In this study, spray-dried double emulsion loaded bromelain was applied to Japanese Spanish mackerel fillets to develop fish-type, elderly-friendly foods. Japanese Spanish mackerel, treated with spray-dried double emulsions, were stored at 4oC for 24 h. For the characterization of emulsion particles, the particle size, ζ-potential, and morphology were determined. The color, TBARS, VBN, TMA, hardness, and adhesiveness of fish fillets treated by emulsion were measured for physicochemical properties. All the particle sizes of spray-dried emulsion were decreased while their double emulsion structure was maintained. Spray-dried emulsion reduced the color difference of fish fillets and did not catalyze lipid oxidation and protein decomposition. Values of TBA, VBN, and TMA of all fish did not exceed 0.5 mg MDA/kg, 30 mg/100 g, and 10 mg/100 g, respectively, which are considered edible limits regardless of bromelain or emulsion application. Bromelain modified fish fillets' hardness and adhesiveness to be suitable for elderly food, although it was encapsulated in the emulsion. Thus, spray-dried fish oil W/O/W double emulsion-loaded bromelain can be applied as a fish tenderizer, and this study’s results can be utilized to develop elderly-friendly food.

A 31-year-old woman was transferred because of dyspnea that occurred immediately after cesarean section. Initial echocar-diography showed akinesia in apex to mid left ventricular (LV) wall with severe LV systolic dysfunction, which was pre-sumed to be stress-induced cardiomyopathy. Because the patient developed cardiogenic shock, we initially planned on inser-tion of an intra-aortic balloon pump. However, due to aggravation of cardiogenic shock and pulmonary edema, we had to resort to extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support. In addition, an LV pigtail catheter was applied for decompressing the LV. Finally, she was successfully weaned from ECMO after recovery of LV function.

A 41-year-old woman arrived at our emergency department with semicomatous mentality due to aborted cardiac arrest from ventricular fibrillation, which occurred during resting state. Prolonged QT interval in condition of hypokalemia and hypomagnesemia was observed on initial electrocardiography. However, even after normalization of serum potassium, magnesium and mentality, QT prolongation was sustained. In addition, genetic analysis showed KCNH2 mutation which was consistent with type 2 congenital long QT syndrome (LQTS). In this case, the patient was treated with an implantable cardioverter defibrillator and genotype specific medical therapy with potassium channel opener.