OBJECTIVES: The aim of this study was to investigate the relationship between job stress and the pulse wave velocity as an indicator of vessel stiffness among male firefighters in a metropolitan city. METHODS: In November and December 2008, a total of 404 participants were analyzed. The questionnaire survey included the participants' general characteristics, job-related factors, health-related behaviors, and job stress. Job stress was measured using the Korean Occupational Stress Scale (KOSS). We merged the job stress data with clinical laboratory data and brachial-ankle Pulse Wave Velocity (baPWV) by conducting medical surveillance. We measured the relationship of job stress to baPWV by using a logistic regression analysis. RESULTS: After adjusting for cardiovascular risk factors, the baPWV was significantly higher in the groups possessing high levels of job insecurity (OR=2.17, 95% CI=1.06~4.42). CONCLUSIONS: Our findings suggest that the level of job stress, especially in regards to job insecurity, was directly related to the baPWV. Therefore, further preventive efforts and studies in regards to firefighters are needed in order to reduce job stress and thereby help to prevent cardiovascular disease.
Cardiovascular Diseases ; Firefighters ; Glycosaminoglycans ; Humans ; Logistic Models ; Male ; Pulse Wave Analysis ; Questionnaires ; Risk Factors

BACKGROUND AND OBJECTIVES: The impact of multivessel coronary disease (MVD) with chronic total occlusion (CTO) on one-year mortality in patients with acute myocardial infarction (AMI) is not clearly known. We investigated the impact of MVD with concurrent CTO lesion on one-year mortality in patients with AMI. SUBJECTS AND METHODS: We studied 1008 consecutive patients who underwent coronary angiography between November 2005 and December 2008 with a diagnosis of AMI. RESULTS: Among 1008 patients, 432 patients (43%) had MVD, and 88 patients (8.7%) had CTO lesion. The one-year overall mortality was higher in patients with MVD than in patients with single vessel disease (SVD) (10.2% vs. 5.9%, p=0.012). However, the one-year overall mortality was not significantly higher in patients with CTO lesion than in patients without that lesion (12.5% vs. 7.3%, p=0.080). In multivariate analysis, independent predictors of one-year overall mortality were age older than 65 years {hazard ratio (HR) 2.41, 95% confidence interval (CI): 1.43 to 4.08}, Killip class > or =III (HR 3.59, 95% CI: 2.24 to 5.77), ST-elevation myocardial infarction (HR 2.45, 95% CI: 1.49 to 4.05) and MVD (HR 1.76, 95% CI: 1.07 to 2.89). CONCLUSION: Patients with MVD showed higher one-year mortality than patients with SVD. However, the presence of CTO was not an independent predictor of one-year mortality in this study that included patients with successfully revascularized CTO lesion.
Chronic Disease ; Coronary Angiography ; Coronary Disease ; Coronary Occlusion ; Glycosaminoglycans ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Prognosis

There are several advantages for groin flap, but its small and unpredictable vessels of pedicle have made it to lose its initial popularity. Although it would be ideal flap when it is focused on its useful advantages such as relative larger size, low donor site morbidity and possible bone graft, there have been few studies for prognostic factors for successful groin flap. Authors intended to determine prognostic factors which are relative with success of free groin flap. From January 1985 to December 2007, 107 patients who underwent groin flap for reconstruction of extremities were selected consecutively. Univariate and multivariate analysis were performed to determine prognostic factors which were related with success of groin flap. Eighty of 107 (74.8%) flaps survived. There was significant difference in success rate according to the recipient site. Nineteen of 20 cases (95%) survived in upper extremities, but 61 of 87 cases (70.1%) survived in lower extremities, which was statistically significant (p=0.022). Univariate analysis showed that mean diameter of donor veins was significantly larger in success group (p=0.021). Groin flap is recommended for reconstruction of upper extremities than lower extremities. It is thought to be critical that surgeons try to match vessel diameters between donor and recipient site.
Extremities ; Glycosaminoglycans ; Groin ; Humans ; Lower Extremity ; Multivariate Analysis ; Tissue Donors ; Transplants ; Upper Extremity ; Veins

OBJECTIVETo investigate the effect of Coriolus versicolor polysaccharide B (CVP-B) on increased membrane glycosaminoglycans (GAG) expression and intracellular glutathione (GSH) of RAW264.7 macrophages exposed to angiotensin II (Ang II).

METHODSThe plasma membrane of RAW264.7 macrophages exposed to Ang II treatment was isolated by ultracentrifugation, and the membrane GAG expression was analyzed using 1, 9-dimethylmethylene blue (DMMB) spectrophotometric assay for sulfated GAG. The intracellular reduced GSH was determined using fluorophotometry.

RESULTSThe GAG content in the macrophage membranes increased by up to 54% following cell exposure to 1.0 micromol/L Ang II, whereas in presence of 1.0 micromol;/L Ang II, CVP-B at 1, 10, and 50 microg/ml decreased the GAG content by 13%, 43% (P<0.01), and 52% (P<0.01), respectively. The macrophage GSH activity decreased by 69% following incubation with 1.0 micromol;/L Ang II for 24 h, and CVP-B treatment at 1, 10, and 50 microg/ml in presence of 1.0 micromol;/L Ang II resulted in significant increment of GSH activity by 31%(P<0.05), 104% (P<0.01), and 168% (P<0.01), respectively.

CONCLUSIONThese data provide the first evidence that CVP-B inhibits elevated GAG expression in RAW264.7 macrophage membrane induced by Ang II.

Agaricales ; chemistry ; Angiotensin II ; pharmacology ; Animals ; Cell Line ; Cell Membrane ; metabolism ; Glutathione ; analysis ; Glycosaminoglycans ; analysis ; Macrophages ; metabolism ; Mice ; Polysaccharides ; pharmacology

OBJECTIVETo evaluate the feasibility of growing tissue-engineered cartilage using chondrocytes seeded onto a biodegradable porous bioceramic, the beta-tricalcium phosphate (beta-TCP).

METHODSA porous bioceramic template of beta-TCP was created in the shape of a disc. Chondrocytes isolated from rabbit articular cartilage were seeded on the beta-TCP template and then kept in rotatory cell culture system (RCCS) for 1 week prior to subcutaneous transplantation into athymic mice. The three-dimensional structure was well-maintained 16 weeks after implantation. After 4, 8, 16 weeks, the specimens were harvested and examined macroscopically, histologically and immunohistochemically.

RESULTSGross morphological and histological analysis of the specimens from the chondrocyte-beta-TCP complex demonstrated new cartilage construction. The overall configuration of the experimental specimens closely resembled the structure of beta-TCP template.

CONCLUSIONThese findings suggest that porous bioceramic (beta-TCP) is a good "matrix" for chondrocyte, and can be used for cartilage engineering.

Animals ; Calcium Phosphates ; pharmacology ; Cartilage ; growth & development ; transplantation ; DNA ; analysis ; Female ; Glycosaminoglycans ; analysis ; Immunohistochemistry ; Mice ; Mice, Nude ; Tissue Engineering

PURPOSE: We evaluated the clinicopathological charicterics and prognostic impacts of lymphatic vessel invasion in gastric cancer without lymph node involvement. MATERIALS AND METHODS: Among 1,795 patients who underwent gastric surgery with gastric cancer at the department of surgery, Hanyang university college of medicine from June 1992 to March 2009, we retrospectively evaluated 890 patients with lymph node negative gastric cancer. RESULTS: The lymphatic vessel invasion correlated significantly with tumor stage, age, tumor size, perineural invasion and operation method. The survival rates were only significantly different between the patients with and without lymphatic vessel invasion in patients with stage Ia (P=0.036). Univariate and multivariate analysis demonstrated that blood vessel invasion and preoperative serum CEA level were significant factor influencing the survival rate in lymph node negative gastric cancer patients with lymphatic invasion. CONCLUSIONS: In patients with lymph node negative gastric cancer, the survival rate is significantly lower in those with lymphatic vessel invasion than in those without. Especially, in patients with stage Ia gastric cancer, the survival rates is significantly different between those with and those without lymphatic vessel invasion. Blood vessel invasion and preoperative serum CEA level is an adverse prognostic indicator in patients with stage Ia gastric cancer with lymphatic invasion. Thus we should consider further adjuvant therapies in case of need and need to show more concern to identify gastric cancer patients early at risk for recurrence.
Blood Vessels ; Glycosaminoglycans ; Humans ; Lymph Nodes ; Lymphatic Vessels ; Multivariate Analysis ; Prognosis ; Recurrence ; Retrospective Studies ; Stomach Neoplasms ; Survival Rate

BACKGROUND AND OBJECTIVES: Advanced glycation end-products (AGEs) contribute to the development of atherosclerosis. We investigated whether serum AGEs are related to the presence or severity of coronary artery disease (CAD), and explored the association between serum AGEs and arterial stiffness according to diabetes status in patients suspected of having CAD. SUBJECTS AND METHODS: The measurement of serum AGEs and brachial-ankle pulse wave velocity (baPWV) were performed in 145 consecutive patients (63+/-9 years, 58% men) who received a coronary angiogram for evaluation of CAD. RESULTS: Forty-four diabetics and 101 non-diabetics were classified into three subgroups based on the number of diseased vessels with obstructive CAD: 0, 1, and 2 or more vessel diseases (VDs). Serum AGEs were significantly higher in diabetics with obstructive CAD than in those without obstructive CAD (2.16+/-0.29 vs. 1.85+/-0.29 mU/mL, p=0.010) and were significantly correlated with the number of VDs only in diabetics (r=0.504, p<0.001). Serum AGEs were not significantly correlated with baPWV in diabetics or non-diabetics. In receiver operating characteristics analysis, the cut-off value of serum AGEs as a predictor of obstructive CAD was 1.98 mU/mL, with 64% sensitivity and 63% specificity in diabetics. In multiple regression analysis, serum AGEs independently predicted obstructive CAD and were associated with the number of VDs in diabetics. CONCLUSION: Serum AGEs independently predict obstructive CAD and the severity of coronary atherosclerosis irrespective of arterial stiffness only in diabetics. Evaluation of PWV and serum AGEs together may be more effective to identify the risk of CAD in diabetic individuals.
Atherosclerosis ; Coronary Artery Disease ; Coronary Vessels ; Diabetes Mellitus ; Glycosaminoglycans ; Humans ; Pulse Wave Analysis ; ROC Curve ; Sensitivity and Specificity ; Vascular Stiffness

PURPOSE: Aging and atherosclerotic changes enhance the stiffness of the arterial wall, and the pulse wave travels faster in stiffer vessel. Measurement of the brachial ankle pulse wave velocity (baPWV) is a non-invasive method for evaluating the stiffness of the vessel wall. We investigated the relation between the baPWV and risk factors for atherosclerosis. METHOD: We studied 180 subjects (38 male and 142 female; mean age 46 years, range 24 to 76 years). The instrument used for evaluating the baPWV was a Vasoguard (VIASYS Healthcare, Dublin, Ohio, USA), and measurements were performed in the right arm and in both ankles. Data were analyzed using Pearson correlation, t-test, and multiple regression analysis. Multiple regression analysis was performed for age, sex, smoking, hypertension, height, weight, body mass index (BMI), total cholesterol, LDL, HDL, TG, and HbA1c. RESULT: Right and left baPWVs were significantly increased (P<0.05) in subjects with the following risks: older age, high body weight, high BMI, high total cholesterol, high LDL, high TG, high HbA1c, and low HDL. Right and left baPWVs were also significantly increased (P<0.05) in male subjects with a history of smoking and hypertension. Multiple regression analysis showed that age, sex, and LDL were independent determinants of the right and left baPWVs. CONCLUSION: This study provides evidence that increased age, male gender, and high serum LDL levels are risk factors that contribute to arterial stiffness. Measurement of the baPWV may be a useful method for evaluating vascular status.
Aging ; Animals ; Ankle ; Arm ; Body Weight ; Cholesterol ; Cholesterol, LDL ; Delivery of Health Care ; Glycosaminoglycans ; Humans ; Hypertension ; Male ; Ohio ; Pulse Wave Analysis ; Risk Factors ; Smoke ; Smoking ; Vascular Stiffness

PURPOSE: Invasive micropapillary carcinoma (IMPC) of the breast is a rare and associated with high incidence of lymph node metastasis and poor outcome. The aims of this study were to provide a comprehensive analysis of clinicopathologic and immunohistochemical characteristics of IMPC and to elucidate the differences between IMPC and invasive ductal carcinoma (IDC). METHODS: Sixty-one patients of IMPC were identified by retrospective review of database from January 2004 to December 2008. 221 patients were randomly selected among the IDC patients who received operation during the same period. Two groups were compared with uni- and multivariate analysis. RESULTS: We observed significant differences in mean number of metastatic lymph nodes (6.1 vs. 1.9, p=0.001), positivity of lymph node (70.5% vs. 45.2%, p<0.001), and presence of lymphatic vessel invasion (75.4% vs. 34.8%, p<0.001) between IMPC and IDC patients. Although it has been known that triple negative breast cancer (TNBC) have lymphotropic tendency in their early T stage, 11.8% (26/221) of IDC and 3.3% (2/61) of IMPC patients were TNBC in this study (p=0.050). In multivariate analysis, IMPC histology showed no correlation with disease-free survival (DFS) and the lymphatic vessel invasion was a significant predictor of DFS. CONCLUSION: The results of this study confirm that IMPC is unique subtype of breast cancer that is commonly accompanied by axillary lymph node metastasis and shows poor outcome, although it rarely presents the pattern of TNBC. Lymphatic vessel invasion rather than histology of IMPC seems to be more closely related to DFS.
Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Disease-Free Survival ; Glycosaminoglycans ; Humans ; Incidence ; Lymph Nodes ; Lymphatic Metastasis ; Lymphatic Vessels ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies

BACKGROUND: Impaired renal function may contribute to development of stroke and small vessel pathology in the brain. We investigated whether stroke subtype, initial stroke severity, early neurologic outcomes, time to cerebral infarction occurrence, and the presence of small vessel pathology in the brain are different between patients with end stage renal disease (ESRD) and those with renal transplantation (RT). METHODS: A total of 57 consecutive de novo RT patients (RT group) and 120 patients undergoing dialysis due to ESRD (ESRD group) who developed a first-ever acute cerebral infarction were enrolled. We compared stroke subtypes based on the Trial of Org 10172 in Acute Stroke Treatment classification, the presence of small vessel pathology (cerebral microbleed, leukoaraiosis and silent lacunar infarction) on MRI, stroke severity based on the National Institutes of Health Stroke Scale (NIHSS) and in-hospital mortality between the groups. RESULTS: The stroke subtypes, NIHSS scores at admission and in-hospital mortality were not different between the two groups. On multivariate analysis, the presence of high grade periventricular white matter changes tended to be more frequently detected in the ESRD group than the RT (P=0.078). The time from starting dialysis to stroke was longer in the RT group (129.9+/-60.9 months) than in the ESRD group (51.1+/-46.1 months). CONCLUSIONS: The stroke patterns, severity and short term outcomes were not different between RT and ESRD. The risk of cerebral infarction and high grade periventricular white matter changes may be reduced after RT in patients with ESRD.
Brain ; Cerebral Infarction ; Chondroitin Sulfates ; Dermatan Sulfate ; Dialysis ; Glycosaminoglycans ; Heparitin Sulfate ; Hospital Mortality ; Humans ; Kidney Failure, Chronic ; Kidney Transplantation ; Leukoaraiosis ; Multivariate Analysis ; National Institutes of Health (U.S.) ; Stroke