An Anomalous Right Coronary Artery Originating From the Distal Left Circumflex Artery: A Case Report / 대한내과학회지

Single coronary artery (SCA) is a rare congenital anomaly and commonly associated with other congenital cardiac malformations. Some subgroups of SCA can lead to angina pectoris, acute myocardial infarction, or even sudden cardiac death in the absence of atherosclerosis. An anomalous origin of the right coronary artery, arising from the distal portion of the left circumflex artery, has previously been reported in a few cases. In this article, we report a case of a right coronary artery arising from the distal portion of the left circumflex artery with no other cardiac congenital anomaly.

A Case of Anorexia Nervosa Complicated With Strongly Suspected Stress-Induced Cardiomyopathy and Mural Thrombus

Stress-induced cardiomyopathy is a unique reversible cardiovascular disease precipitated by acute emotional or physical stress. It is associated with a high prevalence of chronic anxiety disorder that precedes the onset of cardiomyopathy, as well as comorbid cardiovascular risk factors that are similar to the ST segment elevation of myocardial infarction. A thirty-five-year-old woman suffering from anorexia nervosa visited our hospital complaining of severe general weakness. She was diagnosed with stress-induced cardiomyopathy and mural thrombus using a transthoracic echocardiogram. Therefore, she was given anticoagulation therapy and nutrition with immediate psychiatric interventions. After two weeks of treatment, the follow-up echocardiogram indicated a significant improvement of the left ventricular dysfunction and mural thrombus.

A Case of Ankylosing Spondylitis Accompanied by Chronic Myelogenous Leukemia / 대한류마티스학회지

Ankylosing spondylitis (AS) is occasionally accompanied by hematological malignancies such as myelodysplastic syndrome, acute myelogenous leukemia, or multiple myeloma. Chronic myelogenous leukemia (CML) is a myeloproliferative disorder associated with Philadelphia chromosome and is usually treated with imatinib, which inhibits tyrosine kinases. Although there have been reports of CML cases accompanied by several rheumatic diseases such as rheumatoid arthritis, Behcet's disease, systemic sclerosis, or undifferentiated spondylopathy, no studies have reported a case of CML with AS. We experienced a 50-year-old male patient who presented with buttock and low back pain and was diagnosed with both AS and CML. Magnetic resonance imaging showed sacroiliitis along with abnormal marrow infiltration, and a bone marrow biopsy confirmed the CML diagnosis. He was treated with imatinib, which was effective for the CML but not for the AS. This is the first case report of AS accompanied by CML.

Neurolymphomatosis in a patient with T-cell non-Hodgkin's lymphoma / 대한내과학회지

Neurolymphomatosis, defined as a selective infiltration of lymphoma cells into cranial nerves, peripheral nerves and nerve roots, is a rarely recognized manifestation of lymphoma. Its characteristic symptoms are often overlooked or mistaken for other conditions, such as a peripheral polyneuropathy, due to chemotherapeutic agents or clinical findings of metastatic lesions in the central nervous system. Recently, neurolymphomatosis has been increasingly recognized using magnetic resonance imaging and positron emission tomography-computed tomography. We present a case of neurolymphomatosis manifesting as peripheral mononeuropathy in a patient with T-cell non-Hodgkin's lymphoma.

Arrhythmogenic Gene Change and Nerve Sprouting after Acute Myocardial Infarction in Mice

BACKGROUND AND OBJECTIVES: Myocardial infarction (MI) elicits nerve sprouting. However, the time course and spatial distribution of this nerve sprouting and its relationship to the expression of neurotrophic factors is unclear. The aim of this study was to identify the association of nerve sprouting with the expression of neurotrophic factors. MATERIALS AND METHODS: We induced MI in FVB mice by ligating the left coronary artery. The hearts were removed at 3 hours to 13 months after MI for growth associated protein 43 (GAP-43) immunostaining. The nerve density (micrometer2/mm2) was determined by ImagePro software. In another group of mice, their myocardial tissues were processed and analyzed with using an Affymetrix RG U74V2 array. RESULTS: The density of the nerve fibers that were immunopositive for GAP-43 was the highest 3 hours after MI in both the peri-infarct areas and the remote areas. The outer loop of the ventricle had a higher nerve density than that in the inner loop of the ventricle. The differences were at a peak 3 hours after MI, but they persisted for 2 months afterwards. The expressions of nerve growth factor, insulin-like growth factor, leukemia inhibitory factor, transforming growth factor-beta3 and interleukin-1alpha were increased for up to 2 months after MI as compared to the normal control. qRT PCR analyses showed increased mRNA for tyrosine hydroxylase, synaptophysin, nerve growth factor and leukemia inhibiting factor in the peri-infarct areas for up to 2 months after MI, but this occurred only for roughly 3 days after MI in the remote areas. CONCLUSION: We conclude that MI resulted in immediate upregulation of nerve growth factor, insulin-like growth factor, leukemia inhibitory factor, transforming growth factor-beta3 and interleukin-1alpha in the peri-infarct areas and this all occurred to a lesser extent in the remote areas. These changes persisted for at least 2 months, and they were associated with increased nerve sprouting activity, which was most active in the outer loop of the heart.