BACKGROUND: Carotid intima-media thickness (CIMT) is associated with several risk factors for atherosclerosis and has been consistently linked to cardiovascular and cerebrovascular disease. The clinical significance of separate measurements of CIMT, which is the sum of the intima (IT) and media thickness (MT), to use as an assessment of risk for atherosclerosis has not yet been fully established. METHODS: Among 3377 patients who underwent B-mode ultrasound of carotid arteries and coronary angiography in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 1146 subjects (M:F = 616:530; mean age, 57.7 ± 12.1 years) who were diagnosed with normal coronary arteries were enrolled in this study. IT, MT, and CIMT of the enrolled patients were manually measured using high-frequency ultrasonography (15 MHz linear array transducer). RESULTS: In multivariate logistic regression analysis, age (β = 0.063, p < 0.0001), body mass index (BMI) (β = 0.028, p = 0.018), and hypertension (HTN) (β = 0.046, p = 0.0002) were associated with MT (R2 = 0.256) and the IT/MT ratio (R2 = 0.209). Age (β = 0.065, p < 0.0001), BMI (β = 0.025, p = 0.038), hemoglobin A1c (β = 0.045, p = 0.045), and HTN (β = 0.043, p = 0.0006) correlated with mean CIMT (R2 = 0.230). Age (β = -0.071, p < 0.0001) and BMI (β = -0.046, p = 0.002) were associated with the IT/MT ratio (R2 = 0.219) on the left side. Age (β = 0.093, p < 0.0001) was related to MT (R2 = 0.265) and mean CIMT (R2 = 0.243) on the left side. CONCLUSION: We noted different atherosclerotic risk factors were related to measurements of the arterial wall in different ways. Therefore, separate measurements of CIMT might be a useful method to assess the risk for atherosclerosis.
Atherosclerosis* ; Body Mass Index ; Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Vessels ; Humans ; Hypertension ; Logistic Models ; Risk Factors* ; Ultrasonography

PURPOSE: Purpose of this study was to determine if quantitative measures of CT attenuation and ADC values in combination with conventional imaging features can differentiate primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM). MATERIALS AND METHODS: Twenty-six patients with histologically-proven GBM (14 men and 12 women; median age, 50 years; age range, 22 - 73 years) and 14 patients with PCNSL (11 men and 3 women; median age, 61 years; age range, 41 - 74 years) were enrolled. Maximum CT attenuation, minimum ADC, and lesion to normal parenchyma minimum ADC ratios were measured in solid tumor regions. Conventional imaging features were evaluated for the following: ill-defined margin, homogeneous enhancement pattern, degree of necrosis, extent of tumor involvement and multiplicity. The Mann-Whitney test was used to compare maximum CT attenuation and minimum ADC values for PCNSL and GBM. Fisher's exact test was used to evaluate relationships between pathologic diagnoses and imaging features. RESULTS: The CT attenuations were similar for PCNSL and GBM (37.84 +/- 6.90 HU versus 37.00 +/- 5.54 HU, p = 0.68), but minimum ADC and minimum ADC ratio were significant lower in PCNSL than in GBM (595.01 +/- 228.28 10(-6) mm2/s versus 736.52 +/- 162.05 10(-6) mm2/s; p = 0.028, 0.87 +/- 0.26 versus 1.14 +/- 0.29; p = 0.007). PCNSL showed greater homogeneous enhancement and smaller necrotic areas than GBM (p = 0.003 and p < 0.001, respectively) and was more likely to have multiple tumors than GBM (p = 0.039). When necrotic PCNSL (n = 4) and necrotic GBM (n = 24) were compared, minimum ADC and minimum ADC ratios were also significantly lower in PCNSL, but CT attenuation were not. CONCLUSION: Although CT attenuation does not provide valuable information, minimum ADC and minimum ADC ratio and some imaging features can aid the differentiation of PCNSL and GBM.
Central Nervous System ; Diffusion ; Glioblastoma ; Humans ; Lymphoma ; Male ; Necrosis

No abstract available.
Echocardiography ; Thrombosis

BACKGROUND/AIMS: Despite of increasing numbers of reports on intraductal papillary mucinous tumor (IPMT), there is still difficulty in its' diagnosis, treatment and prediction of prognosis. The purpose of this multicenter study was to evaluate the clinico-pathological features of IPMT in Korea and suggest the prediction criteria of malignancy in IPMT. METHODS: We retrospectively reviewed the clinico-pathological data of 208 patients who underwent operations with IPMT between 1993 and 2002 at 28 institutes in Korea. RESULTS: Of the 208 patients with a mean age of 60.5+/-9.7 years, 147 were men and 61 were women. 124 patients underwent pancreatoduodenectomy, 42 distal pancreatectomy, 17 total pancreatectomy, 25 limited pancreas resection. Benign cases were 128 (adenoma (n=62), borderline (n=66)) and malignant cases were 80 (non-invasive (n=29), invasive (n=51)). A significant difference in 5-year survival was observed between benign and malignant group (92.6% vs. 65.3%; p=0.006). Of the 6 factors (age, location, duct dilatation, tumor appearance, main duct type, and tumor size) that showed the statistical difference in univariate analysis between benign and malignant group, we found three significant factors (tumor appearance (p=0.009), tumor size (p=0.023), and dilated duct size (p=0.010)) by multivariate analysis. CONCLUSION: Although overall prognosis of IPMT is superior to ordinary pancreatic cancer, more curative surgery is recommended in malignant IPMT. Tumor appearance (papillary), tumor size (> or =30 mm) and dilated duct size (> or = 12 mm) can be used as preoperative indicators of malig-nancy in IPMT.
Academies and Institutes ; Diagnosis ; Dilatation ; Female ; Humans ; Korea* ; Male ; Mucins* ; Multivariate Analysis ; Pancreas* ; Pancreatectomy ; Pancreatic Neoplasms ; Pancreaticoduodenectomy ; Prognosis ; Retrospective Studies

The overt effects of the anticancer drugs such as cisplatin and taxol appear to be DNA modification and microtubule stabilization respectively. But the mechanism by which these drugs affect tumor cell cycle perturbation and their correlation to apoptosis and cytotoxicity are not well understood, especially in combined sequential treatment of cisplatin and paclitaxel (taxol). In this study, to elucidate the action mechanisms as a function of cell cycle changes and cytotoxicities and to determine the adequate treatment sequence of cisplatin and taxol to acquire more enhanced cytotoxic effects when they are combined, we evaluated the cell cycle perturbations and its correlation to cytotoxic effects, which is measured by the extents of apoptosis and the fractions of cellular debris and live cells after combination treatment of cisplatin and taxol changing their treatment sequences in NIHOVCAR-3 ovarian cancer cell line. Our results were as follows; (1) The accumulation in S phase inhibited the entrance of tumor cells to G2M phase when the cisplatin treatment was preceded to taxol in their combination. (2) The tumor cells were not accumulated in S phase but most of them entered to and accumulated in G2M phase and they were leading to cell death when the taxol treatment was preceded to cisplatin in their combination. (3) Apoptotic peaks in taxol pretreatment group were detected earlier and persisted longer than that of cisplatin pretreatment group. (4) The cytotoxicities represented by the decreased fractions of live cells and the increased fractions of cellular debris were higher in taxol pretreatment group than those of cisplatin pretreatment group. These results suggested that the taxol pretreatment is more effective in combination of cisplatin and taxol and the relative decrease in the cytotoxicity in cisplatin pretreatment group was considered to be derived from the inhibition of entrance of tumor cells to G2M and protected them from the action by taxol. From these results, we concluded that the taxol pretreatment will enhance the cytotoxic effects to tumor cells when cisplatin and taxol will be administered and it indicates that correlations between cell cycle perturbation, apoptosis and cell death have to be considered in the future combination treatment of other drugs and in the development of new treatment regimens.
Apoptosis ; Cell Cycle* ; Cell Death* ; Cell Line* ; Cisplatin* ; DNA ; Microtubules ; Ovarian Neoplasms ; Paclitaxel* ; S Phase

OBJECTIVE: To compare the outcomes of a method of assigning patients to a vaginal or laparoscopically assisted vaginal approach to hysterectomy. METHOD: Hysterectomy is the most common gynecologic operation. A clinical evaluation was attempted to analyze 100 cases of LAVH which was performed at St. Paul hospital from May 1997 to March 2000, and to compare them with 100 cases of vaginal hysterectomy at the same hospital. we used simple electrosurgical technique without using the disposable staples and other instruments. RESULTS: The mean age of the patients for LAVH was 46.18 years and that of VTH was 50.23 years. The most common indication for LAVH and VTH was Myoma uteri. The mean Hb change in LAVH was 2.15 and the Hb change of VTH was 2.17. The mean operative time of LAVH was 142.96 minutes and that of VTH was 77.06 minutes. The mean weight of uterus for LAVH was 221g and the mean weight of VTH was 182 g. The total percentage of urinary tract injury for LAVH was 3 % and that for VTH was 2 %. CONCLUSION: VTH, if possible, must be considered as a primary choice since it is were efficient than LAVH in cost, cosmetic aspects and complications. Further LAVH may be replaced with a laparotomy for hysterectomy in case of an insufficient operational experience, a previous abdominal operation hystory and the incapability of being indicated for VTH.
Female ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Laparotomy ; Myoma ; Operative Time ; Urinary Tract ; Uterus

PURPOSE: The aim of this study is to investigate the reproducibility of the quantitative assessment of segmental wall motion and systolic thickening provided by an automatic quantitation algorithm. MATERIALS AND METHODS: Tc-99m-MIBI gated myocardial SPECT with dipyridamole stress was performed in 31 patients with known or suspected coronary artery disease (4 with single, 6 with two, 11 with triple vessel disease; ejection fraction 51+/-14%) twice consecutively in the same position. Myocardium was divided into 20 segments. Segmental wall motion and systolic thickening were calculated and expressed in mm and % increase respectively, using AutoQUANTTM software. The reproducibility of this quantitative measurement of wall motion and thickening was tested. RESULTS: Correlations between repeated measurements on consecutive gated SPECT were excellent for wall motion (r=0.95) and systolic thickening (r=0.88). On Bland-Altman analysis, two standard deviation was 2 mm for repeated measurement of segmental wall motion, and 20% for that of systolic thickening. The weighted kappa values of repeated measurements were 0.807 for wall motion and 0.708 for systolic thickening. Sex, perfusion, or segmental location had no influence on reproducibility. CONCLUSION: Segmental wall motion and systolic thickening quantified using AutoQUANTTM software on gated myocardial SPECT offers good reproducibility and is significantly different when the change is more than 2 mm for wall motion and more than 20% for systolic thickening.
Coronary Artery Disease ; Dipyridamole ; Humans ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon*

The effects of dehydration on vasopressin and oxytocin immunoreactive neurons in the hypothalamus was investigated by using a immunohistochemistry. Adult Mongolian gerbil[Meriones unguiculates] were deprived of drinking water. Dehydrated animals were sacrificed on the 7th, 14th and 21st day of water retriction. The results are as follows : 1. The body weights were decreased about 1.8% daily. On the 21st day of dehydration, they were shown up to 45% compare to the control. 2. In the hypothalamus of the control group, majority of vasopressin and oxytocin immunoreactive neurons were located in the supraoptic and paraventricular nuclei. 3. Changes due to dehydrated stimulation were mainly observed in vasopressin immunoreactive neurons. And these changes in supraoptic nuclei were more severe than those in paraventricular nucleus. Size of vasopressin immunoreactived cells and of areas were increased as to proceed the dehydration. The numbers of those were increased on the 7th day of dehydration, and then they were continously decreased. 4. Although oxytocin immunoreactive neurons were slightly changed in numbers during dehydration, they were not shown conspicuous changes compare to vasopressin immunoreactive neurons. Thus it is appeared that vasopressin secretory neurons in the hypothalamus of Mongolian gerbil are affected by osmotic stress induced dehydration while oxytocin neurons may be affected by other factors.
Adult ; Animals ; Body Weight ; Dehydration* ; Drinking Water ; Gerbillinae* ; Humans ; Hypothalamus* ; Immunohistochemistry ; Neurons* ; Osmotic Pressure ; Oxytocin* ; Paraventricular Hypothalamic Nucleus ; Supraoptic Nucleus ; Vasopressins* ; Water

BACKGROUND: It is well known that oxygen free radicals (OFR) play a vital role in the various type of acute lung injury. Among various antioxidant defense mechanisms, the superoxide dismutases (SOD) are thought to be the first line of antioxidant defense by catalyzing the dismutation of two superoxide radicals to yield hydrogen peroxide and oxygen. Eukaryotic cells contain two types of intracellular SOD : cytosolic, dimeric copper/zinc- containing enzyme (CuZnSOD) and mitochondrial, tetrameric manganese-containing enzyme (MnSOD). The purpose of this study is to evaluate the time-dependent gene expression of MnSOD and CuZnSOD in the endotoxin-treated rats, and to compare with the manifestations of LPS-induced acute lung injury in rats. METHODS: Total RNA from rat lung was isolated using single step phenol extraction 0, 1, 2, 4, 6, 12, 18, 24 hours after E. coli endotoxin injection (n=3, respectively). RNA was separated by formaldehyde-containing 1.2% agarose gels elctrophoresis, transblotted, baked, prehybridized, and hybridized with 32P-labeled cDNA probes for rat MnSOD and CuZnSOD, which were kindly donated by Dr. Ho (Duke University, Durham, NC, USA). The probes were labeled by nick translation. Blots were washed and autoradiography were quantitated using laser densitometry. Equivalent amounts of total RNA/gel were assessed by monitoring 285 and 185 rRNA. RESULTS: Endotoxin caused a rise in steady-state MnSOD mRNA levels by 4h with peak mRNA accumulation by 6h. Continued MnSOD mRNA expression was observed at 12h. CuZnSOD mRNA expression was observed from 1h to 24h with peak levels by 18h. CONCLUSION: These results suggest that SOD palys an important defensive role in the endotoxin-induced acute lung injury in rats.
Acute Lung Injury ; Animals ; Autoradiography ; Cytosol ; Defense Mechanisms ; Densitometry ; DNA, Complementary ; Eukaryotic Cells ; Free Radicals ; Gels ; Gene Expression* ; Hydrogen Peroxide ; Lung* ; Oxygen ; Phenol ; Rats* ; RNA ; RNA, Messenger ; Sepharose ; Superoxide Dismutase* ; Superoxides*

No abstract available.
Lung Neoplasms* ; Lung* ; Thorax*