Parkinson’s disease (PD) which has various pathological mechanisms, recently, it is attracting attention to the mechanism via microbiome-gut-brain axis. 6-Shogaol, a representative compound of ginger, have been known for improving PD phenotypes by reducing neuroinflammatory responses. In the present study, we investigated whether 6-shogaol and ginger attenuate degeneration induced by Proteus Mirabilis(P. mirabilis) on the intestine and brain, simultaneously. C57BL/6J mice received P. mirabilis for 5 days. Ginger (300 mg/kg) and 6-shogaol (10 mg/kg) were treated by gavage feeding for 22 days including the period of P. mirabilis treatment. Results showed that 6-shogaol and ginger improved motor dysfunction and dopaminergic neuronal death induced by P. mirabilis treatment. In addition, they suppressed P. mirabilis-induced intestinal barrier disruption, pro-inflammatory signals such as toll-like receptor and TNF-α, and intestinal α-synuclein aggregation. Moreover, ginger and 6-shogaol significantly inhibited neuroinflammation and α-synuclein in the brain. Taken together, 6-shogaol and ginger have the potential to ameliorate PD-like motor behavior and degeneration of dopaminergic neurons induced by P. mirabilis in mice. Here, these findings are meaningful in that they provide the first experimental evidence that 6-shogaol might attenuate PD via regulating gut-brain axis.

BACKGROUND: The combination of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) has been the first choice nucleoside reverse transcriptase inhibitor (NRTI) according to many reliable antiretroviral treatment (ART) guidelines because of its high efficacy. However, TDF-related renal toxicity reported in Western countries is a challenging issue regarding clinical use. We conducted this study to evaluate the incidence and characteristics of an acute increase in serum creatinine (Cr) level > 1.5 mg/dL among TDF/FTC-based highly active antiretroviral treatment (HAART)-treated patients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 205 HIV-infected patients treated with TDF/FTC-containing regimens between 1 February 2010 and 30 April 2014. Three groups of TDF/FTC + ritonavir-boosted protease inhibitor (PI/r), TDF/FTC + non-nucleoside reverse transcriptase inhibitor (NNRTI), and TDF/FTC + integrase strand transfer inhibitor (INSTI), and three PI/r subgroups of TDF/FTC + lopinavir (LPV)/r, TDF/FTC + atazanavir (ATV)/r, TDF/FTC + darunavir (DRV)/r were evaluated. RESULTS: A total 136 patients (91 in the TDF/FTC + PI/r group, 20 in the TDF/FTC + NNRTI group and 25 in the TDF/FTC + INSTI group) were included in the statistical analysis. Four cases (4.9%; all in the TDF/FTC + PI/r group) among 136 patients showed an acute increase in serum Cr more than 1.5 mg/dL, so the overall incidence was 2.8 cases per 100 patient-years. One case was a patient treated with TDF/FTC + LPV/r, and the others were treated with TDF/FTC + ATV/r. No case of an acute increase in serum Cr was observed in the TDF/FTC + DRV/r group. The incidence of serum Cr increase more than 1.5 mg/dL in TDF/FTC + PI/r group was 4.0 cases per 100 patient-years. CONCLUSION: Although only a small number of patients were evaluated retrospectively from a single center, the TDF/FTC + PI/r regimen may have been related with relatively higher tendency of increment of serum Cr level. These findings reinforce the importance of close follow-ups of HIV-infected patients treated with the TDF/FTC + PI/r regimens.
Anti-Retroviral Agents ; Antiretroviral Therapy, Highly Active* ; Atazanavir Sulfate ; Creatinine* ; Darunavir ; Emtricitabine ; Follow-Up Studies ; HIV ; Humans ; Incidence* ; Integrases ; Lopinavir ; Medical Records ; Protease Inhibitors ; Retrospective Studies ; RNA-Directed DNA Polymerase ; Tenofovir

The transport proteins such as thyroxine-binding-globulin (TBG), albumin and transthyretin carry over 99% of circulating thyroid hormones. TBG is a major thyroid hormone transport protein in serum. Although TBG deficiency does not have metabolic consequences, it has diagnostic implications as it can lead to an incorrect interpretation of thyroid function tests. We experienced a case that a man who had an abnormal thyroid function showed unexpectedly low concentrations of serum total thyroxine. We detected the low TBG in his serum and he was diagnosed the TBG deficiency. We report this case along with a review of the related literature.
Carrier Proteins ; Prealbumin ; Thyroid Function Tests ; Thyroid Gland ; Thyroid Hormones ; Thyroxine

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. METHODS: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male: female 20: 7; age 47.6+/-12.9 years old; age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. RESULTS: Mean total sleep time on polysomnography was 401.4+/-57.8 min (range of 274.0 to 514.1 min). Mean RDI was 21.7+/-20.4 /hour. Mean FI was 21.9+/-13.0 / hour. RDI and FI showed significant correlation (r=0.55, p< 0.01). CONCLUSIONS: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.
Accident Proneness ; Actigraphy* ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Outpatients ; Polysomnography ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Sleep Wake Disorders ; Wrist

A paragonimiasis infestation is caused by the paragonimus species. It is commonly found in the lung but has also been found to exist extrapulmonary infestations including cerebral, spinal, subcutaneous, hepatic, splenic, abdominal, urinary, and gynecologic infestation. On the other hand, a cutaneous infestation is extremely rare. Human infestation is caused by ingesting raw or undercooked intermediate hosts. Because paragonimus westermani larva mature to an adult worm in the lung, the possibility of identifying the adult worm of paragonimus westermani at extrapulmonary region is very rare. CASE: After ingesting a fresh-water crab 1 month prior to the hospital visit, a 45-year old female patient was suffering from right pleuritic chest pain during that 1 month. The patient also complained of a palpable mass that was movable and migrating, and it was localized at the right upper quadrant of the abdomen. The eosinophil fraction of the white blood cell of peripheral blood and pleural fluid was elevated to 55.1% and 90%, respectively. Parasite eggs were not found in her sputum and stool examination. By using the enzyme-linked immunosorbent assay (ELISA), the paragonimus-specific IgG antibody titer was elevated to 0.28. During incisional biopsy, we were able to find the young adult worm of paragonimus westermani. We experienced the rare case of ectopic paragonimiasis with pleural effusion that was confirmed by identifying the adult worm of paragonimus westermani within the abdominal subcutaneous tissue. We report a case with brief literature reviews.
Abdomen ; Adult ; Biopsy ; Chest Pain ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Eosinophils ; Female ; Hand ; Humans ; Immunoglobulin G ; Larva ; Leukocytes ; Lung ; Middle Aged ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Pleural Effusion* ; Sputum ; Subcutaneous Tissue* ; Young Adult

BACKGROUND: The significance of ER expression and hormone manipulation in gastric cancer is not established. There have been several reports supporting the role of the ER gene as tumor suppressor gene in carcinogenesis. The ER-alpha gene is located on chromosome 6q25.1. Deletions of the long arm of chromosome 6 are common in gastric carcinoma, suggesting the presence of tumor suppressor genes in this region. The proportion of ER-positive gastric cancers ranges between 0% and 67% depending on the method of detection. Epigenetic inactivation might explain the loss of ER-alpha gene expression in gastric cancer. There is no information available regarding the methylation status of the ER-alpha gene promoter region in gastric cancer so far. The aim of this study was to assess the expression of ER-alpha in gastric cancer cell lines and determine whether methylation of the 5' promoter region is associated with loss of ER-alpha expression in gastric cancer. METHODS: We investigated such methylation in 13 gastric cancer cell lines. Western blot analysis, reverse transcription-polymerase chain reaction (PCR), methylation-specific PCR (MS-PCR) and bisulfite sequencing analyses were used. Immunohistochemical staining for the ER-alpha gene was dome for forty-two paraffin embedded tissues from gastric cancer patients. RESULTS: ER-alpha protein was not detected in any cell line, ER-alpha mRNA was expressed in only Kato III cell line. MS-PCR and bisulfite sequencing showed all thirteen gastric cancer cell lines had methylated CpG regions in their ER-alpha gene promoters. Immunohistochemical staining of ER-alpha showed no positivity in any of examined samples. CONCLUSION: Inactivation of ER-alpha gene expression in gastric cancer cell lines appears associated with CpG island methylation near the TGA initiation codon of the ER-alpha gene.
Arm ; Blotting, Western ; Carcinogenesis ; Cell Line ; Chromosomes, Human, Pair 6 ; Codon, Initiator ; CpG Islands ; Epigenomics ; Estrogens* ; Gene Expression ; Genes, Tumor Suppressor ; Humans ; Methylation ; Paraffin ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; RNA, Messenger ; Stomach Neoplasms*

Hyperthyroidism may be associated or present with a variety of neuromuscular disorders, including thyrotoxic myopathy, exophthalmic ophthalmoplegia, periodic paralysis and myasthenia gravis. In contrast to muscle, peripheral nerve involvement in hyperthyroidism is exceedingly rare, and has received little attention. Paraplegia-like weakness during severe hyperthyroidism was first described by Charcot in 1889, and called Basedow's paraplegia' by Joffory in 1894. However, there has been no reported case in Korea. A 38-year-old woman was admitted for evaluation of progressive weakness and a gait disturbance. Her endocrinological results were compatible with hyperthyroidism. The polyneuropathy was also confirmed with sequential electrophysiological studies of the nerves and muscles. Drug therapy for hyperthyroidism resulted in resolution of the clinical neurological symptoms and progressive improvement of electrophysiological findings. Hyperthyroidisms are common medical disorders, which are often accompanied by diverse types of neurological and neuromuscular dysfunctions. All of these neurological manifestations are important, as they can serve as important clues to the diagnosis of a thyroid disorder. Furthermore, they are often related to the patient's presenting complaint. Therefore, the physician must be alert to the diverse manifestations of thyroid dysfunction, as they can lead to the diagnosis of potentially serious but treatable disorders. Herein is reported a case of myopathy and neuropathy associated with hyperthyroidism (Basedow's paraplegia), with a review of the literature
Adult ; Diagnosis ; Drug Therapy ; Female ; Gait ; Humans ; Hyperthyroidism ; Korea ; Muscles ; Muscular Diseases ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia ; Paralysis ; Paraplegia* ; Peripheral Nerves ; Polyneuropathies ; Thyroid Gland

Hyperthyroidism may be associated or present with a variety of neuromuscular disorders, including thyrotoxic myopathy, exophthalmic ophthalmoplegia, periodic paralysis and myasthenia gravis. In contrast to muscle, peripheral nerve involvement in hyperthyroidism is exceedingly rare, and has received little attention. Paraplegia-like weakness during severe hyperthyroidism was first described by Charcot in 1889, and called Basedow's paraplegia' by Joffory in 1894. However, there has been no reported case in Korea. A 38-year-old woman was admitted for evaluation of progressive weakness and a gait disturbance. Her endocrinological results were compatible with hyperthyroidism. The polyneuropathy was also confirmed with sequential electrophysiological studies of the nerves and muscles. Drug therapy for hyperthyroidism resulted in resolution of the clinical neurological symptoms and progressive improvement of electrophysiological findings. Hyperthyroidisms are common medical disorders, which are often accompanied by diverse types of neurological and neuromuscular dysfunctions. All of these neurological manifestations are important, as they can serve as important clues to the diagnosis of a thyroid disorder. Furthermore, they are often related to the patient's presenting complaint. Therefore, the physician must be alert to the diverse manifestations of thyroid dysfunction, as they can lead to the diagnosis of potentially serious but treatable disorders. Herein is reported a case of myopathy and neuropathy associated with hyperthyroidism (Basedow's paraplegia), with a review of the literature
Adult ; Diagnosis ; Drug Therapy ; Female ; Gait ; Humans ; Hyperthyroidism ; Korea ; Muscles ; Muscular Diseases ; Myasthenia Gravis ; Neurologic Manifestations ; Ophthalmoplegia ; Paralysis ; Paraplegia* ; Peripheral Nerves ; Polyneuropathies ; Thyroid Gland

OBJECTIVE: The objective of this study was to determine whether complications and nursing interventions during hemodialysis could be reduced by using gradient ultrafiltration(GUF) and high sodium dialysate(HSD). METHODS: Thirty outpatients who had been on hemodialysis for more than 3 months were enrolled. Patients received Conventional HD(Na+ 137 mEqX4 hrs, constant UF), GUF(UF 62.5%X2 hrs, UF 37.5 %X2 hrs), HSD(Na+ 145 mEqX2 hrs, Na+ 140 mEqX2 hrs) and HSUF(GUF and HSD). Each methods were prescribed for 2 weeks. The clinical features such as thirst, interdialytic weight gain, postdialytic weight loss and MAP(mean arterial pressure) and the frequency of intradialytic complications and nursing interventions were evaluated. RESULTS: The results were as followings. Interdialytic thirst, weight gain, postdialytic weight loss and MAP(pre/post HD) were not significantly different in each method. On the other hand, there was significant difference between 4 methods in serum sodium, osmolality and Hct. There were significantly fewer episodes of hypotention, muscle cramp and headache when using GUF, HSD and HSUF than CHD. The number of nursing interventions was significantly reduced in GUF, HSD and HSUF than CHD. CONCLUSION: Hemodialysis with gradient ultrafiltration and high sodium dialysate leads fewer complications and nursing interventions, more patient's well being.
Hand ; Headache ; Humans ; Muscle Cramp ; Nursing ; Osmolar Concentration ; Outpatients ; Renal Dialysis* ; Sodium* ; Thirst ; Ultrafiltration* ; Weight Gain ; Weight Loss

PURPOSE: To compare ultrasound-guided automated gun biopsy (USG-AGB) with ultrasound-guided fine needle aspiration (USG-FNA) in thyroid disease. MATERIALS AND METHODS: The findings of 156 patients who underwent both USG-AGB and USG-FNA were reviewed. The histopathologic results were categorized as group I (non-tumorous disease), group II (benign tumor), or group III (malignant tumor) on the basis of the results of USG-AGB and surgery. The results of USGAGB and USG-FNA were compared, and the agreement rate between the two was obtained. Based on the histopathologic results of USG-AGB, the sensitivity and specificity of USG-FNA were obtained for each histopathologic group. The histopathologic results obtained at surgery (n=38) and the findings of USG-AGB and USG-FNA were correlated. RESULTS: The pathologic agreement rate between the two methods was very high (kappa=0.805, p<0.01). Based on the histopathologic results of USG-AGB, the sensitivity and specificity of USG-FNA were, respectively, 100%/97.9% for group I, 94.7%/91.7% for group II, and 87.5%/97.1% for group III. When the results of USG-AGB and USG-FNA were correlated with the surgical results obtained in the 38 patients, 21.7 % (5/23) and 27.3 (6/22) of patients found at USG-AGB and USG-FNA, respectively, to be group II, were found at surgery to be group III, while in 93.3 % (14/15) and 81.3 % (13/16) of group II, the respective USG-AGB and USG-FNA findings, and those abtained at surgery, coincided. CONCLUSION: Although the agreement rate between USG-AGB and USG-FNA is high, USG-AGB is a potentially valuable tool in the diagnosis of thyroid malignant tumor, which can be missed at USG-FNA.
Biopsy* ; Biopsy, Fine-Needle* ; Diagnosis ; Humans ; Sensitivity and Specificity ; Thyroid Diseases* ; Thyroid Gland*