Optical Coherence Tomography Findings of Non-ST Elevation Myocardial Infarction with Multivessel Disease

No abstract available.

Comparison of Clinical Outcomes after Implantation of First- and Second-Generation Overlapping Drug-Eluting Stents to Treat Diffuse Long Coronary Lesions / 대한내과학회지

BACKGROUND/AIMS: Despite improved revascularization techniques, the clinical outcomes of patients with diffuse coronary artery lesions after percutaneous coronary intervention are unsatisfactory. However, few studies have compared the efficacy of first- and second-generation drug-eluting stents (DES) in patients with diffuse long coronary artery lesions. METHODS: Between January 2006 and July 2012, 364 patients who were treated with DES for long coronary artery stenosis (> 30 mm) were enrolled in this study and assigned to either Group I (first-generation DES, 62.3 +/- 10.4 years, 136 males, n = 183) or Group II (second-generation DES, 64.3 +/- 10.7 years, 134 males, n = 181). The incidence of major adverse cardiac events (MACE) was compared between the two groups over 2 years of follow-up, and predictive factors associated with MACE were evaluated through a multivariate analysis. RESULTS: Although several coronary angiographic characteristics were different between the two groups, most demographic and baseline clinical variables were the same. The cumulative incidence of MACE was significantly higher in Group I than in Group II (25.7 vs. 6.6%; p < 0.001), mainly due to reduced target lesion revascularization (21.9 vs. 2.2%; p < 0.001). According to the results of the multivariate analysis, the use of a paclitaxel-eluting stent (PES) (hazard ratio [HR], 5.168; 95% confidence interval [CI], 2.515-10.617; p < 0.001), decreased left ventricular function (< or = 45%; HR, 3.586; 95% CI, 1.839-6.990; p < 0.001), and diabetes mellitus (HR, 2.984; 95% CI, 1.605-5.548; p < 0.001) were independent contributors to MACE. CONCLUSIONS: For patients with diffuse long coronary artery stenosis, the use of second-generation DES improved the clinical outcome compared with first-generation DES. In addition, the use of a PES, left ventricular dysfunction, and diabetes were predictors of MACE after overlapping stenting.

Optimizing in vivo gene transfer into mouse corpus cavernosum by use of surface electroporation

PURPOSE: Electroporation is known to enhance the efficiency of gene transfer through a transient increase in cell membrane permeability. The aim of this study was to determine the optimal conditions for in vivo electroporation-mediated gene delivery into mouse corpus cavernosum. MATERIALS AND METHODS: Diabetes was induced in C57BL/6 mice by intraperitoneal injections of streptozotocin. After intracavernous injection of pCMV-Luc (100 microg/40 microL), different electroporation settings (5-50 V, 8-16 pulses with a duration of 40-100 ms) were applied to the penis to establish the optimal conditions for electroporation. Gene expression was evaluated by luciferase assay. We also assessed the undesired consequences of electroporation by visual inspection and hematoxylin-eosin staining of penile tissue. RESULTS: Electroporation profoundly induced gene expression in the corpus cavernosum tissue of normal mice in a voltage-dependent manner. We observed electrical burn scars in the penis of normal mice who received electroporation with eight 40-ms pulses at a voltage of 50 V and sixteen 40-ms pulses, eight 100-ms pulses, and sixteen 100-ms pulses at a voltage of 30 V. No detectable burn scars were noted in normal mice stimulated with eight 40-ms pulses at a voltage of 30 V. Electroporation also significantly induced gene expression in diabetic mice stimulated with 40-ms pulse at a voltage of 30 V without injury to the penis. CONCLUSIONS: We have established the optimal electroporation conditions for maximizing gene transfer into the corpus cavernosum of mice while avoiding damage to the erectile tissue. The electroporation-mediated gene delivery technique will be a valuable tool for gene therapy in the field of erectile dysfunction.

The Association of Socioeconomic Status with Three-Year Clinical Outcomes in Patients with Acute Myocardial Infarction Who Underwent Percutaneous Coronary Intervention

The aim of this study was to evaluate whether the clinical outcomes were associated with socioeconomic status (SES) in patients with acute myocardial infarction (AMI) who underwent percutaneous coronary intervention (PCI). The author analyzed 2,358 patients (64.9 +/- 12.3 yr old, 71.5% male) hospitalized with AMI between November 2005 and June 2010. SES was measured by the self-reported education (years of schooling), the residential address (social deprivation index), and the national health insurance status (medical aid beneficiaries). Sequential multivariable modeling assessed the relationship of SES factors with 3-yr major adverse cardiovascular events (MACEs) and mortality after the adjustment for demographic and clinical factors. During the 3-yr follow-up, 630 (26.7%) MACEs and 322 (13.7%) all-cause deaths occurred in 2,358 patients. In multivariate Cox proportional hazards regression modeling, the only lower education of SES variables was associated with MACEs (hazard ratio [HR], 1.41; 95% confidence interval [CI], 1.04-1.91) and mortality (HR, 1.93; 95% CI, 1.16-3.20) in the patients with AMI who underwent PCI. The study results indicate that the lower education is a significant associated factor to increased poor clinical outcomes in patients with AMI who underwent PCI.

Flow Starting Point and Voiding Mechanisms Measured by Simultaneous Registrations of Intravesical, Intra-abdominal, and Intraurethral Pressures in Awake Rats / 대한배뇨장애요실금학회지

PURPOSE: The aim of this study was to apply a new surgical procedure that allows for the successful monitoring of intraurethral pressure (IUP) changes in the cystometry of awake Sprague-Dawley rats. METHODS: Twenty-six female Sprague-Dawley rats were grouped according to the catheterization method (bladder only; bladder and urethra; or bladder, urethra, and abdomen). Using an arbitrarily determined initial point of the first phase among four rat micturition phases on the simultaneous curves as a reference point, we compared the time differences to the points on an intravesical pressure (IVP) and those on IUP or a detrusor pressure (DP) curve from intra-abdominal pressure (IAP). RESULTS: In awake rat, the start of urethral flow on IUP curve corresponded to the initial point of the second phase, which is same to the results on the anesthetized rat. However, certain results, such as micturition pressure (MP) and intraluminal pressure high-frequency oscillations (IPHFOs), differed between awake and anesthetized rats. Most MP values were checked after the end of urethral flow on the IUP curve, which is due to the peculiar methodology such as transvesical catheterization. Urethral flow was not completely interrupted during the IPHFOs, which suggests the presence of urethral wall tension against the flow during voiding. After removal of the superimposed effects of IAP from IVP, the DP curve clearly showed a peculiar shape, highlighting the possibility of using IAP in place of IUP to detect the flow starting point on the IVP curve. CONCLUSIONS: Awake rat cystometry results have been interpreted based on those in anesthetized rats. However, our awake cystometry data were substantially different in terms of voiding time compared to those of anesthetized rats. This discovery warrants careful interpretation of the voiding parameters in awake rat cystometry.

A Case Report of Testicular Sparganosis Misdiagnosed as Testicular Tumor

Sparganosis is a parasitic infestation of human by plerocercoid larvae. Sparganum is usually reported to be found in the subcutaneous tissues as well as other organs, including scrotum. However, testicular sparganosis is extremely rare, because of strong capsule of tunica albuginea. An urban-living 54-yr-old Korean man presented with left scrotal pain for 6 yr. Both testes look normal physically. Ultrasonography revealed poorly defined, heterogeneous mass with increased echogenicity in the left testis. This case was misdiagnosed as testicular tumor and underwent orchiectomy, but was diagnosed as testicular sparganosis by histopathology. Sparganosis should be included for differential diagnosis of testis tumor in countries where sparganosis is prevalent.

Predictors of Contrast-Induced Nephropathy in Acute Coronary Syndrome Patients with Renal Dysfunction / 대한내과학회지

BACKGROUND/AIMS: Contrast-induced nephropathy (CIN) is an important complication of diagnostic coronary angiography (CAG) and percutaneous coronary intervention (PCI). We investigated the incidence and predictors of the development of CIN in acute coronary syndrome (ACS) patients with renal dysfunction undergoing PCI. METHODS: From January 2005 to June 2010, we evaluated the clinical, laboratory, and angiographic data of 406 patients with ACS who had a serum creatinine > or = 1.3 mg/dL and underwent CAG or PCI. The patients were divided into two groups according to the development of CIN (CIN, n = 92; no CIN, n = 314). RESULTS: Of the 406 patients, 92 (22.7%) developed CIN. The development of CIN was associated with a lower baseline body mass index (p = 0.001), decreased left ventricular ejection fraction (LVEF) (p or = 3.5 (OR, 1.964; 95% CI, 1.243-3.101; p = 0.004) were independent predictors of CIN. The cut-off value for CMV/CrCl was 3.5, and that for albumin was 3.55 g/dL. CONCLUSIONS: CIN occurred in 22.7% of the patients with ACS and renal dysfunction who underwent CAG or PCI. Independent predictors of CIN were decreased LVEF, decreased albumin, and increased CMV/CrCl ratio.

Effect of IN-1130, a Novel Transforming Growth Factor-beta Type I Receptor Kinase (ALK5) Inhibitor, on a Rat Model of Peyronie's Disease Induced by Repeated Intratunical Injections of Fibrin / 대한남성과학회지

PURPOSE: Transforming growth factor-beta1 (TGF-beta1) has been known to be involved in the pathogenesis of Peyronie's disease (PD). In the present study, we investigated the therapeutic effect of IN-1130, a novel small molecule inhibitor of activin receptor-like kinase (ALK)5, a type I receptor of TGF-beta, in an animal model of PD induced by fibrin. MATERIALS AND METHODS: Four-month-old male Sprague-Dawley rats were divided into three groups (n=4 per group): group 1, age-matched control; group 2, PD rats without treatment; group 3, PD rats receiving an intratunical injection of IN-1130 (on day 20, 5 mg/kg in 0.1 ml saline) into the lesion. PD was induced in rats through repeated injections of fibrin (50 microliter each of human fibrin and thrombin solutions, days 0, 3, and 6, respectively) into the tunica albuginea. Penile curvature was evaluated by use of an artificialerection test on day 30. The penis was then harvested and stained with Masson trichrome, hematoxylin- eosin, and antibody to vimentin and phospho-Smad2. RESULTS: PD rats receiving repeated intratunical injections of fibrin revealed an infiltration of inflammatory cells, including lymphocytes, plasma cells, and fibroblasts, and an increase in transnuclear expression of phospho-Smad2 in the fibrotic plaque. However, repeated intratunical injections of fibrin did not induce penile curvature. IN-1130 induced significant regression of fibrotic plaque through reduced infiltration of inflammatory cells and reduced transnuclear expression of phospho-Smad2. CONCLUSIONS: Inhibition of TGF-beta pathway through the use of ALK5 inhibitors may be a curative local treatment modality for PD.

Application and Limitations of Awake Cystometry in Sprague-Dawley Rats with Partial Bladder Outlet Obstruction as a Model of Overactive Bladder or Obstruction

PURPOSE: Partial bladder outlet obstruction (PBOO) in rats leads to changes in bladder function, such as obstruction and detrusor overactivity (DO). The aim of our study was to observe factors essential for the objective descriptions of PBOO rats as an overactive bladder model as well as an obstruction model under awake cystometry. We also aimed to investigate the urodynamic effects of PBOO objectively in view of DO-related parameters as well as conventional pressure and volume-related parameters. MATERIALS AND METHODS: PBOO was produced in 10 female Sprague-Dawley rats by ligating the proximal urethra over a 0.9 mm metal rod; 10 sham-operated rats were used as controls. Intravesical pressure (IVP) was recorded via an open catheter in the bladder, and intraabdominal pressure (IAP) via an intraabdominal balloon catheter. Continuous cystometry was performed 2 weeks after the PBOO procedure. Conventional and newly developed DO-related urodynamic parameters were investigated. RESULTS: PBOO led to a significant increase in bladder weight. Three rats showed the picture of decompensated bladder and were excluded from the analysis. The obstructed group showed some increased pressure- and volume-related parameters. They showed a DO frequency of 1.5+/-0.3/min, but the sham group did not. CONCLUSIONS: Our results showed that bladder decompensation can happen after PBOO, and we need to describe those exclusions accurately in reports. In conscious PBOO rats, simultaneous registration of IAP and IVP is needed for accurate investigations of DO, because PBOO can lead to DO as well as bladder hypertrophy.