Influence of caffeine intake on intravenous adenosine-induced fractional flow reserve.

Background: This study evaluated whether caffeine abstention is required before fractional flow reserve (FFR) measurement by intravenous adenosine triphosphate (ATP) administration in Japanese patients.

Methods: This study was a subanalysis of a previously published study and a total of 208 intermediate lesions that underwent FFR measurements were enrolled for this analysis. Hyperemia was induced by continuous intravenous ATP infusion at 150 μg/kg/min (IVATP150) and 210 μg/kg/min (IVATP210), and by intracoronary administration of nicorandil 2 mg (ICNIC2mg) as a reference standard.

A case of lower lip defect reconstructed with buccal mucosa and a tongue flap.

The use of buccal mucosa and a tongue flap in reconstruction of full-thickness defects of the lower lip is described. The patient's face received a heavy blow in a traffic accident. Necrosis caused by hematogenous disturbance occurred in more than half of the entire lower lip vermilion.

Apical hypertrophy associated with rapid T wave inversion on the electrocardiogram.

A 53-year-old man who had no chest pain and no family history of heart disease demonstrated a rapid T wave change on an electrocardiogram, from a positive T wave to a giant negative T wave, within 1 year. Echocardiography showed no left ventricular hypertrophy before or after the T wave change. Cine-magnetic resonance imaging revealed focal apical hypertrophy after the appearance of the giant negative T wave.