To evaluate left ventricular diastolic function in patients with coronary artery disease, gate radionuclide ventriculography was performed prospectively in 42 patients who were admitted to Seoul National University Hospital from November 1985 to August 1986 because of anterior chest pain. All patients had no valvular heart disease, congenital heart disease, cardiomyopathy and arrhythmia, and no abnormal vall motion in gated nuclide ventriculography and contrast left ventriculography. 25 patients with more than 50% of stenosis in coronary arteriography were compared with 17 control subjects without stenosis. The following results were obtained; 1) There were no significant differences between normal controls and patients with coronary artery disease in the analysis of the parameters of the left ventricular systolic function, such as ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER) and ejection time (TES, TES/BCL). 2) Same results were found with those of the left vnetricular diastolic function, such as peak filling rate (PFR), diastolic time interval (DTI, DTI/BCL), rapid diastolic filling interval and time to late diastolic filling (TLDF). 3) The percent contribution of late diastolic filling to stroke volume (%LDF/SV) was more increased in patients with coronary artery disease than the normal control subjects (38.2+/-12.4% vs 28.3+/-7.8%, P<0.01). 4) As the results of above, it can be concluded that the percent contribution of late diastolic filling to stroke volume (%LDF/SV) obtained by using the non-invasive method of gated radionuclide ventriculography can be a sensitive parameter for early evaluation of the left ventricular diastolic dysfunction in coronary artery disease.
Angiography ; Arrhythmias, Cardiac ; Cardiomyopathies ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Gated Blood-Pool Imaging ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Prospective Studies ; Radionuclide Ventriculography ; Seoul ; Stroke Volume

BACKGROUND: Neck flexion has been shown to increase cranial spread of contrast agent when a small fixed volume was injected into the high thoracic epidural space. The purpose of this study was to evaluate the effect of volume of contrast medium on its distribution through the high thoracic epidural space during neck extension and flexion using the rabbit model. METHODS: An epidural catheter was introduced into the epidural space of New Zealand white rabbits with the tip located at the T3-4 intervertebral level. The neck was extended or flexed (n = 8 for each group), and the contrast medium was injected with the volume increasing by increments of 0.1 ml/kg, up to 0.3 ml/kg. The spread of contrast medium was determined by counting the number of vertebral body units using lateral epidurographic images. RESULTS: In both groups, the total spread of contrast medium was similar, increasing continuously with injected volume. The cranial spread was greater in the flexion group than the extension group. However, the caudal spread was greater in the extension than in the flexion group. In the extension group, the contrast medium spread caudally about twice as far as it spread cranially, but there was no statistically significant difference between cranial and caudal spread in the flexion group. CONCLUSIONS: In the high thoracic epidural space of rabbit, the contrast medium of varying doses showed limited cranial spread. The flexion of the neck increased cranial spread and extension of the neck increased caudal spread.
Catheters ; Epidural Space ; Neck ; Rabbits

PURPOSE: Currently many studies have confirmed the relationship between serum adiponectin and its influence on insulin resistance in adults. But physiologic insulin resistance due to changes in sex hormones exists during puberty, which prohibits us from knowing the influence of adiponectin to insulin resistance in this population. In this study, we investigated the influence of adiponectin on insulin resistance in children and adolescents. METHODS: 18 obese children, from the OPD were selected. From All subjects, blood was sampled after overnight fasting, adiponectin, lipid profiles, AST, ALT, fasting glucose and insulin levels were measured to evaluate correlations with adiponectin. The group were divided into subgroups by BMI, sex and HOMA-IR values. All variables were compared for differences and relationships. RESULTS: Obese groups showed decrease in adiponectin and showed increased insulin. HOMA-IR values were increased in the obese group. In all study participants, adiponectin showed significant correlation with triglyceride and HDL. But adiponectin showed no significant correlation with HOMA-IR, insulin and glucose. In the obese group adiponectin showed no correlation with HOMA-IR, insulin and glucose. HOMA-IR showed significant correlation with BMI, body weight and age. There were no sexual differences in adiponectin, insulin and HOMA-IR values. Insulin resistant group showed decrease in adiponectin but had no statistical significance. CONCLUSION: Decreased adiponectin levels and increased insulin resistance were observed in obese children but adiponectin showed no correlation with insulin resistance in children and adolescence. Factors other than adiponectin may play a more significant role in insulin resistance in this age group.
Adiponectin* ; Adolescent* ; Adult ; Body Weight ; Child* ; Fasting ; Glucose ; Gonadal Steroid Hormones ; Humans ; Insulin Resistance* ; Insulin* ; Puberty ; Triglycerides

BACKGROUND/AIMS: Primary thyroid disease is prevalent in chronic renal disease, especially in patients requiring chronic dialysis. However, the relationship between kidney function and the prevalence of primary thyroid disease has not been studied in Korea, a nation where the dietary iodine intake is excessive. METHODS: Retrospective data from 2201 consecutive adult patients who visited a health promotion center over the last 5 years were analyzed; specifically, 54 patients with chronic kidney disease not requiring hemodialysis and 64 adults treated with hemodialysis. The glomerular filtration rate (GFR) was estimated using the abbreviated Modification of Diet in Renal Disease equation. Multivariable logistic regression was used to evaluate the independent association between the prevalence of primary hypothyroidism and estimated GFR. RESULTS: The prevalence of overt hypothyroidism increased from 0.5% at an estimated GFR > 90 mL/min/1.73 m2 to 6.3% in end-stage renal disease requiring chronic dialysis (p < 0.001 for trend). Compared with participants with an estimated GFR > 60 mL/min/1.73 m2, those with an estimated GFR < 60 mL/min per 1.73 m2 had an increased odds of overt hypothyroidism after adjusting for age, gender, fasting blood glucose (FBS), and the total cholesterol (TC) and triglyceride (TG) concentrations. CONCLUSIONS: These findings suggest that overt primary hypothyroidism is relatively common (6.3%) among persons with chronic kidney disease requiring chronic dialysis, and it is independently associated with a progressively lower estimated GFR.
Adult ; Blood Glucose ; Cholesterol ; Dialysis ; Diet ; Fasting ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Hypothyroidism ; Iodine ; Kidney ; Kidney Failure, Chronic ; Korea ; Logistic Models ; Prevalence ; Renal Dialysis ; Renal Insufficiency, Chronic ; Retrospective Studies ; Thyroid Diseases

PURPOSE: Kawasaki disease-the most common cause of acquired heart disease in children-incidence is increasing yearly. Therefore, we evaluated the predictive indicators of coronary complications of Kawasaki disease based on clinical and laboratory data. METHODS: Between January 2005 and March 2008, of the 201 children with Kawasaki disease treated at the Gil Hospital of Gachon University of Medicine and Science, 51 had coronary artery lesions (Group II) and 150 had no lesions (Group I). The reasons for coronary artery lesions were deduced from the clinical and laboratory data. RESULTS: Analysis of the 2 groups revealed that fever duration and days of fever after and before initial intravenous gammaglobulin (IVIG) treatment were significantly longer in Group 2 than in Group I. IVIG infusions were statistically higher in Group II than in Group I. As per the laboratory data, C-reactive protein (CRP) value was significantly higher in Group II. Collectively, >10 days of fever duration, >48 h of fever duration after, and >10 days of fever before IVIG treatment increased the risk of coronary artery lesions 6-, 5-, and 3.5-fold, respectively. Furthermore, additional IVIG courses and higher CRP level increased the risk of coronary artery lesions 4-fold and 2.3-fold, respectively. CONCLUSION: The following 3 factors were responsible for increased risk of coronary artery lesions in children with Kawasaki disease: fever duration and days of fever after and before IVIG treatment. To identifythe predictive indicators of coronary complications, it is necessary to further elucidate the relationship between well-known forecasting factors.
C-Reactive Protein ; Child ; Coronary Vessels ; Fever ; Forecasting ; Heart Diseases ; Humans ; Immunoglobulins, Intravenous ; Mucocutaneous Lymph Node Syndrome

Helicobacter pylori is a causative agent of type B gastritis and plays a central role in the pathogenesis of gastroduodenal ulcers and gastric cancer. Strategies for the control of H. pylori- induced gastroduodenal diseases based on conventional measures are still of limited utility. Therefore, it seems worthwhile to make a break-through as an alternative strategy by reviewing the host-parasite relationship of H. pylori infection on the basis of genomic structure. In this study, we tried to construct a physical map of H. pylori genome. Chromosomal DNA from a Korean prototype strain, H. pylori 51 was digested with 42 restriction endonucleases to identify restriction patterns suitable for mapping the genome. We identified three enzymes, ApaI, NotI and Sfil, which gave a small number of DNA fragments of higher molecular weight that were well resolved after pulsed-field gel electrophoresis. The H. pylori chromosome contained 7 ApaI fragments ranging from 167 to 311 kb, 7 NotI fragments ranging from 5 to 516 kb and 2 SfiI fragments of 332 and 1,347 kb in size. The genome size of the strain is 1,679 kb. A circular physical map of the H. pylori chromosome was constructed by aligning 3 kinds of restriction fragments by Southern blot analysis of simple ApaI, NotI and SfiI digests or double NotI/ApaI and NotI/SfiI digests with the various probes. When the physical map of H. pylori strain 51 compared with that of strain 26695 of which the cornplete genome sequence was reported, completely different restriction patterns were shown, which suggests the genomic diversity in H. pylori.
Blotting, Southern ; DNA ; DNA Restriction Enzymes ; Electrophoresis, Gel, Pulsed-Field ; Gastritis ; Genome ; Genome Size ; Helicobacter pylori* ; Helicobacter* ; Host-Parasite Interactions ; Molecular Weight ; Peptic Ulcer ; Stomach Neoplasms

To define the genes for production of catalytically active H. pylori urease, we camed out study to elucidate the structure of urease gene transcript, to delineate the genetic region which affected the extent of the expression and the activation of urease structural subunits. UreC and ureD were confirmed not to affect the expression of structural genes and active enzyme production, meaning that these genes are not components of the urease gene cluster of H. pylori. p-independent transcriptional stop signal was found in 12 bp down-stream of ureH stop codon. RNA extension test showed that the transcript starts with 267 bp upstream of ureA start codon. Although accessory genes did not affect the extent of the expression of the structural subunits, they were essential for assembling the active urease in E. coli. E. coli transformants of plasmid clones containing ureAB produced catalytically active urease when they are complemented with the plasmid clones of ureIEFGH or coexisted with ureIEFGH, meaning that accessory gene products could be trans-acting as well as cis-acting. The extent of production of urease structural subunits depended on the region of 241 to 57 bp upstream of ureA start codon. E. coli transformant of pBeloBACII clone containing the urease gene cluster, which is maintained with a single copy in host, did not express the urease. Proteins (60, 38, 30, 29, 27, and 24 kDa) that could hold nickel ions were identified in the cell extract of H. pylori. The results in this study will provide the basis to understand the control mechanism for urease gene expression and formation of the active urease.
Clone Cells ; Codon, Initiator ; Codon, Terminator ; Complement System Proteins ; Gene Expression ; Helicobacter pylori* ; Helicobacter* ; Ions ; Multigene Family ; Nickel ; Plasmids ; RNA ; Urea ; Urease*

BACKGROUND: Peripheral nerve injury may generate pain hypersensitivity, characterized by enhanced nociceptive responses to noxious stimuli and decreased thresholds to innocuous stimuli, and may lead to a chronic neuropathic pain state resulting from an increase in central neuron excitability. This central sensitization is mediated via N-methyl-D-aspartic acid (NMDA) receptor and may involve the production of nitric oxide (NO). In this work, we investigated whether the action of NO and local nitric oxide synthase (NOS) expression play a role in neuropathic pain in a rat model. METHODS: Neuropathic pain was produced by resecting two branches of the sciatic nerve. N-nitro-L-arginine methyl ester (L-NAME) (a nonselective NOS inhibitor), or 7-nitroindazole (7-NI) (a neuronal NOS (nNOS) inhibitor), or aminoguanidine (AG) (an inducible NOS (iNOS) inhibitor) were administered locally for 2, 7, or 14 days via osmotic pumps. Behavioral tests for pain were conducted after nerve injury using mechanical and thermal stimuli applied to the hind paws. We used immunohistochemical methods to provide evidence for endothelial NOS (eNOS), nNOS, and iNOS expression. RESULTS: Following nerve injury, significant mechanical allodynia and thermal hyperalgesia were observed in rats treated with AG or 7-NI. In contrast, when L-NAME, a known potent inhibitor of eNOS was applied locally, no significant mechanical allodynia or thermal hyperalgesia was observed. No dependency on the route or duration of NOS inhibitor administration was noted. Increased immunoreactivities of the eNOS and nNOS isoforms were intense and discrete at 48 hour following nerve injury, unlike sham exposed intact nerves. In 14 day stumps, iNOS staining was observed in the endoneurium and perineurium. eNOS immunoreactivity at 2 days after nerve injury was not observed in L-NAME treated rats. At 14 days after nerve injury, iNOS immunoreactivity was rarely observed in AG and L-NAME treated rats. CONCLUSIONS: Our results indicate that an early eNOS expression plays a critical role in the development of neuropathic pain.
Animals ; Central Nervous System Sensitization ; Hyperalgesia ; Hypersensitivity ; Models, Animal ; N-Methylaspartate ; Neuralgia* ; Neurons ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Peripheral Nerve Injuries ; Peripheral Nerves ; Protein Isoforms ; Rats* ; Sciatic Nerve

Partially purified H. pylori ADH was used to determine the amino acid sequence of ADH N- terminus. The sequence of the ADH N-terminus was determined as MRVQSKGF. The genomic library of H. pylori that has been prepared by pTZ19U plasmid vector was screened with the deduced oligonucleotide probes to select the plasmid clone containing the entire ADH gene. The clone pTZ19U/ADH-6 was selected and its EcoRI-BamHI fragment (1.3 kb) was subcloned into pBluescript II K/S vector to determine nucleotide sequence. The length of H. pylori ADH gene was 1,044 bp. Ribosomal binding site was found in the upstream of start codon and rho- independent transcriptional stop signal was observed in the downstream of stop codon. The ADH gene encodes a protein of 348 amino acids, of which the predicted molecular size and pI value were 38.6 kDa and 7.1, respectively. ADH activity of E. coli transformant of pBluescript/ADH is 10-times greater compared to that of non-transformants. When H. pylori ADH gene was disrupted by pBluescript/ADH-KM whose internal region of 1.3 kb DNA fragment containing ADH gene was replaced by KM resistance sequence, the strain lost the ADH activity completely, despite the normal growth of the strain. This demonstrates that ADH gene is not essential for the viability of H. pylori.
Alcohol Dehydrogenase* ; Amino Acid Sequence ; Amino Acids ; Base Sequence* ; Binding Sites ; Clone Cells ; Cloning, Molecular* ; Codon, Initiator ; Codon, Terminator ; DNA ; Genes, vif* ; Genomic Library ; Helicobacter pylori* ; Helicobacter* ; Oligonucleotide Probes ; Plasmids

BACKGROUND: Until recently, it was not easy to conduct intraoperative autotransfusion in children due to technical limitations, however, due to advanced technology this is now possible. This study was conducted to determine if the intraoperative use of the continuous autotransfusion system (CATS(R)) can reduce homologous transfusion during pediatric orthopaedic surgery. METHODS: Fifty-five children scheduled for elective orthopaedic surgery were reviewed and divided into two groups according to the availability of the CATS(R). The control group (n = 29) had surgery without the cell saver, whereas the CATS(R) group (n = 26) had surgery with the cell saver. The amounts of perioperative homologous transfusion were then compared between the two groups. RESULTS: The amount of homologous blood transfusion required during the operation was significantly less in the CATS(R) group 5 +/- 10 (ml/kg) than in the control group 15 +/- 13 (ml/kg) (P < 0.01). There was no difference in the amount of homologous blood transfusion required after operation between the groups. CONCLUSIONS: CATS(R) can reduce the need for intraoperative homologous transfusion during pediatric orthopaedic surgery.
Blood Transfusion ; Blood Transfusion, Autologous ; Child ; Humans ; Pediatrics