Simultaneous multi-vessel acute myocardial infarction is rare and has poor prognosis. We report a 70-year-old Korean man with an anteroseptal wall ST-elevation myocardial infarction presenting as ventricular tachycardia, sudden cardiac arrest and cardiogenic shock. After successful cardiopulmonary resuscitation, a coronary angiogram revealed three-vessel coronary disease; simultaneous total occlusions of the proximal left anterior descending artery (LAD) and the proximal left circumflex artery (LCX), and chronic total occlusion of the proximal right coronary artery. Primary percutaneous coronary intervention (PCI) of the LAD and LCX was successful and an intra-aortic balloon pump was inserted. Despite the timely and successful PCI result, he died on the 58th day in the hospital due to pneumonia with multiple organ failure.
Aged ; Arteries ; Cardiopulmonary Resuscitation ; Coronary Disease ; Coronary Occlusion ; Coronary Vessels ; Death, Sudden, Cardiac ; Humans ; Multiple Organ Failure ; Myocardial Infarction* ; Percutaneous Coronary Intervention ; Pneumonia ; Prognosis ; Shock, Cardiogenic ; Tachycardia, Ventricular

The H19 gene, located at human chromosome 11p15.5, is imprinted in most normal human tissues. However, imprinting is often lost in tumors suggesting H19 is a putative tumor suppressor. We analyzed the single nucleotide polymorphisms (SNPs) of a 16 kb region that includes the H19 gene and its imprinting control region (ICR) in the Korean population. To identify SNPs, we directly sequenced this region in 18 Korean subjects. We identified 64 SNPs, of which 7 were in the exons of H19, 2 were in the introns, 14 were in the 3' intergenic region and 41 were in the 5' intergenic region. Of the 64 SNPs, 21 had not previously been reported and thus appear to be unique to the Korean population. The identified SNPs of H19 in the Korean population may eventually be useful as genetic markers associated with various diseases. In this study, 7 of the 64 identified SNPs were at CTCF binding sites in the ICR and may affect regulation of H19 gene imprinting. Thus, several genetic variations of the H19 gene may be important markers in human diseases that involve genomic imprinting, including cancer.
Binding Sites ; Chromosomes, Human* ; DNA, Intergenic ; Exons ; Genetic Markers ; Genetic Variation ; Genomic Imprinting ; Haplotypes ; Humans ; Humans* ; Introns ; Polymorphism, Single Nucleotide*

Acute renal failure can be the result of acute renal cortical necrosis (RCN), which commonly occurs from complications occurring during pregnancy. RCN is rarely caused by medications, although tranexamic acid, which is used in patients with acute bleeding for its antifibrinolytic effects, reportedly causes acute RCN in rare cases. An 82-year-old woman experienced gastrointestinal bleeding after endoscopic papillectomy of an ampullary adenoma. The bleeding was controlled with tranexamic acid administration; however, 4 days later, her urine volume decreased and she developed pulmonary edema and dyspnea. Serum creatinine levels increased from 0.8 to 3.9 mg/dL and dialysis was performed. Abdominal pelvic computed tomography with contrast enhancement revealed bilateral RCN with no renal cortex enhancement. Renal dysfunction and oliguria persisted and hemodialysis was continued. Clinicians must be aware that acute RCN can occur after tranexamic acid administration to control bleeding.
Acute Kidney Injury ; Adenoma ; Aged, 80 and over ; Creatinine ; Dialysis ; Dyspnea ; Female ; Hemorrhage* ; Humans ; Kidney Cortex Necrosis* ; Oliguria ; Pregnancy ; Pulmonary Edema ; Renal Dialysis ; Tranexamic Acid

Human toxocariasis is a common helminthozoonosis due to the infestation of toxocara canis or toxocara cati larvae, and is a common cause of blood eosinophilia in Korea. Toxocariasis has various clinical manifestations depending on the involved organ, and cardiac involvement can range from asymptomatic to fulminant myocarditis with cardiogenic shock. Treatment of toxocariasis is based on corticosteroid and anthelmintic therapies. Here, we report a case of a 57-year-old male with eosinophilic myocarditis caused by toxocariasis as diagnosed via serial echocardiography follow up.
Echocardiography ; Eosinophilia ; Eosinophils* ; Follow-Up Studies ; Humans ; Korea ; Larva ; Larva Migrans, Visceral ; Male ; Middle Aged ; Myocarditis ; Shock, Cardiogenic ; Toxocara ; Toxocara canis ; Toxocariasis*