STAT3 and ERK Signaling Pathways Are Implicated in the Invasion Activity by Oncostatin M through Induction of Matrix Metalloproteinases 2 and 9

PURPOSE: Our previous studies have shown that oncostatin M (OSM) promotes trophoblast invasion activity through increased enzyme activity of matrix metalloproteinase (MMP)-2 and -9. We further investigated OSM-induced intracellular signaling mechanisms associated with these events in the immortalized human trophoblast cell line HTR8/SVneo. MATERIALS AND METHODS: We investigated the effects of OSM on RNA and protein expression of MMP-2 and -9 in the first-trimester extravillous trophoblast cell line (HTR8/SVneo) via Western blot. The selective signal transducer and activator of transcription (STAT)3 inhibitor, stattic, STAT3 siRNA, and extracellular signal-regulated kinase (ERK) siRNA were used to investigate STAT3 and ERK activation by OSM. The effects of STAT3 and ERK inhibitors on OSM-induced enzymatic activities of MMP-2 and -9 and invasion activity were further determined via Western blot and gelatin zymography. RESULTS: OSM-induced MMP-2 and -9 protein expression was significantly suppressed by STAT3 inhibition with stattic and STAT3 siRNA silencing, whereas the ERK1/2 inhibitor (U0126) and ERK silencing significantly suppressed OSM-induced MMP-2 protein expression. OSM-induced MMP-2 and MMP-9 enzymatic activities were significantly decreased by stattic pretreatment. The increased invasion activity induced by OSM was significantly suppressed by STAT3 and ERK1/2 inhibition, though to a greater extent by STAT3 inhibition. CONCLUSION: Both STAT3 and ERK signaling pathways are involved in OSM-induced invasion activity of HTR8/SVneo cells. Activation of STAT3 appears to be critical for the OSM-mediated increase in invasiveness of HTR8/SVneo cells.

The Effect of Electrocautery around the Patellar Rim in Patellar Non-Resurfacing Total Knee Arthroplasty

PURPOSE: The purpose of this study was to evaluate the clinical effect of electrocautery on the reduction of pain in patellar non-resurfacing bilateral total knee arthroplasty. MATERIALS AND METHODS: A total of 50 patients were enrolled into this study; all patients had undergone bilateral patellar non-resurfacing total knee arthoplasty at our hospital, between January 2007 to December 2008. The minimum follow-up period was 1 year. The electrocautery of the patellar rim was performed randomly on one side only. The clinical results were evaluated between the electrocautery group and the non-electrocautery group based on measures of anterior knee pain, range of motion, American Knee Society clinical rating score, Feller knee score, Western Ontario and McMaster Universities score, and radiographic analysis. RESULTS: There were statistically significant differences between preoperative and postoperative status for all parameters. There were no statistically significant differences noted between the electrocautery group and the non electrocautery group for all parameters. CONCLUSIONS: Electrocautery of patellar rim is thought to be less effective in reducing anterior knee pain.

Patellar Clunk Syndrome with Polyethylene Wear and Medial Synovial Hypertrophy after Mobile Bearing Total Knee Arthroplasty: A Case Report

Patellar clunk syndrome after total knee arthroplasty is a complication that causes pain and poping or catching of patella. We experienced a case after mobile bearing total knee arthroplasty that medial synovial tissue was impinged between patella and femoral component and intra-articular fibrotic nodule of superior pole of patella was observed. Also, wear of Polyethylene were observed at anterio side. We resolved the patient symptom after excision of fibrotic nodule, synovectomy of medial synovial hypertrophy, and change of polyethylene. We report this case with literature review.

Sero-surveillance of Transmissible Gastroenteritis Virus (TGEV) and Porcine Respiratory Coronavirus (PRCV) in South Korea

Transmissible gastroenteritis (TGE) is sporadic in South Korea. Since porcine respiratory coronavirus (PRCV) infection was identified in South Korea in 1996, the TGE infection has decreased with the PRCV occurrence. In this study, we described the sero-surveillance of TGE/PRCV infection by using a commercially available ELISA kit. A total of 1,295 sera from slaughtered pigs and 69 sera from wild boars were collected in years 2009 and 2010 throughout the country and tested for antibodies against TGE and PRCV. Although there was no clinical sign observed for TGE and vaccination had not been done for TGEV, 4.9% of sera showed positive for antibody against TGEV. Furthermore, 63.7% of finisher and 8.7% of wild boars were positive for antibody against PRCV. Our result suggests that the TGEV infection might still be present in some farms in South Korea.

Ceramic-on-Ceramic Bearing Total Hip Arthroplasty: Five-Year Midterm Follow-up Results

PURPOSE: We believe that cemented femoral stems will relieve the stiffness of ceramic-based bearings, resulting in reduced complication of ceramic-on-ceramic bearing total hip arthroplasty (THA). The purpose of this study was to evaluate the midterm effect of ceramic-on-ceramic bearing THA using cemented femoral stems. MATERIALS AND METHODS: We studied 32cases (30 patients) of THA using ceramic-on-ceramic bearing cemented femoral stems and 33 cases (31 patients) of THA using ceramic-on-ceramic bearing cementless femoral stems. All total hip arthroplasties were performed between January 2004 and December 2005 and were followed up for more than 5 years. The clinical results and radiographic results were evaluated. RESULTS: The mean HHS improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). The mean WOMAC score also improved from points pre-operatively to points at the last follow-up in both the cemented and cementless stem groups (P<0.05). But no statistically significant difference was noted between the cemented and cementless stem groups in HHS and WOMAC scores (P=0.304, P=0.769). There were 3 patients with a sense of discomfort on ambulation and 5 patients with thigh pain in the cementless stem group and no cases in the cemented stem group. There was no instance of acetabular loosening in either group. Subsidenc of the cemented femoral stem was less than 1mm in 30 cases and less than 2 mm in 2 cases. All cementless femoral stems acquired firm bony union. CONCLUSION: Midterm results showed no statistical links between ceramicon-ceramic-bearing THA using cemented femoral stems or cementless femoral stems.

The Effect of Conservative Treatment for the Calcific Tendinitis on Gluteus Medius Tendon / 대한스포츠의학회지

Calcific tendinitis on gluteus medius tendon of the amateur athletes were reviewed, and a study on the therapeutic effect of conservative treatment methods. From January 2003 to December 2010, among the patients who had been treated with calcific tendinitis on gluteus medius tendon, there were nine patients available to monitor more than a year as outpatients. ten cases were observed from them and were retrospectively analyzed and magnetic resonance examinations were performed in every case. All of the ten cases were initially treated with non-steroid anti-inflammatory oral doses. If a non-steroid anti-inflammatory treatment could not relieve pain or caused an aggravation of a condition, a local steroid injection was enforced. There were responses to non-steroid antiinflammatory oral doses of therapeutic methods in four cases and the time required for the symptoms to be improved was approximately 3 weeks (range: 1-3 weeks). In the remainder of six cases, conditions got worsened or did not improve even after 3 weeks. In these cases, the condition was altered for better in 3 days (range: 1-3 days) by using local steroid injections. There was no recurrence in all cases. The amateur athlete with a severe pain around his or her hip joint should be questioned with calcific tendinitis on gluteus medius tendon and differential diagnosis of hip around diseases. After calcific tendinitis was diagnosed, initial treatment was considered conserevative treatment. Although it is invasive, the initial treatment with a local steroid injection is considered to be helpful in treating amateur athletes with calcific tendinitis.

Molecular characterization of Korean rabies virus isolates

The nucleoprotein (N) and glycoprotein (G) of 11 Korean rabies virus (RABV) isolates collected from animals diagnosed with rabies between 2008 and 2009 were subjected to molecular and phylogenetic analyses. Six isolates originated from domestic animals (cattle and dogs) and five were obtained from wild free-ranging raccoon dogs. The similarities in the nucleotide sequences of the N gene among all Korean isolates ranged from 98.1 to 99.8%, while those of the G gene ranged from 97.9 to 99.3%. Based on the nucleotide analysis of the N and G genes, the Korean RABV isolates were confirmed as genotype I of Lyssavirus and classified into four distinct subgroups with high similarity. Phylogenetic analysis showed that the Korean isolates were most closely related to the non-Korean NeiMeng1025B and 857r strains, which were isolated from rabid raccoon dogs in Eastern China and Russia, respectively. These findings suggest that the Korean RABV isolates originated from a rabid raccoon dog in Northeastern Asia. Genetic analysis of the Korean RABV isolates revealed no substitutions at several antigenic sites, indicating that the isolates circulating in Korea may be pathogenic in several hosts.

Molecular Identification of the Vaccine Strain from the Inactivated Rabies Vaccine

Since 1994, several different inactivated rabies vaccines have been used to immunize domestic animals such as dogs, cats, and cattle in South Korea. The Korean Veterinary Authority has conducted safety and efficacy testes of inactivated vaccines using laboratory animals. In this study, we applied a molecular method to investigate the genetic characterization of the rabies virus (RABV) genes in six commercial inactivated rabies vaccines, and determined the efficiency of two extraction reagents (i.e., sodium citrate or isopropyl myristate) to separate the vaccine antigens from the antigen/adjuvant complexes. Six partial nucleocapsid (N: 181 bp) and five partial glycoprotein (G: 306 bp) genes were successfully amplified with specific primer sets, which demonstrated that sodium citrate is more efficient than isopropyl myristate in extracting viral RNA from inactivated gel vaccines. In addition, we identified the viral strain of the vaccine by analyzing the nucleotide sequences of the N and the G genes. The nucleotide similarity of the partial N and G genes ranged from 97.1 to 99.4% and from 91.8 to 100% among rabies vaccine strains, respectively, indicating that each manufacturer used different rabies virus strains to produce their vaccines. The molecular method used in this study could also be used to identify viral strains in other inactivated vaccines.

Results of Osteoporotic Treatment Drug after Periarticular Fracture of Hip

PURPOSE: The Purpose of the study is to know patients' compliance of drug treatment of osteoporosis after operation of fracture and to compare of accompanying fractures between patients who diagnosed with osteoporosis itself and had the drug treatment of osteoporosis after surgery of periarticular fracture of hip. MATERIALS AND METHODS: In experimental group, consecutive 60 patients who had fracture of femoral neck and trochanter. And in control group, 61 patients diagnosed osteoporosis with drug treatment within the same period in orthopedic department from July 2006 to July 2007. The average age is 73.8 (+/-6.7) year in experimental group, and 66.6 (+/-7.46) year in control group. Both groups had at least a year follow-up with drug treatment and had BMD again at least a year later. RESULTS: BMD test in experimental group showed -3.05 (+/-1.35) preoperatively and -2.74 (+/-1.50) in last follow-up. BMD test in control group showed -3.55 (+/-0.52) in initial administration and -3.10 (+/-0.87) in last follow-up. The results showed a significant improvement in statistical analysis (p=0.0002, p<0.0001). CONCLUSION: The compliance of drug treatment of osteoporosis after operation of periarticular fracture of hip is the same as in patients' diagnosed osteoporosis.

Influence of VEGF Genetic Polymorphism on Peritoneal Solute Transport in Pediatric Dialysis Patients

PURPOSE: Genetic and clinical factors can influence the permeability of the peritoneal membrane. The peritoneal equilibration test (PET) is helpful in measuring peritoneal permeability in peritoneal dialysis (PD). We investigated the influence of genetic polymorphism of vascular endothelial growth factor (VEGF) on the PET parameters. METHODS: Pediatric patients who underwent PET within 12 months of initiating PD at Seoul National University Children's Hospital and Samsung Medical Center were selected. The patients with positive history of peritonitis before PET were excluded. The VEGF -2578C/A, -14978T/C, -1154G/A, -634G/C, and +936C/T single-nucleotide polymorphisms were genotyped. RESULTS: The mean 4-hour dialysate-to-plasma ratio for creatinine (D/P creatinine) and the mean 4-hour dialysate glucose to baseline dialysate glucose ratio (D/D0 glucose) were 0.56+/-0.13 and 0.43+/-0.11, respectively. The patients with haplotype CTGGC showed higher 4-hour D/P creatinine (0.67+/-0.12 vs 0.50+/-0.09, P=0.007) and lower 4-hour D/D0 glucose (0.35+/-0.12 vs 0.47+/-0.08, P=0.037) than those without haplotype CTGGC. CONCLUSION: The VEGF genetic polymorphism may influence the peritoneal solute transport.

Efficacy of Physiotherapist after Total Knee Arthroplasty

PURPOSE: The range of motion (ROM) of the knee and the satisfaction rate after total knee arthroplasty are the most important factors when evaluating the result of an operation. The purpose of this study was to determine whether the ROM and the functional outcome of these patients increase after joint exercise that is performed by special physiotherapists. MATERIALS AND METHODS: 200 cases of 120 patients, who underwent total knee replacement arthroplasty for osteoarthritis between August 2006 and May 2008, were enrolled in this study. These cases were randomly divided into 3 groups. Only CPM (continuous passive movement) and MSE (muscle strengthening exercise) were performed after KTA in the first group. In the second group, pROME was performed by physical therapists in our rehabilitation institution during the hospital stay, as well as CPM and MSE. CPM, MSE and pROME were performed by special physiotherapists during the hospital stay and also in the outpatient department after being discharged from the hospital in the third group. We compared the results of these groups. RESULTS: The range of motion was not increased among the groups. On the other hand, the third group showed a significantly higher functional outcome, as compared to that of the first and second groups. Conclusion: Although the range of motion of the knee joint was not increased enough to achieve statistical significance, the functional outcome showed significant increases with the pROME performed by physiotherapists. This result demonstrates that the knee exercises performed by special physiotherapists are useful and they can yield good outcomes in patients who underwent TKA.

Traumatic Dynamic Hallux Varus: A Case Report / 대한족부족관절학회지

The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, 4th extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using 4th extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

Clinico-Genetic Study of Nail-Patella Syndrome

Nail-patella syndrome (NPS) is an autosomal dominant disease that typically involves the nails, knees, elbows and the presence of iliac horns. In addition, some patients develop glomerulopathy or adult-onset glaucoma. NPS is caused by lossof- function mutations in the LMX1B gene. In this study, phenotype-genotype correlation was analyzed in 9 unrelated Korean children with NPS and their affected family members. The probands included 5 boy and 4 girls who were confirmed to have NPS, as well as 6 of their affected parents. All of the patients (100%) had dysplastic nails, while 13 patients (86.7%) had patellar anomalies, 8 (53.3%) had iliac horns, 6 (40.0%) had elbow contracture, and 4 (26.7%) had nephropathy including one patient who developed end-stage renal disease at age 4.2. The genetic study revealed 8 different LMX1B mutations (5 missense mutations, 1 frame-shifting deletion and 2 abnormal splicing mutations), 6 of which were novel. Genotype-phenotype correlation was not identified, but inter- and intrafamilial phenotypic variability was observed. Overall, these findings are similar to the results of previously conducted studies, and the mechanism underlying the phenotypic variations and predisposing factors of the development and progression of nephropathy in NPS patients are still unknown.

Polymorphisms of the NR3C1 gene in Korean children with nephrotic syndrome / 소아과

PURPOSE: Idiopathic nephrotic syndrome (NS) can be clinically classified as steroid-sensitive and steroid-resistant. The detailed mechanism of glucocorticoid action in NS is currently unknown. METHODS: In this study, we investigated 3 known single nucleotide polymorphisms (SNPs) (ER22/23EK, N363S, and BclI) of the glucocorticoid receptor gene (the NR3C1 gene) in 190 children with NS using polymerase chain reaction-restriction fragment length polymorphism and analyzed the correlation between the genotypes and clinicopathologic features of the patients. RESULTS: Eighty patients (42.1%) were initial steroid nonresponders, of which 31 (16.3% of the total) developed end-stage renal disease during follow-up. Renal biopsy findings of 133 patients were available, of which 36 (31.9%) showed minimal changes in NS and 77 (68.1%) had focal segmental glomerulosclerosis. The distribution of the BclI genotypes was comparable between the patient and control groups, and the G allele frequencies in both the groups were almost the same. The ER22/23EK and N363S genotypes were homogenous as ER/ER and NN, respectively, in all the patients and in 100 control subjects. The BclI genotype showed no correlation with the NS onset age, initial steroid responsiveness, renal pathologic findings, or progression to end-stage renal disease. CONCLUSION: These data suggested that the ER22/23EK, N363S, and BclI SNPs in the NR3C1 gene do not affect the development of NS, initial steroid responsiveness, renal pathologic lesion, and progression to end-stage renal disease in Korean children with NS.

Polymorphisms of the NR3C1 gene in Korean children with nephrotic syndrome / 소아과

PURPOSE: Idiopathic nephrotic syndrome (NS) can be clinically classified as steroid-sensitive and steroid-resistant. The detailed mechanism of glucocorticoid action in NS is currently unknown. METHODS: In this study, we investigated 3 known single nucleotide polymorphisms (SNPs) (ER22/23EK, N363S, and BclI) of the glucocorticoid receptor gene (the NR3C1 gene) in 190 children with NS using polymerase chain reaction-restriction fragment length polymorphism and analyzed the correlation between the genotypes and clinicopathologic features of the patients. RESULTS: Eighty patients (42.1%) were initial steroid nonresponders, of which 31 (16.3% of the total) developed end-stage renal disease during follow-up. Renal biopsy findings of 133 patients were available, of which 36 (31.9%) showed minimal changes in NS and 77 (68.1%) had focal segmental glomerulosclerosis. The distribution of the BclI genotypes was comparable between the patient and control groups, and the G allele frequencies in both the groups were almost the same. The ER22/23EK and N363S genotypes were homogenous as ER/ER and NN, respectively, in all the patients and in 100 control subjects. The BclI genotype showed no correlation with the NS onset age, initial steroid responsiveness, renal pathologic findings, or progression to end-stage renal disease. CONCLUSION: These data suggested that the ER22/23EK, N363S, and BclI SNPs in the NR3C1 gene do not affect the development of NS, initial steroid responsiveness, renal pathologic lesion, and progression to end-stage renal disease in Korean children with NS.

Two Korean Infants with Genetically Confirmed Congenital Nephrotic Syndrome of Finnish Type

Congenital nephrotic syndrome is defined as nephrotic syndrome which manifests in utero or during the first 3 months of life. The prototype of congenital nephrotic syndrome is congenital nephrotic syndrome of Finnish type (CNF, OMIM #602716), which is caused by loss-of-function mutations of the nephrin gene (NPHS1). There have been few clinical case reports of CNF in Korea, but none of which was confirmed by genetic study. Here, we report two children with congenital nephrotic syndrome. Genetic analysis of the NPHS1 gene revealed compound heterozygous frame-shifting mutations (c.2156_2163 delTGCACTGC causing p.L719DfsX4 and c.3250_3251insG causing p.V1084GfsX12) in one patient and a missense mutation (c.1381G>A causing p.R460Q) and a nonsense mutation (c.2442C>G causing p.Y814X) in the other patient. The nonsense mutation was novel. The clinical courses of the patients were typical of CNF. This is the first report of genetically confirmed CNF in Korea to date. The early genetic diagnosis of CNF is important for proper clinical management of the patients and precise genetic counseling of the families.

The Effects of Maturation Resistant Donor Dendritic Cells on Alloimmune Response in Mice / 대한신장학회잡지

BACKGROUND: Although dendritic cells (DCs) are the most influential antigen presenting cells maturation of DC is the critical control point toward either activation or regulation of immunity. We hypothesized that pretreatment with donor DCs, if which were maturation-resistant in vivo, could enhance engraftment by inducing inactivated state for allo- reactive T cell clones. METHODS: Immature DCs were prepared by 6- day culture of BM cells and we used paraformaldehyde for locking the DCs as immature phenotypes. We did in vitro and in vivo MLR to evaluate the effect of maturation resistant DCs on alloreactive T cells and we confirmed the effect of DCs in MHC full mismatched skin and islet transplantation model. RESULTS: Fixed DCs in immature state were resistant to maturation stimuli and weak stimulator for allo-reactive T cells (CB6F1-->C3H). In contrast, fixed DCs in mature state stimulated allogeneic T cell proliferation effectively. Splenocytes isolated from mice 2 weeks after maturation resistant DC injection could not be reactivated and maintained naive phenotype when cocultured with allogeneic splenocytes (BALB/c-->C57BL6). Consistent with this finding maturation resistant DC treatment suppressed MLR-driven T cell division (CB6F1-->C3H) as assessed by CFSE analysis. But, CD25+ T cells depletion by treatment with anti-CD25 prior to DCs transfer attenuated this regulatory effect of DCs. In a MHC mismatched transplantation model (CB6F1-->C3H), treatment with maturation-resistant DCs 2 weeks before operation, markedly prolonged skin and islet graft survival. But C3H mice pretreated with CB6F1 DCs rejected DBA1 (H-2q) skin graft within 14 days. CONCLUSION: These findings suggest the maintenance of immaturity of DCs is a key factor in modulating alloimmune responses through dendritic cells.

Self-Esteem of the Schooler of Families in Poverty / 아동간호학회지

The Purpose of this study was to identify factors that influence the self-esteem of the schooler of families in poverty. A descriptive, correlational, and cross-sectional study design was used. The data were collected from February to March, 2001. Convenient sampling was done from 194 subjects living in Jeju Do, but 167 subjects among these were used for the study analysis. Hierarchical Stepwise Regression was used to identify significant factors. The results of this study were as follows: In general, self-esteem status of the schooler in poor families was relatively poor. In stepwise regression analysis, self-esteem status was significantly influenced by emotional home environment, duration of poverty and frequency of parent-child tactics. These variables explained 26.8% of the variance of schooler's self-esteem. Conclusively, it is recommended that nursing intervention programs for schooler in poor family should be a focus to enhance the economic context as well as family effect.