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 and Objectives: This study aimed to investigate the protective effect of polydeoxyribonucleotide (PDRN) against skin flap necrosis in a murine skin flap model.Materials and Method Twenty mice with rectangular skin flaps on the dorsum were randomly divided into the PDRN (n=10) and pentobarbital sodium (PBS) (n=10) injection groups. PDRN (8 mg/kg) was subdermally injected at 12 different points immediately after the operation. After 7 days, the flap perfusions were evaluated using a laser speckle contrast imaging (LSCI) system, and specimens were collected for immunohistochemistry analysis. Results: The percentage of survival area relative to the total flap area was significantly higher in the PDRN group (60.87%±7.63%) than in the PBS group (45.23%±10.72%) (p<0.05). The mean LSCI perfusion signal of the distal part of the skin flap in the PBS group was 0.57±0.12, and that in the PDRN group was 0.74±0.13 (p<0.05). The PDRN group had a significantly lower interleukin 1 beta expression than the PBS group and higher vascular endothelial growth factor α expression than the PBS group (p<0.05). Conclusion These findings suggest that subdermally injected PDRN is more effective in enhancing flap survival during necrosis.

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea’s bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches—expert consensus versus metaanalysis results—forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion Korea’s unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.