다중혈관 관상동맥 환자에서 y-문합을 이용하여 양쪽 내흉동맥만을 사용한 우회술의 조기 성적

抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。

疟原虫var基因转换速率变化导致抗原变异[英]／Paul H, Robert P, Christodoulou Z, et al//Proc Natl Acad Sci U S A

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.

[신간의 별자리x] 우리/미술, 그리고 ‘슬픔의 박물관’

Atherosclerosis, the principal cause of heart attack, stroke and gangrene of the extremities, is responsible for 50% of all mortality in the USA, Europe and Japan. The lesions result from an excessive, inflammatory-fibroproliferative response to various forms of insult to the endothelium and smooth muscle of the artery wall. A large number of growth factors, cytokines and vasoregulatory molecules participate in this process. Our ability to control the expression of genes encoding these molecules and to target specific cell types provides opportunities to develop new diagnostic and therapeutic agents to induce the regression of the lesions and, possibly, to prevent their formation.

The pathogenesis of atherosclerosis: a perspective for the 1990s

https://www.jstage.jst.go.jp/article/naika/99/11/99_2846/_pdf

Non-invasive Angiogenic Therapy Using Extracorporeal Shock Waves.

The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART) Study

Rapid Publication and Announcement of the JCS 2011 Activities

We would like to thank Dr Kupari for his interests and incisive comments on our case report of isolated cardiac sarcoidosis associated with coronary vasomotion abnormalities. We diagnosed our patient with isolated cardiac sarcoidosis according to the clinical diagnosis group proposed by the Japanese Circulation Society (JCS) guidelines.We concur with Dr Kupari that isolated cardiac sarcoidosis is a diagnostic challenge and that cardiac magnetic resonance (CMR) and F-fluorodeoxygenase positron emission tomography (F-FDG-PET) do not necessarily have high specificity. A limitation of the aforementioned study by Divakaran et al. is that only 7 (3.4%) patients underwent both pre-transplant CMR and F-FDG-PET. Among them, only one patient was classified as ‘highly probable’ for cardiac sarcoidosis consistently by both modalities, and indeed, this single patient was confirmed to be cardiac sarcoidosis by post-transplant histological diagnosis. In addition, the cohort of patients was biased towards those with advanced heart failure undergoing cardiac transplant, in whom the diagnostic accuracy of F-FDG-PET in detecting myocardial inflammation may be limited because of altered myocardial glucose metabolism in severe heart failure. As summarized in the Slide Set, clinical presentation, several biomarkers, and an integrated multimodal imaging approach provide additional details and information on the underlying pathophysiology of inflammatory myocardial diseases. In place of just a binary interpretation of findings derived from each imaging modality, the extent, location, pattern, and concordance of late gadolinium enhancement (LGE) and FDG uptake should be evaluated to identify active, inflammatory cardiac sarcoidosis that warrants immunosuppressive therapy without delay. Our patient showed a non-ischaemic, ‘highly probable’ pattern of LGE on CMR aligning exactly with inflammation by F-FDG-PET performed with optimal imaging conditions. Additional clinical findings compatible with isolated cardiac sarcoidosis included (i) typical cardiac manifestations, (ii) no involvement other than the heart, and (iii) regression of FDG uptake on serial F-FDG-PET following corticosteroid therapy. Taken together, these results may help distinguish cardiac sarcoidosis from myocarditis in our patient. Further research is needed to validate the diagnostic value of isolated cardiac sarcoidosis in accordance with the JCS guidelines.

/pdf/multimodal-approach-for-isolated-cardiac-sarcoidosis-r1wyde2m.pdf

Multimodal approach for isolated cardiac sarcoidosis

L'invention concerne des medicaments efficaces contre l'hypertension arterielle pulmonaire, en particulier contre l'hypertension arterielle pulmonaire primitive. L'invention concerne plus particulierement des medicaments preventifs/curatifs destines au traitement de l'hypertension arterielle pulmonaire, comprenant en tant qu'ingredient actif, les composes representes par la formule generale (I) suivante, ainsi que les sels d'addition acide ou les hydrates de ceux-ci : (I) dans laquelle R1 represente l'hydrogene ou hydroxy. Les medicaments preventifs/curatifs pour le traitement de l'hypertension arterielle pulmonaire comprennent les composes representes par la formule generale (I) ci-dessus, les sels d'addition acide ou les hydrates de ceux-ci, associes a un ou plusieurs composes choisis dans le groupe comprenant les derives de prostacycline et les antagonistes de l'endotheline.

Hiroaki Shimokawa

Papers

Non-invasive Angiogenic Therapy Using Extracorporeal Shock Waves.

The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART) Study

Rapid Publication and Announcement of the JCS 2011 Activities

Multimodal approach for isolated cardiac sarcoidosis

Medicaments contre l'hypertension arterielle pulmonaire primitive