A Case of Nephrotic Syndrome Complicated by the Thrombosis of Common Iliac Artery and Coronary Artery of Heart / 대한신장학회잡지

Thrombosis is one of the important complications of nephrotic syndrome. Still, the mechanism of thrombosis of nephrotic syndrome is under debate, but the presence of hypercoagulable state in nephrotic syndrome is regarded as the principal contributing factor to that. Venous thrombosis in nephrotic syndrome has been increasingly reported, but arterial thrombosis is relatively rare and has been reported mainly in nephrotic children. Authors experienced a 35-year old male patient with frequently relapsing nephrotic syndrome of focal segmental glomerulosclerosis, who complained sudden onset of claudication, cold sensation, numbness and cyanosis of right lower extremity. A diagnosis of thrombosis in right common iliac artery and thromboses in septal and distal branch of left anterior descending coronary artery was made by arterial angiography. The patient fully recovered after emergent thrombectomy and anticoagulation therapy.

Incidence of Lipoprotein Lipase Gene Polymorphism and Correlation with Severity of Coronary Artery Disease in Korean

BACKGROUND: Lipoprotein lipase(LPL) is a key enzyme in the metabolism of serum triglyceride(TG) which is utilized in the peripheral tissue as free fatty acid and stored in adipose tissue. LPL gene consists of 10 exons which encode 475 amino acids and more than 9 LPL gene polymorphisms have been reported. LPL gene polymorphism is related to lipids level and the severity of atherosclerosis in coronary artery disease. In Korea, LPL polymorphism has not been reported yet. The purpose of this study is to konw the incidences of LPL gene polymorphism and it's relationship with blood lipids level and the severity of atherosclerosis. METHODS: Subjects were divided into three groups; normal controls(n=50), coronary artery disease(CAD, n=51) and cerebrovascular disease(CVD, n=52). The PCR- amplified genomic DNA from peripheral white blood cell was analyzed with restriction fragment length polymorphism(RFLP) by two different restriction enzymes(Pvu II, Hind III). RESULTS: Total cholesterol(TC) was higher in CVD than in controls and CAD (203+/-60mg/dl vs 188+/-37, 167+/-42, p<0.01). Triglyceride(TG) was also elevated in CAD(166+/-65mg/dl vs 122+/-62 in controls, p<0.05). HDL cholesterol(HDL-C) was higher in controls than in CVD and CAD(49+/-9mg/dl vs 36+/-10, 44+/-9, p<0.05). The incidence of Hind III RFLP and Pvu II RFLP was not different among groups. There was no correlation between LPL gene RFLP and lipid profile. There was no correlation between LPL gene RFLP and severity of coronary arterial stenosis. The incidence of Hind III RFLP (-/-) homozygotes was lower in Korean than in other country(5% vs 7-10%). The incidence of Pvu II RFLP (-/-) homozygotes was lower in Korean than in other country(10.3% vs 18-29%). CONCLUSIONS: The LPL gene mutations in intron 6 and 8 have no direct effects on the lipid profiles and the severity of coronary artery disease. Although LPL is a key enzyme in TG metabolism, two mutations in this study could not change the activity of LPL, nor were a marker linked to other site of mutation(s). The mutation(s) in exon which encode amino acid for enzyme activity should be detected to dissect the pathphysiologic mechanism in the atherogenesis.

Positivity of Chlamydia Pneumoniae Antibody and It's Significance in Atherosclerosis

BACKGROUND: The relationship between infection of microorganism and atherosclerosis has been studied because the pathophysiology after infection is similar to those of cell injury and/or lipid theory. Although there are many reports which described the relationships between the infection of chalamydia pneumoniae and the atherosclerosis. In Korea, even the prevalence of chlamydia infection has not been studied yet. This study was purposed on the prevalence of chlamydia infection and it's correlation to atherosclerosis. METHODS: 235 subjects were enrolled and age and sex adjusted subjects were divided into two groups, normal controls (n=43), atherosclerosis (AS, n=90) group:coronary artery disease (CAD, n=61) and cerebrovascular disease (CVD, n=29). Serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C) were measured, LDL-cholesterol (LDL-C) was calculated. Serum IgG chlamydia antibody were measured by ELISA method. RESULTS: TG was significantly higher in AS (162.51+/-100.04 mg/dL vs 122.91+/-63.31 mg/dL, mean+/-SD, p=0.019), and HDL-C was significantly higher in controls (47.30+/-9.88 mg/dL vs 39.38+/-8.29 mg/dL, p0.01). Levels of LDL-C and TC were not statistical significant. Serum IgG chlamydia antibody was positive in 29.8% (70/235), 30% (27/90) in AS group and 28% in controls and there was no statistical significance between groups (p=0.804). CONCLUSION: In conclusion, there was no significant differences in positivity of IgG chlamydia antibody in AS compared with that of controls. Overall positivity of chlamydia antibody was lower in Korea than in other country. It is still controversial whether Chlamydia pneumoniae is a primary etiologic agent of atherosclerosis or not. This study could not demonstrate the relationship between chlamydia infection and atherosclerosis in Korea. The effectiveness and indications of antichlamydial antibiotics for prevention of cardiovascular complications in atherosclerosis and overall chlamydia infection in general population will be needed in large scale trials.

Repeated Ventricular Fibrillation during Emergence of General Anesthesia Caused by Variant Angina: A case report / 대한마취과학회지

Variant angina is characterized by recurrent attacks of chest pain occurring at rest and associated with ST segment elevation on EKG and its cause is now established to be spasm of a major coronary artery. In patient with variant angina coronary artery spasm can be provoked by a number of physiologic maneuver, hyperventilation and pharmacologic agents such as ergonovine, histamine, epinephrine, methacholine, and dopamine. This may be associated with acute myocardial infarction and severe cardiac arrhythmia including ventricular tachycardia and fibrillation as well as sudden death. We present a case of repeated ventricular fibrillation that occured in a 60 years old male patient at the emergence from anesthesia. The cause of venticullar fibrillation was strongly suspected of variant angina on the basis of EKG findings. The patient was successfully resucitated by intensive treatment and nitroglycerine infusion. The patient recovered uneventfully and diagnosed variant angina by ergonovine test performed after recovery.

A Case of Supraaortic Ridge and Subaortic Membrane Manifestated as Aortic Regurgitation

Supraaortic stenosis is a localized or diffuse congenital narrowing of the ascending aorta at the levels of superior margin of the sinus of Valsalva, just above coronary arteries. Hemodynamically, it is a usually manifestated as aortic stenosis especially when it combined with subaortic membrane. And there is no case report of supraaortic stenosis combined with subaortic membrane which has aortic valvular reurgitation due to secondary change of dilated sinus of Valsalva by supraaortic ridge. We have experienced a case of aortic regurgitation associated with supraaortic ridge combined with subvalvular aortic membrane.

Acute Myocardial Infarction in Patient with Spontaneous Coronary

Spontaneous coronary artery dissection is a rere incident occurring usually in young patients, predominautly in females. It is usually fatal and found postmortem. It is also a rare cause of acute myocardial infarction. We present the case of a twenty nine-year-old-man with spontaneous right coronary artery dissection found angiographically which caused an inferior wall myocardial infarction. He was treated with medical therapy only amd after uneventful hospital course, he was discharged with medication. Three months later, coronary angiography was done to follow up the lesion and found that the site was completely healed.

Effects of cytokine combinations on lymphokine-activated killer(LAK) cell generation / 대한암학회지

No abstract available.