BACKGROUND: Hypertension is one of the common diseases which family physicians encounter to manage. Various research proved that appropriate aerobic exercise had effect on lowering blood pressure efficiently. This study was to find out the status of exercise, the change of exercise according to time and its predicting factors in hypertensive patients. METHODS: A total of 193 of the followed-up hypertensive patients of family physicians in Seoul and kyoungkido from May 11, 2001 to June 10, 2001 were interviewed by doctor according to the previously designed structured questionnaire. RESULTS: Eighty two patients (42.57) were male and mean and was 57.4 +/- 9.9 fears. Using Kaplan-Meier's method, 8% of non-exercise group (N= 115) in diagnosing hypertension started exercise after 1 fear and 40%, after 5 years. Otherwise, 5% of exercise group(N=78) stopped exercise after 1 year and 30%, after 5 years. The characteristics of 5 exercise groups according to sex, age, level of education and adequacy of exercise showed significant difference. In average blood pressure, lately started group showed the lowest (137/84 mmHg) and non-exercise group, the highest (146/91 mmHg) In the degree of recommendation. sporadic group showed the highest and non-exercise group, the lowest which showed significant difference (p =0.0024) . CONCLUSION: I conclude that lately started group among non-exercise group and continuous exercise group were mainly affected by recommendation to exercise of physician. As well as exercise, other nonpharmacologic treatment should be promoted by physician as an important strategy for treatment of hypertension.
Blood Pressure ; Education ; Exercise ; Gyeonggi-do ; Humans ; Hypertension ; Male ; Physicians, Family* ; Seoul ; Surveys and Questionnaires

Immunoadjuvant activities of the extract (KM-110) from Korean mistletoe ( Viscum album coloratum) on the induction of humoral and cellular responses against Keyhole limpet hemocyanim (KLH) as an antigen and allogenic tumor cells were examined. When mice were immunized subcataneously (s.c.) with KLH admixed with KM-110, more than 1000-times higher antibody titers to KLH than those immunized with KLH alone was observed. KM-110 induced high level of KLH- specific IgG1, IgG2a and IgG2b antibodies. In an in vitro analysis of lymphocytes proliferation to KLH on week 4, the splenocytes of mice treated with KLH and KM- 110 exhibited significantly higher proliferating activity than those treated with KLH alone. In addition, the culture supernatnats obtained from the splenocytes of mice treated with both KLH and KM-110 showed high level of IL-2 and IL-4. In the test of cellular immune responses, KM-110 enhanced the DTH reaction to KLH in mice. Furthemore, cytotoxic T-lymphocyte (CTL) activity using an allogenic CTL induction model where C57BL/6 (H-2b) mice were injected with allogenic P815 (H-2d) mastocytoma cells admixed with or without KM-110, mice treated with P815 cells and KM-110 showed higher cytatoxic activity against allogenic tumor cells than those treated without KM-110. This results suggest that KM-110 may possess adjuvant activities to potentially enhance humoral as well as cellular immune responses against antigens.
Animals ; Antibodies ; B-Lymphocytes ; Immunity, Cellular* ; Immunoglobulin G ; Interleukin-2 ; Interleukin-4 ; Lymphocytes ; Mastocytoma ; Mice ; Mistletoe* ; T-Lymphocytes ; T-Lymphocytes, Cytotoxic ; Viscum album* ; Viscum*

To increase the survival area of the venous flap, we studied the arterialized venous flap in a rabbit ear model. The ears of 12 New Zealand white rabbits(n=24) were randomized into three groups, group A receiving arterio-venous anastomosis 14 days before the arterialized venous flap elevation; group B receiving bipedicled flap elevation 14 days before arterialized venous flap elevation; group C receiving no pretreatment before the arterialized venous flap elevation. Tc -pertechnetate scan was performed on all groups immediately after the arterialized venous flap elevation to evaluate the blood flow of the flap. The survival area of the flap was measured 14 days after the arterialized venous flap elevation. Average ratio of survival area was 92% in Group A, 88% in group B, which were comparatively higher than the 12% in group C. The entire flap was visualized in groups A and B on scan images, however, only the proximal area of the anterior and posterior marginal vein was visualized in group C. Flap survival pattern was similar to that of the scan image and the slope of time-activity curve of groups A and B was much steeper than that of group C. High survival rate of group A, which received the arterio-venous anastomosis as a pretreatment, may be due to the decrease of resistance of outflow during the 14 days. Anticipated mechanisms involved are, valve insufficiency due to high pressure arterial inflow, development of vascular collaterals in the flap, and opening of arteriovenous(A-V) shunt. Bipedicled flap elevation as a pretreatment may not effect on valves, however, may impair the sympathetic nerve and cause ischmic stimuli which in turn may develop vascular collaterals and make an opening of the A-V shunt.
Ear ; New Zealand ; Survival Rate ; Veins

Primary gastric lymphorna represents one to 7% of all gastric cancer and is the most common type of extranodal lymphoma. In attempt to evaluate the endoscopic characteristics, we analysed clinical and endoscopic findings in 35 patients with primary gastric lymphoma between January 1980 and August 1994 at the Yonsei Medical Center. The results were as follows: 1) The mean age of patients was 47.1 years with male to female ratio of 1.5: l. 2) Gastroscopy was performed in all 35 patienits, which revealed polypoid lesion in one case(2.9%), ulcerative lesion in 15 cases(42.9%), ulcero-infiltrative lesion in 6 cases(17.1%) and diffuse infiltrative lesion in 2 cases(5.7%). Gastric lymphoma was suggested in 6 cases, advanced gastric cancer in 21 cases, early gastric cancer in 5 cases and benign gastric ulcer in 3 cases. Pathologic diagnosis of biopsy specimens were gastric lymphoma in 24 cases, adenocarcinoma in 5 cases and chronic superficial gastritis in one case. 3) The characteristics of the endoscopic findings in gastric lymphoma were intractable or recurrent ulcer in 10 cases, thickened and mounded ulcer margin in 9 cases, multiple ulcers in 9 cases, giant rugae in 7 cases and polypoid or depressed lesion with central ulceration in 4 cases. In conclusion, recognition of specific endoscopic findings such as intractable or recurrent ulcer, volcano-like ulcer, multiple ulcers, giant rugae and combined lesion, the possibility of a lymphoma should be considered and vigorous biopsy attempts should be carried out. Then if the first microscopic report does not suggest this diagnosis, a second investigation including jumbo biopsies, perhaps by diathermy, should be undertaken.
Adenocarcinoma ; Biopsy ; Diagnosis* ; Diathermy ; Female ; Gastritis ; Gastroscopy ; Humans ; Lymphoma ; Male ; Stomach Neoplasms ; Stomach Ulcer ; Ulcer

There are many reports which show that contraction of the extraocular muscles results in an increase in intraocular pressure(IOP). Goldmann tonometer was used to record IOP after Tensilon injection in 22 patients, 10 myasthenics and 12 patients with other neurologic disease. There was a significant difference in IOP measured at 30 seconds after injection between two groups; 1-7(mean: 3.4) mmHg increase in myasthenics but no change, or 1-6 (mean: 1.7) mmHg decrease in patients with other neurologic disease. It is concluded that Tensilon tonometry is a valuable, sensitive and objective method in the diagnosis of myasthenia gravis.
Diagnosis* ; Edrophonium* ; Humans ; Manometry* ; Muscles ; Myasthenia Gravis*

BACKGROUND: Microchimerism detected after solid organ transplatnation has been reported to be associated with improved graft survival with some controversies. However, the effect of pretransplantation microchimerism on the graft survival has not been studied to date. The aim of this study was to investigate the effect of pretransplantation fetomaternal microchimerism on the graft survival in renal transplantation. METHODS: A total of 27 cases of renal transplantation performed between mother and child pairs during the period from 1996 to 2004 at the Seoul National University Hospital were studied retrospectively. Presence of pretransplantation fetomaternal microchimerism was detected using DNA samples extracted from peripheral blood collected before the operation. Microchimerism for the HLA-DRB1 gene of non-inherited maternal antigen was detected using nested PCR-single strand conformation polymorphism (SSCP) method. The function and survival of allograft was compared between the groups with and without microchimerism. RESULTS: Microchimerism was detected in 10 (37%) of the 27 cases. In the group with microchimerism, serum creatinine levels at one and three years after transplantation tended to be lower in the patients with microchimerism than in those without microchimerism (one year, 1.1 vs 1.3 mg/dL, P=0.133; three years, 1.2 vs 1.5 mg/dL, P=0.083). The rejection free survival tended to be longer in the patients with microchimerism than in those without microchimerism (113.5 vs 72.5 months, P=0.146). CONCLUSIONS: This study was limited by small number of cases, and an extended study on a larger number of patients is needed to clarify the role of pretransplantation fetomaternal microchimerism on allograft survival.
Child ; Chimerism ; Creatinine ; DNA ; Graft Survival ; HLA-DRB1 Chains ; Humans ; Kidney Transplantation ; Mothers ; Rejection (Psychology) ; Retrospective Studies ; Transplantation, Homologous ; Transplants

PURPOSE: To compare the safety and efficacy of cataract surgery using nasal clear corneal incision (CCI) versus superior or temporal CCIs in Korean patients. METHODS: A retrospective comparative study was conducted. Patients underwent cataract surgery using CCI performed by 3 surgeons between January 2012 and December 2013.The patients were divided into the following 3 groups based on CCI direction: nasal CCIs (group I), superior CCIs (Group II), and temporal CCIs (Group III). To assess usability, surgically induced astigmatism (SIA), best-corrected visual acuity (BCVA), intraocular pressure (IOP), keratometry reading, and refractive errors at baseline and 1 month after surgery were compared. Operation times were compared between groups. To assess safety, intraoperative complications and wound stability were compared. RESULTS: A total of 1,374 eyes (Group I, 283 eyes; Group II, 587 eyes; Group III, 504 eyes) were included in the present study. The SIA was not significantly different among the 3 groups. The postoperative mean BCVA, IOP, keratometry reading and spherical equivalent as well as the mean operation times were not significantly different between the 3 groups (14.04 ± 3.79 vs. 13.80 ± 3.27 vs. 13.80 ± 3.70; p = 0.473). The rate of intraocular complications and incidence of corneal wound suture were not significantly different between the 3 groups (1.7% vs. 3.2% vs. 2.3%; p = 0.378). CONCLUSIONS: The safety and efficacy of cataract surgery using nasal CCI were not significantly different compared with the use of temporal or superior CCI. Our results showed that cataract surgery using nasal CCI can be performed safely and conveniently in Korean patients.
Astigmatism ; Cataract* ; Humans ; Incidence ; Intraocular Pressure ; Intraoperative Complications ; Refractive Errors ; Retrospective Studies ; Surgeons ; Sutures ; Visual Acuity ; Wounds and Injuries

PURPOSE: To analyze the positional relationships of various centers in patients undergoing femtosecond laser-assisted cataract surgery (FLACS). METHODS: The locations of the pupil center (PC), limbal center (LC) and lens center were analyzed in each patient using optical coherence tomography during FLACS in 35 eyes of 35 patients. Using the preoperative corneal aberrometry device, angle kappa and the location of the visual axis (VA) were calculated. After acquiring the relative horizontal and vertical coordinates of each center, the distance and location among each center were compared. The relative location and distance of each center were statistically evaluated. RESULTS: The distance from the PC to the lens center was 0.147 ± 0.103 mm, that from the LC to the lens center was 0.205 ± 0.104 mm, and that from the VA to the lens center was 0.296 ± 0.198 mm. The distance from the PC to the VA was 0.283 ± 0.161 mm, that from the LC to the VA was 0.362 ± 0.153 mm, and that from the lens center to the VA was 0.296 ± 0.198 mm. Among the various centers, the PC was the closest to the lens center, whereas the LC and VA were the farthest. Based on the location of the lens center, the PC, LC, and VA exhibited differences in the X and Y coordinate positions (vertical p = 0.004, horizontal p < 0.001). Among them, the LC was significantly inferior and temporal compared to the PC (vertical p = 0.026, horizontal p = 0.023). Based on the location of the VA, the respective locations of the PC, LC and lens center in two dimensions did not significantly differ (vertical p = 0.310, horizontal p = 0.926). CONCLUSIONS: This study demonstrated the positional and locational relationships between the centers regarding FLACS. The locations of the PC, LC, and VA were different from the lens center with the PC being the closest. Surgeons should be aware of these positional relationships, especially in FLACS.
Aberrometry ; Cataract ; Humans ; Pupil ; Surgeons ; Tomography, Optical Coherence

PURPOSE: Vascular smooth muscle cell (VSMC) proliferation plays an important role in the development and progression of chronic allograft vasculopathy. Mycophenolic acid (MPA) inhibits various mesenchymal cell proliferation, and reactive oxygen species (ROS) are involved in the anti-pro-liferative effect of MPA. In this study, we investigated the effects of MPA on oleic acid (OA)-induced VSMC proliferation and also the role of ROS in these processes. METHODS: Primary cultured rat VSMCs from Sprague-Dawley were stimulated with OA 100micrometer. MPA 0.1~10micrometer and N-acetylcystein (NAC) 5 mM were administered 1 hour before adding the OA. Cell proliferation was measured by Methylthiazoletetrazolium (MTT) assay, proliferating cell nuclear antigen (PCNA) expression by Western blot analysis, and dichlorofluorescein (DCF)-sensitive cellular ROS by flow cytometry. RESULTS: OA at 100micrometer significantly increased MTT level by 1.6-fold as well as PCNA expression at 48 hours in rat VSMCs. OA also induced DCF-sensitive cellular ROS by 1.6-fold at 5 minutes and the increment of cellular ROS remained for up to 1 hour. MPA at above 1micrometer inhibited OA- induced VSMC proliferation and cellular ROS in a dose-ependent manner. NAC 5 mM also inhibited OA-induced rat VSMC activation. CONCLUSION: These results suggest that MPA inhibits OA-induced VSMC proliferation partially through the inhibition of cellular ROS.
Allografts ; Animals ; Blotting, Western ; Cell Proliferation* ; Flow Cytometry ; Muscle, Smooth, Vascular* ; Mycophenolic Acid* ; Oleic Acid ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species

BACKGROUND: The pathological features in asthmatic airway remodeling are diverse. The aim of this study was to examine the degree of airway vascularity in relation to the other remodeling parameters in asthmatics. METHODS: Bronchial biopsies were done in 34 asthmatic patients, and 6 control subjects. The basement membrane thickness and the subepithelial thickness were measured in the hematoxylin-eosin stained tissue, and the degree of vascularity was measured using type IV collagen immunostaining. RESULTS: 1) Compared to the control subjects, the asthmatics showed a significant increase in the basement membrane thickness (6.92+/-2.01micrometer vs 9.67+/-2.84micrometer, p<0.05) and the subepithelial thickness (44.49 +/- 31.92micrometer vs 121.22+/-72.79micrometer, p<0.05). 2) Compared to the control subjects, the asthmatics showed a significant increase in the vascular area per unit submucosal area (4.51+/-2.13% vs 10.32+/-6.08%, p<0.05). In addition, the number of vessels per unit submucosal area showed an increased tendency without statistical significance. 3) In the asthmatics, the number of vessels and the vascular area per unit submucosal area showed no correlation with the basement membrane thickness, the subepithelial thickness, the severity, the forced expiratory volume in 1 second(FEV1), and the methacholine provocative concentration 20(PC20). CONCLUSION: This study showed that vascularity was an important parameter in asthmatic airway remodeling but it was not related to the other remodeling parameters such as the basement membrane thickness and the subepithelial thickness. Each of these asthmatic remodeling parameters may have a different clinical significance. Therefore, further studies will be needed.
Airway Remodeling ; Asthma ; Basement Membrane ; Biopsy ; Collagen Type IV ; Forced Expiratory Volume ; Humans ; Methacholine Chloride