Myocardial bridge is not a rare congenital malformation of the coronary artery which takes an intramural course. Most of the lesions are found in proximal half of the left anterior descending coronary artery, but one which occurs in the left circumflex artery is extremely rare. During systole, the intramural coronary artery is compressed by contraction of over bridging ventricular muscle, therefore blood flow distal to the lesion in impaired and angina pectoris or acute myocardial infarction may occur. We experienced a 54-year-old man who complained of severe precordial pain during exercise and at rest for several months, and was diagnosed as myocardial bridging in the left circumflex coronary artery by coronary arteriography. Thus we report this case with literature review.
Angina Pectoris ; Angiography ; Arteries ; Coronary Vessels* ; Humans ; Middle Aged ; Myocardial Bridging ; Myocardial Infarction ; Systole

A new angiotensin converting enzyme inhibitor, enalapril, was administered in 20 hypertensive patients (7 mild, 6 moderate and 7 severe hypertensives) for 8 weeks or longer in order to see the blood pressure lowering effects. Additionally the left ventricular mass index was measured by 2-D guided M-mode echocardiography before and after enalapril therapy, and subjective symptoms and laboratory findings were also followed. The results were as follows: 1) After 8 weeks of enalapril treatment (the doses form 10 mg to 20mg once a day) blood pressure were lowered markedly in 10, moderately in 4, mildly in 4 cases, but the blood pressures were not lowered in 2 cases with severe hypertension. The means of the blood pressures of the group were lowered form 182.1+/-19.2 to 148.0+/-26.0mmHg in systolic and from 111.9+/-14.7 to 95.1+/-17.1mmHg in diastolic after 8 weeks of treatment (p<0.001). 2) Heart rates were not changed significantly with enalapril. 3) The symptoms of insomnia and headache were reported to be improved after enalapril in 13 cases. 4) No discernable changes in CBC and serum level of creatinine were observed. But the random urine protein was decreased in 6 cases with proteinuria in routine urinalysis. The serum lipid profile was not significantly changed, but in the 2 cases in which the ratio of total to HDL-cholesterol was above 5.0, the ratio fell to below 5.0. 5) There was no significant EKG change after enalapril. 6) In 9 cases out of 13 cases with the left ventricular mass index (LVMI) above 125g/m2 BSA, LVMI was followed by echocardiography after enalapril. LVMI was significantly decreased in 8 of 9 cases and mean values after enalapril was decreased from 183.1+/-88.0g/m2 BSA to 150.8+/-61.3g/m2 BSA (p<0.0025). 7) Side effects after enalapril administration were transient dizziness in 4 cases and ageusia in 2 cases. Above results suggest that the enalapril could be an initial choice in the treatment of essential hypertension as a single oral agent in once a day regimen resulting in good antihypertensive effects, improvement of subjective symptoms, regreassion of the left ventricular hypertrophy and few side effects.
Ageusia ; Blood Pressure ; Creatinine ; Dizziness ; Echocardiography ; Electrocardiography ; Enalapril* ; Headache ; Heart Rate ; Humans ; Hypertension ; Hypertrophy, Left Ventricular ; Peptidyl-Dipeptidase A ; Proteinuria ; Sleep Initiation and Maintenance Disorders ; Urinalysis

For the evaluation of the left ventricular diastolic function in mild to moderate hypertensive patients without left ventricular hypertrophy, 15 hypertensive patients (group A) and 15 normotensive subjects (group B) were examined by 2-D guided M-mode echocardiography. Various systolic and diastolic indices were derived from computer-assissted analysis of differential curves of left ventricular dimension and posterior wall thickness. The systolic and diastolic function indices of each of the two groups were compared. The results were as follows : 1) There were no significant differences in ejection fraction, left ventricular peak ejection rate and posterior wall thickening rate between two groups. 2) There were no significant differences in % ventricular A wave, left ventricular peak filling rate and posterior wall peak relaxation rate between two groups. 3) One third filling rate was 2.07+/-0.41 EDD/sec in group A and which was significantly lower than 3.29+/-0.88 EDD/sec of group B. Above result suggests that computer-assisted analysis of differential curves of left ventricular dimension and posterior wall thickness could be helpful in the early detection of diastolic dysfunction, and that left ventricular diastolic dysfunction in its early filling period may develop in the mild to moderate hypertensive patients even before left ventricular hypertrophy develops.
Echocardiography ; Humans ; Hypertrophy, Left Ventricular* ; Relaxation

Airway Obstruction ; Arteries ; Cellulose, Oxidized ; Hemorrhage ; Hemostasis ; Humans ; Male ; Mandible ; Postoperative Hemorrhage

Animals ; Dental Implants ; Dogs ; Durapatite ; Femur ; Humans ; Intention ; Mentors ; Osseointegration ; Osteogenesis ; Reference Values

OBJECTIVE: The aim of this study is to compare the clinical benefits between high-intensity and low-to moderate-intensity statin therapy in patients with acute myocardial infarction (AMI). METHODS: A total of 1,230 patients in the Korea AMI Registry (KAMIR) were enrolled. Patients were divided into two groups according to the dosage of statin for the secondary prevention after AMI. The primary endpoint was composite of major adverse cardiac events (MACEs) including cardiac death, non-fatal MI, repeat revascularization during the 12 months of clinical follow-up. RESULT: The primary endpoint occurred in 101 patients (11.3%) from the low-to moderate-intensity statin group and 45 patients (13.4%) from the high-intensity statin group. The cumulative incidence of MACEs during 12-month follow-up was not significantly different between the two groups (p=0.323). After multi-variate analysis, MACEs-free survival rate was not significantly different between the two groups. CONCLUSION: High-intensity statin therapy did not show additional clinical benefit over low-to moderate-intensity statin therapy after AMI.
Death ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Incidence ; Korea ; Myocardial Infarction* ; Secondary Prevention ; Survival Rate

BACKGROUND AND OBJECTIVES: Congenital long QT syndrome (LQTS) is a genetic disease that brings prolongation of the QT interval on an electrocardiogram and leads to syncope and sudden death by a fatal ventricular arrhythmia. In Korea, there have been studies about the clinical characteristics and treatment of LQTS, but there are no studies for the molecular and biological evaluation of its genetic mutation. SUBJECTS AND METHODS: Six nationwide university hospitals and laboratories segregated DNA from the blood of 10 patients diagnosed with LQTS to analyze the genetic mutation. RESULTS: Nine out of ten individuals were female. Eight showed genetic mutations. Three had an abnormality in the KvLQT1, 6 in the HERG and 2 had abnormalities in both KvLQT1 and HERG. None had abnormalities in KCNE1 and 2 showed no abnormalities in KvLQT1, HERG or KCNE1. CONCLUSION: Congenital LQTS shows various genetic mutations, and this indicates the necessity for further organized study in more individuals for confirmation of the relationship between the results of clinical diagnosis and genetic analysis.
Arrhythmias, Cardiac ; Death, Sudden ; Diagnosis ; DNA ; Electrocardiography ; Female ; Hospitals, University ; Humans ; Korea ; Long QT Syndrome* ; Syncope

BACKGROUND/AIMS: Gastric variceal bleeding is a severe complication of cirrhosis, and it has a high mortality rate. This study was conducted to evaluate the efficacy of n-butyl-2-cyanoacrylate injection therapy for patients suffering with gastric variceal bleeding. METHODS: A total of 86 patients diagnosed with gastric variceal bleeding underwent endoscopic n-butyl-2-cyanoacrylate (Histoacryl(R)) injection therapy at our department between April, 2002 and July, 2005, with a mean follow-up period of 44 weeks (range: 2 to 136 weeks). The initial hemostasis rate and the rebleeding rate of endoscopic sclerotherapy were analyzed. Also, the cumulative survival rate was analyzed according to the status of hepatocellular carcinoma and hyponatremia, the MELD score, the Child-Pugh score and the amount of injected Histoacryl(R). RESULTS: The initial hemostasis rate of Histoacryl(R) injection therapy was 93% and the 1 month rebleeding rate was 16.1%. The total number of session for treating the initial hemostasis was 1.2+/-0.4 and the total volume of Histoacryl(R) was 2.7+/-1.2 mL. The cumulative rebleeding-free rates for the patients treated by the Histoacryl(R) injection method at 1 month, 12 months and 34 months period were 95.1%, 83.2% and 74%, respectively. The cumulative survival rates were 78.3% at 1 month, 61.9% at 12 months and 54.6% at 34 months, respectively. No thromboembolic phenomenon occurred. According to the Cox's proportional hazards analysis, only the MELD score (<15) was an independent predicting factor for survival of the patients with gastric variceal bleeding. CONCLUSIONS: Endoscopic sclerotherapy using n-butyl-2-cyanoacrylate was a safe and effective hemostatic method for patients with gastric variceal bleeding. Also, the MELD score (<15) contributed to predicting survival of the patients with gastric variceal bleeding.
Adult ; Aged ; Aged, 80 and over ; Enbucrilate/*analogs & derivatives/therapeutic use ; Esophageal and Gastric Varices/*therapy ; Female ; Gastrointestinal Hemorrhage/mortality/*therapy ; Hemostasis, Endoscopic ; Humans ; Male ; Middle Aged ; *Sclerotherapy ; Survival Rate ; Treatment Outcome

Dental Implants ; Female ; Follow-Up Studies ; Gingivitis ; Humans ; Male ; Membranes ; Prognosis ; Prosthodontics ; Retrospective Studies ; Sinusitis ; Survival Rate ; Tooth ; Transplants

BACKGROUND AND OBJECTIVES: Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized. SUBJECTS AND METHODS: We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients. RESULTS: Among 14871 patients, 159 (61+/-12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9+/-12.4 years). Group II had 81 patients (61.6+/-12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE. CONCLUSION: Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.
Blood Pressure ; Demography ; Emergencies ; Follow-Up Studies ; Humans ; Korea ; Myocardial Infarction ; Odds Ratio ; Prehypertension ; Prognosis