To darify the cardiotoxic mechanism, the effect of bupivacaine on the cardiac function, especially in coronary flow rate was inveetigated in the isolated working rat heart. When administered into left atrium of the heart, lidocaine(10(-6)-10(-4) M) decreased heart rate in a dose-related fashion, whereae rate of coronary flow and mean coronary resistance tend to decrease and increase transiently, respectively. On the other hand, bupivacaine decreased the coronary flow rate and increased the mean coronary resistanee in a dose(10(-6)-10(-4) M) dependent manner. However, the decrement of heart rate by bupivacaine was not clear, but larger dose(10(-4) M) produced marked bradycardic effect. Bupivaeaine decreased the coronary flow and increased the mean coronary resistance in the isolated working heart, in which the heart rate and aortic pressure were kept constantly by electrical stimulation(3-6 pps, 0.5 mS, 20 V). These effects of bupivacaine were not influenced by 1 uM prazosin and 2 uM atropine pretreatment. But the bupivacaine effeets were completely abolished by 100 mM KC1 pretreatment and were inhibited markedly by 10(-7) M diltiazem, a Ca2+ -antagonist, pretreatment. From these results, it is suggested that the bupivacaine-induced coronary flow decrease is elicited via direct coronary vasoconstriction. And this vasoconstriction is due to the increments of intracellular Ca2+ concentration.
Animals ; Arterial Pressure ; Atropine ; Bupivacaine* ; Diltiazem ; Hand ; Heart Atria ; Heart Rate ; Heart* ; Prazosin ; Rats* ; Vasoconstriction

This survey was to elucidate the bacterial clearance time (BCT) among the patient of L-type and B-group leprosy who had been und.er chernotherapy and foll- ow up with bacterial examination 4 times every year more than 3 years at the Chronic Disease Laboratory of Catholic Medical College. The 99 patients, 53 L-type and 46 B-group, were slected for this study. These patients were classified again into 2 groups: 80 patients with negative bacterial index and 19 patient of posit.ive bacterial index. The patient with negative bacterial index was subdivided into 3 groups by BCT. 1. Rapid decrease group (RA group) BCT<(4years) 2. Standard decrease group (ST group) 4BCT<7 R. Slow decrease group (SL group) 7.
Chronic Disease ; Drug Therapy* ; Humans ; Leprosy* ; Leprosy, Borderline* ; Leprosy, Lepromatous* ; Prognosis*

BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

PURPOSE: The objective of this study was to evaluate an immunoassay for urinary nuclear matrix protein (NMP22) as an indicator for transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Three groups of subjects attended the trial of NMP22. First group was 27 patients with transitional cell carcinoma of the bladder, second group was 24 patients with other urinary cancer consisted of prostate cancer and renal cell carcinoma, and third group was 24 healthy volunteers. NMP22 was determined using a commercial test kit, which is based on an enzyme-linked immunosorbent assay. RESULTS: In normal healthy volunteers and other urinary cancer group median NMP22 levels were 2.24 and 3.27 U/ml, respectively. Median urinary NMP22 levels in patients with transitional cell carcinoma of the bladder were 54.30 U/ml. It was significantly greater than other two groups. Median NMP22 levels according to the tumor stage and the tumor grade did not show the significant difference statistically. CONCLUSIONS: Urinary NMP22 is a useful marker that is more specific for bladder cancer thsn for other urinary cancer. Further tests are required to clarify the influence of other spe- cific conditions, such as urinary tract infection, and intravesical drug instillation or procedure.
Carcinoma, Renal Cell ; Carcinoma, Transitional Cell* ; Enzyme-Linked Immunosorbent Assay ; Healthy Volunteers ; Humans ; Immunoassay ; Instillation, Drug ; Nuclear Matrix* ; Prostatic Neoplasms ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Urinary Tract Infections

Coronary heart disease is still highly prevalent worldwide and remains a common cause of mortality. The underlying cause responsible for stable angina is chronic atherosclerotic narrowing of the coronary artery. Most patients with stable angina can be managed with medical treatment with aspirin, beta-blocker, calcium channel blocker (CCB), and nitrate. High-risk patients with previous myocardial infarction (MI), left ventricular dysfunction, and diabetes mellitus should be considered for angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARB) and aggressive statin treatment. Acute coronary syndromes (ACS) are the clinical spectrum that includes unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Because the atherosclerotic plaque instability with subsequent rupture and thrombus formation is a primary mechanism of ACS, antiplatelet and antithrombotic agents are essential for the prevention of coronary events. Combination treatment with antiplatelet agents (aspirin, clopidogrel and cilostazol) and anticoagulants, such as unfractionated heparin and low-molecular-weight heparins (LMWH), provides improved efficacy for the secondary prevention of ACS. The main goal of treatment in STEMI is quick recovery of the culprit vessel patency and maintaining sufficient myocardial perfusion. It can be done by thrombolytic therapy or primary coronary angioplasty.
Acute Coronary Syndrome ; Angina, Stable ; Angina, Unstable ; Angioplasty ; Anticoagulants ; Aspirin ; Calcium Channels ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Diabetes Mellitus ; Fibrinolytic Agents ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Mortality ; Myocardial Infarction ; Perfusion ; Plaque, Atherosclerotic ; Platelet Aggregation Inhibitors ; Rupture ; Secondary Prevention ; Thrombolytic Therapy ; Thrombosis ; Ventricular Dysfunction, Left

Coronary heart disease is still highly prevalent worldwide and remains a common cause of mortality. The underlying cause responsible for stable angina is chronic atherosclerotic narrowing of the coronary artery. Most patients with stable angina can be managed with medical treatment with aspirin, beta-blocker, calcium channel blocker (CCB), and nitrate. High-risk patients with previous myocardial infarction (MI), left ventricular dysfunction, and diabetes mellitus should be considered for angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARB) and aggressive statin treatment. Acute coronary syndromes (ACS) are the clinical spectrum that includes unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI) and ST-segment elevation myocardial infarction (STEMI). Because the atherosclerotic plaque instability with subsequent rupture and thrombus formation is a primary mechanism of ACS, antiplatelet and antithrombotic agents are essential for the prevention of coronary events. Combination treatment with antiplatelet agents (aspirin, clopidogrel and cilostazol) and anticoagulants, such as unfractionated heparin and low-molecular-weight heparins (LMWH), provides improved efficacy for the secondary prevention of ACS. The main goal of treatment in STEMI is quick recovery of the culprit vessel patency and maintaining sufficient myocardial perfusion. It can be done by thrombolytic therapy or primary coronary angioplasty.
Acute Coronary Syndrome ; Angina, Stable ; Angina, Unstable ; Angioplasty ; Anticoagulants ; Aspirin ; Calcium Channels ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Diabetes Mellitus ; Fibrinolytic Agents ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Mortality ; Myocardial Infarction ; Perfusion ; Plaque, Atherosclerotic ; Platelet Aggregation Inhibitors ; Rupture ; Secondary Prevention ; Thrombolytic Therapy ; Thrombosis ; Ventricular Dysfunction, Left

No abstract available.

We tried to find out any differences between initial characteristics of androgen receptors and of relapse after castration in 6 stage D2 prostatic cancer (mean age, 68.7+/-4.6) (Gleason score 5, 8, 9 ; 1,3, 2 patients respectively), with immunohistochemical expression using the mouse monoclonal antibody against human androgen receptor. The prostate specimens were obtained by either transrectal needle biopsy or transurethral resection at the time of initial diagnosis and of relapse following castration. The age matched 6 benign prostatic hyperplasia (BPH) specimens were used as control. 200 cancer cells were chosen and staining intensity of each nuclei was graded (O-absent, +1-weak, +2-moderate, +3-strong) from randomly selected and photographed from 10 different fields of each specimen. The means of staining intensity of nuclei from BPH and prostatic cancer before treatment were 1.93+/-0.03 and 1.59+/-0.03 respectively (p<0.05). At the time of relapse after bilateral orchiectomy (mean, 24.5+/-5.0 months), the mean staining intensity of nuclei of all cancer patients (1.38+/-0.03) was significantly different from that of before treatment (p<0.05). But in individual comparison, we could find the decrement in only 2 patients. The intervals of relapse from castration of these two patients (29 and 32 months) were longer than the mean of 6 patients. In conclusion, androgen receptors are still expressed significantly after castration in prostatic cancer. In some patients (2/6), castration down regulates the expression of androgen receptors and the down regulation closely correlated with the relapse time."
Animals ; Biopsy, Needle ; Castration* ; Diagnosis ; Down-Regulation ; Humans ; Immunohistochemistry ; Mice ; Orchiectomy ; Prostate* ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Receptors, Androgen* ; Recurrence

Although extracorporeal shock wave lithotripsy(ESWL) has been used to treat renal stones for several years, little is known of its effect on developing tissue. To study the long-term bio-effects of this mode of treatment on the immature animal, we used 32 Sprague-Dawley rats at 4weeks of age and divided 4 groups which consisted of 8 rats respectively. They were weighted and left nephrectomy was then performed. 10 days later, 3 groups received extracorporeal shock waves (16 kV) of 500, 1,000, 1,500 times respectively to the right kidney using Lithoring(3rd generation pendulum-ESWL), but control group didn't received shock waves. They were allowed to mature, and at 16 weeks of age they were evaluated for weight and serum creatinine. The right kidney was then harvested, weighted and stained with hematoxylin and eosin. There were no significant changes in over-all animal growth, renal growth and renal function in the post-treatment groups when compared to the control group. At comparison of histological changes, the grade of interstitial nephritis was proportional to the number of shock wave received In conclusion, shock waves delivered to immature animals do not significantly affect animal growth, renal growth and function, but it can cause significant permanent histological renal changes even at low doses and further studies are needed with an adult control group in an attempt to delineate whether the immature kidney is, indeed, more vulnerable to the shock waves.
Adult ; Animals ; Creatinine ; Eosine Yellowish-(YS) ; Hematoxylin ; Humans ; Kidney* ; Nephrectomy ; Nephritis, Interstitial ; Rats* ; Rats, Sprague-Dawley ; Shock*

Cutaneous leiomyosarcoma is a rare soft-tissue tumor of smooth muscle derivation that accounts for 2%-3% of all soft tissue sarcomas. Cutaneous leiomyosarcomas can be subdivided into dermal and subcutaneous leiomyosarcomas. Because of the different prognosis, it is important to distinguish between dermal and subcutaneous forms. Immunohistochemical stains, such as vimentin, smooth muscle actin (SMA), desmin, CD68, CD34, and S-100, may aid in the recognition of smooth muscle derivation and in the differentiation from other malignant spindle cell tumors. We report a case of cutaneous leiomyosarcoma on the extensor surface of the left thigh in a 61-year-old man.
Actins ; Coloring Agents ; Desmin ; Humans ; Leiomyosarcoma* ; Middle Aged ; Muscle, Smooth ; Prognosis ; Sarcoma ; Thigh ; Vimentin