BACKGROUND: The angiotensin-converting enzyme(ACE) plays an important role in cardiovascular disease by production of angiotensin and degradation of bradykinin. Cloning of ACE gene revealed an insertion/deletion(I/D) polymorphism according to the presence/absence of a 287 base pair fragment in the 16th intron of ACE gene, and the ACE polymophism was associated with ACE activity. The genotype DD was identified as a risk factor for myocardial infarction in several studies. We analyzed the ACE I/D polymorphism in 62 patients with myocardial infarction and 67 normal subjects. METHODS: Genomic DNA from peripheral blood was amplified by polymerase chain reaction and characterized by three ACE genotypes; two insertion alleles(genotype II), two deletion alleles(genotype DD) and heterogenous alleles(genotype ID). ACE activity was determined by spectrophotometric method utilizing the synthetic substrate. RESULTS: There was no significant difference in ACE polymorphism between patients and normal subjects. But, the frequency of genotype DD was significantly increased in the low-risk group of patients compared with the high-risk group. The multi-vessel disease was more strongly associated with genotype DD, but there was no statistical significance. The ACE activity was strongly associated with ACE polymorphism with the activity being highest in genotype DD. There was no significant difference between patients and control subjects of the same genotype. CONCLUSION: There was no significant difference in ACE polymorphism between patients and normal subjects. The frequencies for genotype II, ID, DD were 0.328, 0.537, 0.134, respectively in normal subjects. There was high frequency of genotype II compared with Caucasians. A deletion polymorphism(genotype DD) may increase the risk for myocardial infarction in lowrisk group, and the serum ACE activity was correlated with three genotypes.
Angiotensins ; Base Pairing ; Bradykinin ; Cardiovascular Diseases ; Clone Cells ; Cloning, Organism ; DNA ; Genotype ; Humans ; Introns ; Myocardial Infarction* ; Polymerase Chain Reaction ; Risk Factors

PURPOSE: This study aimed to find out whether there are relationships among anatomic characteristics of inferior oblique muscle insertion, corneal diameter, axial length and inferior oblique recession landmark. METHODS: Thirty-one Korean cadaver orbits were dissected to expose the full length of extraocular muscles and sclera, and then we measured the length from the recession landmark of inferior oblique to the lateral edge of insertion of inferior rectus and to the inferior edge of insertion of lateral rectus. RESULTS: The mean of angles between the inferior oblique muscle insertion and lateral rectus direction is 27.9+/-9.0degrees and the range is from 15 degrees to 50 degrees . There is a statistically significant correlation between cord length of 8 mm recession landmark of inferior oblique and angles of inferior oblique insertion with lateral rectus direction. We divided the shapes of inferior oblique insertion into straight and convexed curves. Twelve insertions are straight and thirteen insertions are curved. There is no statistically significant correlation between shape of inferior oblique insertion and cord length from recession landmark. In corneal diameter and axial length, we found correlations with cord length of 8 mm and 10 mm recession landmark of inferior oblique. CONCLUSIONS: We conclud that there are some correlations among anatomic characteristics, axial length and corneal diameter with recession landmark of inferior oblique.
Cadaver ; Muscles ; Orbit ; Sclera

BACKGROUND: Minimally invasive cardiac surgery has emerged as a new approach to the conventional median sternotomy. The suggested advantages of the minimally invasive technique includes improved cosmesis, simplicity of opening and closing the chest, less postoperative pain, less risk of infection and bleeding, early rehabilitation, and reduced length of hospital stay. MATERIAL AND METHOD: Between March 1997 and December 1997, we performed 36 cases of minimally invasive cardiac surgery via three different approaches ; right paramedian, transverse sternotomy and mini-sternotomy with upper sternal split. RESULT: There was no operative mortality. Postoperative complications were atrial fibrillation in 4 patients, bleeding that required reoperation in 1 patient, and delayed wound closure in 1 patient who underwent 3rd redo operation. Average length of skin incision was 9.1+/-0.9 cm. Average duration of stay in the intensive care unit was 48+/-29 hours and the patients were discharged 10+/-7 days after the operation. CONCLUSION: In spite of the difficulties in defibrillation, deairing, and cardiac decompensation, minimally invasive approaches will be applied increasingly because of the suggested advantages.
Atrial Fibrillation ; Hemorrhage ; Humans ; Intensive Care Units ; Length of Stay ; Mortality ; Pain, Postoperative ; Postoperative Complications ; Rehabilitation ; Reoperation ; Skin ; Sternotomy ; Surgical Procedures, Minimally Invasive ; Thoracic Surgery* ; Thorax ; Wounds and Injuries

PURPOSE: We measured serum lycopene concentration and compared it in normal subjects, normal tension glaucoma (NTG), primary open angle glaucoma (POAG) patients. METHODS: We investigated serum lycopene concentration on 226 subjects, which were divided into 3 groups : group 1 with 136 normal subjects, group 2 with 24 NTG patients, group 3 with 66 POAG patients. Serum concentration of lycopene was measured by high performance liquid chromatography (HPLC). RESULTS: Mean age was 64.1+/-9.2 years old in group 1, 56.4+/-1.2 years old in group 2, 53.8+/-5.3 years old in group 3. Sex ratio (male:female) was 1:1 in group 1, 1.18:1 in group 2, 0.94:1 in group 3 respectively. Serum lycopene concentration was 6.44+/-0.34 microgram/dl in group 1, 2.55+/-0.44 microgram /dl in group 2, 2.17+/-0.27 microgram /dl in group 3 respectively. CONCLUSIONS: Serum lycopene concentration was significantly lower in NTG, POAG patients than normal subjects (P<.05). Further nutritional survey is necessary for new modality of treatment of glaucoma.
Chromatography, Liquid ; Glaucoma* ; Glaucoma, Open-Angle ; Humans ; Low Tension Glaucoma ; Nutrition Surveys ; Sex Ratio

Seven cases of surgically proven sparganosis were serologically tested by means of micro ELISA for their specific IgG antibody levels. For that purpose, crude saline extract of spargana from snake, Natrix tigrina lateralis was prepared and used as antigen. The sparganosis sera were also tested with Paragonimus and Cysticercus antigens to observe the cross reactivity. A total of 71 sera from normal control, ectopic and pulmonary paragonimiasis, clonorchiasis, cysticercosis and Taenia saginata cases were also included. Except for one case of old calcified infection, all of 6 human sparganosis showed higher serum levels of specific IgG antibody when the differential point of positive reaction was set at the absorbance value of 0.25 (the sensitivity being 85.7%). In control and other helminthic infections, all except 3 cases of T. saginata infection showed negative reaction to sparganum antigen (the specificity being 95.7%). None of sparganosis cases showed cross reactivity to Paragonimus and Cysticercus antigens. Undiluted cerebrospinal fluid also showed high levels of antibody when central nervous system was invaded. The serologic diagnosis by means of micro-ELISA could be a useful tool in epidemiological study of human sparganosis in susceptible population, as well as in individual diagnosis.
parasitology-helminth-cestoda ; sparganosis ; sparganum ; Paragonimus ; Cysticercus ; ELISA ; immunology ; serology ; human

BACKGROUND: Dobutamine echocardiography has been shown to be a valuable tool for determining myocardial viability in both acute and chronic coronary artery disease with left ventricular dysfunction. The purpose of the our study was to identify the role of dobutamine echocardiography in the prediction of improvement of regional left ventricular (LV) dysfunction after revascularization of chronic coronary artery disease. METHODS: Twenty-three patients (mean age 61.2+/-9.0 years;20 men) with chronic LV dysfunction underwent dobuta-mine echocardiography (dobutamine:baseline, 5, 10, 20 microgram/Kg/min) before coronary revascularization (coronary artery bypass graft surgery 16, percutaneous coronary angioplasty 7). The mean LV ejection fraction was 42.9+/-8.8% with ranging from 26% to 58%. Follow-up echocardiography was performed at 2 to 21 months (mean 9.0+/-6.2 months) after revascularization. RESULTS: During dobutamine echocardiography, there was no major complication. Improvement of the dysfunctional myocardium was observed in 12 of 23 patients in dobutamine echocardiography. Among them, 10 patients showed functonal recovery after revascularization. Another 11 patients did not show improvement of dysfunctional myocardium in dobutamine echocardiography, however 3 of them showed functional recovery after revascularization. One hundred fifteen dysfunctional segments were found in 368 segments of 23 patients, and improvement of wall motion abnormality was observed in 46 of 115 segments in dobutamine echocardiography. Among them, 31 segments showed functional recovery after revascularization. Another 69 segments did not show wall motion improvement in dobutamine echocardiography. But among them, 13 segments showed functional recovery after revas-cularization. The sensitivity and specificity of dobutamine echocardiography for the prediction of postoperative improvement of segmental wall motion were 70% and 79%, respectively. The positive and negative predictive value of dobutamine echocardiography were 67% and 81%, respectively. CONCLUSION: In patients with chronic LV dysfunction, dobutamine echocardiography can be used as a predictor of the improvement of dysfunctional segments after revascularization.
Angioplasty ; Arteries ; Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography* ; Follow-Up Studies ; Humans ; Myocardium ; Sensitivity and Specificity ; Transplants ; Ventricular Dysfunction, Left*

PURPOSE: To evaluate the clinical and radiologic results of minimally invasive plate osteosynthesis, We analyzed the cases of distal femoral fracture treated with this newly developed surgical technique. MATERIALS AND METHODS: We reviewed 12 cases of distal femoral fracture which had been treated with minimally invasive plate osteosynthesis and each patients had been followed up for a minimum twelve months. Post-operative function was evaluated with checking the range of motion of knee joint and Knee Society Score. Union period and post-operative alignment was measured on radiograph. RESULTS: In all cases, bony union was obtained in average fifteen weeks after operation without bone graft. The arc of motion of knee joint which was checked at the last follow up was 123.75 degrees on average. According to Knee Society Score, there were 9 excellent, 1 fair and 1 poor results. The post-operative complications were malunion in 1 case, soft tissue infection in 1 case and joint stiffness in 1 case. CONCLUSION: The treatment of distal femoral fracture with minimally invasive plate osteosynthesis is one of the good surgical options for clinically preferable results with high union rate without bone graft and early joint motion.
Femoral Fractures* ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Range of Motion, Articular ; Soft Tissue Infections ; Transplants

OBJECTIVES: We investigated the genotoxic effects of 40-59 nm silver nanoparticles (Ag-NPs) by bacterial reverse mutation assay (Ames test), in vitro comet assay and micronucleus (MN) assay. In particular, we directly compared the effect of cytochalasin B (cytoB) and rat liver homogenate (S9 mix) in the formation of MN by Ag-NPs. METHODS: Before testing, we confirmed that Ag-NPs were completely dispersed in the experimental medium by sonication (three times in 1 minute) and filtration (0.2 microm pore size filter), and then we measured their size in a zeta potential analyzer. After that the genotoxicity were measured and especially, S9 mix and with and without cytoB were compared one another in MN assay. RESULTS: Ames test using Salmonella typhimurium TA98, TA100, TA1535 and TA1537 strains revealed that Ag-NPs with or without S9 mix did not display a mutagenic effect. The genotoxicity of Ag-NPs was also evaluated in a mammalian cell system using Chinese hamster ovary cells. The results revealed that Ag-NPs stimulated DNA breakage and MN formation with or without S9 mix in a dose-dependent manner (from 0.01 microg/mL to 10 microg/mL). In particular, MN induction was affected by cytoB. CONCLUSIONS: All of our findings, with the exception of the Ames test results, indicate that Ag-NPs show genotoxic effects in mammalian cell system. In addition, present study suggests the potential error due to use of cytoB in genotoxic test of nanoparticles.
Animals ; Comet Assay ; Cricetinae ; Cricetulus ; Cytochalasin B ; DNA ; Female ; Filtration ; Liver ; Micronucleus Tests ; Mutagenicity Tests* ; Nanoparticles* ; Ovary ; Rats ; Salmonella typhimurium ; Silver* ; Sonication

OBJECTIVES: Aromatase inhibitors that block estrogen synthesis are a proven first-line hormonal therapy for postmenopausal breast cancer. Although it is known that standardized extract of Ginkgo biloba (EGb761) induces anti-carcinogenic effects like the aromatase inhibitors, the effects of EGb761 on steroidogenesis have not been studied yet. Therefore, the effects of EGb761 on steroidogenesis and aromatase activity was studied using a H295R cell model, which was a good in vitro model to predict effects on human adrenal steroidogenesis. METHODS: Cortisol, aldosterone, testosterone, and 17β-estradiol were evaluated in the H295R cells by competitive enzyme-linked immunospecific assay after exposure to EGb761. Real-time polymerase chain reaction were performed to evaluate effects on critical genes in steroid hormone production, specifically cytochrome P450 (CYP11/17/19/21) and the hydroxysteroid dehydrogenases (3β-HSD2 and 17β-HSD1/4). Finally, aromatase activities were measured with a tritiated water-release assay and by western blotting analysis. RESULTS: H295R cells exposed to EGb761 (10 and 100 μg/mL) showed a significant decrease in 17β-estradiol and testosterone, but no change in aldosterone or cortisol. Genes (CYP19 and 17β-HSD1) related to the estrogen steroidogenesis were significantly decreased by EGb761. EGb761 treatment of H295R cells resulted in a significant decrease of aromatase activity as measured by the direct and indirect assays. The coding sequence/ Exon PII of CYP19 gene transcript and protein level of CYP19 were significantly decreased by EGb761. CONCLUSIONS: These results suggest that EGb761 could regulate steroidogenesis-related genes such as CYP19 and 17β-HSD1, and lead to a decrease in 17β-estradiol and testosterone. The present study provides good information on potential therapeutic effects of EGb761 on estrogen dependent breast cancer.
Adrenocortical Carcinoma* ; Aldosterone ; Anticarcinogenic Agents ; Aromatase Inhibitors ; Aromatase* ; Blotting, Western ; Breast Neoplasms ; Clinical Coding ; Cytochrome P-450 Enzyme System ; Estrogens ; Exons ; Ginkgo biloba* ; Humans* ; Hydrocortisone ; Hydroxysteroid Dehydrogenases ; In Vitro Techniques ; Real-Time Polymerase Chain Reaction ; Testosterone ; Therapeutic Uses

A free-floating ball thrombus in the left atrium that may cause fatal systemic emboli or left ventricular inflow obstruction, which often resulting in sudden death, is rarely seen. We describe a very unusual case of a patient with a large, free-floating left-atrial ball thrombus who underwent mechanical mitral valve replacement 7 years ago.
Death, Sudden ; Heart Atria* ; Humans ; Mitral Valve ; Thrombosis*