Objective: The endothelial inflammatory response plays an important role in atherogenesis by inducing nuclear factor (NF)κB-dependent cell adhesion molecule expression and monocyte recruitment. Here, we screened for natural ligands and investigated the ability of shinjulactone A to inhibit interleukin-1β (IL-1β)-induced endothelial inflammatory signaling. Methods: The natural compound library included 880 single compounds isolated from medicinal plants by the Korean Medicinal Material Bank. Primary endothelial cells were pretreated with single compounds before stimulation with IL-1β to induce endothelial inflammation. Endothelial inflammation was measured by assaying NFκB activation and monocyte adhesion. The endothelial-mesenchymal transition (EndMT) was evaluated using cell type-specific marker protein expression and morphology. Results: Shinjulactone A was identified as an efficient blocker of IL-1β -induced NFκB activation, with a half-maximal inhibitory concentration of approximately 1 µM, and monocyte recruitment in endothelial cells. However, it did not affect lipopolysaccharideinduced NFκB activation in macrophages. Compared to Bay 11-782, a well-known NFκB inhibitor that shows considerable cytotoxicity during long-term treatment, shinjulactone A did not affect endothelial cell viability. Furthermore, it also significantly inhibited the EndMT, which is known to promote atherosclerosis and plaque instability. Conclusion We suggest that shinjulactone A may be an effective and safe drug candidate for atherosclerosis because it targets and inhibits both endothelial inflammation and the EndMT, without impairing NFκB-dependent innate immunity in macrophages.

PURPOSE: This study was performed to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. METHODS: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. RESULTS: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean 2.8+/-2.2). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was 21,000+/-5,600/uL; ESR, 60+/-23 mm/hr; CRP, 17+/-10 mg/dl. Pyuria was noted in every patient and persisted for 10.5+/-7.8 days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial (99m)Tc-DMSA scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was 11.8+/-6.3 days(pre-admission, 4.0+/-3.0; post-admission, 7.8+/-5.5 days) and the patients needed hospitalization for 17.2+/-8.1 days. CONCLUSION: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.
Abdominal Pain ; Age Distribution ; Anti-Bacterial Agents ; Child* ; Chills ; Early Diagnosis ; Female ; Fever ; Follow-Up Studies ; Hospitalization ; Humans ; Kidney ; Leukocyte Count ; Male ; Nephritis* ; Pyuria ; Ultrasonography ; Vesico-Ureteral Reflux

No abstract available.
Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic*

PURPOSE: To evaluate injury patterns of facet joints and associated soft tissue injuries in patients withacute traumatic cervical facet joint injuries. MATERIALS AND METHODS: From among patients with cervical spinetrauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzedwith regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, andother associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury,intervertebral disc herniation, and spinal cord injury. RESULTS: The most common location of facet joint injurywas C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) hadbilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fractureof inferior facet was more frequent than superi-or. Patterns of fracture were vertical, transverse, or comminuted,but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facetfractures. Fractures other than facet includ-ed pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13),and spinous process(n=3). On MR im-ages, anterior longitudinal ligament injury was found in 8 patients(30%),posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelvepatients(44%) had spinal cord injuries includ-ing edema(n=8) and hemorrhage(n=4). Among patients with discabnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. CONCLUSION: Traumatic cervical facet joint injuries were manifested as various patterns and frequentlyassoci-ated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patternshelped formulate a therapeutic plan and determine of prognosis.
Dislocations ; Humans ; Intervertebral Disc ; Ligaments ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Prognosis ; Soft Tissue Injuries ; Spinal Cord Injuries ; Spine* ; Tomography, X-Ray Computed ; Zygapophyseal Joint*

BACKGROUND: The cell-mediated immune reaction to tuberculosis infection involves a complex network of cytokines. The extent of inflammation, tissue damage and severity of the disease suggested to be determined by the balance between extent and duration of the proinflammatory cytokine response versus those of the suppressive cytokines. The systemic cytokine response in pathogenesis of tuberculosis can be assessed by measuring serum cytokine levels. METHOD: Serum interleukin-1 beta(IL-1 ), IL-2, IL-4, IL-6, IL-10, IL-12(p40), tumor necrosis factor-alpha(TNF-alpha), interferon-gamma(IFN-gamma) and transforming growth factor-beta(TGF-beta) levels were measured in 83 patients with pulmonary tuberculosis, 10 patients with endobronchial tuberculosis before treatment and 20 healthy subjects by using a sandwich ELISA. In patients with pulmonary tuberculosis, they were divided into mild, moderate and far advanced group according to the severity by ATS guidelines. To compare with those of pretreatment levels, we measured serum IL-1beta, IL-2, IL-4, IL-6, IL-10, IL-12(p40), TNF-alpha, IFN-gamma and TGF-beta levels in 45 of 83 patients with pulmonary tuberculosis after 2 and 6 months of treatment. RESULTS: 1) In sera of patients with active pulmonary tuberculosis(n=83), IL-1beta, IL-6(p<0.05), TNF-alpha, and IFN-gamma were elevated and TGF-beta was decreased comparing to control. IL-2, IL-12(p40), IL-4 and IL-10 were similar between the patients with tuberculosis and control. 2) In endobronchial tuberculosis, IL-6 and TNF-alpha were elevated and TGF-beta was decreased comparing to control. IL-12(p40) seemed to be elevated comparing to pulmonary tuberculosis. 3) Far advanced tuberculosis showed markedly elevated IL-6 and IFN-gamma level(p<0.05). 4) The significant correlations were noted between IL-1, IL-6 and TNF-alpha and between IL-12, IL-2 and IL-4(p<0.01). 5) After 2 and 6 months of standard treatment, the level of IL-6 and IFN-gamma was significantly decreased(p<0.05). CONCLUSION: These results showed that an altered balance between cytokines is likely to be involved in the extent of inflammation, tissue damage and severity of the disease tuberculosis. But, it should be considered diversities of cytokine response according to type of tuberculosis and immunity in clinical application and interpreting future studies.
Cytokines ; Enzyme-Linked Immunosorbent Assay ; Humans ; Inflammation ; Interleukin-1 ; Interleukin-10 ; Interleukin-12 ; Interleukin-2 ; Interleukin-4 ; Interleukin-6 ; Korea* ; Necrosis ; Transforming Growth Factor beta ; Tuberculosis* ; Tuberculosis, Pulmonary ; Tumor Necrosis Factor-alpha

Coarctation of aorta(CoA) has been recognized to be cured by corrective operation, so many clinicians have discontinued follow-up early. However, high incidences of cardiovascular morbidity and mortality, of which causes have been known as persistent resting hypertension and exercise-induced hypertension after corrective operation, have been reported during long-term follow-up. And left ventricular mass increase associated with persistent resting hypertension and exercise-induced hypertension has been known as an independent risk factor of cardiovascular disease. So, even for successfully operated CoA patients, increased left ventricular mass as well as resting hypertension and exercise-induced hypertension must be detected early and normalized through persistent observation to adulthood.
Aortic Coarctation ; Cardiovascular Diseases ; Follow-Up Studies ; Heart Ventricles* ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Incidence ; Mortality ; Risk Factors

Group occupational health service programme started in 1990 is one of the measures to cope with limited human and financial resources in occupational health. The programme has expanded rapidly to include 52 institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. This study has aims to develop the criteria to assess the quality of newly developed group occupational health service programme, and to investigate the quality of institutions, and finally to develop policies for the quality improvement. 1) Criteria development : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, followings are included as core elements of qualitative occupational health programme ; accessibility, continuity, comprehensiveness, technical quality, intersectoral collaboration, emphasis on preventive services, community participation, and adequacy. Again each element is divided into five major components of national health system infrastructure developed by the World Health Organization ; development of health resources, organized arrangement of resources, delivery of health care, economic support, and management. In turn, each component is categorized into three aspects of quality assessment, structure, process and outcome. Expert panel selected several criteria for each category to evaluate the programme. Criteria were modified according to each group of interviewees, to produce two sets of questionnaire, one for chief operating officer and another for nurses in the institutions, and the chief operating officer and workers in the workplace. 2) Subject : Of all 52 institutions, 25 voluntarily participated in the survey. At individual institution, chief operating officer and practicing nurses were interviewed in depth. After intensive education for interviewees, every interview was performed with standardized guideline and questionnaire. The quality of the 'Group occupational health service programme' was found to be lower than expected. Especially In continuity, comprehensiveness, technical quality, community participation and adequacy, lower quality in structural aspect was commonly identified throughout all the institutions. Quality in terms of accessibility and continuity highly varied among institutions. To improve quality of the programme, more comprehensive and systematic programme such as accreditation has to be introduced. In addition, human resources, governmental fund and information systems for individual workers are to be developed. As a long range plan, integration of occupational health services into the national health systems and pooling of financial resources and planned allocation should be considered.
Accreditation ; Consumer Participation ; Cooperative Behavior ; Delivery of Health Care ; Education ; Financial Management ; Health Resources ; Humans ; Information Systems ; Korea* ; Occupational Health Services* ; Occupational Health* ; Primary Health Care ; Quality Improvement ; Questionnaires ; Social Welfare ; World Health Organization

A cross-sectional study was conducted to assess the association between perceived occu-pational psychosocial stress at work and the work-related musculoskeletal disorders (WRMSD) among employees using video display terminals. The study included 111 female telecommunication employees from three companies at ChungBuk province. Cases of WRMSD were defined using symptom questionnaire and physical examination conducted by rehabilitation specialist. Information on demographics, individual factors, and perceived psychosocial stress, were obtained by self-administered questionnaire. For assessing perceived psychosocial stress, we used variables from 'job strain model' proposed by Karasek. Associations between perceived psychosocial stress and WRMSD were assessed by multiple logistic regression models. Forty nine (44% to the total) subjects met our operational definition for WRMSD. Age, seniority, housing load were not associated with WRMSD. Perceived psychosocial stress was associated with WRMSD [odds ratio=3.28, 95% confidence interval: 1.05-10.19]. This study suggests that perceived occupational psychosocial stress is related to the prevalence of WRMSD.
Chungcheongbuk-do ; Computer Terminals* ; Cross-Sectional Studies ; Demography ; Female ; Housing ; Humans ; Logistic Models ; Physical Examination ; Prevalence ; Questionnaires ; Rehabilitation ; Specialization ; Telecommunications

PURPOSE: The purpose of this study was to analyse researches on nursing intervention for elderly health promotion. METHOD: A literature review of 38 researches was carried out using guidelines developed by the present researchers. RESULT: The research papers studied in this research were theses written for doctoral or master's degree and published between 1994 to 2004. These researches applied nursing intervention for health promotion of elders and used experimental study design. The average period of nursing intervention was about 9 weeks and the average frequency was three times per week. As for major characteristics of subject groups, most of them were over 65 years old (76.3%) and resided in community (65.8%), and each group consisted of 10 to 29 elders. The dependent variables used in these studies included physiological variables (blood pressure, blood cholesterol level, pulmonary function, fasting blood sugar, blood cortisol level, body mass etc.), psychologic variables (depression, quality of life, life satisfaction, loneliness, anxiety etc.), cognitive variables (perceived benefits, perceived barriers, self-efficacy, self-concept, subjective health status etc.), activities of daily livings, health promotion behavior, pain, risks of fall, and variables related to Trans Theoretical Model. The majority of these studies (78.9%) applied exercise programs for health promotion including exercise motivating programs (15.8%). CONCLUSION: We suggest that more various nursing interventions must be applied to promote elders' health and to take care of their chronic diseases.
Aged* ; Anxiety ; Blood Glucose ; Blood Pressure ; Cholesterol ; Chronic Disease ; Fasting ; Health Promotion* ; Humans ; Hydrocortisone ; Loneliness ; Models, Theoretical ; Nursing* ; Quality of Life

OBJECTIVE: To evaluate the predictive factors associated with the success of medical abortion by misoprostol monotherapy within 24 hours in the first trimester of pregnancy. METHODS: The records of 228 women with miscarriage up to 11 weeks of gestational age who underwent medical abortion by intravaginal misoprostol monotherapy were reviewed. Success of abortion was defined as complete expulsion of the conceptus without the need for surgical intervention. Outcomes of interest were success of abortion within 24 hours following administration of misoprostol. RESULTS: Among 222 women who continued the process of medical abortion for 24 hours, 209 (94.1%) had a successfully completed abortion. Multivariate logistic regression showed that serum β-human chorionic gonadotropin (β-hCG) above 40,000 mIU/mL is significantly associated with failed medical abortion within 24 hours (odds ratio [OR], 7.13; 95% confidence interval [CI], 1.60–37.32; P=0.011). The area under the receiver operating characteristic curve of β-hCG level associated with successful abortion within 24 hours was 0.705 (95% CI, 0.63–0.77; P=0.007). Previous vaginal delivery seems to be significantly associated with successful abortion within 24 hours on univariate analysis (P=0.037), but the association was lost in multivariate analysis. CONCLUSION: Misoprostol monotherapy has a high success rate for first trimester abortion. Women with serum β-hCG less than 40,000 mIU/mL are likely to achieve a successful abortion within 24 hours after intravaginal administration of misoprostol.
Abortion, Spontaneous ; Administration, Intravaginal ; Chorionic Gonadotropin ; Female ; Gestational Age ; Humans ; Logistic Models ; Misoprostol* ; Multivariate Analysis ; Pregnancy ; Pregnancy Trimester, First ; ROC Curve