Background: Neuroinflammation plays an important role in cognitive decline and memory impairment in neurodegenerative disorders. Previously, we demonstrated that Humulus japonicus (HJ) has anti-inflammatory effects in rodent models of Alzheimer’s disease and Parkinson’s disease. The present study aimed to examine the protective potential of HJ extracts against lipopolysaccharide (LPS)-induced cognitive impairment and scopolamine-induced amnesia in mouse models. Cognitive improvement of mice was investigated by novel object recognition test. For analyzing effects on neuroinflammation, immunohistochemistry and quantitative real-time polymerase chain reaction (qRTPCR) assays were performed. Results: We found that the oral administration of HJ significantly improved cognitive dysfunction induced by LPS in a novel object recognition test. The LPS-induced activation of microglia was notably decreased by HJ treatment in the cortex and hippocampus. HJ administration with LPS also significantly increased the mRNA expression of interleukin (IL)-10 and decreased the mRNA expression of IL-12 in the parietal cortex of mice. The increased expression of LPS-induced complement C1q B chain (C1bq) and triggering receptor expressed on myeloid cells 2 (Trem2) genes was significantly suppressed by HJ treatment. In addition, HJ administration significantly improved novel object recognition in a scopolamine-induced amnesia mouse model. Conclusions These findings revealed that HJ has a beneficial effect on cognitive impairment and neuroinflammation induced by systemic inflammation and on amnesia induced by scopolamine in mice.

Background/Aims: Endoscopic submucosal dissection (ESD) is a curative treatment modality for early gastric neoplasms; however, ESD can be a time-consuming process. To overcome this pitfall, we developed the one-step knife (OSK) approach, which combines an endoscopic knife and injection needle on a single sheath. We aimed to evaluate whether this approach could reduce the ESD procedure time. Methods: This single-blinded randomized multicenter trial at four tertiary hospitals from June 2019 to June 2020 included patients aged 19 to 85 years undergoing ESD. Patients were randomly assigned to two groups (OSK or conventional knife [CK]). The injection time, total procedure time, resected specimen size, submucosal fluid amount, degree of device satisfaction, and adverse events were evaluated and compared between groups. Results: Fifty-one patients were analyzed (OSK: 25 patients and CK: 26 patients). No baseline differences were observed between groups, with the exception of a higher portion of males in the OSK group. The mean injection time was significantly reduced in the OSK group (39.0 seconds) compared to that in the CK group (87.5 seconds, p<0.001). A decrease of more than 10 minutes in the total procedure time (18.0 minutes vs 28.1 minutes, p=0.055) in the OSK group compared to the CK group was observed. Second-look esophagogastroduodenoscopy revealed two delayed bleeding cases in the OSK group that were easily controlled by endoscopic hemostasis. Conclusions OSK reduced the injection time and showed a decrease in total procedure time compared with the CK approach. OSK can be a feasible tool for ESD, especially in difficult cases.

BACKGROUND: Metabolic syndrome (MetS) is a known predictor of diabetes mellitus (DM), but whether longitudinal changes in MetS status modify the risk for DM remains unclear. We investigated whether changes in MetS status over 2 years modify the 10-year risk of incident DM. METHODS: We analyzed data from 7,317 participants aged 40 to 70 years without DM at baseline, who took part in 2001 to 2011 Korean Genome Epidemiology Study. Subjects were categorized into four groups based on repeated longitudinal assessment of MetS status over 2 years: non-MetS, resolved MetS, incident MetS, and persistent MetS. The hazard ratio (HR) of new-onset DM during 10 years was calculated in each group using Cox models. RESULTS: During the 10-year follow-up, 1,099 participants (15.0%) developed DM. Compared to the non-MetS group, the fully adjusted HRs for new-onset DM were 1.28 (95% confidence interval [CI], 0.92 to 1.79) in the resolved MetS group, 1.75 (95% CI, 1.30 to 2.37) in the incident MetS group, and 1.98 (95% CI, 1.50 to 2.61) in the persistent MetS group (P for trend <0.001). The risk of DM in subjects with resolved MetS was significantly attenuated compared to those with persistent MetS over 2 years. In addition, the adjusted HR for 10-year developing DM gradually increased as the number of MetS components increased 2 years later. CONCLUSION: We found that discrete longitudinal changes pattern in MetS status over 2 years associated with 10-year risk of DM. These findings suggest that monitoring change of MetS status and controlling it in individuals may be important for risk prediction of DM.
Diabetes Mellitus ; Epidemiology ; Follow-Up Studies ; Genome ; Life Style ; Proportional Hazards Models

Rhomboid family member 2 gene (Rhbdf2) is an inactive homologue lacking essential catalytic residues of rhomboid intramembrane serine proteases. The protein is necessary for maturation of tumor necrosis factor-alpha (TNF-α) converting enzyme, which is the molecule responsible for the release of TNF-α. In this study, Rhbdf2 knockout (KO) mice were produced by CRISPR/CAS9. To see the effects of the failure of TNF-α release induced by Rhbdf2 gene KO, collagen-induced arthritis (CIA), which is the representative TNF-α related disease, was induced in the Rhbdf2 mutant mouse using chicken collagen type II. The severity of the CIA was measured by traditional clinical scores and histopathological analysis of hind limb joints. A rota-rod test and grip strength test were employed to evaluate the severity of CIA based on losses of physical functions. The results indicated that Rhbdf2 mutant mice showed clear alleviation of the clinical severity of CIA as demonstrated by the significantly lower severity indexes. Moreover, a grip strength test was shown to be useful for the evaluation of physical functional losses by CIA. Overall, the results showed that the Rhbdf2 gene has a significant effect on the induction of CIA, which is related to TNF-α.
Animals ; Arthritis, Experimental* ; Chickens ; Collagen Type II ; Extremities ; Hand Strength ; Humans ; Joints ; Mice ; Mice, Knockout* ; Serine Proteases ; Tumor Necrosis Factor-alpha

Percutaneous needle aspiration biopsy is a relatively simple and safe procedure for the diagnosis of lung and mediastinal lesions. Systemic air embolism during and after percutaneous needle aspiration biopsy of the lung is very rare; however, it is still a complication that can cause fatal outcomes, such as cerebral infarction and myocardial infarction. Here, we report a 72-year-old woman who suffered a change in consciousness immediately after receiving a percutaneous needle aspiration biopsy for the pathologic examination of pulmonary nodules found during a routine health medical examination. She had left side weakness and ST segment elevation on an electrocardiogram. After a high concentration of oxygen, she recovered from neurological symptoms and electrocardiographic abnormalities. The authors report a case of air embolism occurring simultaneously in the brain and coronary arteries after percutaneous needle aspiration biopsy.
Aged ; Biopsy ; Biopsy, Needle* ; Brain ; Cerebral Infarction ; Consciousness ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Embolism ; Embolism, Air* ; Fatal Outcome ; Female ; Humans ; Intracranial Embolism ; Lung* ; Myocardial Infarction ; Needles* ; Oxygen

An aortoesophageal fistula is one of the very few causes of upper gastrointestinal bleeding but can be fatal if the diagnosis is delayed. This usually occurs secondary to esophageal or aortic surgery. A primary aortoesophageal fistula is rare and less likely to be suspected. Here, we present a case of a primary aortoesophageal fistula that presented as massive upper gastrointestinal bleeding. An 81-year-old man with a history of aortic aneurysm had syncope and bright color hematemesis. The aortoesophageal fistula was not diagnosed early enough and the patient died. Therefore, emergency physicians should consider aortoesophageal fistula as a potential cause when encountering upper gastrointestinal bleeding.
Aged, 80 and over ; Aortic Aneurysm ; Diagnosis ; Emergencies ; Esophageal Fistula ; Fistula* ; Gastrointestinal Hemorrhage ; Hematemesis ; Hemorrhage* ; Humans ; Syncope

BACKGROUND AND OBJECTIVES: In the past, subacute thyroiditis causing thyrotoxicosis included both painful and painless subgroup, but it is representative for the painful subacute thyroiditis these days. So we evaluated the clinical and laboratory characteristics of subacute thyroiditis and compared with the painless (silent) thyroiditis, and identified predictive factors of permanent hypothyroidism and recurrence. MATERIALS AND METHODS: This was a retrospective case series study analyzing clinical data of 221 consecutive patients diagnosed between 2009 and 2015. Medical records were reviewed for diagnostic route, age distribution, laboratory data, clinical course and long-term follow up outcome. RESULTS: The mean age was 48 years; female v/s male ratio 3.4:1. Median disease duration was 110 days; mean peak free T4 level was 2.9 ng/dL. 56.7% of painless thyroiditis patients were diagnosed on health checkup or routine thyroid function test with symptoms not typically associated with thyrotoxicosis. Permanent hypothyroidism was not uncommon (11/221; 5.0%). Higher peak thyroid-stimulating hormone (TSH) was associated with permanent hypothyroidism in painless thyroiditis. Lower peak TSH was associated with recurrence rate in both subacute and painless thyroiditis. In painless thyroiditis, short duration of thyrotoxicosis phase was also associated with recurrence rate. CONCLUSION: Considerable numbers of painless thyroiditis without symptoms were diagnosed on health checkup. Higher peak TSH was associated with permanent hypothyroidism in painless thyroiditis. Recurrence rate was related with lower peak TSH in both groups.
Age Distribution ; Female ; Follow-Up Studies ; Humans ; Hypothyroidism ; Male ; Medical Records ; Postpartum Thyroiditis ; Recurrence ; Retrospective Studies ; Thyroid Function Tests ; Thyroid Gland* ; Thyroiditis* ; Thyroiditis, Subacute* ; Thyrotoxicosis ; Thyrotropin

BACKGROUND AND OBJECTIVES: In the past, subacute thyroiditis causing thyrotoxicosis included both painful and painless subgroup, but it is representative for the painful subacute thyroiditis these days. So we evaluated the clinical and laboratory characteristics of subacute thyroiditis and compared with the painless (silent) thyroiditis, and identified predictive factors of permanent hypothyroidism and recurrence. MATERIALS AND METHODS: This was a retrospective case series study analyzing clinical data of 221 consecutive patients diagnosed between 2009 and 2015. Medical records were reviewed for diagnostic route, age distribution, laboratory data, clinical course and long-term follow up outcome. RESULTS: The mean age was 48 years; female v/s male ratio 3.4:1. Median disease duration was 110 days; mean peak free T4 level was 2.9 ng/dL. 56.7% of painless thyroiditis patients were diagnosed on health checkup or routine thyroid function test with symptoms not typically associated with thyrotoxicosis. Permanent hypothyroidism was not uncommon (11/221; 5.0%). Higher peak thyroid-stimulating hormone (TSH) was associated with permanent hypothyroidism in painless thyroiditis. Lower peak TSH was associated with recurrence rate in both subacute and painless thyroiditis. In painless thyroiditis, short duration of thyrotoxicosis phase was also associated with recurrence rate. CONCLUSION: Considerable numbers of painless thyroiditis without symptoms were diagnosed on health checkup. Higher peak TSH was associated with permanent hypothyroidism in painless thyroiditis. Recurrence rate was related with lower peak TSH in both groups.
Age Distribution ; Female ; Follow-Up Studies ; Humans ; Hypothyroidism ; Male ; Medical Records ; Postpartum Thyroiditis ; Recurrence ; Retrospective Studies ; Thyroid Function Tests ; Thyroid Gland* ; Thyroiditis* ; Thyroiditis, Subacute* ; Thyrotoxicosis ; Thyrotropin

OBJECTIVES: This study investigated on the severity of dry mouth in the hansen people and the association between dry mouth(low, moderate and high) with pre and post wearing denture satisfaction. METHODS: Data were obtained from a cross-sectional survey of 104 hansen people(mean age=69.3). Data were collected by means of a personal interview from April 30 through to Jane 20, 2014. Pre and post wearing denture satisfaction was measured by the 24-items and dry mouth was measured by the 4-items. The data was analysed with t-test, One-way ANOVA, and Logistic regression using the SPSS program. RESULTS: Regarding perception of dry mouth, the subjects achieved a mean of 6.13 out of a maximum 12 points. Scores were categorised as high(8~12), medium(5~7) or low(1~4) and the proportion were 24.5%(9.56), 42.2%(5.81) and 33.3%(4.00) respectively. Those who were older and had fewer natural teeth felt that their perception of dry mouth was more severe. A logistic regression analysis showed that the subjects perception of dry mouth had a significant impact on their gender (OR=2.73), comfort (OR=0.21), aesthetic appreciation (OR=7.56) satisfaction. CONCLUSIONS: Based on the findings, the perception of dry mouth has a significant and negative impact on denture satisfaction. These results suggest that oral health promotion should be considered various factors related dry mouth in the elderly with removable denture.
Aged ; Cross-Sectional Studies ; Dentures* ; Humans ; Logistic Models ; Mouth* ; Oral Health ; Tooth

OBJECTIVES: Endobronchial foreign body impaction is a medical emergency because of the air way obstruction. Therefore, immediate foreign body removal is crucial in such situations. Recently, there have been several reports about cryoprobe use as a tool for removal of foreign bodies. In this study, we determined the efficacy and complications of foreign body removal using a cryoprobe during flexible bronchoscopy. METHODS: This is a retrospective review of 27 patients who visited Kosin University Gospel Hospital from August 2007 to August 2010 with respiratory symptoms due to a foreign body in the airway. There were 17 males and 10 females, aged from 7 to 78 years. The foreign bodies were more frequently located (55%) in the right bronchus. The cryoprobe was inserted through the forceps channel of the flexible bronchoscope under local anesthesia. The lesion was quickly frozen for 5 seconds at -80degrees C, and the bronchoscope was removed with the probe after crystal formation on the contacted area. RESULTS: The success rate of removal of foreign bodies was 85% (23/27) using the cryoprobe. One case of broncholith did not undergo attempted removal because of the possibility of excessive hemorrhage by the tight bronchus impaction, and three cases (plastic,silicon,and implant) failed due to limited crystal formation. There were no severe hemorrhages, arrhythmias, or casualties during the procedure. CONCLUSIONS: The removal of foreign body using a cryoprobe during flexible bronchoscopy was shown to be safe and effective. The nature of the material should be attempted before removing a foreign body.
Anesthesia, Local ; Arrhythmias, Cardiac ; Bronchi ; Bronchoscopes ; Bronchoscopy* ; Emergencies ; Female ; Foreign Bodies* ; Hemorrhage ; Humans ; Male ; Retrospective Studies ; Surgical Instruments