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

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: 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*

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

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

BACKGROUND: Atherosclerosis is the most important disease that may cause ischemic syndrome in many organs including heart. It is supposed that apoptosis of vascular smooth muscle cells(VSMCs) is closely related to the progression and rupture of atheromatous plaque. Recent studies have documented evidence for elevated level of nitric oxide(NO) within advanced human atheroma and evidence of regression of atheroma by NO. So this study is designed to evaluate whether exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs and which proapoptotic gene(s) is involved in this type of apoptosis. METHODS: Rat VSMCs were cultured and used for experiment at passage 5 through 7. For NO donor, sodium nitroprusside (SNP) and S-nitroso-N-acetylpenicillamine(SNAP) of 0.5, 1, 2, 4mM were exposed to subconfluent VSMCs. The cells were harvested at 6, 12, 24, 48, 72hours after exposure of NO donors. Apoptosis was to be identified by 4, 6-diamidino-2-phenylindole dihydrochloride(DAPI) staining of nuclei and in-situ nick end labeling(TUNEL). The amount of fragmented DNA was analyzed semiquantitatively by diphenylamine(DPA) assay. Immunocytochemical(ICC) staining and western bolt analyses were designed to detect apoptosisrelated gene products, such as Bax-a, Fas and Bcl-2. RESULTS: 1) Decreased mitotic activity was shown after 12 hours exposure of exogenous NO donors, and condensation and margination of chromatin was identified agter 24 hours exposure, by DAPI staining. 2) Percent DNA fragmentation assessed by DPA method was 0,2,9,48,45% at 0,6,12,24,48 hours after exposure of 2mM of NO donors respectively. 3) The expression of Bax-a and Bcl-2 proteins was demonstrated in apoptotic cells by ICC staining. 4) The expression of Bax-a protein in cells under 24 hours exposure of NO donors was elevated by more than 18% of control level on densitometric analysis of western blot. The level of Bcl-2 was suppressed by 26% of control. So, Bax-a/Bcl-2 ratio in cells under exposure of NO donors was elevated to 2.0 from 1.2 of control level. CONCLUSIONS: Exogenous NO from NO donors can induce apoptosis of cultured rat VSMCs, and it is considered that bax-a and bcl-2 genes are involved in this type of apoptosis.
Animals ; Apoptosis* ; Atherosclerosis ; Blotting, Western ; Chromatin ; DNA ; DNA Fragmentation ; Genes, bcl-2 ; Heart ; Humans ; Muscle, Smooth, Vascular* ; Nitric Oxide ; Nitroprusside ; Plaque, Atherosclerotic ; Rats* ; Rupture ; Tissue Donors

BACKGROUND AND OBJECTIVES: There has been a need for functional status measurement tool with better validity than the existing tools such as New York Heart Association Functional Class. Duke Activity Status Index (DASI) is a representative example of a tool that was developed to enhance the validity of measurement by asking the patients about the ability to perform specific activities and scoring the response. Because such a tool must be culture-sensitive, it is desirable to use 'Koreanized' version of the tool. No Koreanized version of the functional status measurement tool has been developed yet. The objective of this study is to develop a Korean version of DASI. MATERIALS AND METHOD: In the developmental phase, a pilot questionnaire asking the ability to perform specific activity was made with reference to existing tools, such as Specific Activity Scale and DASI. Substitution, correction and addition of items were done through the pilot study. Ninety-nine patients was asked to fill developmental version of questionnaire, then underwent treadmill exercise test. Weight for each items were assigned to optimize the correlation between the calculated index (KASI) and total treadmill exercise time. Criteria for categorical functional classification were determined to maximize the agreement between KASI-estimated functional class (KASIFC) and functional class estimated by exercise time. In the validation phase, final version of questionnaire was tested in independent group of 159 patients. The questionnaire was self-administered. Canadian Cardiovascular Society Functional Class (CCSFC) was estimated by the physician who is in charge of treadmill exercise test. RESULTS: In the validation phase, Spearman correlation coefficient between KASI and treadmill exercise time was 0.62(p=.0001) and between CCSFC and exercise time -0.48(p=.0001). KASIFC agreed with functional class estimated by exercise time in 77% of cases, disagreed by 1 class in 20% and by 2 classes in 1%. KASIFC agreed with functional class estimated by exercise time in 77% of cases, disagreed by 1 class in 20% and by 2 classes in 1%. These two methods did not differ significantly in categorical classification. CONCLUSION: KASI is more accurate or at least as accurate as the existing tool in estimation of functional status. The characteristics such as self-administration, availability of outcome as a continuous variable are expected to make it a convenient, efficacious and useful tool in various clinical researches.
Classification ; Exercise Test ; Heart ; Humans ; Pilot Projects ; Surveys and Questionnaires