Postprandial Hypertriglyceridemia Following a Single High-Fat Meal in Patients with Coronary Artery Disease and Normal Subjects: The Significance of the Postprandial Hypertriglyceridemia and the Effects of Fibrate on the Postprandial Hypertriglyceridemia

BACKGROUND AND OBJECTIVES: It has been recently reported that coronary artery disease (CAD) is more correlated with postprandial triglyceride (TG) levels than fasting TG levels. We performed this study to compare the patients with CAD to age- and sex-matched controls in regard to postprandial TG levels and to know the effects of fenofibrate on postprandial TG levels. MATERIALS AND METHOD: Serum TG, total cholesterol (C), HDL-C and LDL-C were measured before, and 2, 4, 6, 8, and 24 hours after a high-fat meal in 22 patients (mean: 60 yr) with CAD and 12 normal subjects (mean: 54 yr). The same parameters were also serially measured after the high-fat meal plus fibrate in 10 patients with CAD (mean: 59 yr). RESULTS: he patients group without fibrate showed that more prolonged and exaggerated hypertriglyceridemia following the meal than normal subjects, especially 4 to 8 hours after the meal and that lower HDL-C throughout the test duration. These changes were also persisted when hyperlipidemic patients were excluded out of the patients group. The patients with fibrate did not show such a significant elevation of TG levels 4 to 8hours after the meal compared when normal subjects. The time to reach the peak TG levels after the meal was 4, 6, and 4 hours after the meal in normal subjects, patients with CAD, and fibrate group, respectively. CONCLUSION: Coronary artery disease is clearly related with postprandial hypertriglyceridemia than fasting TG levels and postprandial hypertriglyceridemia can be somewhat prevented by fibrate.

Secondary T Wave Changes in Patients with Wolff-Parkinson-White(WPW) Syndrome

OBJECTIVES: The purpose of this study is to evaluate the incidence of secondary T wave changes in WPW syndrome and the relation between the incidence of the secondary T wave changes and sex, age (duration of preexcitation), mean and maximal QRS duration (from the onset of delta wave to the end of S wave) of standard 12 lead electrocardiogram (ECG) and the site of accessory pathway (AP). The secondary purpose of this study is to evaluate the relation between the site of secondary T wave changes and the location of the AP. METHODS: Of the total 128 patients (pts) with WPW syndrome, standard 12 lead ECGs of 125 pts (mean age 35, male 71 pts) who were free from bundle branch block (n=2) and myocardial ischemia (n=1) were analyzed. The locations of Aps were divided into 4 categories (anterior, left lateral, posterior and right lateral) by intracardiac mapping. RESULTS: 82 (66%) pts of 125 pts showed secondary T wave changes. The incidence of secondary T wave changes was not related to sex or duration of preexcitation, but mean QRS duration (<0.12: 46%, 0.12: 88%, p<0.001), maximal QRS duration (<0.12: 32%, 0.12: 73%, p<0.001) and the site of AP (right: 80%, left: 54%, p=0.003). The most frequent lead showing secondary T wave changes in ECG was lateral (lead I, aVL) in pts with anterior (43%, 9 out of 21), posterior (50%, 25 out of 50) and right lateral (86%, 6 out of 7) AP. But, no secondary T wave change was found in most pts with left lateral (n=47) AP. CONCLUSION: The incidence of the secondary T wave changes in pts with WPW syndrome is high (66%). These changes are not related to sex and duration of preexcitation, but to the mean and maximal QRS duration during preexcitation and the location of the AP. The ECG lead showing secondary T wave changes in pts with WPW syndrome appears to be related to the location of the AP and the most frequent lead is I and aVL.

Long-term Follow-Up Results of the Patients with Clinically Inapparent Pericardial Effusion

BACKGROUND: Pericardiocentesis is not routinely recommended in most patients with pericardial effusion (PE), except for patients with cardiac tamponade. However, the long-term follow-up results in patients with clinically not significant PE are few. METHODS: Sixty-five consecutive patients (mean age:57 yrs, 26 males) out of 87 patients with PE, who were clinically not serious, were studied prospectively once in every two month for mean 6 months (2-12 months) without any specific treatment. The amount of PE was measured at the enddiastole period of parasternal long axis view and apical four chamber view. RESULTS: The incidence of insignificant PE in our echocardiographic laboratory is 3.4% (n=87 from 2461). The maximal accumulation site of PE was posterior (n=51, 79%). The next is anterior (n=11, 17%) and right ventricular side (3, 5%). The amount of PE is less (0.37+/-0.17cm vs 0.64+/-0.54cm, p=0.018) in localized PE (n=24, 37%) than that of diffuse form (n=41, 63%), which spreads to more than 2 chambers. The presumptive etiologies of PE were unknown (n=41), heart failure (n=5), myocardial infarction (n=6), viral (n=3), and others (n=10). The amount of PE was decreased from 0.54+/-0.46 cm to 0.30+/-0.26 cm, 0.23+/-0.24 cm, and 0.21+/-0.23 cm 2, 4, and 6 months after intial evaluation, respectively, without any complication. CONCLUSION: The patients with PE, not combining >KERN=

The Short-and Long-Term Effects of Gingko Biloba Extracts on the Endothelial Function in Patients with Coronary Artery Disease

BACKGROUND: The gingko biloba extracts (GBE) are known to inducing vasodilation by increasing NO or PGI2. However, the effects on the endothelial function and clinical symptoms of patients with coronary artery disease (CAD) are not clear. METHODS: The flow-mediated endothelium-dependent brachial artery vasodilation using high-resolution ultrasound was measured before and 2 hours after intake of GBE (120 mg single PO) and 1 month after regular intake of GBE (80 mg bid PO) in 33 patients (mean: 60 yrs, 26 males) with CAD who had been diagnosed by coronary angiogram and managed with medication for more than 1 month. RESULTS: The only one patient could not continue to take GBE due to severe nausea. The frequency or severity of chest pain was decreased in 31 patients among the other 32 patients. The flow-mediated brachial artery vasodilation (mean+/-SD) were significantly (p<0.001) improved from 8.9+/-3.9% before to 13.4+/-4.5% and 13.7+/-4.0% 2 hours and 1 month after taking GBE, respectively. The brachial artery diameter was increased from 4.42+/-0.67 mm before to 4.45+/-0.66 mm and 4.64+/-0.60 (p<0.005) after taking GBE, respectively. The endothelial function in patients with diabetes mellitus (5 from 33) was not improved 2 hours after taking GBE, but improved 1 month after GBE. The improvement of endothelial dysfunction in patients with hyperlipidemia or hypertension was less than patients without it. CONCLUSION: GBE has favorable short- and long-term effects on the endothelial function and clinical symptoms as well as long-term vasodilatation in patients with CAD without serious side effects.

A case of Castleman's disease with paraproteinemia / 대한혈액학회지

No abstract available.

A Study on the Serum Lipid Level In Hypertensive Patients

The plasma cholesterol, TG,LDG,HDL of 101 Korean hypertensive patients were measured to compare with plasma cholesterol, TG,LDL,HDL level of healthy people(control group). The plasma cholesterol level in hypertensive patients was 189.6+/-39.5mg% and was 188.7+/-33.7mg% in healthy people(P>0.5). The plasma TG level in hypertensive patients was 200.5+/-154.2mg% and was 116.1+/-32.4mg% in healthy people(P0.05). The plasma LDL level in hypertensive patients was 119.0+/-68.6mg% and was 98.1+/-53.4mg% in healthy people(P>0.05). The serum level of the total cholesterol, HDL and LDL cholesterol in the hypertensive patients group were not significantly different from the control group, but the serum level of the TG was significantly increased in the patients group. We thought that this difference of plasma TG level is due to exogenous TG in hypertensive patient group but further evalution in properties of TG is required.

Clinical Experiences about Effect of IV Disopyramide Phosphate Injection on PVC

The present study was undertaken to evaluate the effect on PVC with IV disopyramide injection in 23 patients with PVC. There were 6 male and 17 female patients with age from 16 to 71 years. Three patients of hypertension, two patients of atherosclerotic heart disease, one patient of myocardial infarction, one patient of mitral stenosis, one patient of cardiomyopathy, one patient of uremic heart, fourteen patients of fuctional PVC were studied. The dose of 100mg of disopyramide was given with IV injection repeatedly until PVC disappeared.(Total: 40 Times) EKG monitering was performed in all cases to reveal the following results while the patients were on the regimen. 1. PVC disappearance rate in 23 patients was 78.2%. Average disappearance time and average dose is 7 minutes, 70.5mg respectively. 2. EKG revealed no change in P-R interval and pulse rate but slight prolongation of QRS and QTc interval. 3. When repeated injection was performed, the effect against PVC was decreased. 4. Acute heart failure as complication of disopyramide was not developed in all patients. As a result of present study, we recommended IV disopyramide injection, when disappearance of PVC was required immediately and safely.