BACKGROUND: Atherosclerosis is a chronic inflammatory disease of the arterial wall characterized by progressive accumulation of lipids,cells,and extracellular matrix.Matrix metalloproteinases(MMPs)and tissue inhibitor of metalloproteinases(TIMPs)contribute to vascular matrix remodeling in atherosclerosis,and some cytokines may play role in the synthesis or activation of MMPs or TIMPs. MATERIALS AND METHOD: We produced experimental atherosclerotic plaques in 9 rabbits by atherogenic hypercholesterol diet for 12 weeks,and 10 other rabbits were used as control group with standard laboratory chow.At that time,19 rabbits were sacrificed and aorta,coronary arteries and blood specimens were prepared.The expressions of MMP-9,TIMP-2 and interleukin(IL)-18,and the bioactivity of IL-6 were investigated with H&E stain,immunohistochemical stain,immunoblotting(Western blot analysis),and bioassay. RESULT: Serum cholesterol in the experimental group increased up to 1258 +/-262 mg/dL(control group:41 +/-7 mg/dL).All experimental group showed well developed atherosclerotic plaques in aorta and coronary artery.The expression of MMP-9 in aorta and coronary artery of the experimental group showed significant increase than that of the control group by immunohistochemistry.Among the experimental group, complicated lesions with intimal rupture or complete luminal occlusion,demonstrated stronger expression of MMP-9.Interestingly,there was no difference in expression of TIMP-2 between the experimental and the control group.These findings were confirmed by Western blot analysis.The bioassay revealed significant up-regulation of serum bioactivity of IL-6 in the experimental group(4819.60 +/-2021.25 IU/ml)compared to that of IL-6 in the control group(27.20 +/-12.19 IU/ml).IL-18 was expressed in all atherosclerotic plaques, whereas little or no expression was detected in the control group. CONCLUSION: The increased MMP-9 expression along with the unchanged TIMP-2 expression seem to be contributory factors in extracellular matrix degradation in atherosclerosis.Focal overexpression of MMP-9 may promote plaque destabilization and cause complications of atherosclerotic plaques such as thrombosis with/without acute coronary syndrome.Elevation of IL-6 and IL-18 may be more than just markers of atherosclerosis but actual participants in lesion development.Identification of critical regulatory pathway is important to improve the understanding of the cellular and molecular basis of atherosclerosis and may open the way for novel therapeutic strategies.
Aorta ; Arteries ; Atherosclerosis ; Biological Assay ; Blotting, Western ; Cholesterol ; Coronary Vessels ; Cytokines ; Diet ; Extracellular Matrix ; Interleukin-18* ; Interleukin-6* ; Interleukins ; Matrix Metalloproteinase 9* ; Matrix Metalloproteinases ; Phenobarbital ; Plaque, Atherosclerotic ; Rabbits* ; Rupture ; Thrombosis ; Tissue Inhibitor of Metalloproteinase-2* ; Up-Regulation

BACKGROUND: Twenty-four-hour ambulatory blood pressure(ABP) monitoring has become increasingly popular for diagnosing and treating hypertension. Therefore the reference value of normotensive subjects was necessary for interpretation of hypertensive subjects. Several studies were reported on reference values in normotensive subjects. The purpose of this study was to determine 24-hour ABP in normotensive Korean adults stratified for sex and five age groups. This study also assessed ABP in relation to a family history of hypertension, smoking and body mass index(BMI). METHODS: ABP monitoring was performed in 200 healthy normotensive volunteers(ranged in age from 20 to 69 years, five decades, 20 men and 20 women per each decade), over 24 hours, taking measurement at 30-min intervals. The 24-hour interval was divided into day-time(6am-10pm) and night-time(100pm-6am) periods. Mean ABP and pressure loads(percentage of systolic readings>140mmHg, diastolic readings>90mmHg) were obtained. RESULTS: The mean ABP in 200 subjects was 113+/-8.6/72+/-6.9mmHg over 24 hours, 117+/-9.7/75+/-7.0mmHg during day-time, and 106+/-9.8/67+/-8.3mmHg at night-time, and pressure loadd averaged 5.1+/-7.4/7.9+/-8.9% over 24 hours. The +2 standard deviation(SD) as the upper limit of normal was 130/86mmHg over 24 hours in 200 subjects. The mean ABP and pressure load were 116+/-7.6/74+/-7.6mmHg and 6.4+/-8.3/10.1+/-10.2% in 100 subjects of men, and 110+/-8.3+/-70+/-6.6mmHg, 3.7+/-6.0/5.7+/-6.8% in women. Mean ABP and pressure load showed significant difference in relation to age group and sex, however, no significant difference in relation to a family history of hypertension or smoking. In relation to BMI group, diastolic blood pressure and diastolic pressure load were significantly different.
Adult* ; Blood Pressure* ; Female ; Humans ; Hypertension ; Male ; Reference Values ; Smoke ; Smoking

No abstract available.
Niemann-Pick Disease, Type A*

BACKGROUND AND OBJECTIVES: Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven't been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. METHODS AND RESULTS: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female 15) were included in this study. The average age of them was 44.30+/-14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25+/-1.06 cm vs. 5.14+/-0.62 cm, LV mass 272.46+/-107.36 gm vs. 197.30+/-75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. CONCLUSION: Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others.
Ants ; Echocardiography ; Female ; Heart ; Humans ; Medical Records ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve* ; Retrospective Studies ; Thoracic Surgery

PURPOSE: To evaluate the usefulness of whole body bone mineral densitometry in the diagnosis of frequent osteopenia of preterm infants by comparison with the wrist radiographs and biochemical parameters. MATERIALS AND METHODS: From January 1995 to January 1996, we obtained whole body bone mineral density(BMD) studies using dual energy X-ray absorptiometry(DXA) and wrist radiographs of 39 preterm infants. They were divided into three groups according to birth weight, under 1500g, 1501g to 2000g and above 2000g, and four grades of skeletal change, as seen on wrist radiography, according to the scoring method of Koo et al. Groups of birth weight and grades of skeletal change were then correlated with whole body BMD and biochemical parameters. For comparison, normal data were obtained from 13 infants born at full term. Data were analyzed by one way analysis of variation(ANOVA) and correlation and regression analysis. A p-value of less than 0.05 was considered significant. RESUTLS: Whole body BMDs were significantly lower in the more premature and smaller birth weight infants(r=0.77, p=0.0000), and in the higher grade of skeletal change (r=-0.5276, p=0.0000). Aggravated skeletal changes were found in infants with lower birth weight(r=-0.3822, p=0.01). Interobserver variation in grading skeletal change was 42.9%, and intraobserver variation was 18.4%. Biochemical parameters such as serum calcium, phosphate, alkaline phosphatase, parathromone, calcitonin and 25-hydroxy-vitamine D did not vary significantly according to either birth weight or skeletal change (p>0.05). CONCLUSION: Premature osteopenia is more effectively diagnosed by measuring whole body BMD using DXA than by grading radiographical skeletal change or by biochemical parameters.
Alkaline Phosphatase ; Birth Weight ; Bone Diseases, Metabolic* ; Calcitonin ; Calcium ; Densitometry* ; Diagnosis ; Humans ; Infant ; Infant, Newborn ; Infant, Premature* ; Observer Variation ; Parturition ; Radiography* ; Research Design ; Rickets ; Wrist*

This study was performed to evaluate the effect of mixed culture of rat's calvaria cells and periodontal ligament cells on calcification. These cells have been known to do important role on the periodontal tissue regeneration, especially alveolar bone and cementum. Experimental groups were made which based on the different rate of rat's calvaria cells and periodontal ligament cells, and then these cells were cultured with Dulbecco's Modified Eagle's Medium contained with 10% fetal bovine serum, 50microgram/ml ascorbic acid, and 10mM/ ml Na-beta-glycerophosphate. Each group was characterized by examining the cell proliferation rate, amount of total protein synthesis, alkaline phosphatase activity, and the number of calcified nodules in vitro. In cell proliferation rate , the cells of control groups were cultured Dulbecco's Modified Eagle's Medium contained with 10 % fetal bovine serum. The results were as follows ; 1. The cell proliferation rate in control groups decreased stastically significantly along with the decrease of the rate of bone cells at 7 day and 20 day(P < 0.01). 2. The cell proliferation rate in experimental groups decreased stastically significantly along with decrease of the rate of bone cells at 3 day and 14 day(P < 0.01). 3. The amount of total protein synthesis was significantly decreased along with decrease of the rate of bone cells at 3 day and 6 day(P < 0.01). 4. Alkaline phosphatase activity showed reverse time dependent pattern and was significantly decreased along with decrease of the rate of bone cells during the experimental periods (P < 0.01). 5. Calcified nodules were observed in group 1 (Rat calvaria cells alone) for the first time, and the number of calcified nodule decreased stastically significantly along with the decrease of the rate of bone cells at 12 day(P < 0.01). From the above results, When bone cells and periodontal ligament cells were mixed cultured, the cell proliferation rate was mostly dependent on the actual rate of bone cells and same pattern was showed in amount of total protein synthesis, alkalinephosphatase activity, and the number of calcified nodules. And the calcified nodule forming capacity of bone cells was inhibited by periodontal ligament cells
Alkaline Phosphatase ; Animals ; Ascorbic Acid ; Cell Proliferation ; Dental Cementum ; Periodontal Ligament* ; Rats* ; Regeneration ; Skull*

The subjects of the study were the 120 mothers who had children hospitalized in 6 hospitals in P city during the period from Feb. 1. to May 30. 1996. The purpose of the study are (1) the problem encountered when they carried out Home Care after discharge and (2) the degrees of demand that they had against Home Care Services. In order to investigate the purpose above-mentioned the researchers used the 55 items of Home Care services belonging to 10 areas selected by Korea Home-Care Association in 1994. The items were modified and supplemented to 4-point scale. The selected data were analyzed by SPSS:PC+ and the following results were derived. 1. The subjects payed great attention to 5 items such as "pain control, OPD visits, diet-control problems" among the 15 sources of anxiety that they had against Home Care services after discharge. Especially, "OPD visits and knowledge deficit" would to be overcome by the nursing activities of the Home Care Nurses. 2. The acknowledge level of the subjects to the Home Care Project that governmental plans to carry out was surveyed and found as under : 50.0% responded they heard about Home Care Nursing System. 60.8% said that they thought the system was "very necessary" and "somewhat necessary". 65.0% said they would like to use the system. However, the acknowledge level of 50.0% is still low and is thought to need further national promotion and propagation. 3. The demand of the subjects against 55 Home Care Services was investigated and found as

. "Assessment, Lab, basic nursing technology, relay & transfer, training & education and curative nursing" showed comparatively high scores. However, the items belonging to pediatric Home Care Services such as "umbilical cord care, breast=feeding, infant care, and post-parum care & loan of breast-pump" showed relatively low scores.
Anxiety ; Child ; Child, Hospitalized* ; Education ; Home Care Services* ; Humans ; Infant ; Infant Care ; Korea ; Mothers ; Nursing ; Child Health