Primary malignant neoplasm of the pericardium is very rare, Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.
Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland-Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion: Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.
Background/Aims: Dong-Moo Lee Jae-Ma(1837-1900) confirmed the sasangchaejil theory based on the sasang-medicine. This theory has been the main-stem of oriental medicine during 100 years in Korea. But rarely anyone has tried to prove this theory systemicaly. So we have a trial to clarify any relationship between the sasangchaejil and the laboratory and clinical results of mass screening tests. Methods: We evaluated the laboratory values of 280 people who had taken many clinical and laboratory tests. The laboratory examinations were complete blood count, liver and kidney function test, ultrasonogram of the abdomen and breasts, gastrofiberscope, many tumor markers body mass index, blood pressure, glucose, and electrocardiogram, etc. Results: 1) Among the 280 subjects, 187/66.8% were sowumin, 58/20.7% were taewumin and 35/12.5% were soyangin. 2) Those who reacted positive to HBsAb were 22 subjects(62.8%) in soyangin, 57.2% in sowumin and 55.1% in raewumin. But there were no significant correlations. 3) 45 subjects(72.4%) in taewumin had obesity, fatty liver and hyperlipidemia.(P<0.05) 4) 20.6% in taewumin had abnormal LFT suggesting hepatic disease. It was statistically sigificant.(P<0.05) 5) An anemic state was present in women of soyangin and sowumin mostly. Since an iron deficiency anemia is common in women, there were no significant corelations among sasangchaejil. Also urinary tract infectons were common in women. 6) 6 subjects in taewumin(10.3%) had cardiac problems, while only one case(2.8%) occured in soyangin and 7 cases(3.7%) in sowumin. Taewumin was significantly high.(P<0.05) 7) In the case of gastric disease, there was no distinguishable difference among sasangchaejil.(taewumin 37.9%, soyangin 31.4% and sowumin 35.2% rrespectively) 8) There was no significant difference beteen subjects with different blood types using sasangchaejil. Conclusions: There were some significant relationship between sasangchaejil and diseases prevalent to them by the theory of sasang-medicine. But Lee didn't considered the differences of gender, the change of body status according to the development of culture, and circumstances of their lives. Also he didn't consider the existence of infectious agents. Now more systemic study with larger populations are requied.
Angiotensin converting enzyme (ACE) inhibitors have cardioprotective effects in different species including human. This cardioprotective effect is mainly due to the inhibition of bradykinin (BK) degradation rather than inhibition of the conversion of angiotensin I to angiotensir. II. Bradykinin, a nonapeptide, has been considered to be the potential target for various enzymes including ACE, neutral endopeptidase 24.11, carboxypeptidase M, carboxypeptidase N, proline aminopeptidase, endopeptidase 24.15, and meprin. In the present study, the coronary vascular beds of Sprague Dawley rat isolated hearts were perfused (single passage) with Krebs solution alone or with different concentrations of BK i.e. $2.75{\times}10^{-10},\;10^{-7},\;10^{-6}\;and\;10^{-5}M$ solution. Percent degradation of BK was determined by radioimmunoassay. The degradation products of BK after passing through the isolated rat-hearts were determined using RP-HPLC and mass spectroscopy. All the four doses of BK significantly decreased the perfusion pressure during their passage through the hearts. The percentage degradation of all four doses was decreased as the concentration of drug was increased, implying saturation of a fixed number of active sites involved in BK degradation. Bradykinin during a single passage through the hearts degraded to give [1-7]-BK as the major metabolite, and [1-8]-BK as a minor metabolite, detected on HPLC. Mass spectroscopy not only confirmed the presence of these two metabolites but also detected traces of [1-5]-BK and arginine. These findings showed that primarily ACE is the major cardiac enzyme involved in the degradation of bradykinin during a single passage through the coronary vascular of bed the healthy rat heart, while carboxypeptidase M may have a minor role.
Bora Chae;Shin Ahn;Youn-Jung Kim;Seung Mok Ryoo;Chang Hwan Sohn;Dong-Woo Seo;Won Young Kim
Korean Circulation Journal
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v.53
no.9
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pp.635-644
/
2023
Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m2 with the conventional threshold of 30 kg/m2 in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.
Brain-type natriuretic peptide (BNP) is a cardiac hormone that exerts cardiovascular and renal effects and regulates metabolic processes. In the current study, to determine the hepatic effects of BNP, we investigated whether it improves high-fat diet (HFD)-induced hepatic IR and characterized its possible mechanism. No significant differences in body weight, fat mass, or lean mass were observed between the saline- and BNP-treated groups of normal diet-and HFD-fed mice. During the clamp test, the BNP infusion into HFD-fed mice led to lower blood glucose levels and increased glucose infusion rates versus that into saline-treated HFD-fed mice. The BNP infusion also inhibited hepatic glucose production and decreased hepatic triglyceride levels concomitant with decreased expression of gluconeogenesis and lipogenesis-related genes, resulting in reduced levels of alanine aminotransferase and aspartate aminotransferase. BNP increased the phosphorylation of Akt and AMP-acti- vated protein kinase (AMPK) in the livers of HFD-fed mice compared to saline-fed HFD mice. The incubation of AML12 murine hepatocytes with BNP increased the basal levels of phosphorylated Akt and AMPK and recovered the phosphorylated Akt and phosphorylated AMPK levels reduced by palmitate treatment. Furthermore, BNP incubation prevented palmitate-induced increases in lipo- genesis gene expressions. Taken together, the current study's findings indicated that BNP ameliorates hepatic IR, resulting in reduced hepatic glucose production and hepatic steatosis.
Obesity is associated with cardiovascular risk factors, such as dyslipidemia, hypertension and diabetes. However the presence of the obesity related deranged metabolic profiles varies widely among obese individuals. These individuals, known as 'metabolically healthy obese phenotype (MHO)', despite having excessive body fatness, display favorable metabolic profiles characterized by insulin sensitivity, no hypertension, as well as less dyslipidemia, less inflammation. The purpose of this study was to compare cardiac characterization and clinical profile of MHO and Non-MHO (nonmetabolically healthy obese) subjects in men. We measured treadmill exercise capacity (METs) and maximum blood pressure (BP) in 210 subjects through a medical checkup at J General Hospital. Metabolic syndrome was defined according to the modified Adult Treatment Panel III definition criteria. Both MHO and Non-MHO subjects showed statistically significant changes in the left ventricular mass index (P<.001, P<.01, respectively), A-velocity (P<.01, P<.001, respectively), E/A ratio (P<.01, P<.001, respectively), E'-velocity (P<.001, P<.001, respectively), HOMA-IR (P<.01, P<.001, respectively) and maximum systolic BP (P<.01, respectively) compared with the MH-NO (metabolically healthy non obese) subjects. In conclusion, MHO participants were at increased risk of cardiovascular disease and partly metabolic disorder.
Purpoes: The study was done to investigate the effects of an exercise program on body composition, cardiopulmonary function and physical fitness in obese children. Methods: Thirty nine children in grades 4, 5, and 6 in elementary school were employed: experimental group(20) and control group(19). The subjects in the experimental group participated in an exercise program for 8weeks, thirty five minutes per session, four times per week. This data was analyzed by ANCOVA and paired t-test. Result: The Height(F=2.615, p=0.027) of the experimental group was significantly different from the control group. Also, in the experimental group, there were significant differences of height(t=4 79, p=0.000), cardiac rate(t=-6.461, p=0.000), body mass index(t=-2.13 p=0.046), muscle strength(t=3.48, p=0.003), and muscle endurance(t=3.20, p=0.005). Otherwise, in the control group, there were significant differences of weight(t=2.27, p=0.036), waist-hip ratio(t=3.16, p=0.005), and muscle endurance(t=-2.38, p=0.030). Conclusion: Jumping rope improved the body composition, cardiopulmonary function, and physical fitness for obese children.
Park, Bong-Ky;Cho, Chong-Kwan;Kwon, Ki-Rok;Yoo, Hwa-Seung
Journal of Pharmacopuncture
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v.10
no.3
/
pp.143-147
/
2007
Objective To derive further studies evaluating the effectiveness of Cultured Wild Ginseng Pharmacopuncture (CWGP) Therapy on squamous cell carcinoma as a first line. Methods Three cycles (4 weeks/cycle) of CWGP were administered as a dosage of 10 ml per day. Patient was diagnosed with stage IIIB squamous cell carcinoma and refused all therapy of conventional medicine because of old age and cardiac invasion of tumor. Intensive treatment of CWGP for 3 cycles was done on the patient. Computed Topography (CT) was performed to evaluate the therapeutic efficacy. Results After the intravenous infusion of 2 cycles of CWGP, chest CT revealed the mass size and pleural invasion sustained stable disease. After the point injection of 1 cycle of CWGP, chest CT revealed progressive disease. The disease free survival rate was 1 month. Conclusion This case may provide us the possibility that CWGP offers potential benefits for patients with squamous cell lung carcinoma. But this is a single case study and further case-series research should be compensated.
Fourteen cases of pericardia I tumor were clinically experienced from June 1966 to July 1981, for 15 years in St. Mary's Hospital, Department of Thoracic and Cardiovascular Surgery, Catholic Medical College. There were three primary tumors of the pericardium, liposarcoma, teratoma and malignant mesothelioma, and 11 metastatic pericardial tumors. In metastatic pericardial tumors, eight were originated from the lung, one was breast, and the other two cases were unknown origin. There were 6 adenocarcinoma, one small cell carcionoma ~nd one alveolar cell carcinoma in 8 cases from the lung, and 5 male and 3 female patients were composed the metastatic pericardial cancer from the lung. In clinical symptoms were dyspnea in all cases, and 9 cases had the generalized edema and enlarged liver size. Six patients had been operated, three of the primary pericardial tumor and three of metastatic pericardial tumor. Two of the primary tumors were cured satisfactorily by the mass removal, but one died due to cardiac arrest at postoperative one day. In metastatic tumors, operation were performed as two pericardial window formation and one left lower lobectomy with pericardial fenestration, but one was died in second operative day. Other nine metastatic tumors were diagnosed by needle biopsy in one case and by cell block of effusion in eight cases.
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