Normative Values and Correlates of Mean Common Carotid Intima-Media Thickness in the Korean Rural Middle-aged Population: The Atherosclerosis RIsk of Rural Areas iN Korea General Population (ARIRANG) Study

Carotid intima-media thickness (CIMT) is considered as a surrogate marker for cardiovascular disease (CVD). We determined the normative value of CIMT and correlates of CVD risk factors and Framingham risk score (FRS) in Korean rural middle-aged population. We measured CIMT with a B-mode ultrasonography in 1,759 subjects, aged 40 to 70 yr, in a population-based cohort in Korea. A healthy reference sample (n = 433) without CVD, normal weight and normal metabolic parameters was selected to establish normative CIMT values. Correlates between CIMT and conventional CVD risk factors were assessed in the entire population. Mean values of CIMT (in mm) for healthy reference sample aged 40-49, 50-59, and 60-70 yr were 0.55, 0.59, and 0.66 for men and 0.48, 0.55, and 0.63 for women, respectively. In multivariate regression analysis, CIMT was correlated with older age, higher BMI, male gender, higher LDL-cholesterol level and history of diabetes mellitus. The mean CIMT was also correlated with FRS in both gender (r2 = 0.043, P < 0.01 for men; r2 = 0.142, P < 0.01 for women). We identified normative value of CIMT for the healthy Korean rural middle-aged population. The CIMT is associated with age, obesity, gender, LDL-cholesterol, diabetes mellitus and FRS.

Clinical Characteristics and Prognostic Factors of Stress-Induced Cardiomyopathy

BACKGROUND AND OBJECTIVES: Stress-induced cardiomyopathy (SCM) is characterized by a transient left ventricular (LV) dysfunction due to emotional and physical stress. There are limited data about the clinical characteristics in Korean patients. We sought to clarify the clinical features and prognosis in patients with SCM. SUBJECTS AND METHODS: We reviewed 39 cases diagnosed with SCM in a tertiary hospital. The SCM was diagnosed as: 1) no previous history of cardiac disease, 2) acute onset, 3) regional wall motion abnormality, typically in the takotsubo or inverted takotsubo shape by echocardiography, and 4) no significant stenosis in the coronary angiogram. We evaluated clinical characteristics, biomarkers, and prognosis. RESULTS: Mean age was 61.3+/-16.1 years (female 69%). The triggering factors were physical stress in 32 patients (82%) and emotional stress in 5 patients (13%). The initial symptom was dyspnea (n=18, 46%) rather than chest pain (n=10, 26%). An initial electrocardiogram (EKG) presented T-wave inversion (n=18, 46%), ST-elevation (n=11, 28%), and ST-depression (n=2, 5%). Multivariate logistic regression analysis showed that initial high sensitive C-reactive protein (hs-CRP) {odds ratio (OR) 1.41, 95% confidence interval (CI); 1.02-1.97} and initial left ventricular ejection fraction (LVEF) (OR 0.89, 95% CI; 0.80-0.98) were significantly associated with death or cardiogenic shock, respectively. CONCLUSION: The major triggering factor of SCM is physical stress due to illness or surgical procedures, and the first manifestation is dyspnea rather than chest pain. Elevated hs-CRP and decreased LVEF at admission were independent risk factors for death or cardiogenic shock.

Antibody Production of Baculovirus-expressed VP6 from Porcine Group C Rotavirus

The emerging pathogen, group C rotavirus (RVC) has been reported to cause acute diarrhea. But there was the limitation on the detection and monitoring for the absence of rapid sensitive diagnosis system. For the molecular biology study and diagnostic system development, we could detect porcine RVC by reverse transcriptase PCR (RT-PCR) analyses from 60 diarrheal disease porcine stool samples. VP6 full length RT-PCR product (CA-2 RVC, 1352 bp) was cloned and compared the nucleotide and deduced amino acid sequences with those of previously reported other porcine, human, and bovine rotavirus group A, B and C strains. Analyses data showed >82% homology on the nucleotide sequences and >90% homology on the deduced amino acid sequences with other RVCs. Recombinant baculovirus was prepared with cloned PCR product corresponding to VP6 coding sequence (CDS) (position 22~1206) into BaculoDirect(TM) C-term linear DNA, and used for the transfection of insect cells. The polyclonal antibody was produced from mice with purified recombinant VP6 and confirmed with western blot. Both of VP6 antigen and antibody, are useful for the development of rapid diagnostic system against RVC.

Primary Reconstruction of Complete Testicular Rupture / 대한남성과학회지

Testicular rupture most commonly occurs in young men. Although it is not life threatening, loss of a testicle could impair future fertility, contribute to a hypogonadal state, and affect social confidence. We report primary testicular reconstruction over orchiectomy even in the setting of a severe injury with a critical review of the literature.

Pathologic Features of Recurrent Bladder Tumors after Upper Urinary Tract Transitional Cell Carcinoma / 대한비뇨기과학회지

PURPOSE: Recurrence of upper urinary tract transitional cell carcinoma is common, and especially for bladder cancer. We evaluated the pathologic features, grade and recurrence rate of bladder tumors for patients who suffered with upper urinary tract transitional cell carcinoma and who were surgically treated at our hospital. MATERIALS AND METHODS: Between 2001 and 2006, a total of 68 patients without a history of bladder cancer underwent nephroureterectomy for upper urinary tract transitional cell carcinoma. We reviewed the pathologic features, the stage and the grade of the recurrent bladder cancer at a median follow up of 17.1 months. RESULTS: A total of 22 of 68 patients experienced recurred bladder tumors after nephroureterectomy for upper urinary tract transitional cell carcinoma at a mean interval of 17.1 months. Of the 22 patients with recurred bladder tumors, 21 of the patients(95%) had superficial tumor(Stage Ta, Tis, T1), 4(19%) of the patients had superficial tumors of a low grade (grades 1 and 2) and 17 patients(81%) had high grade tumor(grade 3). One patient had muscle invasive bladder tumor, so this was treated with radical cystectomy during the follow-up period. Regardless of the grade of the upper urinary tract transitional cell carcinoma, the pathologic grade of the bladder tumor was mostly high grade(82%). Regardless of the stage of upper urinary tract transitional cell carcinoma, the stage of the recurrent bladder tumors was almost superficial(95%). CONCLUSIONS: Bladder tumors recurred in 33%(22/68) of the patients after surgery for upper urinary tract transitional cell carcinoma. Of these bladder tumors, 95% were superficial and 81% were high grade. Therefore, conducting follow-up studies for bladder cancer is important after nephroureterectomy for upper urinary tract transitional cell carcinoma.

Drug-Induced Dilated Cardiomyopathy Associated with Anagrelide

Anagrelide is an effective drug for essential thrombocythaemia, and its adverse cardiovascular effects are relatively rarely reported. We experienced a 73 year-old man with essential thrombocythaemia developed anagrelide-induced dilated cardiomyopathy. After discontinuation of anagrelide, the patient's left ventricular systolic function was completely recovered.

The factors of pain and anxiety associated with urodynamics in female patients

PURPOSE: Urodynamic study (UDS) is widely used to evaluate voiding dysfunction, however, it is invasive and bothersome for patients because it requires catheterization into the urethra and anus. We assessed patients' anxiety and pain levels caused by UDS. MATERIALS AND METHODS: A total of 60 female patients who were undergoing UDS were included in the study on a prospective basis. Anxiety level was taken prior to the procedure and pain level was taken immediately after the procedure by visual analogue scale (VAS). Just after the procedures, they were asked if they were willing to undergo the same procedure and if they could recommend the procedure to another people if medically indicated. 60 patients were divided into 2 groups: urodynamic urethral catheters (9Fr, PVC, n=30) were used in group I and Foley catheters (10Fr, Silicon, n=30) were used in group II. RESULTS: The mean age of both groups were 45.5+/-5.3 (group I)and 45.5+/-3.8 (group II)years old. The anxiety and pain levels were relatively high, but there was no significant difference between both groups in pain level. Anxiety level prior to UDS was correlated with pain level (r=0.492, p<0.001). 42 out of 60 patients (70.0%) answered they were willing to undergo UDS if they were asked again and 37 patients (61.7%) answered they could recommend the procedure to another people. 21 patients (35.0%) were menopausal women and they showed higher anxiety level compared to non-menopausal women. CONCLUSION: Female patients felt anxiety before UDS and pain immediately after UDS, especially in menopausal women, and the more anxious they were, the more painful they felt. Therefore, we need to provide sufficient explanation with regard to the procedure for patients prior to UDS to diminish patients' anxiety and pain.

Infective Cellulitis of Obturator Foramen and Persistent Vaginal Erosion following Transobturator tape (TOT) procedure

We experienced the case of infected mesh with subsequent infective cellulitis of obturator foramen after a TOT procedure. We reported our case of a 47-year-old woman who presented with persistent vaginal discharge, pain and motion limitation of left leg after having a TOT placed for stress incontinence. Inflammation around obturator foramen was demonstrated on computed tomography (CT) scan. We performed total excision of the mesh material. She ultimately had an uneventful postoperative course and no recurrence of incontinence after follow-up 1 month.

MR Findings to Predict the Site of Dural Attachment in Meningiomas

PURPOSE: To study the MR findings to predict the site of dural attachment in meningiomas. MATERIALS AND METHODS: We retrospectively reviewed MR findings of 23 patients with surgically confirmed meningiomas and analysed the characteristics of dural attachment site of meningiomas and tumor growing vector against dura. RESULTS: In the 10 cases that tumor had a single dural base, the dural base was tumor bed. in the 2 cases that tumor had more than two dural bases, wider, irregular and thicker enhancing dura was tumor bed. In the 7 of the 11 cases of diffuse dural bases with tumor, we could predict tumor bed considering the degree of compression to the brain parenchyma and the tumor growing vector. CONCLUSIONS: In the case of tumor having more than two surfaces contacting the dura or with narrow attachment site, it is possible to predict the site of dural attachment if we consider the characteristrics of dural attachment site and tumor growing vector against dura.