The rupture of ventricular septum complicating acute myocardial infarction requires prompt recognition for the correct management of the patient. The diagnosis of this condition had required right heart catheterization. We performed two-dimensional and Doppler echocardiography in patients with systolic murmur after acute myocardioal infarction. Ventricular septal defect was found at lower interventricular septum by mapping technique of pulsed wave Doppler system and obtained high velocity Doppler tracting by continuous wave Doppler echocardiography. Doppler echocardiography could be useful noninvasive method for detection of ventricular septal rupture after acute myocardial infarction.
Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Echocardiography, Doppler ; Heart Septal Defects, Ventricular* ; Humans ; Infarction ; Myocardial Infarction* ; Rupture ; Systolic Murmurs ; Ventricular Septal Rupture ; Ventricular Septum

A forensic entomological study was conducted using monkey carcasses (Macaca fascicularis Raffles) that were placed in either an outdoor or indoor environment at a coastal area in Tanjung Sepat, Selangor, Malaysia during May until August 2008. We collected pupae of Chrysomya rufifacies (Marquart) from the carcasses and kept them individually. The emergence of 13 parasitic microhymenopteran, from one of the pupae occurring within a week were identified as Exoristobia philippinensis Ashmead (Hymenoptera: Encyrtidae). Another observation was made whereby a pupa of C. rufifacies was predated by a muscid larva, Ophyra spinigera (Stein). The larva squeezed into the pupa and consumed the contents. This paper report C. rufifacies as a new host record for E. philippinensis in Malaysia and highlighted the predatory behavior of O. spinigera larva in natural environment.

Compliance of epileptic patients is one of the most important factors for adequate therapy. Recently, it had been shown that the variability of three serial measurement of the serum levels of antiepileptic drug(AED) may be used as an indication of the degree of compliance. Coefficient variation(CV) of serum drug levels calculated by only one AED had been used to determine the compliance in epileptic patients who took multiple AEDs. We attempted to evaluate the CV of AEDs and then find the objective clue of compliance and the compatible therapeutic planing according to CV. Ninety seven epileptic patients of outpatients department of the Gyengsang National University Hospital were entered to this study. All patients were taking medication at least for 6 months without any changes of drug regimen. Patient's information was acquired by reviewing the chart and interview with questionnaire. With these informations, we determined the compliance of the patients. Antiepileptic serum levels were measured three times at intervals of at least two to four weeks apart, and their CV was calculated. We compared the CV between the compliant and non-compliant group in each AED(phenytoin, carbamazepine , valproic acid) and three drugs in the compliant group. The mean CVs of phenytoin, carbamazepine and valproic acid in the compliant group were 18.3+/-13.0, 15.2+/-10.2 and 23.8+/-8.9, respectively(mean+/-SD). The mean of CV in the compliant and the non-compliant group were 17.9+/-10.9 and 38.8+/-27.2, respectively. The CVs of the compliant group were significantly lower than those of the non-compliant group(p<0.05). However, CVs had no significant difference between three antiepileptic drugs. This study showed that CVs of AEDs were not different between each AEDs, even though they possess different pharmacokinetic properties. Therefore, the CV of one AED can be used in determining the compliance of the epileptics who are taking multiple AEDs.
Anticonvulsants ; Carbamazepine* ; Compliance ; Humans ; Outpatients ; Phenytoin* ; Surveys and Questionnaires ; Valproic Acid*

Central diabetes insipidus (CDI) is a clinical syndrome that result from a failure of the neurohypophyseal axis to produce or release a sufficient quantity of arginine vasopressin (AVP) to permit normal function of the urinary concentrating mechanism. Polyuria and polydipsia are the symptoms associated with CDI. The most common cause of CDI is idiopathic variety and head trauma, neurohypophyseal surgery, primary or metastatic brain tumors acount for most of the remaining cases. CDI in Langerhans cell histiocytosis (LCH) is thought to be to infiltration of the hypothalamus-neurohypophyseal system. We report a patient with CDI and LCH underwent water depriviation test, MR imaging of the pituitary-hypothalamic region, and VATS associated open lung biopsy.
Arginine Vasopressin ; Axis, Cervical Vertebra ; Biopsy ; Brain Neoplasms ; Craniocerebral Trauma ; Diabetes Insipidus* ; Diabetes Insipidus, Neurogenic ; Histiocytosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Lung ; Magnetic Resonance Imaging ; Polydipsia ; Polyuria ; Thoracic Surgery, Video-Assisted

Since the early discovery of H-reflex by Hoffmann in 1918 there have been a great number of articles in the literature suggesting its clinical used by Magladery in the early 1950. Our experiments about measurement of latent time in H-reflex were performed on 40 normal male adult(composed of medicos and medical officers) and 82 patients(lumbago 40, lumbar disc 42) admitted at CAFGH from January '79. to August '79. The result about normal adult are as follows: 1) The mean value and the standard deviation of the latent time in normal adult(height 171+/-5.14 cm) is 27.74+/-1.86 msec at right leg, 27.77+/-1.64 msec at left one respectively. 2) There may be a linear relationship between latency and the height of normal adult and the difference between right and left is revealed 0.15+/-0.19 msec. We compare the measurementon the 82 patients group with the normal adult experimental groups in addition literatures review.
Adult* ; H-Reflex ; Humans ; Leg ; Male

Personalized medicine is a novel medical model with all decisions and practices being tailored to individual patients in whatever ways possible. In the era of genomics, personalized medicine combines the genetic information for additional benefit in preventive and therapeutic strategies. Personalized medicine may allow the physician to provide a better therapy for patients in terms of efficiency, safety and treatment length to reduce the associated costs. There was a remarkable growth in scientific publication on personalized medicine within the past few years in the cardiovascular field. However, so far, only very few cardiologists in the USA are incorporating personalized medicine into clinical treatment. We review the concepts, strengths, limitations and challenges of personalized medicine with a particular focus on cardiovascular diseases (CVDs). There are many challenges from both scientific and policy perspectives to personalized medicine, which can overcome them by comprehensive concept and understanding, clinical application, and evidence based practices. Individualized medicine serves a pivotal role in the evolution of national and global healthcare reform, especially, in the CVDs fields. Ultimately, personalized medicine will affect the entire landscape of health care system in the near future.
Cardiovascular Diseases ; Delivery of Health Care ; Genomics ; Health Care Reform ; Humans ; Precision Medicine ; Publications

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Single nucleotide polymorphisms (SNPs) are the most abundant forms of human genetic variations and resources for mapping complex genetic traits and disease association studies. We have constructed a linkage disequilibrium(LD) map of chromosome 22 in Korean samples and compared it with those of other populations, including Yorubans in Ibadan, Nigeria (YRI), Centred'Etude du Polymorphisme Humain (CEPH) reference families (CEU), Japanese in Tokyo (JPT) and Han Chinese in Beijing (CHB) in the HapMap database. We genotyped 4681 of 111,448 publicly available SNPs in 90 unrelated Koreans. Among genotyped SNPs, 4167 were polymorphic. Three hundred and five LD blocks were constructed to make up 18.6% (6.4 of 34.5 Mb) of chromosome 22 with 757 tagSNPs and 815 haplotypes(frequency > or = 5.0%). Of 3430 common SNPs genotyped in all five populations, 514 were monomorphic in Koreans. The CHB + JPT samples have more than a 72% overlap with the monomorphic SNPs in Koreans, while the CEU + YRI samples have less than a 38% overlap. The patterns of hot spots and LD blocks were dispersed throughout chromosome 22, with some common blocks among populations, highly concordant between the three Asian samples. Analysis of the distribution of chimpanzee-derived allele frequency (DAF), a measure of genetic differentiation, Fst levels, and allele frequency difference (AFD) among Koreans and the HapMap samples showed a strong correlation between the Asians, while the CEU and YRI samples showed a very weak correlation with Korean samples. Relative distance as a quantitative measurement based upon DAF, Fst, and AFD indicated that all three Asian samples are very proximate, while CEU and YRI are significantly remote from the Asian samples. Comparative genome-wide LD studies provide useful information on the association studies of complex diseases.
Asian Continental Ancestry Group ; Chromosomes, Human, Pair 22 ; Gene Frequency ; Genetic Variation ; Haplotypes ; HapMap Project ; Humans ; Nigeria ; Polymorphism, Single Nucleotide ; Tokyo

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.