Diastolic Dysfunction Induced by a High-Fat Diet Is Associated with Mitochondrial Abnormality and Adenosine Triphosphate Levels in Rats

BACKGROUND: Obesity is well-known as a risk factor for heart failure, including diastolic dysfunction. However, this mechanism in high-fat diet (HFD)-induced obese rats remain controversial. The purpose of this study was to investigate whether cardiac dysfunction develops when rats are fed with a HFD for 10 weeks; additionally, we sought to investigate the association between mitochondrial abnormalities, adenosine triphosphate (ATP) levels and cardiac dysfunction. METHODS: We examined myocardia in Wistar rats after 10 weeks of HFD (45 kcal% fat, n=6) or standard diet (SD, n=6). Echocardiography, histomorphologic analysis, and electron microscopy were performed. The expression levels of mitochondrial oxidative phosphorylation (OXPHOS) subunit genes, peroxisome-proliferator-activated receptor gamma co-activator-1alpha (PGC1alpha) and anti-oxidant enzymes were assessed. Markers of oxidative stress damage, mitochondrial DNA copy number and myocardial ATP level were also examined. RESULTS: After 10 weeks, the body weight of the HFD group (349.6+/-22.7 g) was significantly higher than that of the SD group (286.8+/-14.9 g), and the perigonadal and epicardial fat weights of the HFD group were significantly higher than that of the SD group. Histomorphologic and electron microscopic images were similar between the two groups. However, in the myocardium of the HFD group, the expression levels of OXPHOS subunit NDUFB5 in complex I and PGC1alpha, and the mitochondrial DNA copy number were decreased and the oxidative stress damage marker 8-hydroxydeoxyguanosine was increased, accompanied by reduced ATP levels. CONCLUSION: Diastolic dysfunction was accompanied by the mitochondrial abnormality and reduced ATP levels in the myocardium of 10 weeks-HFD-induced rats.

Torsades de Pointes during Treatment of Tachycardia-Induced Cardiomyopathy / 대한구급학회지

Tachycardia-induced cardiomyopathy is caused by persistent tarchyarrhythmias and is characterized by ventricular systolic dysfunction and congestive heart failure. Tachycardia-induced cardiomyopathy is usually reversible via treatment. The cornerstone in the management of disease in these patients is to achieve a normal heart rate. We report a torsades de pointes during treatment of tachycardia-induced cardiomyopathy. Intravenous magnesium sulfate and potassium were administrated, but torsades de pointes was repeated. After overdrive right ventricular pacing, torsades de pointes was terminated. Careful monitoring of the QT interval and serum electrolyte and drug levels in such patients is warranted during treatment of tachycardia-induced cardiomyopathy.

A Prospective, Randomized Comparison of Promus Everolimus-Eluting and TAXUS Liberte Paclitaxel-Eluting Stent Systems in Patients with Coronary Artery Disease Eligible for Percutaneous Coronary Intervention: The PROMISE Study

We aimed comparing two-year clinical outcomes of the Everolimus-Eluting Promus and Paclitaxel-Eluting TAXUS Liberte stents used in routine clinical practice. Patients with objective evidence of ischemia and coronary artery disease eligible for PCI were prospectively randomized to everolimus-eluting stent (EES) or paclitaxel-eluting stent (PES) groups. The primary end-point was ischemia-driven target vessel revascularization (TVR) at 2 yr after intervention, and the secondary end-point was a major adverse cardiac event (MACE), such as death, myocardial infarction (MI), target lesion revascularization (TLR), TVR or stent thrombosis. A total of 850 patients with 1,039 lesions was randomized to the EES (n=425) and PES (n=425) groups. Ischemic-driven TVR at 2 yr was 3.8% in the PES and 1.2% in the EES group (P for non-inferiority=0.021). MACE rates were significantly different; 5.6% in PES and 2.5% in EES (P = 0.027). Rates of MI (0.8% in PES vs 0.2% in EES, P = 0.308), all deaths (1.5% in PES vs 1.2% in EES, P = 0.739) and stent thrombosis (0.3% in PES vs 0.7% in EES, P = 0.325) were similar. The clinical outcomes of EES are superior to PES, mainly due to a reduction in the rate of ischemia-driven TVR.

A Case of Apical Hypertrophic Cardiomyopathy Combined Acute Myocardial Infarction with Multiple Coronary Thrombosis

We report a case of apical hypertrophic cardiomyopathy combined with acute myocardial infarction and multiple coronary thrombosis. The patient presented with signs and symptoms of acute myocardial infarction, showing ST elevation in the lateral leads and ST depression in anterior chest leads on initial electrocardiogram. The coronary angiogram on admission, multiple thrombosis of distal left anterior descending artery, left circumflex, diagonal and obtuse marginal arteries were found. The present case shows that apical hypertrophic cardiomyopathy can be combined with acute myocardial infarction and multiple coronary thrombosis.

Three cases of right coronary anomaly confirmed by multi-detector computed tomography / 대한내과학회지

Congenital anomaly of the right coronary artery is a very rare disease. It can cause syncope, angina pectoris, acute myocardial infarction, ventricular fibrillation and sudden cardiac death during exercise in the young population. The dominancy of the coronary artery, and the site, shape and pathway of the right coronary artery seems to play a key role in developing those above mentioned events. Especially, it has been known that the right coronary artery that courses between the aorta and pulmonary trunk increases the risk of sudden death. Therefore, precise evaluation is needed to diagnose the presence and type of coronary artery anomaly. Nowadays, multi-detector computed tomography is used to diagnose coronary anomalies and this provides clear images of coronary anomaly in a safe and noninvasive way. We report here on three cases of right coronary anomaly that coursed between the aorta and pulmonic trunk, and this was confirmed by multi-detector computed tomography.

The Relationship between the Upright Serum aldosterone Level and the Left Ventricular Geometry in Essentioal Hypertension

BACKGROUND: Aldosterone acts as a non-hemodynamic factors on the hypertensive heart regarding sodium retension or myocardial fibrosis. To elucidate whether aldosterone is associated with the specific left ventricular geometry or not, we investigated the relationship between the upright serum aldosterone levels and the echocardiographicleft ventricular structure in the essential hypertension patients never treated. METHODS: Echocardiographic indices included M-mode measured left ventricular mass index (LVMI), relative wall thickness (RWT). Aldosterone is measured by Radioimmunoassay for the serum withdrawn from the subjects at least 3 hours upright position. 63 patients and 20 normal control subjects were evaluated. RESULTS: 1) 84.1% (63/53) of cases showed left ventricular hypertrophy. 7 patients showed normal LVMI, 3 patients showed concentric remodeling geometry. 19 patients had concentric left ventricular hypertrophy (LVH). 34 patients had eccentric LVH. 2) The serum aldosterone level has negative correlation with the RWT (r=-0.27, p=0.03) but not with LVMI (r=0.08, p=NS). There was difference among groups (ANOVA, F=0.009). Serum aldosterone is higher in eccentric LVH group than in concentric LVH group (10.5+/-1.2 ng/dL vs 5.2+/-0.6 ng/dL, p=0.0001) and than in control group (10.5+/-1.2 ng/dL vs 6.6+/-0.8 ng/dL, p=0.01). CONCLUSION: In this study, we observed that the serum aldosterone level was not correlated with the LVMI but with RWT negatively so that eccentric LVH group showed higher serum aldosterone levels than control group and concentric LVH group.

A Case of Cardiac Tamponade due to Primary Hypothyroidism

Pericardial effusions occur in approximately 30% of patients with untreated hypothyroidism. The effusions are more common in patients with longstanding, severe disease. But, cardiac tamponade is a very rare complication, because of the elasticity of pericardium and slow progression. We experienced a 61 year old female patient with cardiac tamponade due to primary hypothyroidism. She was treated with pericardiocentensis and thyroid hormone replacement, confirmed by echocardiography,thyroid function test and TRH stimulation test.

Stress Relating Factors of Working Women in a Bank / 대한산업의학회지

We surveyed 343 female bank clerks to find out associations between stress and a variety of factors including general, menstruation and reproductive characteristics of the participants. Unmarried women composed the majority of younger, lower income and lower education groups than married did. They also showed higher. though not significantly higher, scores for psychosocial well being index(PWJ) and the first three items of the stress survey. And married women scored slightly higher only in the fourth item of the stress survey. Among the subgroups of married and unmarried women, many factors contributed to a higher stress score in two or more items of the stress survey; in unmarried women, lower education level, little physical exercise, and large family inhabitants, in contrast married women, higher monthly income and greater working hours were related to higher stress scores. According to the menstruation factors, subgroups with dysmenorrhea or irregular cycle and scanty bleedig volume in unmarried women and subgroups with dysmenorrhea in married women showed higher stress scores in PWI. In married women, the proportion of those who have been pregnant was 77.2% and the proportion of those who have experienced spontaneous abortion was 24.1%. Those who have ever experienced two or more spontaneous abortion showed higher, though not statistically significantly higher. scores for PWI. In conclusion, dysmenorrhea was associated with high stress score in two groups. And the other factors related to higher score of PWJ were different between unmarred and married women, which should be considered in a management plan for mental health promotion.

Acute Myocardial Infarction in Patient with Spontaneous Coronary

Spontaneous coronary artery dissection is a rere incident occurring usually in young patients, predominautly in females. It is usually fatal and found postmortem. It is also a rare cause of acute myocardial infarction. We present the case of a twenty nine-year-old-man with spontaneous right coronary artery dissection found angiographically which caused an inferior wall myocardial infarction. He was treated with medical therapy only amd after uneventful hospital course, he was discharged with medication. Three months later, coronary angiography was done to follow up the lesion and found that the site was completely healed.

A Case of Occult Foreign Body Lodged in Bronchus for a Long Period and Removal by Flexible Bronchoscopy / 결핵

Aspiration of foreign bodies into tracheobronchial tree is more common in children than in adults. Foreign bodies in airway commonly occur by accident, and in most cases they get removed without delay. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Although foreign body aspiration is frequently suspected in children with acute or recurrent pulmonary symptoms, it is rarely considered in adults, unless a clear history of an aspiration event can be obtained. We have experienced and studied a case of occult aspiration of a shrimp which had been lodged for a long period.

Clinical Evaluations for Endoscopic Variceal Ligation in Esophageal Varices Bleeding / 대한소화기내시경학회지

Endoscopic injection sclerotherapy(EIS) has been shown to be the most effective simple method for control of bleeding and eradication of varices. This method has been aceepted widely as a standard treatment of bleeding esophageal varices. However, EIS may be associated with undesirable local and systemic complications. (continue...)

A Case of Chronic Gastric Anisakiasis with Massive Bleeding / 대한소화기내시경학회지

Aniskiasis is caused by the accidental infestation of human by larvae of marine mammals found in saltwater fish and squid. The clinical picture may be severe enough to stimulate an acute surgical abdomen. More commonly, colicky pain, diffuse abdominal tenderness, nausea, vomiting, fever, and leukocytosis are seen. Gastroscopically, 2-to 4-cm larvae can be seen penetrating the mucosa. More characteristically, the larvae burrow into the mucosa of the stomach. Here they produce eosinophilic granulomatous tumors with edema, thickening, and induration which may be mistaken for gastric canceer. The pathalogic changes are thought to be the result of a hypersensitivity reaction. We report a case of chronic gastric anisakiasis, which was diagnosed as submucosal tumor with massive bleeding.

Familial Polyposis Coli / 대한소화기내시경학회지

Familial adenomatous polyposis(FAP) is the most oommon of the polyposis syndromes. It is characterized by multiple colorectal adenoma and a high occurrence rate of associated colonic adenocarcinoma in all untreated cases. FPC is inherited as antosomal dominant trait. During 20 years after diagnosis, adenocarcinoma occurs in more than 50% of patients. Clinically, surgical resection should be advised at the time of diagnosis in almost all cases, and acquainted with the potential risks to their children and advised to seek genetic counselling. we report three cases with familial adenomatous polyposis in family.