ABSTRACT
BACKGROUND AND OBJECTIVES: Although recent lipid-lowering therapies are effective in reducing low density lipoprotein-cholesterol (LDL-C) levels, many patients treated with lipid-lowering agents do not achieve target LDL-C levels, especially in very high risk patients. The aim of this study is to compare the effect of ezetimibe/simvastatin 10/20 mg and atorvastatin 20 mg on achieving a target LDL-C goal in very high risk patients. SUBJECTS AND METHODS: A total of 74 patients with very high risk were enrolled in the study. Very high risk patients were defined as patients that displayed established cardiovascular disease with multiple major risk factors, poorly controlled risk factors, multiple risk factors of the metabolic syndrome and acute coronary syndromes. Patients were randomized into two groups: ezetimibe/simvastatin 10/20 mg (n=36) and atorvastatin 20 mg (n=38). Follow-up lipid profile was obtained 6 weeks later. A target goal of LDL-C was defined as less than 70 mg/dL at follow-up. RESULTS: Baseline clinical and laboratory data were similar between the two groups. Achieving a target LDL-C goal was observed in 41.7% of Group 1 and 44.7% of Group 2 at 6 weeks (p=0.82). Changes in other lipid profiles were not significantly different but the tolerability of the two groups was similar. CONCLUSION: Ezetimibe/simvastatin 10/20 mg and atorvastatin 20 mg showed similar effects in achieving target LDL-C levels in patients with very high risk.
Subject(s)
Humans , Acute Coronary Syndrome , Azetidines , Cardiovascular Diseases , Follow-Up Studies , Heptanoic Acids , Pyrroles , Risk Factors , Simvastatin , Atorvastatin , EzetimibeABSTRACT
An intramural hematoma is an accumulation of blood between the internal and external elastic membranes within the medial space, whereas an extramural hematoma is a dilution and/or dissemination of blood throughout the adventitia. Intra- and extra-hematomas are observed by intravascular ultrasound during percutaneous coronary intervention (PCI). The patient described herein presented with angina pectoris. Her coronary angiogram showed diffuse narrowing of the mid-left anterior descending artery and total occlusion of the distal right coronary artery (RCA). Intra- and extra-mural hematomas developed during PCI of the RCA; however, the lesions were covered successfully using long drug-eluting stents.
Subject(s)
Humans , Adventitia , Angina Pectoris , Arteries , Coronary Vessels , Drug-Eluting Stents , Hematoma , Membranes , Percutaneous Coronary Intervention , Ultrasonography, InterventionalABSTRACT
The purpose of the present study was to evaluate cardiovascular regulation during passive standing (PS) after ethanol ingestion by spectral analysis of heart rate variability (HRV) in flushed and nonflushed subjects. Of 24 young male subjects, 8 belonged to flushed group (F) and 16 to nonflushed group (NF). Two sessions of 10-min PS were performed before and after ethanol (0.5 g/kg) ingestion. Powers of R-R interval variability in very low frequency (VLF, 0~0.05 Hz), low frequency (LF, 0.05~0.15 Hz) and high frequency (HF, 0.15~0.50 Hz) bands, normalized powers (LFn and HFn) and LF/HF ratio were obtained. After ethanol ingestion, F showed higher heart rate than NF. PS increased LFn (+ 22.9+/-3.6 in NF, + 12.8+/-4.7 in F, in normalized units) and LF/HF (+ 3.10+/-0.57 in NF, + 3.00+/-1.08 in F) and decreased HFn powers. Ethanol ingestion increased LFn and LF/HF and decreased HFn. PS after ethanol resulted in higher LFn and LF/HF and lower HFn than the prior PS. F showed a greater and more sustained HRV change than NF after ethanol. In conclusion, PS or ethanol ingestion increased LFn and LF/HF and decreased HFn. Flushed subjects showed an accentuated HRV response to ethanol.
Subject(s)
Humans , Male , Arterial Pressure , Dizziness , Eating , Ethanol , Flushing , Heart Rate , HeartABSTRACT
BACKGROUND: Although maximal exercise stress tests are widely used in the athletic and medical fields, studies on professional soccer players are few. The purpose of our study is to observe the cardiopulmonary response to maximal exercise loading and the AT in professional soccer players. METHODS: Maximal exercise stress tests were carried out by a ramp protocol using a treadmill on 20 professional soccer players with a mean age of 25.2 years and with over 10 career years. The tests were also done on 21 college students majoring in physical education with a mean age of 19.4 years, which served as the control group. The AT was determined by the V-slope method. RESULTS: In the players, the VO2 max, VCO2 max and O2 pulse max were significantly larger than those in the control group, and the HR max was smaller for their ages. The VE max, VT max and RP max showed not much difference between the 2 groups but the VE max/VO2 max and VE max/VCO2 max were significantly lower in the players. The AT was larger in the players but the AT/VO2 max was essentially similar to that of the control group. CONCLUSION: Our study reveals that the professonal soccer players, despite their mean ages were approximately 6 years older than the subjects in the control group, had larger VO2 max and VCO2 max, and smaller HR max for their ages. The VE max was similar in both groups. This suggests that the players have higher aerobic capacity than the control group and exchange respiratiory gases more efficiently.
Subject(s)
Child , Humans , Architectural Accessibility , Exercise Test , Gases , Physical Education and Training , Soccer , SportsABSTRACT
BACKGROUND: Hemoptysis always merits thorough investigation because even minimal bleeding may be an early indicator of the presence of significant bronchopulmonary disease. But in patients with hemoptysis & a normal chest roentgenogram, there are no clear guidelines for a diagnostic approach, including the indications of bronchoscopy. METHODS: Eighty patients with hemoptysis and a normal chest roentgenogram were involved in this study. We evaluated the cause of hemoptysis in these patients by bronchoscopy and/or bron- chogram or high-resolution CT of the lung and we analyzed the relationship of clinical features, such as age, sex, smoking and properties of hemoptysis, to the cause of hemoptysis. RESULTS: 1) They were 34 men and 46 women, with the mean age of 46.7 and 41.8 years old, respectively. 2) Initial bronchoscopy provided a diagnosis in 8 patients - bronchogenic carcinoma in 3 patients (3.8%), metastatic cancer in 1 patient(1.3%) and endobronchial tuberculosis in 4 patients(5.0%). 3) Two clinical findings of patients over 50 years and/or with more than 30 pack-year smoking history were associated with bronchogenic carcinoma, and among these two factors, a more than 30 pack-year smoking history was the best predictor for diagnosis of bronchogenic cancer. 4) The 72 patients in whom no specific cause of hemoptysis was identified by initial bronchoscopy underwent bronchogram and/or high resolutional CT of the lung. Then, 6 patients were diagnosed as bronchiectasis and 5 patients rebleeded in the follow up period of 9 to 90 weeks. Of the remaining 66 patients, 33 were followed for 7 to 80 weeks. Among these patients, only 5 patients had recurrent episodes of hemoptysis &A they were diagnosed as bronchiectasis in 1 patient, tuberculosis in 2 patients and catamenial hemoptysis in 2 patients. CONCLUSION: We conclude that patients with hemoptysis and a normal chest roentgenogram who are more than 50 years old or have more than 30 pack-year smoking history should undergo bronchoscopy to exclude possible bronchogenic carcinoma. In patients without these clinical features, a conservative approach with observation appears justified. If hemoptysis recurs to these patients, bronchogram or high-resolutional CT of the lung with sputum examination are necessary.
Subject(s)
Female , Humans , Male , Bronchiectasis , Bronchoscopy , Carcinoma, Bronchogenic , Diagnosis , Follow-Up Studies , Hemoptysis , Hemorrhage , Lung , Smoke , Smoking , Sputum , Thorax , TuberculosisABSTRACT
Carcinoid-type tumorlets of the lung are nodular microscopic proliferation of round and spindle-shaped small cells which originated from bronchial or bronchiolar Kulchitsky-type neuroendocrine cells, which are usually encountered as an incidental finding during microscopic examination of the lungs at autopsy or surgically removed for bronchiectasis or other reasons. We report one case of carcinoid-type tumorlets in the lung which was surgically removed from a patient who had bronchiectasis, and the cells of tumorlets showed immunohistochemical reactivities for markers of epithelial and neuroendocrine differentiation.