To elucidate the Ca2+ release mechanisms in the rabbit coronary artery, arterial preparations were permeabilized with beta-escin and changes in tension were measured under varying experimental conditions. Additionally, we investigated properties and distribution of two kinds of Ca2+ release mechanisms, Ca2+-induced Ca2+ release (CICR) and IP3-induced Ca2+ release (IICR). The results obtained were summarized as follows; 1. When a rabbit coronary artery was incubated in a relaxing solution containing 30 microM beta-escin for 40 min. sensitivity to externally added Ca2+ was much higher in beta-escin permeabilized muscle than in intact preparations. The contractile effect of IP3 in beta-escin permeabilized muscle was also demonstrated; 2. Caffeine and IP3 contracted coronary arteries were permeabilized with beta-escin, but the amplitude of contraction was much larger in the presence of caffeine than of IP3. 3. Intracellular heparin completely inhibited the contractions induced by IP3, but not those by caffeine. On the other hand, procaine inhibited the responses to caffeine, but not those to IP3. Ryanodine inhibited both the caffeine- and IP3-induced contractions. 4. The amplitude of contractile responses was much larger to the maximal stimulation of CICR by applying caffeine than to the maximal stimulation of IICR by applying IP3. After the maximal CICR stimulation by caffeine, the activation of IICR by IP3 without the reloading of Ca2+ could no longer evoke contraction. On the other hand, after the maximal IICR activation, the activation of CICR could still evoke contraction although the amplitude of the contraction was smaller when compared with the case without the initial IICR stimulation. 5. Acetylcholine contracted coronary artery smooth muscles were permeabilized with beta-escin. However, in the absence of added guanosine triphosphate (GTP), the responses were very small. Acetylcholine-induced contraction was inhibited by heparin, but not by procaine. From the above results, it may be concluded that there are two kinds of mechanisms of Ca2+ release, CICR and IICR, in the rabbit coronary artery smooth muscle cell. Also, whereas the CICR mechanism distributes on the membrane of the whole smooth muscle Ca2+ store, the IICR mechanism distributes only on a part of it.
Animal ; Arteries/metabolism ; Calcium/*metabolism ; Capillary Permeability/drug effects ; Coronary Vessels/drug effects/*metabolism ; Escin/pharmacology ; In Vitro ; Intracellular Membranes/*metabolism ; Rabbits ; Support, Non-U.S. Gov't ; Tissue Distribution

PURPOSE: The purpose of this study was to assess the usefulness of MRI in the evaluation of vascular changes of the meningioma. MATERIALS AND METHODS: We retrospectively studied the MRI findings in 20 cases of intracranial meningiomas. The images were assessed for vascular hilum, vascular rim, sinus invasion, and vascular encasement. Cerebral angiograms were obtained in 15 cases and compared with MRI findings. RESULTS: MRI was as accurate as angiography in detection of vascular hilum(MRl=8/20, Anglogram=9/15), vascular rim(MRl=14/20, Angiogram=9/15) and dural sinus invasion(MRl=4/6, Angiogram=5/6). MRI was superior to angiography in detection of vascular encasement(MRl=2/3, Angiogram=0/2) and cavernous sinus invasion(MRI=3/3, Angiogram=0/2). CONCLUSION: MRI is an excellent noninvasive imaging modality in evaluating vascular changes of omas.
Angiography ; Cavernous Sinus ; Magnetic Resonance Imaging* ; Meningioma ; Retrospective Studies

BACKGROUND AND OBJECTIVE: Abciximab has been shown to have beneficial effects beyond the improvement in the patency of an infarct-related artery and the microvascular integrity. However, it remains uncertain whether abciximab may lead to beneficial effects on the left ventricular remodeling in patients with an acute myocardial infarction, treated with primary percutaneous coronary intervention (PCI). Therefore, whether abciximab is effective in the left ventricular remodeling in patients with acute myocardial infarction, treated with primary PCI, was investigated. SUBJECTS AND METHODS: The study included 28 patients with an acute myocardial infarction (1 vessel disease) that had received either a primary PCI alone (group A, n=14) or an abciximab+primary PCI (group B, n=14). The baseline characteristics of the two groups were similar, with the exception of a thrombusburden lesion. All patients were examined by echocardiography within 72 hours, and at an average 11.7 months after the acute myocardial infarction. The change in the left ventricular end-diastolic volume index, end-systolic volume index and ejection fraction, between the two groups, were compared. RESULTS: At an average follow-up of 11.7 months, the left ventricular volume indices were smaller, and the left ventricular ejection fraction higher, compared with those at the baseline in each group. The change of the left ventricular end-diastolic volume index (-7+/-3 mL/m2 vs. -9+/-2 mL/m2, p=0.56), the left ventricular end-systolic volume index (-8+/-3 mL/m2 vs. -9+/-2 mL/m2, p=0.73) and the left ventricular ejection fraction (7+/-3% vs. 9+/-2%, p=0.49) did not show significant differences between groups A and B. CONCLUSION: These results suggest that abciximab does not improve the left ventricular remodeling in patient with an acute myocardial infarction, treated with primary PCI.
Arteries ; Echocardiography ; Follow-Up Studies ; Humans ; Myocardial Infarction* ; Percutaneous Coronary Intervention* ; Platelet Aggregation Inhibitors ; Stroke Volume ; Ventricular Remodeling*

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.
Adolescent ; Adult ; Angiofibroma* ; Head ; Humans ; Male ; Neck ; Recurrence ; Turbinates*

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.
Adolescent ; Adult ; Angiofibroma* ; Head ; Humans ; Male ; Neck ; Recurrence ; Turbinates*

No abstract available.
Liver Cirrhosis* ; Liver* ; Polycythemia Vera* ; Polycythemia*

Background and Objectives: Evaluation of Epworth Sleepiness Scale (ESS), Berlin, STOP, and STOP-Bang questionnaire validities for obstructive sleep apnea (OSA) screening among various adult age groups.Materials and Method: Results for each of those questionnaires were compared with diagnostic overnight polysomnography (PSG) data obtained for 396 patients suffering either insomnia, sleep apnea, excessive daytime sleepiness, or chronic snoring who had been divided into three age groups (20-39, 40-59, or ≥60 years). For each questionnaire, the sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated. Results: Among the OSA group [apnea hypopnea index (AHI) cutoff ＞5], Berlin and STOP questionnaire sensitivity and specificity were significantly different among the age groups. Among the moderate-to-severe OSA sub-group (AHI cutoff ＞15), the specificity of Berlin, STOP, and STOP-Bang questionnaire was significantly different among age groups. Conclusion The Berlin and STOP questionnaires differed with patient age in OSA screening. The ESS questionnaire, by contrast, did not show any age-related differences of sensitivity and specificity in OSA screening or moderate-to-severe OSA screening.

BACKGROUND: Continuous ambulatory peritoneal dialysis(CAPD) is known to be a relatively effective in decreasing the cardiac loading and improving the symptoms and survivals in the patients with severe left ventricular(LV) dysfunction, who are refractory to conventional medical treatments. METHODS: We reviewed retrospectively the clinical course and prognosis of 18 patients initiating CAPD and manifesting severe LV dysfunction at the same from September, 1996 to December, 2000 in Inha University Kidney Center. To know the effect of LV dysfunction on the survival, the outcomes of 103 CAPD patients with normal cardiac function was compared as control group. RESULTS: Total subjects were 11 male and 7 female with a mean age of 59.9+/-1.6 years. Causes of end stage renal disease were diabetic nephropathy (12), chronic glomerulonephritis(1), lupus nephritis(1), and unknown(2). Mean follow-up duration was 12.7+/-10.6 months. In pre-CAPD period, all subjects showed cardiac symptoms of NYHA class III or IV with a mean ejection fraction of 27.6+/-0.6%. Six months after CAPD, mean ejection fraction of all patientswas improved up to 44.8+/-3.1%. 13 patients(72.2%) showed improvement of cardiac function in terms of NYHA class. Five patients showed neither improvement nor aggravation of cardiac function, who were mostly female, older, and transferred from hemodialysis and three of whom died. During follow-up period, seven patients died because of aggravation of previous cardiac disease(4), acute myocardial infraction(1), cerebral hemorrhage(1) and peritonitis(2). When compared to 103 patients without LV dysfunction who started CAPD, 1-year survival was poorer in the patients with LV dysfunction(41.7% vs 77.8%, p<0.05). CONCLUSION: LV dysfunction is still a risk factor of poor survival, CAPD may improve symptoms and systolic cardiac fucntion in ESRD patients with severe LV dysfunction.
Diabetic Nephropathies ; Female ; Follow-Up Studies ; Heart Failure ; Humans ; Kidney ; Kidney Failure, Chronic* ; Male ; Peritoneal Dialysis, Continuous Ambulatory* ; Prognosis ; Renal Dialysis ; Retrospective Studies ; Risk Factors

Leiomyoma is a neoplasm of smooth muscle relatively common in the stomach, but very rare in the duodenal location. Recurrent bouts of severe melana remain the most frequent presenting symptom for leiomyoma. A 69-year-old man presented to us with a 4-day history of melena. Endoscopy revealed norinal mucosa covered ovoid elevated lesion with central linear depression and ulcer at the second portion of duodenum. Endoscopic biopsy showed chronic inflammation only. Duodenal mass was excised through a duodenotomy. Pathological diagnosis was leiomycena.
Aged ; Biopsy ; Depression ; Diagnosis ; Duodenum ; Endoscopy ; Esophagus* ; Hemorrhage* ; Humans ; Inflammation ; Intestines* ; Leiomyoma* ; MART-1 Antigen ; Melena ; Mucous Membrane ; Muscle, Smooth ; Stomach* ; Ulcer

Approximately 2% of patients who are evaluated for symptomatic carotid artery disease have complete occlusion of a common carotid artery. Surgical management for the symptomatic carotid occlusion has various options. Surgical treatment for these patients should be decided according to the patient's condition causes of the obstruction and collateral circulations. We report our experience of surgical management for symptomatic carotid occlusion with contralateral carotid stenosis which were successfully treated with subclavian-carotid artery bypass and carotid endarterectomy.
Arteries* ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Artery, Common ; Carotid Stenosis ; Collateral Circulation ; Endarterectomy, Carotid* ; Humans