No abstract available.
Sepsis*

The aims of this study were to document bronchiolitis obliterans(BO), the long term pulmonary sequelae after mycoplasma pneumonia, and to evaluate the difference of development of BO according to antibody titer and X-ray pattern. Twenty five subjects who had mycoplasma pneumonia underwent high resolution CT(HRCT) 1.3 years(1.0-2.0 years) after the initial infection. Fifteen boys and 10 girls, with mean age of 6.3 years(3-15 year) at the time of the infection, were included. The clinical diagnosis of Mycoplasma pneumoniae(M. pneumoniae) pneumonia was confirmed by a fourfold or higher rise in the antibody titers between acute and convalescent phase or a single very high titers(> or = 1:640) and abnormal chest radiographs. The subjects were divided into two groups as high titer group(antibody titer 1:5120 1:20480, n=15) and low titer group(antibody titer 1:640-1:2560, n=10). Nine of 25 subjects(36.0%) demonstrated BO findings on HRCT which included mosaic perfusion in 8 of 9 subjects(88.9%), bronchiectasis in 6(66.7%), mosaic perfusion associated with bronchiectasis in 6(66.7%), bronchial wall thickening in two(22.2%), and decreased pulmonary vascularity in one(11.1%). Those findings were more commonly seen in high titer group compared to low titer group[53.3%(8/15) vs 10.0%(1/10), P<0.05] and lobar type compared to linear type[58.0%(7/12) vs 15.4% (2/13), P<0.05]. The involved areas on HRCT exactly corresponded with initially involved area on chest radiographs in 8 of 9 subjects (88.9%). The development of BO was closely related to the M. pneumoniae pneumonia and was noted significantly in individuals with high antibody titer and lobar type x-ray pattern. We suggest that it is necessary to pay attention to the development of BO after M. pneumoniae pneumonia with high antibody titer and lobar type x-ray pattern.
Bronchiectasis ; Bronchiolitis Obliterans* ; Bronchiolitis* ; Diagnosis ; Female ; Humans ; Mycoplasma pneumoniae* ; Mycoplasma* ; Perfusion ; Pneumonia* ; Pneumonia, Mycoplasma* ; Radiography, Thoracic

PURPOSE: To find out whether or not the computed tomographic (CT) classification systems of the calcaneal fracture are efficient in illuminating displaced posterior facet fragment and the degree of displacement can be evaluated by analyzing serial CT images. MATERIALS AND METHODS: Seventy-seven hundred calcaneal fractures were classified by CT classification systems including Sanders classification, and the sagittal rotation angle of the posteior facet fragment was measured on the plain lateral radiograph. Among the serial axial CT images, a number of images with the cortical bone embedded in the cancellous portion were recorded and any significant relationship between each data were evaluated. RESULTS: The conventional CT classification systems are rather insufficient in illuminating the extent of sagittal rotatory displacement. However, the number of CT images in which the cortical radiodensity was observed showed a significantly related with the degree of displacement. CONCLUSION: The conventional CT classification of the calcaneal fractures is unsatisfactory in expressing the degree of sagittal rotatory displacement of the posterior facet fragment; this problem may be alleviated by observing the number of axial CT images in which cortical radiodensity was revealed within the calcaneal body.
Calcaneus ; Classification

PURPOSE: High levels and aberrant patterns of Bcl-2 gene expression have been reported in a variety of human cancers, including prostate, colorectal, lung and gastric cancers, neuroblastoma, non-Hodgkins lymphoma, and both acute and chronic leukemia. The Ewings sarcoma is a common malignant bone tumor in children and adolescents. Nearly all Ewings sarcomas have a t(11;22) chromosomal translocations which involves EWS gene and Fli-1 of ETS family transcription factors. The patterns of Bcl-2 gene expression in Ewings sarcoma is less well known. The inhibition of Bcl-2 gene expression leads to increase a apoptosis in several cancer cells. This study was undertaken to characterize the patterns of Bcl-2 gene expression in Ewings sarcoma cell (TC135) expressing fusion protein, EWS-Fli-l, and to induce the apoptosis of Ewings sarcoma cell by targeting Bcl-2 gene expression using antisense strategy. MATERIALS AND METHODS: We used two types of antisense EWS-Fli-1 and Bcl-2 expression vectors. These vectors were transfected to TC135 cells by calcium phosphate method, and transformed cells were selected using G418. The transformed cells were stimulated with apoptosis-inducing reagents, and changes of Bcl-2 expression were analyzed by Western and Northern blot analyses. To confirm the increased apoptosis, we checked DNA fragmentation, cell viability assay by MTT and ICE (interleuldn converting enzyme) activity. RESULTS: The TC135 cells transfected with antisense EWS-Fli-1 expression vector showed negatively regulated Bcl-2 protein and mRNA expression, but those transfected with control vector (pcDNA3) revealed no change of Bcl-2 gene expression. These results strongly suggested that the EWS-Fli-1 fusion protein directly regulate Bcl-2 gene expression on the Bcl-2 gene promotor region. And the TC135 cells transfected with antisense Bcl-2 expression vector showed increased apoptosis. These results suggested that the apoptosis pathway of Ewings sarcoma is regulated by EWS-Fli-1 fusion protein and following Bcl-2 gene. Finally, TC135 cells transfected with antisense Bcl-2 expression vector did not form colonies in soft agar, which may infer the loss of tumorigenicity. CONCLUSION: The targeting of Bcl-2 gene in the TC135 cells using antisense strategy lead to an increased apoptosis in .Ewings sarcoma cells. This approach can be considered as an efficient candidate strategy of cancer gene therapy.
Adolescent ; Agar ; Apoptosis* ; Blotting, Northern ; Calcium ; Cell Survival ; Child ; DNA Fragmentation ; Genes, bcl-2 ; Genes, Neoplasm ; Humans ; Ice ; Indicators and Reagents ; Leukemia ; Lung ; Lymphoma, Non-Hodgkin ; Neuroblastoma ; Promoter Regions, Genetic ; Prostate ; RNA, Messenger ; Sarcoma, Ewing ; Stomach Neoplasms ; Transcription Factors ; Translocation, Genetic

The accumulation of fluid in the pericardium in an amount sufficient to cause serious obstruction to the inflow of blood to the ventricles results in cardiac tamponade. This complication may be fatal if it is not recognized and treated promptly. We report a case of cardiac tamponade caused by acute pancreatitis, which resolved after catheter drainage.
Cardiac Tamponade* ; Catheters ; Drainage ; Pancreatitis* ; Pericardium

OBJECTIVES: In order to understand the biological basis of neurodevelopmental perspectives of mental disorders, the authors investigated the developmental and regional changes in the phosphorylation of the transcription factor CREB following the electroconvulsive shock(ECS) in rat brain. METHODS: Rats of various age groups (7, 14, 21 days postnatal and adults) were given ECS and their hippocampi and cerebella were dissected at specified time points. The content of CREB and phosphorylated CREB were measured by immunoblot analysis. RESULTS: The amount of CREB increased in the hippocampus and decreased in the cerebellum according to the age. Baseline levels of CREB phosphorylation in both tissues were increased from postnatal 14 days, and it was proportional to the amount of CREB protein in the cerebellum. In the hippocampus, ECS increased the phosphorylation of CREB at postnatal 21 days, but in the cerebellum, ECS did not increased the phosphorylation of CREB in any age group. CONCLUSION: CREB mediated signal transduction pathways showed developmental and tissue-specific changes. ECS increased the phosphorylation of CREB in the hippocampus by postnatal 21 days, but not in the cerebellum. CREB activation is supposed to be related with the inducdion of c-fos after ECS in the hippocampus. However, the Ser-133 phosphorylation of CREB could not completely explain the developmental and tissue specificity of c-fos induction.
Animals ; Brain* ; Cerebellum ; Cyclic AMP Response Element-Binding Protein ; Electroshock* ; Hippocampus ; Humans ; Mental Disorders ; Organ Specificity ; Phosphorylation* ; Rats* ; Signal Transduction ; Transcription Factors

BACKGROUND: The previous studies suggested that the rate of the people who reported having sensitivity to cold and Raynaud's disease were 12% and 5~10% of general population respectively. There are surprisingly few data on 'cold hands and feet syndrome', the conventional circulatory disorder in far-eastern Asia in spite of the assumption that it is a common disorder among Korean population. Besides, the prevalence of Raynaud's disease has not been studied for Korean complaint of the syndrome. Therefore, we conducted the survey regarding the frequency of Baynaud's disease and phenomenon among the people appealed abnormal sensory symptoms on hands and feet, and 'cold hands and feet syndrome'. METHODS: The questionnaires were asked to 1,008 out- patients who complained abnormal sensory symptoms on hands and feet. The subjects were screened among the patients who visited the clinics, mainly department of family medicine in Uijongbu St. Mary's hospital from January to July 2003. RESULTS: The most common abnormal sensory symptoms were tingling feeling and coldness, pain in the descending order. The mean age of the patients is 47 years, the average age at the onset of the symptoms is 40 years, and the mean duration they had been suffered by the symptoms is 7 years. During interview, 289 patients voluntarily appealed 'cold hands and feet syndrome' in expression of "I have cold extremities" or "I have the syndrome". Among the screened patients, 510 patients answered, "yes" to the question "Are your fingers unusually sensitive to cold?" Two hundred and nineteen patients (43%) of them showed Raynaud's phenomenon. One hundred and sixty patients were diagnosed as Raynaud's disease among 219 patients who had Raynaud's phenomenon. The rest 59 patients were diagnosed as secondary Raynaud's phenomenon. Eighty-seven patients (30%) of 289 patients who voluntarily reported 'cold hands and feet syndrome' were diagnosed as Raynaud's disease. The average age of Raynaud's disease patients is 37 years old, average first attack age is 24 years, and average suffering period is 14 years. Only 10% of cases experienced the first attacks after 40 years old. The attack rates are different by gender. The ratio is 2.3 and higher in female. Only six patients (4%) of Raynaud's disease had been diagnosed accurately. Fifty-three patients (33%) have family history and 41 of them are the first-degree relatives. The causes of secondary Raynaud's phenomenon (59 patients) are connective tissue disorders, neurologic diseases, carpal tunnel syndrome, hypothyroidism, vascular disorders, etc. The statistically significant factors that influence on Raynaud's disease are female, below 40 years old, stress, family history, hypertension, diabetes, etc. The statistical analysis in this study does not prove the association between the disease and the factors such as physical labor, manual labor using hands heavily, smoking, drinking, thyroid diseases, joint disorders, ischemic heart disease, depression. CONCLUSION: Raynaud's disease has been underlooked even though it is not uncommon and can be easily diagnosed and treated. In conclusion, the result of our study suggests that abnormal sensory symptoms on hands and feet, especially 'cold hands and feet syndrome', the conventional circulatory disorder, are the medical condition where special concern on Raynaud's disease is required.
Adult ; Asia ; Carpal Tunnel Syndrome ; Connective Tissue ; Depression ; Diagnosis* ; Drinking ; Female ; Fingers ; Foot* ; Hand* ; Humans ; Hypertension ; Hypothyroidism ; Joints ; Myocardial Ischemia ; Nervous System Diseases ; Prevalence ; Raynaud Disease* ; Sensation* ; Smoke ; Smoking ; Thyroid Diseases ; Surveys and Questionnaires

OBJECTIVE: The purpose of this study was to investigate the association between the T102C polymorphism in the serotonin 2A receptor gene and attention-deficit/hyperactivity disorder (ADHD) in Korean patients. METHODS: A total of 189 Korean children with ADHD as well as both parents of the ADHD children and 150 normal children participated in this study. DNA was extracted from blood samples from all of the subjects, and genotyping was conducted. Based on the allele and genotype information obtained, case-control analyses were performed to compare the ADHD and normal children, and Transmission disequilibrium tests (TDTs) were used for family-based association testing (number of trios=113). Finally, according to the significant finding which was showed in the case-control analyses, the results of behavioral characterastics and neuropsychological test were compared between ADHD children with and without the C allele. RESULTS: In the case-control analyses, statistically significant differences were detected in the frequencies of genotypes containing the C allele (chi2=4.73, p=0.030). In the family-based association study, TDTs failed to detect linkage disequilibrium of the T102C polymorphism associated with ADHD children. In the ADHD children, both the mean reaction time and the standard deviation of the reaction time in the auditory continuous performance test were longer in the group with the C allele compared to the group without the C allele. CONCLUSION: The results of this study suggest that there is a significant genetic association between the T102C polymorphism in the serotonin 2A receptor gene and ADHD in Korean children.
Alleles ; Case-Control Studies ; Child ; DNA ; Genotype ; Humans ; Linkage Disequilibrium ; Neuropsychological Tests ; Parents ; Reaction Time ; Receptor, Serotonin, 5-HT2A ; Serotonin

OBJECTIVE: We observed the developmental pattern of activation of MAPK signal transduction pathways known to be activated by electroconvulsive shock(ECS) in young rat hippocampus after kainic acid(KA)-induced seizure. METHODS: We used the method of immunoblotting for examining the basal protein amount and basal level of phosphorylation of MAPK kinase(SAPK/ERK kinase -1, SEK-1), MAPK(c-Jun N terminal protein kinase, JNK), transcription factor(c-Jun) and immediate early gene proteins(Fos) in rat hippocampus at postnatal day 7, 14, and 21, respectively. We also examined the changes of phosphorylation of those proteins after kainic acid-induced seizure in the same way. RESULTS: The basal protein amounts of SEK-1, JNK, and c-Jun did not show age-dependent changes and basal level of phosphorylation of JNK and c-Jun remains unchanged throughout the early developmental period. The basal level of phosphorylation of SEK-1 was peaked at postnatal 7 days and then decreased with aging. After kainic acid-induced seizure, the change of phosphorylation of JNK was not observed but those of SEK-1 and c-Jun increased after postnatal day 14. The expression of Fos was observed at postnatal day 7 and also increased with aging. CONCLUSION: These results show that the MAPK signal transduction system in rat hippocampus matures in accordance with aging, but the process of maturation differs depending specific proteins. This study suggests the signal transduction cascade(SEK-1 - JNK - c-Jun - Fos) which is well established in cell line studies may not be applied to rat hipposcampus because we could not observe the activation of JNK after KA-induced seizure in young rat hippocampus.
Aging ; Animals ; Cell Line ; Hippocampus* ; Immunoblotting ; Kainic Acid ; Phosphorylation ; Phosphotransferases ; Protein Kinases ; Rats* ; Seizures* ; Signal Transduction*

PURPOSE: To estimate annual health care and productivity loss costs attributable to overweight or obesity in working asthmatic patients. MATERIALS AND METHODS: This study was conducted using the 2003–2013 Medical Expenditure Panel Survey (MEPS) in the United States. Patients aged 18 to 64 years with asthma were identified via self-reported diagnosis, a Clinical Classification Code of 128, or a ICD-9-CM code of 493.xx. All-cause health care costs were estimated using a generalized linear model with a log function and a gamma distribution. Productivity loss costs were estimated in relation to hourly wages and missed work days, and a two-part model was used to adjust for patients with zero costs. To estimate the costs attributable to overweight or obesity in asthma patients, costs were estimated by the recycled prediction method. RESULTS: Among 11670 working patients with a diagnosis of asthma, 4428 (35.2%) were obese and 3761 (33.0%) were overweight. The health care costs attributable to obesity and overweight in working asthma patients were estimated to be $878 [95% confidence interval (CI): $861–$895] and $257 (95% CI: $251–$262) per person per year, respectively, from 2003 to 2013. The productivity loss costs attributable to obesity and overweight among working asthma patients were $256 (95% CI: $253–$260) and $26 (95% CI: $26–$27) per person per year, respectively. CONCLUSION: Health care and productivity loss costs attributable to overweight and obesity in asthma patients are substantial. This study's results highlight the importance of effective public health and educational initiatives targeted at reducing overweight and obesity among patients with asthma, which may help lower the economic burden of asthma.
Adult ; Asthma/*economics/epidemiology/therapy ; *Cost of Illness ; *Efficiency ; *Employment ; Female ; *Health Care Costs ; Health Expenditures ; Humans ; Male ; Middle Aged ; Obesity/*economics/epidemiology/therapy ; Overweight/economics/epidemiology/therapy ; United States/epidemiology ; Young Adult