Prognostic Significance of Asymptomatic Cerebral Infarction in Patients After Cardiac Catheterization.

Recent studies have showed that asymptomatic cerebral infarction (ACI) developed in a reasonable number of patients after cardiac catheterization. However, no study has investigated the long-term prognostic impact of ACI after cardiac catheterization. We investigated whether ACI after cardiac catheterization affects long-term mortality and subsequent cardiovascular events.

Plaque characteristics and prognosis in patients with peripheral arterial disease by angioscopic analysis.

Background: The plaques with higher grade of yellow color by angioscopy are reported to be associated with vulnerability leading to adverse outcomes in coronary artery diseases. However, no studies have been performed for peripheral artery disease (PAD). We aimed to evaluate the relationship of angioscopic findings of peripheral arteries with the long-term prognosis.

Impact of pericardial fluid glucose level and computed tomography attenuation values on diagnosis of malignancy-related pericardial effusion.

Background: We evaluated malignancy according to the characteristics of pericardial fluid in symptomatic Japanese patients undergoing pericardiocentesis and computed tomography (CT).

Methods: This was a retrospective, single-center, observational study of 125 symptomatic patients undergoing pericardiocentesis. The patients were classified into two groups: a malignancy group and a non-malignancy group, according to the primary disease and cytology of the pericardial effusion (PE).

Impact of Neointimal Condition and Platelet Reactivity on Intrastent Thrombus at Long-Term Follow-up After 2nd- and 3rd-Generation Drug-Eluting Stent Implantation - Insights From a Coronary Angioscopy and Pharmacodynamic Study.

Background: Although the incidence of very late stent failure (VLSF) is reduced with newer generation drug-eluting stent (DES), the mechanism of VLSF has not been fully explored.

Methods and results: This study evaluated both local vascular healing using coronary angioscopy and systemic factors determined by platelet reactivity at long-term follow-up after 2nd- and 3rd-generation DES implantation in patients with acute coronary syndrome. Coronary angioscopy was performed to assess neointimal coverage (NIC), yellow color (YC) grade and presence of thrombus.

Long-term effects of non-retrieved inferior vena cava filters on recurrences of venous thromboembolism in cancer and non-cancer patients: From the COMMAND VTE registry.

Background: There is a paucity of data comparing the long-term outcomes after inferior vena cava (IVC) filters placement for patients with acute venous thromboembolism (VTE) between those with and without active cancer.

Methods: In the COMMAND VTE Registry, we evaluated the effects of IVC filter use on the long-term clinical outcomes stratified by the presence and absence of active cancer.

Results: Among 2,626 patients with acute symptomatic VTE, there were 604 patients with active cancer, and 2022 patients without active cancer.

Retrograde-angioscopy guided wiring technique in chronic total occlusion lead to successful revascularization.

Endovascular therapy (EVT) was performed in two cases with chronic total occlusion (CTO) of superficial femoral artery. In these cases, angioscopy was deployed in the backyard of the CTO lesion from popliteal artery retrogradely, then the guidewire was advanced from antegrade. When the wire crossed the distal of the CTO lesion, the wire penetration was clearly visualized by the retrograde-angioscopy.

Determinants and prognostic implications of instantaneous wave-free ratio in patients with mild to intermediate coronary stenosis: Comparison with those of fractional flow reserve.

The instantaneous wave-free ratio (iFR) is used for assessing the hemodynamic severity of a lesion, as an alternative to the fractional flow reserve (FFR). We evaluated the relationship between iFR and FFR in detail and the clinical significance of iFR in patients with mild to intermediate coronary artery stenosis. We recruited consecutive 323 patients (421 lesions) with lesions exhibiting 30% to 80% diameter stenosis on angiography in whom FFR and iFR were measured.

Impact of impaired glucose tolerance on clopidogrel response in patients with coronary artery disease.

Although patients with impaired glucose tolerance (IGT) are at increased atherothrombotic risk, it is unclear how antiplatelet drugs act in patients with IGT. The aim of this study was to investigate the pharmacodynamic response to clopidogrel in patients with IGT and insulin resistance (IR). A 75 g oral glucose tolerance test was performed in 65 coronary artery disease (CAD) patients on aspirin and clopidogrel therapy.

The kinetics of glomerular deposition of nephritogenic IgA.

Whether IgA nephropathy is attributable to mesangial IgA is unclear as there is no correlation between intensity of deposits and extent of glomerular injury and no clear mechanism explaining how these mesangial deposits induce hematuria and subsequent proteinuria. This hinders the development of a specific therapy. Thus, precise events during deposition still remain clinical challenge to clarify.

Uncoupling of glomerular IgA deposition and disease progression in alymphoplasia mice with IgA nephropathy.

Previous clinical and experimental studies have indicated that cells responsible for IgA nephropathy (IgAN), at least in part, are localized in bone marrow (BM). Indeed, we have demonstrated that murine IgAN can be experimentally reconstituted by bone marrow transplantation (BMT) from IgAN prone mice in not only normal mice, but also in alymphoplasia mice (aly/aly) independent of IgA+ cells homing to mucosa or secondary lymphoid tissues. The objective of the present study was to further assess whether secondary lymph nodes (LN) contribute to the progression of this disease.

Clinical utility of low-pressure implantation of drug-eluting stent into very small vessels.

Background: Although drug-eluting stents (DES) reduce restenosis, the best strategy for DES implantation in small vessels has not been established.

Purpose: We investigated the clinical usefulness of low-pressure implantation of a 2.5-mm DES for small vessels less than 2.

Difference in statin effects on neointimal coverage after implantation of drug-eluting stents.

Objective: This study was carried out to examine the difference in effects between rosuvastatin and pravastatin on neointimal formation after the placement of a drug-eluting stent (DES).

Materials And Methods: Forty patients who underwent placement of a DES in our hospital were prospectively randomized to receive rosuvastatin (n=20) or pravastatin (n=20), and analyzed by optical coherence tomography at the chronic stage. The main outcome measure was comparison of neointimal coverage analyzed at a strut level.

Difference in neointimal coverage at chronic stage between bare metal stent and sirolimus-eluting stent evaluated at stent-strut level by optical coherence tomography.

Compared with the bare metal stent (BMS), suppression of neointimal growth in the sirolimus-eluting stent (SES) reduced restenosis at the cost of more exposed struts that could impose the risk of stent thrombosis. The present study was conducted to analyze neointimal coverage patterns of stents at a strut-level after implantation of BMS or SES with the use of optical coherence tomography (OCT). We enrolled 35 patients and analyzed neointimal coverage of every strut from 41 stents (BMS: n = 8, SES: n = 33) by using OCT at follow-up of the stent implantation.

Reevaluation of the mucosa-bone marrow axis in IgA nephropathy with animal models.

Impaired immune regulation along the 'mucosa-bone marrow axis' has been postulated to play an important role in the pathogenesis of IgA nephropathy (IgAN). Animal models have allowed us to study such changes in detail. Recently, we established several useful animal models, including IgAN-prone mice.

Roles of bone marrow, mucosa and lymphoid tissues in pathogenesis of murine IgA nephropathy.

Previous studies indicated that bone marrow cells may contribute to the pathogenesis of IgA nephropathy (IgAN). However, the cell types and mechanisms responsible remain unclear. Our recent study showed that 'grouped ddY mice' is a useful model to approach the pathogenesis of IgAN.

[Comparison of prediction equations of glomerular filtration rate in Japanese adults].

Objective: Creatinine clearance (Ccr) is widely used for the evaluation of the glomerular filtration rate (GFR). Since the clearance method requires urine collection, formulae for predicting GFR without urine collection have been developed. In the guidelines of the Kidney Disease Outcomes Quality Initiative(K/ DOQI), the formulae developed from the Modification of Diet in Renal Disease Study (MDRD) are recommended for estimating GFR.

[Internal ophthalmoplegia in acute oropharyngeal palsy with anti-GQ1b and anti-GT1a IgG antibodies].

A patient with acute oropharyngeal palsy associated with internal ophthalmoplegia was reported. A 13-year-old boy had fever and diarrhea for two days. Ten days after resolution of these symptoms, he noticed difficulty in speaking (day 1).

A case of primary immunoglobulin light chain amyloidosis with a delayed appearance of Bence Jones protein in urine.

We report here a case of a 58-year-old man who had nephrotic syndrome and immunoglobulin light chain (AL) amyloidosis. This patient underwent a renal biopsy to confirm the diagnosis. Treatment with permanganate before Congo red staining showed systemic secondary amyloidosis (AA) fibrils, which were sensitive to permanganate oxidation.

Fetal heart rate and uterine contraction during automobile driving.

Objective: The purpose of this study was to clarify the influence of automobile driving in the third trimester of pregnancy on fetal heart rate and uterine contraction.

Methods: Twenty-nine pregnant women with singleton pregnancies after 28 weeks of gestation were monitored using a portable cardiotocogram during driving, and the results obtained before and after driving were compared.

Results: Baseline fetal heart rate and its variability, as well as periodic fetal heart rate patterns, showed no abnormal patterns during car driving.