Lovastatin is a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, which catalyzes the conversion of hydroxymethylglutaryl-coenzyme A to mevalonate, anearly and rate-limiting step in the synthesis of cholesterol. We studied the therapeutic effect and safety of lovastatin in 18 patients with nonfamilial primary hypercholesterolemia. Patients received 20mg/day lovastatin therapy as a single evening dose. If the total cholesterol level exceeded 200mg/dl after 2weeks of lovastatin therapy, the dosage of lovastatin was doubled. Mean percent total cholesterol level reductions from baseline were 26.4% and 31.9% after 4, and 8 weeks of lovastatin therapy respectively. Mean percent HDL-cholesterol level increase from baseline were 12% and 13% after 4, and 8 weeks of lovastatin therapy respectively. Adverse effects attributable to lovastatin were mild and temporary and no patient was withdrawn from therapy. We concluded that lovastatin was a well tolerated and effective agent for the treatment of nonfamilial primary hypercholesterolemia. Further studies are needed to establish the long-term safety and effectiveness of this drug.
Cholesterol ; Coenzyme A ; Humans ; Hypercholesterolemia* ; Lovastatin ; Mevalonic Acid ; Oxidoreductases

To elucidate iron utilization patterns of Staphylococcus aureus according to the growth, we checked the residual iron concentration and the production of siderophores at the indicated times while culturing S. aureus ATCC 6538 and 25923 strains in brain heart infusion broth. By using streptonigrin susceptibility test and investigating growth curves in three culture media of which iron concentration is 0.2, 20, 45 uM, respectively, we found out that iron metabolism of 6538 strain was more active than that of 25923 strain. In point of tendency of iron consumption, 6538 strain steeply consumed iron just before the onset of stationary phase, but 25923 strain did gradually iron throughout the growth phase. Nevertheless, total amount of iron consumed by each strain during the growth was almost no difference between the strains. CAS diffusion assay in detecting siderophores showed that siderophore production followed iron consumption. These results suggest that the siderophores play significant role in iron utilization in vitro.
Brain ; Culture Media ; Diffusion ; Heart ; Iron* ; Metabolism ; Siderophores ; Staphylococcus aureus* ; Staphylococcus* ; Streptonigrin

Antihypertensive effect of angiotensin converting enzyme(ACE) inhibitor Captopril was studied in 34 cases of essential hypertension. A single oral dose of 50mg Captopril was administered daily and blood pressure was followed every 2 weeks. Diuretics were added to patients who responded inadequately after 2 weeks of Captopril single treatment. Alpha-blocker, beta-blocker or calcium channel-blocker was added to patients who responded inadequately after another 2 weeks of Captopril and diuretics combined treatment. In 5 cases, Captopril was raised to 100mg and further antihypertensives were added to unresponded 3 cases. The resuts were as follows; 1) In 15 patients, blood pressure dropped from 170.3+/-10.5mmHg/108.7+/-6.1mmHg to 148.3+/-4.4mmHg/93.3+/-3.7mmHg after 8 weeks of Captopril 50mg single therapy. 2) Hydrochlorothiazide 25mg was added to non-responders, and blood pressure dropped from 180+/-6.7mmHg/111.1+/-6.2mmHg to 155.0+/-15.0mmHg/106.2+/-8.7mmHg in 9 of 19 patients after 8 weeks of combined treatment. 3) Alpha-blocker, Beta-blocker or calcium channel blocker was added to 10 non-responders to Captopril-hyprochlorothiazide combination therapy, and blood pressure dropped from 189.0+/-27mmHg/116+/-10mmHg to 137.8+/-15.5mmHg/88.5+/-10.2mmHg after 8 weeks. 4) Increase of captopril from 50mg to 100mg in 5 random nonresponder cases of Captopril single treatment lowered blood pressure from 168.0+/-13.6mmHg/107.1+/-6.4mmHg to 161+/-15.2mmHg/99+/-8.8mmHg after 2 weeks. 5) Heart rate, and serum creatinine, electrolytes and lipid levels showed no significant interval change. 6) Six patients complained of dry cough and one patient complained of poor appetite but no other clinically significant complications were noted during Captopril treatment.
Angiotensins ; Antihypertensive Agents ; Appetite ; Blood Pressure ; Calcium ; Calcium Channels ; Captopril* ; Cough ; Creatinine ; Diuretics ; Electrolytes ; Heart Rate ; Humans ; Hydrochlorothiazide ; Hypertension

Lay public's concerns around health and health information are increasing. In response, governments and government agencies are establishing websites to address such concerns and improve health literacy by providing better access to validated health information. Since 2011, the Korean government has constructed the National Health Information Portal (NHIP) website run in collaboration with the Korean Academy of Medical Sciences (KAMS). This study therefore aimed to 1) examine consumer use of NHIP, with respect to the usage patterns, evaluation on health information provided, and perceived effectiveness of the site; and 2) identify factors that may impact perceived effectiveness of the site. An online survey was conducted with 164 NHIP users, recruited through a popup window on the main screen of the portal website from October to November 2015. The significant predicting factors supported by the data include the relevance of health information on the site, the usefulness of information in making health decisions, and the effective visualization of information. These factors can inform future efforts to design more effective health information websites, possibly based on metadata systems, to further advance the lay public's information seeking and health literacy.
Cooperative Behavior ; Government Agencies ; Health Literacy ; Internet

OBJECTIVE: The aim of this study is to elucidate the effects of transforming growth factor-beta (TGF-beta)1 and L-ascorbic acid on proteoglycan synthesis, and the relationship between Sox9, proteoglycan, and TGF-beta1 in intervertebral disc cells. METHODS: Human intervertebral disc tissue was sequentially digested to 0.2% pronase and 0.025% collagenase in DMEM/F-12 media and extracted cells were cultured in 37degrees C, 5% CO2 incubator. When intervertebral disc cells were cultured with TGF-beta1 or L-ascorbic acid, the production level of sulfated glycosaminoglycan (sGAG) was estimated by dimethyl methyleneblue (DMMB) assay. The changes of Sox9 mRNA and protein levels via TGF-beta1 were detected by RT-PCR and Western blot analysis in each. RESULTS: The amount of sGAG was increased with the lapse of time during incubation, and sGAG content of pellet cultured cells was much larger than monolayer culture. When primary cultured intervertebral disc cells in monolayer and pellet cultures were treated by TGF-beta1 20 ng, sGAG content of experimental group was increased significantly compared to control group in both cultures. L-Ascorbic acid of serial concentrations (50-300 ug/ml) increased sGAG content of mono layer cultured intervertebral disc cells significantly in statistics. The co-treatment of TGF-beta1 and L-ascorbic acid increased more sGAG production than respective treatment. After treating with TGF-beta1, Sox9 mRNA and protein expression rates were significantly increased in disc cells compared with the control group. CONCLUSION: This study suggests that TGF-beta1 would increase sulfated glycosaminoglycan (sGAG) and other proteoglycans such as versican by elevating Sox9 mRNA and protein expressions in order.
Ascorbic Acid ; Blotting, Western ; Cells, Cultured ; Collagenases ; Glycosaminoglycans ; Humans ; Incubators ; Intervertebral Disc ; Pronase ; Proteoglycans ; RNA, Messenger ; Transforming Growth Factor beta1 ; Versicans

Acute nonmyoglobinuric renal failure with severe loin pain and patchy renal vasoconstriction is a clinical syndrome that occurs following exercise in previously healthy young persons. Also nonsteroidal anti-inflammatory drugs predispose to acute renal failure in conditions associated with decreased renal blood flow. Probably exercise-induced renal ischemia and prostaglandin inhibition by NSAIDs may predispose to develop this syndrome. Here, we report two cases of acute renal failure with severe loin pain after strenuous exercise while taking NSAIDs with review of literature.
Acute Kidney Injury* ; Anti-Inflammatory Agents, Non-Steroidal ; Humans ; Ischemia ; Renal Circulation ; Renal Insufficiency ; Vasoconstriction

BACKGROUND: Efforts for improving surgical outcomes in elderly patients should include the prevention of perioperative complications and proper postoperative pain management. Epidural analgesia is effective in decreasing perioperative stress and postoperative complications, and in improving recovery. Recently, it has been suggested that epidural analgesia may attenuate immune suppression during the perioperative period and lead to reductions in cancer recurrence and improvements in overall survival. Assuming that these effects of epidural analgesia are present in vulnerable elderly patients, we compared the efficacy of epidural patient-controlled analgesia and intravenous patientcontrolled analgesia on postoperative outcomes in elderly patients who had undergone gastrectomy. METHODS: We evaluated 214 elderly patients who had undergone elective open gastrectomy for gastric cancer from 2011 to 2014. The demographic characteristics, analgesic efficacy, complications within the first 30 postoperative days, hospital stay, 24-month postoperative morbidity, cancer recurrence, and mortality were studied retrospectively. RESULTS: Two-hundred and five patients were analyzed. Eighty-five patients received epidural patient-controlled analgesia (EPCA group) and 120 patients received intravenous patient- controlled analgesia (IVPCA group). The maximum pain scores were decreased to a greater extent in the EPCA group on the day of the operation (P < 0.001) and on the first postoperative day (P = 0.001) when compared to the IVPCA group. The patients in the EPCA group also required less analgesics on the day of the operation (P = 0.033) than those in the IVPCA group. The effect of EPCA on complications within the first 30 postoperative days, 24-month postoperative morbidity, cancer recurrence, and mortality were negligible in our study. CONCLUSIONS: EPCA provided more effective pain control than IVPCA in elderly patients who had undergone elective gastric cancer surgery, but did not affect postoperative outcomes.
Aged* ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Analgesics ; Gastrectomy* ; Humans ; Length of Stay ; Mortality ; Pain, Postoperative ; Perioperative Period ; Postoperative Complications ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms

BACKGROUND: Efforts for improving surgical outcomes in elderly patients should include the prevention of perioperative complications and proper postoperative pain management. Epidural analgesia is effective in decreasing perioperative stress and postoperative complications, and in improving recovery. Recently, it has been suggested that epidural analgesia may attenuate immune suppression during the perioperative period and lead to reductions in cancer recurrence and improvements in overall survival. Assuming that these effects of epidural analgesia are present in vulnerable elderly patients, we compared the efficacy of epidural patient-controlled analgesia and intravenous patientcontrolled analgesia on postoperative outcomes in elderly patients who had undergone gastrectomy. METHODS: We evaluated 214 elderly patients who had undergone elective open gastrectomy for gastric cancer from 2011 to 2014. The demographic characteristics, analgesic efficacy, complications within the first 30 postoperative days, hospital stay, 24-month postoperative morbidity, cancer recurrence, and mortality were studied retrospectively. RESULTS: Two-hundred and five patients were analyzed. Eighty-five patients received epidural patient-controlled analgesia (EPCA group) and 120 patients received intravenous patient- controlled analgesia (IVPCA group). The maximum pain scores were decreased to a greater extent in the EPCA group on the day of the operation (P < 0.001) and on the first postoperative day (P = 0.001) when compared to the IVPCA group. The patients in the EPCA group also required less analgesics on the day of the operation (P = 0.033) than those in the IVPCA group. The effect of EPCA on complications within the first 30 postoperative days, 24-month postoperative morbidity, cancer recurrence, and mortality were negligible in our study. CONCLUSIONS: EPCA provided more effective pain control than IVPCA in elderly patients who had undergone elective gastric cancer surgery, but did not affect postoperative outcomes.
Aged* ; Analgesia ; Analgesia, Epidural ; Analgesia, Patient-Controlled* ; Analgesics ; Gastrectomy* ; Humans ; Length of Stay ; Mortality ; Pain, Postoperative ; Perioperative Period ; Postoperative Complications ; Recurrence ; Retrospective Studies* ; Stomach Neoplasms

BACKGROUND: We postulated that palonosetron, a novel antiemetic agent, might have the effect of alleviating injection pain from propofol and rocuronium. A double-blind, controlled study was undertaken to evaluate the effect of palonosetron on injection pain during total intravenous anesthesia and postoperative nausea and vomiting (PONV) using propofol-remifentanil in breast and thyroid cancer surgery. METHODS: Sixty patients were randomly allocated to one of two groups. Before injection of propofol and rocuronium, patients in group S (n = 30) received 4 ml of saline and patients in group P (n = 30) received 75 microg (1.5 ml) of palonosetron mixed with 2.5 ml of saline (n = 30). Patients were evaluated by a blinded anesthesiologist with regard to the scoring of injection pain of propofol, withdrawal response by rocuronium, PONV, shivering, postoperative pain, recall of pain, and overall satisfaction. RESULTS: The differences between groups in the incidence of injection pain due to propofol and rocuronium were insignificant. However, in group P, the severity of propofol-induced injection pain (3% vs. 33%, P = 0.003) and postoperative pain (P = 0.038) was significantly lower during the first 12 h after surgery. No differences were observed between the groups with respect to PONV, shivering, recall of pain, and overall satisfaction. CONCLUSIONS: We concluded that pretreatment of palonosetron was effective to reduce the severity of propofol-induced injection pain and early postoperative pain, although it did not reduce the incidence of injection pain from propofol and rocuronium.
Anesthesia* ; Anesthesia, Intravenous ; Breast* ; Humans ; Incidence ; Pain, Postoperative ; Postoperative Nausea and Vomiting ; Propofol ; Shivering ; Thyroid Neoplasms*

Central catheterization has been widely employed because of its various uses. However, there are many complications which are classified as mechanical complications, infectious complications, and thrombotic complications. Especially, subclavian catheterization has a high rate of mechanical complication such as pneumothrax and hemothorax. We experienced an unusual complication of central catheter misplacement in thoracic surgery and identified it with video assisted thoracoscopic equipment. We consider hemothorax to be the cause of this type of central catheter misplacement.
Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Hemothorax ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted