Polydeoxyribonucleotide Attenuates Airway Inflammation Through A2AR Signaling Pathway in PM10-Exposed Mice / 대한배뇨장애요실금학회지

Purpose@#Inhalation of air containing high amounts of particular matter (PM) causes various respiratory disorders including asthma, chronic obstructive pulmonary disease, and lung cancer. The changes of expression of inflammatory factors by polydeoxyribonucleotide (PDRN) administration in the PM10-exposed trachea inflammation model were evaluated. @*Methods@#PM10 was administered to mouse trachea to induce acute inflammatory damage, and changes in inflammatory factors were observed after administration of PDRN and 3,7-dimethyl-1-propargylxanthine (DMPX) for 3 days daily. Expression of inflammatory cytokines, adenosine A2A receptor (A2AR), protein kinase A (PKA), 3΄,5΄-cyclic adenosine monophosphate responsive element binding protein (CREB) were detected by enzyme‐linked immunosorbent assay, immunofluorescence, and western blot assay. @*Results@#PM-exposed trachea showed increased tumor necrosis factor (TNF)-α and interleukin (IL)-1β expression, and expression of TNF-α and IL-1β was inhibited by PDRN treatment in PM-exposed mice. PM-exposed trachea showed increased nuclear factor (NF)-κB phosphorylation, and phosphorylation of nuclear factor-kappa B was inhibited by PDRN treatment in PM-exposed mice. PM-exposed trachea showed increased expression of A2AR, but PDRN treatment more enhanced A2AR expression in PM-exposed mice. PKA phosphorylation was not changed and CREP phosphorylation was decreased, however PDRN treatment increased phosphorylation of PKA and CREB in PM-exposed mice. DMPX treatment blocked all the effects of PDRN on PM-exposed mice, demonstrating that the action of PDRN occurs via A2AR. @*Conclusions@#PDRN treatment attenuated inflammation in the trachea of the PM10-exposed mice. This improving effect of PDRN can be ascribed to the activation of A2AR through the cAMP-PKA pathway.

Polydeoxyribonucleotide Attenuates Airway Inflammation Through A2AR Signaling Pathway in PM10-Exposed Mice / 대한배뇨장애요실금학회지

Purpose@#Inhalation of air containing high amounts of particular matter (PM) causes various respiratory disorders including asthma, chronic obstructive pulmonary disease, and lung cancer. The changes of expression of inflammatory factors by polydeoxyribonucleotide (PDRN) administration in the PM10-exposed trachea inflammation model were evaluated. @*Methods@#PM10 was administered to mouse trachea to induce acute inflammatory damage, and changes in inflammatory factors were observed after administration of PDRN and 3,7-dimethyl-1-propargylxanthine (DMPX) for 3 days daily. Expression of inflammatory cytokines, adenosine A2A receptor (A2AR), protein kinase A (PKA), 3΄,5΄-cyclic adenosine monophosphate responsive element binding protein (CREB) were detected by enzyme‐linked immunosorbent assay, immunofluorescence, and western blot assay. @*Results@#PM-exposed trachea showed increased tumor necrosis factor (TNF)-α and interleukin (IL)-1β expression, and expression of TNF-α and IL-1β was inhibited by PDRN treatment in PM-exposed mice. PM-exposed trachea showed increased nuclear factor (NF)-κB phosphorylation, and phosphorylation of nuclear factor-kappa B was inhibited by PDRN treatment in PM-exposed mice. PM-exposed trachea showed increased expression of A2AR, but PDRN treatment more enhanced A2AR expression in PM-exposed mice. PKA phosphorylation was not changed and CREP phosphorylation was decreased, however PDRN treatment increased phosphorylation of PKA and CREB in PM-exposed mice. DMPX treatment blocked all the effects of PDRN on PM-exposed mice, demonstrating that the action of PDRN occurs via A2AR. @*Conclusions@#PDRN treatment attenuated inflammation in the trachea of the PM10-exposed mice. This improving effect of PDRN can be ascribed to the activation of A2AR through the cAMP-PKA pathway.

Comparison of Angle Measurements on Hallux Valgus with Two Different Methods Using Digital Images / 대한족부족관절학회지

PURPOSE: To study inter- and intra-observer reliabilities of computerized measurements of the angular parameters of hallux valgus deformity, using two different kinds of software tools for angle measurement on the digital radiography. MATERIALS AND METHODS: On 35 digital radiographies of standing foot anteroposterior view of hallux valgus, two observers (A, B) independently measured hallux valgus angle (HVA) and 1-2 intermetatarsal angle (IMA1-2) twice, using two methods. In method I, an angle was determined from duplicated lines to longitudinal axes made for bisecting line on the target bones with software tool. In method II, an angle was calculated automatically and directly from bisecting lines (longitudinal axes) made on the target bones. We compared two methods using paired t-test to determine significance of differences. Inter- and intra-observer reliabilities were evaluated using the intraclass correlation coefficients (ICC). RESULTS: There were no significant differences between measurements of method I and II for each observer (p>0.05) and intraobserver reliability were good. (ICC>0.9) Inter-observer reliability for method I and II was good of the HVA (ICCs, 0.912 and 0.905) and moderate of the IMA1-2 (ICCs, 0.505 and 0.537). There were interobserver differences in HVA of method I and II. CONCLUSION: No significant difference was found statistically between measurements of method I and II. Both methods I and II would be acceptable to measure angular parameters of hallux valgus deformity.

Matrixplasty for the Treatment of Pincer Nail with Nail Growth Plate Deformity / 대한족부족관절학회지

PURPOSE: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. MATERIALS AND METHODS: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was 14.0+/-1.3months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. RESULTS: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was 73.1+/-12.8, and it improved to 98.7+/-1.1 by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from 53.3+/-12.9 degrees to 18.2+/-7.4 degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. CONCLUSION: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.

Comparison of Proteome Components of Helicobacter pylori Before and After Mouse Passage

The mouse model is alleged to be a useful tool for understanding of pathophysiological roles of Helicobacter pylori in the development of gastric disorders. However, it has been observed that H. pylori strains significantly differed in their fitness in mice and even mouse strains differed in their susceptibilities to a H. pylori strain. Bacterial components of H. pylori which could affect on its fitness in mice have to be elucidated for the establishment of the mouse model for H. pylori infections. In the comparison of colonization ability between two H. pylori Korean isolates, 51 (isolated from a patient with duodenal ulcer) and 52 (isolated from a patient with gastric cancer), 52 could colonize better than 51 on the gastric mucosa of mouse. Proteome components of H. pylori 52, as a good colonizer and H. pylori 51, as a poor one were quantitatively compared each other. Five bacterial proteins including catalase, urease subunit alpha/beta, enolase and ferritin, were up-regulated in 52. In addition, the respective proteome components of the two strains were also compared with their mouse-passaged homologous strains. Seven and five proteins, which included catalase, flagellin A/B in common, were up-regulated in mouse-adapted 51 and 52, respectively. Among the fourteen identified proteins, urease subunit alpha/beta, flagellin A/B, catalase, ferritin, superoxide dismutase and neutrophil-activation protein have been previously known to be necessary to gastric colonization of H. pylori in animal models. The other up-regulated proteins including enolase, elongation factor Tu and fructose-bisphosphate aldolase have been reported to be associated with acid tolerance of H. pylori. These data provide confirmatory evidence for the importance of those proteins in the development of H. pylori-associated gastric disorders.

Ileovesical Fistula Caused by Ingested Foreign Material

Ileovesical fistula is a rare condition in children. A case of 13 year-old female with ileovesical fistula caused by an ingested foreign material is presented. She had dysuria and lower abdominal pain for one month. There was no history of medico-surgical illness such as Crohn's disease or diverticulitis. Preoperative imaging study showed a movable calcified object in the pelvic cavity and air bubbles in the bladder. At laparotomy a bezoar-like mass was found at the antimesenteric border of the terminal ileum adherent to the dome of bladder. Segmental resection of the ileum and partial cystectomy were performed.

Identification of Helicobacter pylori Strain 51 Major Outer Membrane Proteins by Quadrupole Time of Flight Mass Spectrometry

As part of an initial inquiry into the function of the outer membrane proteins (OMPs) of Helicobacter pylori Korean strain 51, we have conducted an extensive proteome analysis via quadrupole time of flight (Q-TOF) mass spectrometry (MS). Fifty one OMPs of H. pylori were purified using sarcosine and resolved via two-dimensional electrophoresis with immobilized pH gradient strips. The most abundant proteins were observed in the alkaline pI regions (6.0~11.0) at molecular masses between 10~100 KDa. Here, 15 spots were identified, representing 9 types of genes (KHP0852, KHP0853, KHP1353, KHP1017, KHP0172, KHP0076, KHP0617, KHP1069, KHP0614) from the sarcosin-insoluble fraction of H. pylori 51. These may be employed in the characterization of the OMPs of H. pylori 51, which will help to identify new potential target proteins for vaccine development and drug therapy.

Liver Dysfunction due to Hepatic Glycogenosis in a Girl with Type 1 Diabetes / 대한소아내분비학회지

Hepatic glycogenosis is an under-recognized cause of hepatomegaly and elevated serum aminotransferase levels in patients with type 1 diabetes; further, most cases of hepatic glycogenosis are reported to be associated with poor glycemic control. In this report, we describe the case of a 12-year-old girl with hepatic glycogenosis, who presented with elevated liver enzymes. She was diagnosed with type 1 diabetes at the age of 6 years, and her diabetes was very "brittle" with recurrent episodes of hypoglycemic attacks. Her recent hemoglobin A1C (HbA1c) level was 8.4%, and the average HbA1c level during the last 2 years was 8.7%. Her aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were persistently elevated during the last year, up to 700 and 258 U/L, respectively. Her growth rate and pubertal development were normal. Her serum was negative for hepatitis viral markers, and the plasma levels of ceruloplasmin and ferritin were also normal. Ultrasound examination revealed hepatomegaly with increased hepatic echogenicity. Liver biopsy demonstrated irregular glycogen deposition in hepatocytes. Recurrent hypoglycemia was resolved with continuous subcutaneous insulin infusion, and after 3 weeks, her AST and ALT levels decreased to 47 and 33 U/L, respectively. We conclude that hepatic glycogenosis should be suspected as a cause of abnormal liver function tests in patients with poorly controlled or brittle type 1 diabetes. After excluding other causes of hepatic dysfunction, a 1-month trial for achieving improved glycemic control, while avoiding hypoglycemia, is recommended before proceeding with invasive investigation of the patient.

Traumatic Experiences and Mental Health of North Korean Refugees in South Korea

OBJECTIVE: This study was conducted at Hanawon-a government sponsored educational facility for the settlement of North Korean refugees during their initial phase in South Korea-in 2004 to explore their mental health status and traumatic experiences in North Korea and during their escape period. METHODS: A survey was conducted in November 2004 with 62 North Korean refugees at Hanawon, and the Trauma Checklist was used to measure their traumatic experiences. To measure their psychological-mental health status, the Personality Assessment Inventory was administered. RESULTS: In comparison with the traumatic experiences of the North Korean refugees found in the study conducted in 2001 at Hanawon using the same methods, the current study showed a relatively lower frequency of traumatic experiences among the participants. The Personality Assessment Inventory results revealed that the study participants scored higher than average South Koreans in all clinical scales. Particularly, their mania (62.51) and schizophrenia (61.75) scores were above 60, a clinically meaningful score. In the gender comparison, the males exhibited meaningfully higher levels of alcohol problem, non-support, and warmth scale scores. CONCLUSION: Compared to the 2001 study, the overall traumatic experiences among North Korean refugees participated in this study. But continous support is necessary for their successful adaptation to South Korean Society have declined. The North Korean refugees at Hanawon experienced difficulties maintaining their mental health and the men in particular requested more intensive care and support for this purpose.

Posterior Plating in Distal Fibular Fracture

PURPOSE: To report the technical experience of posterior plating for the distal fibular fracture. MATERIALS AND METHODS: 20 Weber type-B fibular fractures were included in this study, which were treated with the posterior plating. 1/3 semitubular plate was used and orientation of all screws were intended to be perpendicular to the plate as possible. Fixation stability and maintenance of reduction after plating was assessed manually in the operating field. Clinical results were evaluated at least 1 year after operation, using American Orthopaedic Foot and Ankle Society (AFOAS) Ankle-Hindfoot score. RESULTS: 5 cases were firmly stabilized without using any lag screw or fixation of distal fragment. For improving stability or achieving proper reduction, a lag screw was placed posteroanteriorly through the plate in 14 cases. Anteroposterior interfragmentary fixation in 1 case before plating, and contouring of the plate in 3 cases were needed in cases of which the posterior plating impeded reduction of distal fibular fracture. In all cases, fracture was stabilized without fixation through the most distal hole. There were no major postoperative complications. AFOAS score was 95.5±5.2. CONCLUSION: The posterior plating technique for distal fibular fracture is regarded as a recommendable option. Additional fixation with interfragmentary screw or contouring of the plate, however, would be needed in some cases to achieve anatomical reduction or sufficient stability.

3-Year Follow up Study of the Way of Thinking and Satisfaction Level of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: The aim of this study was to examine the change in attitudes and satisfaction level of North Korean defectors in South Korea over a 3 year period (2001-2004). METHODS: In our first study in 2001, a total of 200 defectors were interviewed. In the follow up study after 3 years, 151 defectors were re-interviewed by an in-person interview. RESULTS: The level of satisfaction to the governmental support policy to defectors decreased significantly. However, the general level of satisfaction increased slightly (from 3.52 to 3.56 ; 5-score scale). This shows that North Korean defectors are stably adapting to South Korean society. The level of satisfaction significantly correlated with the defectors' confusion of the different value systems, the defectors' understanding of the South Korean people, satisfaction with their physical and mental health, and the prejudice of South Korean people to defectors. In terms of the attitudes, the type of schooling, the military service and the communist party membership in North Korea were not related to the change in attitude. However, there was a significant correlation with gender and age. Women showed a greater change in attitude compared to men. Older people had difficulty in understanding the South Korean people, but they showed little psychological affiliation to North Korea. Moreover, they showed a high level of satisfaction with the economic situation in South Korea and had an optimistic viewpoint for their future than younger people. Even though many defectors attended churches, religion was not associated with the level of satisfaction or their change in attitude. CONCLUSION: The factors that influence the level of satisfaction and attitudes of North Korean defectors have changed over 3 years. Therefore, the government, nongovernmental organizations (NGOs) associated with defectors and the churches need to be more sensitive to these changes and make plans to support the adaptation of defectors to South Korean society.

A 3-Year Follow-Up Study of Posttraumatic Stress Disorder among North Korean Defectors / 신경정신의학

OBJECTIVE: This study is a follow-up of a first survey of 200 North Korean defectors who entered South Korea in 2001. The purpose of this study is to examine changes in the current prevalence of partial PTSD and full PTSD after 3 years and to evaluate related factors. METHODS: This study followed up on 151 of the 200 North Korean defectors from our first survey. 20 interviewers conducted face-to-face interviews and assisted defectors in completing a self-report assessment. The traumatic events which participants with chronic PTSD and delayed onset PTSD experienced were then examined. RESULTS: Over the 3 years, the current prevalence rate of partial PTSD was reduced from 31.8% to 5.3%, and the current prevalence rate of full PTSD was reduced from 27.2% to 4.0%. Of particular interest was that 88.8% of those diagnosed with full or partial PTSD in the first survey had recovered after 3 years. CONCLUSION: The current prevalence rate of partial and full PTSD rapidly decreased during 3 years.

The Ego Defense Mechanism of North Korean Defectors in South Korea / 신경정신의학

OBJECTIVES: The purpose of present study was to explore the differences of ego defense mechanisms between South Koreans, North Korean defectors in South Korea and Korean-Chinese in South Korea, and the correlations between ego defense mechanisms and perceptions of socio-cultural characteristics of these three groups. METHODS: The Defense Style Questionnaire and the Socio-Cultural Characteristic Questionnaire were administered to 100 South Koreans, 93 North Korean defectors and 86 Korean-Chinese. 21 North Korean defectors and 10 Korean-Chinese in South Korea were interviewed regarding the questionnaire results of the study. RESULTS: North Korean defectors used more active defense styles and emotion repressive defense styles than South Koreans. Korean-Chinese used more passive defense styles than North Korean defectors and South Koreans. North Korean defectors scored significantly higher than South Koreans on 'denial', 'splitting', 'withdrawal', 'suppression', 'altruism', 'task orientation' and 'anticipation' in the Defense Style Questionnaire. The defense styles were significantly related to the socio-cultural characteristics of the three countries. CONCLUSION: From our results it was inferred that there are differences in the defense styles among three groups, and the socio-cultural characteristics have effects on defense mechanisms. On the gasis of the results of this study, the direction of future study was discussed.

A Case of Rickets Developed after Feeding on Sunsik for Seven Months

Rickets is a nutritional disorder which is caused either by deficiency of vitamin D or by a defective activation of vitamin D. In these days, even though the incidence of rickets has decreased through adequate nutritional support, we sometimes experience rickets in babies receiving a prolonged special diet as therapy for chronic diarrhea, or those subject to a in receiving the prolonged elimination of milk because of allergy. But there are no reports about rickets caused by absolute elimination of milk because of allergies in Korea. We report here a case of rickets developed after feeding on Sunsik(a mixture of several grain and fruits powder) during a seven months period in an 8-month-old male patient. This male infant manifested vomiting, poor feeding, decreased serum calcium and 25- hydroxycholecalciferol levels, and markedly increased serum alkaline phosphatase and parathyroid hormone levels. Skeletal X-rays showed cupping and fraying in distal metaphyses of radius and ulna, and generalized osteopenia. The patient improved with vitamin D and calcium therapy.

Fast FLAIR MR Images of Intracranial Hemorrhage

PURPOSE: To evaluate the signal characteristics of intracranial hemorrhage, as seen on fluid attenuatedinversion recovery(FLAIR) MR imaging according to various stages, and to compare FLAIR imaging with spin-echo T1-and T2-weighted MR imaging. MATERIALS AND METHODS: We retrospectively evaluated fast FLAIR images along withspin-echo T1- and T2-weighted MR images of 32 lesions in 26 patients (12 males and 14 females, aged 3-84 yrs) withintracranial hemorrhagic lesions. For imaging, a 1.5T unit was used, and the nature of the lesions was found to beas follows : intracranial hemorrhage(n=15) ; tumor(n=9) ; infarction (n=4) ; arteriovenous malformation (n=3) ;and arachnoid cyst with hemorrhage(n=1). On the basis of spin-echo MR imaging, lesions were classified as acute,early subacute, late subacute, early chronic, or late chronic stage. The signal characteristics of intracranialhemorrhage were analysed in accordance with each staging, as seen on MR FLAIR imaging, and compared to the stagingseen on spin-echo T1- and T2-weighted MR imaging. RESULTS: For the 32 hemorrhagic lesions, staging was found to beas follows : acute(n=4) ; early subacute(n=8) ; late subacute(n=11) ; early chronic(n=5) and late chronic(n=1). Inthe remaining three patients with arteriovenous malformation, the stage of the hemorrhage was found to be mixedsubacute and chronic. The signal intensity of hemorrhage, as seen on FLAIR imaging during the acute andearly-subacute stage, was low, and during the late subacute stage it was high ; for T2WI, the findings weresimilar. FLAIR imaging, however, showed that hemorrhage intensity during the early chronic stage was low, and thatof the late chronic stage was very low ; these findings were similar to those of T1WI. CONCLUSION: The signalintensity of intracranial hemorrhage, as seen on FLAIR imaging, was not characteristic ; it was similar to that ofT2WI during the acute and subacute stages, and similar to that of T1WI during the chronic stage. When usedtogether with spin-echo T1- and T2-weighted MR imaging, however, FLAIR imaging may be useful for theclassification of chronic intracranial hemorrhage as either early or late stage.