Variant angina pectoris is characterized by chest symptoms at rest and transient ST elevation on the electrocardiography due to coronary artery spasm. Although most patients with coronary spasm respond well to medical treatment with vasodilators such as calcium channel blockers and nitrates, some patients show intractable attack of coronary vasospasm despite standard medical therapy. We experienced 50-year-old woman with intractable chest pain due to coronary artery spasm, who suffered from ventricular fibrillation despite continuous intravenous nitrate therapy.
Angina Pectoris, Variant ; Arrhythmias, Cardiac* ; Calcium Channel Blockers ; Chest Pain ; Coronary Vasospasm ; Coronary Vessels ; Electrocardiography ; Female ; Humans ; Middle Aged ; Muscle Spasticity* ; Nitrates ; Nitroglycerin* ; Spasm ; Thorax ; Vasodilator Agents ; Ventricular Fibrillation

The purpose of this study was proposed to identify the association of trunk body composition with spinal bone mineral density (BMD) in Korean male and female farmers. A total of 523 Korean farmers (259 males, 44 premenopausal females, and 220 postmenopausal females) were recruited. Computed tomography scans were acquired at the mid-L4 vertebral level, and total trunk muscle mass (TMM, cm3), back muscle mass (BMM), and abdominal wall muscle mass (AMM), total trunk fat mass (TFM), visceral fat mass (VFM), and subcutaneous fat mass (SFM) were assessed. Spinal BMD (g/cm2) was estimated from dual-energy X-ray absorptiometry at the L4 level. In terms of muscle mass, spinal BMD was significantly correlated with all the components of the trunk muscle mass (r = 0.171-0.360; P < 0.05, P < 0.001) in female farmers, while only with AMM (r = 0.181; P < 0.01) in male farmers. In terms of fat mass, spinal BMD was significantly correlated with all components of the trunk fat mass (r = 0.142-0.424; P < 0.05, P < 0.001) in male and premenopausal female farmers, while only with VFM (r = 0.132; P < 0.05) in postmenopausal females. Adjusted multivariate regression analysis showed that AMM in male and post-menopausal female farmers was closely associated with spinal BMD. There may be positive associations between trunk muscle and fat mass and spinal BMD with sexual dimorphism, and abdominal wall muscle mass was an explanatory variable closely related to spinal BMD in Korean farmers. Registered at the Clinical Research Information Service (CRIS, http://cris.nih.go.kr), number KCT0000829.
Abdominal Wall ; Absorptiometry, Photon ; Adipose Tissue ; Back Muscles ; Body Composition* ; Bone Density* ; Cohort Studies* ; Farmers ; Female* ; Humans ; Information Services ; Intra-Abdominal Fat ; Male* ; Sex Characteristics ; Spine ; Subcutaneous Fat

Gouty arthritis is a metabolic disorder characterized by hyperuricemia, deposition of monosodium urate crystal in the joints, and recurrent episodes of acute inflammatory arthritis. Depending on the actual causes of hyperuricemia, gout is classified as primary or secondary gout. In myeloproliferative neoplasms, a turnover of nucleic acids is greatly augmented and therefore the blood concentration of uric acid may be markedly increased. But an acute attack of gout is extremely rare in patients with myeloproliferative neoplasms. Essential thrombocythemia, one of the myeloproliferative neoplasms, is characterized by megakaryocytic hyperplasia in bone marrow and marked thrombocytosis. We report a case of secondary gout in a 66-year-old man with essential thrombocythemia.
Aged ; Arthritis ; Arthritis, Gouty ; Bone Marrow ; Gout ; Humans ; Hyperplasia ; Hyperuricemia ; Joints ; Nucleic Acids ; Thrombocythemia, Essential ; Thrombocytosis ; Uric Acid

BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS: Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0.075 mg, n = 50) or dexamethasone (5 mg, n = 50). Treatments were administered intravenously to the patients 30 min before the beginning of surgery. The total incidence of PONV and incidence in each time period, severity of nausea, need for rescue anti-emetics, pain score, and adverse effects during the first 48 h postoperatively were evaluated. RESULTS: The total incidence of PONV was lower in the palonosetron group compared with the dexamethasone group (18.4% vs. 36.7%, P = 0.042), but there were no statistically significant differences in incidence between the groups at all time points. No significant intergroup differences were observed in the severity of nausea, use of rescue anti-emetics, pain score, and adverse effects. CONCLUSIONS: Although there were no significant differences in the incidence of PONV between the treatment groups at all time points, intravenous palonosetron reduced the total incidence of PONV in orthopedic patients receiving PCEA compared with dexamethasone.
Analgesia, Epidural* ; Analgesia, Patient-Controlled ; Anesthesia ; Antiemetics ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Dexamethasone* ; Hip ; Humans ; Incidence ; Joints ; Nausea ; Orthopedics* ; Postoperative Nausea and Vomiting*

The current PET/CT system with high quality CT images not only increases diagnostic value by providing anatomic localization, but also shortens the acquisition time for attenuation correction than primary PET system. All commercially available PET/CT system uses the CT scan for attenuation correction instead of the transmission scan using radioactive source such as 137Cs, 68Ge. However the CT scan may substantially increase the patient dose. The purpose of this study was to evaluate quality of PET images reconstructed by CT attenuation map using various tube currents. In this study, images were acquired for 3D Hoffman brain phantom and cylindrical phantom using GE DSTe PET/CT system. The emission data were acquired for 10 min using phantoms after injecting 44.03 MBq of 18F-FDG. The CT images for attenuation map were acquired by changing tube current from 10 mA to 95 mA with fixed exposure time of 8 sec and fixed tube voltage of 140 kVp. The PET images were reconstructed using these CT attenuation maps. Image quality of CT images was evaluated by measuring SD (standard deviation) of cylindrical phantom which was filled with water and 18F-FDG solution. The PET images were evaluated by measuring the activity ratio between gray matter and white matter in Hoffman phantom images. SDs of CT images decrease by increasing tube current. When PET images were reconstructed using CT attenuation maps with various tube currents, the activity ratios between gray matter and white matter of PET images were almost same. These results indicated that the quality of the PET images using low dose CT data were comparable to the PET images using general dose CT data. Therefore, the use of low dose CT is recommended than the use of general dose CT, when the diagnostic high quality CT is not required. Further studies may need to be performed for other system, since this study is limited to the GE DSTe system used in this study.
Brain ; Fluorodeoxyglucose F18 ; Humans ; Positron-Emission Tomography and Computed Tomography* ; Tomography, X-Ray Computed ; Water

PURPOSE: To validate the use of harmonic ultrasonography (US) in the detection of gallbladder microlithiasis. METHODS: From November 30, 2012, to January 18, 2014, fundamental US (FUS) and harmonic US with a high background noise (HUS-N) were performed for evaluation of gallbladder during the routine abdomen US. During the US, a dot-like stone (or stones) with Brownian motion was regarded as a positive finding of microlithiasis. Fifty-five patients with microlithiasis in the gallbladder detected on US were enrolled as the subjects of a retrospective review. With respect to the obtained images, two abdominal radiologists independently scored the conspicuity of gallbladder microlithiasis on FUS and HUS-N by using a 4-grade scale. The statistical analysis employed a kappa test and a Wilcoxon rank-sum test. RESULTS: For FUS, the conspicuity grades of gallbladder microlithiasis were G1 in 25 and 37, G2 in 21 and 9, G3 in 6 and 6, G4 in 3 and 3 patients, while HUS-N showed G1 in 0 and 0, G2 in 3 and 2, G3 in 12 and 15, and G4 in 40 and 38 patients, respectively, by each of the two radiologists. The kappa value was 0.633 for FUS between the two radiologists and 0.708 for HUS-N. HUS-N showed better conspicuity of gallbladder microlithiasis than FUS with significant P-values of less than 0.001 and 0.001 for the two radiologists, respectively. CONCLUSION: Compared with FUS, HUS-N enables better detection of microlithiasis in the gallbladder.
Abdomen ; Cholecystolithiasis ; Gallbladder* ; Humans ; Noise ; Retrospective Studies ; Ultrasonography*

Target herbal ingredient (THI) is an extract made from two herbs, Scutellariae Radix and Platycodi Radix. It has been developed as a treatment for metabolic diseases such as hyperlipidemia, atherosclerosis, and hypertension. One component of these two herbs has been reported to have anti-inflammatory, anti-hyperlipidemic, and anti-obesity activities. However, there have been no reports about the effects of the mixed extract of these two herbs on metabolic diseases. In this study, we investigated the metabolic effects of THI using a diet-induced obesity (DIO) mouse model. High-fat diet (HFD) mice were orally administered daily with 250 mg/kg of THI. After 10 weeks of treatment, the THI-administered HFD mice showed reduction of body weights and epididymal white adipose tissue weights as well as improved glucose tolerance. In addition, the level of total cholesterol in the serum was markedly reduced. To elucidate the molecular mechanism of the metabolic effects of THI in vitro, 3T3-L1 cells were treated with THI, after which the mRNA levels of adipogenic transcription factors, including C/EBPalpha and PPARgamma, were measured. The results show that the expression of these two transcription factors was down regulated by THI in a dose-dependent manner. We also examined the combinatorial effects of THI and swimming exercise on metabolic status. THI administration simultaneously accompanied by swimming exercise had a synergistic effect on serum cholesterol levels. These findings suggest that THI could be developed as a supplement for improving metabolic status.
3T3-L1 Cells ; Adipose Tissue, White ; Animals ; Atherosclerosis ; Body Weight ; Cholesterol ; Diet, High-Fat ; Flavonoids ; Glucose ; Hyperlipidemias ; Hypertension ; Metabolic Diseases ; Mice ; Obesity ; PPAR gamma ; RNA, Messenger ; Scutellaria baicalensis ; Swimming ; Transcription Factors ; Weights and Measures

OBJECTIVE: To evaluate scientific papers published by Korean radiologists in the Science Citation Index Expanded (SCIE) radiology journals, between 1986 and 2010. MATERIALS AND METHODS: The Institute for Scientific Information Web of Knowledge-Web of Science (SCIE) database was searched for all articles published by Korean radiologists, in SCIE radiology journals, between 1986 and 2010. We performed the analysis by typing "Korea" and "radiol" in the address section and selecting the subject area of "Radiology, Nuclear Medicine, and Medical Imaging" with the use of the general search function of the software. Analyzed parameters included the total number of publications, document types, journals, and institutions. In addition, we analyzed where Korea ranks, compared to other countries, in terms of the number of published articles. All these data were analyzed according to five time periods: 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2010. RESULTS: Overall, 4974 papers were published by Korean radiologists, in 99 different SCIE journals, between 1986 and 2010, of which 4237 (85.2%) were article-type papers. Of the total 115395 articles, worldwide, published in radiology journals, Korea's share was 3.7%, with an upward trend over time (p < 0.005). The journal with the highest number of articles was the American Journal of Roentgenology (n = 565, 13.3%). The institution which produced the highest number of publications was Seoul National University (n = 932, 22.0%). CONCLUSION: The number of scientific articles published by Korean radiologists in the SCIE radiology journals has increased significantly between 1986 and 2010. Korea was ranked 4th among countries contributing to radiology research during the last 5 years.
*Bibliometrics ; Biomedical Research/*statistics & numerical data ; Periodicals as Topic/*statistics & numerical data ; *Radiology ; Republic of Korea

Background: In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. Methods: The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation.The questionnaires were sent to regional public and private medical institutions and public health management institutions. Results: In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. Conclusion Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.