BACKGROUND AND OBJECTIVE: The aim of this study was to compare the residual diameter stenosis after PTCA with fractional flow reserve (FFR) and coronary flow reserve (CFR), and investigate the correlation between FFR and CFR in patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: The study population consisted of twenty seven patients with myocardial infarction. Baseline and hyperemic average peak velocity (APV) were measured using Doppler wire 15 minutes after restoration of infarct-related artery (IRA). CFR was obtained by the ratio of distal hyperemic APV to baseline APV. Distal coronary arterial pressure (Pd) was measured with advancing the wire distal to the lesion of IRA. Simultaneous proximal aortic pressure (Pa) was measured using guiding catheter. Myocardial FFR was obtained by the ratio of hyperemic Pd to hyperemic Pa. RESULTS: Post-interventional CFR and FFR were 0.85+/-0.44, 0.91+/-0.09. CFR did not show significant correlation with luminal diameter stenosis (%ST). There was no significant correlation between FFR and CFR with a correlation coefficient of 0.29 (p=.25). But, significant correlation was found between %ST and FFR, %ST and hyperemic PG (hPG) with correlation coefficient of -0.70 (p=.0012) and 0.68 (p=.0018). CONCLUSION: In AMI patients, %ST has a significant correlation with FFR and hPG after PTCA. But, there was no significant correlation between FFR and CFR.
Arterial Pressure ; Arteries ; Catheters ; Constriction, Pathologic ; Humans ; Myocardial Infarction* ; Phenobarbital

Vasculitic neuropathy is a clinical manifestation affecting peripheral nerve in necrotizing vasculitis. It is generally regarded that natural courses are poor as there are abundant histologic and electrophysiologic evidences of axonal destruction. In this study, authors collected 15 cases of vasculitic neuropathy these six years and analyzed the data retrospectively to understand the clinical course. In 15 cases, the diagnosis of vasculitic neuropathy was made by the prominent clinical features, electrophysiological findings and sural nerve biopsies. Four cases were associated with polyarterits nodosa, one with systemic lupus erythematosus, two with rheumatoid arthritis, and one with polyangiitis overlap syndrome. However in other seven- cases the underlying dignoses were not made completely, but suspected some vasculitic conditions, such as isolated PNS vasculitis or undefined connective tissue disease. Electrophysiological studies showed mononeuritis multiplex in six, sensonmotor polvneuropathy in seven, and overlapped mononeuritis multiplex and polyneuropathy in two. Typical necrotizing vasculitis was found in nine out of twelve sural nerve biopsies. During the follow up period for up to two years, there was much improvement in ten, slight in three, and no improvement in two. In ten out of twelve patients prednisolone or prednisolone plus cyclophosphamide regimens showed improvement. Therefore authors thought that the clinical outcome was relatively fair in vasculitic neu . Ropathy when the therapy was started very early and the tirne factor between the onset and the uutiation of immunosuppressant therapy could be very important and critical.
Arthritis, Rheumatoid ; Axons ; Biopsy ; Connective Tissue Diseases ; Cyclophosphamide ; Diagnosis ; Follow-Up Studies ; Humans ; Lupus Erythematosus, Systemic ; Mononeuropathies ; Peripheral Nerves ; Polyneuropathies ; Prednisolone ; Retrospective Studies ; Sural Nerve ; Vasculitis

PURPOSE: The purpose of this study was to identify the correlation between communication skills for emotional empathy and academic achievement on the Clinical Performance Examination (CPX). METHODS: One hundred twelve medical school students were observed to determine the extent to which they applied communication skills for emotional empathy (preparation stage: interview attitude, respect; rapport stage: encouragement, active listening, will for support; empathy stage: verbal expression empathy, nonverbal expression empathy, acceptance) to the CPX, as well as their level of understanding of these skills to calculate the Pearson r, which can be used to determine the correlation between communication skills and academic achievement (hematochezia, fatigue, abnormal menstruation, chest pain, alcohol problems). RESULTS: Male students had higher scores than females for all communicational skills except verbal expression empathy. Fourth-year students had statistically more significant correlations than third-year students with regard to the rapport stage 'active listening' and empathy stage 'nonverbal expression' and abnormal menstruation and chest pain. Correlations were also more significant for hematochezia in the preparation stage 'interview attitude,' rapport stage 'encouragement,' and empathy stages 'verbal and nonverbal expression' and 'acceptance.' The empathy stage 'nonverbal expressions' was more significant for fourth-year students with alcohol problems. Third-year students largely had negative correlations between emotional empathy communication skills and CPX academic achievement, especially between the preparation stage 'respect' and abnormal menstruation, and between the rapport stage 'encouragement' and hematochezia. CONCLUSION: There was a significant correlation between hematochezia, wherein MS students deliver bad news to patients, and communication skills for emotional empathy.
Achievement ; Chest Pain ; Clinical Competence ; Empathy ; Fatigue ; Female ; Gastrointestinal Hemorrhage ; Humans ; Male ; Menstruation ; Schools, Medical

Autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and primary biliary cirrhosis (PBC) are chronic autoimmune liver diseases. Overlap syndrome is defined as a condition in which the clinical, biochemical, and histological features of these autoimmune diseases are overlapped. Thus, it is difficult to appreciate overlap syndrome as an actual diagnostic entity. Only a few cases of the overlap syndrome of AIH and PSC have been reported, especially in children. Moreover, PSC is known to be the most frequent liver disorder associated with inflammatory bowel diseases such as ulcerative colitis. We report one case of AIH-PSC overlap syndrome in a child who was diagnosed as having ulcerative colitis.
Autoimmune Diseases ; Child ; Cholangitis, Sclerosing ; Colitis, Ulcerative ; Hepatitis, Autoimmune ; Humans ; Inflammatory Bowel Diseases ; Liver ; Liver Cirrhosis, Biliary ; Liver Diseases ; Ulcer

A 12-year-old neutered male Golden Retriever presented with a progressively enlarging mass in the submandibular region. Histopathological diagnosis confirmed lymphangiosarcoma with metastasis to the liver and spleen. The pleomorphic neoplastic endothelial cells of the tumor grow directly on bundles of dermal collagen, forming numerous clefts and interconnecting channels that are devoid of conspicuous hematic elements. As lymphangiosarcoma is an uncommon malignant neoplasm, the number of previously reported cases and information of the tumor is limited. The present report describes the clinical history and histopathological diagnosis of a progressive lymphangiosarcoma in the submandibular region with metastases in a dog.

Spontaneous bilateral rupture of the quadriceps tendons without a significant history of trauma is an uncommon disease. It is generally associated with mechanical factors and coexisting systemic and local factors are taken into consideration in the pathogenesis of these ruptures. In patients with some chronic systemic diseases, simultaneous rupture can occur spontaneously or with minor trauma. We present a case of patient with chronic renal failure on hemodialysis for the past 9 years, who sustained this injury, and subsequently had surgical repair of both tendons. We performed a preoperative magnetic resonance imaging to confirm the diagnosis, then we repaired the ruptured quadriceps tendons and performing MRI postoperatively 1 yr later. He regained his normal knee joint functions 1 yr after the operation.
Humans ; Kidney Failure, Chronic ; Knee Joint ; Magnetic Resonance Imaging ; Quadriceps Muscle ; Renal Dialysis ; Rupture ; Rupture, Spontaneous ; Tendons

Solid and papillary epithelial neoplasm (SPEN) of the pancreas is an uncommon tumor and is found predominantly in young females. The most common clinical presentation is an abdominal mass. The tumor has a low grade malignant potential and complete removal is the treatment of choice. We report a case of SPEN in a 13-year-old girl who presented with abdominal pain and increasing size of an abdominal mass after abdominal trauma. CT and sonographic findings showed a well-demarcated mass in the pancreas tail with solid and cystic portion. She got a distal pancreatectomy and pathologic finding was SPEN of pancreas.
Abdominal Pain ; Adolescent* ; Child ; Female ; Humans ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreatectomy ; Ultrasonography

Colitis cystica profunda is a rare benign condition characterized by the presence of mucus-filled cysts in the submucosa of the colon and the rectum. Although it may diffusely involve the entire colon, this disease primarily affects the pelvic colon and rectum. It has rarely been described in the pediatric literature. The surgical treatment has been widely advocated. We report a 7-month-old case, successfully treated by colonoscopic polypectomy without complication. Histologically, components of juvenile retention polyp were mixed with colitis cytsica profunda.
Colitis* ; Colon ; Humans ; Infant* ; Polyps* ; Rectum

Non-alcoholic fatty liver disease (NAFLD) is typically associated with obesity and insulin resistance. Non-alcoholic steatohepatitis (NASH) is a more serious form of NAFLD. Although fibrosis is common in pediatric NASH, cirrhosis has been rarely reported. Patients with hypothalamic or pituitary dysfunction are at risk for obesity and insulin resistance with subsequent development of NAFLD. We report a case of NAFLD progressing to cirrhosis in an obese 16 year-old boy with hypopituitarism.
Fatty Liver ; Fibrosis ; Humans ; Hypopituitarism ; Insulin Resistance ; Obesity

We report a 10-year-old girl with the blue rubber bleb nevus syndrome (BRBNS) who had chronic severe anemia caused by chronic occult bleeding in the gastrointestinal (GI) tract. The patient was admitted to the hospital frequently for recurrent pallor and fatigue since the age of 7 years. Gastroduodenoscopy and capsule endoscopy revealed multiple venous malformations with blood oozing in the stomach, small bowel and colon. The patient was treated by aggressive surgical resection of the 23 vascular malformations in the GI tract. The patient is well without anemia 15 months post surgery.
Anemia ; Blister ; Capsule Endoscopy ; Child ; Colon ; Fatigue ; Gastrointestinal Neoplasms ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Nevus ; Nevus, Blue ; Pallor ; Rubber ; Skin Neoplasms ; Stomach ; Vascular Malformations