Arotinolol was administered orally to 31 patients to evaluate is antihypertensive action. After one week of antihypertensive medication, they were given Arotinolol 30mg daily for 4 week. Routine serum chemistries, electrolytes, urinalysis and electrocardiography were studied before and after Arotinolol. Blood pressure measured in sitting, supine and standing position was 175.3+/-5.4/115.7+/-4.0, 168.0+/-5.2/150.0+/-3.8, 154.4+/-8.5/103.4+/-3.2mmHg in control and 143.8+/-2.8/93.3+/-2.8, 144.6+/-5.4/88.1+/-4.3, 139.7+/-4.6/86.8+/-3.4mmHg in Arotinolol treatment group. The differences between both blood pressure were statistically significant(P<0.01). No laboratory test showed significant difference between both period. There were no significant side effects except 2 cases of transient headache and dizziness respectively, and one case of diarrhea. In summary, Arotinolol apears to reduce blood pressure effectively with minimal side effects.
Blood Pressure ; Diarrhea ; Dizziness ; Electrocardiography ; Electrolytes ; Headache ; Humans ; Hypertension* ; Urinalysis

OBJECTIVE: Under ubiquitous-healthcare circumstances, interest of one's health condition has been increased. People were required the measurement of biosignal by the wearable computing technology. The purpose of this paper is to measure the portable ECG (Electro- cardiogram) with the application of wearable computing technology. Therefore, the normal ECG measurement can be measured with a chest belt either in direct contract state or loose contact state. METHODS: The belt type circuit for measuring ECG was developed. In order to remove noises in loosely contact condition, a shield circuit was assembled with the measuring electrodes. Both of High performance differential amplifiers and notch filters were incorporated into the main amplifier circuits. The ECG data was converted from analog to digital form by MCU (Micro Control Unit). The main memory was composed of a memory controller and a memory card. RESULTS: The ECG measurement having bad electrode contact to body would be usually done in daily life, so we measured the biosignal by using the loose contact potable belt for accurate ECG data. The belt can be used to measure ECG by loose contact method. CONCLUSION: In this study, we could measure ECG without any spatial-temporal restriction due to the portable belt. This device is suitable for the ubiquitous-healthcare environment.
Contracts ; Electrocardiography ; Electrodes ; Memory ; Noise ; Thorax

PURPOSE: The authors evaluated the possibility of protein C and protein S as risk factors for retinal vein occlusion (RVO). METHODS: We evaluated the medical histories and performed laboratory tests, including protein C and protein S, in patients who were diagnosed with RVO by fundus examination and fluorescein angiography. The same data were obtained from a healthy control group. We analyzed mean activity and the ratio of patients with decreased levels of protein C or protein S. RESULTS: Forty-seven patients with RVO in this study consisted of 14 with central retinal vein occlusion (CRVO) and 33 with branch retinal vein occlusion (BRVO). Sixteen normal subjects were also enrolled in this study as controls. There are no cases that presented decreased protein C activity. However, there was a statistically significant difference in the number of cases with protein S deficiency between the patients and the control group (p<0.05). CONCLUSIONS: Deficiency of anticoagulant proteins, especially protein S, may be a risk factor of retinal vein occlusion. Examination of the coagulation system may be useful in the systemic evaluation of RVO patients.
Fluorescein Angiography ; Humans ; Protein C* ; Protein S Deficiency ; Protein S* ; Retinal Vein Occlusion* ; Retinal Vein* ; Retinaldehyde* ; Risk Factors*

PURPOSE: To determine CD133+ cells defined as cancer stem cells (CSCs) in colon cancer, we examined whether CD133+ clones in HCT116 demonstrate known features of CSCs like sphere-forming ability, chemodrug-resistance, and metastatic potential. METHODS: Magnetic cell isolation and cell separation demonstrated that <1% of HCT116 cells expressed CD133, with the remaining cells being CD133- clones. In colon cancer cells, radioresistance is also considered a CSC characteristic. We performed clonogenic assay using 0.4 Gy γ-irradiation. RESULTS: Interestingly, there were no differences between HCT116 parental and HCT116 CD133+ clones when the cells comprised 0.5% of the total cells, and CD133- clone demonstrated radiosensitive changes compared with parental and CD133+ clones. Comparing gene expression profiles between sphere-forming and nonforming culture conditions of HCT116 subclones by whole RNA sequencing failed to obtain specific genes expressed in CD133+ clones. CONCLUSION: Despite no differences of gene expression profiles in monolayer attached culture conditions of each clone, sphere-forming conditions of whole HCT116 subclones, parental, CD133+, and CD133- increased 1,761 coding genes and downregulated 1,384 genes related to CSCs self-renewal and survival. Thus, spheroid cultures of HCT116 cells could be useful to expand colorectal CSCs rather than clonal expansion depending on CD133 expressions.
Cell Separation ; Clinical Coding ; Clone Cells* ; Colonic Neoplasms ; HCT116 Cells ; Humans ; Neoplastic Stem Cells ; Parents ; RNA* ; Sequence Analysis, RNA* ; Transcriptome

Recent reports on growth hormone (GH) therapy have shown that GH has various beneficial effects in GH deficient adults. In most of these studies, GH was administered daily. Because GH is still expensive and has to be delivered by subcutaneous injection, we studied the 6-month therapeutic effects of thrice weekly GH injection therapy and compared it with daily therapy. Twenty eight adult patients with GH deficiency were randomly assigned into group 1 (ten cases, thrice weekly injections of GH), group 2 (nine cases, daily injections), and group 3 (nine cases, placebo injections). Lean body mass, serum basal GH levels, and insulin-like growth factor 1 levels significantly increased after six months of GH therapy in both groups 1 and 2. According to computed tomography, the mean mid-thigh muscle mass significantly increased in group 1, while the visceral fat mass significantly decreased in group 2. GH levels significantly increased exercise rate-pressure product and hand grip strength only in group 1. These results suggest that thrice weekly injections of GH are as effective as daily injections in GH deficient adults.
Adult ; Anthropometry ; Body Composition/drug effects ; Bone Density/drug effects ; C-Peptide/blood ; Carbohydrate Metabolism ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Exercise/physiology ; Female ; Growth Hormone/*administration & dosage/adverse effects/*deficiency ; Humans ; Insulin/blood ; Insulin-Like Growth Factor I/metabolism ; Lipids/blood ; Male ; Middle Aged ; Tomography, X-Ray Computed

Central neurocytoma (CN) typically presents as an intraventricular mass causing obstructive hydrocephalus. The first line of treatment is surgical resection with adjuvant conventional radiotherapy. Stereotactic radiosurgery (SRS) was proposed as an alternative therapy for CN because of its lower risk profile. The objective of this systematic analysis is to assess the efficacy of SRS for CN. A systematic analysis for CN treated with SRS was conducted in PubMed. Baseline patient characteristics and outcomes data were extracted. Heterogeneity and publication bias were also assessed. Univariate and multivariate linear regressions were used to test for correlations to the primary outcome: local control (LC). The estimated cumulative rate of LC was 92.2% (95% confidence interval: 86.5-95.7%, p<0.001). Mean follow-up time was 62.4 months (range 3-149 months). Heterogeneity and publication bias were insignificant. The univariate linear regression models for both mean tumor volume and mean dose were significantly correlated with improved LC (p<0.001). Our data suggests that SRS may be an effective and safe therapy for CN. However, the rarity of CN still limits the efficacy of a quantitative analysis. Future multi-institutional, randomized trials of CN patients should be considered to further elucidate this therapy.
Brain Neoplasms ; Follow-Up Studies ; Humans ; Hydrocephalus ; Linear Models ; Neurocytoma* ; Particle Accelerators ; Population Characteristics ; Publication Bias ; Radiosurgery* ; Radiotherapy ; Tumor Burden

INTRODUCTIONOvarian carcinoma usually presents at an advanced stage with diffuse intraabdominal manifestations. We report a patient who presented with a right groin swelling.

CLINICAL PICTUREThe only clinical abnormality was an enlarged right inguinal lymph node (3 x 2 cm), for which excision biopsy revealed metastatic adenocarcinoma. A computed tomography (CT) scan showed an enlarged left ovarian lesion (9.0 x 6.4 cm).

TREATMENT AND OUTCOMELaparotomy with total hysterectomy, bilateral salpingo-oophrectomy and partial omentectomy were performed. Histology confirmed left ovarian adenocarcinoma, consistent with the earlier histology of the right inguinal lymph node. There were no other sites of involvement. Postoperatively, the patient received adjuvant chemotherapy for treatment of FIGO Stage IIIc ovarian carcinoma and is clinically disease free 13 months after surgery.

CONCLUSIONSOvarian cancer presenting with inguinal lymph node metastases is uncommon. Ovarian cancer which manifests solely as a contralateral inguinal lymph node metastasis has not been previously reported. This case illustrates a rare presentation of ovarian carcinoma, and underscores the need to consider ovarian carcinoma in the differential diagnosis of women with inguinal lymphadenopathy.

Adenocarcinoma ; pathology ; surgery ; Female ; Groin ; Humans ; Lymphatic Metastasis ; Middle Aged ; Ovarian Neoplasms ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

INTRODUCTIONThe revised Human Organ Transplant Act (HOTA) was implemented in Singapore in July 2004. We aim to evaluate expanding the potential donor pool for liver transplant in Singapore with the inclusion of marginal donors.

MATERIALS AND METHODSAll donor referrals between July 2004 and June 2007 were studied. All potential deceased liver donors were heart-beating. After being reviewed by the transplant coordinator, potential donors were assessed by a transplant hepatologist and a transplant surgeon for suitability of organ donation strictly based on the programme's donor assessment protocol. Reasons for rejection as potential donors were documented. The clinical characteristics of all donor referrals were retrospectively reviewed, and an independent decision was made as to whether liver retrieval in each rejected case might have been possible.

RESULTSAmong the 128 potential donor referrals, 20 donors (15.6%) underwent liver retrieval. Of the 20 livers retrieved, 16 were implanted and 4 were not implanted (3 unfit recipients, and 1 donor liver with 40% steatosis). Another 10 donor livers were assessed intraoperatively and were rejected because of varying levels of steatosis. Of these livers assessed, 5 donor livers had steatosis <40% and 5 had steatosis >40%. Of the remaining potential donors, 45 were deemed not possible because of prolonged hypotension (9), on-going or unresolved sepsis (13), high-risk behaviour (4), non-actualisation (8), or pre-existing medical conditions (11). Another 53 donors may potentially have been suitable donors but were rejected because of possible sepsis (13), no suitable recipients (12), transient hypotension (10), transient abnormal liver function test (6), history of alcohol ingestion (5), non-actualisation because of consent (4) and other reasons (3). Overall, it was deemed that 61 donors (47.7%) might potentially have been suitable liver donors.

CONCLUSIONSDespite new legislation (HOTA) in Singapore, the utilisation of cadaveric donor livers showed no increase in the last 3 years. By expanding our donor criteria to include marginal donors, we could potentially increase the availability of deceased donor livers to meet our waiting list demands.

Adult ; Female ; Humans ; Liver Transplantation ; Living Donors ; legislation & jurisprudence ; supply & distribution ; Male ; Middle Aged ; Referral and Consultation ; organization & administration ; Retrospective Studies ; Singapore ; Tissue and Organ Procurement ; legislation & jurisprudence ; Waiting Lists

OBJECTIVE: To identify the precise locations of the motor branches and motor points of hamstring and triceps surae muscles to the bony landmarks. METHOD: Twenty-eight limbs of 14 adult cadavers were anatomically dissected. The adult cadavers were selected randomly without regard to gender and age. The cadravers which were unable to obtain a neutral position or which received a trauma to the posterior thighs or the lower legs were excluded from the study. The number and location of the motor branches and motor points from sciatic nerve to each hamstirng muscles and from tibial nerve to each triceps surae muscles were identified related to the bony landmarks. Bony landmarks were ischial tuberosity, medial and lateral epicondyles of femur, and medial and lateral malleolli of tibia. The length of femur was defined as the distance from the ischial tuberosity to the intercondylar line of femur and the length of lower leg was defined as the distance from the intercondylar line of femur to the intermalleolar line of tibia. The locations of the muscular branches and the motor points were expressed as the percentage of the length of femur and lower leg. RESULTS: One muscular branch from the sciatic nerve to the semimembranosus muscle and from the posterior tibial nerve to the soleus muscle, and one or two muscular branches to the biceps femoris, semitendinosus, and semimembranosus, medial gastrocnemius, lateral gastrocnemius and soleus muscle were located at 23.0+/-5.7%, 21.0+/-10.5%, 25.0+/-10.3% of the femur from the ischial tuberosity and 2.0+/-6.2%, 4.0+/-3.3% and 10.0+/-3.3% of the lower leg from the intercondylar line of femur. There were one to four motor points in the hamstring and triceps surae muscles. The motor points of biceps femoris, semitendinosus and semimembranosus were located at 33.0+/-7.8%, 28.0+/-14.5% and 48.0+/-19.0% of the femur. The motor points of the medial gastrocnemius, lateral gastrocnemius and soleus were located in 5.0+/-0.6%, 10.0+/-3.0% and 18.0+/-4.3% of the lower leg below the intercondylar line of femur. CONCLUSION: The identification of the locations of muscular branches and motor points related to the bony landmarks from this study would increase the accuracy of the motor branch blocks or motor point blocks to the hamstrings and triceps surae muscles.
Adult ; Cadaver ; Extremities ; Femur ; Humans ; Leg ; Muscle, Skeletal ; Muscles* ; Sciatic Nerve ; Thigh ; Tibia ; Tibial Nerve

OBJECTIVE: The object of this study was to assess the accuracy of dipyridamole stress intravenous (IV) myocardial contrast echocardiography (MCE) using pulse inversion harmonic imaging and PESDA in the detection of perfusion defect in the patients with coronary artery disease in comparison with dipyridamole stress Tc-99m sestamibi SPECT. METHODS: Total 46 patients (29 males, mean age 64 years old) were consecutively enrolled. Patients with prior myocardial infarction were excluded. MCE and Tc-99m sestamibi SPECT were performed at the same day during rest and after 0.56 or 0.84mg/Kg dipyridamole infusion. Continuous IV infusion of PESDA (2-5 mL/min) was administered while obtaining triggered (1:1) end-systolic apical 2, 4 chamber and long axis views. Tc-99m sestamibi was injected 3 minutes after dipyridamole. Tc-99m sestamibi SPECT images were obtained one hour later. Coronary angiography was followed within two days in all patients. Tc-99m sestamibi SPECT images were matched to the sixteen segments of left ventricle according to American Society of Echocardiography for segmental comparison. Both images were analyzed visually. Results Using coronary angiography as the standard, MCE showed overall sensitivity of 70.7%, specificity of 95.8%, positive predictive value (PPV) of 87.8% and negative predictive value (NPV) of 88.5% in the detection of coronary atherosclerosis (70% stenosis). Tc-99m sestamibi SPECT showed sensitivity of 75.6%, specificity of 98.9%, PPV of 96.8% and NPV of 90.6%. The overall concordance rate between MCE and Tc-99m sestamibi SPECT for the detection of perfusion defects was 86.9% (Cohen's kappa value 0.63) according to the coronary territory and 86.8% (Cohen's kappa value 0.55) according to segmental analysis. CONCLUSION: Dipyridamole stress IV MCE using pulse inversion harmonic imaging and PESDA is feasible and comparable to Tc-99m sestamibi SPECT in identifying significant coronary stenosis and inducible myocardial perfusion defects in the patients with coronary artery disease. MCE using pulse inversion harmonic imaging seems to be a promising modality for assessing myocardial perfusion in the patients with suspected coronary artery disease.
Axis, Cervical Vertebra ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Dipyridamole ; Echocardiography* ; Heart Ventricles ; Humans* ; Male ; Myocardial Infarction ; Perfusion* ; Sensitivity and Specificity ; Tomography, Emission-Computed, Single-Photon*