OBJECTIVE: Whether exposure to chronic noise induces an increase in blood pressure, or the development of hypertension, has not been established. A cohort study was performed to identify the effects of chronic noise exposure on blood pressure. METHODS: 530 males working at a metal manufacturing factory in Busan, Korea were enrolled for the study. They were monitored for 9 consecutive years, from 1991 to 1999, with an annual health check-up. The subjects were divided into 4 groups, which were determines by noise level categories(NLC) according to noise intensity ; NLC-I: office workers, exposed to noise a level below 60dB(A); NLC-II: field technical supporters or supervisors, frequently exposed to workplace noise, wearing no hearing protection device; NLC-III: workers, exposed to workplace noise below 85 dB(A), wearing ear plugs or muffs; NLC-IV: workers, exposed to workplace noise over 85 dB(A), wearing both ear plugs and muffs. RESULTS: After controlling possible confoundens, such as baseline age, smoking, alcohol intake, exercise, family history of hypertension, systolic(SBP) or diastolic blood pressure(DBP) and changes in BMI (body mass index), the pooled mean for the systolic blood pressures, over the duration of the study period, were 3.8mmHg, 2.0mmHg and 1.7mmHg higher in NLC-IV, NLC-III NLC-II groups, respectively, than in the NLC-I group. There were no significant differences in the diastolic blood pressures between the groups. CONCLUSION: This study suggests that chronic noise exposure increases systolic blood pressure independently, among male workers.
Blood Pressure* ; Busan ; Cohort Studies* ; Ear ; Hearing ; Humans ; Hypertension ; Korea ; Male* ; Noise* ; Smoke ; Smoking

BACKGROUND: Hypertrophy of podocytes is observed in type 2 diabetic patients. Cellular hypertrophy requires combined effects of various mitogen- induced entry into the cell cycle and subsequent cell cycle arrest at the G1/S interphase. This cell cycle arrest is mediated by various cyclin-dependent kinase inhibitors (CKIs). We investigated the effect of angiotensin II receptor blocker (ARB) treatment on podocyte hypertrophy and CKIs expression in cultured podocytes stimulated by long-term high glucose. METHODS: Immortalized mouse podocytes were cultured in media containing 5.6 mM normal glucose (NG), 30 mM high glucose (HG), or NG+angiotensin II (AII, 10(-7)M) for 7 days with or without ARB (L-158,809, 10(-6)M). Cellular hypertrophy was assessed by measurement of cellular protein/cell counts, and CKIs mRNA and protein expression were assessed by reverse-transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. RESULTS: Cellular hypertrophy was induced in podocytes exposed to HG or AII compared to NG cells and this HG-induced cellular hypertrophy was inhibited with ARB treatment by 70% (p<0.05). In addition, there were 1.5-fold and 2.0 fold increases in p27Kip1 mRNA and protein expression, respectively, in HG-stimulated podocytes compared to NG- treated cells (p<0.05). p27Kip1 mRNA and protein expression were also increased in cultured podocytes stimulated by AII by 156% and 199%, respectively (p<0.05). ARB treatment ameliorated HG-induced increase in p27Kip1 mRNA by 75% and protein expression by 70% (p<0.05). In contrast, there were no significant changes in p21Cip1 and p57Kip2 protein expression in cultured podocytes exposed to HG or AII. CONCLUSION: High glucose induced significant cellular hypertrophy and increased p27Kip1 mRNA and protein expression in cultured mouse podocytes, and these changes were effectively inhibited by ARB treatment.
Mice ; Animals

BACKGROUND: Hypertrophy of podocytes is observed in type 2 diabetic patients. Cellular hypertrophy requires combined effects of various mitogen- induced entry into the cell cycle and subsequent cell cycle arrest at the G1/S interphase. This cell cycle arrest is mediated by various cyclin-dependent kinase inhibitors (CKIs). We investigated the effect of angiotensin II receptor blocker (ARB) treatment on podocyte hypertrophy and CKIs expression in cultured podocytes stimulated by long-term high glucose. METHODS: Immortalized mouse podocytes were cultured in media containing 5.6 mM normal glucose (NG), 30 mM high glucose (HG), or NG+angiotensin II (AII, 10(-7)M) for 7 days with or without ARB (L-158,809, 10(-6)M). Cellular hypertrophy was assessed by measurement of cellular protein/cell counts, and CKIs mRNA and protein expression were assessed by reverse-transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. RESULTS: Cellular hypertrophy was induced in podocytes exposed to HG or AII compared to NG cells and this HG-induced cellular hypertrophy was inhibited with ARB treatment by 70% (p<0.05). In addition, there were 1.5-fold and 2.0 fold increases in p27Kip1 mRNA and protein expression, respectively, in HG-stimulated podocytes compared to NG- treated cells (p<0.05). p27Kip1 mRNA and protein expression were also increased in cultured podocytes stimulated by AII by 156% and 199%, respectively (p<0.05). ARB treatment ameliorated HG-induced increase in p27Kip1 mRNA by 75% and protein expression by 70% (p<0.05). In contrast, there were no significant changes in p21Cip1 and p57Kip2 protein expression in cultured podocytes exposed to HG or AII. CONCLUSION: High glucose induced significant cellular hypertrophy and increased p27Kip1 mRNA and protein expression in cultured mouse podocytes, and these changes were effectively inhibited by ARB treatment.
Mice ; Animals

No abstract available.
Intercostal Nerves* ; Neurilemmoma*

Cyclosporine is one of the most useful immunosuppressants for many diseases including nephrotic syndrome, glomerulonephritis, organ transplantation, and other autoimmune diseases. However, cyclosporine is known to cause renal tubular acidosis (RTA) due to a decrease in urinary ammonium excretion. Cyclosporine also can lead to significant hypocitraturia due to a higher proximal tubular reabsorption of citrate and increase the risk for nephrolithiasis. Citrate excretion is essential for the prevention of urinary supersaturation and hypocitraturia is a major risk factor for nephrocalcinosis and nephrolithiasis. Now we report two cases of nephrolithiasis treated with cyclosporine. The first patient is a renal transplantation recipient and the second patient has membranous glomerulonephritis. Therefore, these two cases lead us to conclude that patients treated with cyclosporine have to be regularly followed up for nephrolithiasis caused by cyclosporine-induced tubular dysfunction.
Acidosis, Renal Tubular ; Autoimmune Diseases ; Citric Acid ; Cyclosporine ; Glomerulonephritis ; Glomerulonephritis, Membranous ; Humans ; Immunosuppressive Agents ; Kidney Transplantation ; Nephrocalcinosis ; Nephrolithiasis ; Nephrotic Syndrome ; Organ Transplantation ; Quaternary Ammonium Compounds ; Risk Factors ; Transplants

This study was carried out to evaluate the effect of noise exposure and age on the changes of group mean hearing threshold level(HTL) over 7-year period. For this purpose, consecutive annual audiometric tests were performed from 1991 to 1997. among 718 male employees of a metal product manufacturing factory. The subjects were divided four groups as follows according to noise level category(NLC). NLC-I officer, exposed noise level was under 60 dB(A) of time weighted average(TWA) NLC-JI technical assistant or engineer, they exposed to workplace noise occasionally NLC-IJJ worker, exposed noise level was below 85 dB(A) of TWA. wore hearing protection device(earmuff or earplug) NLC-IV worker, exposed noise level was over 85 dB(A) of TWA, wore hearing protection device(earmuff and earplug). The results were as follows 1. The improvement of group mean HTL was continued until the fifth year, showing the peak at the third year. The magnitudes of this learning effect were 1.5 - 4.6 dB. 2. The mean HTL of each age group tended to increase after the third year and the tendency was more prominent at 4000 Hz. 3. In noise exposed group(NLC-II, III, and IV), mean HTL increased from the third year after decreasing, meanwhile, in noise free group(NLC-I). it was few changed for the entire period. Among the noise exposure group, the mean HTL of NLC-IV was lower than that of NLC-III and NLC-IV. 4. After learning effect, the mean increase of HTL in noise free group(NLC-I) was 0.4-1.7 dB that suggests aging effect, and that in noise exposure group(NLC-ll, III, and IV) was 0.9 -4.1 dB that suggests noise effect. 5. Statistical analysis of the general linear model implicated that the effect of age was statistically significant at 500, 3000, 4000 and 6000Hz. and the effect of noise exposure was statistically significant at all frequencies except 6000Hz. However, the age * noise interaction was not significant at all frequencies. From these results, it was concluded that the effect of age and noise exposure seems to affect the mean HTL independently and these two factors contribute to an additive effect for the mean HTL change. Furthermore, more concerns should be needed for hearing conservation of low level exposures without any specific protection.
Aging ; Follow-Up Studies* ; Hearing* ; Humans ; Learning ; Linear Models ; Male ; Noise*

No abstract available.
Arteriovenous Malformations* ; Axilla* ; Median Nerve*

OBJECTIVE: To assess the clinical utility of the swallowing provocation test (SPT) and water swallowing test (WST) as a predictive factor of supraglottic penetration (SP) and subglottic aspiration (SA) in stroke patient with dysphagia. METHOD: Fourty-one patients suffered from ischemic stroke with dysphagia and 20 normal controls were recruited. We performed 2-step SPT (0.4 ml, 2.0 ml) via nasopharyngeal tube and 2-step WST (10 ml, 30 ml) per oral, combined with the videofluoroscopic swallowing study (VFSS) to determine the presence of SP and SA. RESULTS: The cutoff values of the swallowing provocation latency in SPT for the detection of SP and SA were 2.45 sec, 2.75 sec (first step) and 2.25 sec, 2.34 sec (second step). For SPT, the sensitivity and specificity were 78.8%, 64.3% (first step) and 71.4%, 77.8% (second step) for the SP, and 77.8%, 76.7% (first step) and 75.0%, 66.7% (second step) for the SA. For WST, the sensitivity and specificity were 66.7%, 90.9% (first step) and 70.0%, 90.9% (second step) for the SP, and 61.1%, 56.5% (first step) and 72.2%, 60.9% (second step) for the SA. CONCLUSION: SPT was more useful for the detection of SA than WST in stroke patient with dysphagia.
Deglutition Disorders ; Deglutition* ; Humans ; Sensitivity and Specificity ; Stroke* ; Water*

BACKGROUNDS/AIMS: The prognosis of cirrhotic patients with hepatocellular carcinoma (HCC) depends on both residual liver function and tumor characteristics. The aims of this study was to construct a new prognostic index for HCC patients: the modified CLIP score, and to compare its discriminatory ability and predictive power with those of the CLIP score that is currently the most commonly used integrated staging score in patients of HCC. METHODS: A retrospective analysis of 237 cases of HCC diagnosed at Dong-A university hospital was performed. Prognostic analysis was performed for single variables by estimating survival distributions with the Kaplan-Meier's method, and statistically compared by the log-rank test. RESULTS: Patients had a mean age of 57.5 years and were predominantly males (79.7%). The overall median survival period was 25.7 months. It was correlated to ascites, portal vein thrombosis, AFP, tumor size, and Child-Pugh classification. The median survival period was 41.0, 25.2, 13.8, 13.4, and 6.5 months for CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001), and 42.1, 34.0, 25.7, 14.0, and 6.8 months for modified CLIP scores 0, 1, 2, 3, and 4 to 6, respectively (P<0.001). The Kaplan-Meier's curve showed that the modified CLIP score had additional explanatory power above that of the CLIP score. CONCLUSIONS: The modified CLIP score, compared with the CLIP score, particularly in the score 2- to 3- patient groups of HCC, had greater discriminant ability and survival predictive power, but was not able to discriminate 4- to 6- patient group.
alpha-Fetoproteins/analysis ; Venous Thrombosis/complications ; Survival Analysis ; Prognosis ; Neoplasm Staging ; Middle Aged ; Male ; Liver Neoplasms/complications/mortality/*pathology ; Liver Cirrhosis/complications ; Humans ; Female ; Carcinoma, Hepatocellular/complications/mortality/*pathology ; Aged, 80 and over ; Aged ; Adult

PURPOSE: This study was undertaken to investigate the effect of a p38 mitogen-activated protein kinase (p38 MAPK) inhibitor, FR167653, on urinary albumin excretion and on the expression of slit diaphragm-associated proteins in diabetic rats. METHODS: Thirty-two Sprague-Dawley rats were injected with diluent [control (C), N=16] or streptozotocin intraperitoneally (DM, N=16). Eight rats from each group were treated with 5 mg/kg/day FR 167653 (C+FR, DM+FR) for 6 weeks. At the time of sacrifice, 24-hour urinary albumin excretion was determined by ELISA. Glomerular nephrin, P-cadherin, and ZO-1 mRNA and protein expression were determined by real-time PCR and Western blot, respectively, with sieved glomeruli. RESULTS: Urinary albumin excretion was significantly higher in DM compared to C rats, and this increase in albuminuria was significantly inhibited by the administration of FR167653 in DM rats. Glomerular phospho-p38 MAPK protein expression was significantly increased in DM rats compared to C rats, and FR167653 treatment significantly attenuated the increase in phospho-p38 MAPK expression in DM glomeruli. Nephrin mRNA and protein expression were higher in 6-week DM compared to C glomeruli, and these increases were significantly abrogated with FR167653 treatment in DM rats. In contrast, FR167653 had no effects on the decrease in P-cadherin expression and the increase in ZO-1 expression observed in DM glomeruli. CONCLUSION: These findings suggest that FR167653, a p38 MAPK inhibitor, reduce the amount of albuminuria in early diabetic nephropathy, and this anti-proteinuric effect seems to be related with the change of glomerular nephrin expression.
Albuminuria ; Animals ; Blotting, Western ; Cadherins ; Diabetic Nephropathies ; Enzyme-Linked Immunosorbent Assay ; Membrane Proteins ; p38 Mitogen-Activated Protein Kinases ; Protein Kinases ; Proteins ; Pyrazoles ; Pyridines ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Streptozocin