BACKGROUND/AIMS: The true incidence of aristolochic acid nephropathy (AAN) is thought to be underestimated because numerous ingredients known or suspected to contain aristolochic acid (AA) are used in traditional medicine in Korea. METHODS: We collected data on cases of AAN since 1996 via a database in Korea. We evaluated the year of AAN development, route to obtaining AA-containing herbal medicine, gender, reason for taking AA-containing herbal medicine, clinical manifestations, histological findings, phytochemical analysis, and prognosis of patients with AAN. RESULTS: Data on 16 cases of AAN were collected. Thirteen cases developed AAN before and three cases after the prohibition of AA-containing herbal medicine by the Korea Food and Drug Administration. Patients were prescribed AA-containing herbal medicine from oriental clinics or had purchased it from traditional markets. AAN was distributed in all age groups. Young females were most commonly exposed to AA-containing herbal medicine for slimming purposes and postpartum health promotion, while older adults took AA-containing compounds for the treatment of chronic diseases. The most common symptoms presented at hospitalization were nausea and vomiting, and acute kidney injury was accompanied by Fanconi syndrome in almost half of the patients. Phytochemical analysis of AA in herbal medicine was available in six cases. Progression to end stage renal disease (ESRD) was observed in seven patients (43.8%), and five patients (31.3%) had progressed to ESRD within 6 months of diagnosis. CONCLUSIONS: Our report shows that patients were still exposed to AA-containing herbal medicine and that there is a possibility of underdiagnosis of AAN in Korea. A stronger national supervision system of herbal ingredients and remedies in oriental medicine is needed to prevent AAN.
Acute Kidney Injury ; Adult ; Chronic Disease ; Diagnosis ; Fanconi Syndrome ; Female ; Health Promotion ; Herbal Medicine ; Hospitalization ; Humans ; Incidence ; Kidney Failure, Chronic ; Korea* ; Medicine, East Asian Traditional ; Medicine, Traditional ; Nausea ; Organization and Administration ; Postpartum Period ; Prognosis ; United States Food and Drug Administration ; Vomiting

Analysis of the T-cell receptor (TCR) repertoire of innate CD4+ T cells selected by major histocompatibility complex (MHC) class II-dependent thymocyte-thymocyte (T-T) interaction (T-T CD4+ T cells) is essential for predicting the characteristics of the antigens that bind to these T cells and for distinguishing T-T CD4+ T cells from other types of innate T cells. Using the TCRmini Tg mouse model, we show that the repertoire of TCRalpha chains in T-T CD4+ T cells was extremely diverse, in contrast to the repertoires previously described for other types of innate T cells. The TCRalpha chain sequences significantly overlapped between T-T CD4+ T cells and conventional CD4+ T cells in the thymus and spleen. However, the diversity of the TCRalpha repertoire of T-T CD4+ T cells seemed to be restricted compared with that of conventional CD4+ T cells. Interestingly, the frequency of the parental OT-II TCRalpha chains was significantly reduced in the process of T-T interaction. This diverse and shifted repertoire in T-T CD4+ T cells has biological relevance in terms of defense against diverse pathogens and a possible regulatory role during peripheral T-T interaction.
Amino Acid Sequence ; Animals ; Antigens, Surface/metabolism ; CD4-Positive T-Lymphocytes/cytology/*immunology/*metabolism ; Cell Communication ; Cell Differentiation/genetics/immunology ; Clonal Evolution ; Histocompatibility Antigens Class II/*immunology ; *Immunity, Innate ; Immunophenotyping ; Lymphocyte Count ; Mice ; Mice, Knockout ; Mice, Transgenic ; Peptide Fragments/chemistry ; Phenotype ; Receptors, Antigen, T-Cell/chemistry/*genetics/metabolism ; Receptors, Antigen, T-Cell, alpha-beta/chemistry/genetics ; Spleen/cytology ; Thymocytes/cytology/immunology/metabolism

Calf losses have an economic impact on larger Korean native cattle (KNC) breeding farms due to replacement, productivity, and marketing. However, little research on KNC calf mortality or causes of calf death on large-scale breeding farms has been conducted. Based on medical records and autopsy findings from the Hanwoo experimental station of the National Institute of Animal Science, calf death records from 2002 to 2011 were used to identify the causes of mortality. Mortality rate of KNC calves was 5.7%. Large differences (1.8~12.6%) in year-specific mortalities were observed. Calf deaths were due to digestive diseases (68.7%), respiratory diseases (20.9%), accidents (6.0%), and other known diseases (2.2%). The main cause of calf death was enteritis followed by pneumonia, rumen indigestion, and intestinal obstruction. The greatest number of calf deaths occurred during the fall followed by summer. These results indicated that enteritis and pneumonia were the main reasons for calf death. However, autopsy findings demonstrated that other factors also caused calf death. This study suggested that seasonal breeding and routine vaccinations are the most important factors for preventing calf death, and improving calf health in high land areas with low temperature.
Animals ; Autopsy ; Breeding* ; Cattle ; Death Certificates ; Dyspepsia ; Efficiency ; Enteritis ; Intestinal Obstruction ; Marketing ; Medical Records ; Mortality* ; Pneumonia ; Rumen ; Seasons ; Vaccination

Allergic reaction to insulin is uncommon since the introduction of human recombinant insulin preparations and is more rare in pregnant than non-pregnant females due to altered immune reaction during pregnancy. Herein, we report two cases of allergic reaction to insulin in gestational diabetes that were successfully managed. One case was a 33-year-old female using isophane-neutral protamine Hagedorn human insulin and insulin lispro. She experienced dyspnea, cough, urticaria and itching sensation at the sites of insulin injection immediately after insulin administration. We discontinued insulin therapy and started oral hypoglycemic agents with metformin and glibenclamide. The other case was a 32-year-old female using insulin lispro and insulin detemer. She experienced pruritus and burning sensation and multiple nodules at the sites of insulin injection. We changed the insulin from insulin lispro to insulin aspart. Assessments including immunoglobulin E (IgE), IgG, eosinophil, insulin antibody level and skin biopsy were performed. In the two cases, the symptoms were resolved after changing the insulin to oral agents or other insulin preparations. We report two cases of allergic reaction to human insulin in gestational diabetes due to its rarity.
Adult ; Biopsy ; Burns ; Cough ; Diabetes, Gestational* ; Dyspnea ; Eosinophils ; Female ; Glyburide ; Humans ; Hypersensitivity* ; Hypersensitivity, Immediate ; Hypoglycemic Agents ; Immunoglobulin E ; Immunoglobulin G ; Immunoglobulins ; Insulin Aspart ; Insulin Lispro ; Insulin* ; Metformin ; Pregnancy ; Pruritus ; Sensation ; Skin ; Urticaria

Hepatic ischemia/reperfusion (I/R) injury leads to oxidative stress and acute inflammatory responses that cause liver damage and have a considerable impact on the postoperative outcome. Much research has been performed to develop possible protective techniques. We aimed to investigate the efficacy of SPA0355, a synthetic thiourea analog, in an animal model of hepatic I/R injury. Male C57BL/6 mice underwent normothermic partial liver ischemia for 45 min followed by varying periods of reperfusion. The animals were divided into three groups: sham operated, I/R and SPA0355 pretreated. Pretreatment with SPA0355 protected against hepatic I/R injury, as indicated by the decreased levels of serum aminotransferase and reduced parenchymal necrosis and apoptosis. Liver synthetic function was also restored by SPA0355 as reflected by the prolonged prothrombin time. To gain insight into the mechanism involved in this protection, we measured the activity of nuclear factor-kappaB (NF-kappaB), which revealed that SPA0355 suppressed the nuclear translocation and DNA binding of NF-kappaB subunits. Concomitantly, the expression of NF-kappaB target genes such as IL-1beta, IL-6, TNF-alpha and iNOS was significantly downregulated. Lastly, the liver antioxidant enzymes superoxide dismutase, catalase and glutathione were upregulated by SPA0355 treatment, which correlated with the reduction in serum malondialdehyde. Our results suggest that SPA0355 pretreatment prior to I/R injury could be an effective method to reduce liver damage.
Animals ; Anti-Inflammatory Agents/*therapeutic use ; Benzoxazines/*therapeutic use ; Liver/*drug effects/immunology/*injuries/pathology ; Male ; Mice, Inbred C57BL ; NF-kappa B/immunology ; Reperfusion Injury/*drug therapy/immunology/pathology ; Signal Transduction/drug effects ; Thiourea/*analogs & derivatives/therapeutic use

BACKGROUND/AIMS: The purpose of this study was to evaluate the clinicopathologic characteristics of colon cancers detected at the SOK Sokpeynhan Internal Medical Network, a nationwide system of primary health care institutions. METHODS: We analyzed 579 colon cancer patients diagnosed using colonoscopy at the SOK network from January 2011 through December 2012. Cancers from the rectum to the splenic flexure were classified as left colon cancer. Patients over 65 were classified as senior. RESULTS: The mean age (+/-SD) of subjects was 60.9+/-10.5 years and 61.1% were men. More than one quarter (28.2%) of patients were asymptomatic. The prevalence of left colon cancer was higher (77.9%) than that for right colon cancer. The most frequent macroscopic and histologic types were depressed (58.9%) and moderately differentiated adenocarcinoma (52.2%), respectively. Asymptomatic subjects displayed protruding or well differentiated adenocarcinoma, while symptomatic patients were more likely to display depressed or moderately differentiated adenocarcinoma (P<0.05). The mean age of the right colon cancer group was higher than that for the left colon cancer group (P<0.05). Among symptomatic patients, the most frequent symptoms were bloody stool for patients with left colon cancer and abdominal discomfort for patients with right colon cancer (P<0.05). The prevalence of depressed cancer was higher in older subjects as compared to younger subjects (P<0.05). The prevalence of right colon cancer tended to increase with age, although this difference did not achieve statistical significance (P>0.05). CONCLUSIONS: Study results indicated an increase of colon cancer amongst younger demographics in recent years. The effectiveness of colonoscopy screening was also evident, as asymptomatic patients demonstrated frequent findings of well differentiated adenocarcinomas. Study results also suggested a need for closer examination of older patients, as right colon cancer tended to increase with age.
Adenocarcinoma ; Colon, Transverse ; Colonic Neoplasms* ; Colonoscopy ; Demography ; Humans ; Male ; Mass Screening ; Population Characteristics ; Prevalence ; Primary Health Care* ; Rectum

The beet armyworm Spodoptera exigua (Lepidoptera: Noctuidae) is difficult to control using chemical insecticides because of the development of insecticide resistance. Several pest control agents are used to control the beet armyworm. Entomopathogenic fungi are one of the candidates for eco-friendly pest control instead of chemical control agents. In this study, among various entomopathogenic fungal strains isolated from soil two isolates were selected as high virulence pathogens against larva of beet armyworm. Control efficacy of fungal conidia was influenced by conidia concentration, temperature, and relative humidity (RH). The isolates Metarhizium anisopliae FT83 showed 100% cumulative mortality against second instar larvae of S. exigua 3 days after treatment at 1 x 10(7) conidia/mL and Paecilomyces fumosoroseus FG340 caused 100% mortality 6 days after treatment at 1 x 10(4) conidia/mL. Both M. anisopliae FT83 and P. fumosoroseus FG340 effectively controlled the moth at 20~30degrees C. M. anisopliae FT83 was significantly affected mortality by RH: mortality was 86.7% at 85% RH and 13.4% at 45% RH. P. fumosoroseus FG340 showed high mortality as 90% at 45% RH and 100% at 75% RH 6 days after conidia treatments. These results suggest that P. fumosoroseus FG340 and M. anisopliae FT83 have high potential to develop as a biocontrol agent against the beet armyworm.
Beta vulgaris ; Fungi* ; Humidity ; Insecticide Resistance ; Insecticides ; Larva ; Metarhizium* ; Mortality ; Moths ; Paecilomyces* ; Pest Control ; Soil ; Spodoptera* ; Spores, Fungal ; Virulence*

BACKGROUND/AIMS: Colorectal cancer is the third most common cancer and the fourth leading cause of cancer death in Korea. Colonoscopic screening with removal of adenomas is an effective strategy for reducing the incidence and mortality of colorectal cancer. This study was conducted to investigate predictable factors of early colorectal cancer (ECC) in patients with advanced adenoma (AA), tumor in situ (Tis), and submucosal (SM) cancer diagnosed after colonoscopic polypectomy. METHODS: Between August 2003 and June 2012, a total of 1,001 patients who underwent colonoscopic polypectomy in Jeju National University Hospital were enrolled in this study. RESULTS: Patients were classified into four groups; non-AA, AA, Tis, and SM cancer. Compared to the AA group, the ECC group (n=50) had large adenoma size (12.2+/-5.9 mm vs. 15.3+/-6.5 mm, P<0.01), distal location (39.3% vs. 52.0%, P=0.05) and diabetes mellitus (13.1% vs. 25.0%, P=0.04). However, age, sex, body mass index, the mean number of polyps, and morphological features (polypoid vs. nonpolypoid lesions) were not significantly different between the AA and ECC groups. In multivariate analysis, adenoma size >15 mm (odds ratio [OR], 4.49; 95% confidence interval [CI] 2.40-8.38), distal location (OR, 2.59; 95% CI, 1.33-5.05), and diabetes mellitus (OR, 2.10; 95% CI, 1.07-4.43) were significantly associated with ECC. Of the 12 patients with SM cancer, 5 underwent additional operations and had no remnant carcinoma. CONCLUSIONS: Predictable factors of ECC after colonoscopic polypectomy may be adenoma size >15 mm, distal location and diabetes mellitus.
Adenoma ; Body Mass Index ; Colonoscopy ; Colorectal Neoplasms ; Diabetes Mellitus ; Humans ; Incidence ; Korea ; Mass Screening ; Multivariate Analysis ; Polyps

OBJECTIVE: The goal of this study was to assess the incidence and risk factors for post-traumatic hydrocephalus (PTH) following decompressive craniectomy (DC). An additional objective was to investigate the relationship between hydrocephalus and subdural hygroma (SDG) after DC. METHODS: We conducted a retrospective study of 94 patients who were admitted to our department between 2007 and 2010 with severe head injury requiring DC. Post-traumatic hydrocephalus was defined as: frontal horn index (FHI) > or =0.4 or modified FHI > or =0.33 accompanying transependymal edema; the presence of either clinical worsening or failure to make neurological improvement over time; and clinical improvement after ventriculoperitoneal shunt. Post-traumatic SDG was defined as the presence of low density at computerized tomography (CT) of more than 5mm thickness. RESULTS: Among the 94 patients, we could follow up more than 3 months and obtain more than 4 serial CT scans in 41 patients. PTH developed in 29.3% (12/41) and SDG developed in 48.8% (20/41) of these patients. The development of PTH was significantly associated with delayed craniplasty after DC and with interhemispheric SDG. No relationship was found between PTH and age, sex, Glasgow Coma Scale (GCS) score, intraventricular hemorrhage, subarachnoid hemorrhage, midline shift, basal cistern effacement, or cortical opening during DC. CONCLUSION: Hydrocephalus occurred in 29.3% of the patients with severe traumatic brain injury who required DC. Delayed cranioplasty and interhemispheric SDG after DC were risk factors for the development of PTH.
Animals ; Brain Injuries ; Craniocerebral Trauma ; Decompressive Craniectomy ; Follow-Up Studies ; Glasgow Coma Scale ; Hemorrhage ; Horns ; Humans ; Hydrocephalus ; Incidence ; Retrospective Studies ; Risk Factors ; Subarachnoid Hemorrhage ; Subdural Effusion ; Ventriculoperitoneal Shunt

It is not yet understood how the enhanced expression of pancreatic adenocarcinoma up-regulated factor (PAUF; a novel oncogene identified in our recent studies), contributes to the oncogenesis of pancreatic cells. We herein report that PAUF up-regulates the expression and transcriptional activity of beta-catenin while the suppression of PAUF by shRNA down-regulates beta-catenin. The induction of beta-catenin by PAUF is mediated by the activities of Akt and GSK-3beta, but inhibition of downstream ERK does not reduce beta-catenin expression. To test whether PAUF emulates either the Wnt3a-mediated or the protein kinase A-mediated signaling pathway for the stabilization of beta-catenin, we examined the phosphorylation status of beta-catenin in the presence of PAUF compared with that of beta-catenin during treatment with Wnt3a or dibutyryl cAMP, a cell permeable cyclic AMP analogue. PAUF expression induces phosphorylation at Ser-33/37/Thr-41 and Ser-675 of beta-catenin but no phosphorylation at Ser-45, indicating that a unique phosphorylation pattern of beta-catenin is caused by PAUF. Finally, the expression of PAUF up-regulates both cyclin-D1 and c-Jun, target genes of beta-catenin, leading to a rapid proliferation of pancreatic cells; conversely decreased PAUF expression (by shRNA) results in the reduced proliferation of pancreatic cells. Treatment with hexachlorophene (an inhibitor of beta-catenin) reduces the proliferation of pancreatic cells despite the presence of PAUF. Taken together, we propose that PAUF can up-regulate and stabilize beta-catenin via a novel pattern of phosphorylation, thereby contributing to the rapid proliferation of pancreatic cancer cells.
*Adenocarcinoma/metabolism/pathology ; Cell Line, Tumor ; Cell Proliferation ; Cyclin D1/metabolism ; Gene Expression Regulation, Neoplastic ; Glycogen Synthase Kinase 3/metabolism ; HEK293 Cells ; Humans ; Lectins/genetics/*metabolism ; *Pancreatic Neoplasms/metabolism/pathology ; Phosphorylation ; Proto-Oncogene Proteins c-akt/metabolism ; Proto-Oncogene Proteins c-jun/metabolism ; Signal Transduction ; *Up-Regulation ; beta Catenin/genetics/*metabolism