The 2007 European Society of Hypertension/European Society of Cardiology guidelines acknowledged that the central (aortic) blood pressure (BP), which is the pressure exerted on the heart and brain, may differ from the pressure that is measured at the arm. They also recognized that central pressure may predict outcome in specific populations and is affected differently by antihypertensive drugs. These guidelines also regarded an increased carotid-femoral pulse wave velocity as subclinical organ damage and classified increased arterial stiffness into high/very-high risk. Clinical studies have indicated that the central BP and central hemodynamics (aortic stiffness, augmentation index) are important components in the determination of cardiovascular risk in some patients. More importantly, recent large-scale trials have shown that central hemodynamics may constitute a worthwhile treatment target. In addition, central hemodynamics can now be assessed reliably noninvasively with a number of devices. Accordingly, because arterial stiffness and central hemodynamics are markers and manifestations of organ damage, they independently predict future cardiovascular events.
Antihypertensive Agents ; Arm ; Blood Pressure ; Brain ; Cardiology ; Heart ; Hemodynamics ; Humans ; Pulse Wave Analysis ; Vascular Stiffness

No abstract available.
Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors*

Povidone-iodine (PVP-I, Betadine) has many advantages as a disinfectant solution for preoperative preparations, especially for oral surgery. It is widely used because of its low toxicity and excellent bactericidal effect. The authors report a case of pneumonia secondary due to the aspiration of PVP-I, which was used as an oral disinfectant. We present a case of aspiration pneumonia that resulted from the careless use of PVP-I during preoperative preparation. The patient was a 10-month-old female scheduled for elective surgery to correct a complete cleft of secondary palate. During the preparation of the oral cavity for that cleft palate patient, PVP-I was incidentally aspirated to the airway. The lung resistance was noted with positive pressure and pneumonic infiltration on chest radiograph was seen. The operation was postponed and the patient underwent respiratory care. Three months later, elective palatoplasty under general anesthesia was performed without complication. Based on the experiences of this case, the authors advise that throat-packing should be placed before oral preparation to prevent serious pulmonary complications.
Anesthesia, General ; Cleft Palate ; Female ; Humans ; Lung ; Mouth ; Palate ; Pneumonia ; Pneumonia, Aspiration ; Povidone-Iodine ; Surgery, Oral ; Thorax

We report herein the optical coherence tomography (OCT) and stent boost imaging guided bioresorbable vascular scaffold (BVS) implantation for right coronary artery (RCA) chronic total occlusion (CTO) lesion. The gold standard for evaluating BVS expansion after percutaneous coronary intervention is OCT. However, stent boost imaging is a new technique that improves fluoroscopy-based assessments of stent overlapping, and the present case shows clinical usefulness of OCT and stent boost imaging guided ‘overlapping’ BVS implantation via antegrade approach for a typical RCA CTO lesion.
Coronary Vessels ; Percutaneous Coronary Intervention ; Stents* ; Tomography, Optical Coherence*

PURPOSE: Dermatofibrosarcoma protuberans is a relatively rare tumor that originates from the dermis and subcutaneous tissue. It is generally known that this tumor easily recurs but can be successfully treated with a wide excision. Therefore, this study was conducted to investigate postoperative outcomes and risk factors for recurrence in patients with dermatofibrosarcoma protuberans who were treated at a single institution for 20 years. METHODS: We retrospectively reviewed the medical records of 35 patients who had underwent surgery between June 1992, and September 2010. The patients were assessed in terms of predilection site and size of the tumor, the incidence according to sex, discrepancy between biopsy results and histopathological diagnosis of the surgical specimen, additional treatment after recurrence, recurrence rate and the time interval to recurrence. RESULTS: In multivariate analysis, the depth and site of the tumor were significant risk factors for tumor recurrence. The recurrence rate was significantly higher in tumors occurring in the upper extremity than those occurring in other regions(p=0.0348). In addition, the recurrence rate was significantly higher in tumors with involvement of the fascia and the deeper structures(p=0.0324, odds ratio=6, relative risk=1.588). Since dermatofibrosarcoma protuberans has strong invasiveness, its tissue involvement is difficult to evaluate accurately. CONCLUSION: The results of this study shows that involvement of the fascia and the deeper structures and occurrence in the upper extremity were associated with tumor recurrence. Therefore, clinicians should be aware of these risk factors to achieve better treatment outcomes.
Biopsy ; Dermatofibrosarcoma ; Dermis ; Fascia ; Humans ; Incidence ; Medical Records ; Multivariate Analysis ; Recurrence ; Retrospective Studies ; Risk Factors ; Subcutaneous Tissue ; Upper Extremity