BACKGROUND: Toll like receptor (TLR), an element of innate immunity, is upregulated by Ischemia/reperfusion (IR) injury and may be involved in adaptive immune response. Immunosuppressive agents may increase or attenuate IR injury and TLR expression. To explore the involvement of TLRs in hypoxic tubular injury and modification by mycophenolic acid (MPA) rapamycin (RAP), this study examined TLR expression in hypoxia-induced human renal proximal tubular epithelial cells (HK-2). METHODS: HK-2 cells were cultured in keratinocyte-SFM media supplemented with epidermal growth factor and bovine pituitary extract. The Induction of hypoxia was achieved using GasPak pouch system. TLR 2, 3, and 4 mRNA expression was analyzed by real time RT-PCR using SYBR green and TLR 4 protein expression was evaluated by Western blot analysis. MPA at concentration of 100 nM and 1uM and RAP at concentration of 20, 50, and 100 nM were added to culture medium. RESULTS: TLR4 but noTLR2 or TLR3 mRNA expressions increased in hypoxic HK-2 cells at 24 and 48 hrs. TLR4 protein expression also increased in hypoxic HK-2 cells at 24 and 48 hrs. MPA (100 nM and 1uM) and RAP (20, 50, and 100 nM) decreased hypoxia-induced TLR4 mRNA expression in HK-2 cells compared to normoxia at 24 hrs. However, TLR4 protein expression was decreased only by RAP at 20 and 50 nM. CONCLUSIONS: The results suggest that RAP may modify hypoxic renal tubular damage by decreasing TLR4-mediated inflammatory and immune reactions.
Adaptive Immunity ; Anoxia ; Blotting, Western ; Epidermal Growth Factor ; Epithelial Cells ; Humans ; Immunity, Innate ; Immunosuppressive Agents ; Mycophenolic Acid ; RNA, Messenger ; Sirolimus ; Toll-Like Receptors

Objectives: This study aimed to determine the nutritional status of residents, to examine the perception and needs of community nutrition care service, and to compare and analyze the results of females and males living in Daejeon, Korea. Methods: The subjects were 592 adults and elderly (278 men and 314 women) residents of Daejeon. The dietary quality was assessed using the nutrition quotient (NQ), and data of the perception and needs for community nutrition care service were obtained by a questionnaire survey. Descriptive analysis was applied to analyze the demographic characteristics, perception and needs of the respondents, and independent t-test and chi-square test were performed to analyze and compare the differences between female and male participants. Results: A nutritional status that required monitoring was established in 78.9% of the respondents in this study. The balance factor (29.1 points) was much lower than the national average. In the diversity factor, the NQ score of the female group was 47.6 points, which was 8 points lower than that of males; the NQ grade was 43.9%, showing a significant difference between females and males (P < 0.001). The respondents answered that those who needed community nutrition care services were residents experiencing health care difficulties.Additionally, dietitians (35.6%) were pointed out as the most suitable service providers. The most important factor of community nutrition care service operation was securing the budget (47.0%). Conclusions The results of the present study show that Daejeon residents need overall nutrition support, and a demand for community nutrition care services exists. Our findings provide basic data and can serve as a foundation for the development and establishment of a community nutrition care service model.

PURPOSE: The purpose of this study was to identify validity the Korean version of resilience scale and identify performance status and resilience in patients with colorectal cancer. METHODS: A sample of 110 patients with colorectal cancer was recruited from a hospital in Seoul. Data were analyzed using descriptive statistics, t-test, factor analysis, MAP test and Parallel test and multiple regression with the SPSS/WIN 12.0 program. RESULTS: The reliability, validity, and factor analytic structure of the scale were evaluated. The scale demonstrated good psychometric properties and factor analysis yielded two factors. The resilience for colorectal cancer patients showed a significant difference according to marital status and performance status. The two variables were the significant factors influencing resilience, which they explained 26.5% of the variance. CONCLUSION: The results of the study show the importance of performance status in explaining the resilience in patients with colorectal cancer. Therefore, This study suggests that intervention programs to increase the performance status among patients could improve the resilience of cancer patients.
Activities of Daily Living ; Colorectal Neoplasms* ; Humans ; Marital Status ; Psychometrics ; Seoul

Pancreaticopleural fistula (PPF) a fistulous connection between the pancreas and pleural space due to prolonged chronic pancreatitis (CP). PPF is a very rare complication which presents in 0.4% of chronic pancreatitis cases, especially among children. We report a case involving a 3-year-old boy who presented with pleural effusion caused by a PPF, a complication of hereditary pancreatitis, which was, for the first time in Korea, successfully managed with endoscopic treatment. Chest radiography and computed tomography showed massive pleural effusion. Percutaneous catheter drainage was performed. High amylase levels were observed in the pleural fluid and serum, suggesting PPF. The patient was managed with bowel rest and octreotide infusion. Endoscopic retrograde cholangiopancreatography revealed CP, and pleural effusion was successfully managed with stent placement. PRSS1 genetic screening revealed R122H mutation.
Amylases ; Catheters ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Fistula ; Genetic Testing ; Humans ; Korea ; Male ; Octreotide ; Pancreas ; Pancreatic Fistula ; Pancreatitis ; Pancreatitis, Chronic ; Pleural Effusion ; Radiography ; Stents ; Thorax

PURPOSE: To evaluate effectiveness of percutaneous transluminal angioplasty (PTA) for transposed brachiobasilic arteriovenous fistula (tBBAVF), and to analyze the factors influencing patency after PTA. MATERIALS AND METHODS: In 101 patients who underwent operation for tBBAVF from January 2006 to February 2008, we identified 42 patients undergoing PTA. We conducted a retrospective analysis of sequential PTAs in these patients from 2006 to 2017. RESULTS: A total of 100 PTAs were performed. The technical success rate was 93% and the clinical success was 100%. Only ruptures occurred in 12% as minor complications. Primary patency rate was 61%, 29%, 7%, and secondary patency was 91%, 82%, 59% at 6, 12, and 24 months, respectively. Primary patency rate was lower in tBBAVF with rupture (p = 0.024). Secondary patency rate was significantly lower in the diabetes (p = 0.002). CONCLUSION Repetitive PTAs in tBBAVF are acceptable due to excellent secondary patency. Primary patency of tBBAVF is low in patients with rupture. Diabetes itself has a significant effect on secondary patency.

PURPOSE: Deposition of polymeric IgA1 in the kidney mesangium is the hallmark of IgA nephropathy, but the molecular mechanisms of IgA-mediated mesangial responses and inflammatory injuries remain poorly understood. We hypothesize that Toll-like receptor 4 (TLR4) is involved in IgA-induced mesangial cell activation. MATERIALS AND METHODS: Mouse mesangial cells were stimulated with lipopolysaccharide (LPS) (1 microg/mL), IgA (20 microg/mL), or both, and TLR4 expression was measured by real time RT-PCR and Western blot. Intracellular responses to LPS or IgA were assessed by Western blot for ERK1/2, JNK, p38 MAP kinases (MAPKs), Ikappa-Balpha degradation and fibronectin secretion. MCP-1 secretion was assessed by ELISA. Small interfering RNA (siRNA) of TLR4 was used to confirm that the effects were caused by TLR4 activity. RESULTS: LPS- or IgA-treatment upregulated the levels of TLR4 mRNA and protein in cultured MMC at 24 h. LPS and IgA induced rapid phosphorylation of MAPKs, but degradation of Ikappa-Balpha was observed only in LPS-treated MMC. LPS, but not IgA, induced increased secretion of MCP-1 and fibronectin at 24 h or 48 h. Combined LPS and IgA treatment did not cause additional increases in TLR4 mRNA and protein levels or Ikappa-Balpha degradation, and MCP-1 and fibronectin secretions were less than with LPS alone. LPS- or IgA-induced TLR4 protein levels and MAPK activation were inhibited by transfection with TLR4 siRNA. CONCLUSION: These results indicate that the activation of MAPKs and MCP-1 secretion are mediated by TLR4, at least in part, in IgA-treated mesangial cells. TLR4 is involved in mesangial cell injury by induction of pro-inflammatory cytokines in IgA nephropathy.
Animals ; Chemokine CCL2/secretion ; Enzyme-Linked Immunosorbent Assay ; Extracellular Signal-Regulated MAP Kinases/metabolism ; Fibronectins/secretion ; Glomerulonephritis, IGA/*metabolism ; I-kappa B Proteins/metabolism ; Mesangial Cells/*metabolism/secretion ; Mice ; Mice, Transgenic ; Phosphorylation ; RNA Interference ; RNA, Messenger/metabolism ; *Signal Transduction ; Toll-Like Receptor 4/antagonists & inhibitors/genetics/*metabolism

Childhood and adolescence are critical periods that affect adults' health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children's Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.
Adolescent Health ; Adolescent ; Child Health ; Child ; Cohort Studies ; Critical Period (Psychology) ; Environmental Health ; Health Surveys ; Humans ; Korea ; Obesity ; Risk-Taking

Childhood and adolescence are critical periods that affect adults' health status. Therefore, the factors influencing the health of children and adolescents should be analyzed. In Korea, a wide range of youth-related health data has been obtained, both on the regional level and on the national level. This report summarizes the current status of studies related to the health of Korean children and adolescents. Data for which open access is offered include the Korea Youth Risk Behavior Web-based Study, the Panel Study on Korean Children, the Korean Youth Panel Survey, the Korean Children and Youth Panel Survey, and the Student Health Examination. In addition, the Health Examination of Korean Youth Outside of School, the Korean Children and Adolescents Obesity Cohort Study, the Korean Children's Environmental Health Study, the Korea Youth Media Use and Harmful Environment Survey, the Comprehensive Survey of Korean Youth, and the Multicultural Adolescents Panel Study are summarized.
Adolescent Health ; Adolescent* ; Child Health ; Child* ; Cohort Studies ; Critical Period (Psychology) ; Environmental Health ; Health Surveys ; Humans ; Korea ; Obesity ; Risk-Taking

Pelvic actinomycosis is an uncommon infectious disease. It induces a chronic, suppurative illness characterized by an infiltrative and granulomatous response and, thus, the clinical and radiologic findings may mimic other inflammatory and neoplastic conditions. A 56-year-old female with a long-standing intrauterine device was diagnosed with pelvic actinomycosis manifesting as a large uterine mass with locally infiltrative spread into surrounding tissue that mimicked uterine malignancy. Actinomyces israelii infection was confirmed with a surgical specimen, and the patient was treated with antibiotic medication. Pelvic actinomycosis must be included in the differential diagnoses of patients with an infiltrative pelvic mass extending across tissue planes or in patients with findings of multiple microabscesses, particularly in a patient with an intrauterine device, even the lesion primarily involves the uterus.
Actinomyces ; Actinomycosis ; Communicable Diseases ; Diagnosis, Differential ; Female ; Humans ; Intrauterine Devices ; Middle Aged ; Pelvic Inflammatory Disease ; Uterus

The national licensing examination is used to evaluate the medical competency at the time of graduation, however no study has been performed on the validity of traditional Korean medicine license examination yet. The purpose of this study was to develop learning analytics using item response theory (IRT) to examine the validity and academic competency of the mock test of the national licensing exam. Classical test theory and IRT were used to evaluate the validity of test items, and IRT was used for test validity and competency analysis. The correlation between competency score of 12 subjects was analyzed using Pearson’s correlation. The distribution of students’ latent competencies was examined by gender and administrative group using a Kernel density map, Latent Profile Analysis, and χ2. The guessing parameter of 340 items was relatively high, and the information level of 12 subjects were relatively low. Significant correlations (r = 0.49–0.83, p < 0.05) were observed between the competency scores of total and 12 subjects. Two (high and low) latent academic competency groups were identified based on the competency score of 12 subjects. The low academic competency group requiring intensive management has a significantly higher frequency of male students with the experience of academic fail in the seven-year course. This study presented the quantitative learning analytics for the national licensing exam of traditional Korean medicine. The multifaceted item and test validities of the mock license test were provided, and an evidence-based approach to competency-based student management and national licensing exam of traditional Korean medicine was suggested.