BACKGROUND: Hypertriglyceridemia and hypercholesterolemia have been associated with atherosclerosis, myocaridal infarction, and premature death. However, the causes of hyperlipidemia are not well understood. Variations in apolipoprotein C-III (apo C-III) are candidate for contributing to the occurrence of hypertriglyceridemia. A genetically variant form of human apo C-III promoter, containing five single base pair changes, has been shown that it seems to be associated with hypertriglyceridemia. Especially, the loss of insulin regulation was mapped to polymorphic sites at -482 and -455, which fall within an insulin response element. METHODS: We studied 146 subjects with hyperlipidemia and also had 94 controls. Screening for mutations at codon -482 and -455 of apo C-III promoter were carried out by PCR-RFLP analyses. RESULTS: 1) In the codon -482 site of the patient group, the genotype frequency of T/T homozygote was higher than in the control group, whereas the frequency of T/C heterozygote and C/C homozygote were lower. 2) Serum triglyceride related to genotype shows positive correlation trend with freguency of -482 T allele and -455 C allele, but has not stastistical significancy. 3) In complete mutated groups of both -482 T/T and -455 C/C in hyperlipidemia patients, serum triglyceride and fasting blood glucose are higher than in wild type groups of both -482 C/C and -455 T/T. CONCLUSION: We suggest that variations of the promoter of apolipoprotein C-III may be a genetic marker in patients with hyperlipidemia.
Alleles ; Apolipoprotein C-III* ; Apolipoproteins* ; Atherosclerosis ; Base Pairing ; Blood Glucose ; Codon ; Fasting ; Genetic Markers ; Genotype ; Heterozygote ; Homozygote ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Hypertriglyceridemia ; Infarction ; Insulin ; Mass Screening ; Mortality, Premature ; Response Elements ; Triglycerides

Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual’s risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients.The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.

Purpose: The aims of the present study were twofold. First, the research investigated the effect of an individual’s risk factors and the prevalence of psychotropic drugs on QTc prolongation, TdP (torsades de pointes), and death. Second, the study compared the risk scoring systems (the Mayo Pro-QT risk score and the Tisadale risk score) on QTc prolongation. Methods: The medical records of intoxicated patients who visited the emergency department between March 2010 and February 2019 were reviewed retrospectively. Among 733 patients, the present study included 426 psychotropic drug-intoxicated patients.The patients were categorized according to the QTc value. The known risk factors of QTc prolongation were examined, and the Mayo Pro-QT risk score and the Tisadale risk score were calculated. The analysis was performed using multiple logistic regression, Spearman correlation, and ROC (receiver operating characteristic). Results: The numbers in the mild to moderate group (male: 470≤QTc<500 ms, female: 480≤QTc<500 ms) and severe group (QTc≥500 ms or increase of QTc at least 60ms from baseline, both sex) were 68 and 95, respectively. TdP did not occur, and the only cause of death was aspiration pneumonia. The statically significant risk factors were multidrug intoxications of TCA (tricyclic antidepressant), atypical antipsychotics, an atypical antidepressant, panic disorder, and hypokalemia. The Tisadale risk score was larger than the Mayo Pro-QT risk score. Conclusion Multiple psychotropic drugs intoxication (TCA, an atypical antidepressant, and atypical antipsychotics), panic disorder, and hypokalemia have been proven to be the main risk factors of QTc prolongation, which require enhanced attention. The present study showed that the Tisadale score had a stronger correlation and predictive accuracy for QTc prolongation than the Mayo Pro-QT score. As a result, the Tisadale risk score is a crucial assessment tool for psychotropic drug-intoxicated patients in a clinical setting.

BACKGROUND: It is evident that cytokines play a role in the pathogenesis as well as the progression of renal diseases. The purpose of this study was to determine whether cytokine gene polymorphism is a marker of susceptibility to end-stage kidney failure (ESKF) in Korean populations. METHODS: -308 G/A polymorphism of tumor necrosis factor-alpha (TNF-alpha) gene was genotyped in 257 dialysis patients and 277 age-matched healthy controls, 86 NIDDM patients with kidney failure and 102 NIDDM controls without nephropathy. RESULTS: We found a decreased frequency of TNF-alpha allele 2 (TNF2, 2.9%) in ESKF patients compared to healthy controls (7.5%, p<0.05). We also found a decreased frequency of TNF-alpha allele 2 (TNF2, 2.3%) in NIDDM patients with kidney failure compared to NIDDM controls without nephropathy (7.6%, p<0.05). The carriage rate of TNF2 was significantly lower in NIDDM patients with kidney failure than in NIDDM controls without nephropathy (4.4% vs. 13.2%, p<0.05). In addition, allele frequency of TNF2 were remarkably different from those previously reported, indicating a significant ethnic difference. CONCLUSION: There is a significant ethnic difference in the polymorphism of TNF-alpha gene. The non-carriage TNF2 was more prevalent in the kidney failur group. But, we could not determine any association between the TNF-alpha gene polymorphism and the development of kidney failure.
Alleles ; Cytokines ; Diabetes Mellitus, Type 2 ; Dialysis ; Gene Frequency ; Humans ; Kidney* ; Renal Insufficiency* ; Tumor Necrosis Factor-alpha*

A cystic parathyroid adenoma is rare. A case of primary hyperparathyroidism, with the cystic formation of a parathyroid adenoma and a severe bony lesion, is reported. A 52-year-old male was admitted due to pain in both hips and for evaluation of hypercalcemia. The plasma level of the intact parathyroid hormone(iPTH) was elevated to 1424pg/mL. Ultrasonography and the computed tomography revealed a parathyroid cyst on the left thyroid lower pole. Parathyroid scintigraphy detected a parathyroid adenoma. A radiograph showed a subperiosteal bone resorption on the phalanges, and a brown tumor(osteitis fibrosa cystica) on the femur shaft was noted. A surgical excision of the parathyroid adenoma was performed. The PTH level in the cystic fluid was increased. A histological examination confirmed a cystic parathyroid adenoma. The PTH level was normalized after the operation.
Bone Resorption ; Femur ; Hip ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Male ; Middle Aged ; Osteitis Fibrosa Cystica ; Parathyroid Neoplasms* ; Plasma ; Radionuclide Imaging ; Thyroid Gland ; Ultrasonography

Staphylococcus lugdunensis is a Gram-positive, coagulase-negative Staphylococcus (CNS) species that is found as a skin commensal and has been implicated in fulminant invasive diseases such as infective endocarditis. S. lugudunensis infections resemble Staphylococcus aureus infections in terms of virulence, tissue destruction and clinical course. Although correct identification and determination of the susceptibility profile are important, some commercial systems may misidentify S. lugdunensis. We report a case of native valve infective endocarditis caused by S. lugdunensis, which was misidentified by the Vitek 2 system but identified correctly by 16S ribosomal RNA (rRNA) gene sequencing in a 72-year-old male patient. The patient had multiple vegetations on his mitral valve, and the largest one was found on the posterior mitral valve leaflet. It was 2.5 cm in size and hypermobile. Diffuse valvular abscess was also observed. He had persistent bacteremia for appoximately 8 days, which was resolved after immediate surgery and antibiotic therapy. When a patient with severe sepsis syndrome grows S. aureus or CNS other than S. lugdunensis on a commercial automatic culture system, the possibility of S. lugdunensis should be considered and further confirmatory testing such as 16S rRNA sequencing may be very useful.
Abscess ; Aged ; Bacteremia ; Endocarditis ; Humans ; Male ; Mitral Valve ; RNA, Ribosomal, 16S ; Sepsis ; Skin ; Staphylococcus ; Staphylococcus aureus ; Staphylococcus lugdunensis