Hypotension in patients administered indigo carmine containing impurities -A case report-

Indigo carmine has been used for eight decades with few adverse effects. Several of our patients, however, experienced severe hypotensive episodes after indigo carmine administration within a period of one month. Analysis of the raw materials used to formulate the preparation of indigo carmine we used showed that they contained impurities. Following recall of these impure materials, none of our patients experienced further hypotensive episodes

Relationship between Silent Gastroesophageal Reflux and Food Sensitization in Infants and Young Children with Recurrent Wheezing

It is known that early childhood wheezing associated with sensitization to allergens, including food, has an increased risk of developing asthma later during school age. Gastroesophageal reflux (GER) is well known to be associated with asthma. The purpose of this study was to determine whether there is an association between silent GER and food sensitization in infants and young children with recurrent wheezing. Eighty-five infants or young children with recurrent wheezing, and no gastrointestinal symptoms, underwent 24 hr esophageal pH monitoring, as well as total serum IgE and specific IgE testing for eggs and milk. Among the 85 subjects, 48.2% had significant GER. There was no significant difference in the GER between atopic and non-atopic recurrent wheezers (41.7% and 50.8%, respectively). The sensitization rate to food (eggs or milk) was 12.2% and 20.5% in the GER and non-GER groups, respectively and showed no statistically significant difference between the two groups (P=0.34). In conclusion, about half of infants and young children with recurrent wheezing and no gastrointestinal symptoms have silent GER. The silent GER may not contribute to food sensitization in infants and young children with recurrent wheezing

Is there association between thyroid stimulating hormone levels and the four phenotypes in polycystic ovary syndrome?

Objectives: The aim of this study was to determine whether the incidence of subclinical hypothyroidism (SCH) is higher in polycystic ovary syndrome (PCOS) group than the control group. Additionally, the study investigated whether serum thyroid stimulating hormone (TSH) level is associated with various clinical parameters of PCOS regarding different phenotypes of the disease. Material and methods: This retrospective, case-control study included 329 PCOS patients and 162 control women who were aged between 20 and 42 years and visited the Gynecology outpatient clinic in Pusan National University Hospital from January 2014 to December 2017. PCOS patients were further classified according to their phenotypes: phenotype A as the combination of all hyperandrogenism (HA), ovulatory dysfunction (OD), and polycystic ovarian morphology (PCOM); phenotype B as the combination of HA and OD; phenotype C as the combination of HA and PCOM; and finally, phenotype D as the combination of OD and PCOM. Laboratory blood tests included follicle stimulating hormone (FSH), luteinizing hormone (LH), TSH and anti-mullerian hormone (AMH). The ovarian volume was calculated using three diameters by gynecologic ultrasonography. Results: Serum TSH level was significantly higher in PCOS patients than in the control group after adjusting for age and body mass index (BMI). Serum TSH level was not related to HA and OD, but its significant association with PCOM was confirmed in comparative analysis in quartiles. The proportion of phenotype A patients increased as serum TSH level increased, while the proportion of phenotype B and D decreased. Phenotype C stayed relatively consistent with varying TSH levels. Conclusions: More numbers of patients showed elevated TSH level satisfying SCH diagnosis in PCOS group than the control group. In addition, a significant correlation between serum TSH level and different PCOS phenotypes has been observed; especially, PCOS patients with phenotype A, which displays all of HA, OD, and PCOM, tended to have the higher TSH levels than the PCOS patients with other phenotypes, requiring proper and thorough evaluation for potential endocrine disparity and according to management in such patient group

The Role of Nuclear Factor-E2-Related Factor 1 in the Oxidative Stress Response in MC3T3-E1 Osteoblastic Cells

BackgroundReactive oxygen species (ROS) and antioxidants are associated with maintenance of cellular function and metabolism. Nuclear factor-E2-related factor 1 (NFE2L1, Nrf1) is known to regulate the expression of a number of genes involved in oxidative stress and inflammation. The purpose of this study was to examine the effects of NFE2L1 on the response to oxidative stress in osteoblastic MC3T3-E1 cells.MethodsThe murine calvaria-derived MC3T3-E1 cell line was exposed to lipopolysaccharide (LPS) for oxidative stress induction. NFE2L1 effects were evaluated using small interfering RNA (siRNA) for NFE2L1 mRNA. ROS generation and the levels of known antioxidant enzyme genes were assayed.ResultsNFE2L1 expression was significantly increased 2.4-fold compared to the control group at 10 µg/mL LPS in MC3T3-E1 cells (P<0.05). LPS increased formation of intracellular ROS in MC3T3-E1 cells. NFE2L1 knockdown led to an additional increase of ROS (20%) in the group transfected with NFE2L1 siRNA compared with the control group under LPS stimulation (P<0.05). RNA interference of NFE2L1 suppressed the expression of antioxidant genes including metallothionein 2, glutamatecysteine ligase catalytic subunit, and glutathione peroxidase 1 in LPS-treated MC3T3-E1 cells.ConclusionOur results suggest that NFE2L1 may have a distinct role in the regulation of antioxidant enzymes under inflammation-induced oxidative stress in MC3T3-E1 osteoblastic cells

Fatigue and weakness hinder patient social reintegration after liver transplantation

Background/Aims With improvements in the survival of liver transplantation (LT) recipients, the focus is shifting to patient quality of life (QOL), and employment is an important factor in aiding the social reintegration of LT patients. This study aims to evaluate the current employment status of liver graft recipients and various factors that may hinder reemployment. Methods Fifty patients above age 18 who underwent either living or deceased donor LT at a single center from March 2009 to July 2016 were interviewed during their visit to the outpatient clinic. The internally developed questionnaire consisted of 10 items. The Karnofsky Performance Scale and EQ-5D were used to evaluate patient function and QOL. Results A total of 25 (50%) patients returned to work after transplantation (the working group), and 21 (84%) patients in the working group returned to work within the first year after transplantation. In the non-working group (n=25), 17 (68%) answered that their health was the reason for unemployment. Fatigue and weakness were the most frequent symptoms. Conclusions The data shows that as many as 50% of total patients returned to work after receiving LT. Fatigue and weakness were the most common complaints of the unemployed group, and resolving the causes of these symptoms may help to increase the employment rate

Clinical Characteristics of TZAP (ZBTB48) in Hepatocellular Carcinomas from Tissue, Cell Line, and TCGA

Background and Objectives: ZBTB48 is a telomere-related protein that has been renamed telomeric zinc finger-associated protein (TZAP). It favorably binds to elongated telomeres to regulate their appropriate length. However, TZAP expression has not been investigated in hepatocellular carcinomas (HCC). Materials and Methods: The clinical significance of TZAP expression in 72 HCC was investigated. Additionally, its findings were supported by open big data and cancer cell lines. Results: TZAP expression level was not associated with the clinical parameters of HCC. TZAP expression induced a poorer survival result (overall survival, p = 0.020; disease-free survival, p = 0.012). TCGA data showed TZAP expression was more frequently found in HCCs with hepatitis C infection (p = 0.023). However, TCGA data revealed that TZAP expression did not predict HCC prognosis. In a cell line study, TZAP inhibition via siRNA suppressed PLC/PRF/5 cell growth; however, cell viability was increased in HepG2 cells. Conclusions: We presented the clinical and prognostic values of TZAP expression in HCC tissues and cancer cell lines. Additionally, the TCGA results also revealed a significant role for TZAP expression. TZAP expression may involve HCC progression and its prognosis

Clinical applicability of biologically effective dose calculation for spinal cord in fractionated spine stereotactic body radiation therapy

Background. The aim of the study was to investigate whether biologically effective dose (BED) based on linearquadratic model can be used to estimate spinal cord tolerance dose in spine stereotactic body radiation therapy (SBRT) delivered in 4 or more fractions