BACKGROUND: As a complication of iron deficiency anemia, only a few cases of the infarction involving major cerebral artery territory area have been reported. Although the reactive thrombocytosis secondary to iron-deficiency anemia may be suggested as a cause, the exact mechanism is unclear. Until now, the sole possible level of thrombocytosis associated with iron deficiency anemia for cerebrovascular accident has been reported as more than 8.0 x 105/mm3. Case Description : We present a case of young woman with mild reactive thrombocytosis(5.95 x 105/mm3) secondary to iron deficiency anemia who developed left middle cerebral artery territorial infarction. We did not find any other precipitating factors despite of all possible etiological evaluations including cerebral angiography. After the treatment of iron supplement and antiplatelet agent, the recovery was relatively good and no definite neurological deficits were remained. CONCLUSION: We suggest that this large territorial infarction might be related to the severe iron deficiency anemia and the reactive thrombocytosis associated with iron deficiency anemia and the correction of anemia and antiplatelet therapy is a reasonable approach.
Anemia ; Anemia, Iron-Deficiency* ; Cerebral Angiography ; Cerebral Arteries ; Female ; Humans ; Infarction* ; Iron* ; Middle Cerebral Artery ; Precipitating Factors ; Stroke ; Thrombocytosis*

PURPOSE: Baroreceptor reflex regulation has been shown to reset towards a higher blood pressure level. This study was designed to assess alterations of chronotropic baroreflexes in two-kidney, one clip (2K1C) and deoxycorticosterone acetate (DOCA)-salt hypertensive rats. METHODS: Arterial pressure and heart rate (HR) were monitored continuously during intravenous infusions of phenylephrine or sodium nitroprusside. Ensuing reflex HR responses during each drug infusion were determined in two ways: (a) at 10 s intervals (time analysis), and (b) with every 10 mmHg change in pressure (pressure analysis). RESULTS: Both pressor and depressor responses produced by phenylephrine or sodium nitroprusside were comparable between normotensive and hypertensive rats. Both reflex tachycardia and bradycardia were attenuated in 2K1C hypertensive rats as compared with normotensive rats, whereas no significant differences were shown in DOCA-salt hypertensive rats. CONCLUSION: These results indicate that chronotropic baroreflexes are impaired in 2K1C hypertensive rats, but not in DOCA-salt hypertensive rats.
Animals ; Arterial Pressure ; Baroreflex ; Blood Pressure ; Bradycardia ; Desoxycorticosterone ; Dihydrotachysterol ; Heart Rate ; Hypertension ; Infusions, Intravenous ; Nitroprusside ; Phenylephrine ; Rats ; Reflex ; Tachycardia

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.
Biopsy ; Child* ; Cholesterol ; Diagnosis, Differential ; Dyslipidemias ; Enzyme Replacement Therapy ; Fibrosis ; Glycogen Storage Disease ; Hepatocytes ; Hepatomegaly ; Humans ; Liver ; Lysosomes ; Macrophages ; Male ; Sterol Esterase*

Patients with lysosomal acid lipase (LAL) deficiency and glycogen storage disease (GSD) demonstrated hepatomegaly and dyslipidemia. In our case, a 6-year-old boy presented with hepatosplenomegaly. At 3 years of age, GSD had been diagnosed by liver biopsy at another hospital. He showed elevated serum liver enzymes and dyslipidemia. Liver biopsy revealed diffuse microvesicular fatty changes in hepatocytes, septal fibrosis and foamy macrophages. Ultrastructural examination demonstrated numerous lysosomes that contained lipid material and intracytoplasmic cholesterol clefts. A dried blood spot test revealed markedly decreased activity of LAL. LIPA gene sequencing identified the presence of a novel homozygous mutation (p.Thr177Ile). The patient's elevated liver enzymes and dyslipidemia improved with enzyme replacement therapy. This is the first report of a Korean child with LAL deficiency, and our findings suggest that this condition should be considered in the differential diagnosis of children with hepatosplenomegaly and dyslipidemia.
Biopsy ; Child* ; Cholesterol ; Diagnosis, Differential ; Dyslipidemias ; Enzyme Replacement Therapy ; Fibrosis ; Glycogen Storage Disease ; Hepatocytes ; Hepatomegaly ; Humans ; Liver ; Lysosomes ; Macrophages ; Male ; Sterol Esterase*

PURPOSE: Hypertension may be involved an alteration of intrinsic basal tone in vascular smooth muscle. The purpose of this study was to investigate the vasorelaxant effect of atrial natriuretic peptide (ANP) on isolated non-contracted aorta from two-kidney, one clip (2K1C) renovascular hypertensive rats. METHODS: 2K1C hypertension was induced by clipping the left renal artery and were used 6 weeks later. Age-matched rats receiving a sham treatment, which served as controls. The thoracic aortae were mounted in tissue baths to measure the isometric tension. RESULTS: ANP diminished basal tone in previously unstimulated thoracic aortic rings from 2K1C hypertensive rats, while it had no effect in the control rats. Endothelial destruction potentiated the vasorelaxant effect of ANP on basal tone in 2K1C rats. A similar potentiation of the ANP response was observed by pre-treatment with N omega-nitro-L-arginine methyl ester (L-NAME) or methylene blue in aortic rings with endothelium. Treatment with calcium-free Krebs decreased basal tone and abolished ANPresponse. These effects were observed only in aortic rings from 2K1C rats. Similarly, staurosporine and calphostin C, inhibitors of protein kinase C (PKC), lowered basal tone and abolished ANP-response in hypertensive rats. CONCLUSION: These results demonstrate that ANP has a vasorelaxant effect on basal tone in 2K1C renovascular hypertension. Inhibition of ANP effects on basal tone by calcium-free Krebs and PKC antagonists suggests that altered Ca2+ -active tone is involved in hypertension, that modifies the response of vascular smooth muscle to the ANP.
Animals ; Aorta ; Aorta, Thoracic ; Atrial Natriuretic Factor ; Baths ; Endothelium ; Hypertension ; Hypertension, Renovascular ; Methylene Blue ; Muscle, Smooth, Vascular ; Naphthalenes ; NG-Nitroarginine Methyl Ester ; Placebos ; Protein Kinase C ; Rats ; Renal Artery ; Salicylamides ; Staurosporine

PURPOSE: Evidence has emerged that oxygen-derived free radicals may induce vascular relaxations via ATP-sensitive K+ (K(ATP)) channels and the level of free radicals is increased in animal models of hypertension. The present study was conducted to determine whether relaxations to an K(ATP) channel opener, pinacidil, are increased in the aorta from two-kidney, one clip (2K1C) hypertensive rats and whether free radial scavengers reduce these relaxations. METHODS: 2K1C hypertension was induced by clipping the left renal artery and age-matched control rats received a sham treatment. Rings of aortae without endothelium were suspended for isometric force recording. RESULTS: Relaxations to pinacidil (10(-8) to 10(-5) M), which are abolished by glibenclamide (10(-5) M), were augmented in the aorta from 2K1C rats, compared to those from control rats. In the aorta from 2K1C rats, catalase (1,200 U/mL), but neither superoxide dismutase (150 U/mL) nor deferoxamine (10(-4) M), reduced relaxations to pinacidil, whereas in the aorta from control rats, the free radical scavengers did not affect these relaxations. CONCLUSION: These results suggest that in 2K1C hypertension, vasorelaxation to an KATP channel opener is augmented and that hydrogen peroxide in smooth muscle cells may partly contribute to these relaxations.
Animals ; Aorta ; Catalase ; Deferoxamine ; Endothelium ; Free Radical Scavengers ; Free Radicals ; Glyburide ; Hydrogen Peroxide ; Hypertension ; Hypertension, Renal ; Models, Animal ; Myocytes, Smooth Muscle ; Pinacidil ; Placebos ; Rats ; Relaxation ; Renal Artery ; Salicylamides ; Superoxide Dismutase ; Vasodilation

PURPOSE: Thiazide diuretics exert their hypotensive efficacy through a combined vasodilator and diuretic effect. The present study was conducted to assess the inhibitory effect of thiazide diuretic, hydrochlorothiazide, and the thiazide-like diuretics, indapamide and chlorthalidone on contractile responses to norepinephrine and arginine vasopressin in aortic rings from 2K1C renal hypertensive and sham-clipped normotensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and age-matched control rats received a sham treatment. Changes in the tension of aortic ring preparations were measured isometrically. RESULTS: Indapamide inhibits the contractile responses to norepinephrine and vasopressin in aortic rings from 2K1C rats, while it did not modify in control rats. The inhibitory effect of indapamide was abolished by endothelium removal. Hydrochlorothiazide or chlorthalidone did not affect the vasoconstriction induced by norepinephrine and vasopressin either in sham or in 2K1C hypertensive rats. CONCLUSION: These results suggest that indapamide inhibits the contractile responses to norepinephrine and vasopressin via an endothelium-dependent mechanism in 2K1C renal hypertension.
Animals ; Aorta ; Arginine Vasopressin ; Chlorthalidone ; Diuretics ; Endothelium ; Hydrochlorothiazide ; Hypertension ; Hypertension, Renal ; Indapamide ; Norepinephrine ; Placebos ; Rats ; Renal Artery ; Salicylamides ; Sodium Chloride Symporter Inhibitors ; Vasoconstriction ; Vasodilation ; Vasopressins

No abstract available.
Female ; Humans

PURPOSE: This study were designed to supply the opportunity to make a base of emergency syndromic surveillance warning system to detect the bioterrors through the construction of predictive models which were made by reported patients in 'Emergency Syndromic Surveillance System' who were diagnosed as waterborne contagious diseases. METHODS: On this study, we used the neural network analysis methods among the data mining to analyze the reliable variables which was extracted from the reported data bases in the Emergency Syndrome Surveillance System. RESULTS : In this study, we were using the patients data pools from 13th May 2002 to 13th May 2003 in Emergency Syndrome Surveillance System. So we could get the reliable variables - clinical symptoms, severity of patient, humidity and temperature - to predict the waterborne infections. This study shows the successful predictation rate of 96% in error rate of 0.4 with sensible variables through Chisquare analysis and the construction of one hidden layer which is near linearity. CONCLUSION: Early emergency syndromic surveillance warning models made by the neural network in Emergency Syndrome Surveillance System could make the early detection of waterborne infections, could also stop the transmission of waterborne infections in early stage, and furthermore could be used as the preventive and detective methods of bioterror attacks.
Bioterrorism ; Data Mining ; Emergencies* ; Humans ; Humidity

Recently, the prevalence of prostate cancer has been increased with the screening of prostate-specific antigen and the increase in the elderly population. In particular, the diagnosis of the low-risk prostate cancer has increased greatly, and social interest for overtreatment has been heightened in Korea. Therefore, this review aimed to provide evidence-based treatment guidelines in low-risk prostate cancer based on Korean population. The literature provides evidence on treatment options, such as watchful waiting, active surveillance, radical prostatectomy, and radiation therapy according to the life expectancy of patients with low-risk prostate cancer. Furthermore, this review provides information on the efficacy of pelvic lymph node dissection and adjuvant radiation therapy during/after radical prostatectomy in low-risk prostate cancer.
Aged ; Diagnosis ; Evidence-Based Medicine ; Humans ; Korea ; Life Expectancy ; Lymph Node Excision ; Mass Screening ; Medical Overuse ; Neoplasms, Second Primary ; Prevalence ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Watchful Waiting