OBJECTIVE: The objective of this study is to assess whether genetic functional variants of disintegrin and metalloprotease 33 (ADAM33) are associated with susceptibility to systemic lupus erythematosus (SLE) in a Korean population. METHODS: We previously identified 48 single nucleotide polymorphisms (SNPs) in ADAM33. Six SNPs were selected with regard to the linkage disequilibrium pattern. An association study of ADAM33 was conducted in 190 patients with SLE and 469 control subjects. SNPs were genotyped using the TaqMan Real-time polymerase chain reaction method, and haplotype analyses of related variants were performed. RESULTS: All SNPs were in Hardy-Weinberg equilibrium. Significant associations were found between the ADAM33 polymorphisms and SLE at rs2787094 (adjusted odds ratio [OR] 1.88, 95% confidence interval [CI] 1.00 to 3.54; p<0.0001). The rs554743 polymorphism was associated with the presence of the immunoglobulin M anti-cardiolipin antibody (adjusted OR 0.29, 95% CI 0.10 to 0.83; p=0.021). CONCLUSION: ADAM33 polymorphisms were associated with susceptibility to SLE and development of clinical disease manifestations in a Korean population. Further study is warranted to clarify the role of ADAM33 in SLE pathogenesis.
Haplotypes ; Humans ; Immunoglobulin M ; Linkage Disequilibrium ; Lupus Erythematosus, Systemic* ; Odds Ratio ; Polymorphism, Single Nucleotide ; Real-Time Polymerase Chain Reaction

BACKGROUND/AIMS: Three-dimensional (3D) imaging is gaining popularity and has been partly adopted in laparoscopic surgery or robotic surgery but has not been applied to gastrointestinal endoscopy. As a first step, we conducted an experiment to evaluate whether images obtained by conventional gastrointestinal endoscopy could be used to acquire quantitative 3D information. METHODS: Two endoscopes (GIF-H260) were used in a Borrmann type I tumor model made of clay. The endoscopes were calibrated by correcting the barrel distortion and perspective distortion. Obtained images were converted to gray-level image, and the characteristics of the images were obtained by edge detection. Finally, data on 3D parameters were measured by using epipolar geometry, two view geometry, and pinhole camera model. RESULTS: The focal length (f) of endoscope at 30 mm was 258.49 pixels. Two endoscopes were fixed at predetermined distance, 12 mm (d12). After matching and calculating disparity (v2-v1), which was 106 pixels, the calculated length between the camera and object (L) was 29.26 mm. The height of the object projected onto the image (h) was then applied to the pinhole camera model, and the result of H (height and width) was 38.21 mm and 41.72 mm, respectively. Measurements were conducted from 2 different locations. The measurement errors ranged from 2.98% to 7.00% with the current Borrmann type I tumor model. CONCLUSIONS: It was feasible to obtain parameters necessary for 3D analysis and to apply the data to epipolar geometry with conventional gastrointestinal endoscope to calculate the size of an object.
Aluminum Silicates ; Endoscopes ; Endoscopes, Gastrointestinal ; Endoscopy, Gastrointestinal ; Laparoscopy ; Pilot Projects ; Resin Cements

OBJECTIVES: The purpose of present study is to identify the differences between temperament and character traits among adolescents classified by ego resilience and ego control level. METHODS: A Junior Temperament and Character Inventory (TCI) was performed on participants, and a California Child Q-Test (CCQ) was tested for by the parents of the adolescent participants. RESULTS: The result of the factor analysis and discriminant analysis show that the participants are classified into three different groups based on CCQ score and item response patterns. The three groups are named the ego resilience group, the undercontrolled group, and the overcontrolled group. The ego resilience group indicates that they have a high level of interest and curiosity but yet they are not easily tempered. Moreover, they behave proactively with a reasonable level of responsibility in order to improve themselves. In contrast, among the undercontrolled group, it is observed that, although the group shows even higher level of interest, curiosity and honesty, they are careless, more impulsive, and have a lack of delayed gratification and shame. CONCLUSION: The overcontrolled group shows that they are the most cautious and reflective group among the three but also show emotional instability such as strong criticism and passive-aggressiveness. In this study, implications and limitations are discussed.
Adolescent ; California ; Child ; Ego ; Exploratory Behavior ; Humans ; Parents ; Temperament

PURPOSE: The aim of this study was to clarify the risk factors and clinicopathologic features of gastric cancer patients with a second primary cancer (SPC). METHODS: The data on 2455 patients with gastric cancer was analyzed retrospectively with respect to the clinicopathologic features of the pathologically proven SPC. RESULTS: Of the 2,455 patients, there were 90 (3.7%) gastric cancer patients with SPC. Among them, 31 patients had synchronous cancers and 59 had metachronous cancers. Of the 59 metachronous cancers, 21 were found before the gastric surgery and 38 were found after the gastric surgery. The most prevalent SPC was colorectal cancer (28 cases) and followed by cancer in the liver (13 cases) kidney and pancreas (6 cases each, respectively). Among the 61 patients with SPC found after gastric cancer surgery, 31 cases (50%) were diagnosed within 2 years. On comparison of the clinicopathologic features, the patients with SPC tended to be older, more prone to have early gastric carcinoma and to have multiple gastric lesions. The survival rate of the patients with SPC and gastric cancer alone was not different; however, there was a significantly difference for the patients with early gastric cancer (61.7% vs. 91.3%, respectively, P < 0.05). CONCLUSION: For the patients who were older, had multiple primary lesions or they had early gastric cancer, evaluation for SPC, and especially in the colon and liver, should be considered during routine follow up.
Colon ; Colorectal Neoplasms ; Humans ; Kidney ; Liver ; Neoplasms, Second Primary ; Pancreas ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; Survival Rate

The forkhead-box J1 (FOXJ1) transcription factor could suppress a spontaneous activation of T cells and B cells through an induction of IkappaBbeta that results in repression of NF-kappaB activity. In Foxj1 deficiency mice, systemic autoimmune inflammation is quite common symptom. Therefore, deregulated Foxj1 is supposed to be associated with autoimmune diseases and/or other inflammatory diseases. Previously, we identified that polymorphisms of human FOXJ1 gene (g.-460C>T, g.1805G>T and g.3375G>C) are associated with allergic rhinitis in a Korean population. In present study, we compared the genotype and allele frequencies of these SNPs between healthy controls and systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA) patients. We also investigated the relationships between each genotype and the expression levels of anti-nuclear antibodies in SLE patients, and rheumatoid factor and anti-cyclic citrullinated peptide in RA patients. The frequencies of haplotypes constructed by these FOXJ1 SNPs were compared between controls and SLE (or RA) patients. The results of genotype and allele analysis showed that the prevalence of polymorphism g.3375G>C was associated with the susceptibility of SLE (P = 0.0072 and 0.0042, respectively). But no significant association was found with RA. In the haplotype analysis, however, the main CGG showed a weak association between controls and RA patients (P = 0.048).
Adult ; Arthritis, Rheumatoid/complications/*genetics ; Asian Continental Ancestry Group ; Female ; Forkhead Transcription Factors/*genetics ; Gene Frequency ; Genetic Predisposition to Disease ; Haplotypes ; Humans ; Korea ; Lupus Erythematosus, Systemic/complications/*genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; *Polymorphism, Single Nucleotide

Hepatitis E virus is an enterically transmitted virus that causes endemic cases of acute hepatitis in many countries in Africa, and Southeast and Central Asia. Sporadic cases of acute hepatitis E also have been reported in developed countries. In non-endemic areas, most of the sporadic cases of hepatitis E are introduced from the endemic areas. Until now, only three cases of acute hepatitis E have been reported in Korea. Recently, we experienced nine cases of acute hepatitis, in which serologic studies showed positive of IgM anti-HEV. We report these as cases of acute hepatitis E. These cases suggest that HEV infection occurs sporadically in Korea and should be considered as a cause of cryptogenic acute hepatitis.
Middle Aged ; Male ; Korea/epidemiology ; Humans ; Hepatitis E/diagnosis/*epidemiology ; Female ; Adult ; Acute Disease

Recently the transcriptional up-regulation of human beta-defensin 2 (HBD-2) by lipopolysaccharide (LPS) was found to be associated with NF-kappaB binding site. Although the general mechanisms of NF-kappaB activation by LPS stimulation are well understood, less is known about the signal transduction pathway leading to LPS-induced NF-kappaB activation in human corneal epithelial (HCE) cells. The aim of this study was to investigate the intracellular signals involved in LPS-induced HBD-2 mRNA expression in HCE cells. Pretreatments of inhibitors for NF-kappaB, protein tyrosine kinase, p38 mitogen activated protein kinase (MAPK), and c-Jun N-terminal kinase (JNK) attenuated the LPS-induced NF-kappaB DNA binding activity and HBD-2 mRNA expression. Furthermore, pretreatments with inhibitors for protein kinase C (PKC), phosphatidylcholine-phospholipase C, phosphatidylinositol-phospholipase C, or phosphatidate phosphohydrolase prevented LPS-induced HBD-2 mRNA expression and HBD-2 prmoter-driven luciferase activity. However, the increased expression of HBD-2 mRNA and the increased DNA binding activity of NF-kappaB induced by LPS were not changed by the blockage of extracellular signal-regulated kinase (ERK) and of addition of antioxidants. Forskolin, a protein kinase A (PKA) agonist did not induce HBD-2 mRNA expression. These data demonstrate that LPS-induced HBD-2 mRNA expression via NF-kappaB is, at least in part, dependent on PKC, p38 MAPK, JNK, and protein tyrosine kinase status, but appears to be independent on PKA, ERK and ROS in HCE cells. Taken together, there may be more than one signaling pathways that lead to LPS-induced up-regulation of HBD-2 mRNA expression in HCE cells.
Antioxidants ; Binding Sites ; Colforsin ; Cyclic AMP-Dependent Protein Kinases ; DNA ; Epithelial Cells* ; Humans* ; JNK Mitogen-Activated Protein Kinases ; Luciferases ; NF-kappa B ; p38 Mitogen-Activated Protein Kinases ; Phosphatidate Phosphatase ; Phosphotransferases ; Protein Kinase C ; Protein Kinases ; Protein-Tyrosine Kinases ; RNA, Messenger* ; Signal Transduction ; Up-Regulation

PURPOSE: Rapid diagnosis of congestive heart failure (CHF) is important for prompt and appropriate treatment, but is often difficult. The B-type natriuretic peptide (BNP) has been described as a powerful diagnostic test for heart failure. The goal of this study was to determine the diagnostic cutoff values of BNP, to evaluate useful factors for the diagnosis of CHF, and to develope a diagnostic algorithm for CHF with acute dyspnea patients. METHODS: BNP levels were obtained in 721 patients presenting to the emergency medical center with acute dyspnea from January 2001 to December 2002. With the use of inclusion criteria, 305 patients were excluded. Blood samples were collected by venipuncture and were analyzed by using Triage BNP assay. Included patients underwent echocardiography to evaluate the left ventricular (LV) dysfunction. RESULTS: The mean BNP concentration was higher in patients with CHF (n=214) than in those with other diagnose (517.31+/-37.70 pg/mL vs 75.53+/-11.25 pg/mL, p<0.001). At a blood concentration of 100 pg/mL, BNP showed a sensitivity of 79 %, a specificity of 83 %, a positive predictive value of 83%, and a negative predictive value of 79%. CONCLUSION: The BNP measurement is a useful tool in the diagnosis of CHF in patients presenting with dyspnea. We propose a diagnostic algorithm for CHF based on the BNP assay.
Diagnosis* ; Diagnostic Tests, Routine ; Dyspnea ; Echocardiography ; Emergencies ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Humans ; Natriuretic Peptide, Brain ; Phlebotomy ; Sensitivity and Specificity ; Triage

PURPOSE: Subacute sclerosing panencephalitis(SSPE) is a severe and usually fatal neurodegenerative disorder of childhood and adolescence. The etiology is related to previous measles infection especially during the first 2 years of life. Since recent measles epidemics in Korea may increase the late risk of SSPE, the authors investigated the clinical characteristics of SSPE focusing on brain MRI. METHODS: Six cases(4 males, 2 females) of SSPE patients were retrospectively reviewed for clinical, EEG, laboratory and brain MRI findings. RESULTS: Four of 6 had a history of measles infection in the first year of life. Clinical manifestations were as follows:myoclonus(6), falling(4), ataxia(4), dysarthria(3), seizures (2), involuntary movements(2), tremor(2), head drop(1), sleep disturbance(1). In all cases, CSF IgG, CSF IgG/albumin ratio, and CSF/serum IgG index increased, oligoclonal bands were positive, and CSF antimeasles antibodies were positive. Frontal high amplitude sigma activities and anteriorly-accentuated multifocal epileptiform discharges were noted on EEG. Brain MRI revealed T2-weighted high signal intensity of the deep white matter. CONCLUSION: The diagnosis of SSPE depends on characteristic clinical features and elevation of measles antibodies in CSF, supported by others including EEG, CSF and brain MRI findings. We hope the clinical characteristics we mentioned may be useful for the early diagnosis and active management of SSPE in Korea.
Adolescent ; Antibodies ; Brain ; Diagnosis ; Early Diagnosis ; Electroencephalography ; Head ; Hope ; Humans ; Immunoglobulin G ; Korea ; Magnetic Resonance Imaging ; Male ; Measles ; Neurodegenerative Diseases ; Oligoclonal Bands ; Retrospective Studies ; Seizures ; Subacute Sclerosing Panencephalitis*

PURPOSE: To evaluate the incidence of orthopaedic injuries and develop guidelines for routine radiologic examinations in patients with traumatic brain injury in order to reduce the incidence of delayed diagnosis. MATERIALS AND METHODS: For this study, 175 out of 720 traumatic brain injury patients, who were treated at Sun General Hospital from May 1994 through December 1997, were analyzed. The incidences of musculoskeletal injury and delayed diagnosis were checked. RESULTS: Clavicle fracture occurred most frequently, followed by tibia-fibular fracture, femur fracture, pelvic fracture or hip fracture-dislocation, axial spine fracture, radius-ulnar fracture, knee ligament injury, fracture of the hand and humerus. The overall incidence of delayed diagnosis was 14 percent (24 patients) . And multiple (more than 2) injuries occurred in 43 patients (24%) . CONCLUSION: The data of this study suggest that a radiologic survey, including X-rays of chest, long bones of the lower extremites, pelvis (both hips) and entire axial spine, should be obtained in patients with traumatic brain injury. Also careful examination of the knee should be included.
Brain Injuries* ; Clavicle ; Delayed Diagnosis ; Femur ; Hand ; Hip ; Hospitals, General ; Humans ; Humerus ; Incidence ; Knee ; Ligaments ; Pelvis ; Solar System ; Spine ; Thorax