Three groups of patients with newely diagnosed hypertension, or with hypertension not optimally controlled by previous treatment, completed a comparative study on the effects of Dihydrochlorothiazide, propranolol, and prazosin on plasma lipids after three months therapy. The drugs showed equipotent antihypertensive effects(P<0.01). Dihydrochlorothiazide administration was associated with a significant elevation of total cholesterol(42%, P<0.05), and triglyceride(8.1%, P<0.01). Changes of HDL-C(5.1%), LDL-C(3.3%), and cholesterol ratio(-4.8%) were not significant. Propranolol administration was associated with significant elevation of total cholesterol(3.8%, P<0.05), triglyceride(14.5%, P<0.005), and LDL-C(5.6%, P<0.005). Reduction of HDL-C(-7.8%, P<0.05) and cholesterol ratio(-14.7%, p<0.005) was also statistically significant. Prazosin administration was associated with significant decrease in total cholesterol(-6.6%, P<0.005), triglycride(-9.6%, P<0.005), and LDL-C(-11.7%, P<0.005), and significant elevation of HDL-C(10.6%,P<0.005) and cholesterol ratio(24.2%, P<0.005) was noted.
Cholesterol ; Humans ; Hydrochlorothiazide* ; Hypertension* ; Plasma ; Prazosin* ; Propranolol*

Dental Occlusion ; Humans ; Malocclusion ; Mandible ; Masks ; Maxilla ; Orthognathic Surgery ; Osteotomy, Sagittal Split Ramus ; Photography

Homer protein was identified based on its rapid induction in rat hippocampal granule cell neurons following excitatory synaptic activity. Although the presence of the Homer gene in the peripheral tissues has been observed in previous reports, the physiological function of the Homer protein in these tissues has not been noted. In this experiment, a Homer-2a cDNA fragment was successfully amplified by RTPCR in the involuting phase of human hemangioma but not in the human vascular malformation and normal vessel. After isolation of full Homer cDNA in a mouse liver cDNA library, E1-deleted recombinant adenovirus expressing the Homer protein (Adv.CMV.mHomer-2a) was constructed to determine its physiological function in peripheral tissues. Adv.CMV.mHomer2a, but not Adv.CMV.LacZ (recombinant adenovirus expressing beta-galactosidase), strongly inhibited the growth rate of HUVECs (human umbilical vein endothelial cells) probably via inducing apoptosis determined by acridine orange/ethidium bromide (AO/EB) staining methods. This study suggests that the Homer gene is present in human specimens in the involuting phase of hemangioma, and it might be involved in the growth control.
Adolescent ; Adult ; Animals ; Apoptosis ; Base Sequence ; Blood Vessels/*abnormalities ; Carrier Proteins/genetics/*physiology ; Cells, Cultured ; Child ; Child, Preschool ; DNA, Complementary/genetics ; Endothelium, Vascular/cytology ; Female ; Hemangioma/blood supply/*genetics ; Humans ; Male ; Mice ; Middle Aged ; Neuropeptides/genetics/*physiology ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Skin/blood supply ; Skin Neoplasms/blood supply/*genetics

To eveluate the risk factors which are related to recurrence of ischemic stroke, we selected subjects who were admitted to YNUH due to recurrent stroke and compared their risk factors with non-recurred group- who suffered from single ischemic stroke. In the subjects, 55 of them are men and 22 were women and in the non-recurred groups, 84 of them were men and 40 were women, Subject's age ranged from 29 to 86 years(Mean 62. 5years), and non-recurred group's age ranged from 27 to 90 years(Mean 60.7years), Peak incidence of ischemic stroke is in the 7th decade in both groups. Age and sex are not statistically significant for recurrence of ischemic stroke. The patient's history of diabetes mellitus, myocardial infarction, atrial fibrillation, transient attack and type or site of ischemic stroke had no significant effect statistically on the recurrent ischemic stroke. However, when the patient had previous history of hypertension or systolic blood pressure more than 160mmHg and diastolic more than 95mmHg, there was substantial difference (P<0.05) between the two group in the recurrence of ischemic stroke. According to the above results, hypertension is most likely significang risk factor of the recurrence of ischemic stroke within 2yeats after initial one. Therefore, adequate treatment of the hypertension is impertant for the prevention of ischemic stroke. Further study is required for searching other risk factors.
Atrial Fibrillation ; Blood Pressure ; Diabetes Mellitus ; Female ; Humans ; Hypertension ; Incidence ; Male ; Myocardial Infarction ; Recurrence ; Risk Factors* ; Stroke*

OBJECTIVES: The purpose of this study was to evaluate gender differences with respect to the internalization or externalization of symptoms according to the amount of time spent engaged in extracurricular education. METHODS: The study included a community sample of 755 boys and girls (mean age, 6.6 years), collected from five elementary schools in Gunpo, South Korea. Primary caregivers completed a questionnaire which included information on demographics, the amounts of time children spent in extracurricular education and with other activities, and an adapted form of the Behavior Assessment System for Children (BASC-2). Gender differences regarding externalizing and internalizing behavior problems were examined according to extracurricular education. RESULTS: With respect to the boys, there was a difference in the frequency of those who had externalizing behavior problems according to their time spent in extracurricular education. In contrast, the girls exhibited no difference. With respect to those children who spent a lot of time engaged in extracurricular education, there was a gender-specific difference only with respect to externalizing behavior problems. CONCLUSION: A gender-specific difference exists only in terms of externalizing behavior problems according to time spent engaged in extracurricular education.
Caregivers ; Child ; Demography ; Humans ; Republic of Korea ; Surveys and Questionnaires

PURPOSE: Distinguishing malaria from severe infection among febrile patients in emergency room is difficult, so we tried to analyze the clinical manifestations of malaria and the results of using devices as a quick way to detect malaria among febrile patients visiting an emergency medical center (EMC). METHODS: We retrospectively reviewed the clinical records of patients visiting a local EMC from January 2001 to December 2004 and confirmed as having vivax malaria by using a peripheral blood smear and Malaria antibody test (Immunochromatographic assay). RESULTS: All of the 108 included patients were infected with Plasmodium vivax and suffered from high fever, but tertian fever was seen in only 41 patients (37.9%). Various symptoms included headache, myalgia, abdominal pain, and so on. Laboratory findings noted thrombocytopenia, anemia, elevated alanin aminotransferase, and coagulopathies. Malaria antibody test was used in all cases for early diagnosis in the EMC. Compared with the peripheral blood smear, malaria antibody test identified 103 cases as positive, and five cases as negative. The diagnostic sensitivity of the malaria antibody test is 95.3%. CONCLUSION: Since south Korea is a malaria endemic area, for patients visiting an emergency room with a high fever, accompanied by thrombocytopenia and anemia, malaria must be included in the differential diagnosis whether the fever is tertian or not. The Malaria antibody test can be done by even an unskilful person, so it is a very helpful screening test and an early detection tool for malaria.
Abdominal Pain ; Anemia ; Diagnosis, Differential ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Fever ; Headache ; Humans ; Korea ; Malaria* ; Malaria, Vivax ; Mass Screening ; Myalgia ; Plasmodium vivax ; Retrospective Studies ; Thrombocytopenia

PURPOSE: There have been many reports that point to the increasing death and emergency operation rate in traumatic hemorrhagic shock patients. The purpose of this study was to discover the clinical difference between the hypotensive traumatic patients and the non-hypotensive traumatic patients that had been managed in intensive care unit (ICU). METHODS: We retrospectively reviewed the medical records of 122 patients admitted to ICU for trauma from January 2001 to December 2002. We compared the hypotensive (systolic blood pressure (SBP) < 90 mmHg) group with the non-hypotensive group about age, diastolic blood pressure, initial hemoglobin, Injury Severity Score (ISS), Glasgow Coma Scale (GCS), Revised Trauma Score (RTS), transfusion volume at emergency department, blood pH, blood base deficit, duration of admission, ICU stay, death rate, transfusion volume and others. RESULTS: There was no difference between two groups in age, causes of injury, situation whether or not the patient was directly transported from the scene and ISS. But there were differences between two groups in initial hemoglobins, GCS, RTS, blood pH, blood base deficit, duration of admission, ICU stay, and death rate. It was documented that the ICU stay correlated with systolic blood pressure, diastolic blood pressure, initial hemoglobin, blood base deficit, ISS, GCS, and RTS but not correlated with transfusion volume in emergency department. CONCLUSION: Systolic blood pressure is not the sensitive parameter of blood loss. Various kinds of indices of hypotensive group are more severe than non-hypotensive group. If traumatic patients are hypotensive blood pressure on arrival at emergency department, we should be careful of the state of these patients.
Blood Pressure ; Emergencies ; Emergency Service, Hospital ; Glasgow Coma Scale ; Humans ; Hydrogen-Ion Concentration ; Injury Severity Score ; Intensive Care Units ; Medical Records ; Mortality ; Retrospective Studies ; Shock, Hemorrhagic

Splenic artery aneurysms are an uncommon form of vascular disease that carry the risk of rupture and fatal hemorrhage. Precise cause of splenic artery aneurysms are not be established, the most common pathologic finding is defect of the media. Splenic artery aneurysms occur in patient with multiple pregnancies, portal hypertension, splenomegaly, after orthotopic liver transplantation and fibrodysplasia. Most patients who are diagnosised with splenic artery aneurysm are asymptomatic. Arteriography is a confirmed diagnostic method for detecting splenic artery aneurysms and searching the location of aneurysms. Operative treatment and therapeutic catheter embolization have been used for treatment of splenic artery aneurysms.
Aneurysm* ; Angiography ; Catheters ; Diagnosis ; Embolization, Therapeutic ; Female ; Hemorrhage ; Humans ; Hypertension, Portal ; Liver Transplantation ; Pregnancy ; Pregnancy, Multiple ; Rupture* ; Splenic Artery* ; Splenomegaly ; Vascular Diseases

PURPOSE: To evaluate the results of primary cementless total hip arthroplasty (THA)using the Landos Atoll hydroxyapatite (HA)-coated cup and the Euroform HA-coated stem. MATERIALS AND METHODS: Sixty-four primary THA were performed between November 1991 and October 1994, and were followed more than 5 years. Clinical and radiological results were assessed.Also, the evidence of loosening were observed. RESULTS: The mean Harris hip score improved from 57.0 points preoperatively to 88.5 points postoperatively. Of the 64 cases of emoral stems, 54 cases (84.4%) were classified as stable bone-ingrowth ixa tion, and 10 cases (15.6%)as stable fibrous fixation at the last follow-up. The linear wear of polyethylene insert was 1.83 mm (0.14-4.15 mm)and the linear wear rate was 0.23 mm/yr (0.02-0.72 mm/yr).During the follow-up period, revisions were required in 31 cases (48.4%);18 cases (28.1%)had been reoperated upon and 13 cases were (20.3%)awaiting for reoperation. Excessive early osteolysis were observed in 3 cases within 5 year.1 case in those 3 cases underwent cup revision and another 2 cases underwent head and liner change with bone grafting. CONCLUSION: Landos Atoll HA-coated acetabular cup which followed for minimum 5 years reveals 48.4% failure rate.
Acetabulum ; Arthroplasty, Replacement, Hip ; Bone Transplantation ; Durapatite ; Follow-Up Studies* ; Head ; Hip ; Osteolysis ; Polyethylene ; Prostheses and Implants* ; Reoperation

BACKGROUND: Dipeptidyl peptidase 4 (DPP-4, also known as CD26) binds with adenosine deaminase (ADA) to activate T lymphocytes. Here, we investigated whether ADA activity is specifically affected by treatment with DPP-4 inhibitor (DPP4I) compared with other anti-diabetic agents. METHODS: Fasting ADA activity, in addition to various metabolic and biochemical parameters, were measured in 262 type 2 diabetes mellitus (T2DM) patients taking various anti-diabetic agents and in 46 non-diabetic control subjects. RESULTS: ADA activity was increased in T2DM patients compared with that in non-diabetic control subjects (mean+/-standard error, 23.1+/-0.6 U/L vs. 18.6+/-0.8 U/L; P<0.05). ADA activity was correlated with fasting plasma glucose (r=0.258, P<0.05), HbA1c (r=0.208, P<0.05), aspartate aminotransferase (r=0.325, P<0.05), and alanine aminotransferase (r=0.248, P<0.05). Compared with the well-controlled T2DM patients (HbA1c<7%), the poorly controlled group (HbA1c>9%) showed significantly increased ADA activity (21.1+/-0.8 U/L vs. 25.4+/-1.6 U/L; P<0.05). The effect of DPP4I on ADA activity in T2DM patients did not differ from those of other oral anti-diabetic agents or insulin. T2DM patients on metformin monotherapy showed a lower ADA activity (20.9+/-1.0 U/L vs. 28.1+/-2.8 U/L; P<0.05) compared with that of those on sulfonylurea monotherapy. CONCLUSION: Our results show that ADA activity is increased in T2DM patients compared to that in non-diabetic patients, is positively correlated with blood glucose level, and that DPP4I has no additional specific effect on ADA activity, except for a glycemic control- or HbA1c-dependent effect.
Adenosine ; Adenosine Deaminase ; Alanine Transaminase ; Aspartate Aminotransferases ; Blood Glucose ; Diabetes Mellitus, Type 2 ; Dipeptidyl Peptidase 4 ; Fasting ; Glucose ; Humans ; Insulin ; Metformin ; Plasma ; T-Lymphocytes