Although the role of alpha-synuclein aggregation on Parkinson's disease is relatively well known, the physiological role and the regulatory mechanism governing the expression of alpha-synuclein are unclear yet. We recently reported that alpha-synuclein is expressed and secreted from cultured astrocytes. In this study, we investigated the effect of valproic acid (VPA), which has been suggested to provide neuroprotection by increasing alpha-synuclein in neuron, on alpha-synuclein expression in rat primary astrocytes. VPA concentration-dependently increased the protein expression level of alpha-synuclein in cultured rat primary astrocytes with concomitant increase in mRNA expression level. Likewise, the level of secreted alpha-synuclein was also increased by VPA. VPA increased the phosphorylation of Erk1/2 and JNK and pretreatment of a JNK inhibitor SP600125 prevented the VPA-induced increase in alpha-synuclein. Whether the increased alpha-synuclein in astrocytes is involved in the reported neuroprotective effects of VPA awaits further investigation.
Acetylation ; alpha-Synuclein* ; Animals ; Astrocytes* ; MAP Kinase Signaling System* ; Neurons ; Neuroprotective Agents ; Parkinson Disease ; Phosphorylation ; Rats* ; RNA, Messenger ; Valproic Acid*

Objective To study the incentives created by both government service purchase mode and direct funding mode on village clinics.Methods Sampling on village clinics in 24 counties in Guizhou province,to learn their public health services and villagers' satisfaction under both modes.Results Except for the infectious disease report,health lectures and health records,values of most public health service indexes of the government purchase services group are better than those of the direct investment one (P＜0.05).Villagers' satisfaction scores for facilities and service attitude showed no significant difference between the two modes,but the purchase services mode was better than direct funding one in other dimensions and comprehensive scores (P＜ 0.05).Conclusion Government purchase of health services has a great potential to improve the service efficiency of village clinics.It is,however,imperative to further break the monopoly,identify reasonable purchasing projects and approaches,and construct scientific supervision mechanisms to achieve incentive-compatible effects.

OBJECTIVE: The purpose of this study was to investigate the effects of video feedback training for the parents of autistic spectrum disorder children. METHOD: Ten Autistic spectrum disorder children and their mothers participated in this training. Twenty minutes play times were videotaped including free play time and chosen play time. After one session, watching videotape, the researcher analyzed the relation of the children and their mother and had a feedback training with the mother of child. RESULTS: The child's responses to the mother's start actions had significant differences (p<0.05). The language responses of children increased in the organized environment of chosen play. Language responses increased but negative actions and no responses reduced when mother encouraged child centered play rather than mother engaged in children's play directly. In log sector model, mother's responses according to the play type had meaningless difference (p0.05). But in division analysis mother's responses to child's start action had meaningful difference in pre/post treatment and play type. CONCLUSION: The effects of video feedback training of autistic spectrum disorder children's parents were positive. Through this investigation the interaction and the communication with autistic spectrum disorder children and their parents are influenced positively.
Child ; Humans ; Language Development* ; Mothers ; Parents* ; Videotape Recording

AIMStudy on the relationship between the degraded spinal cord injuries and the changes of the motor evoked potentials (MEP) to prove the diagnosis and prognosis value of MEP.

METHODSAfter injury at T8-T9 cord using modified Allen's weight-drop method, 27 male SD rats were divided randomly into control group (n = 5), group A (50 gcf, n = 8), group B (70 gcf, n = 8) and group C (100 gcf, n = 6). MEPs elicited by monopolar transcortical stimulation were recorded continuously before injury, just after injury, 15 minutes, 1 hour, 3 hours and 6 hours after injury. The rate of the size of the bleeding or necrosis area to the total cord was also calculated.

RESULTSMEP had no significant change in the control group. The amplitude of MEP's early components in group A or group B decreased or even obliterated after SCI, and then partially recovered, while the late components were lost without any recovery signals. All animals in group C showed no MEP waves excepting 2 rats had recovery signals. The size of the cord injuries area increased according to the dropping force and was correlated significantly with the amplitude of the largest peaks of scMEP 1 hour after SCI (r = -0.821).

CONCLUSIONThe scMEP changes after SCI are correlated with the injury forces and the pathological changes in the cord, which indicates that scMEP can be used as an objective index for the cord functional monitoring.

Animals ; Electric Stimulation ; Evoked Potentials, Motor ; physiology ; Male ; Rats ; Rats, Sprague-Dawley ; Spinal Cord Injuries ; pathology ; physiopathology

PURPOSES: To investigate the viral etiology of community-acquired pneumonia in Korean adults, we have detected respiratory viruses (Respiatory syncytial virus, adenovirus, influenza virus and parainfluenza virus) in the way of prospective, multi-center study. METHODS: From July 1997 to April 2000, nasal aspirates or sputum were obtained from adults patients with community pneumonia admitted to the participating hospitals and transferred immediately to the central laboratory in the Seoul National University Children's Hospital. The specimens were divided into three parts. One part was used for indirect immunofluorescent test for respiratory viruses, the other part for the culture of RSV and adenovirus in HEp-2 cell monolayer. Another part was used for the culture of influenza virus and parainfluenza virus in MDCK or LLC- MK2 cell monolayers. RESULTS: Of 317 samples, 32 (10.1%) specimens were positive for viral isolation by indirect IF staining or culture, including one dual-infected specimen (adenovirus and parainfluenza virus). Influenza virus was most commonly detected (16 specimens). Parainfluenza virus, adenovirus and RSV were detected in 10, 4 and 3 patients, respectively. All isolated influenza viruses were type A (H3N2 in 9 patients, H1N1 in 2 and unspecified in 5), and 8 out of 10 parainfluenza virus isolates were type 3. CONCLUSION: Similar to previous foreign reports, a significant portion of community-acquired pneumonia in Korean adult is caused by respiratory viruses. Our data empathized the need of referral system for viral diagnosis and of nationwide investigation on respiratory virus infections.
Adenoviridae ; Adult* ; Diagnosis ; Humans ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia* ; Prospective Studies ; Referral and Consultation ; Seoul ; Sputum

PURPOSE: Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis. MATERIALS AND METHODS: From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities. RESULTS: The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01). CONCLUSION: In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.
Brain* ; Diagnosis ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis* ; Neurologic Manifestations ; Prognosis* ; Retrospective Studies ; Survival Rate

Very little is known about the relation between isoflavone intake and menopausal symptoms in Korean woman To find the effects and correlations between these factors, questionnaires(maternal factors, menopausal symptoms) anthropometric measurement, 24hr dietary recalls, and urinary isoflavones analysis were conducted in 100 postmenopausal women residing in the Kyunggi-do rural area. The average age hight and weight of the subject were 61.5 years, 153.6 cm and 56.2kg. The average age at menarche, menopause, and menstrual cycle were 16.7 years, 47.2 years, 29.8 years, respectively. Most of the postmenopausal women experienced mildly menopausal symptoms. The mean calorie, protein and calcium intake were 1417.6 kcal(74.7% of the Korean RDA) 53.2 g(88.6% of the Korean RDA) and 454.0mg(65.6% of the Korean RDA) respectively. The ration of energy from carbohydrate, protein, and fat was 68: 15: 17 The average isoflavone intake from soy foods was 27.27 mg. The major food source of the isoflavone were soybeans and soybean curd. The average urinary isoflavone excretion was 2. 78nmol/mg Cr and showed significant positive correlation with isoflavone intake. Isoflavone intake from soy foods had a negative correlation with the severity of menopausal symptoms. Therefore, soy foods which contain isoflavone may have a protective effect on menopausal symptoms of women in Korea.
Calcium ; Female ; Gyeonggi-do ; Humans ; Isoflavones ; Korea ; Menarche ; Menopause ; Menstrual Cycle ; Soy Foods* ; Soybeans

BMP-4 signaling is mediated through Smad proteins which may translocate to the nucleus to activate transcription. Little is known about how BMP-4 signaling regulates the transcription of its target genes, e.g., Xvent genes. Therefore, we isolated the genomic clone of a BMP-4 responsive homeobox gene, Xbr-1a/Xvent-2. This clone contains a promoter and three exons for the entire coding region. Using the primer extension, we identified the transcription initiation site corresponding to position -64 bp upstream to the ATG codon of the Xvent-2 gene. The promoter was linked to the luciferase reporter gene, and promoter activity determined by luciferase assay. The temporal promoter activity peaked between embryonic stages 13~17, in agreement with its temporal mRNA expression in the whole embryo. Through the serial deletion mutation, the upstream -235 bp of the promoter retains the full transcriptional activity, and is regulated by BMP-4 signaling. The present results suggest that the BMP-4 responsive element is located on the upstream 235 bp of the promoter.
Clinical Coding ; Clone Cells ; Codon ; Embryonic Development* ; Embryonic Structures ; Exons ; Female ; Genes, Homeobox ; Genes, Reporter ; Luciferases ; Pregnancy ; RNA, Messenger ; Sequence Deletion ; Smad Proteins ; Transcription Initiation Site ; Xenopus laevis ; Xenopus*

Pulmonary embolism is a common and lethal, which accounts for substantial morbidity and mortality. Clinical manifestations of pulmonary embolism are nonspecific during general anesthesia. A 60 years old female received elective operation for left femur fracture under general anesthesia. At the end of operation, she suddenly became hypotensive and developed cyanosis. Immediate cardiopulmonary resuscitation(CPR) was performed without definitive diagnosis. Pulmonary embolism was suspected by clinical signs and echocardiography. So, patient was transferred to intensive care unit and with intensive care and aggressive treatment, patient's vital signs and ventilatory status were progressively improved. However, the endotracheal tube was accidentally extubated by the patient at the second postoperative day, and then cardiac arrest was developed and the patient expired. The primary goal of therapy for pulmonary embolization is to prevent reembolization. In the pulmonary thromboembolization, early diagnosis and intensive care improve outcome.
Anesthesia, General* ; Cyanosis ; Diagnosis ; Early Diagnosis ; Echocardiography ; Embolism ; Female ; Femur* ; Heart Arrest ; Humans ; Critical Care ; Intensive Care Units ; Middle Aged ; Mortality ; Pulmonary Embolism* ; Vital Signs

Many surgical procedures are delayed or cancelled due to inadequate preoperative assess- ment and preparation. To improve patient care and minimize operative delays and cancella- tions, preoperative evaluation and preparation of medically compromised patients is neces- sary. We analyzed 174 cases of written interdepartmental consultations submitted to our department from January 1991 to December 1992. Thus we expected more systemized and improved preoperative consultstion from reviewing the past consultations. The analysis were as follows: 1. The overall consultation rate was 1.38%. 2. Age distribution : 21.8% of total consulted cases were in the fifties and 39.7% were over 60 years old. 3. Sex distribution: Male : Female = 58%: 42%. 4. Departmental distribution of consultation : orthopedic surgery 41.4%, general surgery 16.7 %, neurosurgery 12.6%, urology 12.6%. 5. Interdepartmental consultation rate: orthopedic surgery 4.4%, urology 3.1%, neurosurgery 1.9%, cardiothoracic surgery 1.1%. 6. The primary reasons for consultation were related to the cardiovascular system (28.8% of cases), gastrointestinal system including hepatic disease(24%), respiratory system(23% ) and the endocrine system(15% ). Among the cardiovascular problems, 58% were associated with hypertension and 33% were associated with EKG abnormalities. The most frequently consulted problem was hepatic disease ineluding elevated transaminases(50 cases, 21.5% ) followed by hypertension(39 cases, 16.7%), diabetes mellitus(26 cases, 11.2% ) and EKG abnormalities(22 cases, 9.4%). 7. Results of consultation: 1) Frequency of consultation : 166 eases (95.4%) were once and the rest were twice. 2) Contents of problems : 129 cases(74.1%) had single problem, 35 cases(20.1%) had two problems, 8 cases(4.6%) had three problems. 3) Operation was done in 115 cases (66.1% of the consulted cases), delayed in 42 cases(24.1%) and cancelled in 17 cases(9.8%). Major causes of delay of elective surgery were elevated transaminases(26.4%) followed by hypertenaion(20.4%), diabetea. mellitua(15.1 %), others were tuberculosis and abnormal PFT. Major causes of cancellation were similar to that of delayed surgery, i.e., elevated transaminases(35.3%), decreased pulmonary function (14.8% ), liver cirrhosis (14.8%). Above results suggested thst the more systemized protocol may be needed to minimize the delay and cancellation of elective surgery.
Age Distribution ; Anesthesiology* ; Cardiovascular System ; Electrocardiography ; Female ; Humans ; Hypertension ; Liver Cirrhosis ; Male ; Middle Aged ; Neurosurgery ; Orthopedics ; Patient Care ; Referral and Consultation ; Sex Distribution ; Tuberculosis ; Urology