Withaferin A (WFA) is known as a constituent of Ayurvedic medicinal plant, Withania somnifera, and has been used for thousands of years. Although WFA has been used for the treatment of osteoarthritis (OA) and has a wide range of biochemical and pharmacologic activities, there are no findings suggesting its properties on chondrocytes or cartilage. The aim of the present study is to investigate the effects of WFA on apoptosis with focus on generation of intracellular reactive oxygen species (ROS). Here we showed that WFA significantly increased the generation of intracellular ROS in a dose-dependent manner. We also determined that WFA markedly leads to apoptosis as evidenced by accumulation of p53 by Western blot analysis. N-Acetyl-L-Cystein (NAC), an antioxidant, prevented WFA-caused expression of p53 and inhibited apoptosis of chondrocytes. We also found that WFA causes the activation of PI3K/Akt and JNKinase. Inhibition of PI3K/Akt and JNKinase with LY294002 (LY)/triciribine (TB) or SP600125 (SP) in WFA-treated cells reduced accumulation of p53 and inhibited fragmented DNA. Our findings suggested that apoptosis caused by WFA-induced intracellular ROS generation is regulated through PI3K/Akt and JNKinase in rabbit articular chondrocytes.
Animals ; Anti-Inflammatory Agents/administration & dosage ; Apoptosis/drug effects/physiology ; Cartilage, Articular/cytology/drug effects/*metabolism ; Cells, Cultured ; Chondrocytes/drug effects/*metabolism ; Dose-Response Relationship, Drug ; MAP Kinase Kinase 4/*metabolism ; Phosphatidylinositol 3-Kinases/*metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; Rabbits ; Reactive Oxygen Species/*metabolism ; Withanolides/*administration & dosage

PURPOSE: This study aimed to identify the degree of accident prevention behavior, self-esteem, self-regulation ability, and social support among middle-school students, and investigate factors influencing their practice of accident prevention behaviors.METHODS: The participants were 174 students from two middle schools located in J city. Data were collected from December 28, 2017 to February 9, 2018 using self-reported questionnaires.RESULTS: The mean score were 3.08±0.37 of 4 for practice of accident prevention behaviors, 3.07±0.57 of 4 for self-esteem, 3.69±0.48 of 5 for self-regulation ability, and 3.38±0.75 of 5 for social support. Positive correlations were found among self-regulation ability, self-esteem, social support, and practice of accident prevention behaviors. The factors influencing the practice of accident prevention behaviors were personality (being ‘haste’) (β=−.20, p=.003), self- regulation ability (β=.48, p<.001), and social support (β=.23, p<.001). These factors explained 39.0% of the variance in practice of accident prevention behaviors.CONCLUSION: It was found that the middle-school students engaged in prevention behavior to an extent that was insufficient to prevent accidents. Therefore, it is necessary to develop intervention strategies to improve the practice of accident prevention behavior among middle-school students, considering self-regulation ability, social support, and personality, which affect the practice of accident prevention behaviors.
Accident Prevention ; Humans ; Self Concept ; Self-Control ; Social Control, Formal

BACKGROUND: Caveolin, a family of integral membrane proteins are a principal component of caveolae membranes. In this study, we investigated the effect of p38 kinase on differentiation and on inflammatory responses in sodium nitroprusside (SNP)- treated chondrocytes. METHODS: Rabbit articular chondrocytes were prepared from cartilage slices of 2-week-old New Zealand white rabbits by enzymatic digestion. SNP was used as a nitric oxide (NO) donor. In this experiments measuring SNP dose response, primary chondrocytes were treated with various concentrations of SNP for 24 h. The time course of the SNP response was determined by incubating cells with 1 mM SNP for the indicated time period (0~24 h). The cyclooxygenase-2 (COX-2) and type II collagen expression levels were determined by immunoblot analysis, and prostaglandin E2 (PGE2) assay was used to measure the COX-2 activity. The tyrosine phosphorylation of caveolin-1 was determined by immunoblot analysis and immunostaining. RESULTS: SNP treatment stimulated tyrosine phosphorylation of caveolin-1 and activation of p38 kinase. SNP additionally caused dedifferentiation and inflammatory response. We showed previously that SNP treatment stimulated activation of p38 kinase and ERK-1/-2. Inhibition of p38 kinase with SB203580 reduced caveolin-1 tyrosine phosphorylation and COX-2 expression but enhanced dedifferentiation, whereas inhibition of ERK with PD98059 did not affect caveolin-1 tyrosine phosphorylation levels, suggesting that ERK at least is not related to dedifferentiation and COX-2 expression through caveolin-1 tyrosine phosphorylation. CONCLUSION: Our results indicate that SNP in articular chondrocytes stimulates dedifferentiation and inflammatory response via p38 kinase signaling in association with caveolin-1 phosphorylation.
Cartilage ; Caveolae ; Caveolin 1 ; Chondrocytes* ; Collagen Type II ; Cyclooxygenase 2* ; Digestion ; Dinoprostone ; Humans ; Membrane Proteins ; Membranes ; Nitric Oxide ; Nitroprusside ; Phosphorylation ; Phosphotransferases* ; Rabbits ; Tissue Donors ; Tyrosine

Cyclooxygenase-2 (COX-2) is known to modulate bone metabolism, including bone formation and resorption. Because cartilage serves as a template for endochondral bone formation and because cartilage development is initiated by the differentiation of mesenchymal cells into chondrocytes (Ahrens et al., 1977; Sandell and Adler, 1999; Solursh, 1989), it is of interest to know whether COX-2 expression affect chondrocyte differentiation. Therefore, we investigated the effects of COX-2 protein on differentiation in rabbit articular chondrocyte and chick limb bud mesenchymal cells. Overexpression of COX-2 protein was induced by the COX-2 cDNA transfection. Ectopic expression of COX-2 was sufficient to causes dedifferentiation in articular chondrocytes as determined by the expression of type II collagen via Alcian blue staining and Western blot. Also, COX-2 overexpression caused suppression of SOX-9 expression, a major transcription factor that regulates type II collagen expression, as indicated by the Western blot and RT-PCR. We further examined ectopic expression of COX-2 in chondrifying mesenchymal cells. As expected, COX-2 cDNA transfection blocked cartilage nodule formation as determined by Alcian blue staining. Our results collectively suggest that COX-2 overexpression causes dedifferentiation in articular chondrocytes and inhibits chondrogenic differentiation of mesenchymal cells.
Animals ; Cartilage, Articular/cytology ; Cell Differentiation ; Cells, Cultured ; Chick Embryo ; Chondrocytes/*cytology/enzymology ; Chondrogenesis ; Collagen Type II/metabolism ; Cyclooxygenase 2/*biosynthesis/genetics ; Interleukin-1beta/pharmacology ; Mesenchymal Stem Cells/*cytology/enzymology ; Rabbits ; SOX9 Transcription Factor/metabolism

BACKGROUND: Although adult immunization is as important as childhood immunization, is being inadequately performed. However, previous studies concerning adult immunization could not be sufficiently evaluate because studies were restricted to the residents in rural area or those who have visited a doctor. METHOD: We conducted a study by telephone interview which included 201 household(375 adult family members) selected by systematic sampling from the yellow pages of Kangnam-gu and Sungbuk-gu districts of Seoul. The types of immunization covered in this study were immunizations against hepatitis B, influenza, pneumococcus, and hemorrhagic fever with renal syndrome(HFRS). Immunization status of all adult household members, cognition of the feed for immunization and of interviewees were surveyed. Sex, age, area of residency, education medical history of study subjects were considered as factors related to the cognition of the need for immunization and immunization performance. RESULT: The cognition rates of immunization were as follows: hepatitis B 85.1%, influenza 45.8% pneumonra 38.3%, and HFRS 38.3%. In the people over 65 years old, the cognition rate against influenza and pneumococeus were 6.25%, 6.25% respectively and for those she have chronic disease.80.0%, 20.0%, respectively. The cognition rates of immunization was significantly higher among those subject who were young, well educated, and those residing in Kangnam-gu district. The immunization performance rate of hepatitis B was 6.5%, influenza 5.6%, pneumonia 0.8%, and HFRS 1.1%. 75.5% of subjects vaccinated against hepatitis B had received at least three titles. The immunization performance rate of influenza and pneumococcus by the immunization indication are as follows 8.0%, 0.0%, respectively in the subjects over 65 years old, and 11.1%, 0.0,% respectively in the people who have chronic disease. The immunization performance rate of hepatitis B was higher among young, well educated subjects living in Kangnam-gu district. But age, education, area of residency played no apparent role in the case of other types of immunization. The immunization performance rate of those who felt the need for immunization as significant1y higher then that of those who did not. To assess the factors which re]ate to the correct cognition for immunization necessity, we used a multiple logistic regression test. For all types of immunization surveyed, sex(femals) and age (young) seemed to be significantly related to the correct necessity cognition. Medical history of chronic disease was also related to the correct necessity cognition for immunization against hepatitis B and influenza. CONCLUSION: This study reveals that among living in urban area the immunization performance rate and the correct cognition rate concerning the necessity for adult immunization was generally very low. Therefore, an active publicity and pubic education will be needed to increase the level of correct necessity cognition for immunization in which the disease status, sex, and age of vaccinee are considered. And more active effort to increase the cognition for immunization necessity performance is required.
Adult* ; Aged ; Chronic Disease ; Cognition* ; Education ; Family Characteristics ; Fever ; Hemorrhagic Fever with Renal Syndrome ; Hepatitis B ; Humans ; Immunization* ; Influenza, Human ; Internship and Residency ; Interviews as Topic ; Logistic Models ; Pneumonia ; Seoul ; Streptococcus pneumoniae

Conjoined twins are uncommon complications of monoamniotic twinning. Among them, cephalopagus twins are very rare. The accurate prenatal diagnosis of conjoining is essential for the optimal obstetric counseling and management. We describe a case where prenatal sonographic diagnosis of cephalopagus associated with multiple anomalies including meningomyelocele, diaphragmatic hernia, omphalocele, and club feet was made at 18 weeks of gestation.
Counseling ; Diagnosis* ; Foot ; Hernia, Diaphragmatic ; Hernia, Umbilical ; Humans ; Meningomyelocele ; Pregnancy ; Prenatal Diagnosis ; Twins, Conjoined ; Ultrasonography*

PURPOSE: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. METHODS: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. RESULTS: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (±14.90), 41.15 (±16.04), 53.44 (±24.67), and 54.33 (±22.80) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ≥70 years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ≥36.5℃ (OR 3.12, 95% CI: 1.17~8.17); age ≥70 years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ≥36.5℃ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. CONCLUSION: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.
Blood Pressure ; Body Mass Index ; Body Temperature ; Critical Care* ; Hospitals, Teaching ; Humans ; Hypoalbuminemia ; Intensive Care Units* ; Korea ; Logistic Models ; Lung Diseases ; Nursing Care ; Oxygen ; Pressure Ulcer ; Risk Factors ; Serum Albumin ; Skin

Tuberculosis of thyroid gland is rare. We experienced a case of tuberculosis of the thyroid gland with contralateral lymph node enlargement in a 45-year-old female patient. She had no clinical respiratory symptom and no weight change. Thyroid sonography demonstrated 5.4 × 3.8 mm sized round low echogenic mass on lower pole of left thyroid gland and right cervical lymph node enlargement. Core needle biopsy of thyroid showed epithelioid chronic granuloma in the caseous necrosis. She was administrered anti-tuberculosis therapy for 24 weeks. After medication, thyroid sonographic finding improved and thyroid mass and right cervical lymph node enlargement disappeared.
Biopsy, Large-Core Needle* ; Diagnosis* ; Female ; Granuloma ; Humans ; Lymph Nodes* ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Ultrasonography

PURPOSE: To predict the energy expenditure using the stress factor representing the ratio of the metabolic variation between pre-operation and post-operation in a pancreaticoduodenectomy (PD). METHODS: This was a prospective study conducted on 17 patients (11 males and 6 females) who underwent PD at Chonbuk National University Hospital between March 2010 and October 2011. The rest energy expenditure was measured by indirect calorimetry 1 day before and 3 days after surgery. The height, weight, and fat free mass were also measured 1 day before surgery. RESULTS: The mean measured rest energy expenditure 1 day before PD (mREEpre) and 3 days after PD (mREEpost) were significantly different (16.8±2.6 vs. 18.8±3.5 kcal/kg/d, P=0.0076). The stress factor, representing the ratio of the metabolic changes between pre- and post-PD, was 1.12±0.17. The recommended energy requirement for PD patients is estimated to be 23∼24 kcal/ideal body weight/d [determined from the measured preoperative rest energy expenditure (16.8±2.6 kcal/kg/d)×activity factor (1.2∼1.3)×stress factor (1.12)]. CONCLUSION: PD patients maintained a hypermetabolic status and the applicable stress factor was 1.12.
Calorimetry, Indirect* ; Energy Metabolism* ; Humans ; Jeollabuk-do ; Male ; Pancreaticoduodenectomy* ; Prospective Studies

Endoplasmic reticulum (ER) stress regulates a wide range of cellular responses including apoptosis, proliferation, inflammation, and differentiation in mammalian cells. In this study, we observed the role of 2-deoxy-D-glucose (2DG) on inflammation of chondrocytes. 2DG is well known as an inducer of ER stress, via inhibition of glycolysis and glycosylation. Treatment of 2DG in chondrocytes considerably induced ER stress in a dose- and time-dependent manner, which was demonstrated by a reduction of glucose regulated protein of 94 kDa (grp94), an ER stress-inducible protein, as determined by a Western blot analysis. In addition, induction of ER stress by 2DG led to the expression of COX-2 protein with an apparent molecular mass of 66-70kDa as compared with the normally expressed 72-74 kDa protein. The suppression of ER stress with salubrinal (Salub), a selective inhibitor of eif2-alpha dephosphorylation, successfully prevented grp94 induction and efficiently recovered 2DG-modified COX-2 molecular mass and COX-2 activity might be associated with COX-2 N-glycosylation. Also, treatment of 2DG increased phosphorylation of Src in chondrocytes. The inhibition of the Src signaling pathway with PP2 (Src tyrosine kinase inhibitor) suppressed grp94 expression and restored COX-2 expression, N-glycosylation, and PGE2 production, as determined by a Western blot analysis and PGE2 assay. Taken together, our results indicate that the ER stress induced by 2DG results in a decrease of the transcription level, the molecular mass, and the activity of COX-2 in rabbit articular chondrocytes via a Src kinase-dependent pathway.
Animals ; Cartilage, Articular/pathology ; Cells, Cultured ; Chondrocytes/drug effects/immunology/*metabolism/pathology ; Cyclooxygenase 2/genetics/*metabolism ; Deoxyglucose/*pharmacology ; Down-Regulation ; Endoplasmic Reticulum/drug effects/*metabolism/pathology ; Glycosylation/drug effects ; Inflammation ; Rabbits ; Signal Transduction/drug effects ; Stress, Physiological/drug effects/immunology ; src-Family Kinases/*metabolism