Vanadate is a trace element in animal tissues and has been known to inhibit NA(+)-K(+) ATPase in various tissues including skeletal and cardiac muscles and smooth muscles. Vanadate shows contractile actions on various types of smooth muscles. Prolonged dietary administration of vanadate has been shown to cause arterial hypertension, increased peripheral resistance, and a marked reduction of coronary, visceral and renal blood flow.In isolated vascular smooth muscle of aorta, application of vanadate caused contraction. These studies have been conducted the preparation of vascular smooth muscles from which endothelial cell were removed. It has been reported that endothelial cell releases relaxing factor(s) (endothelium-derived relaxing factor, EDRF) in response to acetylcholine and a number of other stimuli and also produces vasoconstrictor substances (endothelium-derived contracting factor, EDCF). The aim of this present experiment is to elucidate whether vascular response of isolated rabbit aorta induced by vanadate are endothelium dependent or not. The result obtained were summarized as follows ; 1) When endothelium was intact, vanadate induced vascular relaxation of aorta precontracted with norepinephrine. But K+ induced contraction was augmented by vanadate in the aorta with or without endothelium. Whereas relaxation produced by vanadate precontracted with angiotensin II was endothelium-independent. 2) Hemoglobin, methylene blue, hydroquinone, and verapamil inhibited vanadate-induced vascular relaxation. But indomethacin and quinacrine had no effect on vanadate induced vascular relaxation. From the above results, it is speculated the vanadate act on endothelium, modifies the synthesis or release of endothelium-dependent relaxing factor and thus changes the contractile responses to norepinephrine in rabbit aorta.
Acetylcholine ; Adenosine Triphosphatases ; Angiotensin II ; Animals ; Aorta ; Endothelial Cells ; Endothelium ; Endothelium-Dependent Relaxing Factors ; Hypertension ; Indomethacin ; Methylene Blue ; Muscle, Smooth ; Muscle, Smooth, Vascular* ; Myocardium ; Norepinephrine ; Quinacrine ; Relaxation ; Vanadates* ; Vascular Resistance ; Verapamil

Osteoporosis is the most common generalized skeletal disease, which lays a significant socioeconomic burden to Korea. The early diagnosis and treatment of osteoporosis are of the great interest to minimize the economic co nsequence. We have studied vertebral BMD and bone scan of 30 patients with osteoporotic compression fractures. The purpose of this study was to investigate the effect of osteoporotic compression fracture on bone mineral density(BMD). We have measured the vertebral heights, vertebral bone mineral density, and bone scan counts of vertebral bodies on osteoporotic patients. Vertebral BMD was measured from T12 to L4 using dual photon absorptiometry. Anterior(Ha), middle(Hm), and posterior(Hp) height of vertebrae were measured from T12 to L4, and the spinal deformity indices(Ha/Hp, Hm/Hp, and Hp/Hi ratios) were calculated. The bone scan counts were measured from T12 to L4, and bone scan ratios were calculated. The BMD of fractured vertebrae was significantly higher than that of non-fractured vertebrae The spinal deformity indices were not correlated to the BMD of fractured vertebrae. The bone scan ratio was correlated to the BMD of fractured vertebrae. This study suggests that the increased BMD observed in fractured vertebrae is related to metabolic effect of compression fractures rather than mechanical effect.
Absorptiometry, Photon ; Bone Density* ; Congenital Abnormalities ; Early Diagnosis ; Fractures, Compression* ; Humans ; Korea ; Osteoporosis ; Spine

Giant cell myocarditis(GCM) is a rare inflammatory heart disease which is characterized by multinucleated giant cells and a granulomatous reaction. It usually progresses rapidly and results in a fatal course. We report a patient with giant cell myocarditis who was treated by cardiac transplantation. A 35-year-old male was admitted with dyspnea which had developed 4 months before. On echocardiography, the right and left ventricles were markedly dilated and severe global hypokinesia was noted. He was diagosed with dilated cardiomyopathy with secondary severe mitral regurgitation. His cardiac function deteriorated progressively. He underwent orthotopic heart transplantation. Grossly the heart was enlarged, weighing 420gm and round with a blunt apex. Both right and left ventricles were markedly dilated. There were numerous white patches, measuring up to 4cm, throughout the epi- and myocardium. Microscopically, extensive fibrosis and multiple exuberant granulomas with numerous scattered multinucleated giant cells were seen. Lymphocytes and eosinophils were also frequent. Coronary arteries were unremarkable. Neither microorganisms nor foreign materials were found. By serial endomyocardial biopsies of the transplanted heart, only mild perivascular lymphocytic infiltration was occasionally observed without any evidence of rejection or recurrence of giant cell myocarditis. The patient's postoperative course has been uneventful so far(postoperative 21 months). The etiology of GCM remains to be clarified, although various factors are suspected. No matter what the cause, our experience suggests that this grave disease might be treated well by heart transplantation.
Male ; Humans ; Biopsy

No abstract available.
Aortic Rupture*

Heart transplantation was first performed in 1967. It is now regarded as a well-established treatment modality for end-stage cardiac diseases. Once the transplantation is performed, endomyocardial biopsy(EMB) is the examination of choice in monitoring the transplanted heart. We analyzed the pathological findings of follow-up EMB of 6 heart transplant patients. All patients have been suffered from severe heart failure. Four patients were adult male and two were adult females. All the hearts, except for one, displayed characteristic features of dilated cardiomyopathy. The remaining heart was diagnosed as having giant cell myocarditis. Post-transplantion EMBs were performed according to the protocol and standard cardiac biopsy grading of ISHT (1990). The standards were applied for grading of cellular rejection. In five patients, there were one or two episodes of biopsy proven acute rejection, grade II or IIIA without any clinical symptoms of rejection. Immediate "pulse therapy" was performed and follow-up biopsies were done. All episodes of rejection were cleared in subsequent biopsies. All patients are doing well without evidence of cardiac problem. The postoperative monitoring of acute rejection is critical since clinical signs of rejection are usually absent. At present, EMB is regarded as the most reliable method for diagnosis and grading of acute rejection and is an efficient guide to the monitoring of the cardiac recipients. Our experience of post-transplantation EMB corresponds with previously published reports.
Adult ; Male ; Female ; Humans ; Biopsy

Coronary artery aneurysm is an uncommon disease. The optimal medical or surgical treatment for this disease remains obscure. The causes of coronary artery aneurysms include atherosclerosis, Kawasaki disease, infectious vascular disease, connective tissue disorder and congenital malformation. A 50 year old man visit our institution for chest pain that had started 3 days previously. After coronary angiography, multiple coronary aneurysms were diagnosed and successful surgical intervention was performed.
Aneurysm ; Angina, Unstable ; Atherosclerosis ; Chest Pain ; Connective Tissue ; Coronary Aneurysm ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Mucocutaneous Lymph Node Syndrome ; Vascular Diseases

Though leiomyosarcoma usually occurs in the gastrointestinal tract and uterus, it rarely occurs in the wall of large veins and arteries. We present a case of primary leiomyosarcoma arising in the great saphenous vein of the left inner thigh and spreading for some extent along the vein in a 54 year old female. Diagnosis was confirmed by desmin stain and electron microscopy. Postoperative course was fine. This is the first report of this in Korean literature.
Female ; Humans ; Leiomyosarcoma/*pathology ; Middle Aged ; *Saphenous Vein ; Soft Tissue Neoplasms/*pathology ; Vascular Diseases/pathology

Accumulated evidence suggests that sporadic cases of Alzheimer's disease (AD) make up more than 95% of total AD patients, and diabetes has been implicated as a strong risk factor for the development of AD. Diabetes shares pathological features of AD, such as impaired insulin signaling, increased oxidative stress, increased amyloid-beta (Aβ) production, tauopathy and cerebrovascular complication. Due to shared pathologies between the two diseases, anti-diabetic drugs may be a suitable therapeutic option for AD treatment. In this article, we will discuss the well-known pathologies of AD, including Aβ plaques and tau tangles, as well as other mechanisms shared in AD and diabetes including reactive glia and the breakdown of blood brain barrier in order to evaluate the presence of any potential, indirect or direct links of pre-diabetic conditions to AD pathology. In addition, clinical evidence of high incidence of diabetic patients to the development of AD are described together with application of anti-diabetic medications to AD patients.
Alzheimer Disease ; Blood-Brain Barrier ; Encephalitis ; Humans ; Incidence ; Insulin ; Neuroglia ; Oxidative Stress ; Pathology ; Risk Factors ; Tauopathies

BACKGROUND: Aortic intramural hemorrhage (IMH), which presents clinical manifestations identical to acute aortic dissection, is suggested to have different pathology and pathophysiology. The purposes of this study were to diagnose IMH by transesophageal echocardiography (TEE) prospectively and to compare clinical and echocardiographic outcome of IMH with those of aortic dissection. METHODS: Between August 1991 and November 1996, 27 IMH and 73 acute aortic dissection were diagnosed using TEE in 202 consecutive patients with suspected aortic dissection. TEE diagnoses of IMH and aortic dissection were initially compared with computed tomography and magnetic resonance imaging and later confirmed by operative findings (n=39) or follow-up changes (n=12). RESULTS: In the 49 patients whose diagnosis was confirmed by operation or follow-up changes, the sensitivity and specificity for the diagnosis of IMH were 27 of 27 (100%) and 20 of 22 (91%), respectively. There were 11 deaths (15%) in acute aortic dissection and 1 death (4%) in IMH during follow-up of 1.7+/-1.5 years (p=NS). Stanford classification and types of treatment were not related to death in both groups. Complications were less frequently noted in IMH (3/27) than in acute aortic dissection (24/73) (p<0.001) and no death occurred in uncomplicated IMH who were medically treated. Follow-up study of 12 IMH patients showed 8 complete resolution, 3 regression, 1 progression. CONCLUSION: TEE is very useful in diagnosis of IMH and IMH has better outcome than the aortic dissection due to absence of communication and intimal tear.
Classification ; Diagnosis ; Echocardiography* ; Echocardiography, Transesophageal ; Follow-Up Studies ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Pathology ; Prospective Studies ; Sensitivity and Specificity

BACKGROUND: Aortic intramural hemorrhage (IMH), which presents clinical manifestations identical to acute aortic dissection, is suggested to have different pathology and pathophysiology. The purposes of this study were to diagnose IMH by transesophageal echocardiography (TEE) prospectively and to compare clinical and echocardiographic outcome of IMH with those of aortic dissection. METHODS: Between August 1991 and November 1996, 27 IMH and 73 acute aortic dissection were diagnosed using TEE in 202 consecutive patients with suspected aortic dissection. TEE diagnoses of IMH and aortic dissection were initially compared with computed tomography and magnetic resonance imaging and later confirmed by operative findings (n=39) or follow-up changes (n=12). RESULTS: In the 49 patients whose diagnosis was confirmed by operation or follow-up changes, the sensitivity and specificity for the diagnosis of IMH were 27 of 27 (100%) and 20 of 22 (91%), respectively. There were 11 deaths (15%) in acute aortic dissection and 1 death (4%) in IMH during follow-up of 1.7+/-1.5 years (p=NS). Stanford classification and types of treatment were not related to death in both groups. Complications were less frequently noted in IMH (3/27) than in acute aortic dissection (24/73) (p<0.001) and no death occurred in uncomplicated IMH who were medically treated. Follow-up study of 12 IMH patients showed 8 complete resolution, 3 regression, 1 progression. CONCLUSION: TEE is very useful in diagnosis of IMH and IMH has better outcome than the aortic dissection due to absence of communication and intimal tear.
Classification ; Diagnosis ; Echocardiography* ; Echocardiography, Transesophageal ; Follow-Up Studies ; Hemorrhage* ; Humans ; Magnetic Resonance Imaging ; Pathology ; Prospective Studies ; Sensitivity and Specificity