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￭ S-197 ￭
The Changes of Individual Carotid Artery Wall Layer by Aging
1Cardiology, Konyang University Hospital, Daejeon, Korea, 2Korea Research Institute of Standards and Science, Daejeon, Korea, 3Cardiology, Daegu Catholic University Medical Center, Daegu, Korea, 4Cardiology, Cheil General Hospital, Dankook University, Seoul, Korea, 5Endocrinology, Kyung
Hee University Medical Center, Seoul, Korea
*Yong-kyun Kim1, Jang-Ho Bae 1, Keum Won Kim1, Ki-Hong Kim1, Taek-Geun Kwon1, Duck-Jun Seo1, In Geol Song1, Dong-Ju Yang1, Wan-Ho Kim1, Hwan-Hyi Cho1, Young-Hoon Seo1, Hyun-Woong Park1, Wuon-Shick Kim2, Kee-Sik Kim3, Jeong Bae Park4, Jeong Taek Woo5 Aim: It is still unclear which layer (intima or media) is mainly involved in increased carotid intima-media thickness (CIMT) by aging and also unclear regarding CIMT value suggesting high cardiovascular risk, although 75th percentile value of CIMT is known as a high risk in asymptomatic adults. We sought to find the changes of carotid intima thickness (CIT) and carotid media thickness (CMT) by aging and the 75th percentile value of CIMT in asymptomatic Korean adults. Method: This is an observational cohort study. Carotid ultrasound findings (n＝2,204 from 12 hospital) were pro- spectively collected. The carotid images were sent to Korea Research Institute of Standards and Science for analysis using specialized software which can measure intima and media wall also. Results: Mean age was 58.1±13.5 years old (52% of men). Pearson correlation coefficient between age and right CIMT (r＝0.489, p＜0.001) and right CMT (r＝0.482, p＜0.001) were higher than those between age and right CIT (r＝0.284, p＜0.001). Mean right CIMT in male and female was 0.696±0.163 mm and 0.686±0.167 mm (p＝0.180) and the 75 percentile value was 0.778mm and 0.771 mm, respectively. Mean right CIT was 0.311±0.069 mm and 0.303±0.064mm (p＝0.009) and mean right CMT was 0.391±0.124 mm and 0.388±0.131 mm (p
＝0.694) in male and female, respectively. Left carotid ultrasound findings showed similar to the right one. Conclusions: An increased CIMT by aging was mainly due to increased CMT rather than CIT in asymptomatic adults. The 75th percentile values of right CIMT were 0.778 mm and 0.771 mm in asymptomatic Korean male and female adults, respectively.
￭ S-198 ￭
Purulent pericarditis caused by Staphylococcus aureus in non-immunocompromised patient
Department of Internal Medicine, Konkuk University School of Medicine, Konkuk University Chungju Hospital, Chungju-si, Korea
*Sang Hoon Park, Eun Joo Lee, Seung Hun Kang, Ho Hyun Park, Soo Hyun Kim
Introduction: Purulent pericarditis in adults is very rare in non-immunocompromised patient. We report a rare case of purulent pericarditis cultured by S. aureus without any patient’s medical history. Case: A 84-year-old woman complained dyspnea for 3 days. She had been in good health before the symptom appeared. She had hypertension for 20 years and she had no history of tabacco or alcohol abuse and trauma. At the emergency department, her blood pressure was 130/80 mmHg, heart beat was 126 beats/minutes and oxygen saturation was 87%. The laboratory findings showed white blood cell (WBC) 15350/μl, neutrophil 86%, C-reactive protein 3.26 mg/dL, CK-MB 2.3 ng/ml, Troponin I ＜0.01 ng/ml and brain natriuretic peptide 225 pg/ml.
A chest x-ray demonstrated cardiomegaly. The electocardiogram showed sinus tachycardia. The transthoracic echocardiography revealed large peri- cardial effusion, measuring 22 mm at the posterior wall in diastole. Pericardiocentesis was done and 740 ml of yellowish and turbid fluid was drained.
Pericardial fluid laboratory tests were WBC 219200/μl, neutrophil 90%, lymphocyte 10%, glucose 10 mg/dL, lactate dehydrogenase ＞1870 IU/L, total protein 4.6 mg/dL and adenosine deaminase 216.8 U/L. Tuberculosis polymerase chain reaction and acid-fast bacillus stain were negative. The patient had been treated with antibiotics empirically. The culture of pericardial fluid was positive for S. aureus. Blood cultures were negative. Chest computed tomography (CT), abdominal CT and bronchoscopy were done that had no evidence of malignancy or tuberculosis. She was completely resolved. There is no recurrence of pericardial effusion following 2 months later after discharged. Conclusions: In Korea, several cases of purulent pericarditis have been reported. Most common cause of purulent pericarditis is S. aureus. Most of them have occurred in immunocompromised individuals, such as un- derlying malignancies, end-stage renal disease or an acute infectious illness. It is a rare case in Korea that the patient manifested an uncommon pre- sentation of purulent pericardial effusion without immunocompromised condition.
