A novel missense mutation in NR0B1 causes delayed-onset primary adrenal insufficiency in adults.

A novel missense mutation (c.775T>C; p.ser259Pro) in the NROBI gene cause a late-onset adrenal insufficiency without hypogonadism.

Clinical association between serum γ-glutamyltransferase levels and the development of insulin resistance in Korean men: a 5-year follow-up study.

AIMS: In recent years, γ-glutamyltransferase has emerged as a predictor of cardiovascular disease, Type 2 diabetes mellitus, the metabolic syndrome and hypertension. However, it is not yet certain whether γ-glutamyltransferase is a predictor for insulin resistance. The aim of this study was to examine the longitudinal association between baseline γ-glutamyltransferase level and the development of insulin resistance in Korean men. METHODS: We performed a prospective cohort study, involving 22 931 healthy Korean men without baseline insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR < 2.7) for 5 years. We checked the HOMA-IR serially to monitor the development of insulin resistance (incidence of HOMA-IR ≥ 2.7). A Cox proportional hazards model was used to determine hazard ratios for insulin resistance by quartile groups of baseline serum γ-glutamyltransferase levels. RESULTS: During 81 208.6 person-years of follow-up, 3856 (16.8%) cases of insulin resistance developed between 2006 and 2010. After adjusting for multiple covariates, including baseline HOMA-IR, the hazard ratios (95% CI) for incident insulin resistance comparing the second to the fourth quartile of baseline serum γ-glutamyltransferase levels with the first quartile were 1.19 (1.06-1.33), 1.38 (1.23-1.53) and 1.58 (1.41-1.77), respectively (P for trend < 0.001). CONCLUSIONS: Our findings show that serum γ-glutamyltransferase level could be a predictor of the development of insulin resistance in Korean men.

Trends in the incidence of and survival rates for oral cavity cancer in the Korean population.

OBJECTIVE: This study assessed trends in the incidence of and survival rates for oral cavity cancer in the Korean population. MATERIALS AND METHODS: Data from the Korea Central Cancer Registry were extracted for 10,282 patients diagnosed with oral cavity cancer (C01-C06) between 1999 and 2010 to evaluate the age-standardised incidence rate, annual percentage change (APC) and 5-year relative survival rate (RSR) according to gender and age. RESULTS: In males, the incidence rate slightly decreased [APC of -0.2% (P = 0.6427)]; in females, the incidence rate increased [APC of 3.1% (P < 0.05)]. In males and females, the incidence of oral tongue cancer (C02) significantly increased [APC of 2.2% and 4.1%, respectively (P < 0.05)]. This increase in oral tongue cancer incidence was most prominent in the younger age group (<40 years, APC = 6.1%, P < 0.05). The incidence of buccal cheek cancer increased only among males [APC of 4.8% (P < 0.05)]. The 5-year RSR improved from 42.7% (1993-1995) to 59.5% (2006-2010), corresponding to an increase of 16.8% from 1993 to 2010 (P < 0.05). CONCLUSION: The incidence of oral cavity cancer in females increased, whereas it stabilised or decreased in males. However, the incidence of oral tongue cancer increased in both males and females, especially in the younger age group.

Apelin as a new therapeutic target for COVID-19 treatment.

BACKGROUND: Apelin is an endogenous neuropeptide that binds to the G-protein-coupled receptor (APJ) and participates in a variety of physiological processes in the heart, lungs and other peripheral organs. Intriguingly, [Pyr1]-Apelin-13, a highly potent pyroglutamic form of apelin, has the potential to bind to and be degraded by angiotensin-converting enzyme 2 (ACE2). ACE2 is known to operate as a viral receptor in the early stages of severe acute respiratory coronavirus (SARS-CoV-2) infection. AIM: This study aimed to determine if apelin protects against SARS-CoV-2 infection by inhibiting ACE2 binding to SARS-CoV-2 spike protein. DESIGN AND METHODS: To determine whether [Pyr1]-Apelin-13 inhibits ACE2 binding to the SARS-CoV-2 spike protein (S protein), we performed a cell-to-cell fusion assay using ACE2-expressing cells and S protein-expressing cells and a pseudovirus-based inhibition assay. We then analyzed publicly available transcriptome data while focusing on the beneficial effects of apelin on the lungs. RESULTS: We found that [Pyr1]-Apelin-13 inhibits cell-to-cell fusion mediated by ACE2 binding to the S protein. In this experiment, [Pyr1]-Apelin-13 protected human bronchial epithelial cells, infected with pseudo-typed lentivirus-producing S protein, against viral infection. In the presence of [Pyr1]-Apelin-13, the level of viral spike protein expression was also reduced in a concentration-dependent manner. Transcriptome analysis revealed that apelin may control inflammatory responses to viral infection by inhibiting the nuclear factor kappa B pathway. CONCLUSION: Apelin is a potential therapeutic candidate against SARS-CoV-2 infection.

U-shaped relationship between depression and body mass index in the Korean adults.

BACKGROUND: Although a number of studies have examined the relationship between depression and obesity, it is still insufficient to establish the specific pattern of relationship between depression and body mass index (BMI) categories. Thus, this study was aimed to investigate the relationship between depression and BMI categories. METHODS: A cross-sectional study was conducted for a cohort of 159,390 Korean based on Kangbuk Samsung Health Study (KSHS). Study participants were classified into 5 groups by Asian-specific cut-off of BMI (18.5, 23, 25 and 30kg/m2). The presence of depression was determined by Center for Epidemiologic Studies-Depression scales (CES-D)≥16 and≥25. The adjusted odd ratios (ORs) for depression were evaluated by multiple logistic regression analysis, in which independent variable was 5 categories of BMI and dependent variable was depression. Subgroup analysis was conducted by gender and age. RESULTS: When normal group was set as a reference, the adjusted ORs for depression formed U-shaped pattern of relationship with BMI categories [underweight: 1.31 (1.14-1.50), overweight: 0.94 (0.85-1.04), obese group: 1.01 (0.91-1.12), severe obese group: 1.28 (1.05-1.54)]. This pattern of relationship was more prominent in female and young age group than male and elderly subgroup. BMI level with the lowest likelihood of depression was 18.5kg/m2 to 25kg/m2 in women and 23kg/m2 to 25kg/m2 in men. CONCLUSIONS: There was a U-shaped relationship between depression and BMI categories. This finding suggests that both underweight and severe obesity are associated with the increased risk for depression.

Perfusion of the oesophagus and stomach during hepatic artery chemotherapy via an aberrant gastric artery.

Symptoms of pain, dyspepsia and nausea arising during the administration of intrahepatic chemotherapy should be investigated with endoscopy to exclude inadvertent perfusion of the stomach.