BACKGROUND: It has been found that sterss challenge with heat shock produces the acquisition of cellular resistance to ischemin injury in the hearts, which is associated with stress protein induction. The conventional heat shock(42degrees C of rectal temperature for 15min, anesthetized animal), however, is strong enough to endanger the animal life and then not suitable for practiocal application in human. The present study was performedd in an attempt to search the safely applicabel stress modalities to acquire the myocardial tolerance to ischemia-reperfusion in jury. METHODS: Male, Sprague-Ddawley rats(200-250g) were exposed to various stressful conditions, such as heat stimulation(environmental temperature of 42degrees C for 30min, live animal), swimming(20min), immobilization(60min), treadmill exercise(20M/min, 30min) and hyperbaric oxygenation(3atm, 60min) given once a day for 5 days. Twenty-four hours after the last application the hearts were isolated and perfused with oxygenated Krebs-Henseleit buffer solution by Langendorff method. Ischemia-reperfusion injury was produced by 20 min-global ischemia followed by 30 min-reperfusion. Cardiac mechanical function, lactate dehydrogenase release, the induction of stree proteins were assayed and compared dbetween the stressed dand the control animals. RESULTS: Upon reperfusion after ischemia the recovery of cardiac function was significantly improved in the stressed animals. The percentile recovery at 30min of reperfusion was in a range from 55.3%(swimming) to 89.3%(treadmill exercise), which was significantly higher than that of the control hearts(38%). The functional recovery of the conventional heat shocked heart was 57.7%. In stressed animals, lactate dehydrogenase release, which indicates myocardial cell injury, was significantly reduced by 20 to 30% compared to that for the control. The expression of an inducible form of 70 series stress protein, SP72, which was assayed by immunoblotting method, was markedly increased by heat stimulation while the other stress modalities failed to increase, it. There were no appreciable inductions of SP73(constitutive form) and GRR78 in the stressed animals. CONCLUSION: These results suggest that the cardiac protection from the ischemia-reperfusion injury could be induced by the repetitive non-fatal stress stimulations and that SP70 family proteins may be partly involved in the cardioprotective effect produced by heat stimulation, but not play the essential roles in anti-ischemic effects produced by other stress modalities.
Animals ; Heart* ; Hot Temperature ; Humans ; Immunoblotting ; Ischemia ; L-Lactate Dehydrogenase ; Male ; Oxygen ; Rats* ; Reperfusion ; Reperfusion Injury ; Shock

We retrospectively analysed plain radiographs and MR imaging of 16 conventional osteosarcoma cases(8 children, 8 adults) which underwent amputations or limb salvage operations. Pathologic correlation was performed with gross and microscopic sections to evaluate 1) whether the open epiphyseal plate can function as a barrier against transphyseal spread of osteosarcoma and 2) the diagnostic value of MR imaging for the detection of the detection of the epiphyseal involvement of osteosarcoma. In children with open epiphyseal plates, conventional radiographs suggested transphyseal tumor growth in one of eight cases(12.5% and MR imaging in seven cases(87.5%). Pathologic examination confirmed epiphyseal involvement in six of seven cases noted with MR imaging(75%). On the the other hand, in adult patients with closed epiphyseal plates, conventional radiographs showed transphyseal tumor growth in six of eight cases(75%), while MR imaging and pathologic exam demonstrated tumor invasion in all cases(100%). We conclude that open epiphyseal plate does not function as and effective barrier against tumor extension, and MR imaging is an excellent method in detecting the extent of transphyseal tumor growth.
Adult ; Amputation ; Child ; Growth Plate ; Hand ; Humans ; Limb Salvage ; Magnetic Resonance Imaging* ; Methods ; Osteosarcoma* ; Retrospective Studies

No abstract available.
Blood Flow Velocity* ; Humans ; Infant, Newborn*

Intracranial calcification is known to be a physiologic phenomenon and is often seen in brain CTs of patients visiting the emergency department. The pattern of a calcified lesion may be related to the pathologic condition, and calcified lesion itself may cause neurologic symptoms. The causes of pathologic intracranial calcification are infection, brain tumor, vascular disorder, endocrinologic disorders, and genetic disorder associated with calcium metabolic defects. The most common sites of intracranial calcification are the basal ganglia, subcortical tissue of the cerebrum, the thalamus, the choroid plexus, and the dentate nucleus of the cerebellum. The diagnosis of pathologic calcification can be done by using brain CT or MRI, and pathologic calcification should be differentiated from other causes of calcification by using laboratory data. We report and discuss a case of extensive intracranial calcification with idiopathic hypoparathyroidism.
Basal Ganglia ; Brain ; Brain Neoplasms ; Calcinosis ; Calcium ; Cerebellar Nuclei ; Cerebellum ; Cerebrum ; Choroid Plexus ; Diagnosis ; Emergency Service, Hospital ; Humans ; Hypoparathyroidism* ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Thalamus

Myocardial bridge is not a rare congenital malformation of the coronary artery which takes an intramural course. Most of the lesions are found in proximal half of the left anterior descending coronary artery, but one which occurs in the left circumflex artery is extremely rare. During systole, the intramural coronary artery is compressed by contraction of over bridging ventricular muscle, therefore blood flow distal to the lesion in impaired and angina pectoris or acute myocardial infarction may occur. We experienced a 54-year-old man who complained of severe precordial pain during exercise and at rest for several months, and was diagnosed as myocardial bridging in the left circumflex coronary artery by coronary arteriography. Thus we report this case with literature review.
Angina Pectoris ; Angiography ; Arteries ; Coronary Vessels* ; Humans ; Middle Aged ; Myocardial Bridging ; Myocardial Infarction ; Systole

A new angiotensin converting enzyme inhibitor, enalapril, was administered in 20 hypertensive patients (7 mild, 6 moderate and 7 severe hypertensives) for 8 weeks or longer in order to see the blood pressure lowering effects. Additionally the left ventricular mass index was measured by 2-D guided M-mode echocardiography before and after enalapril therapy, and subjective symptoms and laboratory findings were also followed. The results were as follows: 1) After 8 weeks of enalapril treatment (the doses form 10 mg to 20mg once a day) blood pressure were lowered markedly in 10, moderately in 4, mildly in 4 cases, but the blood pressures were not lowered in 2 cases with severe hypertension. The means of the blood pressures of the group were lowered form 182.1+/-19.2 to 148.0+/-26.0mmHg in systolic and from 111.9+/-14.7 to 95.1+/-17.1mmHg in diastolic after 8 weeks of treatment (p<0.001). 2) Heart rates were not changed significantly with enalapril. 3) The symptoms of insomnia and headache were reported to be improved after enalapril in 13 cases. 4) No discernable changes in CBC and serum level of creatinine were observed. But the random urine protein was decreased in 6 cases with proteinuria in routine urinalysis. The serum lipid profile was not significantly changed, but in the 2 cases in which the ratio of total to HDL-cholesterol was above 5.0, the ratio fell to below 5.0. 5) There was no significant EKG change after enalapril. 6) In 9 cases out of 13 cases with the left ventricular mass index (LVMI) above 125g/m2 BSA, LVMI was followed by echocardiography after enalapril. LVMI was significantly decreased in 8 of 9 cases and mean values after enalapril was decreased from 183.1+/-88.0g/m2 BSA to 150.8+/-61.3g/m2 BSA (p<0.0025). 7) Side effects after enalapril administration were transient dizziness in 4 cases and ageusia in 2 cases. Above results suggest that the enalapril could be an initial choice in the treatment of essential hypertension as a single oral agent in once a day regimen resulting in good antihypertensive effects, improvement of subjective symptoms, regreassion of the left ventricular hypertrophy and few side effects.
Ageusia ; Blood Pressure ; Creatinine ; Dizziness ; Echocardiography ; Electrocardiography ; Enalapril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Peptidyl-Dipeptidase A ; Proteinuria ; Sleep Initiation and Maintenance Disorders ; Urinalysis

For the evaluation of the left ventricular diastolic function in mild to moderate hypertensive patients without left ventricular hypertrophy, 15 hypertensive patients (group A) and 15 normotensive subjects (group B) were examined by 2-D guided M-mode echocardiography. Various systolic and diastolic indices were derived from computer-assissted analysis of differential curves of left ventricular dimension and posterior wall thickness. The systolic and diastolic function indices of each of the two groups were compared. The results were as follows : 1) There were no significant differences in ejection fraction, left ventricular peak ejection rate and posterior wall thickening rate between two groups. 2) There were no significant differences in % ventricular A wave, left ventricular peak filling rate and posterior wall peak relaxation rate between two groups. 3) One third filling rate was 2.07+/-0.41 EDD/sec in group A and which was significantly lower than 3.29+/-0.88 EDD/sec of group B. Above result suggests that computer-assisted analysis of differential curves of left ventricular dimension and posterior wall thickness could be helpful in the early detection of diastolic dysfunction, and that left ventricular diastolic dysfunction in its early filling period may develop in the mild to moderate hypertensive patients even before left ventricular hypertrophy develops.
Echocardiography ; Humans ; Hypertrophy, Left Ventricular* ; Relaxation

A 15 year-old boy who was supposed to have had rheumatic myocarditis manifested acute heart failure and transient left ventricular hypertrophy in the early phases of the disease process. Serial echocardiographic examination was very helpful to follow the clinical course and observe the anatomic and functional changes of the heart in conjunction with the clinical status.
Adolescent ; Echocardiography ; Heart ; Heart Failure ; Humans ; Hypertrophy, Left Ventricular* ; Male ; Myocarditis*

PURPOSE: The aim of this pilot study was to determine the relationship between the beta-fibrinogen G/A-455 single nucleotide polymorphism and the risk of ischemic stroke in Korea because there are racial differences in polymorphisms and Koreans have never been studied before. METHODS: From March to September 2003, we compared 80(male : female=1.2 : 0.8) patients who were diagnosed with ischemic stroke at Kyung Hee university hospital emergency center had been to 150 control subjects. The genotypes of the beta-fibrinogen G/A-455 polymorphism were confirmed by using the polymerase chain reaction (PCR) followed by HaeIII restriction enzyme digestion. RESULTS: The results showed that the patient group had a much higher rate of heterozygotism (GA or AG). A statistical analysis of the genotype frequency showed chi2 to be 6.24, indicating a significant difference between the patient and the control groups (p=0.044). For the allele frequency, the odds ratio was 1.88(95% CI 1.16-3.04), indicating a significant difference between the two groups, and also allele frequency in ischemic stroke patient with or without hyperfibrinogenemia, male sex and smoking history showed odds ratio to be 2.38(95% CI 1.26~4.49), 1.78(95% CI 1.01~3.14)and 1.94(95% CI 1.12~3.35) indicating significant difference. CONCLUSION: The high rate of polymorphisms of the AA genotype of beta-fibrinogen G/A-455 in ischemic stroke patients in our study leads us to the belief of the possibility that beta-fibrinogen G/A-455 polymorphisms in males with a smoking history and hyperfibrinogenemia, if found in advance, could lead to an improved prognosis and reduced clinical expenses by allowing early diagnosis and preventive management.
Digestion ; Early Diagnosis ; Emergencies ; Gene Frequency ; Genetics ; Genotype ; Humans ; Korea ; Male ; Odds Ratio ; Pilot Projects* ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Prognosis ; Smoke ; Smoking ; Stroke*

Catopril, an angiotensin converting enzyme inhibitor, was administrated in 30 hypertensive patients(mild 8, moderate 12, severe 10 cases)for 12 weeks or longer in order to observe the hypertensive effects. Changes in quality of life, side effects, electrocardiogram and left ventricular mass index(LVMI) by 2D-guided M-mode echocardiography were also evaluated before and after captopril. 1) After 12 weeks treatment with 25 to 150mg of captopril alone, blood pressures were lowered markedly in 16(53%), moderatly in 5(17%) and midly in 2(7%), while the addition of 25mg hydrochlorthiazide to captopril in the patients who showed no satisfactory responses the blood pressure were lowered markly in 21(70), moderately in 6(20%) and mildly 3(10%) out of 30 patients studied. The average of blood pressure of the 30 subjects were systolic 180.7+/-20.7mmHg(M+/-SD) and diastolic 113.2+/-12.5 before treatment, which were lowered to 148+/-15.8 and 92.5+/-8.0mmHg respectively after 12 weeks(P<0.005). 2) Heart rates were not changed with captopril and/or hydrochlorothiazide. 3) Quality of life improved markedly in 5(17%) and slightly in 12(40%) out of 30 subjects. 4) Complete blood cell count, urinalysis and serum enzymes followed revealed no significant changes. 5) By electrocardiographic follow-up studies 1 out of 13 subjects with LVH, 1 out of 4 LAH, 1 out of 2 ST-T changes were revealed to improved to normal. 6) In 25 out of 30 cases left ventricular mass indices(LVMI) were above 125g/m2 before treatment, among which 15 cases were followed with satisfactoriness good quality of the echocardiographic recorings and the LVMI was reduced from 169.6+/-40.7 to 141.7+/-40.9g/m2(P<0.01). 7) Undesirable side effects were dry cough 3, skin rash 2, dysgeusia 1 and renal dysfunction 1. 8) Considering the blood pressure lowering effects, life quality changed and side effects together the captopril was considered very useful in 8(27%) and useful in 16(53%) out of 30 subjects. Above results suggest that captopril can be prescribed as an effective initial single agent or with in combinations with thiazide for the treatment of hypertensive of various severities with acceptably low side effects.
Blood Cell Count ; Blood Pressure ; Captopril* ; Cough ; Dysgeusia ; Echocardiography ; Electrocardiography ; Exanthema ; Follow-Up Studies ; Heart Rate ; Humans ; Hydrochlorothiazide ; Peptidyl-Dipeptidase A ; Quality of Life ; Urinalysis