Neuronal intestinal dysplasia in pediatric patients has similar clinical symptoms and often similar radiologic findings to those of Hirschsprung's disease. Yet neuronal intestinal dysplasia shows hyperplasia of the myenteric plexus for the pathology, and it requires different treatment compared with Hirschsprung disease. This disease has been reported many times in Europe but, to date, only one case has been reported in the radiologic literatures in Korea. We report here on a case of neuronal intestinal dysplasia that involved the entire colon in a two-month-old boy, and we include the radiographic findings.
Colon ; Europe ; Hirschsprung Disease ; Humans ; Hyperplasia ; Infant* ; Korea ; Male ; Myenteric Plexus ; Neurons* ; Pathology

Neuronal intestinal dysplasia in pediatric patients has similar clinical symptoms and often similar radiologic findings to those of Hirschsprung's disease. Yet neuronal intestinal dysplasia shows hyperplasia of the myenteric plexus for the pathology, and it requires different treatment compared with Hirschsprung disease. This disease has been reported many times in Europe but, to date, only one case has been reported in the radiologic literatures in Korea. We report here on a case of neuronal intestinal dysplasia that involved the entire colon in a two-month-old boy, and we include the radiographic findings.
Colon ; Europe ; Hirschsprung Disease ; Humans ; Hyperplasia ; Infant* ; Korea ; Male ; Myenteric Plexus ; Neurons* ; Pathology

PURPOSE: Nipple-sparing mastectomy (NSM) has become increasingly popular due to improved cosmesis without compromising oncologic safety. Radial and inframammary incisions are usually used to achieve NSM, with periareolar incisions usually being avoided because of the risk to nipple-areola complex viability. In an attempt to maximize esthetic effects, we performed NSM through periareolar incision with immediate reconstruction. We report our initial experience. METHODS: This case series consisted of all consecutive patients (n = 34) who underwent NSM through a periareolar incision in our institution between August 2017 and December 2018. All patients underwent NSM through periareolar incision followed by immediate reconstruction with an implant or deep inferior epigastric perforator flap. Patient demographics, tumor and treatment characteristics, and short-term postoperative outcomes were reviewed. RESULTS: The mean patient age was 46.74 ± 6.69 years (range, 38–62 years), and the mean operation time was 96.68 ± 28.00 minutes. Indications included in situ cancer in 12 cases and invasive cancer in 22 cases. There was 1 major complication (postoperative hematoma) requiring operative reintervention. No other complications including fistula, implant exposure, or reconstruction failure was observed. At the time of writing, no case of local recurrence has been observed. CONCLUSION Our initial report shows that NSM with immediate reconstruction may successfully be performed through periareolar incision. This method maximizes esthetic effects and may be an appropriate surgical option for NSM.

Eosinophilic granulomatosis with polyangiitis (EGPA), previously called Churg-Strauss syndrome, is an anti-neutrophil cytoplasmic antibody associated vasculitis, accompanied by asthma, hypereosinophilia, nonfixed pulmonary infiltrates, and sinusitis. Peripheral neuropathy is common in patients with EGPA; however, a few cases of EGPA with central nervous system (CNS) involvement have been reported. A 45-year-old female referred for right side weakness and posterior neck pain was diagnosed as EGPA with subarachnoid hemorrhage and mononeuritis multiplex. She was effectively treated with a high dose glucocorticoid, cyclophosphamide, and intravenous immunoglobulin. EGPA with CNS involvement is uncommon and causes significant morbidity and mortality. Therefore more rapid and accurate diagnostic evaluation may be required. EGPA should be considered in patients with neurological symptoms and hypereosinophilia.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Central Nervous System ; Churg-Strauss Syndrome ; Cyclophosphamide ; Eosinophils* ; Female ; Humans ; Immunoglobulins ; Middle Aged ; Mononeuropathies* ; Mortality ; Neck Pain ; Peripheral Nervous System Diseases ; Sinusitis ; Subarachnoid Hemorrhage* ; Vasculitis

BACKGROUND AND OBJECTIVES: A relationship between renin-angiotensin system (RAS) components and metabolic syndrome (MetS) has been suggested, but not elucidated clearly. We examined the levels of RAS components in patients with and without MetS and their association with MetS in Korean population. METHODS: This study was approved by the review boards of the participating institutions and endorsed by the Korean Society of Lipid and Atherosclerosis. We screened 892 Koreans aged ≥20 years who underwent evaluation of hypertension, diabetes, or dyslipidemia at 6 tertiary hospitals in 2015–2016. After excluding patients who were taking diuretics, β-blockers, or RAS blockers, or suspected of primary aldosteronism, 829 individuals were enrolled. Anthropometric and biochemical parameters including aldosterone, plasma renin activity (PRA), and aldosterone-to-PRA ratio were evaluated. The homeostasis model assessment for insulin resistance (HOMA-IR) were used for evaluating insulin resistance. RESULTS: The mean age of the participants was 52.8±12.8 years, 56.3% were male, and their mean systolic and diastolic blood pressures were 133.9±20.0 and 81.2±14.6 mmHg, respectively. The levels of serum aldosterone, but not PRA, were significantly higher in subjects with MetS than in those without (20.6±33.6 vs. 15.3±12.2 ng/dL, p < 0.05), and positively correlated with waist circumference, blood pressure, triglycerides, and glycated hemoglobin. The levels of aldosterone were independently associated with the number of MetS components and HOMA-IR after adjusting for conventional risk factors. CONCLUSIONS Serum aldosterone levels were higher in Korean adults with MetS than in those without. This finding suggests that increased aldosterone level might be closely associated with insulin resistance.

BACKGROUND AND OBJECTIVES: A relationship between renin-angiotensin system (RAS) components and metabolic syndrome (MetS) has been suggested, but not elucidated clearly. We examined the levels of RAS components in patients with and without MetS and their association with MetS in Korean population. METHODS: This study was approved by the review boards of the participating institutions and endorsed by the Korean Society of Lipid and Atherosclerosis. We screened 892 Koreans aged ≥20 years who underwent evaluation of hypertension, diabetes, or dyslipidemia at 6 tertiary hospitals in 2015–2016. After excluding patients who were taking diuretics, β-blockers, or RAS blockers, or suspected of primary aldosteronism, 829 individuals were enrolled. Anthropometric and biochemical parameters including aldosterone, plasma renin activity (PRA), and aldosterone-to-PRA ratio were evaluated. The homeostasis model assessment for insulin resistance (HOMA-IR) were used for evaluating insulin resistance. RESULTS: The mean age of the participants was 52.8±12.8 years, 56.3% were male, and their mean systolic and diastolic blood pressures were 133.9±20.0 and 81.2±14.6 mmHg, respectively. The levels of serum aldosterone, but not PRA, were significantly higher in subjects with MetS than in those without (20.6±33.6 vs. 15.3±12.2 ng/dL, p < 0.05), and positively correlated with waist circumference, blood pressure, triglycerides, and glycated hemoglobin. The levels of aldosterone were independently associated with the number of MetS components and HOMA-IR after adjusting for conventional risk factors. CONCLUSIONS: Serum aldosterone levels were higher in Korean adults with MetS than in those without. This finding suggests that increased aldosterone level might be closely associated with insulin resistance.
Adult ; Aldosterone ; Atherosclerosis ; Blood Pressure ; Diuretics ; Dyslipidemias ; Hemoglobin A, Glycosylated ; Homeostasis ; Humans ; Hyperaldosteronism ; Hypertension ; Insulin Resistance ; Insulin ; Male ; Metabolic Syndrome X ; Plasma ; Renin ; Renin-Angiotensin System ; Risk Factors ; Tertiary Care Centers ; Triglycerides ; Waist Circumference

Hyperplastic polyps are common gastric lesions that are characterized by nonneoplastic epithelial hyperplasia. However, to our knowledge, there are no reports of a hyperplastic polyp arising from an endoscopic mucosectomy site of early gastric cancer. We describe the CT findings with a histopathology correlation in a case of a hyperplastic polyp arising from a mucosectomy site that mimicked polypoid gastric cancer.
Endoscopy ; Hyperplasia ; Polyps* ; Stomach Neoplasms*

In previous studies, we introduced that mangosteen extract complex (MEC; ethanol extracts of Garcinia mangostana L. peel and propolis) had inhibitory effects on inflammation and alveolar bone loss in silk-ligature applied and Porphyromonas gingivalis lipopolysaccharide (LPS) induced periodontitis model in rats. This study was conducted to evaluate whether MEC had inhibitory effect of alveolar bone loss when a higher inflammatory state was induced by increasing the injection amount of P. gingivalis LPS by 20 times and increasing the treatment dose of MEC by twice the amount or maintaining MEC dose that used in the previous study. The data showed that alveolar bone loss was significantly reduced in the Lig+L+MEC 1:34 group (treated with mixture of 16 µg mangosteen peel extract powder and 544 µg propolis extract powder) and in the Lig+L+MEC 2:68 group (treated with mixture of 32 µg mangosteen peel extract powder and 1,088 µg propolis extract powder) by 24.3% and 28.9%, respectively. This result reveals that the mixture of MEC 1:34 could be useful in improving periodontal tissue health and may be able to be used as a therapeutic adjuvant for periodontitis.

In previous studies, we introduced that mangosteen extract complex (MEC; ethanol extracts of Garcinia mangostana L. peel and propolis) had inhibitory effects on inflammation and alveolar bone loss in silk-ligature applied and Porphyromonas gingivalis lipopolysaccharide (LPS) induced periodontitis model in rats. This study was conducted to evaluate whether MEC had inhibitory effect of alveolar bone loss when a higher inflammatory state was induced by increasing the injection amount of P. gingivalis LPS by 20 times and increasing the treatment dose of MEC by twice the amount or maintaining MEC dose that used in the previous study. The data showed that alveolar bone loss was significantly reduced in the Lig+L+MEC 1:34 group (treated with mixture of 16 µg mangosteen peel extract powder and 544 µg propolis extract powder) and in the Lig+L+MEC 2:68 group (treated with mixture of 32 µg mangosteen peel extract powder and 1,088 µg propolis extract powder) by 24.3% and 28.9%, respectively. This result reveals that the mixture of MEC 1:34 could be useful in improving periodontal tissue health and may be able to be used as a therapeutic adjuvant for periodontitis.

Ultraviolet (UV) irradiation is a relevant environment factor to induce cellular senescence and photoaging. Both autophagy- and silent information regulator T1 (SIRT1)-dependent pathways are critical cellular processes of not only maintaining normal cellular functions, but also protecting cellular senescence in skin exposed to UV irradiation. In the present studies, we investigated whether modulation of autophagy induction using a novel synthetic SIRT1 activator, heptasodium hexacarboxymethyl dipeptide-12 (named as Aquatide), suppresses the UVB irradiation-induced skin aging. Treatment with Aquatide directly activates SIRT1 and stimulates autophagy induction in cultured human dermal fibroblasts. Next, we found that Aquatide-mediated activation of SIRT1 increases autophagy induction via deacetylation of forkhead box class O (FOXO) 1. Finally, UVB irradiation-induced cellular senescence measured by SA-β-gal staining was significantly decreased in cells treated with Aquatide in parallel to occurring SIRT1 activation-dependent autophagy. Together, Aquatide modulates autophagy through SIRT1 activation, contributing to suppression of skin aging caused by UV irradiation.
Autophagy ; Cell Aging* ; Fibroblasts ; Humans ; Skin ; Skin Aging