BACKGROUND: We evaluated 1) the sequential changes of angiotensin-converting enzyme (ACE) mRNA expression in lung (main site for circulating ACE synthesis) and left ventricle, and 2) whether such expression is modified by ACE inhibitor or angiotensin II receptor blocker treatment after acute myocardial infarction (MI) in rats. METHODS: Placebo, captopril (2 g/liter drinking water) or TCV-116 (10 mg/kg/day gavage) was administered 3 days before left coronary occlusion and continued for 6 weeks. At 1, 3 and 6 weeks after operation, hemodynamic measurement was performed and pulmonary and myocardial ACE mRNA expression was analyzed by quantitative RT-PCR using rcRNA as an internal standard. RESULTS: Mean BP and LVEDP increased in untreated rats compared with captopril- and TCV-116-treated rats (post-MI 6week, p<0.05). Pulmonary ACE mRNA increased in acute phase (post-MI 1 week, max. 1.4 fold, p<0.05 vs. pre-MI) and returned to pre-MI value thereafter. In contrast, cardiac ACE mRNA expression showed slightly decreasing tendency in acute phase, and was increased up to 1.6 fold in chronic phase after MI (post-MI 3 and 6weeks, p<0.05 vs. pre-MI). No changes in pulmonary ACE gene expression were found with RAS blockade. However, in acute phase after MI, cardiac ACE mRNA increased with both captopril and TCV-116 treatment (post-MI 24hour and 1week, max. 2 fold, p<0.05 vs. untreated group). CONCLUSION: 1) In contrast to the pulmonary ACE mRNA that is activated in acute phase, the cardiac ACE mRNA is activated in chronic phase after MI. 2) RAS blockade does not affect the change of pulmonary ACE expression, but modulate the change of cardiac ACE expression after MI.
Animals ; Captopril ; Coronary Occlusion ; Drinking ; Gene Expression* ; Heart Ventricles ; Hemodynamics ; Lung* ; Myocardial Infarction* ; Myocardium* ; Peptidyl-Dipeptidase A ; Rats ; Receptors, Angiotensin ; RNA, Messenger

Anterior ischemic optic neuropathy is due to acute ischemia of the anterior part of the optic nerve, whose main source of blood supply is from the posterior ciliary circulation, either by direct branches or through the peripapillary choroid, with minor and differing contributions from other sources. The clinical features are charaterized by sudden visual impairment, optic nerve related visual field defect and optic disc edema. For pathogenetic as well as therapeutic reasons, these patient can be subdivided into two major subgroups: a nonarteritic group, an arteritic group. The authors experienced a case of AION, which occurred in a young male, probably arteritic. So, the literature of the AION was briefly reviewed and the purpose of this review is to increase awareness of this not uncommon condition.
Choroid ; Edema ; Humans ; Ischemia ; Male ; Optic Nerve ; Optic Neuropathy, Ischemic ; Vision Disorders ; Visual Fields

BACKGROUND AND OBJECTIVES: Human Troponin T & I (TnT, TnI) has several isoforms which have different functional property. This study was designed to describe the isoform expression of TnT & TnI in failing and hypertrophic human heart and during normal development. MATERIALS AND METHOD: Myocardium was attained from hypertrophic hearts (n=10) of TOF patients who underwent myomectomy, from failing hearts (n=10) of transplant recipients, from normal hearts (n=5) of patients in brain death and from aborted fetal hearts (n=5). After the extraction of RNA, RT-PCR was performed for TnT & TnI isoforms and GAPDH to evaluate the isoform expression qualitatively and quantitatively. RESULTS: In terms of TnI, slow skeletal TnI was expressed more than cardiac TnI in fetal hearts[ratio of Troponin over GAPDH (R)=1.3:0.5] but cardiac TnI was dominant in adult hearts (r=0.3:1.1) (p 0.05). Failing hearts showed similar pattern with adult hearts (r=0.3:1.2) and hypertrophic hearts showed the intermediate pattern (r=0.9:1.3). In terms of TnT, T1 and T3 were expressed in fetal hearts (r=0.04, 0.8) but only T3 was expressed in adult hearts (r=1.1). Failing hearts and hypertrophic hearts showed similar pattern with adult hearts and no differences in the amount of expression (r=1.4, 1.3). CONCLUSION: There is isoform switch from fetal to adult form during development and it might be responsible for the differences of myocardial functional property between fetal and adult heart. Failing and hypertrophic hearts showed no differences with normal hearts, which means the isoform switch of TnT & I might have no significant role in functional disturbances in these conditions.
Adult ; Brain Death ; Fetal Heart ; Heart* ; Humans* ; Myocardium ; Protein Isoforms ; RNA ; Transplantation ; Trinitrotoluene ; Troponin T* ; Troponin*

Organic causes of astasia or asterixis have been described in the literature. However, concurrent unilateral manifestation of the two symptoms is extremely rare. We report two cases presenting with astasia and asterixis due to infarcts involving the ventrolateral nucleus of the left thalamus. Acute onset of astasia or asterixis in patients without significant metabolic disorder should alert the clinician on the possibility of acute stroke involving the thalamus.
Dyskinesias* ; Humans ; Infarction* ; Stroke ; Thalamus

BACKGROUND AND OBJECTIVES: Altered environmental gravity, including both hypo- and hypergravity, may result in space adaptation syndrome. To explore the characteristics of this adaptive plasticity, the expression of immediate early gene c-fos mRNA in the vestibular system following an exposure to hypergravity stimulus was determined in rats. MATERIALS AND METHOD: The animals were subjected to 2 G force (two-fold earth's gravity) stimulus for 3 hours, and were examined at post-stimulus hours 0, 2, 6, 12, and 24. Real time reverse transcription-polymerase chain reaction (RT-PCR) was adopted to analyze temporal changes in the expression of c-fos mRNA. RESULTS: The hypergravity stimulation produced the expression of c-fos mRNA in the vestibular ganglion, medial vestibular nucleus, inferior vestibular nucleus, hippocampus, vestibulocerebellum, and vestibular cortex. The peak expression occurred at hour 6 in the animals hypergravity-stimulated for 3 hours. Bilateral labyrinthectomy significantly attenuated the degree of up-regulation in c-fos mRNA expression. MK-801, an NMDA receptor antagonist, also significantly attenuated the degree of up-regulation in c-fos mRNA expression. CONCLUSION: These results indicate that the adaptive neuroplasticity in response to an altered gravity occurs in the vestibular-related organs in the central nervous system, in which peripheral vestibular receptors and NMDA receptors play an important role.
Animals ; Central Nervous System ; Dizocilpine Maleate ; Ganglion Cysts ; Genes, fos ; Gravitation ; Hippocampus ; Hypergravity* ; N-Methylaspartate ; Neuronal Plasticity* ; Plastics ; Rats ; Receptors, N-Methyl-D-Aspartate ; RNA, Messenger ; Space Motion Sickness ; Up-Regulation ; Vestibular Nuclei

BACKGROUND: Many Studies regarding hemodynamic changes by various vasodilators, such as nitroprusside, nifedipine, and hydralazine have been reported, however little data are available upon acute hemodynamic change due to captopril, an angiotensin converting enzyme inhibitor especially in chronic regurgitant valvular heart disease. Therefore the aim of this study is to evaluate the acute hemodynamic effects of sublingual captopril in patients with regurgitant valvular heart diseases. METHODS: Among the 9 patients enrolled in this study, 5 patients mitral regurgitation, 2 had aortic regurgitation, and 2 had both. Five had patients were male and 4 were female. Before, 15 minutes and 30 minutes after administration of 25mg of captopril via sublingual route, forward cardiac output was measured three times using Swan-Ganz catheter. Right and left cardiac catheterization were also done at each phase and measurement of pulmonary capillary wedge pressures, pulmonary artery pressures, right atrial pressures, aortic pressures, left ventricular pressures were done. RESULTS: 1) Heart rate, pulmonary capillary wedge pressures, cardiac output and cardiac indices left ventricular end-diastolic pressure, diastolic and mean aortic pressures, and diastolic pulmonary artery pressure showed no significant change after administration of sublingual captopril. 2) Systolic aortic pressure decreased significantly from basal value(130+/-35) to 15 minute value(126+/-39). 3) Systemic vascular resistance at 15 minute showed significant reduction as compared with basal value(from 1743+/-551 to 1642+/-491). Pulmonary vascular resistance at 30 minutes(254+/-193) was significantly lower than basal value(282+/-229). CONCLUSIONS: Reductions of systemic and pulmonary vascular resistance occurred relatively rapidly, however, acute effects on cardiac output and pulmonary capillary wedge pressures were not evident. Clinical implication of sublingual captopril in patients with regurgitant valvular heart diseases is worth evaluationg by more extensive hemodynamic studies.
Aortic Valve Insufficiency ; Arterial Pressure ; Arteries ; Atrial Pressure ; Blood Pressure ; Capillaries ; Captopril* ; Cardiac Catheterization ; Cardiac Catheters ; Cardiac Output ; Catheters ; Female ; Heart Rate ; Heart Valve Diseases* ; Hemodynamics* ; Humans ; Hydralazine ; Male ; Mitral Valve Insufficiency ; Nifedipine ; Nitroprusside ; Peptidyl-Dipeptidase A ; Pulmonary Artery ; Pulmonary Wedge Pressure ; Vascular Resistance ; Vasodilator Agents ; Ventricular Pressure

BACKGROUND: The restenosis after coronary angioplasty is the unresolved problem even if the improvement of interventional skills and pharmacological therapies. Nitric oxide, known as endothelial derived relaxing factor (EDRF), regulates the vascular tone and inhibits the proliferation of vascular smooth muscle cells and platelet adhesions and endothelium-leukocyte interactions. Nitric oxide is produced by endothelial nitric oxide synthase (eNOS). We studied the significance of eNOS gene polymorphism for the prediction of restenosis after coronary angioplasty in Koreans with ischemic heart disease. METHODS: We analyzed the two eNOS poly-morphisms using PCR (eNOS A/B polymorphism is the VNTR in intron 4 and eNOS T/G polymorphism is a missense mutation in exon 7) in 199 Korean patients who had 257 lesions undergoing percutaneous coronary angioplasty (ballooning=152, stenting=105). The angiography was repeated 6 months later to assess the relation between the rate of restenosis and types of eNOS gene polymorphism. RESULTS: We found no significant differences of restenosis rate in eNOS A/B and T/G polymorphism in those with balloon angioplasty or with stent (restenosis rate of A/A, A/B, B/B, respectively (n=257): 25% (1/4), 26% (14/53), 31% (62/200) (p=not significant), and T/T, T/G, G/G (n=249): 0% (0/3), 36% (16/44), 29% (58/202)(p=not significant)) Patients with A allele (non BB) or GG phenotype had lower restenosis rate, so we analyzed protective effect of non BB and GG phenotype on restenosis, but there was no significant statistical difference (restenosis rate of non BB and GG, BB and non GG respectively: 20% (15/57), 34% (16/47)(p=not significant)). CONCLUSION: eNOS A/B and T/G polymorphism is not associated with a significantly elevated risk of restenosis after coronary angioplasty.
Alleles ; Angiography ; Angioplasty* ; Angioplasty, Balloon ; Blood Platelets ; Exons ; Humans ; Introns ; Muscle, Smooth, Vascular ; Mutation, Missense ; Myocardial Ischemia* ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Phenotype ; Polymerase Chain Reaction ; Stents

BACKGROUND: Lipoprotein(a)(Lp(a))is known as an independent risk factor of the coronary artery disease(CAD). However, it is not clear whether the level of the Lp(a) is elevated in the presence of atherosclerotic peripheral vascular disease(PVD) of lower extremities. MATERIALS AND METHODS: Considering high prevalence of the coronary artery disease in PVD, the association between the serum level of Lp(a) and the presence of PVD was investigated by comparing Lp(a) level in PVD patients with CAD(PVD+CAD group, N=15), PVD patients without CAD(PVD-CAD group, N=12), and control group who had normal coronary angiograms and no clinical evidence of PVD(Control group, N=22). In all PVD patients coronary angiograms were performed simultaneously with peripheral angiograms. Clinical characteristics, lipid profiles and the level of lipoprotein(a) were compared between two PVD group. The serum level of Lp(a) was measured with ELISA technique. RESULTS: Serum levels of lipoprotein(a) in patients with PVD as a whole(20.4+/-18.7mg/dl, mean standard deviation) were not significantly higher than those in control group(14.9+/-10.5mg/dl). In patients with PVD and CAD, the levels were significantly higher(27.0+/-20.2mg/dl) than those in patients with PVD but without CAD(12.2+/-13.3mg/dl). There was no significant difference between two groups with PVD in age, sex, association of hypertension, smoking, and other lipid profiles. CONCLUSIONS: Lipoprotein(a) level might not be related to the presence of PVD, but rather associated with CAD.
Coronary Artery Disease ; Coronary Vessels ; Enzyme-Linked Immunosorbent Assay ; Humans ; Hypertension ; Lipoprotein(a)* ; Lower Extremity* ; Peripheral Vascular Diseases* ; Prevalence ; Risk Factors ; Smoke ; Smoking

OBJECTIVES: The purpose of this study was to investigate the prevalence and correlates of major and minor depressive disorders in college students. METHODS: A cross-sectional study was completed on a sample of 906 students (507 men and 399 women) with the self-administered form of Korean version of Mini International Neuropsychiatric Interview (K-MINI). RESULTS: Estimated 12-month prevalence of major depressive disorder was 4.2% in men and 9.5% in women, and that of minor depressive disorder was 15.4% in men and 23.2% in women. The factors, 'female gender' and 'age of 20-21', were significantly associated with major depressive disorder. 'Poor adaptation to school' was significantly associated with major depressive disorder both in men and women, but 'poor interpersonal relationship' and 'history of school withdrawal' were associated only in men. Idea of self-injury and suicidal behaviors (suicidal ideation, plan and attempt) were significantly associated with major depressive disorder in women, but were not associated with minor depressive disorder. CONCLUSION: Major and minor depressive disorders are highly prevalent in the college students. Major depressive disorder was more associated with dysfunctions and suicidal behaviors than minor depressive disorder. Campus-based mental health service is needed for the high-risk students.
Cross-Sectional Studies ; Depressive Disorder* ; Depressive Disorder, Major ; Female ; Humans ; Male ; Mental Health Services ; Prevalence* ; Risk Factors*

OBJECTIVES: This study evaluated the prevalence of suicide-related behaviors (suicidal ideation, plan and attempt) and the status of depression, anxiety and function in college students. METHODS: A cross-sectional study was completed to a sample of 880 students with the self-administered form of Korean version of the Mini International Neuropsychiatric Interview (K-MINI), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). RESULTS: Estimated lifetime prevalence of suicidal ideation was 39.2%, that of suicidal plan was 4.7% and that of suicidal attempt was 3.0%. Students with any suicide-related behaviors showed higher lifetime prevalence of major and minor depression, higher BDI and BAI scores, and poor interpersonal relationship, adaptation to college life and physical health compared to the students with no suicide-related behaviors. The average points of grades during their college life were not significantly different according to kinds of suicide-related behaviors they experienced (F=0.39, p=0.82). 96% of suicidal attempters did not use mental health services. CONCLUSION: Results suggest that a high proportion of college students experience suicide-related behaviors. The students who had experienced suicide-related behaviors showed higher depression and anxiety and poorer function compared to students with no suicide-related behaviors. Most of suicidal attempters, however, did not use mental health service. Establishing campus mental health system is necessary to early detect mental health problems and to prevent suicide of college students.
Anxiety ; Cross-Sectional Studies ; Depression ; Depressive Disorder ; Humans ; Mental Health ; Mental Health Services ; Prevalence ; Suicidal Ideation ; Suicide