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In the clinical training study, we compared non-targeted plaques in 38 patients by a previous IB-IVUS system (38 MHz) and a new IB-IVUS system (60 MHz). In a pathological study, images were acquired from 221 cross-sections of 18 coronary arteries from 13 cadavers obtained at autopsy. The purpose of the present study was to develop a 60 MHz integrated backscatter intravascular ultrasound (IB-IVUS) and to evaluate its usefulness for the detection of lipid area with backward attenuation of ultrasound signal (AT) that for the prediction of post-procedural myocardial injury (PMI) after percutaneous coronary intervention (PCI). Salivary cortisol level measurements during the athletes' circadian rhythms could detect the differences in acclimatization and exercise stress between two altitudes. The rate of change in the salivary cortisol concentration during the morning exercise was significantly higher in the higher-altitude camp than in lower-altitude camp (p = 0.028) despite the same exercise programs and intensities. Before dinner, the basal salivary cortisol concentrations were significantly higher in the higher-altitude camp. The salivary cortisol concentrations were measured using electrochemiluminescence immunoassay. Their saliva was sequentially collected on the last 2 days during each camp which involved different intensity exercises in the morning and afternoon. For the second lower-altitude camp, they lived at 1550 m and trained at 1300 m for 7 days. For the first higher-altitude camp, the runners lived at 1800 m and trained at 1700 m for 7 days.

We enrolled 12 elite female long-distance runners living near sea level. This study aimed to verify whether the automated measurement of salivary cortisol concentration via sequential sampling could detect the differences in exercise stress between two altitudes. There are conflicting reports regarding the efficacy of cortisol as a stress marker in altitude training due to the influence of the circadian rhythm. CONCLUSION: This case highlights importance of prompt diagnosis of asymptomatic Fabry disease through endomyocardial biopsy as well as the potential benefit of chaperon therapy. Follow-up after one year revealed reduction of both the ECG abnormality and microalbuminuria, suggesting disease progression was halted. Through endomyocardial biopsy, the patient was ultimately diagnosed with early stage cardiac involvement of her Fabry disease, and chaperon therapy was initiated. Echocardiography, cardiac magnetic resonance and coronary angiography showed normal findings. After 8 years of follow-up, increased QRS voltage and strain T waves developed in the left precordial ECG leads in the absence of hypertension, left ventricular hypertrophy or ischemia. CASE SUMMARY: We report the case of a 39-year-old asymptomatic female patient with Fabry disease.

Still, it is important to initiate treatment before the disease progresses too far. This often makes it difficult to decide on the best time to initiate treatment in female patients.

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Heterozygous female patients remain free of serious complications, including cardiovascular symptoms, until late in life. Therefore, this case is noteworthy for considering the progression of immune-related cholangitis.īACKGROUND: Fabry disease is a lysosomal disorder caused by a deficiency in α-galactosidase A. CONCLUSION: No previous case reports have described the changes and progression in bile duct images in immune-related adverse events. The intrahepatic bile duct showed stenosis and dilated findings, which was considered to be a factor for repeated infectious cholangitis. Given the history of recurrent infectious cholangitis, magnetic resonance cholangiopancreatography was carried out on day 70 of admission. Following PSL initiation, a decrease in serum bilirubin level was observed however, significant decrease was not observed in alkaline phosphatase. However, the liver disorder did not improve and overt jaundice appeared subsequently therefore, an immune-related cholangitis was suspected, and prednisolone (PSL) 35 mg/day was introduced from day 59 of admission. Endoscopic retrograde cholangiopancreatography showed no obvious stenosis in the lower bile duct however, a parapapillary diverticulum was found, and papillary incision and bile duct plastic stent insertion were carried out. On endoscopic ultrasound, the common bile duct was dilated to 11 mm, and the wall, throughout its length from the papilla, was thickened. CASE PRESENTATION: Eight courses of pembrolizumab maintenance therapy were given as first-line treatment for squamous cell lung cancer however, the patient was subsequently hospitalized due to a rapid increase in hepatobiliary enzymes. AIM: We report a rare case of immune-related cholangitis in which the natural course could be demonstrated.

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