Combining SGLT2 Inhibition With a Thiazolidinedione Additively Attenuate the Very Early Phase of Diabetic Nephropathy Progression in Type 2 Diabetes Mellitus

Although both sodium glucose co-transporter 2 inhibition by dapagliflozin and thiazolidinedione, pioglitazone have glucose-lowering and anti-inflammatory effects, the therapeutic efficacy of their combination on diabetic nephropathy has not been investigated. 9-week-old male db/db mice were randomly assigned to 4 groups and administrated with (1) vehicle, (2) dapagliflozin, (3) pioglitazone, or (4) dapagliflozin and pioglitazone combination. Human proximal tubule (HK-2) cells were treated with glucose or palmitate acid in the presence of medium, dapagliflozin, pioglitazone, or both. Glomerular tuft area and mesangial expansion of the kidney more reduced in the combination group compared to control and single therapy groups. Podocyte foot process width and glomerular basement membrane thickness decreased regardless of treatment, while the combination group showed the slowest renal hypertrophy progression (P < 0.05). The combination treatment decreased MCP-1, type I and IV collagen expression in the renal cortex. Only the combination treatment decreased the expression of angiotensinogen, IL-6, and TGF-β while it enhanced HK-2 cell survival (all P < 0.05). In conclusion, dapagliflozin and pioglitazone preserved renal function, and combination therapy showed the greatest benefit. These findings suggest that the combination therapy of dapagliflozin with pioglitazone is more effective than the single therapy for preventing the progression of nephropathy in patients with type 2 diabetes

Pentoxifylline Attenuates Methionine- and Choline-Deficient-Diet-Induced Steatohepatitis by Suppressing TNF- α

Background. Pentoxifylline (PTX) anti-TNF properties are known to exert hepatoprotective effects in various liver injury models. The aim of this study was to investigate whether PTX has beneficial roles in the development of methionine- and choline-deficient-(MCD-) diet-induced NAFLD SD rats in vivo and TNF-α-induced Hep3B cells in vitro. Methods. SD Rats were classified according to diet (chow or MCD diet) and treatment (normal saline or PTX injection) over a period of 4 weeks: group I (chow + saline, n=4), group II (chow + PTX), group III (MCD + saline), and group IV (MCD + PTX). Hep3B cells were treated with 100 ng/ml TNF-α (24 h) in the absence or presence of PTX (1 mM). Results. PTX attenuated MCD-diet-induced serum ALT levels and hepatic steatosis. In real-time PCR and western blotting analysis, PTX decreased MCD-diet-induced TNF-alpha mRNA expression and proapoptotic unfolded protein response by ER stress (GRP78, p-eIF2, ATF4, IRE1α, CHOP, and p-JNK activation) in vivo. PTX (1 mM) reduced TNF-α-induced activation of GRP78, p-eIF2, ATF4, IRE1α, and CHOP in vitro. Conclusion. PTX has beneficial roles in the development of MCD-diet-induced steatohepatitis through partial suppression of TNF-α and ER stress

Overjet at the Anterior and Posterior Segments: Three-Dimensional Analysis of Arch Coordination

Objectives: To compare the amounts of anatomical overjet measured from facial axis (FA) points with the amounts of bracket overjet measured from bracket slot center (BSC) points. Materials and Methods: The samples consisted of 27 subjects with normal occlusion whose models were fabricated with a three-dimensional (3D) scanner and the 3Txer program (Orapix Co Ltd, Seoul, Korea). 3D virtual brackets (0.022″ Slot, MBT setup, 3M Unitek, Monrovia, Calif) constructed with a 3D-CAD program were placed on an FA point with the 3Txer program. The arch dimension and the amounts of overjet from FA and BSC points were measured. Paired t-tests and analysis of variance (ANOVA) tests were used for statistical analysis. Results: No significant difference in arch width and depth was observed between FA and BSC points. Although the amounts of overjet measured from FA points showed homogenous distribution, a tendency to decrease from the anterior segment (2.3 mm) to the posterior one (2.0 mm) was noted. However, the amounts of overjet measured from BSC points were variable, especially in the premolar and molar areas. Significant discrepancies in the amounts of overjet in most of the areas between FA and BSC points (more than P < .05), except the lower second premolar and second molar areas, were reported, even though insets and offsets are part of the prescription for the base of straight-wire appliance (SWA) brackets. Conclusions: The hypotheses that the amount of overjet measured from BSC points was 3 mm through the whole segments and that distribution of the amounts of overjet from BSC points was the same as that from FA points were rejected

Safe and cost-effective method for application of liquid ethyl formate (FumateTM) as a methyl bromide alternative for perishable commodities: Poster

The cylinderized liquid ethyl formate (EF) formulated with CO2 is one of the great potential fumigants to replace methyl bromide (MeBr) for fresh fruit. However, it is too expensive to adapt commercial practices, and also involves work place safety issue including handling of heavy cylinders as well as restrict emission of CO2, particularly for use in large scale commercial fumigationw. Therefore, it is urgently needed to develop environmental friendly, safe for workers and cost-effective alternative method for application of liquid ethyl formate as a MeBr alternative for perishable commodities. Recently, the environmentally friendly, cost-effective and practically safe use of liquid EF (FumateTM, registered name) with nitrogen gas has been developed and commercialized in Republic of Korea and Australia. The new technology for application of liquid EF is 100 times safer than MeBr in terms of threshold values (EF, TLV = 100 ppm). Ethyl formate is known as food additive and naturally occurred substances as well as a non-ozone depletion chemical. In this report, we demonstrate the liquid EF application technology that offers a clean environment (no ozone depletions and CO2 emissions), safe to fumigators and related workers and practically cost-effective technology to fumigation industry.The cylinderized liquid ethyl formate (EF) formulated with CO2 is one of the great potential fumigants to replace methyl bromide (MeBr) for fresh fruit. However, it is too expensive to adapt commercial practices, and also involves work place safety issue including handling of heavy cylinders as well as restrict emission of CO2, particularly for use in large scale commercial fumigationw. Therefore, it is urgently needed to develop environmental friendly, safe for workers and cost-effective alternative method for application of liquid ethyl formate as a MeBr alternative for perishable commodities. Recently, the environmentally friendly, cost-effective and practically safe use of liquid EF (FumateTM, registered name) with nitrogen gas has been developed and commercialized in Republic of Korea and Australia. The new technology for application of liquid EF is 100 times safer than MeBr in terms of threshold values (EF, TLV = 100 ppm). Ethyl formate is known as food additive and naturally occurred substances as well as a non-ozone depletion chemical. In this report, we demonstrate the liquid EF application technology that offers a clean environment (no ozone depletions and CO2 emissions), safe to fumigators and related workers and practically cost-effective technology to fumigation industry

Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study.

CONTEXT: The risk for dementia among subjects who are obese with normal metabolic profiles, or called metabolically healthy obese (MHO), remains uninvestigated. OBJECTIVE: To determine the association between late-life metabolic health and obesity status and risk of incident dementia. DESIGN: Retrospective cohort study. SETTING: The National Health Insurance System, Republic of Korea. PATIENTS: A total of 12,296,863 adults >50 years old who underwent health examinations from 2009 to 2012 without baseline history of dementia. MAIN OUTCOME MEASURE: Incident overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD). RESULTS: Among subjects ≥60 years old, 363,932 (6.4%) developed dementia during a median follow-up of 65 months (interquartile range 51 to 74 months). The MHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95% CI, 0.84 to 0.86] and AD (HR 0.87; 95% CI, 0.86 to 0.88), but not VaD, compared with the metabolically healthy nonobese group. All components of metabolic syndrome except obesity significantly elevated the risk of dementia, and these associations were more pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia. CONCLUSIONS: The MHO phenotype in late life demonstrated lower risk of overall dementia and AD but not VaD. Additional studies in other populations are warranted to elucidate current results and may predict individuals most at risk for developing dementia

Estimation of Stellate Ganglion Block Injection Point Using the Cricoid Cartilage as Landmark Through X-ray Review

BACKGROUND: Stellate ganglion block is usually performed at the transverse process of C6, because the vertebral artery is located anterior to the transverse process of C7. The purpose of this study is to estimate the location of the transverse process of C6 using the cricoid cartilage in the performance of stellate ganglion block. METHODS: We reviewed cervical lateral neutral-flexion-extension views of 48 patients who visited our pain clinic between January and June of 2010. We drew a horizontal line at the surface of the cricoid cartilage in the neutral and extension views of cervical lateral x-rays. We then measured the change in the shortest distance from this horizontal line to the lowest point of the transverse process of C6 between the neutral and extension views. RESULTS: There was a statistically significant difference in the shortest distance from the horizontal line at the surface of the cricoid cartilage to the lowest point of transverse process of C6 between neutral position and neck extension position in both males and females, and between males and females in both neutral position and neck extension position. The cricoid cartilage level was 4.8 mm lower in males and 14.4 mm higher in females than the lowest point of transverse process of C6 in neck extension position. CONCLUSIONS: Practitioners should recognize that the cricoid cartilage has cephalad movement in neck extension. In this way, the cricoid cartilage can be still useful as a landmark for stellate ganglion block.ope

The Relation between Birth Weight and Insulin Resistance in Korean Adolescents

Low birth weight is associated with insulin resistance and type 2 diabetes in adults. The fetal programming hypothesis has shown that insulin resistance and its associated metabolic disturbances result from a poor gestational environment, for which low birth weight is a surrogate. An at-home questionnaire survey was performed on 660 middle school students (12-15 years) in Seoul, Korea, and 152 cases were randomly selected based on their birth weight. Subjects were divided into three groups according to birth weight. We recorded their birth weight and measured their current anthropometric data, blood pressure, lipid profile, HOMA-IR, and HOMA-β, and compared these parameters among the groups. The relation of birth weight to physiological characteristics in adolescence was examined. Systolic blood pressure, lipid profiles, and fasting plasma glucose, HOMA-β were not significantly different among the groups, but diastolic blood pressure was lower in the third tertile. Insulin, C-peptide, and HOMA-IR were higher in the lower birth weight tertile. After adjustment for confounding factors, birth weight was inversely related to diastolic blood pressure, insulin, C-peptide, and HOMA-IR. We conclude that low birth weight may predict the risk of the insulin resistance and its progression over age, and that adequate gestational nutrition is therefore necessary to prevent low birth weight

A Case of Multiple Endocrine Neoplasia Type 1 Combined with Papillary Thyroid Carcinoma

This is the first report of papillary thyroid carcinoma combined with multiple endocrine neoplasia type 1 (MEN1) in Korea. MEN1 is a hereditary disease comprising neoplastic disorders such as pituitary, parathyroid and pancreatic neuroendocrine tumor, such as gastrinoma. But papillary thyroid cancer was never regarded as its component before in Korea. Herein we present a 39-year-old woman who manifested typical features of MEN1 with a coincidental papillary thyroid carcinoma. Although the family history of MEN1 was definite, her genetic analysis of DNA had revealed no germline mutation in MEN1 gene locus. Unidentified culprit gene unable us further genetic study to find LOH (loss of heterogeneity) in 11q13, the possible explanation of papillary thyroid carcinoma as a new component of MEN1. As we have first experienced a case of MEN1 combined with papillary thyroid carcinoma in Korea, we report it with the review of literature