Therapeutic ionizing radiation can damage the permanent pacemaker. Reimplantation of pacemaker should be considered when the pacemaker site is included in the radiation field. We report a case of successful repositioning of preexisting pacemaker generator and leads with subcutaneous tunneling method across the sternum instead of insertion of new leads in a female patient with breast cancer who had DDD pacemaker.
Breast Neoplasms ; Dichlorodiphenyldichloroethane ; Female ; Humans ; Radiation, Ionizing ; Replantation ; Sternum

Nonalcoholic fatty liver disease (NAFLD) is one of the causes of fatty liver, occurring when fat is accumulated in the liver without alcohol consumption. NAFLD is the most common liver disorder in advanced countries. NAFLD is a spectrum of pathology involving hepatic steatosis with/without inflammation and nonalcoholic steatohepatitis with accumulation of hepatocyte damage and hepatic fibrosis. Recent studies have revealed that NAFLD results in the progression of cryptogenic cirrhosis that leads to hepatocarcinoma and cardiovascular diseases such as heart failure. The main causes of NAFLD have not been revealed yet, metabolic syndromes including obesity and insulin resistance are widely accepted for the critical risk factors for the pathogenesis of NAFLD. Nuclear receptors (NRs) are transcriptional factors that sense environmental or hormonal signals and regulate expression of genes, involved in cellular growth, development, and metabolism. Several NRs have been reported to regulate genes involved in energy and xenobiotic metabolism and inflammation. Among various NRs, farnesoid X receptor (FXR) is abundantly expressed in the liver and a key regulator to control various metabolic processes in the liver. Recent studies have shown that NAFLD is associated with inappropriate function of FXR. The impact of FXR transcriptional activity in NAFLD is likely to be potential therapeutic strategy, but still requires to elucidate underlying potent therapeutic mechanisms of FXR for the treatment of NAFLD. This article will focus the physiological roles of FXR and establish the correlation between FXR transcriptional activity and the pathogenesis of NAFLD.
Alcohol Drinking ; Bile Acids and Salts ; Bile* ; Cardiovascular Diseases ; Fatty Liver ; Fibrosis ; Heart Failure ; Hepatocytes ; Inflammation ; Insulin Resistance ; Liver ; Metabolism ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Pathology ; Receptors, Cytoplasmic and Nuclear ; Risk Factors

This study was performed to assess the influence of the cryoinjury on the dynamics of wavefronts and to determine whether they can convert ventricular fibrillation (VF) to ventricular tachycardia (VT) in fibrillating right ventricular (RV) of swines using an optical mapping system. A cryoinjury with a diameter of 12 mm was created on the epicardium of perfused RV of swines (n = 6) and optical mapping were taken from baseline until 10 minutes after the cryoinjury. Out of 35 cryoinjuries, the images were possible to be interpreted in 32. The optical action potential could not be observed in either the cryoinjury or peri-injury sites at 1 and 3 minutes, was observed in only the cryoinjury site at 5 minutes, and recovered in both sites at 10 minutes. The cycle length of the tachycardia was 135.9 +/- 23.6 msec at baseline, 176.2 +/- 79.3 msec at 1 minute, 187.6 +/- 97.9 msec at 3 minutes, 185.5 19.2 msec at 5 minutes, and 152.1 +/- 64.1 msec at 10 minutes. The cycle lengths at 1, 3, and 5 minutes after the cryoinjury were significantly more prolonged than that at baseline (p = 0.001, p = 0.006, p = 0.016). After the cryoinjury, the VF changed to VT in 9 (28.0%), and terminated in 2 (6.3%). These changes were observed mainly within 5 minutes after cryoinjury. The cryoinjury had anti-fibrillatory effects on the tissue with VF. This phenomenon was related to a decreasing mass and stabilizing wavefronts.
Ventricular Fibrillation/*physiopathology ; Tachycardia, Ventricular/*physiopathology ; Swine ; Heart Ventricles/*physiopathology/surgery ; Female ; Disease Models, Animal ; *Cryosurgery ; Animals

Genetically engineered mouse models are commonly preferred for studying the human disease due to genetic and pathophysiological similarities between mice and humans. In particular, Cre-loxP system is widely used as an integral experimental tool for generating the conditional. This system has enabled researchers to investigate genes of interest in a tissue/cell (spatial control) and/or time (temporal control) specific manner. A various tissue-specific Cre-driver mouse lines have been generated to date, and new Cre lines are still being developed. This review provides a brief overview of Cre-loxP system and a few commonly used promoters for expression of tissue-specific Cre recombinase. Also, we finally introduce some available links to the Web sites that provides detailed information about Cre mouse lines including their characterization.
Animals ; Humans ; Mice* ; Recombinases

PURPOSE: To evaluate the clinical outcomes of cataract surgery using novel diffractive trifocal intraocular lenses (IOLs) in Koreans. METHODS: This was a retrospective, consecutive, interventional study of cataract surgery using POD FineVision IOL implantation. Complete ophthalmologic examinations were performed preoperatively and postoperatively. Defocus curves were assessed over a range of +1.5 to −4.0 diopters in 0.5-diopter steps at one month postoperatively. Uncorrected distant visual acuity, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distant visual acuity, distant-corrected intermediate visual acuity, and distant-corrected near visual acuity were assessed one month postoperatively, and manifest refraction was performed during every visit. RESULTS: The study analyzed 31 eyes in 20 patients. There were statistically significant improvements in uncorrected distance visual acuity, uncorrected intermediate visual acuity, uncorrected near visual acuity, corrected distance visual acuity, distance-corrected intermediate visual acuity, and distance-corrected near visual acuity (p < 0.001). The final postoperative refractive outcomes showed statistically significant myopic shifts compared to the target refraction based on SRK/T, SRK-II, Haigis, and Hoffer Q formulas (p < 0.001). CONCLUSIONS: POD FineVision IOLs provide stable visual restoration with improvements of near and intermediate vision in presbyopic eyes. POD FineVision IOLs show myopic shift in a Korean population; therefore, surgeons should be cautious when selecting IOL power in such patients.
Cataract ; Humans ; Lenses, Intraocular ; Refractive Errors ; Retrospective Studies ; Surgeons ; Visual Acuity

Though bile acids have been well known as digestive juice, recent studies have demonstrated that bile acids bind to their endogenous receptors, including Farnesoid X receptor (FXR) and G protein-coupled bile acid receptor 1 (GPBAR1; TGR5) and serve as hormone to control various biological processes, including cholesterol/bile acid metabolism, glucose/lipid metabolism, immune responses, and energy metabolism. Deficiency of those bile acid receptors has been reported to induce diverse metabolic syndromes such as obesity, hyperlipidemia, hyperglycemia, and insulin resistance. As consistent, numerous studies have reported alteration of bile acid signaling pathways in type II diabetes patients. Interestingly, bile acids have shown to activate TGR5 in intestinal L cells and enhance secretion of glucagon-like peptide 1 (GLP-1) to potentiate insulin secretion in response to glucose. Moreover, FXR has been shown to crosstalk with TGR5 to control GLP-1 secretion. Altogether, bile acid receptors, FXR and TGR5 are potent therapeutic targets for the treatment of metabolic diseases, including type II diabetes.
Bile ; Bile Acids and Salts ; Biological Processes ; Energy Metabolism ; Enteroendocrine Cells ; Glucagon-Like Peptide 1* ; Glucose ; Homeostasis* ; Humans ; Hyperglycemia ; Hyperlipidemias ; Insulin ; Insulin Resistance ; Metabolic Diseases ; Metabolism ; Obesity

BACKGROUND: Doppler variable of mitral inflow have been used to assess left ventricular siastolic function indirectly. Pulmonary venous flow(PVF) variables could supplement mitral inflow in the estimation of left ventricular diastolic function. The purpose of this study are to assess the feasibility of PVF measurement by using transthoracic pulsed wave Doppler echocardiogram and to estimate the LV end-diastolic pressure with PVF parameters. METHODS: Fifty six patients underwent transthoracic pulsed wave Doppler echocardiagraphy (HP Sonos 1500) within 2 hours before left heart catheterization for the measurement of left ventricular pressure. RESULTS: 1) Measurement of transthoracic PVF was feasible in 50 patients(89.3%). 2) The difference between the duration of pulmonary venous reversal flow and mitral A wave(D difference, delta D) was strongly correlated with left ventricular end diastolic pressure(r=0.73, p<0.01). PVF reversal duration exceeding that of mitral A wave predicted left ventricular end diastolic pressure > or =12mmHg(sensitivity 90.6%, specificity 50.0%). CONCLUSION: PVF could be assessed with transthoracic Doppler ultrasound with good feasibility. PVF may be an important parameter in the evaluation of left ventricular diastolic function. PVF reveral duration exceeding that of mitral A wave would be a marker of elevated left ventricular end diastolic pressure(> or =12mmHg). Plumonary venous flow . Transmitral inflow . Left ventricular end diastolic pressure. Transthorasic doppler echocardiography.
Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography, Doppler* ; Humans ; Sensitivity and Specificity ; Ultrasonography ; Ventricular Pressure

PURPOSE: The optimal pacing mode with either single chamber atrial pacemaker (AAI or AAIR) or dual chamber pacemaker (DDD or DDDR) is still not clear in sinus-node dysfunction (SND) and intact atrioventricular (AV) conduction. MATERIALS AND METHODS: Patients who were implanted with permanent pacemaker using AAI(R) (n = 73) or DDD(R) (n = 113) were compared. RESULTS: The baseline characteristics were comparable between the two groups, with a mean follow-up duration of 69 months. The incidence of death did not show statistical difference. However, the incidence of hospitalization for congestive heart failure (CHF) was significantly lower in the AAI(R) group (0%) than the DDD(R) group (8.8%, p = 0.03). Also, atrial fibrillation (AF) was found in 2.8% in the AAI(R) group, which was statistically different from 15.2% of patients in the DDD(R) group (p = 0.01). Four patients (5.5%) with AAI(R) developed AV block, and subsequently switched to DDD(R) pacing. The risk of AF was lower in the patients implanted with AAI(R) than those with DDD(R) [hazard ratio (HR), 0.84; 95% confidence interval, 0.72 to 0.97, p = 0.02]. CONCLUSION: In patients with SND and intact AV conduction, AAI(R) pacing can achieve a better clinical outcome in terms of occurrence of CHF and AF than DDD(R) pacing. These findings support AAI(R) pacing as the preferred pacing mode in patients with SND and intact AV conduction.
Aged ; Atrial Fibrillation/complications/physiopathology ; Atrioventricular Node/*physiopathology ; Cardiac Pacing, Artificial ; Cohort Studies ; Female ; Follow-Up Studies ; Heart Failure/complications ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Sick Sinus Syndrome/*physiopathology ; Treatment Outcome