Purpose : Atrial fibrillation (AF) is highly prevalent in patients with non-cardiac diseases and in patients with cardiac disease. However, only a few studies have evaluated the characteristics of patients with AF complicated with non-cardiac diseases. We aimed to investigate whether the safety and efficacy of landiolol, an ultra-shortacting β1-selective blocker for controlling rapid heart rate (HR), for patients with AF differed between those with cardiac disease and those with non-cardiac diseases.
Materials and Methods : All AF patients with HRs≥ 120 beats/min who received continuous intravenous landiolol administration were included in this study (n＝133). The patients were divided into the cardiac (n＝55) and non-cardiac (n＝78) disease groups. Successful HR control was defined as an HR<110 beats/min and a ≥ 20％ decrease in HR in 2 hr after landiolol initiation.
Results : Landiolol significantly decreased the HRs of patients with rapid AF in both groups (cardiac : 145±17 to 103±22 beats/min, P<0.001 ; non-cardiac : 145±18 to 114±23 beats/min ; P<0.001). The proportion of patients achieving the efficacy endpoint was higher in the cardiac group than in the non-cardiac group (58.2％, n＝32 vs. 35.9％, n＝28 ; P＝0.02). No intergroup difference was noted in the incidence of adverse events. C-reactive protein levels were independent factors associated with non-effective landiolol responses (odds ratio : OR, 0.958 ; 95％ CI, 0.920－0.997 ; P＝0.04). A non-effective landiolol response was significantly and independently associated with 30-day mortality (Hazard ratios : HzR, 5.043 ; 95％ CI, 1.516-16.777 ; P<0.01).
Conclusions : Landiolol may be a therapeutic option for the acute control of rapid AF in patients with either cardiac or non-cardiac complications, especially in those without marked inflammation.

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Background : The pathogenesis of chronic obstructive pulmonary disease (COPD) is suggested to be involved with systemic inflammation and influenced by genetic factors. Myeloperoxidase (MPO) is secreted by activated polymorphonuclear neutrophils and plays a crucial role in the inflammation response. This study attempts to examine the associations of the genetic variants of the MPO gene with susceptibility to COPD in Japanese patients.
Methods : Six single nucleotide polymorphisms (SNPs) within the MPO were genotyped, including rs2107545 (A/G) and rs2243828 (A/G, variants of expression quantitative trait loci : eQTL) in the promotor region, rs7208693 (C/A, Val53Phe) in exon 2, rs35921530 (C/A, eQTL) in intron 7, rs35670089 (C/T, Arg604Cys) in exon 11, and rs2071409 (T/G, eQTL) in intron 11, in 260 patients with COPD and 129 non-COPD smokers. These 6 SNPs were able to capture at least more than 50 SNPs throughout the length of MPO gene. In addition, the plasma MPO concentrations were measured in both groups.
Results : There were no significant differences of allele frequencies of the six SNPs between the COPD and non-COPD groups. In addition, the plasma MPO concentration was not significantly different between the two groups.
Conclusion : The genetic variants of MPO were not associated with the susceptibility to COPD in the Japanese population. The MPO biomolecule is not involved with the pathogenesis of COPD.

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A 79-year-old woman was referred to our institution because of suspected of lung cancer due to a partsolid-nodule in her right lower lobe, and received thoracoscopic wedge resection. Postoperative oral intake was started on the first postoperative day (POD) ; however, the drainage turned white on the 2nd POD. We diagnosed this as postoperative chylothorax, and octreotide and a low-fat-diet therapy were started. A chest computed tomography (CT) showed pleural effusion on the left side on the 6th POD, so thoracentesis of the left side was performed and diagnosed as bilateral chylothorax. Conservative management decreased the chylous leakage, and chylothorax did not recur after evaluation of the chest drain. The pathological diagnosis was adenocarcinoma (pTisN0M0 stage 0), and the patient has been recurrence-free for 3 years postoperatively. Chylothorax following thoracoscopic wedge resection is an extremely rare occurrence.

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