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Atypical antipsychotics have replaced conventional antipsychotics in the treatment of schizophrenia because they have less of a propensity to cause undesirable neurologic adverse events including extrapyramidal symptoms, tardive dyskinesia, and neurolep- tic malignant syndrome (NMS). However, atypical antipsychotics have been known to result in various metabolic complications such as impaired glucose tolerance, diabetes and even diabetic ketoacidosis (DKA). In addition, a number of NMS cases have been reported in patients treated with atypical antipsychotics, although the absolute incidence of neurologic side effects is currently sig- nificantly low. Here, we report a patient who simultaneously developed DKA, acute renal failure and NMS with rhabdomyolysis after olanzapine treatment. Olanzapine-induced metabolic complications and NMS were dramatically improved with cessation of the olanzapine treatment and initiation of supportive management including fluid therapy, hemodialysis, and intensive glycemic control using insulin. At short-term follow-up, insulin secretion was markedly recovered as evidenced by a restoration of serum C-peptide level, and the patient no longer required any hypoglycemic medications. Despite the dramatic increase in the use of atypical antipsychotics treatment, individualized treatments along with careful monitoring may be prudent for high risk or vulner- able patients in order to avoid the development of metabolic side effects. [ABSTRACT FROM AUTHOR]

Background: Hyperuricemia is associated with obesity. The visceral adiposity and subcutaneous adiposity may be associated with the differential metabolic risk, and the distribution of abdominal adipose tissue was significantly altered in people with type 2 diabetes mellitus (DM) compared to healthy people. Our study was performed to determine to the association between the regional abdominal adipose tissue distribution and serum uric acid levels in people with type 2 DM. Methods: A total of 699 people with type 2 DM and who had undergone abdominal computed tomography assessment of the visceral fat area and subcutaneous fat area were included. The serum uric acid levels were measured by the uricase method. Hyperuricemia was defined by cut-off value of > 7 mg/dl for men and > 6 mg/ dl for women. Results: The visceral fat area was positively associated with the serum uric acid levels after adjustment for age, sex, systolic blood pressure, diastolic blood pressure, serum creatinine, hemoglobin, serum albumin, serum high-density lipoprotein, serum triglyceride and hemoglobin A1c (β-coefficient = 0.117, p < 0.001). The logistic regression analysis showed that the visceral fat area was the significant independent predictor of hyperuricemia (OR 2.33, 95% CI, 1.21-4.50, p = 0.012). But there was no significant association between the subcutaneous fat area and the serum uric acid levels (β-coefficient = 0.061, p = 0.255). Conclusions: our data shows that the visceral fat area was positively associated with the serum uric acid levels, but the subcutaneous fat area was not in people with type 2 DM. [ABSTRACT FROM AUTHOR]

It has been suggested that oxidative stress is associated with the pathogenesis of osteoporosis. The objective of this study was to explore the association between a marker of oxidative stress and either bone turnover markers or bone mineral density (BMD) in postmenopausal women. In addition, the effects of oxidative stress on the formation of osteoclasts in human bone marrow cell culture were examined. We performed a cross-sectional analysis in healthy postmenopausal women aged 60–78 years ( n = 135, 68.2 ± 4.9). Oxidative stress was evaluated in the serum by measuring 8-hydroxy-2′-deoxyguanosine (8-OH-dG) levels. The biochemical markers of bone turnover and areal BMD were measured in all participants. Multivariate linear regression analysis revealed a negative association between 8-OH-dG levels and BMD of the lumbar spine, total hip, femoral neck, and trochanter and positive association with type I collagen C-telopeptide (ICTP) levels. The odds ratio of 8-OH-dG for osteoporosis was 1.54 (1.14–2.31, P = 0.003). In cultures of primary human marrow cells, HO caused concentration-dependent activation of TRAP-positive multinucleated giant cells. HO also increased the area of pits per osteoclast activity assay substrate. RT-PCR showed that HO stimulated the expression of M-CSF and RANKL and increased the RANKL/OPG ratio. The data support the view that oxidative stress is associated with increased bone resorption and low bone mass in otherwise healthy women. In addition, RANKL and M-CSF stimulation induced by oxidative stress may participate in osteoclastogenesis in human bone. [ABSTRACT FROM AUTHOR]

Background: Intensive insulin treatment in type2 diabetes can improve β-cell function. The rapid insulin analogs(lispro) used as prandial and the long acting insulin analogs (glargine)used as basal can simulate physiological insulin profile more closely. Subjects and Method: Type2 diabetic patients(18 males and 24 females) were hospitalized and treated with multiple split insulin injection (lispro + glargine). We performed oral glucose tolerance test on subjects and HbA1C, blood glucose, insulin, C-peptide and other indexes were measered before and after MSII. Result: Total patient insulin requirement is 40.97±14.04 IU(0.65±0.26IU per kg) and basal insulin(Glargine) requirement is 16.29±5.76 IU.(39.7% of total amount). According to DM duration, we divided these patients into 2 groups, drug naive group, secondary failure to sulfonylurea. After MSII, the AIR of naive group was significantly higher than before treatment.(0.07±0.05 vs 0.61 ±0.72 pmol/L/min, p<0.05) The HOMA-β and AUCi/AUCg were also elevated significantly.(HOMA-β 8.03 vs 195.20; AUCi/AUCg 0.02±0.01 vs 0.38±0.38, p<0.05). But WBISI(whole body insulin sensitivity index) increase from 7.66± 4.69 to 2.79±1.75 (p<0.05). Conclusion: HOMA-β, AIR, AUCi/AUCg were used for evaluating β cell function. These indexes were markedly improved after MSII. Our results showed that strict correction of hyperglycemia could greatly improve β cell function, especially in drug naive patients. [ABSTRACT FROM AUTHOR]

Background Surgeries in patients with coronavirus disease 2019 (COVID-19) put medical staff at a high risk of infection. We report the anesthetic management and infection control of a mechanically ventilated COVID-19 patient who underwent exploratory laparotomy for suspected duodenal ulcer perforation. Case A 73-year-old man, mechanically ventilated for confirmed COVID-19, showed clinical and radiographic signs of a perforated duodenal ulcer, and he was transferred under sedation and intubation to a negative-pressure operating room. The operating and assistant staff wore personal protective equipment. High-efficiency particulate absorbing filters were inserted into the expiratory circuits of the anesthesia machine and portable ventilator. No participating staff contracted COVID-19, although the patient later died due to pneumonia. Conclusions This report can contribute to establishing clinical guidelines for the surgical management and operation room setting of COVID-19 patients.

Background The analgesic effect of perineural opioid in clinical practice are still controversial. This randomized controlled trial compared analgesic effect of ropivacaine with fentanyl or ropivacaine alone for continuous femoral nerve block following unilateral total knee arthroplasty. Methods Fourty patients of ASA PS Ⅰ or Ⅱ receiving total knee arthroplasty with spinal anesthesia were enlisted and randomly allocated into two groups. Group R; bolus injection of 0.375% ropivacaine, 30 ml and an infusion of 0.2% ropivacaine at 8 ml/h (n = 20). Group RF; 0.375% ropivacaine, 29 ml added with 50 μg of fentanyl as a bolus and an infusion of 0.2% ropivacaine mixed with 1 μg/ml of fentanyl at 8 ml/h (n = 20). Local anesthetic infusion via a femoral nerve catheter was started at the end of operation and continued for 48 h. Intravenous patient-controlled analgesia with hydromorphone (0.15 mg/ml, 0-1-10) were used for adjuvant analgesics. Position of catheter tip and contrast distribution, visual analogue scale of pain, hydromorphone consumption, side effects were recorded for 48 h after operation. Patient satisfaction for the pain control received were noted. Results The pain visual analogue scale, incidences of side effects and satisfaction were not different between the two groups (P > 0.05), but the hydromorphone usage at 48 h after operation were lower in the Group RF than in the Group R (P = 0.047). Conclusions The analgesic effect of ropivacaine with fentanyl for continuous femoral nerve block after knee replacement arthroplasty was not superior to that of the ropivacaine alone.

Chronic ethanol consumption induces pancreatic β-cell dysfunction through glucokinase (Gck) nitration and down-regulation, leading to impaired glucose tolerance and insulin resistance, but the underlying mechanism remains largely unknown. Here, we demonstrate that Gck gene expression and promoter activity in pancreatic β-cells were suppressed by chronic ethanol exposure in vivo and in vitro, whereas expression of activating transcription factor 3 (Atf3) and its binding to the putative Atf/Creb site (from -287 to -158 bp) on the Gck promoter were up-regulated. Furthermore, in vitro ethanol-induced Atf3 inhibited the positive effect of Pdx-1 on Gck transcriptional regulation, enhanced recruitment of Hdac1/2 and histone H3 deacetylation, and subsequently augmented the interaction of Hdac1/Pdx-1 on the Gck promoter, which were diminished by Atf3 siRNA. In vivo Atf3-silencing reversed ethanol-mediated Gck down-regulation and β-cell dysfunction, followed by the amelioration of impaired glucose tolerance and insulin resistance. Together, we identified that ethanol-induced Atf3 fosters β-cell dysfunction via Gck down-regulation and that its loss ameliorates metabolic syndrome and could be a potential therapeutic target in treating type 2 diabetes. The Atf3 gene is associated with the induction of type 2 diabetes and alcohol consumption-induced metabolic impairment and thus may be the major negative regulator for glucose homeostasis. [ABSTRACT FROM AUTHOR]

A new soybean cultivar for soy-paste, 'Daeha 1', was developed by soybean breeding team in the Yeongnam Agricultural Research Institute (YARI) in 2008. A promising line, SS97214-S-S-S-15, was selected from the combination between 'Suwon192' and a pedigree came from cross combination between 'Jangyeobkong' and 'Hwaeomputkong'. It was designated as the name of 'Milyang 164'. It had good result from regional adaptation yield trial (RYT) for three years from 2006 to 2008 and released as the name of 'Daeha 1'. It has a determinate growth habit, white flower, grey pubescence, yellow seed coat, yellow hilum, large spherical seed (25.4 grams per 100 seeds). 'Daeha 1' is tolerant to soybean mosaic virus and bacterial pustule, the major soybean disease in Korea. The average yield of 'Daeha 1' was 2.62 ton per hectare in the regional yield trial (RYT) carried out for three years from 2006 to 2008, which was 5 percent higher than that of check cultivar, 'Taekwangkong'. [ABSTRACT FROM AUTHOR]

A new black seed coat soybean cultivar, 'Daeheug', was developed at the National Institute of Crop Science (NICS) in 2007. The breeding goal for black seed coat soybean is to develop the cultivar with large seed size, high yield, lodging tolerance, and resistance to disease such as soybean mosaic virus (SMV), and bacterial pustule. 'Daeheug' was selected from the cross between 'Daehwang' which had yellow seed coat, large seed size, and late maturity, and 'Milyang 79' which was lodging tolerant, and SMV resistant with medium seed size, black seed coat, and yellow cotyledon. The preliminary, advanced and regional yield trials for evaluation and selection of this cultivar were carried out from 2003 to 2007. It has determinate growth habit, purple flower, brown pubescence, brown pod color, black seed coat, yellow cotyledon, spherical flattened seed shape, oval leaf shape and large seed size (34.3 g/100 seeds). In maturity, 'Daeheug' was 2 days later than the check cultivar 'Ilpumgeomjeongkong'. In the seed quality such as isoflavone contents (635 μ/g), and anthocyanin contents (11.2 ml/g of seed coat), 'Daeheug' was better than the check cultivar. It has good adaptability for cooking with rice in ratio of water absorption and seed hardness. Specially, it has good processability for soybean tea with 2.13 absorbance at 530 nm, scavenge activity of DPPH radical was high, and contents of total phenolics was 1,263 μ/?. The average yield of 'Daeheug' was 2.26 ton per hectare in the regional yield trials (RYT) carried out in six locations of Korea from 2005 to 2007. [ABSTRACT FROM AUTHOR]