Diagnostic Availability of Ultrasonography and the Effects of Methotrexate Therapy in Patients with Eosinophilic Fasciitis: Report of Two Cases / 대한류마티스학회지

Eosinophilic fasciitis (EF) is a rare disorder of unknown etiology characterized by eosinophilia, indurations of the skin, and inflammation of the fascia. Magnetic resonance imaging (MRI) has been used to assist the diagnosis and to monitor the response to treatment, and the commonly used therapy has been corticosteroids. However, the use of ultrasonography (US) in the diagnosis and the management of EF has not been reported previously in Korea. In addition, the effects of methotrexate (MTX) treatment have rarely been reported in corticosteroid-resistant patients with EF. Here, we describe two cases of EF resistant to corticosteroid therapy alone where the combination of MTX and corticosteroids was effective. Furthermore, we show that US is useful modality in supporting the clinical diagnosis and monitoring the response to treatment of patients with EF.

The Efficacy of Drug Eluting Stents on Restenosis Reduction in Small Coronary Arteries

BACKGROUND AND OBJECTIVES: The previous studies have demonstrated the superiority of implanting drug eluting stent (DES) for restenosis reduction compared with the implantation of uncoated stents in small coronary arteries. However, the arteries in those studies tended to have short lesions. So, we evaluated the efficacy of a drug eluting stent in small coronary lesions with a relatively long length. SUBJECTS AND METHODS: From July 2003 to March 2005, DESs (Cypher or Taxus) were implanted into 100 consecutive patients with 116 lesions that were less than 2.75 mm in diameter. All patients received aspirin indefinitely and clopidogrel for 6 months. The primary end point was 6 month angiographic in-segment restenosis, and the secondary end points were procedural success and any major adverse cardiac events (MACE: death, non fatal myocardial infarction and target lesion revascularization) at 9 months. RESULTS: The mean age of the patients was 63 years, 53% were male, 24% were diabetics, 34% were current smokers and 55% had hypertension. A total of 121 DESs were implanted into 116 lesions (mean number of DESs/lesion: 1.1/lesion). The mean proximal and distal reference diameters were 2.21+/-0.39 and 2.01+/-0.40 mm, respectively. The mean lesion length was 19.14+/-7.89 mm. The mean pre- and post-minimal lumen diameters were 0.73+/-0.42 mm and 2.26+/-0.41 mm, respectively. The mean size and length of the stents were 2.65+/-0.13 mm and 28.46+/-10.04 mm, respectively. The procedural success rate was 98.3%. The angiographic follow-up rate was 78.4%. The binary in-segment restenosis rate was 15.4% (14 lesions). The MACE at 9 months was 8.0%. CONCLUSION: DES implantation in small coronary lesions with a relatively long length demonstrated favorable results. However, a larger scale study is needed to clarify the efficacy of the DES in small coronary arteries.