No abstract available.
Child* ; Humans ; Rheumatic Heart Disease*

BACKGROUND: Recent data suggest that the colonization rate of group B streptococci(GBS) in pregnant women and the incidence of neonatal infections by GBS is increasing trend in Korea, but the antimicrobial susceptibilities and serotypes in pregnant women have not been reported in Korea. So, we studied to define the antimicrobial susceptibility patterns and frequency of serotypes of GBS in pregnant women. METHODS: The susceptibility and serotyping of 60 GBS isolates from 27 pregnant women and four isolates from their two neonates were tested by an agar dilution method and agglutination test, respectively. The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Minimal inhibitory concentration range of 60 GBS from pregnant women were penicillin G 0.015-0.12 microgram/ml, vancomycin 0.5-2 microgram/ml, clindamycin 0.015-4.0 microgram/ml, chloramphenicol 2-4 microgram/ml, erythromycin 0.015-2 microgram/ml, tetracycline 0.5-256 microgram/ml, cephalothin 0.12-0.25 microgram/ml, ceftriaxone 0.03-0.12 microgram/ml, respectively. The resistance rate of GBS were 6.7% to clindamycin, 0% to erythromycin, and 98.3% to tetracycline. Most of GBS serotypes from pregnant women in decreasing order were Ib(48.3%), Ia(24.1%), III(20.7%). CONCLUSION: All GBS strains isolated from pregnant women are highly susceptible to commonly used antimicrobial agents with the exception of tetracycline. The low prevalence of severe neonatal GBS infections in Korea is not due to the absence of serotype III, but probably due to a low genital carriage rate of GBS by pregnant women.
Agar ; Agglutination Tests ; Anti-Infective Agents ; Ceftriaxone ; Cephalothin ; Chloramphenicol ; Clindamycin ; Colon ; Erythromycin ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Penicillin G ; Pregnant Women* ; Prevalence ; Serotyping ; Tetracycline ; Vancomycin

Coronary artery fistula (CAF) is an abnormal communication between an epicardial coronary artery and a cardiac chamber, major vessel or other vascular structures. This report presents a rare case of CAF in which a dilated left main trunk and proximal circumflex coronary artery are connected to a dilated coronary sinus. There were also two other fistulae and persistent left superior vena cava. The coronary fistula was managed conservatively.
Arteriovenous Fistula ; Coronary Sinus ; Coronary Vessel Anomalies ; Coronary Vessels ; Fistula ; Glycosaminoglycans ; Vena Cava, Superior

The widespread application of coronary angiography and poen heart surgery have resulted in more frequent detection of patients with coronary artery anomaly. In 0.6 to 1.2 percent of individials, the coronary arteries arise aberrantly from the aorta. Anomalous origin of the left coronary artery from the fight coronary sinus with subsequent coursing between the aorta and pulmonary artery is a rare and sometimes fatal coronary amonaly. This anomaly has been reported in young and healthy men who died suddenly during or immediately forllowing vigorous physical exercise. The exact mechanism of sudden death is unclear. It is believed to be related to either extrinsic compression of the left coronary artery or distorsion of the vessel orifice, with resultant global ischemia and ventricular fibrllation. A 13-years old healthy boy, who was completely asymptomatic until he had sudden chest pain after running, arrived at hospital with typical clinical picture of acute myocardial infarction. The electrocardiography taken on admission demonstrated pathologic Q wave changes on lead I, aVL, V2, V3 and V4. Cardiac enzymes were elevated. The selective coronary angiography demonstrated that left coronary artery arose from the right coronary sinus. The anomalous left coronary artery passed posterioly around aortic root to reach its normal position in the interventricular groove. We report the patient with anomalous origined left coronary artery which causes the acute myocardial infarction.
Adolescent ; Aorta ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessels* ; Death, Sudden ; Electrocardiography ; Exercise ; Humans ; Ischemia ; Male ; Myocardial Infarction* ; Pulmonary Artery ; Running ; Thoracic Surgery

BACKGROUND AND OBJECTIVES: It is well known that anti-platlet agents decrease the rate of subacute thrombosis after intracoronary stenting significantly. The aim of this study is to assess the antithrombotic effect and safety of 2-month combined regimen of cilostazol and aspirin on intracoronary stenting. METHODS: The study population consisted of 78 lesions of 57 patients (age: 58.1+/-10.3, male 47, female 10) with ischemic heart disease who were underwent successful intracoronary stenting. They were received cilostazol(200mg/day) and aspirin(100mg/day) two days before intracoronary stenting and continued for 8 weeks, and then aspirin was medicated continuously during the study. The laboratory and clinical findings were evaluated before cilostazol administration, 4 weeks, 8 weeks and 6 months after intervention. The excercise treadmill test was done at 6 months after intervention. RESULTS: Subacute thrombosis occurred in 2 patients(3.5%). Target lesion revascularization(TLR) was done in 4 patients(7.3%). Clinical restenosis (symptomatic or positive stress test, subacute thrombosis and TLR) occurred in 15 patients(26.3%). There was no granulocytopenia, or severe liver dysfunction. HDL-cholesterol was increased significantly at 2 months(36.6+/-7.4 mg/dl versus 41.6+/-9.3 mg/dl. p<0.01) and 6 months(36.6+/-7.4 mg/dl versus 42.4+/-10.6 mg/dl. p<0.01) follow up. CONCLUSION: Two-month combined regimen of cilostazol and aspirin was effective and safe after intracoronary stenting. Subacute thrombosis and clinical restenosis rate were comparable with pervious reports. Further large randomized trials are needed for the evaluation of favorable effect of cilostazol on lipid metabolism.
Agranulocytosis ; Aspirin* ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Lipid Metabolism ; Liver Diseases ; Male ; Myocardial Ischemia ; Stents* ; Thrombosis

BACKGROUND AND OBJECTIVES: It is well known that anti-platlet agents decrease the rate of subacute thrombosis after intracoronary stenting significantly. The aim of this study is to assess the antithrombotic effect and safety of 2-month combined regimen of cilostazol and aspirin on intracoronary stenting. METHODS: The study population consisted of 78 lesions of 57 patients (age: 58.1+/-10.3, male 47, female 10) with ischemic heart disease who were underwent successful intracoronary stenting. They were received cilostazol(200mg/day) and aspirin(100mg/day) two days before intracoronary stenting and continued for 8 weeks, and then aspirin was medicated continuously during the study. The laboratory and clinical findings were evaluated before cilostazol administration, 4 weeks, 8 weeks and 6 months after intervention. The excercise treadmill test was done at 6 months after intervention. RESULTS: Subacute thrombosis occurred in 2 patients(3.5%). Target lesion revascularization(TLR) was done in 4 patients(7.3%). Clinical restenosis (symptomatic or positive stress test, subacute thrombosis and TLR) occurred in 15 patients(26.3%). There was no granulocytopenia, or severe liver dysfunction. HDL-cholesterol was increased significantly at 2 months(36.6+/-7.4 mg/dl versus 41.6+/-9.3 mg/dl. p<0.01) and 6 months(36.6+/-7.4 mg/dl versus 42.4+/-10.6 mg/dl. p<0.01) follow up. CONCLUSION: Two-month combined regimen of cilostazol and aspirin was effective and safe after intracoronary stenting. Subacute thrombosis and clinical restenosis rate were comparable with pervious reports. Further large randomized trials are needed for the evaluation of favorable effect of cilostazol on lipid metabolism.
Agranulocytosis ; Aspirin* ; Exercise Test ; Female ; Follow-Up Studies ; Humans ; Lipid Metabolism ; Liver Diseases ; Male ; Myocardial Ischemia ; Stents* ; Thrombosis

BACKGROUND: The intimal thickening of coronary artery was understood as an early process in the beginning of atherosclerosis. However, the implication of intimal thickening as a morphologic change of coronary artery disease, on the coronary vascular hemodynamics has not been explored. METHODS: To evaluate the effect of intimal thickening on the coronary vascular hemodynamics, we studied the extent of intimal thickening on intravascular ultrasound(IVUS) and the coronary vascular flow and resistance by using Doppler wire in left anterior descending coronary arteries after successful intervention in 40 patients(29 males, mean age 55+/-9 years) with coronary artery disease. Mean intimal index and mean lumen cross sectional area were determined by IVUS and coronary flow average peak velocity was obtained by using Doppler wire before and after intracoronary adenosine in distal artery to the stenosis. Coronary flow velocity reserve(CFR), volumetric coronary blood flow(CBF) and coronary vascular resistance index(CVRI) were calculated. Hyperemic pressure-to-flow ratio(hyperemic mean aortic pressure/hyperemic volumetric coronary blood flow), ie, an index of minimal coronary vascular resistance(mCVR), was further derived. RESULTS: Intimal index(mean 20.0+/-8.3%) was significantly correlated with CVRI(mean 0.33+/-0.14, r=.37, p=.02) and mCVR(mean 0.81+/-0.40mmHg/ml/min, r=.36, p=.02). However, there was no correlation with CBF and CFR. CONCLUSION: The CVRI and mCVR(hyperemic pressure to flow ratio), the indices coronary microvascular resistance, were significantly related to the degree of intimal thickness of coronary artery. The extent of intimal thickness of coronary artery on IVUS study may be related to microvascular integrity.
Adenosine ; Arteries ; Atherosclerosis ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Hemodynamics ; Humans ; Male ; Vascular Resistance*

We report a rare case of tricuspid valve and pulmonary valve endocarditis associated with a double-chambered right ventricle in an adult female with pulmonary artery aneurysm and septic pulmonary embolism by Streptococcus mitis. She was treated with aggressive antibiotic therapy followed by debridement of the infective lesion of tricuspid valve, pulmonary valve replacement using xenograft and resection of obstructing muscular bundles in right ventricle.
Adult ; Aneurysm ; Debridement ; Endocarditis* ; Endocarditis, Bacterial ; Female ; Heart Defects, Congenital ; Heart Ventricles* ; Heterografts ; Humans ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Streptococcus mitis ; Tricuspid Valve

Women with menopause or rats with ovariectomy is associated with increased body weight, body fat and insulin resistance, which are components of metabolic syndrome. Increased prevalence of metabolic syndrome after menopause might be associated with mitochondrial dysfunction, since mitochondrial oxidative and phosphorylation activity is strongly correlated with insulin sensitivity. Although estradiol replacement prevents the metabolic syndrome, harmful effect of estradiol hampers the casual usage to prevent the metabolic syndrome. It has been reported that genistein has a mild estrogenic activity, decreases fat mass in mice and has an antidiabetic role in diabetic rats. Although insulin resistance is closely related to mitochondrial functions, there has not been yet any study in regard to the effect of dietary genistein on mitochondrial function in the insulin resistant female subjects induced by ovariectomy or similar situation. The present study investigated whether the supplementation of genistein in the high fat diet affected the mitochondrial function of high fat fed ovariectomized rats. Female Sprague Dawley rats (8 weeks old) were assigned to the following groups: sham-operated + high fat diet (S, n = 6); sham-operated + high fat diet with 0.1% genistein (S + G, n = 7); ovariectomized + high fat diet (OVX, n = 8); ovariectomized + high fat diet with 0.1% genistein (OVX + G, n = 8). Ovariectomy significantly increased body weight compared with S group. Genistein consumption in ovariectomized (OVX + G) rats decreased body weight gain compared with OVX rats. Liver weights were increased by ovariectomy. The hepatic mitochondrial protein density expressed as mg per g liver was lower in the OVX group than in the S group. However, OVX + G group showed the increased mitochondrial protein density similar to the level of S group. When mRNA levels of genes related to mitochondria such as peroxisome proliferator-activated receptor gamma coactivator 1 (PGC-1) and cytochrome c oxidase subunit III (COX III) were measured, there were decreases in the mRNA levels of PGC-1 and COX III in S + G, OVX and OVX + G group. The activity of cytochrome c oxidase was not different between groups. We could observe the decrease in succinate dehydrogenase (SDH) activity per g liver in OVX rats. Genistein supplement increased SDH activity. In conclusion, genistein supplementation to the OVX rats enhanced mitochondrial function by increasing mitochondrial protein density and SDH activity. The improvement in mitochondrial function by genistein can contribute to the improvement in metabolic syndrome.
Adipose Tissue ; Animals ; Body Weight ; Diet, High-Fat ; Electron Transport Complex IV ; Estradiol ; Estrogens ; Female ; Genistein* ; Humans ; Insulin ; Insulin Resistance ; Liver ; Menopause ; Mice ; Mitochondria ; Mitochondrial Proteins ; Ovariectomy* ; Phosphorylation ; PPAR gamma ; Prevalence ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Succinate Dehydrogenase ; Weights and Measures

Postmenopausal women or ovariectomized rats are associated with increased cholesterol levels, which are risk factors of metabolic syndrome and cardiovascular diseases. Increased prevalence of metabolic syndrome after menopause might be associated with estradiol deficiency. Harmful effect of estradiol hampers the casual usage of hormone to prevent the metabolic syndrome. Soy protein has been reported to show several beneficial effects on health, however it is unclear which components of soy protein is responsible for anti-obesity and hypocholesterolemic effects. Soy isoflavones, genistein and daizein, are suggested to have anti-obesity and hypocholesterolemic effects but with inconsistency. The present study investigated the effect of supplementation of genistein (experiment I) and soy protein containing isoflavones (experiment II) to high fat diet on body weight gain, food intake, liver and fat tissue weight and the lipid levels in ovariectomized rats. Plasma and hepatic lipid contents and the mRNA levels of genes encoding lipid metabolism related proteins, such as CPT1 and HMGR were measured. Ovariectomy increased body weight, fat tissue weight and plasma and hepatic lipid levels which increase the risk of metabolic syndrome. Soy protein could improve plasma and hepatic lipids levels. Soy protein also increased hepatic CPT1 and HMGR mRNA levels. Plasma and hepatic lipids levels could not be decreased by dietary genistein alone. In contrast, lipids levels could be decreased by isoflavone-fortified soy protein, suggesting that the ingestion of soy protein enriched with isoflavone gives more benefit for protecting postmenopausal women from metabolic syndrome.
Animals ; Body Weight ; Cardiovascular Diseases ; Cholesterol ; Diet, High-Fat ; Eating ; Estradiol ; Female ; Genistein* ; Humans ; Isoflavones ; Lipid Metabolism ; Liver ; Menopause ; Metabolism* ; Ovariectomy ; Plasma ; Prevalence ; Rats* ; Risk Factors ; RNA, Messenger ; Soybean Proteins*