BACKGROUND: Being obese during adolescence leads to undue physical or psychological problems and may increase the incidence of cardiovascular disease or endocrinological disorders. Recently authors have experienced a case of hyperinsulinemic obese girl with virilization. We report it with a review of the literature. CASE: A 17-year old female came into 'obesity clinic' of Asan Medical Center due to weight gain. She had virilizing feature, hirsutism, underdeveloped female sexual characteristics, and acanthosis nigricans. Work-up by laboratory tests and imaging studies showed very severe obesity with metabolic disturbances, and hyperandrogenism with hyperinsulinemia. Treatment for obesity was multidisciplinary method including behavior modification, calorie restriction, exercise, and medication with fluoxetine 40mg po qd, and for hyperandrogenism, provera 10mg po qd was described. CONCLUSIONS: Severe hyperinsulinemia in obese female leads to male-type hirsutism, disturbance of menstrual cycle, abdominal obesity, and cardiovascular disorders. One of the physical findings of hyperinsulinemia or insulin resistance is acanthosis nigricans. So, if an female obese patient have acanthosis nigricans with hyperinsulinemia, should be assessed and treated for risk factors of cardiovascular disorders and hormonal disturbances.
Acanthosis Nigricans ; Adolescent* ; Behavior Therapy ; Cardiovascular Diseases ; Chungcheongnam-do ; Female* ; Fluoxetine ; Hirsutism ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Insulin Resistance ; Medroxyprogesterone Acetate ; Menstrual Cycle ; Obesity ; Obesity, Abdominal ; Obesity, Morbid ; Risk Factors ; Virilism* ; Weight Gain

Skin fibrotic disorders are understood to develop under the influence of various cytokines, such as transforming growth factor(TGF)-beta1, connective tissue growth factor(CTGF) and vascular endothelial growth factor (VEGF). To establish an appropriate animal model of skin fibrosis by exogenous application of growth factors, the author investigated the in vivo effects of growth factors by injecting recombinant TGF-beta1 protein and pCMV- Flag5-CTGF into the subcutaneous tissue of Sprague- Dawley rats. A single application of TGF-beta1 protein and CTGF DNA resulted in the formation of transient granulation tissue. Immunohistochemical finding showed increased expression of TGF-beta1 protein after injection of pCMV-Flag5-CTGF. In situ hybridization analysis revealed the expression of CTGF mRNA after injection of TGF-beta1 protein. VEGF expression was not affected by the TGF-beta1 and CTGF injection. These findings suggest TGF-beta1 and CTGF are deeply related with skin fibrosis and it appears that TGF-beta1 may cause the induction of CTGF expression. The animal model on skin fibrosis by exogenous application of TGF-beta1 protein and CTGF DNA developed in this study may be useful for future studies on fibrotic disorders.
Animals ; Cicatrix* ; Connective Tissue ; Connective Tissue Growth Factor ; Cytokines ; DNA ; Fibrosis ; Granulation Tissue ; In Situ Hybridization ; Intercellular Signaling Peptides and Proteins ; Models, Animal ; Rats* ; RNA, Messenger ; Skin ; Subcutaneous Tissue ; Transforming Growth Factor beta1* ; Vascular Endothelial Growth Factor A*

Background/Aims: Tegoprazan, a novel potassium-competitive acid blocker, has shown rapid action and gastric acid inhibition. In this study, we evaluated the efficacy of a tegoprazan-based, nonbismuth-containing quadruple (concomitant) therapy for the primary eradication of Helicobacter pylori. Methods: We conducted a prospective, single-arm, single-center, primitive study to verify the efficacy of a 10-day tegoprazan- based (50-mg dose) concomitant therapy, including amoxicillin (1,000-mg dose), clarithromycin (CLA; 500-mg dose), and metronidazole (MET; 500-mg dose) twice daily as a first-line treatment for H. pylori eradication. Results: We tested consecutive cultures for antibiotic susceptibility and minimum inhibitory concentrations. We enrolled 84 participants; 79 (94.0%) completed first-line therapy. The overall intention-to-treat and per-protocol eradication rates were 90.5% (95% confidence interval [CI], 82.1−95.8) and 96.2% (95% CI, 83.4–97.6), respectively. Of the 73 participants evaluated for antibiotic resistance, 19 (26.0%), 32 (42.5%), and 8 (11.0%) exhibited CLA, MET, and CLA and MET dual resistance, respectively. Of these, 39 participants (66.1%) exhibited successful eradication after the therapeutic regimen despite antibiotic resistance. Conclusions The 10-day tegoprazan-based concomitant therapy may be an effective first-line treatment for eradicating H. pylori.

Background and Objectives: Mesenchymal stem cells (MSCs) elicit therapeutic effects against liver fibrosis in animal models. Human liver stem cells (HLSCs) are cells isolated from human liver tissue that have mesenchymal morphology and express MSC markers. HLSCs also possess intrahepatic stem cell properties. We introduce a rat model of liver fibrosis and trans-portal transplantation of HLSC to demonstrate alleviation of liver fibrosis. Methods: and Results: Liver fibrosis was induced by intraperitoneal injection of Carbon tetrachloride (CCl 4 ). Sprague Dawley rats underwent simultaneous partial hepatectomy of the left hepatic lobe and HLSC transplantation via the portal vein. Gross appearance of the liver observed following CCl 4 injection showed cholestasis and surface nodularity. Sirius red staining revealed deposition of collagen fibers in the extracellular matrix (ECM). Following HLSC transplantation, human albumin secreting cells were detected by immunohistochemistry in liver specimens. Quantitative measurements of fibrosis area stained by Sirius red were compared between baseline and post-HLSC transplant (1×10 7 cells) following 10 weeks of CCl 4treatment liver specimens. Fibrosis area (p＜0.05), serum markers of liver inflammation and fibrosis (AST, ALT levels and APRI, p＜0.05) significantly decreased from baseline after HLSC transplantation. RNA expression in liver tissues revealed significant decrease in tissue inhibitor of matrix metalloproteinase 1 (TIMP1), TIMP2 expression and increase in hepatocyte growth factor expression following HLSC transplantation (p＜0.05). Conclusions HLSC transplantation effectively reduced the area of liver fibrosis with increased expression of factors promoting ECM degradation. These findings suggest the potential therapeutic role of HLSCs in various liver diseases presenting with liver fibrosis.

Purpose: Respiratory virus infection is a common cause of hospitalization in children. Rapid testing for respiratory viruses, such as the FilmArray method, can be clinically useful. However, insufficient evidence exists to support its use in standard clinical care. Methods: We retrospectively analyzed data from children under 18 years old who received the multiplex real-time polymerase chain reaction array (multiplex RT-PCR) method in 2017 and by FilmArray respiratory panel (FilmArray RP) in 2018. Results: Between January, 2017 and December, 2018, we reviewed data from 1,480 hospitalized children. The number of children with virus detection in respiratory viral PCR was 523 in the multiplex RT-PCR method and 419 in the FilmArray method. Seasonal virus outbreak patterns were similar to those of Korea Centers for Disease Control and Prevention in both groups. There was no difference between the 2 groups in the mean length of hospital stay. The time from admission to isolation by influenza infection was significantly shorter in the FilmArray group than in the multiplex RT-PCR group among patients who were not diagnosed with influenza infection by rapid antigen test at the time of admission. Conclusion The use of FilmArray method for respiratory viruses did not diminish length of hospital stay. However, the FilmArray method may quickly detect the prevalence of respiratory infection and aid in clinical treatment. In addition, it was related with a reduced time from admission to isolation by influenza infection in hospitalized children who were not identified with influenza infection by rapid antigen test at the time of admission.

Ochratoxin A is a natural contaminant of mouldy food and feed, which is produced by Penicillium and Aspergillus, and is suspected of being one of the etiological agents responsible for Balkan endemic nephropathy and the associated urinary tract tumors. For evaluation of the mutagenicity of ochratoxin A, we performed in vitro chromosome aberration tests using Chinese hamster lung fibroblast cells (CHL cells) and monkey kidney cells (VERO cells), in vivo micronueleus tests using ddY mouse bone marrow cells and somatic mutation and recombination tests (SMART) using Drosophila melanogaster. The results of chromosome aberration tests in CHL cells showed no incidence of increased structural and numerical aberrations regardless of metabolic activation, while in VERO cells treated with 2.0, 1.0, 0.5, 0.3 ug/ml of ochratoxin A showed significant increase of structural aberrations without metabolic activation. Aspartame and-phenylalanine, structural analogs of ochratoxin A, didn't affect the chromosome aberrations induced by ochratoxin A. The in vivo induction of micronucleated polychromatic erythrocytes were measured in bone marrows of ddY mice treated with 10.0, 5.0, 2.5mg/kg/10ml of ochratoxin A through intraperitoneal route once. At 24 and 48 hours after treatment, ochratoxin A didn't induce micronuclei in bone marrows of ddY mice. And at the concentration of 40, 20, 10 ug/ml of ochratoxin A, which was administered by feeding to larvae of Drosophila melanogaster, showed no incidence of increased multiple wing hairs and flares. Summarizing all results, we concluded that ochratoxin A is a kidney cell specific direct genotoxicant.
Animals ; Asian Continental Ancestry Group* ; Aspartame ; Aspergillus ; Balkan Nephropathy ; Biotransformation ; Bone Marrow ; Bone Marrow Cells ; Chromosome Aberrations ; Cricetinae ; Cricetulus* ; Drosophila melanogaster* ; Drosophila* ; Erythrocytes ; Fibroblasts ; Hair ; Haplorhini ; Humans ; Incidence ; Kidney ; Larva ; Lung* ; Mice* ; Penicillium ; Recombination, Genetic ; Urinary Tract ; Vero Cells*

PURPOSE: Both atopy and bronchial hyperresponsiveness (BHR) are characteristic features of asthma. Several BHR studies comparing groups of atopic and nonatopic asthmatics have reported conflicting results. The aim of this study was to compare BHR to indirect stimuli, such as mannitol or exercise, between atopic and nonatopic asthmatics in children. METHODS: We performed a retrospective analysis of data from 110 children with asthma, aged 6–18 years using skin prick tests, and serum total and specific IgE levels. Atopy degree was measured using the sum of graded wheal size or the sum of the allergen-specific IgE. Bronchial provocation tests (BPTs) using methacholine were performed on all subjects. BPTs using indirect simuli, including exercise and mannitol, were also performed. RESULTS: Asthma cases were classified as atopic asthma (n=83) or nonatopic asthma (n=27) from skin prick or allergen-specific IgE test results. There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics. Atopic asthma had a significantly lower postexercise maximum decrease in % forced expiratory volume in 1 second (FEV1) (geometric mean [95% confidence interval]: 31.9 [22.9–40.9] vs. 14.0 [9.4–18.6], P=0.015) and a methacholine PC20 (provocative concentration of methacholine inducing a 20% fall in FEV1) than nonatopic asthmatics (geometric mean [95% confidence interval]: 1.24 [0.60–1.87] ng/mL vs. 4.97 [3.47–6.47]) ng/mL, P=0.001), whereas mannitol PD15 (cumulative provocative dose causing a 15% fall in FEV1) was not significantly different between the 2 groups. CONCLUSION: There was no significant difference in the prevalence of BHR to mannitol or exercise between atopic and nonatopic asthmatics in children.
Asthma ; Bronchial Provocation Tests ; Child* ; Forced Expiratory Volume ; Humans ; Immunoglobulin E ; Mannitol ; Methacholine Chloride ; Prevalence ; Retrospective Studies ; Skin

PURPOSE: It was found that periostin and squamous cell carcinoma-related antigens (SCCAs) were strongly interleukin-13-inducible gene products. This study measures the serum periostin and SCCA levels in children suffering from atopic dermatitis (AD) and to evaluate the association between the severity of AD and their values. METHODS: Seventy AD children aged 1 month to 10 years were included in our study. Subjects were characterized as having atopic eczema (AE; n=55) or non-AE (NAE; n=15) by atopic sensitization. Serum SCCA and periostin levels were measured. RESULTS: The serum periostin levels were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 80.47 ng/mL [75.06–85.93 ng/mL] vs. 67.45 ng/mL [59.99–75.64] ng/mL, P=0.020). The serum concentrations of both SCCA1 and SCCA2 were significantly higher in children with AE than in those with NAE (geometric mean [95% confidence interval]: 1.401 [1.198–1.643] ng/mL vs. 0.969 [0.723–1.268] ng/mL, P=0.039 for SCCA1) (1.178 [0.974–1.455] ng/mL vs. 0.711 [0.540–0.994] ng/mL, P=0.025 for SCCA2). The serum periostin levels were significantly correlated with disease severity and with peripheral blood eosinophil counts. The SCCA levels were not significantly correlated with disease severity. Both SCCA1 and SCCA2 were significantly correlated with serum periostin levels and blood eosinophil counts. CONCLUSION: Serum periostin levels may be significantly correlated with disease severity and blood eosinophil counts in children with AD. Serum SCCA levels can be significantly correlated with serum periostin levels and blood eosinophil counts in children with AD.
Child* ; Dermatitis, Atopic* ; Eosinophils ; Epithelial Cells* ; Humans

A 4-month-old female maltese dog was admitted to Veterinary Medical Teaching Hospital of Seoul National University for evaluation of abnormal color of bilateral irises. This patient had the photophobia in the light and exhibited the complete absence of pigment resulting in white hair, pink muzzle, eyelids and foot-pads. Central zone of the irises were yellow in color influenced by tapetal reflex, and peripheral zone were pale blue. The iridal capillaries were transparented on the irises. Ophthalmoscopic examination revealed a yellow tapetal fundus but no pigment in the nontapetal fundus.
Albinism, Oculocutaneous/diagnosis/*veterinary ; Animals ; Dog Diseases/*diagnosis ; Dogs ; Female ; Ophthalmoscopy/veterinary ; Photophobia/diagnosis/veterinary

The purpose of this study was to investigate and examine the relationship between dietary habits, food intake patterns, and depression in Korean women with polycystic ovary syndrome (PCOS). The Center for Epidemiologic Studies Depression Scale Korean Version was used to determine whether a participant was depressed or not. The dietary habits were assessed by the Min-Dietary Assessment (MDA) method, and food intake data were collected by the 24-hour recall method on two non-consecutive days, at least 7 days apart, and the average of the two days was used to estimate the usual dietary intake. The total MDA scores of the Depression Group was significantly lower than that of the No-Depression Group (31.5 +/- 6.4 vs 33.4 +/- 6.0, p = 0.027). The intake of cereals/potatoes/sugar products, milk and milk products, plant protein, and calcium for the Depression Group were significantly lower compared to the No-Depression Group. The Depression Group had a significantly higher percentage of energy intakes from protein as well as the consumption of fish and shellfish compared to the No-Depression Group. There was a significant inverse relationship between milk and milk products consumption and the prevalence of depression [OR (95% CI) for the highest tertile compared to the lowest: 0.390 (0.177-0.857); p for trend = 0.016]. There were also significant positive relationships between the prevalence of depression and the consumption of the following: fish and shellfish [OR (95% CI) for the highest tertile compared to the lowest: 2.319 (1.128-4.770); p for trend = 0.009], animal protein (p for trend = 0.049), and the percentage of energy intakes from protein [OR (95% CI) for the highest tertile compared with the lowest: 2.546(1.156-5.609); p for trend = 0.025]. Further studies are needed in order to investigate whether the intake of protein and of animal protein is indeed associated with depression in PCOS patients in Korea and the possible mechanisms thereof. The results of our study can be applicable for the development of effective nutrition counseling and education programs regarding PCOS patients with depression as part of their successful treatment regimen.
Animals ; Calcium ; Counseling ; Depression ; Eating ; Epidemiologic Studies ; Female ; Food Habits ; Humans ; Korea ; Milk ; Plants ; Polycystic Ovary Syndrome ; Prevalence ; Shellfish ; Staphylococcal Protein A