BACKGROUND: Microalbuminuraia is a strong prognostic factor for cardiovascular morbidity and mortality in type I and II diabetics. Recent data suggest that microalbuminuria predicted cardiovascular disease independent of hypertension in one of two large-scale studies performed in non-diabetics. Additional possibilities could be a previously documented association with other major and interconnected cardiovascular risk factors, such as insulin resistance, and elevated cardiac mass, abnormal circulation lipid levels, and overweight. The object of this study os to investigat the incidence of microalbuminuria, and to define the pathophysiologic mechanism of microalbuminuria to contribute coronary heart disease in non-diabetic patients with angiographiclly documented coronary artery disease(CAD). METHODS: The study group comprised 31 patients(M;21, mean age 60+/-30 year) with angiographically documented CAD and 15 normal control(m;9, mean age 62+/-7 year). Urinary albumin excretion, blood pressure, echocardiographic left ventricular mass indes, plasma abdominal/hip circumference ratio, fasting glucose, insulin, and c-peptide were studied. The microalbuminuria was defined urinary albumin more than 20ug/min. RESULTS: 1) Six of 31 patients with CAD(19.4%) and none of 15 normal control had microalbuminuria. Hypertension were documented 13 of 31 patients with CAD, and none of 15 normal control(p<0.01). Five of 6 patients with CAD and microalbuminuria and 8 of 25 patients with non-microalbuminuric aptients had hypertension (p<0.05). 2) In the microalbuminuric subjects with CAD, body mass index(29.0+/-3.2vs 24.8+/-3.5), systolic blood pressure(138+/-31 vs 118+/-15mmHG), lipoprotein(a) (69+/-31vs 32+/-32mg/dl), fastion C-peptide(5.5+/-2.2 vs 2.7+/-1.6ng/ml), and microalbumin(221+/25 vs 9.6+/-7.9mg/day)were significantly greater than in normal control(p<0.05). But no difference in left ventricular mass, lipid profile, and abdominal/hip circumference ratio existed between the microalbminuric patients with CAD and normal control. 3) Between the microalbuminuric patients with CAD and without CAD, no signficant difference were noted excepr lipoprotein(a) lever(69+/-31 vs 29+/-29mg/dl), fasting C-peptide(5.5+/-2.4 vs 2.5+/-1.2ng/ml), and microalbumin(221+/-247 vs 8.6+/-6.7mg/day). CONCLUSION: Microalbuminuria was associated with history of hypertension or concurrent antihypertension therapy and insulin resistance in non-diabetics with CAD. But left ventricular cardiac mass, central obesity inedw, and lipid profile were not related with microalbuminuria. The underlying presence of a major risk factor such as hypertension and insulin resistance might be explain the previously reported predictive value of microalbuminuria for cardiac events.
Blood Pressure ; C-Peptide ; Cardiovascular Diseases ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Echocardiography ; Fasting ; Glucose ; Humans ; Hypertension ; Incidence ; Insulin ; Insulin Resistance ; Lipoprotein(a) ; Mortality ; Obesity, Abdominal ; Overweight ; Plasma ; Risk Factors

BACKGROUND: During and immediately after percutaneous transluminal coronary angioplasty(PTCA), reversible ischemic electrocardiographic change and/of left ventricular dysfunction are developed. But it is not investigated whether there are potential myocardial cell damages following PTCA or not, and the clinical Significance of myocardial cell damage following PTCA. Recently cardiac Troponin-T has been developed as a new myocardial specific marker, especially myocardial damage. The object of this study is to investigate whether potential Myocardial damage following PTCA was occurred and the utility of cardiac Tropoin-T for predicting the complications during and immediately after PTCA. METHODS: The study group comprised 12 patients(M/F;8/4mean age;60 +/- 4year,AMI in 6) undergoing PTCA, Samples for Troponin-T were obtained before, directly after, after 2 hours, 6 hours, and after 12 hours and was determined by enzyme immunoassay on an ES 300 analyzer(Boehringer Mannheim). Discrimination limit for myocardial cell damage is 0.1 ng/ml in normal baseline level but if the baseline level is elevated such as acute myocardial infarction or unstable angina, myocardial cell damage is defined with further increase of cardiac Troponin-T(>0.1 ng/ml) compare to baseline level. RESULTS: 1) The mean duration of total balloon inflation is 10.7 +/- 2(3-22) minutes and the mean duration of single maximal inflation is 3.9 +/- 0.6(1-8) minutes. There are no significant change in concentration of Troponin-T by inflation time. None of the patients showed electroca rdiographic evidence for myocardial infarction. 2) Troponin-T were increased in 2 patients with unstable angina(0.01 vs 0.11 ng/ml) which were developed major dissection including acute closure during PTCA, and 2 patients with acute myocardial infarction(2.37 vs 3.73 ng/ml) which didn't developed dcomplication. The increase of cardiac Troponin-T were observed in 2 of 10 patients with uncomplicated PTCA(20%). 3)The subacute complications were not developed. CONCLUSION: The cardiac Troponin-T were increased significantly in two AMI patients with uncomplicated PTCA(2/10,20%). The increase of cardiac Troponin-T following PTCA is associated with periprocedural complications but the prognostic significance to detect postprocedural complication did not define in this study because there were no subacute complications after PTCA and may be limited value due to time course of complication(usaully within 1 hour after PTCA) and relatively long analytic time.
Angina, Unstable ; Discrimination (Psychology) ; Electrocardiography ; Humans ; Immunoenzyme Techniques ; Inflation, Economic ; Myocardial Infarction ; Troponin T* ; Ventricular Dysfunction, Left

PURPOSE: We investigated the effectiveness of the delta neutrophil index (DNI) for the prediction of neonatal bacteremia and compared it to other indices. METHODS: A total of 146 pediatric patients, aged less than 31 days, admitted to the neonatal intensive care unit of Wonju Severance Christian Hospital with fever before or during hospitalization were enrolled in this study. We divided the patients into two groups based on the existence of neonatal bacteremia and performed blood culture tests on both groups. We examined white blood cell count, absolute neutrophil count, DNI, platelet count, and C-reactive protein (CRP) test. We used a receiver operating characteristic (ROC) curve to evaluate their diagnostic significance. RESULTS: Seventy-seven patients were diagnosed with neonatal bacteremia. The mean gestational age was 38.74 weeks and the mean birth weight was 3.20 kg. The mean gestational age of the control group was 33.34 weeks and the mean birth weight was 2.20 kg. Causative organisms of bacteremia included Staphylococcus aureus (n=22), Staphylococcus epidermidis (n=18), and Streptococcus agalactiae (n=8). Both DNI and CRP were significantly associated with neonatal bacteremia after adjusting for gestational age and birth weight. The area under the ROC curve (AUC) for DNI (0.70) was higher than that for CRP (0.68). CONCLUSIONS: The DNI can be used to effectively predict neonatal bacteremia. The prediction will be more accurate if DNI is used in conjunction with other indices. In future, it will be useful to compare DNI with other indices and investigate its relationship with prognosis.
Bacteremia* ; Birth Weight ; C-Reactive Protein ; Fever ; Gangwon-do ; Gestational Age ; Hospitalization ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Leukocyte Count ; Neutrophils* ; Platelet Count ; Prognosis ; ROC Curve ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus agalactiae

This article describes the normal range of orbital linear dimensions (eq. orbital breadths, orbital height, orbital depth, interorbital breadths and biorbital breadth) and orbital indicies. One hundred and eighty-seven Korean skulls from grown-up individuals are studied with analysis for the purpose of evaluating anthropometric characteristics of Korean orbits. The results are compared to previously published data for modern Korean skulls. The width of the orbit is larger on the right side than the left and sexual difference was also shown. On the other hand, the heights of both orbits are much the same. Consequently, there is a slight tendency that chamaeconch is met with more frequently on the right side, whilst hypsiconch on the left side. The orbital depth is larger on the right side, however, depth index did not show any side difference. There are sexual differences on the biorbital breadth and upper facial breadth but not on the interorbital breadth on the basis of dacryon. These results represent the asymmetry of Korean orbit and that measurement on both sides must be necessary for anthropological comparison.
Adult* ; Hand ; Humans ; Orbit* ; Reference Values ; Skull*

BACKGROUND: An earlier index of reperfusion is desirable to determine whether additional therapy is necessary for myocardial salvage. Using the washout phenomenon of biochemical markers, many investigator have reported noninvasive methods for detection coronary reperfusion in patients with acute myocardial infarction. Recently cardiac Troponin-T has been developed as a new myocardial specific marker, especially myocardial damage. The object of this study is to investigate the utility of cardiac Troponin-T for early assessment of reperfusion therapy. METHODS: The study group comprised 10 patients with acute myocardial infarction and reperfusion therapy that was initiated within 6 hours after the onset of symptoms. Blood samples were taken before treatment, every 30 min interval for 3 hours and then 6, 24, 72 hours after the onset of reperfusion therapy to measuring Troponin-T, Creatin Kinase(CK), and CK-MB level. Serum concentration of cardiac Troponin-T level was measured with immunoassed using ES-300, Boehringer Mannheim. We compared the real reperfusion that was assessed by coronary angiogram, chest pain disappearence and resolusion of St-segment elevation with an index of coronary reperfusion, the increase in Troponin-T(big up tri, open Troponin-T) 60, 90 min after repefusion therapy(Successful Reperfusion Index : Tn-T 60(90)-0>0.3 ng/ml) and the sensitivity, specificity, Positive, and negative predictive value were calculated using this threshold(Successful Reperfusion Index). RESULTS: 1) The studied patients(M/F : 7/3, mean age 54+/-12 year) were treated within 3 hour with thrombolytic therapy(7 patients, t-PA) or emergency angioplasty(3 patients). 2) The cardiac Troponin-T levels in eight patients with successful reperfusion showed early peak within 24 hours after reperfusion therapy were initiated but in 2 patients without successful reperfusion showed sustained increase without early peak within 24 hours. The CK-MB levels in patients with successful reperfusion also showed early peak within 24 hours but 5 of 8 patients showed no significant increase until 2 hours after reperfusion therapy. 3) The sensivity, specificity, positive and negative predictive value for detecting reperfusion using a threshold value of 0.3 ng/ml of big up tri, open Troponin-T 90 min(60 min) after reperfusion therapy was 100%(56%), 50(100%), 89%(100%), and 100%(20%), respectively. CONCLUSION: Serial measurements of cardiac Troponin-T, especially reperfusion index(0.3 ng/ml of big up tri, open Troponin-T 90 min after reperfusion therapy) are useful for early assessment of reperfusion therapy in acute myocardial infarction.
Biomarkers ; Chest Pain ; Emergencies ; Humans ; Myocardial Infarction* ; Myocardial Reperfusion ; Reperfusion* ; Research Personnel ; Sensitivity and Specificity ; Troponin T*

OBJECTIVE: The rate of developmental progression of frozen-thawed embryos is lower than that of nonfrozen embryos in mice, cows, humans and other mammalians. This study was designed and performed to evaluate the beneficial effects of coculture of Vero cells on the development of frozen-thawed two-cell stage embryos of ICR strain mice. MATERIASL AND METHODS: The late two-cell stage mouse embryos were obtained from oviducts of 5~6 week old mated ICR mice superovulated with pregnant mare's serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Two-cell stage mouse embryos were frozen slowly with 1,2-propanediol and sucrose as cryoprotectants and thawed rapidly, followed by stepwise dilution. The frozen-thawed embryos were cultured in Ham's F-10+10% Fetal Bovine Serum (FBS) basal culture medium with and without Vero cells. The rates of development in both groups were compared every 24 hours for 5 days. RESULTS: Vero cells did not significantly stimulate the rate of embryonal development compared to controls at 24 hours after culture, 124 (69.3%) and 68 (61.3%), respectively (p=0.161). On day 4, however, 55 (30.7%) cocultured embryos had developed to expanded-hatching blastocysts, which was the significantly higher number than that of the embryos in controls: 16 (14.4%) (p=0.002). In addition, more embryos in coculture developed to hatching-hatched blastocysts (43[24.0%]) compared to the controls (10[9.0%]) (p=0.001). CONCLUSION: Coculture of cryopreserved embryos after thawing with Vero cells seems to be an useful tool to remove the postthaw deleterious effects of freezing and to obtain better quality embryos appropriate for transfer. These beneficial effects of Vero cell coculture appear to become more prominent as the embryonic development progresses over time.
Animals ; Blastocyst ; Chorionic Gonadotropin ; Coculture Techniques* ; Cryopreservation ; Embryonic Development ; Embryonic Structures* ; Female ; Freezing ; Gonadotropins ; Humans ; Mice ; Mice, Inbred ICR* ; Oviducts ; Pregnancy ; Propylene Glycol ; Sucrose ; Vero Cells*

This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern. Among 310 patients, 9 patients (2.9%) were diagnosed as HCQ retinopathy. Among the patients with HCQ use ≥ 5 years (n = 174), the frequency was 5.2%. Only 1 (11.1%) of the 9 patients was symptomatic. The mean daily dose per kilogram of real body weight of the 9 patients was 5.6 mg, and only 3 had used 6.5 mg or more. Four of the 9 patients had severe HCQ retinopathy. Six of the 9 patients showed pericentral or mixed pattern of retinal damage. Consequently, the frequency of HCQ retinopathy in Korean patients was not low, especially when administered at a high cumulative dose and for a long duration. Screening of HCQ retinopathy by the recommended guidelines that include SD-OCT seems useful and should be done to detect retinal damage earlier in patients with chronic exposure to HCQ.
Body Weight ; Humans ; Hydroxychloroquine* ; Mass Screening ; Medical Records ; Retinaldehyde ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Field Tests

In order to clarify the anthropological characteristics of the zygomatic bones that influence to the facial morphology, authors measured the metric dimensions of the zygomatic bones and observed the non -metric traits of Korean 192 skulls (122 males, 43 females, and unknown 27 cases). The results were as follows. In the anterior aspects of the skull, the bizygomatic breadth was 134.8 +/-6.0 mm in the male and 126.6 +/-5.5 mm in the female and the bijugale breadth was 117.3 +/-5.1 mm and 110.1 +/-4.0 mm in the male and female, respectively. The mid -orbital breadth was 53.5 +/-5.7 mm in the male and 52.2 +/-4.7 mm in the female and the bimaxillary breadth was 98.9 +/-5.0 mm in the male and 94.8 +/-4.4 mm in the female. In the lateral aspects of the skulls, the distance from the porion to the ectoconchion (oder - tiefe) was 71.1 +/-2.7 mm in the female and 69.0 +/-3.0 mm in the female and the distance between the porion and the jugale (ohrjochbeinlange) was 54.2 +/-2.7 mm in the male and 53.1 +/-2.7 mm in the female. The maximum zygomatic length was 54.5 +/-3.7 mm in the male and 50.5 +/-2.9 mm in the female and the zygomatic height was 49.6 +/-3.0 mm in the male and 45.8 +/-2.4 mm in the female. The incidences of the absence of the zygomaticofacial foramina and the zygomaticotemporal foramina were 12.0% and 7.3%, respectively. The average number of the zygomaticofacial and the zygomaticotemporal foramina was 1.7 and 0.8, respectively. The positions of these foramina located on the bodies of the zygomatic bones in many cases, and the other cases were that these foramina located on the frontal processes of the zygomatic bones or on the borderlines of the body and frontal process.
Female ; Humans ; Incidence ; Male ; Skull

Necrotizing enterocolitis (NEC) characterized by inflammatory intestinal necrosis is a major cause of mortality and morbidity in newborns. Deep RNA sequencing (RNA-Seq) has recently emerged as a powerful technology enabling better quantification of gene expression than microarrays with a lower background signal. A total of 10 transcriptomes from 5 pairs of NEC lesions and adjacent normal tissues obtained from preterm infants with NEC were analyzed. As a result, a total of 65 genes (57 down-regulated and 8 up-regulated) revealed significantly different expression levels in the NEC lesion compared to the adjacent normal region, based on a significance at fold change ≥ 1.5 and P ≤ 0.05. The most significant gene, DPF3 (P < 0.001), has recently been reported to have differential expressions in colon segments. Our gene ontology analysis between NEC lesion and adjacent normal tissues showed that down-regulated genes were included in nervous system development with the most significance (P = 9.3 × 10⁻⁷; P(corr) = 0.0003). In further pathway analysis using Pathway Express based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, genes involved in thyroid cancer and axon guidance were predicted to be associated with different expression (P(corr) = 0.008 and 0.020, respectively). Although further replications using a larger sample size and functional evaluations are needed, our results suggest that altered gene expression and the genes' involved functional pathways and categories may provide insight into NEC development and aid in future research.
Axons ; Colon ; Enterocolitis, Necrotizing* ; Gene Expression Profiling* ; Gene Expression* ; Gene Ontology ; Genome ; Humans* ; Infant, Newborn ; Infant, Premature ; Mortality ; Necrosis ; Nervous System ; Pilot Projects* ; Sample Size ; Sequence Analysis, RNA ; Thyroid Neoplasms ; Transcriptome

PURPOSE: To evaluate changes in the peripapillary retinal nerve fiber layer (RNFL) thicknesses using spectral-domain optical coherence tomography (SD-OCT) in hydroxychloroquine (HCQ) users. METHODS: The medical records of HCQ users were retrospectively reviewed. In these HCQ users, an automated perimetry, fundus autofluorescence photography, and SD-OCT with peripapillary RNFL thickness measurements were performed. The peripapillary RNFL thicknesses were compared between the HCQ users and the control groups. The relationships between the RNFL thicknesses and the duration or cumulative dosage of HCQ use were analyzed. RESULTS: This study included 77 HCQ users and 20 normal controls. The mean duration of HCQ usage was 63.6 ± 38.4 months, and the cumulative dose of HCQ was 528.1 ± 3.44 g. Six patients developed HCQ retinopathy. Global and six sectoral RNFL thicknesses of the HCQ users did not significantly decrease compared to those of the normal controls. No significant correlation was found between the RNFL thickness and the duration of use or cumulative dose. The eyes of those with HCQ retinopathy had temporal peripapillary RNFL thicknesses significantly greater than that of normal controls. CONCLUSIONS: The peripapillary RNFL thicknesses did not change in the HCQ users and did not correlate with the duration of HCQ use or cumulative doses of HCQ. RNFL thickness is not a useful biomarker for the early detection of HCQ retinal toxicity.
Humans ; Hydroxychloroquine* ; Medical Records ; Nerve Fibers* ; Photography ; Retinaldehyde* ; Retrospective Studies ; Tomography, Optical Coherence ; Visual Field Tests