BACKGROUND: Although current dietary guidelines recommend to increase the consumption of whole grain, these recommendations are mainly derived from the belief that replacing fats with carbohydrate may reduce risk of coronary artery disease (CAD) by improving serum lipids. Our objective was to evaluate whether the isocalorical replacement of refined rice with whole grain reduce CAD risk factors such as insulin demand and lipid peroxidation in CAD patients. METHODS: Thirty-eight male patients with CAD were provided with 70 g powder of whole grain (220 kcal) for 16 weeks, replacing cooked refined rice as a carbohydrate source of breakfast. An oral glucose tolerance test (OGTT) was performed in all subjects to determine the effect of whole grain consumption on serum concentrations of insulin and glucose in CAD patients with different degree of glucose tolerance. RESULTS: With the substitution of whole grain for refined rice, serum glucose concentrations decreased by 24% without altering body weight and energy intake. Estimates of daily fiber and vitamin E intakes increased by 24% and 50%, respectively. Whole grain consumption in CAD patients without diabetes decreased fasting glucose (22%) and the area under the curve (AUC) for insulin (26%) and glucose (19%) during an OGTT. CAD patients with diabetes also showed reductions in fasting glucose (27%) and AUC for glucose (25%) during the OGTT, compared with baseline values. Whole grain consumption reduced plasma malondialdehyde and homocysteine and urinary 8-epi-prostaglandin F 2alpha concentrations by about 30%. Lipid-corrected concentrations of alpha-carotene, retinol, alpha- and gamma-tocopherol and lycopene increased by 22-46%, compared with baseline values. Whole grain consumption decreased the percentage composition of w6 fatty acids of serum phospholipid increased by 14%. CONCLUSION: The replacement of refined rice with whole grain as a carbohydrate source of a meal showed significant beneficial effects on glucose, insulin and homocysteine concentrations and lipid peroxidation in CAD patients. These effects are likely to substantially reduce the risk factors of CAD and diabetes in CAD patients.
Area Under Curve ; Blood Glucose ; Body Weight ; Breakfast ; Edible Grain* ; Coronary Artery Disease* ; Coronary Vessels* ; Energy Intake ; Fasting ; Fats ; Fatty Acids ; gamma-Tocopherol ; Glucose ; Glucose Tolerance Test ; Homocysteine* ; Humans ; Insulin* ; Lipid Peroxidation* ; Male ; Malondialdehyde ; Meals ; Nutrition Policy ; Plasma* ; Risk Factors ; Vitamin A ; Vitamin E ; Vitamins

Williams syndrome, initially described by Williams et al. in 1961 is associated with characteristic dysmorphic features, congenital heart disease, distinctive behavior, and emotional traits. Sudden death has been reported perioperatively due to congenital heart disease in patients suffering from Williams syndrome. We present a case of a patient with Williams syndrome underwent preauricular fistulectomy and medial rectus recession. Airway management and tracheal intubation were successfully performed on the patient. For anesthetic management, sevoflurane and vecuronium, as well as sevoflurane and rocuronium were employed during the first and second operation, respectively. Anesthetic managements were performed uneventfully in this patient.
Airway Management ; Anesthesia ; Death, Sudden ; Heart Defects, Congenital ; Humans ; Intubation ; Vecuronium Bromide ; Williams Syndrome

In 1965 Gillespie reported a new syndrome of bilateral aniridia, cerebellar ataxia, and oligophrenia (mental retardation). This new syndrome was named Gillespie syndrome. Since then only 17 cases of Gillespie syndrome have been reported in UK, Brazil, Ireland, Belgium, Australia, and US. A case of Gillespie syndrome was not reported in Korea. A 4 year-old girl has triad of Gillespie syndrome, which are partial aniridia, cerebellar ataxia and mental retardation. We confirmed this with ophthalmologic examination, brain MRI, and developmental delay. We report the typical manifestation of Gillespie syndrome in a 4 year-old girl with the brief review of literature.
Aniridia* ; Australia ; Belgium ; Brain ; Brazil ; Cerebellar Ataxia* ; Child, Preschool ; Female ; Humans ; Intellectual Disability ; Ireland ; Korea ; Magnetic Resonance Imaging

Lactic acid bacteria (LAB), including L. plantarum isolated from Kimchi, are beneficial and safe microorganisms that improve disturbances of the indigenous microflora and the host's immune system. The adhesion abilities of Kimchi-derived L. plantarum PM008 and yogurt-derived L. casei were measured in vitro and in vivo. When L. plantarum or L. casei was incubated with Caco-2 cells, these Lactobacillus strains were potently attached. When these strains were orally administered to mice, the LABs were attached on the large intestine of mice. The attachment of L. plantarum on murine intestine or Caco-2 intestinal epithelial cell lines was more potent than that of L. casei, although numbers of LAB between their feces were not different. Treatment with either L. plantarum or L. casei for 14 days suppressed fecal beta-glucuronidase activity, although treatment for one day did not affect it. L. plantarum showed more potent inhibition than L. casei. In addition, L. plantarum and L. casei were stable to artificial gastric and intestinal juice. L. plantarum was more stable than L. casei. Based on these findings, the survival and adhesion effects of orally administered LAB strains in the intestine may increase numbers of LAB in intestine and express their biological activities.
Animals ; Bacteria ; Caco-2 Cells ; Epithelial Cells ; Feces ; Glucuronidase ; Humans ; Immune System ; Intestine, Large ; Intestines ; Lactic Acid ; Lactobacillus ; Lactobacillus casei ; Lactobacillus plantarum ; Mice ; Pyridines ; Thiazoles

Gastrointestinal complications are frequently followed by combination chemotherapy. Based on recent reports, colitis is very rare but serious complication associated with taxane based chemotherapy. Despite of aggressive management, clinical course of colitis associated with chemotherapy is potentially fatal. We report the first case in Korea who was developed extensive colitis after docetaxel-based chemotherapy. A man aged 58 years with recurrent oral cavity carcinoma received chemotherapy with docetaxel, cisplatin and 5-fluorouracil (5-FU). On the 7th day of first cycle of chemotherapy, he complained of abdominal pain and fever, followed by hypotension because of large amount of hematochezia. Abdominal CT and colonoloscopy revealed extensive pancolitis with bleeding. He underwent two times of transarterial embolization with microcoils and gelform. Nevertheless these managements, bleeding foci were remained. Then, colonoscopic hemostasis such as hemoclipping and epinephrine injection were performed and fully recovered after 6 weeks.
Abdominal Pain ; Cisplatin ; Colitis* ; Drug Therapy ; Drug Therapy, Combination* ; Epinephrine ; Fever ; Fluorouracil ; Gastrointestinal Hemorrhage ; Hemorrhage ; Hemostasis ; Hypotension ; Korea ; Mouth ; Tomography, X-Ray Computed

Background: This retrospective study was undertaken to assess the effectiveness of the 8-French (Fr) catheter (Pleuracan(R)) for the initial treatment of primary spontaneous pneumothorax. MATERIAL AND METHOD: Between July 2004 and July 2006, 59 patients (72 cases) underwent a closed thoracostomy for primary spontaneous pneumothorax. We divided these patients into two groups: group T (large bore (>20 Fr) chest tube group) and group P (Pleuracan(R) group). RESULT: Initially, the Pleuracan(R) catheters were inserted in 41 cases. There were four catheter malfunctions (9.8%); three cases had a subsequent closed thoracostomy with a large bore chest tube. Ultimately, there were 34 cases in group T and 38 cases in group P. There were no significant differences in indwelling catheter time (T: 2.1+/-1.5 days, P: 2.1+/-1.3 days), hospital stay (T: 6.4+/-5.4 days, P: 5.2+/-2.9 days) and complications (T: 3%, P: 0%) between the two groups. The percentage of cases that needed intravenous analgesics in group P was 60% (23/38); this was significantly lower than the number for group T (90%, 31/34) (p=0.003). In a subgroup of patients that did not undergo bullectomy (T: 17 cases, P: 19 cases), there were no significant differences in the duration of air leakage (T: 0.5+/-0.7 days, P: 0.5+/-1.2 days) and in the percentage of patients with complete lung re-expansion (T: 94%, P: 84%) between the two groups. CONCLUSION: Application of the Pleuracan(R) catheter for the initial treatment of primary spontaneous pneumothorax was as effective as the large bore chest tube.
Analgesics ; Catheters* ; Catheters, Indwelling ; Chest Tubes ; Humans ; Length of Stay ; Lung ; Pneumothorax* ; Retrospective Studies ; Thoracostomy

BACKGROUND: Postoperative atrial fibrillation is the most frequently arrhythmic complication associated with coronary artery bypass graft surgery. This study was designed to investigate the incidence of atrial fibrillation in patients undergoing OPCAB and on-pump CABG and to identify the risk factors associated with its development. MATERIAL AND METHOD: 247 consecutive patients were evaluated among 306 patients who underwent the coronary artery bypass graft surgery between January, 2002 and December, 2005. 178 patients underwent OPCAB (OPCAB group) and 69 patients underwent On-pump CABG (On-pump CABG group). The incidence and the risk factors of atrial fibrillation in two groups were determined. RESULT: There were no significant differences between two groups with respect to the preoperative demographic characteristics of the patients. The incidences of postoperative atrial fibrillation were 25 cases (14%) in OPCAB group and 15 cases (21%) in On-pump CABG group. Age over 65 years, net positive fluid imbalance for postoperative 3 days, and chest tube bleeding for postoperative 3 days were independent predictive factors in OPCAB group. Age over 65 years and net positive fluid imbalance for postoperative 3 days were independent predictive factors in On-pump CABG group. In multivariate analysis, age over 65 years was the only risk factor of postoperative atrial fibrillation in both groups. CONCLUSION: Atrial fibrillation is a common complication after procedures of myocardial revascularization. There wasn't a low incidence of postoperative atrial fibrillation in OPCAB, compared with On-pump CABG. Age over 65 years was associated with postoperative atrial fibrillation irrespective of the use of cardiopulmonary bypass.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cardiopulmonary Bypass ; Chest Tubes ; Coronary Artery Bypass* ; Coronary Vessels* ; Hemorrhage ; Humans ; Incidence ; Multivariate Analysis ; Myocardial Revascularization ; Risk Factors* ; Transplants

PURPOSE: There have been some studies on the hazardous effects of air pollution for patients with cardiovascular diseases. This study was designed to evaluate the possible relationship between air pollution and development of chest pain in acute coronary syndrome patients. METHODS: The medical records of 109 acute coronary syndrome patients, who visited two university hospital emergency rooms in the Seoul area between January 1999 and July 2001, were reviewed. Hourly concentrations of particulate mass < 10 micrometa and of four gaseous air pollutants were measured at 19 different points in the Seoul area. The data were analyzed using a case-crossover approach. RESULTS: The analysis of the data showed no definite relationship between chest pain development and either the concentrations of particulate mass < 10 micrometa (PM10) or of four gaseous air pollutants: namely, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide ( SO2). However, increases in the concentrations of particulate matter, gaseous NO2, and gaseous O3 showed a positive correlation, but without statistical significance. CONCLUSION: This study shows no relationship between the concentrations of PM10 and other air pollutants with the development of chest pain in acute coronary syndrome patients. However, for particulate mass < 2.5 micrometa, which is currently not measured in the Seoul area, the possibility of a relationship between development of chest pain in acute coronary syndrome patients and particulate air pollutants still exists.
Acute Coronary Syndrome* ; Air Pollutants ; Air Pollution* ; Carbon Monoxide ; Cardiovascular Diseases ; Chest Pain* ; Emergency Service, Hospital ; Humans ; Medical Records ; Nitrogen Dioxide ; Ozone ; Particulate Matter ; Seoul* ; Sulfur Dioxide ; Thorax*

In addition to its well-known glycolytic activity, GAPDH displays multiple functions, such as nuclear RNA export, DNA replication and repair, and apoptotic cell death. This functional diversity depends on its intracellular localization. In this study, we explored the signal transduction pathways involved in the nuclear translocation of GAPDH using confocal laser scanning microscopy of immunostained human diploid fibroblasts (HDFs). GAPDH was present mainly in the cytoplasm when cultured with 10% FBS. Serum depletion by culturing cells in a serum-free medium (SFM) led to a gradual accumulation of GAPDH in the nucleus, and this nuclear accumulation was reversed by the re-addition of serum or growth factors, such as PDGF and lysophosphatidic acid. The nuclear export induced by the re-addition of serum or growth factors was prevented by LY 294002 and SH-5, inhibitors of phosphoinositide 3-kinase (PI3K) and Akt/protein kinase B, respectively, suggesting an involvement of the PI3K signaling pathway in the nuclear export of GAPDH. In addition, 5-aminoimidazole-4-carboxamide-1-beta-D-ribofuranoside (AICAR), an activator of AMP-activated protein kinase (AMPK), stimulated the nuclear translocation of GAPDH and prevented serum- and growth factor-induced GAPDH export. AMPK inhibition by compound C or AMPK depletion by siRNA treatment partially prevented SFM- and AICAR-induced nuclear translocation of GAPDH. Our data suggest that the nuclear translocation of GAPDH might be regulated by the PI3K signaling pathway acting mainly as a nuclear export signal and the AMPK signaling pathway acting as a nuclear import signal.

BACKGROUND: This study evaluated the position and relationship between the right internal jugular vein (IJV) and the surrounding external landmarks using ultrasonography. METHODS: Fifty-four patients undergoing central vein access for cardiac surgery were enrolled in this study. The IJV, carotid artery (CA) and sternocleidomastoid muscle (SCM) at the cricoid cartilage level in 15o trendelenburg position with 30o head rotation were examined using a two dimensional ultrasound transducer of a TEE machine. Images of the vessels and the demographic data of the patients were recorded and analysed. RESULTS: At the level of the cricoid cartilage, the position of the right IJV was medial to middle of the clavicular head of the SCM muscle in 26 cases (48.2%), lateral in 11 cases (20.4%) and just above the middle of clavicular head of the SCM muscle in 17 cases (31.5%). In 43 patients (79.6%), the IJV overlapped the CA anterolaterlly < 5 mm, and these cases were regarded as normal. Ten patients (18.5%) had a medially positioned IJV overlapping the CA more than 5 mm and the IJV was positioned lateral to CA in 1 (2%) patient. The mean ratio of the overlapped diameter and the diameter of the CA was 33.6% and the overlapping ratios were greater than 50% in 10 patients (31.4%). The mean skin-to-vein distance at the angle of 30degrees was 1.82 cm. CONCLUSIONS: In 18.5% of patients positioned in the 15o Trendelenburg position, with their head turned to the left 30degrees, the IJV overlapped the CA medially more than 5 mm, which increased the risk of a carotid puncture using the blind technique.
Carotid Arteries* ; Catheterization ; Cricoid Cartilage ; Head* ; Head-Down Tilt* ; Humans ; Jugular Veins* ; Prospective Studies* ; Punctures ; Thoracic Surgery ; Transducers ; Ultrasonography ; Veins