Dexamethasone is a widely used anti-inflammatory agent for a broad spectrum of diseases. The effectiveness of this agent is thought to be due to the capacity to modulate cytokine production in inflammatory cells. We examined the effects of dexamethasone on expressions of interferon gamma (IFN-gamma) and interleukin 4 (IL-4) by human peripheral blood mononuclear cells (PBMCs) in response to interleukin 12 (IL-12). Dexamethasone (10-5 M) inhibited IFN-gamma secretion, through direct suppression of IFN-gamma, IL-12 receptor (IL-12R) -beta1, and -beta2 expressions. Conversely dexamethasone increased IL-4 secretion as well as IL-4 expressions by PBMCs in response to IL-12. In addition, dexamethasone increased expression of suppressor of cytokine signalling (SOCS)-1, which inhibits JAK-STAT pathway of IL-12R signalling. The result of our study suggested that dexamethasone directly inhibited IFN-gamma expression, through suppression of IL-12 signalling and indirectly increases IL-4 expression, through suppression of IFN-gamma expression.
Dexamethasone* ; Humans ; Interferons ; Interleukin-12* ; Interleukin-4* ; Receptors, Interleukin-12

PURPOSE: This study was conducted to obtain difference in fracture strength according to the diameter of one-body O-ring-type of mini implant fixture, to determine the resistance of mini implant to masticatory pressure, and to examine whether overdenture using O-ring type mini implant is clinically usable to maxillary and mandibular edentulous patients. MATERIALS AND METHODS: For this study, 13 mm long one body O-ring-type mini implants of different diameters (2.0 mm, 2.5 mm and 3.0 mm) (Dentis, Daegu, Korea) were prepared, 5 for each diameter. The sample was placed at 30degrees from the horizontal surface on the universal testing machine, and off-axis loading was applied until permanent deformation occurred and the load was taken as maximum compressive strength. The mean value of the 5 samples was calculated, and the compressive strength of implant fixture was compared according to diameter. In addition, we prepared 3 samples for each diameter, and applied loading equal to 80%, 60% and 40% of the compressive strength until fracture occurred. Then, we measured the cycle number on fracture and analyzed fatigue fracture for each diameter. Additionally, we measured the cycle number on fracture that occurred when a load of 43 N, which is the average masticatory force of complete denture, was applied. The difference on compressive strength between each group was tested statistically using one-way ANOVA test. RESULTS: Compressive strength according to the diameter of mini implant was 101.5 +/- 14.6 N, 149 +/- 6.1 N and 276.0 +/- 13.4 N, respectively, for diameters 2.0 mm, 2.5 mm and 3.0 mm. In the results of fatigue fracture test at 43 N, fracture did not occur until 2x106 cycles at diameter 2.0 mm, and until 5x106 cycles at 2.5 mm and 3.0 mm. CONCLUSION: Compressive strength increased significantly with increasing diameter of mini implant. In the results of fatigue fracture test conducted under the average masticatory force of complete denture, fracture did not occur at any of the three diameters. All of the three diameters are usable for supporting overdenture in maxillary and mandibular edentulous patients, but considering that the highest masticatory force of complete denture is 157 N, caution should be used in case diameter 2.0 mm or 2.5 mm is used.
Bite Force ; Collodion ; Compressive Strength ; Denture, Complete ; Denture, Overlay ; Fatigue ; Fractures, Stress ; Humans

Preparation for colonoscopy involves a thorough cleansing of the large bowel. Cleansing is performed using several methods, including ingestion of 4 liters of polyethylene glycol solution. However, these methods can induce hyponatremia by various mechanisms. Severe or rapidly progressing hyponatremia can result in the swelling of the brain, and the symptoms of hyponatremia are mainly neurological. Recently, we encountered a 41-year-old woman who developed acute hyponatremia with encephalopathy after undergoing bowel preparation for colonoscopy. She presented with general weakness, nausea, headache, agitation, delusions, and slurred speech one day after the ingestion of polyethylene glycol solution. Her serum sodium level was very low (110 to 115 mEq/L). Her symptoms pertaining to hyponatremia continued to persist for more than 2 days despite continuous intravenous administration of hypertonic saline for the correction of hyponatremia.
Administration, Intravenous ; Adult ; Brain ; Colonoscopy ; Delusions ; Dihydroergotamine ; Eating ; Female ; Headache ; Humans ; Hyponatremia ; Nausea ; ortho-Aminobenzoates ; Polyethylene ; Polyethylene Glycols ; Sodium

PURPOSE: To analyze and compare the clinical and radiologic results of treatments in unstable intertrochanteric fractures of the femur with proximal femoral nail antirotation (PFNA) and compression hip screw with trochanter stabilizing plate (CHS with TSP). MATERIALS AND METHODS: We retrospectively reviewed the results of 66 cases of unstable intertrochanteric fractures of the femur treated with PFNA (Group I) and CHS with TSP (Group II) which could be followed up for minimum a year. We evaluated several comparative factors such as operation time, blood loss, time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, social-function score of Jensen, and mobility score of Parker and Palmer. RESULTS: Group I showed shorter operation time and less blood loss with significance than group II (p<0.05), but there were no differences between the groups in the mean time to bone union, changes in neck-shaft angle, sliding of screw (or blade), complications, postoperative pain, and social-function score of Jensen (p>0.05). Two cases of cutting out of the blade through the femoral head were found in group I. One case of cutting out of the screw, one case of the breakage of the plate, and loosening of the plate were found in group II as complications. CONCLUSION: We think that there were no significant differences between PFNA and CHS with TSP in view point of radiologic and clinical outcomes in unstable intertrochanteric fractures of the femur, but PFNA is less invasive device than CHS with TSP, therefore it may be useful device in elderly patients.
Aged ; Femur ; Head ; Hip ; Hip Fractures ; Humans ; Nails ; Postoperative Complications ; Retrospective Studies

BACKGROUND: Although there are growing evidences linking Chlamydophila pneumoniae infection to myocardial infarction, it remains controversial. The authors intended to assess whether C. pneumoniae infection is associated with myocardial infarction. METHODS: Sera and peripheral mononuclear cells (PMNCs) were collected from 54 cases of acute myocardial infarction (MI), 33 cases of old MI, and 60 normal controls. Anti-C.pneumoniae IgG and IgM antibodies were measured using a microimmunofluorescence (mIF) method, and C.pneumoniae DNA was detected using polymerase chain reaction (PCR). RESULTS: Seropositivity of anti-C.pneumoniae IgM antibody by mIF was shown 5.0% in control group, 29.6% (OR=8.00) in the acute MI and 6.1% (OR=1.23) in old MI group. Seropositivity of anti C.pneumoniae IgG antibody were 60.0 % in control group, 92.6% (OR=8.33) in the acute MI and 87.9% (OR= 4.83) in old MI group. The antibody titers in the acute MI and old MI group tended to be higher compared to those in control group. No C.pneumoniae DNA was detected in any case by PCR. CONCLUSION: The seropositivity and antibody titers were significantly higher in the acute MI and old MI group than in control group, suggesting that C.pneumoniae infection may be a risk factor for myocardial infarction.
Antibodies ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; DNA ; Immunoglobulin G ; Immunoglobulin M ; Myocardial Infarction* ; Pneumonia ; Polymerase Chain Reaction ; Risk Factors

PURPOSE: The purpose of this study is to evaluate the pronator quadrates muscle in patients who underwent internal fixation with a volar locking plate for unstable distal radius fractures. MATERIALS AND METHODS: Forty patients who underwent internal fixation with a volar locking plate for unstable distal radius fracture were enrolled. We evaluated the clinical results according to the Mayo wrist score, the wrist range of motion, and the grip strength at the last follow-up. Using ultrasonography, muscle thickness of the pronator quadrates was compared between injured and uninjured arm. RESULTS: Bone union was achieved in all cases. The mean Mayo wrist score was 82.79 points. The grip strength of the injured arm was decreased to 89.1% of the uninjured side. The decrease of pronation range of the injured wrist motions was significant (82.3degrees, p=0.004). There was significant atrophy of the pronator quadrates muscle on the injured side (injured side: 3.19 mm, uninjured side: 4.72 mm, p=0.001); and the decrement of muscle thickness in pronator quadrates showed an association with the Mayo wrist score (r=-0.35, p=0.042). CONCLUSION: These results suggest that continuity of the muscle is maintained after use of the volar locking plating for unstable distal radius fractures with repair of pronator quadrates; however, there is atrophy of pronator quadrates muscle and limitation of pronation in the injured wrist.
Arm ; Atrophy ; Follow-Up Studies ; Hand Strength ; Humans ; Pronation ; Radius Fractures* ; Range of Motion, Articular ; Ultrasonography ; Wrist

PURPOSE: This study was performed to investigate the present condition of drug abuse and its association with depression, self-rated health and health behaviors by job status in Korean adults. METHODS: Data were derived from the study on four addiction problem and suicide in 2014. Multiple logistic regression was used to analyze patterns of drug abuse according to depression, self-rated health and health behaviors. RESULTS: The prevalence of drug abuse during the past year was 17.1% of the 4,018 subjects. About 3.3 times risk for drug abuse was found among individuals who had high depression scores. The risk of drug abuse was higher among those who were smoking (OR:1.46, 95% CI:1.17~1.83), drinking more frequently (OR:1.30, 95% CI:1.07~1.58), sleeping insufficiently (OR:1.31, 95% CI:1.03~1.67), eating irregularly (OR:1.45, 95% CI:1.19~1.76). Drug abuse problem was detected more seriously among employed than unemployed adults. CONCLUSION: Health-related behaviors, such as smoking, drinking, sleeping, eating should be considered simultaneously when designing strategies to deal with drug abuse problem, and it is important to understand the interaction between drug abuse and mental health. Furthermore, workplace based intervention can be effective in solving drug abuse problem.
Adult ; Depression* ; Drinking ; Eating ; Health Behavior* ; Humans ; Logistic Models ; Mental Health ; Prevalence ; Smoke ; Smoking ; Substance-Related Disorders* ; Suicide

OBJECTIVES: We aimed to develop a common health information exchange (HIE) platform that can provide integrated services for implementing the HIE infrastructure in addition to guidelines for participating in an HIE network in South Korea. METHODS: By exploiting the Health Level 7 (HL7) Clinical Document Architecture (CDA) and Integrating the Healthcare Enterprise (IHE) Cross-enterprise Document Sharing-b (XDS.b) profile, we defined the architectural model, exchanging data items and their standardization, messaging standards, and privacy and security guidelines, for a secure, nationwide, interoperable HIE. We then developed a service-oriented common HIE platform to minimize the effort and difficulty of fulfilling the standard requirements for participating in the HIE network. The common platform supports open application program interfaces (APIs) for implementing a document registry, a document repository, a document consumer, and a master patient index. It could also be used for testing environments for the implementation of standard requirements. RESULTS: As the initial phase of implementing a nationwide HIE network in South Korea, we built a regional network for workers' compensation (WC) hospitals and their collaborating clinics to share referral and care record summaries to ensure the continuity of care for industrially injured workers, using the common HIE platform and verifying the feasibility of our technologies. CONCLUSIONS: We expect to expand the HIE network on a national scale with rapid support for implementing HL7 and IHE standards in South Korea.
Computer Security ; Computer Systems ; Continuity of Patient Care ; Delivery of Health Care ; Electronic Health Records ; Health Level Seven ; Humans ; Information Services* ; Korea ; Privacy ; Referral and Consultation ; Workers' Compensation

BACKGROUND: The purpose of this study was to evaluate the clinical feasibility of an electric nerve stimulator in a lumbar transforaminal epidural block. METHODS: Using an electric nerve stimulator, transforaminal epidural blocks were performed in 105 segments of 49 patients who presented with lower back pain with radiating pain to lower extremities. The contrast medium was injected to delineate the nerve root after positioning an insulated needle at the intervertebral foramen under fluoroscopic guidance. Then, the nerve root was electrically stimulated with the insulated needle to confirm whether or not the same radiating pain was evoked. RESULTS: Of the 105 foraminal segments, the same radiating pain was evoked at 0.5 mAh in 47 segments (44.8%), at 1.0 mAh in 22 (21.0%), at 1.5 mAh in 3 (2.9%), at 2.0 mAh in 15 (14.3%), at 2.5 mAh in 4 (3.8%), and at 3.0 mAh in 5 (4.8%). No response was observed in 9 segments (8.6%). The fluoroscopy revealed successful positioning of the needle in the patients with an evoked radiating pain over 2.0 mAh. The visual analogue scale (VAS) obtained for pain improved from a mean of 7.5 to 2.7 after the block (p = 0.001). In the 9 cases without response to electrical stimulation, the patients showed an improvement on VAS from 7.8 to 3.4 (p = 0.008) also. CONCLUSIONS: A nerve stimulator can help to predict the accuracy of needle positioning as a supplemental aid for a successful lumbar transforaminal epidural block. It is sufficient to initiate a proper stimulation amplitude of the nerve at 2 mAh.
Adult ; Aged ; Aged, 80 and over ; Analgesia, Epidural ; *Electric Stimulation Therapy ; Feasibility Studies ; Female ; Humans ; Low Back Pain/etiology/*therapy ; *Lumbar Vertebrae ; Male ; Middle Aged ; *Nerve Block ; Radiculopathy/etiology/therapy ; Spinal Diseases/*complications

Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.
Cleft Lip ; Cleft Palate* ; Congenital Abnormalities ; Deglutition ; Humans ; Mastication ; Mouth ; Nasal Cavity ; Palatal Obturators* ; Palate ; Palate, Soft ; Velopharyngeal Insufficiency*