Many factors exert an influence on enzyme activity and thus on the rate of reactions that they catalyse. The most important of these factors are pH, temperature, substrate concentration, and the concentration of some inhibitors present. A solution of the enzyme diastase, which breaks down molecules of the polysaccharide starch to the disaccharide maltose by hydrolysis, was provided. Activity of these enzyme was measured by the rate at which starch was removed from the reaction mixture. These experiments were designed to study this reaction rate under varying conditions and the following results were obtained. 1. The range of optimum pH for this enzyme at room temperature was 4.0-7.0 and the optimum pH was 5.0. 2. The range of optimum temperatures for this enzyme at pH 7.0 was 30-50 degrees C and the optimum temperature was 40 degrees C. 3. The relationship between the enzyme activity and substrate concentration could be expressed by the Michaelis-Menten equation. The limiting velocity of these enzyme at room temperature and pH 7.0 was 415 microgram starch removed/ml of reaction mixture/min and Km, Michaelis constant, was 343 microgram/ml. 4. Inhibitors NaCl and HgCl2 blocked this enzyme activity completely at 1% and 0.01% respectively.
Amylases* ; Hydrogen-Ion Concentration ; Hydrolysis ; Maltose ; Mercuric Chloride ; Starch ; Water*

PURPOSE: The purpose of this study was to evaluate the safety, feasibility and effectiveness of an endoluminally-placed bifurcated stent-graft (Vanguard) for the treatment of infrarenal abdominal aortic aneurysm (AAA). METHODS: Transluminal endovascular stent-graft placements were attempted in 29 patients (28 male, mean age 69+/-7 years) with AAAs involving the common iliac arteries from Aug. 1997 to Jan. 1999. Endovascular therapy was performed in the cardiac catheterization laboratory with epidural anesthesia. One side of the femoral artery was opened by surgical cutdown for the bifurcated stent-graft entry and the other side was punctured percutaneously for the straight stent-graft. Computed tomography and/or intraarterial angiography were performed during an average follow-up of 10 months (2-18 months). RESULTS: Primary success rate was 75.9% (22 of 29 patients) and the overall success rate was 79.3% with successful correction of one perigraft leak. Twenty patients (69.0%) had significant coronary artery disease. There were two technical failure cases, the one was tortuous iliac vessel with spasm, the other was disconnection of the stent-graft connecting portion. Complications related to procedure occurred in 13.8% of patients (4 of 29 patients) and two of these four patients had procedure-related mortality because of acute renal failure following contrast overdose and sepsis after operation. CONCLUSIONS: Endovascular treatment of infrarenal AAA with bifurcated stent-graft (Vanguard<0A397>) is effective, feasible and relatively safe. However, further investigation for the outcome, complication and long-term follow-up are needed.
Acute Kidney Injury ; Anesthesia, Epidural ; Angiography ; Aortic Aneurysm, Abdominal* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Artery Disease ; Endoleak ; Femoral Artery ; Follow-Up Studies ; Humans ; Iliac Artery ; Male ; Mortality ; Sepsis ; Spasm

BACKGROUND: The real incidence of atherosclerotic lesions in carotid and peripheral arteries in coronary artery disease patients is not well known in Korea. The aim of this study was to prospectively evaluate the prevalence of atherosclerotic involvement of the coronary, carotid, and peripheral arteries in each arterial disease patients. This study was also designed to evaluate the risk factors, the clinical characteristics of associated carotid artery stenosis in patients with coronary artery disease, and associated peripheral vascular disease in patients with coronary artery disease. METHODS: Between June 1996 and March 1998, 475 patients (369 males, 106 females, mean age 60+/-10 years) were studied. Three hundred and seventy-three patients who presented with ischemic symptoms were enrolled in the coronary artery disease group, 81 patients were enrolled in the peripheral vascular disease group due to presenting claudications, and 21 patients were enrolled in the carotid stenosis group due to presenting cerebrovascular symptoms. Coronary angiography was done by the routine method. Carotid angiography was performed at the aortic arch by the digital subtraction angiography method. Peripheral vascular angiography was taken from the suprarenal abdominal aorta to both femoral arteries. RESULTS: 1) Risk factors for coronary stenosis, peripheral vascular disease, and carotid stenosis: The risk factors were not different between coronary stenosis, peripheral vascular disease, and carotid stenosis groups, but smoking was more frequent among patients with peripheral vascular disease than in patients with coronary stenosis (p-value=0.001). 2) Coronary artery stenosis and carotid artery stenosis: The mean age of coronary artery patients with carotid stenosis was significantly older (p-value=0.006) than for patients without carotid stenosis. The prevalence of peripheral vascular disease was more common in patients with carotid stenosis than in patients without carotid stenosis. 3) Coronary artery stenosis and peripheral vascular disease: Carotid stenosis was more common inpatients with peripheral vascular disease than in patients without peripheral vascular disease in the coronary stenosis group. 4) Prevalence of coronary, carotid, and peripheral artery disease: In patients with coronary stenosis, the prevalence of carotid stenosis was 13.9% and that of peripheral vascular disease was 29.2%. In patients with peripheral artery stenosis, the prevalence of coronary stenosis was 45.7% and that of carotid artery disease was 33.3%. In patients with carotid stenosis, the prevalence of coronary stenosis was 81.0% and that of peripheral vascular disease was 52.4%. CONCLUSION: Carotid artery disease and peripheral vascular disease developed concurrently with coronary artery disease in a significant proportion of patients. Therefore, routine angiography of peripheral and carotid arteries in patients with coronary artery disease is considered, especially in old age.
Angiography* ; Angiography, Digital Subtraction ; Aorta, Abdominal ; Aorta, Thoracic ; Arteries ; Carotid Arteries* ; Carotid Artery Diseases ; Carotid Stenosis ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Incidence ; Inpatients ; Korea ; Male ; Peripheral Arterial Disease ; Peripheral Vascular Diseases ; Prevalence ; Prospective Studies ; Risk Factors ; Smoke ; Smoking

BACKGROUND AND OBJECTIVES: Though the surgical intervention of subclavian artery stenosis has been effective, its high morbidity and mortality have limited its clinical application. In 1980 percutaneous balloon angioplasty of stenotic artery was introduced as a substitute for surgical intervention and subsequent reports have supported its efficacy noting that it is more effective when combined with stent. The purpose of this study was to assess the feasibility, safety, and efficacy of percutaneous intervention as an alternative or primary therapy for symptomatic subclavian artery stenosis. METHODS: Between September 1993 and October 1998, 17 lesions in 16 patients of symptomatic subclavian artery stenosis were enrolled as candidates for nonsurgical intervention. We performed percutaneous balloon angioplasty with stenting to the subclavian artery stenosis and evaluated the early results. RESULTS: 1)The patients had a mean age of 55+/-14 years and 13 of 16 patients were male. 2)Subclavian artery stenting was successful in 94% (16/17) of the lesion without significant complications. The cause of failure was suboptimal result after deployment of stent. 3)The types of stents deployed were Strecker stents in 4, Palmaz stents in 8, Wall stents in 3 and Jo stents in 2 cases. 4)The peak and mean pressure gradient reduced from 58.5+/-17.0 to 8.5+/-7.4 and 31.4+/-13.0 to 4.7+/-5.5 mmHg respectively (p<0.01) and the degree of luminal stenosis decreased from 92.5+/-8.5% to 10.0+/-14.3%. (p<0.01) CONCLUSION: Subclavian artery stenosis can be managed safely and effectively through percutaneous balloon angioplasty with stenting, with an excellent technical success rate and less morbidity and mortality particularly in patients coexisting other vascular and systemic diseases. However, the long-term patency and clinical effects should be warranted.
Angioplasty, Balloon ; Arteries ; Constriction, Pathologic ; Humans ; Male ; Mortality ; Phenobarbital ; Stents* ; Subclavian Artery* ; Subclavian Steal Syndrome

No abstract available.
Carcinoma, Squamous Cell* ; Teratoma*

The purpose of this study was to determine the frequency of chromosomal or genetic causes of primary amenorrhea, and was made to assess the etiology of disorders in those patients whose chromosome appeared normal. Sixty eight patients with primary amenorrhea were evaluated clinically and cytogenetically, which were refered to our Cytogenetic Laboratory in Department of Obstetrics and Gynecology, Pusan National University Hospital, from Aug. 1988 to Dec. 1996. The results were as follows. l. Out of 68 cases with primary amenorrhea, 40 cases (58.9%) had the normal chromosome constitutions and 28 cases (41.1%) had the abnormal chromosome constitutions including 46, XY. 2. Turner's syndrome was found in 25 cases (36.7%), consisting of 11 cases (16.1%) of 45, X, 3 cases (4.3%) of 46, X, i (Xq), 1 case (1.5%) of 46, X, inv (X), 1 case (1.5%) of 46, X, del (Xq), 1 case (1.5%) of 46, X, del (Xp), 1 case (1.5%) of 46, X, tel (Xq), 1 case (1.5%) of 45, X/46, XX, 1 case (1.5%) of 45, X/46, XY, 1 case (1.5%) of 45, X/47, XXX, 2 cases (2.9%) of 45, X/46, X, del (Xq), I case (1.5%) of 45, X/46, X, del (Xq), 1 case (1.5%) of 45, X/46, X, r (X). 3. 3 cases (4.3%) had the 46, XY chromosome constitution consisting of 2 cases (2.9%) of testicular feminization syndrome and 1 case (1.5%) of pure gonadal dysgenesis. 4. Among 40 patients whose chromosome are normal, the etiologies of amenorrhea were assumed to be caused by 11 cases (27.5%) of hypogonadotropic hypogonadism (idiopathic), 10 cases (25.0%) of congenital absence of vagina, 5 cases (12.5%) of pure gonadal dysgenesis in order of frequency.
Amenorrhea* ; Androgen-Insensitivity Syndrome ; Busan ; Constitution and Bylaws ; Cytogenetics* ; Female ; Gonadal Dysgenesis ; Gynecology ; Humans ; Hypogonadism ; Male ; Obstetrics ; Turner Syndrome ; Vagina

OBJECTIVE: To evaluate the impact of the cytologic smear of the endocervical canal immediately after cervical conization on the rate of residual cervical lesions. METHOD: A retrospective review of 229 patients who underwent cervical conization for high grade cervical intraepithelial neoplasia or microinvasive cancer followed by hysterectomy. Endocervical Papanicolaou smear with a cytologic brush performed immediately after cervical conization in all 229 patients. RESULTS: Fifty-four of 229 patients undergoing cervical conization followed by hysterectomy had residual lesion in the hysterectomy specimen. The prevalence rate of residual lesion according to the margin status of conization specimen as well as the results of the postconization Papanicolaou smear of the endocervical canal was compared. Forty-one of 78 patients (52.6 %) with positive margins had residual lesion compared with thirteen of 151 patients (8.6 %) with negative margins. Twenty-six of 34 patients (76.5 %) with positive postcone cytology had residual lesion compared with twenty-eight of 195 patients (14.4 %) with negative postcone cytology. CONCLUSIONS: Postcone cytologic smear of the endocervical canal as well as margin status are useful in predicting residual lesion after conization.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization* ; Female ; Humans ; Hysterectomy ; Papanicolaou Test ; Prevalence ; Retrospective Studies

BACKGROUND: Previous reports have suggested that alleles at the plasminogen activator inhibitor-1 (PAI-1) gene are associated with increased risk of developing coronary artery disease, including myocardial infarction and stroke through their effect on PAI-1 levels. Method: We attempted to search English literatures for all reports of possible effects of PAI-1 gene on cardiovascular disease in human published prior to November 1998. We used a Mantel-Haenszel method (fixed effect model) and random effect model, respectively, to perform a meta-analysis of 7 case-control studies that provided information related to the effects of PAI-1 gene on risk of cardiovascular disease. RESULTS: From 7 studies for diagnosed cardiovascular disease, the relative frequencies of the three genotypes among controls was (5G/5G) (homozygous normal), 24.5%; (4G/5G) (heterozygous), 48.2%, and (4G/4G) (homozygous for the mutant, 675 GGGG), 27.3%. These relative frequencies in cases were 21.7% for 5G/5G, 48.0% for 4G/5G, and 30.3% for 4G/4G. In fixed effect model, compared with those with genotype (5G/5G), the overall odds ratio (OR) for cardiovascular disease among those with (4G/5G) was 1.12 (95% CI, 0.93 to 1.34), and it was 1.20 (1.01 to 1.44) for the (4G/4G) genotype. For five studies with myocardial infarction as the outcome, the overall OR of myocardial infarction was 1.20 (0.99 to 1.47) for those with (4G/5G) and 1.24 (1.00, 1.54) for those with (4G/4G) genotypes, respectively. CONCLUSION: Our findings provide support for the weak association between PAI-1 gene and cardiovascular disease, in particular, myocardial infarction.
Alleles ; Cardiovascular Diseases* ; Case-Control Studies* ; Coronary Artery Disease ; Genotype ; Humans ; Myocardial Infarction ; Odds Ratio ; Plasminogen Activator Inhibitor 1* ; Plasminogen Activators ; Polymorphism, Genetic* ; Stroke

PURPOSE: To investigate the significance of E-cadherin expression in transitional cell carcinoma of bladder, as the prognostic value. MATERIALS AND METHODS: We have analyzed its immunoreactivity in 41 transitional cell carcinomas using a labelled streptavidin-biotin immunoperoxidase technique on the formalin-fixed and the paraffin-embedded tissues. E-cadherin is a Ca2+-dependent intracellular adhesion molecule of the epithelial tissue and the urothelium. We determined the E-cadherin expression in bladder carcinoma using immunohistochemical method and investigated relationship between pathological and clinical data. RESULTS: The percentage of cases showing weak pattern was higher in cases with high-grade or high-stage tumors as compared with those of low grade or low stage. The E-cadherin was expressed in a normal membranous pattern in all control cases. Abnormal E-cadherin expression was found in 8 of 20 superficial tumors and in 19 of 21 invasive tumors. Abnormal immunoreactivity was related to tumor differentiation and stage. Eight of 13 well-differentiated tumors showed preservation of membranous E-cadherin immunoreactivity, while 2 of 28 moderately and poorly differentiated tumors demonstrated normal staining patterns. CONCLUSIONS: We conclude that the loss of expression of E-cadherin in high grade or high stage transitional cell carcinoma of bladder is associated with bladder wall invasion, indicates metastasis, and may be clinical value in the assessment of prognosis.
Cadherins* ; Carcinoma, Transitional Cell* ; Immunoenzyme Techniques ; Neoplasm Metastasis ; Prognosis ; Urinary Bladder* ; Urothelium

BACKGROUND: Since percutaneous mitral valvuloplasty(PMV) using balloon was introduced by Inoue in 1984, this procedure has been accepted as a new non-surgical therapeutic modality for the treatment of selected patients with mitral stenosis. Pregnant women with mitral stenosis has suffered from life threatening complication due to altered hemodynamic changes and heart failure. Surgical valvotomy has been performed after failure of medical therapy with high risk of fetal mortality and teratogenicity. PMV can be an adequate alternative to surgical valvotomy in pregnant women. METHODS: After precise echocardiographic examination of mitral valve and its surrounding structures including thrombi in left artrium was performed, antegrade transseptal procedure was done in all 3 cases with abdominal shield using Inoue balloon technique. RESULTS: Mitral valve area increased over 1.5cm2 and hemodynamic variables improved immediately after PMV. Symptoms subsided soon after PMV in all 3 cases. Healthy normal babies were delivered transvaginally without difficulties in all 3 patients. CONCLUSIONS: Percutaneous mitral valvuloplasty is a safe and effective therapeuteic alternative to surgical valvotomy in a pregnant women with mitral stenosis who failed medical therapy, in a high risk or symptomatic pregnant women.
Echocardiography ; Female ; Fetal Mortality ; Heart Failure ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Stenosis ; Pregnancy* ; Pregnant Women