We examined the associations between adiponectin or leptin and serum ICAM-1 levels in seventy-six hypercholesterolemic patients (mean age 59 yrs, 25 males and 51 females, LDL-cholesterol>=130mg/dL at screening). Blood lipid profiles and HOMA-IR derived from fasting glucose and insulin concentrations were determined. Serum levels of adiponectin, leptin and ICAM-1 were analyzed using ELISA. The results showed that serum levels of leptin were positively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =0.392, p<0.001). Serum levels of adiponectin were negatively associated with serum levels of ICAM-1 independent of age, sex and BMI (r =-0.343, p<0.005). Stepwise multiple linear regression analysis showed that serum leptin was an independent factor to be associated with serum ICAM-1 levels after adjusting for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.001). With respect to adiponectin, its association with serum ICAM-1 was attenuated but still significant when further adjustments were made for age, sex, BMI, alcohol intake, smoking status, blood lipids such as total cholesterol, triglyceride, HDL cholesterol and LDL cholesterol and HOMA-IR (p<0.005). In conclusion, this study suggests that adiponectin and leptin are associated with endothelial derived inflammation.
Adipokines ; Adiponectin* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Enzyme-Linked Immunosorbent Assay ; Fasting ; Female ; Glucose ; Humans ; Hypercholesterolemia ; Inflammation ; Insulin ; Intercellular Adhesion Molecule-1* ; Leptin* ; Linear Models ; Male ; Smoke ; Smoking ; Triglycerides

BACKGROUND: Conventional echocardiography provides fundamental information about mitral valve morphology and function but is often subjective and has a relatively low specificity in evaluating valve calcific deposit, which is critical information for the preoperative decision. We hypothesized that mitral valvular calcification could be detected in standard two-dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis so that we could overcome the subjectivity and low specificity of conventional echocardiography. METHODS: We tested this hypothesis by performing standard 2.5MHz two-dimensional echoes on mitral valve and myocardium in 30 patients with mitral stenosis, scheduled to undergo mitral valve replacement. We compared gray level of each region of interest in mitral valve and myocardium in stop-frame images with the degree of calcifications identified by pathologic and radiographic examinations. RESULTS: Ratio of mean gray level of mitral valve to mean gray level of myocardium was the most reliable value in evaluating degree of calcification. Quantitatively, region of calcification displayed the ratio of significantly higher value than that of no calcification. In case of anterior mitral valve, the ratio of the evident calcified region was greater than 3.11, that of the region without calcification was less than 2.42 and that of microcalcification was betwwn 2.42 and 3.11. For posterior mitral valve, the ratio of the evident calcified region was greater than 3.50, that of the region without calcification was less than 2.19 and that of microcalcification was between 2.19 and 3.50. The sensitivity and specificity of this method for assessment of degree of calcification was 75% and 100% for anterior mitral valve and 9% and 87.5% for posterior mitral valve. CONCLUSION: Mitral valvular calcification could be detected quantitatively in standard two dimensional echocardiograms of mitral valve in vivo by evaluating regional gray level(echo amplitude) using computerized image analysis.
Echocardiography ; Humans ; Mitral Valve ; Mitral Valve Stenosis* ; Myocardium ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Marfan syndrome is an autosomal dominant heritable disease of connective tissue which is characterized by cardinal features mainly in the cardiovascular, ocular and skeletal systems. Aneurysms or dissections of the aorta are the major cardiovascular complications of the disorder causing early mortality. Mutations in the fibrillin-1 (FBN1) gene on chromosome 15q21.1 have been found to be major causes of Marfan syndrome. The purpose of this study was to characterize the molecular defect in Korean Marfan patients, thus contributing to the effort of correlating the genotype with the phenotype. SUBJECTS AND METHODS: We screened all 65 exons of the FBN1 gene in 14 subjects diagnosed as Marfan syndrome by the method of single strand conformation polymorphism-heteroduplex analysis. RESULTS: We found mutations in only 10 among 14 patients. This study identified 8 novel mutations and 2 previously reported mutations in 14 Korean Marfan patients. Two cases were nonsense mutations and 8 were missense mutations, including 3 frameshift. Seven cases of the mutations occurred in one of the 43 calcium binding epidermal growth factor-like domains within an FBN1 gene. Mutations in Marfan patients occurred variably over the whole field of this FBN1 gene. CONCLUSION: Our results will contribute to the establishment of a database of Korean Marfan patients. Extending this study and using the database will help early detection of the disease and prevention of complications.
Aneurysm ; Aorta ; Calcium ; Codon, Nonsense ; Connective Tissue ; Exons ; Genotype ; Humans ; Marfan Syndrome* ; Mortality ; Mutation, Missense ; Phenotype

A 72-year-old man presented with incidentally found palpable abdominal mass of unknown duration. On admission, he had blood pressure of 120/80mmHg and pulse of 70 beats per minute. He consumed a pack of cigarettes per day for 45 years. He denied any prior chest pain episodes. The serum lipid profiles were within normal range. Electrocardiogram revealed sinus rhythm without ST-T wave change. Digital subtraction angiography revealed aneurysmal dilatation of both common iliac arteries to the proximal part of the external iliac arteries. Transthoracic echocardiography revealed normal left ventricular wall motion except a pseu-doaneurysm at the apex (Fig. 1). Color Doppler (Fig. 2) and intravenous contrast echocardiography (Fig. 3) showed free blood flow communication through the neck of the pseudoaneurysm. Coronary angiography revealed no significant luminal narrowing of coronary arteries. Left ventriculogram showed an aneurysm at the apex (Fig. 4). During the period of 8 months follow-up, the patient did not have any event or complain any symptom.
Aged ; Aneurysm ; Aneurysm, False* ; Angiography, Digital Subtraction ; Blood Pressure ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Dilatation ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Humans ; Iliac Artery ; Neck ; Phenobarbital ; Reference Values ; Tobacco Products

PURPOSE: In the present study, we tested whether the presence of metabolic syndrome (MetS) would worsen the features of inflammation, plasma omega 3 fatty acid levels and antioxidant potential in treated hypertensive patients. MATERIALS AND METHODS: Two groups were classified by the components of MetS: a reference group of treated hypertensive subjects: hypertension (HTN) group (n = 39) and with more than two additional MetS components: HTN with Mets group (n = 40). We further compared the parameters between HTN group and HTN with MetS group. RESULTS: The results showed that age (p < 0.001) and body mass index (BMI) (p < 0.001) were significantly different between HTN group and HTN with MetS group. Age- and BMI-adjusted total radical trapping antioxidant potential (TRAP) (p < 0.01) was significantly lower, whereas age- and BMI-adjusted CD (p < 0.05) and interleukin (IL) 6 (p < 0.05) were significantly higher in HTN with MetS group than in HTN group. Moreover, HTN with MetS group had significantly lower levels of age- and BMI-adjusted plasma phospholipid eicosapentaenoic acid (EPA) than HTN group (p < 0.05). On the other hand, the levels of age- and BMI-adjusted intracellular cell adhesion molecule-1 (ICAM-1), adiponectin and high molecular weight (HMW)-adiponectin were not significantly different between the groups. CONCLUSION: In conclusion, our results showed increased inflammatory marker, reduced antioxidant potential and EPA levels in treated hypertensive patients in the presence of MetS, suggesting the importance of changes of therapeutic lifestyle to modify the features of MetS.
Adiponectin/blood ; Age Factors ; Antihypertensive Agents/therapeutic use ; Antioxidants/*metabolism ; Body Mass Index ; Eicosapentaenoic Acid/*blood ; Female ; Humans ; Hypertension/*blood/drug therapy/*immunology ; Inflammation/*immunology ; Intercellular Adhesion Molecule-1/blood ; Interleukin-6/blood ; Male ; Metabolic Syndrome X/blood/*complications/immunology ; Middle Aged

BACKGROUND AND OBJECTIVES: The purpose of this study was to evaluate the age-related differences in clinical features, coronary anatomy, risk factors, hospital courses, and long-term prognosis of acute myocardial infarction(AMI) in women. MATERIALS AND METHODS: Total 513 female patients with AMI were divided into 3 groups ; group 1(n=3, 50 years old or less), group 2(n=02, between 51 years and 70 years old), and group 3(n=68, older than 70 years). Clinical follow-up including cardiac events was performed for mean duration of 26 months(1~155 months). Cardiac events include cardiac death, reinfarction, CABG, PTCA, CHF, stroke, and recurrent angina. RESULTS: Minimal lesion(<50% stenosis) in infarct-related artery was more prevalent in group 1 than in group 3(p<0.05). In group 2, the number of low high density lipoprotein(HDL) was significantly more than in group 3(p<0.01). During hospitalization, death and shock were more prevalently observed in group 3 than group 1(p<0.005) and group 2(p<0.001). Group 3 had more heart failures than group 1(p<0.001) and group 2(p<0.001) and group 2 had more heart failures than group 1(p<0.05). The younger age group showed a significantly higher survial rate(7 years : group 1; 76.1%, group 2; 60.6%, group 3; 34.2%, p<0.0001, Log Rank Stat =49.4) and cardiac event-free survival rate(7 years : group 1; 48.4%, group 2; 32.3%, group 3; 16.0%, p<0.0001, Log Rank Stat =37.5) for each 3 comparisons. In Cox proportional harzard analysis, LV systolic function influenced the group 2 survival (odds ratio 3.8, 95% CI 1.7 to 8.3, p<0.005) and the group 3 survival (odds ratio 2.2, 95% CI 1.1 to 4.5, p<0.05). The cardiac event free survival was influenced by age(odds ratio 1.6, 95% CI 1.2 to 2.1, p<0.005) and LV systolic function(odds ratio 1.8, 95% CI 1.3 to 2.5, p<0.001). CONCLUSION: Younger female patients with AMI had a more favorable prognosis compared with older female patients. LV systolic fuction was important as a prognostic factor for long-term survival except younger female AMI patients.
Arteries ; Death ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart ; Hospitalization ; Humans ; Middle Aged ; Myocardial Infarction* ; Prognosis* ; Risk Factors ; Shock ; Stroke

BACKGROUND AND OBJECTIVES: Screening strategies for aortic aneurysm (AA) according to risk factors and ethnicity are controversial. This study explored the prevalence of AA and determined whether screening is necessary in a population of multiple risk factors. SUBJECTS AND METHODS: From June, 2012 to April, 2013, 542 consecutive elderly (> or =65 years) male hypertensive patients without a history of AA were prospectively enrolled. After excluding 15 patients (2.8%) with aortic valve surgery, 30 patients (5.5%) with suboptimal computed tomography (CT) images, the remaining 496 patients (age 73+/-5 years) comprised the study population. Maximal diameters of the thoracic and abdominal aorta were measured using non-contrast CT. RESULTS: The prevalence of thoracic AA (TAA, diameter > or =40 mm) and abdominal AA (AAA, diameter > or =30 mm) was 36.5% (181/496) and 6.0% (30/496), respectively. In the multivariate logistic regression analysis, determinants for TAA were age {odds ratio (OR) 1.059, 95% confidence interval (CI) 1.018-1.101, p=0.005}, dyslipidemia (OR 0.621, 95% CI 0.418-0.923, p=0.018), body surface area (OR 11.92, 95% CI 2.787-50.97, p=0.001), diastolic blood pressure (OR 1.029, 95% CI 1.009-1.049, p=0.004) and AAA (OR 3.070, 95% CI 1.398-6.754, p=0.005). In contrast, AAA was independently associated with dysplipidemia (OR 2.792, 95% CI 1.091-7.143, p=0.032), current/past smokerfs (OR 4.074, 95% CI 1.160-14.31, p=0.028), and TAA (OR 3.367, 95% CI 1.550-7.313, p=0.002). CONCLUSION: The prevalence of AA was significant and TAA was more prevalent than AAA in elderly Korean males with hypertension. Future research should establish distinct screening strategies for TAA and AAA according to risk factors and ethnicity.
Aged ; Aneurysm ; Aorta ; Aorta, Abdominal ; Aortic Aneurysm* ; Aortic Valve ; Blood Pressure ; Body Surface Area ; Dyslipidemias ; Humans ; Hypertension* ; Logistic Models ; Male ; Mass Screening* ; Prevalence ; Prospective Studies ; Risk Factors

BACKGROUND: Paradoxical embolism through the patent foramen ovale (PFO) is a well-recognized mechanism for otherwise unexplained ischemic stroke. Although transthoracic contrast echocardiography (TCE) has been used frequently for noninvasive diagnosis of right to left shunt through PFO, its diagnostic accuracy appears limited, especially in patients with poor acoustic window. Since harmonic imaging (HI) can enhance the definition of contrast microbubbles, theoretical advantages of HI in the detection of right to left shunt through PFO using microbubbles can be considered. However, there are few data regarding the diagnostic efficacy of HI in the detection of right to left shunt through PFO. The purpose of this study was to compare the diagnostic value of transthoracic HI in the detection of right to left shunt through PFO in patients with stroke with that of fundamental imaging (FI). Methods: One hundred thirty-six consecutive patients with stroke (82 male, mean age:9) underwent TCE in both HI and FI and transesophageal echocardiography (TEE) during rest and Valsalva maneuver with intravenous administration of agitated saline. PFO was judged to be present if microbubbles appeared in the left atrium within 3 cardiac cycles of their appearance in the right atrium. TEE was regarded as the gold standard for assessing the diagnostic accuracy of TCE. Results: Right to left shunt through PFO was detected in 40 of 136 patients by TEE (29.4%). FI of TCE detected shunt through PFO in only 9 of 136 patients (6.6%). In contrast, HI detected shunt through PFO in 25 of 136 patients (18.4%). The overall sensitivity and specificity of FI and HI for detection of right to left shunt through PFO were 22.5%, 62.5% (p<0.05) and 100%, 100%, respectively. Valsalva maneuver during HI significantly increased the detection rate of shunt through PFO (during rest in 9 and during Valsalva maneuver in 25, p<0.05). CONCLUSION: HI with contrast microbubble injection significantly enhanced the detection of right to left shunt through PFO in patients with ischemic stroke compared with FI by transthoracic approach.
Acoustics ; Administration, Intravenous ; Diagnosis ; Dihydroergotamine ; Echocardiography* ; Echocardiography, Transesophageal ; Embolism, Paradoxical ; Foramen Ovale, Patent* ; Heart Atria ; Humans ; Male ; Microbubbles ; Sensitivity and Specificity ; Stroke ; Valsalva Maneuver

Feline parasites were investigated in the area of Suwon in Korea from September to October, 2003. Wild cat had spread to zoonotic parasites, these parasites could cause infection with a person. People have a lot of interest in parasite infection of wild cat. This article reviews rate of infection of a parasites and kind of a parasite of wild cats. We will report the critical characteristic features of parasites to a better understanding of the disease. The incidence rates of Toxocara cati, Trichuris felis, Ancylostoma braziliense and Capillaria sp were 37.0, 4.3, 1.1 and 1.1% in nematodes. Those of Taenia taeniaformis and Opisthorchis sp were 2.2 and 1.1% in cestode and trematode. Those of Isospora felis, Toxoplasma gondii, and Sarcocystis sp were 8.7, 9.8, and 2.2% in protozoa. Almost of these were zoonotic parasites without Isospora felis.
Ancylostoma ; Animals ; Capillaria ; Cats ; Cestoda ; Felis ; Humans ; Incidence ; Isospora ; Korea ; Opisthorchis ; Parasites ; Prevalence ; Sarcocystis ; Taenia ; Toxocara ; Toxoplasma ; Trichuris

PURPOSE: Primary vascular dysregulation (PVD) is a condition in which the response to cold temperature or external stimuli is abnormal. We investigated whether triflusal use results in amelioration of PVD symptoms and improvement of several related parameters compared with aspirin. MATERIALS AND METHODS: Eighty-eight PVD patients (54% female, 56+/-8 years) were randomly selected to receive either triflusal (300 mg, b.i.d.) or aspirin (150 mg, b.i.d.) for a period of 6 weeks followed by crossover. PVD was defined as both red-blood-cell standstill in video-assisted microscopic capillaroscopy during cold stimulation using carbon dioxide gas and a score of more than 7 points in a validated questionnaire. Efficacy of treatment was assessed by 1) cold intolerance symptom severity (CISS) score, 2) finger Doppler indices, and 3) indocyanine green perfusion imaging. RESULTS: The use of triflusal resulted in a greater improvement in CISS score (44.5+/-18.4 vs. 51.9+/-16.2; p<0.001) and in mean radial peak systolic velocity (69.8+/-17.2 vs. 66.1+/-16.4; p=0.011) compared to aspirin. Furthermore, significant differences were also observed in perfusion rates on indocyanine green perfusion imaging between triflusal and aspirin (45.6+/-25.8 vs. 51.6+/-26.9; p=0.020). CONCLUSION: Triflusal was more effective and demonstrated a more consistent impact on the improvement of symptoms and blood flow in patients with PVD than aspirin.
Adult ; Aspirin/*therapeutic use ; Cardiovascular Diseases/*drug therapy ; Cross-Over Studies ; Double-Blind Method ; Female ; Humans ; Indocyanine Green ; Male ; Middle Aged ; Perfusion Imaging ; Platelet Aggregation Inhibitors/*therapeutic use ; Recurrence ; Salicylates/*therapeutic use ; Treatment Outcome