Purpose: Data are limited on the long-term efficacy and safety of drug-coated balloon (DCB) treatment in comparison to drugeluting stent (DES) for de novo coronary lesions. We investigated the long-term clinical outcomes of DCB treatment in percutaneous coronary intervention (PCI) for de novo coronary lesions. Materials and Methods: A total of 103 patients scheduled for elective PCI for de novo non-small coronary lesions (≥2.5 mm) who were successfully treated with DCB alone were retrospectively compared with 103 propensity-matched patients treated with second-generation DES from the PTRG-DES registry (n=13160). All patients were followed for 5 years. The primary endpoint was major adverse cardiac events [MACE; cardiac death, myocardial infarction, stroke, target lesion thrombosis, target vessel revascularization (TVR), and major bleeding] at 5 years. Results: At 5-year clinical follow-up, Kaplan-Meier estimates of the rate of MACE were significantly lower in the DCB group [2.9% vs. 10.7%; hazard ratio (HR): 0.26; 95% confidence interval (CI): 0.07–0.96; log-rank p=0.027]. There was a significantly lower incidence of TVR in the DCB group (1.0% vs. 7.8%; HR: 0.12; 95% CI: 0.01–0.98; long-rank p=0.015), and there was major bleeding only in the DES group (0.0% vs. 1.9%; log-rank p=0.156). Conclusion At 5-year follow-up, DCB treatment was significantly associated with reduced incidences of MACE and TVR, compared with DES implantation, for de novo coronary lesions.

An intramural duodenal hematoma has been mostly reported as a consequence of trauma. It can also result from a hematological disorder, anticoagulant drug use and a post-therapeutic endoscopic procedure. Common symptoms of patients with an intramural duodenal hematoma are vomiting and abdominal pain. An intramural duodenal hematoma is rarely accompanied with pancreatitis and cholangitis due to intestinal obstruction. A diagnosis is made by esophagogastroduodenoscopy and the use of an abdominal CT scan. An intramural duodenal hematoma is mainly treated with conservative therapy but it may sometimes be treated with a surgical procedure. We report one case of an intramural duodenal hematoma after performing a therapeutic endoscopic procedure in a chronic renal failure patient undergoing maintenance hemodialysis.
Abdominal Pain ; Cholangitis ; Duodenal Ulcer ; Duodenoscopy ; Duodenum ; Endoscopy, Digestive System ; Epinephrine ; Hematoma ; Hemorrhage ; Humans ; Intestinal Obstruction ; Kidney Failure, Chronic ; Pancreatitis ; Renal Dialysis ; Vomiting

A 56-year-old male presented with resting dyspnea and chest discomfort for several years. During transthoracic and transesophageal echocardiography, a spontaneously healed membranous type ventricular septal defect (VSD) with malaligned interventricular septal wall, aneurysmal changes, a subaortic ridge and a double-chambered right ventricle (DCRV) was observed. When combined with DCRV, VSD with malalignment between the outlet and trabecular septa was associated with tetralogy of Fallot. The subaortic ridge was due to turbulent flow caused by the malalignment-type VSD. The VSD with malaligned interventricular septal wall can be developed after aneurismal changes of a perimembranous VSD. We report here in the unusual case of a 56-year-old patient who had a pathology complex comprising DCRV, subaortic ridge, spontaneously healed membranous type VSD with malaligned interventricular septal wall, and survived with surgical treatment.
Aneurysm ; Dyspnea ; Echocardiography, Transesophageal ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Tetralogy of Fallot ; Thorax

PURPOSE: This study aimed at evaluating the pattern of changes in estrogen receptor (ER), progesterone receptor (PR) and the HER2 expression in primary and recurrent breast cancer. METHODS: In the study, we analyzed the changes of the ER and PR and the HER2 immunohistochemical expression to identify the patterns of changes and the predictive factors for the changes in 153 patients with primary and recurrent breast cancer between 1991 and 2005. RESULTS: There was a significant decrease in the positive rate of ER (50.3% to 38.6%, p<0.001), PR (43.8% to 26.8%, p=0.0095) and the HER2 (40.3% to 36.3%, p<0.001) expression in the primary breast cancers and recurrent breast cancers. The rate of triple negativity (ER/PR/HER2: all negative) was increased from 25.8% to 43.5% (p<0.001). Among 44 (28.6%) patients with changes in ER and ER status changed from positive to negative in 31 patients (20.3%) and negative to positive in 13 patients (8.3%) (p=0.007). For 58 patients (37.9%) who showed a change of the PR, the PR status changed from positive to negative in 42 patients (27.5%) and vice versa in 16 patients (10.4%) (p=0.0006). Twenty one patients (16.9%) changed from HER2 positive to HER2 negative and vice versa in 9 patients (7.3%) (p=0.029) among the 30 patients (24.2%) with changes in the HER2 expression. A multivariate analysis indicated that hormonal therapy was a significant factor that had an influence on the ER (odds ratio, 4.4) and PR (odds ratio, 2.6) changes. There were no significant differences in the survival rates according to the changes of the ER and PR, and the HER2 expression. CONCLUSION: The more common changes from positive to negative among the ER, PR, and HER2 indicated poor tumor biology of recurrent tumor. Therefore, the assessment of the ER, PR, and HER2 statuses is important for effectively treating recurrent breast cancer and especially those who have a previous history of hormonal therapy although survival benefit was not observed in this study.
Biology ; Breast ; Breast Neoplasms ; Estrogens ; Humans ; Multivariate Analysis ; Receptors, Progesterone ; Recurrence ; Survival Rate