Health behaviour and quality of life in Korean adults with respiratory disease: National Health Survey, 2005

OBJECTIVES

To describe disease management, health behaviour, psychological health and quality of life (QOL) in people with chronic respiratory disease (CRD).

METHODS

We analysed data from 798 adults with CRD drawn from the Korean National Health and Nutrition Examination Survey (KNHANES) 2005: 514 subjects with asthma alone, 258 with chronic obstructive pulmonary disease (COPD) alone, and 56 with asthma and COPD.

RESULTS

Disease management and health behaviour in this cohort were poor. One third of the cohort was not seeking any medical treatment, although many were currently experiencing respiratory symptoms. Twenty-six per cent of the subjects were current smokers who averaged 0.8 packs/day. More than half of the subjects did not exercise, only half of the subjects had regular health examinations and one third of the subjects did not get enough sleep. The study population exhibited poor psychological indices, functional health status and QOL. The combined asthma and COPD group was characterised by an increased frequency of problems related to functional status and QOL.

CONCLUSIONS

People with CRD are at high risk for functional limitations, unhealthy behaviour, poor mental status and poor QOL. A comprehensive disease management programme for people with CRD should be developed using collaborative team efforts.

Effects of direct-fed microbials on growth performance, gut morphometry, and immune characteristics in broiler chickens

This study was conducted to compare growth performance, gut morphometry, and parameters of local and systemic immunity in broiler chickens fed for 22 consecutive days with a diet supplemented with Bacillus spp. as direct-fed microbials (DFM), a commercial product incorporating 3 DFM, or a nonsupplemented diet. Direct-fed microbials did not significantly modify BW gain and most failed to affect serum antibody levels in response to immunization with a recombinant Eimeria protein. However, altered intestinal morphometric measurements were readily apparent in DFM-fed chickens as revealed by increased villus height and crypt depth compared with non-DFM-fed controls. In addition, serum levels of alpha-1-acid glycoprotein as an inflammatory marker were reduced in DFM-fed birds, whereas splenic lymphocyte proliferation, intestine intraepithelial lymphocyte subpopulations, and cytokine mRNA levels in intraepithelial lymphocytes were increased, decreased, or unchanged compared with controls depending on the DFM used. These results provide a rational scientific basis for future studies to investigate DFM as immunomodulating agents to enhance host protective immunity against enteric pathogens in broiler chickens.

Ethanol and PTZ effects on siRNA-mediated GABAB1 receptor: down regulation of intracellular signaling pathway in prenatal rat cortical and hippocampal neurons

GABA(B) receptors (R) are widely expressed and distributed in the nervous system, and have been implicated in variety of neurodegenerative and pathophysiological disorders. However, the exact molecular mechanism regarding responsibility of GABA(B1)R in downstream signaling pathway is not well understood. The present study was undertaken to explore the downstream signaling and role of GABA(B1)R upon acute ethanol and pentylenetetrazol (PTZ) exposure for (20 min) in cortical and hippocampal neuronal cell cultures by using GABA(B1)R RNA interference (i) (30 nM, 48 h) at gestational days 17.5. The results showed that GABA(B1)R and protein kinase A-alpha (PKA) showed decreased expression upon ethanol and PTZ exposure in cortical and hippocampal neurons during transfected and nontransfected conditions, whereas these effects could lead to significant changes in phosphorylation of cAMP-response element binding protein (p-CREB) expression where GABA(B1)R was knocked down. Furthermore, intracellular Ca(+2) concentrations were also reduced in some groups after transfection with GABA(B1)R RNAi. These results showed a critical role of GABA(B1)R upon ethanol and PTZ exposure by modulating downstream signaling pathway. Finally, these findings suggested that inhibition of GABA(B1)R results in the modulation of PKA, p-CREB pathway may play a role in long-term changes in the nervous system, and may be an underlying cause of ethanol's effects.

Low-dose intra-arterial urokinase and aggressive mechanical clot disruption for acute ischemic stroke after failure of intravenous thrombolysis

BACKGROUND AND PURPOSE

Intravenous (IV) thrombolysis often fails to achieve recanalization of occluded cerebral arteries, especially in patients with proximal large arterial occlusions. The goal of this study was to assess the feasibility, safety, and efficacy of low-dose intra-arterial (IA) urokinase and aggressive mechanical clot disruption (AMCD) after failure of IV thrombolysis for acute ischemic stroke.

MATERIALS AND METHODS

We prospectively enrolled 12 patients with acute ischemic stroke who initially received IV recombinant tissue plasminogen activator (rtPA) and were subsequently treated with combined low-dose IA urokinase and AMCD. Time to treatment, urokinase dose, duration of the procedure, recanalization rates, and symptomatic hemorrhage were analyzed. Clinical outcome measures were assessed on admission and at discharge (National Institutes of Health Stroke Scale [NIHSS]), and at 3 months after treatment (modified Rankin Scale [mRS]).

RESULTS

Median NIHSS score on admission was 17. Median time from symptom onset to IV rtPA was 120 minutes, and median time from symptom onset to IA therapy was 230 minutes. The median duration of IA therapy was 55 minutes. Median dose of urokinase was 300,000 U. Recanalization (thrombolysis in cerebral ischemia grade II or III) was achieved in all patients. No procedure-related complications were observed. There was no symptomatic hemorrhage. At discharge, median NIHSS score was 3. The 3-month outcome was excellent (mRS, 0-1) in 8 patients, good (mRS, 2) in 1 patient, and poor (mRS, 3-5) in 3 patients. There was no hospital or 3-month mortality.

CONCLUSIONS

In this study, combination therapy with low-dose IA urokinase and AMCD is safe and effective after failed IV thrombolysis in patients with acute ischemic stroke. A high rate of recanalization, low rate of symptomatic hemorrhage, and excellent functional outcome can be achieved.

Endovascular treatment of unruptured intracranial aneurysms in the elderly: analysis of procedure related complications

INTRODUCTION

The management of unruptured intracranial aneurysms in the elderly remains controversial. Treatment risks are thought to be higher in this group. Large series assessing endovascular treatment of unruptured intracranial aneurysms in the elderly are lacking. Our single center endovascular experience in treating unruptured intracranial aneurysms in the elderly is presented.

METHODS

77 patients, 70 years or older, were referred to the endovascular neurosurgery service for treatment of an unruptured intracranial aneurysm between February 2000 and May 2008. Hospital records, operative reports, angiograms and radiology reports were reviewed and analyzed retrospectively.

RESULTS

99 aneurysms were treated in 77 patients in 102 procedures. Mean patient age was 75±4 years, and the average aneurysm size was 11±7 mm. Adjuvant techniques were used in 66% of cases. Endovascular procedures included coiling alone (32%), balloon assisted coiling (19%), stent assisted coiling (37%), balloon assisted stent and coiling (8%), stent only (1%) and glue (2%). The permanent morbidity and mortality rates were 1% and 3%, respectively. Four adverse events were attributed to the patient's age. Posterior circulation aneurysms were associated with more adverse events (41%) than anterior circulation aneurysms (14%). Endovascular treatments using adjuvant techniques were associated with a higher complication rate than coiling alone.

CONCLUSIONS

With only a 4% permanent rate of neurological morbidity and mortality, endovascular treatment of unruptured aneurysms can be performed safely in the elderly. Age should not be the limiting factor when considering endovascular therapy.

Minimally invasive thoracic corpectomy and anterior fusion in a patient with metastatic disease: case report and review of the literature

For patients with metastatic disease to the spine there are numerous surgical approaches for decompression of neural elements and maintenance of mechanical stability. The challenge is to accomplish this while minimizing patient morbidity. Here we report on the feasibility and utility of a minimally invasive extreme lateral approach to the mid to high thoracic spine for anterior decompression and fusion.

Brain abnormalities in Sjogren syndrome with recurrent CNS manifestations: association with neuromyelitis optica

Background and objectives

Optic neuritis or longitudinally extensive myelitis in Sjogren syndrome (SS) suggests a neuromyelitis optica spectrum disorder (NMOSD). However, brain abnormalities of SS remain to be elucidated for the association with neuromyelitis optica (NMO).

Methods

Twelve primary SS patients (all women, 42 ± 13.2 years) who had recurrent central nervous system (CNS) manifestations with brain involvement were retrospectively identified. Brain MRI, and neurologic and serologic findings were analyzed with the measurement of anti-aquaporin-4 antibody (AQP4-Ab).

Results

All patients showed brain lesions characteristic of NMO as follows: 1) the involved sites adjacent to the third and fourth ventricles and in the posterior limb of the internal capsule, 2) unique configurations, such as the longitudinal course from the internal capsule to the midbrain, large cerebral or cerebellar lesions over 3 cm, and cavity-like formations. AQP4-Ab was positive in six of eight patients tested, and all the seropositive patients showed lesions with increased diffusion, suggestive of vasogenic edema. Four patients met the revised criteria of NMO, and nine had features of NMOSDs. Of the remaining three patients showing only brain involvement, one had AQP4-Ab.

Conclusions

This study demonstrates that SS patients with recurrent CNS involvement have brain abnormalities characteristic of NMO and AQP4-Ab in Korea. The presence of AQP4-Ab in one SS patient with only brain involvement may suggest that the coexistence of NMO should be explored in SS patients with recurrent CNS manifestations, even without optic neuritis or myelitis.

Long-term therapy with clevudine for chronic hepatitis B can be associated with myopathy characterized by depletion of mitochondrial DNA

Clevudine (Revovir), a pyrimidine nucleoside analogue, is a recently introduced antiviral drug. Clinical trials have demonstrated potent, sustained antiviral activity against hepatitis B virus without specific adverse events. The lack of cytotoxicity and absence of an effect on mitochondrial function have been considered the reasons for the fewer adverse events. However, it came to our attention that several hepatitis B patients developed myopathy during clevudine therapy. Our study was aimed to analyze the clinical and pathological features of patients with clevudine-induced myopathy with some consideration of its pathogenetic mechanism. Seven hepatitis B patients who developed severe skeletal myopathy during clevudine therapy were examined in this study. The demographic data, clinical features, pathological findings, and molecular studies of these patients were analyzed with speculation about the underlying pathogenic mechanisms. All seven patients were treated with clevudine for more than 8 months (8-13 months). In all, the main symptom was slowly progressive proximal muscular weakness over several months. A markedly elevated creatine kinase level and myopathic patterns on electromyography were found. Muscle biopsies revealed severe myonecrosis associated with numerous ragged red fibers, cytochrome c oxidase-negative fibers, and predominant type II fiber atrophy. Molecular studies using quantitative polymerase chain reaction showed a depletion of the mitochondrial DNA in the patients' skeletal muscle.

CONCLUSION

To the best of our knowledge, this is the first report of myopathy associated with clevudine therapy. This study has clearly shown that long-term clevudine therapy can induce the depletion of mitochondrial DNA and lead to mitochondrial myopathy associated with myonecrosis. Careful clinical and laboratory attention should be paid to patients on long-term clevudine therapy for this skeletal muscle dysfunction.

A Ubiquitous Chronic Disease Care system using cellular phones and the internet

AIMS

The rapidly increasing prevalence of chronic diseases is an important challenge to healthcare systems worldwide. To improve the quality and efficiency of chronic disease care, we investigated the effectiveness and applicability of the Ubiquitous Chronic Disease Care (UCDC) system using cellular phones and the internet for overweight patients with both Type 2 diabetes and hypertension.

METHODS

We conducted a randomized, controlled clinical trial over 3 months that included 123 patients at a university hospital and a community public health centre.

RESULTS

After 12 weeks, there were significant improvements in HbA(1c) in the intervention group (7.6 +/- 0.9% to 7.1 +/- 0.8%, P < 0.001) compared with the control group (7.4 +/- 0.9% to 7.6 +/- 1.0%, P = 0.03). Furthermore, we observed a significant reduction in systolic and diastolic blood pressure, as well as improvements in total cholesterol, low-density lipoprotein-cholesterol and triglyceride levels in the intervention group. Furthermore, there was a significant increase in adiponectin levels in the intervention group compared with the control group, although high-sensitivity C-reactive protein and interleukin-6 levels did not change in either group.

CONCLUSIONS

The novel UCDC system presented in this paper improved multiple metabolic parameters simultaneously in overweight patients with both Type 2 diabetes and hypertension.

Growth, characterization and technological applications of semiconductor SnO2 nanotubes and In2O3 nanowires

Tin dioxide nanotubes (200 nm in diameter) were synthesised by the sol-gel template method. The gas sensitivity of SnO2 nanotubes has been investigated. Due to the small grain size and large amount of grain boundary, SnO2 nanotubes demonstrated good sensitivity in sensing ethanol gas and had an ability to detect ammonia gas without any doping or surface modification. In2O3 semiconductor nanowires were synthesized efficiently by the chemical vapor deposition method through carbon thermal reduction. The diameter, length and morphologies of In2O3 nanowires can be varied by controlling the synthetic conditions. The In2O3 nanowires were characterised by field emission scanning electron microscopy (FE-SEM) and high resolution transmission electron microscopy (HRTEM). The application of In2O3 nanowires for gas sensors was tested.

Residual pelvic rotation after single-event multilevel surgery in spastic hemiplegia

Our aim in this retrospective study of 52 children with spastic hemiplegia was to determine the factors which affected the amount of residual pelvic rotation after single-event multilevel surgery. The patients were divided into two groups, those who had undergone femoral derotation osteotomy and those who had not. Pelvic rotation improved significantly after surgery in the femoral osteotomy group (p < 0.001) but not in the non-femoral osteotomy group. Multiple regressions identified the following three independent variables, which significantly affected residual pelvic rotation: the performance of femoral derotation osteotomy (p = 0.049), the pre-operative pelvic rotation (p = 0.003) and the post-operative internal rotation of the hip (p = 0.001). We concluded that there is a decrease in the amount of pelvic rotation after single-event multilevel surgery with femoral derotation osteotomy. However, some residual rotation may persist when patients have severe rotation before surgery.

In vivo and in vitro ethanol exposure in prenatal rat brain: GABA(B) receptor modulation on dopamine D(1) receptor and protein kinase A

We have investigated the effects of prenatal ethanol exposure on GABA(B) receptors (GABA(B)Rs), protein kinase A (PKA), and DA D(1) receptor (DAD(1)R) expressions. GABA(B1)R and GABA(B2)R showed different age-dependent expressions in in vivo fetal rat forebrain from gestational days (GD) 15.5 to 21.5 upon 10% ethanol treatment to mother, with and without baclofen at a dose of 10 mg/kg body weight/day. The protein level changes could not be attributed to changes in the level of transcription since GABA(B)R mRNA presented different expression patterns upon in vivo ethanol treatment. Using in vitro cultivated cortical neurons from GD 17.5 fetuses, we also explored the modulatory effects of ethanol on PKA and DAD(1)R through GABA(B)Rs, under 50 microM baclofen and 100 microM phaclofen administrations, with or without 100 mM of ethanol treatment in the culture media. The results showed that 20 min ethanol treatment without baclofen or phaclofen had increasing effects on both the GABA(B)Rs. Further, baclofen and phaclofen administration significantly affected PKA and GABA(B)R levels upon 20 min and 1 h ethanol treatment. In contrast, DAD(1)R showed increasing effects upon ethanol treatment, which was modulated by GABA(B)R's agonist baclofen and antagonist phaclofen. Therefore the present study suggested that the GABA(B)R activity could modulate ethanol's cellular effects, which possibly including PKA and DAD(1)R activities, and may be an underlying cause of ethanol's effects.

Effects of lysine intake during late gestation and lactation on blood metabolites, hormones, milk composition and reproductive performance in primiparous and multiparous sows

Modern genotype primiparous and multiparous sows (Yorkshire x Landrace, n=48) were used to evaluate effects of dietary lysine intake during late gestation and lactation, and their interaction on reproductive performance. Sows were randomly allotted to two gestation lysine (G, 0.6% or 0.8% lysine) treatments based on parity in a 2 x 2 factorial arrangement, and each treatment had 12 replicates comprising 1 sow. Then all the sows were assigned to two lactation lysine (L, 1.0% or 1.3% lysine) treatments within parity and gestation treatments in a 2 x 2 x 2 factorial design, and each treatment comprised six replicates with 1 sow/replicate during lactation. Feeding higher lysine level during gestation increased sow body weight and backfat thickness (P=0.001) and body condition was better (P=0.001) in multiparous than that of primiparous sows. Both of the lysine levels during lactation and parity influenced sow body condition and reproductive performance (P<0.05). Higher lysine intake during lactation increased the concentrations of total solids (P=0.024), protein (P=0.001) and solids not-fat (P=0.042) in colostrum and total solids (P=0.001), protein (P=0.001), fat (P=0.001) and solids not-fat (P=0.005) in milk. Protein concentration of milk was greater (P=0.001) in multiparous sows than that of primiparous sows. Feeding of high lysine diets resulted in an increment of plasma urea N (P=0.010; P=0.047) and a decrease of creatinine (P=0.045; P=0.002) on the day of postfarrowing and weaning, respectively. Furthermore, as lysine intake increased, the secretions of insulin, FSH, and LH were increased (P<0.05) and multiparous sows showed higher (P<0.05) concentrations of FSH and LH pulses on the day of postfarrowing and weaning, respectively. These results indicated that higher lysine intake than that recommended by NRC [NRC, 1998. Nutrient Requirements of Swine, 10th ed. National Academy Press, 458 Washington, DC] could improve sow performance during late gestation and lactation. Furthermore primiparous sows need higher lysine intake than multiparous sows. Moreover, nutritional impacts on reproduction may be mediated in part through associated effects on circulating LH concentration.

Overview of the cell cycle

Progression through the cell cycle is regulated by inductive signals from outside the cell and intracellular signal pathways, while the cycle itself is regulated by cyclin-dependent kinases (CDKs). An understanding of the functions of these molecules is necessary to understand the processes of mitosis, differentiation, senescence, apoptosis, and tumorigenesis. This overview reviews the current state of knowledge for the biology of the cell-cycle, the CDKs, the role of proteolysis, targets of the cell cycle machinery, and a paradigm of cell cycle analysis.

Low levels of serum cholesterol and albumin and the risk of community-acquired pneumonia in young soldiers

SETTING

The risk factors of community-acquired pneumonia (CAP) in high-risk groups have been examined in many studies. Such studies, however, have limited application for young people in special environments.

OBJECTIVE

To study the risk factors of CAP in young soldiers.

DESIGN

A hospital-based case-control study was carried out during the two winters between 2003 and 2005. A total of 255 CAP cases aged 18-23 years were enrolled and were matched by age and date of hospitalisation with 255 controls.

RESULTS

All CAP cases and 148 controls (58.0%) were military trainees. Most cases (96.1%) were non-severe CAP (pneumonia severity index risk class 1). Serum levels of total cholesterol, albumin, total protein and body mass index (BMI) were lower in CAP cases than in controls. In conditional logistic regression analysis, an increased risk of CAP was independently associated with military trainees, low levels of cholesterol and albumin. However, low BMI (<18.5 kg/m(2)) was not found to be associated with the risk of CAP after adjusting for other factors.

CONCLUSION

In Korea, the risk of CAP is significantly high in military trainees, with low levels of cholesterol and albumin being associated with the development of CAP in young soldiers.

Comparison of diabetic neuropathy symptom score and medial plantar sensory nerve conduction studies in diabetic patients showing normal routine nerve conduction studies

OBJECTIVE

Diabetic Neuropathy Symptom (DNS) scoring and medial plantar NCS are useful methods for diagnosis of diabetic polyneuropathy (DPN). We evaluated the correlation between DNS score and medial plantar NCS in diabetic patients with a normal routine NCS.

METHOD

Nineteen healthy subjects were included as a control group. Fifty patients with diabetes mellitus who were referred for the evaluation of DPN were recruited (35 asymptomatic and 15 symptomatic). Control subjects and diabetic patients over the age of 70 were excluded from this study.

RESULTS

Medial plantar nerve action potential (NAP) was recordable in all 19 control subjects and was not obtainable in 7 out of 15 symptomatic patients and in 5 out of 35 asymptomatic patients. The amplitudes of sural (Spearman r=-0.293, p=0.003) and medial plantar NAP (Spearman r=-0.215, p=0.03) correlated with DNS score.

CONCLUSION

An abnormality finding in the medial plantar sensory nerve conduction study is a more sensitive indicator than sural nerve conduction study in the diagnosis of DPN and the medial plantar sensory nerve should be included in the evaluation of DPN in patients showing normal routine NCS.

Ethanol's effect on intracellular signal pathways in prenatal rat cortical neurons is GABAB1 dependent

To confirm the modulation role of GABA(B) on ethanol' effects, we studied the effects of ethanol on the neuronal intracellular signals, protein kinase A (PKA) and cAMP-response element binding protein (CREB), by using a system where GABA(B1) receptors were specifically knocked down in the in vitro cultivated cortical neurons. The results showed that the PKA alpha subunit was increased with ethanol treatment, and could be further increased by administering baclofen and phaclofen. By contrast, baclofen and/or phaclofen could decrease ethanol's up-regulation effects on PKA alpha subunit expression in primary cultured cortical neurons in which the GABA(B1) receptor was specifically knocked down using GABA(B1) receptor RNA interference. Furthermore, these effects could lead to changes of phospho (p)-CREB expression, which showed the same expression pattern as PKA. Finally, we observed changes of GABA(B1), PKA, and p-CREB distribution within the same neuronal cells. These results showed that the GABA(B) receptors are critical to ethanol's cellular effects, which occur via modulating the PKA and CREB transcription pathway, and may be an underlying cause of ethanol's effects.

Anisotropy of the Sommerfeld coefficient in magnesium diboride single crystals

The anisotropic field dependence of the Sommerfeld coefficient gamma has been measured down to B-->0 by combining specific heat and Hall probe magnetization measurements in MgB2 single crystals. We find that gamma(B,theta) is the sum of two contributions arising from the sigma and pi band, respectively. We show that gammasigma(B,theta)=B/Bc2(theta) where Bc2(theta)=Bc2ab/sqrt[sin2theta+Gamma2cos2theta] with Gamma approximately 5.4 (theta being the angle between the applied field and the c axis) and gammapi(B,theta)=gammapi(B)=B/Bpi(B). The "critical field" of the pi band Bpi is fully isotropic but field dependent increasing from approximately 0.25 T for B< or =0.1 T up to 3 T approximately Bc2c for B-->3 T. Because of the coupling of the two bands, superconductivity survives in the pi band up to 3 T but is totally destroyed above for any orientation of the field.

Prenatal GABAB1 and GABAB2 receptors: cellular and subcellular organelle localization in early fetal rat cortical neurons

Gamma-aminobutyric acid (GABA)(B) receptors appear to influence developmental events, depending on whether they are found at a synapse or in extrasynaptic areas. Little, if anything, is known as to the cellular and subcellular localization of GABA(B1) and GABA(B2) receptors during early fetal development. We used Western blots, immunohistochemistry, and postembedding immunoelectronmicroscopy to investigate fetal rat brain expression and distribution of these receptor proteins. GABA(B1) is expressed as early as gestational day (GD) 11.5 and 12.5, with immunoreactivity found in the all neuroepithelium, and a high expression in the mantel zone and the cortical area's plate; no immunolabeling for GABA(B2) receptor was observed. Our immunogold studies define a pattern of early GABA(B1) receptor protein in dendrite processes, endoplasmic reticulum, and axon terminals of the cortical neuroepithelium on GD 11.5. On GD 12.5, GABA(B1) receptor immunogold was found in dendrite processes, spines and tree, axon terminals, mitochondria, and intracellular organelles of the cortical neuroepithelium. No synapse formation was apparent as no synaptophysin could be found on either GD 11.5 or 12.5. We suggest that GABA(B1) has a functional role in the early fetal brain during neuronal proliferation and migration, and that it is different from the established functional GABA(B) receptor.

New insight of amino acid-based dialysis solutions

Malnutrition is a major complication of peritoneal dialysis (PD) and is associated with increased morbidity and mortality. Daily losses of proteins and amino acids (AAs) into dialysate contribute to this problem. Previous metabolic balance study demonstrated that treatment with 1.1% AA-based dialysis solution is safe and may improve protein malnutrition in continuous ambulatory peritoneal dialysis (CAPD) patients ingesting low protein intake. Other prospective studies also showed that AA solution can provide nutritional benefit for malnourished PD patients resulting in a significant improvement in some biochemical and/or anthropometric nutritional parameters. However, there are other studies showing no particular improvement in nutritional parameters after long-term use of AA solution. This may be related to the differences in the study design, sample size, methods used to assess nutritional status, and other factors such as dietary intake and comorbidities of study subjects. Published data will be reviewed to further emphasize the nutritional benefit of long-term use of AA solution in malnourished PD patients along with a brief discussion on the various reasons that may partly explain the different study results. We will also present the results of a longitudinal observational study evaluating changes in nutritional parameters following use of one exchange of 1.1% AA solution in malnourished Korean PD patients. A significant improvement of somatic protein status such as lean body mass (LBM) and hand grip strength was observed. No significant change in serum albumin level was noted. Patients with a positive estimated coefficient for LBM in the fitted regression model to the repeated observations over 1 year were classified as responders and patients with neutral or negative coefficient were considered as non-responders. Thirty-one out of 43 malnourished patients (72%) showed nutritional benefit based on the change of LBM. Hand grip strength and back lift strength were significantly higher in responders at baseline. Other baseline parameters did not differ between the two groups.

Morphometric analysis of acetabular dysplasia in cerebral palsy

We carried out a morphometric analysis of acetabular dysplasia in patients with cerebral palsy requiring hip surgery using three-dimensional CT. We evaluated 54 hips in 27 patients. The contralateral normal hips of ten patients with unilateral Perthes’ disease were used as a control group. The acetabular defects were assessed qualitatively as anterior, posterior or global. Quantitative assessments were made using three-directional acetabular indices (anterosuperior, superolateral and posterosuperior) and measured by multiplanar reformation, from which we calculated the acetabular volume.

In the qualitative study, posterior defects were most common in the subluxation group whereas global defects predominated in the dislocation group. In the quantitative study, all acetabular indices in both the subluxation and dislocation groups were higher than those in the control group and the superolateral indices showed a tendency to elevation in the dislocation group. The acetabular volume was largest in the control group, smallest in the dislocation group, and intermediate between the two in the subluxation group.

Shear-dependent aggregation characteristics of red blood cells in a pressure-driven microfluidic channel

Though the aggregation of red blood cells (RBCs) is a major determinant of blood viscosity, there have not been any available techniques to measure the effect of RBC aggregation on blood viscosity over a range of shear rates. The microfluidic shearing technique with vibration has been applied to an aggregometer for measuring the dynamic aggregation characteristic of RBCs. In measuring backscattered light intensity I(t) and pressure p(t) over time, both aggregation and the stress-shear rate information can be determined simultaneously. The feasibility and accuracy of the new aggregation measurement technique has been demonstrated to correlate with blood viscosity for normal and heated blood. We found that RBC aggregability showed shear-dependent behavior, which can be correlated directly with shear-thinning blood viscosity. The present measurements of the dynamic aggregation characteristic over shear rate enable the interpretation of the shear-rate dependent blood viscosity, which is greatly affected by RBC aggregation.

Comparison of evidence-based therapeutic intervention between community- and hospital-based primary care clinics

The purpose of this study was to compare the proportion of therapeutic interventions that is supported by scientific evidence between hospital-based and community-based primary care clinics. The study setting is a primary care clinic in university-affiliated tertiary hospital and community-based primary care clinic in a region in Seoul. A retrospective review of patients' medical records was done according to the primary diagnosis and treatment for 890 patients in community-based clinic and 307 in hospital-based clinic. The evidence for the intervention was searched for in Medline (1966-2001) and other evidence-based databases. The evidence was then classified as one of the three categories (i) evidence from randomised controlled trials (RCTs); (ii) convincing non-experimental evidence; and (iii) interventions without substantial evidence. In the hospital-based clinics, out of 356 primary diagnosis and treatment pairs, 59.6% were supported by evidence from at least one RCTs, and 19.4% were supported by convincing non-experimental evidence. In the community-based clinics, 47.1% out of 893 pairs and 10.5% fell into each category. As a result, the proportion of interventions in community settings that were based on evidence meeting our criteria was significantly lower than that of the hospital-based settings. To facilitate evidence-based practice, supportive activity should be focused on the primary care settings based on community where medical practices are less evidence-based.

Muon-spin-rotation measurements of the penetration depth of the infinite-layer electron-doped Sr0.9La0.1CuO2 cuprate superconductor

Muon-spin-rotation (muSR) measurements of the in-plane penetration depth lambda(ab) have been performed in the infinite-layer electron-doped Sr0.9La0.1CuO2 high-T(c) superconductor (HTS). Absence of the magnetic rare-earth ions in this compound allowed us to measure for the first time the absolute value of lambda(ab)(0) in electron-doped HTSs using muSR. We found lambda(ab)(0)=116(2) nm. The zero-temperature depolarization rate sigma(0) proportional, variant 1/lambda(2)(ab)(0)=4.6(1) micros(-1) is more than 4 times higher than expected from the Uemura line. Therefore, this electron-doped HTS does not follow the Uemura relation found for hole-doped HTSs.

Ethanol modulates the expression of GABAB receptor mRNAs in the prenatal rat brain in an age and area dependent manner

Prenatal ethanol exposure has various deleterious effects on neuronal development. As GABA(B) receptor is known to play an important role during the development of the CNS, we now focused on its mRNA expression pattern in the rat brain during the late gestational days (GD) from 15.5 to GD 21.5. Ethanol's effect was also observed from GD 11.5 to GD 21.5. GABA(B1) receptor mRNA showed a high expression level in GD 15.5 and 19.5, while GABA(B2) receptor mRNA did in GD 15.5 and 21.5. The mRNAs levels depended on age and area during development. Ethanol exposure decreased GABA(B1) receptor from GD 11.5 to GD 19.5 with slight increases in GD 21.5. The decreasing effects were area dependent, with the highest effects in the forebrain including cortex, whereas slight effects were observed in the midbrain and hindbrain. The present results suggest an important role of GABA(B) receptor in the effects of ethanol on prenatal brain developmental processes.

Sequence variation in the gene encoding the major capsid protein of Korean fish iridoviruses

Ten iridoviruses were isolated from cultured fish from various regions in Korea; 7 from rock bream, 1 from red sea bream, 1 from sea bass, and 1 from rockfish. The full open-reading frame (ORF) encoding the major capsid protein (MCP) (1362 bp) from ten iridoviruses were sequenced and the nucleotide sequences were phylogenetically analyzed. Phylogenetic analysis revealed that the ten Korean isolates were classified into one cluster. However, their sequences were not identical and, based on the nucleotide sequence variation, they could be further divided into two subgroups. While nine Korean isolates were similar to the Japanese isolate red sea bream iridovirus (RSIV), one isolate was distinct from other iridovirus isolates. These results suggest that a diversity of iridoviruses exist in Korea and that a new variant strain has emerged.

Routine transradial access for conventional cerebral angiography: a single operator's experience of its feasibility and safety

The purpose of this study is to describe a single operator's experience with the feasibility and safety of transradial access in conventional cerebral angiography. 153 patients were enrolled consecutively. Among them, 20 patients were not suitable for transradial access. A Simmons catheter was used. Haemostasis was achieved using a compressive dressing of the wrist. We analysed the success rates of the arterial puncture and the successful catheterization rate for each supra-aortic vessel as well as all complications. The arterial access was successful in 96.3%. The supra-aortic vessels were catheterized with success rates of 99.2% (127/128) for the left subclavian artery and 100% for the other arteries. The mean procedure time was 19.3 min (range 10-55 min). Haemostasis was successfully achieved in every case. The most frequent complication was arm pain which occurred in 37 patients (28.9%). In conclusion, transradial selective cerebral angiography with a reversed-angle catheter is technically feasible and safe. It might be helpful in imaging follow-up of patients with arterial stenting or coil embolisation of the cerebral aneurysms. Modification of the catheter design is required to improve the selectivity of the supra-aortic branches.

Familiarity with, knowledge of, and attitudes toward epilepsy in residents of Seoul, South Korea

BACKGROUND AND PURPOSE

The aim of this study was to investigate the perceptions of epilepsy in Seoul, South Korea, a country where social stigma toward epilepsy is still pronounced.

METHODS

We randomly selected 1000 persons living in Seoul and performed telephone interviews regarding public awareness, knowledge, and attitudes toward epilepsy.

RESULTS

Among 1000 respondents, the 92% who had read or heard about epilepsy became the subjects of the study. Word of mouth was most often referenced as a source of knowledge (78%). Forty-seven percentage believed that epilepsy is inheritable, whereas 5% thought that epilepsy is a mental illness. Marriage of their children to an epileptic person, childbearing by women with epilepsy, and employing a person with epilepsy were opposed by more than 50% of respondents. The reasons for the negative attitudes were that epilepsy was hereditary and untreatable (P < 0.05, respectively).

CONCLUSIONS

Our study revealed that there still remains negative attitudes regarding the marriage, childbearing, and employment of persons with epilepsy, which may stem from misconceptions about the cause and treatability of epilepsy, possibly due in part to the influence of herbal medicine, and South Korea's ethnic homogeneity. Public health education either through media or school health education is urgently needed to improve knowledge about, and attitudes toward epilepsy.

The TB structural genomics consortium: a resource for Mycobacterium tuberculosis biology

The TB Structural Genomics Consortium is an organization devoted to encouraging, coordinating, and facilitating the determination and analysis of structures of proteins from Mycobacterium tuberculosis. The Consortium members hope to work together with other M. tuberculosis researchers to identify M. tuberculosis proteins for which structural information could provide important biological information, to analyze and interpret structures of M. tuberculosis proteins, and to work collaboratively to test ideas about M. tuberculosis protein function that are suggested by structure or related to structural information. This review describes the TB Structural Genomics Consortium and some of the proteins for which the Consortium is in the progress of determining three-dimensional structures.

Sludge thickening performance of mesh filtration process

Small-scale wastewater treatment facilities play an important role in improving the aquatic environment in many countries. Although sludge treatment is essential for overall wastewater treatment, it is difficult for small-scale facilities to use mechanical equipment or other facilities. As the first step of the sludge treatment, it is important to develop a convenient sludge thickening process for small-scale facilities. In this work, we examined the sludge thickening performance of a mesh filtration system: the mesh opening sizes of 100-500 microm, and the sludge (3,000-9,000 mg-SS/L) was obtained from a domestic wastewater treatment facility. The filtration was carried out only under the hydraulic pressure between the water level and the effluent port connected to the mesh filter module. The sludge reduction rates were in the range of 85-95% for 6-7 h; the initial filtration rate was very high, but the rate decreased with a decrease in hydraulic pressure due to the reduction of the water level in the vessel. In addition, the effluents (passed through the mesh) contained very low SS and could be directly discharged into the environment.

Multiple mechanisms for oxygen-induced regulation of the Clara cell secretory protein gene

The Clara cell secretory protein (CCSP) imparts a protective effect to the lung during oxidant injury. However, exposure to supplemental oxygen, a common therapeutic modality for lung disease, represses the expression of CCSP in the adult mouse lung. We investigated the mechanisms of hyperoxia-induced repression of the mouse CCSP promoter. Deletion experiments in vivo and in vitro indicated that the hyperoxia-responsive elements are localized to the proximal -166 bp of the CCSP promoter. Electrophoretic mobility shift and supershift analyses demonstrated increased binding of c-Jun at the activator protein-1 site, increased binding of CCAAT/enhancer binding protein (C/EBP) beta at the C/EBP sites, and decreased binding at the Nkx2.1 sites. Western analyses revealed that hyperoxia exposure induced an increase in the expression of the C/EBPbeta isoform liver-inhibiting protein (LIP) and an increase in cytoplasmic Nkx2.1. Cotransfection of LIP or c-Jun expression plasmids decreased the transcriptional activity of the proximal -166-bp CCSP promoter. These observations suggest that hyperoxia-induced repression of the CCSP gene is mediated, at least in part, at the level of transcription and that multiple mechanisms mediate this repression. Moreover, these novel observations may provide insights for generation of therapeutic interventions for the amelioration of oxidant-induced lung injury.

Dietary supplementation of (+)-catechin protects against UVB-induced skin damage by modulating antioxidant enzyme activities

PURPOSE

The aim of this study was to investigate the effects of dietary supplementation with (+)-catechin on cutaneous antioxidant enzymes and the skin damage caused by UVB irradiation.

METHODS

BALB/c mice were divided into three groups. Each group was fed a regular diet (RD) or a 2% catechin-supplemented diet for either 2 weeks (2CSD) or 4 weeks (4CSD) ad libitum prior to UVB irradiation. Skin was removed for the antioxidant enzyme assay, hematoxylin and eosin staining, and the TEM analysis before and at various time points after UVB (200 mJ/cm2) irradiation.

RESULTS

Before UVB irradiation, the superoxide dismutase (SOD) and catalase (CAT) activities of the 2CSD and the 4CSD groups were found to be lower than those of the RD group, whereas the glutathione peroxidase (GPx) activity of the 4CSD group was higher than those of the RD and the 2CSD groups (P<0.05). The SOD and CAT activities of the RD group decreased after UVB irradiation, while those of the 2CSD and the 4CSD groups increased immediately after irradiation and then decreased (P<0.05). Immediately after UVB irradiation, the GPx activities of the 4CSD and the 2CSD groups increased, but that of the RD group decreased. The GPx activity of all three groups showed a tendency to return to pre-UVB irradiation levels with time. Light microscopic findings of the RD group showed epidermal thinning and apoptotic cells at 24 h after UVB irradiation and mostly necrotic cells at 48 h, whereas only moderate thickening of the epidermis was observed in the 2CSD group at 48 h after irradiation. An electron microscopic examination produced similar findings. At 48 h after irradiation, nearly all epidermal cells seemed to be damaged in the RD group as compared to the 2CSD group.

CONCLUSION

These results demonstrate that dietary supplementation with (+)-catechin could protect epidermal cells against UVB-induced damage by modulating antioxidant enzyme activities.

Transcriptional regulation of CCSP by interferon-gamma in vitro and in vivo

Interferon gamma (IFN-gamma), a potent cytokine inducing a wide range of immunologic activities, is increased in the airway secondary to viral infection or during an inflammatory response. This increase in IFN-gamma concentration may alter the expression of specific airway epithelial cell genes that regulate adaptation of airway inflammatory responses. One protein induced by IFN-gamma is Clara cell secretory protein (CCSP), which may contribute to the attenuation of airway inflammation. This study was done to investigate the molecular mechanism by which IFN-gamma stimulates the expression of the CCSP gene in mouse transformed Clara cells and transgenic mice. Deletion mapping and linker-scanning mutations demonstrated that IFN-gamma-induced expression of CCSP was regulated, in part, at the level of transcription. In vitro and in vivo studies verified that the minimal IFN-gamma-responsive segment was localized to the proximal 166 bp of the 5'-flanking region. Additionally, IFN-gamma-induced expression of CCSP was mediated indirectly through an interferon regulatory factor-1-mediated increase in hepatocyte nuclear factor-3beta.

l-myc Polymorphism in Gastric Cancer, Lung Cancer, and Hepatocellular Carcinoma

PURPOSE

This study was performed to see if a particular polymorphism in the l-myc, a nuclear oncogene at the 1p32 locus, might be associated with greater risk of gastric cancer, lung cancer and hepatocellular carcinomas (HCC) in Korean patients.

MATERIALS AND METHODS

Genomic DNA, derived from patients diagnosed with gastric cancer (n=57), lung cancer (n=39), HCC (n=35) and healthy individuals (n= 176), was examined. The l-myc polymorphism under study was visualized by PCR followed by EcoRI digestion.

RESULTS

There was no significant difference in the distribution of the l-myc polymorphism genotypes and allele frequencies between the cancer patients and the controls.

CONCLUSION

The l-myc polymorphism does not appear to be indicative of elevated risk of cancers of the stomach, lung and HCC.

A recurred carotid siphon pseudoaneurysm after detachable coil embolization. Successfull endovascular management with detachable balloons

SUMMARY

Massive posterior epistaxis is one of the peculiar symptoms of pseudoaneurysms of the carotid siphon. We experienced a case of trauma- related pseudoaneurysm of the carotid siphon. The lesion was initially silent except for the mass effect. We initially treated the lesion with platinum detachable coil embolization of the pseudoaneurysm sac with preservation of the parent artery. However, the patient had delayed massive epistaxis with recurrence of the pseudoaneurysm. The patient was subsequently managed with endovascular occlusion of the affected internal carotid artery using detachable balloons. Complete internal carotid artery trapping is recommended as an initial treatment modality if the patient can tolerate to the occlusion test. Careful observation and follow-up of the patient is required if the lesion is inevitably managed with coil embolization of the pseudoaneurysm sac alone.

A non-class I MHC intestinal epithelial surface glycoprotein, gp180, binds to CD8

The activation of CD8(+) T cells by normal intestinal epithelial cells in antigen-specific or allogeneic mixed cell culture systems has significant implications for the modulation of mucosal immune responses due to the fact that these T cells appear to have regulatory rather than cytolytic activity. A 180-kDa glycoprotein (gp180) has been identified and shown to be important in CD8(+) T cell activation by intestinal epithelial cells. In this study, we examine, in further detail, the role that the CD8 molecule plays in this interaction. It has been previously shown that monoclonal antibodies against gp180 inhibited the activation of CD8-associated p56(lck) in T cells. Although indirectly suggested by these data, there was no evidence that the activation of this protein tyrosine kinase was a direct result of gp180 interacting with the CD8 molecule. In this study, we document that soluble gp180 is able to bind to CD8-Fc fusion proteins and is absorbed by human CD8 alpha but not CD4 transfected murine T cells and that this interaction is dependent upon carbohydrate on the gp180 molecule. Furthermore, the sites used for binding by gp180 are distinct from those used by the conventional CD8 ligand, class I MHC. Thus, gp180 appears to be a novel CD8 ligand that plays an important role in the activation of CD8-associated kinases and of CD8(+) T cells.

Thrombospondin-1, vascular endothelial growth factor expression and their relationship with p53 status in prostate cancer and benign prostatic hyperplasia

OBJECTIVE

To evaluate the expression of thrombospondin-1 (TSP-1, a potent inhibitor of angiogenesis) and vascular endothelial growth factor (VEGF, an important angiogenic factor in solid tumours) in prostate cancer, and their relationship with p53 status.

PATIENTS AND METHODS

Using immunohistochemistry, the expression of VEGF, TSP-1 and p53 was assessed in 82 archival tissue specimens from 23 patients with benign prostatic hyperplasia (BPH), 22 with localized prostate cancer and 37 with metastatic prostate cancer. Seven of the last group had received androgen deprivation therapy. The relationship between the expression of VEGF, TSP-1 and p53 status was also evaluated with tumour grade and stage in patients with prostate cancer.

RESULTS

The seven patients receiving hormonal treatment were excluded from the analysis because androgen deprivation significantly increased TSP-1 and decreased VEGF expression (both P < 0.01). Immunohistochemical analysis showed significantly higher VEGF and significantly lower TSP-1 expression (both P < 0.01) in prostate cancer than in BPH tissues. There was also significantly higher VEGF and significantly lower TSP-1 expression (both P < 0.05) in tissues from metastatic than localized prostate cancer. There was no significant correlation between VEGF or TSP-1 expression and Gleason score, but a significant inverse correlation between TSP-1 and VEGF expression. There was a significant association between VEGF expression and p53 status (P < 0.05), but TSP-1 expression was not associated with p53 status.

CONCLUSIONS

Angiogenic factors, including VEGF and TSP-1, might be important in the development and progression of prostate cancer. These changes seem to be influenced by p53 status. Identifying the angiogenic factors involved in prostate cancer might lead to the development of diagnostic or therapeutic strategies based on anti-angiogenesis.

Recombinant Newcastle disease virus as a vaccine vector

A complete cDNA clone of the Newcastle disease virus (NDV) vaccine strain Hitchner B1 was constructed, and infectious recombinant virus expressing an influenza virus hemagglutinin was generated by reverse genetics. The rescued virus induces a strong humoral antibody response against influenza virus and provides complete protection against a lethal dose of influenza virus challenge in mice, demonstrating the potential of recombinant NDV as a vaccine vector.

Determination of propranolol concentration in small volume of rat plasma by HPLC with fluorometric detection

A simple, rapid and sensitive fluorescence high performance liquid chromatographic method was developed to determine propranolol concentration in the small volume of rat plasma without the solvent extraction step using pronethanol as the internal standard. The analysis was accomplished using a 5 microm CAPCELL PAK analytical cyano column at room temperature and a mobile phase consisted of 1% aqueous acetic acid containing 0.2% triethylamine and acetonitrile (65:35, v/v; pH 3.8). The flow-rate was kept at 0.5 mL/min and column effluent was monitored with a fluorescence detector at an excitation wavelength of 230 nm and an emission wavelength of 340 nm. Retention times for pronethalol and propranolol were 8.5 min and 10.5 min, respectively. Linear regressions for the standard curves were linear in the range 2-800 ng/mL, giving correlation coefficients above 0.998. The detection limit was 1.34 ng/mL. No analytical interference was observed from endogenous components in rat plasma. This simple and sensitive assay method was feasibly applied to the pharmacokinetic study of propranolol after intravenous administration of 2 mg/kg of propranolol to normal and carbon tetrachloride-induced liver cirrhotic rats.

Bile duct injuries leading to portal vein obliteration after transcatheter arterial chemoembolization in the liver: CT findings and initial observations

PURPOSE

To document the computed tomographic (CT) findings of transcatheter arterial chemoembolization (TACE)-induced, localized bile duct injuries leading to portal vein branch obliteration in the liver and to elucidate the clinical implications with retrospective review of the authors' experiences.

MATERIALS AND METHODS

Follow-up CT scans obtained in 11 patients with TACE-induced intrahepatic bile duct dilatation were reviewed retrospectively to evaluate serial changes in the adjacent portal vein branches and hepatic parenchyma. Clinical data, including time between TACE and CT and serum alkaline phosphatase levels, also were analyzed.

RESULTS

Of 11 patients with marked (n = 8) or mild (n = 3), lobar (n = 4) or segmental (n = 7) bile duct dilatation with or without bile collection in the tissue sheaths of the Glisson capsule or hepatic parenchyma, nine (82%) had bile duct changes at the first CT follow-up, within 1 month after TACE. Marked narrowing or obliteration of the adjacent intrahepatic portal vein branches in 10 (91%) patients resulted in progressive atrophy of the corresponding hepatic parenchyma in nine (82%) at variable times after TACE. The serum alkaline phosphatase level increased to more than 200 U/L in eight (89%) of nine patients 1 month after TACE.

CONCLUSION

TACE-induced intrahepatic bile duct injury resulting in obliteration of the adjacent portal vein branch seems to be one cause of hepatic parenchymal atrophic changes after TACE.

Solution structure of Pyrobaculum aerophilum DsrC, an archaeal homologue of the gamma subunit of dissimilatory sulfite reductase

The solution structure of DsrC, an archaeal homologue of the gamma subunit of dissimilatory sulfite reductase, has been determined by NMR spectroscopy. This 12.7-kDa protein from the hyperthermophilic archaeon Pyrobaculum aerophilum adopts a novel fold consisting of an orthogonal helical bundle with a beta hairpin along one side. A portion of the structure resembles the helix-turn-helix DNA-binding motif common in transcriptional regulator proteins. The protein contains two disulfide bonds but remains folded following reduction of the disulfides. DsrC proteins from organisms other than Pyrobaculum species do not contain these disulfide bonds. A conserved cysteine next to the C-terminus, which is not involved in the disulfide bonds, is located on a seven-residue C-terminal arm that is not part of the globular protein and is likely to dynamically sample more than one conformation.

Morphology and biology of parasite responsible for scuticociliatosis of cultured olive flounder Paralichthys olivaceus

Based on the arrangement and shape of the buccal structure, scuticociliates isolated from cultured olive flounder Paralichthys olivaceus belonged to the family Uronematidae and showed many characteristics of Uronema marinum. There was variation in the morphometry of clinical isolates taken from different organs of infected flounder. However, the isolates did not show any significant difference in morphometry under cultured conditions. The ciliates were easily maintained in in vitro medium to which antibiotic agents had been added and which had been enriched with the raw brain tissue of a healthy olive flounder. The ciliates propagated in a wide range of both temperature (6 to 30 degrees C) and salinity (10 to 35 ppt).

A case of del(13)(q22) with multiple major congenital anomalies, imperforate anus and penoscrotal transposition

"13q-"syndrome is known to have widely variable manifestations, including retinoblastoma, mental & growth retardation, malformation of brain & heart, anal atresia, and anomalies of the face and limbs. Here we report a case of del(13)(q22) with multiple major congenital anomalies for the first time in Korea. The patient was born at 36(+4) weeks of pregnancy by caesarian section. Birth weight was 1490g. On examination the following features were noted: - imperforate anus, ambiguous genitalia (bifid scrotum, penoscrotal transposition, hypospadia), syndactyly of toes, absence of thumbs, abnormal facies (dolichocephaly, telecanthus, large low set ears, saddle nose, high arched palate, micrognathia). Neurocranial ultrasonography showed atrophy of the corpus callosum and multiple calcifications. He died at 14 days. Post-mortem autopsy findings showed cholestasis and fatty metamorphosis of liver, abnormal lobulation (Rt:2, Lt:1) and lymphangiectasis of the lung, VSD, ASD, PDA of heart, and acute tubular necrosis of kidney. Cytogenetic studies was confirmed to 46,XY,del(13) (q22) by Giemsa banded chromosomes from peripheral blood lymphocytes.