Thrombomodulin (TM) is thrombin receptor present on the luminal surface of endothelial cells. Because the thrombin-TM complex acts as an anticoagulant, the functional variants or deficiency of TM may lead to increment of thrombotic tendency. In this study, we screened the genetic variants of the TM gene in patients with myocardial infarction (MI) and analyzed the genotype to elucidate the effects of genetic variations of TM gene on the development of the MI. We screened a promoter region and coding sequence of the TM gene using single strand conformation polymorphism-heteroduplex analysis and identified three common genetic variants: those were TM G-33A, TM Ala455Val, and TM C1922T. The genotype frequencies were investigated in the patients with MI (n=234) and control subjects (n=291) by the method of allele-specific oligomer hybridization. The frequencies of mutant genotypes (TM -33A, TM 455Val, and TM 1922T) were higher in patient group compared to the control subjects in males while there were no significant differences in females. In the multiple logistic regression analysis, TM 455Val and TM 1922T alleles were independent risk factors for MI (OR[95% CI: 1.799[1.125-2.878] p=0.014 and 5.624[1.019-31.025], p=0.048, respectively) in males. However, the genetic variations were not independent risk factors for MI in females. There were significant linkage disequilibriums among three genetic variants. These linkage disequilibriums explain the similar effects of three genetic variants on the development of MI. To investigate the effect of the TM G-33A mutation on TM promoter activity, the two TM promoter constructs (pTM-355 and pTM-125, bearing TM -33G or TM -33A) containing of firefly luciferase gene were transfected into HepG2, BAE, and CHO cells. The promoter activities were higher in the promoter constructs with TM -33G compared to the constructs with TM -33A in pTM-355. These results suggest the possibility of the positive predisposing effect of TM -33A allele on MI in males. The functional study for TM Ala455Val and TM C1922T should be followed to elucidate the genotype effects of these mutations on the development of MI. In this study, we identified three genetic variants of TM gene and showed the significant associations between genetic variants and MI in males. These results proposed that TM gene is an attractive candidate for genetic risk factor for MI in Koreans.
Alleles ; Animals ; CHO Cells ; Clinical Coding ; Cricetinae ; Endothelial Cells ; Female ; Fireflies ; Genetic Variation ; Genotype ; Humans ; Linkage Disequilibrium ; Logistic Models ; Luciferases ; Male ; Myocardial Infarction* ; Phenobarbital ; Promoter Regions, Genetic ; Receptors, Thrombin ; Risk Factors* ; Thrombomodulin

No abstract available.
Humans ; Uterine Cervical Neoplasms*

Lipoprotein(a)[Lp(a)] is a LDL-like particle with a glycoprotein called apo(a) attached to its apoB through disulfide bond. Many case-control studies support the opinion that plasma Lp(a) levels were associated with coronary artery disease. This study was conducted to assess the relationship between plasma Lp(a) level and coronary artery disease in Korean population. Serum levels of Lp(a), in addition to other lipids and known clinical risk factors for coronary artery disease were determined in 92 subjects undergoing coronary angiography. Among them 30 patients had no obstruction in the coronary artery(cath-control group), while the others revealed the presence of coronary artery stenosis more than 50%(CAD group). The Lp(a) levels of the CAD group were significantly higher the those of cath-control group(31.8+/-25.0mg/dl vs 14.6+/-11.9mg/dl, p<0.005). Other lipids except triglycerides(166.9+/-70.5mg/dl vs 116.2+/-56.1mg/dl, p<0.005) were not significantly different between two groups. The patients with significant coronary artery disease of two or more vessels were found to have higher Lp(a) levels than those of one vessel disease. Lp(a) levels had no relations with other lipids, diabetes, smoking, hypertension and age. Stepwise discriminant analysis revealed that Lp(a) was the best discriminator among risk factors for coronary artery disease. These results suggested that Lp(a) level was a significant independent risk factor for coronary artery disease.
Apolipoproteins B ; Case-Control Studies ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Glycoproteins ; Humans ; Hypertension ; Lipoprotein(a)* ; Plasma ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Fibrinogen* ; Plasma*

No abstract available.
Coronary Artery Disease* ; Coronary Vessels* ; Fibrinogen* ; Plasma*

The 70 adult patients with idiopathic membranous glomerulonephritis(IMGN), in whom renal biopsy has been performed at Keimyung University Dongsan Hospital, between January 1982 and December 1995 were studied for the clinical evolution of the disease and factors which might be involved in the development of chronic renal failure. There was 41 males and 29 females with a mean age of 41 years. Mean time from the onset to the renal biopsy was 13 months. The clinical presentations at the time of diagnosis were nephrotic syndrome(61.4%), asymptomatic urinary abnormality(21.4%), acute nephritic syndrome(14.3%), and recurrent gross hematuria(2.9%). During the mean follow-up period of 40+/-31 months, eleven(15.7%) of the patients developed chronic renal failure and five of them had end-stage renal disease. Five and ten years renal survival were 81.2% and 66.4%, respectively. In univariate analysis of clinical prognostic factors for progression to renal failure using Kaplan-Meier method, four parameters ; serum creatinine >or=1.4mg/ dL(p=0.011), hypoalbuminemia 2.5g/dL(p<0.01), heavyproteinuria >or=10.0g/day(p=0.036) and remission of proteinuria < 2.0g/24hr (p<0.01) were found to have predictive value. No effect was observed in the age, sex, steroid and/or immunosuppressive therapy, hypertension and serum total cholesterol concentration on prognosis. In univariate analysis of pathologic prognostic factors, interstitial fibrosis(p=0.036) and inflammation(p=0.011) were significant for predictive value.
Adult* ; Biopsy ; Cholesterol ; Creatinine ; Diagnosis ; Female ; Follow-Up Studies ; Glomerulonephritis, Membranous* ; Humans ; Hypertension ; Hypoalbuminemia ; Kidney Failure, Chronic ; Korea* ; Male ; Prognosis ; Proteinuria ; Renal Insufficiency

Primary gastrointestinal lymphoma is the most common type of extranodal non-Hodgkin's lymphoma. Most cases are defined histologically as mucosa-associated lymphoid tissue (MALT) lymphoma, while low-grade MALT lymphoma affecting the stomach and duodenum simultaneously is rare. In this case report, we describe the case of a 55-year-old female who presented to the gastroenterology clinic at our hospital for management of gastric adenoma and duodenal polyp by endoscopic mucosal resection and polypectomy. The pathology report noted MALT lymphoma with submucosal tubulovillous adenoma and hyperplastic polyps in the stomach and duodenum. She underwent eradication of Helicobacter pylori using proton pump inhibitor-based triple therapy.
Adenoma ; Duodenum ; Endoscopy* ; Female ; Gastroenterology ; Helicobacter pylori ; Humans ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Pathology ; Polyps ; Proton Pumps ; Stomach

Mucoceles of the paranasal sinuses are chronic expanding lesions containing inspissated mucus, which occurs when sinus ostium is obstructed. A variety of conservative and radical surgical procedures have been introduced, with each approach having advantages as well as disadvantages. Diseased frontal sinus mucosa and bone were commonly ablated by radical frontal sinus surgery such as osteoplastic flap surgery in the past. During the last decade, endoscopic sinus surgery has become the major choice for the treatment of paranasal sinus mucoceles, and the technique of endoscopic sinus marsupialization has been considered non-invasive and successful. But the technique has limitation in cases with small frontal recess or mucocele in the lateral portion of the frontal sinus which is not accessible via the nose, and hypertrophic mucosa obstructing the entire sinus. A 52-year-old man was presented with a supraorbital cell mucocele located in the lateral side of frontal sinus mucocele, which could not be treated by endoscopic surgery alone. Endoscopic surgery with sinus marsupialization, trephination and transillumination technique was introduced. We report this case with a review of related literatures.
Endoscopy ; Frontal Sinus ; Humans ; Middle Aged ; Mucocele* ; Mucous Membrane ; Mucus ; Nose ; Paranasal Sinuses ; Transillumination* ; Trephining*

BACKGROUND AND OBJECTIVES: We studied the correlation between radiologically identified bony osteitis and prognosis of the functional endoscopic sinus surgery in chronic rhinosinusitis patients. SUBJECTS AND METHOD: A retrospective review of medical records were carried out on 77 patients who had been diagnosed as chronic paranasal sinusitis and undergone endoscopic sinus surgery from 2002 through 2003 at our institution. Computed tomography scans were used for grading according to the Lund-Mackay radiologic grading system and diagnosis the pansinusitis coexistence. Medical records were used for grading according to the Lund-Mackay surgical grading system and for follow-up observation and age. Statistical analysis was done for correlation between radiologically identified indices and post-operative prognosis. RESULTS: The study revealed that radiologically identified bony osteitis need a longer post-operative medical management period and also found that if pansinusitis coexist with osteitis, poorer outcome would be accompanied. CONCLUSION: This study provides further evidence that radiologically identified bony osteitis and pansinusitis may act as poor prognostic factors.
Diagnosis ; Follow-Up Studies ; Humans ; Medical Records ; Osteitis* ; Prognosis* ; Retrospective Studies ; Sinusitis ; Tomography, X-Ray Computed

No abstract available.
Adult* ; Cytarabine* ; Cytosine* ; Humans ; Leukemia* ; Mitoxantrone*