ABSTRACT
Atrial fibrillation (AF) is the most common cardiac abnormality associated with ischemic stroke. Anticoagulant therapy plays an important role in the prevention of stroke associated with AF. Risk stratification and selection of oral anticoagulants in patients with AF are usually performed according to international guidelines from Europe or the United States of America. However, pivotal trials enrolled only a small number of Asian subjects, limiting the application of international guidelines to Korean patients with AF. The Korean Heart Rhythm Society organized a Korean AF Management Guideline Committee and analyzed all available studies regarding the management of AF, including studies on Korean patients. Expert consensus or guidelines for the optimal management of Korean patients with AF were achieved after a systematic review with intensive discussion. This article provides general principles for appropriate risk stratification and selection of anticoagulation therapy in Korean patients with AF.
Subject(s)
Humans , Americas , Anticoagulants , Asian People , Atrial Fibrillation , Consensus , Embolism and Thrombosis , Europe , Heart , Stroke , United StatesABSTRACT
This erratum is being published to correct the printing error on Table 5 of the article.
ABSTRACT
Dengue is an acute febrile viral disease which is found in tropical and sub-tropical regions around the world. Dengue fever has steadily increased in both incidence and distribution over the past 50 years. Even though Korea is not an endemic country for dengue fever, with the increasing numbers of overseas travelers in Korea, the numbers of imported dengue cases are steadily increasing. Here, we report a case of imported dengue hemorrhagic fever in a Korean child presenting with fever and epistaxis. Dengue fever should be considered if a patient who has a recent travel history to endemic areas showed classical symptoms.
Subject(s)
Child , Humans , Dengue , Severe Dengue , Epistaxis , Exanthema , Fever , Incidence , Korea , Purpura , Virus DiseasesABSTRACT
We experienced a pregnancy with a situs inversus totalis fetus in an overt diabetic woman, which was recognized by obstetric ultrasonography during the mid- trimester and this case is presented with a review of the literature.
Subject(s)
Female , Humans , Pregnancy , Fetus , Situs Inversus , UltrasonographyABSTRACT
We experienced a pregnancy with a situs inversus totalis fetus in an overt diabetic woman, which was recognized by obstetric ultrasonography during the mid- trimester and this case is presented with a review of the literature.
Subject(s)
Female , Humans , Pregnancy , Fetus , Situs Inversus , UltrasonographyABSTRACT
We experienced two cases of the intramural pregnancy, the rarest form of ectopic pregnancy and a life-threatening condition, that were successfully managed through different techniques of uterus-preserving laparoscopic surgery, thus we present these cases with a review of the literature.
Subject(s)
Female , Pregnancy , Laparoscopy , Pregnancy, EctopicABSTRACT
BACKGROUND AND OBJECTIVES: This study was designed to examine whether the multifractal Hurst exponents of heart rate can estimate activating and deactivating spontaneous baroreflex sensitivity (SBRS). SUBJECTS AND METHODS: Age and sex matched 24 healthy volunteers were placed in the supine position and head-up tilt position for 30 minutes, and the systolic blood pressure and heart rate were measured in an noninvasive manner. When the RR interval (RRI) sequence and systolic pressure sequence simultaneously increased or decreased for more than three successive beats, the slope of the linear regression line of systolic blood pressure and RR interval sequence was defined as the value of spontaneous baroreflex sensitivity (SBRS). From the RR intervals, very short-term (alpha range, or =12 heartbeats), and the multrifractal Hurst exponents were calculated to determine the linear correlation.coefficients for SBRS. RESULTS: In the supine position, the linear correlation coefficients (p) of SBRS and H-5alpha, H-4alpha, H-3alpha, H-2alpha, H-1alpha, H1alpha, H2alpha, H3alpha, H4alpha, H5alpha were -0.195 (NS), -0.207 (NS), -0.232 (NS), -0.282 (NS), -0.355 (NS), -0.621 (0.003), -0.650 (0.001), -0.677 (0.001), -0.699 (0.0006) and -0.708 (0.0005), respectively. In the tilting position, the linear correlation coefficients of SBRS and H-5beta, H-4beta, H-3beta, H-2beta, H-1beta, H1beta, H2beta, H3beta, H4beta, H5beta were 0.024 (NS), 0.020 (NS), 0.010 (NS), -0.028 (NS), -0.193 (NS), -0.627 (0.0034), -0.607 (0.0045), -0.598 (0.0053), -0.572 (0.0084) and -0.539 (0.0141), respectively. CONCLUSION: Some of the very short-term and short-term generalized Hurst exponents, such as H5alpha and H1beta, can be used for the estimation of spontaneous baroreflex sensitivity during patient placement in the supine and head-up tilt position, respectively.
Subject(s)
Humans , Baroreflex , Blood Pressure , Healthy Volunteers , Heart Rate , Heart , Linear Models , Supine PositionABSTRACT
We experienced a case of diastasis of the symphysis pubis accompanying severe pubic pain and serious gait disturbance, which was developed at 34 weeks gestation before labor pain in 36-year-old primiparous woman, who has experienced previous cesarean section at her first pregnancy due to pelvic pain before onset of labor, so we report a case with a review of the literature.
Subject(s)
Adult , Female , Humans , Pregnancy , Cesarean Section , Gait , Labor Pain , Pelvic PainABSTRACT
We experienced 3 cases of early stage tubal cancer incidentally recognized during the operation and diagnosed pathologically after surgery of the tubo-ovarian abscess, the symptomatic adenomyosis, the myoma with adnexal cyst patients, so we report our cases with a review of the literature.
Subject(s)
Humans , Abscess , Adenomyosis , MyomaABSTRACT
Intrauterine contraceptive device (IUD) is the most common contraceptive method in the world, but it exists a little risk of uterine perforation and even more severe risk such as a perforation of intra-abdominal organs. In this case, the patient recognized that the previously inserted IUD was translocated but she was asymptomatic without any management. After insertion of the second IUD, she visited our hospital for lower abdominal pain. The abdominal X-ray finding and transvaginal sonography revealed one translocated IUD in peritoneal cavity and another IUD in intrauterine cavity. Thus, we report a case with the laparoscopic diagnosis of small bowel perforation by a previously inserted IUD and its removal by segmental resection of small bowel after mini-laparotomy, along with the brief review.
Subject(s)
Humans , Abdominal Pain , Contraception , Diagnosis , Intrauterine Devices , Peritoneal Cavity , Uterine PerforationABSTRACT
Postoperative cheek cysts develop as a delayed complication of Caldwell-Luc operation, usually 10 to 20 years following the surgery. The general clinical presentations are swelling of the cheek, accompanied by dull maxillary facial pain and numbness. Enlarged postoperative cheek cysts infrequently protrude into the orbit and elevate the eyeball, causing double vision. Recently, we experienced two cases of exophthalmos caused by the protrusion of a postoperative cheek cyst into the orbit. One patient, a 39-year-old man, underwent Caldwell-Luc operation 21 years ago, and the other patient, a 53-year-old man, 36 years ago. We were able to secure an accurate measurement of the defective orbital floor using the preoperative 3-dimensional reconstruction CT scan. The postoperative cheek cyst was completely removed using the endonasal and transantral endoscopic approach, and the widely defective orbital floor was reconstructed with Medpor(R).
Subject(s)
Adult , Humans , Middle Aged , Cheek , Diplopia , Exophthalmos , Facial Pain , Hypesthesia , Orbit , Tomography, X-Ray ComputedABSTRACT
BACKGROUND AND OBJECTIVES: It has been suggested that nitric oxide (NO) and atrial natriuretic peptide (ANP) share a final common pathway for vascular smooth muscle relaxation. The aim of the present study was to determine the role of NO on the hypotensive and vasorelaxant effects of ANP. MATERIALS AND METHODS: Sprague-Dawley rats weighing 250-300 g each were anesthetized with thiopental (50 mg/kg IP). The femoral artery was cannulated and the arterial blood pressure and heart rate were continuously monitored in the anesthetized rats (n=19). ANP was administered into the jugular vein after L-NAME treatment. In vitro experiments were performed on intact and endothelium-denuded isolated thoracic aortic rings (n=51) in the presence of either L-NAME or methylene blue. RESULTS: Intravenous administration of ANP (5 ug/kg bolus and 0.2 ug/kg/min infusion) caused a decrease in the mean arterial pressure. L-NAME-pretreatment (1 mg/kg) suppressed the depressor response of ANP. In vitro, the ANP caused a dose-dependent relaxation, and the relaxation response to ANP was attenuated by L-NAME (10-4 M). Endothelium removal or methylene blue (10-5 M) also inhibited the ANP-induced vascular relaxation. CONCLUSION: These results suggest that the hypotensive and the vasorelaxant effect of ANP are, at least in part, NO-dependent.
Subject(s)
Animals , Rats , Administration, Intravenous , Arterial Pressure , Atrial Natriuretic Factor , Endothelium , Femoral Artery , Heart Rate , Jugular Veins , Methylene Blue , Muscle, Smooth, Vascular , NG-Nitroarginine Methyl Ester , Nitric Oxide , Rats, Sprague-Dawley , Relaxation , ThiopentalABSTRACT
The interstitial cells of Cajal (ICCs) are the pacemaker cells in gastrointestinal tract and generate electrical rhythmicity in gastrointestinal muscles. Therefore, ICC may be modulated by endogenous agents such as neurotransmitter, hormones, and prostaglandins (PGs). In the present study, we investigated the effects of prostaglandins, especially PGE2, on pacemaker currents in cultured ICCs from murine small intestine by using whole-cell patch clamp techniques. ICCs generated spontaneous slow waves under voltage-clamp conditions and showed a mean amplitude of -452+/-39 pA and frequency of 18+/-2 cycles/min (n=6). Treatments of the cells with PGE2 (1muM) decreased both the frequency and amplitude of the pacemaker currents and increased the resting currents in the outward direction. PGE2 had only inhibitory effects on pacemaker currents and this inhibitory effect was dose-dependent. For characterization of specific membrane EP receptor subtypes, involved in the effects of PGE2 on pacemaker currents in ICCs, EP receptor agonists were used: Butaprost (1muM), EP2 receptor agonist, reduced the spontaneous inward current frequency and amplitude in cultured ICCs (n=5). However sulprostone (1muM), a mixed EP1 and EP3 agonist, had no effects on the frequency, amplitude and resting currents of pacemaker currents (n=5). SQ-22536 (an inhibitor of adenylate cyclase; 100muM) and ODQ (an inhibitor of guanylate cyclase; 100muM) had no effects on PGE2 actions of pacemaker currents. These observations indicate that PGE2 alter directly the pacemaker currents in ICCs, and that the PGE2 receptor subtypes involved are the EP2 receptor, independent of cyclic AMP- and GMP-dependent pathway.
Subject(s)
Adenylyl Cyclases , Dinoprostone , Gastrointestinal Tract , Guanylate Cyclase , Interstitial Cells of Cajal , Intestine, Small , Membranes , Muscles , Neurotransmitter Agents , Patch-Clamp Techniques , Periodicity , ProstaglandinsABSTRACT
Interstitial Cells of Cajal (ICC) are pacemaker cells that generates slow waves and drive spontaneous mechanical contractions of gastrointestinal smooth muscle. Slow waves are generated the periodic activation of spontaneous inward currents (pacemaker currents). We studied the modulation of pacemaker activities by bradykinin (10-8 M) in cultured ICC with the whole cell patch-clamp technique, and the localization of bradykinin-2 receptor-immunoreactivity using double labelling immunohistochemistry in the murine small intestine. Externally applied bradykinin produced membrane depolarization in current-clamping mode. At a -70 mV of holding potential bradykinin increased tonic inward pacemaker currents. Double labelling with bradykinin-2 receptor and and c-kit was shown that ICC expressed the bradykinin-2 receptor-immunoreactivity. These results suggest that bradykinin modulates electrical activities of ICC via bradykinin-2 receptor, which may regulate gastrointestinal motility.
Subject(s)
Animals , Mice , Bradykinin , Gastrointestinal Motility , Immunohistochemistry , Interstitial Cells of Cajal , Intestine, Small , Membranes , Muscle, Smooth , Patch-Clamp Techniques , Receptors, BradykininABSTRACT
BACKGROUND: It has been established that hypertension is characterized by a dysfunctional endothelium. Among the endothelial factors that cause vasorelaxation, nitric oxide has been most widely known, which is synthesized by the enzyme nitric oxide synthase. This study was aimed to evaluate the role of the inducible nitric oxide synthase in chronic two-kidney, one clip (2K1C) hypertensive rats. METHODS: 2K1C hypertension was made by clipping the left renal artery and age- matched rats received a sham treatment served as control. In vitro experiments were preformed on intact and endothelium-denuded isolated thoracic aortic rings from lipopolysaccharide (LPS)-treated rats, in the presence of aminoguanidine alone, considered to be a selective inhibitor of the inducible nitric oxide synthase and of aminoguanidine and the nonselective nitric oxide synthase inhibitor Nomega-nitro-L-arginine (L-NNA). RESULTS: LPS treatment induced a shift to the right of concentration-response curves to norepinephrine in aortic rings with or without endothelium from sham- clipped control rats, while it did not modify in 2K1C hypertensive rats. In aortic rings with endothelium, aminoguanidine caused a significant shift of the norepinephrine concentration-response curve to the left in LPS-treated control rats, but had no effect in hypertensive rats. L-NNA caused an additional shift of the concentration-response curve to norepinephrine in both control and hypertensive rats, although the magnitude was diminished in hypertensive rats. In the endothelium-denuded rings, norepinephrine-induced contractions were enhanced by aminoguanidine in LPS- treated control rats, whereas no significant changes were observed in hypertensive rats. LPS treatment inhibited the relaxation response to acetylcholine in aortic rings from control rats, while it was without effect in hypertensive rats. L-arginine caused a dose-dependent relaxation in endothelium-denuded rings from LPS-treated rats. The relaxation response to L-arginine was attenuated by aminoguanidine in control rats, but no significant changes were noted in hypertensive rats. CONCLUSION: These results provide indirect evidence for an impaired activity of the inducible nitric oxide synthase in 2K1C hypertension, although involvement of an altered activity of constitutive nitric oxide synthase in the endothelium cannot be excluded.