Recent Updates of Lipoprotein(a) and Cardiovascular Disease.

In recent years, epidemiological studies, genome-wide association studies, and Mendelian randomization studies have shown a strong association between increased levels of lipoproteins and increased risks of coronary heart disease and cardiovascular disease (CVD). Although lipoprotein(a) [Lp(a)] was an independent risk factor for ASCVD, the latest international clinical guidelines do not recommend direct reduction of plasma Lp(a) concentrations. The main reason was that there is no effective clinical medicine that directly lowers plasma Lp(a) concentrations. However, recent clinical trials have shown that proprotein convertase subtilisin/kexin-type 9 inhibitors (PCSK9) and second-generation antisense oligonucleotides can effectively reduce plasma Lp(a) levels. This review will present the structure, pathogenicity, prognostic evidences, and recent advances in therapeutic drugs for Lp(a).

Comparison of Clinical and Echocardiographic Characteristics between Cardiac Myxomas and Masses Mimicking Myxoma.

BACKGROUND AND OBJECTIVES: Cardiac myxoma is the most frequent benign cardiac tumor that can result in cardiac and systemic symptoms. We investigated clinical and echocardiographic characteristics of patients with cardiac masses suggesting myxoma. METHODS: We investigated 265 consecutive patients with an echocardiographic diagnosis of cardiac myxomas in 4 teaching hospitals in Korea. RESULTS: The mean age was 61±16 years and 169 patients (63.8%) were female. The most frequent referral reason for echocardiography was an evaluation of cardiac symptoms (43.4%). Tumors were incidentally detected in 82 patients (30.9%). Left atrium (LA) was the most frequently involved site (84.5%) and 19 patients (7.2%) had non-atrial tumors. The mean tumor size was 38.7×26.0 mm (range, 4-96 mm). Of 186 patients (70.2%) who had pathological diagnosis, 174 (93.5%) were confirmed with myxoma, 8 (4.3%) with other tumors and 4 (2.2%) with thrombi. Compared to myxoma, smaller size (20.4×12.6 mm vs. 41.4×27.6 mm, p<0.01) and non-LA location (87.5% vs. 10.5%, p<0.001) were associated with non-myxoma tumors, and more frequent atrial fibrillation (AF, 75.0% vs. 7.0%, p<0.001) and larger LA diameter (55.0±14.6 mm vs. 41.3±7.7 mm, p=0.001) were related to thrombi. CONCLUSIONS: Of 265 patients with an echocardiographic diagnosis with cardiac myxomas, 174 (65.7%) were surgically confirmed with myxomas. Compared with cardiac myxoma, other tumors were smaller and more frequently found in non-atrial sites. Thrombi were associated with AF and larger LA diameter.

Structural and Electronic Origin of Bis-Lactam-Based High-Performance Organic Thin-Film Transistors.

We describe herein the comprehensive theoretical and experimental studies on the transistor mobility of organic semiconductors by correlating a two-dimensional (2D) intermolecular interaction with thin-film morphology and the electronic coupling structure. We developed a novel bis-lactam-based small molecule, 1,5-dioctyl-3,7-di(thiophen-2-yl)-1,5-naphthyridine-2,6-dione (C8-NTDT), with a 2D-type C-H···O═C intermolecular interaction along the in-plane directions of the crystal packing structure, which is characteristically different from the one-dimensional-type intermolecular interaction shown in the typical bis-lactam molecule of 2,5-dioctyl-3,6-di(thiophen-2-yl)pyrrolo[3,4- c]pyrrole-1,4-dione (C8-DPPT). Experimentally and theoretically, C8-NTDT exhibited more favorable thin-film morphology and an electronic coupling structure for charge transport because of its unique 2D intermolecular interactions compared with C8-DPPT. In fact, C8-NTDT exhibited a hole mobility of up to 1.29 cm2 V-1 s-1 and an on/off ratio of 107 in a vacuum-processed device. Moreover, the high solubility with the 2D electronic coupling structure of C8-NTDT enables versatile solution processing for device fabrication without performance degradation compared to the vacuum-processed device. As an example, we could demonstrate a hole mobility of up to 1.10 cm2 V-1 s-1 for the spin-coated devices, which is one of the best performances among the solution-processed organic field-effect transistors based on bis-lactam-containing small molecules.

Self-Assembled Organic Single Crystalline Nanosheet for Solution Processed High-Performance n-Channel Field-Effect Transistors.

Submillimeter sized n-channel organic single crystalline nanosheet based on dicyanodistyrylbenzene derivative, (2E,2'E)-3,3'-(2,5-dimethoxy-1,4-pheny-lene)bis(2-(5-(4-(trifluoromethyl)phenyl)thiophen-2-yl)acrylonitrile) (Me-4-TFPTA), is developed. Strong π-π interaction, hydrogen bonding interactions derived from cyano group (CN) as well as solvent inclusion along the lateral direction play a key role in forming nanosheet morphology. Me-4-TFPTA nanosheets exhibit excellent field-effect electron mobility of up to 7.81 cm(2) v(-1) s(-1) .

Laparoscopic colposuspension to the Cooper's ligament after hysterectomy for uterovaginal prolapse.

AIM: The goal of this study was to evaluate the long-term outcomes of laparoscopic colposuspension to the Cooper's ligament after hysterectomy for uterovaginal prolapse. MATERIAL AND METHODS: We performed chart reviews of 43 patients with uterovaginal prolapse who underwent laparoscopic colposuspension to the Cooper's ligament after hysterectomy at Daejeon St. Mary's Hospital, Catholic University of Korea from 2003 to 2009. These patients exhibited grade 3 (29 patients) or grade 4 (14 patients) uterovaginal prolapse. RESULTS: The mean age was 63.2 years (range, 39-76). The mean follow-up period was 44.2 months (95% CI, 36.8-51.5). Forty-three patients showed no sign or recurrence of prolapse. Postoperative complications were tolerable and curable. Urinary frequency (2 patients, 4.7%), voiding difficulty (2 patients, 4.7%), nocturia (1 patient, 2.3%) and vaginal spotting (1 patient, 2.3%) were reported. CONCLUSION: Laparoscopic colposuspension using Cooper's ligament after hysterectomy could be an effective surgical option for the treatment of uterovaginal prolapse.

Ganglion cyst of the spinoglenoid notch: comparison between SLAP repair alone and SLAP repair with cyst decompression.

BACKGROUND: Some authors have described the ganglion cyst of the spinoglenoidal notch as related to repetitive overhead activities and labral tear caused by trauma, while others have explained lesions of the capsulolabral complex and ganglion cysts to have separate pathologies. The purpose of this study is to compare clinical and radiological outcomes between 2 groups: 1 with superior labrum anterior and posterior (SLAP) repair only and the other with SLAP repair and cyst decompression prospectively. MATERIALS AND METHODS: From August 2000 to March 2007, 28 patients matching the inclusion criteria were selected for the study. They were divided into 2 groups: 1 who received SLAP repair and the other with concomitant SLAP repair and cyst decompression. A visual analogue scale (VAS) and Rowe and Constant scores were used to make evaluation. Preoperative magnetic resonance images (MRIs) of 2 patient groups were compared with 2 follow-up MRIs taken 3 months after the operation and at final follow-up. RESULTS: Mean VAS and Constant and Rowe scores in groups I and II improved significantly from mean preoperative score compared to last follow-up score; however, there was no statistically significant difference between the 2 groups (P > .05). Preoperative MRI and arthroscopy revealed type II SLAP lesions and a type V lesion, respectively, as accompanying lesions in 24 cases. CONCLUSION: The hypothesis stating 1-way valve mechanism of SLAP lesion as an initial cause of ganglion cysts has been proved indirectly in this study. Furthermore, direct decompression of the cyst does not lead to different results.

Umbilical arterial blood gas and perinatal outcome in the second twin according to the planned mode of delivery.

PURPOSE: To compare umbilical arterial gas parameters in the second twin of twin pregnancies according to the mode of delivery. METHODS: We retrospectively analyzed the medical records of twin deliveries after 34 weeks of gestation for 3 years. Excluding the cases which underwent emergency cesarean delivery during trial of labor, a total of 79 twin gestations had umbilical arterial blood gas values available and were and divided into cesarean delivery group (N=40) and vaginal delivery group (N=39). The mean differences of umbilical arterial blood parameters and the Apgar score between the first and second twin in each pregnancy were compared according the mode of delivery. RESULTS: The differences of umbilical arterial gas parameters between twin siblings showed no significant difference according to the mode of delivery. With regard to the 1 minute and 5 minute Apgar scores, the differences between twin siblings are significantly increased in vaginal delivery group compared to cesarean delivery group (p=0.048, and p=0.038, respectively). In comparing the 28 cases delivered vaginally with an inter-twin delivery interval < 10 minutes and 40 cases delivered by cesarean section, no significant differences were observed in the umbilical arterial gas parameters and Apgar scores. CONCLUSION: The inter-twin umbilical arterial blood gas parameters according to the mode of delivery showed no difference. For twin deliveries, it is relatively safe to plan for a vaginal delivery, but an effort should be made to reduce the inter-twin delivery interval time.

Two cases of angular pregnancy complicated by preterm labor and placental abruption at mid-pregnancy.

Angular pregnancy is the rare condition in which the gestational sac is implanted in the lateral angle of the uterine cavity. There have been several reports on angular pregnancies; however, due to a lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This report involves two women with angular pregnancies: one had placenta abruption and the other had preterm delivery at mid-trimester and postpartum endometritis. The former was diagnosed early with Three-dimensional sonography, but the other was not diagnosed until the time of cesarean section. This is the first report on the sonographic diagnosis of angular pregnancy. Through these cases, we emphasize the benefit of an accurate early diagnosis of angular pregnancy and careful prenatal care because of the possible risk of adverse perinatal outcome.

Specific human papillomavirus types and other factors on the risk of cervical intraepithelial neoplasia: a case-control study in Korea.

OBJECTIVE: Cervical neoplasia is attributed to a persistent human papillomavirus (HPV) infection. We performed a hospital-based, case-control study to evaluate the associations of HPV genotypes and other cofactors with cervical intraepithelial neoplasia (CIN). METHODS: A total of 158 women were enrolled after we received their informed consent, and the control group (the non-CIN group; n = 80) was selected from women at St Paul's Health Promotion Center. The CIN group (n = 78) was enrolled from the outpatient clinics at Kangnam St Mary's Hospital. Cervical intraepithelial neoplasia was confirmed with colposcopic-guided biopsy or loop electrosurgical excision procedure-conization. A structured questionnaire, Papanicolaou test, and HPV testing were completed. We compared each risk factor using chi2 tests and simple logistic regression analysis between the CIN and non-CIN groups. Finally, odds ratios (ORs) were calculated again by multiple logistic regression analysis. RESULTS: The most frequent HPV types in CIN were HPV-16, HPV-58, HPV-31/-33, and HPV-35/-56. The OR of the A9 group (HPV-16, HPV-31, HPV-33, HPV-35, HPV-52, HPV-58) was 22.7 (95% confidence interval [CI], 8.3-62.5), that of the A6 group (HPV-53, HPV-56, HPV-66) was 2.9 (95% CI, 1.1-7.5), and that of the A7 group (HPV-18, HPV-39, HPV-45, HPV-59, HPV-68) was 1.5. Sexual debut before 20 years old had significantly higher OR than did a sexual debut after 30 years (OR, 32.9; 95% CI, 2.8-364.7). The OR for CIN in single women versus married women was 6.2 (95% CI, 2.5-15.2). Compared with parous women (parity >3), nonparous women had a higher OR (95% CI, 1.4-16.7). On the multiple logistic regression analysis including the sexual debut age, the marital status, parity, cytology, and the HPV groups, the A9 group had a significant OR for CIN (6.1; 95% CI, 1.6-23.6). CONCLUSIONS: The risk of CIN was higher for women infected with the HPV-A9 group after multiple logistic regression analysis. The other clinical risk factors were not significant factors of CIN.