BACKGROUND: Cardiovascular disease is the major cause of morbidity and mortality. It is well known that androgen and sex hormone-binding globulin(SHBG) in women were associated with risk factors for cardiovascular disease such as obesity, central fat accumulation and atherogenic lipid profile. High resolution B-mode ultrasonography can visualize directly both luminal and vessel wall characteristics, and ultrasonic measurement of carotid intima-medial thickness(IMT) can be used to investigate the atherosclerosis of coronary, cerebral and peripheral arteries. The aim of this study was to evaluate the relationship between the serum dehydroepiandrosterone sulfate(DHEA-S) and SHBG, and body fat distribution pattern, cardiovascular risk factor and carotid atherosclerosis in women. METHODS: Blood pressure, fasting serum glucose, insulin, lipid profile, SHBG and DHEA-S were measured. Body fat distribution pattern was assessed by waist to hip ratio, waist to thigh ratio and subscapular to triceps skin fold thickness ratio, faf mass measured by bioelectric impedance analyzer, subcutaneous fat area, visceral fat area, and visceral to subcutaneous fat area ratio(VSR) at the level of umbilicus using the computed tomography. The IMT of the carotid artery was measured by high resolution B mode ultrasound as a marker of atherosclerosis. RESULTS: 1) There was no significant difference of age-adjusted values of carotid IMT among subjects with NGT(0.426+/-0.09mm), IGT(0.46+/-10.09mm) and NIDDM(0.453+/-0.11mm). 2) In postrnenopausal women, carotid IMT was greater(0.484+/-0.11mm, p=0.05) than premenopausal women(0.426+/-0.08mm), but it was not significant after age adjustment. Serum SHBG and DHEA-S levels in postmenopausal women were significantly lower(p<0.05) than premenopausal women, but they were not significant after age adjustment. 3) Carotid IMT was significantly correlated with age(r=0.37, p<0.01), fasting serum glucose (r=0.32, p<0.01), total cholesterol(r= 0.25, p<0.05), LDL-cholesterol(r=0.26, p<0.05), visceral fat area(r=0.35, p<0.01) and VSR(r=0.31, p<0.05). 4) By the stepwise multiple regression analysis, carotid IMT was positively and significantly associated with age(p<0.01) and serum DHEA-S concentration(p<0.05) in dent of age, body mass index, waist to hip ratio, fasting serum glucose. CONCLUSION: Carotid IMT was associated with age and serum DHEA-S concentration in women without cardiovascular disease. Therefore, serum DHEA-S may be one of risk factors for cardiovascular disease in women. However, we could not conclude its cause-result relationship because of cross sectional nature of our study, and prospective study will be needed.
Arteries ; Atherosclerosis ; Blood Glucose ; Blood Pressure ; Body Fat Distribution ; Body Mass Index ; Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery Diseases* ; Dehydroepiandrosterone Sulfate* ; Dehydroepiandrosterone* ; Electric Impedance ; Fasting ; Female ; Humans ; Insulin ; Intra-Abdominal Fat ; Mortality ; Obesity, Abdominal ; Phenobarbital ; Risk Factors ; Sex Hormone-Binding Globulin* ; Skin ; Subcutaneous Fat ; Thigh ; Ultrasonics ; Ultrasonography ; Umbilicus ; Waist-Hip Ratio

No abstract available.
Humans ; Internship and Residency*

PURPOSE: This study was done to develop standards for educational equipment in fundamental nursing practice courses in BSN programs. METHOD: The participants in this study were 30 professors who taught fundamental nursing in colleges or departments of nursing. The data were gathered between December 2002 and May 2003 using a questionnaire on the present state of fundamental nursing practice and the educational equipment list for fundamental nursing practice. RESULT: There was variety in the content of the courses of fundamental nursing practice in BSN programs, and the environment for fundamental nursing practice was in diverse setting. A standard for educational equipment was developed consisting of 93 pieces of equipment for fundamental nursing practice. CONCLUSION: The standard for educational equipment for fundamental nursing practice in BSN programs provides the basics for fundamental nursing practice. Of these 72 were selected and the authors suggests establishing an educational committee of fundamental nursing practice and holding a workshop on educational equipment for fundamental nursing practice in BSN programs every 5 years.
Education ; Nursing* ; Questionnaires

The syndrome of ectopic production of ACTH by non-pituitary neoplasm occur with various types of tu#rnors. Pheochromocytoma is a rare, but one of the important causes of this syndrome. Recently we experienced a 36-year-old male patient with ACTH-producing pheochromocytoma. After left adrenalectomy, serum ACTH level retumed to the normal range. The patient became normotensive without antihypertensive agents and hyperglycemia resolved and insulin therapy was discontinued. Secretion of ACTH was confirmed by immunohistochemical stain.
ACTH Syndrome, Ectopic* ; Adrenalectomy ; Adrenocorticotropic Hormone ; Adult ; Antihypertensive Agents ; Humans ; Hyperglycemia ; Insulin ; Male ; Pheochromocytoma* ; Reference Values

Abdominal aortic aneurysm is included in the differential diagnosis of lower back pain. Although rare, this important disease can cause potentially lethal complications. In this case, expanding abdominal aortic aneurysm coexisted with intervertebral disc extrusion. The diagnosis of abdominal aortic aneurysm was delayed, putting the patient at risk of aneurysmal rupture. In the management of patients with degenerative spinal diseases, we should not overlook the possibility of comorbidities such as an abdominal aortic aneurysm. We also suggest the importance of interpreting images more carefully, especially for elderly male patients.
Aged ; Aneurysm ; Aortic Aneurysm, Abdominal* ; Comorbidity ; Diagnosis, Differential ; Humans ; Intervertebral Disc* ; Low Back Pain ; Male ; Rupture ; Spinal Diseases

OBJECTIVE: The role of obesity in the pathogenesis of NIDDM has long been recognized. However, the relation between weight change and risk for diabetes has been less well defined and earlier studies have shown inconsistent results. We conducted a cross-sectional study to evaluate the relationship between weight change after 20 years of age and the risk of NIDDM in the Korean urban population. METHODS: From April 1997 to February 1998, we examined 642 subjects among a total of 776 persons aged over 30 years living in Mokdong apartment area selected using a random cluster sampling method for the survey of the prevalence of diabetes in urban area. After 75g oral glucose tolerance test, they were diagnosed with normal glucose tolerance or diabetes by WHO criteria. We excluded the subjects with impaired glucose tolerance. We obtained the data about weight change since 20 years of age and measured the current weight, height and waist-hip ratio. RESULTS: 1) Among 642 subjects, 46 were diabetic and the prevalence of diabetes was significantly increased with the increase of BMI in both men and women but with the increase of waist-hip ratio only in women. 2) The weight gain between 25 and 30 years of age was significantly greater in the subjects aged 30-39 than the older age groups. 3) In both men and women, weight gain of greater than 10 kg after 30 years of age increased the risk of diabetes. In women, weight gain greater than 20 kg between 20 years of age and the time of maximal obesity also increased the risk of diabetes. However, the significant risk factors for diabetes were age in men, whereas age and waist-hip ratio in women by multiple logistic regression analysis. 4) In women, weight gain less than 10kg after 30 years of age decreased the risk of diabetes, independent of age, BMI and family history of diabetes. CONCLUSION: Moderate weight gain after 30 years of age in women reduced the risk of diabetes. Extreme weight gain after 30 years of age in both men and women is related with high prevalence of diabetes. And in women, weight gain associated with pregnancy and otherwise after 20 years of age increased the risk of diabetes. However, the significance was disappeared after adjustment for age, BMI and family history of diabetes. The prospective study about the relationship between weight changes and the risk of diabetes would be needed.
Cross-Sectional Studies ; Diabetes Mellitus, Type 2* ; Female ; Glucose ; Glucose Tolerance Test ; Humans ; Logistic Models ; Male ; Obesity ; Pregnancy ; Prevalence ; Risk Factors ; Urban Population ; Waist-Hip Ratio ; Weight Gain

BACKGROUND: The minimal effect of etomidate on cardiovascular function sets it apart from other rapid fast-acting induction agents. Clinically, etomidate has been reported to cause minimal effects on systemic hemodynamics and PVR. There are few reports of direct effects of etomidate in pulmonary vessels or other vascular beds. METHODS: We studied the effects of etomidate on the tension of the aortic smooth muscle using an isolated rat thoracic aortic preparation. We studied the cumulative effect of etomidate in a rat thoracic aorta after phenylephrine (PE) pretreating, the cumulative effect of phenylephrine (PE) in a rat thoracic aorta with or without endothelium after etomidate pretreating, the effect of L-NAME and indomethacin and metylene blue in a rat thoracic aorta contractile response for phenylephrine after etomidate pretreating, and the effects of etomidate on a phenylephrine and ECF Ca2 induced contraction in a rat thoracic aorta. RESULTS: Etomidate produced dose-dependent relaxation and these relaxation responses were significantly less in a thoracic aorta with denuded endothelium than in a thoracic aorta with intact endothelium. Response of PE contraction with etomidate was increased by pretreatment with L-NAME and methylene blue, but was decreased by pretreatment with indomethacin in intact endothelium. Response of PE contraction had no significant change in Ca2 free, but Etomidate significantly attenuated the response of PE contraction to Ca2 entry. CONCLUSIONS: We have found that vasodilation produced by etomidate is endothelium-dependent and this effect is related with cyclooxygenase inhibition and also guanylate cyclase activation. In addition, a relaxation effect is caused by an extracellular Ca2 influx blockade through receptor-operated calcium channels.
Animals ; Aorta, Thoracic* ; Arteries ; Calcium Channels ; Endothelium ; Etomidate* ; Guanylate Cyclase ; Hemodynamics ; Indomethacin ; Methylene Blue ; Muscle, Smooth ; NG-Nitroarginine Methyl Ester ; Phenylephrine ; Prostaglandin-Endoperoxide Synthases ; Rats* ; Relaxation ; Vasodilation

PURPOSE: Tamoxifen has been well known as an effective anti-tumor agent against breast cancer. The important role of bcl-2 and p53 proteins in tamoxifen-induced apoptosis of breast cancer cells has been suggested. However, the paradoxical fact that bcl-2 over-expression is assdegrees Ciated with better prognosis in clinic has not yet been clearly explained. To investigate this paradox, we analyzed the effect and dynamics of bcl-2 and p53 on the apoptosis after treatment of breast cancer cells with tamoxifen. MATERIALS AND METHODS: The human breast cancer cell lines MCF-7 and MB MDA-468 were treated with 17-betaestradiol (E2) and tamoxifen. RESULTS: Following tamoxifen treatment, MCF-7 cells underwent apoptosis accompanied by reduced bcl-2 expression. E2 pre-treatment led to the inhibition of tamoxifen-mediated apoptosis and bcl-2 down-regulation. When MB MDA-468 cells were treated with E2 or tamoxifen, bcl-2 and p53 protein expression did not change and apoptosis did not develop. CONCLUSION: We observed that the down-regulation of bcl-2 by tamoxifen treatment can facilitate the apoptosis of breast cancer cells without p53 mutations. This finding was consistent with clinical experiences in which bcl-2 positive tumors were assdegrees Ciated with more indolent phenotypes in breast cancer.
Apoptosis* ; Breast Neoplasms* ; Breast* ; Cell Line* ; Down-Regulation ; Humans* ; MCF-7 Cells ; Phenotype ; Prognosis ; Tamoxifen

Cervical disc herniation is a common disorder characterized by neck pain radiating to the arm and fingers as determined by the affected dermatome. This condition has a favorable prognosis, but pain can have a serious detrimental impact on daily activities. Epidural neuroplasty has been applied as a treatment option for cervical disc herniation; however, no study has addressed the clinical outcomes. This retrospective study evaluated the clinical outcomes of epidural neuroplasty on 128 patients for the treatment of cervical disc herniation. To measure pain-related disabilities over time, the changes of pain scores in neck and arm were evaluated using a numerical rating scale (NRS) and the neck disability index (NDI). Compared with preprocedural values, the pain NRS of neck and arm demonstrated significant improvement at day 1, and 1, 3, 6, and 12 months after the procedure (P < 0.001). Likewise, the NDI was significantly reduced at 3, 6, and 12 months after the procedure (P < 0.001). There were no serious complications. Cervical epidural neuroplasty shows good clinical outcomes in the treatment of cervical disc herniation and can be considered a treatment modality for cervical disc herniation refractory to conservative treatment.
Adult ; Aged ; Amides/administration & dosage ; Anesthetics, Local/administration & dosage ; Anti-Inflammatory Agents/administration & dosage ; Cervical Vertebrae/*radiography ; Dexamethasone/administration & dosage ; Disability Evaluation ; Epidural Space/radiography ; Female ; Follow-Up Studies ; Humans ; Hyaluronoglucosaminidase/therapeutic use ; Injections, Epidural ; Intervertebral Disc Displacement/radiography/*surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck Pain/drug therapy ; Pain/drug therapy ; Pain Measurement ; Questionnaires ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

BACKGROUND: Decreased antioxidant defense mechanisms and over-generated free radicals by either normal or aberrant metabolism play an important role in the pathogenesis of cardiovascular disease and cancer. And the life style and diet including antioxidant vitamin A and E have been thought an important factor in antioxidant systems. Recently, Total Antioxidant Status kit (TAS; Randox, UK) has been developed for measuring the total antioxidant capacity of blood. So we evaluated the association of life style and total antioxidant capacity in patients with chronic cardiovascular disease. METHODS: Sixty six cases of chronic cardiovascular disease and sixty three normal controls were evaluated. Serum total antioxidant capacity was measured by Hitachi 747 (Hitachi Ltd, Japan) with TAS kit, vitamin A and E were measured by high performance liquid chromatography method, and serum lipid profile by Hitachi 7060 (Hitachi Ltd, Japan). RESULTS: The mean total antioxidant capacity did not show difference between patients and controls. After 3 months, we detected significant increase of total antioxidant capacity, high-density lipoprotein cholesterol and mild increase of antioxidant vitamins and significant decrease of total cholesterol, triglyceride, lipoprotein (a). The heavy alcohol consumption group showed significant difference with other groups (P<0.05). CONCLUSIONS: The measurement of total antioxidant capacity for the cardiovascular disease patients was thought to be useful to evaluate oxidative stress and antioxidant status. Alcohol consumption and supplementation with antioxidant vitamins could have an effect on total antioxidant capacity.
Alcohol Drinking ; Antioxidants ; Cardiovascular Diseases* ; Cholesterol ; Chromatography, Liquid ; Defense Mechanisms ; Diet* ; Free Radicals ; Humans ; Life Style* ; Lipoprotein(a) ; Lipoproteins ; Metabolism ; Oxidative Stress ; Triglycerides ; Vitamin A ; Vitamins