Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

Bezoars are indigestible masses that can cause gastrointestinal complications such as obstructions and perforations. We report the case of a 60-year-old man with a history of type 2 diabetes mellitus and duodenal ulcer surgery. The patient developed a large gastric phytobezoar that caused persistent dyspepsia and epigastric pain. Upper endoscopy confirmed a 10-cm phytobezoar and a 1.5-cm active ulcer at the gastric angle. To soften the bezoar, Coca-Cola and cellulase were administered to the patient. This treatment significantly reduced the bezoar’s hardness, permitting its successful endoscopic fragmentation using conventional devices. Over three endoscopic sessions, the bezoar was fragmented into pieces smaller than 1 cm and removed; thereafter, the gastric ulcer healed completely. This case illustrates the effectiveness of combining the actions of Coca-Cola and cellulase with endoscopic methods to treat large bezoars, providing an alternative to surgical approaches in community healthcare settings.

Dysregulation of the Wnt pathway causes various diseases including cancer, Parkinson’s disease, Alzheimer’s disease, schizophrenia, osteoporosis, obesity and chronic kidney diseases. The modulation of dysregulated Wnt pathway is absolutely necessary. In the present study, we evaluated the anti-inflammatory effect and the mechanism of action of Wnt-C59, a Wnt signaling inhibitor, in lipopolysaccharide (LPS)-stimulated epithelial cells and macrophage cells. Wnt-C59 showed a dose-dependent anti-inflammatory effect by suppressing the expression of proinflammatory cytokines including IL6, CCL2, IL1A, IL1B, and TNF in LPS-stimulated cells. The dysregulation of the Wnt/β-catenin pathway in LPS stimulated cells was suppressed by WntC59 treatment. The level of β-catenin, the executor protein of Wnt/β-catenin pathway, was elevated by LPS and suppressed by Wnt-C59. Overexpression of β-catenin rescued the suppressive effect of Wnt-C59 on proinflammatory cytokine expression and nuclear factor-kappa B (NF-κB) activity. We found that the interaction between β-catenin and NF-κB, measured by co-immunoprecipitation assay, was elevated by LPS and suppressed by Wnt-C59 treatment. Both NF-κB activity for its target DNA binding and the reporter activity of NF-κB-responsive promoter showed identical patterns with the interaction between β-catenin and NF-κB. Altogether, our findings suggest that the anti-inflammatory effect of Wnt-C59 is mediated by the reduction of the cellular level of β-catenin and the interaction between β-catenin and NF-κB, which results in the suppressions of the NF-κB activity and proinflammatory cytokine expression.

Dysregulation of the Wnt pathway causes various diseases including cancer, Parkinson’s disease, Alzheimer’s disease, schizophrenia, osteoporosis, obesity and chronic kidney diseases. The modulation of dysregulated Wnt pathway is absolutely necessary. In the present study, we evaluated the anti-inflammatory effect and the mechanism of action of Wnt-C59, a Wnt signaling inhibitor, in lipopolysaccharide (LPS)-stimulated epithelial cells and macrophage cells. Wnt-C59 showed a dose-dependent anti-inflammatory effect by suppressing the expression of proinflammatory cytokines including IL6, CCL2, IL1A, IL1B, and TNF in LPS-stimulated cells. The dysregulation of the Wnt/β-catenin pathway in LPS stimulated cells was suppressed by WntC59 treatment. The level of β-catenin, the executor protein of Wnt/β-catenin pathway, was elevated by LPS and suppressed by Wnt-C59. Overexpression of β-catenin rescued the suppressive effect of Wnt-C59 on proinflammatory cytokine expression and nuclear factor-kappa B (NF-κB) activity. We found that the interaction between β-catenin and NF-κB, measured by co-immunoprecipitation assay, was elevated by LPS and suppressed by Wnt-C59 treatment. Both NF-κB activity for its target DNA binding and the reporter activity of NF-κB-responsive promoter showed identical patterns with the interaction between β-catenin and NF-κB. Altogether, our findings suggest that the anti-inflammatory effect of Wnt-C59 is mediated by the reduction of the cellular level of β-catenin and the interaction between β-catenin and NF-κB, which results in the suppressions of the NF-κB activity and proinflammatory cytokine expression.

Postconditioning has been shown to protect the mouse brain from ischemic injury. However, the neuroprotective mechanisms of postconditioning remain elusive. We have found that toll-like receptor 5 (TLR5) plays an integral role in postconditioning-induced neuroprotection through Akt/nuclear factor kappa B (NF-κB) activation in cerebral ischemia. Compared to animals that received 30 min of transient middle cerebral artery occlusion (tMCAO) group, animals that also underwent postconditioning showed a significant reduction of up to 60.51% in infarct volume. Postconditioning increased phospho-Akt (p-Akt) levels and NF-κB translocation to the nucleus as early as 1 h after tMCAO and oxygen-glucose deprivation. Furthermore, inhibition of Akt by Akt inhibitor IV decreased NF-κB promoter activity after postconditioning. Immunoprecipitation showed that interactions between TLR5, MyD88, and p-Akt were increased from postconditioning both in vivo and in vitro. Similar to postconditioning, flagellin, an agonist of TLR5, increased NF-κB nuclear translocation and Akt phosphorylation. Our results suggest that postconditioning has neuroprotective effects by activating NF-κB and Akt survival pathways via TLR5 after cerebral ischemia. Additionally, the TLR5 agonist flagellin can simulate the neuroprotective mechanism of postconditioning in cerebral ischemia.
Animals ; Brain ; Brain Ischemia* ; Flagellin ; Immunoprecipitation ; In Vitro Techniques ; Infarction, Middle Cerebral Artery ; Mice* ; Neuroprotection ; Neuroprotective Agents ; NF-kappa B ; Phosphorylation ; Toll-Like Receptor 5

OBJECTIVES: Clinical utility of the Short Form of the Samsung Dementia Questionnaire (S-SDQ) as a screening instrument for Mild Cognitive Impairment (MCI). METHODS: Three groups (n=27, Subjective Memory Impairment (SMI); n=41 MCI; n=79, Early Alzheimer's Disease(AD)) recruited from memory clinic were administered a battery of neuropsychological tests including S-SDQ and Korean version-Mini Mental State Examination (K-MMSE). RESULTS: S-SDQ, unlike the K-MMSE, had no association with the age and education of the subjects. Scores of S-SDQ was found to correlate (r=-.496) with scores of K-MMSE. Result of Receiver Operating Characteristic (ROC) analysis revealed that S-SDQ discriminated between the SMI and the MCI groups. CONCLUSION: S-SDQ may be a solution to the problem of contamination by education and age which affect traditional cognitive screening instruments like K-MMSE, and it may be a useful tool for screening MCI.
Dementia* ; Education ; Mass Screening ; Memory ; Mild Cognitive Impairment* ; Neuropsychological Tests ; Surveys and Questionnaires* ; ROC Curve

OBJECTIVES: Dry eye disease (DED) is an increasingly important public health problem in Korea. Previous studies conducted in Korea have reported inconsistent results regarding the protective effects of vitamin D on DED, and these discrepancies may be related to the relatively simple questionnaire that has been used. Thus, we evaluated the association of serum vitamin D levels with DED using the ocular surface disease index (OSDI). METHODS: The present study evaluated data from participants in the Study Group for Environmental Eye Disease (2014-2015). This group included data from 752 participants, and data from 740 participants (253 men and 487 women) were analyzed in the present study. DED severity was evaluated using the OSDI. RESULTS: Higher serum vitamin D levels were associated with a non-significantly reduced risk of DED in the crude analysis (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.971 to 1.011) and in the adjusted analysis (OR, 0.988; 95% CI, 0.966 to 1.010). In the crude analysis of no/mild DED vs. moderate/severe DED, men exhibited a decreased risk with increasing serum vitamin D levels (OR, 0.999; 95% CI, 0.950 to 1.051), while women exhibited an increased risk (OR, 1.003; 95% CI, 0.979 to 1.027). In these analyses, we found no significant associations. CONCLUSIONS: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.
25-Hydroxyvitamin D 2 ; Dry Eye Syndromes ; Eye Diseases* ; Female ; Humans ; Keratoconjunctivitis Sicca ; Korea ; Male ; Public Health ; Vitamin D* ; Vitamins*