The Study of Coronary Spasm by Follow-up Coronary Angiography in Variant Angina

BACKGROUND AND OBJECTIVES: The therapeutic duration of variant angina is controversial. This study sought to determine the remission rates for coronary artery spasms, the factors associated with remission and the changes in spasm sites. SUBJECTS AND METHODS: Fifty-eight patients were enrolled in the study. Initial, and follow-up, coronary angiographies (CAG), with ergonovine stimulation tests, were performed. Paired CAG were performed at a mean interval of 27+/-17 months. Medication was stopped 3 days prior to the follow-up CAG, and the occurrence of chest pain during these 3 days was studied. Coronary spasms were confirmed by follow-up CAG. Any changes, and the diameters, of spasm sites were analyzed on each paired CAG. RESULTS: The remission rate of coronary spasms was 24% (14 patients), when the smoking group (49 patients) stopped smoking (31 patients), the remission rate was 29% (9 patients). In the current smoking group (18 patients), the remission rate was 6% (1 patient, p=0.05). 31 patients had chest pains after stopping medication prior to their follow-up CAG. Of those patients, 1 patient had a remission (3%). Among another 27 patients with no chest pain, 13 patients had a remission (48%, p<0.001). In 28 out of 44 patients (64%, non-remission), fluctuations in spastic locations were observed at the follow-up CAG. The interval changes in the diameter of the spasm sites were not significant. CONCLUSION: The non-chest pain group showed higher remission rates, but lack of chest pain did not identify the loss of coronary spasm. Atherosclerosis at spasm sites did not progress, as confirmed by the paired CAG in our study.

A case of Sulfone syndrome hypersensitivity associated with dapsone / 천식및알레르기

Sulfone hypersensitivity syndrome, which is characterized by fever, skin rash, hemolytic anemia, atypical lymphocytosis, and acute hepatic injury, is a potentially fatal variant of dapsone hypersensitivity. A 62-year-old woman with a history of arthralgia developed sulfone syndrome while receiving dapsone 100 mg/day for 20 days. Fever, malaise, prominent rashes, hepatitis, eosinophilia and hemolytic anemia developed and she which required hospitalization. The patient's symptoms reversed following discontinuation of dapsone and administration of steroid (0.5 mg/kg). A case of sulfone syndrome and a brief review of the literature were presented.

Effects of specific monoclonal antibodies to dense granular proteins on the invasion of Toxoplasma gondii in vitro and in vivo

Although some reports have been published on the protective effect of antibodies to Toxoplasma gondii surface membrane proteins, few address the inhibitory activity of antibodies to dense granular proteins (GRA proteins). Therefore, we performed a series of experiments to evaluate the inhibitory effects of monoclonal antibodies (mAbs) to GRA proteins (GRA2, 28 kDa; GRA6, 32 kDa) and surface membrane protein (SAG1, 30 kDa) on the invasion of T. gondii tachyzoites. Passive immunization of mice with one of three mAbs following challenge with a lethal dose of tachyzoites significantly increased survival compared with results for mice treated with control ascites. The survival times of mice challenged with tachyzoites pretreated with anti-GRA6 or anti-SAG1 mAb were significantly increased. Mice that received tachyzoites pretreated with both mAb and complement had longer survival times than those that received tachyzoites pretreated with mAb alone. Invasion of tachyzoites into fibroblasts and macrophages was significantly inhibited in the anti-GRA2, anti-GRA6 or anti-SAG1 mAb pretreated group. Pretreatment with mAb and complement inhibited invasion of tachyzoites in both fibroblasts and macrophages. These results suggest that specific antibodies to dense-granule molecules may be useful for controlling infection with T. gondii.

Allergic bronchopulmonary aspergillosis with coexistent aspergilloma / 천식및알레르기

A 61-year-old woman with a history of asthma and pulmonary tuberculosis was presented with purulent bloody sputum. She was treated as having lung abscess initially, but her signs and symptoms did not improve with traditional therapy. Finally, in the clinical course and laboratory data during hospitalization, she was diagnosed as ABPA with coexistent aspergilloma. Thereafter she was treated with itraconazole for aspergilloma, and corticosteroid for ABPA. The symptoms of hemoptysis and dyspnea were improved. A case of ABPA with coexistent aspergilloma and a brief review of the literature were presented.

Imported tertian malaria resistant to primaquine

In Plasmodium vivax and Plasmodium ovale malaria, some of the liver stage parasites remain dormant. The activation of these dormant forms (called hypnozoite) can give rise to relapse weeks, months or years after the initial infection. To prevent relapses, a course of primaquine may be given as terminal prophylaxis to patients. Different strains of Plasmodium vivax vary in their sensitivity to primaquine and, recently, cases of relapse of Plasmodium vivax after this standard primaquine therapy were reported from various countries. We reported a case of primaquine resistant malaria which initially was thought to be relapsed caused by loss of terminal prophylaxis.

A Case of Thyrotoxic Periodic Paralysis Presenting as Ventricular Tachycardia / 대한내분비학회지

sociated with hyperthyroidism occurs in 2.0% of Graves disease and is characterized by myasthenia or bilateral flaccid paralysis of lower extremity, in some cases, it may be accompanied with cardiac arrhythmias which are mostly due to hypokalemia. The most common type of cardiac arrhythmias associated with hyperthyroidism is sinus tachycardia, 1015% of patients have atrial fibrillation. Rarely, ventricular tachycardia or ventricular fibrillation develop and lead to cardiac arrest in severe case. A 26-year-old man was admitted to the hospital because of weakness of lower extremity. The initial EKG showed ventricular tachycardia. The laboratory results were, TSH 0.08 microunit/mL, free T4 4.11 ng/mL, T3 2.88 ng/mL, serum K 1.9 mEq/L. He was diagnosed as ventricular tachycardia associated with hypokalemic thyrotoxic periodic paralysis. His symptoms improved during the treatment with propylthiouracil and potassium replacement. We report a case of thyrotoxic periodic paralysis presenting as ventricular tachycardia with brief review of literatures.