No abstract available.
Wernicke Encephalopathy*

T cell receptor (TCR) signaling plays a critical role in T cell development, survival and differentiation. In the thymus, quantitative and/or qualitative differences in TCR signaling determine the fate of developing thymocytes and lead to positive and negative selection. Recently, it has been suggested that self-reactive T cells, escape from negative selection, should be suppressed in the periphery by regulatory T cells (Tregs) expressing Foxp3 transcription factor. Foxp3 is a master factor that is critical for not only development and survival but also suppressive activity of Treg. However, signals that determine Treg fate are not completely understood. The availability of mutant mice which harbor mutations in TCR signaling mediators will certainly allow to delineate signaling events that control intrathymic (natural) Treg (nTreg) development. Thus, we summarize the recent progress on the role of TCR signaling cascade components in nTreg development from the studies with murine model.
Animals ; Mice ; Receptors, Antigen, T-Cell ; T-Lymphocytes ; T-Lymphocytes, Regulatory ; Thymocytes ; Thymus Gland ; Transcription Factors ; United Nations

BACKGROUND: Several predictor of successful outcome after percutaneous mitral valvuloplasty(PMV) have been identified but the results were controversial. We analyzes the clinical and echocardiographic predictors of successful outcome after PMV. METHOD: We studied 214 patients(167 women and 47 men) undergoing PMV from October 1991 to December 1995. Echocardiographic evaluation was performed before and after PMV. RESULT: The study population had mean age of 41+/-11years, and the total echocardiographic score was 7.5+/-1.5. PMV using Inoue balloon and double balloon technique were performed in 113cases and 101 cases respectively. The successful outcome from PMV(defindedas mitral valve area > or =1.5cm2 and increase in valve area >+25% and less than grade 3 mitral regurgitation(MR)) was achieved in 178 cases(83.2%). The mean mitral valve area was increased from 0.90+/-0.21cm2 to 1.82+/-0.34cm2(p<0.01). The successful outcome group had good echocardiographic score(7.3+/-1.4 vs. 8.8+/-1.4, p<0.01) and larger valve area before procedure(0.92+/-0.21cm2 vs. o.75+/-0.17cm2, p<0.01) than suboptimal result group. The patients with total echocardiographic score <=8 had more increment in valve area after PMV(0.97+/-0.21cm2) than those with total echocardiographic score >8(0.83+/-0.22cm2, p<0.01). Significant MR(>=grade 3 MR) after PMV was developed in 10 cases(4.7%). In patients with significant MR afterPMV, echocardiographic calcification score were high(2.3+/-0.8 vs. 1.7+/-0.7, p<0.01) and mitral valve area before PMV were smaller(0.82+/-0.10cm2 vs. 0.90+/-0.22cm2, p<0.05) than in those without significant MR. CONCLUSIONS: The predictors of successful outcome after PMV are large mitral valve area and good echocardiographic score. The predictors of significant MR is severe calcified mitral valveand small mitral valve area before PMV.
Echocardiography ; Female ; Humans ; Mitral Valve

BACKGROUND: Restenosis remains as the major limitation of percutaneous translumainal coronary balloon angioplasty (PTCA). Although its mechanism remains incompletely understood, proliferative action of arterial smooth muscle cells has been found to play an important role on restenosis by neointimal formation after PTCA. Glycosaminoglycan-containing compounds, including Sulodexide (Vessel Due , ALFA, Wasserman, S.p.A, Italy), inhibit the proliferation and maigration of vascular smooth muscle cells in vitro. OBJECTIVES: This study was performed to assess the efficacy of Sulodexide, a glycosaminoglycan compound with antithrombotic and antiproliferative properties, in preventing restenosis after PTCA. METHOD: Two hundred eighty-four patients with ischemic heart disease were randomized to receive either the standard PTCA without Sulodexide in 144 patients (control group, M : F = 99 : 45, Age = 58 +9 or -9), 160 lesions or the standard PTCA with Sulodexide in 140 patients (treated group, M : F = 89 : 51, age = 58 +10 or -10), 158 lesions. Successful angioplasties were performed in 258 atheromatous coronary lesions in 224 patients for whom follow-up angiographic data were obtained 6 month later. Quantitative coronary angiographic analysis (QCA) was performed before , immediate after PTCA and 6-month later. Angiographic restenosis (>50% diameter stenosis at follow-up) was the primary end point : miniamal luminal diameter at follow-up angiogram was the secondary end point. RESULT: Successful PTCA was 97.6% and 97.5% in the standard PTCA with Sulodexide and the standard PTCA without Sulodexide, respectively. Although reference vessel size and minimal luminal diamater after PTCA were larger in the control group than in the Sulodexide group(2.94+0.11 or-0.11 vs 2.83+0.13 or -0.13 mm and 2.26+0.12 or -0.12 vs 2.18+0.08 or -0.08 mm, respectively, p=NS), there was a increased tendency of minimal lumen diameter at 6 months angiogram in the Sulidexide group than in the control group (1.12+0.50 or -0.50 vs 1.07 + 0.53 or -0.53 mm, respectively, p=NS). Angiographic restenosis occured in 42% of lesions in the Sulodexide group and 52% of the control group (p=NS). CONCLUSIONS: Sulodexide treatment had a tendency to reduce restenosis rate in 6 months after coronary angioplasty. However, further study is necessary to verify the antiproliferative effect of Sulodexide with much larger number of patients.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Muscle, Smooth, Vascular ; Myocardial Ischemia ; Myocytes, Smooth Muscle ; Phenobarbital ; Prospective Studies*

BACKGROUND: Detection of left ventricular regional wall motion abnormality(RWMA) by 2 dimensional echocardiography during ergonovine provocation(Erg Echo) can be used for noninvasive diagnosis of coronary vasospasm(CVS). The aim of this study was to test the safety and diagnostic validity of Erg Echo as a screening test in patients with chest pain syndromes before coronary angiography was undertaken. METHODS: From Mar 1993 to Jun 1994, Erg Echo was performed in 80 consecutive patients (56 males) with chest pain syndromes suggestive of variant angina, after the confirmation of negative treadmill or normal stress myocardial perfusion scan using thallium 201. A bolus of ergonovine maleate was injectedd at 5min intervals up to total cumulative dosage of 0.35mg with echocardiographic montioring of the left ventricular wall motion. Twelve leads ECG was also recorded every 3min after each ergonovine injection. The positive criteria of the test was transient ST segment clevation or depression greater than 0.1mV in 12-leads ECG or development of RWMA. Coronary angiography was undertaken 2(+/-4) days after Erg Echo, and spasm provocation test with acetylcholine, or ergonovine was done in case of normal angiogram or luminal narrowing of less than 70%. The appearance of total or subtotal occlusion of a major coroary artery associated with ST segment elevation or depression on the ECG or chest pain, or both, was considered to be a manifestation of spasm. RESULTS: According to the invasive angiographic criteria, 56 patients revealed CVS ; CVS was ruled oup in 19 patients showing near normal angiogram with negative spasm provocation test and in 5 patients with restion high degree fixed stenosis(luminal narrowing of 97+/-4%). Erg Echo could diagnose CVS before the angiography with the sensitivity of 91%(51/56,95% confidence interval [CI] ; 84-98%) and the specificity of 88%(21/24,95% CI ; 75-100%). Of 53 patients showing RWMA in Erg Echo, 42%(22/53) revealed no significant changes in the simultaneously recorded ECG and characteristic ST elevation was recorded in only 38%(20/53). There was no case of myocardial infarction or fatal arrhythmia during Erg Echo. CONCLUSION: Erg Echo befor the coronary angiography is safe and can e utilized as a reliable diagnostic screening test of CVS in patients with negative tradmill or normal stess myocardial perfusion scan, This finding suggests that invasive coronary angiography can be avioded in selected patients for the diagnosis of vasospastic angina.
Acetylcholine ; Angiography ; Arrhythmias, Cardiac ; Arteries ; Chest Pain ; Coronary Angiography* ; Coronary Vasospasm* ; Depression ; Diagnosis* ; Echocardiography* ; Electrocardiography ; Ergonovine* ; Humans ; Mass Screening ; Myocardial Infarction ; Perfusion ; Phenobarbital ; Sensitivity and Specificity ; Spasm ; Thallium

OBJECTIVE: This study consists of a single open clinical trial to evaluate the treatment effects of paroxetine on symptoms of hwa-byung, a Korean culture-related anger syndrome. METHODS: Eighty-nine patients with depressive disorders, anxiety disorders, somatoform disorders, or self-labeled hwa-byung were treated with paroxetine (Paxil CR) 12.5-37.5 mg/day for 8 weeks. Treatment effects were evaluated using the Hamilton Depression Scale (HAMD), the State and Trait Anger Inventory (STAXI), and the Hwa-byung Scale. RESULTS: Scores on all items ; total score on the Hwa-byung Scale ; scores on state anger, trait anger, and anger-in ; total score on the STAXI ; and total score on the HAM-D decreased significantly after eight weeks of paroxetine treatment compared to baseline. CONCLUSION: Paroxetine was shown to be effective for treating symptoms of hwa-byung, a chronic anger syndrome.
Anger ; Anxiety Disorders ; Depression ; Depressive Disorder ; Humans ; Paroxetine ; Somatoform Disorders

Antimicrobial peptides (AMPs) are an important component of innate defense mechanisms with broad-spectrum activities against various pathogenic microorganisms, including Gram-positive and Gram-negative bacteria, fungi, and viruses. Antibiotic resistance has become a pervasive and global health burden, resulting in the immediate need to develop a new class of antibiotic substances. We screened a 16-mer random peptide library using the yeast two-hybrid system with Beclin 1 as bait and found that two 16-mer peptides (named P4 and P30) appeared to interact with Beclin1 in the beta-gal assay. The two candidate cDNAs were introduced into the yeast secretory system of Pichia pastoris and their expression induced in the presence of methanol. Spectrophotometric analysis and Disc clear zone assay using the supernatant of the yeast growth media showed that both of the two peptides had strong activities against Staphylococcus aureus, MRSA (methicillin resistance Staphylococcus aureus), MRSA2242, and MRSA-2250, but no effect on commensal Lactobacillus strains. PCR analysis of the genomic DNA of transformed Pichia pastoris using AOX1 primers revealed that the two cDNAs were integrated into the genome at the AOX1 locus. Our result suggests that these peptides could be developed as a useful alternative to classic chemical antibiotics.
Anti-Bacterial Agents ; Defense Mechanisms ; DNA ; DNA, Complementary ; Drug Resistance, Microbial ; Fungi ; Genome ; Gram-Negative Bacteria ; Lactobacillus ; Lactobacillus casei ; Methanol ; Methicillin-Resistant Staphylococcus aureus ; Peptide Library* ; Peptides* ; Pichia* ; Polymerase Chain Reaction ; Staphylococcus ; Staphylococcus aureus ; Two-Hybrid System Techniques ; Yeasts*

BACKGROUND: In patients with variant angina, previous data have been inconclusive as to whether basal coronary artery tone is elevated at the spastic sites and nonspastic sites. The purpose of this study was to assess the basal coronary artery tone and to evaluate the responsiveness to acetylcholine and ergonovine in patients with variant angina. METHODS: Basal coronary artery tone was assessed by obtaining the percent increase in coronary artery diameter induced by nitroglycerin in 66 patients with variant angina and 26 control subjects. We also compared the basal coronary tone and the constrictive responses to acetylcholine and ergonovine between the 31 patients with variant angina whom spasm was provoked by the low doses of acetylcholine(Ach; intracoronary, 20microg) or ergonovine(Erg; intravenous, 50microg)(Group 1) and the 35 patients provoked by higher doses of acetylcholine(intracoronary, 100microg) or ergonovine(intravenous cumulative dose of 350microg)(Group 2). RESULTS: Patients with variant angina whom spasm was provoked by low doses of acetylcoline and ergonovine, have a more tendency of combine fixed disease(mix disease), multivessel spasm and high disease activity. Basal coronary artery tone at the spastic sites was significantly elevated in the Group 1 in whom spasm was provoked by low doses of acetycholine and ergonovine than that in Group 2(44+/-17 vs 13+/-11%, respectively, p<0.05). Basal coronary artery tone of spasm-related artery, but not nonspasm related artery, at the non spastic site was greater in the Group 1 than that in Group 2 (26+/-14 vs 16+/-10%, respectively, p<0.05). In the patients with variant angina in whom spasm was provoked by higher dose of acetylcholine or ergonovine, basal coronary artery was comparable at the spastic and nonspastic sites and was not different from that in the control subjects. The magnitude of vasoconstrictive responses to acetylcoline and ergonovine, at the nonspastic sites, were also greater in Group 1 than those in Group 2 and the control groups(Ach; 40+/-20 vs 26+/-11. 27+/-12% : Erg ; 37+/-18 vs 12+/-8, 13+/-10%, respectively, p<0.05). CONCLUSION: These findings suggest that elevated basal coronary artery tone of the spastic sites and nonspastic sites of spasm-related artery in patients with variant angina may be related to occurrence of coronary spasm.
Acetylcholine* ; Arteries ; Coronary Vessels* ; Ergonovine* ; Humans ; Muscle Spasticity ; Nitroglycerin ; Spasm*

BACKGROUND: The purpose of this study was to assess the clinical outcome and echocardiographic incidence of restenosis after successful percutaneous transmitral commissurotomy (PTMC) and to identify predictors of restenosis. METHODS: Between 1989 and 1992, Inoue PTM (n=73) and double balloon technique (n=85) were used in 158 consecutive patients (male 52, age; 41+/-11 year) with mitral stenosis. Clinical and echocardiographic examinations were performed annually in 137 patients who exhibited good initial result with PTMC (mitral valve area 1.5cm (2) and mitral regurgitation[MR] 2+). Restenosis was defined as a mitral valve area< (MVA) 1.5cm (2) or more than 50% loss of the initial gain in MVA. Commissural mitral regurgitation (CMR) was defined as MR originating from medical or lateral commissure on color flow imaging and regarded as an index of complete commissural splitting. RESULTS: Immediately after PTMC, MVA increased from 0.9+/-0.2cm (2) to 1.8+/-0.3cm (2) and functional class improved up to NYHA class 1 or 2 in all patients. Annual echocardiographic follow-ups were completed in 129 (94%) patients and mean follow-up duration was 54+/-21 months. Adverse events occurred in 16 (13%) patients (1 death, 3 mitral valve replacement, 3 re-PTMCs, 9 deterioration of the NYHA class), and restenosis occurred in 41 (32%) patients. Event-free and restenosis-free survival rates at 7 years were 776 % and 586 %, respectively. According to multivariate Cox analysis, restenosis (p=0.0017, relative risk[r.r]=2.82) was the only predictor of adverse events ; smaller increase ( 1.0cm (2)) of MVA (p=0.0001, r.r=4.8) and the absence of CMR (p=0.0000, r.r=4.8) were independent predictors of restenosis. CONCLUSION: Long-term clinical outcomes and restenosis rates after PTMC are favorable and immediate results after PTMC can predict late restenosis better than baseline clinical and echocardiographic characteristics.
Echocardiography* ; Follow-Up Studies ; Humans ; Incidence ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Survival Rate

Diabetes, which has shown an explosive increase in terms of its incidence, is regarded as a serious disease that must be overcome for the sake of human life. Among animal models used for testing of drug efficacy, the mini-pig model has shown a rapid upload due to its many similarities with human, particularly concerning the pharmacokinetics of compounds after subcutaneous administration, the structure and function of the gastrointestinal tract, the morphology of the pancreas, and overall metabolic status. Based on these various advantages, we sought to develop an animal model of type II diabetic mellitus using the Micro-pig, which differs from other miniature pigs. We used six male Micro-pigs for induction of a moderate insulin deficient model with nicotinamide (NIA)/streptozotocin (STZ) treatment and three animals for control. For evaluation of incidence of type II diabetes, we measured blood glucose level, and performed oral glucose tolerance test and immunohistochemistry on pancreatic tissue using insulin antibody. Compared to control animals, all animals treated with NIA/STZ showed high levels of glucose and low levels of insulin. In addition, we observed the partially destroyed beta cell population from tissue of the pancreas in treated animals. Based on these results, we report that the Micro-pig model developed in this study can be used for testing of the efficacy of therapeutic agents for treatment of Type 2 diabetic mellitus.
Animals ; Blood Glucose ; Gastrointestinal Tract ; Glucose ; Glucose Tolerance Test ; Humans ; Immunohistochemistry ; Incidence ; Insulin ; Male ; Models, Animal ; Niacinamide ; Pancreas ; Swine