PURPOSE: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. METHODS: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). RESULTS: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). CONCLUSION: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.
Biomarkers ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Diet ; Fatty Acids ; Information Services ; Insurance Benefits ; Juglans* ; Nuts ; Phytochemicals ; Population Characteristics ; Publication Bias ; Risk Factors ; Triglycerides

Myocardial bridging is defined that short segments of coronary artery descend into the myocardium for a variable distance and each systolic contraction of these fibers can cause narrowing of the artery. Systolic narrow-ing may rarely be caused by connective tissue such as fibrous band. Myocardial ischemia, infarction and sudden death may be seen in some patients with myocardial bridging. Myocardial infarction in association with isolated myocardial bridges with systolic narrowing is uncommon. We report a case of Q wave myocardial infarction in a patient with angiographic systolic narrowing at the middle segment left anterior descending coronary artery which was caused by fibrous band.
Arteries ; Connective Tissue ; Coronary Vessels ; Death, Sudden ; Humans ; Infarction ; Myocardial Bridging* ; Myocardial Infarction* ; Myocardial Ischemia ; Myocardium

Left atrial thrombus is frequently associated with rheumatic mitral valvular heart disease. Left atrial thrombus is usually attached to the atrial wall, but rarely it is freely floating in the cavity. In that case the patient may present with the symptoms of acute hemodynamic decompensation due to the so-called "hole-in-one" effect or multiple systemic embolism. We report a case of multiple systemic embolism associated with left atrial free-floating ball thrombus in mitral valvular heart disease.
Echocardiography ; Embolism* ; Heart Valve Diseases ; Hemodynamics ; Humans ; Thrombosis*

One hundred patients who have a urethral stone lesser than 1.0cm in diameter were evaluated for spontaneous passage during 8 months between July, 1991 and February, 1992. The spontaneous, passage in accordance with duration of follow-up, the stone site, size, shape and degree of urethra obstruction was investigated. The overall rate of spontaneous passage was 56.0 % with the duration or 39.3 days ranging from 2 days to 8 months. Among these 56 patients, 48(85.7% ) obtained a spontaneous passage within 8 weeks. The rate and duration of spontaneous passage according to stone site were 57.7%, 67.4 days in upper ureter, 25.0%, 64.0 days in mid ureter and 57.1%. 21.9 days in lower ureter, respectively. Spontaneous passage rate was insignificantly correlated with the increment of stone size, but the duration requiring for spontaneous passage of lower ureteral stone was shorter than those of upper or mid ureteral stones. For stone shape the smooth surface or cylindrical shaped stone was more easily passed out spontaneously than the irregular or round shaped one. And, the severer ureteral obstruction, the poorer spontaneous passage was observed. Therefore, the ureteral stone which is smaller than 1.0cm in diameter could be expected a spontaneous passage for 8 weeks at least unless there are specific symptoms or impairment of renal function, especially when the stone has smooth-cylindrical shape and the ureter shows minimal obstruction.
Follow-Up Studies ; Humans ; Ureter* ; Ureteral Obstruction ; Urethra

BACKGROUND: Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method was investigated in patients suspected to have asthma. METHOD: One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. RESULTS: According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonashmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second(FEV1) after the IHCA between the asthmatics(-10.0±6.8%) and the symptomatic nonasthmatics(-2.3±2.5%). The factors associated with a reactivity to IHCA were FEV1/FVC, FEF25-75/FVC and FEV1(% of predicted). The accuracy was highest using a 7% fall in FEV1; the sensitivity was 76% and the specificity 96%. CONCLUSION: IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.
Adult* ; Asthma* ; Forced Expiratory Volume ; Humans ; Hyperventilation* ; Methacholine Chloride ; Sensitivity and Specificity ; Smoke ; Smoking

A 43-year-old man was admitted complaining of swallowing difficulties. The esophagography revealed severe stenosis at the esophagogastric anastomotic site. Esophagography after balloon dilatation showed a transmural perforation with mediastinal leakage. The patient was treated conservatively for one week at which time the esophagography showed no further leakage at the anastomotic site and the good passage of barium. A 2-year follow-up chest computed tomography (CT) showed good patency of the esophageal lumen and the marked resorption of barium in the mediastinum.
Adult ; Barium ; Constriction, Pathologic ; Deglutition ; Dilatation ; Esophagus ; Follow-Up Studies ; Humans ; Mediastinum ; Thorax

The traditional treatment of splenic artery aneurysm (SAA) is generally surgery and/or transcatheter arterial embolization, but recently, the treatment of SAA using a stent graft has been reported. However, the acute angle of the celiac axis, as well as the tortuous path of the splenic artery makes the use of stent graft difficult for treatment of aneurysms. We report here a case of SAA treated with the technique of double overlapping metallic stents.
Aneurysm* ; Axis, Cervical Vertebra ; Blood Vessel Prosthesis ; Splenic Artery* ; Stents*

BACKGROUND: IGF-I is an important mitogen in many types of malignancies. Tumors also express many IGF binding proteins, which modulate IGF action. The purpose of this study was to evaluaste the effect of IGF-I and IGFBP on cell proliferation in mouse lung cancer cells (3LL). METHODS: The cellular proliferation of 3LL with the treatment of growth factors was evaluated using MTT assay. Western ligand blot was performed in order to determine whether 3LL cells secrete IGFBPs and we evaluated the effect of IGFBP on cellular proliferation. RESULTS: The treatment of 3LL cells with IGF-I increased cellular proliferation in a serum free media. Western ligand blot of conditioned medium of 3LL with 125I-IGF-I demonstrated one single major band with an estimated molecular mass of 24 kDa. This band was identified as IGFBP-4 with immunoblot analysis using antisera. The addition of anti-IGFBP-4 antibody to abrogate the effect of IGFBP-4 resulted in increased cellular prolife ration suggesting that IGFBP-4 inhibits cell growth. CONCLUSION: IGF-I increases cellular proliferation, however the secreted IGFBP- 4 has an ingibitory function on cell growth in 3LL. These findings suggest that IGF-I and IGFBP are involved in the cell proliferation.
Animals ; Carrier Proteins* ; Cell Proliferation ; Culture Media, Conditioned ; Culture Media, Serum-Free ; Immune Sera ; Insulin-Like Growth Factor Binding Protein 4 ; Insulin-Like Growth Factor Binding Proteins ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins ; Lung Neoplasms* ; Lung* ; Mice*

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

BACKGROUND: The prognostic indicators of patients who received massive transfusion were studied to assist management of high risk patients. METHODS: Medical records and laboratory data of 184 adult patients who received massive transfusions during 1996-1998 were reviewed. The indicators studied were outcome of treatment, cause of transfusion, age, sex, vital signs at admission, number of units of blood components, results of platelet counts (Plt), hematocrit (Hct), prothrombin time (PT), activated thromboplastin time (aPTT) and arterial blood pH (pH) performed within 24 hours after transfusion. RESULTS: The percent and mean age of survivor were 60.3% and 44.8 years old and nonsurvivor were 39.7 and 49.7, respectively. The frequency and survival rate by causative disorders were as follows: trauma 33.2% and 56%; liver disease 23.9% and 57%, cancer 13.6% and 56%, cardiovascular disorders 7.5% and 78.6%. Nonsurvivors had lower systolic and diastolic pressures in liver disease and cancer, and lower body temperature in trauma patients than those of survivors. In trauma patients nonsurvivors had lower Plt counts and pH, and prolonged PT and aPTT results than those of survivors. In cancer patients nonsurvivors showed lower Hct and pH, but those of liver disease patients showed only lower Plt counts. The average unit of blood components transfused per patient in nonsurvivors were 27.3 of RBC, 13.4 of FFP, and 15.2 of platelet concentrate, respectively. The percent of patients who were transfused more than 20 units of RBC was 28% in survivors, but 55% in nonsurvivors. CONCLUSIONS: It is concluded that the patients transfused with more than 20 units of RBC showed low systolic and diastolic pressures, body temperature, Plt counts, Hct and arterial blood pH, and prolonged PT and aPTT results appeared to be poor prognostic indicator of massive transfusions.
Adult ; Blood Platelets ; Body Temperature ; Hematocrit ; Humans ; Hydrogen-Ion Concentration ; Liver Diseases ; Medical Records ; Platelet Count ; Prognosis* ; Prothrombin Time ; Survival Rate ; Survivors ; Thromboplastin ; Vital Signs