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

Coronary microvascular dysfunction (CMD) has emerged as a third potential mechanism of myocardial ischemia in addition to coronary atherosclerotic disease (CAD) and epicardial coronary artery spasm. Since several studies indicated that CMD could be associated with increased risk of cardiovascular events, it is important to make correct diagnosis and assessment of CMD. However, in contrast with epicardial coronary arteries, the coronary microcirculation cannot be directly visualized in vivo with coronary angiography or intracoronary imaging technique. Although there are several non-invasive (e.g. transthoracic Doppler echocardiography, positron emission tomography, cardiac magnetic resonance imaging) and invasive (e.g. assessment of coronary flow reserve and microvascular resistance using adenosine, microvascular coronary spasm with acetylcholine) approaches for the evaluation of coronary microvascular function, all of them have several limitations. Currently, the interventional diagnostic procedure, which consists of acetylcholine testing for the detection of coronary spasm as well as coronary flow reserve and microvascular resistance assessment in response to adenosine using a coronary pressure–temperature sensor guidewire, could represent the most comprehensive coronary vasomotor evaluation. Furthermore, several biomarkers have recently attracted much attention as a diagnostic tool for CMD. Especially, plasma concentration of serotonin may be a novel biomarker to dissect CMD from epicardial coronary artery spasm. Correct diagnosis of the underlying cause of angina should enable us to stratify the treatment for distinct disorders, including CMD, vasospastic angina, and non-cardiac chest pain.

Diagnosis of Coronary Microvascular Dysfunction

patients with severe angina pectoris for the first time.5,6 In addition, low-energy SW therapy improves the walking ability of patients with PAD and intermittent claudication.7 Ultrasound, another type of acoustic wave, is widely used for ultrasound diagnostic devices and also applied clinically at high intensity to tumor ablation, related mainly to its thermal effect. Recently, low-intensity pulsed ultrasound (LIPUS) was reported to exert angiogenic effects in a rat model of hindlimb ischemia.8 We also demonstrated that LIPUS improved myocardial ischemia in a pig model of chronic myocardial ischemia to the same extent as low-energy SW therapy.9

/pdf/the-future-of-non-invasive-angiogenic-therapy-using-acoustic-2l0st6g39h.pdf

The Future of Non-Invasive Angiogenic Therapy Using Acoustic Waves

This study was to evaluate whether Low-energy shock wave therapy (LESW) improves ischemic-induced overactive bladder in rats and investigate its therapeutic mechanisms. Sixteen-week-old male Sprague-Dawley rats were divided into three groups: arterial injury (AI), AI with LESW (AI-SW), and control groups. LESW was irradiated in AI-SW during 20-23 weeks of age. At 24 weeks of age, conscious cystometry was performed (each n = 8). The voiding interval was shortened in AI (mean ± SEM: 5.1 ± 0.8 min) than in control (17.3 ± 3.0 min), whereas significant improvements were observed in AI-SW (14.9 ± 3.3 min). The bladder blood flow was significantly increased in AI-SW than in AI. Microarray analysis revealed higher gene expression of soluble guanylate cyclase (sGC) α1 and β1 in the bladder of AI-SW compared to AI. Protein expression of sGCα1 and sGCβ1 was higher in AI-SW and control groups than in AI. Cyclic guanosine monophosphate (cGMP) was elevated in AI-SW. As an early genetic response, vascular endothelial growth factor and CD31 were highly expressed 24 h after the first LESW. Suburothelial thinning observed in AI was restored in AI-SW. Activation of sGC-cGMP may play a therapeutic role of LESW in the functional recovery of the bladder. 

/pdf/low-energy-shock-wave-therapy-ameliorates-ischemic-induced-2ou6fdx8.pdf

Low-energy shock wave therapy ameliorates ischemic-induced overactive bladder in a rat model

https://doi.org/10.1016/j.ijcha.2022.101139

Hiroaki Shimokawa

Papers

Diagnosis of Coronary Microvascular Dysfunction

The Future of Non-Invasive Angiogenic Therapy Using Acoustic Waves

Low-energy shock wave therapy ameliorates ischemic-induced overactive bladder in a rat model

Prognostic association of plasma NT-proBNP levels in patients with microvascular angina -A report from the international cohort study by COVADIS-

The presence of right ventricular endocardial activation delay in female case with a Brugada type ECG