This is to study the incidence of Diabetes and its risk factors in the impaired glucose tolerance group. 1084 subjects who had been examined 3 times for regular check-up in one human dock center under the university hospital were studied between 1986~1993. The results are as follows; Prevalence rate of diabetes was 3.56%, and that of impaired glucose tolerance was 30.90% as of initial examination. The rate of diabetes was increasing with the age where 1.2% at age group 30~39, 3.21% at age group 40~49, 5.84% at age group 50~59, 14.28% at age group 60 and over. And also the rate of impaired glucose tolerance was increasing with the age where 21.29% at age group 30~39, 31.42% at age group 40~49, 38.91% at age group 50~59, 33.33% at age group 60 and over. Of the examinees who were initially examined, total incidence rate of diabetes who developed to obvious diabetes at the 3rd follow-up examination from the initially impaired glucose tolerance group was 4.63% and it was 11.3 times higher than from the normal group (0.41%). After controlling for the effects of both age and obesity, the risk of subsequent diabetes for subjects with impaired glucose tolerance remained significantly higher than for normal subjects (Relative Risk, 10.48). Test for trends for developing to diabetes by the increasing level of fasting blood sugar and 1 hr blood sugar at the initial examination were statistically significant in either normal and impaired glucose tolerance group. To determine the risk factor for developing to diabetes, logistic regression test was applied. Only fasting blood sugar and 1 hr blood sugar were predictors for developing diabetes from the impaired glucose tolerance group at initial examination.
Blood Glucose ; Fasting ; Follow-Up Studies ; Glucose* ; Humans ; Incidence* ; Logistic Models ; Obesity ; Prevalence ; Risk Factors*

BACKGROUND: The pericytes in the blood vessel wall have recently been identified to be important in regulating vascular formation, stabilization, remodeling, and function. We isolated and identified pericyte-like platelet-derived growth factor receptor beta-positive (PDGFRβ+) cells from the stromal vascular fraction (SVF) of adipose tissue from critical limb ischemia (CLI) patients and investigated their potential as a reliable source of stem cells for cell-based therapy. METHODS: De-identified subcutaneous fat tissues were harvested after amputation in CLI patients. Freshly isolated SVF cells and culture-expanded adipose-derived stem cells (ADSCs) were quantified using flow cytometry. A matrigel tube formation assay and multi-lineage differentiation were performed to assess pericytic and mesenchymal stem cell (MSC)-like characteristics of PDGFRβ+ ADSCs. RESULTS: PDGFRβ+ cells were located in the pericytic area of various sizes of blood vessels and coexpressed mesenchymal stem cell markers. PDGFRβ+ cells in freshly isolated SVF cells expressed a higher level of stem cell markers (CD34 and CXCR4) and mesenchymal markers (CD13, CD44, CD54, and CD90) than PDGFRβ– cells. In vitro expansion of PDGFRβ+ cells resulted in enrichment of the perivascular mesenchymal stem-like (PDGFRβ+/CD90+/CD45–/CD31–) cell fractions. The Matrigel tube formation assay revealed that PDGFRβ+ cells were located in the peritubular area. CONCLUSIONS: PDGFRβ+ ADSCs cells demonstrated a good multilineage differentiation potential. Pericyte-like PDGFRβ+ cells from the SVF of adipose tissue from CLI patients had MSC-like characteristics and could be amplified by in vitro culture with preservation of their cell characteristics. We believe PDGFRβ+ cells in the SVF of adipose tissue can be used as a reliable source of stem cells even in CLI patients.
Adipose Tissue ; Adipose Tissue, White* ; Adult Stem Cells ; Amputation ; Blood Vessels ; Extremities* ; Flow Cytometry ; Humans ; In Vitro Techniques ; Ischemia* ; Mesenchymal Stromal Cells ; Pericytes ; Platelet-Derived Growth Factor* ; Receptors, Platelet-Derived Growth Factor ; Stem Cells ; Subcutaneous Fat

This is to analyze and compare the distribution of the liver function test and its abnormal rates of the preemployment screening for office workers in asymptomatic young age groups between female and male. Liver function test(SGPT and SGOT) of 8,184 young adults(2,633 in female and 5,551 in male) were examined during the period from Jan.1,1994 to Dec. 31, 1994. The results were as follows; 1. Mean level of SGPT was 9.l+/-7.6(IU/L) in female, 21.0+/-27.9(IU/L) in male, and that of SGOT was 15.1+/-6.0(IU/L) in female, 20.5+/-26.5(IU/L) in male. There were significant differences(p<0.01) between female and male in both SPT and SGOT. And also there was significant increasing trend(p<0.05) by age groups in male for SGPT, decreasing trend(p<0.01) in female for SGOT. 2. In the abnormal rates of liver function test by the level of cut-off value, there were significant differences up to twice between the lowest and the highest cut-off value in both female(0.4% vs 0.7%) and male(6.5% vs 12.4%) 3. Abnormal rate of SGPT was 0.4% in female and 6.3% in male, and that of SGOT was 0.2% in female and 1.2% in male with significant differences between female and male in both tests.
Alanine Transaminase ; Aspartate Aminotransferases ; Female ; Humans ; Liver Function Tests* ; Liver* ; Male ; Mass Screening*

OBJECTIVES: This study was to develop effective managements and to avoid the abuse of human rights in mentally-ill patients. The Mental Health Judgement Board of Chungchongbuk-do province has been held monthly since August, 1997 according to the Mental Health Act. In this study, the procedures and the problems of judging continuing hospitaliztion of chronic mentally-ill patients were reviewed. METHODS: The mentally-ill patients who submitted the request for continuing hospitalization with the certificate of charged doctor and the agreement of caregiver were reviewed by the Mental Health Judgement Board of Chungchongbuk-do province. The analysis of the diagnoses, caregivers, medical care systems, and rejection rate for the patients were done. RESULTS: Total mumber of mentally-ill patients who requested for continuing hospitalization were 7,981 from twenty-one monthly meetings. The diagnostic distributions were 80.9% for schizophrenic patients, 8.1% for alcoholics and 11.0% for others including dementia. As for the caretakers, the rate of majors was 29.8%, parents 26.9%, sibling 26.1%, spouse 6.3%, offspring 5.9%, and others 5.0%. And 73.0% of the patients were on Medicaid and 27.0% were insured. The patients who got the rejection for continuing hospitalization were 196 at the rate of 2.46%. And the rejection rates of schizophrenic and alcoholic patients were 0.73% and 17.6%, respectively. CONCLUSIONS: New policies for decreasing longterm hospitalization of chronic mentally-ill patients are required. And the social support systems for psychiatric rehabilitation and readjustment are presently insufficient for the already discharged mentally-ill. Moreover, the practical guidelines for human rights of patients remains to be suggested.
Alcoholics ; Caregivers ; Dementia ; Diagnosis ; Hospitalization* ; Human Rights ; Humans ; Medicaid ; Mental Health ; Parents ; Rehabilitation ; Siblings ; Spouses

BACKGROUND AND OBJECTIVES: Circulating B-type natriuretic peptide (BNP) has been used as a marker of left ventricular hypertrophy and heart failure, and known to be increased after exercise in healthy men as well as patients with left ventricular dysfunction. However, the relationship between exercise duration and BNP level, and the determinants of circulating BNP concentration during exercise have not been fully elucidated. For these reason, we measured circulating BNP level during exercise, and exercise-induced changes of cardiac function by echocardiography in healthy men. MATERIALS AND METHODS: Ten healthy male volunteers (mean age 27+/-3 year-old) underwent symptom-limited bicycle ergometer in supine position for 30 min. The workload started at 25 W for 6 min with increment of 50 W every 3 min. Blood samples for BNP were obtained at baseline, every 1 min for first 3 min, 25 W, 75 W, 125 W, peak exercise and 10 min after resting. RESULTS: BNP level was increased only at peak exercise (mean:5.3+/-0.5 vs 7.7+/-4.1 pg/ml, median:5.0 vs 6.3 pg/ml, p<0.05), not during submaximal exercise, and sustained 10 minutes after exercise (190+/-25 watt, 14.9+/-12 min). Peak BNP level was significantly correlated with baseline BNP level (r=0.723, p<0.05), E' (0.18+/-0.04 vs 0.29+/-0.08 m/sec, r=-0.649, p<0.05) and E/E' (4.18+/- 0.87 vs 5.66+/-2.31, r=0.769 p<0.01) by bivariate correlation analysis, but correlated with only baseline BNP level by multiple linear regression analysis (p<0.05). CONCLUSION: Circulating BNP concentration was minimally increased only after peak exercise in young healthy men, not increased at submaximal exercise The BNP concentration after exercise is only determined by baseline BNP level, not by duration and workload of exercise.
Echocardiography ; Echocardiography, Stress ; Heart Failure ; Humans ; Hypertrophy, Left Ventricular ; Linear Models ; Male ; Natriuretic Peptide, Brain* ; Supine Position ; Ventricular Dysfunction, Left ; Volunteers

BACKGROUND AND OBJECTIVES: A reduction of the coronary flow reserve (CFR) following successful percutaneous coronary intervention (PCI) is related to microvascular impairment. Embolization of atherosclerotic debris during PCI is a possible explanation for the finding of abnormal coronary Doppler flow following PCI. SUBJECTS AND METHODS: The CFR and intravascular ultrasound (IVUS), both before and after PCI, were recorded in 69 lesions of 69 patients with coronary artery disease. An abnormal CFR was defined as one with no change or a decrease after successful PCI. RESULTS: The patients were divided into abnormal (n=17) and normal CFR (n=52) groups. After stenting, the hyperemic flow velocity was significantly lower in the abnormal CFR group (39.3+/-12.6 vs. 48.9+/-15.4 cm/s, p=0.022). 94 and 29% of the abnormal group had soft plaques and lipid cores, respectively, compared with 62 and 2% in the normal CFR group (soft plaque: p=0.029, lipid core: p=0.002). The abnormal CFR group had smaller post-procedural vessels (15.1+/-4.2 vs. 18.2+/-4.9 mm2, p=0.039) and plaque areas (6.8+/-2.7 vs. 9.9+/-3.8 mm2, p=0.006). Furthermore, the abnormal CFR group showed less vessel expansion (1.7+/-5.5 vs. 5.0+/-3.9 mm2, p=0.018) and greater plaque loss (4.1+/-5.3 vs. 0.7+/-3.4 mm2, p=0.009). The abnormal CFR group had an increased CK-MB following PCI (4 patients, 23.5% vs. 2 patients, 3.8%, p=0.029). In a multivariable analysis, the only predictor of an abnormal CFR was the presence of a lipid core within the plaque. CONCLUSION: Soft plaques, the presence of a lipid core and a large reduction in plaques increase the risk of microembolization during the PCI procedure.
Coronary Artery Disease ; Humans ; Percutaneous Coronary Intervention ; Stents* ; Ultrasonics ; Ultrasonography*

BACKGROUND AND OBJECTIVES: It has been shown that the coronary flow reserve (CFR) of an infarct related artery can predict left ventricular functional recovery following acute myocardial infarction (AMI). However, the prognostic value of CFR on the long-term clinical outcome of patients with an AMI has not been studied. SUBJECTS AND METHODS: Using a Doppler guide wire, we measured the CFR in 130 patients with an AMI following successful intervention (6+/-3 days after onset of the AMI). Two-year follow-up was conducted with regard to end points, including : cardiac death, non-fatal AMI, and severe congestive heart failure (CHF; > or = NYHA III). RESULTS: During the follow-ups, cardiac events occurred in 17 patients (5 deaths, 3 non-fatal AMIs and 9 severe CHFs). After analysis of the receiver operating characteristic curves, the best cut-off value for CFR in predicting cardiac events was 1.4 (sensitivity 76.5%, specificity 73.5%, accuracy 82.0%). With cardiac events as an end point, a 2-year Kaplan-Meier event survival analysis revealed that the patients with a CFR < or = 1.4 had a worse prognosis than those with a CFR >1.4 (Event free survival rates were 69.8% vs. 95.4%, respectively, p<0.001). Using Cox proportional hazard analyses, as an independent predictor, age, heart rate, CFR and left ventricular end systolic volume index, were also found to be significantly associated with cardiac events (hazard ratios 1.1224, 1.0404, 0.1887, and 1.0588, respectively). CONCLUSION: The coronary flow reserve, of infarct related arteries, measured during the early recovery phase can be used as an independent predictor for the prognosis of patients with an acute myocardial infarction following successful intervention.
Arteries ; Coronary Circulation ; Death ; Follow-Up Studies ; Heart Failure ; Heart Rate ; Humans ; Myocardial Infarction* ; Prognosis ; ROC Curve ; Sensitivity and Specificity ; Stroke Volume ; Survival Rate

Proinflammatory cytokines and their receptors are increased in the peripheral blood of patients with heart failure. We measured cytokines and their receptors in systemic artery (SA), coronary sinus (CS) and infra-renal inferior vena cava (IVC), in order to investigate their origin and influential factors. Thirty patients with idiopathic dilated cardiomyopathy were performed echocardiography at admission, and right heart catheterization after stabilization. Blood was drawn from 3 sites for measurement of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6) and soluble tumor necrosis factor- receptor (sTNFR) I, II. TNF-alpha at CS (3.25+/-0.34 pg/mL) was higher than those of SA (1.81+/-0.39 pg/mL) and IVC (1.88+/-0.38 pg/mL, p<0.05). IL-6 at CS (18.3+/-3.8 pg/mL) was higher than that of SA (5.8+/-1.2 pg/mL, p<0.01). The levels of sTNFR I, II showed increasing tendency in sequence of SA, IVC and CS. TNF-alpha and sTNFR I, II from all sites were proportional to worsening of functional classes at admission (p<0.05). E/Ea by Doppler study at admission, which reflects left ventricular end-diastolic pressure (LVEDP) was positively correlated with TNF-alpha from SA (R=0.71, p<0.01), CS (R=0.52, p<0.05) and IVC (R=0.46, p<0.05). Thus, elevated LVEDP during decompensation might cause cytokine release from myocardium in patients with idiopathic dilated cardiomyopathy.
Adult ; Aged ; Cardiomyopathy, Congestive/*blood/*immunology ; Female ; Heart/anatomy & histology ; Hemodynamic Processes ; Human ; Interleukin-6/*blood ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor/*blood ; Statistics ; Tumor Necrosis Factor/*metabolism

A 34-year-old man, who had been treated with an endoscopic injection of a mixture of n-butyl-2-cyanoacrylate (Histoacryl) and Lipiodol for control of variceal bleeding 6 months previously, presented with an intracardiac mass in the right atrium (RA). Two-dimensional echocardiography revealed an intracardiac mass in the RA that appeared to extend from the inferior vena cava. The origin of the sclerosant was traced by computed tomography (CT). This is a very rare case in which the sclerosant migration route was demonstrated by CT scan. The findings of this case suggest that the systemic migration of sclerosant into an intracardiac chamber should be considered in patients with an intracardiac mass, especially with a history of previous sclerotherapy for variceal bleeding.
Adult ; Echocardiography ; Embolism ; Enbucrilate ; Esophageal and Gastric Varices ; Esophagus ; Ethiodized Oil ; Heart Atria ; Hemorrhage ; Humans ; Sclerotherapy ; Vena Cava, Inferior

The in vitro antifungal susceptibility of 636 Candida bloodstream isolates collected from 15 tertiary hospitals in Korea was determined using the Vitek-2 yeast susceptibility system (bioMerieux, France). Overall susceptibility rates were 98.1%, 95.9%, 99.1%, and 97.3% for amphotericin B, fluconazole, voriconazole, and flucytosine, respectively. The results show that the rates of resistance to 4 antifungal drugs remain low among Candida bloodstream isolates in Korea.