Backgrounds/Aims: During the acute phase response, cytokines induce marked alterations in lipid metabolism including an increase in serum triglyceride levels and a decrease in hepatic fatty acid oxidation, in bile acid synthesis, and in high-density lipoprotein levels. Methods: Peroxisome proliferator-activated receptors (PPARs: PPARα, β/δ, and γ) regulate fatty acid metabolism, glucose homeostasis, cell proliferation, differentiation and inflammation. Proinflammatory profiles including tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) are the important pathological factors in inflammatory responses during the pathological progression of the acute phase response. Lipopolysaccarides (LPS) induced the expression of TNF-α, IL-1β, and IL-6. LPS-induced inflammation decrease the expression of peroxisome proliferator-activated receptor α (PPARα), PPARβ/δ, PPARγ, and coactivators PPARγ coactivator 1 α (PGC-1α), PGC-1β messenger RNA (mRNA) in the liver of Balb/c mouse. In addition, LPS-induced inflammation diminishes the protein level of PPARα, PPARβ/δ, and PPARγ. Proinflammatory cytokines including TNFα, IL-1β, and IL-6 are the principal reducer of PPARs. However, the knockout mouse model against TNFα and IL-6 does not block decrease of PPARs in serum and liver. The mice were pretreated with fenofibrate at 100 mg/kg for 2 days. Results: These treatment protocols increased the amount of PPARs mRNA in the liver. Fenofibrate inhibited LPS-induced TNF-α, IL-1β, and IL-6 production in the serum and liver. Similar results were obtained when human hepatoma HepG2 cells exposed to LPS were co-incubated with fenofibrate. LPS-treated HepG2 cells decreased expression of IκB. Moreover, activation of PPARs abrogated LPS-induced degradation of IκB, thus suppressing LPS-induced NF-κB activities. Conclusions: Therefore, fenofibrate decreases the expression and secretion of TNF-α, IL-1β, and IL-6 via the NF-κB signaling pathway, thus serving as therapeutic targets to attenuate inflammation that is involved in hepatic pathological progression. (Korean J Hepatobiliary Pancreat Surg 2013;17:89-108)

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Objective.: Sparganosis locations in humans are usually presented with a subcutaneous tissue of abdominal wall, chest, abdominal vicera and brain, but are rarely found in the breast. Methods. A case of sparganosis was confirmed by surgical excision of two parasites in a 76-year-old female patient present to a palpable mass in the right breast (presumed to have been sparganosis approximately 3 years ago). She had no history to direct ingestion of snakes or frogs, but had the history of drinking contaminated water. Mammography, ultrasonography, MRI, and FDG PET/CT imaging findings for patient were characteristic of sparganosis due to suspicion of breast cancer. Conclusions: The first route of infection in humans is drinking contaminated water. The second route is the ingestion of raw or partially cooked snakes or frogs. The third route is infected wound snake, frog muscle that attach to the case. However, only a few cases of drinking contaminated water have been reported in the country. Ultrasonography, MRI is known to be helpful for diagnosis of breast sparganosis. However, Mammography, ultrasonography, MRI, and FDG PET/CT for breast sparganosis is not reported present in the country. Reported the case and reviewed the related literature briefly.

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