The global obesity epidemic and associated metabolic diseases require alternative biological targets for new therapeutic strategies. In this study, we show that a phytochemical sulfuretin suppressed adipocyte differentiation of preadipocytes and administration of sulfuretin to high fat diet-fed obese mice prevented obesity and increased insulin sensitivity. These effects were associated with a suppressed expression of inflammatory markers, induced expression of adiponectin, and increased levels of phosphorylated ERK and AKT. To elucidate the molecular mechanism of sulfuretin in adipocytes, we performed microarray analysis and identified activating transcription factor 3 (Atf3) as a sulfuretin-responsive gene. Sulfuretin elevated Atf3 mRNA and protein levels in white adipose tissue and adipocytes. Consistently, deficiency of Atf3 promoted lipid accumulation and the expression of adipocyte markers. Sulfuretin’s but not resveratrol’s anti-adipogenic effects were diminished in Atf3 deficient cells, indicating that Atf3 is an essential factor in the effects of sulfuretin. These results highlight the usefulness of sulfuretin as a new anti-obesity intervention for the prevention of obesity and its associated metabolic diseases.
Activating Transcription Factor 3 ; Adipocytes ; Adiponectin ; Adipose Tissue, White ; Animals ; Diet* ; Insulin Resistance ; Metabolic Diseases* ; Mice ; Mice, Obese* ; Microarray Analysis ; Obesity* ; RNA, Messenger

This research aimed to investigate the changes in ethical issues in everyday clinical practice recognized by critical care nurses during two observation periods. We conducted a retrospective analysis of data obtained by prospective questionnaire surveys of nurses in the intensive care units (ICU) of a tertiary university-affiliated hospital in Seoul, Korea. Data were collected prospectively during two different periods, February 2002-January 2003 (Period 1) and August 2011-July 2012 (Period 2). Significantly fewer cases with ethical issues were reported in Period 2 than in Period 1 (89 cases [2.1%] of 4,291 ICU admissions vs. 51 [0.5%] of 9,302 ICU admissions, respectively; P < 0.001). The highest incidence of cases with identified ethical issues in both Periods occurred in MICU. The major source of ethical issues in Periods 1 and 2 was behavior-related. Among behavior-related issues, inappropriate healthcare professional behavior was predominant in both periods and mainly involved resident physicians. Ethical issue numbers regarding end-of-life (EOL) care significantly decreased in the proportion with respect to ethical issues during Period 2 (P = 0.044). In conclusion, the decreased incidence of cases with identified ethical issues in Period 2 might be associated with ethical enhancement related with EOL and improvements in the ICU care environment of the studied hospital. However, behavior-related issues involving resident physicians represent a considerable proportion of ethical issues encountered by critical care nurses. A systemic approach to solve behavior-related issues of resident physicians seems to be required to enhance an ethical environment in the studied ICU.
Critical Care Nursing/*ethics ; Humans ; *Intensive Care Units ; Nurses ; Retrospective Studies ; Terminal Care ; Tertiary Care Centers

PURPOSE: We analyzed the patients who needed reoperation after undergoing a thoracolumbar spine operation and investigated the causes, pattern of timing, medical history and clinical outcome after reoperation. MATERIALS AND METHODS: Out of 2,198 patients who underwent spine surgery for thoracolumbar spine disease from 1988 to 2011, we targeted 193 patients who underwent reoperation. We studied the causes, operative method of initial surgery, time-variant causes and outcome of reoperation. RESULTS: The number of patients who underwent thoracolumbar spine reoperation was 193 out of 2,198 and the reoperation rate was 8.7%. We researched time-variant causes of reoperation. In six weeks after the initial operation, exploration for hematoma and neurologic deficit was 18 (26.8%), recurred heniated intervertebral disc (HIVD) was 18 (26.8%), and surgical site infection was 17 (25.4%). From six weeks to six months, recurred HIVD was 10 (47.6%), surgical site infection was 7 (33.3%), and after six months, adjacent segmental disease (ASD) was 38 (35.7%), recurred HIVD was 26 (23.2%), and implant related problem was 17 (16.0%). CONCLUSION: Causes of thoracolumbar spine reoperation included complications (2.8%); infection, hematoma, neurologic deficit, incomplete decompression, and natural courses (5.9%); ASD, recurred HIVD, implant related problem, instability after decompression, tumor recur, progression of deformity.
Congenital Abnormalities ; Decompression ; Hematoma ; Humans ; Intervertebral Disc ; Neurologic Manifestations ; Reoperation ; Spine

The authors would like to amend a reference (Lee et al., 2003) that was cited in "Cell culture" section of "Materials and Methods". Instead of "(Lee et al., 2003)", we would like to change the reference to "(Kim et al., 2003)". In "References", it also needs to include the following reference. Kim YY, Seol HW, Ahn HJ. Temporal expression of differentiation markers in embryoid bodies from various human embryonic stem cell line. International Society for Stem Cell Research 1st Annual Meeting, Washington, DC. U.S.A. June 8-11, 2003, Abstract No. 35. The authors apologize for any inconvenience.

Mouse embryonic stem (mES) cells are capable of undergoing chondrogenesis in vitro. To enhance this process, the human SOX9 (hSOX9) cDNA was delivered into mES cells and the clones overexpressing hSOX9 (denoted as mES-hSOX9 cells) were verified by Western blot analysis. The transcripts of collagen IIA (a juvenile form), aggrecan and Pax1 were expressed in mES-hSOX9 cells grown on feeder layers, suggesting the immediate effect of exogenous SOX9 on chondrogenesis. However, SOX9 overexpression did not affect the cell cycle distribution in undifferentiated mES cells. Upon differentiation, collagen IIB (an adult form) was detected in day 3 immature embryoid bodies. In addition, the overexpression of exogenous SOX9 significantly induced transcriptional activity driven by SOX9 binding site. Taken together, we for the first time demonstrated that constitutive overexpression of exogenous SOX9 in undifferentiated mES cells might have dual potentials to induce both chondrogenic commitment and growth capacity in the undifferentiated status.
Animals ; Cell Differentiation/genetics ; Cell Line ; *Chondrogenesis ; Collagen Type II/genetics ; Embryo/*cytology ; Enhancer Elements (Genetics)/genetics ; Extracellular Matrix Proteins/genetics ; Genetic Markers/genetics ; High Mobility Group Proteins/genetics/*metabolism ; Humans ; Lectins, C-Type/genetics ; Mice ; Paired Box Transcription Factors/genetics ; Proteoglycans/genetics ; Research Support, Non-U.S. Gov't ; Stem Cells/*metabolism/physiology ; Trans-Activation (Genetics) ; Transcription Factors/genetics/*metabolism

Human embryonic stem (hES) cells are capable of differentiating into pluralistic cell types, however, spontaneous differentiation generally gives rise to a limited number of specific differentiated cell types and a large degree of cell heterogeneity. In an effort to increase the efficiency of specified hES cell differentiation, we performed a series of transient transfection of hES cells with EGFP expression vectors driven by different promoter systems, including human cellular polypeptide chain elongation factor 1 alpha (hEF1alpha), human cytomegalo-virus, and chicken beta-actin. All these promoters were found to lead reporter gene expression in undifferentiated hES cells, but very few drug-selectable transfectants were obtained and failed to maintain stable expression of the transgene with either chemical or electroporation methods. In an attempt to increase transfection efficiency and obtain stable transgene expression, differentiated hES cells expressing both mesodermal and ectodermal markers were derived using a defined medium. Differentiated hES cells were electroporated with a hEF1alpha promoter-driven EGFP or human noggin expression vector. Using RT-PCR, immunocytochemistry and fluorescence microscopy, the differentiated hES cells transfected with foreign genes were confirmed to retain stable gene and protein expression during prolonged culture. These results may provide a new tool for introducing exogenous genes readily into hES cells, thereby facilitating more directed differentiation into specific and homogenous cell populations.
Actins/genetics ; Animals ; Bone Morphogenetic Proteins/genetics ; *Cell Differentiation ; Chickens ; Cytomegalovirus/genetics ; Drug Delivery Systems ; Embryo/*cytology ; *Gene Therapy ; Green Fluorescent Proteins/genetics/*metabolism ; Humans ; Immunoenzyme Techniques ; Microscopy, Fluorescence ; Peptide Elongation Factor 1/genetics ; Pluripotent Stem Cells/*cytology ; Promoter Regions (Genetics)/*genetics ; Research Support, Non-U.S. Gov't ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription, Genetic/genetics

OBJECTIVE: p63 is a member of the p53 gene family. The main aim of this study was to compare p63 and p53 expression in precancerous lesions and invasive squamous cell carcinoma of the uterine cervix. METHODS: Total 81 formalin-fixed, paraffin-embedded sections of low-grade squamous intraepithelial lesion (22 cases), high-grade squamous intraepithelial lesion (42 cases) and invasive squamous cell carcinomas (17 cases) in the uterine cervix were stained by immunohistochemistry for expression of p63, p53 and topoisomerase II-alpha. RESULTS: p63 was statistically significant higher immunoreactivity according to progression of uterine cervical squamous lesions, but p53 was not significant. No statistical correlation was found between p63 and p53. Topoisomerase II-alpha index was statistically significant higher according to increase of p63 expression. CONCLUSION: These findings suggest that the expression of p63 protein may play a roles in progression and proliferative activities of the uterine cervical squamous lesions.
Carcinoma, Squamous Cell* ; Cervix Uteri* ; Female ; Genes, p53 ; Humans ; Immunohistochemistry

To our knowledge, only one case of vaginal cavernous hemangioma in pregnancy has been reported all over the world and there is no report in Korea. The authors have experienced one case of vaginal cavernous hemangioma in pregnancy and report our case with a brief review of literature.
Hemangioma, Cavernous* ; Korea ; Pregnancy* ; Vagina

PURPOSE: To compare the effectiveness of Magnetic Resonance Imaging and discography in the diagnosis of internal disc derangement (IDD) . MATERIALS AND METHODS: This study was confined to 90 discs of 30 patients diagnosed as IDD by MRI & disco-CT. We compared the pain nature of discogram, degree of annular tear in the disco-CT and degree of disc degeneration in MRI. The presence of HIZ (High Intensity Zone) in MRI was also compared with the pain of discogram. RESULTS: Those discs with more severe annular tears in the disco-CT showed more definite pain pattern in the discogram. More degeneration in the MRI was also correlated with more anatomical deterioration in disco-CT. Of the 27 discs with normal MRI, 6 (22%) showed severe pain provocation in discography. Of the 63 discs with degeneration in MRI, 14 (22%) showed no pain provocation in discography. Of all discs, HIZ was present in 16% (15/90) . When HIZ was present in a disc of a symptomatic patient, the possibility of it being a painful disc was 93%. CONCLUSION: In the diagnosis of IDD, MRI was helpful is seeing the degree of disc degeneration to rule out disc herniation or spinal stenosis. But the discogram is considered the only way for definite diagnosis of painful discs.
Diagnosis* ; Humans ; Intervertebral Disc Degeneration ; Magnetic Resonance Imaging* ; Spinal Stenosis

PURPOSE: We intend to define age-specific ranges for serum prostate-specific antigen (PSA) and to investigate the relationship of age to serum PSA in Korean healthy men. MATERIALS AND METHODS: From April 1992 to February 1997, 7,718 Korean men aged 30 to 79 years visited to Soonchunhyang health promotion center and were examined with serum PSA. We evaluated serum PSA of 2,321 Korean healthy men aged 50 to 79 years(1,943 aged 50 to 59 years, 292 aged 60 to 69 years, and 86 aged 70 to 79 years) using Hybritech Tandem-R aasay. Statistical analysis was performed by simple linear regression analysis using SPSS. RESULTS: Average serum PSA of 2,321 Korean healthy men was 1.25+/-1.02ng/ml, and mean value for serum PSA for men aged 50 to 59 years was 1.18+/-0.95ng/ml; for 60 to 69 years, 1.48+/-1.19ng/ml; and 70 to 79 years, 1.99+/-1.18ng/ml. Age-specific reference ranges for serum PSA for men aged 50 to 59 years were 0-3.1ng/ml; for 60 to 69 years, 0-3.9ng/ml; and for 70 to 79 years, 0-5.5ng/ml, respectively. Serum PSA concentration was correlated with age(r=0.35, p-value<0.05). CONCLUSIONS: The serum PSA concentration was correlated with age and age-specific reference ranges for serum PSA in Korean healthy men were lower than those in white men. Therefore, we suggest that age-specific reference ranges for serum PSA in Korean should be defined in order to increase the detection rate of localizing prostate cencer in younger ages, and to decrease the risk of missing prostate cancer in older ages.
Health Promotion* ; Humans ; Linear Models ; Male ; Prostate ; Prostate-Specific Antigen* ; Prostatic Neoplasms ; Reference Values*