Left Atrial Appendages Occlusion: Current Status and Prospective

Stroke continues to be a major cause of morbidity and mortality in atrial fibrillation (AF) patients. Oral anticoagulation (OAC) provides protection against stroke and peripheral embolization in AF but significant proportion of patients could not be started on anticoagulation because of bleeding complications. Left atrial appendage harbors clot in about 90% of nonvalvular AF. The advent of left atrial appendage occlusion (LAAO) techniques has provided these patients with alternative to OAC for stroke prophylaxis. Multiple LAAO devices are currently available with Watchman and Amulet being the most commonly used in clinical practice. Randomized studies are available for Watchman device only. Data on Amplatzer Cardiac Plug, Amulet and Lariat devices are limited by the paucity of randomized data. Long-term data on different LAAO techniques are showing promising results. Device related thrombosis continues to be a serious complication associated with LAAO. Future studies should look into comparative effectiveness between different LAAO techniques, optimal patient selection, risk of complications, and anticoagulant treatment after LAAO. This article aims to provide current available evidence on efficacy and safety of different LAAO devices and future prospective.

A case of baboon synrome due to mercury smoke of an amulet / 대한피부과학회지

Baboon syndrome is used to denote a systemic allergic contact dermititis with a characteristic color and distribution pattern. It is also referred to as mercury exanthem, because inhalation of mercury vapor usually causes the skiri lesion in a sensitized person. Diffuse pi,ikish erythema of the buttock, upper inner thigh, and axilla are characteristic features. We report a case of baboon syndrome developed after exposure to the smoke of a burning amulete a charm written on a piece of paper in a 12 year-old female. Mercury sensitivity was confirrned by a patch test. Atomic absorption by a spectrographic method and Scanning electron microscopy/energy dispersive for analysis X-ray detected mercury in the urine and the ed scraped pigments from the amulet, respectively.