BACKGROUND: Beta-adrenergic receptor Kinase 1(betaARK1) is a serine/threonine kinase attached, which inhibits the coupling of beta-adrenergic receptor with G-protein. Myocardial betaARK1 level is usually elevated in heart failure and hypertrophy, but it is not known whether the circulating betaARK1 level is related with the degree of cardiac hypertrophy. This study was performed to evaluate the association of the betaARK1 level in circulating mononuclear leukocytes(MNL) in untreated hypertension with left ventricular mass in hypertensive patients. Method: Nineteen non-treated hypertensive patients were included for this study. High blood pressure was confirmed when systolic BP is over 150 mmHg or diastoli BP is over 95 mmHg. Echocardiography was performed to evaluate the degree of hypertrophy by measuring the left ventricular mass index(LVMI) and relative wall thickness(RWT), and test the LV function by measuring the ejection fraction(EF) according to ASE guideline. At the same time, blood was collected from each patient and MNL were isolated by gradient centrifuge with Ficoll-400. Total RNA was purified from MNL and semi-quantitative RT-PCR was performed. After reverse transcription, PCR was done with primers for human betaARK1 and GAPDH as external control. betaARK1 levels were expressed by ratio to GAPDH level and estimated the relations with clinical and Echocardiographic parameters. Result: We studied confirmed 19 hypertensive patients(10 men and 9 women, mean age of 50.6 years). Echocardiographically measured indices(mean+/-SD) were as follows; LVMI(137.3+/-30.6g/m2), PWT(0.53+/-0.09) and EF(54.6+/-8.5%). Ratio of betaARK1 levels to GAPDH was from 0.10 to 0.96 (0.62+/-0.25). betaARK1 levels were correlated with LVMI(correlation coefficient: r=.502, p=.029) and RWT(r=.627, p=.004). But Systolic BP(r=0.009, p=.93), diastolic BP(r=.07, p=.85) or EF(r=.045, p=.84) were not related to level of betaARK1. CONCLUSIONS: The betaARK1 level of circulating MNL was correlated well with the degree of the cardiac hypertrophy estimated by LVMI and RWT. This data suggests that activation of sympatho-adrenal system would exert a major role in developing cardiac hypertrophy and we can expect the decreased responsiveness to catecholamine in the heart of hypertensive patients. betaARK1 in circulating MNL might be used as a predictor or marker for LV hypertrophy in hypertensive patients.
beta-Adrenergic Receptor Kinases ; Cardiomegaly ; Echocardiography ; Female ; GTP-Binding Proteins ; Heart ; Heart Failure ; Humans ; Hypertension ; Hypertrophy ; Leukocytes, Mononuclear* ; Male ; Phosphotransferases ; Polymerase Chain Reaction ; Reverse Transcription ; RNA

Few cases of ichthyosis bullosa of Siemens(IBS) have been reported since 1939, as a distinct entity from bullous congenital ichthyosiform erythroderma(BCIE). IBS can be differentiated from BCIE by the absence of congenital erythroderma and a different distribution of involved skin area. It's characteristic features include blistering, superficial erosion or moulting of the outer skin. Histological features are tonofilaments aggregation confined to the granular and upper spinous layer of the epidermis. However, in BCIE these findings are present in the whole suprabasal compartment. The original reports of Siemens and cases from other authors showed an autosomal dominant inheritance. Our patient developed IBS sporadically without a familial background.
Blister ; Dermatitis, Exfoliative ; Epidermis ; Humans ; Ichthyosis Bullosa of Siemens* ; Ichthyosis* ; Intermediate Filaments ; Molting ; Skin ; Wills

No abstract available.
Acanthoma*

Mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland is a very rare malignant tumor characterized by rapidly progressive clinical course and radioresistance. A 63-year-oid woman had mixed squamous cell carcinoma and papillary carcinoma in the thyroid gland diagnosed by fine needle aspiration cytology (FNA), and the diagnosis was confirmed by histological examination. She had complained of a fixed, egg-sized mass of the anterior neck with hoarseness for 1 year. The findings of FNA consisted of sheets and clusters of polygonal epithelial cells with hyperchromatic, pleomorphic nuclei and eosinophilic, abundant, laminated cytoplasm. These findings were consistent with squamous cell carcinoma. Also, foci of papillary carcinoma were noted, and the cells exhibited nuclear groovings and intranuclear cytoplasmic inclusions. Total thyroidectomy specimen showed a diffusely infiltrating tumor in the left thyroid which was composed of mixed papillary carcinoma and well-differentiated squamous cell carcinoma. In junction between two components, squamous metaplasia of papillary carcinoma was noted.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Child* ; Cytoplasm ; Diagnosis ; Eosinophils ; Epithelial Cells ; Female ; Giant Cell Tumors ; Giant Cells ; Glomerulosclerosis, Focal Segmental* ; Hoarseness ; Humans ; Inclusion Bodies ; Metaplasia ; Neck ; Ribs ; Thyroid Gland ; Thyroidectomy

Extramammary Paget's disease is able to affect genital, perianal, axillary, periauricular regions and eyelids. Extramammary Paget's disease has been almost always reported on the genital and perinanal area. Extramammary Paget's disease of the axilla has not been reported until now in Korean literature. We report a case of extramammary Paget's disease of the axilla in a 53-year-old female.
Axilla* ; Eyelids ; Female ; Humans ; Middle Aged ; Paget Disease, Extramammary*

BACKGROUND: Coronary arterigraphy has been used as a tool to assess the degree of coronary artery narrowing and the result of balloon angioplasty, which frequently underestimates the degree of atherosclerosis. Intravascular ultrasound(IVUS) can give more delicate information about plaque morphology and the result of coronary intervention. We compared qualitaive and quantitative measurement between IVUS and coronary angiography after coronary intervention. METHODS: We used 30 or 20 MHz intravascular ultrasound catheter which was connected to Hewlett Packard Sonos 1500 Intravasscular equiment in 5 coronary balloon angiopasty and 3 Palmaz-Schatz stent implantation cases. Sites of intervention were at the left anterior descending coronary artery in 7 patients and at the left circumflex artery in one patient. Quantitative coronary angiography(QCA) was done by CAAS II system. We measured referenc diameter(RD), minimal lumen diamter(MLD), Lumen and vessel cross sectional areas(LCSA,VCSA) obstraction area(OA) and plaque area(PA) and also analysed plaque morphology. RESULTS: 1) IVUS is more sensitive in the detection of eccentricity, Calcification and dissection. 2) Before intervention, the mean reference diameter was 2.87+/-0.42mm,3.07+/-0.39mm,% diameter stenosis was 52.4+/-11.6%,65.3+/-9.22% and MLD was 1.32+/-0.24mm, 1.07+/-0.23mm in IVUS and QCA, respectively, which were no statistical significance between these parameters(p>0.05). After intervention, MLD and OA increased significantly(p<0.01) com pared with basal values but there were no significant difference between MLD and OA between 2 measurements(p>0.05). Plaque area measured by IVUS decreased from 9.84 to 7.26mm2 without statistical significance(p>0.05). 3) There was a good correlation in the measurement of the reference segments before intervention but this correlation was much lower after intervention in the reference and stenosis segments between 2 methods(r=0.8723 vs 0.6538, p<0.01). CONCLUSION: IVUS is considered as a sensitive tool in the detection of calcification, eccentricity and dissection and in evaluationg the results of the coronary intervention.
Angioplasty, Balloon ; Arteries ; Atherosclerosis ; Catheters ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Humans ; Stents ; Ultrasonography*

STATEMENT OF PROBLEM: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. PURPOSE: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. MATERIAL AND METHODS: Twenty-four patients were included and randomly assigned to treatment with Branemark system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. RESULTS: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of 0.83+/-0.31mm; Group 2 had a mean crestal bone level changes of 0.44+/-0.36mm. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. CONCLUSION: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.
Bone Resorption ; Dental Implants ; Follow-Up Studies ; Humans ; Neck ; Phenothiazines ; Statistics as Topic

OBJECTIVE: Reflex sympathetic dystrophy (RSD) is a syndrome of post-traumatic neuropathic pain in association with dystrophic changes and signs of sympathetic overactivity. Pain following spinal cord injury occurs frequently, but RSD is not usually considered as one of the common sources of pain. There have only been a few reports of RSD in spinal cord injured patients, although this condition is well-known in the painful upper extremity of hemiplegia due to stroke. The purpose of this study was to investigate the rate of occurrence, characteristic clinical features and more objective evaluation tools for the diagnosis of RSD in cervical cord injured patients. METHOD: Thirty-two cervical cord injured patients were evaluated for hand pain, swelling, vasomotor changes and dystrophic skin or nail changes. The patients were evaluated with studies such as three phase bone scintigrathy, digital infrared thermographic imaging (DITI) and plain roentgenograms of the hands. RESULTS: Eighteen patients (56.3%) were diagnosed as RSD based on the clinical symptoms and findings of three phase bone scintigraphy. Characteristic symptoms were hand pain, edema and dystrophic skin or nail changes, in the order of frequency. In patients with spasticity of the upper extremity, the incidence of RSD was higher than in patients without spasticity. CONCLUSION: We should consider RSD as a cause of upper extremity pain in cervical cord injured patients. This will lead to early diagnosis and treatment of the condition and it will be helpful in preventing various complications.
Diagnosis ; Early Diagnosis ; Edema ; Hand ; Hemiplegia ; Humans ; Incidence ; Muscle Spasticity ; Neuralgia ; Radionuclide Imaging ; Reflex Sympathetic Dystrophy* ; Reflex* ; Skin ; Spinal Cord ; Spinal Cord Injuries ; Stroke ; Upper Extremity

BACKGROUND: Atopic dermatitis, characterized by dry, flasky, easily irritated skin, is the most common form of dermatitis seen during childhood. Infants with atopic dermatitis and other eczematous conditions need special dermatologic care to hydrate their skin and to minimize contact with irritants or allergens. OBJECTIVE: The purpose of our study is to evaluate the safety and efficacy of the skin products developed for children. METHODS: Twenty-eight normal children and 26 children with atopic dermatitis were evaluated clinically after using following commercal skin products : (lotion, cream, shampoo, soap, face wash wash) for 2 weeks. Water content of the skin of 14 volunteers was measured serialy over 8 haurs at 2 hour intervals after the application of each skin product. The skin pH of 16 volunteers was also measured serialy over 60 minutes at 30 minute intervals after application. We performed visual skin erythema grading, skin erythema grading by dermaspectrometer, transepidermal water loss measurement, skin water content measurement, and keratinocyte morphology observation by D-squame after the application of the skin products to 13 volunteers for 4 days.
Allergens ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Child ; Dermatitis ; Dermatitis, Atopic ; Erythema ; Humans ; Hydrogen-Ion Concentration ; Infant ; Irritants ; Keratinocytes ; Keratosis, Seborrheic ; Skin* ; Soaps ; Volunteers

BACKGROUND: Echocardiographically detected left ventricular(LV) hypertrophy is a risk factor for cardiovascular morbidity and mortality. A better understanding of the determinants of LV mass may aid in strategies directed toward the promary and secondary prevention of LV hypertrophy and its consequences. Previous studies have reported that male gender, arterial blood pressure(BP), obesity, age, aortic valvular stenosis, dietary sodium, endocrine factors, and physical activity are positively correlated with LV mass. Of these determinants male gender, hypertension, and obesity are well known but age and blood pressure in healthy adults are controversial. To assess the determinants of LV mass, the relation of 2-dimensional(2D) echocardiographically determined LV mass to body mass inedx(BMI), age, sex, casual BP, and 24 hour ambulatory blood pressure(ABP : systolic, diastolic, and mean BP of 24 hour, day-time, and night-time) was examined in healthy adults. METHODS: The study population consisted of 200 healthy adults who were normotensive, nonobese, and had no evidence of cardiovascular disease(range in age from 20 to 69 years, five decades, 20 men and 20 women per each decade). LV mass was derived from area length method measurements obtained by 2D echocardiography and corrected for height. ABP monitoring was performend over 24 hour(divided into day-time(6am-10pm) and night-time(10pm-6am)periods) with 30 minute inervals. RESULTS: 1) BMI was significantly and independently related to LV mass corrected for height (p<0.001, partial R2=0.31 in men and 0.43 in women). An increase of BMI by 1 kg/m2increased LV mass corrected for height by 1.9g/m in men and 2.0g/m in women. 2) Age was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.15 in men and 0.17 in women). The increments of Lv mass corrected for height per decade were 2.1 g/m in men and 3.4 g/m in women. 3) Gender was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.12), which was greater in men than in women by 6.34g/m. 4) Casual Bp and 24 hour ABP were not significantly associated with LV mass corrected for height in total population and women, and 24 hour systolic BP was significantly related to LV mass corrected for height only in men(p<0.001) with weak partial R2(0.05). CONCLUSION: BMI, age, and male gender were statistically significant and independent correlates of LV mass corrected for height(p<0.001). Maintenance of ideal body weight and normal BP, weight reduction in obese persons and BP control inhypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequalae.
Adult* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Constriction, Pathologic ; Echocardiography* ; Female ; Humans ; Hypertension ; Hypertrophy ; Ideal Body Weight ; Male ; Mortality ; Motor Activity ; Obesity ; Risk Factors ; Secondary Prevention ; Sodium, Dietary ; Weight Loss