Background: Identifying the risks related to the complications of electrical cardioversion (ECV) can alert the determinaton of rhythm control in patients with atrial fibrillation (AF). Methods: We retrospectively reviewed 1,058 patients who underwent ECV for persistent or long-standing persistent AF/atrial flutter (AFL) from multiple centers. Patients were classified into the no-complication (1,023 patients) and complication (35 patients) groups based on the following major complications: stroke and/or systemic embolism (SSE), myocardial infarction, major bleeding, implantation of cardiac implantable electronic devices, ventricular tachycardia/fibrillation, and death at 1 year follow-up after ECV. Results: Compared with the no-complication group, the complication group exhibited a higher proportion of female patients (37% vs. 22%), as well as a higher proportion of patients with older age (67 ± 11 vs. 61 ± 10 years), diabetes mellitus (DM) (49% vs. 24%), heart failure (HF) (49% vs. 30%), SSE (23% vs. 9%), high CHA 2 DS 2 -VASc (CV) score (3.6 ± 1.8 vs.2.2 ± 1.4), low left ventricular ejection fraction (LVEF) (50 ± 16% vs. 58 ± 21%), and high left atrial volume index (LAVI) (51 ± 26 vs. 40 ± 20 mL/m 2 ). Class I and III antiarrhythmics were less prescribed in the complication group than in the no-complication group (57% vs.76%). Univariate analysis for complications revealed age (≥ 65 years), female sex, DM, HF, SSE, LVEF (< 50%), LAVI (≥ 40 mL/m 2 ), CV score (≥ 3), bradycardia on Holter (< 60/min), and no antiarrhythmics as risk factors. Among these, multivariate analysis revealed clinical significance of female sex and SSE. Conclusion Female sex and a history of SSE were the most important risk factors of complications in patients with persistent or long-standing persistent AF/AFL who underwent ECV.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Spontaneous coronary artery dissection (SCAD) is a condition in which an intramural hematoma within the coronary artery leads to acute coronary syndrome without atherosclerosis, trauma, or iatrogenic causes. It predominantly affects middle-aged women and is associated with several predisposing conditions, including fibromuscular dysplasia, systemic inflammatory disorders, connective tissue diseases, and coronary artery spasms. We report the case of a 64-year-old male with a history of hypertension who died of SCAD. His death occurred suddenly and without preceding trauma while the decedent was working overtime at a construction site. On gross examination, a thrombus-like material was identified in a branch of the left anterior descending artery and was initially presumed to be a postmortem clot. However, microscopic examination revealed an intramural hemorrhage, medial dissection, and formation of a false lumen within the coronary artery. This case report highlights the importance of a thorough histopathological examination of the coronary arteries during autopsy, even in the absence of atherosclerosis.

Background: Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials. Methods: We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs. Results: Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health. Conclusion AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.

Background: Recent studies have elucidated the quorum-sensing mechanisms, biofilm formation, inter-pathogen interactions,and genes related to oral pathogens. This review aims to explore the recent expansion of drug targets against oral pathogens and summarize the current research on novel antibiotic substances derived from marine organisms that target oral pathogens. Methods: A comprehensive literature review summarized the novel mechanisms pertaining to quorum-sensing signal transmission systems, biofilm formation, and metabolite exchange in oral pathogens. The amino acid sequences of the 16 proteins identified as potential drug targets were systematically classified and compared across various oral microorganisms. Results: Through a literature review, we identified nine studies researching quorum sensing signaling inhibitors targeting oral pathogens. A comparison of the amino acid sequences of 16 potential drug targets in oral microorganisms revealed significant differences between oral pathogens and beneficial oral symbiotic microorganisms. These findings imply that it is possible to design drugs that can bind more selectively to oral pathogens. Conclusion By summarizing the results of recent research on the signaling mechanisms that cause pathogenicity, new drug targets against oral pathogens were proposed. Additionally, the current status of developing new antibiotics for oral pathogens using recently developed quorum sensing inhibitors and natural products derived from marine organisms was introduced.Consequently, marine natural products can be used to develop drugs targeting new proteins in oral pathogens.

Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan–Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712–1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

Background: Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials. Methods: We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs. Results: Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health. Conclusion AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.

Background: Antimicrobial peptides (AMPs) are small, naturally occurring molecules that are integral components of the innateimmune system across many organisms. In humans, saliva is rich in various AMPs that play a pivotal role in maintaining oral health by serving as the primary line of defense in the oral cavity. These peptides are essential for protection against a broad spectrum of pathogens, including bacteria and fungi. Recently, active research has been conducted on both naturally occurring AMPs and modified or synthetic AMPs for the treatment of oral pathogens and their application in dental materials. Methods: We compiled previous studies on AMPs present in saliva and their target oral microorganisms. Additionally, wesummarized research on artificially created AMPs targeting oral pathogens. Furthermore, we analyzed recent trends in applied studies, such as the development of oral rinses, toothpaste, and implant coatings using AMPs. Results: Through a literature review, we identified 19 studies on AMPs present in the oral cavity and 40 studies testing AMPs derivedfrom other organisms or synthetically engineered against oral pathogens. Additionally, we reviewed seven studies on the development of implant coatings and oral hygiene material additives using AMPs. These findings suggest the potential for discovering or developing AMPs with activity against specific oral pathogens that can be applied to improve oral health. Conclusion AMPs exhibit broad antimicrobial activity against a wide range of pathogens. Their mechanisms of action primarilyinvolve attacking and disrupting the cell membranes of target microorganisms, making them effective against various pathogens.AMPs have the potential for use as coating materials for dental implants or restorative materials that require long-term use.Further research is needed to investigate the cytotoxicity, durability, and stability of AMPs in the oral environment to support their clinical use in dentistry.