Nerium indicum is a tree belonging to the order: Gentianales, Family Apocynaceae, which grows mainly on Jeju Island in Korea and is predominantly used as an ornamental plant. The tree contains toxic substances such as oleandrin and adynerin, and of these, oleandrin acts as a potent cardiac glycoside, causing symptoms similar to digoxin poisoning. A 38-year-old male was admitted to the emergency department with symptoms of nausea, vomiting, dizziness, and abdominal pain after ingesting about 1 L of water boiled with oleander that he had collected intending to commit suicide. The electrocardiogram (ECG) showed a 2:1 atrioventricular block with ST-segment depression and T-wave inversion. He was treated with atropine and digoxin-specific antibody fragments (DigiFab). The patient was discharged without any specific complaints or findings except for persistent ST-segment and T-wave abnormalities on the ECG. In cases of poisoning due to Nerium indicum, atropine may be helpful in the management of severe bradycardia. The use of a digoxin-specific antibody as an antidote, even in small doses, followed by additional doses based on the clinical course, may be effective in treating the poisoning.

Orthostatic headache is a hallmark symptom of spontaneous intracranial hypotension (SIH). However, SIH can manifest without headache, which can lead to a significant delay in treatment initiation. We hereby report a 70-year-old male with progressive gait disturbance and superficial siderosis. Magnetic resonance myelography showed an extensive extradural cerebrospinal fluid collection in the cervicothoracic spine. After a series of targeted epidural blood patch, the patient’s symptoms significantly improved. SIH should be considered as a potential cause of otherwise unexplained superficial siderosis to prompt an early diagnosis and treatment.

In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

Background The benefit of statin use after acute ST-segment elevation myocardial infarction (STEMI) has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention (PCI). Methods This analysis of the Korea Working Group on Myocardial Infarction registry (KorMI) study included 3,584 STEMI patients (mean age, 63 ±13 years;male, 2,684, 74.9%) undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events (MACE:all-cause death, recurrent MI, and target lesion revascularization) were compared among patients grouped according to statin therapy timing:I, both during and after hospitalization (n=2,653, 74%);II, only during hospita-lization (n=309, 8.6%);III, only after discharge (n=157, 4.4%);and IV, no statin therapy (n=465, 13%). Mean follow-up duration was 234 ± 113 days. Results Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups III and IV had the highest MACE rates (2.3%, 3.9%, 5.1%, and 4.9%for groups I-IV, respectively, P=0.004). After adjusting for confounders, groups II-IV had a higher MACE risk than group I [hazard ratio (HR):3.20, 95%confidence interval (95%CI):1.31-7.86, P=0.011;HR:3.84, 95%CI:1.47-10.02, P=0.006;and HR:3.17, 95%CI:1.59-6.40, P=0.001;respectively]. Conclusions This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical prac-tice.

We investigated the effect of phenylephrine (PE)- and isoproterenol (ISO)-induced cardiac hypertrophy on subcellular localization and expression of caveolin-3 and STAT3 in H9c2 cardiomyoblast cells. Caveolin-3 localization to plasma membrane was attenuated and localization of caveolin-3 to caveolae in the plasma membrane was 24.3% reduced by the catecholamine-induced hypertrophy. STAT3 and phospho-STAT3 were up-regulated but verapamil and cyclosporin A synergistically decreased the STAT3 and phospho-STAT3 levels in PE- and ISO-induced hypertrophic cells. Both expression and activation of STAT3 were increased in the nucleus by the hypertrophy. Immunofluorescence analysis revealed that the catecholamine-induced hypertrophy promoted nuclear localization of pY705-STAT3. Of interest, phosphorylation of pS727-STAT3 in mitochondria was significantly reduced by catecholamine-induced hypertrophy. In addition, mitochondrial complexes II and III were greatly down-regulated in the hypertrophic cells. Our data suggest that the alterations in nuclear and mitochondrial activation of STAT3 and caveolae localization of caveolin-3 are related to the development of the catecholamine-induced cardiac hypertrophy.
Animals ; Catecholamines/*pharmacology ; Caveolae/*metabolism ; Caveolin 3/*metabolism ; Cell Line ; Hypertrophy/metabolism ; Mitochondria/*metabolism ; Myocardium/cytology/*pathology ; Myocytes, Cardiac/cytology/*drug effects/metabolism ; Rats ; STAT3 Transcription Factor/*metabolism

OBJECTIVETo identify waterborne enteric viruses in Korean surface water.

METHODSIntegrated cell culture (ICC)-multiplex reverse transcription-polymerase chain reaction (RT-PCR) was simultaneously designed to detect coxsackieviruses (CV), polioviruses (PV), and reoviruses (RV). ICC-multiplex RT-PCR and phylogenetic analysis were conducted using 21 total culturable virus assay (TCVA)-positive sample-inoculated cell cultures.

RESULTSCV and RV were detected in 9 samples each, and 3 samples were positive for both CV and RV. PV was not detected in any sample. Molecular phylogenetic analysis of the VP1 gene sequences revealed that CV types B2 and B4 predominated in Korean surface water, and the nucleotide sequences of CV type B2 were clustered with those of CVs isolated from China and Japan. The results suggested that the evolution of these viruses occurred in a region-specific manner.

CONCLUSIONCV and RV are detectable in Korean surface water, with a predominance of CV type B2, and the evolution of CV type B2 occur in a region-specific manner.

Animals ; Cells, Cultured ; Enterovirus ; classification ; genetics ; isolation & purification ; Fresh Water ; virology ; Korea ; Phylogeny ; Reverse Transcriptase Polymerase Chain Reaction ; Water Microbiology ; Water Supply

Objective To identify waterborne enteric viruses in Korean surface water. Methods Integrated cell culture(ICC)-multiplex reverse transcription-polymerase chain reaction (RT-PCR) was simultaneously designed to detect coxsackieviruses (CV), polioviruses (PV), and reoviruses (RV). ICC-multiplex RT-PCR and phylogenetic analysis were conducted using 21 total culturable virus assay (TCVA)-positive sample-inoculated cell cultures. Results CV and RV were detected in 9 samples each, and 3 samples were positive for both CV and RV. PV was not etected in any sample. Molecular phylogenetic analysis of the VPl gene sequences revealed that CV types B2 and B4 redominated in Korean surface water, and the nucleotide sequences of CV type B2 were clustered with those of CVs isolated from China and Japan. The results suggested that the evolution of these viruses occurred in a region-specific manner. Conclusion CV and RV are detectable in Korean surface water, with a predominance of CV type B2, and the evolution of CV type B2 occur in a region-specific manner.