BACKGROUND: Color M-mode doppler echocardiography has been suggested as a new noninvasive technique for assessing left ventricular diastolic function. The present study was performed to define the feasibility and value of color M-mode echocardiography for the assessment of left ventricular diastolic function in patients with acute coronary syndrome. METHODS: Thirty six patients with acute myocardial infarcion and twenty three patients with unstable angina were included (M/F=41/18, 61+/-12.2 years). Doppler study was performed using ATL HDI-3000 within 24 hours after the attack. In color M-mode study, ROP was measured with 'Front wave method' and 'Baseline shift method'. The patients were grouped into three groups based on E/A ratio and deceleration time (DT) in transmitral flow and S/D ratio in pulmonary venous flow; Group I=Normal pattern (E/A>1, S/D>1, DT>140 ms), Group II=Impaired relaxation pattern (E/A<1, DT>140 ms) and Group III=Pseudonormal/Restrictive pattern (E/A>1.5, S/D<1, with or without DT< or =140 ms). RESULT: Twenty two, thirty four, and three patients were assigned to Group I, II, III, respectively. The ROP could be measured with 'Front wave method' in 50 patients (84.7%), but with 'Baseline shift method' only in 19 patients (32.2%). ROP with 'Front wave method' was 65+/-25.7, 61+/-35.6, 71+/-35.2 cm/sec in Group I, II, III, respectively. There was no statistically significant difference in the value of ROP between group I and II (p>0.05). CONCLUSION: The ROP seems not to reflect the diastolic function in acute coronary syndrome, although it is measurable with the 'Front wave method' in most cases. The measurement of the ROP with 'Baseline shift method' is not feasible in the patients with acute coronary syndrome.
Acute Coronary Syndrome* ; Angina, Unstable ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Relaxation

Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about 70 μm, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.
Abdomen ; Abdominal Abscess* ; Abdominal Pain ; Abdominal Wall ; Abscess ; Animals ; Central Nervous System ; Colon ; Colon, Ascending ; Diagnosis ; Diverticulitis* ; Egg Shell ; Eggs ; Granuloma ; Humans ; Intestines ; Korea ; Liver ; Lung ; Ovum ; Paragonimiasis* ; Paragonimus ; Paragonimus westermani ; Parasites ; Parasitic Diseases ; Peritoneal Cavity

Life cycle stages, including daughter sporocysts, cercariae, and metacercariae, of Parvatrema duboisi (Dollfus, 1923) Bartoli, 1974 (Digenea: Gymnophallidae) have been found in the Manila clam Ruditapes philippinarum from Aphaedo (Island), Shinan-gun, Jeollanam-do, Korea. The daughter sporocysts were elongated sac-like and 307-570 (av. 395) μm long and 101-213 (av. 157) μm wide. Most of the daughter sporocysts contained 15-20 furcocercous cercariae each. The cercariae measured 112-146 (av. 134) μm in total length and 35-46 (av. 40) μm in width, with 69-92 (av. 85) μm long body and 39-54 (av. 49) μm long tail. The metacercariae were 210-250 (av. 231) μm in length and 170-195 (av. 185) μm in width, and characterized by having a large oral sucker, genital pore some distance anterior to the ventral sucker, no ventral pit, and 1 compact or slightly lobed vitellarium, strongly suggesting P. duboisi. The metacercariae were experimentally infected to ICR mice, and adults were recovered at day 7 post-infection. The adult flukes were morphologically similar to the metacercariae except in the presence of up to 20 eggs in the uterus. The daughter sporocysts and metacercariae were molecularly (ITS1-5.8S rDNA-ITS2) analyzed to confirm the species, and the results showed 99.8-99.9% identity with P. duboisi reported from Kyushu, Japan and Gochang, Korea. These results confirmed the presence of various life cycle stages of P. duboisi in the Manila clam, R. philippinarum, playing the role of the first as well as the second intermediate host, on Aphae-do (Island), Shinan-gun, Korea.