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, p<0.001 for all results). Both PWVs differed significantly between risk categories (<10, 10-20 and >20%) and (<5 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.
Atherosclerosis ; Blood Flow Velocity ; Cardiovascular Diseases ; Cross-Sectional Studies ; Discrimination (Psychology) ; Pulse Wave Analysis* ; Risk Assessment ; Vascular Stiffness

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.
Angina, Unstable* ; Anticoagulants ; Central Nervous System ; Enoxaparin ; Hematoma, Epidural, Spinal* ; Hemorrhage ; Heparin ; Humans ; Male ; Middle Aged

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.
Anticoagulants* ; Atrial Fibrillation* ; Food-Drug Interactions ; Humans ; Korea ; Stroke* ; Thromboembolism ; Vitamin K ; Warfarin ; Dabigatran ; Rivaroxaban

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.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

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.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

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.

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

Hidradenitis suppurativa is a chronic inflammatory disease that originate in the apocrine glands of the skin, It results in fibrosis, sinus track formation, and scarring. Rarely it is complicated by squamous cell carcinoma arisihg from hidradenitis suppurativa were reported in the literature. We present a patient who suffered over 20 years from persistent, extensive hidradenitis suppurativa and who developed squamous cell carcinoma at the perianal area. During the 18 month follow-up period, no evidence of recurrence nor metastasis was found.
Apocrine Glands ; Carcinoma, Squamous Cell ; Cicatrix ; Fibrosis ; Follow-Up Studies ; Hidradenitis Suppurativa* ; Hidradenitis* ; Humans ; Neoplasm Metastasis ; Recurrence ; Skin

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.
Atrioventricular Node ; Humans ; Pre-Excitation Syndromes ; Tachycardia* ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Paroxysmal ; Tachycardia, Reciprocating ; Tachycardia, Supraventricular ; Wolff-Parkinson-White Syndrome*

No abstract available.
Atrial Appendage* ; Humans ; Infarction*