The authors regret that two co-authors were missing in the article.

BACKGROUND: Both left ventricular hypertrophy (LVH) and microalbuminuria (MA) are well described markers or surrogate for cardiovascular outcome. Many factors are known to be related to the two markers which are encountered together in some patients. But the epidemiological backgrounds for the two markers are not clearly demonstrated so far. METHODS: Measurements of echocardiographic left ventricular mass index (LVMI) and MA were introduced to the population survey in Yangpyeong County, Korea in 2005 and 2006 for 1,767 among 2,028 subjects. The criteria for MA were 17-250 mg/g of albumin creatinine ratio (ACR) in male and 25-355 mg/g in female. 1,636 data were analyzed. RESULTS: Age was 60.9 +/- 10.4 years and the proportion of female was 59.4% (972). Body mass index (BMI) was 24.7 +/- 3.21 kg/m2 and blood pressure were 124.1 +/- 17.3 mm Hg/80.0 +/- 10.5 mm Hg. LVMI was 45.3 +/- 11.6 g/m2.7 and ACR was 23.9 +/- 150.9 mg/g. Prevalence of LVH and MA were 23.5% and 12.2%, respectively. In male/female, odds ratios for MA were 1.035 (range, 1.010-1.061)/1.01 (range, 0.988-1.032) for age, 0.962 (range, 0.882-1.049)/0.941 (range, 0.881-1.006) for BMI, 1.754 (range, 1.097-2.804)/2.158 (range, 1.413-3.298) for hypertension (HTN), 4.87 (range, 2.883-8.226)/2.154 (range, 1.311-3.539) for diabetes, 1.005 (range, 0.999-1.012)/1.007 (range, 1.002-1.012) for cholesterol, and 1.011 (range, 0.987-1.035)/1.011 (range, 0.994-1.029) for LVH. CONCLUSIONS: In a population level, even if diabetes was strongest factor for MA, HTN is also independent factor for MA in both genders.
Albuminuria ; Blood Pressure ; Body Mass Index ; Cholesterol ; Creatinine ; Female ; Humans ; Hypertension ; Hypertrophy ; Hypertrophy, Left Ventricular ; Korea ; Male ; Obesity ; Odds Ratio ; Prevalence ; Republic of Korea

It has been known that the size of arterial diameter during growth in primates is closely dependent on blood flow. Flow induced arterial size can be influenced by contractile or structual characters of vascular smooth muscle cells. Furthermore it had been confirmed through experimental study that vascular endothelium releases vasoactive substances which adjust smooth muscle tone, and could detect shear stress on the vascular wall by its direct contact with luminal flow. The authors tried to prove it through the angiographic measurement of the major vessel sizes in cerebrovascular diseases with changed blood flow. We measured the major vessel sizes of 36 cases of cerebrovascular diseases:arteriovenous malformation in 14 cases, cerebral infarction in 8, cerebral hemiatrophy in 6 moyamoya disease 5, occlusion of the internal carotid artery in 2, and carotid-cavernous fistula in 1, which may influence cerebral blood flow, on angiography under the same circumstances. Results are as the followings: 1) In the cases of arteriovenous malformation and carotid-cavernous fistula, all of the major vessel sizes of the lesion wite were increased and all became decreased postoperatively. 2) In the cases of major vessel occlusion and cerebral hemiatrophy, the major vessel size of the lesion site was smaller than that of the normal site. 3) In the cases of moyamoya disease, there was no definite size different between both ICA sizes. In conclusion, the change in cerebral blood flow is a determinant factor of the major vessel sizes in the cases of cerebrovascular disorders which an influence cerebral blood flow.
Angiography ; Arteriovenous Malformations ; Carotid Artery, Internal ; Cerebral Infarction ; Cerebrovascular Disorders ; Endothelium, Vascular ; Fistula ; Moyamoya Disease ; Muscle, Smooth ; Muscle, Smooth, Vascular ; Phenobarbital ; Primates

Pulmonary hypertension is an increase in blood pressure in the pulmonary artery, pulmonary vein or pulmonary capillaries. Depending on the cause, pulmonary hypertension can be a severe disease with markedly decreased exercise tolerance and right-sided heart failure. Pulmonary hypertension can present as one of five different types: arterial, venous, hypoxic, thromboembolic, or miscellaneous. Chronic obstructive pulmonary disease with severe pulmonary hypertension is a rare disease. A 52-year-old man presented with a complaint of aggravating dyspnea. The mean pulmonary arterial pressure was 61.5 mmHg by Doppler echocardiogram. The patient was prescribed diuretics, digoxin, bronchodilator, sildenafil, bosentan and an oxygen supply. However, he ultimately died of cor pulmonale. Thus, diagnosis and early combination therapy are important.
Arterial Pressure ; Blood Pressure ; Capillaries ; Digoxin ; Diuretics ; Dyspnea ; Exercise Tolerance ; Heart Failure ; Humans ; Hypertension ; Hypertension, Pulmonary ; Middle Aged ; Oxygen ; Piperazines ; Pulmonary Artery ; Pulmonary Disease, Chronic Obstructive ; Pulmonary Heart Disease ; Pulmonary Veins ; Purines ; Rare Diseases ; Sulfonamides ; Sulfones ; Sildenafil Citrate

BACKGROUND: Masked hypertension is well known for its poor cardiovascular outcome. But clinical clues related to the masked hypertension and/or masked effect (ME) are rarely known. Physical activity and/or job stress are related to increased daytime blood pressure (BP). This study is to identify whether ME is caused by physical activity and/or job category. METHODS: Physical activity using Actical and masked effect by clinic BP and ambulatory BP monitoring were applied to 167 person for this study. RESULTS: Age of the subjects was 54.9 +/- 9.6 and 74 subjects were female (57.4%). Field worker was 81 (48.5%) and office worker was 86 (51.5%). Clinic BP was 125.8 +/- 14.3 mmHg / 79.8 +/- 10.9 mmHg in male and 119.0 +/- 14.0 mmHg / 74.2 +/- 8.9 mmHg in female (p = 0.03). Daily energy expenditure representing physical activity was 1,831.1 +/- 420.4 kcal. ME for systolic BP was 11.0 +/- 11.1 mmHg and ME for diastolic BP was 3.9 +/- 8.0 mmHg. In multiple linear regression adjusted by smoking and antihypertensive medication showed that clinic systolic BP was the only significant factor related to the ME (beta = -0.44755, p < 0.0001 in male, beta = -0.396, p < 0.0001 in female). Physical activity or job category was not related to ME. CONCLUSIONS: Neither physical activity nor job category is related to ME. This indicates that diagnosis of the masked hypertension is not affected by physical activity or job status.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Energy Metabolism ; Female ; Health Personnel ; Humans ; Hypertension ; Linear Models ; Male ; Masked Hypertension ; Masks ; Motor Activity ; Smoke ; Smoking

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

BACKGROUND: Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Biopsy ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Solitary Pulmonary Nodule*

PURPOSE: The administration of 5-fluorouracil (5-FU) by protracted intravenous infusion is an alternative to the bolus administration of 5-FU in patients with advanced colorectal cancers. This study was performed to evaluate the response rate and toxicities of protracted infusion of 5-FU in patients with advanced or recurrent colorectal cancers who had been treated with 5-FU by bolus or shortterm continuous administration. MATERIALS AND METHODS: Between March 1995 and June 1997, twenty-eight patients with advanced colorectal cancer previously exposed to 5-FU based chemotherapy were enrolled in this triaL Patients received 5-FU (250 mg/m(2)/day days 1-28) or 5-FU plus leucovorin (5-FU; 200 mg/m/day days 1-28, leucovorin; 20 mg/m IV days 1, 8, 15, 21) by ambulatory infusion pump. Treatment course was repeated every 42 days until disease progression. RESULT: Twenty-eight patients entered. All 28 patients were assessable for response and toxicity. Five (19%) patients achieved a partial response, with the median response duration of 15 weeks (range; 7-22 weeks), and median survival time of entire patients was 54 weeks (range 7-151+ weeks). Gastrointestinal toxicity, specifically stomatitis was a major toxicity (grade 2, 12%; grade 3, 4%), but hand-foot syndrome was less frequent (5%) compared with other trials with protracted infusion of 5-FU reported in the literature. Hematologic toxicity was generally of low grade. CONCLUSION: Prolonged intravenous infusion of 5-FU can produce a response rate of 19% with low toxicity among patients refractory to bolus or short-term infusion of S-FU.
Colorectal Neoplasms* ; Disease Progression ; Drug Therapy* ; Fluorouracil* ; Hand-Foot Syndrome ; Humans ; Infusion Pumps ; Infusions, Intravenous ; Leucovorin ; Stomatitis

BACKGROUND: The best way of delivering drugs for the treatment of asthma and chronic obstructive pulmonary disease (COPD) is via the inhaled route of administration. However, many patients use inhaler devices incorrectly. To augment the proper use of inhalation medicine and to improve knowledge of the disease and compliance, we have developed a "Computerized Respiratory Service Program" and applied the use of this program to educate patients. METHODS: Prospectively, this study was performed in 164 patients with asthma or COPD prescribed with inhaled medication. When inhalation medication was first prescribed, education using a drug model was conducted two times and thereafter every month. In addition, education using a drug model was conducted and the ability of the patient to use inhalation medicine properly was evaluated. RESULTS: A total of 164 patients participated in the sessions more than two times and received education. Fifty-seven patients participated in three sesions. After the patients received education one time, the ability of these patients to use an inhaler had an average score of 20.6. After the patients received education two times, the average score was 21.9. After the patients received education three times, the average score was 22.3, a further increase. The compliance of using the inhaler was 70.1% at the second session and increased to 81.8% at the third session. CONCLUSION: Feedback education using the "Computerized Respiratory Service Program" will increase the ability of the patient to use an inhaler and consistent education can maintain patient compliance with inhaler use.
Asthma ; Compliance ; Education* ; Humans ; Inhalation* ; Nebulizers and Vaporizers ; Patient Compliance ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive

Leptin serves an important role in suppressing appetite in mice and is known to be elevated in chronic renal failure (CRF) patients. But clinical significance of leptin as an appetite-reducing uremic toxin, remains to be determined. So we studied the relationship between plasma leptin and nutritional status in 46 chronic hemodialysis (HD) patients. Pre HD leptin was measured and divided by body mass index (BMI) to give adjusted leptin levels. KT/Vurea (K, dialyzer urea clearance; T, duration of HD; V, volume of distribution of urea), C-reactive protein (CRP), plasma insulin and nutritional parameters such as serum albumin, normalized protein catabolic rate (nPCR), subjective global assessment (SGA), BMI and mid-arm muscle circumference (MAMC) were also measured. Mean plasma leptin levels were 8.13+/-2.91 ng/mL (male 3.15+/-0.70; female 14.07+/-6.14, p<0.05). Adjusted leptin levels were positively correlated with nPCR (male r=0.47, p<0.05; female r=0.46, p<0.05), SGA (male r=0.43, p<0.05; female r=0.51, p<0.05) and MAMC (male r=0.60, p<0.005; female r=0.61, p<0.05). They did not correlate with KT/Vurea, serum albumin, hematocrit, bicarbonate, insulin and CRP. Presence of DM and erythropoietin therapy had no effect on leptin levels. These results suggest that leptin is a marker of good nutritional status rather than a cause of protein energy malnutrition in chronic HD patients.
Adult ; Biological Markers/blood ; Cross-Sectional Studies ; Female ; Human ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/blood* ; Leptin/blood* ; Male ; Middle Age ; Nutrition Disorders/etiology ; Nutrition Disorders/diagnosis ; Nutritional Status* ; Obesity/metabolism ; Obesity/etiology ; Renal Dialysis*/adverse effects ; Sex Factors