OBJECTIVE: This study was conducted to measure radiographic joint space width and to estimate erosion in the hands of patients with rheumatoid arthritis. It showed that joint space width, homogeneity, and invariant moments are parameters to discriminate between the normal and the rheumatoid joint. METHODS: In order to measure the joint space width and to estimate erosion in the finger joint, 32 radiographic images were used - 16 images for training and 16 images for testing. The joint space width was measured in order to quantify the joint space narrowing. Also, homogeneity and invariant moments was computed in order to quantify erosion. Finally, artificial neural networks were constructed and tested as a classifier distinguishing between the normal and the rheumatoid joint. RESULTS: The joint space width of normal was 1.04+/-0.15 mm and the width of patients with rheumatoid arthritis was 0.94+/-0.15 mm. The Homogeneity of normal was 16568.83+/-2669.83 and invariant moments were 6843.45+/-2937.55. They were statistically difference (p<.05). Using these characteristics, artificial neural networks showed that they discriminate between normal and rheumatoid arthritis (AUC=0.91). CONCLUSION: Measuring joint space width, estimating homogeneity, and invariant moments provide the capability to distinguish between a normal joint and a rheumatoid joint.
Arthritis, Rheumatoid ; Finger Joint ; Hand ; Humans ; Joints

Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1x10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 microg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 microg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.
Animals ; Bacteria ; Gastric Mucosa ; Helicobacter pylori ; Homicide ; Humans ; Hydrogen-Ion Concentration ; Male ; Mice ; Oenothera biennis* ; Urease

As the request of the authors, Acknowledgments section has been changed.
Oenothera biennis*

We report a case of ruptured mycotic aneurysm involving innominate artery requiring an urgent surgical treatment. A 62-yr-old woman presented with fever and dyspnea. Previously, she was diagnosed with colon cancer and received right hemicolectomy and one cycle of adjuvant chemotherapy. On echocardiogram, pericardial effusion was noted and emergency pericardiocentesis was performed. CT scan revealed aortic aneurysm involving ascending aorta and innominate artery, and thrombi surrounding those structures. Patch repair of the defect in the ascending aorta and ringed Goretex graft to bypass the innominate and ascending aorta were performed. We believe that this is the first case of ruptured mycotic aneurysm involving innominate artery.
Aneurysm, Infected/*surgery ; Aorta/pathology ; Aortic Aneurysm/surgery ; Brachiocephalic Trunk/pathology ; Colonic Neoplasms/drug therapy/surgery ; Female ; Human ; Middle Aged ; Tomography, X-Ray Computed ; Transplants

PURPOSE: We evaluated the effects of emergency department (ED)-based video-nystagmography (VNG) testing on consultation with other departments and length of ED stay of patients with dizziness. METHODS: A before-and-after study was performed at a tertiary ED from May 13, 2011 to May 12, 2012. Adult patients (age> or =15 years) with dizziness were enrolled, excluding patients with incomplete information. We defined the before- and after-phase according to implanting of the ED-based VNG test. The VNG test was performed by an internship physician supervised by 2nd or 3rd grade emergency medicine residents. Primary outcome was any consultation to other specialty departments and the secondary outcome was the length of stay at the ED. The adjusted odds ratios (ORs) with 95% confidence interval (95% CI) for outcomes by phase were estimated using multivariate logistic regression analysis adjusting for potential co-variates. RESULTS: Of 1,485 eligible patients, 1,449 patients (male: 37.0%, mean age: 59.2+/-15.5 years) were enrolled (415 in the before-phase and 1,034 in the after-phase). The final diagnosis group was stroke (4.8%), peripheral vestibulopathy (44.9%), other specific disease (29.0%), and non-diagnostic symptom (21.4%). The consultation request was more reduced in the after-phase (38.1%) than the before-phase (52.5%). The LOS was not changed between both phases (7.4+/-7.5 hours versus 7.4+/-7.3 hours, p=0.76). The adjusted OR (95% CI) for the consultation of after-phase compared to before-phase was 0.46(0.35, 0.61), while the adjusted OR (95% CI) for LOS was 1.39(0.99, 1.95). CONCLUSION: Implementation of ED-based VNG test significantly reduced the consultation with other specialty departments, while LOS was not affected.
Adult ; Dizziness ; Emergencies ; Emergency Medicine ; Humans ; Internship and Residency ; Length of Stay ; Logistic Models ; Nystagmus, Pathologic ; Odds Ratio ; Stroke ; Vertigo

OBJECTIVES: This study aims to develop a Korean version of the Composite International Diagnostic Interview(K-CIDI). METHODS: The Composite International Diagnostic Interview(CIDI) is a comprehensive, fully standardized interview that can be used to assess psychiatric disorders and provide diagnoses. The K-CIDI was developed according to the guidelines provided by the WHO. The reliability and validity of the K-CIDI was evaluated by examining 135 psychiatric patients and five community residents. Subjects were jointly interviewed twice with a one-week interval. A psychiatric resident and clinical psychologist jointly determined clinical diagnoses using the Structured Clinical Interview for DSM-IV. RESULTS: Notable modifications were done in sex-related expression, health system and help-seeking behavior, subjects for phobic disorder, and kinds of alcohol and substance. Long and complex questions were divided into two or more questions. Field test and back-translation of the K-CIDI confirmed the appropriateness of the translation of the CIDI. The inter-rater reliability, test/retest reliability, and validity of the K-CIDI indicated kappa values ranging from 0.86-1.00, 0.42-0.89, and 0.50-1.00, respectively. CONCLUSION: The K-CIDI was deemed to be appropriate for the sociocultural background of Koreans. The reliability and validity of the K-CIDI were judged to be exceptionally acceptable.
Diagnosis ; Diagnostic and Statistical Manual of Mental Disorders ; Epidemiology ; Humans ; Phobic Disorders ; Psychology ; Reproducibility of Results

The effects of an ethanolic extract of Angelica gigas (EAG) on the vascular smooth muscle cell (VSMC) proliferation and high-cholesterol diet-induced hypercholesterolemia and atherosclerosis were investigated. Rat aortic VSMCs were stimulated with platelet-derived growth factor-BB (25 ng/mL) for the induction of DNA synthesis and cell proliferation. EAG (1-10 microg/mL) significantly inhibited both the thymidine incorporation and cell proliferation in a concentration-dependent manner. Hypercholesterolemia was induced by feeding male New Zealand white rabbits with 0.5% cholesterol in diet for 10 weeks, during which EAG (1% in diet) was given for the final 8 weeks after 2-week induction of hypercholesterolemia. Hypercholesterolemic rabbits exhibited great increases in serum total cholesterol and low-density lipoproteins (LDL) levels, and finally severe atheromatous plaque formation covering 28.4% of the arterial walls. EAG significantly increased high-density lipoproteins (HDL), slightly decreased LDL, and potentially reduced the atheroma area to 16.6%. The results indicate that EAG attenuates atherosclerosis not only by inhibiting VASC proliferation, but also by increasing blood HDL levels. Therefore, it is suggested that EAG could be an alternative or an adjunct therapy for the improvement of hypercholesterolemia and atherosclerosis.
Angelica* ; Animals ; Atherosclerosis* ; Cell Proliferation* ; Cholesterol ; Diet ; DNA ; Ethanol* ; Humans ; Hypercholesterolemia ; Lipoproteins, HDL ; Lipoproteins, LDL ; Male ; Muscle, Smooth, Vascular* ; Plaque, Atherosclerotic ; Rabbits ; Rats ; Thymidine

The rate of dependence among ever-users of a drug indicates the risk of developing dependence once an individual has been exposed to the drug. This is the first study to investigate 12-month tobacco dependence (TD) among ever-smokers in a community-based population. Analyses were based on two national studies of representative samples aged 18-64 in 1984 (n=5,025) and in 2001 (n=6,275), conducted with household visits and face-to-face interviews. The rates of 12-month TD among ever-smokers in men showed no significant difference between 51.6% in 1984 and 50.6% in 2001. On the contrary, the rates in women significantly increased from 33.3% in 1984 to 52.8% in 2001. After adjusting for the sociodemographic variables, 'male gender' was significantly associated with 12-month TD among eversmokers in 1984, but not in 2001. 'Unmarried' was significantly associated in 2001 but not in 1984. 'Alcohol dependence' was the only psychiatric disorder associated with 12-month TD in both study years. In conclusion, 12-month TD was found in about 50% of ever-smokers, and gender differences between the rates of 12-month TD which was observed in 1984 disappeared in 2001. Individuals with 12-month TD showed higher comorbidity with alcohol dependence than ever-smokers without TD.
Adolescent ; Adult ; Alcoholism/complications ; Comorbidity ; Female ; Health Surveys ; Humans ; Korea ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Factors ; *Smoking ; Tobacco Use Disorder/complications/*diagnosis/*epidemiology

Recently the transcriptional up-regulation of human beta-defensin 2 (HBD-2) by lipopolysaccharide (LPS) was found to be associated with NF-kappaB binding site. Although the general mechanisms of NF-kappaB activation by LPS stimulation are well understood, less is known about the signal transduction pathway leading to LPS-induced NF-kappaB activation in human corneal epithelial (HCE) cells. The aim of this study was to investigate the intracellular signals involved in LPS-induced HBD-2 mRNA expression in HCE cells. Pretreatments of inhibitors for NF-kappaB, protein tyrosine kinase, p38 mitogen activated protein kinase (MAPK), and c-Jun N-terminal kinase (JNK) attenuated the LPS-induced NF-kappaB DNA binding activity and HBD-2 mRNA expression. Furthermore, pretreatments with inhibitors for protein kinase C (PKC), phosphatidylcholine-phospholipase C, phosphatidylinositol-phospholipase C, or phosphatidate phosphohydrolase prevented LPS-induced HBD-2 mRNA expression and HBD-2 prmoter-driven luciferase activity. However, the increased expression of HBD-2 mRNA and the increased DNA binding activity of NF-kappaB induced by LPS were not changed by the blockage of extracellular signal-regulated kinase (ERK) and of addition of antioxidants. Forskolin, a protein kinase A (PKA) agonist did not induce HBD-2 mRNA expression. These data demonstrate that LPS-induced HBD-2 mRNA expression via NF-kappaB is, at least in part, dependent on PKC, p38 MAPK, JNK, and protein tyrosine kinase status, but appears to be independent on PKA, ERK and ROS in HCE cells. Taken together, there may be more than one signaling pathways that lead to LPS-induced up-regulation of HBD-2 mRNA expression in HCE cells.
Antioxidants ; Binding Sites ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; DNA ; Epithelial Cells* ; Humans* ; JNK Mitogen-Activated Protein Kinases ; Luciferases ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Phosphatidate Phosphatase ; Phosphotransferases ; Protein Kinase C ; Protein Kinases ; Protein-Tyrosine Kinases ; RNA, Messenger* ; Signal Transduction ; Up-Regulation

The effects of nattokinase on the in vitro platelet aggregation and in vivo thrombosis were investigated in comparison with aspirin. Rabbit platelet-rich plasma was incubated with nattokinase and aggregation inducers collagen and thrombin, and the platelet aggregation rate was analyzed. Nattokinase significantly inhibited both the collagen- and thrombin-induced platelet aggregations. Nattokinase also reduced thromboxane B2 formation from collagen-activated platelets in a concentration-dependent manner. Rats were orally administered with nattokinase for 1 week, and their carotid arteries were exposed. Arterial thrombosis was induced by applying 35% FeCl3-soaked filter paper for 10 min, and the blood flow was monitored with a laser Doppler probe. Nattokinase delayed the FeCl3-induced arterial occlusion in a dose-dependent manner, doubling the occlusion time at 160 mg/kg. In addition, a high dose (500 mg/kg) of nattokinase fully prevented the occlusion, as achieved with aspirin (30 mg/kg). The results indicate that nattokinase extracted from fermented soybean inhibit platelet aggregation by blocking thromboxane formation, and thereby delay thrombosis following oxidative arterial wall injury. Therefore, it is suggested that nattokinase could be a good candidate without adverse effects for the improvement of blood flow.
Animals ; Aspirin ; Blood Platelets* ; Carotid Arteries ; Collagen ; Platelet Aggregation* ; Platelet-Rich Plasma ; Rats ; Soybeans ; Thrombin ; Thrombosis* ; Thromboxane B2