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Minami T.,Nagasaki University | Kawano H.,Nagasaki University | Yamachika S.,Shunkaikai Inoue Hospital | Tsuneto A.,Nagasaki University | And 5 more authors.
International Heart Journal | Year: 2012

Preoperative information concerning the severity and etiology of MR is very important for selecting the most appropriate surgical strategy. Ruptured chordae tendineae (RCT) are one of the most important preoperative findings. We compared the diagnostic power of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) to detect RCT in patients with MR. We studied 61 patients with MR (30 men, 31 women; mean age, 61 ± 12 years) who underwent mitral valve repair or replacement. Both TTE and TEE were performed before the operations, and the sensitivity and specificity of TTE and TEE to detect RCT were determined. In addition, other factors that influenced the detection of RCT by these two methods were investigated. At the time of an operation, RCT was confirmed in 39 of 61 cases. Transesophageal echocardiography had a higher sensitivity than TTE (74% versus 44%; P = 0.006) to detect RCT, although the specificity was not significantly different. In patients with a body mass index (BMI) > 22 (P = 0.023) or MR grade 4 (P = 0.026), TEE had a significantly higher diagnostic sensitivity than TTE, although there was no significant difference in patients with BMI < 22 or MR grade ≤ 3. In the lateral and medial segments of the mitral valve, TEE had a significantly higher diagnostic sensitivity to detect RCT than TTE (P = 0.0012), although there was no significant difference in the middle segments. There was no significant difference between TTE and TEE with respect to the sensitivity to detect RCT in myxomatous mitral valves. Although the sensitivity of TEE was higher than that of TTE to detect RCT, it was affected by BMI, MR grade, the RCT-presenting segments, and the etiology of MR.


Sakai M.,Nagasaki University | Tsujino A.,Nagasaki University | Eguchi H.,Nagasaki University | Sato K.,Nagasaki University | And 6 more authors.
Acta Medica Nagasakiensia | Year: 2010

Objective: Sporadic Parkinson's disease (PD) is thought to be a complex multifactorial, age-related neurodegenerative disease caused by the interaction between genetic and environmental factors. Whether PARK2, a major responsible gene causing familial PD, affects to the disease susceptibility or the phenotypic variability in sporadic PD remains controversial. In this study, we perform the sequence analysis of PARK2 and assess the correlation between clinical features of sporadic PD patients and the detected variants. Materials and Methods: A total of 92 sporadic PD patients were sequenced and underwent the clinical examinations. MIBG scintigraphy was performed in 61 patients and the cardiac uptake was measured as the heart/mediastinum (H/M) ratio. Results: We only detected two novel variants (R51R, L272I) in 3 patients and three common polymorphisms, S167N, V380L, and R366W, which had the allele frequencies of 38.6%, 7% and 0.5%, respectively. There were no significant difference of the allele frequencies between patients and controls. On the evaluation of clinical features, the patients with S167N had the younger onsets of age and the tendency of preserved cardiac uptake of MIBG in the early Hoehn and Yahr (HY) stage compared to the patients without S167N. Conclusions: These results suggest the common polymorphisms of PARK2 might affect the phenotype of sporadic PD without altered susceptibility to PD. © 2010.

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