BACKGROUND/OBJECTIVES: (Cheonggukjang) is a traditional fermented soybean paste with significant health-promoting effects. On the other hand, there have been insufficient studies on the safety and efficacy of (Cheonggukjang), which is produced using traditional methods containing toxins and biogenic amines (BAs). This study compared the laxative effect of (Cheonggukjang), containing high or low levels of toxins and BAs (HTBC or LTBC) in a loperamide (Lop)-induced constipation mouse model.MATERIALS/METHODS: To induce constipation, Lop (5 mg/kg) was administered orally to ICR mice twice a day for 4 days, and the dose was increased to 8 mg/kg after a 3-day rest period. (Cheonggukjang) (500 mg/kg, HTBC, or LTBC respectively) was administered for four weeks before the Lop treatment. RESULTS: The number of stools, fecal weight, water contents, gastrointestinal transit, and histological alterations were recovered significantly in the HTBC or LTBC groups. HTBC and LTBC administration did not induce significant changes in body weight, dietary intake, and behavior. The opioid-receptor downstream signaling pathway in colon tissues was also evaluated. The c-Kit, stem cell kinase, and mitogen-activated protein kinases subfamilies, including extracellular signal-regulated kinase 1/2, c-Jun N-terminal kinases, and p38, were all downregulated in the HTBC or LTBC-administered mice colon compared to the Lop group. CONCLUSION These results show that (Cheonggukjang), containing high levels of toxins and BAs, have a similar laxative effect in a mouse model of Lop-induced constipation.

OBJECTIVES: To evaluate the Community-Based Participatory Research (CBPR) professional periodontal care program model for patients with hypertension and diabetes. METHODS: This descriptive case study included 151 participants of the professional periodontal care program. The CBPR-based professional periodontal care program consists of 5-steps: ‘Issue identification and prioritization’ (Step 1), ‘Strategy development’ (Step 2), ‘Entry into community’ (Step 3), ‘Implementation’ (Step 4), and ‘Transition’ (Step 5). Quantitative data were analyzed using frequency analysis, and descriptive data with PASW 23.0 (SPSS Inc., Chicago, IL, USA). The results of the Focus group interview (FGI) were classified as ‘general opinions regarding the program planning and operation receptiveness’, ‘sustainability’, ‘potential spread of the program’, and ‘improvement of program’. The interviews were qualitative research involving seven people. RESULTS: 1. Participants increased their interest in health and oral health by managing their hypertension, diabetes, and periodontal disease using community resources. Through this, healthy practices and improved awareness helped to prevent complications and manage periodontal diseases. 2. Community organizations actively cooperated, resulting in positive changes in oral health practices (increased registration of patients in education centers for hypertension and diabetes, and increased number of patients visiting the local dental clinic). In the future, it was positive to participate in the program continuously. CONCLUSIONS: The most important step is ‘Entry into community’, which has led to active participation and cooperation of community organizations and participants. Therefore, community organizations and strategy development should be discussed, and the role of community leaders should be emphasized to build cooperative relationships. In addition, participation in and collaboration with health-based projects should be achieved through a search of various community organizations.
Chronic Disease ; Community-Based Participatory Research ; Consumer Participation ; Cooperative Behavior ; Education ; Focus Groups ; Humans ; Hypertension* ; Oral Health ; Periodontal Diseases ; Qualitative Research

BACKGROUND/AIMS: The prevalence of occult HBV infection depends on the prevalence of HBV infection in the general population. Hemodialysis patients are at increased risk for HBV infection. The aim of this study was to determine the prevalence of occult HBV infection in hemodialysis patients. METHODS: Total of 98 patients undergoing hemodialysis in CHA Bundang Medical Center (Seongnam, Korea) were included. Liver function tests and analysis of HBsAg, anti-HBs, anti-HBc and anti-HCV were performed. HBV DNA testing was conducted by using two specific quantitative methods. RESULTS: HBsAg was detected in 4 of 98 patients (4.1%), and they were excluded. Among 94 patients with HBsAg negative and anti-HCV negative, one (1.1%) patient with the TaqMan PCR test and 3 (3.2%) patients with the COBAS Amplicor HBV test were positive for HBV DNA. One patient was positive in both methods. Two patients were positive for both anti-HBs and anti-HBc and one patient was negative for both anti-HBs and anti-HBc. CONCLUSIONS: The present study showed the prevalence of occult HBV infection in HBsAg negative and anti-HCV negative patients on hemodialysis at our center was 3.2%. Because there is possibility of HBV transmission in HBsAg negative patients on hemodialysis, more attention should be given to prevent HBV transmission.
Adult ; Aged ; Aged, 80 and over ; Antibodies/blood ; DNA, Viral/analysis ; Feces/*virology ; Female ; Hepatitis B/complications/*epidemiology/transmission ; Hepatitis B Core Antigens/immunology ; Hepatitis B virus/genetics/immunology ; Hepatitis C Antibodies/blood ; Humans ; Kidney Failure, Chronic/*complications/diagnosis ; Male ; Middle Aged ; Polymerase Chain Reaction ; Prevalence ; Renal Dialysis ; Risk Factors

Cholangiocarcinoma is a malignant disease originating from the epithelium of the biliary tract, and its prognosis is dismal due to distant metastasis in its early stages. The most common metastatic sites are the intra-abdominal organs, lymph nodes, and lungs. A patient was diagnosed with intrahepatic cholangiocarcinoma and underwent surgical resection. During the follow-up period, metastases were detected at the remnant liver and both lung fields. Eleven months after resection, the patient complained of severe headache. An approximately 5-cm cystic mass was found at the left occipital lobe of the cerebrum, and metastatic malignant cells were present on cerebrospinal fluid cytology. The patient underwent whole-brain radiotherapy. We herein report a rare case of cholangiocarcinoma with cystic brain metastasis together with a review of the relevant literature.
Biliary Tract ; Brain ; Cerebrum ; Cholangiocarcinoma ; Epithelium ; Follow-Up Studies ; Headache ; Humans ; Liver ; Liver Neoplasms ; Lung ; Lymph Nodes ; Meningeal Carcinomatosis ; Neoplasm Metastasis ; Occipital Lobe ; Prognosis

Heme oxygenase-1 (HO-1), an inducible heme-degrading enzyme, is expressed by macrophages and endothelial cells in response to inflammatory stresses. It has been known to show strong immunosuppressive properties although its mechanisms are not completely understood. This study was designed to determine the effects of HO-1 modulation on collagen induced arthritis (CIA) model. CIA model was induced by subcutaneous injection of collagen on tail of DBA/1J mice. For evaluation of HO-1 effects, an inducer of HO-1, cobalt protoporphyrin IX (CoPPIX), or an inhibitor of HO-1, tin protoporphyrin IX (SnPPIX), were administered every other days into peritoneal cavity from day 1 to day 42 after CIA induction. The macrocopic clinical findings of CIA were evaluated and histo-pathologic findings and radiographic analysis were carried out. The expressions of TNF-alpha, IL-6, and VEGF which have important roles in pathogenesis of rheumatoid arthritis were observed by immuno-histochemical staining. Collagen on DBA/1J mice induced arthritis at knee joint and ankle joint. Administration of CoPPIX significantly aggravated the severity of arthritis while SnPPIX protected collagen induced arthritis. SnPPIX strongly suppressed inflammatory cell infiltration, swelling of synovial membrane, and erosion and destruction of bone on CIA mice. Furthermore subcutaneous injection of collagen also increased expression of TNF-alpha, IL-6, and VEGF which are important pro-inflammatory mediators in rheumatoid arthritis. SnPPIX suppressed expression of the pro-inflammatory mediators on CIA mice. Finally, we suggest that HO-1 mediates the expression of pro-inflammatory mediators and bone destruction during pathogenesis of CIA, which indicates modulation of HO-1 can be a new therapeutic target of rheumatoid arthritis.
Animals ; Ankle Joint ; Arthritis* ; Arthritis, Rheumatoid ; Cobalt ; Collagen* ; Endothelial Cells ; Heme Oxygenase-1* ; Heme* ; Injections, Subcutaneous ; Interleukin-6 ; Knee Joint ; Macrophages ; Mice ; Peritoneal Cavity ; Synovial Membrane ; Tail ; Tin ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

PURPOSE: Since the introduction of newborn screening, the detection rate of transient hypothyroidism has been increased. Therefore, we aimed to reevaluate the prevalences of congenital hypothyroidism according to etiology and to evaluate the clinical characteristics to differentiate between transient and permanent hypothyroidism before L-thyroxine withdrawal to avoid unnecessary prolonged treatment. METHODS: We retrospectively reviewed medical records of 25 male and 46 female patients diagnosed as congenital hypothyroidism by newborn screening from 1992 to 2002. We performed thyroid function test such as T3, TSH and total T4 before 1997, and free T4 from 1997. RESULTS: Since the introduction of newborn screening, the prevalences of permanent congenital and transient hypothyroidism were 53.5% and 46.5%, respectively. Thyroid dysgenesis was more common in females (males 3, females 22, P<0.05). Among 58 patients, who were not confirmed as thyroid dysgenesis at L-thyroxine therapy, the proportion of transient and permanent hypothyroidism were 32 (55.2%) and 26 (44.8%) respectively. There were no significant differences in free T4, total T4, TSH levels at initial diagnosis between transient and permanent hypothyroidism patients. Permanent hypothyroidism patients could not withdraw L-thyroxine during the first 3 years. Among 32 patients with transient hypothyroidism, 30, 23, and 17 patients continued L-thyroxine therapy at 1, 2, and 3 years of age, respectively. The mean duration of L-thyroxine therapy was 26.4+/-11.8 months. The dose of L-thyroxine had been significantly decreased since 6 months of age in the patients with transient hypothyroidism (P<0.05). The patients with thyroid aplasia received the highest dose of L-thyroxine from 6 to 36 months of age (P<0.05). Among 13 patients who were confirmed as thyroid dysgenesis at L-thyroxine therapy, 12 patients were confirmed as permanent hypothyroidism, while one patient, who was diagnosed as thyroid aplasia by thyroid scan, revealed normal thyroid gland and could be ceased thyroid hormone therapy at 3 years of age. CONCLUSION: We could not differentiate between transient and permanent hypothyroidism by free T4, total T4 and TSH levels at the initial diagnosis. We could diagnose as permanent hypothyroidism in patients with thyroid dysgenesis and with higher or appropriate L-thyroxine doses for weight to maintain euthyroid during follow-up. We therefore suggest that diagnostic test maybe done before 3 years of age in some patients who had the histories of suspecting transient hypothyroidism and significantly low L-thyroxine doses for weight.
Congenital Hypothyroidism* ; Diagnosis ; Diagnostic Tests, Routine ; Female ; Follow-Up Studies ; Humans ; Hypothyroidism* ; Infant, Newborn* ; Male ; Mass Screening* ; Medical Records ; Neonatal Screening ; Prevalence ; Retrospective Studies ; Thyroid Dysgenesis ; Thyroid Function Tests ; Thyroid Gland ; Thyroxine

PURPOSE: It is known that 3-50 percent of type 1 diabetes mellitus(T1DM) patients develop autoimmune thyroid disease. We analyzed the clinical characteristics of autoimmune thyroid disease(AITD) developed in patients with T1DM in Korean. METHODS: The medical records of 139 patients, who were followed up in Department of Pediatrics, Seoul National University Children's Hospital from Jan. 1981 to Jul. 2004, were analyzed retrospectively. RESULTS: Forty-four males and 95 females were enrolled. At least one of the autoantibodies for thyroid was positive in 54 cases. The detection rate for AITD was not correlated with sex ratio, control of T1DM, body mass index, age at diagnosis of T1DM, and familial history of thyroid disease, between two groups. In the male group, AITD was more frequently found at a younger age than in the female group. The frequency of AITD was significantly higher in the goiter group without sex differences. In the thyroid disease group, 40 patients(74.0 percent) were euthyroid, seven patients(12.9 percent) were hypothyroid, and seven patients(12.9 percent) were hyperthyroid. CONCLUSION: We should monitor thyroid function and autoantibodies routinely in T1DM patients who develop goiters, or young boys with T1DM.
Autoantibodies ; Body Mass Index ; Diabetes Mellitus, Type 1* ; Diagnosis ; Female ; Goiter ; Humans ; Male ; Medical Records ; Pediatrics ; Retrospective Studies ; Seoul ; Sex Characteristics ; Sex Ratio ; Thyroid Diseases* ; Thyroid Gland*

PURPOSE: Short stature is one of the characteristic features of Turner syndrome. We investigated the factors affecting final adult height(FAH) in patients with Turner syndrome. METHODS: The study group was comprised of 60 patients who were diagnosed with Turner syndrome by chromosomal study and clinical phenotypes and attained FAH. Data were obtained from retrospective review of the medical records. We analyzed the factors influencing FAH in growth hormone(GH) treated and GH untreated groups. RESULTS: Sixty patients were enrolled; 48 patients received GH treatment, and 12 patients did not. Mean duration of GH treatment was 35.8 months(range 4 to 120 months), and mean dosage of GH was 0.8+/-0.2 IU/kg/wk in GH treated group. Mean growth velocity was 5.6+/-2.0 cm/yr, which was significantly higher than that during pretreatment period. In the GH treated group, mean chronological age, bone age, mean height, and height standard deviation(SD) score at GH treatment were 12.2+/-2.7 yr, 10.3+/-2.5 yr, 127.5+/-10.1 cm and -3.1+/-1.1, respectively. In the GH treated group, the mean FAH and SD score of FAH were 146.9+/-5.8 cm and -2.7+/-1.2, respectively, which showed significant differences compared with those of the GH untreated group. Analyzing the factors affecting FAH in GH-treated patients, only the SD score of height at the time of treatment was significantly related to FAH. CONCLUSION: GH treatment leads to an increment in FAH in patients with Turner syndrome. Average FAH gain was as much as 5.8 cm. SD score of height at the time of GH treatment was the only factor influencing FAH.
Adult* ; Growth Hormone ; Humans ; Medical Records ; Phenotype ; Retrospective Studies ; Turner Syndrome*

PURPOSE: We evaluated adult final height and factors influencing adult height outcome in patients with congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency. METHOD: We retrospectively reviewed medical records of 20 male and 22 female patients with 21- hydroxylase deficiency who reached adult final height from 1980 to 2004. We obtained final adult height and analysed possible factors influencing final adult height such as urine 17-ketosteroid (17- KS), plasma 17-OH-progesterone (17-OHP), plasma renin activity, pubertal initiaton age, glucocorticoid dose, age at diagnosis and effect of growth hormone or gonadotropin releasing hormone analogue. RESULT: Mean FH (final height) SDS-MPH (midparental height) SDS were -1.89+/-1.0 in male simple virilization (SV) and -0.83+/-0.8 in female SV patients, -2.27+/-1.3 in male salt wasting (SW) and -1.12+/-1.1 in female SW patients. Mean final adult height and mean FH SDS-MPH SDS were not different between SV and SW patients, but mean FH SDS-MPH SDS in males was significantly lower than that of females (-2.12+/-1.2 vs 0.95+/-0.9, P<0.05). In SW mean FH SDS-MPH SDS were correlated positively with pubertal height gain (r=0.484. P<0.05) and correlated negatively with pubertal initiation age (r=-0.334, P<0.05). but mean FH SDS-MPH SDS were not correlated with age at diagnosis, glucocorticoid dose, urine 17-KS level, plasma 17-OHP level, plasma renin activity, treatment with growth hormone or gonadotropin releasing hormone analogue in both SW and SV. CONCLUSION: Mean final height and mean FH SDS-MPH SDS in 21-hydroxylase deficiency were below the mean for the general population. In SW, adult final height was correlated with pubertal initiation age and pubertal height gain. Therefore it should be important to control early onset of puberty and make improvement pubertal height gain during puberty.
Adolescent ; Adrenal Hyperplasia, Congenital* ; Adult* ; Diagnosis ; Female ; Gonadotropin-Releasing Hormone ; Growth Hormone ; Humans ; Male ; Medical Records ; Plasma ; Puberty ; Renin ; Retrospective Studies ; Steroid 21-Hydroxylase* ; Virilism

PURPOSE: We aimed to determine whether prepubertal children born with low birth weight (LBW) have decreased insulin sensitivity, compared with children born with normal birth weight and to know a relationship between insulin sensitivity and adiponectin concentration in those children. METHODS: LBW (n=33) was defined as a birth weight less than 2.5 kg and control (n=20) was defined as a birth weight between 2.5 kg and 4.0 kg. Height and weight were measured for calculation of BMI. Fasting blood samples were taken for the measurements of glucose, insulin, lipid and adiponectin concentration. Body fat mass and abdominal fat ratio were measured. HOMA-IR and QUICKI were calculated, as a mean of insulin sensitivity. RESULTS: Children with LBW showed significantly higher levels of QUICKI and adiponectin than control group (P<0.05). Taller children with LBW (height SDS>-1) were more resistant to insulin than shorter children with LBW (height SDS<-1), but there was no difference in adiponectin level between those two groups. Younger (age<6 yr) children with LBW were more sensitive to insulin and had higher levels of adiponectin than older(age>6 yr) children with LBW. In children with LBW, age was negatively correlated with QUICKI adjusted by BMI percentile (r=-0.373, P<0.05). CONCLUSION: These findings suggest that the levels of adiponectin increase to compensate for the diminished insulin sensitivity in younger children with LBW and this phenomenon is faded away with aging. Additionally, the results suggest that LBW children with better postnatal growth have a tendency to have insulin resistance.
Abdominal Fat ; Adiponectin ; Adipose Tissue ; Aging ; Birth Weight ; Child* ; Fasting ; Glucose ; Humans ; Infant, Low Birth Weight* ; Infant, Newborn ; Insulin Resistance* ; Insulin*