Detoxification Combining Fasting with Fluid Therapy for Refractory Cases of Severe Atopic Dermatitis

To introduce and determine the clinical benefits of a detoxification program that combines fasting with fluid therapy for refractory cases of severe atopic dermatitis (AD), we performed a retrospective chart review of inpatients with AD from March 2010 to February 2012 at the Department of Ophthalmology, Otorhinolaryngology and Dermatology of Korean Medicine in the Kyung Hee Medical Center. Patients were treated with the detoxification program, which combined fasting with fluid therapy, and herbal medicine, herbal wet wrap dressings, or acupuncture treatment when clinically necessary. The primary outcome was the SCORAD total index. The secondary outcome was the pruritus visual analogue scale (VAS) score in SCORAD as evaluated by a trained dermatology specialist. Among the 130 inpatients that have done detoxification, 7 patients met the inclusion criteria. The mean total SCORAD scores significantly decreased from to () after the detoxification program. There was also a significant decrease in VAS score for pruritus from to () between admission and discharge. We suggest that fasting with fluid therapy as a complementary and alternative treatment method may provide some benefits for patients with refractory cases of severe atopic dermatitis

Current Status of Biportal Endoscopic Decompression for Lumbar Foraminal Stenosis: Endoscopic Partial Facetectomy and Outcome Factors

Degenerative lumbar foraminal stenosis is relatively common condition in which the circumferential narrowing of the space available for the nerve root leads to back pain and radicular symptoms. The preferred surgical treatment to relieve the compression of the nerve root has not been established yet. Recently, several reports have shown good clinical outcomes in patients who underwent biportal endoscopic decompression for the treatment of degenerative lumbar foraminal stenosis. The floating-type biportal endoscopic technique could be used with various surgical instruments without docking in the narrowed foramen, unlike the full-endoscopic technique. Multiple sites can be accessed with more freedom in the approaching angle through triangulation and portal switching. We reviewed articles to understand putative outcome factors and discuss the appropriate indications for biportal endoscopic foraminal decompression. Lumbar lordosis, degenerative lumbar scoliosis, height of the posterior intervertebral disc and level of procedure were all related to clinical outcomes. The best indications and contraindications to the endoscopic foraminal decompression still depends on the surgeon’s skill level and evolving experience. However, we could suggest that biportal endoscopic spinal surgery is supposed to be an alternative treatment for foraminal decompression preserving motion and stability, and decreasing the need for fusion surgery in various lumbar degenerative disease

Glucose repression of the Escherichia coli sdhCDAB operon, revisited: regulation by the CRP·cAMP complex

Expression of the Escherichia coli sdhCDAB operon encoding the succinate dehydrogenase complex is regulated in response to growth conditions, such as anaerobiosis and carbon sources. An anaerobic repression of sdhCDAB is known to be mediated by the ArcB/A two-component system and the global Fnr anaerobic regulator. While the cAMP receptor protein (CRP) and Cra (formerly FruR) are known as key mediators of catabolite repression, they have been excluded from the glucose repression of the sdhCDAB operon. Although the glucose repression of sdhCDAB was reported to involve a mechanism dependent on the ptsG expression, the molecular mechanism underlying the glucose repression has never been clarified. In this study, we re-examined the mechanism of the sdhCDAB repression by glucose and found that CRP directly regulates expression of the sdhCDAB operon and that the glucose repression of this operon occurs in a cAMP-dependent manner. The levels of phosphorylated enzyme IIA(Glc) and intracellular cAMP on various carbon sources were proportional to the expression levels of sdhC-lacZ. Disruption of crp or cya completely abolished the glucose repression of sdhC-lacZ expression. Together with data showing correlation between the intracellular cAMP concentrations and the sdhC-lacZ expression levels in several mutants and wild type, in vitro transcription assays suggest that the decrease in the CRP·cAMP level in the presence of glucose is the major determinant of the glucose repression of the sdhCDAB operon

Prediction of males’ physical work capacity in various simulated altitudes using an incremental cycle ergometer exercise test at sea level

Standard approach to predict the decrease in physical fitness that will occur following a transition to a higher altitude is unavailable. Therefore, the study aimed to design simple mathematical models to predict submaximal exercise performance in various altitude environments, using a simple physical work capacity test conducted at sea level involving >200 subjects. After splitting the subjects’ data in a ratio of 7:3, we used 70% of the data for regression model development and employed 30% for cross-validation testing. All subjects performed submaximal exercise tests using a cycle ergometer at artificial altitudes of 2000 m, 3000 m, 4000 m, 5000 m, and at sea level. We applied simple regression analysis to create a predictive model with the statistical significance set at the level of <5%. There were 233 subjects involved in this study. The coefficient of determination of our regression model was 40–58%, and the standard error of estimation was 14.96–17.27 watts. The cross-validation of our regression model was 8–10%. Among the regression models developed, the one applied to an artificial altitude of 5000 m was 17%, and the regression model applied to an artificial altitude below 4000 m had no issues in generalization since the cross-validation was less than 10%. However, the regression model applied to an artificial altitude of 5000 m had a cross-validity of 17%; therefore, it should be used with caution

Activation of spleen tyrosine kinase is required for TNF-α-induced endothelin-1 upregulation in human aortic endothelial cells

AbstractEndothelin-1 (ET-1) promotes atherosclerosis. We tested whether spleen tyrosine kinase (Syk) mediates tumor necrosis factor-α (TNF-α)-induced ET-1 upregulation in human aortic endothelial cells (HAECs) and sought to identify the signal pathways involved. TNF-α-induced reactive oxygen species (ROS) activated Syk and phosphatidylinositol 3-kinase (PI3K), which was required for the activation of AP-1 and subsequent ET-1 gene transcription. ROS mediated c-Jun NH2-terminal kinase (JNK) is also required for AP-1 activation, but Syk and PI3K regulated AP-1 activation independently of JNK. Through regulation of ET-1 production, Syk could be implicated in atherosclerosis

Commentary on: Incidental Breast Cancers Identified in a One-Stop Symptomatic Breast Clinic

In a recent study published in the Journal of Breast Cancer, Mehrotra et al. [1] reported incidental breast cancers identified in a one-stop symptomatic breast clinic where patients receive the results of their radiological examinations and tissue sampling on the same day. Medical environments differ from country to country and from culture to culture. Nevertheless, breast cancer is the most frequent cancer among women in developed and developing countries [2]. They reported 87.2 % symptomatic cancers and 12.8 % incidental cancers using a definition of symptomatic cancers as “breast cancers correlated to the patient’s symptoms ” and that of incidental cancers as “breast cancers detected only by imaging in a completely separate location to the site of presenting symptoms and not palpable by the clinician. ” In this study, the mean age of patients with symptomatic cancers and incidenta