The effect of antiplatelet drug on coronary endothelial and microvascular function: comparison with ticagrelor and clopidogrel

Background/Aims@#Coronary endothelial and microvascular function play important roles in cardiovascular disease. We aimed to evaluate the effect of ticagrelor on coronary artery function and tested the antiplatelet effect of low dose ticagrelor in East-Asian patients. @*Methods@#Sixty-one consecutive patients with non-significant coronary disease were included in the study. Initially, patients were randomized in 1:1:1 ratio to receive drugs: ticagrelor 90 mg twice a day (bid; n = 22), ticagrelor 45 mg bid (n = 19) or clopidogrel 75 mg once a day (qd; n = 20) and then divided into two groups (ticagrelor vs clopidogrel) for evaluation of coronary artery function, and three groups for evaluation of antiplatelet function. Endothelial dysfunction was measured by coronary flow reserve (CFR), and changes in the levels of asymmetric dimethylarginine (ADMA), cluster of differentiation (CD) 40 ligand, and P-selectin. Microvascular function was evaluated as index of microvascular resistance (IMR). Platelet reactivity was assessed by VerifyNow P2Y12 assay. @*Results@#The levels of CFR, ADMA, and CD 40 ligand were not different between the two groups. However, P-selectin was lower in the ticagrelor group compared with clopidogrel group. IMR was significantly lower in the ticagrelor group compared with clopidogrel group (median, 15.0 [interquartile range, 12.0 to 21.0] vs. 47.5 [23.0 to 67.5], p = 0.014). There was significant difference in platelet inhibition among the three groups (ticagrelor 90 mg bid vs. ticagrelor 45 mg bid vs. clopidogrel 75 mg qd; 85.57 ± 47.63 vs. 120.33 ± 51.09 vs. 256.42 ± 55.10, p < 0.001) @*Conclusions@#It is hypothesized that ticagrelor might ameliorate the coronary microvascular function. When compared with clopidogrel, low dose ticagrelor exhibited satisfactory antiplatelet effect in the present study.

CORM-2-entrapped ultradeformable liposomes ameliorate acute skin inflammation in an ear edema model

The short release half-life of carbon monoxide (CO) is a major obstacle to the effective therapeutic use of carbon monoxide-releasing molecule-2 (CORM-2). The potential of CORM-2-entrapped ultradeformable liposomes (CORM-2-UDLs) to enhance the release half-life of CO and alleviate skin inflammation was investigated in the present study. CORM-2-UDLs were prepared by using soy phosphatidylcholine to form lipid bilayers and Tween 80 as an edge activator. The deformability of CORM-2-UDLs was measured and compared with that of conventional liposomes by passing formulations through a filter device at a constant pressure. The release profile of CO from CORM-2-UDLs was evaluated by myoglobin assay.

Delayed presentation of aggravation of thyrotoxicosis after radioactive iodine therapy at Graves disease / 영남의대학술지

Radioactive iodine (RAI) therapy is widely used for the treatment of Graves disease. After RAI therapy, 44% become hypothyroid and up to 28% remain hyperthyroid. The development of thyrotoxicosis after RAI therapy is believed to be mediated by 2 different mechanisms: a transient increased release of thyroid hormone due to radiation thyroiditis and the rare development of Graves disease due to the formation of antibodies to the thyroid-associated antigens released from the damaged follicular cells. A 55-year-old woman was hospitalized with severe headache, weight loss, and palpitation. She received a dose of 7 mCi of RAI (I-131) about 6 weeks earlier. Thyroid function test showed 7.98 ng/dL free T4, >8 ng/mL T3, <0.08 microIU/L thyroid stimulating hormone, and high titer thyroid stimulating immunoglobulin (TSI) (85.8 IU/L). She improved with propylthiouracil, propranolol, and steroid treatment. The TSI, however, was persistently elevated for 11 months.

THE STUDY OF MUTATION SPECTRUM OF HEMOPHILIA / Шинэ санаа Шинэ нээлт

Background:Hemophilia is life-threatening and hereditary bleeding disorder caused by deficiencies of pi coagulation VIII. IX, XI factor, and that is inherited by X-linkcd recessive.However, hemophilic treatment is getting increase in our country, but still insufficient or poor because of high cost, which is about 50000-70000$ per patient per year in other countries. Now, we need to detect hemophilia heterozygote (XAX*) or no symptomatic carrier among hemophiliac siblings (including mother, younger sister, sister) that is essential for prevention of hemophilia. We need to screen the mutation spectrum of FS and F9 gene among patients with hemophilia in order to detect hemophilia carriers.Objective:to detect a mutation 1'Ó ø! f9 gene among patients with hemophilia Methods:The blood samples were collected from paffeflf* who had been hospitalizing in department ot hematology of the First Clinical Hospital and the National Center for Maternal and Child Health from 2010 to 2011. We have carried out the screening of most common mutation named int- 22 inversion by Long-Range PC'R method is previously described by Lui Q et al.. 1998. Direct sequence method was used to detect the SNP and small deletion in patients who had no int-22 inv and large deletion.Results:In total, If pillitfhis with hemophilia (ÈË-14, IIB=1) participated in this study. The 9 patients positive for an int-22 inversion mutation, while the one patient had a multiple exon deletion (exon 1-13) which was demonstrated by repeated PC'R amplification failure. I wo missense mutation and 1 frame shift mutation were detected. The one patient had nonsense mutation but he was diagnosed as a severe hemophilia-A patient.Conclusion:We have to urgently adopt the molecular diagnosis and carrier detection ol hemophilia in our rnuntrv

THE STUDY OF MUTATION SPECTRUM OF HEMOPHILIA / Шинэ санаа Шинэ нээлт

Background: Hemophilia is life-threatening and hereditary bleeding disorder caused by deficiencies of pi coagulation VIII. IX, XI factor, and that is inherited by X-linkcd recessive. However, hemophilic treatment is getting increase in our country, but still insufficient or poor because of high cost, which is about 50000-70000$ per patient per year in other countries. Now, we need to detect hemophilia heterozygote (XAX*) or no symptomatic carrier among hemophiliac siblings (including mother, younger sister, sister) that is essential for prevention of hemophilia. We need to screen the mutation spectrum of FS and F9 gene among patients with hemophilia in order to detect hemophilia carriers. Objective: to detect a mutation 1'Ó ø! f9 gene among patients with hemophilia Methods: The blood samples were collected from paffeflf* who had been hospitalizing in department ot hematology of the First Clinical Hospital and the National Center for Maternal and Child Health from 2010 to 2011. We have carried out the screening of most common mutation named int- 22 inversion by Long-Range PC'R method is previously described by Lui Q et al.. 1998. Direct sequence method was used to detect the SNP and small deletion in patients who had no int-22 inv and large deletion. Results: In total, If pillitfhis with hemophilia (ÈË-14, IIB=1) participated in this study. The 9 patients positive for an int-22 inversion mutation, while the one patient had a multiple exon deletion (exon 1-13) which was demonstrated by repeated PC'R amplification failure. I wo missense mutation and 1 frame shift mutation were detected. The one patient had nonsense mutation but he was diagnosed as a severe hemophilia-A patient. Conclusion: We have to urgently adopt the molecular diagnosis and carrier detection ol hemophilia in our rnuntrv

Atypical Progression of Acute Renal Failure Associated with Cisplatin Chemotherapy / 대한내과학회지

Cisplatin is commonly used as chemotherapy for solid tumors. Its most important side effect is nephrotoxicity, which typically produces a gradual decline in renal function. Acute tubular necrosis is the usual pathological finding, while other findings are rare. A 75-year-old man presented to the emergency department (ED) with diarrhea and hypoglycemia. He was on 5-fluorouracil (5-FU)/cisplatin chemotherapy after a radical total gastrectomy for gastric cancer. Ten days earlier, he had been discharged after the third cycle of chemotherapy with normal renal function. When he arrived in the ED, he had azotemia (creatinine = 9.2 mg/dL) necessitating emergency hemodialysis. His renal function did not recover despite hydration and conservative treatment. Since he could not receive further chemotherapy due to the renal failure, he died 4 months later due to cancer progression. A renal biopsy performed 3 months after the renal failure showed acute tubular necrosis and severe interstitial fibrosis with normal glomeruli suggesting tubulointerstitial nephritis.

Response: The Association between Serum Endogenous Secretory Receptor for Advanced Glycation End Products and Vertebral Fractures in Type 2 Diabetes (Endocrinol Metab 2012;27:289-94, Cheol Ho Lee et al.)

No abstract available.

The Association between Serum Endogenous Secretory Receptor for Advanced Glycation End Products and Vertebral Fractures in Type 2 Diabetes

BACKGROUND: Patients with type 2 diabetes are known to have an increased risk for osteoporotic fractures compared with non-diabetic subjects. We investigated whether the serum endogenous secretory receptor for advanced glycation end products (esRAGE) or pentosidine was associated with prevalent vertebral fractures in patients with type 2 diabetes. METHODS: We enrolled 140 patients with type 2 diabetes mellitus (73 men aged 50 or older and 67 postmenopausal women). Lateral X-ray films of the spine revealed prevalent vertebral fractures. The serum concentration of esRAGE and pentosidine were measured. RESULTS: The mean age of all patients was 66.2 +/- 6.5 years and 22% of patients had prevalent vertebral fractures. Serum pentosidine levels were similar between those with and without vertebral fractures. There were no significant correlations between serum esRAGE levels and age, body mass index, duration of diabetes, and hemoglobin A1c. However, patients with moderate or severe vertebral fractures have a lower esRAGE level compared to those without after adjusting for age and gender (0.33 +/- 0.12 ng/mL vs. 0.24 +/- 0.03 ng/mL, P < 0.05). Logistic regression analysis demonstrated that patients in the lowest tertile of esRAGE had a higher risk of moderate or severe vertebral fractures (odds ratio, 16.6; 95% confidence interval, 1.4-198.5) than patients in the highest tertile. CONCLUSION: These results revealed that a low esRAGE level was independently associated with moderate or severe vertebral fractures in type 2 diabetic patients.

A Case of Dermatomyositis Associated with Non-Small Cell Carcinoma of The Lung / 대한류마티스학회지

Dermatomyositis is a disorder of unknown etiology characterized by an inflammatory myopathy involving striated skeletal muscle and associated characteristic skin lesions.The relationship between dermatomyositis and malignant tumor remains controversial,but we must be concerned about evaluation of suspected malignancy in a patient with dermatomyositis. We present a case of dermatomyositis associated with lung cancer.A 51-year-old male has suffered proximal muscle weakness and facial erythema for 2 months.Pathologic results showed adenocarcinoma and pneumonectomy of the left lung was performed.Myositis resolved completely after removing the malignant mass.Few cases of malignant tumors associated with dermatomyositis were reported in Korea,but dermatomyositis associated with non-small cell lung cancer and complete remission of myositis after the tumor resection has not been reported previously.

A Case of Spontaneous Regression of Spindle Cell Type Thymoma during Regular Hemodialysis / 대한신장학회잡지

A 34-year-old male who has recieved regular hemodialysis three times a week for 2years due to chronic renal failure was admitted due to chest pain. Chest x-ray and computed tomography showed large sized anterior mediastinal mass compressing heart and great vessels posteriorly. Open lung biopsy was performed and the result was spindle cell type thymoma. We recommanded surgical resection but he refused and discharged. After 8 months, we observed marked regression of the thymoma without any other treatment. We report a case of spontaneous regression of thymoma in patient with chronic renal failure during regular hemodialysis.

A Case of spinal epidural emphysema complicating in patient with bronchial asthma / 결핵

Spinal epidural emphysema is rare, and only a few cases have ever been reported. A 18 year-old man was admitted for neck and chest pain for 3 days. Before admission he experienced rhinorrhea and severe cough. Physical examination revealed wheezing on whole lung field and subcutaneous emphysema over the upper portion of the chest and neck. Chest radiograph showed pneumomediastinum ajdn subcutaneous emphysema in the neck and chest CT images demonstrate a free air in the prevertebral fascia. With coservative management, the patient's condition and the pneumomediastinum improved. The patient was discharged to home on the fourteenth day.

A Case of Behcet's Disease with Esophageal and Ileocecal Valve Ulcers / 대한소화기내시경학회지

Behcet's disease is a multisystemic, chronic inflammatory disease with a triad of symptoms including oral ulcers, genital ulcers, and inflammatory ocular lesions. While intestinal Behcet's disease commonly affects the ileocecal region, esophageal ulceration with odynophagia is very uncommon. A 38-year-old male patient was admitted due to odynophagia, a postprandial epigastric burning sensation, and right lower quadrant abdominal pain. He had a history of recurrent oral and genital ulcerations. An esophagogastroduodenoscopy revealed relatively well demarcated ulcerative lesions with mucosal nodularities on the mid to distal esophagus which was suspected to be esophageal cancer. But repeated biopsies showed lymphocytic and plasma cell infiltrations on the lamina propria. A colonoscopy revealed a well demarcated, deep ulcerative lesion with stenotic narrowing in the ileocecal valve. The diagnosis of intestinal Behcet's disease with an esophageal ulcer was made on the basis of clinical and pathological findings. The patient was treated with steroids and sulfasalazine and the response was favorable.

A case of primary pulmonary angiocentric lymphoma manifested as a mass / 결핵

The primary pulmonary lymphomas are uncommon, accounting for 0.5% of primary lung tumor and 0.4% of all malignant lymphomas. The majority of primary pulmonary lymphomas are of B-cell originating from bronchus associated lymphoid tissue(BALT). Angiocentric lymphoma is a rare type of primary pulmonary lymphomas characterized by polymorphic lymphoid infiltrates, which make it even more difficult to differentiate from benign infiltration. The radiographic findings are variable, depending on the stage of evolution of the disease. The prognosis of angiocentric lymphoma is poor, nearly two-thirds of the patients with grade 2 or 3 angiocentic lymphomas were died within a year of diagnosis. We report a case of primary pulmonary angiocentric lymphoma manifested as a mass of right lower lobe.

A Case of Primary Duodenal Carcinoid Tumor / 대한소화기내시경학회지

Carcinoid tumors are slow growing, rare neoplasms that arise from enterochromaffin cells, with malignant potential. Primary duodenal carcinoid tumors are rare, the reported incidence being 2.0 ~8.9% of all gastrointestinal carcinoid tumors. Unless the carcinoid syndrome has developed, the non-specificity of the symptoms and physical findings, makes the clinical diagnosis of these tumors difficult. However, with the introduction of large and deep endoscopic biopsies, it is possible to diagnose duodenal carcinoid tumors at an early stage. Usually, local resection is the therapy of choice because of the very slow growth of the lesion and the low incidence of metastasis. Radical surgery is mandatory only in lesions more than 2 cm in diameter, or in the presence of muscular invasion. A 69-year-old female visited our medical department, having had symptoms of upper ab-dominal pain and intermittent melena for 1 week. Endoscopic examination showed 2.5 2.5 cm sized elevated mass lesion with central ulceration in the anterior wall side of the duodenal bulb. Immunohistochemical stains of the biopsy specimen showed that the tumor cells are positive reactivity for NSE (neuron-specific-enolase), chromogranin A, and cyto-keratin.

A Study on Comparison of the Metabolites Related with Working Methods and Immunity of the Toluene diisocyanate-Exposed Workers / 대한산업의학회지

Following recent advanced industrialization. the amount of polyurethane to use as thermal insulating materials, upholstery mattresses and packing materials in automotive and furniture industry is increasing world-widely, and the number of polyurethane-producing worker will be increased. Because the numerous organic solvents are used in polyurethane-producing factory, the workers in this work site is exposed to many organic solvents. Of the organic solvents. Toluene Diisocyanate(TDI) has many hazardous effects to human. The effects of TDI on human are the irritation to respiratory mucosa and gastrointestinal symptoms. Conjunctival irritation, dermal inflammation (redness, pain, vesicular formation) and gastrointestinal symptom(nausea, vomiting, abdominal pain) are reported just after short-term exposure of TDI. TDI is known to give rise to bronchial asthma, as the immune disorder. And because of strongly volatile characteristics of TDI, it is suggested as a more injurious material to human health, especially human immune system, than other organic solvents. Bronchial asthma inducing mechanism of TDI is not clearly known, but on the analogy of TDI-induced symptoms and recent studies, early-onset asthma is type I hypersensitivity reaction mediated by immunoglobulin E(IgE), and late-onset asthma is maybe type III hypersensitivity reaction by circulating IgG. And we know that the complicated human immune function is likely to move in such that mechanisms, there are not studies on immune indices evaluating the bronchial asthma-related immune function. The evaluation of change patterns of humoral immunity including IgE and IgG and cellular immunity including T-helper cell, T-suppressor cell and T-cytotoxic cell will be helpful to evaluate exposure degrees and prognosis in TDI-exposed workers. Because TDA(toluene diamine) as a biological exposure index of TDI becomes the focus of interest, we know that a study on the correlation between urinary TDA and air TDI and immunological indices will make a contribution to biological effect monitoring indicies. We examined human immunity indicators such as WBC. %Lymph (percentile of Lymphocyte in WBC). %T-cell(percentile of T-lymphocyte in total lymphocyte). CD4, CD8, C3, C4, IgA, IgG, IgM, IgE in peripheral blood to evaluate the health hazard of the TDI-exposed workers. And we examined TDA to evaluate correlation between exposure and effect. Total 90 subjects was selected, 45 workers who worked in the polyurethane-producing factories as an exposed group, and 45 cases who were office workers(10 cases), other blue collors(27 cases), and medical college students(8 cases) as a control group. And the results were as follows ; 1. The logarithm of IgE -Log10(IgE)+/-SD- in peripheral blood of a exposed group was significantly higher than a control group, 2 22+/-.62 in case group compared with 1.98+/-.53 in control group.(p0.05). 3. WBC, %Lymph, %T-cell, C3, C4, CD4, CD8, CD4/CDB ratio and IgG in case group were 6,391.1 ea/ml, 37.53%, 59.54%, 76.68 mg/dl, 30.54 mg/dl, 0.76x10(9) ea/L, 0.63x10(9) ea/L, 1.39, and 1606.29 mg/dl, respectively, and 6,974.7 ea/ml, 35.12%, 59.64%, 71.95 mg/dl, 33.94 mg/dl, 0.80x109 ea/L, 0.61x10(9) ea/L, 1.39, and 1581.51 mg/dl in control group. There was no statistical sinificance between two groups. (p>0.05) 4. In the comparison of each other companies, average of individual urinary TDA in polyurethane paint manufacturing companies is higher than that of polyurethane sponge foaming companies. And, the concentration of 2,6-TDA which is a metabolite of well-vaporized 2,6-TDI is higher than that of 2,4-TDA in the polyurethane sponge foaming companies. But, the concentration of 2,4-TDA which is a metabolite of illvaporized but well skin-absorbed 2,4-TDI is higher in polyurethane paint manufactures. 5. There were no statistical significance in the correlations between individual urinary TDA and immunologic indices.

A Case of Hemoperitoneum due to Splanchnic Artery (Left gastric artery) Aneurysmal Rupture / 대한내과학회지

Splanchnic artery aneurysms, previously thought to be rare, are being diagnosed with incresed frequency because of development of noninvasive imaging techniques. The pathogenesis of visceral aneurysms is varied and may be secondary to arteriosclerosis (30%), trauma (25%), inflammation (11%), gestational alteration, surgery, infection, medial necrosis, collagen vascular disease, arteritis, and congenital anomalies. Clinical manifestation of visceral artery aneurysms is vague and not specific. The diagnosis and treatment for them are difficult. Preoperative arteriography may be helpful in emergency situation to detect the aneurysm and visualize multiple aneurysms. Surgical ligation, resection and/or reconstructive surgery are first choice of treatment for them. Otherwise, transarterial embolization has also been reported for them recently. We report a case of hemoperitoneum due to left gastric artery aneurysmal rupture and a rare complication of splanchnic artery aneurysm "Double rupture". The patient was treated successfully with simple ligation of the ruptured vessel.

Multiple Primary Carcinoma Associated with Gynecologic Malignancies / 대한부인종양콜포스코피학회잡지

Sixteen multiple primary carcmomas were found in 674 patients with gynecologic malignancies who were treated in our departiment from 1980 to 1992. Cases with possible metastasis or recurrence were not included in this study, The incidence of rnultiple primary carcinomas in gynecologic rnalignancies was 2.1%, Multiple primary carcinomas were encountered in 2.4% of 674 cervical cancers, 1.4% of 73 ovarian cancers respectively. The most frequent sites of uther cancers were seen in the stomach(5/16) and lung(3/l6).

A case of 46, XY pure gonadal dysgenesis / 대한산부인과학회잡지

No abstract available.

Clinical application of laparoscopy in gynecology / 대한산부인과학회잡지

No abstract available.

Selectivity Index of Proteinuria in Childhood Minimal Change Nephrotic Syndrome

No abstract available.