To raise traditional medicine to a higher level of scientific research, a mathematical model has been proposed using symbolic notations and operators to describe several disease symptoms generally recognized in traditional medicine. Even though this model to a certain degree offers a mathematical approach to identify the relationships between yin-yang and the five viscera, it is not an efficient means of explaining the pathology in traditional medicine due to its use of superfluous notations and definitions. In this paper, we introduce two concise operators, a self-development operator and an action operator: the former describes the effect of a viscus in the unbalanced state on other viscera: the latter explains the engendering and restraining relationships between the two viscera. These tools are useful to elucidate the interactions among the states of the five viscera based on yin-yang and the five elements theory. Our mathematical model with these two operators facilitates description for the scheme of deficiency-excess of yin-yang in the five viscera. Accordingly, we have mathematically refined the existing results and shown clinical applications as well.
Heart ; physiopathology ; Humans ; Liver ; pathology ; Lung ; pathology ; Models, Theoretical ; Viscera ; pathology ; Yin-Yang

OBJECTIVES: To provide accurate personalized medical care, it is necessary to gather individual-related data or contextual information regarding the target person. Nowadays a large number of people possess smartphones, which enables sensors in the smartphones to be used for lifelogging. The objective of the study is to analyze human activity pattern by using lifelog agent cooperating with the Health Avatar platform. METHODS: Using the lifelog measured by accelerometer and gyroscope in a smartphone at a 50 Hz rate, the agent reveals how long the user walks, runs, sits, stands, and lies down, and this information is summarized by hours. The summaries are sent to the Health Avatar platform and finally are written in the Continuity of Care Record (CCR) format. RESULTS: The lifelog agent is successfully operated with the Health Avatar platform. In addition, we implement an application that displays the user's activity patterns in a graph and calculates the metabolic equivalent of task based calorie burned by hour or by day using the lifelog of the CCR form to show that the lifelog can be used as medical records. CONCLUSIONS: The agent shows how lifelogs are analyzed and summarized to help activity recognition. We believe that our agent demonstrates a way of incorporating lifelogs into medical care and a way of exploiting lifelogs in a medical format.
4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic Acid ; Activities of Daily Living ; Burns ; Continuity of Patient Care ; Health Behavior ; Human Activities* ; Humans* ; Medical Records ; Metabolic Equivalent ; Pattern Recognition, Automated ; Smartphone

BACKGROUND: Physical disability may result in some impairment of the score for Instrumental Activities of Daily Living (IADL). The aim of this study was to evaluate the effect of physical disability on IADL in patients with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), subcortical vascular dementia (SVD), and vascular mild cognitive impairment of the subcortical type (svMCI). METHODS: Fifty-six patients with AD, 30 with SVD, 27 with aMCI, and 21 with svMCI were recruited consecutively from a memory clinic. Informants for the subjects completed a Korean version of the IADL (K-IADL). In addition, the informants were asked to choose the cause of each dependent activity of K-IADL from the following: cognitive impairment, physical disability, or both. The cause of the physical disability was defined as being focal neurologic symptoms, other physical disease, or both. RESULTS: Compared to AD patients, SVD patients had higher K-IADL scores [2.02+/-0.80 (mean+/-SD) vs. 1.45+/-0.90, p<0.01] and focal neurologic signs (FNS; 8.0+/-5.8 vs. 0.0+/-0.0, p<0.001), and lower Barthel Index scores (14.7+/-5.1 vs. 19.6+/-1.2, p<0.001). Patients with svMCI had higher FNS (3.8+/-4.5 vs. 0.0+/-0.0, p<0.001) compared to those with aMCI. The most common cause of dependency of activities in K-IADL was cognitive impairment in AD, aMCI, and svMCI patients, and the combined effect of cognitive impairment and physical disability in those with SVD. The cause of physical disability was FNS in 96% of SVD patients and in all patients with svMCI. CONCLUSIONS: The effects of FNS as well as cognitive impairment should be considered when measuring the IADL of the patients with SVD or svMCI.
Activities of Daily Living ; Alzheimer Disease ; Dementia, Vascular ; Dependency (Psychology) ; Humans ; Memory ; Mild Cognitive Impairment ; Neurologic Manifestations

PURPOSE: The entry of bacteria or harmful substances through the epithelial seal of human gingival keratinocytes (HGKs) in the junctional epithelium (JE) is blocked by specialized intercellular junctions such as E-cadherin junctions (ECJs). However, the influence of roughened substrates, which may occur due to apical migration of the JE, root planing, or peri-implantitis, on the development of the ECJs of HGKs remains largely unknown. METHODS: HGKs were cultured on substrates with varying levels of roughness, which were prepared by rubbing hydrophobic polystyrene dishes with silicon carbide papers. The activity of c-Jun N-terminal kinase (JNK) was inhibited with SP600125 or by transfection with JNK short hairpin RNA. The development of intercellular junctions was analyzed using scanning electron microscopy or confocal laser scanning microscopy after immunohistochemical staining of the cells for E-cadherin. The expression level of phospho-JNK was assessed by immunoblotting. RESULTS: HGKs developed tight intercellular junctions devoid of wide intercellular gaps on smooth substrates and on rough substrates with low-nanometer dimensions (average roughness [Ra]=121.3±13.4 nm), although the ECJs of HGKs on rough substrates with low-nanometer dimensions developed later than those of HGKs on smooth substrates. In contrast, HGKs developed short intercellular junctions with wide intercellular gaps on rough substrates with mid- or high-nanometer dimensions (Ra=505.3±115.3 nm, 867.0±168.6 nm). Notably, the stability of the ECJs was low on the rough substrates, as demonstrated by the rapid destruction of the cell junction following calcium depletion. Inhibition of JNK activity promoted ECJ development in HGKs. JNK was closely associated with cortical actin in the regulation of ECJs in HGKs. CONCLUSIONS: These results indicate that on rough substrates with nanometer dimensions, the ECJs of HGKs develop slowly or defectively, and that this effect can be reversed by inhibiting JNK.
Actins ; Bacteria ; Cadherins* ; Calcium ; Dental Implants ; Epithelial Attachment ; Humans* ; Immunoblotting ; Intercellular Junctions ; JNK Mitogen-Activated Protein Kinases ; Keratinocytes* ; Microscopy, Confocal ; Microscopy, Electron, Scanning ; Peri-Implantitis ; Periodontal Diseases ; Polystyrenes ; Re-Epithelialization ; RNA, Small Interfering ; Root Planing ; Silicon ; Transfection

PURPOSE: Despite the well-known anti-inflammatory effects of vitamin D in periodontal health, its mechanism has not been fully elucidated. In the present study, the effect of vitamin D on strengthening E-cadherin junctions (ECJs) was explored in human gingival keratinocytes (HGKs). ECJs are the major type of intercellular junction within the junctional epithelium, where loose intercellular junctions develop and microbial invasion primarily occurs. METHODS: HOK-16B cells, an immortalized normal human gingival cell line, were used for the study. To mimic the inflammatory environment, cells were treated with tumor necrosis factor-alpha (TNF-α). Matrix metalloproteinases (MMPs) in the culture medium were assessed by an MMP antibody microarray and gelatin zymography. The expression of various molecules was investigated using western blotting. The extent of ECJ development was evaluated by comparing the average relative extent of the ECJs around the periphery of each cell after immunocytochemical E-cadherin staining. Vitamin D receptor (VDR) expression was examined via immunohistochemical analysis. RESULTS: TNF-α downregulated the development of the ECJs of the HGKs. Dissociation of the ECJs by TNF-α was accompanied by the upregulation of MMP-9 production and suppressed by a specific MMP-9 inhibitor, Bay 11-7082. Exogenous MMP-9 decreased the development of ECJs. Vitamin D reduced the production of MMP-9 and attenuated the breakdown of ECJs in the HGKs treated with TNF-α. In addition, vitamin D downregulated TNF-α-induced nuclear factor kappa B (NF-κB) signaling in the HGKs. VDR was expressed in the gingival epithelium, including the junctional epithelium. CONCLUSIONS: These results suggest that vitamin D may avert TNF-α-induced downregulation of the development of ECJs in HGKs by decreasing the production of MMP-9, which was upregulated by TNF-α. Vitamin D may reinforce ECJs by downregulating NF-κB signaling, which is upregulated by TNF-α. Strengthening the epithelial barrier may be a way for vitamin D to protect the periodontium from bacterial invasion.
Bays ; Blotting, Western ; Cadherins ; Cell Line ; Down-Regulation ; Epithelial Attachment ; Epithelium ; Gelatin ; Humans ; Intercellular Junctions ; Keratinocytes ; Matrix Metalloproteinase 9 ; Matrix Metalloproteinases ; NF-kappa B ; Periodontium ; Receptors, Calcitriol ; Tumor Necrosis Factor-alpha ; Up-Regulation ; Vitamin D ; Vitamins