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Background/aims The aim of this study was to assess the association between the number of existing permanent teeth and chronic kidney disease (CKD) in a representative sample of the elderly Korean population. Methods A total of 2,519 subjects who participated in the Korean National Health and Nutrition Examination Survey were cross-sectionally examined. The number of existing permanent teeth was evaluated by clinical oral examination. CKD was defined based on definition and classification by Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines. Multivariable logistic regression analyses were performed controlling for age, gender, income, education, tooth-brushing frequency, periodontitis, state of dentition, smoking, alcohol consumption, hypertension, obesity, diabetes mellitus, and hypercholesterolemia. Subgroup analyses by age and gender were also performed. Results The number of teeth was significantly associated with CKD after controlling for all potential confounders (adjusted odds ratio [AOR], 1.67; 95% confidence interval [CI], 1.04 to 2.70 for lower number of teeth; AOR, 1.59; 95% CI, 1.14 to 2.23 for moderate number of teeth). In the subgroup analyses, the association was highlighted in females aged 75 years over (AOR, 2.55; 95% CI, 1.05 to 6.20 for lower number of teeth; AOR, 1.95; 95% CI, 1.01 to 3.80 for moderate number of teeth). Conclusion Our findings suggest that the number of existing permanent teeth may be associated with CKD among Korean elderly.

Background No studies have reported the association between the number of teeth and hypertension in the Korean national data. The purpose of this study was to investigate whether the number of teeth is associated with blood pressure and hypertension in a representative sample of the Korean population. Methods A cross-sectional study was conducted on 13,561 participants aged ≥19 years using the 2012 to 2014 Korea National Health and Nutrition Examination Survey data. The number of teeth was divided into four groups: 0, 1 to 19, 20 to -27, and 28. The definition of hypertension was systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or being medicated for hypertension. Multivariate logistic regression analyses were performed after controlling for age, sex, income, education, smoking, drinking, diabetes mellitus, obesity, and hypercholesterolemia. Age- and sex-stratified analyses were performed. Results The fully adjusted odds ratios (AOR) of the number of teeth group for hypertension were as follows: AOR: 1.25, 95% CI: 1.11 to 1.43 for 20 to 27 teeth; AOR: 1.46, 95% CI: 1.22 to 1.76; 1 to 19 teeth; and AOR: 1.63, 95% CI: 1.22 to 2.18 for edentulism. The strength of the association was highest in women aged ≥60 years across all age and sex groups (OR = 1.81, 95% CI = 1.15 to 2.86). Conclusion Findings suggest that a decrease in the number of teeth may be independently associated with hypertension in the Korean population.

Obesity is characterized by a state of chronic low-grade inflammation and insulin resistance, which are aggravated by the interaction between hypertrophic adipocytes and macrophages. In this study, we investigated the effects of tangeretin on inflammatory changes and glucose uptake in a coculture of hypertrophic adipocytes and macrophages. Tangeretin decreased nitric oxide production and the expression of interleukin (IL)-6, IL-1β, tumor necrosis factor-α, inducible nitric oxide synthase, and cyclooxygenase-2 in a coculture of 3T3-L1 adipocytes and RAW 264.7 cells. Tangeretin also increased glucose uptake in the coculture system, but did not affect the phosphorylation of insulin receptor substrate (IRS) and Akt. These results suggest that tangeretin improves insulin resistance by attenuating obesity-induced inflammation in adipose tissue.

While the short-term effects of hormonal events on gingival inflammation have been well described, long-term effects on the periodontium have received less attention. The aim of this cross-sectional population-based study was to evaluate the association between hormone-related events and periodontitis in a representative sample of the postmenopausal women of South Korea.A total of 10,273 postmenopausal women representative of 6.1 million of Koreans were examined. Periodontitis and severe periodontitis were defined according to the Community Periodontal Index (CPI ≧ 3 and CPI = 4, respectively). Univariate and multivariate regression analyses using 3 different models were applied controlling for age, smoking, marital status, educational level, income, BMI, hypertension, stress and frequency of toothbrushing.Severe periodontitis was directly associated with a longer reproductive life (p-trend = .027) and with a longer duration of breastfeeding (48-72 vs. 1-17 months: OR = 1.49; 95% CI: 1.01-2.21). Conversely, early menopausal age (46 vs. 49-50 years: OR = 0.74; 95% CI: 0.56-0.97), history of artificial menopause (OR = 0.72; 95% CI: 0.53-0.97), having had more than 6 pregnancies (vs. 4: OR = 0.73; 95% CI: 0.55-0.97), having had more than three abortions (vs. 0: OR = 0.51; 95% CI: 0.28-0.93) and having had the first birth age26 years (vs.21 years: OR = 0.71; 95% CI: 0.52-0.97) were inversely associated with severe periodontitis.In this large nationally representative population, severe periodontitis was related to menopausal age, reproductive life length, number of pregnancies/abortions, first birth age and breastfeeding duration, while it was not to oral contraceptive and hormone replacement therapy usages.

Background The objective of this study was to investigate the association between periodontal status and non-alcoholic fatty liver disease (NAFLD) indicators in a representative Korean population. Methods A cross-sectional study was conducted on 4061 participants >19 years of age using the 2010 Korea National Health and Nutrition Examination Survey data. Periodontal status was assessed by trained dentists using the community periodontal index. To identify the presence of NAFLD, biochemical data were defined using two validated indicators: the fatty liver index (FLI) and the hepatic steatosis index (HSI). The associations of the presence of periodontal pockets with FLI and HSI were evaluated by multivariable logistic regression analysis after adjusting for age, income, education level, smoking status, alcohol consumption, physical activity, diabetes mellitus, obesity, hypertension, and hypercholesterolemia. Results The adjusted means in the FLI indicator increased in the presence of periodontal pockets, whereas there was no significant difference in the HSI (P = 0.005 for FLI; P = 0.142 for HSI). Periodontal pockets were consistently associated with the two NAFLD indicators in the sequential logistic models for women throughout the adjustment process. (OR = 1.77, 95% CI = 1.05 to 2.98 for FLI, OR = 1.64, 95% CI = 1.08 to 2.51 for HSI). Conclusions Our findings showed that the presence of periodontal pockets may be independently associated with NAFLD indicators. Further study will be clarified by well-designed longitudinal studies.

Objectives To investigate the association between periodontitis and cognitive impairment in elderly Koreans. Design Cross-sectional study with age- and sex-matched case–control selection. Setting The Yangpyeong cardiovascular cohort (YCC), a part of the Korean Genome Epidemiologic Study (KoGES), Yangpyeong, South Korea. Participants Individuals with cognitive impairment (n = 65) and cognitively normal controls (n = 124) aged 60 and older from the YCC. Measurements Alveolar bone loss was assessed on dental panoramic radiographs to categorize the cumulative history of periodontitis (HOP) into three groups: normal, moderate periodontitis, severe periodontitis. The Mini-Mental State Examination (MMSE) was used to categorize participants as cognitively normal or cognitively impaired. Age- and sex-matched conditional logistic regression models were used for analysis. Confounders considered in the analysis were age, sex, drinking, smoking, exercise, total cholesterol, total protein, body mass index, fasting plasma glucose, intima-media thickness, hypertension medication, and depression. Results Participants with HOP were more likely to have cognitive impairment than those without (odds ratio = 2.14, 95% confidence interval = 1.04–4.41). The interaction effect of smoking and exercise on periodontitis highlighted the link. Conclusion Periodontitis was independently associated with cognitive impairment after controlling for various confounders. Further longitudinal research is needed to determine whether periodontitis plays a role in cognitive decline in older adults.

Obesity is associated with inflammatory status and linked with metabolic syndrome. Interaction between adipocytes and macrophages aggravates inflammation and leads to insulin resistance in adipocytes. Resveratrol improved reportedly obesity-related inflammatory responses, but the effects of resveratrol on the production of inflammatory mediators and glucose metabolism in inflamed adipose tissue is not completely known. In this study, we investigated the effects of resveratrol on inflammatory change and insulin resistance in the coculture of hypertrophied 3T3-L1 adipocytes and RAW 264.7 macrophages. Resveratrol decreased nitric oxide production and the expression of interleukin (IL)-6, IL-1β, tumor necrosis factor-α, inducible nitric oxide synthesis, and cyclooxygenase-2 in the coculture. Resveratrol increased glucose uptake by stimulating the phosphorylation of IRS-1 and AKT in the coculture. These results support that resveratrol have beneficial effect on inflammation and insulin resistance in inflamed adipose tissue.

Purpose: The serum levels of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) have recently been shown to be correlated highly with disease activity in patients with intestinal Behcet’s disease (BD). However, it remains unclear whether sTREM-1 levels reflect endoscopic activity in intestinal BD. This study aimed to evaluate the correlation of sTREM-1 levels with endoscopic activity in intestinal BD. Materials and Methods: A total of 84 patients with intestinal BD were enrolled. Endoscopic activity was compared with sTREM-1 levels as well as other laboratory findings, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Results: sTREM-1 levels were significantly increased in intestinal BD patients compared with controls (37.98±27.09 pg/mL vs. 16.65±7.76 pg/mL, p=0.002), however, there was no difference between endoscopically quiescent and active diseases (43.53±24.95 pg/mL vs. 42.22±32.68 pg/ mL, p=0.819). Moreover, serum sTREM-1 levels did not differ in terms of number, shape, depth, size, margin, or type of ulcer in patients with intestinal BD. However, mean ESR and CRP levels in patients with active disease were signifi cantly higher than those in patients with quiescent disease (p=0.001, p

Nitric oxide (NO) is known to play an important role in many biologic systems, although the relationship between NO metabolites and periodontitis remains controversial. Moreover, little evidence of an association between salivary NO (S-NO) and periodontitis in the general population has been reported. This study aims to investigate the relationship between S-NO and periodontitis in an elderly Korean population.A cross-sectional study was conducted using participants and salivary samples from Sunchang Elderly Cohort Study. The total number of final participants was 242 (91 males and 151 females; 48 to 93 years old). Periodontitis was determined by a clinical attachment loss of6 mm at six probe points on 12 index teeth. NO was measured in unstimulated saliva via the Griess reaction. Sociodemographic status, general/oral health, and health-related behaviors were investigated as confounders. Bivariate analysis and multivariable linear regression analyses including confounders were applied.After controlling for age, sex, education, salivary flow rate, number of teeth, smoking status, physical activity, hypertension, and diabetes, three metabolites of S-NO (total NO, nitrite, and nitrate) were independently associated with the percentage of probe points exhibiting periodontitis. Of these linear associations, total NO was found to have the strongest correlation with periodontitis (partial r = 0.181, P = 0.009). These associations were most pronounced in females (except for nitrate), non-smokers, those without hypertension, and those without diabetes.Our data suggest that high concentrations of S-NO are associated with severe periodontitis. Thus, S-NO may serve as a potential biologic marker for detecting and monitoring periodontitis.

Background and aims We aimed to evaluate the association of periodontitis with the development of early atherosclerotic vascular disease in Korean adults. Methods In this cross-sectional study, a total of 1343 adults aged over 40 years were recruited from a community-based cohort of Yangpyeong county, Korea, during the period 2010–2014. Only dentate individuals were included in the study. Subclinical atherosclerosis (SA) was defined as carotid intima-media thickness (cIMT)≥0.754 mm, as assessed bilaterally by B-mode ultrasound. Peripheral arterial disease (PAD) was defined as ankle-brachial index (ABI)≤1.0, as measured by Doppler. History of periodontitis was assessed by measuring the radiographic alveolar bone loss (RABL) on a digital dental panorama and was classified into three groups: normal, moderate and severe periodontitis (≥2 non-adjacent interproximal sites with RABL≥4 mm and 6 mm, respectively). The associations of periodontitis with SA and PAD were evaluated by multivariable logistic regression analysis and analysis of covariance, adjusted for age, sex, education level, tooth loss, smoking, drinking, exercise, obesity, triglycerides, HDL, LDL, hs-CRP, diabetes and hypertension. Stratified analyses were performed to identify specific risk groups. Results After controlling for confounders, severe periodontitis was associated with SA [adjusted odds ratio (aOR) = 1.55; 95% confidence interval (CI): 1.07–2.24] and PAD (aOR = 2.03; 95% CI: 1.05–3.93). These associations were highlighted in never-smokers. For increasing severity of periodontitis, the adjusted mean cIMT increased ( p = 0.011) while that of ABI decreased ( p = 0.033). Conclusions Our data showed that periodontitis is a substantially important risk factor for atherosclerotic vascular disease among Korean adults.

Background and Aim: Little information is available about the antiviral efficacy of lamivudine (LAM) and entecavir (ETV) in patients with hepatitis B virus (HBV)-related advanced hepatocellular carcinoma (HCC). Thus, we compared the antiviral efficacy of LAM and ETV in these patients. Methods: The medical records of 134 antiviral therapy-naive patients with HBV-related advanced HCC (modified Union for International Cancer Control [UICC] Tumor, Nodes, and Metastases [TNM] stages III–IV) treated between January 2005 and September 2009 were reviewed. After HCC diagnosis, 87 (64.9%) and 47 (35.1%) patients received LAM and ETV, respectively. Results: The mean age of patients (115 men, 19 women) was 53 years. Sixty-five (48.5%) and 69 (51.5%) patients had TNM stages III and IV HCC, respectively. Treatment outcomes during follow-up, including virologic, biochemical, and serologic responses and appearance of antiviral resistance, were similar in the LAM and ETV groups (all P > 0.05). Multivariate analysis identified Child–Pugh class, α-fetoprotein, and TNM stage as independent predictors of overall survival (all P

Recent epidemiologic studies have shown that individuals with periodontitis have a significantly increased risk of metabolic syndrome (MetS). Chronic infection and subsequent production of systemic inflammatory markers may be associated with this increased risk. The aim of present study is to determine whether the presence of periodontitis and MetS is associated with a group or an individual of C-reactive protein (CRP), interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α), and homocysteine (HCY) in the serum of a Korean population.Medical and periodontal parameters, including CRP, IL-1β, IL-6, IL-8, TNF-α, and HCY, were evaluated in 118 individuals (73 healthy; 20 with periodontitis only; 13 with MetS only; and 12 with both). The community periodontal index was used to assess periodontitis. Age, sex, monthly household income, smoking, and drinking were evaluated as confounders. Analysis of covariance, linear regression analysis, and factor analysis were applied.The group of serologic cytokines was synergistically associated with the periodontitis-MetS coexistence. TNF-α and IL-6 were two representing serologic cytokines in the group.Our results suggest that a group of systemic biologic markers represented by TNF-α and IL-6 might mediate the association between MetS and periodontitis adjusted for various confounders. Additional evidence is needed to generalize our results more widely.

In this study, we investigated the antiobesity properties of Petalonia binghamiae extract (PBE) in mice in which obesity was induced with a high-fat diet (HFD). PBE administration (150 mg/kg/day) for 70 days decreased body weight gain, adipose tissue weight, and the serum triglyceride level in mice fed a HFD. PBE reduced serum levels of glutamic pyruvic transaminase and glutamic oxaloacetic transaminase as well as the accumulation of lipid droplets in the liver. PBE restored the HFD-induced decrease in phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) in epididymal adipose tissue. PBE increased the phosphorylation of AMPK and ACC and decreased the expression of SREBP1c in mature 3T3-L1 adipocytes. In addition, we further explored the active compound responsible for AMPK activation by PBE in 3T3-L1 adipocytes. Fucoxanthin isolated from PBE increased the phosphorylation of AMPK and ACC with increasing LKB1 phosphorylation in mature 3T3-L1 adipocytes. Taken together, these data suggest that PBE (or fucoxanthin) exert improving effects on HFD-induced obesity by promoting β-oxidation and reducing lipogenesis.

The peel of Citrus sunki HORT. ex TANAKA has been widely used in traditional Asian medicine for the treatment of many diseases, including indigestion and bronchial asthma. In this study, we investigated the antiobesity activity of immature C. sunki peel extract (designated CSE) using high-fat diet (HFD)-induced obese C57BL/6 mice and mature 3T3-L1 adipocytes. In the animal study, body weight gain, adipose tissue weight, serum total cholesterol, and triglyceride in the CSE-administered group decreased significantly compared to the HFD group. Also, CSE supplementation reduced serum levels of glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, and lactate dehydrogenase. Moreover, it significantly decreased the accumulation of fatty droplets in liver tissue, suggesting a protective effect against HFD-induced hepatic steatosis. Dietary supplementation with CSE reversed the HFD-induced decrease in the phosphorylation levels of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC), which are related to fatty acid β-oxidation, in the epididymal adipose tissue. Also, CSE increased AMPK and ACC phosphorylation in mature 3T3-L1 adipocytes. CSE also enhanced lipolysis by phosphorylation of cAMP-dependent protein kinase (PKA) and hormone-sensitive lipase (HSL) in mature 3T3-L1 adipocytes. These results suggest that CSE had an antiobesity effect via elevated β-oxidation and lipolysis in adipose tissue.

Progression of 3T3-L1 preadipocyte differentiation is divided into early (days 0-2, D0-D2), intermediate (days 2-4, D2-D4), and late stages (day 4 onwards, D4-). In this study, we investigated the effects of fucoxanthin, isolated from the edible brown seaweed Petalonia binghamiae, on adipogenesis during the three differentiation stages of 3T3-L1 preadipocytes. When fucoxanthin was applied during the early stage of differentiation (D0-D2), it promoted 3T3-L1 adipocyte differentiation, as evidenced by increased triglyceride accumulation. At the molecular level, fucoxanthin increased protein expression of peroxisome proliferator-activated receptor γ (PPARγ), CCAAT/enhancer-binding protein α (C/EBPα), sterol regulatory element-binding protein 1c (SREBP1c), and aP2, and adiponectin mRNA expression, in a dose-dependent manner. However, it reduced the expression of PPARγ, C/EBPα, and SREBP1c during the intermediate (D2-D4) and late stages (D4-D7) of differentiation. It also inhibited the uptake of glucose in mature 3T3-L1 adipocytes by reducing the phosphorylation of insulin receptor substrate 1 (IRS-1). These results suggest that fucoxanthin exerts differing effects on 3T3-L1 cells of different differentiation stages and inhibits glucose uptake in mature adipocytes.

Normally, cortisol levels rise during the early morning hours and are highest at about 7 a.m. They drop to very low levels in the evening and during the early phase of sleep. The factor controlling this rhythm is not completely defined and can be disrupted by a number of physical and psychological conditions. ACTH and cortisol are secreted independent of the circadian rhythm in response to physical and psychological stress. Elevated cortisol levels and a lack of diurnal variation have been identified with Cushing’s disease, phenomena of ACTH hypersecretion. Elevated circulating cortisol levels have also been identified in patients with adrenal tumors. Low cortisol levels are found in primary adrenal insufficiency, identified with Addison’s disease, and in ACTH deficiency. Due to the normal circadian variation in cortisol levels, it is difficult to distinguish normal cortisol levels from abnormally-low levels. Therefore, several daily collections are recommended. 1

The anti-diabetic potential of Petalonia binghamiae extract (PBE) was evaluated in vivo. Dietary administration of PBE to streptozotocin (STZ)-induced diabetic mice significantly lowered blood glucose levels and improved glucose tolerance. The mode of action by which PBE attenuated diabetes was investigated in vitro using 3T3-L1 cells. PBE treatment stimulated 3T3-L1 adipocyte differentiation as evidenced by increased triglyceride accumulation. At the molecular level, peroxisome proliferator-activated receptor {gamma} (PPAR{gamma}) and terminal marker protein aP2, as well as the mRNA of GLUT4 were up-regulated by PBE. In mature adipocytes, PBE significantly stimulated the uptake of glucose and the expression of insulin receptor substrate-1 (IRS-1). Furthermore, PBE increased PPAR{gamma} luciferase reporter gene activity in COS-1 cells. Taken together, these results suggest that the in vivo anti-diabetic effect of PBE is mediated by both insulin-like and insulin-sensitizing actions in adipocytes.

Background Synchronous development of primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma has been reported rarely. In literature review, there have been only 35 reported cases of synchronous hepatocellular carcinoma and intrahepatic cholangiocarcinoma, and most of these tumors developed in patients with hepatitis C-related liver cirrhosis. Here, we present synchronous development of hepatocellular carcinoma and intrahepatic cholangiocarcinoma in two patients with chronic B-viral hepatitis. Case presentation Two patients with chronic hepatitis B were referred to our hospital due to a hepatic mass. Patient 1 had a 6.4 cm multinodular hepatic mass in the left lobe and a small nodule in the right lobe. Patient 2 had a 4.3 cm hypervascular mass in the right lobe and a 1.1 cm nodule in the left lobe. The pre-operative diagnosis of both cases was hepatocellular carcinoma with metastatic nodule, however, surgical resection pathology revealed that hepatocellular carcinoma and intrahepatic cholangiocarcinoma existed independently in the other side of the liver in both cases. Additionally, the background liver histology of both cases was hepatitis B-related chronic hepatitis without cirrhotic change. Conclusion Our cases suggest that hepatitis B virus infection can also predispose to development of double liver cancers.

Background Metabolic syndrome (MetS) may be associated with periodontitis. This study aimed to investigate whether the existence of periodontitis and MetS is cross-sectionally associated with matrix metalloproteinase (MMP) in gingival crevicular fluid (GCF) among community Koreans. Materials and Methods Medical and periodontal parameters were evaluated by physicians and dentists in 314 subjects (199 healthy, 58 only periodontitis, 34 only MetS and 23 both). The community periodontal index was used to assess periodontitis. MMP-8, 9, 13 were determined by enzyme-linked immunosorbent assay. Age, gender, monthly household income, smoking and drinking were interviewed as confounders. Analysis of covariance (ANCOVA) was applied. Gender-stratified analyses were applied. Results After controlling for various confounders, MMP-8, MMP-9 and MMP-13 in GCF were significantly associated with periodontitis in both genders and MMP-9, MMP-13 were associated with MetS in women. MMP-8, MMP-9 and MMP-13 showed association with periodontitis–MetS coexistence non-synergistically in both genders. MMP-9 was synergistically associated with periodontitis–MetS coexistence in women. Conclusion Our results suggest that MMP-8, MMP-9, MMP-13 in GCF were independently related to coexistence of periodontitis and MetS. MMP-9 and MMP-13 could be an appropriate common indicator of periodontitis and MetS in women. Further studies might guarantee that MMPs in GCF could screen periodontitis and MetS.

This study explores the anti-obesity properties of a Sasa quelpaertensis leaf extract (SQE) in high-fat diet (HFD)-induced obese C57BL/6 mice and mature 3T3-L1 adipocytes. SQE administration with HFD for 70 d significantly decreased the body weight gain, adipose tissue weight, and serum total cholesterol and triglyceride levels in comparison with the HFD group. SQE administration also reduced the serum levels of glutamic oxaloacetic transaminase, glutamic pyruvic transaminase and lactate dehydrogenase, and the accumulation of lipid droplets in the liver, suggesting a protective effect against HFD-induced hepatic steatosis. SQE administration restored the HFD-induced decreases with phosphorylation of AMP-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) in epididymal adipose tissue. SQE also induced AMPK phosphorylation in mature 3T3-L1 adipocytes. These results suggest that SQE exerted an anti-obesity effect on HFD-induced obese mice by activating AMPK in adipose tissue and reducing lipid droplet accumulation in the liver.

We previously showed that an ethanolic extract of the edible brown algae Petalonia binghamiae promotes the differentiation of 3T3-L1 preadipocytes and decreases hyperglycemia in streptozotocin-induced diabetic mice. Here, we report that a water-soluble extract of P. binghamiae thalli, prepared by enzymatic digestion, inhibits preadipocyte differentiation and adipogenesis in a dose-dependent manner. In differentiating 3T3-L1 preadipocytes, the extract (designated PBEE) decreased the expression of peroxisome proliferator-activated receptor γ, CCAAT/enhancer-binding proteins α and β, and fatty acid-binding protein aP2. It also inhibited the mitotic clonal expansion process of adipocyte differentiation, and it inhibited insulin-stimulated uptake of glucose into mature 3T3-L1 adipocytes by reducing phosphorylation of insulin receptor substrate-1. In rats with high-fat diet (HFD)-induced obesity, PBEE exhibited potent anti-obesity effects. In this animal model, increases in body weight and fat storage were suppressed by the addition of PBEE to the drinking water at 500 mg/L for 30 days. PBEE supplementation reduced serum levels of glutamic pyruvic and glutamic oxaloacetic transaminases and increased the serum level of high-density lipoprotein cholesterol. Moreover, it significantly decreased the accumulation of lipid droplets in liver tissue, suggesting a protective effect against HFD-induced hepatic steatosis. Taken together, these data demonstrate that PBEE inhibits preadipocyte differentiation and adipogenesis in cultured cells and in rodent models of obesity.

음 발표되기 시작하였으며 1990년대에 증례 보고가 증가하면서 점 차 증후군 형태로 진단되기 시작하였다. 주로 일본을 중심으로 보고 되었던 이 질병은 2000년대에 들어오면서 서양에서도 입원 환자 및 중환자실 환자에서의 하부위장관 출혈 원인으로 분류되기 시작하였 다. 점차적으로 복합 기저질환 환자의 생존 기간이 연장되면서 급성 출혈성 직장 궤양이 하부위장관 출혈의 주요 원인으로 보고되고 있 고, 진단이 증가하고 있어 이 질환에 대한 중요성 또한 높아지고 있 다. 최근에는 국내에서도 급성 출혈성 직장 궤양 환자에 대한 단순 증례 보고 뿐 아니라 이에 대한 임상적 내시경적 특징 및 재출혈 위험 인자에 대한 보고가 있었다. 그러나, 적은 환자수의 후향적인 연구이 고 예후에 대한 구체적인 연구가 아직 없었다. 이에 저자들은 급성 출 혈성 직장 궤양 환자들의 기본적인 임상적 특징을 확인하고 더불어 재출혈 및 입원기간 중 사망의 위험 요인을 분석하여 해당 질환 발생 The Rebleeding Risk and Prognostic Factors of Acute Hemorrhagic Rectal Ulcer

Esophageal candidiasis is a common opportunistic infection that develops in human immunodeficiency virus (HIV)-infected patients. It is usually effectively treated with fluconazole, and the occurrence of an esophageal stricture in association with esophageal candidiasis has rarely been reported in HIV-infected patients. In the case presented here, a 49-year-old man was diagnosed with severe esophageal candidiasis with HIV infection. At the time of the HIV diagnosis, he had immunodeficient status with a CD4+ T lymphocyte count of 150 cells/mm 3 . He received antifungal treatment with fluconazole and combined antiretroviral therapy. Although the esophageal candidiasis improved with rapid recovery of the CD4+ T lymphocyte count, a recurrent esophageal stricture developed. To treat the recurrent esophageal stricture, the patient received repeated balloon dilatation and stent insertion. We report this rare case of severe esophageal stricture complication of esophageal candidiasis in an HIV-infected patient. (Korean J Med 2012;82:247-251)

Obstruction of the bile duct owing to the direct extension of a tumor is occasionally found in patients with a hepatic neoplasm, but bile duct tumor thrombus caused by the intrabiliary transplantation of a free-floating tumor is a rare complication of hepatocellular carcinoma A 50-year-old woman was diagnosed with HCC with bile duct tumor thrombi. She received transarterial chemoembolization (TACE) because her liver function was not suitable for surgery at the time of diagnosis. After TACE, infected biloma occurred recurrently. Thus, resection of the HCC, including the bile duct tumor thrombi, was performed. Six months after the surgery, recurred HCC in the distal common bile duct as drop metastasis was noted. The patient was treated with tomotherapy and has been alive for three years as of this writing, without recurrence. The prognosis of HCC with bile duct tumor thrombi is considered dismal, but if appropriate procedures are selected and are actively carried out, long-term survival can occasionally be achieved.