BACKGROUND AND OBJECTIVES: Arterial stiffness is a precursor to premature cardiovascular disease. The augmentation index (AI) and pulse pressure (PP) are cardiovascular risk factors. The aim of this study was to define the diagnostic values of the AI and PP from the peripheral arterial and central aortic waveforms in healthy subjects. SUBJECTS AND METHODS: We recruited 522 consecutive subjects (mean age 46.3+/-9.6 years, 290 males) who came to our facility for a comprehensive medical testing. We measured the body mass index (BMI), blood pressure, peripheral and central PP, and a pulse wave analysis that included the central and peripheral AI. RESULTS: The peripheral and central AIs in the female subjects were significantly higher than that in the male subjects (p<0.001). The peripheral and central PPs in the subjects with hyperlipidemia were significantly higher than subjects with normal lipid profiles (p<0.001). The peripheral and central PPs and peripheral and central AIs significantly increased with age. CONCLUSION: Pending validation in prospective outcome-based studies, a peripheral PP of 70 mmHg, central PP of 50 mmHg, peripheral AI of 100%, and central AI of 40% may be preliminary values in adult subjects.
Adult ; Arteries ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Female ; Humans ; Hyperlipidemias ; Male ; Porphyrins ; Prospective Studies ; Pulse Wave Analysis ; Reference Values ; Risk Factors ; Vascular Stiffness

PURPOSE: This study aimed to investigate the factors of occurrence of amenorrhea and the severity of climacteric symptoms in breast cancer patients who underwent chemotherapy. METHOD: Women diagnosed with breast cancer without metastasis or recurrence, had surgery followed by chemotherapy, and had menses at the time of surgery were recruited from S hospital located in Seoul. A total of 99 women aged 31 thru 55 years participated and filled out a structured questionnaire including the Functional Assessment Cancer Therapy-Breast plus Endocrine Symptom when they visited the clinic for follow-up. RESULT: In 88 women amenorrhea occurred within an average of 2 months since beginning chemotherapy, and menstruation was resumed in only 11 women. About 98% of women aged over 40 experienced a cessation in menses thus age was an apparent factor of amenorrhea (Exp(B)=.76, p<.05). Presence of chronic disease (beta=.25, p<.05) and body weight change (beta=.30, p<.01) were significant factors influencing the severity of climacteric symptoms. CONCLUSION: Nurses need to have clinical evidences of menstrual changes due to breast cancer treatment. Information about premature menopause and climacteric symptoms should be provided according to women's health conditions so that they cope better during their survival.
Aged ; Amenorrhea ; Body Weight Changes ; Breast ; Breast Neoplasms ; Chronic Disease ; Climacteric ; Female ; Humans ; Menopause, Premature ; Menstruation ; Neoplasm Metastasis ; Phosphatidylethanolamines ; Surveys and Questionnaires ; Recurrence ; Women's Health

BACKGROUND: Due to the irreversible nature of chronic obstructive pulmonary disease (COPD), the treatment aim in patients with COPD is not to cure but to reduce the symptoms, increase lung function, and improve the quality of life. It has been suggested that depression is a common emotional disturbance in patients with COPD who are faced with a major physical impairment and embarrassing symptoms. This study evaluated the prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. METHODS: A total of 59 patients with a registered diagnosis of chronic obstructive pulmonary disease were selected. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale. The quality of life was assessed using the Korean version of the St. George's Respiratory Questionnaire. RESULTS: The prevalence of depression was 17.0%. In the correlation model, the interaction of the FEV1% over predicted value and SGRQ score(symptom, activity, impact, overall score) was statistically significant. The interaction of the FEV1% over predicted value and depression scale(CES-D) was also statistically significant. There was a positive correlation between the SGRQ scores(symptom, activity, impact, overall score) and the depression scale. CONCLUSION: The prevalence of depression in patients with chronic obstructive pulmonary disease is relatively high. The pulmonary function and the living standards were found to be significant risk factors for depression.
Affective Symptoms ; Depression ; Epidemiologic Studies ; Humans ; Lung ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Socioeconomic Factors

Duodenal abscess is a rarely reported disease throughout the entire world. Duodenal abscesses are developed mostly from the complication of duodenal ulcer perforation, and only small percentage of duodenal abscesses are the result of cholecysto-duodenal fistula which was made by gall bladder perforation. We report a 84-year-old male patient who presented to the emergency department with severe anorexia and generalized weakness for 2 weeks. The upper gastrointestinal endoscopy done and revealed a protruding mass at the lesser curvature of the duodenal bulb. As soon as the mass was punched with a biopsy forceps, a large amount of abscess began to pour out into the intestinal lumen. Abdominal CT scan demonstrated the presence of an air-fluid level the in gall bladder and also abscess in the porta hepatitis which was located between the gall bladder and the duodenum. Because the patient refused any surgical intervention, we treated him conservatively with intravenous antibiotics. Patient's symptom of anorexia was slowly resolved, and patient was discharged 10 days later.
Abscess* ; Aged, 80 and over ; Anorexia ; Anti-Bacterial Agents ; Biopsy ; Duodenal Ulcer ; Duodenum ; Emergency Service, Hospital ; Endoscopy ; Endoscopy, Gastrointestinal ; Fistula ; Hepatitis ; Humans ; Male ; Surgical Instruments ; Tomography, X-Ray Computed ; Urinary Bladder

Apoptosis has been implicated in the pathogenesis of neurodegenerative diseases such as stroke and Alzheimer's disease. Apo-1/Fas gene is one of the mediators of apoptosis in stroke. MvaI polymorphism is the first polymorphic marker identified in the Apo-1/Fas gene promoter, which was typed by PCR and followed by MvaI digestion and gel electrophoresis. DNA isolated from peripheral blood collected from 91 stroke patients and 103 healthy blood donors was used for genotypes of GG, GA and AA by sequence specific primer PCR. MvaI polymorphism was examined based on Fas gene promotor region by restriction fragment length polymorphism (RFLP). The Fas-GG genotype was the least frequent in patients with stroke and healthy controls (P = 0.57). In normal Korean controls the MvaI polymorphism GA, AA and GG were 48.6%, 34.9% and 16.5%. In stroke patients were 56.2%, 29.6% and 14.2% respectively. And the allelic frequencies of MvaI*2 (G) allele were less frequent than MvaI*1 (A) allele in patients with stroke and healthy controls (P = 0.76). In normal Korean controls MvaI*1 (A) and MvaI*2 (G) alleles were 59.2% and 40.8%. In stroke patients were 57.6% and 42.4%, respectively. Our results, pending confirmation in a larger study, indicate that the Fas genotype may not appear to be a risk factor for stroke in Korean stroke patients.
Adult ; Aged ; Antigens, CD95/*genetics ; Cerebral Infarction/*genetics ; Comparative Study ; Female ; Gene Frequency ; Genotype ; Human ; Korea ; Male ; Middle Aged ; *Polymorphism (Genetics) ; *Promoter Regions (Genetics)

Apoptosis has been implicated in the pathogenesis of neurodegenerative diseases such as stroke and Alzheimer's disease. Apo-1/Fas gene is one of the mediators of apoptosis in stroke. MvaI polymorphism is the first polymorphic marker identified in the Apo-1/Fas gene promoter, which was typed by PCR and followed by MvaI digestion and gel electrophoresis. DNA isolated from peripheral blood collected from 91 stroke patients and 103 healthy blood donors was used for genotypes of GG, GA and AA by sequence specific primer PCR. MvaI polymorphism was examined based on Fas gene promotor region by restriction fragment length polymorphism (RFLP). The Fas-GG genotype was the least frequent in patients with stroke and healthy controls (P = 0.57). In normal Korean controls the MvaI polymorphism GA, AA and GG were 48.6%, 34.9% and 16.5%. In stroke patients were 56.2%, 29.6% and 14.2% respectively. And the allelic frequencies of MvaI*2 (G) allele were less frequent than MvaI*1 (A) allele in patients with stroke and healthy controls (P = 0.76). In normal Korean controls MvaI*1 (A) and MvaI*2 (G) alleles were 59.2% and 40.8%. In stroke patients were 57.6% and 42.4%, respectively. Our results, pending confirmation in a larger study, indicate that the Fas genotype may not appear to be a risk factor for stroke in Korean stroke patients.
Adult ; Aged ; Antigens, CD95/*genetics ; Cerebral Infarction/*genetics ; Comparative Study ; Female ; Gene Frequency ; Genotype ; Human ; Korea ; Male ; Middle Aged ; *Polymorphism (Genetics) ; *Promoter Regions (Genetics)

OBJECTIVE: To determine the correlation between total anti-oxidant capacity (TAOC)and lipid peroxidase (LPO)levels in serum and disease activity in systemic lupus erythematosus (SLE). METHODS: The study population consisted of 99 patients with SLE according to the 1982 revised ACR criteria and 83 healthy controls.The serum TAOC levels in 99 patients with SLE and 83 healthy controls by the ABTS(R) inhibition method (Randox Ltd,Antrim,UK)and serum malondialdehyde (MDA)levels in 37 out of 99 patients with SLE were measured.Anti-dsDNA antibody (anti-dsDNA),albumin,AST,ALT,cholesterol,uric acid and creatinine were mea-sured to determine the association with the serum TAOC levels.The correlation between the serum TAOC levels and nephritis in 27 cases with nephritis out of 99 SLE patients was also investigated.The SLE disease activity was determined by the SLE disease activity index (SLEDAI)at the time of sample collection. RESULTS: Compared to the controls (1.37 +/- 0.127mmol/L),serum TAOC levels were significantly decreased (1.29 +/- 0.124mmol/L)in SLE patients (p=0.001). And there was a negative correlation between serum TAOC levels and SLEDAI total scores in the SLE patients (r=-0.388,p=0.0001),but no significant correlation between TAOC levels and C3 and anti-dsDNA.Further,a significant difference (p<0.04)in TAOC levels was found in SLE patients with and without nephritis.In comparison with other parameters such as AST,ALT,and cholesterol which might change anti-oxidant level,there was no correlation between the serum TAOC levels and them,except for serum uric acid (r=0.387, p=0.0001),creatinine,and albumin (r=0.507,p=0.0001).Additionally,we couldn't find significant correlation between the serum TAOC levels and MDA. CONCLUSIONS: The serum TAOC levels correlate significantly with SLE disease activity and are associated with nephritis.Also,this study showed a significant correlation with serum albumin levels in these patients.Conclusively,the measurement of the serum TAOC levels in patients with SLE will provide useful information on SLE disease activity.
Cholesterol ; Creatinine ; Humans ; Lupus Erythematosus, Systemic* ; Malondialdehyde ; Nephritis ; Peroxidase ; Serum Albumin ; Uric Acid

PURPOSE: Although the liver is an important source of IL-6 and the primary site for its clearance, the role of IL-6 in liver disease remains unclear. Warm ischemia/reperfusion (WI/Rp) injury to the liver occurs in numerous clinical situations including liver transplantation and surgery, trauma, hemorrhagic and endotoxic shocks, and thermal injury. A better understanding of the pathogenesis of WI/Rp injury of the liver and the availability of an agent that could alleviate Rp injury would have important clinical implications. The aim of this study was to evaluate the role of IL-6 in WI/Rp injury of the liver. METHODS: Thirteen patients who had undergone hepatectomy were evaluated with regard to postoperative changes in serum IL-6. The measurements were performed before surgery, within 30 minutes after WI/Rp injury, and at postoperative 24 hr, 48 hr, 1 wk, 2 wk, and 4 wk. Seven of 13 patients had the complication of cirrhosis. RESULTS: The mean value of IL-6 was 8.13 pg/ml preoperatively, and peaked at 20.51 pg/ml on the first postoperative day. Serum IL-6 levels within 30 minutes following WI/Rp injury and at postoeprative 1 day were higher in patients with cirrhosis than non-cirrhotic patients, although statistically insignificant. In the case of the cirrhotic patients, IL-6 values on the first postoperative day peaked at 40.81 pg/ml, compared to 35.27 pg/ml in non-cirrhotic patients. SGOT and SGPT were consistently increased with IL-6 on the first postoperative day, and gradually decreased thereafter. CONCLUSION: This study shows that IL-6 may be an indicatorin WI/Rp injury of the liver. Procedures undertaken to reduce the excessive production of this cytokine may be useful of improving postoperative liver function with or without cirrhosis.

Primary biliary cirrhosis (PBC)is a chronic inflammatory disease characterized by fibrous obliteration of intrahepatic bile ductules.Although the etiopathogenesis of PBC remains unclear,several studies suggest that a disordered immune response may be involved.This disease is commonly associated with various autoimmune diseases,such as Sjogren's syndrome,scleroderma, rheumatoid arthritis,Hashimoto's thyroiditis,polymyositis,and pernicious anemia.More than 80%of cases with PBC are accompanied by at least one autoimmune disorder,and 40%by two or more. Sjogren's syndrome,defined by dry eyes and xerostomia,may be found in 69 to 81%of PBC patients. However, concurrent coexistence of PBC and systemic lupus erythematosus (SLE)has been rarely described in the literature.We report a 46-year-old female with PBC and Sjogren's syndrome who also satisfied a classification criteria of SLE.
Bile ; Classification ; Female ; Humans ; Liver Cirrhosis, Biliary* ; Lupus Erythematosus, Systemic* ; Middle Aged ; Sjogren's Syndrome

OBJECTIVES: To assess height, weight and body mass index from childhood to adolescence according to the age at menarche and hence to study the influence of childhood growth on the menarche age. METHODS: "The Kangwha Study" was a community-based prospective cohort study which included the entire population of 219 female first graders in Kangwha county in 1986. Among the 219 girls, 119 girls who had received complete follow up checks during the study period(1986~1997), were included in this study, except one for whom menarche age information was unavailable. The remaining 118 girls were divided into three groups according to the timing of menarche : early(<25 percentile), intermediate and late(> or =75 percentile) maturers. RESULTS: The average age at menarche was 12.7 years : early 11.3 years, intermediate 12.6 years and late 13.7 years. The early maturers were taller and heavier between 6~8 years. But, the mean weight and body mass index at the menarche age did not differ statistically among the three groups. The weight and body mass index of the early maturers were consistently higher than those of the late maturers over the entire period of the study. CONCLUSIONS: Critical body weight and body mass index must be attained for menstruation to be attained and the age at menarche is largely determined by the childhood growth. In addition, it seems that childhood growth and age at menarche are associated with adolescent weight and body mass index.
Adolescent* ; Body Mass Index ; Body Weight ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Menarche* ; Menstruation ; Prospective Studies