The Current Status of Intervention for Intermediate Coronary Stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry

BACKGROUND AND OBJECTIVES: Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea. METHODS: We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not. RESULTS: Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD). CONCLUSIONS: These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.

The Current Status of Intervention for Intermediate Coronary Stenosis in the Korean Percutaneous Coronary Intervention (K-PCI) Registry

BACKGROUND AND OBJECTIVES@#Intermediate coronary lesion that can be under- or over-estimated by visual estimation frequently results in stenting of functionally nonsignificant lesions or deferral of percutaneous coronary intervention (PCI) of significant lesions inappropriately. We evaluated current status of PCI for intermediate lesions from a standardized database in Korea.@*METHODS@#We analyzed the Korean percutaneous coronary intervention (K-PCI) registry data which collected a standardized PCI database of the participating hospitals throughout the country from January 1, 2014, through December 31, 2014. Intermediate lesion was defined as a luminal narrowing between 50% and 70% by visual estimation and then compared whether the invasive physiologic or imaging study was performed or not.@*RESULTS@#Physiology-guided PCI for intermediate lesions was performed in 16.8% for left anterior descending artery (LAD), 9.8% for left circumflex artery (LCX), 13.2% for right coronary artery (RCA). PCI was more frequently performed using intravascular ultrasound (IVUS) than using fractional flow reserve (FFR) for coronary artery segments (27.7% vs. 13.9% for LAD, 32.9% vs. 8.1% for LCX, and 33.8% vs. 10.8% for RCA). In accordance with or without FFR, PCI for intermediate lesions was more frequently performed in the hospitals with available FFR device than without FFR, especially in left main artery (LM), proximal LAD lesion (40.9% vs. 5.9% for LM, 24.6% vs 7.6% for proximal LAD).@*CONCLUSIONS@#These data provide the current PCI practice pattern with the use of FFR and IVUS in intermediate lesion. More common use of FFR for intermediate lesion should be encouraged.

Gender Differences in Empathic Ability and Facial Emotion Recognition of Schizophrenic Patients

OBJECTIVES: The aim of the present study was to investigate gender difference in empathic ability and recognition of facial emotion expression in schizophrenic patients. METHODS: Twenty-two schizophrenic outpatients (11 men and 11 women) and controls (10 men and 12 women) performed both the scale of Empathic Quotient (EQ) and facial emotion recognition test. We compared the scores of EQ and the facial emotion recognition test among each group according to diagnosis and gender. RESULTS: We found a significant sex difference in the scores of EQ and the facial emotion recognition test in the schizophrenic patients. And there were significantly negative correlation between the score of the facial emotion recognition test and the scores of Positive and Negative Symptom Scale (PANSS) in female schizophrenic patients. However, in male schizophrenic patients, there were no significant correlations between the score of each test and the scores of PANSS. CONCLUSIONS: This study suggests that the sex difference in empathic ability and facial emotion recognition would be very important in chronic schizophrenic patients. Investigation of sex effects in empathic ability and facial emotion recognition in chronic schizophrenic patients would present an important solution for constructing optimal rehabilitation program.

A Case of Extensive Ventricular Wall Rupture from the Posterior Wall to the Ventricular Septum after Acute Myocardial Infarction Demonstrated by Real-Time 3D Echocardiography

2D echocardiography (2DE) is a well established tool for the diagnosis of the mechanical complications after acute myocardial infarction (AMI) such as free wall and ventricular septal rupture. However, the extension of the rupture and the relationship with contiguous anatomic structures may not be clearly defined by 2DE. Real-time 3D echocardiography (RT3DE) is known to provide surgical enface view allowing complete visualization of the cardiac structures and comprehension of their spatial orientations to other anatomic structures. Obtaining such information with RT3DE before operation in AMI patient with mechanical complication may be essential for the optimal surgical treatment. We report a case of extensive ventricular wall rupture from the posterior wall to the ventricular septum after AMI demonstrated by RT3DE.

Idiopathic Hyperammonemia: A Rare Complication Following Allogeneic Bone Marrow Transplantation / 대한내과학회지

Idiopathic hyperammonemia is a rare and serious complication of intensive cytoreductive chemotherapy for hematologic malignancies as well as after autologus or allogeneic bone marrow transplantation (BMT). A 42-year-old woman with Philadelphia chromosome positive acute lymphoblastic leukemia was undertaken unrelated BMT. Fourteen days later, the patient developed hallucination, mental confusion, lethargy, incoordination and stupor. Laboratory tests revealed normal serum aminotransferases. The serum ammonia level is moderately increased. Parenteral alimentation was discontinued to lower protein intake and treatment with lactulose, metronidazole, carnitine, and flumazenil was started. Also, hemodialysis was performed. Despite of these appropriate therapies, she died of idiopathic hyperammonenia at twenty-two days after allogeneic BMT.

Significance of Farnsworth-Munsell 100 Hue Test and Anomaloscope on Acquired Color. Vision Deficiency in Glaucoma Patients

It is well known that, optic nerve damage in glaucoma begins and proceeds before the glaucomatous visual field defects become evident. Recently, various diagnostic methods were introduced to detect early optic nerve damage in patients with suspected glaucoma, Using the Farnsworth-Munsell 100 Hue test and the Neitz anomaloscope, the incidence, severity, and patterns of color vision deficiency was investigated in 65 normal eyes, 24 ocular hypertensive eyes, and 64 glaucoma eyes to find out the relation between glaucomaand color vision deficiency. The incidence of color vision deficiency in the normal subjects, ocular hypertensives. and glaucoma patients were 20%, 25%, and 78.1% respectively, which confirmed the correlation of glaucoma to the occurrence of color vision deficiency(R2=0.63). The glaucoma patients with color vision deficiency were found to have more profound defect compared to the normal individuals or ocular hypertensives. Among the glaucoma patients, those with severe visual field defect showed more profound color vision deficiency compared to those with mild or moderate visual field defect(p<0.01). The patterns of color vision deficiency in glaucoma patients were tritanoid in 84%, and non specific in 16%, which signified the high correlation of glaucoma to the tritanoid defect(R2=0.66).

Implantation of Posterior Chamber Intraocular Lens by Trans-Scleral Fixation

We performed trans scleral fixation techniques for implantation of posterior chamber lens in 25 eyes, in case of incomplete zonular or capsular support. This was done by securing both haptics of the posterior chamber lens to the sclera at the ciliary sulcus with 10-Onylon suture. Postoperative follow-up time ranged from 12 to 23 months, with all patients having at least one year of follow up. At the last follow up visit, 16 eyes (72%) had a vision of 20/50 or better, and 13 eyes (52%) had a vision of 20/30 or better. The transscleral fixation related complications included retinal detatchment, glaucoma and cystoid macular edema. During the relatively longterm follow up period, we did not find any serious complications due to the intraocular lens and there was no significant postoperative changes in the visual acuities.

Significance of Farnsworth-Munsell 100 Hue Test and Anomaloscope on Acquired Color Vision Deficiency in Glaucoma Patients

It is well known that, optic nerve damage in glaucoma begins and proceeds before the glaucomatous visual field defects become evident. Recently, various diagnostic methods were introduced to detect early optic nerve damage in patients with suspected glaucoma Using the Farnsworth-Munsell 100 Hue test and the Neitz anomaloscope, the incidence, severity, and patterns of color vIsIon deficiency was investigated in 65 normal eyes, 24 ocular hypertensive eyes, and 64 glaucoma eyes to find out the relation between glaucoma and color vision deficiency. The incidence of color vision deficiency in the normal subjects, ocular hypertensives, and glaucoma patients were 20%, 25%, and 78.1 % respectively, which confirmed the correlation of glaucoma to the occurrence of color vision deficiency (R2=0.63). The glaucoma patients with color vision deficiency were found to have more profound defect compared to the normal individuals or ocular hypertensives. Among the glaucoma patients, those with severe visual field defect showed more profound color vision deficiency compared to those with mild or moderate visual field defect (p

A Case of Molluscum Contagiosum on the Upper and Lower Eyelids

Molluscum contagiosum is a contagious disease of the skin charaterized by the appearance of small globular, umblicated epithelial tumors, and caused by a virus of pox virus group. Authors experienced a case of molluscum contagiosum on the right upper and lower eyelids. And there was follicular conjunctivitis, but no corneal complication. The lesion was managed by simple extraction of the lesion under the local infiltration anesthesia.

A Case of the Oculopharyngeal Muscular Dystrophy

The oculopharyngeal muscular dystrophy is a distinct, clinically well-defined myopathy of later life inherited in an autosomal dominant fashion with complete penetrance. Blepharoptosis, dysphagia, lower leg weakness are the most prominent findings. It is a systemic myopathy which affects all voluntary muscles and appears to spare smooth and cardiac muscle. The authors experienced a case of the oculopharyngeal muscular dystrophy which showed characteristic signs and symptoms such as symmetric ptosis, dysphagia, and progressive external ophthalmoplegia, and the literature were reviewed.

The Levator Action in Korean

The measurement of levator action is most important guide to the diagnosis, management of the blepharoptosis, especially to the choice of operation. Levator action was determined by the Berke's method on 850 normal Koreans(1700 eyes) who were seen in the Severance Hospital from November, 1985 through April, 1986. The results were as follows. 1. The average levator action of 850 normal Korean was 13.3 +/- 0.4mm, but no significant difference of levator action was found neither between right and left eye, nor between male and female. The levator action below 10 or over 60 years old was significantly weaker than the other age groups. 2. The average action of the frontalis muscle was 3.2 +/- 0.4mm, but there was no significant difference of frontalis muscle action in bilaterality or sex. The frontalis muscle action under 10 or beyond 60 years old was significantly weaker than the other age groups. 3. The average height of the palpebral fissure was 8.6 +/- 0.4mm, but the discrepancy of the height was not found neither among sex nor between both eyes. The height of the palpebral fissure becomes higher until 40 years old, whereas it becomes lower after 40 years old. 4. The correlation coefficient was 0.43.

The Levator Action in Korean

The measurement of levator action is most important guide to the diagnosis, management of the blepharoptosis, especially to the choice of operation. Levator action was determined by the Berke's method on 850 normal Koreans(1700 eyes) who were seen in the Severance Hospital from November, 1985 through April, 1986. The results were as follows. 1. The average levator action of 850 normal Korean was 13.3 +/- 0.4mm, but no significant difference of levator action was found neither between right and left eye, nor between male and female. The levator action below 10 or over 60 years old was significantly weaker than the other age groups. 2. The average action of the frontalis muscle was 3.2 +/- 0.4mm, but there was no significant difference of frontalis muscle action in bilaterality or sex. The frontalis muscle action under 10 or beyond 60 years old was significantly weaker than the other age groups. 3. The average height of the palpebral fissure was 8.6 +/- 0.4mm, but the discrepancy of the height was not found neither among sex nor between both eyes. The height of the palpebral fissure becomes higher until 40 years old, whereas it becomes lower after 40 years old. 4. The correlation coefficient was 0.43.