Macrophage-associated inflammation is crucial for the pathogenesis of diverse diseases including metabolic disorders. Rhodanthpyrone (Rho) is an active component of Gentiana rhodantha, which has been used in traditional Chinese medicine to treat inflammation. Although synthesis procedures of RhoA and RhoB were reported, the biological effects of the specific compounds have never been explored. In this study, the anti-inflammatory activity and mechanisms of action of RhoA and RhoB were studied in lipopolysaccharide (LPS)-stimulated macrophages. Pretreatment with RhoA and RhoB decreased inducible nitric oxide synthase and cyclooxygenase-2 expressions in RAW 264.7 cells and in thioglycollate-elicited mouse peritoneal macrophages. In addition, it downregulated transcript levels of several inflammatory genes in LPS-stimulated RAW 264.7 cells, including inflammatory cytokines/chemokines (Tnfa, Il6, and Ccl2) and inflammatory mediators (Nos2 and Ptgs2). Macrophage chemotaxis was also inhibited by treatment with the compounds. Mechanistic studies revealed that RhoA and RhoB suppressed the nuclear factor (NF)-κB pathway, but not the canonical mitogen activated protein kinase pathway, in LPS-stimulated condition. Moreover, the inhibitory effect of RhoA and RhoB on inflammatory gene expressions was attenuated by treatment with an NF-κB inhibitor. Our findings suggest that RhoA and RhoB play an anti-inflammatory role at least in part by suppressing the NF-κB pathway during macrophage-mediated inflammation.
Animals ; Chemotaxis ; Cyclooxygenase 2 ; Gene Expression ; Gentiana ; Inflammation ; Interleukin-6 ; Macrophages ; Macrophages, Peritoneal ; Medicine, Chinese Traditional ; Mice ; Nitric Oxide Synthase Type II ; Protein Kinases ; RAW 264.7 Cells

OBJECTIVE: We present an evaluation of the clinical outcome and an investigation of the optimal use of papaverine angioplasty for the treatment of symptomatic vasospasm following subarachnoid hemorrhage. METHODS: The authors retrospectively analyzed 24 cases of symptomatic vasospasm treated by papaverine angioplasty from July 1994 to February 1998. Detailed clinical features and detailed techniques of papaverine angioplasty including sex, age, symptoms, time interval from symptom onset to angioplasty, papaverine dose, concentration and duration of infusion were investigated. RESULTS: After papaverine angioplasty, immediate angiographic vasodilatation was achieved in 23 cases (96%). Fifty eight percent showed clinical improvement within 24 hours but symptomatic vasospasm recurred in 21% of them. Retreatment with papaverine for the recurred cases showed a less response than the initial treatment. Statistical analyses showed that time interval from symptom onset to angioplasty was the factor related to the effects of papaverine angioplasty. CONCLUSION: Our study shows that optimal timing of papaverine angioplasty is very important for clinical improvement.
Angioplasty* ; Papaverine* ; Retreatment ; Retrospective Studies ; Subarachnoid Hemorrhage ; Vasodilation ; Vasospasm, Intracranial*

BACKGROUND: Measurement of echocardiographic mitral valve area (MVA) is an useful noninvasive method of estimating the stenotic mitral valve area. This study was undertaken to evaluate the accuracy of echocardiographic MVA measurement by comparing MVAs measured by the planimetric and pressure half-time method versus direct MVA measurement by using a cone shaped device specifically made for direct measurement of MVA. METHODS AND RESULTS: The study population consisted of 22 consecutive patients from August 1993 to February 1996. All the patients underwent 2D planimetry and Doppler echocardiographic MVA measurement before and after valve replacement surgery ; direct measurement also was performed after surgery. Five patients (22.7%) had normal sinus rhythm, and the rest of the patients had atrial fibrillation. Two-dimensional echocardiographic examinations were attempted in 22 patients, and adequate measurements were obtained in 21 of the patients studied. Mean mitral valve area were 0.99+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on 2D planimetry method, 0.93+/-0.32cm (2) ranged from 0.42 to 1.68cm (2) on Doppler pressure half-time method, 1.17+/-0.20cm (2) ranged from 0.93 to1.68cm (2) on direct measurement of mitral valve area after surgery. 2D planimetry method (r=0.621, p=0.003, SE=0.165), pressure half-time method (r=0.454, p=0.003, SE=0.187), and transmitral peak velocity (r=-0.480, p=0.026, SE=0.189) was relatively well correlate with operative mitral valve area. There was relatively good agreement between direct and 2D planimetric measurement and between direct and Dopler pressure-half time method. CONCLUSION: 2D planimetry and Doppler pressure half-time method on echocardiography are useful, noninvasive measurement method in patients with mitral stenosis.
Atrial Fibrillation ; Echocardiography* ; Humans ; Mitral Valve Stenosis* ; Mitral Valve*

The molecular mechanisms control the function of PDL(periodontal ligament) cells and/or fibroblasts remain unclear. PDLs17, PDL-specific gene, had previousely identified the cDNA for a novel protein from cultured PDL fibroblasts using subtraction hybridization between gingival fibroblasts and PDL fibroblasts. The purpose of this study was to determine the regulation by growth factors and cytokines on PDLs17 gene expression in cultured human periodontal ligament cells and observe the immunohistochemical localization of PDLs17 protein in various tissues of mouse. Primary PDL fibroblasts isolated by scraping the root of the extracted human mandibular third molars. The cells were incubated with various concentration of human recombinant IL-1beta, PDGF-BB and TGF betafor 48h and 2 weeks. At each time point total RNA was extracted and the levels of transcription were assessed by reverse transcription-polymerase chain reaction (RT-PCR assay). Polyclonal antiserum raised against PDLs17 peptides, CLSVSYNRSYQINE and SEAVHETDLHDGC, were made, and stained the tooth, periodontium, developing bone, bone marrow and mid-palatal suture of the mouse. The results were as follows. 1. PDLs17 mRNA levels were increased in response to PDGF (10ng/ml) and TGF beta(20ng/ml) after treatment of the IL-1beta, PDGF-BB and TGFbetafor 48 h. 2. PDLs17 was up-regulated only by TGFbeta(20 ng/ml) after treatment of the IL-1beta, PDGF-BB and TGF betafor 2 weeks and unchanged by the other stimulants. 3. PDLs17 was a novel protein coding the 142 amino acid peptides in the ORF and the nucleotide sequences of the obtained cDNA from RT-PCR was exactly same as the nucleotides of the database. 4. Immunohistochemical analysis showed that PDLs17 is preferentially expressed in the PDL, differentiating osteoblast-like cells and stromal cells of the bone marrow in the adult mouse. 5. The expression of PDLs17 protein was barely detectable in gingival fibroblasts, hematopoetic cells of the bone marrow and mature osteocytes of the alveolar bone. These results suggest that PDLs17 might upregulated by PDGF-BB or TGFbetaand acts at the initial stage of differentiation when the undifferentiated mesenchymal cells in the bone marrow and PDL differentiate into multiple cell types. However, more research needs to be performed to gain a better understanding of the exact function of PDLs17 during the differentiation of bone marrow mesenchymal and PDL cells.
Adult ; Animals ; Base Sequence ; Blood Platelets* ; Bone Marrow ; Clinical Coding ; Cytokines ; DNA, Complementary ; Ecthyma, Contagious ; Fibroblasts* ; Gene Expression ; Humans* ; Immunohistochemistry ; Intercellular Signaling Peptides and Proteins ; Interleukins* ; Mice ; Molar, Third ; Nucleotides ; Osteocytes ; Peptides ; Periodontal Ligament* ; Periodontium ; RNA ; RNA, Messenger* ; Stromal Cells ; Sutures ; Tooth ; Transforming Growth Factor beta

BACKGROUND: Recently, the incidence of acute myocardial infarction (AMI) rapidly increased with prolongation of life spans, improvements of food and life styles in Korea. The mortality rate of AMI is higher than other disease. The purpose of this study is to evaluate which factors can affect the early outcome of AMI in Korean. METHODS: A retrospective clinical study was done on 555 consecutive patients{Male:Female=387 (69.7%):168 (30.3%), mean age 61.3 years} with AMI who had been admitted to Dong-San Medical Center from January 1990 to May 1997 . The subjects were devided into two groups. Group I was dead patients during the in-hospital period (85 patients, 15.3%), and Group II was living patients (470 patients, 84.7%) wen they discharged from hospital. We compared clinical and laboratory results in both groups and analysed the cause of death according to the time of death during hospitalization. RESULTS: The results were as folows; 1) The mean age and female percentage of Group I (65.4 years, 43%) were higher than Group II (60.5 years, 28%). The mean of systolic/diastolic blood pressure and percentage of smoker of Group I (108/65mmHg, 48%) were lower than Group II (125/76mmHg, 65%), significantly. 2) The degree of Killip classification was higher in Group I (class 1:29.4%, II:18.8%, III:21.2%, IV:30.6%) than in Group II patients (class 1:73.4%, II:13.6%, III:8.7%, IV:4.3%), significantly. 3) 47 patients were died first day of hospitalization and the most common cause of death was cardiogenic shock (27 patients, 31%). The most common cause of death within 1 week was cardiogenic shock, afterthen congestive heart failure. 4) The most common cause of death in Killip class I patients was ventricular tachycardia or ventricular fibrillation and in Killip class II-IV patients was cardiogenic shock. CONCLUSION: The risk of in-hospital death was higher in elderly, female sex, and patients with higher killip classification. Cardiogenic shock was most common cause of death within 1 week, and was congestive heart failure after 1 week.
Aged ; Blood Pressure ; Cause of Death ; Classification ; Female ; Heart Failure ; Hospitalization* ; Humans ; Incidence ; Korea ; Life Style ; Life Support Care ; Mortality ; Myocardial Infarction* ; Retrospective Studies ; Shock, Cardiogenic ; Tachycardia, Ventricular ; Ventricular Fibrillation

A psoas abscess (PA) is a rare clinical entity but is potentially serious condition which presents diagnostic and therapeutic challenges. The diagnosis is frequently delayed due to its variable and nonspecific features and occult clinical course. The delay in diagnosis and treatment of PA is the major poor prognostic factor. We describe herein a case of the sterile psoas abscess complicating Cronh's disease which presented as hip flexion contracture. A 29-year-old man, at remission stage of CD involving ileocolic segment, was admitted due to pain from hip contracture. He had no bloody diarrhea and no abdominal pain. PA was confirmed by abdominal ultrasound. PA with hip contracture was completely treated with surgical excision, irrigation, drainage, and antibiotics. PA was sterile and there was no evidence of a fistulous communication from the bowel. Once suspected, aggressive diagnostic work up and definitive operative intervention is needed.
Adult ; Crohn Disease/*complications/drug therapy ; Diagnosis, Differential ; Drainage ; Hip Contracture/complications/*diagnosis/surgery ; Humans ; Male ; Psoas Abscess/*diagnosis/etiology/ultrasonography ; Tomography, X-Ray Computed

Intravariceal injection of N-butyl-2-cyanoacrylate is widely used for the hemostasis of bleeding gastric varices, but not routinely for esophageal variceal hemorrhage because of various complications such as pyrexia, bacteremia, deep ulceration, and pulmonary embolization. We report a rare case of esophageal sinus formation after cyanoacrylate obliteration therapy for uncontrolled bleeding from post-endoscopic variceal ligation (EVL) ulcer. A 50-year-old man with alcoholic liver cirrhosis presented with hematemesis. Emergent esophagogastroscopy revealed bleeding from large esophageal varices with ruptured erosion, and bleeding was initially controlled by EVL, but rebleeding from the post-EVL ulcer occurred at 17th day later. Although we tried again EVL and the injections of 5% ethanolamine oleate at paraesophageal varices, bleeding was not controlled. Therefore, we administered 1 mL cyanoacrylate diluted with lipiodol and bleeding was controlled. Three months after the endoscopic therapy, follow-up endoscopy showed medium to large-sized esophageal varices and sinus at lower esophagus. Barium esophagography revealed an outpouching in esophageal wall and endoscopic ultrasonography demonstrated an ostium with sinus. It is noteworthy that esophageal sinus can be developed as a rare late complication of endoscopic cyanoacrylate obliteration therapy.
Cyanoacrylates/administration & dosage/*adverse effects ; *Embolization, Therapeutic ; Endoscopy, Digestive System ; Esophageal and Gastric Varices/complications/*diagnosis/therapy ; Esophagus/radiography/ultrasonography ; Ethiodized Oil/therapeutic use ; Gastrointestinal Hemorrhage/surgery/*therapy ; Humans ; Ligation ; Liver Cirrhosis, Alcoholic/*complications/diagnosis ; Male ; Middle Aged ; Tissue Adhesives/administration & dosage/*adverse effects ; Ulcer/*complications

Although bleeding is a major complication of oral anticoagulant therapy, warfarin-induced spontaneous intramural hematoma of the small bowel is a very rare complication. The clinical features of spontaneous intramural hematoma vary from mild abdominal pain to panperitonitis due to bowel perforation. Because spontaneous intramural hematoma can proceed to a life threatening situation, early diagnosis is of vital importance. Although there are a number of radiologic diagnostic tools available including abdominal ultrasonography and computed tomography, confirmation of the diagnosis through direct visualization of the involved bowel mucosa is very helpful. Direct confirmation of warfarin-induced spontaneous intramural hematoma of the small bowel is possible using double-balloon enteroscopy. We report a case of warfarin-induced spontaneous intramural hematoma with a review of the relevant literature.
Abdominal Pain ; Double-Balloon Enteroscopy ; Early Diagnosis ; Hematoma ; Hemorrhage ; Mucous Membrane

BACKGROUND/AIMS: The optimal timing for interventional endoscopy in bleeding peptic ulcer disease is controversial. This study compared the outcomes between early endoscopy and delayed endoscopy in patients with bleeding peptic ulcer disease. METHODS: We conducted a prospective analysis of data from 90 patients with bleeding peptic ulcer disease who visited the emergency room between May 2006 and September 2007. Patients were categorized into two groups: the early-endoscopy group (admitted during the daytime or at night with prompt endoscopic management) and the delayed-endoscopy group (admitted at night or during weekends, with endoscopic management delayed until the next day). We compared the clinical outcomes of endoscopy between the two groups. RESULTS: There were 49 patients in the early-endoscopy group and 41 patients in the delayed-endoscopy group. Patient demographics, clinical characteristics, bleeding control modality, and Rockall score did not differ between the two groups. There were also no significant differences between the early- and delayed-endoscopy groups in the re-bleeding rate (3/49 vs 5/41, p=0.313), the duration of hospital stay (10.7 vs 9.3 days, p=0.437), and the total amount of blood transfused (3.4 vs 2.7 units, p=0.240). CONCLUSIONS: The effectiveness of interventional endoscopy for patients with bleeding peptic ulcer disease is not significantly affected by the timing of endoscopy.
Demography ; Emergencies ; Endoscopy ; Hemorrhage ; Humans ; Length of Stay ; Peptic Ulcer ; Prospective Studies

Segmental colitis associated with diverticular disease (SCAD) is a colonic inflammatory disorder with localized non-granulomatous inflammation at sigmoid colon, and associated with colonic diverticulosis. SCAD is an apparently uncommon disorder in Western. We experienced a rare case of SCAD in a 46-year-old woman who visited the hospital due to abdominal discomfort. Colonoscopic examination showed multiple sigmoid diverticula in association with a segment length colitis. Colonoscopic biopsies of the sigmoid colon demonstrated cryptitis and crypt abscess along with chronic inflammatory cells infiltration. The biopsies of the rectum was histologically normal. The patient was given the diagnosis of SCAD and treated with oral mesalamine. This is the first case of SCAD reported in Korea.
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Colitis/complications/*diagnosis/drug therapy ; Colon, Sigmoid/pathology ; Colonoscopy ; Diverticulitis, Colonic/complications/*diagnosis/drug therapy ; Female ; Humans ; Mesalamine/therapeutic use ; Middle Aged