Objective: Vascular calcification requires the differentiation of vascular smooth muscle cells (VSMCs) into osteoblast-like cells. This phenomenon can be enhanced by inflammation and oxidative stress. Zingerone is one of the active ingredients present in the ginger plant that has anti-inflammatory and antioxidant effects. Other functions include anti-obesity, antinausea effects. However, the functions of zingerone on vascular calcification has not yet been elucidated. This study investigated the effect of zingerone on vascular calcification and its molecular mechanism. Methods: Reverse transcription-polymerase chain reaction (PCR), real-time PCR and Western blot analysis was used to measure expression levels of osteogenic marker genes and to investigate whether calcification was regulated by the expression of AMP-activated protein kinase (AMPK) and tissue inhibitor of metalloproteinase 4 (TIMP4). Alizarin red S staining was used to measure calcium deposition. Studies were carried out in VSMCs. Results: Zingerone induced the expression of 2 markers of VSMCs differentiation (α-smooth muscle actin (α-SMA) and smooth muscle 22α (SM22α)) and decreased the expression of corebinding factor α-1 (CBFA1). Additionally, zingerone decreased inorganic phosphate (Pi)-induced expression of distal-less homeobox 5 and CBFA1. AMPK phosphorylation and TIMP4 expression were increased by zingerone. Importantly, zingerone protected VSMCs from calcification, and this protective effect was confirmed by increased TIMP4 via overexpression of AMPK, and inhibition of TIMP4 by Compound C. Zingerone upregulated AMPK/TIMP4 expression and recovered Pi-induced inhibition of TIMP4. Conclusions Taken together, our results show that zingerone inhibits Pi-induced vascular calcification by regulating the AMPK/TIMP4 signaling cascade in VSMCs. These results suggest that the natural product zingerone could be useful for treating vascular and metabolic diseases.

PURPOSE: To evaluate the chest radiographic findings of rickettsial disease including murine typhus and tsutsugamushi disease in Chunchon. MATERIALS & METHODS: Chest radiographic films of 81 cases diagnosed as rickettsial disease(55 cases of tsutsugamushi disease, 26 cases of murine typhus) by immunofluorescence test were retrospectively analyzed. RESULTS: Main serotypes of Rickettsia tsutsugamushi were Gilllain and Karp. Incidence rate of tsutsugamushi disease was 2.1 times greater than that of murine typhus. Chest radiographs were abnormal in 63.6% of tsutsugamushi disease, and in 30.8% of murine typhus. Radiographic findings were Kerly's B line, reticu-Ionodular densities, hilar enlargement, pleural effusion, and splenomegaly in both entities, but pulmonary consolidation was only found in tsutsugamushi disease. The patients with the abnormal radiographic findings were statistically well correlated with cardiomegaly(p<0.01) and azygos engorgement(p<0.05), as compared to the patients with normal radiographic findings. CONCLUSION: Radiographic findings of both murine typhus and tsutsugamushi disease were interstitial pattern. But the chest radiographs in patients with tsutsugamushi disease showed more severe pattern with higher rate of abnormality.
Fluorescent Antibody Technique ; Gangwon-do* ; Humans ; Incidence ; Orientia tsutsugamushi ; Pleural Effusion ; Radiography, Thoracic* ; Retrospective Studies ; Scrub Typhus* ; Splenomegaly ; Thorax* ; Typhus, Endemic Flea-Borne*

OBJECTIVE: The purpose of this study was to evaluate the validity and reliability of Korean version of Addiction Severity Index for the systematic diagnosis and evaluation of alcoholism. METHODS: The authors selected 65 alcoholic patients with the criteria of DSM-VI. RESULTS: The results were as follows: 1) The exception of the significant correlation between psychiatric and the family/social problem area, the 6 sections of ASI were mutually independent. 2) There was significant inter-rater reliability in all sections of ASI. 3) In medical, alcohol use, family/social and psychiatry section, the calculation of composite score showed reasonable level of item consistency. In all sections, there was significant correlation between composite scores and severity ratings of corresponding section. 4) The important items of each section were most highly correlated with their corresponding severity ratings except two sections. 5) In the multiple regression analysis, the amount of variance accounted far by the most important 4 items were 83% in medical section, 45% in employment/support,43% in alcohol use section, 55% in legal section,53% in family/social section and 84% in psychiatric section. 6) Severity rating of psychiatric section was significantly correlated with the scores of MMFI, MAST and SCL-90-R. CONCLUSION: The result suggests that Korean version of the ASI showed relatively reasonable reliability and validity and it can be used in treatment and study of alcoholic patients.
Alcoholics* ; Alcoholism ; Diagnosis ; Humans ; Reproducibility of Results*

OBJECTIVE: Ovarian failure is often common complication by the conditioning protocol used for bone marrow transplantation (BMT). To determine the frequency of recovery of ovarian function after allo-BMT and the major factor that predict recovery, we monitored ovarian function in 24 premenopausal women METHOD: Twenty-four women met the inclusion criteria, which were (1) moderate to severe aplastic anemia before BMT, (2) disease-free at least 18 month after transplantation, (3) age younger than 40 years and more than 3 years after menarche at transplantation and (4) regular menstrual periods before transplantation. Recovery of ovarian function was determined by regular menses without menopausal symptom and sign. we divided conditioning regimen to two groups, Group I : cytoxan alone(n=17), Group II : cytoxan plus total body irradiation (TBI)(n=7). RESULTS: All women became amenorrhea after BMT and the clinical characteristics were not significant between two groups. 17 patients who received only cytoxan all recovered ovarian function between 1 to 14 months(median : 7.28) after BMT. The median age at BMT of women with regained ovarian function was 26 years (range, 21 to 33) versus 30 (range, 21 to 37) for those who did not. The age at transplantation was not significant between two groups in our study and the most predictive independent factor in ovarian recovery is the presence of total body irradiation. None of women who received TBI regained ovarian function during 19-49 month follow up. CONCLUSION: Gonadal insufficiency due to pre-BMT conditioning is more severe in radiation based regimen than cytoxan alone. therefore, we recommend early hormone replacement therapy in radiation treated women to prevent the complication of premature menopause.
Amenorrhea ; Anemia, Aplastic* ; Bone Marrow Transplantation* ; Bone Marrow* ; Cyclophosphamide ; Female ; Follow-Up Studies ; Gonads ; Hormone Replacement Therapy ; Humans ; Menarche ; Menopause, Premature ; Whole-Body Irradiation

Diagnosing pseudoaneurysms of the popliteal artery is usually straightforward in physical examinations and imaging findings. However, when a pseudoaneurysm shows a soft tissue mass with adjacent osseous change, it can mimic a bone tumor or a soft tissue sarcoma. We present a case of a 65-year-old man who had a pseudoaneurysm of the popliteal artery showing soft tissue mass and insinuating into the intramedullary cavity of the tibia. This presented case emphasizes the importance of considering pseudoaneurysms in the differential diagnosis of an apparent soft tissue mass with pressure erosion in adjacent bone.
Aged ; Aneurysm, False ; Diagnosis, Differential ; Humans ; Hydrazines ; Physical Examination ; Popliteal Artery ; Sarcoma ; Tibia

Hypertensive intracerebral hemorrhage(ICH) is one of the leading causes of death in Korea. However, there are too many controversies regarding the pathogenesis and proper management of this disease. The author investigated the role of surgical treatment in improving the outcome of hypertensive ICH by analyzing the results of surgical and conservative therapy performed in 339 patients with hypertensive ICH during the past 8 years from 1986 to 1993. The peak age incidence of patients with hypertensive ICH was in the sixth decade(29.2%), and 88.5% of the cases occurred after the fifth decade. There was no sexual preponderance. Winter was the most prevalent season. Location of the hemorrhage was putamen in 9.2%, thalamus in 23.6%, lobular in 14.5%, cerebellum in 11.2%, caudate nucleus in 5.9%, and brain stem in 4.7%. The Glasgow coma scale(GCS) on admission was 3-5 in 17.7%, 6-8 in 2.4%, 9-12 in 20.1%, and 13-15 in 39.8%. Surgery was performed in 127 patients(37.5%) and the remaining patients were treated conservatively. The surgery rate was the highest(52.7%) for patients with 6-8 GCS, and the volume of hemorrhage was 0-45 cc. The outcome of all patients at discharge was graded as good recovery in 24.2%, moderate disability in 33.0%, severe disability in 11.8%, vegetative state in 8.6% and death in 22.4%. The mortality rate was 42.7% for patients with a 3-8 GCS, 23.5% for 9-12 GCS, and 1.5% for 13-15 GCS. The mortality rate was 9.2% in cases with a hemorrhage volume of less than 15cc, while in those over 60cc, the mortality rate was 75%. The results of surgical and conservative treatment were compared in each subgroups because the method of treatment differed according to the GCS and the volume of hemorrhage. When the GCS was less than 8, and when the hemorrhage volume was over 30cc, better results were obtained with surgery than with of conservative management(P<0.025, P<0.01, respectively).
Brain Stem ; Caudate Nucleus ; Cause of Death ; Cerebellum ; Coma ; Hemorrhage ; Humans ; Incidence ; Intracranial Hemorrhage, Hypertensive* ; Korea ; Mortality ; Persistent Vegetative State ; Putamen ; Seasons ; Thalamus

No abstract available.
Humans ; Laparoscopy* ; Pleural Effusion*

The aim of this study was to evaluate the role of demineralized and particulate autogenous tooth, and interleukin-6 in bone regeneration. A demineralized and particulate autogenous tooth was prepared and human osteoblast-like cells (MG63) and human osteosarcoma cells were inoculated into the culture. The rate of cell adhesion, proliferation and mineralization were examined, and the appearance of cellular attachment was observed. An 8 mm critical size defect was created in the cranium of rabbits. Nine rabbits were divided into three groups including: An experimental group A (3 rabbits), in which a demineralised and particulate autogenous tooth was grafted; an experimental group B (3 rabbits), in which a demineralized, particulate autogenous tooth was grafted in addition to interleukin-6 (20 ng/mL); and a control group. The rabbits were sacrificed at 1, 2, 4 and 6 weeks for histopathological examination with H-E and Masson's Trichrome, and immunohistochemistry with osteocalcin. The cell-based assay showed a higher rate of cell adhesion, mineralization and cellular attachment in the experimental group A compared with the control group. The animal study revealed an increased number of osteoclasts, newly formed and mature bones in the experimental group A compared with the control group. Eventually, a higher number of osteoclasts were observed in the experimental group B. However, the emergence of newly formed and mature bone was lower than in the experimental group A. The current results suggest that treatment with demineralized and particulate autogenous tooth and interleukin-6 is not effective in stimulating bone regeneration during the bone grafting procedure.
Animals ; Bone Regeneration* ; Bone Transplantation ; Cell Adhesion ; Dentin* ; Humans ; Immunohistochemistry ; Interleukin-6* ; Miners ; Osteocalcin ; Osteoclasts ; Osteosarcoma ; Rabbits ; Skull ; Tooth ; Transplants

BACKGROUND/AIMS: This study was conducted to develop an optimal strategy to achive long-term survival after liver resection for hepatocellular carcinoma. METHODS: Between July 1975 and March 1995, 109 patients who underwent liver resection for hepatocellular carcinoma at Inje University Seoul Paik Hospital were analyzed retrospetively. RESULTS: 38 patients (34.9%) survived longer than 5 years after the operation. Prognostic factors of statistical significance were the diagnostic clue, ICG R15, TNM stage, extent of tumor, intrahepatic metastasis, portal vein thrombosis, serosal infiltration, tumor grade, resection margin, Glissonian approach, radicality of operation, cancer recurrence and disease free interval. For the 63 cases with no intrahepatic metastasis, there was no survival difference between the lobectomy group and the segmentectomy/subsegmentectomy group(36.8% vs. 50.0%). In those cases with satellite nodules in one segment of the liver, 66.7% of the lobectomy group lived longer than 5 years while 17.6% of lessthan- lobectomy group survived long-term(p=0.025). CONCLUSION: For long-term survival, a systemic segmentectomy/ subsegmentectomy is adquate for those tumors without intrahepatic metastasis, while the presence of satellite nodules in one segment mandates a standard hepatic lobectomy.
Carcinoma, Hepatocellular* ; Humans ; Liver* ; Neoplasm Metastasis ; Recurrence ; Seoul ; Survivors* ; Venous Thrombosis

PURPOSE: To evaluate functional results and complications after minimally invasive plate osteosynthesis through an anterior approach for distal tibial fractures, including pilon fracture. MATERIALS AND METHODS: Between March 2007 and December 2008, thirteen patients with fractures of the distal tibia were treated with minimally invasive plate osteosynthesis through an anterior approach, and were followed for a mean of 16.2 months (range, 12-30 months). Fractures according to the AO/OTA classification were six 43A, four 43B and three 43C. We analyzed functional results by bone union, postoperative complications, and the Olerud and Molander ankle scoring system. RESULTS: All fractures were united after a mean of 15.7 weeks (range, 12 to 24 weeks) except one case. There were 2 cases of superficial wound infection, one case of fibular shortening and metal failure, and two cases of tibialis anterior tendon adhesion. The average functional score was 79 points (range, 35-95 points) and results were four excellent, six good and three fair. CONCLUSION: Minimally invasive plate osteosynthesis through an anterior approach may be used for distal tibial fracture with medial soft tissue injury, and has an advantage in that the metaphyseal and distal articular fracture are fixed at the same time through a single incision However, it should be approached with caution because of the risk of complications due to the anterior approach, such as iatrogenic injury of the tibialis anterior tendon.
Animals ; Ankle ; Humans ; Imidazoles ; Nitro Compounds ; Postoperative Complications ; Soft Tissue Injuries ; Tendons ; Tibia ; Tibial Fractures ; Wound Infection