BACKGROUND AND OBJECTIVES: The relationship of cold pressor, hyperventilation and exercise test responses to circadian patterns and types of angina in vasospastic angina have still not been known. The aim of this study was to identify subgoups of patients who have similar clinical features and provocation test response. MATERIALS AND METHODS: Twenty-one consecutive patients with pure vasospastic angina were studied. Six exercise tests were performed in the early morning, late morning, and late afternoon in consecutive days, and 2 hyperventilation tests and 2 cold pressor tests in the early morning. Circadian distribution and types of angina(at rest, on physical activity or both) were evaluated by clinical history, clinical records and ambulatory ECG recordings during admission and follow-up periods(mean 19+/-9 months). RESULTS: Three patterns of circadian distribution of anginal attacks were identified during all observation periods together(morning and night: MN n=, morning and afternoon or evening: M+/E n=, morning, night and afternoon and/or evening: MN+/E n=1). Exercise test was positive in 36%(40/111) without circadian variation, hyperventilation test in 66%(23/35) and cold pressor test in 6%(2/33). Neither hyperventilation test nor cold pressor test was related to circadian patterns, types or activity of angina, or numbers of spastic artery. But positive exercise test increased significantly in patients with angina on physical activity(43% vs 21%, p<0.05), high activity(57% vs 18%, p<0.01), multivessel spasm(50% vs 27%, p<0.05 ) and circadian patterns of M+/E and MN+/E(29%, 55% vs 4%, p<0.05, p<0.01). All patients with MN had rest angina and single vessel spasm. All 6 patients with M+/E had angina both at rest and on physical activity and 5 single vessel spasm. Eight of 11 patients with MN+/E had angina both at rest and on physical activity and 8 multivessel spasm. CONCLUSION: These findings suggest that hyperventilation test is highly sensitive in vasospastic angina without any relationship to clinical features, but exercise test response is related well to circadian patterns of angina attacks which are associated with characteristic clinical features.
Arteries ; Electrocardiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm

The p53 gene is believed to play an important role through the mutation and overexpression in the progression of various human malignant tumors. The type IV collagenase (matrix metalloproteinase: MMP-2) initiates the degradation of the extracellular matrix, and consequently may play a role in the tumor invasion and metastasis. To investigate the correlation between clinicopathologic features of the colorectal adenocarcinomas and benign tumors and expression of p53 and MMP-2 proteins, we performed an immunohistochemical study on 40 colorectal adenocarcinomas, 20 adenomas and 20 hyperplastic polyps by using the antibodies to p53 and MMP-2 proteins. The positive expression rate of the p53 protein in adenocarcinomas was 62.5% and significantly higher than in benign tumors. The positive expression rate of the MMP-2 protein was 47.5% in adenocarcinomas, but there was no expression of MMP-2 protein in benign tumors. The difference in p53 and MMP-2 expression rates between malignant and non-malignant tumors was statistically significant. The positive expression rate of p53 protein in the non-metastatic and metastatic adenocarcinomas was 59.1 and 66.7%, respectively. The positive expression rate of MMP-2 protein in the non-metastatic and metastatic adencarcinomas was 45.5 and 50.0%, respectively. The correlation between several clinicopathologic features and expression of p53 and MMP-2 protein was not statistically significant, but the rate of positive MMP-2 immunoreactivity showed a statistically significant difference between Astler-Coller stage B1 C1 group and B2 C2 group of adenocarcinoma (p=0.0431). We concluded that the expression of p53 and MMP-2 protein contributes to the cancer development and MMP-2 may play a certain role in the invasiveness of the colorectal tumor. p53 and MMP-2 protein expression is not correlated with lymph node metastasis.
Adenocarcinoma* ; Adenoma ; Antibodies ; Collagenases ; Colorectal Neoplasms ; Extracellular Matrix ; Genes, p53 ; Humans ; Lymph Nodes ; Matrix Metalloproteinase 2* ; Neoplasm Metastasis ; Polyps

Kinship testing in forensic casework is largely based on a likelihood ratio (LR) approach with short tandem repeat (STR) markers; however, in order to efficiently identify potential relatives in a specific population, the threshold values for kinship prediction should be determined by analyzing the kinship index distributions of the population in question. In this study, 250,000 DNA profiles were simulated using allele frequencies at 20 autosomal STR loci in Koreans, then the LRs were calculated for true close relatives and unrelated pairs. The LR distributions in related and unrelated pairs under a given relationship were compared in 2 sets of 13 Combined DNA Index System (CODIS) and 20 STR profiles. Using 13 CODIS STRs, true relatives in parent/child and full-sibling relationships were sufficiently discriminated from unrelated pairs with LR thresholds of 1,000 and 100, respectively. However, the CODIS STRs lacked the discriminatory power to differentiate between related and unrelated pairs in uncle/nephew and first cousin relationships due to high false-positive and false-negative rates with a LR threshold of 10. Increasing the number of STR loci to 20 increased discrimination of close relatives, but high false results remained in uncle/nephew and first cousin relationships. The kinship index data from this study will help make decisions on various kinship testing and familial searching in Koreans.
Asian Continental Ancestry Group ; Discrimination (Psychology) ; DNA ; Gene Frequency ; Humans ; Microsatellite Repeats

Recently, next generation sequencing (NGS) has received attention as the ultimate genotyping method to overcome the limitations of capillary electrophoresis (CE)-based short tandem repeat (STR) analysis, such as the limited number of STR loci that can be measured simultaneously using fluorescent-labeled primers and the maximum size of STR amplicons. In this study, we analyzed 15 autosomal STR markers via the NGS method and evaluated their effectiveness in STR analysis. Using male and female standard DNA as single-sources and their 1:1 mixture, we sequentially generated sample amplicons by the multiplex polymerase chain reaction (PCR) method, constructed DNA libraries by ligation of adapters with a multiplex identifier (MID), and sequenced DNA using the Roche GS Junior Platform. Sequencing data for each sample were analyzed via alignment with pre-built reference sequences. Most STR alleles could be determined by applying a coverage threshold of 20% for the two single-sources and 10% for the 1:1 mixture. The structure of the STR in each allele was accurately determined by examining the sequences of the target STR region. The mixture ratio of the mixed sample was estimated by analyzing the coverage ratios between assigned alleles at each locus and the reference/variant ratios from the observed sequence variations. In conclusion, the experimental method used in this study allowed the successful generation of NGS data. In addition, the NGS data analysis protocol enables accurate STR allele call and repeat structure determination at each locus. Therefore, this approach using the NGS system will be helpful to interpret and analysis the STR profiles from singe-source and even mixed samples in forensic investigation.
Alleles ; DNA ; Electrophoresis, Capillary ; Female ; Gene Library ; Humans ; Ligation ; Male ; Microsatellite Repeats ; Multiplex Polymerase Chain Reaction ; Statistics as Topic

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*

No abstract available.

Although a lot of articles examining concomitant intrauterine and ectopic pregnancy have been presented, we have not found any reports on ectopic implantation of chorionic villi in the vagina with normal intrauterine pregnancy. We experienced a case of chorionic villi on the vaginal wall as a hemorrhagic mass during the second trimester of pregnancy. A pregnant woman (gestational age of 16 weeks and 1 day) visited our hospital due to vaginal bleeding. There was no abnormal finding except vaginal hemorrhagic mass, and the mass revealed a product of conception.
Chorion* ; Chorionic Villi* ; Female ; Fertilization ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnancy, Ectopic ; Pregnant Women ; Uterine Hemorrhage ; Vagina

In order to study the clinical characteristics of primary acute angle closure glaucoma, we analyzed the data of 72 eyes from 63 patients with the disease from January 1, 1990 to December 31, 1993 to the Department of Ophthalmology of Chonnam University Hospital. The mean age of the patients was 63.3 years and female and male ratio was 5.9:1. And the mean IOP at first visit was 53.2 mmHg. There was no significant difference of rop between right and left eyes, and 11 patients had the disease in both eyes. 38% of the patients developed the disease in winter time. The development of the disease was closely associated with physical illness and emotional stress. 39 eyes(49.3%) of them was required filtering surgery because medication and laser treatment was insufficient to lower IOP.
Female ; Filtering Surgery ; Glaucoma, Angle-Closure* ; Humans ; Jeollanam-do ; Male ; Ophthalmology ; Stress, Psychological ; Trabeculectomy

Otologic complaints, including otalgia, tinnitus, vertigo, and hearing loss, are known to be related to temporomandibular disorders (TMDs). There have been several hypotheses regarding the clinical correlation between otologic complaints and TMDs, based on clinical phenomena with corresponding symptoms, the close neurological relationship between otic and masticatory structures, and anatomical features of the tympanic cavity and jaw joint. Function of the tensor tympani muscle seems to be crucial to understanding TMD-related otologic symptoms. The tensor tympani inserts into the handle of the malleus and it modulates sound transduction in situations of excessive noise. This muscle is innervated by the trigeminal nerve, like the masticatory muscles. Voluntary eardrum movement by pathological tensor tympani contraction results in various otologic symptoms. Thus, co-contraction of the tensor tympani with the masticatory muscle could be a possible cause of TMD-related otologic symptoms. The tensor tympani is rather unrelated to the acoustic reflex, in which the stapedius is strongly involved. The tensor tympani seem to be controlled by proprioceptive information from the trigeminal sensory nucleus. The peripheral innervation pattern of the tensor tympani and masticatory muscles is also supposed to be interconnected. The middle ear structure, including the malleus, incus, and tensor tympani, of mammals had been adapted for acoustic function and lacks the masticatory role seen in non-mammalian jawed vertebrates. The tensor tympani in non-mammals is one of the masticatory muscles and plays a role in the modulation of sound transduction and mastication. After the functional differentiation of the mammalian middle ear, the nervous connection of the tensor tympani with other masticatory apparatus still remains. Through this oto-stomatognathic vestige, the tensor tympani seems to contract unnecessarily in some pathological conditions of the TMD in which the masticatory muscles contract excessively. We hypothesized that the phylogenic relationship between the tensor tympani and masticatory apparatus is a significant and logical reason for TMD-related otologic complaints.
Acoustics ; Ear, Middle ; Earache ; Hearing Loss ; Incus ; Jaw* ; Joints ; Logic ; Malleus ; Mammals ; Mastication ; Masticatory Muscles ; Noise ; Reflex, Acoustic ; Stapedius ; Temporomandibular Joint Disorders ; Tensor Tympani* ; Tinnitus ; Trigeminal Nerve ; Tympanic Membrane ; Vertebrates ; Vertigo

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.