Abnormal inflammatory responses are closely associated with intestinal microbial dysbiosis. Oral administration of Qmatrix-diabetes-mellitus complex (QDMC), an Aloe gel-based formula, has been reported to improve inflammation in type 2 diabetic mice; however, the role of the gut microbiota in ameliorating efficacy of QDMC remains unclear. We investigated the effect of QDMC on the gut microbiota in a type 2 diabetic aged mouse model that was administered a high-fat diet. Proinflammatory (TNF-α and IL-6) and anti-inflammatory (IL-4 and IL-10) cytokine levels in the fat were normalized via oral administration of QDMC, and relative abundances of Bacteroides, Butyricimonas, Ruminococcus, and Mucispirillum were simultaneously significantly increased. The abundance of these bacteria was correlated to the expression levels of cytokines. Our findings suggest that the immunomodulatory activity of QDMC is partly mediated by the altered gut microbiota composition.

Extramedullary relapse of acute promyelocytic leukemia is rare and has been reported in 3%- 5% of patients. Relapse in the external auditory canal and the temporal bone is even more uncommon and scarcely reported. We encountered a 69-year-old male who complained about right ear pain and hearing loss. The patient had extramedullary relapse of acute promyelocytic leukemia in the right external auditory canal and in the temporal bone.

Hyperlipidemia, which is closely associated with a fatty diet and aging, is commonly observed in the western and aged society. Therefore, a novel therapeutic approach for this disease is critical, and an immunological view has been suggested as a novel strategy, because hyperlipidemia is closely associated with inflammation and immune dysfunction. In this study, the effects of an aqueous extract of Rubus occidentalis (RO) in obese mice were investigated using immunological indexes. The mice were fed a high-fat diet (HFD) to induce hyperlipidemia, which was confirmed by biochemical analysis and examination of the mouse physiology. Two different doses of RO and rosuvastatin, a cholesterol synthesis inhibitor used as a control, were orally administered. Disturbances in immune cellularity as well as lymphocyte proliferation and cytokine production were significantly normalized by oral administration of RO, which also decreased the elevated serum tumor necrosis factor (TNF)-α level and total cholesterol. The specific immune-related actions of RO comprised considerable improvement in cytotoxic T cell killing functions and regulation of antibody production to within the normal range. The immunological evidence confirms the significant cholesterol-lowering effect of RO, suggesting its potential as a novel therapeutic agent for hyperlipidemia and associated immune decline.
Administration, Oral ; Aging ; Animals ; Antibody Formation ; Cholesterol ; Diet ; Diet, High-Fat ; Homicide ; Hyperlipidemias* ; Inflammation ; Lymphocytes ; Mice ; Mice, Obese* ; Physiology ; Reference Values ; Rosuvastatin Calcium ; Rubus* ; Tumor Necrosis Factor-alpha

Charcot-Marie-Tooth disease type 1A (CMT1A) is associated with duplication of chromosome 17p11.2-p12, whereas hereditary neuropathy with liability to pressure palsies (HNPP), which is an autosomal dominant neuropathy showing characteristics of recurrent pressure palsies, is associated with 17p11.2-p12 deletion. An altered gene dosage of PMP22 is believed to the main cause underlying the CMT1A and HNPP phenotypes. Although CMT1A and HNPP are associated with the same locus, there has been no report of these two mutations within a single family. We report a rare family harboring CMT1A duplication and HNPP deletion.
Charcot-Marie-Tooth Disease ; Gene Dosage ; Humans ; Paralysis ; Phenotype

Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.

IL-18 is a crucial pro-inflammatory cytokine that mediates chronic intestinal inflammation. Metformin, an anti-diabetic drug, was reported to have ameliorative effects on inflammatory bowel disease. Recently, the mechanism of action of metformin was explained as a modulation of gut microbiota. In this study, fecal microbiota transplantation (FMT) using fecal material from metformin-treated mice was found to upregulate the expression of GLP-1 and pattern-recognition receptors TLR1 and TLR4 for the improvement in hyperglycemia caused by a high-fat diet. Further, FMT downregulated the expression of the inflammatory cytokine IL-18. Within the genera Akkermansia, Bacteroides, and Butyricimonas, which were promoted by metformin therapy, Butyricimonas was found to be consistently abundant following FMT. Our findings suggest that modulation of gut microbiota is a key factor for the anti-inflammatory effects of metformin which is used for the treatment of hyperglycemia.
Animals ; Bacteroides ; Diet, High-Fat ; Down-Regulation ; Fecal Microbiota Transplantation ; Gastrointestinal Microbiome ; Glucagon-Like Peptide 1 ; Hyperglycemia ; Inflammation ; Inflammatory Bowel Diseases ; Interleukin-18 ; Metformin ; Mice ; Toll-Like Receptors

Background and Objectives: Cognitive behavioral therapy (CBT) is a treatment option for subjective tinnitus. There are many reports on its clinical efficacy, but the protocol has not been well established. The purpose of this study was to set an outpatient-based CBT protocol and evaluate its clinical efficacy for tinnitus.Subjects and Method A total of 85 chronic tinnitus patients was assessed in this prospective study. After evaluating for eligibility, 30 patients completed CBT based on a protocol of 5 weekly sessions in an outpatient setting. Therapeutic efficacy was assessed by Tinnitus Handicap Inventory (THI) questionnaires and visual analogue scale (VAS) for tinnitus. The initial scores were compared with the final scores, which were assessed a month after the fifth CBT session. Results: The results showed that CBT reduced THI and VAS scores significantly (p<0.05). Conclusion The results of the study suggest that an outpatient-based CBT protocol can be clinically beneficial for patients with tinnitus.

Purpose: There are no reliable biomarkers to guide treatment for patients with borderline resectable pancreatic cancer (BRPC) in the neoadjuvant setting. We used plasma circulating tumor DNA (ctDNA) sequencing to search biomarkers for patients with BRPC receiving neoadjuvant mFOLFIRINOX in our phase 2 clinical trial (NCT02749136). Materials and Methods: Among the 44 patients enrolled in the trial, patients with plasma ctDNA sequencing at baseline or post-operation were included in this analysis. Plasma cell-free DNA isolation and sequencing were performed using the Guardant 360 assay. Detection of genomic alterations, including DNA damage repair (DDR) genes, were examined for correlations with survival. Results: Among the 44 patients, 28 patients had ctDNA sequencing data qualified for the analysis and were included in this study. Among the 25 patients with baseline plasma ctDNA data, 10 patients (40%) had alterations of DDR genes detected at baseline, inclu-ding ATM, BRCA1, BRCA2 and MLH1, and showed significantly better progression-free survival than those without such DDR gene alterations detected (median, 26.6 vs. 13.5 months; log-rank p=0.004). Patients with somatic KRAS mutations detected at baseline (n=6) had significantly worse overall survival (median, 8.5 months vs. not applicable; log-rank p=0.003) than those without. Among 13 patients with post-operative plasma ctDNA data, eight patients (61.5%) had detectable somatic alterations. Conclusion Detection of DDR gene mutations from plasma ctDNA at baseline was associated with better survival outcomes of pati-ents with borderline resectable pancreatic ductal adenocarcinoma treated with neoadjuvant mFOLFIRINOX and may be a prognostic biomarker.

Asian-lineage H5 highly pathogenic avian influenza (HPAI) viruses have caused continuous outbreaks in poultry and wild birds. Development of rapid and accurate diagnostic methods is needed for preventing further spread of the virus and reducing the time required for eradication of the virus. We developed a low-density microarray for the rapid detection and identification of avian influenza virus subtypes H5, H7, and H9 and their pathotypes in a previous study. In the present study, we evaluated previously developed diagnostic microarray using avian influenza viruses isolated in Mongolia, including H5 HPAI viruses. All H5 HPAI viruses isolated in Mongolia were shown as H5-specific and highly pathogenic pattern in the microarray. H2, H3 and H12 viruses isolated in Mongolia used in this study did not show any H5, H7 and H9 patterns. These results indicated that this diagnostic microarray has enormous potential for the rapid subtyping and pathotyping of influenza viruses, including viruses isolated in Mongolia.
Animals ; Birds ; Disease Outbreaks ; Influenza in Birds* ; Mongolia* ; Orthomyxoviridae ; Poultry