BACKGROUND: The purpose of this study was to investigate the mechanism of endothelium-dependent and independent responses to endothelins (ETs) in porcine coronary artery. METHODS: The vascular rings of left anterior descending artery or left circumflex artery from 7 pigs were suspended in conventional organ chambers for the measurement of isometric force. To evaluate relaxation responses, vascular rings with endothelium were exposed to ET-1 and ET-3. To evaluate contraction responses, vascular rings with and without endothelium were exposed to ET-1 and ET-3 in the presence or absence of BQ 123 (ET(A) receptor antagonist) or TAK-044 (ET(A) and ET(B) receptor antagonist). RESULTS: Transient relaxation responses of vascular rings occurred after exposure of ET-1 and ET-3. These transient responses disappeared after preincubation with N-nitro-L arginine. There was an increased contractions of vascular rings according to increasing concentration of ET-1 and ET-3. The initial responses were enhanced in vascular rings without endothelium in ET-1 and ET-3. In vascular rings with endothelium, the contraction responses were more reduced in vascular rings with preincubation of BQ 123 than in vascular rings without BQ 123 in ET-1. In vascular rings without endothelium, the contraction responses were more reduced in vascular rings with preincubation of TAK-044 than in vascular rings without TAK-044 in ET-1. CONCLUSION: ET(B) receptor on the endothelium might mediate the transient vasodilator responses to ET-1 and ET-3 through release of nitric oxide in porcine coronary artery. ET(A) and ET(B) receptor on vascular smooth muscle cells might mediate vasoconstrictor responses to ETs.
Arginine ; Arteries ; Coronary Vessels* ; Endothelins* ; Endothelium ; Muscle, Smooth, Vascular ; Nitric Oxide ; Receptors, Endothelin ; Relaxation ; Swine

BACKGROUND: Previous studies have suggested that regular exercise may increase bone mineral density. However, the effects on bone mineral density are different depending on the types of exercises and recent studies on the effects of different exercises on bone mineral density are insufficient. This study was conducted to assess the effects of 2 different exercises(Judo, Taekwondo) and physical fitness(back muscle strength, grip strength, broad jump, vertical jump, flexibility, sit ups) on regional BMD. METHODS: Subjects were healthy adults female volunteers aged 19 to 22 years and consisted of eight Judo athletes, twelve Taekwondo athletes, and eight nonathletic controls. We measured their bone mineral density of lumbar spine, femoral neck, femoral greater trochanter, Wards triangle, femoral shaft and distal radius using dual energy X ray absorptiometry and assessed their physical fitness. We investigated the mean differences of regional bone mineral density between the groups and the relationships between physical fitness and regional bone mineral density. RESULTS: ANCOVA revealed that there were significant differences in the regional bone mineral density between the groups. The Judo athletes group had significantly higher bone density of greater trochanter, femoral shaft, distal radius, femoral neck and lumbar spine than the control group and had significantly higher bone density of greater trochanter, femoral shaft and distal radius.than the Taekwondo atheletes group. There were no significant differences of bone density in all the regions between the Taekwondo atheletes and the control groups. Partial correlation coefficients between the back muscle strength and the bone density of Wards triangle, greater trochanter, distal radius, femoral neck, femoral shaft, and lumbar were 0.581, 0.570, 0.526, 0.502, 0.424, and 0.418, Respectively (P<0.05). Correlation coefficients between the broad jump and the bone density of femoral neck, greater trochanter, and femoral shaft were 0.577, 0.539, and 0.457, respectively(P<0.05). Correlations of the grip strength, flexibility, sit ups and vertical jump with bone density of all regions were not high(r< or=0.5). CONCLUSIONS: Different types of exercises showed different effects of bone density. The back muscle strength among the physical fitness factors was considered to be the most important predictor of bone density. In the future, further studies are necessary for the effects of other exercises on bone density.
Absorptiometry, Photon ; Adult ; Athletes* ; Back Muscles ; Bone Density* ; Exercise* ; Female* ; Femur ; Femur Neck ; Hand Strength ; Humans ; Martial Arts ; Muscle Strength ; Physical Fitness ; Pliability ; Radius ; Spine ; Volunteers ; Young Adult*

BACKGROUND AND OBJECTIVES: Many studies have shown that coronary artery bypass graft (CABG) surgery prolongs the life of patients with left main coronary artery disease (LMCD). Recently, percutaneous coronary intervention (PCI) has been applied to treat LMCD, with good clinical results. However, a significant portion of patients decline any revascularization therapy, so receive medical treatment only. The aim of this study was to evaluate the long term clinical outcome in these patients with LMCD, according to the treatment strategies. SUBJECTS AND MEHTODS: The clinical outcomes of 281 consecutive patients, with significant LMCD, between January 1997 and December 2000, were evaluated. The patients were divided into three groups, according to their initial treatment strategies;1) CABG, 2) PCI and 3) medical treatment. The mean follow-up duration was 37.4+/-14.9 months. RESULTS: The 1- and 3-year survival rates in the CABG group (97.4+/-1.5% and 95.6+/-1.9%) were significantly higher than those of the medical group (89.8+/-3.9% and 76.1+/-5.9%;p=0.03). The survival rates in the PCI group (one year and 3-year survival rate, 98.1+/-1.3% and 93.8+/-2.5%) were similar to those of the CABG group (p=0.93). The incidence of 3-year MACE in the medical group (40.7%) was higher than those of the CABG (10.5%, p<0.001) and PCI groups (20.4%, p=0.007). There was no significant difference between the CABG and PCI groups (p=0.06). CONCLUSION: In patients with LMCD, a CABG remains the standard therapy for prolonging survival and lowering the incidence of MACE. PCI offers similar survival benefits in selected patients. Medical treatment is associated with a significantly higher mortality and MACE. Active revascularization therapy should be the treatment of choice for the patients with LMCD.
Angioplasty ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies* ; Humans ; Incidence ; Mortality ; Percutaneous Coronary Intervention ; Survival Rate ; Transplants

BACKGROUND: It is widely accepted tht Tai Chi has been suited for whole aged people, especially old aged women and improves bone mineral density and physical fitness levels. To investigate the efficacy of Tai Chi in postmenopausal women, we compared the bone mineral density and physical fitness levels between Tai Chi and control groups. METHODS: The study subjects were 10 Tai Chi and 18 control group who were postmenopausal women aged 40 years and older. Bone mineral density(BMD) was measured at the lumbar spine and femoral area using dual energy x-ray absorptiometry and maximal O2 intake, flexibility, grip strength, sit up, broad jump, balance, side-to-side step were checked for assessment of fitness levels. Other data was gathered from the questionnaire. RESULTS: The BMD of lumbar spine and Ward's triangle was significantly higher in control group(P<0.05) and the results of maximal O2 intake(P<0.05), grip strength(P<0.05), sit up(P<0.05), balance(P<0.01) were significantly higher in the control group. Logistic regression analysis showed that the results of grip strength, sit up, balance were significantly higher in the control group(P<0.05). CONCLUSIONS: Tai Chi improve physical finess levels and bone mineral density and can be a useful exercise type for menopausal women.
Absorptiometry, Photon ; Bone Density* ; Female ; Hand Strength ; Humans ; Logistic Models ; Physical Fitness* ; Pliability ; Spine ; Tai Ji* ; Surveys and Questionnaires

No abstract available.
Humans ; Physicians, Family*

Objective: This study examined the efficacy of trans-thoracic echocardiography (TTE) performed by emergency physicians in the diagnosis and treatment of acute myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS). Methods: This study enrolled patients with suspected symptoms of ACS from January 1, 2017, to June 30, 2017, in the emergency department (ED). One hundred and eighteen patients, who underwent TTE (TTE group), and 384 patients, who did not undergo TTE (control group), were enrolled in this study. The rate of performed coronary angiography (CAG) and percutaneous coronary intervention (PCI) were analyzed in the TTE group. The primary outcomes included the rate of CAG and PCI performed and door-to-puncture time (DTPT). Results: The rates of CAG and PCI were significantly higher in the TTE group than in the control group (CAG: 38% vs. 28%, P=0.039; PCI: 31% vs. 21%, P=0.034). The mean DTPT in non-ST segment elevation was 110 minutes (110.2±38.86 minutes) in the TTE group and 151 min (151.3±108.01 minutes) in the control group (P=0.054). Conclusion Patients with suspected ACS in ED with TTE had a higher rate of CAG and PCI performed compared to the patients without TTE. In patients with non-ST segment elevation in the initial electrocardiogram, TTE performed by emergency physicians tended to shorten the time to diagnose MI and DTPT.

Objective: This study examined the efficacy of trans-thoracic echocardiography (TTE) performed by emergency physicians in the diagnosis and treatment of acute myocardial infarction (MI) in patients with suspected acute coronary syndrome (ACS). Methods: This study enrolled patients with suspected symptoms of ACS from January 1, 2017, to June 30, 2017, in the emergency department (ED). One hundred and eighteen patients, who underwent TTE (TTE group), and 384 patients, who did not undergo TTE (control group), were enrolled in this study. The rate of performed coronary angiography (CAG) and percutaneous coronary intervention (PCI) were analyzed in the TTE group. The primary outcomes included the rate of CAG and PCI performed and door-to-puncture time (DTPT). Results: The rates of CAG and PCI were significantly higher in the TTE group than in the control group (CAG: 38% vs. 28%, P=0.039; PCI: 31% vs. 21%, P=0.034). The mean DTPT in non-ST segment elevation was 110 minutes (110.2±38.86 minutes) in the TTE group and 151 min (151.3±108.01 minutes) in the control group (P=0.054). Conclusion Patients with suspected ACS in ED with TTE had a higher rate of CAG and PCI performed compared to the patients without TTE. In patients with non-ST segment elevation in the initial electrocardiogram, TTE performed by emergency physicians tended to shorten the time to diagnose MI and DTPT.

BACKGROUND AND OBJECTIVE: The long-term effects of beta-irradiation on intimal hyperplasia (IH) within the stented segment and vessel, and the lumen dimensions of non-stented adjacent segments, have not been sufficiently evaluated in patients with ISR. The long-term (24 months) effects of beta-irradiation ((188)Re-MAG3-filled balloon) were evaluated using intravascular ultrasound (IVUS) in patients with in-stent restenosis (ISR). SUCJECTS AND METHODS: A two-year follow-up IVUS was performed in 30 patients with patent ISR segments at the 6-monthly follow-up angiography. Serial IVUS images were acquired at 5 equidistant intra-stent sites and 3 different reference segment sites (1, 2 and 4 mm from stent margin). RESULTS: The mean intra-stent IH area and IH burden significantly increased between 6 and 24 months-from 2.1+/-1.1 to 2.6+/-1.4 mm2 (p<0.001) and from 26+/-10 to 33+/-14% (p<0.001), respectively. There were significant decreases in the mean external elastic membrane (from 10.1+/-3.9 to 9.7+/-3.9 mm2, p=0.015) and lumen area (from 5.6+/-2.3 to 5.1+/-2.3mm2, p=0.021) within the distal reference segments between 6 and 24 months. Target lesion revascularization (TLR) was performed between 6 and 24 months in 6 patients (20%) following the beta-irradiation therapy. There were no significant differences between the TLR and non-TLR groups, with the exception of a smaller minimum lumen CSA at 24 months in the TLR group. CONCLUSION: Because of a small amount of late loss between 6 and 24 months, most irradiated ISR vessel segments remained stable for up to 2 years. However, quantitative evidence of late catch-up was evident in most patients and was significantly associated with 24-month TLR in some patients with a smaller minimum lumen area.
Angiography ; Brachytherapy* ; Follow-Up Studies ; Humans ; Hyperplasia ; Membranes ; Stents ; Ultrasonography*

PURPOSE: The objective of this study was to compare the clinicopathologic characteristics of the patients with extrahepatic bile duct cancer between the patients who are younger than 54 years and those who are older than 75 years. METHODS: Between 1994 and 2008, 63 patients underwent resectional surgery or palliative treatment for extrahepatic bile duct cancer. The medical records of these patients, including the clinicopathologic characteristics and the other relevant data, were retrospectively reviewed. RESULTS: There were some differences between the patient groups for the tumor location, distant metastasis and preoperative co-morbidity. The frequency of tumor locations were 58% proximal, 13% middle, 22% distal and 5% diffuse in the young patients and these were 33%, 18%, 48% and 0%, respectively, in the older patient group (p=0.049). The frequency of distant metastasis was 13% in the young patient group and none in the older patient group (p=0.026). The elderly patient group showed more preoperative co-morbidities (68% vs 29%, respectively) (p=0.009), but there was no statistical difference between the two groups for postoperative complications (p=0.301). There was no correlation between the preoperative co-morbidity and the operative complications for both groups. There were no differences in the other clinicopathologic characteristics and the survival rate for both groups. CONCLUSION: Young and elderly patients with extrahepatic bile duct cancer had different clinicopathologic characteristics. Especially, in the young patients, there were more proximally located-tumors and distant metastases. Although there were more preoperative co-morbidities in the elderly patient group over the age of 75, this did not affect the operative complication rate when the co-morbidities were well controlled preoperatively.
Aged ; Bile ; Bile Duct Neoplasms ; Bile Ducts ; Bile Ducts, Extrahepatic ; Humans ; Medical Records ; Neoplasm Metastasis ; Palliative Care ; Postoperative Complications ; Retrospective Studies ; Survival Rate

Coronary artery fistula (CAF) is an abnormal communication between an epicardial coronary artery and a cardiac chamber, major vessel or other vascular structures. This report presents a rare case of CAF in which a dilated left main trunk and proximal circumflex coronary artery are connected to a dilated coronary sinus. There were also two other fistulae and persistent left superior vena cava. The coronary fistula was managed conservatively.
Arteriovenous Fistula ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels ; Fistula ; Glycosaminoglycans ; Vena Cava, Superior