An Observational Study on the Obesity and Metabolic Status of Psoriasis Patients

Background

Recent studies have suggested that obesity, hyperlipidemia, ischemic heart diseases, metabolic syndrome and hypertension can combine with psoriasis. However, the metabolic comorbidities have not been clearly demonstrated in Korean psoriasis patients.

Objective

The purpose of this study was to analyze the association between psoriasis and metabolic abnormalities including obesity, glucose intolerance, hypertension and dyslipidemia in our center. Treatment response of cyclosporine between a high body mass index (BMI) group and normal BMI group was also analyzed to investigate how obesity may affect psoriasis treatment.

Methods

A retrospective observational study was made on the obesity and metabolic status of psoriasis patients versus normal control group through electronic medical records from January 2008 to April 2009 at Department of Dermatology, Samsung Medical Center, (Seoul, Korea). Medical records, demographics and the Psoriasis Area and Severity Index score before and after cyclosporine treatment were analyzed.

Results

There were no significant differences in the metabolic status between normal control and psoriasis patients. Also, there was no significant difference in the treatment response between high BMI group and normal BMI group, after 4 weeks and 8 weeks of cyclosporine treatment.

Conclusion

Our study suggests that in Korean patients, an association between psoriasis and metabolic abnormalities is not obvious. This may reflect a different severity of obesity and metabolic abnormalities between Western and Asian populations.     

Isoliquiritigenin in licorice functions as a hepatic protectant by induction of antioxidant genes through extracellular signal-regulated kinase-mediated NF-E2-related factor-2 signaling pathway

Purpose

Liver is the major site of biotransformation for exogenous toxins, in having a defense system against oxidative stress as well as cytochrome P450 system. Isoliquiritigenin (isoLQ) is an active component present in Glycyrrhizae radix and has been shown to have various biological activities. This study investigated the effect of isoLQ as a liver protectant against oxidative stress, both in vivo and in vitro, and also its molecular mechanisms.

Methods

We used tert-butylhydroperoxide-induced hepatocyte damage model and cadmium (Cd)-stimulated liver toxicity animal model, which are assessed by immunoblot and flow cytometry as well as plasma and histopathological parameters.

Results

In HepG2 cells, pretreatment of 10 and 30 µM isoLQ significantly inhibited the induction of apoptosis and mitochondrial damage, and production of reactive oxygen species. Moreover, isoLQ induced the activation of nuclear factor erythroid 2-related factor-2 (Nrf2), as indicated by an increase in its nuclear translocation and antioxidant response element-luciferase activity. IsoLQ also induced the expression of Nrf2 target phase II enzymes, such as heme oxygenase-1, glutamate–cysteine ligase catalytic subunit and NAD(P)H:quinone oxidoreductase 1. IsoLQ also induced phosphorylation of extracellular stimuli-regulated kinase (ERK), and its activation of Nrf2 was mediated with ERK-dependent phosphorylation of Nrf2, as determined by its chemical inhibitor. In rats, oral treatment of 5 and 20 mg/kg isoLQ prevented Cd-induced acute hepatic damage, as assessed by plasma parameters and semiquantative histology, such as the modified HAI grading scores and the degenerative regions in hepatic parenchyma.

Conclusion

These findings are considered as scientific evidence that isoLQ in licorice has the function of being a hepatic protectant against oxidative damages through ERK-mediated Nrf2 activation.

     

Systematic study on active compounds as antibacterial and antibiofilm agent in aging onions

Quantitative investigation and systematic studies of quercetin, total phenolics, flavonoids, antioxidants, antibacterial and antibiofilm or antibiofouling properties of methanolic extracts of onions obtained from six different varieties have been carried out to explore their relative merits in terms of biological activities of fresh and aging onions. Total phenolic content in the extracts was examined spectrophotometrically using Folin–Ciocalteau's phenol reagent and total antioxidant activity was studied by FRAP and DPPH methods. In vitro antibacterial activity of the extracts was investigated on Gram-negative (Escherichia coli and Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus and Bacillus cereus) respectively, by using a modified Kirby–Bauer disc diffusion method. Antibiofilm activity was tested by crystal violet assay. The best results against biofilm formation were observed for the extracts obtained from onions stored for three months. The total phenolic and antioxidant content found to be increased upon aging in all the six varieties; red skinned onion (Happyhong) showed the highest level of total phenolics (5110.07 ± 196.56 μg GAEg^?1 FW) and total flavonoids (2254.00 ± 154.82 μg QEg^?1 FW) after three months. The results showed that in all the varieties, quercetin content as well as biological activity increases with aging in the stored onions compared with the fresh ones.     

Cutaneous mastocytosis associated with congenital alopecia

Mastocytosis is a rare disorder that shows accumulation of mast cells in tissues. Atypical clinical features may mimic impetigo, Langerhans cell histiocytosis, and carcinoid syndrome; however, only 1 case of scarring alopecia associated with mastocytosis has been reported. We present the first case of cutaneous mastocytosis associated with congenital alopecia areata in a 3-year-old Korean girl. This case showed an atypical clinical presentation of congenital alopecia areata, but histopathological results confirmed the diagnosis of cutaneous mastocytosis.     

Palliative chemotherapy preferences and factors that influence patient choice in incurable advanced cancer

OBJECTIVE: To determine the extent of informed decision-making and treatment preference of Korean patients receiving palliative chemotherapy. METHODS: We assessed 138 patients (median age: 58 years; 73% male) with advanced cancer who had received at least one cycle of chemotherapy. General demographic information, the extent of information received, patient preferences for palliative chemotherapy and randomized trials were determined using structured patient interviews. We investigated the survival threshold for justifying toxicity, the factors influencing individual preference for chemotherapy and the attitude of patients towards randomized trials. RESULTS: Before chemotherapy, 72.1% of patients were given information about adverse events of treatment, but only 39.5% were told of alternative treatments. There was significant inter-individual variability in willingness to accept chemotherapy, as well as a wide range of thresholds. Patients reporting higher quality of life were more likely to judge treatment as acceptable. When given the choice for randomization for conventional chemotherapy, investigational agents or supportive care, patients usually refused enrollment into randomized trials. CONCLUSION: Self-assessed quality of life was a significant predictor of stronger preference for chemotherapy. In the palliative setting, good doctor-patient communications and consideration of patients' preferences are necessary for making decisions about proper treatment.     

Treatment of oesophageal bile reflux in children: the results of a prospective study with omeprazole

OBJECTIVES: Reflux of duodenal juice into the oesophagus has a role in the pathogenesis of both oesophageal and laryngopharyngeal inflammatory and neoplastic lesions. As little is known about effective therapy, we studied the effect of proton pump inhibitor therapy on oesophageal bile reflux in children. METHODS: Twenty-nine children with moderate to severe erosive oesophagitis and abnormal oesophageal bile reflux were studied before and after treatment with omeprazole 1 mg/kg per day. Outcomes included a clinical symptom score, oesophageal acid and bile reflux (simultaneous 24-hour pH and Bilitec 2000 monitoring), and mucosal healing. RESULTS: After 8 weeks of therapy, 17 (59%) of the patients were symptom-free, and 5 (17%) had minimal symptoms. Mucosal healing or reduction to low-grade oesophagitis was achieved in 25 children (86%; P < 0.0005). Mean percentages of total, upright, and supine time with oesophageal pH less than 4 were reduced from 17.0%, 16.8%, and 19.2% before treatment, to 2.83%, 3.17%, and 2.07%, respectively, after treatment (all P < 0.00001). Similarly, mean percentages of total, upright, and supine time with bile reflux were reduced from 16.96%, 12.67%, and 22.0%, to 2.27%, 1.91%, and 2.23%, respectively (P < 0.000001, P < 0.0001, and P < 0.000001, respectively). CONCLUSIONS: Omeprazole 1 mg/kg per day is an effective therapy for the majority of children with severe erosive oesophagitis due to abnormal isolated bile reflux or combined acid and bile reflux. It remains unclear how patients with treatment-resistant bile reflux should be managed.     

Papillary thyroid microcarcinoma: prognostic factors and treatment

BACKGROUND AND OBJECTIVES: Within the group of patients with papillary thyroid microcarcinoma (PTMC), the prognostic factors have not been well defined and the optimal treatment has not been proved. The aim of this study was to find out the factors associated with the tumor recurrence in the patients with PTMC. METHODS: A total of 228 patients with PTMC (189 females, 39 males; age 14-85 years, median 46 years) were treated at our Institute between 1975 and 2006. The data on patients' gender, age, extent of disease, pathomorphological characteristics, therapy, locoregional control, disease-free survival and disease-specific survival were collected. Statistical correlation between possible prognostic factors and the duration of disease-free interval was analyzed by univariate and Cox's multivariate survival analysis. RESULTS: The tumor diameter ranged from 0.1 to 10 mm (mean 6.1 mm). The median length of observation was 84 months (range 1-385). During the follow-up period, the recurrence was diagnosed in 7 patients (6 locoregional and 1 distant). Multivariate analysis showed that tumor size and lymph node metastases were independent prognostic factors for disease-free interval. CONCLUSIONS: Longer disease-free interval was found in the patients with a tumor diameter < or =6 mm and without lymph-node metastases.