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Fukuoka-shi, Japan

Yamamoto H.,Shiga University of Medical Science | Nakae H.,Akita University | Uji Y.,Shinkoga Hospital | Maeda K.,Osaka University | And 2 more authors.
Therapeutic Apheresis and Dialysis | Year: 2015

Plasma filtration with dialysis (PDF) is a blood purification therapy in which simple plasma exchange (PE) is performed using a selective membrane plasma separator while the dialysate flows outside of the hollow fibers. Improvement of hypoadiponectinemia is considered to be a useful therapeutic approach for ameliorating fatal conditions including cardio-metabolic and infectious disease. We investigated the effects of PDF in comparison to PE in terms of plasma adiponectin (APN) changes in patients with acute liver failure. Seventeen patients with liver failure were studied; PDF was performed 55 times and PE 14 times. Plasma APN levels increased significantly after PDF, while decreasing significantly after PE. PDF appears to be among the most useful blood purification therapies in acute liver failure cases in terms of increasing APN levels. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society of Dialysis Therapy.

Muramatsu T.,Saiseikai Yokohamashi Tobu Hospital | Tsuchikane E.,Toyohashi Heart Center | Oikawa Y.,Cardiovascular Institute | Otsuji S.,Higashi Takarazuka Satoh Hospital | And 5 more authors.
EuroIntervention | Year: 2014

Aims: To assess the incidence and impact on clinical outcomes of subintimal tracking in patients undergoing percutaneous coronary intervention for chronic total occlusion (CTO).Methods and results: Patients at 27 centres were consecutively enrolled when guidewire crossing of the CTO by either the antegrade or the retrograde approach was confirmed by intravascular ultrasound (IVUS). IVUS images were examined to identify the course of the wire. Clinical follow-up at one year and angiographic follow-up at nine months were performed after everolimus-eluting stent implantation. Among a total of 163 patients (59 antegrade and 104 retrograde), subintimal tracking was more frequent with the retrograde approach (24.2- vs. 12.3-, p=0.10). Although there was no difference in the one-year target vessel revascularisation rate between intimal and subintimal tracking with either the antegrade or the retrograde approach, angiographic follow-up revealed greater late loss in the subintimal group compared with the intimal group. Multivariate analysis identified the pre-procedural reference diameter as a predictor of subintimal tracking.Conclusions: Subintimal tracking was more frequent with the retrograde approach. After medium-term follow-up, no negative clinical impact of subintimal tracking was observed in this small study. However, further evaluation of the angiographic impact is needed.

Akazawa S.,Shinkoga Hospital | Tojikubo M.,Shinkoga Hospital | Kuratomi A.,Shinkoga Hospital | Towatari T.,Clinical Laboratory | And 2 more authors.
Journal of the Japan Diabetes Society | Year: 2010

We studied the relationship between carotid atherosclerosis and coronary artery disease in 131 subjects with diabetes mellitus undergoing multislice computed tomography (MSCT) coronary angiography. Carotid atherosclerosis was evaluated based on intima-media complex thickness (IMT) in the common carotid artery and plaque score (PS), defined as the sum of maximum thickness of all plaque observed in the bilateral carotid artery. IMT and PS were significantly higher in subjects with significant (≧50%) coronary artery disease (CAD) than in those without Logistic regression analysis of significant CAD showed PS to be a significant independent variable. The receiver operating characteristic for IMT and PS use in predicting significant CAD showed sensitivity of 59% and specificity of 60% in IMT for a cutoff of 0.888 mm. Sensitivity was 74% and specificity 70% for PS for a cutoff of 3.6 mm. The number of significant (≧50%) stenotic segments correlated significantly with IMT (r = 0.252, p<0.01) and PS (r = 0.391, p <0.01). Multiple regression analysis showed PS and LDL-C to be significantly associated with the number of significant (≧50%) stenotic segments in the coronary artery (R2 = 0.205, p <0.001). The proportion of plaque type in the carotid artery was 3.1% in hypoechoic lesions, 20.8% in isoechoic lesions, 20.5% in hyperechoic lesions, and 55.6% in heterogenous (mixed) lesions. The proportion of plaque type in the coronary artery was 35.2% in noncalcified lesions, 30.4% in calcified lesions, and 34.4% in mixed lesions. The plaque type in the carotid and coronary arteries was similar in 24% of subjects. These results indicate that PS was more useful than IMT in identifying significant coronary artery disease. PS was also independently associated with coronary artery disease, together with such conventional risk factors as hyperlipidemia.

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