No abstract available.
Glomerulonephritis*

BACKGROUNG AND OBJECTIVES: Diet is the basic and principal therapeutic modality for hyperlipidemia. However, diet therapy alone showed variable responses in lowering lipid levels in different studies. This research is to prove the effect of diet and Apo E polymorphism on the variation of serum lipid profile in Korean males. MATERIALS AND METHODS: To evaluate the gene-diet interation, serum total cholesterol (Chol), triglycerides (TG), HDL-cholesterol and LDL-cholesterol (HDLc, LDLc), lipoprotein (a) (Lp (a)), and fasting blood glucose (FBS) were measured with Apo E genotyping in vegeterians (group A, n=154) and in healthy Korean male adults (group B, n=150) of similar mean age (50.1 vs. 49.3). RESULTS: Lipid profiles showed significantly lower levels in group A compared to group B (Chol 168.3+/-30.5 mg/dL vs. 181.3+/-33.4 mg/dL, p<0.001;TG 131.0+/-62.9 mg/dL vs. 149.4+/-76.7 mg/dL, p=0.023;HDLc 56.0+/-11.0 mg/dL vs. 56.9+/-11.5 mg/dL, p=0.509;LDLc 92.5+/-28.1 mg/dL vs 100.6+/-29.9 mg/dL, p=0.016;Lp (a) 22.1+/-14.6 mg/dL vs. 26.9+/-13.8 mg/dL, p=0.004;FBS 85.1+/-14.1 mg/dL vs. 102.7+/-16.6 mg/dL, p<0.001). The Apo E genotyping showed Epsilon3/3, 64.1%; Epsilon3/4, 20.7%;Epsilon2/3, 11.8%;Epsilon2/2, 1.3%;Epsilon4/4, 0.6% in the combined groups. The distribution was similar in both groups. Chol and LDLc were significantly (p<0.05) higher in Epsilon3/4 allele group compared to other allele groups among non-vegetarians. On the other hand, Chol and LDLc were significantly (p<0.01) lower in vegetarians compared to non-vegetarians only in Epsilon3/4 allele group. CONCLUSION: Vegetarian diet significantly lowered Chol, TG, LDLc, Lp (a) and FBS levels. Significant lipid lowering effect of vegetarian diet was noted in Apo E allele Epsilon3/4 group which had significantly higher Chol and LDLc levels without diet intervention. These data suggest that the influence of diet on serum lipid profiles differ according to apo E genotypes.
Adult ; Alleles ; Apolipoproteins E ; Blood Glucose ; Cholesterol ; Diet Therapy ; Diet* ; Diet, Vegetarian ; Fasting ; Genotype ; Hand ; Humans ; Hyperlipidemias ; Lipoprotein(a) ; Male* ; Triglycerides

This study investigated the stress of community residents in Kwang-Ju and Chonnam areas by using the General Health Questionnaire(GHQ-60) as a instrument of stress measurement. The number of subject were 445 residents who lived in three areas (large city, middle city, and rural area) and they were individually interviewed in March, 1994. The result of study showed that the degrees of stress measured by GHQ-60 were statistically significant in the residents' area, age. sex variables: (a) the residents in middle city among three area had the highest level of stress: (b) the resident who were more than 60 in age had the highest level of stress: (c) the female resident had more stress than male residents: (d) particularly, the residents who were more than 60 years old in the middle city had the highest level of stress. Further, the results of factor analysis showed that there were three factors of social dysfunction, depression and anxiety, and psychosomatic symptom. The social dysfunction factor was statistically significant in both age and resident area variables. The depression and anxiety factor was statistically significant in the residents' area, age. sex variables. The psychosomatic symptom factor was statistically significant in both age and sex variables. The study suggested that they should give a special attention to solve the old people's stress because stress was closely related to residents age.
Anxiety ; Depression ; Factor Analysis, Statistical ; Female ; Gwangju ; Humans ; Jeollanam-do ; Male ; Mass Screening* ; Middle Aged ; Surveys and Questionnaires*

No abstract available.
Cleidocranial Dysplasia*

The purpose of this randomized, prospective study was to compare the intubation time, hemodynamic effect and complication rates of orotracheal intubation performed by direct laryngoscopic or lighted stylet (lightwand) methods in the controlled settings of the operating room. After approval of clinical investigation committee and informed consent from patients, healthy ASA class 1 and 2 elective surgical patients were studied. On arrival to operating room, EKG, radial arterial cannulation to monitor blood pressure continously and neuromuscular monitoring device were applied to patients. Anesthesia was induced with fentanyl 3 ug/kg, thiopental 4 mg/kg and vecuronium 0.15 mg/kg to facilliate relaxation. Ventilation was controlled for 5 min by facemask with oxygen-isoflurane (1.2 vol%) or enflurane(1.7 vol%) before intubation. The patients were intubated randomly using either direct curved laryngoscope (DL, 37 patients) or lightwand (LW, 36 patients). The time to intubation (TTI) was recorded. The mean arterial pressure(MAP) and heart rate(HR) were recoreded every 30 sec after intubation for 5 min. The changes of MAP and HR after intubation were compared with pre-intubation value. After extubation, complications such as mucosal trauma and postoperative sore throat were recorded. The data were analyzed using either unpaired t-test or Chi-square analysis, where appropriate. There were no failed intuhation in either groups. There was no significant differences between the groups with respect to sex, age, weight, height, existence of nasogastric tube. The TTI was similar between groups(14.5+/-8.1 sec for LW, 16.8+/-9.5 sec for DL). There was no differences in incidence of trauma(19.4% for LW, 16.2% for DL) between groups. There were no statistically significant difference in the maximal increase in MAP(44% for LW, 55% for DL at 30 sec) and HR(25.6% for LW, 24.1% for DL at 30 sec) and during 5 min following intubation. In canclusion, even though the hemadynamic effect after intubation was not influenced by using LW, the results of this study indicate that the use of the LW is as useful, effective and safe method as using DL for oro-endotracheal intubation. Further study may prove that using the LW to be an effective alternative technique of intubation in patients with difficult airway.
Anesthesia ; Blood Pressure ; Catheterization ; Electrocardiography ; Fentanyl ; Heart ; Hemodynamics* ; Humans ; Incidence ; Informed Consent ; Intubation* ; Laryngoscopes ; Neuromuscular Monitoring ; Operating Rooms ; Pharyngitis ; Prospective Studies ; Relaxation ; Thiopental ; Vecuronium Bromide ; Ventilation

High frequency jet ventilation(HFJV) administered through a thin catheter instead of a standard endotracheal tube provides improved operation field during laryngeal microsurgery. In this study, effect of changes in inspiration time and frequency on gas exchange was observed. Sixty five patients(ASA class 1-2) underwent laryngeal microsurgery were divided into 3 groups according to inspiration time(50%, 40% and 30%) and then subdivided into 3 groups according to frequency(3.3 Hz, 2.5 Hz and 1.7 Hz). Driving pressure was same in all groups(2.4 kg, cm). Anesthesia was induced with thiopental sodium, fentanyl and succinylcholine with 100% oxygen mask ventilation and maintained with intermittent intravenous anesthetics during jet ventilation via 10 Fr. catheter with 100% oxygen. Jet cannular was located 1 cm proximal to carina. Arterial blood gas analysis and hemodynamic data(blood pressure and heart rate) were measured at 0 minute(just after catheter intubated and jet ventilation started), 5 minute, 10 minute and after then, every 10 minutes. There was significant change in PaCO; by varing inspiration time but, no significant change by frequency except in group of 3.3 Hz at inspiration time 40% and 30%. Number of patients who showed in excess of 45 mmHg of PaCO2 at 20 minute were 2 out of 19, 9 out of 23 and 9 out of 23 in inspiration time 50%, 40% and 30%, respectively. In summary, HFJV via thin catheter located 1 cm proximal to carina during laryngeal microsurgery can be done safely with inspiration time 50% under good operation field at driving pressure 2.4 kg/cm and frequency 3.3, 2.5 and 1.7 Hz.
Anesthesia ; Anesthetics, Intravenous ; Blood Gas Analysis ; Catheters ; Fentanyl ; Heart ; Hemodynamics ; High-Frequency Jet Ventilation* ; Humans ; Masks ; Microsurgery* ; Oxygen ; Succinylcholine ; Thiopental ; Ventilation

Cryosupernatant which is the residual plasma fraction after removing cryoprecipitate has been used for plasma exchange in thrombotic thrombocytopenic purpura and hemolytic uremic syndrome replacing the fresh frozen plasma. Recently, the unusually large yon Willebrand factor multireefs (ULvWFM) has been observed in patients with refractory or chronic relapsing hemolytic uremic syndrome as well as thrombotic thrombocytopenic purpura which disappeared by infusion or plasma exchange with cryosupernatant, and infusion of fresh frozen plasma, the largest multimers of yon Willebrand factor were replenished that it might be a cause of refractoriness. This study was conducted to investigate the characteristics of home-made cryosupernatant from thawed fresh frozen plasma and its thehrapeutic effect in a hemolytic uremic syndrome patient. The level of fibrinogen, coagulation factor VIII, vWF antigen, and ristocetin cofactor activity was decreased and yon Willebrand factor multimers were barely seen in cryosupernatant than those of in fresh frozen plasma. A hemolytic uremic syndrome patient tried with exchange and infusion of cryosupernatant showed excellent recovery. It is concluded that home-made cryosupernatant shares many of the features of fresh frozen plasma except factor VIII, especially von Willebrand factor multimers, and thus it could be a useful alternative to fresh frozen plasma in case of refractory hemolytic uremic synydrome.
Factor VIII ; Fibrinogen ; Hemolytic-Uremic Syndrome ; Humans ; Plasma Exchange* ; Plasma* ; Purpura, Thrombotic Thrombocytopenic ; von Willebrand Factor

BACKGROUND: High-resolution carotid ultrasonography is considered a fundamental technique for the investigation of the vascular system. However, it is still very unclear whether ultrasonographic studies of carotid arteries are useful for the prediction of cardiovascular events in patients with coronary heart disease. We have tried to assess the usefulness of carotid ultrasonography to predict the severity of coronary artery stenosis in the patients with ischemic heart disease. METHODS: We studied in 80 patients(53 men, 27 women) with acute chest pain, mean ages 63.1 10.8 yr(35 to 84 yrs), who underwent both coronary angiography and carotid ultrasonography with 10 MHz transducer. The patients who had received revascularization procedure were excluded. We classified the patients into two groups, the control group without significant coronary stenosis(23 patients) and the coronary artery disease(CAD) group(57 patients) with significant stenosis(>50%). The intima-media thickness (IMT) was measured in the far wall of CCA at 10 mm proximal to carotid bulb and the abnormal IMT was defined when the measurement was greater than mean IMT+2 SD of control group(>0.99 mm). Serum total cholesterolQlC), low density lipoprotein(LDL), high density lipoprotein(HDL), triglyceride(TG) and lipoprotein (a) (LP(a)) were measured and history of hypertension, diabetes mellitus, and smoking were investigated. RESULTS: A significant difference in IMT of the CCA was found between control and CAD group(0.75+/-0.12mm vs. 1.02+/-0.34 mm; p<0.001). Also a significant difference in the existence of plaque(control; 26.1% vs. CAD; 73.7%, p<0.00l) and the number of plaque(control; 0.39+/-0.94 vs. CAD; 2.20+/-1.87 p<0.001) was found. The existence and number of carotid plaque were more conelated with coronary artery stenosis severity than carotid IMT. The sensitivity of IMT for prediction of significant CAD was 42.1%, the specificity 95.7%, the positive predictive value 96%, and the negative predictive value 40%. The sensitivity of plaque presence on the carotid artery for prediction of CAD was 73.7%, the specificity 73.9%, the positive predictive value 87.5% and the negative predictive value 53.1%. Among the risk factors, age and LP(a) were correlated with IMT of CCA, and diabetes, hypertension, age were correlated with the presence of plaque. Smoking and hypertension were correlated with coronary artery disease. CONCLUSION: Carotid atherosclerosis was significantly correlated with severity of coronary atherosclerosis. We therefore suggest that carotid ultrasonography is useful to predict the severity of coronary artery stenosis and that the best index of coronary artery stenosis severity may be carotid plaque rather than carotid intima-media thickness.
Carotid Arteries ; Carotid Artery Diseases ; Carotid Intima-Media Thickness ; Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Coronary Stenosis* ; Coronary Vessels* ; Diabetes Mellitus ; Humans ; Hypertension ; Lipoprotein(a) ; Male ; Myocardial Ischemia ; Risk Factors ; Sensitivity and Specificity ; Smoke ; Smoking ; Transducers ; Ultrasonography*

No abstract available.
Blister* ; Nevus* ; Rubber*

No abstract available.
Blister* ; Nevus* ; Rubber*