Background and Objectives：Metabolic syndrome and high sensitivity C-reactive protein (hs-CRP) are known to be strong predictors of coronary atherosclerosis. Even though there have been many observations and much research concerning the association of coronary atherosclerosis with CRP and metabolic syndrome, certain problems still need to be resolved in order to produce clear mechanistic illustrations. Therefore, the correlations of metabolic syndrome, hs-CRP and the severity of coronary atherosclerosis were evaluated herein. Subjects and Methods： 271 patients, aged between 29 and 87, who had undergone diagnostic coronary angiograms at the National Medical Center, between January, 2004 and June, 2006 were evaluated. Coronary angiograms were performed in patients who complained of typical chest pain and had risk factors associated with coronary atherosclerosis. The correlations of metabolic syndrome, hs-CRP and coronary atherosclerosis were analyzed in these patients. Results：Positive relationships were found between the metabolic syndrome risk factor clustering and an increased level of hs-CRP (p<0.01). The severity of coronary atherosclerosis increased with the increasing number of metabolic syndrome risk factors. As metabolic syndrome risk factor clustering increased, the quantity of 1, 2 and 3 vessel diseases also increased (Odd ratios 1.61, 1.83 and 2.50; p=0.001, <0.001 and <0.001, respectively). In contrast to metabolic syndrome risk factor clustering, no definite relationship between the hs-CRP level and the severity of coronary atherosclerosis was observed. Conclusion：The more metabolic syndrome risk factors clustered, the greater the severity of coronary atherosclerosis. The extension of coronary atherosclerosis maybe predicted using evaluation of metabolic syndrome risk factor clustering in patients with angina. (Korean Circulation J 2006;36:802-808)

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Klippel-Trenaunay syndrome is a rare congenital mesodermal abnormality characterized by varicose veins, cutaneous hemangiomas, soft tissue and bony hypertrophy of limb. Potential complications such as deep venous thrombosis and pulmonary thromboembolism have not been reported in Korea to date. We demonstrate the case of a 48-year-old woman with Klippel-Trenaunay syndrome with extensive varicose veins on right lower limb, hypertrophy of left big toe and basilar artery tip aneurysm, complicated with acute submassive pulmonary thromboembolism treated successfully with intravenous thrombolytic therapy.

Background and ObjectivesThe clinical efficacy of transdermal nitroglycerin patch in patients with angina has not known exactly. After the application of transdermal nitroglycerin, the influences of transdermal nitrate on exercise capacity and clinical symptom in patients with angina were compared with the clinical effects of oral nitroglycerin. Materials and Method Long acting oral nitrate was administered in 20 patients 9 male, 11 female, age 56.3 4.6 and transdermal nitrate Angiderm Patch applied in 20 patients 8 male, 12 female, age 53.9 9.8 , who suffered from angina more than 4 attacks per week. All patients were evaluated at 4-week interval after 2 weeks' run-in period, after 4 weeks of randomized non-titrated treatment first visit , after 8 and 12 weeks of titrated treatment second and third visits . The frequency of angina, side effects of headache and skin irritation, blood pressure, echocardiographic ejection fraction and exercise treadmill score were compared between the two groups. Results The frequency of angina attack was 14.4 6.0 in oral nitrate and 14.0 4.9 in transdermal nitrate per two weeks during run-in period. After nitrates, the frequency of angina reduced to 8.1 4.5, 5.4 2.2 on the first, to 3.0 3.5 and 1.7 1.4 on the second, and to 1.2 1.7 and 0.3 0.4 on the third visit in oral and transdermal nitrate groups respectively. Blood pressure and ejection fraction were unchanged in both groups. Exercise treadmill score was 10.4 4.3 in oral and 10.6 2.3 in transdermal nitrate group during run-in period, which was increased to 12.6 4.0, 13.7 2.5 on the first, to 13.6 3.0, 15.1 2.2 on the second, and to 15.3 2.7, 15.6 1.9 on the third visit after oral and transdermal nitrates respectively. However, changes in the frequency of anginal episodes and exercise treadmill score were not different between two groups. Side effects of headache were observed in 7 of oral and 4 of transdermal nitrate group and skin irritation in 2 of transdermal group. Conclusion Transdermal nitroglycerin is equally effective as oral nitroglycerin in the reduction of the frequency of angina attack and the improvement of exercise tolerance without significant side effects in patients with angina. Korean Circulation J 2000 ; 30 1 : 66-71 KEY WORDS Transdermal nitroglycerin·Angina·Headache.

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