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Angiotensinogen gene M235T polymorphism as a predictor of cardiovascular risk in hypertensive adolescents (고혈압 청소년의 심혈관계 위험요소로서 Angiotensinogen M235T 유전자 다형)

  • Gil, Joo Hyun;Lee, Jung Ah;Park, Eun Young;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.36-43
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    • 2009
  • urpose : The renin-angiotensin system (RAS) has been demonstrated to play a major role in regulating blood pressure. Therefore, components of the RAS are likely candidate genes that may predispose an individual to essential hypertension and cardiovascular complications. Among them, the M235T polymorphism of the angiotensinogen gene has been speculated to be associated with elevated circulating angiotensinogen concentrations and essential hypertension. This study aimed to analyze the angiotensinogen M235T polymorphism in hypertensive adolescents and investigate its relationship with cardiovascular risks. Methods : Forty Korean hypertensive adolescents (aged 16-17, systolic $BP{\geq}140 mmHg$ and/or diastolic $BP{\geq}90 mmHg$) and fifty seven normal adolescents were included. Obesity index (OI), body mass index (BMI) were calculated. BP was measured by oscillometric methods in resting state. Polymerase chain reaction (PCR) technique was performed on DNA from the hypertensives subjects to analyze the M235T polymorphism. Serum homocysteine, insulin, renin, aldosterone and angiotensin converting enzyme (ACE) were tested according to each genotype. The carotid intima-media thickness (IMT) and carotid artery diameter, Pulse wave velocity (PWV) and ankle-brachial index (ABI) were measured according to each genotype. Results : Genotype frequencies of T/T, M/T and M/M were 62.5%, 35.0%, 2.5%, respectively in hypertensive adolescents. The results were not significantly different compared to control group. Serum insulin, renin levels, BMI and OI were significantly higher in thoses with the M/M genotype as compared to those with the T/T of M/T genotype. Conclusion : This study showed that the M235T polymorphism was not associated with essential hypertension or any cardiovascular risks. Further clinical research is required to ascertain the relationship between this polymorphism and cardiovascular complications in Korean hypertensive adolescents.

A Clinical Study of Child Abuse (아동학대로 진단된 환아의 임상적 고찰)

  • Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.436-442
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    • 2007
  • Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.

The characteristics of neurocardiogenic syncope in children (소아 신경-심인성 실신의 특징)

  • Lee, Kyung Yeon;Lee, Jin Young;Kim, Myoung Hyun;Lee, Jeong Eun;Kim, Yong Dae;Lee, Eun Ju;Lim, Young Su;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.512-517
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    • 2008
  • Purpose : Syncope is relatively common in children and adolescents. Among the etiologies of syncope, neurocardiogenical syncope is the most common, but it is often confounded with seizure. We investigated the clinical features of patients under the age of 15 with neurocardiogenical syncope, compared to patients with neurologic disorders including epilepsy. Methods : Among the children who visited the Department of Pediatrics at Cheongju St. Mary's Hospital and Chungbuk National University Hospital from March 2005 to February 2007, we retrospectively analyzed 69 patients whose chief complaint was syncope. We classified the patients by syncope etiology and made comparisons between the neurocardiogenical syncope (NCS) group and the neurological disorders (ND) group regarding to age; location; time and season in which syncope occurred; associated symptoms, including seizures, provocation factors; prodromes; duration of syncope; frequency of previous syncope; birth history; associated disease; past medical history; family history; neurological exam; physical exam; laboratory findings; electrocardiography; electroencephalography (EEG); head-up tilt test; brain CT; and MRI. Results : Among 69 syncope patients, 53 (76.8%) were in the NCS group and 11 (15.9%) were in the ND group. There were no statistically significant differences between the two study groups except for the presence of prodromes and EEG abnormalities. The presence of prodromes in the NCS group was more common than in the ND group [46.9% (23/49) vs. 9.1% (1/11), (P=0.038)]. The EEG abnormality in the ND group was more common than in the NCS group [90% (9/10) vs. 5.8% (3/52), (P<0.01)]. Conclusion : Our study suggests that detailed history-taking, including that concerning prodromes, is important for the accurate diagnosis of neurocardiogenical syncope, and EEG should be obtained if neurological disorders are suggested.

Diagnostic Role of F-18 FDG PET/CT in the Follow-up of Patients with Colorectal Cancer: Comparison with Serum CEA, CA 19-9 Levels and Computed Tomography (대장암 치료 후 추적 검사로서 F-18 FDG PET/CT의 역할: 혈청 CEA, CA 19-9 및 Computed Tomography와의 진단 성능 비교)

  • Kang, Sung-Min;Song, Bong-Il;Lee, Hong-Je;Seo, Ji-Hyoung;Lee, Sang-Woo;Yoo, Jeong-Soo;Ahn, Byeong-Cheol;Lee, Jae-Tae;Choi, Kyu-Suk;Jun, Soo-Han
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.120-128
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    • 2009
  • Purpose: Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of CEA, CA 19-9, CT and PET/CT has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to compare the diagnostic ability of PET/CT, tumor marker and CT for recurrence in colorectal cancer patients after treatment. Materials and Methods: F-18 FDG PET/CT imaging was performed in 189 colorectal cancer patients who underwent curative surgical resection and/or chemotherapy. Measurement of serum levels of CEA, CA 19-9 and CT imaging were performed within 2 months of PET/CT examination. Final diagnosis of recurrence was made by biopsy, radiologic studies or clinical follow-up for 6 months after each study. Results: Overall sensitivity, specificity of PET/CT was 94.7%, 91.1%, while those of serum CEA were 44.7% and 97.3%, respectively. Sensitivity and specificity were 94.2%, 90.4% for PET/CT and better than those of combined CEA and CA 19-9 measurement(52.1%, 88.5%) in 174 patients measured available both CEA and CA 19-9 data. In 115 patients with both tumor markers and CT images available, PET/CT showed similar sensitivity but higher specificity(92.9%, 91.3%) compared to combination of tumor markers and CT images(92.9%, 74.1%). Conclusion: PET/CT was superior for detection of recurred colorectal cancer patients compared with both CEA, CA 19-9, and even with combination of both tumor markers and CT. Therefore PET/CT could be used as a routine surveillance examination to detect recurrence or metastasis of colorectal cancer.

Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • 홍기환;이상헌;최승철;임현실;김연우;전희석;양윤수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.173-179
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    • 2002
  • Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

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Hepatitis B Virus-Induced TNF-a Expression in Hepa-lc1c7 Mouse Hepatoma Cell Line (마우스 Hepa-1c1c7 세포주에서 B형 간염 바이러스에 의한 tumor necrosis factor-a의 발현 유도)

  • Yea Sung Su;Jang Won Hee;Yang Young-Il;Lee Youn Jae;Kim Mi Seong;Seog Dae-Hyun;Park Yeong-Hong;Paik Kye-Hyung
    • Journal of Life Science
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    • v.15 no.1 s.68
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    • pp.38-44
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    • 2005
  • Infection with hepatitis B virus (HBV) is a major health problem worldwide. Although a tremendous amount has been known about HBV, there have been obstacles in the study of HBV due to the narrow host range of HBV limited to humans and primates. In the present study, we investigated the susceptibility to HBV infection of mouse hepatoma cell line, Hepa-1c1c7. In addition, based on that human hepatocytes infected by HBV increase the expression of the pro-inflammatory cytokine TNF-a, the inducibility of TNF-a expression by HBV in the cells was determined. HBV surface antigen (HBsAg) secretion was measured by the microparticle enzyme immunoassay and steady state mRNA expression was analyzed by quantitative competitive RT-PCR. Transient transfection of Hepa-1c1c7 cells with HBV expression vector resulted in a dose-dependent induction of TNF-a expression. Infection of Hepa-1c1c7 cells with the serum of HBV carrier also increased TNF-a mRNA expression. Both in the transfected and infected cells, HBV mRNA was expressed and significant HBsAg secretion was detected. There was no significant variation in $\beta-actin$ mRNA expression by HBV. These results demonstrate that HBV is infectious to Hepa-lc1c7 in vitro and the viral infection induces TNF-a expression, which suggests that Hepa-lc1c7, a mouse hepatoma cell line, may be a possible model system for analysis of various molecular aspects of HBV infection.

In Vivo Immunological Activity in Fermentation with Black Rice Bran (유색미 미강발효물의 면역활성 효과)

  • Kim, Dong-Ju;Ryu, Su-Noh;Han, Sang-Jun;Kim, Hwa-Young;Kim, Jung-Hak;Hong, Seong-Gil
    • The Korean Journal of Food And Nutrition
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    • v.24 no.3
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    • pp.273-281
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    • 2011
  • Rice bran is byproducts of the hulling of rice, an important food resource in Korea. Various studies have been reported immune-enhancing effects of rice bran cultured with Lentinus edodes. In particular black rice bran contains anthocyanin, and the effects of antioxidant have been reported. The objective of the this study was to investigate the possible immune-enhancing effects of black rice bran substance extracted from a submerged culture of Lentinus edodes with black rice bran (crude fermentation-polysaccharide, CFP) and products(crude fermentation-polysaccharide-S. cerevisiae CFP-S, crude fermentation-polysaccharide-L. gasseri, CFP-L) which are of secondary fermentation of by using Saccharomyces cerevisiae and Lactobacillus gasseri in the Blab/c male mice. We found that supplementation of CFP, CFP-S and CFP-L enhanced macrophage and splenocyte proliferation compared to the control group(NC) in mice. Also, we measured the concentration of cytokines(IFN-${\gamma}$, TNF-${\alpha}$, IL-6) secreted by activated macrophage and splenocyte. The results of the experiment are that supplementation of CFP and CFP-S increased the macrophage and splenocyte proliferation compared to the control group but supplementation of CFP-L decreased the splenoyte proliferation compared to the control group(without mitogen and treated with LPS). When macrophage and splenocyte were stimulated by CFP and CFP-S supplementation, it was increased IFN-${\gamma}$, TNF-${\alpha}$ and IL-6 concentration compared with the control group. These results suggest that the capacity of CFP and CFP-S seem to act as a potent immune modulator causing augmentation of immune cell activity, and enhance the immue function through regulating cytokine production capacity by activated macrophage and splenocyte in mice.

Effects of hydrocolloids on wheat flour rheology (Hydrocolloid의 첨가가 밀가루 반죽의 특성에 미치는 영향)

  • 임경숙;황인경
    • Korean journal of food and cookery science
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    • v.15 no.3
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    • pp.203-209
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    • 1999
  • The effect of several hydrocolloids on the rheological behavior of wheat flour was investigated. The influence of the selected hydrocolloids (alginate, carrageenan, CMC, guar, locustbean and xanthan) on wheat flour was tested by using two different techniques; amylograph and texture analyzer. In order to have a general overview of their effects hydrocolloids were chosen from different sources implying a broad diversity of chemical structures. The hydrocolloid addition decreased the brightness(L) but increased yellowness(b). The interaction between hydrocolloid and flour produces a slight modification of the amylogram parameters, being the most clearly affected parameter breakdown, which is increased by carrageenan, guar and xanthan. Hardness and cutting force were augmented by hydrocolloid addition, while springeness was decreased except guar and locustbean. In summary, when looking for the improvement of the noodle texture, guar, locustbean are the best candidate additives due to their effects on pasting and texture properties. These hydrocolloids increase the hardness, cutting force, gumness, chew-ness, so were thought to increase the eating quality. So, each tested hydrocolloid affected in a different way the rheological properties of wheat flour, the results obtained are important for the appropriate use of these hydrocolloid as ingredients in the noodle making process.

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A Clinical Study on the Hypercalcemia in Primary Bronchogenic Carcinoma (고칼슘혈증을 동반한 원발성 폐암의 임상적 특징)

  • Park, Hye-Jung;Shin, Kyeong-Cheol;Moon, Young-Chul;Chung, Jin-Hong;Lee, Kwan-Ho;Sung, Cha-Kyung;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.208-218
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    • 1999
  • Background: Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic disorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advanced stage with obvious bulky tumor and carry a poor prognosis. Materials and Methods: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level ${\geq}$ 10.5 mg/dL, and symptoms which could possibly be attributed to hypercalcemia. In this retrospective study, we evaluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics. Results: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance status, and bone metastasis, it was not significant statistically. Altered consciousness was significantly more frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. Conclusion: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of death and should be treated aggressively to prevent sudden deterioration or death.

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Risk Factors in Relation to Blood Pressure in Schoolchildren (국민학교 학동의 혈압에 관련된 요인분석)

  • Lee, Dong-Soo;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.345-359
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    • 1993
  • This study was conducted to identify the factors related to the blood pressure in school children. The study subjects were 144 boys and 140 girls aged 10 years old, 4th grade student of one elementary school in Taegu City. Blood pressure and 18 variables for 284 school children were measured in May 1992. A weight-for-height index, R$\ddot{o}$hrer index(weight/$height^3$) was calculated for each individual as a measure of obesity. Body fat percent, fat weight, and lean body mass were measured by impedance fat meter(Model SIF-891). Serum total cholesterol, high-density lipoprotein, triglyceride, uric acid, total protein, and electrolyte were measured by automated clinical chemistry analyzer(Hitachi 4020). Low-density lipoprotein and atherogenic index were calculated by the equation. The variables assessed were sex, systolic blood pressure, diastolic blood pressure. R$\ddot{o}$hrer index, body fat percent, body fat weight, lean body mass, total cholesterol, high-density lipoprotein, low-density lipoprotein, uric acid, total protein, serum electrolyte and blood glucose. The mean systolic and diastolic blood pressures for boys were 104.1mmHg and 66.6mmHg and those for girls were 102.9mmHg and 67.5mmHg. Systolic blood pressure of boys was positively correlated with height, weight, R$\ddot{o}$hrer index, fat weight, lean body mass, and triglyceride. Systolic blood pressure of girls was positively correlated with height, weight, lean body mass, and uric acid. Diastolic blood pressure of boys was positively correlated with weight. R$\ddot{o}$hrer index, and lean body mass. Diastolic blood pressure of girls was positively correlated with height, weight, fat weight, and lean body mass and negatively with total serum protein. In multiple regression analysis for the systolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index and serum sodium in boys, and serum uric acid, fat percent, and R$\ddot{o}$hrer index in girls. In multiple regression analysis of the diastolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index in boys and total serum protein in girls. This study indicated that important factors influencing blood pressure in school children were R$\ddot{o}$hrer index, fat percent, serum sodium, uric acid, and total protein. R$\ddot{o}$hrer index was most important among these. It is recommended to enforce the nutritional education for diet control of obesity to prevent hypertention in children and to adopt healthy life-styles that promote good health and prevent development of cardiovascular risk factors.

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