It appears that a low-carbohydrate high-fat diet is more effective in weight loss than conventional low-fat diets for short-term periods of approximately 6 months. However, for long-term periods of about 1 year or more, the effects of a low-carbohydrate diet are reduced and the difference in weight loss between low-carbohydrate and low-fat diets disappears. A low-carbohydrate diet can lead to low triglycerides and high HDL cholesterol, and may even lead to an increase in LDL cholesterol. The effects of a low-carbohydrate diet on glycemic control are not clear, and there is no effect on blood pressure. A low-carbohydrate diet may lead to cardiovascular disease, and can increase cardiovascular and all-cause mortality.
Blood Pressure ; Cardiovascular Diseases ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Diet, Fat-Restricted ; Diet, High-Fat ; Mortality ; Triglycerides ; Weight Loss

Ion channel inhibitors are widely used for pharmacological discrimination between the different channel types as well as for determination of their functional role. In the present study, we tested the hypothesis that 4-aminopyridine (4-AP) could affect the large conductance Ca2+ -activated K+ channel (BKCa) currents using perforated-patch or cell-attached configuration of patch-clamp technique in the rabbit pulmonary arterial smooth muscle. Application of 4-AP reversibly inhibited the spontaneous transient outward currents (STOCs). The reversal potential and the sensitivity to charybdotoxin indicated that the STOCs were due to the activation of BKCa. The BKCa currents were recorded in single channel resolution under the cell-attached mode of patch-clamp technique for minimal perturbation of intracellular environment. Application of 4-AP also inhibited the single BKCa currents reversibly and dose-dependently. The membrane potential of rabbit pulmonary arterial smooth muscle cells showed spontaneous transient hyperpolarizations (STHPs), presumably due to the STOC activities, which was also inhibited by 4-AP. These results suggest that 4-AP can inhibit BKCa currents in the intact rabbit vascular smooth muscle. The use of 4-AP as a selective voltage-dependent K+ (KV) channel blocker in vascular smooth muscle, therefore, must be reevaluated.
4-Aminopyridine* ; Charybdotoxin ; Discrimination (Psychology) ; Ion Channels ; Membrane Potentials ; Muscle, Smooth* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle* ; Patch-Clamp Techniques ; Pulmonary Artery

PURPOSE: The bedside lung ultrasound in emergency (BLUE) protocol is an excellent diagnostic tool for acute respiratory failures requiring admission to the intensive care unit. We incorporated cardiac ultrasound in the BLUE algorithm because cardiac origin is also necessary to examine in an emergency setting. We studied the usefulness of the emergency department (ED)-BLUE protocol for patients complaining of dyspnea in an emergency department. METHODS: At first, we assessed lung sliding, artifacts (Alines and B-lines), alveolar consolidation and pleural effusion on stage I and II evaluation. Then, we checked heart to detect 3Es (Effusion, Equality, and Ejection fractions). We divided all the possible conditions into 10 categories. We compared it with final diagnosis and examined the agreements using kappa statistics. We compared the physician's level of confidence for the first impression. The 10 categories were: 1) normal or inconclusive, 2) pulmonary embolism, 3) airway disease (chronic obstructive pulmonary disease or asthma), 4) pneumothorax, 5) large pleural effusion, 6) alveolar consolidation, 7) acute pulmonary edema due to systolic congestive heart failure, 8) acute respiratory distress syndrome, 9) chronic interstitial lung disease with exacerbation, and 10) pericardial effusion with/without tamponade. RESULTS: This prospective study was performed for 172 patients over 18-years-of-age with dyspnea during a 25-month period. Kappa value between the diagnosis after ED-BLUE and final diagnosis was 0.812(p<0.001). The mean of physician's full term for LOC for the first impression before and after ED-BLUE was 3.09+/-0.83 and 4.36+/-0.70 (paired t-test, p<0.001). CONCLUSION: ED-BLUE protocol could help the emergency physician make an accurate diagnosis in patients with dyspnea in the emergent setting.
Artifacts ; Dyspnea ; Emergencies ; Heart ; Heart Failure ; Humans ; Intensive Care Units ; Lung ; Lung Diseases, Interstitial ; Lung Diseases, Obstructive ; Pericardial Effusion ; Pleural Effusion ; Pneumothorax ; Prospective Studies ; Pulmonary Edema ; Pulmonary Embolism ; Respiratory Distress Syndrome, Adult

The current study aimed to compare the pH, solubility value, and ion release capability of premixed mineral trioxide aggregates (MTAs) versus conventional pulp capping materials before and after setting. The following materials were used: resin-modified calcium silicate cement (TheraCal LC®, TLC), resin-modified calcium hydroxide cement (Ultra-BlendTM plus, UBP), and 2 kinds of premixed MTA (Endocem MTA® premixed regular 〔EMPR〕 and Well-RootTM PT 〔WRP〕). The specimens of each material were prepared before and after setting and were immersed in distilled water. The materials’ pH and solubility value were assessed. Next, three kinds of ion (calcium, sulfide, and strontium) released by pulp capping materials were evaluated via inductively coupled plasma atomic emission spectrometry. In the after-setting group, the pH of TLC and UBP decreased. However, the pH of the premixed MTAs increased with time. TLC released a higher concentration of strontium ion compared with the other materials. Meanwhile, EMPR released a significantly high concentration of sulfide ion (p < 0.05). In the after-setting group, the 2 kinds of premixed MTAs released a significantly higher concentration of calcium ion compared with the other materials (p < 0.05). In the after-setting group, EMPR had a significantly low solubility value (p < 0.05). The Kruskal-Wallis test, followed by the Mann-Whitney U test with Bonferroni correction, was used in statistical analysis. In conclusion, resin-modified calcium silicate cement, modified calcium hydroxide cement, and the 2 kinds of premixed MTAs had an alkaline pH and low solubility value and they released various concentrations of ions after setting.

The hyalinizing trabecular adenoma (HTA) of the thyroid gland is a rare benign tumor, which is characterized by a trabecular growth pattern with hyaline stroma. This tumor is occasionally misdiagnosed as papillary carcinoma and medullary carcinoma. Distinguishing pathologic findings and immunochemical studies are needed to make a definite diagnosis. Recently, we experienced a case of HTA of the thyroid gland. A 54-year-old woman presented with both thyroid nodules (mainly the left thyroid). Fine needle aspiration cytology showed atypical follicular cells. We performed left hemithyroidectomy and finally diagnosed the specimen as HTA. We present this rare case with a brief review of the disease entity.
Adenoma ; Biopsy, Fine-Needle ; Carcinoma, Medullary ; Carcinoma, Papillary ; Female ; Humans ; Hyalin ; Thyroid Gland ; Thyroid Nodule

Pseudoaneurysm formation in the profunda femoris artery (PFA) is a rare complication of femur shaft fractures or, more usually, a consequence of operative repair. Over the past few years, percutaneous transcatheter arterial embolization (TAE) has increasingly been considered the most effective treatment for pseudoaneurysms of the PFA. We report two cases with pseudoaneurysms of the PFA that were caused by femur shaft fractures and were successfully treated using TAE with n-butyl cyanoacrylate (NBCA). When a pseudoaneurysm of the PFA occurs due to a femur shaft fracture, early recognition and prompt radiologic intervention may prevent severe vascular injury without the need for additional surgery. The advent of TAE using NBCA enables minimally invasive treatment to be undertaken and it is effective for managing pseudoaneurysms of the PFA.

No abstract available.
Central Nervous System* ; Humans ; Lymphoma* ; Methotrexate*

OBJECTIVE: Although surgical intervention, such as percutaneous vertebroplasty (PVP), is the standard treatment for osteoporotic vertebral compression fractures (OVCFs), its effectiveness and safety are unclear. Therefore, this study compared the safety and efficacy of conservative treatment with that of PVP for acute OVCFs.METHODS: Patients with single-level OVCFs who were treated conservatively with a transdermal fentanyl patch (TFP) or with PVP between March 2013 and December 2017 and followed-up for more than 1 year were retrospectively evaluated. Patients with pathologic fractures, fractures of more than two columns, or a history of PVP were excluded. Clinical outcomes (visual analog scale [VAS] scores) and radiographic factors were evaluated, including changes in the compression rate of the corresponding vertebral body at onset and after 12 months, sagittal Cobb angle at onset and after 6 and 12 months, and the incidence of adjacent compression fractures.RESULTS: Of the 131 patients evaluated, 75 were treated conservatively using TFPs and 56 underwent PVP. We divided the patients into TFP and PVP groups. Their baseline characteristics (including sex, level of fracture, and bone mineral density T-scores) were similar, but the TFP group was significantly younger. The overall VAS score for pain showed a greater decrease during the first month (1 week after PVP) in the PVP group but remained similar in the two groups thereafter. The compression rate after 12 months increased in the TFP group but decreased in the PVP group. Five patients in the PVP group, but none in the TFP group, experienced adjacent compression fractures within 12 months.CONCLUSION: We compared clinical and radiological outcomes between the TFP and PVP groups. The immediate pain reduction effect was superior in the PVP group, but the final clinical outcome was similar. Although the PVP group had a better-preserved compression rate than the TFP group for 1 year, the development of adjacent fractures was significantly higher. Although TFPs seemed to be beneficial in reducing the failure rate of conservative treatment, the possibility of side effects (22.6%, 17 out of 75 patients, in this study) should be carefully monitored.
Bone Density ; Fentanyl ; Fractures, Compression ; Fractures, Spontaneous ; Humans ; Incidence ; Retrospective Studies ; Vertebroplasty

The objective of the present study was to investigate the effects of heat treatment (HT) time on the optical properties, mechanical properties, and microstructure of lithium disilicate (Li 2 Si 2 O 5) glass-ceramic blocks. Samples were prepared by cutting lithium disilicate glass-ceramic blocks – Amber® Mill Prototype (AMP) and IPS e.max CAD (IEC) – into a disc shape (diameter of 12 mm and thickness of 1.2 mm) and evenly polishing the surface. Each sample was heat treated according to the manufacturer’s manual and HT holding time was set to 15, 30, 45, and 60 minutes according to different groups. The samples were tested by color difference analysis using a spectrophotometer. X-ray diffraction analysis, HR FE-SEM observation, Vickers hardness test, fracture toughness test, and biaxial flexural strength test were carried out. The acicular crystals of lithium disilicate became coarser and less transparent with increasing HT time. The results for color difference (ΔE * ) compared to VITA A2 standard shade showed that the difference was significantly higher in the AMP groups than the IEC groups (P<0.05). Translucency parameter (TP) values were significantly higher in the AMP groups than the IEC groups (P<0.05). The AMP30 group showed the highest TP value, while all other experimental groups showed the tendency of decrease in TP value with increase in HT time. Moreover, increase in TP value was associated with decrease in contrast ratio. When fracture toughness was measured by indentation fracture method, both AMP and IEC groups showed similar results with 1.77 MPa·m 1/2 after HT for 15 minutes. However, as HT time increased, the IEC groups showed significantly higher values than the AMP groups (P<0.05). X-ray diffraction analysis results showed that quartz (SiO 2) and cristobalite (SiO 2) peaks were observed together with the lithium disilicate (Li 2Si 2O 5) peak in the AMP groups, whereas a lithium phosphate (Li 3PO 4) peak was observed together with the lithium disilicate (Li 2Si 2O 5) peak in the IEC groups. With respect to biaxial flexural strength in the AMP groups, the AMP15 group (HT for 15 minutes) showed the highest value of (524.09±89.95) MPa, whereas the AMP60 group (HT for 60 minutes) showed the lowest value of (446.56±76.75) MPa, with a significant difference between the two groups (P<0.05). In the IEC groups, IEC30 group showed the highest value of (668.51±158.57) MPa and the IEC45 group showed the lowest value of (517.37±129.52) MPa, with a significant difference between the two groups (P<0.05). Within the limitations of the present study, it is concluded that if increased strength is required when fabricating restorations using lithium disilicate glass-ceramic, then changing the HT time could be considered as long as such change does not significantly alter the color tone.

α-Synuclein and tau deposition in the central nervous system is responsible for various parkinsonian syndromes, including Parkinson’s disease, multiple system atrophy, dementia with Lewy bodies, progressive supranuclear palsy and corticobasal degeneration. Emerging evidence has suggested that pathologic α-synuclein and tau are transmitted from cell to cell and further accelerate the aggregation of pathologic proteins in neighboring cells. Furthermore, extracellular pathologic proteins have also been reported to provoke inflammatory responses that lead to neurodegeneration. Therefore, immunotherapies targeting extracellular α-synuclein and tau have been proposed as potential disease-modifying strategies. In this review, we summarize completed phase I trials and ongoing phase II trials of immunotherapies against α-synuclein and tau and further discuss concerns and hurdles to overcome in the future.