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Common Co-Morbidities in Heart Failure – Diabetes, Functional Mitral Regurgitation and Sleep Apnoea
Stewart Coats Andrew J. 대한심부전학회 2019 International Journal of Heart Failure Vol.1 No.1
Heart failure (HF) is a condition that carries a considerable burden of disability many now related to co-existing co-morbidities. The drive to find newer effective therapies targeting novel mechanisms has led to a recent emphasis on treating common co-morbidities that are clustered around contemporary HF patients. Here is renewed contemporary co-morbidities that until recently have received little attention but which are now subject of considerable interest and potential therapeutic advance. These include, diabetes, functional mitral regurgitation and sleep disordered breathing. These three contemporary co-morbidities that have recently been subject to major trial evaluation will be reviewed in this paper.
Pulmonary Embolism during a Retrial of Low-dose Clozapine
Gregg Alan Robbins-Welty,Shannon Coats,Andrew N. Tuck,Bryan K. Lao,Zachary Lane 대한정신약물학회 2022 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.20 No.3
Pulmonary emboli (PE) are increasingly recognized as an adverse effect of clozapine. However, little is known about the characteristics or mechanisms of clozapine-associated PE. We present a case of a 34-year-old with treatment-refractory schizophrenia who developed rhabdomyolysis during his first clozapine trial. During re-trial on a lower dose than his initial trial, the patient developed chest pain that he attributed to “pacemakers.” The pleuritic description and associated tachycardia prompted medical workup and the patient was ultimately diagnosed with a clozapine-associated PE. The patient’s only risk factors for PE were obesity and tobacco use, while his hypercoagulability workup was unrevealing. Clozapine use was continued at a lower dose following these adverse effects given inefficacy of other agents in managing the patient’s psychotic symptoms. The patient experienced significant relief of psychotic symptoms with continued clozapine therapy and a course of electroconvulsive therapy. The patient’s presentation was unusual in that it occurred during a retrial of clozapine, after the initial trial was stopped when he developed rhabdomyolysis. This case demonstrates the importance of maintaining vigilance for PE in patients on clozapine as well as not dismissing somatic complaints in patients experiencing psychosis. Additionally, given his history rhabdomyolysis, an uncommon adverse effect of clozapine, the development of a second uncommon adverse effect (PE) raises the question of whether these events may be associated.
진해만에 출현하는 기생성 와편모류 Amoebophrya spp.와 숙주 와편모류
박종규,허현정,이원호,하나,Park, Jong-Gyu,Hur, Hyun-Jung,Coats, D. Wayne,Yih, Won-Ho,Ha, Na 한국해양학회 2007 바다 Vol.12 No.4
Amoebophrya는 숙주생물에 기생하여 이들을 단기간에 사멸시키는 내부기생성 진핵와편모류로서 숙주 특이성과 숙주 생물의 개체군 동태에 미치는 막대한 영향으로 인해 오래 전부터 유해적조생물에 대한 생물학적 제어 가능성이 제기되었다. 그 동안 숙주 - 기생생물 시스템 배양이 어려워 수 십 년간 연구가 답보상태에 빠졌으나, 최근 소수 종의 숙주 - 기생생물 시스템 배양에 성공하여 새로운 전기를 맞았다. 본 연구는 Amoebophrya가 숙주생물의 개체군 동태에 미치는 영향을 탐색하기 위한 예비연구로서 진해만에서 2년 동안 숙주 와편모류에 기생하는 Amoebophrya spp.의 출현 시기를 관찰하고 Heterocapsa triquetra의 숙주 - 기생생물 시스템 배양을 통하여 이들의 숙주특이성을 평가하였다. 연구기간 동안 9종의 와편모류, Akashiwo sanguinea, Ceratium fusus, Dinophysis acuminata, Heterocapsa triquetra, Oblea sp., Prorocentrum minimum, P. triestinum, Scrippsiella spinifera, S. trochoidea에서 내부기생 Amoebophrya에 의한 감염을 관찰하였으며, 이 중 무각 와편모류 A. sanguinea와 유각 와편모류 H. triquetra 2종에 대한 숙주 - 기생생물 시스템의 실내 배양체 확립에 성공하였다. 연구해역이나 이전에 Amoebophrya가 관찰 또는 보고된 6종의 숙주생물에 H. triquetra에 기생하는 Amoebophrya를 교차 접종하여 이들이 다른 와편모류보다 자기 숙주에 매우 큰 선호도를 가짐을 확인하였다. 앞으로도 우리나라 주변 해역에 출현하는 기생성 와편모류 Amoebophrya를 탐색하여 다양한 숙주 - 기생생물 시스템 배양체를 지속적으로 확보할 필요가 있다. 이러한 기생성 와편모류 Amoebophrya에 대한 생리 생태 특성 연구를 통하여 해양생태계 내에서 그들의 역할을 이해하고 생물학적으로 적조를 제어하는 데에 크게 도움을 얻을 수 있다. Amoebophrya is an obligate endoparasitic eukaryotic dinoflagellate infecting host species and eventually killing them within a short period. Because of its host specificity and significant impacts on population dynamics of host species, it has long been proposed to be a potential biological agent for controlling harmful algal bloom (HAB). For several decades, the difficulties of culturing host - parasite systems have been a great obstacle to further research on the biology of Amoebophrya but recent success of several culture systems reactivates this research field. In this study, as a preliminary work for understanding the impacts of Amoebophrya on the population dynamics of host species, semimonthly occurrence of infected host dinoflagellates by Amoebophrya spp. had been observed in Jinhae Bay for two years and with a host - parasite system cultivated, host specificity of Amoebophrya spp. on several dinoflagellates was tested. Amoebophrya spp. were observed in the cellular organelle and cytoplasm of several species including Akashiwo sanguinea, Ceratium fusus, Dinophysis acuminata, Heterocapsa triquetra, Oblea sp., Prorocentrum minimum, P. triestinum, Scrippsiella spinifera, and S. trochoidea. Among them two host - parasite systems for an athecate dinoflagellate, A. sanguinea, and for a thecate dinoflagellate, H. triquetra, had been able to be successfully established as laboratary cultures. Cross-infection tests for 6 species of dinoflagellates in which Amoebophrya was observed or had been reported to exist confirmed high preference for host species of the parasite. Through the continuous research on Amoebophrya occurring in Korean coastal waters, we need to maintain various host - parasite culture systems, which will be very helpful for understanding its ecological role in marine food webs and for applying the species to biologically control harmful algal blooms.