Aim
To investigate the effects of LY2405319, an analogue of fibroblast growth factor 21 (FGF21), on glucose homeostasis in streptozotocin (STZ)‐induced insulin‐deficient mice (STZ mice).
Methods
...Nine‐week‐old male C57BL/6J mice were administered a single intraperitoneal injection of STZ (150 mg/kg). One week later, after confirmation of hyperglycaemia, saline or LY2405319 (5 mg/kg) was injected subcutaneously daily for 4 weeks. Changes in glucose homeostasis, energy metabolism and brown adipose tissue (BAT) function were assessed.
Results
The STZ mice had elevated blood glucose and reduced plasma FGF21 levels, impaired glucose uptake in the BAT, and BAT mitochondria with absent or swollen cristae and fewer lipid vacuoles. LY2405319 significantly reduced blood glucose levels and this was associated with increased BAT glucose uptake and changes in gene expression and morphology, indicating improved mitochondrial lipid metabolism in the BAT. Importantly, the ability of LY2405319 to lower blood glucose in STZ mice was compromised after removing interscapular BAT.
Conclusions
Our results show that LY2405319 reduces blood glucose levels in insulin‐deficient diabetes by improving BAT metabolism. Additional studies investigating the therapeutic potential of FGF21 for the treatment of type 1 diabetes are warranted.
Summary
Bone mineral density (BMD) is significantly decreased after gastrectomy in patients with gastric cancer. Calcium malabsorption, secondary hyperparathyroidism, and dominant bone resorption ...appear to contribute to bone loss in these patients. Patients should undergo early surveillance and nutritional or pharmacologic intensive interventions for bone health.
Purpose
Survivorship care, including bone health, has become an important issue in gastric cancer. We performed a meta-analysis of the available observational studies to determine whether and how osteoporosis risk is increased after gastrectomy in patients with gastric cancer.
Methods
A total of 1204 patients (802 men) from 19 cohort studies were included. We evaluated the prevalence of osteoporosis in postgastrectomy patients, comparing the incidence according to the type of gastrectomy and sex. Additionally, we evaluated changes in bone mineral density (BMD) and bone metabolism-related markers pre- to postoperatively and between patients who underwent gastrectomy and matched controls. Proportion meta-analysis was performed and pooled odds ratios (ORs) were calculated.
Results
The pooled incidence estimate was 36% 95% confidence interval (CI), 32–40. The incidence of osteoporosis was significantly higher in women than in men (OR = 1.90,
p
< 0.001) but was similar between partial and total gastrectomy groups (OR = 0.983,
p
= 0.939). BMD was significantly decreased, and calcium, phosphorous, and parathyroid hormone levels were significantly increased in patients after gastrectomy compared to those before gastrectomy. BMD and calcium and 25OH-vitamin D levels were significantly decreased, and parathyroid hormone and 1,25OH-vitamin D levels were significantly increased in the gastrectomy group compared to that in the control group.
Conclusion
We found that BMD is significantly decreased after gastrectomy in patients with gastric cancer. Vitamin D deficiency and secondary hyperparathyroidism are suggested to be common mechanism underlying BMD impairment. After resection, patients should undergo long-term nutritional and bone health surveillance, in addition to their oncological follow-up.
Summary
In Korean, atypical subtrochanteric fractures (ASF) were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.
Introduction
Recently, ASF have been reported to ...increase among patients on bisphosphonate. However, the incidence of ASF and the association between ASF and bisphosphonate use have not been well defined in Asian population. Our purposes are (1) to estimate the proportion of ASF among Korean patients with proximal femur fracture and (2) to determine the associated risk factors of ASF in the Korean patients.
Methods
We conducted a multicenter (16 academic hospitals), prospective Korean hip fracture study on hip fracture in a cohort of patients aged 50 years or older from South Korea between July 2014 and May 2016. As a part of Korean hip fracture study, primary analysis examined the proportion of ASF among proximal femur fracture. To identify ASF, according to the definition by ASBMR task force, all radiographs of subtrochanteric fracture were reviewed. Associated risk factors for occurrence of ASF were also evaluated by using multivariable logistic regression analysis.
Results
Among 1361 patients with proximal femoral fractures due to low-energy trauma, 17 fractures (1.2%) were identified as ASF. Higher BMI and use of bisphosphonate before injury were independent risk factors of ASF.
Conclusion
In Korean, ASF were rare. Higher BMI and use of bisphosphonate were significant risk factors of ASF.
Objective: To evaluate the impact of neurological and medical complications on 3‐month outcomes in acute ischaemic stroke patients.
Methods: We prospectively investigated complications for all the ...consecutive acute ischaemic stroke patients admitted within 7 days from onset in four university hospitals during a 1‐year period. Baseline data and 3‐month outcomes were collected. Poor outcome was defined as a modified Rankin Scale score 3–6.
Results: A total of 1 254 patients were recruited: 264 (21.1%) and 303 (24.2%) patients experienced one or more neurological and medical complications, respectively. The most common complications were ischaemic stroke progression (17.1%) and pneumonia (12.0%). Of 1 233 patients with available 3‐month outcomes, 34.9% had a poor outcome. Multivariate analysis revealed that neurological (odds ratio, 95% confidence interval; 5.47, 3.63–8.24) and medical (3.47, 2.30–5.23) complications were independent predictors of the poor outcome. For the individual complications, ischaemic stroke progression (7.48, 4.73–11.84), symptomatic hemorrhagic transformation (3.57, 1.33–9.54), pneumonia (4.44, 2.20–8.99), extracranial bleeding (4.45, 1.88–10.53), and urinary tract infection (2.72, 1.32–5.60) were independently associated with the poor outcome.
Conclusion: Outcome after ischaemic stroke is adversely influenced by complications, especially ischaemic stroke progression, symptomatic hemorrhagic transformation, pneumonia, extracranial bleeding, and urinary tract infection. Interventions to prevent those complications might improve ischaemic stroke outcome.
► Cu2+ substituted CoFe2O4 ferrite synthesized by sol–gel method. ► Characterization by XRD, AFM, dielectric spectroscopy and impedance spectroscopy, FT-IR, SEM, VSM techniques. ► Fe3++Cu2+↔Fe2++Cu3+ ...responsible for conduction mechanism. ► Cu doped CoFe2O4 nanoparticles exhibit room temperature ferrimagnetic behaviour.
We report structural, electrical and magnetic properties of Cu doped Co ferrite nanoparticles prepared by sol–gel method. Analysis of structural properties has been carried out by using XRD and reveals that all samples have single phase cubic spinel structure. The permittivity (ɛ), dielectric loss (tanδ) and ac conductivity (σac) were determined at room temperature as a function of frequency. The results of dielectric properties indicated the normal Maxwell–Wagner type dielectric dispersion due to interfacial polarization. Complex impedance spectroscopic studies reveal that the conduction in these samples is through the grain boundaries. Room temperature magnetic hysteresis measurements infer that the saturation magnetization decreases with Cu doping which may be due to the difference of the magnetic moment of Cu and Fe ions.
Hand grip strength (HGS) is a simple way of predicting the risk of cardiovascular disease and all-cause mortality in the general population. However, the practical significance of grip strength in ...patients with COPD is uncertain. The aim of this study was to compare HGS between subjects with and without COPD and to evaluate its clinical relevance in patients with COPD by using a national survey.
Data were collected from the Korean National Health and Nutrition Examination Survey. The study included 421 adults with COPD and 2,542 controls who completed questionnaires, spirometry, and a HGS test. HGS was compared between subjects with and without COPD, and the association between grip strength, lung function, and quality of life (QoL) was evaluated.
The mean HGS was 33.3±9.1 kg in the COPD group and 29.9±9.5 kg in the non-COPD group; adjusted HGS was 30.9±0.33 kg and 30.9±0.11 kg, respectively (
=0.99). HGS was not related to forced vital capacity (β=0.04,
=0.70) or forced expiratory volume in 1 second (β=0.11,
=0.24) in multivariable analysis. HGS was independently associated with the EQ-5D index, but the relationship was stronger in the COPD group (β=0.30,
<0.001) than in the non-COPD group (β=0.21,
<0.001). The results were similar for each component of the EQ-5D, including mobility (β=-0.25,
<0.001), daily activity (β=-0.19,
=0.01), pain/discomfort (β=-0.32,
<0.001), and anxiety/depression (β=-0.16,
=0.01).
HGS was not different between subjects with and without COPD, but was associated with QoL - including mobility, daily activity, pain/discomfort, and anxiety/depression - in patients with COPD. The HGS test could be used as a marker of QoL in patients with COPD and could assist risk stratification in clinical practice.
Background
Few studies have investigated the incidence of anaphylaxis induced by individual or structurally similar cephalosporins. The aims of the study were to assess the incidence of ...cephalosporin‐induced anaphylaxis and evaluate the clinical efficacy of screening skin tests.
Methods
In this retrospective cohort study, we obtained information on total cephalosporin use and cephalosporin‐induced anaphylaxis in intravenous cephalosporin recipients in 12 general hospitals between 2013 and 2015. Cephalosporins were divided into 4 groups according to similar side‐chain structures. The incidence of cephalosporin‐induced anaphylaxis was assessed for each cephalosporin, cephalosporin generation, and side‐chain group. To verify the efficacy of screening intradermal tests (IDT) with cephalosporin, the 12 hospitals were assigned to the intervention or control group depending on whether they performed screening IDT before the administration of cephalosporins.
Results
We identified 76 cases of cephalosporin‐induced anaphylaxis with 1 123 345 exposures to intravenous cephalosporins (6.8 per 100 000 exposures), and the incidence of fatal anaphylaxis by cephalosporin was 0.1 cases per 100 000 exposures. The highest incidences of anaphylaxis occurred in the ceftizoxime (13.0 cases per 100 000 exposures) and side‐chain group 1 (cefepime, cefotaxime, ceftizoxime, ceftriaxone, and cefuroxime; 9.3 per 100 000). There was no case of anaphylaxis induced by cefoxitin, cefmetazole, cefminox, and cefotiam. The clinical effectiveness of routine screening IDT was not significant (P = .06).
Conclusions
The incidence of cephalosporin‐induced anaphylaxis differed according to individual drugs and side‐chain structure. Screening IDT showed no clinical efficacy at a population level.
Among total 1 140 354 cephalosporin treatment courses from 12 hours hospitals, the incidence of cephalosporin induced anaphylaxis was 6.8 per 100 000 exposures and the related fatality was 1.3%. The incidence of cephalosporin induced anaphylaxis varies with each drug type, and the highest incidences of anaphylaxis occurred in the ceftizoxime (13.0 cases per 100 000 exposures). Screening intradermal tests with cephalosporin failed to show preventive effect on cephalosporin‐induced anaphylaxis.
Landslide debris is a common occurrence in mountainous regions around the world that can potentially result in disastrous consequences to downstream facilities. Flow-impeding structures are often ...constructed along the flow path to impede this hazardous phenomenon. Baffles are a type of flow-impeding structure regularly installed using empirical and prescriptive design methods as the interaction mechanism and the influence of baffle configuration on flow impedance is not well understood. A series of flume experiments were carried out to investigate flows characterizing landslide debris impacting an array of baffles using dry uniform sand. The influence of baffle height, row number, and spacing between successive rows was examined. Photoconductive sensors were used to estimate flow velocity, laser sensors were installed to measure flow depth profiles, and high-speed cameras were used to capture flow kinematics. Experimental results reveal that baffles can be categorized relative to the approach flow depth (h) and increasing the baffle height from 0.75h to 1.5h leads to a 40% increase in upstream flow depths from backwater effects, more effective development of subcritical conditions, and additional energy losses of up to 9%. Increasing the number of rows of 1.5h baffles from a single row to a three-row staggered array results in up to 72% additional energy loss. The energy loss is attributed to the deflection of granular jets and additional backwater effects. Increasing the row spacing from 50 to 100 mm results in up to a 14% increase in energy loss.
Summary
We evaluated trends in the incidences of typical and atypical hip fracture in relation to bisphosphonate use in Korea from 2006 to 2010, using nationwide data obtained from the Health ...Insurance Review and Assessment Service (HIRA).
Introduction
Recently, atypical hip fractures in the subtrochanteric region have been reported among patients on bisphosphonate. However, the association between atypical hip fracture and bisphosphonate is controversial. We evaluated trends in the incidences of typical and atypical hip fracture in relation to bisphosphonate use in Korea from 2006 to 2010, using nationwide data obtained from the HIRA.
Methods
All new visits or admissions to clinics or hospitals for a typical and atypical hip fractures were recorded nationwide by HIRA using the ICD-10 code classification. Typical and atypical hip fractures were defined as femoral neck/intertrochanteric and subtrochanteric fracture, respectively. Bisphosphonate prescription data were also abstracted from the HIRA database.
Results
The absolute number of typical and atypical hip fracture increased during the study period. Although age-adjusted incidence rates of typical hip fractures were stable in men and women, those of atypical hip fractures increased in women. Nationally, the annual numbers of prescriptions of bisphosphonate also increased during the study period.
Conclusions
The results of this study suggest a possible causal relationship between bisphosphonate use and the increased incidence of atypical hip fracture in Korea.
We medicated teriparatide in three patients, who had a nonunion of the femur even after the initial surgical intervention. Teriparatide was administered for 3–9 months after a diagnosis of nonunion. ...A successful union was obtained in all three patients without further surgical intervention, and no adverse events related to the use of teriparatide were observed. Our report showed that teriparatide could be an alternative to surgical intervention in nonunion of the femur.
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