Eosinophilic gastroenteritis (EGE) is known to have a low incidence among the pediatric population, but it can result in serious complications, such as gastric outlet obstruction. In previously published EGE cases with the obstruction in adults, surgeries were often performed. In this report, we present a 14-year-old girl who came to our facility with severe abdominal pain and vomiting. On the initial abdominal physical examination, diffuse tenderness and severe epigastric pain were noted. Computed tomography scan of the abdomen showed the findings of superior mesenteric artery (SMA) syndrome. However, she had no history of recent weight loss, and the medical history was inconsistent with SMA syndrome. We planned upper gastrointestinal series with barium, and then verified gastric outlet obstruction. We performed esophagogastroduodenoscopy and obtained a final diagnosis of EGE through mucosal biopsy specimen. Corticosteroids and anti-inflammatory medications were administered. Dietary modification and education were done as well. The symptoms resolved, and the follow-up esophagogastroduodenoscopy and ultrasonography showed improvements in the obstruction. Our case emphasizes that gastric outlet obstruction due to EGE must be carefully differentiated from SMA syndrome because of their similarities in clinical features and radiologic images. In doing so, we can avoid surgical intervention and perform medical/dietary treatment for gastric outlet obstruction.

PURPOSE: This study aimed to investigate the relationships between body mass index (BMI) and prostate-specific antigen (PSA) levels, international prostate symptom score (IPSS), quality of life (QoL), and prostate volume (PV). MATERIALS AND METHODS: Height, weight, PSA levels, PV, and IPSS were analyzed in 15,435 patients who underwent a prostate examination between 2001 and 2014. Patients aged <50 years or with a PSA level ≥10 ng/mL were excluded. The relationships between BMI and PSA, IPSS, QoL, and PV were analyzed by a scatter plot, one-way analysis of variance, and the Pearson correlation coefficient. RESULTS: The mean age was 71.95±7.63 years, the mean BMI was 23.59±3.08 kg/m2, the mean PSA level was 1.45±1.45 ng/mL, the mean IPSS was 15.53±8.31, the mean QoL score was 3.48±1.25, and the mean PV was 29.72±14.02 mL. PSA, IPSS, and QoL showed a tendency to decrease with increasing BMI, and there were statistically significant differences for each parameter (p≤0.001). PV showed a significant tendency to increase with BMI (p < 0.001). In the correlation analysis, BMI showed a statistically significant correlation (p < 0.001) with PSA, IPSS, and QoL, although the correlations were very weak. In contrast, BMI showed a significant correlation with PV (p < 0.001), with a meaningful Pearson correlation coefficient of 0.124. CONCLUSIONS: Higher BMI was associated with lower PSA levels and higher IPSS and QoL scores. Meanwhile, PV increased with BMI. Although obese individuals had a greater PV, obesity did not aggravate lower urinary tract symptoms.
Body Mass Index* ; Humans ; Lower Urinary Tract Symptoms ; Male ; Obesity ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Quality of Life

Nerve growth factor (NGF) is known to regulate both cancer cell survival and death signaling, depending on the cellular circumstances, in various cell types. In this study, we showed that NGF strongly upregulated the protein level of tropomyosin-related kinase A (TrkA) in TrkA-inducible SK-N-MC cancer cells, resulting in increases in various TrkA-dependent cellular processes, including the phosphorylation of c-Jun N-terminal kinase (JNK) and caspase-8 cleavage. In addition, NGF enhanced TrkA-induced morphological changes and cell death, and this effect was significantly suppressed by the JNK inhibitor SP600125, but not by the phosphatidylinositol 3-kinase (PI3K) inhibitor wortmannin. To investigate novel targets associated with the enhancement of TrkA-induced SK-N-MC cell death caused by NGF, we performed Coomassie Brilliant Blue staining and two-dimensional (2D) proteomic analysis in TrkA-inducible SK-N-MC cells. We identified 31 protein spots that were either greatly upregulated or downregulated by TrkA during NGF treatment using matrix-associated laser desorption/ionization time of flight/time of flight mass spectrometry, and we analyzed the effects of SP600125 and wortmannin on the spots. Interestingly, 11 protein spots, including heterogeneous nuclear ribonucleoprotein K (hnRNP K), lamin B1 and TAR DNA-binding protein (TDP43), were significantly influenced by SP600125, but not by wortmannin. Moreover, the NGF/TrkA-dependent inhibition of cell viability was significantly enhanced by knockdown of hnRNP K using small interfering RNA, demonstrating that hnRNP K is a novel target associated with the regulation of TrkA-dependent SK-N-MC cancer cell death enhanced by NGF.
Caspase 8 ; Cell Death* ; Cell Survival ; Heterogeneous-Nuclear Ribonucleoprotein K ; JNK Mitogen-Activated Protein Kinases ; Mass Spectrometry ; Nerve Growth Factor* ; Phosphatidylinositol 3-Kinase ; Phosphorylation ; Phosphotransferases ; RNA, Small Interfering

Graves' ophthalmopathy occurs in 25-50% of patients with Graves' disease. Although patients with Graves' ophthalmopathy mostly present with hyperthyroidism, a minority of patients have euthyroid or hypothyroid characteristics, which may delay a correct diagnosis. Here, we report a case of euthyroid Graves' ophthalmopathy that was initially negative for thyroid autoantibodies, but later changed to positivity.
Autoantibodies* ; Diagnosis ; Graves Disease ; Humans ; Hyperthyroidism ; Thyroid Gland

BACKGROUND: Bile acids were important for the regulation of cholesterol homeostasis. Thyroid hormone increased the expression of CYP7A1 (cholesterol 7alpha-hydroxylase), catalyzing the first step in the biosynthesis of bile acids. However, the effect of thyroid hormone on bile acid export has not been previously assessed. The principal objective of this study is to evaluate the effects of thyroid hormone on the bile salt export pump (BSEP). METHODS: Thyroid hormone, T3 (1 mg/g) was administered to male mice via intraperitoneal injection. After 6 hours and 5 days of T3 treatment, we measured serum total and LDL cholesterol and hepatobiliary bile acid concentrations. We assessed the changes associated with bile acid synthesis and transport. In order to evaluate the direct effect of thyroid hormone, we assessed the changes in the levels of BSEP protein after T3 administration in human hepatoma cells. RESULTS: Serum total and LDL cholesterol were reduced and hepatobiliary bile acid concentrations were increased following T3 treatment. Expressions of Cyp7a1 and BSEP mRNA were increased following T3 treatment. The levels of the BSEP protein in the mouse liver as well as in the human hepatoma cells were increased after T3 treatment. CONCLUSION: Thyroid hormone can regulate LDL cholesterol metabolism. It increases bile acid synthesis and the excretion of bile acids via increased BSEP expression.
Animals ; Bile ; Bile Acids and Salts ; Carcinoma, Hepatocellular ; Cholesterol ; Cholesterol, LDL ; Homeostasis ; Humans ; Injections, Intraperitoneal ; Liver ; Male ; Mice ; Resin Cements ; RNA, Messenger ; Thyroid Gland ; Triiodothyronine

Renal cell carcinoma (RCC) is one of the most malignant tumors in urology, and due to its insidious onset patients frequently have advanced disease at the time of clinical presentation. Thus, early detection is crucial in management of RCC. To identify tumor specific proteins of RCC, we employed proteomic analysis. We prepared proteins from conventional RCC and the corresponding normal kidney tissues from seven patients with conventional RCC. The expression of proteins was determined by silver stain after two-dimensional polyacrylamide gel electrophoresis (2D-PAGE). The overall protein expression patterns in the RCC and the normal kidney tissues were quite similar except some areas. Of 66 differentially expressed protein spots (p<0.05 by Student t-test), 8 different proteins from 11 spots were identified by MALDI-TOF-MS. The expression of the following proteins was repressed (p<0.05); aminoacylase-1, enoyl-CoA hydratase, aldehyde reductase, tropomyosin alpha-4 chain, agmatinase and ketohexokinase. Two proteins, vimentin and alpha-1 antitrypsin precursor, were dominantly expressed in RCC (p<0.05).
Aged ; Aldehyde Reductase/analysis ; Amidohydrolases/analysis ; Carcinoma, Renal Cell/*metabolism/pathology ; Comparative Study ; Electrophoresis, Gel, Two-Dimensional ; Enoyl-CoA Hydratase/analysis ; Female ; Fructokinases/analysis ; Humans ; Kidney Neoplasms/*metabolism/pathology ; Male ; Middle Aged ; Proteome/*analysis ; Proteomics/*methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Tropomyosin/analysis ; Ureohydrolases/analysis ; Vimentin/analysis ; alpha 1-Antitrypsin/analysis

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common type of entrapment neuropathy in clinical practice. There are patients with symptoms and signs suggestive of CTS who remain difficult to diagnose using standard electrophysiologic techniques. To date, there have been few studies concerning the efficacy of the various techniques for measuring median motor conductions in the diagnosis of CTS. The purpose of this study was to determine which motor conduction techniques are more sensitive for diagnosing CTS. METHODS: We analyzed 139 patients (221 hands) who were diagnosed with CTS for the past year in our hospital. Median motor and sensory nerve conduction velocities (MCV and SCV) with wrist (W), palm (P) and finger (F) stimulations were performed with traditional methods. W-P MCV and two motor distal latency differences between the median and ulnar nerves were measured and calculated. The sensitivity of each test was also calculated. RESULTS: The sensitivities of the nerve conduction techniques were noted in W-P MCV (71.95%), median thenar-ulnar thenar latency difference (71.95%), and median thenar-ulnar hypothenar latency difference (69.23). The sensitivities of the existing nerve conduction methods were noted in the terminal latency of the median nerve (73.30%), 2nd finger-wrist (II-W) segment (94.57%), 3rd finger-wrist (III-W) segment (92.31%), palm-wrist (P-W) segment (93.21%), and distoproximal ratio in the 3rd finger (85.07%). CONCLUSIONS: The most sensitive technique was the II-W segment SNV. MCV is also valuable and is no more difficult a method than SCV for the diagnosis of CTS. In patients with suspected CTS, studying both motor and sensory nerve conduction techniques increased the diagnostic yield.
Carpal Tunnel Syndrome* ; Diagnosis ; Fingers ; Humans ; Median Nerve ; Neural Conduction ; Ulnar Nerve ; Wrist

We recently encountered a Korean patient with oculopharyngeal muscular dystrophy (OPMD). His major clinical manifestations were late onset bilateral ptosis, dysarthria, and dysphagia. Direct sequencing analysis of the PABPN1 gene demonstrated a heterozygous insertion of 9 bp sequence [(GCG)(GCA)(GCA); c.28insGCGGCA GCA], resulting in an in-frame insertion of 3 alanines (p. A10insAAA). To our knowledge, this is the first report of a genetically confirmed case of OPMD in Korea.
Deglutition Disorders ; Dysarthria ; Humans ; Korea ; Muscular Dystrophies ; Muscular Dystrophy, Oculopharyngeal*

Isolated noncompaction of the left ventricular myocardium is a rare cardiac disorder due to an arrest in myocardial morphogenesis. It is characterized by prominent and excessive trabeculation in a ventricular wall segment, with deep intertrabecular spaces perfused from the ventricular cavity. Echocardiographic findings are important clues for the diagnosis. Clinical symptoms include signs of left ventricular systolic dysfunction even to the point of heart failure, ventricular arrhythmias, and embolic events. We describe two cases of isolated noncompaction of the myocardium, with ventricular tachycardia in one, and chest pain due to microvascular dysfunction in the other.
Adult* ; Arrhythmias, Cardiac ; Chest Pain ; Diagnosis ; Echocardiography ; Heart Failure ; Humans ; Morphogenesis ; Myocardium* ; Tachycardia, Ventricular

Leptin serves an important role in suppressing appetite in mice and is known to be elevated in chronic renal failure (CRF) patients. But clinical significance of leptin as an appetite-reducing uremic toxin, remains to be determined. So we studied the relationship between plasma leptin and nutritional status in 46 chronic hemodialysis (HD) patients. Pre HD leptin was measured and divided by body mass index (BMI) to give adjusted leptin levels. KT/Vurea (K, dialyzer urea clearance; T, duration of HD; V, volume of distribution of urea), C-reactive protein (CRP), plasma insulin and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assessment (SGA), BMI and mid-arm muscle circumference (MAMC) were also measured. Mean plasma leptin levels were 8.13+/-2.91 ng/mL (male 3.15+/-0.70; female 14.07+/-6.14, p<0.05). Adjusted leptin levels were positively correlated with nPCR (male r=0.47, p<0.05; female r=0.46, p<0.05), SGA (male r=0.43, p<0.05; female r=0.51, p<0.05) and MAMC (male r=0.60, p<0.005; female r=0.61, p<0.05). They did not correlate with KT/Vurea, serum albumin, hematocrit, bicarbonate, insulin and CRP. Presence of DM and erythropoietin therapy had no effect on leptin levels. These results suggest that leptin is a marker of good nutritional status rather than a cause of protein energy malnutrition in chronic HD patients.
Adult ; Biological Markers/blood ; Cross-Sectional Studies ; Female ; Human ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/blood* ; Leptin/blood* ; Male ; Middle Age ; Nutrition Disorders/etiology ; Nutrition Disorders/diagnosis ; Nutritional Status* ; Obesity/metabolism ; Obesity/etiology ; Renal Dialysis*/adverse effects ; Sex Factors