No abstract available.
Gait* ; Humans ; Spinal Cord Diseases*

BACKGROUND: Periventricular white matter changes(PVWC) in chronic cerebrovascular disease are regarded to be caused by chronic low perfusion and as forms of small arterial disease of cerebral circulation. In some reports, these are suggested to be concerned with the fluctuation of blood pressure. The purpose of this study was to elucidate the diurnal pattern of BP in chronic cerebrovascular disease and the relationship between severity of PVWC and decrement of nocturnal dip through the ambulatory 24 hour blood pressure monitoring (ABPM). Subjects and METHODS: ABPM were carried out every 30 minutes in 36 patients with chronic cerebrovascular disease, prospectively. Twenty-five had PVWCS and/or multiple lacunar infarction (MLI) with various grades, 11 had large artery territorial infarction (LATI) without PVWC. The patterns of ABPM in each group were analyzed by disease entity and severity of PVWC. RESULTS: There was no differences in the two groups; PVWC/MLl and LATI, in properties(age, sex, etc.) and possible stroke risk factors (hypertension, diabetes mellitus, hypercholesterolemia, smoking, etc.) (P<.05). The pattern of ABPM of PVWC/MLl group showed the decrement of nocturnal dip of BP unlike LATI group (P<.05). The decrement of nocturnal dip of BP correlated with severity of PVWC (P<.05). CONCLUSION: We conclude that the diurnal pattern of BP in small artery disease is different from that of large arterial disease group and related to the severity of PVWC.
Arteries ; Blood Pressure Monitors* ; Blood Pressure* ; Diabetes Mellitus ; Humans ; Hypercholesterolemia ; Infarction ; Perfusion ; Prospective Studies ; Risk Factors ; Smoke ; Smoking ; Stroke ; Stroke, Lacunar

PURPOSE: The cell cycle control system is necessary for the normal growth and differentiation of cells. The purposes of this study were to compare CD99 expression with a known intracellular marker of a specific cell cycle and to evaluate the potential of CD99 as surface marker for this cell cycle. METHODS: We induced arrest of the cell cycle in fetal lung fibroblast by contact inhibition or serum deprivation from culture media. We activated peripheral blood lymphocytes with the treatment of phytohemagglutinin (PHA) and interleukin-2 (IL-2). Next, we synchronized the cell cycle of peripheral blood lymphocytes to the late G1 phase with rapamycin. According to their CD99 expression, the peripheral blood lymphocytes were separated by magnetic bead and analyzed by Western blotting. RESULTS: CD99 expression in fetal lung fibroblast rapidly decreased in cell cycle arrest and recovered soon after G1 activation of the cell cycle. By analyzing chronologic changes of CD99 expression and PI-histogram, we found CD99 expression decreased after passing the G1 checkpoint. G1/S transition was interrupted by potent immunosuppresant, rapamycin. IL-2 receptor remained high after rapamycin treatment in the activated lymphocytes, whereas CD99 expression and propium iodide decreased as compared with the same condition without rapamycin. This suggested that CD99 expression was decreased in the late G1 phase. Retinoblastoma gene (Rb) and CDK-2 are necessary for G1/S transition. We found both of these in CD99+ lymphocyte through Western blotting only. Cyclin B, which has an important role in S/G2/M transition, was only found in CD99-activated lymphocytes. CONCLUSION: CD99 may be a G1 phase specific surface marker.
Blotting, Western ; Cell Cycle Checkpoints ; Cell Cycle* ; Contact Inhibition ; Culture Media ; Cyclin B ; Fibroblasts ; G1 Phase ; Genes, Retinoblastoma ; Interleukin-2 ; Lung ; Lymphocytes ; Receptors, Interleukin-2 ; Sirolimus

BACKGROUND AND PURPOSE: Triflusal(TR), 2-acetoxy-4-trifluoromethyl banzoic acid, is a platelet aggregation inhibitor structurally related to aspirin, proven to possess both in vitro and in vivo platelet antiaggregatoy activity. The aim of this study was to evaluate the effect of TR with different dosages on platelet function using platelet aggregation, adenosine triphosphate (ATP) secretion, and thromboxane generation after TR administration. METHODS: Twenty healthy volunteers (age 25-41years, 15 males 5 females) were randomly divided into two groups of ten subjects who were receiving one of two regimens (TR 300mg/day; TR 900mg/day) for seven days. Platelet functions including platelet aggregation by impedance methods using whole blood with ADP (5, 10uM) and collagen (1,2uM), ATP secretion and thromboxane B2 generation were determined. RESULTS: The inhibitory effect of platelet aggregation was observed in both groups. The degree of inhibitory effect was depended on the dosage of TR and the types of aggregating agent. Thromboxane B2 concentrations were significantly decreased by TR ingestion in both groups (p<0.01), but there was no differences in ATP secretion. CONCLUSIONS: This study show that TR exerts a remarkable platelet antiaggregation effect and inhibition of thromboxane synthesis in whole blood. In addition, the fact that TR does not affect ATP secretion means selective blocking of the platelet cyclooxygenase pathway.
Adenosine Diphosphate ; Adenosine Triphosphate ; Aspirin ; Blood Platelets* ; Collagen ; Eating ; Electric Impedance ; Healthy Volunteers ; Humans* ; Male ; Platelet Aggregation* ; Prostaglandin-Endoperoxide Synthases ; Thromboxane B2

BACKGROUND & OBJECTIVES: Severe hemispheric infarction(SHI) reportedly has various range of high mortality. Recently it has been reported that more aggressive therapeutic intervention, such as decompressive hemicraniectomy or mild hypothermia might has potential benefits in the management of SHI. However, the mortality and the prognosis of Sill under the conservative treatment were rarely studied yet in Korea. METHODS: Sixty-six patients with CT proven SHI were subjected among 1649 acute stroke patients registered at the Hallym Stroke Data Bank since Jan. 1993. We analyzed the computerized databases for the mortality and compared inclusively demographic features, clinical characteristics, etiology, therapy modalities and CT findings of fatal group with those of survivors. RESULTS: Twenty-five patients were expired among 66 SI-il patients(mean age: 64.9+/-11.5, male to female ratio;37:29). The mean time to expire was 160.4 hours. The fatal group had a significantly higher incidence of cardioembolism. uncontrolled BP during the acute stage, and extensive infarction territory(MCA+ACA). Risk factors for ischemic stroke such as hypertension, hyperlipidemia. smoking, previous stroke history, diabetes mellitus. and old age were not related to mortality low densities and hyperdense MCA signs on brain imaging were not different between two groups. CONCLUSIONS: The early mortality rate of Sill under the conservative care was 38% in a referral hospital of Korea. intractable hypertension in the acute stage, cardioembolism and extent of infarct area may have predictable values of early mortality of SHI.
Diabetes Mellitus ; Female ; Humans ; Hyperlipidemias ; Hypertension ; Hypothermia ; Incidence ; Infarction ; Korea ; Male ; Mortality* ; Neuroimaging ; Prognosis ; Referral and Consultation ; Risk Factors ; Smoke ; Smoking ; Stroke ; Survivors

We studied the ultrastructural alteration of glomerular anionic sites in 6 patients with minimal change nephrotic syndrome, 5 patients with membranous glomerulonephritis, 4 patients with focal segmental glomerulosclerosis, and 4 patients with IgA nephropathy by staining with polyethyleneimine (PEI) as a cationic probe. The control study was examined by using a nephrectomy specimen of non-glomerular disease which had no proteinuria. This method seems to selectively stain heparan sulphate in the basement membranes and has been widely used to evaluate changes in basement membrane charge in various human diseases as well as in experimental studies. The anionic sites in the lamina rara interna and lamina densa of normal glomerular basement membrane were always less numerous and less regularly distributed than those in the lamina rara externa. Characteristic common findings in these glomeruli showed a marked decrease of glomerular anionic sites in the regions with immune-complex deposits and normal distribution in the regions with focally those being absorbed and newly forming glomerular basement membrane. They were not detected in the gap of the basement membrane and on the area of the detached overlying epithelium using the PEI method. But the foot process fusion of epithelial cells seems not to influence the loss of anionic sites on the glomerular basement membrane.
Basement Membrane ; Epithelial Cells ; Epithelium ; Foot ; Glomerular Basement Membrane* ; Glomerulonephritis, IGA ; Glomerulonephritis, Membranous ; Glomerulosclerosis, Focal Segmental ; Humans ; Nephrectomy ; Nephrosis, Lipoid ; Polyethyleneimine ; Proteinuria

BACKGROUND: In cardiac arrest, the survival rate increases with the provision of bystander cardiopulmonary resuscitation (CPR), of which the initial response and treatment are critical. Telephone CPR is among the effective methods that might increase the provision of bystander CPR. This study aimed to describe and examine the improvement of neurological outcomes in individuals with out-of-hospital acute cardiac arrest by implementing the nationwide, standardized telephone CPR program. METHODS: Data from the emergency medical service-based cardiac arrest registry that were collected between 2009 and 2014 were used. The effectiveness of the intervention in the interrupted time-series study was determined via a segmented regression analysis, which showed the risk ratio and risk difference in good neurological outcomes before and after the intervention. RESULTS: Of 164,221 patients, 148,403 were analyzed. However, patients with unknown sex and limited data on treatment outcomes were excluded. Approximately 64.3% patients were men, with an average age of 63.7 years. The number of bystander CPR increased by 3.3 times (95% confidence interval [CI], 3.1–3.5) after the intervention, whereas the rate of good neurological outcomes increased by 2.6 times (95% CI, 2.3–2.9 [1.6%]; 1.4–1.7). The excess number was identified based on the differences between the observed and predicted trends. In total, 2,127 cases of out-of-hospital cardiac arrest (OHCA) after the intervention period received additional bystander CPR, and 339 cases of OHCA had good neurological outcomes. CONCLUSION: The nationwide implementation of the standardized telephone CPR program increased the number of bystander CPR and improved good neurological outcomes.
Cardiopulmonary Resuscitation* ; Emergencies ; Heart Arrest ; Humans ; Male ; Odds Ratio ; Out-of-Hospital Cardiac Arrest* ; Survival Rate ; Telephone*

BACKGROUND: Intravenous recombinant tissue plasminogen activator (r-tPA) infusion is the only established treatment for acute ischemic stroke so far. We explored whether the demonstrated efficacy of r-tPA could be applied to communi-ty-based hospitals in Korea and whether the immediate improvements after r-tPA infusion had any predicting value for long-term outcomes. METHODS:Twenty-six patients (mean age, 69; 46% female) with acute ischemic stroke were treated with r-tPA, abiding by the National Institute of Neurological Disorders and Stroke (NINDS) protocol. The Neurological status was measured with the National Institutes of Health Stroke Scale (NIHSS) at baseline, at 1 hour after r-tPA , at 24 hours, and at 7 days and the functional outcome was evaluated with the modified Rankin scale (mRS) and Barthel Index at 90 days after stroke. RESULTS: Of 26 patients, 16 (62%) made full recovery or became independent, 4 (15%) had severe physical disability, and 6 (23%) patients died. Three patients (11.5%) had intracranial hemorrhage (asymptomatic, 2; symptomatic, 1). There were no significant differences in age, sex, risk factors, baseline NIHSS scores, hemorrhagic complication, initial brain CT abnormalities, and onset to needle time between good (full recovery or mRS 0-2) and poor groups (mRS 3-5 or death) at day 90, except for the improvement of NIHSS examined at 1 hour after r-tPA (repeated measured ANOVA test, p<0.01). CONCLUSIONS The NINDS r-tPA protocol is feasible in the community-based hospitals in Korea with the safety and efficacy comparable to the results of NINDS r-tPA trials. In addition, we suggest that the immediate neurological improvement after r-tPA be a predictor for favorable long-term outcomes. (J Korean Neurol Assoc 19(4):364~369, 2001)
Brain ; Cerebral Infarction ; Humans ; Intracranial Hemorrhages ; Korea ; National Institute of Neurological Disorders and Stroke ; National Institutes of Health (U.S.) ; Needles ; Risk Factors ; Stroke* ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; Treatment Outcome

The present study details the rationale and methodology of the Korean Early Psychosis Cohort Study (KEPS), which is a clinical cohort investigation of first episode psychosis patients from a Korean population. The KEPS is a prospective naturalistic observational cohort study that follows the participants for at least 2 years. This study includes patients between 18 and 45 years of age who fulfill the criteria for one of schizophrenia spectrum and other psychotic disorders according to the diagnostic criteria of DSM-5. Early psychosis is defined as first episode patients who received antipsychotic treatment for fewer than 4 consecutive weeks after the onset of illness or stabilized patients in the early stages of the disorder whose duration of illness was less than 2 years from the initiation of antipsychotic treatment. The primary outcome measures are treatment response, remission, recovery, and relapse. Additionally, several laboratory tests are conducted and a variety of objective and subjective psychiatric measures assessing early life trauma, lifestyle pattern, and social and cognitive functioning are administered. This long-term prospective cohort study may contribute to the development of early intervention strategies and the improvement of long-term outcomes in patients with schizophrenia.
Cohort Studies* ; Early Intervention (Education) ; Humans ; Life Style ; Outcome Assessment (Health Care) ; Prospective Studies ; Psychotic Disorders* ; Recurrence ; Schizophrenia ; Schizophrenia Spectrum and Other Psychotic Disorders

BACKGROUND: Despite improved operator technique and advanced equipment designs, acute closure and restenosis remain as serious limitations to both the short and long-term success of balloon angioplasty. Atherectomy is a new transluminal interventional technique for the treatment of coronary artery obstructive disease. We evaluate preliminary experience of directonal coronary atherectomy (DCA) for complex coronary artery lesions. METHODS: We tried DCA in the 16 lesions of 15 nonrandomized sequential patients(mean age 66 years, M/F : 12/3) with coronary artery lesions that were ostial lesion in 4, ulcerated and/or eccentric in 13, restenosis after PTCA in 2 and after stent implantation in 2. The target vessel was right coronary artery in 7 and left anterior descending artery in 9. RESULTS: Primary success was achieved in 14 of 16 lesions (88%) by atherectomy and in 5(36%) by additional use of balloon angioplasty. Atherectomy retrieved tissue in 15 out of 15 attempts(100%). One patients suffered acute closure due to large dissection during the DCA which was solved successfully after stent implantation. CONCLUSIONS: Atherectomy can predictably treat selected patients with eccentric, ostial bulky coronary lesions with overall safety comparable to that of conventional balloon angioplasty, although the procedure as currently performed does not appear to prevent restenosis.
Angioplasty, Balloon ; Arteries ; Atherectomy ; Atherectomy, Coronary* ; Coronary Vessels ; Equipment Design ; Humans ; Stents ; Ulcer