Cyclosporine(CsA) has been known to cause an endothelial dysfunction following its use as an immunosuppressive agent. On the other hand, the vascular endothelium has been recognized as an endocrine organ in its own right, i.e., it releases vasoactive factors such as nitric oxide(NO) and hyperpolarizing factor(EDHF). NO is synthesized by at least three isoforms of NO synthases(NOS), among which ecNOS is constitutively expressed in the endothelium. The principle of EDHF has not been determined. The present study was aimed at further investigating the mechanisms underlying the CsA-induced vasculopathy. Rats were treated with CsA (25mg/kg/day, subcutaneous) for one week and their thoracic aortae were isolated. Their changes of iso-metric tension in responses to acetylcholine, diazoxide, and high concentrations of calcium were recorded. The expression of ecNOS mRNA and protein was determined by reverse transcription-polymerase reaction and Western blot analysis, respectively. The acetylcholine-induced relaxation of the aortic rings was significantly diminished follawing the CsA-treatment, which was prevented by L-arginine supplemented along with the CsA-treatment. The relaxation of the thoracic aorta in response to either diazoxide or high concentrations of extracellular calcium was not affected by CsA-treatrnent. The vascular tissue contents of NO metabolites were significantly decreased following the CsA-treatment, which was also prevented by L-arginine-supple-mentation. Neither ecNOS mRNA nor protein expression was significantly altered following the CsA-treatment. It is suggested that CsA induces an endothelial dysfunction, which cannot be attributed to an altered role of EDHF, but to an impairment in L-arginine/NO pathway at the steps beyond NOS protein expression.
Acetylcholine ; Animals ; Aorta, Thoracic ; Arginine ; Blotting, Western ; Calcium ; Diazoxide ; Endothelium ; Endothelium, Vascular ; Hand ; Protein Isoforms ; Rats* ; Relaxation ; RNA, Messenger

The purpose of this study is to develop the computerized health instruction system to manage the Health Management Members(HMM) of the Gangbook-ku Health center in Seoul who have registered for the life-time health promotion. The HMM have been checked up and classified into 3 groups - healthy, borderline and ill group - based on their health assessment data through the computerized management system. But the computerized supporting programs for intensive management have not been sufficient enough to offer clear health instructions to the HMM and more than one user in the health center have not been able to use the system at the same time. Therefore, we have developed some new health instruction programs and upgraded the system to be used concurrently. For that purposes, we have used Delphi, Microsoft Access, ActiveX Data Objects(ADO) technology as development tools. We expect thi system to be used for health management of other public health centers, schools, and occupational settings, furthermore for evaluation of health promotion services. Additionally, this new computerized health management system supplemented with health instruction programs should be integrated to the computerized health care system at health centers in near future.
Delivery of Health Care ; Health Promotion ; Humans ; Public Health ; Seoul

The risk factors of chronic degenerative diseases are related to daily life style such as lack of exercise, obesity, smoking, stress, insufficient sleep, and etc. This study is conducted to develop a computerized system that check-up, guide and manage the residents' health through life-span. The morbidity of chronic degenerative diseases such as hypertension, diabetes mellitus and arthritis has been high in the survey on community health needs. These diseases are selected as the object of the study. The subjects who register as a health management member are over 40 and under 65 years old in the community. The combined approach method to individuals and groups is applied to the health management. The modeling of database for the system is constructed by entity-relationship model and relational data model. The subjects are classified into three groups of health, borderline and disease, on the basis of their clinical test result and daily life style. The intensive health care is provided to the subjects according to the result of analysis. We anticipate the community health promotion through the life style modification of the subjects by this intensive health care system.
Aged ; Arthritis ; Delivery of Health Care ; Diabetes Mellitus ; Health Promotion ; Humans ; Hypertension ; Critical Care* ; Life Style ; Obesity ; Risk Factors ; Smoke ; Smoking

Mycobacterium abscessus, a rapidly growing mycobacterium, is an opportunistic pathogen which causes a wide variety of clinical symptoms. Recently non-tuberculous mycobacterial infections are increasing among immunocompromised patients and made 4% of total cases of mycobacterial infection. To our knowledge, there has been no report of systemic infection caused by rapidly growing mycobacterium in Korea. We experienced a case of M. abscessus septicemia due to chemoport infection in a 47-year old female who was diagnosed as ovarian cancer stage IIIc and was in the immunocompromised state after systemic chemotherapy. The patient manifested with fever, chilling, headache, and nausea, though, there were no abnormalities on physical examination. When the patient was receiving empirical antibiotic therapy, a rapidly growing mycobacterium was detected in repeated blood cultures. She was improved with not only systemic an-tibiotic treatment but also removing the chemoport. But short course (4 weeks) of antibiotic therapy caused incomplete treatment and made multiple skin abscess. After incision and drainage of the lesions and administration of prolonged antibiotic therapy, no additional infection was observed. Based on our experience and the review of the literatures, catheter-related bacteremia due to rapidly growing mycobacterium, including M. abscessus, should be treated with catheter removal and appropriate antibiotic therapy for at least 3 to 6 months based on in vitro susceptibility testing. When a patient in neutropenic state presents sustained fever after treatment with conventional antibiotics, non-tuberculous mycobacterial infection should be considered.
Abscess ; Anti-Bacterial Agents ; Bacteremia ; Catheters ; Drainage ; Drug Therapy ; Female ; Fever ; Headache ; Humans ; Immunocompromised Host ; Korea ; Middle Aged ; Mycobacterium* ; Nausea ; Ovarian Neoplasms ; Physical Examination ; Sepsis* ; Skin