Mild therapeutic hypothermia of 32-35degrees C improved neurologic outcomes in outside hospital cardiac arrest survivor. Furthermore, in experimental studies on infarcted model and pilot studies on conscious patients with acute myocardial infarction, therapeutic hypothermia successfully reduced infarct size and microvascular resistance. Therefore, mild therapeutic hypothermia has received an attention as a promising solution for reduction of infarction size after acute myocardial infarction which are not completely solved despite of optimal reperfusion therapy. Nevertheless, the results from randomized clinical trials failed to prove the cardioprotective effects of therapeutic hypothermia or showed beneficial effects only in limited subgroups. In this article, we reviewed rationale for therapeutic hypothermia and possible mechanisms from previous studies, effective methods for clinical application to the patients with acute myocardial infarction, lessons from current clinical trials and future directions.
Acute Disease ; Body Temperature ; Humans ; Hypothermia, Induced/*methods ; Male ; Middle Aged ; Myocardial Infarction/*therapy ; Myocardial Reperfusion Injury/*prevention & control ; Time Factors ; Treatment Outcome

No abstract available.

No abstract available.
Autoimmunity* ; Hypothyroidism* ; Thyroid Gland*

We report the case of a middle aged woman who was previously diagnosed with hypertension. She had been drinking a kelp concentrate solution daily for her hypertension instead of taking the prescribed medicine due to her personal beliefs about the kelp solution. As a consequence, she experienced vasospastic angina complicated by myocardial infarction and cardiogenic syncope resulting from iatrogenic thyrotoxicosis. Complementary medicine is widely used by the general population. However, there is still a lack of evidence regarding their efficacy and safety. This case shows that inadequate use of complementary medicine could have no effect and may even be harmful. In patients with chronic diseases such as hypertension, self-care in the form of life style modification, home blood pressure monitoring and medial adherence are important for disease management.
Angina Pectoris, Variant ; Arteries* ; Blood Pressure Monitoring, Ambulatory ; Chronic Disease ; Complementary Therapies ; Disease Management ; Drinking ; Female ; Humans ; Hypertension ; Kelp ; Life Style ; Middle Aged ; Myocardial Infarction ; Self Care ; Syncope ; Thyrotoxicosis*

PURPOSE: We investigated the feasibility and clinical applicability of sentinel lymph node biopsy (SLNB) in patients with neoadjuvant chemotherapy, tumor size > 2 cm, and privious excisional biopsy. METHODS: 175 patients with 176 breast cancer underwent aLNB between October 2001 and October 2002. Among them twenty-five patients with locally advanced breast cancer underwent SLNB after neoadjuvant chemotherapy. Eighty-nine (50.6%) had primary tumor > 2 cm. The recent biopsy method used before SLNB was excision in thirty-one (17.6%) procedures. The identification rate, false-negative rate, negative prediction value and accuracy of SLNB were determined. RESULTS: SLNB was successful in 164 of 176 cases (detection rate, 93.2%). The identification rate of patients who had neoadjuvant chemotherapy was 68% and lower than that of who had not (97.3%), significantly (P=0.00). However, mapping success was not influenced by large tumor size (> 2 cm) or previous excisional biopsy. The false-negative rate and accuracy were 16.5% and 91.5, respectively. The false negative rate was 21.3% (3/14) in those patients received neoadjuvant chemotherapy compared with a 15.5% in those patents not received neoadjuvant chemotherapy (P> 0.05). In addition, Tumor size > 2 cm and previous excision did not adversely impact the false negative rate and accuracy. CONCLUSION: Neoadjuvant chemotherapy was associated with a lower identification rate for SLNB. But if detected, SLNB after neoadjuvant chemotherapy might reliably predict axillary status. SLNB is feasible and accurate in patients with large tumor (> 2 cm) and previous excision.
Biopsy ; Breast Neoplasms ; Drug Therapy* ; Humans ; Sentinel Lymph Node Biopsy*

OBJECTIVES: This study was conducted to assess the development of posttraumatic stress disorder (PTSD) after occupational physical injuries and the risk factors in occupational accident patients for PTSD. METHODS: Forty-seven occupational accident patients with physical injuries were administered BDI, STAI I and II, SCL-90-R, IES and questionnaires for risk factors and Clinician-Administered PTSD Scale(CAPS). RESULTS: 1) 12 patients(25%) were diagnosed as PTSD. 2) The BDI, STAI I and II and IES scores are significantly high(<0.05) in PTSD group than non-PTSD group. 3) The subscales of SCL-90-R, with an exception of PAR subscale, showed higher scores(<0.05) in PTSD group. 4) The loss of consciousness(LOC) was only significant risk factor in the occupational accident-related factors(<0.05). CONCLUSION: The results of this study show the development of PTSD among occupational accident patients. The loss of consciousness(LOC) was the only signiticant risk factor for PTSD in occupational accident patients.
Accidents, Occupational* ; Humans ; Surveys and Questionnaires ; Risk Factors ; Stress Disorders, Post-Traumatic*

BACKGROUND AND OBJECTIVES: Exercise myocardial perfusion scans in patients with hypertrophic cardiomyopa-thy have shown reversible perfusion abnormalities with unknown clinical significance. We performed this study to characterize dipyridamole Tl-201 SPECT imaging and correlate with clinical findings in patients with hyper-trophic cardiomyopathy. METHODS: Tl-201 SPECT was performed in 25 patients of hypertrophic cardiomyopa-thy with asymmetric septal hypertrophy and 20 normal controls after dipyridamole infusion (0.56 mg/kg). Myocardial wall was divided into 8 segments. Tl-201 uptake and relative washout rate were calculated. RESULTS: Tl-201 SPECT showed significantly lower Tl-201 uptake in basal septal (81.3+/-3.4% vs 78.2+/-6.4%, p<0.05) and apical septal wall on stress (88.2+/-4.7% vs 83.9+/-6.5%, p<0.05) and higher apical septal (86.6+/-5.2% vs 89.2+/-3.1%, p<0.05) and apical anterior wall uptake (88.7%+/-4.0% vs 91.4+/-4.9%, p<0.05) on redistribution images in patients with hypertrophic cardiomyopathy. Basal lateral wall uptake of hypertrophic cardiomyopathy was significantly lower than normal control on both stress (84.7+/-3.5% vs 81.2+/-7.3%, p<0.05) and redistribution images (85.0+/-5.8% vs 76.8+/-7.2%, p<0.0001). The septum/lateral uptake ratio of patients on rest image was significantly higher than that of normal controls (0.98+/-0.07 vs 1.07+/-0.10, p<0.001). There was no difference in age, sex, symptom, cardiac medication and the parameters of 2D-echo including left ven-tricular outflow obstruction between subgroups of normal vs abnormal washout in patients with hypertrophic cardiomyopathy. CONCLUSION: Dipyridamole Tl-201 myocardial SPECT shows reduced coronary vasodilatory capacity of myocardium, especially septum in patients with hypertrophic cardiomyopathy. High septal/lateral uptake ratio on redistribution image may be a characteristic finding. However, no correlation between abnorm-al Tl-201 washout and clinical findings was observed.
Cardiomyopathies ; Cardiomyopathy, Hypertrophic* ; Dipyridamole* ; Humans ; Myocardium ; Perfusion* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND AND OBJECTIVES: Although estrogen replacement therapy has been associated with reduction of cardiovascular events in postmeno-pausal women (PMW), the underlying mechanisms are pooly understood. Because the beneficial effect of estrogen on vasomotor function and production of vasoconstrictive endothelin-1 may be a mechanism by which cardiovascular disease events are reduced, we accessed the acute effect of estrogen on endothelial dependent, independent vasodilaton and plasma endothelin-1 level and investigated whether the acute effect of estrogen on vascular response is related to reduced circulating plasma endothelin-1 level. MATERIALS AND METHOD: The diameter of the brachial artery at rest, during reactive hyperemia (FMV) and to response to nitroglycerine (NMV) were measured using high resolution ultrasound. Twenty-one PMW, 523 years old, 8 of whom had hypercholesterolemia were included and randomized to receive placebo, conjugated estrogen 2.5 mg and 5.0 mg with one week between each investigation. FMV and plasma endothelin-1 were assessed before and 30 minutes after iv administration of each substance. Sublingual nitroglycerine (NG) was given at the end of each investigation and NMV was measured. RESULTS: FMV and plasma endothelin-1 were not changed after placebo administration. FMV increased sinigicantly only after administration of CE 5.0 mg in healhy PMW and both after administration of CE 2.5 and 5.0 mg in PMW with hypercholesterolemia. NG induced more significant vasodilation after administration of estrogen than placebo in only PMW with hypercholesterolemia. Plasma endothelin-1 level decreased significantly after administration of CE 5.0 mg in PMW with hypercholesterolemia. We could not find direct correlation between increase of FMV and decrease of plasma endothelin-1 level. CONCLUSION: IV administration of conjugated estrogen improves endothelium-dependent vasodilation in PMW and may improve endothelium-independent vasodilation in PMW with hypercholesterolemia. These finding may be partly originated by reduced plasma endothelin-1 level after estrogen administration.
Brachial Artery ; Cardiovascular Diseases ; Endothelin-1* ; Endothelium ; Estrogen Replacement Therapy ; Estrogens* ; Female ; Humans ; Hypercholesterolemia ; Hyperemia ; Menopause ; Nitroglycerin ; Plasma* ; Ultrasonography ; Vasodilation

No abstract available.
Depression* ; Diabetes Mellitus* ; Humans

This study was conducted to investigate which food items are perceived as HANSIK (Korean food) in Korea. 562 males and females aged 20-70 were surveyed on 512 most frequently consumed dish items from 4th Korean National Health and Nutrition Survey if they perceive it as HANSIK. Dish items in kimchi, namul - sukchae (cooked and seasoned vegetable) and jeotgal (salt-fermented food) category showed high response rate to be perceived as HANSIK. The response rate of twigim (frying foods) as HANSIK was low showing less than 70%. The response rate as HANSIK for foreign origin foods such as ramen and jjajangmyeon (black bean paste noodle) were lower than 25%. In jang . yangnyum (seasoning) category, doenjang (soybean paste) and gochujang (red pepper paste) showed high response rate as HANSIK more than 90%. Females showed a higher response rate as HANSIK than males for most food items except several items of myen . mandu (noodle and dumpling). The younger age group had higher HANSIK perception on many items of recently consumed foods, especially budae-jjigae (spicy sausage stew) (p < 0.001) and jwipo-jorim (braised dried filefish) (p < 0.001), implying that they already accept the common foods as HANSIK regardless of the origin. These results provide an information on the foods perceived as HANSIK among currently consumed common foods in Korea and these results can be utilized for establishment of HANSIK concept reflecting transition of dietary life in Korea.
Adult ; Aged ; Female ; Humans ; Korea ; Male ; Nutrition Surveys ; Seasons