A Case of Anomalous Left Coronary Artery Originating from the Right Sinus of the Valsalva Presenting with Syncope / 대한내과학회지

Congenital anomalies of the coronary artery are associated with various symptoms including syncope, myocardial ischemia, and sudden cardiac death. The abnormality depends on the adjacent structure and pathway of the coronary artery. Most patients with an anomalous left coronary artery that arises from a right coronary sinus of the valsalva have no symptoms and are usually diagnosed at autopsy. Therefore, their first symptom might present as sudden death, particularly when the left coronary arterial course is between the aorta and the pulmonary trunk. Symptomatic patients could be diagnosed early with an anomalous coronary artery, and the risk of fatal events could be decreased by surgical correction. Here, we report the case of 62-year-old male who experienced a first episode of syncope with an anomalous left coronary artery arising from the right sinus of the valsalva with a separate orifice from the right coronary artery. He is alive and in good health receiving medical treatment, and has had no medical events for over 2 years.

Amiodarone Induced Multiorgan Toxicity in a Patient of Hypertrophic Cardiomyopathy With Atrial Fibrillation

Amiodarone is an antiarrhythmic drug known to have adverse effects on multiple organs. Most studies have reported the side effects of the drug, which may result from rapid administrations or from long-term, high dosage administrations. However, toxicity issues have also been reported from patients administered with low doses of the drug for a long period of time. Here we report a case of an 82-year-old female who had shown symptoms and signs of pulmonary, hepatic, and neurotoxicity after taking amiodarone for 14 months in order to treat her atrial fibrillation without regular outpatient follow-up. We highlight the importance of the recommended evaluations, including lung, liver, and thyroid functions, as well as the neurological examinations in patients treated with amiodarone for a long period of time during regular follow-up.

A Blood-Filled Cystic Mass Attached to the Anterolateral Papillary Muscle

A 22 year-old male had a cystic mass attached to the anterolateral papillary muscle which was diagnosed using transthoracic and transesophageal echocardiography. Cardiac MRI was done to prove the nature of cystic mass. This cystic mass was successfully resected by da Vinci system without damage to the valve. Histologically this cystic mass proved to be a blood-filled cystic mass.

Efficacy and safety of combination chemotherapy with docetaxel and cisplatin as a first-line treatment for advanced gastric cancer / 대한내과학회지

BACKGROUDN: To evaluate the activity and safety of docetaxel and cisplatin for advanced gastric cancer as a first-line chemotherapy treatment. METHODS: Between December 2001 and February 2006, forty-two patients with recurrent or metastatic gastric cancer were enrolled. Docetaxel (75 mg/m2) was administered as a 1-hour intravenous infusion on day 1 and cisplatin (60 mg/m2) was also administered as a 30-minute intravenous infusion on day 1 every three weeks until disease progression or severe toxicity was detected. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to NCI toxicity criteria. RESULTS: The median age of the patients was 66 (range, 33~77) years. Among the forty-two patients, 38 were male. Twenty-seven patients had an Eastern Cooperative Oncology Group performance score of 0 or 1 and fifteen patients had a score of 2. All patients had adenocarcinoma. Thirty-three of the forty-two patients were assessable for response. Partial responses were observed in 14 patients. The overall response rate was 42.4% (95% C.I., 25.259.6%) and the median response duration was 5.7 (range, 1.4~17.2) months. The median overall survival of all patients was 8.1 (range, 1.2~47.0) months. During a total of 170 cycles, granulocytopenia worse than National Cancer Institute toxicity grade 3 occurred in 7.6% of the patients, thrombocytopenia in 0.6% and anemia in 3.5%, respectively. No deaths resulting from toxicity were observed. Non-hematologic toxicities were minor and were easily controlled. CONCLUSION: Combination chemotherapy with docetaxel and cisplatin has a tolerable efficacy with acceptable toxicities in patients with advanced gastric cancer as a first-line treatment.