BACKGROUND AND OBJECTIVES: Platelets play an important role in the pathogenesis of acute coronary syndrome. Prostacyclin inhibits platelet aggregation, smooth muscle cell proliferation and vasoconstriction, and it counteracts thromboxane A2 activity. The purpose of this study is to evaluate the association between a single nucleotide polymorphism in the prostacyclin synthase gene and myocardial infarction in Koreans. SUBJECTS AND METHODS: We studied total 119 patients (M: F=72: 47, mean ages=57.9). We compared 60 acute coronary syndrome patients who underwent coronary angiography with the diagnosis of acute myocardial infarction (MI), with 59 normal control group patients who had normal coronary angiograms. With the use of polymerase chain reaction-restriction fragment length polymorphism analysis, we identified a single nucleotide polymorphism, C1117A, in exon 8. RESULTS: The genotype distribution and allele frequencies were significantly different between the control group and MI group. Frequency of the genotype C1117A was: AA: AC: CC=3.4%: 30.5%: 66.1% in control group, respectively, and AA: AC: CC=1.7%: 10.0%: 88.3% in MI group, respectively. Prostacyclin synthase polymorphism was observed in the MI group and the control group, but the frequency of the CC genotype was high in MI group (odds ratio, 3.88; 95% CI 1.49-10.88, p=0.003). Compared to control group, being male, having diabetes, hypertension or obesity, and the smoking rate were high in MI group. There were not significantly differences between genotypes for clinical characteristics. CONCLUSION: We conclude that the C1117A polymorphism in exon 8 of the prostacyclin synthase gene is associated with MI, and it may be a genetic marker of MI in Koreans.
Acute Coronary Syndrome* ; Coronary Angiography ; Diagnosis ; Epoprostenol* ; Exons ; Gene Frequency ; Genetic Markers ; Genotype ; Humans ; Hypertension ; Male ; Myocardial Infarction ; Myocytes, Smooth Muscle ; Obesity ; Platelet Aggregation ; Polymorphism, Single Nucleotide ; Smoke ; Smoking ; Thromboxane A2 ; Vasoconstriction

PURPOSE: To investigate the cytotoxic effect of rigid gas permeable(RGP) and reverse geometry lens(RGL) on rabbit corneal cells. METHODS: In 36 white rabbits, right eyes were worn with either RGP or RGL. Left eyes were served as control. The rabbits were sacrificed at 1, 3, 7, 14 days after fitting and 7, 14 days after removal. Morphological changes of the basal epithelial cells and stromal keratocytes were observed using the light and transmission electron microscopy. The samples were examined after TUNEL staining in 3 high power fields (x400). RESULTS: In control eyes, 2.26% of central corneal epithelial cells showed apoptosis. After RGP wearing, the epithelial apoptosis decreased by 0.32% compared to control eyes(2.17%) at 14 days(p<0.001), and returned to 1.55% at 14 days after lens removal(2.04% in control, p=0.161). After RGL wearing, the degree of apoptosis was also lower than control(3.22%) by 0.30% at 14 days(p=0.003). However, it increased to 0.75% at 14 days after lens removal(1.67% in control, p=0.077). A few TUNEL positive fibroblasts were found in superficial stroma in both RGP and RGL group, but not in control eyes. CONCLUSIONS: Both RGP and RGL wearing may decrease the degree of apoptosis in corneal epithelium and lead the apoptosis in corneal stroma. The degree of apoptosis was recovered after lens removal, suggesting the process might to be reversible. The fitting with RGL induced apoptosis of keratocyte more than the fitting with RGP did. It suggests that the RGL wearing may be less physiologic than RGP wearing.
Apoptosis* ; Cornea* ; Corneal Stroma ; Epithelial Cells ; Epithelium, Corneal ; Fibroblasts ; In Situ Nick-End Labeling ; Microscopy, Electron, Transmission ; Rabbits

For the treatment of coarction of aorta, surgical intervention has been known as a standard therapy.During last decade balloon angioplasty for coarctation of the aorta has been reported as a successful and safe procedure in about 300 cases. This angioplasty was done mainly in infants and children, and little cases in adults and adolescents. A 22 year-old adult with coarctation of aorta have recieved balloon angioplasty. He visited to emergency room due to severe headache and the blood presure of arm was 240/130mmHg at emergency room. The blood pressure at ward was 168/92mmHg in upper extremities, 104/82mmHg in lower extrimities. His aortogram showed coarctation of thoracic aorta below left subclavian artery. The pressure gradient beween ascending aorta and right femoral artery was decreased from 60mmHg to 0mmHg after balloon dilatation (2 times, balloon diameter 18mm). There were no significant complications. The follow-up magnetic resonance image in 4 month after balloon angioplasty showed no evidence of restenosis or saccular aneurysm. Initial hypertension turned to normal blood pressure in 4 months after balloon angioplasty. This adult case of successful balloon angioplasty for coarctation of aorta is the first case reported in Korea.
Adolescent ; Adult* ; Aneurysm ; Angioplasty ; Angioplasty, Balloon* ; Aorta ; Aorta, Thoracic ; Aortic Coarctation* ; Arm ; Blood Pressure ; Child ; Dilatation ; Emergency Service, Hospital ; Femoral Artery ; Follow-Up Studies ; Headache ; Humans ; Hypertension ; Infant ; Korea ; Subclavian Artery ; Upper Extremity ; Young Adult

We experienced five cases of solitary fibrous tumor; two in the pleura, two in the orbital soft tissue, and one in the lung parenchyma. Three patients were male, and the age of the patients ranged from 38 to 71 years (mean age: 53.6). Grossly, the masses were well circumscribed and had varying sizes from 2.5 to 30.0 cm. The cut surfaces were grayish-yellow firm with focal variegated hemorrhage, necrosis, cystic change, and myxoid area. Microscopically, these were characterized by a haphazard proliferation of spindle cells or polygonal cells separated by variable amounts of hyalinized collagen and showed a prominent vascular channels reminiscent of hemangiopericytoma in foci. Immunoperoxidase stains showed a strong reactivity for CD34, and were weakly positive for vimentin. Electron microscopical examination revealed features of fibroblast; spindle to round tumor cells were arranged in groups and surrounded by collagen. Nucleoli were seldom prominent. The cytoplasm contained many microfilaments and a moderate number of cisternae of rough endoplasmic reticulum.
Actin Cytoskeleton ; Collagen ; Coloring Agents ; Cytoplasm ; Endoplasmic Reticulum, Rough ; Fibroblasts ; Hemangiopericytoma ; Hemorrhage ; Humans ; Hyalin ; Lung ; Male ; Necrosis ; Orbit ; Pleura ; Solitary Fibrous Tumors* ; Vimentin

PURPOSE: Voiding function of the neonate is considered to be different from that of adult. Although immaturity in the central nervous system that governs urinary bladder is thought to be the cause, few well-designed physiological studies on the properties of bladder itself have been reported. MATERIALS AND METHODS: Urinary bladders were removed from male Sprague-Dawley rats, 1 to 3-day old neonate and 12 week-old adult. Anterior longitudinal muscle strips without mucosa were obtained and isometric contractions were recorded. Contractile responses induced by carbachol (CCh 0.05-10.0 microM) were obtained. To investigate length-tension relationship between adult and neonate bladder, each strip was stepwise stretched up to 300% L (taking L, 100% length in a resting state) by micropositioner. In each step it was fully permitted to reach steady state in which electrical field stimulations (0.8ms, 50Hz, 2.5s duration) were applied to assess optimal length for contraction. RESULTS: CCh produced a large phasic contraction followed by a sustained tonic contraction superimposed by rapid phasic activities (RPAs) in both group but the patterns were quite different. Neonatal bladder was characterized by its tonic contractions; lesser tone increase with dose increment and taller RPAs of shorter duration. Amplitude of CCh-induced contraction were corrected by tissue weight, neonatal bladder generated greater force than that of adult. Length-tension analysis revealed that the range of active contraction in neonatal bladder according to the stretch were similar, while passive properties were quite different from that of adult bladder. Stress in the muscle strips was derived from tension divided by cross-sectional area of the strip (g/cm2). Steep increase in total tension per area as stepwise stretch was observed in neonatal bladder, which was mainly ascribed to passive properties of the bladder. Optimal length of maximal active force generation was noted in 220% of resting length in both neonatal and adult bladder. CONCLUSIONS: Our results demonstrated that CCh-induced contractile pattern and length-tension relationship in neonatal bladder are quite different from those of adult bladder in the rats, which suggests, aside from the neural immaturity, functional difference exists in the bladder itself. During development, neonatal urinary bladder seems to undergo remarkable changes in both active and passive properties.
Adult* ; Animals ; Carbachol ; Central Nervous System ; Humans ; Infant, Newborn ; Isometric Contraction ; Male ; Mucous Membrane ; Rats* ; Rats, Sprague-Dawley ; Urinary Bladder*

BACKGROUND AND OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is known to induce chronic rhinosinusitis (CRS). Nasal polyp, which is frequently found in patients with CRS, seems to have close relationship with COPD, but little is known about its relationship with COPD. In this study, we investigated the relationship between COPD and nasal polyp in middle aged and elderly CRS patients. SUBJECTS AND METHOD: We analyzed the clinical data of 174 patients (age of over 50 years) with CRS. Patients were divided as COPD [forced expiratory volume (FEV1)/forced vital capacity (FVC)<70%, n=30] and non-COPD group (FEV1/FVC≥70%, n=144) according to the pulmonary function test results. Binary logistic regression analysis was used to describe the relationships between clinically relevant factors related to nasal polyp. RESULTS: On logistic regression analysis, no significant relationship was found between age [adjusted odds ratio (AOR): 1.058, 95% confidence interval for the difference (CI)=0.995-1.126, p=0.073], sex AOR: 0.897, 95% CI=0.366-2.415, p=0.897), smoking (AOR: 0.434, 95% CI=0.154-1.219, p=0.113) and obesity (underweight AOR: 3.833, 95% CI=0.781-18.808, p=0.098, overweight AOR: 5.169, 95% CI=0.996-26.814, p=0.051, obese AOR: 2.911, 95% CI=0.335-25.329, p=0.333) with polyp. However, there was a negative correlation between COPD history and nasal polyp with statistical significance (AOR: 0.288, 95% CI=0.102-0.809, p=0.018). CONCLUSION: Our findings suggest that patients with COPD are less likely to have nasal polyp than patients without COPD.
Aged* ; Humans ; Logistic Models ; Middle Aged* ; Nasal Polyps* ; Obesity ; Odds Ratio ; Overweight ; Polyps ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Sinusitis ; Smoke ; Smoking ; Vital Capacity

Endomyocardial biopsy often fails to show myocardial inflammation for patients with clinically suspected myocarditis. The serum isoforms of troponin T (cTnT) level is a very sensitive marker of myocardial injury and it is elevated even in the absence of myocardial inflammation. We investigated the correlations for myocardial injury, virus titers and inflammation in acute viral infection. Using the murine coxsackievirus group B3 (CVB3) myocarditis model, the histopathologic findings and virus titers in mouse hearts were compared with the serum cTnT levels measured by ELISA at various time points. Viable virus titers in the hearts peaked at 3 days after infection (8.22+/-0.13 log10 PFU/100 mg of heart); they decreased at day 7 and no viable virus was detected from day 14. Myocardial inflammation was minimal at day 3, peaked at day 7 and markedly decreased at day 14. The individual serum TnT levels were significantly increased at day 3 (7.37+/-1.46 ng/ml), persisted to day 7 (0.73+/-0.08 ng/ml), and normalized at day 14. Serum cTnT levels were correlatable with virus titers in the heart (r=0.744, P <0.01), but the serum cTnT levels were not correlated with the degrees of inflammation. Using the less myocarditic strain of CVB3, similar relationships were observed between the changes for the serum cTnT levels and the heart virus titers. During the course of viral infection, myocardial injury precedes the pathologic evidence of inflammation, and the elevated cTnT levels provide evidence of myocardial injury even in the absence of any histologic findings of myocarditis.
Acute Disease ; Animals ; Coxsackievirus Infections/*pathology ; Enterovirus B, Human/isolation & purification/pathogenicity/*physiology ; Female ; Heart/*virology ; Hela Cells ; Humans ; Inflammation/*immunology ; Mice ; Mice, Inbred BALB C ; Myocardial Infarction/immunology/*pathology ; Myocarditis/immunology/pathology/*virology ; *Myocardium/immunology/pathology ; Research Support, Non-U.S. Gov't ; Troponin T/blood ; Virus Replication

Acute pulmonary embolism is usually caused by deep vein thrombosis of the lower extremities. However, vegetations of the tricuspid valve (TV) can cause embolic occlusion of the pulmonary vasculature and hence pulmonary embolism. We experienced a case of acute pulmonary embolism caused by subacute infective endocarditis of the TV. The computerized tomographic scans showed huge vegetations on the patient's TV and obstruction of the bilateral pulmonary arteries. He was successfully treated with intravenous antibiotics and TV replacement.
Anti-Bacterial Agents ; Endocarditis ; Lower Extremity ; Pulmonary Artery ; Pulmonary Embolism ; Tricuspid Valve ; Venous Thrombosis

Atrial septal defect (ASD) with severe pulmonary arterial hypertension (PAH) is thought to preclude shunt closure. However, there are several reports that vasodilator treatment is associated with good clinical outcome in these patients, recently. We report a case of good clinical outcome in a patient with ASD and severe PAH successfully treated with operative closure of ASD and subsequent use of oral bosentan medication. This case supports that the corrective repair of ASD and an oral bosentan treatment can be one of the treatment options in the selected patients with severe PAH associated with ASD.
Heart Septal Defects, Atrial ; Humans ; Hypertension ; Hypertension, Pulmonary ; Sulfonamides

No abstract available.
Aortic Valve Stenosis* ; Aortic Valve* ; Humans