BACKGROUND AND OBJECTIVES: Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared. RESULTS: Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV). CONCLUSION: Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.
Acute Coronary Syndrome* ; Angina, Unstable ; Angioplasty ; Blood Platelets* ; Coronary Artery Bypass ; Dalteparin ; Follow-Up Studies ; Glycoproteins* ; Hemorrhage ; Heparin ; Heparin, Low-Molecular-Weight* ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Activation ; Prognosis ; Thrombosis ; Transplants ; Troponin

BACKGROUND: Melasma is a common, acquired, symmetrical hypermelanosis that occurs on sun exposed areas of the skin. It is more prevalent among Asian women than among Caucasian women. Many different treatment modalities have been used with various efficacies, but none of them have been completely satisfactory. Arbutin is a naturally occurring gluconopyranoside that may reduce tyrosinase activity, which is a rate-limiting enzyme for melanin production. OBJECTIVE: The purpose of this study was to investigate the depigmenting effect and safety of a mask that contains 2% arbutin for the treatment of melasma. METHODS: A total of 54 female volunteers with melasma were enrolled in this randomized, double-blind, 8-week treatment study. The patients were instructed to apply an arbutin-containing mask or an arbutin-free mask once a day for 8 weeks. The assessment of outcomes included the Melasma Area and Severity Index (MASI) score, colorimetric value (L*), overall patient satisfaction and investigator assessment score (evaluated using photography). RESULTS: The arbutin-containing mask significantly increased the right and left colorimetric values (L*) after the 8-week treatment (p<0.05) compared to the arbutin-free mask. The MASI score was decreased more in the arbutin mask group (p>0.05). The arbutin mask scored better than the control in patient satisfaction and investigator assessment. No significant adverse reactions were observed. CONCLUSION: The arbutin mask appears to be effective and well-tolerated when used for the treatment of melasma.
Arbutin ; Asian Continental Ancestry Group ; Female ; Humans ; Hydrogel ; Hyperpigmentation ; Masks ; Melanins ; Melanosis ; Monophenol Monooxygenase ; Patient Satisfaction ; Research Personnel ; Skin ; Solar System

BACKGROUND AND OBJECTIVES: The purpose of the study was to evaluate the usefulness of cardiac troponin as a marker for the detection of minor myocardial injury following percutaneous coronary interverntion (PCI). SUBJECTS AND METHODS: In 79 patients who underwent successful PCI under the diagnosis of stable angina, serum creatinine kinase MB isoenzyme (CK-MB), cardiac troponin T (cTnT), and cardiac troponin I (cTnI) were measured before and at 6, 12 and 24 hours after PCI, and the angiographic findings and procedural characteristics of PCI were compared between the elevated and the normal enzyme groups. RESULTS: Abnormal values of one or more markers following PCI were observed in 17 patients (22%) ; 11 after stenting and 6 after balloon angioplasty alone. The frequency of abnormal cTnI levels was 19% and was significantly higher than that of CK-MB (6%, p < 0.01). No significant differences in target vessel number, target artery, ACC/AHA type, TIMI flow, stenting, time and number of ballooning, maximal inflation pressure or balloon diameter and length were observed between the two groups. Small side branch occlusions developed in 23% of the elevated enzyme group and in 3% of the normal enzyme group. CONCLUSION: Minor myocardial injury can be detected by cTnI and is observed frequently in patients with stable angina following PCI. A small side branch occlusion is related with elevated cTnI.
Angina Pectoris ; Angina, Stable ; Angioplasty, Balloon ; Arteries ; Coronary Disease ; Creatinine ; Diagnosis ; Humans ; Inflation, Economic ; Percutaneous Coronary Intervention* ; Phosphotransferases ; Stents ; Troponin I ; Troponin T ; Troponin*

BACKGROUND: Although electrocardiographic manifestations of idiopathic dilated cardiomyopathy (DCMP) are usually nonspecific, several studies have suggested that electrocardiogram (ECG) might be used to predict the prognosis. METHODS: The present study was performed to determine the role of standard 12-lead ECG variables as a prognostic factor of patients with idiopathic DCMP. We retrospectively analyzed the ECG findings at the time of the diagnosis in 89 patients with DCMP during a mean follow-up period of 53.2+/-37.1 months. RESULTS: Twenty-eight (31.5%) of the 89 patients died and the cumulative survival rate was 87% at 2 years and 68% at 5 years. By univariate life table analysis, premature ventricular contraction, left bundle branch block, and age were proved as significant predictors. Multivariate analysis using Cox proportional hazards model identified premature ventricular contraction (p=0.014) and left bundle branch block (p=0.02) as an independent predictor for cardiovascular mortality in DCMP. The presence of a premature ventricular contraction increased the mortality 2.8 times and left bundle branch block 2.6 times. CONCLSUION: The present study demonstrates that independent ECG predictors for prognosis of idiopathic DCMP are premature ventricular contraction and left bundle branch block and ECG may be useful in predicting the prognosis of idiopathic dilated cardiomyopathy.
Bundle-Branch Block ; Cardiomyopathy, Dilated* ; Deoxycytidine Monophosphate ; Diagnosis ; Electrocardiography* ; Follow-Up Studies ; Humans ; Life Tables ; Mortality ; Multivariate Analysis ; Prognosis* ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Ventricular Premature Complexes