Objective: We aimed to elucidate the metabolic function and phenotype of AK5, a gene with an unknown function in metabolism. Methods: We generated AK5 knockout (KO) mice and administered high-fat and fasting diets to the mice to confirm their physiological phenotype and metabolic differences. Results: In the high-fat diet (HFD) test, no differences in body weight, epididymal white adipose tissue (eWAT), or fat mass of AK5 KO mice were observed. In indirect calorimetry, the respiratory exchange ratio and activity counts increased in normal chow diet mice, but there was no difference between the HFD groups. At the mRNA level, there were no significant differences in the expression of lipid metabolism markers between wild-type and AK5 KO mice. Still, the glucose signal of adipocytes increased in AK5 KO mice. In the fasting test, the eWAT of AK5 KO mice was significantly reduced, as was the expression of lipid metabolism and inflammation-related immune markers. Thus, the apoptosis of adipocytes increased, and an imbalance in energy metabolism occurred. Conclusions and Relevance: When AK5 KO mice are energy deficient, it becomes difficult to use eWAT for energy storage, imbalance occurs, and apoptosis of adipocytes in eWAT increases.

Elastofibroma is a rare soft tissue tumor that most commonly occurs in the subscapular region. It has also been reported in several other anatomical locations. To our knowledge, no previous reports have described elastofibromas in the anterior aspect of the face. A 36-year-old man with intellectual disability was referred to our department for the evaluation of a painless multinodular lesion on the philtrum. The lesion was initially misdiagnosed as a dermatologic condition by the department of dermatology and was treated accordingly, however, it worsened, prompting referral to our department. We performed a surgical excision of the lesion and reconstructed the resulting skin defect with a skin graft. Histopathological examination confirmed the diagnosis of elastofibroma. This case underscores the importance of including elastofibroma in the differential diagnosis of facial neoplasms, particularly when the presentation is phymatous.

Objective: We aimed to elucidate the metabolic function and phenotype of AK5, a gene with an unknown function in metabolism. Methods: We generated AK5 knockout (KO) mice and administered high-fat and fasting diets to the mice to confirm their physiological phenotype and metabolic differences. Results: In the high-fat diet (HFD) test, no differences in body weight, epididymal white adipose tissue (eWAT), or fat mass of AK5 KO mice were observed. In indirect calorimetry, the respiratory exchange ratio and activity counts increased in normal chow diet mice, but there was no difference between the HFD groups. At the mRNA level, there were no significant differences in the expression of lipid metabolism markers between wild-type and AK5 KO mice. Still, the glucose signal of adipocytes increased in AK5 KO mice. In the fasting test, the eWAT of AK5 KO mice was significantly reduced, as was the expression of lipid metabolism and inflammation-related immune markers. Thus, the apoptosis of adipocytes increased, and an imbalance in energy metabolism occurred. Conclusions and Relevance: When AK5 KO mice are energy deficient, it becomes difficult to use eWAT for energy storage, imbalance occurs, and apoptosis of adipocytes in eWAT increases.

Elastofibroma is a rare soft tissue tumor that most commonly occurs in the subscapular region. It has also been reported in several other anatomical locations. To our knowledge, no previous reports have described elastofibromas in the anterior aspect of the face. A 36-year-old man with intellectual disability was referred to our department for the evaluation of a painless multinodular lesion on the philtrum. The lesion was initially misdiagnosed as a dermatologic condition by the department of dermatology and was treated accordingly, however, it worsened, prompting referral to our department. We performed a surgical excision of the lesion and reconstructed the resulting skin defect with a skin graft. Histopathological examination confirmed the diagnosis of elastofibroma. This case underscores the importance of including elastofibroma in the differential diagnosis of facial neoplasms, particularly when the presentation is phymatous.

Objective: We aimed to elucidate the metabolic function and phenotype of AK5, a gene with an unknown function in metabolism. Methods: We generated AK5 knockout (KO) mice and administered high-fat and fasting diets to the mice to confirm their physiological phenotype and metabolic differences. Results: In the high-fat diet (HFD) test, no differences in body weight, epididymal white adipose tissue (eWAT), or fat mass of AK5 KO mice were observed. In indirect calorimetry, the respiratory exchange ratio and activity counts increased in normal chow diet mice, but there was no difference between the HFD groups. At the mRNA level, there were no significant differences in the expression of lipid metabolism markers between wild-type and AK5 KO mice. Still, the glucose signal of adipocytes increased in AK5 KO mice. In the fasting test, the eWAT of AK5 KO mice was significantly reduced, as was the expression of lipid metabolism and inflammation-related immune markers. Thus, the apoptosis of adipocytes increased, and an imbalance in energy metabolism occurred. Conclusions and Relevance: When AK5 KO mice are energy deficient, it becomes difficult to use eWAT for energy storage, imbalance occurs, and apoptosis of adipocytes in eWAT increases.

Elastofibroma is a rare soft tissue tumor that most commonly occurs in the subscapular region. It has also been reported in several other anatomical locations. To our knowledge, no previous reports have described elastofibromas in the anterior aspect of the face. A 36-year-old man with intellectual disability was referred to our department for the evaluation of a painless multinodular lesion on the philtrum. The lesion was initially misdiagnosed as a dermatologic condition by the department of dermatology and was treated accordingly, however, it worsened, prompting referral to our department. We performed a surgical excision of the lesion and reconstructed the resulting skin defect with a skin graft. Histopathological examination confirmed the diagnosis of elastofibroma. This case underscores the importance of including elastofibroma in the differential diagnosis of facial neoplasms, particularly when the presentation is phymatous.

Objective: We aimed to elucidate the metabolic function and phenotype of AK5, a gene with an unknown function in metabolism. Methods: We generated AK5 knockout (KO) mice and administered high-fat and fasting diets to the mice to confirm their physiological phenotype and metabolic differences. Results: In the high-fat diet (HFD) test, no differences in body weight, epididymal white adipose tissue (eWAT), or fat mass of AK5 KO mice were observed. In indirect calorimetry, the respiratory exchange ratio and activity counts increased in normal chow diet mice, but there was no difference between the HFD groups. At the mRNA level, there were no significant differences in the expression of lipid metabolism markers between wild-type and AK5 KO mice. Still, the glucose signal of adipocytes increased in AK5 KO mice. In the fasting test, the eWAT of AK5 KO mice was significantly reduced, as was the expression of lipid metabolism and inflammation-related immune markers. Thus, the apoptosis of adipocytes increased, and an imbalance in energy metabolism occurred. Conclusions and Relevance: When AK5 KO mice are energy deficient, it becomes difficult to use eWAT for energy storage, imbalance occurs, and apoptosis of adipocytes in eWAT increases.

Fungal sinusitis is relatively rare, but it has become more common in recent years. When fungal sinusitis invades the orbit, it can cause proptosis, chemosis, ophthalmoplegia, retroorbital pain, and vision impairment. We present a case of an extensive orbital floor defect due to invasive fungal sinusitis. A 62-year-old man with hypertension and a history of lung adenocarcinoma, presented with right-side facial pain and swelling. On admission, the serum glucose level was 347 mg/dL, and hemoglobin A1c was 11.4%. A computed tomography scan and a Waters’ view X-ray showed right maxillary sinusitis with an orbital floor defect. On hospital day 3, functional endoscopic sinus surgery was performed by the otorhinolaryngology team, and an aspergilloma in necrotic inflammatory exudate obtained during exploration. On hospital day 7, orbital floor reconstruction with a Medpor Titan surgical implant was done. In principle, the management of invasive sino- orbital fungal infection often begins with surgical debridement and local irrigation with an antifungal agent. Exceptionally, in this case, debridement and immediate orbital floor reconstruction were performed to prevent enophthalmos caused by the extensive orbital floor defect. The patient underwent orbital floor reconstruction and received intravenous and oral voriconazole. Despite orbital invasion, there were no ophthalmic symptoms or sequelae.

Background: To date, various genotypes of infectious bronchitis virus (IBV) have cocirculated and in Korea, GI-15 and GI-19 lineages were prevailing. The spike protein, particularly S1 subunit, is responsible for receptor binding, contains hypervariable regions and is also responsible for the emerging of novel variants. Objective: This study aims to investigate the putative major amino acid substitutions for the variants in GI-19. Methods: The S1 sequence data of IBV isolated from 1986 to 2021 in Korea (n = 188) were analyzed. Sequence alignments were carried out using Multiple alignment using Fast Fourier Transform of Geneious prime. The phylogenetic tree was generated using MEGA-11 (ver.11.0.10) and Bayesian analysis was performed by BEAST v1.10.4. Selective pressure was analyzed via online server Datamonkey. Highlights and visualization of putative critical amino acid were conducted by using PyMol software (version 2.3). Results: Most (93.5%) belonged to the GI-19 lineage in Korea, and the GI-19 lineage was further divided into seven subgroups: KM91-like (Clade A and B), K40/09-like, QX-like (I-IV).Positive selection was identified at nine and six residues in S1 for KM91-like and QX-like IBVs, respectively. In addition, several positive selection sites of S1-NTD were indicated to have mutations at common locations even when new clades were generated. They were all located on the lateral surface of the quaternary structure of the S1 subunits in close proximity to the receptor-binding motif (RBM), putative RBM motif and neutralizing antigenic sites in S1. Conclusions Our results suggest RBM surrounding sites in the S1 subunit of IBV are highly susceptible to mutation by selective pressure during evolution.

An epidermal cyst, also known as an epidermoid cyst or epidermal inclusion cyst, is the most prevalent type of cutaneous cyst. This noncancerous lesion can appear anywhere on the body, typically presenting as an asymptomatic dermal nodule with a visible central punctum. In the case presented herein, an epidermal cyst with uncommon features was misdiagnosed as a lymphatic malformation based on preoperative magnetic resonance imaging (MRI). A 61-year-old man came to us with a swollen left cheek that had been present for 11 months. The preoperative MRI revealed a 3 × 3.8 × 4.6 cm lobulated cystic lesion with thin rim enhancement in the left masticator space. The initial differential diagnosis pointed toward a lymphatic malformation. We proceeded with surgical excision of the lesion via an intraoral approach, and the specimen was sent to the pathology department. The pathological diagnosis revealed a ruptured epidermal cyst, indicating that the initial diagnosis of a lymphatic malformation based on preoperative MRI was incorrect. Epidermal cysts located under the muscle with no visible central punctum are uncommon, but should be considered if a patient presents with facial swelling.