Transforming growth factor-beta1 (TGF-beta1) and bone morphogenetic protein-2 (BMP-2) are abundant proteins in the bone matrix. However, their interaction in controlling osteoblast differentiation is not clearly understood. In this study, HBMSCs were cultured in collagen gel matrix with different condition of exogenous rhBMP-2 and TGF-beta1 in order to determine the interaction of BMP-2 and TGF-beta1 on human bone marrow stromal cells (HBMSCs) differentiation. The cultured cells were analyzed for cell proliferation, alkaline phophatase (ALP) activity and mineralization stainning with Von-Kossa. The cells treated with TGF-beta1 exhibited a higher rate of cell growth than those without. However, the cells cultured in collagen gel matrix showed a lower rate of cell growth than the cells cultured in a monolayer. To investigate the effects of both cytokines on osteoblast differentiation, the cells were treated with 0, 1, 5, 10 ng/ml of TGF-beta1 for 2 days. This was followed by culturing with 0, 1, 5, and 10 ng/ml of TGF-beta1 and 100 ng/ml of rhBMP-2 together for 3 days with the alkaline phosphatase (ALP) activity measured. The cells treated with 1 ng/ml of TGF-beta1 responded efficiently to rhBMP-2 and expressed ALP activity with a level equivalent to that exhibited by cells that were not treated with TGF-beta1. The cells treated with 5 and 10 ng/ml of TGF-beta1 showed a dramatic decrease in ALP activity. The cells treated with 10ng/ml of TGF-beta1 followed by rhBMP-2 alone exhibited an intermediate ALP activity. The cells treated with 100 ng/ml of rhBMP-2 demonstrated Von-Kossa positive solid deposits after 3 weeks, while there were few Von-Kossa positive solid deposits when the cells treated with 10 ng/ml of TGF-beta1. These results show that TGF-beta1 inhibits the effects of rhBMP-2 on the osteoblast differentiation of HBMSCs in a dose dependant manner. Furthermore, the effects of TGF-beta1 on HBMSCs are reversible. This suggest that TGF-beta1 and rhBMP-2 are coordinately controlled during the osteoblast differentiation of HMBSCs.
Alkaline Phosphatase/metabolism ; Bone Marrow Cells/*drug effects ; Bone Morphogenetic Proteins/*pharmacology ; Cell Differentiation/drug effects ; Cell Division/drug effects ; Cells, Cultured ; Collagen/*pharmacology ; Human ; Recombinant Proteins/pharmacology ; Stromal Cells/*drug effects ; Transforming Growth Factor beta/*pharmacology

The paper presented the basic concepts and methodology of the perfection management as applied in Toyota Auto Company, and the use of the current state value stream mapping (VSM). Examples cited justified the introduction of perfection management in the medical industry and the desirable outcomes. In addition, it described the inspirations of perfection management to the medical industry as to corporate culture, process optimization and business efficiency.

No abstract available.
Animals ; Cattle ; Encephalopathy, Bovine Spongiform/epidemiology ; Meat/*analysis ; United States

PURPOSE: Indoor risk factors for allergic diseases in low-income households in Korea have been characterized only partially. We evaluated the prevalences of atopic dermatitis, asthma, and allergic rhinitis in Seoul, Korea, to identify key housing and behavioral risk factors of low-income households. METHODS: Statistical analysis of the prevalence of these diseases and various risk factors was conducted using data from a 2010 Ministry of Environment household survey. Logistic regression models were generated using data from 511 low-income household apartments in districts of Seoul. RESULTS: In general, housing factors such as renovation history (P<0.1) and crowding status (P<0.01) were associated with allergic rhinitis, whereas behavioral factors such as frequency of indoor ventilation (P<0.05) and cleaning (P<0.1) were inversely correlated with atopic dermatitis. Indoor smoking was a major trigger of asthma and atopic dermatitis in low-income households (P<0.05). The presence of mold and water leakage in houses were the most important risk factors for all three diseases (P<0.05). CONCLUSIONS: Various risk factors play a role in triggering allergic diseases among low-income households in Seoul, and health or environmental programs mitigating allergic diseases should be tailored to address appropriate housing or behavioral factors in target populations.
Asthma ; Crowding ; Dermatitis, Atopic ; Family Characteristics* ; Fungi ; Health Services Needs and Demand ; Housing ; Korea ; Logistic Models ; Poverty ; Prevalence* ; Rhinitis ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Ventilation ; Water

PURPOSE: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs. METHODS: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematurity with plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013 and followed up for at least 9 months. RESULTS: Mean gestational age was 26 + 4 weeks +/- 11 days and mean birth weight was 822 +/- 251.4 g. The locations of disease were zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 +/- 1 day after plus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks +/- 16 days. Mean follow-up period was 16.6 +/- 6.9 months. Plus signs started to regress after the mean 4.6 +/- 2.3 days after injection and completely regressed after the mean 24.3 +/- 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injection procedure, but was regarded as a treatment failure. There were no local or systemic complications. CONCLUSIONS: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellent short-term efficacy and safety.
Birth Weight ; Cataract ; Cataract Extraction ; Follow-Up Studies ; Gestational Age ; Humans ; Medical Records ; Retinopathy of Prematurity* ; Retrospective Studies ; Treatment Failure ; Bevacizumab

PURPOSE: To characterize epidemiologically open-globe injuries and to identify prognostic factors for visual outcomes after open-globe injuries in Korea. METHODS: The medical records of 138 patients with open-globe injuries presenting to the Severance Hospital between January 2005 and June 2011 were retrospectively reviewed. RESULTS: Out of 138 patients, 85.5% were men. The types of injury included penetrating injury (44.2%), intraocular foreign body (15.9%), blunt injury (35.5%), and perforating injury (3.6%). The most common cause of injury was accidents at work (49.3%) and 60.9% of these injuries were a penetrating wound in zone I limited to the cornea. Predictors of poor visual outcome using univariate analysis included wound extended to posterior sclera, wound length of 10 mm or more, poor initial visual acuity of hand motion or less, and presence of associated ocular injuries at presentation including hyphema, lens injury, vitreous hemorrhage, and retinal detachment. Initial visual acuity and wound size were independent prognostic factors of visual outcome. CONCLUSIONS: Accidents at work are the most important cause of open-globe injuries in Korea. Accordingly, protective measures such as appropriate eyewear and safety education at work are warranted. Initial visual acuity and wound size predicted favorable visual outcome.
Cornea ; Foreign Bodies ; Hand ; Humans ; Hyphema ; Korea ; Male ; Medical Records ; Retinal Detachment ; Retrospective Studies ; Sclera ; Visual Acuity ; Vitreous Hemorrhage ; Wounds, Nonpenetrating ; Wounds, Penetrating

BACKGROUND: In most cases of a foreign body in the esophagus, an ENT specialist is consulted, which may be time consuming if not evaluated in a timely fashion. The patients are admitted to the hospital and sent to the operating room, where they are placed under anesthesia and the object is removed by using an esophagoscope. METHODS: A prospective randomized trial was conducted during the period from January 1998 to June 2000. All patients presenting to emergency department with blunt objects in the esophagus were included. In one group, with fluoroscopic guidance, a Foley catheter was placed to remove the blunt foreign bodies. And in the other group, we removed them by using the esophagoscpe. We used the t-test for statistical analysis in this study. RESULTS: Total number of patients enrolled in this study was 38. 22 patients were enrolled in the Foley Catheter removal group, and the remaining 16 were enrolled in the esophagoscope removal group. The success rate for the Foley catheter was 21/22(95.5%), and that for the esophagoscope was 15/16(93.8%). The average time of removal for the Foley catheter group was 0.70+/-0.28 hours while that for the esophagoscope group was 5.96+/-2.22 hours. One side effect, nonfatal hypoxia, was noted in the Foley catheter removal group. The average cost for the Foley catheter group were 78,800 won(approximately 60 US dollars) while that for the esophagoscope group took 722,800 won(approximately 600 US dollars). CONCLUSION: In our study, we found that the success rate for removing blunt foreign bodies from the esophagus by using a simple Foley catheter was high, also the Foley catheter was a time saving and cost effective procedure with an excellent safety profile.
Anesthesia ; Anoxia ; Catheters* ; Emergencies* ; Emergency Service, Hospital* ; Esophagoscopes ; Esophagus ; Foreign Bodies* ; Humans ; Operating Rooms ; Prospective Studies ; Specialization

PURPOSE: To compare clinical, angiographic, and optical coherence tomographic characteristics between eyes with acute Vogt-Koyanagi-Harada (VKH) disease and eyes with acute bilateral central serous chorioretinopathy (CSC), and to demonstrate distinguishing features between the two diseases in confusing cases. METHODS: The medical records of 35 patients with VKH disease and 25 patients with bilateral CSC were retrospectively reviewed. Characteristics according to slit-lamp biomicroscopy, ophthalmoscopy, fundus photography, fluorescein angiography, indocyanine green angiography, and spectral-domain optical coherence tomography were compared between the two diseases. RESULTS: Five of 35 patients (10 of 70 eyes, 14.3%) with VKH disease were initially misdiagnosed as CSC patients, and six of 25 patients (12 of 50 eyes, 24%) with bilateral CSC were initially misdiagnosed as patients with VKH disease. Pigment epithelial detachment in CSC and optic disc hyperemia in VKH disease show the highest positive predictive values of 100% for each disease. CONCLUSIONS: Optic disc hyperemia in VKH disease and pigment epithelial detachment in bilateral CSC are the most specific clinical manifestations of each disease at initial patient presentation.
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Central Serous Chorioretinopathy/*diagnostic imaging ; Female ; Fluorescein Angiography ; Humans ; Hyperemia/diagnosis ; Indocyanine Green/administration & dosage ; Male ; Middle Aged ; Multimodal Imaging ; Ophthalmoscopy ; Optic Disk/blood supply ; Photography ; Retinal Detachment/diagnosis ; Retinal Pigment Epithelium/pathology ; Retrospective Studies ; Slit Lamp Microscopy ; Tomography, Optical Coherence ; Uveomeningoencephalitic Syndrome/*diagnostic imaging ; Young Adult

Treatment of rainbow trout macrophages with glycyrrhizin (GL), an aqueous extract of licorice (Glycyrrhiza glabra), enhanced their respiratory burst activity. Maximal effects were seen using concentrations of 10-100 ug/ml. GL also modulated trout lymphocytes, increasing proliferation responses to the mitogen phytohemagglutinin two-fold over a range of GL concentrations. In addition, GL elicited the release of a macrophage activating factor (MAF) kom head kidney leukocytes, as assessed by the ability of generated supernatants to increase respiratory burst activity of target macrophages. MAF activity was most apparent using 100 ug/ml GL to induce MAF release and a 48 h incubation period with the target macrophages. Finally, GL was shown to enhance the release oF MAF in response to the mitogen concanavalin A. The results suggest that GL might modulate the innate defences in fish.
Concanavalin A ; Glycyrrhiza ; Glycyrrhizic Acid* ; Head Kidney ; Leukocytes* ; Lymphocytes ; Macrophages ; Oncorhynchus mykiss* ; Oncorhynchus* ; Respiratory Burst ; Trout

The temporalis muscle is usually described as a single layer originating at the temporal line, converging to a tendon, and inserting onto a narrow site of the coronoid process. However, recent studies have shown that the temporalis muscle can be divided into two or three separate segments and the distal attachment continues inferiorly beyond the coronoid process. Therefore, the aims of this study were to analyze the morphology of the temporalis muscle focusing on the tendinous attachment onto the coronoid process and to provide educational values. The temporalis muscle was carefully dissected in 26 cadavers and classified based on the muscle fascicle direction. Each divided part was sketched and measured based on bony landmarks to elucidate its tendinous insertion site onto the coronoid process, and the results obtained were reviewed through the literature. The temporalis muscle ends at two distinct terminal tendons with wider insertion sites than usually presented in textbooks and atlases and separates into two parts that combine to act as a single structural unit. The superficial part is a large fan-shaped muscle commonly recognized as the temporalis muscle. This converges infero-medially to form the superficial tendon and the lateral boundary of the retromolar triangle. Meanwhile, the deep part is a narrow vertically oriented rectangular muscle that converges postero-laterally to form the deep tendon and the medial boundary of the retromolar triangle. These results indicate that understanding the temporalis muscle’s insertion site onto the coronoid process will be useful clinically with educational values during surgical procedures.