A 35-year-old male presented with atypical aphasia following left anterior choroidal artery infarction associated with distal internal carotid artery dissection. He presented with 1) lexical-semantic deficit without semantic impairment, 2) frequent surface errors (both surface dyslexia and dysgraphia), and 3) intact non-word reading/repetition (preserved sub-lexical route), suggesting deficit in the phonological output lexicon. Diffusion-tensor tractography analysis revealed disruption in the inferior fronto-occipital fasciculus and inferior longitudinal fasciculus, which might serve as potential subcortical neural correlates for phonological output lexicon.

This article evaluated levels of Estimated Average Requirements (EARs), Reference Nutrient Intakes (RNIs), and Acceptable Macronutrient Distribution Ranges (AMDRs) of protein using the recently revised Dietary Reference Intakes (DRIs) for Koreans (2020). Dietary protein requirements are based on amounts sufficient to satisfy physiological demands to accomplish nitrogen equilibrium. The same principle was applied to estimate EARs and RNIs, for adults in DRIs conducted in 2015 and 2020 in Koreans. EAR was estimated to be 0.73 g/kg body weight/day, according to data (0.66 g/kg body weight/day) obtained using the nitrogen balance method and adjusted by efficiency of protein use (90%). RNI was calculated as EAR increased by an amount equal to twice the standard deviation of an age group so as to cover 97.5% of the group and was found to be 0.91 g/kg body weight/day. For weaned infants, children, and adolescents, growth requirement was added to estimate EAR. In particular, growth requirement was adjusted by efficiency of protein use in the revised EAR, which led to higher EARs for weaned infants, children, and adolescents of both genders as compared with 2015 DRIs. The AMDR for protein was set at 7%–20% of energy intake, which was the same as 2015 DRIs. Current, average protein intake by the Korean population is almost twice times the EAR, which suggests it might be better to increase the minimal margin for AMDR.However, it was not adjusted in this revision due to lack of evidence.

Background: Various regional analgesia techniques are used to reduce postoperative pain in patients undergoing video-assisted thoracic surgery (VATS). This study aimed to determine the relative efficacy of regional analgesic interventions for VATS using a network meta-analysis (NMA). Methods: We searched the Medline, EMBASE, Cochrane Controlled Trial Register, Web of Science, and Google Scholar databases to identify all randomized controlled trials (RCTs) that compared the analgesic effects of the following interventions: control, thoracic paravertebral block (TPVB), erector spinae plane block (ESPB), serratus plane block (SPB), and intercostal nerve block (INB). The primary outcome was opioid consumption during the first 24-h postoperative period. Pain scores were also collected during three different postoperative periods: the early (0–6 h), middle (6–18 h), and late (18–24 h) periods. Results: A total of 21 RCTs (1391 patients) were included. TPVB showed the greatest effect on opioid consumption compared with the control (mean difference [MD] = −13.2 mg; 95% CI [−16.2, −10.1]). In terms of pain scores in the early period, ESPB had the greatest effect compared to control (MD = −1.6; 95% CI [−2.3, −0.9]). In the middle and late periods, pain scores showed that TPVB, ESPB and INB had superior analgesic effects compared to controls, while SPB did not. Conclusions TPVB had the best analgesic efficacy following VATS, though the analgesic efficacy of ESPBs was comparable. However, further studies are needed to determine the optimal regional analgesia technique to improve postoperative pain control following VATS.

The Korea National Health and Nutrition Examination Survey of 2013 to 2017 reported that the average protein consumption of the Korean population is above the current recommended nutrient intake of protein proposed by the Dietary Reference Intakes for Koreans. Some health professionals and the media often advise consuming diets high in protein for promoting metabolic regulation, weight control, and muscle synthesis. However, due to lack of scientific evidence, the validity and safety of high protein consumption are yet to be fully ascertained. The present review assesses recent evidence published in 2014–2020 from human studies, focusing on adequate protein intake and protein sources for the prevention of chronic diseases, particularly metabolic disorders and sarcopenia.

BACKGROUND: We previously reported that percutaneous dilatational tracheostomy (PDT) can be safely performed 2 cm below the cricothyroid membrane without the aid of a bronchoscope. Although our simplified method is convenient and does not require sophisticated equipment, the precise location for tracheostomy cannot be confirmed. Because it is recommended that tracheostomy be performed at the second tracheal ring, we assessed whether patient characteristics could predict the distance between the cricothyroid membrane and the second tracheal ring. METHODS: Data from 490 patients who underwent three-dimensional neck computed tomography from January 2012 to December 2015 were analyzed, and the linear distance from the upper part of the cricoid cartilage (CC) to the lower part of the second tracheal ring (2TR) was measured in the sagittal plane. RESULTS: The mean CC-to-2TR distance was 25.26 mm (95% CI 25.02–25.48 mm). Linear regression analysis showed that the predicted CC-to-2TR distance could be calculated as −5.73 + 0.2 × height (cm) + 1.22 × sex (male: 1, female: 0) + 0.01 × age (yr) −0.03 × weight (kg) (adj. R² = 0.55). CONCLUSIONS: These results suggest that height and sex should be considered when performing PDT without bronchoscope guidance.
Airway Management ; Bronchoscopes ; Bronchoscopy ; Cricoid Cartilage ; Critical Care ; Female ; Humans ; Linear Models ; Membranes ; Methods ; Neck ; Regression Analysis ; Trachea ; Tracheostomy

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a common metabolic disease triggered by epigenetic alterations, including lysine acetylation at histone or non-histone proteins, affecting the stability or transcription of lipogenic genes. Although various natural dietary compounds have anti-lipogenic effects, their effects on the acetylation status and lipid metabolism in the liver have not been thoroughly investigated. MATERIALS/METHODS: Following oleic-palmitic acid (OPA)-induced lipid accumulation in HepG2 cells, the acetylation status of histone and non-histone proteins, HAT activity, and mRNA expression of representative lipogenic genes, including PPARγ, SREBP-1c, ACLY, and FASN, were evaluated. Furthermore, correlations between lipid accumulation and HAT activity for 22 representative natural food extracts (NExs) were evaluated. RESULTS: Non-histone protein acetylation increased following OPA treatment and the acetylation of histones H3K9, H4K8, and H4K16 was accelerated, accompanied by an increase in HAT activity. OPA-induced increases in the mRNA expression of lipogenic genes were down-regulated by C-646, a p300/CBP-specific inhibitor. Finally, we detected a positive correlation between HAT activity and lipid accumulation (Pearson's correlation coefficient = 0.604) using 22 NExs. CONCLUSIONS: Our results suggest that NExs have novel applications as nutraceutical agents with HAT inhibitor activity for the prevention and treatment of NAFLD.
Acetylation ; Dietary Supplements ; Epigenomics ; Hep G2 Cells ; Histone Acetyltransferases ; Histones ; Lipid Metabolism ; Lipogenesis ; Liver ; Lysine ; Metabolic Diseases ; Non-alcoholic Fatty Liver Disease ; RNA, Messenger ; Sterol Regulatory Element Binding Protein 1

BACKGROUND: We previously reported that percutaneous dilatational tracheostomy (PDT) can be safely performed 2 cm below the cricothyroid membrane without the aid of a bronchoscope. Although our simplified method is convenient and does not require sophisticated equipment, the precise location for tracheostomy cannot be confirmed. Because it is recommended that tracheostomy be performed at the second tracheal ring, we assessed whether patient characteristics could predict the distance between the cricothyroid membrane and the second tracheal ring. METHODS: Data from 490 patients who underwent three-dimensional neck computed tomography from January 2012 to December 2015 were analyzed, and the linear distance from the upper part of the cricoid cartilage (CC) to the lower part of the second tracheal ring (2TR) was measured in the sagittal plane. RESULTS: The mean CC-to-2TR distance was 25.26 mm (95% CI 25.02–25.48 mm). Linear regression analysis showed that the predicted CC-to-2TR distance could be calculated as −5.73 + 0.2 × height (cm) + 1.22 × sex (male: 1, female: 0) + 0.01 × age (yr) −0.03 × weight (kg) (adj. R² = 0.55). CONCLUSIONS These results suggest that height and sex should be considered when performing PDT without bronchoscope guidance.

BACKGROUND/OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease and is closely associated with metabolic syndrome. In the present study, we observed the effect of ethanol extract of Allium fistulosum (EAF) on NAFLD and have suggested the possibility of using EAF as a natural product for application in the development of a treatment for NAFLD. MATERIALS/METHODS: The preventive effect on hepatic lipid accumulation was estimated by using an oleic acid (OA)-induced NAFLD model in vitro and a Western diet (high-fat high-sucrose; WD)-induced obese mouse model. Animals were divided into three groups (n = 7): normal diet group (ND), WD group, and WD plus 1% EAF group. RESULTS: EAF reduced OA-stimulated lipid accumulation in HepG2 cells in the absence of cellular cytotoxicity and significantly blocked transcriptional activation of sterol regulatory element-binding protein 1 and fatty acid synthase genes. Subsequently, we investigated these effects in vivo in mice fed either ND or WD in the presence or absence of EAF supplementation. In comparison to the ND controls, the WD-fed mice exhibited increases in body weight, liver weight, epididymal fat weight, and accumulation of fat in hepatocytes, and these effects were significantly attenuated by EAF supplementation. CONCLUSIONS: Allium fistulosum attenuates the development of NAFLD, and EAF elicits anti-lipogenic activity in liver. Therefore, EAF represents a promising candidate for use in the development of novel therapeutic drugs or drug combinations for the prevention and treatment of NAFLD.
Allium* ; Animals ; Body Weight ; Diet ; Diet, Western ; Drug Combinations ; Ethanol* ; Hep G2 Cells ; Hepatocytes ; In Vitro Techniques ; Lipogenesis ; Liver ; Liver Diseases ; Mice ; Mice, Obese ; Non-alcoholic Fatty Liver Disease* ; Oleic Acid ; Sterol Regulatory Element Binding Protein 1 ; Transcriptional Activation

In this study, the effect of particle size of genistein-loaded solid lipid particulate systems on drug dissolution behavior and oral bioavailability was investigated. Genistein-loaded solid lipid microparticles and nanoparticles were prepared with glyceryl palmitostearate. Except for the particle size, other properties of genistein-loaded solid lipid microparticles and nanoparticles such as particle composition and drug loading efficiency and amount were similarly controlled to mainly evaluate the effect of different particle sizes of the solid lipid particulate systems on drug dissolution behavior and oral bioavailability. The results showed that genistein-loaded solid lipid microparticles and nanoparticles exhibited a considerably increased drug dissolution rate compared to that of genistein bulk powder and suspension. The microparticles gradually released genistein as a function of time while the nanoparticles exhibited a biphasic drug release pattern, showing an initial burst drug release, followed by a sustained release. The oral bioavailability of genistein loaded in solid lipid microparticles and nanoparticles in rats was also significantly enhanced compared to that in bulk powders and the suspension. However, the bioavailability from the microparticles increased more than that from the nanoparticles mainly because the rapid drug dissolution rate and rapid absorption of genistein because of the large surface area of the genistein-solid lipid nanoparticles cleared the drug to a greater extent than the genistein-solid lipid microparticles did. Therefore, the findings of this study suggest that controlling the particle size of solid-lipid particulate systems at a micro-scale would be a promising strategy to increase the oral bioavailability of genistein.
Absorption* ; Animals ; Biological Availability* ; Drug Liberation ; Genistein* ; Nanoparticles* ; Particle Size* ; Powders ; Rats

BACKGROUND/OBJECTIVES: Dietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents. SUBJECTS/METHODS: We pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records. RESULTS: Mean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls). CONCLUSIONS: These results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.
Adolescent* ; Beverages ; Child* ; Diet Records ; Education ; Energy Intake ; Female ; Fruit ; Humans ; Korea* ; Snacks