Hypertension is a well known causative factor of congestive heart failure and other cardiovascular disease, and usually induce myocardial hypertrophy. Recent study shows that some antihypertensive drugs may reduce the hypertrophied cardiac mass reversibly. And over the past some decades, increasing attention was focused on these drugs. These drugs include methyldopa, angiotensin converting enzyme inhibitor, calcium channel inhibitor, beta-adrenergic blocker, but diuretics and vasodilators were known not to reduce the hypertrophied ventricular mass. In this study, 46 hypertensive patients were managed by captopril, atenolol, or hydrochlorothiazide monotherapy. And wer estimated and follow up LV mass by echocardiography during 3 months. Captopril and atenolol group showed LV mass reduced, but hydrochlorothiazide group did not. LV mass was reduced more in captopril group than in atenolo group. In conclusion, we have been impressed by this study that diuretics monotherapy for hypertension shoud be reconsidered. And we concluded that drugs which can reduce myocardial mass shoud be chosen to control hypertension as a monotherapeutic drug or a additive drug.
Antihypertensive Agents ; Atenolol ; Calcium Channels ; Captopril ; Cardiovascular Diseases ; Diuretics ; Echocardiography ; Follow-Up Studies ; Heart Failure ; Humans ; Hydrochlorothiazide ; Hypertension* ; Hypertrophy ; Methyldopa ; Peptidyl-Dipeptidase A ; Vasodilator Agents

Objective:To determine the effect of Lentinula edodes extract on ultraviolet (UV) A and UVB-induced changes in matrix metalloproteinase (MMP) and typeⅠprocollagen expression using human immortalized HaCaT keratinocytes. Methods:Lentinula edodes ethanol extract (LEE) was obtained by extraction with 80％ ethanol for 4 h at 80 ℃. Effect of LEE on UV-induced alteration on the expression and production of MMPs and typeⅠprocollagen in keratinocytes was investigated using ELISA, RT-PCR, and Western blotting assay. To determine the underlying mechanism of LEE-mediated effects, mitogen-activated protein kinase (MAPK) and activator protein 1 signaling pathways were analysed by Western blotting assay. Results:LEE significantly inhibited the expression of MMP-1 and MMP-9 and increased the expression of typeⅠprocollagen in UVA and UVB-irradiated HaCaT keratinocytes. The phosphorylation levels of p38 were significantly inhibited by LEE whereas it did not affect c-Jun N-terminal kinase and extracellular signal-regulated kinase phosphorylation. Suppression of p38 phosphorylation was also accompanied by downregulation of UVA and UVB-induced increase in c-Fos. Conclusions:LEE effectively inhibits the expression of MMP-1 and MMP-9 and increases typeⅠprocollagen production through the p38 MAPK/c-Fos signaling pathway in UVA and UVB-irradiated HaCaT keratinocytes. This findings suggest that Lentinula edodes may be developed as a cosmetic material to suppress UV exposure-mediated skin aging.

BACKGROUND/AIMS: Obstructive jaundice is developed from the cholangiocarcinoma, biiliary tract stone, biliary benign stricture and pancreatic head cancer and is rapidly progress to cholangitis or sepsis. So early decompression, accurate diagnosis and treatment are very important. Percutaneous transhepatic choledocoscopy (PTCS) and endoscopic retrograde choledocoscopy (ERCS) have been used for evaluation of the obstructive jaundice. We performed, through the PTCS, electrohydraulic lithotripsy (EHL) for biliary tract stone rernoval, biopsy for diagnosis of biliary stric and self expandible metalic coil stent (EndocoilTM stent, Instent Co.) insertion on biliary stricture to evaluate the usefullness of PTCS in patients with obstructive jaundice. METHODS: Between Auguest 1994 and September 1995, PTCS was performed in 37 patients with obstructive jaundice. First, percutaneous transhepatic biliary drainage (PTBD) with 7Fr. drainage tube was done. Three days later, we exchainged the 7Fr. drainage tube with 16Fr.. Seven days later, through the PTCS, we performed EHL, biopsy and EndocoilTM stent insertion.
Biliary Tract ; Biopsy ; Cholangiocarcinoma ; Cholangitis ; Constriction, Pathologic ; Decompression ; Diagnosis ; Drainage ; Head and Neck Neoplasms ; Humans ; Jaundice, Obstructive ; Lithotripsy ; Sepsis ; Stents

PURPOSE: Recent literature has shown that lymph node ratio is superior to the absolute number of metastatic lymph nodes in predicting the prognosis in several malignances other than colorectal cancer. The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer. METHODS: We included 186 stage III colorectal cancer patients who underwent a curative resection over a 10-year period in one hospital. The cutoff point of LNR was chosen as 0.07 because there was significant survival difference at that LNR. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to LNR. RESULTS: There was statistically significant longer overall survival in the group of LNR > 0.07 than in the group of LNR < or = 7 (P = 0.008). Especially, there was a survival difference for the N1 patients group (LN < 4) according to LNR (5-year survival of N1 patients was lower in the group of LNR > 0.07, P = 0.025), but there was no survival difference for the N2 group (4 > or = LN) according to LNR. The multivariate analysis showed that the LNR is an independent prognostic factor. CONCLUSIONS: LNR can be considered as a more accurate and potent modality for prognostic stratifications in patients with stage III colorectal cancer.
Colorectal Neoplasms ; Humans ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.
Abdomen ; Abdominal Pain ; Alligators and Crocodiles ; Colitis, Ischemic ; Colon* ; Constriction ; Constriction, Pathologic* ; Dilatation* ; Foreign Bodies* ; Humans ; Melena ; Middle Aged ; Phenobarbital ; Plastics ; Sigmoid Neoplasms ; Stomach

Gastric tuberculosis is a rare disease and is usually secondary to pulmonary or intestinal tuberculosis. Only a few cases of gastric tuberculosis have been reported in the literature. In most cases, gastric tuberculosis exists as an ulcerating lesion, whereby the clinical symptom is non-specific and similar to that of a peptic ulcer. The diagnosis af gastric tuberculosis is based on either positive histological or bacteriological study. Submucasal tumors resembling gastric tuberculosis has been reported extremely rare in incidence. In this study we report a case of a young woman admitted with intermittent abdominal pain due to gastric tuberculosis presenting as submucosal tumor in the greater curvature of the lower body. After gastric resection, a histological examination revealed chronic granulomatous inflammation with caseation necrosis which is consistent with tuberculosis. There was no evidence of the tuberculous lesion anywhere else. The patient was put on antituberculosis medications. The patient's follow-up observation in the clinic was uneventful.
Abdominal Pain ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Incidence ; Inflammation ; Necrosis ; Peptic Ulcer ; Rare Diseases ; Tuberculosis* ; Ulcer

PURPOSE: (-)-epigallocatechin-3-gallate (EGCG) has been reported to exert anti-inflammatory and antibacterial effects in periodontitis. However, its exact mechanism of action has yet to be determined. The present in vitro study evaluated the anti-inflammatory effects of EGCG on human periodontal ligament fibroblasts (hPDLFs) and human periodontal ligament stem cells (hPDLSCs) affected by bacterial lipopolysaccharide (LPS) extracted from Porphyromonas gingivalis. METHODS: hPDLFs and hPDLSCs were extracted from healthy young adults and were treated with EGCG and/or P. gingivalis LPS. After 1, 3, 5, and 7 days from treatment, cytotoxic and proliferative effects were evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and bromodeoxyuridine assay, respectively. And then, the gene expressions of hPDLFs and hPDLSCs were observed for interleukin (IL)-1beta, IL-6, tumor necrosis factor (TNF)-alpha, osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), and RANKL/OPG using real-time polymerase chain reaction (PCR) at 0, 6, 24, and 48 hours after treatment. The experiments were performed with the following groups for hPDLFs and hPDLSCs; 1) No treat, 2) EGCG alone, 3) P. gingivalis LPS alone, 4) EGCG+P. gingivalis LPS. RESULTS: The 20 microM of EGCG and 20 microg/mL of P. gingivalis LPS had the lowest cytotoxic effects, so those concentrations were used for further experiments. The proliferations of hPDLFs and hPDLSCs increased in all groups, though the 'EGCG alone' showed less increase. In real-time PCR, the hPDLFs and hPDLSCs of 'EGCG alone' showed similar gene expressions to those cells of 'no treat'. The gene expressions of 'P. gingivalis LPS alone' in both hPDLFs and hPDLSCs were highly increased at 6 hours for IL-1beta, IL-6, TNF-alpha, RANKL, and RANKL/OPG, except the RANKL/OPG in hPDLSCs. However, those increased gene expressions were down-regulated in 'EGCG+P. gingivalis LPS' by the additional treatment of EGCG. CONCLUSIONS: Our results demonstrate that EGCG could exert an anti-inflammatory effect in hPDLFs and hPDLSCs against a major pathogen of periodontitis, P. gingivalis LPS.
Anti-Inflammatory Agents ; Bromodeoxyuridine ; Fibroblasts ; Gene Expression ; Humans ; Interleukin-6 ; Interleukins ; Osteoprotegerin ; Periodontal Ligament ; Periodontitis ; Porphyromonas ; Porphyromonas gingivalis ; Real-Time Polymerase Chain Reaction ; Stem Cells ; Tetrazolium Salts ; Thiazoles ; Tumor Necrosis Factor-alpha ; Young Adult

BACKGROUND/AIMS: The reported frequency of stress-induced cardiomyopathy (SCMP, Takotsubo cardiomyopathy) is increasing; however, there are no data regarding predictors of in-hospital mortality and the recovery of left ventricular (LV) systolic function in patients with SCMP. Therefore, in this study, we sought to identify clinical predictors of in-hospital mortality and of the recovery of LV dysfunction in Korean patients with SCMP. METHODS: From November 2004 to November 2010, 155 patients who fulfilled the clinical diagnostic criteria of the Mayo clinic for SCMP were enrolled retrospectively from eight medical centers in Korea. We checked in-hospital deaths and compared the LV ejection fraction (LVEF) and wall-motion score index (WMSI) upon enrollment for each patient with that after 1 week using echocardiograms. A total of 55 continuous variables and 52 nominal variables were analyzed to find variables associated with in-hospital mortality and the recovery of LV dysfunction. All significant variables were entered into a logistic regression analysis. RESULTS: The mean age of the patients was 64 +/- 15 years; 118 (76.1%) patients were female. The in-hospital mortality rate was 5.2% (n = 8). An elevated initial platelet count was identified as a predictor of in-hospital mortality (odds ratio [95% CI]: 0.99 [0.99-1.00]). There were no predictors of the recovery of LVEF. Predictors of the recovery of WMSI were an absence of arrhythmic events (odds ratio [95% CI]: 22.89 [1.98-265.34]) and an elevated initial LV end-systolic diameter (odds ratio [95% CI]: 0.86 [0.74-1.00]). CONCLUSIONS: An initial absence of arrhythmic events and elevated LV end-diastolic pressure in patients with SCMP may be predictors of the timely recovery of LV dysfunction.
Cardiomyopathies ; Female ; Hospital Mortality ; Humans ; Korea ; Logistic Models ; Platelet Count ; Retrospective Studies ; Takotsubo Cardiomyopathy ; Ventricular Dysfunction, Left

BACKGROUND AND AIMS: To investigate the morphological and histopathological associations between an individual pit seen on stereomicroscopy or magnifying colonoscopy and an individual crypt seen in histological sections of colorectal tumors. METHODS: Fifty two colorectal lesions were examined by colonoscopy. The mucosal pits of the lesions were observed using a magnifying colonoscopy with a zoom 1 to 100 magnification after administering indigo carmine spray. The pits of the excised specimens were observed by using a stereomicroscopy after 0.2% cresyl violet stain. The pit patterns were classified into six types: normal round pit (I); asteroid pit (II); small round pit (IIIs); large tubular pit (IIIL); gyrus-like pit (IV); and non-structural pattern or amorphysm (V). Histologic diagnoses were determined by H&E staining under light microscopy. RESULTS: The histologic findings according to the pit patterns were 1 chronic nonspecific inflammation and 1 submucosal tumor in 2 cases with type I pit pattern; 4 hyperplastic polyps in 4 cases with type II; 1 hyperplastic polyp, 16 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 1 carcinoma in situ in 21 cases with type IIIL; 4 adenomas with low-grade dysplasia, 3 adenomas with high-grade dysplasia, and 4 carcinoma in situ in 11 cases with type IV; 1 adenoma with low-grade dysplasia in 1 case with type II IIIL; 3 adenomas with low-grade dysplasia, 4 adenomas with high-grade dysplasia, and 2 carcinoma in situ in 9 cases with type IIIL IV; 1 adenoma with high-grade dysplasia, 2 carcinoma in situ, and 1 adenocarcinoma in 4 cases with type IV V. In assessing the histologic findings according to pit pattern by stereomicroscopy, the overall diagnostic predictive value was 82.6% (43/52), and the diagnostic accuracy in differential diagnosis between nonneoplastic and neoplastic lesions was 98% (51/52). The ratio of agreement of the pit pattern between the magnifying colonoscopy and the stereomicroscopy was 68% (17/25). CONCLUSIONS: The results suggest that there was a close correlation between the pit patterns and the histologic findings of colorectal tumors, and that the observation of pit patterns of colorectal lesions provides a differential diagnosis between neoplastic and nonneoplastic lesions.
Adenocarcinoma ; Adenoma ; Carcinoma in Situ ; Colonoscopy ; Colorectal Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Indigo Carmine ; Inflammation ; Microscopy ; Polyps ; Viola

PURPOSE: As allergic diseases become common and their socio-economic burden increases, the government needs to develop measures to prevent and manage allergic diseases. Gyeonggi-do Atopy Asthma Education Information Center, funded by the Ministry of Health and Welfare, the Korean Center for Disease Control and Gyeonggi-do, was established in October 2011 to carry out the community-based programs for the patients with allergic diseases in Gyeonggi-do. We investigated the demand on learning, preferred topics and the way of learning about allergic diseases from the public health centers in Gyeonggi-do. METHODS: From March to May 2012, 54 administrators from 45 public health centers in Gyeonggi-do answered about their educational demand and preferred way of learning and having information. RESULTS: A total of 52 administrators (96%) from the public health centers answered that they wanted to participate in the education programs on allergic diseases from Gyeonggi-do Atopy Asthma Education Information Center. Forty eight percent of them had learned about allergic diseases at least once previously by lectures, followed by information brochures and by on-line searching. They wanted to learn about an overview of atopic eczema and how to care it, followed by overviews of asthma and allergic rhinitis. They preferred small group seminars with about 10 participants for learning and wanted to have video clips of lectures, followed by booklets for educational materials. CONCLUSION: This research on the educational demand from the public health centers will be useful in planning the future community-based allergy programs and enhancing communication with the administrators in Gyeonggi-do.
Administrative Personnel ; Asthma ; Centers for Disease Control and Prevention (U.S.) ; Dermatitis, Atopic ; Financial Management ; Humans ; Hypersensitivity ; Information Centers ; Learning ; Lectures ; Pamphlets ; Public Health ; Rhinitis ; Rhinitis, Allergic, Perennial