Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina and Its Prognostic Implications in 3,094 Consecutive Patients

BACKGROUND AND OBJECTIVES: Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population. METHODS: We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed. RESULTS: The overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p 220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs. CONCLUSIONS: ErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.

Ergonovine Stress Echocardiography for the Diagnosis of Vasospastic Angina and Its Prognostic Implications in 3,094 Consecutive Patients

BACKGROUND AND OBJECTIVES@#Ergonovine stress echocardiography (ErgECHO) has been proposed as a noninvasive tool for the diagnosis of coronary vasospasm. However, concern over the safety of ErgECHO remains. This study was undertaken to investigate the safety and prognostic value of ErgECHO in a large population.@*METHODS@#We studied 3,094 consecutive patients from a single-center registry who underwent ErgECHO from November 2002 to June 2009. Medical records, echocardiographic data, and laboratory findings obtained from follow-up periods were analyzed.@*RESULTS@#The overall positive rate of ErgECHO was 8.6%. No procedure-related mortality or myocardial infarction (MI) occurred. Nineteen patients (0.6%) had transient symptomatic complications during ErgECHO including one who was successfully resuscitated. Cumulative major adverse cardiac events (MACEs) occurred in 14.0% and 5.1% of the patients with positive and negative ErgECHO results, respectively (p 220 mg/dL, and positive ErgECHO result itself were independent factors associated with MACEs.@*CONCLUSIONS@#ErgECHO can be performed safely by experienced physicians and its positive result may be an independent risk factor for long-term adverse outcomes. It may also be an alternative tool to invasive ergonovine-provoked coronary angiography for the diagnosis of vasospastic angina.

Removal of Anorectal Cancer by Endoscopic Submucosal Dissection / 대한내과학회지

Anorectal cancer is traditionally treated via abdominoperineal resection and/or chemoradiation. Currently, endoscopic submucosal dissection (ESD) is widely used to treat early gastrointestinal epithelial neoplasias. However, the use of ESD to treat lesions of the anal canal raises concerns that do not arise when treating lesions of the stomach and colorectum. Therefore, particular care is needed when treating lesions in the anal area. We recently treated a 75-year-old woman who was scheduled for surgical resection to treat anorectal cancer. The lesion was successfully removed using ESD. This is the first report of the use of ESD to treat anorectal cancer in Korea. Here, we present our case report and review the relevant literature.

Spontaneous Rupture of Pancreatic Mucinous Cystadenocarcinoma: A Case Report and Review of Literature / 대한췌담도학회지

The pancreatic cystic lesions are known to be incidentally found up to 10-15% of patients undergoing cross-sectional imaging. And the prevalence of mucinous cystic neoplasm which has malignant potential is known to be up to 25% of all pancreatic cystic neoplasm in South Korea. The symptoms included abdominal pain, palpable mass, weight loss, loss of appetite, jaundice, asymptomatic and etc. However, spontaneous rupture of pancreatic mucinous cystadenocarcinoma (MCAC) is an extremely rare complication. Here we report a case of spontaneous rupture of pancreatic MCAC in a 72-year-old male with review of the literature. To the best of our knowledge, this is the first ruptured case of pancreatic MCAC in male patient.

Association between Change in Body Weight and Insulin Resistance in Individuals at Increased Risk of Diabetes / 대한내과학회지

BACKGROUND/AIMS: The present study aimed to investigate the associations between a change in body weight from 20 years of age to the present with insulin resistance and several parameters of metabolic syndrome in individuals at an increased risk of diabetes. METHODS: From patients with a diagnosis related to an increased risk of diabetes who were examined at our endocrinology clinic from January 2012 to December 2014, the present study recruited 125 individuals between 30 and 64 years of age with hemoglobin A1c levels from 5.7 to 6.4%. The change in body weight of each patient from 20 years of age to the present was retrospectively determined, and the associations of this change with insulin resistance and several parameters of metabolic syndrome were analyzed. RESULTS: The average gain in body weight after 20 years of age was 11.3 kg and there was no significance difference between the male and female patients. The proportion of overweight and obese patients at 20 years of age was 14%, but was 74% at the time of the visits to our endocrinology clinic. A change in body weight was significantly correlated with body mass index, insulin resistance, and waist circumference. Additionally, as the tertile of change in body weight increased, fasting insulin levels, insulin resistance, and the prevalence of abdominal obesity significantly increased. CONCLUSIONS: In the present study, an increase in body weight from 20 years of age to the present was correlated with insulin resistance and several parameters of metabolic syndrome in individuals at an increased risk of diabetes.