OBJECTIVES: It is widely accepted that estrogen has favorable effects on cardiovascular diseases, especially in the postmenopausal women. Endothelin-1(ET-I), released from the vascular endothelium, is a 21-amino acid peptide with strong vasoconstrictor activity. However, the effect of estrogen on the vasoconstriction to ET-1 has not been extensively studied. METHODS: To investigate the effect of estrogen (175beta-estradiol) on the vascular contraction to ET-1, porcine coronary artery(PCA) rings were suspended in organ chambers(37 degrees C, 95% O2/5% CO2) for measurement of isometric tension change. Endothelium was removed mechanically if necessary. In acute experiments, vascular rings were preincubated for 15minutes with 3different concentrations of 170beta-estradiol(10(-6), 10(-5), 10(-4)M) and concentration-contraction curves to cumulative doses of ET-1 were constructed. In the experiments after a longer exposure to 17beta-estradiol, the vessels with endothelium were exposed in the 5% CO2 incubator to 3different concentrations of 17beta-estradiol(10(-9), 10(-8), 10(-7)M) for 44-50 hours, and then concentrationcontraction curves to ET-1 were obtained. RESULTS: Incubation for 15minutes with 170beta-estradiol(10(-4)M) inhibited ET-1-induced contraction in the vessels with endothelium(area under the curve and maximal contraction, p<0.05 compared with control). This effect persisted regardless of the sex and the presence or absence of the endotheliurn. Incubation of the vessels far a longer time with 170beta-estradiol(44-50 hours) resulted in the inhibition of maximal contraction to ET-1(p<0.05) by a lower concentration of 175beta-estradiol(10(-7)M) than in acute experiments in male PCA rings, but an enhanced contraction to ET-1(area under the curve; p<0.05) by 10M of 175beta-estradiol was observed in female PCA rings. CONCLUSION: Short-time incubation with 17Pbeta-estradiol has an inhibitory effect on the contraction to ET-1 in PCA rings. This effect is independent of the presence of the endothelium and the sex of the pigs. A longer incubation with 17beta-estradiol results in a similar inhibitory effect on male(but not female) PCA rings, suggesting that a sex-related difference may exist concerning the effect of 17beta-estradiol on ET-1-induced contraction.
Cardiovascular Diseases ; Coronary Vessels* ; Endothelin-1* ; Endothelins ; Endothelium ; Endothelium, Vascular ; Estrogens ; Female ; Humans ; Incubators ; Male ; Passive Cutaneous Anaphylaxis ; Swine ; Vasoconstriction

Clinical analysis was done of 284 head injured patients admitted to the hospitals in the Chonbuk area from January to December 31, 1984. The results were the following. 1) Head injury occureed mostly in the 3rd and 4th decade and male patients were 3.7 times as friquent as the female patients. 2) The main cause of head injury was traffic accidents(79%) Other causes were blunt traums, falls, and gunshot in that orer. Many of the traffic accidents involved motorcycles. 3) The accidents were prevalent between 6 and 12 P.M. on Wednesday and Thursday, and in spring and autumn. 4) There was close relation between the level of the consciousness and the death rate of the victims. That is, everyone who was clear or in a stuporous mental state at the time of operation survived, while most of the patients who were semi-or fully comatose died. 5) The time lag between the accident and the surgical operation was 1 to 3 hours. 6) 71% of the injuries were epidural and subdural hematomas, and the rest of the injuries were compressed skull fracture, hemorrage inside the brain parenchyme, in that order. 7) The anesthesia was induced mostly with thiopental sodium and maintained with halothane-N2O-O2 sequence(91.5%). NLA was used in the rest ofr anesthesia(9.1%). 8) Total anesthesia time lapsed for the operation was 2~3 hour in 38%, 3~4 hour in 25% and less than 1 hour in 1.7%.
Accidents, Traffic ; Anesthesia ; Brain ; Coma ; Consciousness ; Craniocerebral Trauma* ; Female ; Head* ; Hematoma, Subdural ; Humans ; Jeollabuk-do ; Male ; Mortality ; Motorcycles ; Skull Fractures ; Stupor ; Thiopental

PURPOSE: In order to evaluate the effects of GAC, which is the combination of active hexose correlated compound (AHCC) and genistein combined polysaccharide (GCP), we investigated the changes in the biochemical profiles and the quality of life of prostate cancer patients with androgen suppression after the administration of GAC. MATERIALS AND METHODS: Thirty two eligible metastatic prostate cancer patients between the ages of 54 and 84 were enrolled in this study, and they were supplemented with 5g GAC per day (n=23) or placebo (n=9) for a 6 months period. Blood and urine sample analysis were taken and the quality of life (QoL) was assessed using the Visual Analogue Scale (VAS) and the Functional Assessment of Cancer Therapy Scale Questionnaire (FACT-G) at baseline and at post intervention (after 3 and 6 months). RESULTS: Twenty six patients (n=18 in the GAC group and n=8 in the placebo group) completed the 6 months intervention. No statistically significant adverse events were reported by the study participants. GAC had no significant effect on the serum biochemical parameters. However, all 7 GAC-treated hypercholesterolemic patients had their cholesterol level decreased after 3 months treatment (p<0.02). Results of Comet assay showed significant decreases in tail moment (p<0.009) and tail length (p<0.004) at 6 months compared to baseline for the GAC group. Although the results of the VAS were inconsistent, the score for physical well-being was increased in GAC group on the FACT-G analysis (p<0.05 between baseline and 3 months, respectively). CONCLUSIONS: Oral administration of GAC 5g per day for 6 months showed a decrease in DNA damage of blood lymphocytes and in the total serum cholesterol level in hypercholesterolemic patients without any significant influences on the serum biochemical parameters of the metastatic prostate cancer patients. Further studies on the role of GAC are necessary to clarify the advantage of GAC supplementation in prostate cancer patients with androgen suppression.
Administration, Oral ; Cholesterol ; Comet Assay ; DNA Damage ; Genistein ; Humans ; Lymphocytes ; Prostate* ; Prostatic Neoplasms* ; Quality of Life* ; Surveys and Questionnaires

Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of fibroinflammatory tissue around the abdominal aorta and ureteral entrapment in most cases. Idiopathic RPF is frequently reported in association with autoimmune diseases; however, there have been few reports of idiopathic RPF associated with Hashimoto's thyroiditis. Here, we report a case of idiopathic RPF with Hashimoto's thyroiditis in a patient with a single functioning kidney, which was successfully treated by corticosteroid therapy and transient intraureteral stent insertion with a double-J catheter.
Aorta, Abdominal ; Autoimmune Diseases ; Catheters ; Humans ; Kidney* ; Rare Diseases ; Retroperitoneal Fibrosis* ; Stents ; Thyroid Gland* ; Thyroiditis* ; Ureter

BACKGROUND: In comparison to the decreasing smoking rate of adults, the smoking rate in adolescents and women is still increasing worldwide including Korea. Previous studies on the smoking rate of adolescents were done by questionnaires allowing bias in their response because of smoking ban among adolescents in Korea. In order to know the actual smoking rate of Korean adolescents, we performed an objective study using urine nicotine detection. METHODS: From April to July 2002, 306 boy's high school students and 325 girl's high school students in Seoul were included for this study. We obtained self-reported questionnaire from them and assessed urine nicotine level by NicCheck I Test Strip to check their actual smoking status. RESULTS: The current smoking rate of male students by self-reported questionnaire was 14.9%, 20.4%, 22.5%, respectively and that by detection of urine nicotine was 26.6%, 38.0%, 29.6%, respectively, in the 1st, 2nd and 3rd grade. The current smoking rate of female students by self-reported questionnaire was 22.6%, 23.9%, respectively and that by detection of urine nicotine was 46.6%, 35.4%, respectively in the 2nd and 3rd grade. The Kappa index of the questionnaire results was 0.27, 0.46, 0.75, respectively in the 1st, 2nd and 3rd grade male students and 0.33, 0.44, respectively in the 2nd and 3rd grade female students respectively. CONCLUSION: The smoking rate of students by detection of urine nicotine was higher than that of the self-reported questionnaire results. The validity of the questionnaire results was more accurate in males than females, and higher grade than lower grade. The self-reported questionnaire was an insufficient tool for evaluation of adolescents' smoking status, especially in female students and lower grade students.
Adolescent ; Adult ; Bias (Epidemiology) ; Female ; Humans ; Korea ; Male ; Nicotine* ; Seoul ; Smoke* ; Smoking* ; Surveys and Questionnaires

The concomitant presence of posterior mitral annular calcification and infectious mitral valve lesions poses a technical challenge with considerable perioperative risk when using previously proposed techniques for mitral valve surgery. Herein, we report a case of the use of a modified surgical technique to successfully treat a patient with mitral infective endocarditis complicated by a subendocardial abscess and extensive posterior mitral annular calcification.
Abscess ; Endocarditis* ; Humans ; Mitral Valve*

BACKGROUND AND OBJECTIVES: We aimed to investigate the association between serum parathyroid hormone (PTH) levels and the prevalence of atrial fibrillation (AF) in a population based study. METHODS: This study included a total of 9,007 community-dwelling Koreans aged 50 years and over who were enrolled in the Dong-gu study from 2007 to 2010. Electrocardiograms were recorded from the subjects using the HP-PageWriter 200 M1771A. All potential cases of AF were determined by 2 cardiologists. PTH concentration was measured by a chemiluminescent microparticle immunoassay. Multiple logistic regression analysis was used to evaluate the relationship between the quartiles of PTH and AF, adjusting for potential confounders. RESULTS: The prevalence of AF was 2.41% in males and 0.9% in females and increased with advanced age in both genders. The median and interquartile range (IQR) of serum PTH was 39.5 pg/mL (IQR, 30.6–50.8), which was significantly higher in patients with AF than in patients without AF (p < 0.001). The prevalence of AF increased with increasing PTH quartile (0.8%, 0.9%, 1.6%, and 2.8% in the lowest, second, third, and highest PTH quartiles, respectively; p < 0.001). Multivariable logistic analysis adjusted for cardiovascular risk factors showed the highest quartile of serum PTH levels was associated with a higher prevalence of AF than the lowest quartile (odds ratio, 3.34; 95% confidence interval, 1.93–5.78). CONCLUSIONS: Higher levels of serum PTH were associated with higher prevalence of AF. Further studies are needed to determine whether this association is present in other populations and in a prospective study setting.
Atrial Fibrillation ; Electrocardiography ; Female ; Humans ; Immunoassay ; Logistic Models ; Male ; Parathyroid Hormone ; Prevalence ; Prospective Studies ; Risk Factors

Background: This study assessed the effect of a single bolus administration of lidocaine on the prevention of tourniquet-induced hypertension (TIH) and compared the effect of lidocaine to that of ketamine in patients undergoing general anesthesia. Methods: This randomized, controlled, double-blind study included 75 patients who underwent lower limb surgery using a tourniquet. The patients were administered lidocaine (1.5 mg/kg, n = 25), ketamine (0.2 mg/kg, n = 25) or placebo (n = 25). The study drugs were administered intravenously 10 min before tourniquet inflation. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured before tourniquet inflation, after tourniquet inflation for 60 min at 10 min intervals, and immediately after tourniquet deflation. The incidence of TIH, defined as an increase of 30% or more in SBP or DBP during tourniquet inflation, was also recorded. Results: SBP, DBP, and HR increased significantly over time in the control group compared to those in the lidocaine and ketamine groups for 60 min after tourniquet inflation (P < 0.001, P < 0.001, and P = 0.007, respectively). The incidence of TIH was significantly lower in the lidocaine (n = 4, 16%) and ketamine (n = 3, 12%) group than in the control group (n = 14, 56%) (P = 0.001). Conclusion Single-bolus lidocaine effectively attenuated blood pressure increase due to tourniquet inflation, with an effect comparable to that of bolus ketamine.

We report a patient with severe neurological deterioration due to leptomeningeal metastases involving brain and spinal cord from anaplastic lymphoma kinase (ALK)-positive lung adenocarcinoma, managed rapidly and successfully with lorlatinib therapy. A 48-year-old male patient presented with acute mental deterioration, severe headache, and weakness of both legs. The patient’s previous medical history included cerebral metastases from ALK-positive lung adenocarcinoma, which had been successfully managed via whole brain radiation therapy and gamma knife radiosurgery one year and three months before, respectively. Physical examination revealed neck stiffness and paraparesis with motor grade I.Gadolinium-enhanced brain MRI showed newly developed leptomeningeal enhancement along cerebellar folia, and whole spine MRI revealed similar leptomeningeal metastasis along the whole spinal axis. Lorlatinib was started orally with a dose of 100 mg/day. The patient showed rapid clinical improvement after one week. The patient was alert and the headache disappeared, while the paraparesis improved to normal ambulatory status. Two months of lorlatinib treatment resulted in almost complete disappearance of previous leptomeningeal enhancement of brain and spinal cord, and absence of newly developed metastatic lesions in the central nervous system, based on MRI results. The patient had been regularly followed with ongoing lorlatinib therapy for 5 months without any systemic complications or neurological abnormality. Conclusively, lorlatinib could be a rapid and effective treatment for patients with central nervous system leptomeningeal metastases arising from ALK-positive lung cancer.

BACKGROUND AND OBJECTIVES: We aimed to investigate the association between serum parathyroid hormone (PTH) levels and the prevalence of atrial fibrillation (AF) in a population based study. METHODS: This study included a total of 9,007 community-dwelling Koreans aged 50 years and over who were enrolled in the Dong-gu study from 2007 to 2010. Electrocardiograms were recorded from the subjects using the HP-PageWriter 200 M1771A. All potential cases of AF were determined by 2 cardiologists. PTH concentration was measured by a chemiluminescent microparticle immunoassay. Multiple logistic regression analysis was used to evaluate the relationship between the quartiles of PTH and AF, adjusting for potential confounders. RESULTS: The prevalence of AF was 2.41% in males and 0.9% in females and increased with advanced age in both genders. The median and interquartile range (IQR) of serum PTH was 39.5 pg/mL (IQR, 30.6–50.8), which was significantly higher in patients with AF than in patients without AF (p < 0.001). The prevalence of AF increased with increasing PTH quartile (0.8%, 0.9%, 1.6%, and 2.8% in the lowest, second, third, and highest PTH quartiles, respectively; p < 0.001). Multivariable logistic analysis adjusted for cardiovascular risk factors showed the highest quartile of serum PTH levels was associated with a higher prevalence of AF than the lowest quartile (odds ratio, 3.34; 95% confidence interval, 1.93–5.78). CONCLUSIONS Higher levels of serum PTH were associated with higher prevalence of AF. Further studies are needed to determine whether this association is present in other populations and in a prospective study setting.