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Park KH, Choi YJ, Min WK, Lee SH, Kim J, Jeong SH, Lee JH, Choi BM, Kim S. Particulate matter induces arrhythmia-like cardiotoxicity in zebrafish embryos by altering the expression levels of cardiac development- and ion channel-related genes. Ecotoxicol Environ Saf 2023; 263:115201. [PMID: 37418944 DOI: 10.1016/j.ecoenv.2023.115201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023]
Abstract
Air pollution is a risk factor that increases cardiovascular morbidity and mortality. In this study, we investigated the cardiotoxicity of particulate matter (PM) exposure using a zebrafish embryo model. We found that PM exposure induced cardiotoxicity, such as arrhythmia, during cardiac development. PM exposure caused cardiotoxicity by altering the expression levels of cardiac development (T-box transcription factor 20, natriuretic peptide A, and GATA-binding protein 4)- and ion-channel (scn5lab, kcnq1, kcnh2a/b, and kcnh6a/b)-related genes. In conclusion, this study showed that PM induces the aberrant expression of cardiac development- and ion channel-related genes, leading to arrhythmia-like cardiotoxicity in zebrafish embryos. Our study provides a foundation for further research on the molecular and genetic mechanisms of cardiotoxicity induced by PM exposure.
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Affiliation(s)
- Kyu Hee Park
- Department of Pediatrics, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Sun Hwa Lee
- Zebrafish Translational Medical Research Center, Korea University, Ansan 15588, Gyeonggi-do, the Republic of Korea
| | - Jaeyoung Kim
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Sang Hoon Jeong
- Medical Science Research Center, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Ju-Han Lee
- Department of Pathology, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Byung Min Choi
- Department of Pediatrics, Ansan Hospital, Korea University College of Medicine, Ansan 15588, the Republic of Korea
| | - Suhyun Kim
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 04763, the Republic of Korea; Zebrafish Translational Medical Research Center, Korea University, Ansan 15588, Gyeonggi-do, the Republic of Korea.
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Lee KS, Min WK, Choi YJ, Jin S, Park KH, Kim S. The Effect of Maternal Exposure to Air Pollutants and Heavy Metals during Pregnancy on the Risk of Neurological Disorders Using the National Health Insurance Claims Data of South Korea. Medicina (Kaunas) 2023; 59:medicina59050951. [PMID: 37241184 DOI: 10.3390/medicina59050951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/15/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023]
Abstract
The objective of this study was to evaluate the effects of high levels of maternal exposure to ambient air pollution and heavy metals on risks of autism spectrum disorder (ASD) and epilepsy using the National Health Insurance claims data of South Korea. The data of mothers and their newborns from 2016 to 2018 provided by the National Health Insurance Service were used (n = 843,134). Data on exposure to ambient air pollutants (PM2.5, CO, SO2, NO2, and O3) and heavy metals (Pb, Cd, Cr, Cu, Mn, Fe, Ni, and As) during pregnancy were matched based on the mother's National Health Insurance registration area. SO2 (OR: 2.723, 95% CI: 1.971-3.761) and Pb (OR: 1.063, 95% CI: 1.019-1.11) were more closely associated with the incidence of ASD when infants were exposed to them in the third trimester of pregnancy. Pb (OR: 1.109, 95% CI: 1.043-1.179) in the first trimester of pregnancy and Cd (OR: 2.193, 95% CI: 1.074-4.477) in the third trimester of pregnancy were associated with the incidence of epilepsy. Thus, exposure to SO2, NO2, and Pb during pregnancy could affect the development of a neurologic disorder based on the timing of exposure, suggesting a relationship with fetal development. However, further research is needed.
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Affiliation(s)
- Kuen Su Lee
- Department of Anesthesiology and Pain Medicine, Eulji University Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu 11759, Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of Korea
| | - Sejong Jin
- Department of Neuroscience, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Kyu Hee Park
- Department of Pediatrics, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Suhyun Kim
- Department of Biomedical Sciences, College of Medicine, Korea University, Seoul 02841, Republic of Korea
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Min WK, Jin S, Choi YJ, Won YJ, Lee K, Lim CH. Lung ultrasound score-based assessment of postoperative atelectasis in obese patients according to inspired oxygen concentration: A prospective, randomized-controlled study. Medicine (Baltimore) 2023; 102:e32990. [PMID: 36800571 PMCID: PMC9936007 DOI: 10.1097/md.0000000000032990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND According to a recent meta-analysis, in patients with a body mass index (BMI) ≥ 30, a high fraction of inhaled oxygen (FiO2) did not increase postoperative atelectasis. However, a high FiO2 generally increases the risk of postoperative atelectasis. Therefore, this study aimed to evaluate the effect of FiO2 on the development of atelectasis in obese patients using the modified lung ultrasound score (LUSS). METHODS Patients were assigned to 4 groups: BMI ≥ 30: group A (n = 21) and group B (n = 20) and normal BMI: group C (n = 22) and group D (n = 21). Groups A and C were administered 100% O2 during preinduction and emergence and 50% O2 during anesthesia. Groups B and D received 40% O2 for anesthesia. The modified LUSS was assessed before and 20 min after arrival to the postanesthesia care unit (PACU). RESULTS The difference between the modified LUSS preinduction and PACU was significantly higher in group A with a BMI ≥ 30 (P = .006); however, there was an insignificant difference between groups C and D in the normal BMI group (P = .076). CONCLUSION High FiO2 had a greater effect on the development of atelectasis in obese patients than did low FiO2; however, in normal-weight individuals, FiO2 did not have a significant effect on postoperative atelectasis.
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Affiliation(s)
- Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Gyeonggi- do, Republic of Korea
| | - Sejong Jin
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Gyeonggi- do, Republic of Korea
- Department of Neuroscience, Korea University College of Medicine, Seoul, Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Gyeonggi- do, Republic of Korea
- * Correspondence: Yoon Ji Choi, Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do 15355, Republic of Korea (e-mail: )
| | - Young Ju Won
- Department of Anesthesiology and Pain Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kaehong Lee
- Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Choon-Hak Lim
- Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Jin S, Choi EJ, Choi YJ, Min WK, Park JY, Yoon SZ. Relationship between Arachidonate 5-Lipoxygenase-Activating Protein Gene and Peripheral Arterial Disease in Elderly Patients Undergoing General Surgery: A Retrospective Observational Study. Int J Environ Res Public Health 2023; 20:1027. [PMID: 36673783 PMCID: PMC9858772 DOI: 10.3390/ijerph20021027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/01/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Patients with peripheral arterial disease (PAD) are at a higher risk of developing postoperative complications. Arachidonate 5-lipoxygenase-activating protein (ALOX5AP) plays an important role in atherosclerosis pathogenesis. In this study, the relationship between PAD and several single nucleotide polymorphisms (SNPs) of ALOX5AP (rs17216473, rs10507391, rs4769874, rs9551963, rs17222814, and rs7222842) was investigated in elderly patients undergoing general surgery. The medical records of 129 patients aged > 55 years who underwent elective general surgery between May 2018 and August 2019 were retrospectively reviewed. The A/A in rs17216473, A/A in rs10507391, G/G in rs4769874, and A/A in rs9551963 were calculated as 0 points and the rest as 1 point to define the genetic risk score. The prevalence of PAD tended to increase with higher genetic risk scores (patients had less ALOX5AP gene polymorphism of A/A in rs17216473, A/A in rs10507391, G/G in rs4769874, or A/A in rs9551963) (p = 0.005). Multivariate logistic regression analysis revealed that the genetic risk score (p = 0.009) and age (p = 0.007) were positively correlated with the prevalence of PAD. Genetic polymorphisms of ALOX5AP and age were associated with the prevalence of PAD in this study.
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Affiliation(s)
- Sejong Jin
- Department of Neuroscience, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Eun-Ji Choi
- Department of Dental Anesthesia and Pain Medicine, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan 50612, Republic of Korea
| | - Yoon Ji Choi
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
| | - Ju Yeon Park
- Department of Anesthesiology and Pain Medicine, Daedong Hospital, Busan 47737, Republic of Korea
| | - Seung Zhoo Yoon
- Department of Anesthesiology and Pain Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea
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Choi YJ, Park KH, Park JY, Min WK, Lee YS. The effect of alpha-2A adrenergic receptor (ADRA2A) genetic polymorphisms on the depth of sedation of dexmedetomidine: a genetic observational pilot study. Braz J Anesthesiol 2021; 72:241-246. [PMID: 33915198 PMCID: PMC9373641 DOI: 10.1016/j.bjane.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background The genetic polymorphisms of the alpha-2A adrenergic receptor (ADRA2A), which plays a significant role in sedation, anxiety relief, and antinociception, particularly in dexmedetomidine, may differ in the degree of sedation. This study aimed to investigate the effect of the genetic polymorphisms of ADRA2A (rs11195418, rs1800544, rs2484516, rs1800545, rs553668, rs3750625) on the sedative effects of dexmedetomidine. Methods A total of 131 patients aged 50 years or more from May 2018 to August 2019 were included in this study. The ADRA2A gene variants were evaluated using the TaqMan Assay. Dexmedetomidine diluted in normal saline to a concentration of 4 μg.mL-1 was infused at a dose of 2 μg.kg-1 to achieve procedural sedation (modified Ramsay sedation scale 4 [mRSS 4]). Results A total of 131 patients were evaluated. The genetic polymorphisms (rs11195418) of the ADRA2A receptor gene demonstrated no variation in our participants. The ADRA2A receptor gene polymorphisms (rs1800544, rs2484516, rs1800545, rs553668, and rs3750625) exhibited no differences in total dexmedetomidine doses (p > 0.217), bispectral index at mRSS 4 (p > 0.620), and time to obtain mRSS 4 (p > 0.349). Conclusion This study suggested that the genetic polymorphisms of ADRA2A did not affect the sedative efficacy of dexmedetomidine.
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Affiliation(s)
- Yoon Ji Choi
- Korea University Ansan Hospital, College of Medicine, Department of Anesthesiology and Pain Medicine, Ansan, Republic of Korea
| | - Kyu Hee Park
- Korea University Ansan Hospital, Department of Pediatrics, Ansan, Republic of Korea
| | - Ju Yeon Park
- Daedong Hospital, Department of Anesthesiology and Pain Medicine, Busan, Republic of Korea; Pusan National University Yangsan Hospital, Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Republic of Korea.
| | - Won Kee Min
- Korea University Ansan Hospital, College of Medicine, Department of Anesthesiology and Pain Medicine, Ansan, Republic of Korea
| | - Yoon Sook Lee
- Korea University Ansan Hospital, College of Medicine, Department of Anesthesiology and Pain Medicine, Ansan, Republic of Korea
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Kang HW, Kim HJ, Kim WY, Min WK, Min TJ, Lee YS, Kim JH. Effects of cranial electrotherapy stimulation on preoperative anxiety and blood pressure during anesthetic induction in patients with essential hypertension. J Int Med Res 2020; 48:300060520939370. [PMID: 32865096 PMCID: PMC7469723 DOI: 10.1177/0300060520939370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective Cranial electrotherapy stimulation (CES) is a non-invasive treatment that improves symptoms such as anxiety and pain. The purpose of this study was to analyze the effect of CES pretreatment on levels of preoperative anxiety, pain, and hemodynamic responses—especially changes in blood pressure—during anesthetic induction in patients with essential hypertension. Methods Eighty patients undergoing general anesthesia were randomly assigned to receive either no pretreatment (control group, n = 40) or CES pretreatment (CES group, n = 40). Anxiety scores, systolic and diastolic blood pressures, mean arterial pressure, and heart rate were measured in the general ward the evening before surgery, as well as in the preoperative holding area, operating room, and after intubation. Withdrawal responses to rocuronium injection were also measured. Results Anxiety scores in the operating room were significantly lower in the CES group. Withdrawal responses to rocuronium injection were also significantly lower in the CES group. There were no significant differences in hemodynamic values between the two groups. Conclusions CES pretreatment reduces both preoperative anxiety levels and withdrawal responses to rocuronium injection. However, it does not have a significant effect on hemodynamic responses.
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Affiliation(s)
- Hee Won Kang
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Hyun Joong Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Woon Young Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Won Kee Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Too Jae Min
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Yoon Sook Lee
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jae Hwan Kim
- Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
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Lee HJ, Min WK, Kim JS, Yoon SD, Kim DH. Transfibular ankle arthrodesis using burring, curettage, multiple drilling, and fixation with two retrograde screws through a single lateral incision. J Orthop Surg (Hong Kong) 2016; 24:101-5. [PMID: 27122523 DOI: 10.1177/230949901602400123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To review the outcome of 23 ankle arthrodeses using burring, curettage, multiple drilling, and fixation with 2 retrograde screws through a single lateral incision. METHODS Records of 22 consecutive patients aged 39 to 79 (mean, 62.4) years who underwent 23 ankle arthrodeses for end-stage ankle arthritis were reviewed. Through a single lateral incision, articular cartilage was removed using burring and curettage, and multiple holes were drilled using a Kirschner wire, followed by fixation with 2 retrograde screws. The resected distal fibula was fixed to the distal part of the talus and tibia. The position of the ankle and subtalar joint arthrosis was assessed by 2 orthopaedic specialists. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) scores were evaluated. RESULTS The mean operating time was 122 minutes. The mean follow-up period was 41 months. The mean postoperative ankle alignment was suboptimal: 2.7º varus, 6.7º plantar flexion, and 2.9º internal rotation. The mean AOFAS score improved from 30 to 71 (p<0.01). The postoperative varus ankle alignment was not associated with the AOFAS score (r= -0.13, p=0.569). Of the 23 cases, one was nonunion and 22 achieved bone union after a mean of 5.4 (range, 2-16) months; 3 of them were delayed union. Despite bone union, 7 patients complained of persistent pain; 4 of them had progressive arthrosis of the adjacent subtalar joints (n=2) or subtalar and talonavicular joints (n=2). CONCLUSION Ankle arthrodesis using burring, curettage, multiple drilling, and fixation with 2 retrograde screws achieved a high union rate and acceptable functional score without serious complications.
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Affiliation(s)
- H J Lee
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea
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Yun KA, Lee W, Min WK, Chun S, Lee YW, Kim SB, Park JS, Yang WS, Park H, Hwang SH. Discrepancy of interleukin-6 levels between end-stage renal disease patients and patients with acute-phase response with increased lipoprotein(a) concentrations. Scand J Clin Lab Invest 2005; 64:223-8. [PMID: 15222632 DOI: 10.1080/00365510410005749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Though the concentration of serum lipoprotein(a) [Lp(a)] is mostly determined by genetic factors, secondary factors such as acute-phase response (APR) and end-stage renal disease (ESRD) also contribute to its increase. Lp(a) is known to be one of the acute-phase reactants and interleukin-6 (IL-6) is the key cytokine in the hepatic synthesis of acute-phase proteins. The serum concentrations of Lp(a) and IL-6 were measured in patients with APR and in patients with ESRD to investigate the relationship between Lp(a) and IL-6. A total of 180 patients were selected for the study: 60 patients were normal controls, 60 were patients with renal disease who had been on hemodialysis for more than 6 months [C-reactive protein (CRP)<4.0 mg/L], and 60 were APR patients who had a erythrocyte sedimentation rate (ESR) of over 50 mm/h. The three groups were age- and sex matched. The serum concentrations of Lp(a) and IL-6 were measured by ELISA. The serum concentrations of Lp(a) [median (interquartile range)] in normal controls, ESRD patients, and APR patients were 0.222 (0.103-0.364) g/L, 0.511 (0.308-0.755) g/L, and 0.546 (0.234-0.747) g/L, respectively; those of IL-6 were 1.0 (0.7-1.3) pg/mL, 2.1 (1.4-3.3) pg/mL, and 26.2 (15.2-35.6) pg/mL. The concentration of IL-6, which increases Lp(a) synthesis, was much lower in ESRD patients than in APR patients (p<0.001). However, there were no significant differences in Lp(a) concentration between the two groups (p=0.88). In APR patients, the increase in Lp(a) synthesis seems to play a significant role in the increase in blood Lp(a), but there might be different mechanisms that regulate the increment of serum Lp(a) concentrations in ESRD patients other than synthesis of Lp(a).
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Affiliation(s)
- K A Yun
- Department of Laboratory Medicine, Asan Medical Center and University of Ulsan College of Medicine, Songpa-Gu, Seoul, Korea
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Abstract
OBJECTIVES Paraoxonase (PON) plays an important role in preventing low density lipoprotein (LDL) oxidation and thus may be involved in protection against atherosclerosis. Several studies have suggested that genetic variations of the PON gene are associated with plasma HDL levels and coronary artery disease (CAD). This study was conducted to elucidate the association between three polymorphisms of the PON1 and PON2 genes and Korean patients with CAD. DESIGN AND METHODS One hundred ninety-one patients with CAD and 113 age-matched normal controls were examined by polymerase chain reaction (PCR). The PCR products were analyzed for PON polymorphisms by restriction enzyme digestion. RESULTS There was linkage disequilibria between each polymorphism pair in the CAD and control groups. The Hsp92II polymorphism at codon 54 of the PON1 gene was positively associated with HDL-cholesterol levels in the control group (p = 0.02). An association between the AlwI polymorphism and HDL-cholesterol level appeared statistically significant in women of the normal group (p = 0.04). In addition, the DdeI and AlwI polymorphisms were positively associated with HDL (p = 0.02) and LDL (p = 0.03) levels in men of the CAD group, respectively. CONCLUSIONS Our study suggested a gene-gene interaction between the PON1 and PON2 polymorphisms for CAD risk. However, we could not exclude the possibility that these polymorphisms may have linkage disequilibrium with a tightly linked PON3 locus or significant atherosclerotic alleles of nearby genes. Family studies may, therefore, help to confirm the role of the PON polymorphism for CAD risk.
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Affiliation(s)
- S H Hong
- Department of Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
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Chun S, Min WK, Kim JW, Park H, Jang S, Yang SE, Kim JQ. Apolipoprotein E polymorphism and serum lipoprotein(a) concentrations in a Korean male population. Ann Clin Biochem 2001; 38:129-34. [PMID: 11269753 DOI: 10.1258/0004563011900434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to investigate the effect of apolipoprotein E polymorphism on lipoprotein(a) metabolism by comparing serum lipoprotein(a) concentration with apolipoprotein E genotype in a Korean male population whose high molecular weight (HMW) lipoprotein(a) frequency was 95-98%. Serum lipoprotein(a), total cholesterol, triglyceride and high-density lipoprotein-cholesterol concentrations were measured and the apolipoprotein E genotype determined in 1189 healthy Korean males. The medians of serum lipoprotein(a) concentration in the apo E 2/3 group (0.105 g/L) and the apo E 3/4 group (0-116 g/L) were significantly lower than that in the apo E 3/3 group (0.155 g/L; P < 0.001). The medians of serum triglyceride were 1.497 mmol/L in the apo E 2/3 group, 1.356 mmol/L in the apo E 3/4 group, and 1.452 mmol/L in the apo E 3/3 group (P<0.05). With the significant difference in the serum lipoprotein(a) concentration in Korean males according to apolipoprotein E genotype, and with the negative correlation between serum triglyceride concentration and serum lipoprotein(a) concentration, it is suggested that apolipoprotein E polymorphism and serum triglyceride participate in the metabolism of lipoprotein(a) with HMW.
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Affiliation(s)
- S Chun
- Department of Clinical Pathology, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
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Park JS, Jung HH, Yang WS, Kim SB, Min WK, Chi HS. Effects of hormonal replacement therapy on lipid and haemostatic factors in post-menopausal ESRD patients. Nephrol Dial Transplant 2000; 15:1835-40. [PMID: 11071974 DOI: 10.1093/ndt/15.11.1835] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hormone replacement therapy (HRT) has been known to have beneficial effects on various atherosclerotic parameters in the general population of post-menopausal women. To evaluate the effects of HRT on those factors in end-stage renal disease (ESRD) patients, we evaluated the changes of lipid profile, coagulation and fibrinolysis markers, and plasma homocysteine levels after treatment. METHODS Sixty-five post-menopausal women on maintenance haemodialysis were randomly assigned to either an HRT group (n=33) or a control group (n=32). Median age (range) and duration of haemodialysis (range) were 57 years (40-73) and 42 months (6-150) in the HRT group and 61 years (44-78) and 54 months (8-174) in the control group respectively. Oral conjugated oestrogen (0.625 mg) combined with medroxyprogesterone acetate (2.5 mg) was given daily for 12 weeks to the HRT group. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), lipoprotein (a) (Lp(a)), fibrinogen, plasminogen activator type 1 antigen (PAI-1), tissue plasminogen antigen (t-PA), von Willebrand factor (vWF), and plasma total homocysteine (tHcy) were measured before and 12 weeks after the start of the study in both groups. RESULTS There was no difference in baseline values between the control and HRT groups. At 12 weeks, HRT increased HDL-C by 12% (P:<0.01) and TG by 20% (P:<0. 01). HRT decreased LDL-C by 9% (P:<0.01), and Lp(a) by 36% (P:<0.01). PAI-1 and t-PA concentrations were also reduced by 21% (P:<0.01) and 9% (P:<0.05) respectively. The mean values of TC, fibrinogen, vWF, and tHcy levels did not change significantly after HRT. CONCLUSIONS The above results suggest that HRT has favourable effects on atherosclerosis risk parameters in post-menopausal women with ESRD as in the general population of post-menopausal women.
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Affiliation(s)
- J S Park
- Departments of Internal Medicine and Clinical Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Min WK, Park KK, Kim YS, Park HC, Kim JY, Park SP, Suh CK. Atherothrombotic middle cerebral artery territory infarction: topographic diversity with common occurrence of concomitant small cortical and subcortical infarcts. Stroke 2000; 31:2055-61. [PMID: 10978029 DOI: 10.1161/01.str.31.9.2055] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE MRI has superior capabilities for the detection of cerebral infarcts compared with CT. CT was used to locate infarcts in most previous studies of atherothrombotic middle cerebral artery (MCA) territory infarcts. Thus, there was a possibility of missing concomitant small infarcts. More accurate identification of topographic lesions in MCA territory with MRI may help to establish the pathogenesis of stroke. The present study determines topographic patterns, distribution of vascular lesions, and probable mechanisms. METHODS Forty-two patients with MCA territory infarcts on routine MRI and no major cause of cardioembolism were studied with conventional angiography or MR angiography. RESULTS The topographic patterns seen on MRI were subdivided into 4 groups: cortical border-zone infarcts (n=6), pial territory infarcts without insular infarct (n=3), pial territory infarcts with insular infarct (n=14), and large subcortical infarcts (n=19). Of 6 patients with cortical border-zone infarcts, 4 had concomitant small cortical or subcortical multiple lesions. Angiography showed intrinsic MCA disease in 4 patients. Of 3 patients with pial territory infarcts without insular infarct, 2 also had small multiple centrum ovale lesions. All had intrinsic MCA disease. Pial territory infarcts with partial or whole insular lesions were present in 10 and 4 patients, respectively. Five patients had additional multiple cortical or subcortical lesions. Ten patients had intrinsic MCA disease. Of the 19 patients with large subcortical infarcts, 12 had centrum ovale infarcts, and 4 had both basal ganglia and centrum ovale lesions. Ten had concomitant small cortical or subcortical lesions. Six patients had intrinsic MCA disease. CONCLUSIONS Similar vascular lesions induce different topographic patterns in MCA territory infarction, which are related to individual vascular variability, degree of primary and secondary collateralization, and pathogenesis of infarcts. Our study indicates that concomitant small cortical or subcortical lesions are also commonly associated findings in diverse patterns of MCA territory infarction, which can mostly be explained by probable embolic mechanism.
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Affiliation(s)
- W K Min
- Department of Neurology, Kyungpook National University Hospital, Taegu, South Korea
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13
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Abstract
OBJECTIVE The object of this study was to investigate the in vivo antioxidant effect of green tea and dosage effect of green tea on antioxidant effect. DESIGN We tested 10 healthy subjects (aged 23-25 y, five women and five men) with overnight fasting. The total antioxidant capacity of plasma was measured at baseline and 60 min and 120 min after ingestion of 150 ml green tea. Green tea was prepared by infusing 2.5 g of dried green tea leaves for 2 min at 80 degrees C in 150 ml of water. In the second week, they took 300 ml of tea (5.0 g of green tea leaves) and, in the third week, 450 ml of tea (7.5 g of green tea leaves). The total antioxidant capacities of plasma were determined with a Total Antioxidant Kit (Randox Laboratories Ltd, UK) using a Cobas Mira analyser (Roche Diagnostic Systems Inc., Switzerland). The mean intra-assay coefficient of variation was 1.2%. RESULTS The total antioxidant capacity of plasma increased by 1.1% at 60 min and 2.1% at 120 min over baseline value in subjects consuming 150 ml of green tea, which was statistically not significant. However, total antioxidant capacity of plasma after consuming 300 ml of green tea showed a significant increase of 7.0% after 60 min and 6.2% after 120 min (P<0.0001), and after consuming 450 ml 12.0% after 60 min and 12.7% after 120 min over baseline value (P<0.0001). CONCLUSIONS Total antioxidant capacity of plasma was significantly increased after taking green tea in amounts of 300 and 450 ml. A positive increment according to green tea dosage was also observed. SPONSORSHIP This work was funded by the Pacific Corporation (Korea).
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Affiliation(s)
- H Sung
- Department of Clinical Pathology, Asan Medical Center and University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Korea
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Kim SB, Yang WS, Min WK, Lee SK, Park JS. Reduced oxidative stress in hypoalbuminemic CAPD patients. Perit Dial Int 2000; 20:290-4. [PMID: 10898045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVE Albumin is one of the plasma antioxidants. The higher incidence of cardiovascular disease in dialysis patients with hypoalbuminemia may be related to decreased antioxidant capacity resulting from low serum albumin. We evaluated malondialdehyde (MDA), a marker of oxidative stress, and total antioxidant capacity (TAC) in relation to serum albumin in continuous ambulatory peritoneal dialysis (CAPD) patients. PATIENTS AND METHODS In this cross-sectional study, we measured MDA, TAC, albumin, uric acid (another important plasma antioxidant), prealbumin, and C-reactive protein (CRP) in the blood of 66 CAPD patients and 30 normal controls.Twenty-two CAPD patients with albumin less than or equal to 3.5 g/dL were divided into two groups: In the experimental group (n = 11), MDA,TAC, and CRP were measured before and after repeated infusion of 20% albumin 100 mL daily for 7 days. In the control group (n = 11), the same parameters were measured without albumin infusion. RESULTS CAPD patients had lower albumin and higher MDA,TAC, and uric acid than normal controls. There were positive correlations between albumin and TAC or uric acid in CAPD patients. Contrary to our expectation, there was also positive correlation between albumin and MDA in CAPD patients (r = 0.37, p = 0.004). MDA showed a positive correlation with TAC. Uric acid was correlated with TAC. It did not, however, show correlation with MDA. Log CRP was negatively correlated with albumin, but did not show correlation with MDA or TAC. Prealbumin was correlated with MDA, TAC, albumin, and uric acid. Serum albumin in the experimental group increased from 2.5+/-0.3 g/dL to 3.6+/-0.2 g/dL (p < 0.001) at the end of repeated infusions. No changes were seen in MDA, TAC, and CRP in either group. CONCLUSIONS The present study suggests that lipid peroxidation is increased in CAPD patients and that this is not due to weakening of antioxidant defenses of plasma. Increased TAC was mainly caused by a higher level of uric acid. Reduced, rather than increased, MDA in hypoalbuminemic patients and lack of effects of albumin infusion on levels of MDA suggest that the frequent occurrence of cardiovascular disease in dialysis patients with hypoalbuminemia is not due to the decrease in antioxidant capacity resulting from low serum albumin.
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Affiliation(s)
- S B Kim
- Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
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Yang SE, Min WK, Park H, Chun S, Nah J, Kim JQ. Distribution of haptoglobin phenotypes in a Korean population, using the semi-automated PhastSystem. Ann Clin Biochem 2000; 37 ( Pt 2):205-9. [PMID: 10735365 DOI: 10.1258/0004563001899014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We have established a new phenotyping method for haptoglobin, based on sodium dodecyl sulphate-polyacrylamide gel electrophoresis using the PhastSystem (Pharmacia Biotech, Uppsala, Sweden), followed by immunoblotting for detection. We measured haptoglobin concentrations and determined the haptoglobin phenotypes of 316 healthy Koreans using this method: 31 (9.8%) were of Hp 1-1 type, 140 (44.3%) of Hp 2-1 type and 145 (45.9%) of Hp 2-2 type. The haptoglobin allele frequencies were calculated to be 0.32 for Hp1 and 0.68 for Hp2. We were able to visualize up to 12 bands from the human Hp 2-2 polymeric series, with molecular weights in the range 171.9 x 10(3) to 802.2 x 10(3). The reference range of serum haptoglobin concentrations obtained by the IFCC (International Federation of Clinical Chemistry) standard method was 0.27-2.14 g/L. The serum haptoglobin concentration in Koreans was similar to that of Caucasians, but the Hp1 allele frequency was lower in Koreans. Our method could be used in clinical laboratories as a simple and practical method of haptoglobin phenotyping. In addition, the Hp 2-2 polymeric series could be used as high molecular weight standards.
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Affiliation(s)
- S E Yang
- Department of Clinical Pathology, Asan Medical Center and University of Ulsan College of Medicine, Seoul, South Korea
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16
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Abstract
BACKGROUND AND PURPOSE Correlation of MRI findings with atherosclerotic vascular lesions has rarely been attempted in patients with cerebellar infarction. The aim of this study was to correlate the MRI lesions with the vascular lesions seen on conventional cerebral angiography in cerebellar infarction. METHODS The subjects included 31 patients with cerebellar infarcts who underwent both MRI and conventional cerebral angiography. We analyzed the risk factors, clinical findings, imaging study, and angiography results. We attempted to correlate MRI lesions with the vascular lesions shown in the angiograms. RESULTS The vascular lesions seen on angiograms were subdivided into 3 groups: large-artery disease (n=22), in situ branch artery disease (n=6), and no angiographic disease with hypertension (n=3). The proximal segment (V1) lesions of vertebral artery were the most common angiographic features in patients with large-artery disease in which stroke most commonly involved the posterior inferior cerebellar artery (PICA) cerebellum. The V1 lesions with coexistent occlusive lesions of the intracranial vertebral and basilar arteries were correlated with cerebellar infarcts, which had no predilection for certain cerebellar territory. The intracranial occlusive disease without V1 lesion was usually correlated with small cerebellar lesions in PICA and superior cerebellar artery (SCA) cerebellum. The subclavian artery or brachiocephalic trunk lesion was associated with small cerebellar infarcts. The in situ branch artery disease was correlated with the PICA cerebellum lesions, which were territorial or nonterritorial infarct. No angiographic disease with hypertension was associated with small-sized cerebellar infarcts within the SCA, anterior inferior cerebellar artery, or SCA cerebellum. CONCLUSIONS Our study indicates that the topographic heterogeneity of cerebellar infarcts are correlated with diverse angiographic findings. The result that large-artery disease, in which nonterritorial infarcts are more common than territorial infarcts, is more prevalent than in situ branch artery disease or small-artery disease, suggest that even a small cerebellar infarct can be a clue to the presence of large-artery disease.
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Affiliation(s)
- W K Min
- Department of Neurology, Kyungpook National University Hospital, Taegu, South Korea
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Chun S, Min WK, Park H, Song J, Kim JQ, Min YI, Kim SR, Lee SH. The risk groups for coronary heart disease in Koreans. Assessment by distribution of serum lipid concentrations. Clin Chem Lab Med 1999; 37:969-74. [PMID: 10616751 DOI: 10.1515/cclm.1999.143] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coronary heart disease is the most severe form of disease caused by atherosclerosis; and there is a strong relationship between serum lipid concentrations and atherosclerosis. By decade of life, means, standard deviations and selected percentiles were calculated according to sex for serum concentrations of total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride in 69,563 Koreans. The prevalence of dyslipoproteinemias which were related to high risk of coronary heart disease were assessed. The mean concentrations of serum total cholesterol and LDL-C in the Korean population were 5.02 mmol/l and 3.00 mmol/l. The 75th and 90th percentile concentrations of total cholesterol were 5.59 mmol/l and 6.24 mmol/l. The mean concentrations of serum triglyceride and HDL-C were 1.58 mmol/l and 1.30 mmol/l. The hyperlipoproteinemia type IV (4.8%) was the most frequent, followed by Type IIa (4.6%), hypoalphalipoproteinemia (3.3%), and type IIb (0.2%). According to the National Cholesterol Education Program Adult Treatment Panel II, 4.1% of Korean adults needed the initial drug therapy and 10.8% the initial dietary therapy for hypercholesterolemia. The age and sex-specific treatment guidelines for hypercholesterolemia would make it possible that early intervention could be applied to atherosclerosis in Korean adults.
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Affiliation(s)
- S Chun
- Department of Clinical Pathology, Asan Medical Center and University of Ulsan College of Medicine, Seoul, Korea
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Min WK, Chun S, Hwang SH, Park H. No relationship between serum lipoprotein(a) and albumin concentrations in patients with acute phase response. Ann Clin Biochem 1999; 36 ( Pt 5):617-21. [PMID: 10505212 DOI: 10.1177/000456329903600509] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the relationship between lipoprotein(a) [Lp(a)] and albumin concentrations in the serum of patients with acute phase response (APR). We have compared the Lp(a) concentrations and apolipoprotein [apo(a)] phenotypes of 40 controls with those of 40 APR patients with normoalbuminaemia and 40 APR patients with hypoalbuminaemia. We have also compared concentrations of haptoglobin (Hp) and alpha 1-antitrypsin (AAT) containing a high sialic acid content, similar to Lp(a). The mean serum Lp(a) concentration (SD) of the 40 controls was 0.190 (0.142) g/L. The mean serum Lp(a) concentration was 0.358 (0.257) g/L (P < 0.001) in 80 APR patients. However, there was no difference in serum Lp(a) concentrations between the APR patients with hypoalbuminaemia [0.353 (0.268) g/L] and the APR patients with normoalbuminaemia [0.362 (0.249) g/L]. No significant difference was found in the distributions of apo(a) phenotypes between the controls, the APR patients with hypoalbuminaemia, and the APR patients with normoalbuminaemia (P = 0.183). In the APR patients, the serum concentrations of AAT and Hp were respectively 2.709 (0.822) g/L and 2.631 (1.340) g/L, whereas those of normal controls were respectively 1.422 (0.219) g/L (P < 0.001) and 0.956 (0.442) g/L (P < 0.001). In conclusion, the Lp(a) is one of the acute phase reactants whose synthesis concurrently increases with other APRs, especially those with a high sialic acid content. The increase of the serum Lp(a) concentrations in the APR patients is not related to serum albumin concentration.
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Affiliation(s)
- W K Min
- Department of Clinical Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Abstract
PURPOSE To determine whether endolaser photocoagulation to the retinal pigment epithelium at the base of a macular hole increases the anatomic success rate of surgery. METHODS In a prospective consecutive clinical trial, eight eyes of seven patients with idiopathic macular hole underwent vitrectomy with posterior cortical vitreous removal and peeling of visible epiretinal membrane when present. A single shot of argon endolaser photocoagulation was applied to the retinal pigment epithelium at the center of the macular hole with a duration of 0.05 to 0.2 seconds and an intensity of 50 to 200 mW. After fluid-gas exchange was performed with 14% perfluoropropane gas, patients maintained face-down positioning for 2 weeks. RESULTS One eye with stage 2 macular hole, six eyes with stage 3 macular hole, and one eye with stage 4 macular hole were included. All eight eyes had a closed macular hole (100% anatomic success rate) at final examination 6 to 12 months after surgery. Best-corrected visual acuity improved 3 or more lines on the Early Treatment Diabetic Retinopathy Study visual acuity chart in all eyes. Four (50%) of the eight eyes had a final visual acuity of 20/40 or better. CONCLUSIONS Endolaser photocoagulation may be a useful adjunct to macular hole surgery but requires further investigation and long-term evaluation.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Samsung Medical Center, Sung Kyun Kwan University College of Medicine, Seoul, Korea.
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20
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Abstract
OBJECTIVE The purpose of this study was to investigate the two polymorphisms of fibrinogen gene (RsaI and MnlI RFLPs in the coding region of the fibrinogen gene) in Koreans, and their relation to plasma fibrinogen. METHODS Using PCR-amplified DNAs, RsaI and MnlI RFLPs were analyzed in 112 patients with coronary artery disease (CAD) and 137 healthy subjects. To compare the mean of plasma fibrinogen and lipid levels among different genotypes, one-way analysis of variance (ANOVA) test was performed. RESULTS Allele frequencies of fibrinogen gene polymorphism in Koreans were not significantly different between CAD and control groups; fibrinogen polymorphism in this population showed a lack of association with plasma fibrinogen levels, but significant association with BMI (p < 0.05). CONCLUSION This evidence suggests that in Korean populations, fibrinogen gene polymorphism is not a factor in the expression of atherosclerosis. There might, however, be an association between fibrinogen gene and obesity in such population.
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Affiliation(s)
- D H Lee
- Department of Clinical Pathology, Daejin Medical Center, Pundang Jesaeng General Hospital, Sungnam, Korea
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21
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Abstract
The purpose of this study was to assess surgical results of internal limiting membrane (ILM) maculorrhexis in macular hole surgery. This study is a part of continuing prospective clinical trial of our team of researchers. Thirteen eyes of 13 patients with idiopathic macular hole underwent vitrectomy with the removal of posterior cortical vitreous, peeling of the macular ILM, and intraocular gas tamponade, followed by postoperative face-down positioning. The excised specimens were evaluated with transmission electron microscopy. Complete closure of the hole was observed in all 13 eyes (100% anatomic success rate). Visual improvement of 2 or more lines on ETDRS visual acuity chart was achieved in 11 (85%) of the 13 eyes. Six (54.5%) eyes attained visual acuity of 20/50 or better. Electron microscopy showed ILM in the removed specimens. ILM maculorrhexis is a promising new surgical approach to close idiopathic macular holes but requires further investigation and long-term evaluation.
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Affiliation(s)
- D W Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea
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Hong SH, Min WK, Cheon SI, Lee CC, Song J, Kim JQ. Association between apolipoprotein(a) polymorphism and Lp(a) levels in Koreans. Mol Cells 1998; 8:544-9. [PMID: 9856341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
In view of the clinical importance of lipoprotein(a) [(Lp(a)] in coronary artery disease (CAD), we investigated the apo(a) size polymorphism, sequence polymorphisms of five base repeats [(TTTTA)n] in the noncoding region, and of Met/Thr in the coding region of the apolipoprotein(a) [apo(a)] gene. The apo(a) polymorphisms were examined in 184 Korean patients with CAD and 121 healthy subjects. In size polymorphism, there was an inverse association between plasma Lp(a) levels and the apo(a) isoforms in the CAD group (p < 0.005). For (TTTTA)n sequence polymorphism, subjects with the 8/8 genotype were most frequently observed in the two groups. Plasma Lp(a) levels showed a significant difference between the 8/5 versus the 8/8 genotype in the CAD group. On the other hand, Lp(a) levels varied significantly among the genotypes of a Met/Thr polymorphism in normal controls (P < 0.01). The heterozygous genotype had an intermediate level of Lp(a) between the two homozygous genotypes, thereby showing gene dosage effect. Thus, it is possible that the apo(a) polymorphisms are responsible for variations in the Lp(a) levels.
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Affiliation(s)
- S H Hong
- Department of Molecular Biology, Seoul National University, Korea
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Wallace RJ, Min WK, Witt MW, Grant G, MacRae JC, Maeng WJ, Newbold CJ, Rode LM. Uptake of acetylated peptides from the small intestine in sheep and their nutritive value in rats. Br J Nutr 1998; 80:101-8. [PMID: 9797649 DOI: 10.1017/s0007114598001822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Acetylation is a potential method for protecting dietary peptides from degradation by rumen micro-organisms. As a first step in determining the nutritive value of acetylated peptides, their disappearance in the small intestine of sheep and their ability to support growth in a rat bioassay were measured. 15N-labelled peptides were prepared from lucerne which had been grown with 15N-labelled (NH4)2SO4 in the absence of Rhizobium. Peptides were prepared by enzymic hydrolysis of the extracted protein. Two peptide preparations were made using different proteinase mixtures. These mixtures contained peptides with an average molecular weight of 559 and 522 Da. They were treated with acetic anhydride, which resulted in 85 and 88% modification respectively, and their uptake from the small intestine was determined by injecting 1 g of untreated or acetylated peptides in a Cr-EDTA solution into the jejunum of two sheep fitted with jejunal catheters and ileal cannulas. Ileal digesta were collected and analysed for Cr and 15N. The uptake of dialanine (Ala2) and N-acetyl-Ala2 were compared in a similar way. The disappearance of 15N from lucerne peptides was high (88 and 93% respectively) and this was not affected significantly by acetylation (86 and 87%). Corresponding values for Ala2 and N-acetyl-Ala2 were both 96%, as measured by HPLC. It was therefore concluded that acetylation did not affect the uptake of peptides from the small intestine in sheep. Two feeding trials were carried out with rats. The first trial was carried out with a protein-free diet to which was added 10% lactalbumin or 5% lactalbumin and then a mixture of methionine-free amino acids, either alone or supplemented with Met, Gly-Met or acetylated Gly-Met. The rats grew equally well on all sources of Met, but failed to grow significantly on the mixture of Met-free amino acids. In the second trial the diet contained casein as 5.9% of the basal diet. Additional casein, pancreatic casein hydrolysate (peptides) and acetylated pancreatic casein hydrolysate (acetylated peptides) were compared as sources of amino acids, at inclusion rates of 100 g/kg final diet. Feed intake was similar with casein and peptides treatments, but was depressed by 23% with acetylated peptides. Live weight gain was 15 and 75% lower with the peptides and acetylated peptides diets respectively. Addition of lysine, arginine or histidine did not restore feed intake or weight gain of rats receiving acetylated peptides, but feed intake was restored immediately when peptides replaced acetylated peptides. When intake was restricted to 9 g/d and acetylated casein hydrolysate replaced half of the protein in the diet, rats gained weight less rapidly (1.44 v. 1.09 g/d) and retained less N, such that only 0.36 of the acetylated peptide-N was calculated to remain available to the animal. This N retention compared with 0.70 for unmodified casein. Thus, the rat bioassay indicated that certain specific peptides may well be of high nutritive value following acetylation, but that there may be problems of inappetance and inefficient utilization with acetylated peptide mixtures.
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Affiliation(s)
- R J Wallace
- Rowett Research Institute, Bucksburn, Aberdeen, UK.
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Lee JS, Min WK, Kim JH. Migrating towards a client server architecture: a successful application in a 2,200-bed general hospital. Stud Health Technol Inform 1998; 52 Pt 2:927-30. [PMID: 10384594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Asan Medical Center (AMC) completed a major migration process of the hospital information system from a mainframe towards an open Unix client server architecture from August of 1993 to August of 1996. Along with the east wing extension of AMC, the number of inpatient beds is greatly increased from 1,000 to 2,200 and information transaction increased from 300,000 to 700,000. A gradual departmental migration strategy with local area network connection and data conversion between the two systems were applied. The successful migration process towards a client server architecture provided improved user interface, enhanced flexibility and productivity of the system, better integration with diverse medical devices and improved networking flexibility.
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Affiliation(s)
- J S Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea
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Min WK, Lee JO, Kim CH, Song J, Kim JQ. Identification of apo(a) phenotypes in a Korean population using a standardized nomenclature system based on the number of kringle IV repeats. Ann Clin Biochem 1997; 34 ( Pt 6):681-7. [PMID: 9367008 DOI: 10.1177/000456329703400614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We determined serum lipoprotein(a) [Lp(a)] concentrations and apolipoprotein(a) [apo(a)] phenotypes in 193 healthy Koreans. We analysed the apo(a) phenotypes by a simplified sodium dodecyl sulphate-polyacrylamide gel electrophoresis method and classified apo(a) isoforms objectively using an apo(a) phenotype standard with a known number of kringle IV repeats. The frequency distribution of Lp(a) levels showed marked positive skew with a mean of 0.143 g/L and a median of 0.052 g/L. Of the 193 subjects tested, no bands were detected in three, and single- and double-band phenotypes were observed in 103 and 87, respectively. Among the Koreans, the most frequent phenotype was S5(39.4%), followed by S4S5(17.1%), S5S5(14.0%), S4(11.4%), S3S5(5.2%), and the remaining phenotypes (13.0%). The calculated apo(a) allele frequencies were LpF, 0.003; LpS1, 0.013; LpS2, 0.010; LpS3, 0.048; LpS4, 0.198; LpS5, 0.563 and Lp0, 0.165. We found that the serum Lp(a) concentration in Koreans was similar to that of Caucasians, but the apo(a) allele size distribution was shifted toward higher molecular weights.
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Affiliation(s)
- W K Min
- Department of Clinical Pathology, Asan Medical Center, Seoul, Korea
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Abstract
Lipoprotein(a) [Lp(a)], an independent risk factor for atherosclerotic cardiovascular disease in the general population, is known to be elevated in patients with renal disease accompanied by hypoalbuminemia such as nephrotic syndrome and end-stage renal disease. In this study, the role of hypoalbuminemia in the elevation of serum Lp(a) was investigated in 20 continuous ambulatory peritoneal dialysis (CAPD) patients with serum albumin below 3.5 g/dL. The patients were divided into two groups. In group 1 (n = 10), fasting serum Lp(a) and albumin were measured before, after repeated infusion of 20% albumin 100 mL three times per week for 2 weeks, and 4 weeks after withdrawal of albumin infusion. In group 2 (n = 10), serum albumin and Lp(a) were measured similarly without albumin infusion. C-reactive protein was monitored in both group as an indicator of acute-phase reactant. Serum Lp(a) was also measured in 20 age- and sex-matched normal controls. Apolipoprotein(a) [apo(a)] phenotype was determined in all the subjects. CAPD patients as a whole (n = 20; median, 70.2 mg/dL; interquartile range, 45.0 to 86.2 mg/dL) had higher serum Lp(a) than normal controls (n = 20; median, 9.9 mg/dL; interquartile range, 2.4 to 24.3 mg/dL) (P < 0.0001), although the distribution of apo(a) phenotype was similar. Serum albumin in group 1 increased from 2.6+/-0.5 g/dL to 3.5+/-0.6 g/dL (P < 0.0005) at the end of repeated infusion of albumin, whereas serum Lp(a) decreased from 73.7 mg/dL (range, 43.2 to 89.0 mg/dL) to 25.6 mg/dL (range, 10.7 to 71.7 mg/dL) (P < 0.01). Four weeks after withdrawal of albumin infusion, serum albumin decreased again to 2.9+/-0.5 g/dL (P < 0.001), whereas serum Lp(a) increased to 65.2 mg/dL (range, 43.3 to 106.0 mg/dL) (P < 0.05). Serum albumin in group 2 was 2.8+/-0.6 g/dL, 3.0+/-0.4 g/dL, and 2.9+/-0.7 g/dL, respectively. The change of serum Lp(a) was not significant (67.0 mg/dL [range, 46.8 to 84.8 mg/dL], 62.8 mg/dL [range, 45.1 to 81.0 mg/dL], and 63.0 mg/dL [range, 44.7 to 74.0 mg/dL]). C-reactive protein was stable during the study period in both groups. These findings support the hypothesis that hypoalbuminemia is one of the important trigger factors in the elevation of serum Lp(a) in CAPD patients.
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Affiliation(s)
- W S Yang
- Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
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Min WK, Lee JO, Huh JW. Relation between lipoprotein(a) concentrations in patients with acute-phase response and risk analysis for coronary heart disease. Clin Chem 1997; 43:1891-5. [PMID: 9342009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study investigated whether lipoprotein(a) [Lp(a)] is an acute-phase reactant that can cause important bias in risk factor analysis for coronary heart disease among patients with an acute-phase response (APR patients). To determine whether serum Lp(a) concentrations increase among APR patients, we compared the Lp(a) concentrations and apolipoprotein(a) [apo(a)] phenotypes of 100 controls with those of a random sampling of 100 APR patients. Serum Lp(a) concentration was measured by ELISA; Lp(a) phenotyping was performed by electrophoresis on sodium dodecyl sulfate-polyacrylamide gel. Lp(a) was significantly (P <0.0001) higher among APR patients (mean +/- SD 0.300 +/- 0.284 g/L) than among controls (0.118 +/- 0.193 g/L) even though the distribution of apo(a) phenotypes did not differ significantly. The 100 APR patients were grouped into 4 categories: 48 patients with infections, 25 postoperative patients, 17 patients with tumors, and 10 patients with other diseases, all of whom showed substantially higher Lp(a) values than did the controls. For the S5, S4S5, S5S5, and S4 phenotypes, the mean concentrations of serum Lp(a) were substantially higher among the APR patients.
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Affiliation(s)
- W K Min
- Department of Clinical Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
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Kim SB, Yang WS, Kang ES, Min WK, Park JS. Lipoprotein(a) and apolipoprotein(a) phenotypes in patients with end-stage renal disease. ARCH ESP UROL 1997; 17:236-42. [PMID: 9237283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To evaluate the distribution pattern of apolipoprotein(a) [Apo(a)] phenotypes in Koreans and the effect of dialysis modality on serum lipoprotein(a) [Lp(a)] concentration according to apo(a) phenotype in patients with end-stage renal disease (ESRD). DESIGN Cross-sectional study. SETTING A university hospital. PARTICIPANTS 153 normal controls, 99 hemodialysis (HD) patients and 82 continuous ambulatory peritoneal dialysis (CAPD) patients. MAIN OUTCOME MEASURES Fasting serum Lp(a), lipids, and apo(a) phenotypes were measured. RESULTS The frequencies of the subjects with apo(a) phenotypes of high-molecular weight only, including S3, S4, or S5 or null type were 95.4% of control, 100% of HD patients, and 95.1% of CAPD patients. The frequent apo(a) phenotypes in Koreans consisted of S4, S4S5, S5, and S5S5 isoforms. Significant difference was found in serum Lp(a) concentration among controls and HD and CAPD patients [median (Interquartile range): 0.05 g/L, (0.01-0.19); 0.19 g/L, (0.10-0.35); 0.63 g/L, (0.28-0.90), p < 0.001]. Lp(a) levels in CAPD patients were significantly higher than in HD patients for all four common apo(a) isoforms found in Korean subjects. CAPD patients had higher total and LDL cholesterol levels, and higher ApoB levels than HD patients. Significant differences were found in serum albumin levels between controls and HD and CAPD patients (44 +/- 3 g/L, 40 +/- 4 g/L, 32 +/- 7 g/L, respectively, p < 0.05). There were significant inverse correlations between serum albumin and Lp(a) (r = -0.33, p < 0.01), total cholesterol (r = -0.31, p < 0.01), LDL (r = -0.39, p < 0.01) or ApoB (r = -0.35, p < 0.01) in ESRD patients. A significant positive correlation was found between serum albumin and ApoA1 (r = 0.24, p < 0.01). CONCLUSION These findings indicate that Koreans have mainly high molecular weight apo(a) phenotypes and serum Lp(a) is elevated in CAPD patients compared to HD patients for common apo(a) phenotypes, which may contribute to the frequent cardiovascular mortality in CAPD patients.
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Affiliation(s)
- S B Kim
- Department of Internal Medicine, College of Medicine, University of Ulsan, Seoul, Korea
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Lee DS, Lesniewski RR, Sung YC, Min WK, Park SG, Lee KH, Kim HS. Significance of anti-E2 in the diagnosis of HCV infection in patients on maintenance hemodialysis: anti-E2 is frequently detected among anti-HCV antibody-negative patients. J Am Soc Nephrol 1996; 7:2409-13. [PMID: 8959633 DOI: 10.1681/asn.v7112409] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A routine screening test used in the diagnosis of hepatitis C virus (HCV) infection is the anti-HCV antibody (anti-HCV) test containing core, NS3, NS4, and NS5 antigens of HCV. When HCV infection occurs in immunocompromised hosts, antibody formation against core, NS3, or NS4 antigens may be weak in the presence of HCV viremia and cannot be detected by routine anti-HCV tests. This study proposed that in immunocompromised hosts such as patients with chronic renal failure (whose capacity to form antibodies is diminished), antibody formation against the E2 region would be preserved, because the E2/NS1 region of HCV is strongly immunogenic. The aim of this study is to evaluate the significance of anti-E2 in the diagnosis of HCV infection among patients on maintenance hemodialysis who are anti-HCV-negative, using a conventional third-generation enzyme immunoassay (EIA) kit. The E2/NS1 gene of HCV encoding the amino acid sequence 388-664 was molecularly cloned into a vector containing an SV 40 promotor and was expressed in Chinese Hamster ovary cells. Using this E2 protein, the anti-E2 test was performed by EIA on 100 patients on maintenance hemodialysis, and on 50 patients with chronic hepatitis C who were anti-HCV-positive, to evaluate the antigenecity of the E2 protein. Of the 100 hemodialysis patients, 15 (15.0%) tested anti-HCV-positive using a third generation anti-HCV ELISA kit. Of the 85 patients who tested negative for anti-HCV, nine (10.6%) were anti-E2-positive and six (66.7%) of these anti-E2 positive patients showed HCV RNA viremia by HCV reverse transcription-polymerase chain reaction. Fourty-two (84.0%) of 50 patients with chronic hepatitis C were anti-E2-positive. As a control group, we tested for anti-E2 among 30 blood donors who were anti-HCV-negative, and also among 85 patients with hepatocellular carcinoma who were anti-HCV-negative, but in both groups, none (0%) was anti-E2-positive. In conclusion, these data suggest that the E2 protein of HCV should be included in a diagnostic anti-HCV kit for the detection of HCV infection in immunocompromised patients.
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Affiliation(s)
- D S Lee
- Department of Clinical Pathology, Korea Cancer Center Hospital, Seoul
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Lee IS, Cho YK, Kim A, Min WK, Kim KS, Mok JE. Lamellar body count in amniotic fluid as a rapid screening test for fetal lung maturity. J Perinatol 1996; 16:176-80. [PMID: 8817425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We conducted a 2-year prospective clinical outcome study to evaluate the usefulness of amniotic fluid lamellar body count (LBC) as a screening test for fetal lung maturity. During the interval under study, outcomes of 170 neonates were used to evaluate the test; 14 neonates had respiratory distress syndrome (RDS). Both LBC and lecithin-sphingomyelin ratio (L/S ratio) test results were available in 129 cases. All the cases of RDS had LBC of 50,000/microliter or less and L/S ratio of 2.8 or less; 72.7% of cases with no RDS had LBC greater than 50,000/microliter, and 80.4% of normal cases had L/S ratio higher than 2.8. LBC test results showed good correlation with L/S ratio test results between 26 weeks and 33 weeks of gestation (r = 0.78, p < 0.0001). With the cutoff value of 50,000/microliter for LBC, the diagnostic sensitivity and specificity were 100% and 80%, respectively. Determining LBC by cell counter is justified as a useful rapid initial screening test for the assessment of fetal lung maturity.
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Affiliation(s)
- I S Lee
- Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
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Abstract
The occurrence of a retinal detachment in a patient with a macular hole is quite rare unless the patient is a high myope or has experienced ocular trauma. The incidence of spontaneous reattachment of retinal detachment with a macular hole is not uncommon in the highly myopic patients. However, data on nonmyopic cases are lacking. I herein describe two nonmyopic cases of retinal detachment with a macular hole, of which retinas reattached spontaneously.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Samsung Medical Center, Seoul, Korea
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Min WK, Kim YB, Ahn BH, Seong GH. Repetitive low-dose tissue plasminogen activator for the clearance of experimental vitreous hemorrhage. Korean J Ophthalmol 1994; 8:45-8. [PMID: 7853730 DOI: 10.3341/kjo.1994.8.2.45] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Our previous experimental work with tissue plasminogen activator (TPA) suggested the possibility of the clearance of vitreous hemorrhage by repetitive injections of low-dose TPA. We therefore investigated in rabbits the effect of both repeated injections of TPA and the change of the integrity of the vitreous body on the clearance of vitreous hemorrhage. Vitreous hemorrhage was produced by intravitreal injection of 0.05 ml of autologous whole blood in the pigmented rabbit eyes with intact vitreous or gas-compressed vitreous. Three intravitreal injections of 3-g TPA (total dose of 9 micrograms), separated by 7-day intervals, were performed. The endpoint for vitreous hemorrhage clearance was defined as clear visualization of the posterior central retina of the rabbits. Regardless of whether gas compression vitrectomy was performed, repeated injections of low-dose TPA resulted in rapid clearance of fresh vitreous hemorrhage in approximately two to three weeks after the last TPA injection. No evidence of retinal toxicity was seen in all experimental groups. Repetitive injections of low-dose TPA may be effective in the treatment of fresh vitreous hemorrhage.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Samsung Medical Center, Seoul, Korea
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Abstract
Intravitreal fibrin clots were produced by intravitreal injection of 0.2 ml of autologous plasma in 62 rabbit eyes. The intravitreal injection of 0.25 micrograms or more of tissue plasminogen activator(tPA) resulted in a total clearing of intravitreal fibrin within one day in all treated eyes. This was significantly faster than in the control eyes, in which complete clearing was not seen until 8 days later. This represents the plateau on the dose-response curve in doses ranging from 0.25 to 200 micrograms. With light microscopy and transmission electron microscopy, retinal toxicity was demonstrated in eyes enucleated seven days after injection of 25 micrograms or more of tPA. This study demonstrates that tPA was effective and safe at 12.5 micrograms or less in clearing intravitreal fibrin in an experimental model. These results suggest that low dosages of tPA, probably of 3 micrograms or less, may be useful in the treatment of severe postvitrectomy fibrin formation seen clinically.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Chungnam National University, College of Medicine, Daejeon, Korea
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Abstract
One patient with bilateral acute retinal necrosis underwent encircling scleral buckle, vitrectomy, and intravitreal acyclovir on both eyes. This procedure was performed on the right eye while the retina was attached. The retina of the right eye was reattached by performing fluid-gas exchange and modified panretinal photocoagulation when the retina subsequently detached. Soon after the development of retinal detachment in the left eye, the above surgical procedures were performed on the left eye, and the retina was successfully reattached. Bilateral acute retinal necrosis with significant vitreous opacification, which is a devastating ocular disease causing possible blindness in both eyes, requires more aggressive, early surgical management.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
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Abstract
Tissue plasminogen activator(tPA) is a fibrin-specific fibrinolytic agent that has recently been shown to be effective in accelerating the clearance of hyphema. Intravitreal injection of tPA can promote rapid lysis of experimental intravitreal fibrin clots. The purpose of this study was to investigate the efficacy of intravitreal tPA injection for the treatment of vitreous hemorrhage in normal phakic non-vitrectomized rabbit eyes. Vitreous hemorrhages were produced by intravitreal injections of 0.05 ml of autologous whole blood in 25 rabbit eyes with intact vitreous. The injection of 25 or 100 micrograms of tPA in 15 eyes resulted in the clearance of vitreous hemorrhage in 99 +/- 19 or 34 +/- 6.5 days, respectively. This was significantly faster than in the control eyes in which the clearance was not seen until 131 +/- 17 days later. No tractional retinal detachment was observed.
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Affiliation(s)
- W K Min
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
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