Beta-Meta: a meta-analysis application considering heterogeneity among genome-wide association studies

Many packages for a meta-analysis of genome-wide association studies (GWAS) have beendeveloped to discover genetic variants. Although variations across studies must be considered, there are not many currently-accessible packages that estimate between-study heterogeneity. Thus, we propose a python based application called Beta-Meta which can easilyprocess a meta-analysis by automatically selecting between a fixed effects and a randomeffects model based on heterogeneity. Beta-Meta implements flexible input data manipulation to allow multiple meta-analyses of different genotype-phenotype associations in asingle process. It provides a step-by-step meta-analysis of GWAS for each association inthe following order: heterogeneity test, two different calculations of an effect size and ap-value based on heterogeneity, and the Benjamini-Hochberg p-value adjustment. Thesemethods enable users to validate the results of individual studies with greater statisticalpower and better estimation precision. We elaborate on these and illustrate them with examples from several studies of infertility-related disorders.

A Case of Nummular Eczema-Like Eruption after Secukinumab Treatment / 대한피부과학회지

Secukinumab is an anti-interleukin 17A monoclonal antibody used for treating chronic plaque psoriasis. Eczematous eruption is a relatively unknown adverse effect of secukinumab. A 32-year-old man developed eczematous eruptions on both lower extremities following secukinumab treatment for severe plaque psoriasis. The lesions were clinically diagnosed as a nummular eczema-like eruption and were treated with topical corticosteroids without switching or stopping secukinumab. Considering the increased use of secukinumab and other interleukin-17A inhibitors, dermatologists should be aware of the cutaneous side effects of the drug.

Notch1 in Tumor Microvascular Endothelial Cells and Tumoral miR-34a as Prognostic Markers in Locally Advanced Triple-Negative Breast Cancer / 한국유방암학회지

Congenital Absence of the Left Atrial Appendage: An Unexpected and Incidental Anomaly in a Patient with Multiple Cerebellar Infarctions / 전남의대학술지

No abstract available.

Spontaneous Transition of Double Tachycardias with Atrial Fusion in a Patient with Wolff-Parkinson-White Syndrome

Among patients with Wolff-Parkinson-White syndrome, atrioventricular reciprocating tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT) can coexist in a single patient. Direct transition of both tachycardias is rare; however, it can occur after premature atrial or ventricular activity if the cycle lengths of the two tachycardias are similar. Furthermore, persistent atrial activation by an accessory pathway (AP) located outside of the AV node during ongoing AVNRT is also rare. This article describes a case of uncommon atrial activation by an AP during AVNRT and gradual transition of the two supraventricular tachycardias without any preceding atrial or ventricular activity in a patient with preexcitation syndrome.

Application of New Oral Anticoagulants: Prevention of Stroke in Patients with Nonvalvular Atrial Fibrillation / 대한내과학회지

Only anticoagulation has been shown to reduce atrial fibrillation-related deaths. Vitamin K antagonists are difficult to use due to their narrow therapeutic range, unpredictable response, requirement for frequent coagulation monitoring, frequent dose adjustment, slow onset-offset, and numerous drug-drug and drug-food interactions. New oral anticoagulants (NOACs), such as dabigatran, rivaroxaban, and apixaban have been developed and are available in Korea, and edoxaban was shown to be effective and safe, also. NOACs showed better pharmacodynamics with predictable serum concentrations and effects, and no requirement for coagulation monitoring. These drugs have been shown to be more effective and safer than warfarin for prevention of stroke and systemic thromboembolism in patients with nonvalvular atrial fibrillation. Broad, appropriate, and aggressive use of NOACs would improve the results of treatment in patients with nonvalvular atrial fibrillation in Korea.

Paradoxical Heart Failure Precipitated by Profound Dehydration: Intraventricular Dynamic Obstruction and Significant Mitral Regurgitation in a Volume-Depleted Heart

Occurrence of dynamic left ventricular outflow tract (LVOT) obstruction is not infrequent in critically ill patients, and it is associated with potential danger. Here, we report a case of transient heart failure with hemodynamic deterioration paradoxically induced by extreme dehydration. This article describes clinical features of the patient and echocardiographic findings of dynamic LVOT obstruction and significant mitral regurgitation caused by systolic anterior motion of the mitral valve in a volume-depleted heart.

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

Iatrogenic Perforation of the Left Ventricle during Insertion of a Chest Drain

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.

Relationship of Blood Pressure Variability and Heart Rate with Plasma hsCRP in Patients with Recently Diagnosed Hypertension / 대한내과학회지

BACKGROUND/AIMS: Blood pressure (BP) variability and heart rate (HR) are associated with target organ damage and cardiovascular complications; however, the exact mechanisms are uncertain. In this study, we examined the association of an inflammatory marker with BP variability and HR. METHODS: A total of 151 patients diagnosed recently with hypertension were subjected to 24-h ambulatory BP monitoring. BP variability was assessed as the standard deviation of the BP recordings. The average HR and HR variability were calculated from concomitantly recorded HR values. Plasma high-sensitivity C-reactive protein (hsCRP) was used as a marker of inflammation. RESULTS: The mean age of the study population was 44 +/- 11.3 years, and 74.2% of the patients were male. The plasma hsCRP level was higher in male patients (0.131 +/- 0.014 vs. 0.06 +/- 0.023, p = 0.001) and patients with a history of smoking (0.136 +/- 0.017 vs. 0.101 +/- 0.017, p = 0.003). A correlation analysis showed that the variability in diastolic BP during 24-h monitoring was associated with hsCRP (p = 0.002, r = 0.258). The 24-h (p = 0.004, r = 0.236), daytime (p = 0.003, r = 0.239), and nighttime (p = 0.020, r = 0.190) average HRs were related to the hsCRP level. The 24-h HR variability (p = 0.025, r = 0.182) was also associated with hsCRP. After adjusting for the effect of related variables, the 24-h diastolic BP variability (beta = 0.286, p = 0.011) and daytime average HR (beta = 0.169, p = 0.049) were positively related to hsCRP. CONCLUSIONS: Plasma hsCRP is related to diastolic BP variability in recently diagnosed hypertensive patients. Moreover, HR measured with BP is associated with hsCRP. These findings suggest that inflammation mediates adverse cardiovascular outcomes of BP variability and an elevated HR.

Nontraumatic spinal epidural hematoma complicating anticoagulation therapy in unstable angina: a case report / 대한내과학회지

Patients who receive anticoagulation therapy are at risk of central nervous system (CNS) hemorrhage. CNS hemorrhage must be sought in any patient who develops neurologic complaints during anticoagulation. Nontraumatic spinal epidural hematoma is a rare entity, but it can occur during anticoagulation. Early imaging and management are essential to improve outcome of this potentially serious complication. We describe a 53-year-old male patient who developed nontraumatic spinal epidural hematoma associated with enoxaparin, a low-molecular weight heparin for unstable angina.

The Relation of Pulse Wave Velocity with Framingham Risk Score and SCORE Risk Score

BACKGROUND AND OBJECTIVES: The pulse wave velocity (PWV) reflects arterial stiffness, which is related to atherosclerotic vascular damage. This cross-sectional study was performed to evaluate the relation of the PWV with 10-year cardiovascular risk, as assessed by the revised Framingham risk scoring and European SCORE system. SUBJECTS AND METHODS: Using an automatic wave form analyzer, the heart-femoral (hf) and brachial-ankle (ba) PWVs were simultaneously measured in 327 subjects (men:women 195:132 and age 49.7+/-7.5 years) without clinical atherosclerotic cardiovascular disease, diabetes or systemic disease. The Framingham (FRS) and the SCORE (SRS) risk scores were obtained. RESULTS: The FRS and SRS were both significantly correlated with hfPWV and baPWV (r=0.412 and 0.398 and r=0.554 and 0.603, respectively, p20%) and ( or =5%) by the FRS and SRS, respectively. A logistical regression analysis demonstrated that an hfPWV >920 cm/s or baPWV >1 400cm/s was an independent variable for the discrimination of a more than moderate risk (> or =1 0%) stratification by the FRS. An hfPWV >975cm/s or baPWV >1 600cm/s was an independent variable for the discrimination of a high risk (> or =5%) stratification by the SRS. CONCLUSION: Both PWVs correlated significantly with the FRS and SRS, but their correlation coefficients were not high. The simply measured baPWV may be useful in stratifying cardiovascular risk, which is comparable to hfPWV.