Impact of low signal intensity assessed by cine magnetic resonance imaging on detection of poorly viable myocardium in patients with prior myocardial infarction.

Late gadolinium enhancement magnetic resonance imaging (LGE-MRI) has been established as a modality to detect myocardial infarction (MI). However, the use of gadolinium contrast is limited in patients with advanced renal dysfunction. Although the signal intensity (SI) of infarct area assessed by cine MRI is low in some patients with prior MI, the prevalence and clinical significance of low SI has not been evaluated.

Short-course radiotherapy with delayed surgery versus conventional chemoradiotherapy: A comparison of the short- and long-term outcomes in patients with T3 rectal cancer.

Introduction: The aim of this study was to compare the short- and long-term outcomes between short-course radiotherapy with delayed surgery (SRT-delay) and a standard conventional chemoradiotherapy (CRT) regimen.

Methods: Two collaborating institutions adopted different regimens; the SRT-delay regimen was selected by Meiwa Hospital and the CRT regimen was selected by Hyogo College of Medicine. The inclusion criteria were T3 middle and low rectal cancer patients treated with radical surgery after preoperative therapy.

Myocardial Damage Detected by Two-Dimensional Speckle-Tracking Echocardiography in Patients with Extracardiac Sarcoidosis: Comparison with Magnetic Resonance Imaging.

Background: The aim of this study was to determine whether two-dimensional speckle-tracking echocardiography can identify the myocardial damage detected by delayed enhancement (DE) magnetic resonance imaging via the differences in myocardial deformation in patients with extracardiac sarcoidosis who showed no structural and functional abnormalities in the heart.

Methods: Forty-five patients with biopsy-proven extracardiac sarcoidosis were analyzed retrospectively. Patients with abnormal electrocardiographic and echocardiographic findings, including ventricular arrhythmias, heart block, regional wall motion abnormalities, valvular heart disease, and cardiomyopathy, were excluded.

Two cases of delayed cardiac tamponade due to pericarditis after pulmonary vein (PV) isolation for atrial fibrillation.

Catheter ablation is an established treatment for atrial fibrillation (AF). The incidence of major complications related to the procedure is reported to be 4.5%, and delayed cardiac tamponade (DCT) is a rare, although recently recognized, complication.

Circulating CD14++CD16+ Monocyte Subsets as a Surrogate Marker of the Therapeutic Effect of Corticosteroid Therapy in Patients With Cardiac Sarcoidosis.

Background: We aimed to evaluate whether specific monocyte subsets could serve as surrogate markers of disease activity in cardiac sarcoidosis (CS) evaluated by 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET).

Methods And Results: We studied 28 patients with CS (8 men; mean age: 61±9 years) diagnosed according to consensus criteria. We divided the patients into 2 groups: known CS receiving corticosteroid therapy (Rx(+); n=13) and new-onset CS (Rx(-); n=15), and analyzed 3 distinct monocyte subsets (CD14+CD16-, CD14++CD16+, and CD14+ -CD16+).

[A systematic review of decided litigated cases on adverse drug events in Japan: classification of decided cases appearing in law reports].

Much of the damage to health caused by drugs could be prevented by appropriate care. A well-defined duty of care and further information are required for healthcare professionals. Although there are many litigation cases to use as references, neither the extent of the duty of care nor the obligation to explain medication according to the type of drug prescribed has yet been fully established.

Abrupt change in the shape of a left ventricular mural thrombus after intra-aortic balloon pump-supported percutaneous coronary intervention in recent myocardial infarction.

A 77-year-old woman was diagnosed with congestive heart failure and broad anterior acute myocardial infarction that had occurred 10 days prior to her presentation in our hospital. A flat and immobile thrombus was widely attached to the luminal surface of the left ventricular antero-apical wall with dyskinetic motion. For treatment-resistant heart failure, the patient underwent percutaneous coronary intervention (PCI), with intravenous heparin, supporting an intra-aortic balloon pump.

[Two cases of dural metastasis of breast cancer].

The first case of dural metastasis occurred in a 60s years old woman, who presented with bone metastasis to the right breast. Nine months later, disorientation and left hemiplegia developed, the right coronal bone metastasis enlarged, and dural metastases were detected close to the tumor, as observed by using cranial magnetic resonance imaging (MRI). Whole brain radiation and chemotherapy(weekly paclitaxel)were administered.

Pathologic evaluation of the response of mesorectal positive nodes to preoperative chemoradiotherapy in patients with rectal cancer.

Background: The response of positive mesorectal lymph nodes to chemoradiotherapy remains largely unstudied in patients with rectal cancer. The aim of this study was to investigate the requirements of the total regression of positive nodes treated with chemoradiotherapy.

Methods: The response of the primary tumor was evaluated according to the tumor regression grade (TRG 0-4) in resected specimens, and positive lymph nodes were assessed according to the lymph node regression grade (LRG 1-3), with TRG 4 and LRG 3 indicating total regression.

Association between hyperglycemia at admission and microvascular obstruction in patients with ST-segment elevation myocardial infarction.

Background: Blood glucose level at admission in ST-segment elevation myocardial infarction (STEMI) is a predictor of heart failure and mortality. A previous study showed the association between hyperglycemia and microvascular dysfunction using myocardial contrast echocardiography. Late gadolinium enhancement (LGE) cardiovascular magnetic resonance imaging (CMR) can demonstrate microvascular obstruction (MVO) as the area with hypointense core within LGE.

Improvement of cardiac function by increasing stimulus strength during left ventricular pacing in cardiac resynchronization therapy.

Cardiac resynchronization therapy (CRT) is an established therapy in patients with severe heart failure due to left ventricular (LV) dyssynchrony. Increasing stimulus strength (SS) of LV pacing could capture an enlarged myocardial area and provide rapid electrical conduction. The aim of the present study was to investigate whether increasing SS of LV pacing improves LV mechanical dyssynchrony and cardiac function in patients treated with CRT.

Feasibility of optical coronary tomography in quantitative measurement of coronary arteries with lipid-rich plaque.

Background: The aim of the present study was to evaluate the feasibility of optical coherence tomography (OCT) for measurement of vessel area in coronary arteries with lipid-rich plaque as compared with intravascular ultrasound (IVUS). METHODS AND RESULTS: We investigated 80 coronary artery segments with lipid-rich plaque on OCT and non-attenuated plaque on IVUS. According to the lipid arc on OCT, the plaques were classified into 4 groups: group 1, lipid arc ≤90°; group 2, 90°270°.

Effect of atorvastatin therapy on fibrous cap thickness in coronary atherosclerotic plaque as assessed by optical coherence tomography: the EASY-FIT study.

Background: The detailed mechanism of plaque stabilization by statin therapy is not fully understood.

Objectives: The aim of this study was to assess the effect of lipid-lowering therapy with 20 mg/day of atorvastatin versus 5 mg/day of atorvastatin on fibrous cap thickness in coronary atherosclerotic plaques by using optical coherence tomography (OCT).

Methods: Seventy patients with unstable angina pectoris and untreated dyslipidemia were randomized to either 20 mg/day or 5 mg/day of atorvastatin therapy.

Comparison of vascular response between everolimus-eluting stent and bare metal stent implantation in ST-segment elevation myocardial infarction assessed by optical coherence tomography.

Aims: The long-term safety of second-generation everolimus-eluting stents (EESs) in ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of this study was to evaluate the late vascular response after stent implantation in STEMI between EES and bare-metal stent (BMS) by using optical coherence tomography (OCT).

Methods And Results: A prospective OCT examination was performed in 102 patients at 10 months after stent implantation for treatment of STEMI.

Long-term outcome after deferral of revascularization in patients with intermediate coronary stenosis and gray-zone fractional flow reserve.

Background: A strategy of deferred percutaneous coronary intervention for coronary stenosis with fractional flow reserve (FFR) 0.75-0.80, termed the gray zone, remains a matter of debate.

Procedure-dependent construction of two isomers of trimeric self-assembled boronic esters.

A procedure-dependent selective construction of two isomers of trimeric boronic esters was realized. A capsule-like trimeric boronic ester was constructed by the direct connection of two kinds of self-assembled boronic esters via [3+2] cycloaddition, while the tricyclic trimeric boronic ester was obtained by the self-assembly of pre-connected components.

Incremental value of coronary flow velocity reserve, measured by transthoracic echocardiography, compared with computed tomography angiography alone, for detecting flow-limiting coronary stenoses.

Background: Computed tomographic (CT) angiography provides high sensitivity for the detection of coronary stenosis, while its specificity is relatively low. The aim of this study was to determine the incremental value of coronary flow velocity reserve (CFVR) by transthoracic echocardiography when used with CT angiography for detecting stenosis of the major coronary arteries compared with invasive quantitative coronary angiography.

Methods: Sixty patients who underwent CFVR measurement before coronary angiography were retrospectively selected, and the cutoff value of CFVR to predict diameter stenosis > 70% was determined using receiver operating characteristic curve analysis.

Dynamic Change in Cells Expressing IL-1β in Rat Hippocampus after Status Epilepticus.

Background: The time course of cytokine dynamics after seizure remains controversial. Here we evaluated the changes in the levels and sites of interleukin (IL)-1β expression over time in the hippocampus after seizure.

Methods: Status epilepticus (SE) was induced in adult Wistar rats by means of intraperitoneal injection of kainic acid (KA).

The timing of surgery after preoperative short-course S-1 chemoradiotherapy with delayed surgery for T3 lower rectal cancer.

Purpose: The purpose of this study was to analyze the influence of variations in clinical practice regarding the timing of surgery with short-course chemoradiotherapy with delayed surgery (SCRT-delay) for lower rectal cancer.

Methods: A total of 171 patients with T3 N0-2 lower rectal cancer treated with SCRT-delay (25 Gy/10 fractions/5 days (S-1); days 1-10) were retrospectively evaluated. The median waiting period of 30 days was used as a discriminator (group A: waiting period, ≤30 days; group B: waiting period, ≥31 days).

Impact of eicosapentaenoic acid treatment on the fibrous cap thickness in patients with coronary atherosclerotic plaque: an optical coherence tomography study.

Aim: Previous clinical trials have demonstrated the effectiveness of eicosapentaenoic acid (EPA) in preventing cardiovascular events. The aim of the present study was to investigate the effects of EPA treatment on the accumulation of coronary atherosclerotic plaque using optical coherence tomography (OCT).

Methods: A total of 46 acute coronary syndrome (ACS) patients without dyslipidemia were divided into two groups: those who received 1,800 mg/day of EPA (n = 15) or the control group (n = 31).

Two-dimensional speckle tracking echocardiography for the prediction of reversible myocardial dysfunction after acute myocardial infarction: comparison with magnetic resonance imaging.

Background: We aimed to determine the predictive value of longitudinal, circumferential, and radial strains by two-dimensional speckle tracking echocardiography (2DSTE) for improvement in cardiac function after acute myocardial infarction (AMI) compared with that of contrast-enhanced cardiac magnetic resonance imaging (ceMRI).

Methods: In 35 patients with first-time AMI, myocardial viability was assessed to predict recovery of function at follow-up (7 ± 2 months), prospectively. For each left ventricular segment, each peak strains were determined using 2DSTE, and the relative extent of hyperenhancement was assessed using ceMRI.

Angioscopic observation in chronic thromboembolic pulmonary hypertension before and after balloon pulmonary angioplasty.

: We here report the angioscopic assessment of inoperable peripheral chronic thromboembolic pulmonary hypertension in an 81-year-old man who was previously diagnosed with the disease. To assess the pathological morphology of the web lesion, pouch defect and band lesion, we used two types of angioscopic catheter: blood flow-maintaining type and blood flow-blocking type. Angioscopy revealed a heterogeneous thrombus that contained white organized thrombus, red fragile thrombus and yellowish thrombus.

Difference of ruptured plaque morphology between asymptomatic coronary artery disease and non-ST elevation acute coronary syndrome patients: an optical coherence tomography study.

Background: Autopsy studies have reported that rupture of a thin-cap fibroatheroma and subsequent thrombus formation is the major mechanism leading to acute coronary syndrome (ACS). However, it is not clear why only some plaque ruptures lead to ACS. Optical coherence tomography (OCT) is a high-resolution imaging modality which is capable of investigating detailed coronary plaque morphology in vivo.