is elevated in inflammatory diseases such as atherosclerosis, diabetes and rheumatoid arthritis. Recent evidence has suggested that beta2 adrenergic receptor (beta2AR) activation in osteoblasts suppresses osteogenic activity. In the present study, we explored whether TNFalpha modulates betaAR expression in osteoblastic cells and whether this regulation is associated with the inhibition of osteoblast differentiation by TNFalpha. In the experiments, we used C2C12 cells, MC3T3-E1 cells and primary cultured mouse bone marrow stromal cells. Among the three subtypes of betaAR, beta2 and beta3AR were found in our analysis to be upregulated by TNFalpha. Moreover, isoproterenol-induced cAMP production was observed to be significantly enhanced in TNFalpha-primed C2C12 cells, indicating that TNFalpha enhances beta2AR signaling in osteoblasts. TNFalpha was further found in C2C12 cells to suppress bone morphogenetic protein 2-induced alkaline phosphatase (ALP) activity and the expression of osteogenic marker genes including Runx2, ALP and osteocalcin. Propranolol, a beta2AR antagonist, attenuated this TNFalpha suppression of osteogenic differentiation. TNFalpha increased the expression of receptor activator of NF-kappaB ligand (RANKL), an essential osteoclastogenic factor, in C2C12 cells which was again blocked by propranolol. In summary, our data show that TNFalpha increases beta2AR expression in osteoblasts and that a blockade of beta2AR attenuates the suppression of osteogenic differentiation and stimulation of RANKL expression by TNFalpha. These findings imply that a crosstalk between TNFalpha and beta2AR signaling pathways might occur in osteoblasts to modulate their function.
Alkaline Phosphatase ; Animals ; Arthritis, Rheumatoid ; Atherosclerosis ; Bone Morphogenetic Proteins ; Durapatite ; Mesenchymal Stromal Cells ; Mice ; Osteoblasts ; Osteocalcin ; Propranolol ; Receptor Activator of Nuclear Factor-kappa B ; Receptors, Adrenergic ; Tumor Necrosis Factor-alpha

Multiple primary malignancy is called when two cancers occur independently in one individual. Multiple primary malignancy may be divided into two groups, synchronous or metachronous depending on the interval between their diagnosis. Synchronous cancer is diagnosed simultaneously or within an interval of 6 months and metachronous cancer at interval of more than 6 months. Since Billroth reported the first case of multiple primary malignancy, many cases have been reported partly owing to the advancement of diagnostic procedures and treatment modalities. The incidence of multiple primary malignancy tends to increase and it is fundamental that patients who have been treated for cancer receive a careful follow-up study. Here we report on a case of stage-IV advanced gastric cancer with stage-I renal cell carcinoma which was discovered during the staging procedure of gastric cancer. Both cancers were confirmed histologically and classified as gastric adeno-carcinoma and renal cell carcinoma.
Carcinoma, Renal Cell ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Kidney ; Stomach ; Stomach Neoplasms*

Although intestinal bleeding is known to occur in amyloidosis, it is rare as a presenting symptom or sole manifestation of the disease. We experienced a case of intestinal hemor-rhage in a 64-year old female patient with primary amyloidosis, kappa type. Antral muco-sal erosions were discovered and one shallow healing ulcer at the angle. Colonoscopy revealed multiple purplish nodules in the sigmoid colon and descending colon, as well as a large shallow ulcer with blood clots in the sigmoid colon which was suspected to be the intestinal hemorrhage site. Endoscopic biopsy established amyloidosis. Polarizing microscopy after Congo red staining and immunohistochemical staining identified primary amyloid, kappa type. A case of intestinal hemorrhage in patients with primary amyloidosis is presented and the literature is reviewed.
Amyloid ; Amyloidosis* ; Biopsy ; Colon, Descending ; Colon, Sigmoid ; Colonoscopy ; Congo Red ; Female ; Hemorrhage* ; Humans ; Microscopy ; Middle Aged ; Ulcer