Modulation of Vascular Smooth Muscle Cell Phenotype by High Mobility Group AT-Hook 1

Objective@#The purpose of this study is to examine the effect of high mobility group AT-hook 1 (HMGA1) on the phenotyptic change of vascular smooth muscle cells (VSMCs). @*Methods@#Gene silencing and overexpression of HMGA1 were introduced to evaluate the effect of HMGA1 expression on the phenotypic change of VSMCs. Marker gene expression of VSMCs was measured by promoter assay, quantitative polymerase chain reaction, and western blot analysis. Common left carotid artery ligation model was used to establish in vivo neointima formation. @*Results@#HMGA1 was expressed strongly in the synthetic type of VSMCs and significantly downregulated during the differentiation of VSMCs. Silencing of HMGA1 in the synthetic type of VSMCs enhanced the expression of contractile marker genes thereby enhanced angiotensin II (Ang II)-dependent contraction, however, significantly suppressed proliferation and migration. Stimulation of contractile VSMCs with platelet-derived growth factor (PDGF) enhanced HMGA1 expression concomitant with the downregulation of marker gene expression which was blocked significantly by the silencing of HMGA1. Silencing of HMGA1 retained the Ang II-dependent contractile function, which was curtailed by PDGF stimulation, however, overexpression of HMGA1 in the contractile type of VSMCs suppressed marker gene expression. Proliferation and migration were enhanced significantly by the overexpression of HMGA1. Furthermore, the Ang II-dependent contraction was reduced significantly by the overexpression of HMGA1. Finally, the expression of HMGA1 was enhanced significantly in the ligated artery, especially in the neointima area. @*Conclusion@#HMGA1 plays an essential role in the phenotypic modulation of VSMCs.Therefore, paracrine factors such as PDGF may affect vascular remodeling through the regulation of HMGA1.

Actual Condition, Knowledge and Attitude of Patient Controlled Analgesics(PCA) in Postoperative Patients / 기본간호학회지

PURPOSE: This study was to identify knowledge, attitude, use and state of the Patient Controlled Analgesics (PCA) in postoperative patients. METHOD: The research design was a descriptive research. From December 7, 2005 to January 6, 2006, 102 postoperative patients in a university hospital at Daegu were participated in the study. RESULTS: Analgesics with PCA were mainly morphine complex 73.5% and Demerol complex 26.5%. Previous experience of using PCA was only 28.4%, and the main sources of information were other post-op patients and families(43.1%). The most common reason of choice was a recommendation from other post-op patients and families(46.1%). The most common side effects of PCA were nausea and vomiting(20.6%). About 57% of the patients were satisfied with PCA, and pain scores decreased with PCA. Mean score for knowledge about PCA was 2.55 out of a possible 6, and for attitude related to pain medication. 2.31 out of possible 5. CONCLUSION: To increase the score on knowledge of PCA, a structured preoperative PCA education program should be developed by nursing staff.

The Time Course and Determinants of B-Type Natriuretic Peptide in Healthy Men during Supine Bicycle Exercise

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.

The Prevalence of Iron Deficiency and Iron Deficiency Anemia in Korean Adolescents / 대한혈액학회지

BACKGROUND: Iron deficiency anemia frequently occurs in adolescence because of accelerated physical growth in both boys and girls, and because of menstrual iron loss and dieting to avoid obesity in female teenagers. As little is known about iron deficiency in adolescents in Korea, this study was aimed at assessing the prevalence of iron deficiency and iron deficiency anemia (IDA) in apparently healthy Korean adolescents in relation to gender, physical development, and dietary habit. METHODS: With a questionnaire regarding their demographic characteristics, blood samples were obtained from apparently healthy students aged 10~18 years by venipuncture at Sept. and Oct. 1996. Hemoglobin (Hb), hematocrit, RBC indices, serum ferritin levels, iron and total iron-binding capacity (TIBC) were measured. RESULTS: A total of 1,164 students (M:F = 610:554) aged 10~18 years were included in this study. In boys, the mean Hb concentration increased with age from 13.3g/dL in the 10~12 years group to 15.3g/dL in the 17~18 years group. In girls, the mean Hb concentration was 13.2g/dL in the 10~12 years group, and 12.7g/dL in the 15~16 years group. In boys, iron deficiency prevalence was 5.6% in the 10~12 years group, 10.6% in the 13~16 years. In girls, the prevalence of anemia increased with age: 0.8% in the 10~12 years group; 5.5% in the 13~14 years group; 16.9% in the 15~16 years group; 19.7% in the 17~18 years group. Iron deficiency prevalence in girls was 9.2% in the 10~12 years group, 14.1%in the 13~14 years group, 22.6% in the 15~16 years group, and 30.7% in the 17~18 years group. The prevalence of IDA in girls was 0.8% in the 10~12 years group, 4.3% in the 13~14 years group, 7.3% in the 15~16 years group, and 13.1% in the 17~18 years group. On questionnaire, 19.5% of males and 40.0% of females usually missed one meal a day. The proportion of missed meals in girls increased with age. The proportions of Hb<12g/dL and ferritin<10ng/dL were significantly high in boys aged 10~14 years with vegetarian parents. The prevalence of anemia and iron deficiency in the students with menstruation was 14.9% and 21.6%, which was higher than the prevalence of 3.3% and 13.2% in those who did not have the menarche (P<0.001 and P<0.05, respectively). CONCLUSION: As the prevalence of iron deficiency and IDA were substantially greater than expected, studies of iron state in adolescent girls, especially middle to high school age, should be undertaken to assess iron deficiency. In addition, nutritional education for adolescents is warranted.

The Prevalence of Anemia and Microcytosis in 10~18 year-old Students / 대한혈액학회지

BACKGROUND: Anemia still remains the most common single nutrient deficiency disorder in the world, especially among adolescence period because of the accelerated physical growth both in boys and girls and menstrual losses in iron and dieting for fear of obesity in female teenagers. The purpose of this study was to determine the prevalence of anemia and microcytosis among healthy students. METHODS: We conducted blood tests in apparently healthy girls (n=49,162) and 2,203 boys aged 10 to 18 years who went to school in Pucheon. Hemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell and platelet count were determined at same day with the use of a Coulter T 540 (Coulter Corp., F1, U.S.A.). RESULTS: 1) In boys the mean Hb concentration increased with age from 13.2g/dL in 10~12 yr to 15.3g/dL in 17~18 yr. In girls the mean Hb concentration was 13.3g/dL in 10~12 yr, 13.1g/dL in 15~16 yr, and 12.9g/dL in 17~18 yr. The difference in mean Hb levels between both sexes was significant (P<0.001) after 13 yrs of age. The mean MCV and MCH increased with age in each sex. 2) In boys, the prevalence of anemia showed 6.5% in 10~12 years, 2.4% in 13~14 years, 5.7% in 15~16 years and 3.0% in 17~18 years. In girls, the prevalence of anemia increased with age: 2.1% in 10~12 years, 4.2% in 13~14 years, 12.1% in 15~16 years and 20.5% in 17~18 years. 3) The prevalence of microcytosis (MCV< 78 fL in 10~14 yr; MCV< 79 fL in 15~18 yr) in boys was about 1% in each group. The prevalence of microcytosis in girls was2.0% in 10~12 years, 2.7% in 13~14 years, 6.1% in 15~16 years and 8.1% in 17~18 years. CONCLUSION: As the prevalence of anemia was substantially greater than expected, studies of iron deficiency in adolescent girls should be performed to assess iron deficiency. In addition, nutritional education for adolescents is warranted.

Investigation of Plasma Catecholamines with Tramadol during Balanced Anesthesia / 대한마취과학회지

Recently introduced tramadol structually similar to morphine, was a new category in analgesia. Also it was reported that that drug could be used in the shale of balanced anesthesia. So we carried out the experiment for evaluation of its effect on sympathoa-drenal system activity, indexed by plasma epinephrine and norepinephrine levels, to compare with other methods of balanced techniques in 18 Patients. Patients in group 1 who received Thalamonal-N2O-O2, patients in group 2 were given pethidine. diazepam-N2O-O2, patients in group 3 were tramadol. diase7am-N2O-O7, Venous samples were obtained before induction of anesthesia, after induction but before skin incision and immediately after skin incision. Sequential results of plasma epinephrine(pg/ml)were 62.0+16.8(mean+s.e.), 134.3+18.7, 127.3+26.2 in group 1, 65.8+13.1, 79.7+13.1, 91.3+22.5 in group 2 and 74.0+24.9, 88.0+17. 1, 108.4+23.2 in group 3. Values of norepinephrine(pg/ml) were 212.5+27.1, 167.7+23.9, 236.2+34.4 in group 1, 213.8+59.1, 162.0+33.2, 246.8+55.7 in group 2 and 236.0+39.6, 197.7+59.4, 208.4+25.6 in group 3. Those values did not differ significantly between three groups. Theae data revealed that this method of balanced anesthesia using tramadol could effectively block the sympathetic response to anesthestic and surgical stress as other method of balanced techniques.