No abstract available.
Foreign Bodies* ; Pulmonary Artery*

Intraocular (IO) retinoblastoma (RB) has traditionally been treated with enucleation (ENU) or external beam radiotherapy (EBRT). Recently, clinical trials are in progress to cure RB without ENU or EBRT in order to salvage the globe and to avoid unacceptable side effects of EBRT. We performed a pilot study to treat patients with advanced Reese-Ellsworth (RE) stage IO RB with initial chemotherapy (CRx) followed by local therapy (LT) and adjuvant CRx. Ten eyes (8 RE group V, 2 RE group IV) from 9 patients were enrolled from March 2001 to November 2001. All tumors responded to CRx. In 5 of 10 eyes, the RB was enough to be treated with LT after chemoreduction. One patient who underwent LT is waiting for ENU due to post-cryotherapy complication. For a median follow-up of 13 months (8-16 mo), 4 eyes that received LT and adjuvant CRx were relapse-free. A patient with bilateral RB who failed to be a candidate for LT was rescued with high-dose CRx and hematopoietic stem cell transplantation. Consequently, by treating patients according to our strategy, we were able to salvage 6 out of 10 eyes without ENU or EBRT. These results suggest that chemoreduction followed by LT and adjuvant CRx might offer the opportunity to salvage the globe and vision even in patients with advanced stage IO RB.
Antineoplastic Combined Chemotherapy Protocols/administration & dosage/therapeutic use ; *Chemotherapy, Adjuvant ; Child, Preschool ; Cyclophosphamide/therapeutic use ; Epirubicin/therapeutic use ; Female ; Humans ; Infant ; Male ; Pilot Projects ; Retinal Neoplasms/*drug therapy ; Retinoblastoma/*drug therapy ; Time Factors ; Vincristine/therapeutic use

The present study was undertaken to investigate the influence of hypothermia on endothelium-independent vascular smooth muscle contractility and to determine the mechanism underlying the relaxation. Denuded aortic rings from male rats were used and isometric contractions were recorded and combined with molecular experiments. Hypothermia significantly inhibited fluoride-, thromboxane A2-, phenylephrine-, and phorbol ester-induced vascular contractions regardless of endothelial nitric oxide synthesis, suggesting that another pathway had a direct effect on vascular smooth muscle. Hypothermia significantly inhibited the fluoride-induced increase in pMYPT1 level and phorbol ester-induced increase in pERK1/2 level, suggesting inhibition of Rho-kinase and MEK activity and subsequent phosphorylation of MYPT1 and ERK1/2. These results suggest that the relaxing effect of moderate hypothermia on agonist-induced vascular contraction regardless of endothelial function involves inhibition of Rho-kinase and MEK activities.
Animals ; Fluorides ; Humans ; Hypothermia* ; Isometric Contraction ; Male ; Muscle, Smooth, Vascular ; Nitric Oxide ; Phosphorylation ; Rats ; Relaxation ; rho-Associated Kinases*

No abstract available.
Echocardiography ; Heart Atria

No abstract available.
Angiography ; Coronary Angiography ; Iatrogenic Disease ; Radial Artery

No abstract available.
Percutaneous Coronary Intervention

PURPOSE: The triad of chest pain, normal coronary arteries and a positive stress test has been called microvascular angina. The link between coronary flow reserve(CFR) and Duke treadmill score(DTS) in patients with microvascular angina remains elusive. METHODS: We studied 108 subjects (M:F=8:60, mean age 54+/-9 yrs) with chest pain and normal coronary angiogram. Exercise treadmill test(ETT) was performed by Bruces protocol and the equation for calculating DTS was DTS=xercise time- (5xST deviation)-(4x exercise angina), with 0=one, 1=onlimiting, 2=exercise-limiting. The coronary flow velocity at diastole(PDV) using Transesophageal echocardiography (TEE) was obtained from the proximal left anterior descending coronary artery and coronary flow reserve(CFR) was calculated as the ratio of hyperemic PDV after the intravenous infusion of dipyridamole(0.56 mg/kg) to baseline PDV. RESULTS: 1) CFR was 3.04+/-0.45 in group with negative ETT and 2.19+/-0.62 in group with positive ETT(p<0.001). 2) CFR was 1.51+/-0.31 in high-risk group with a score of <-10, 2.39+/-0.63 in moderate-risk group with scores from -10 to + and 3.04+/-0.43 in low-risk group with a score of > or =+ on DTS(p< 0.001 versus low-risk, respectively). 3) DTS was significantly related to CFR (r=.704, p<0.001). CONCLUSION: The composite DTS is closely related to CFR using TEE and might be a useful tool that can help clinicians determine the severity of ischemia and evaluate the efficacy of treatment in patients with microvascular angina.
Chest Pain ; Coronary Vessels ; Echocardiography, Transesophageal* ; Exercise Test ; Humans ; Infusions, Intravenous ; Ischemia ; Microvascular Angina*

BACKGROUND: Increased homocysteine levels are an independent risk factor for coronary artery disease (CAD). A common genetic mutation (nucleotide 677 C-to-T) in methylenetetrahydrofolate reductase (MTHFR), an enzyme required for efficient homocysteine metabolism, creates a thermolabile enzyme with reduced activity. Homozygotes of MTHFR mutation represent 5% to 12% of general population in Canada, America, and Japan. In this study, we examined the distribution of the MTHFR genotypes in CAD patients and healthy volunteers and the association between the genotypes and the total homocysteine level (tHcy). METHODS: We screened 60 Korean patients with CAD (CAD group) and 97 healthy volunteers (control group) for the MTHFR 677 C-to-T mutation. Fasting and post-methionine-load tHcy level, folic acid, and vitamine B12 level were determined with other clinical variables in CAD group. RESULTS: The frequency of the MTHFR V/V homozygous genotype was 20% in CAD group (with 40% heterozygous and 40% wild type) and 14% in control group (with 48% heterozygous and 38% wild type). In CAD group, homozygotes of MTHFR mutation had significant higher fasting tHcy level than wild type (homozygote, 18.83+/-6.37 micromol/L: wild type, 12.36+/-3.21 micromol/L: p<0.01). The tHcy level correlated with the age (r=0.425, p<0.01), the folate level (r=-0.534, p<0.01), and the presence of the mutant MTHFR gene (r=0.565, p<0.01) after adjustment of other clinical variables. CONCLUSION: We find that homozygotes of MTHFR mutation have higher homocysteine level independent of folic acid in patients with CAD. Large case-control study needed to confirm whether MTHFR mutation increases the risk of CAD independent of plasma tHcy level.
Americas ; Canada ; Case-Control Studies ; Coronary Artery Disease* ; Coronary Vessels* ; Fasting ; Folic Acid ; Genotype* ; Healthy Volunteers ; Homocysteine* ; Homozygote ; Humans ; Japan ; Metabolism ; Methylenetetrahydrofolate Reductase (NADPH2)* ; Plasma ; Risk Factors ; Vitamins

BACKGROUND AND OBJECTIVES: Ventricular remodeling after acute myocardial infarction can have a strong influence on the function of the ventricle and the prognosis of the patients. The aim of this study was to investigate the effect of carvedilol on the ventricular remodeling with respect to infarct size after myocardial infarction in rats. MATERIALS AND METHODS: Rats were randomly assigned to a carvedilol-treated (n=24), or untreated group (n=31) after left coronary artery ligation. Passive pressure-volume relationships of the left ventricle were determined to evaluate ventricular volume and the slopes of this relationship were analyzed to characterize ventricular chamber stiffness at about 6 weeks. RESULTS: In the case of infarct size in the range 10-34%, ventricular volume indeces indices of the carvedilol-treated rats (n=5) tended to be decreased to a greater extent than those of the untreated rats (n=5) as shown in the pressure-volume curve. In the case of infarct size in the range 35-49%, there was no significant difference in ventricular volume indices between the carvedilol-treated (n=6) and the untreated (n=6) rats. In the case of infarct size greater than 50%, the pressure-volume curve stiffness constant k0 (2.5-30 mmHg) of the carvedilol-treated rats (n=3, 2.13+/-0.35) was significantly greater than that of the untreated rats (n=5, 1.55+/-0.16) and the ventricular volumes of left ventricular filling pressure 10-30 mmHg were lower in the carvedilol-treated rats than in the untreated rats. CONCLUSION: A leftward shift of the pressure-volume curves was noted in experimentally induced myocardial infarction-induced rats, that treated by carvedilol.
Animals ; Coronary Vessels ; Echocardiography ; Heart Ventricles ; Humans ; Ligation ; Myocardial Infarction* ; Prognosis ; Rats* ; Ventricular Remodeling*

There were few studies about anatomic characteristics in Korean humerus recently. In addition, there was no comparison between Westerner (European and American) and Korean in anatomic characteristics of humerus. The aims of this paper are therefore to investigate anatomic characteristics in Korean humerus and to compare them with those of Westerner humerus. The seventy-two humerus (male : 66, female : 6) were scanned by computed tomography and three dimensional (3D) models of humerus were then reconstructed from acquired cross-section images. The twenty-one anatomic characteristics of the humerus were analyzed and were measured for each humerus. From the results, humeral head vertical diameter in the present study was generally bigger than that in the previous study (p<0.05). There was no significant difference between the anatomic characteristics of the right and left humerus in the present Korean (p>0.05). Humeral head inclination angle, greater tuberosity lateral offset distance, humeral head height in Korean were generally bigger than those in Westerner (p<0.05). This study may contribute to develop an optimal implants and prostheses for the treatment of humerus fractures of Koran.
Female ; Humans ; Humeral Head ; Humerus ; Prostheses and Implants