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Kasama S.,Gunma University | Toyama T.,Gunma Prefectural Cardiovascular Center | Sato M.,Gunma University | Sano H.,Gunma University | And 6 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2016

Purpose: Patients with chronic kidney disease (CKD) have an increased risk of adverse cardio-cerebrovascular events. We examined whether stress myocardial perfusion single photon emission computed tomography (SPECT) provides reliable prognostic markers for these patients. Methods: In this multicenter, prospective cohort trial from the Gunma-CKD SPECT study protocol, patients with CKD [estimated glomerular filtration rate (eGFR) < 60 min/ml per 1.73 m2] undergoing stress 99mTc-tetrofosmin SPECT for suspected or possible ischemic heart disease were initially followed for 1 year, with the following study endpoints: primary, the occurrence of cardiac deaths (CDs), and secondary, major adverse cardiac, cerebrovascular, and renal events (MACCREs). The summed stress score (SSS), summed rest score, and summed difference score (SDS) were estimated with the standard 17-segment, 5-point scoring model. Left ventricular end-diastolic volume, end-systolic volume (ESV), and ejection fraction were measured using electrocardiogram-gated SPECT. Results: During the first year of follow-up, 69 of 299 patients experienced MACCREs (CD, n = 7; non-fatal myocardial infarction, n = 3; hospitalization for heart failure, n = 13; cerebrovascular accident, n = 1; need for revascularization, n = 38; and renal failure, i.e., hemodialysis initiation, n = 7). ESV and SSS were associated with CDs (p < 0.05), and eGFR and SDS were associated with MACCREs (p < 0.05), in multivariate logistic analysis. Patients with high ESV and high SSS had a significantly higher CD rate during the first year than the other CKD patient subgroups (p < 0.05). Patients with low eGFR and high SDS had a significantly higher MACCRE rate than the other subgroups (p < 0.05). Conclusion: Myocardial perfusion SPECT can provide reliable prognostic markers for patients with CKD. © 2015, Springer-Verlag Berlin Heidelberg. Source

Yamagishi T.,Takasaki General Medical Center
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

A 67-year-old female was operated upon because of transthoracic echocardiograms revealing a 13 x 8 mm mass in right atrium. However, there was no mass and was prominent crista terminalis (CT) instead. CT is the largest and strongest fibromuscular bundle in the right atrium, which separates primitive right atrium from the venous sinus. Prominent CT can mimic right atrial mass on transthoracic echocardiography. It was difficult to make a differential diagnosis because prominent CT formed a bridge-like shape in this case. To obtain certain diagnosis, transesophageal echocardiography (TEE) is necessary, and prevalence of three-dimensional (3D)-TEE is expected to improve the accuracy of diagnosis. We report this case as a pitfall of the diagnosis for the right atrial mass. Source

Muller U.,University of Leipzig | Matsuo Y.,University of Leipzig | Matsuo Y.,Takasaki General Medical Center | Matsuo Y.,Gunma University | And 5 more authors.
Metabolism: Clinical and Experimental | Year: 2013

Background The noninvasive measurement of endothelial function is a very powerful tool to assess cardiovascular disease. Especially in children this is not an easy task, and therefore an easy method like the Endo-Pat device is helpful. Due to the still existing uncertainties of the validity of endothelial measurement by the Endo-PAT device in children, we thought to analyze the correlation between endothelial functional measurement by Endo-PAT, and the capability of HDL to modify nitric oxide (NO) production by phosphorylation of endothelial nitric oxide synthase at the stimulatory site (Ser1177) and the inhibitory site (Thr495). Methods The reactive hyperemic index (RHI) was measured in 11 school children by the Endo-PAT device. HDL was isolated by ultracentrifugation, and the capability to stimulate eNOS phosphorylation was assessed in cell culture. Results A close correlation between the RHI and the eNOS-Ser1177 phosphorylation (r = 0.66, p = 0.02) and the eNOS-Thr495 phosphorylation (r = -0.60, p = 0.04) was detected. Conclusion The results obtained in our limited study performed in healthy children supports the validity of endothelial function measurement in children using the Endo-PAT device. Nevertheless, studies measuring FMD and the RHI index need to confirm the strength of the Endo-Pat device also in children. © 2013 Elsevier Inc. Source

Mangner N.,University of Leipzig | Matsuo Y.,University of Leipzig | Matsuo Y.,Takasaki General Medical Center | Matsuo Y.,Gunma University | And 2 more authors.
Endocrine | Year: 2013

It is well documented in the current literature that chronic heart failure is often associated with cachexia, defined as involuntary weight loss of 5 % in 12 month or less. Clinical studies unraveled that the presence of cachexia decreases significantly mean survival of the patient. At the molecular level mainly myofibrillar proteins are degraded, although a reduced protein synthesis may also contribute to the loss of muscle mass. Endocrine factors clearly regulate muscle mass and function by influencing the normally precisely controlled balance between protein breakdown and protein synthesis The aim of the present article is to review the knowledge in the field with respect to the role of endocrine factors for the regulation of cachexia in patients with CHF and deduce treatment perspectives. © 2012 Springer Science+Business Media, LLC. Source

Takagi H.,Takasaki General Medical Center | Hoshino T.,Takasaki General Medical Center | Naganuma A.,Takasaki General Medical Center | Koitabashi E.,Takasaki General Medical Center | And 6 more authors.
Hepato-Gastroenterology | Year: 2013

Sixty year-old male positive for both HCV-RNA and HBsAg was treated by triple therapy of peginterferon alpha2b, ribavirin and telaprevir. Eight weeks after the beginning of the therapy, the patient developed drug induced hypersensitivity syndrome (DIHS) with general erythema multiforme and 64 times anti-HHV6 antibody elevation. Sixty milligram of prednisolone was administered with gradual dose reduction and the skin lesion was improved. HBV-DNA and transaminase elevated one week after the steroid induction and entecavir improved them. DIHS itself and the aggravation of hepatitis B by corticosteroid should be kept in mind in cases with dual infection of HBV and HCV treated by antivirals including telaprevir. © H.G.E. Update Medical Publishing S.A. Source

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