Comparison of the clinical features of apical hypertrophic cardiomyopathy versus asymmetric septal hypertrophy in Korea.

Background: We sought to test whether patients with apical hypertrophic cardiomyopathy (APH) have different clinical features compared to those with typical asymmetric septal hypertrophy (ASH).

Methods: Among 32,534 patients who underwent routine echocardiography at Asan Medical Center from January 2000 to December 2001, 305 patients (0.9%), who were finally diagnosed with hypertrophic cardiomyopathy (HCMP), were evaluated.

A potent opiate agonist protects against myocardial stunning during myocardial ischemia and reperfusion in rats.

Objective: Opioids have a cardioprotective effect during ischemia. Previously, we showed in an ex-vivo model of myocardial ischemia and reperfusion that 2',6'-dimethyltyrosine-D-Arg-Phe-Lys-NH2, a highly potent and long-acting opioid peptide analgesic with fewer side effects than morphine, provides improved cardioprotection compared with morphine. The purpose of this study was to confirm, in an in-vivo model, the cardioprotective effect of 2',6'-dimethyltyrosine-D-Arg-Phe-Lys-NH2.

Assessment of papillary muscle function in patients with inferior wall myocardial infarction using Doppler tissue imaging.

Objectives: We sought to assess the relationship between infarct status and systolic contractile function of papillary muscle (PM) for patients with inferior wall myocardial infarction (MI).

Methods: Peak systolic velocity (V) of posteromedial PM, systolic strain (epsilon) of posteromedial PM (epsilonPM), V of adjacent inferior wall, and of adjacent inferior wall (epsilonW) were calculated from color Doppler tissue imaging images obtained at apical views in 25 patients with inferior MI and in 13 healthy control subjects. All 25 patients with MI underwent magnetic resonance imaging to assess the infarct status of PM.

The site of plaque rupture in native coronary arteries: a three-vessel intravascular ultrasound analysis.

Objectives: We evaluated the axial location of plaque ruptures in native coronary arteries.

Background: It is clinically important to understand the potential sites of plaque rupture.

Methods: We performed three-vessel intravascular ultrasound (IVUS) examination in 392 patients; 231 had acute coronary syndrome (ACS) and 161 had stable angina pectoris (SAP).

Comparison of angiographic and clinical outcomes between rotational atherectomy versus balloon angioplasty followed by radiation therapy with a rhenium-188-mercaptoacetyltriglycine-filled balloon in the treatment of diffuse in-stent restenosis.

Background: The purpose of this study was to compare the efficacy of rotational atherectomy (RA) with simple balloon angioplasty, prior to beta-radiation therapy with a rhenium-188-mercaptoacetyltriglycine (188Re-MAG3)-filled balloon for diffuse in-stent restenosis (ISR).

Methods: After completing 50 cases with RA prior to beta-radiation (Group I), we performed optimal balloon angioplasty followed by beta-radiation in the next 53 consecutive patients (Group II) for the treatment of diffuse ISR. The radiation dose was 15 Gy at a depth of 1.

Terminal QRS complex distortion on the admission electrocardiogram in anterior acute myocardial infarction and association with residual flow and infarct size after primary angioplasty.

Background: Terminal QRS complex distortion on admission is a simple and reliable predictor of infarct size in patients with acute myocardial infarction (AMI). It is uncertain, however, whether this reflects reduced myocardial perfusion of the infarct area and a larger area of the myocardium at risk. This study was conducted to investigate whether terminal QRS distortion complex on admission is a reliable predictor of reduced residual flow and a larger area of the myocardium at risk compared to patients who are admitted without a terminal QRS distortion.

Two-year follow-up intravascular ultrasound analysis after bare metal stent implantation in 120 lesions.

The objective of this study was to examine long-term changes after bare metal stent implantation in a relatively large number of patients. There are few reports of intravascular ultrasound (IVUS) studies performed on stented and nonstented (reference) segments beyond 6 months after bare metal stenting. Using IVUS, we evaluated serial changes in stented and reference segments between 6 and 24 months after stent implantation in 110 patients with 120 lesions.

Randomized comparison of carbon ion-implanted stent versus bare metal stent in coronary artery disease: the Asian Pacific Multicenter Arthos Stent Study (PASS) trial.

Background: Heavy metal ions can cause allergic and inflammatory reactions that might be associated with in-stent restenosis. This randomized multicenter clinical study was designed to determine if carbon ion-implanted stents reduce luminal late loss by blocking heavy metal ion diffusion into the surrounding tissue.

Methods: A total of 225 patients with 230 native coronary lesions were randomly assigned to receive either a carbon ion-implanted Arthos Inert stent (group 1, n = 113) or a bare metal Arthos stent (group 2, n = 117).

Influence of stent length to lesion length ratio on angiographic and clinical outcomes after implantation of bare metal and drug-eluting stents (the TAXUS-IV Study).

Longer bare metal stent lengths have been associated with greater restenosis. However, the effect of the ratio of stent length to lesion length on clinical and angiographic restenosis after implantation of bare metal and drug-eluting stents has not been clearly defined. Patients in the TAXUS-IV study who underwent single-study stent placement were categorized into tertiles based on ratios of stent length to lesion length.

An uncommon form of the rare extensor carpi radialis accessorius.

Two accessory muscles were found in the lateral compartment of the forearm while dissecting a 92-year-old female cadaver. One of these originated from the extensor carpi radialis brevis, became tendinous and travelled between the two radial extensor tendons. It inserted independently into the second metacarpal bone, and may be regarded as an extensor carpi radialis intermedius.

Effects of focused force angioplasty: pre-clinical experience and clinical confirmation.

Balloon angioplasty results in a combination of plaque compression and fracture, creation of intimal flaps and localized medial dissection, as well as the stretching and remodeling of the arterial wall. The application of eccentric pressure to the vessel wall allows for the balloon force to be focused along a specified line resulting in a reduction in vessel resistance with an improved or equivalent result at a lower pressure. The FX miniRAIL is a novel balloon angioplasty catheter that has two external wires that are compressed by the inflating balloon into the vessel wall.

The limits of competing interest disclosures.

Objective: To assess the effectiveness of conflict of interest disclosure policies by comparing a competing interests disclosure statement that met the requirements established by the journal in a 2003 article on health effects of secondhand smoke based on the American Cancer Society CPS-I dataset with internal tobacco industry documents describing financial ties between the tobacco industry and authors of the study.

Design: Descriptive analysis of internal tobacco industry documents retrieved from the Legacy Tobacco Documents Library, University of California, San Francisco.

Results: Meeting the requirements for financial disclosure established by the journal did not provide the reader with a full picture of the tobacco industry's involvement with the study authors.

Comparison of cilostazol and clopidogrel after successful coronary stenting.

This study compared the safety and efficacy of cilostazol and clopidogrel after coronary stenting. Patients (n = 689) who underwent successful stenting were randomly assigned to receive cilostazol (group 1, n = 344, 612 lesions) or clopidogrel (group 2, n = 345, 628 lesions). The incidence of subacute stent thrombosis or major adverse cardiac events, including death, myocardial infarction, and target lesion revascularization within 30 days (2.

Is the testis intraperitoneal?

The relationship of the testis to the peritoneal cavity, and hence its position as an intraperitoneal or extraperitoneal organ, remains controversial. Adult anatomy texts favour an extraperitoneal position during and after testicular descent, whereas journal articles favour an intraperitoneal position. Interestingly, there is no similar debate around the position of the ovary despite the common origin of each as indifferent gonads.

Long-term outcomes after treatment of diffuse in-stent restenosis with rotational atherectomy followed by beta-radiation therapy with a 188Re-MAG3-filled balloon.

Background: Intracoronary radiation therapy for in-stent restenosis has been demonstrated to reduce restenosis and major adverse cardiac events. However, long-term angiographic and clinical outcomes after beta radiation therapy have not been sufficiently evaluated.

Methods: We evaluated the long-term angiographic and clinical outcomes of 50 consecutive patients who had received beta-radiation therapy with a 188Re-MAG3-filled balloon after rotational atherectomy for diffuse in-stent restenosis (lesion length>10 mm) in native coronary arteries.

Predictors of improvement in renal function after calcineurin inhibitor withdrawal for post-liver transplant renal dysfunction.

Background: Renal dysfunction after liver transplantation is a major management problem. Predictors of improvement in renal dysfunction after calcineurin inhibitor therapy (CNI) withdrawal and replacement with either mycophenolate mofetil (MMF) or azathioprine (AZA) have not previously been examined.

Methods: Retrospective analysis of 33 post-transplant patients with creatinine clearance (CrCl) below 50 mL/min who were changed from CNI to either MMF or AZA.

Feasibility and safety of regional myocardial hypothermia during myocardial ischemia and infarction in pigs.

Objective: Mild systemic hypothermia has been shown to be feasible and safe in patients during acute myocardial infarction (AMI). Regional myocardial hypothermia of the ischemic myocardium only may be more effective in myocardial salvage with fewer side effects compared with systemic hypothermia. The purpose of this study was to evaluate the feasibility and safety of regional myocardial hypothermia in pigs.

Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis: comparison with bare metal stent implantation.

Objectives: This study was designed to compare the clinical and angiographic outcomes of sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) stenosis.

Background: The safety and effectiveness of SES implantation for unprotected LMCA stenosis have not been ascertained.

Methods: Elective SES implantation for de novo unprotected LMCA stenosis was performed in 102 consecutive patients with preserved left ventricular function from March 2003 to March 2004.

Development of 99mTc-neomannosyl human serum albumin (99mTc-MSA) as a novel receptor binding agent for sentinel lymph node imaging.

Background And Aim: Various mannose receptor-binding agents, for example 99mTc-diethylenetriaminepentaacetic acid (DTPA)-mannosyl-polymer, have been developed for sentinel lymph node (SLN) imaging. In order to simplify the synthesis and labelling procedure and to improve the biological properties, we developed a novel mannose receptor-binding agent, 99mTc-neomannosyl human serum albumin (99mTc-MSA), for SLN imaging.

Methods: MSA was synthesized by conjugating mannopyranosylphenylisothiocyanate to human serum albumin (HSA).

Intravascular ultrasound assessment of neointima distribution and the length of stent that was free of intravascular ultrasound-detectable intimal hyperplasia in paclitaxel-eluting stents.

Using data from the ASian Paclitaxel-Eluting Stent Clinical Trial, a 3-center, randomized, placebo-controlled trial of nonpolymeric paclitaxel-coated stents with a single center, 81-patient intravascular ultrasound (IVUS) substudy, the length of a stent that was free of IVUS-detectable intimal hyperplasia measured 3.2 +/- 4.8 mm in placebo stents, 6.

Comparison of quantitative angiographic parameters with the magnitude of neointimal hyperplasia measured by volumetric intravascular ultrasound in patients treated with bare metal and nonpolymeric paclitaxel-coated stents.

We used data from the ASian Paclitaxel-Eluting Stent Clinical Trial (a 3-center, randomized, placebo-controlled trial of nonpolymeric paclitaxel-coated stents with a single-center intravascular ultrasound substudy) to compare angiographic indexes of drug-eluting stent efficacy with the magnitude of intimal hyperplasia (IH) assessed by intravascular ultrasound. Overall, percent IH (IH volume divided by stent volume) was larger in restenotic lesions than in nonrestenotic lesions (46 +/- 19% vs 15 +/- 13%, p <0.0001); angiographic late loss and follow-up diameter stenoses correlated strongly with percent IH.

Can we identify vulnerable patients at risk for ST-segment elevation myocardial infarction based on their clinical characteristics?

Objective: Coronary artery plaque rupture is a sudden, unpredictable event leading to acute coronary syndrome. Thus far, there is no clinical characteristic to distinguish the patients at risk for acute myocardial infarction from those with more stable coronary artery disease. The purpose of this study was to identify clinical predictors of first ST-segment elevation myocardial infarction (STEMI).

Randomized comparison of debulking followed by stenting versus stenting alone for ostial left anterior descending artery stenosis: intravascular ultrasound guidance.

Background: Although directional coronary atherectomy (DCA) before stenting has the advantage of combining substantial removal of atheromatous plaque and prevention of elastic recoil, there has been no randomized study to investigate its efficacy in ostial left anterior descending artery (LAD) lesions. This study was aimed to evaluate the effect of DCA followed by stenting on ostial LAD stenosis under the guidance of intravascular ultrasound (IVUS).

Methods: Eighty-six patients with ostial LAD stenoses were randomly assigned to DCA followed by stenting (group I) or stenting alone (group II).

Late intravascular ultrasound findings of patients treated with brachytherapy for diffuse in-stent restenosis.

This study aimed at evaluating long-term (24-month) effects of beta-irradiation (188Re-MAG3-filled balloon) using intravascular ultrasound (IVUS) in patients with in-stent restenosis (ISR). Long-term effects of beta-irradiation on intimal hyperplasia (IH) within the stented segment and vessel and lumen dimensions of nonstented adjacent segments in patients with ISR have not been sufficiently evaluated. Two-year follow-up IVUS was performed in 30 patients with patent ISR segments at 6-month follow-up angiography.