Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Thiazolidinediones (TZDs) have been associated with various safety concerns including weight gain, bladder cancer, and congestive heart failure (CHF). This study evaluated the efficacy and safety of lobeglitazone, a novel TZD in patients with type 2 diabetes mellitus (T2DM) in real practice. Methods: In this non-interventional, multi-center, retrospective, and observational study conducted at 15 tertiary or secondary referral hospitals in Korea, a total of 2,228 patients with T2DM who received lobeglitazone 0.5 mg for more than 1 year were enrolled. Results: Overall adverse events (AEs) occurred in 381 patients (17.10%) including edema in 1.97% (n=44). Cerebrovascular and cardiovascular diseases were identified in 0.81% (n=18) and 0.81% (n=18), respectively. One case of CHF was reported as an AE. Edema occurred in 1.97% (n=44) of patients. Hypoglycemia occurred in 2.47% (n=55) of patients. Fracture occurred in 1.17% (n=26) of all patients. Lobeglitazone significantly decreased HbA1c level, resulting in a mean treatment difference of -1.05%± 1.35% (P<0.001), and decreased total cholesterol, triglyceride, and low-density lipoprotein cholesterol. However, it increased high-density lipoprotein cholesterol, regardless of statin administration. The patients who received lobeglitazone 0.5 mg showed an apparent reduction in glycosylated hemoglobin (HbA1c) from baseline during the first 6 months of treatment. The HbA1c levels remained stable between months 6 and 42. Conclusion Lobeglitazone has long-term safety profile, good glycemic-lowering effect and long-term durability of glycemic control in real-world clinical settings.

BACKGROUND: Oxytocin (OXT) has been reported to act as a growth regulator in various tumor cells. However, there is a paucity of data on the influence of OXT on cell proliferation of corticotroph adenomas. This study aimed to examine whether OXT affects cell growth in pituitary tumor cell lines (AtT20 and GH3 cells) with a focus on corticotroph adenoma cells. METHODS: Reverse transcription polymerase chain reaction and enzyme-linked immunosorbent assay were conducted with AtT20 cells to confirm the effects of OXT on hormonal activity; flow cytometry was used to assess changes in the cell cycle after OXT treatment. Moreover, the impact of OXT on proliferating cell nuclear antigen (PCNA), nuclear factor κB, and mitogen-activated protein kinase signaling pathway was analyzed by Western blot. RESULTS: OXT treatment of 50 nM changed the gene expression of OXT receptor and pro-opiomelanocortin within a short time. In addition, OXT significantly reduced adrenocorticotropic hormone secretion within 1 hour. S and G2/M populations of AtT20 cells treated with OXT for 24 hours were significantly decreased compared to the control. Furthermore, OXT treatment decreased the protein levels of PCNA and phosphorylated extracellular-signal-regulated kinase (P-ERK) in AtT20 cells. CONCLUSION: Although the cytotoxic effect of OXT in AtT20 cells was not definite, OXT may blunt cell proliferation of corticotroph adenomas by altering the cell cycle or reducing PCNA and P-ERK levels. Further research is required to investigate the role of OXT as a potential therapeutic target in corticotroph adenomas.
ACTH-Secreting Pituitary Adenoma ; Adrenocorticotropic Hormone ; Blotting, Western ; Cell Cycle ; Cell Line ; Cell Proliferation ; Corticotrophs ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Gene Expression ; Oxytocin ; Phosphotransferases ; Pituitary Neoplasms ; Polymerase Chain Reaction ; Pro-Opiomelanocortin ; Proliferating Cell Nuclear Antigen ; Protein Kinases ; Reverse Transcription

OBJECTIVE: Sacral insufficiency fracture (SIF) contributes to severe low back pain. Prolonged immobilization resulting from SIF can cause significant complications in the elderly. Sacroplasty, a treatment similar to vertebroplasty, has recently been introduced for providing pain relief in SIF. The purpose of this study is to investigate the clinical short-term effects of percutaneous sacroplasty on pain and mobility in SIF. METHODS: This study is conducted prospectively with data collection. Sixteen patients (3 men and 13 women) with a mean age of 77.5 years (58 to 91) underwent sacroplasty. Patients reported visual analogue scale (VAS; 0–10) and Oswestry disability index (ODI; 0–100%) scores. VAS and ODI scores were collected preoperatively and again at one day, one month, and three months postoperatively. Questionnaires measuring six activities of daily living (ADLs) including ambulating, performing housework, dressing, bathing, transferring from chair, and transferring from bed were collected. Ability to perform ADLs were reported preoperatively and again at three months postoperatively. RESULTS: The mean preoperative VAS score (mean±SD) of 7.5±0.8 was significantly reduced to 4.1±1.6, 3.3±1.0, and 3.2±1.2 postoperatively at one day, one month, and three months, respectively (p<0.01). The mean ODI score (%) also significantly improved from 59±14 preoperatively to 15.5±8.2 postoperatively at one month and 14.8±8.8 at three months (p<0.01). All ADL scores significantly improved at three months postoperatively (p<0.01). CONCLUSION: Percutaneous sacroplasty alleviates pain quickly and improves mobility and quality of life in patients treated for SIF.
Activities of Daily Living ; Aged ; Bandages ; Baths ; Data Collection ; Fractures, Stress* ; Housekeeping ; Humans ; Immobilization ; Low Back Pain ; Male ; Prospective Studies ; Quality of Life ; Vertebroplasty

Human airways contact with pathogen-associated molecular patterns and danger-associated molecular patterns present in many environments. Asthmatic's airways may be more susceptible to these patterns and lead to inflammasome activation; however, the participation of inflammasome in the development and exacerbation of asthma is not fully understood and remains controversial. Asthma is a heterogeneous group composed of different airway inflammation patterns with different underlying immune mechanisms. One mechanism is neutrophilic airway inflammation based on the axis of inflammasome activation, interleukin (IL) 1β/IL-18 production, T helper 17 activation, IL-8/IL-6 overproduction, and neutrophilic inflammation. The role of inflammasome activation has been highlighted in experimental asthma models and some evidence of inflammasome activation has been recently demonstrated in human neutrophilic asthmatic airways. In addition to caspase-1 activation, proteinase 3 and other protease from activated neutrophils directly cleave pro-IL-1β and pro-IL-18 to IL-1β and IL-18, which contribute to the phenotype of subsequent adaptive immune responses without inflammasome activation. Data suggests that neutrophilics in asthmatic airways may have an additional effect in initiating inflammasome activation and amplifying immune responses. Among the mediators from neutrophils, S100A9 seems to be one candidate mediator to explain the action of neutrophils in amplifying the airway inflammation in concert with inflammasome.
Asthma ; Calgranulin B ; Humans ; Inflammasomes ; Inflammation ; Interleukin-18 ; Interleukins ; Myeloblastin ; Neutrophils ; Pathogen-Associated Molecular Pattern Molecules ; Phenotype ; Th17 Cells

Agar* ; Diffusion* ; Iron ; Oxygen* ; Staphylococcus aureus* ; Staphylococcus*

Agar* ; Diffusion* ; Iron ; Oxygen* ; Staphylococcus aureus* ; Staphylococcus*

OBJECTIVES: To investigate the role of annexin-I in human cervical cancer, we evaluated the expression of annexin-I and the relation with the proliferation of cancer cells. Methods: By immunohistochemical analysis and the western blotting of annexin-I , we investigated the extent and distribution of the expression of annexin-I in cervical cancer tissues. After treating the human cancer cell lines ( SiHa and HeLa cell lines ) with tamoxifen, estradiol, and retinoic acid for 5 days to make the cells proliferate and antiproliferate, we measured the proliferation simultaneously with 3-(4,5- dimethyl thiazol- 2-yl)-2,5-diphenyl-tetr -azolium bromide (MTT) colorimetric assay and the expression level of annexin-I with flowcytometry. RESULTS: In the immunohistochemical stains, a granular staining pattern involving the entire cytoplasm was more heavily observed in malignant lesions than in normals. In the western blotting, the antibodies against 35-kDa annexin-I appeared to react more strongly with the lysates of cancer tissues than normal and benign tissues. In SiHa and HeLa cell lines with tamoxifen and beta- estradiol treatment, increased expressions of annexin-I were noted with correlated increased proliferation of cells, and with the treatments of all trans retinoic acid, decreased expressions of annexin-I were noted with correlated decreased proliferation of cells. CONCLUSIONS: The results suggest that the expression of annexin-I might correlate with cervical cancer than normal and the proliferation of cancer cells.
Antibodies ; Blotting, Western ; Cell Line ; Cell Proliferation* ; Coloring Agents ; Cytoplasm ; Estradiol ; HeLa Cells ; Humans ; Tamoxifen ; Tretinoin ; Uterine Cervical Neoplasms*

PURPOSE: To evaluate whether the presence of a peripheral echogenic rim surrounding internal low echogenicityis helpful in the diagnosis of atypical hepatic hemangioma. MATERIALS AND METHODS: Within a two-year period, aretrospective review of the sonographic appearances of 24 atypical hemangiomas in 21 patients was performed. Diagnosis was made by dynamic and delayed enhanced CT, MR imaging or clinical follow up for one year, including follow-up sonogram. The sonographic appearances of these hemangiomas were analyzed for pattern and thickness ofthe echogenic rim, internal echo pattern, shape, and size. Additionally, forty six lesions of hepatoma, metastasis, abscess and intrahepatic cholangiocarcinoma confirmed by pathology within the same period were also evaluated for the presence of echogenic rim. RESULTS: Twenty-three of 24 lesions showed an echogenic rim ; these were thick in nine cases, and thin in 14 cases. The thickness of the rim was either uniform(n=10) or eccentric(n=13). The average maximum diameter of atypical hemangioma was 4.4cm (range of diameters, 1.5-12cm). The internal echo pattern was partially or entirely hypoechoic in 15 lesions, homogeneously isoechoic in three, and mixed insix cases. Twenty-one lesions were round, and the shape of three was irregular. The other forty six masses including hepatocellular carcinoma, metastases, cholangiocarcinoma and hepatic abscesses did not show an echogenicrim. CONCLUSIONS: The presence of a sonographic echogenic rim in a hepatic mass may help in the diagnosis ofhepatic hemangioma.
Abscess ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Diagnosis ; Follow-Up Studies ; Hemangioma* ; Humans ; Liver Abscess ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pathology ; Ultrasonography*

PURPOSE: To evaluate the CT and US features of the colonic villous tumors. MATERIALS AND METHODS: We retrospectively reviewed the CT findings of 11 cases with histologically proved colonic villous tumor. CT parameters evaluated were morphological appearances and enhancing pattern (size, shape, margin, presence or absence of fronds, bowel wall thickening). CT features of six cases with malignant change were compared with five tumors without malignant change. US features available in 10 patients were also analyzed. RESULTS: On CT, thetumors showed irregular margin(n=9), presence of fronds(n=6), lobulated shape(n=11), with pericolonic invasion(n=1). Six cases with malignant change were larger(mean, 6.8cm in diameter) than those without malignant change(mean, 3.3 cm). US features in 10 cases were intraluminal mass(n=5), colonic wall thickening(n=5), with variable echogenicity. CONCLUSIONS: Colonic villous tumor appeared as a nonspecific mass on CT and US with adifficulty in distinguishing from colon carcinoma.
Colon* ; Humans