0.05) were also similar between two groups. Conclusions The transradial coronary angioplasty can be performed safely and successfully in selected elderly patients.

0.05) were also similar between two groups. Conclusion The transbrachial coronary angioplasty can be performed safely and successfully in selected elderly patients.

In Japan, the number of people 65 and over is increasing while the number of children is decreasing. A greater number of senior citizens live by themselves or husband and wife alone than before.
To realize comfortable and independent life for aged people, it is important to prepare housing and environment which have special services for them.
We would like to explain two housing projects which were planned and are being put into execution in Japan. One is ‘Silver Housing’ multiunit dwellings for the aged built by the Ministry of Construction and the Ministry of Health and Welfare since 1987. The other is ‘Silver Peer’ project which has been pushed forward by the Tokyo Metropolitan Government since 1987.

Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases with aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. In detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation. 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface. 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes.

Animals ; Cell Differentiation ; Clinical Trials as Topic ; Humans ; Induced Pluripotent Stem Cells ; cytology ; Mice ; Stem Cell Transplantation ; Teratoma ; pathology

OBJECTIVETo explore the diagnostic feasibility of noninvasive assessment of coronary atherosclerotic plaques with MSCT in comparison with IVUS.

METHODSContrast-enhanced MSCT angiography (Sensation 64, Siemens Medical Solutions) was performed before percutaneous coronary intervention (PCI), and three-vessel IVUS (Boston Scientific, Natick, MA) was performed during procedure in 12 patients with stable angina pectoris. Complete investigation was digitally stored, and assessed offline with EchoPlaque (Indec Systems, Mountain View, CA). The comparison of MSCT with IVUS was performed based on segment at plaque site (American Heart Association 15-segment model).

RESULTSA total of 88 segments in 31 vessels (left anterior descending: 12, left circumflex: 10, and right coronary artery: 9) were investigated by both IVUS and MSCT. Among 68 assessable segments (54 proximal-middle segments and 14 distal segments) by MSCT (20 segments were excluded for poor image quality: 16 for severe calcification, 2 for motion artifact, 2 for poor opacification), MSCT correctly detected 47 of the 51 segments with plaques (sensitivity: 92%), and correctly evaluated 16 of 17 segments without plaques (specificity: 94%). Concerning plaque quantification, MSCT correlated well with IVUS in grading whether the vessel obstruction was less or more than 50% (simple kappa: 0.63, 95% CI: from 0.47 to 0.78). Plaque area by MSCT also correlated with that by IVUS (r = 0.53, P < 0.01), but overestimated plaque area [(9.09 +/- 3.89) mm(2) vs. (6.80 +/- 2.81) mm(2), P < 0.01]. In addition, 30 of 43 hypoechoic compositions were detected as low-density compositions by MSCT with average CT number as 67.39 HU.

CONCLUSIONSIn segments without severe calcification, contrast-enhanced 64-slice CT angiography could detect plaques in coronary artery with high accuracy. Plaque area quantification by MSCT correlated with that of IVUS though with limited accuracy.

OBJECTIVEMaternal exposure to dioxins [polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (DFs)] during pregnancy is known to affect infant growth and neurodevelopment in humans and animals. The aim of this study was to investigate the relationship between newborn size and the concentration of dioxin isomers in breast milk and to subsequently evaluate the potential toxicity of each dioxin isomer among mothers living in sea coast areas who are at a high risk of contamination due to a high consumption of fish.

METHODSA total of 75 milk samples were obtained within 1 month of delivery from Japanese mothers living in the coastal areas of the Japan Sea. The relationships between the levels of seven dioxins and ten furan isomers in maternal breast milk, measured by high-resolution-gas chromatography/mass spectrometry, and the birth size of newborns, which is related to fetal growth, were investigated after adjustment for confounding factors.

RESULTSThe concentrations of 1,2,3,6,7,8-HxCDD (hexachlorodibenzo-p-dioxin), 2,3,4,7,8-PeCDF (pentachlorodibenzofuran), 2,3,4,6,7,8-HxCDF, and three dioxin toxic equivalent (TEQ) levels (PCDDs-TEQ, PCDFs-TEQ, and total-TEQ) in maternal breast milk were inversely correlated to newborn length even after adjustment for gestational weeks, infant sex, and maternal age and height. These isomers were abundant among the 17 isomers tested and reflected the TEQ levels. Only 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-TCDD), the most toxic isomer, was negatively correlated with newborn head circumference, even after adjustment for gestational weeks, infant birth weight, and other confounding factors.

CONCLUSIONSBased on our results, fetal growth may be influenced by maternal total exposure to dioxins, but only exposure to 2,3,7,8-TCDD would appear to possibly affect fetal head size during pregnancy.

BACKGROUND/AIMS: To determine which drug-eluting stents are more effective in acute myocardial infarction (MI) patients with chronic kidney disease (CKD). METHODS: This study included a total of 3,566 acute MI survivors with CKD from the Korea Acute Myocardial Infarction Registry who were treated with stenting and followed up for 12 months: 1,845 patients who received sirolimus-eluting stents (SES), 1,356 who received paclitaxel-eluting stents (PES), and 365 who received zotarolimus-eluting stents (ZES). CKD was defined as an estimated glomerular filtration rate < 60 mL/min/1.73 m2 calculated by the modification of diet in renal disease method. RESULTS: At the 12-month follow-up, patients receiving ZES demonstrated a higher incidence (14.8%) of major adverse cardiac events (MACEs) compared to those receiving SES (10.1%) and PES (12%, p = 0.019). The ZES patients also had a higher incidence (3.9%) of target lesion revascularization (TLR) compared to those receiving SES (1.5%) and PES (2.4%, p = 0.011). After adjusting for confounding factors, ZES was associated with a higher incidence of MACE and TLR than SES (adjusted hazard ratio [HR], 0.623; 95% confidence interval [CI], 0.442 to 0.879; p = 0.007; adjusted HR, 0.350; 95% CI, 0.165 to 0.743; p = 0.006, respectively), and with a higher rate of TLR than PES (adjusted HR, 0.471; 95% CI, 0.223 to 0.997; p = 0.049). CONCLUSIONS: Our findings suggest that ZES is less effective than SES and PES in terms of 12-month TLR, and has a higher incidence of MACE due to a higher TLR rate compared with SES, in acute MI patients with CKD.
Aged ; *Drug-Eluting Stents/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*etiology/mortality/*therapy ; Paclitaxel/administration & dosage ; Prospective Studies ; Registries ; Renal Insufficiency, Chronic/*complications ; Republic of Korea/epidemiology ; Sirolimus/administration & dosage/analogs & derivatives