Search

There are limited long-term outcome data comparing BioLinx polymer (B)-zotarolimus-eluting stents (ZES) with phosphorylcholine polymer (P)-ZES. The aim of this study was to compare the efficacy and safety of B-ZES with P-ZES in patients who underwent percutaneous coronary intervention (PCI) during a 3-year follow-up period.One thousand two hundred fifty four patients who underwent PCI with P-ZES (Endeavor [ZES-E] or Endeavor sprint [ZES-S], n = 356) or B-ZES (Endeavor resolute [ZES-R] or Resolute Integrity [ZES-I], n = 889) were enrolled. The primary endpoint was major adverse cardiac events (MACE); the composite of total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), non-target vessel revascularization (Non-TVR), and the secondary endpoint was stent thrombosis (ST).After PSM, 2 propensity-matched (PSM) groups (275 pairs, n = 550, C-statistic = 0.730) were generated. During the 3-year follow-up period, the cumulative incidence of MACE (hazard ratio [HR], 1.525; 95% confidence interval [CI], 0.920-2.526; P = .101) and ST (HR, 1.248; 95% CI, 0.335-4.4649; P = .741) were similar between P-ZES and B-ZES after PSM. However, TLR rate was significantly higher in ZES-S than ZES-I (11.3% vs 3.8%, log rank P = .029) and TVR rate was higher in ZES-S than ZES-R (14.1% vs 4.8%, log rank P = .025).In this single-center, all-comer registry, despite different polymers, P-ZES, and B-ZES showed comparable safety and efficacy during a 3-year follow-up period after PCI.

Background The second-generation drug-eluting stents (DES) have shown superiority in many studies relating to safety and efficacy when compared with the first-generation DES. However, it is unclear whether there are differences in efficacy and safety among the second-generation DES after long-term follow-up. Methods This multicenter, prospective, randomized, open-labeled trial will directly compare the efficacy and safety among the patients treated with either everolimus-eluting stent (EES), zotarolimus-eluting stent with biolinx polymer (ZES-R), or biolimus-eluting stent (BES) with minimal exclusion criteria. The primary end point is a patient-oriented composite consisted of cardiac death, myocardial infarction not clearly attributable to a nontarget vessel and clinically indicated target lesion revascularization at 24-month clinical follow-up post-index procedure. With the hypothesis that “BES is non-inferior to EES” or “BES is non-inferior to ZES-R” in primary end point, approximately 2,600 patients will be assigned to one of the types of stents using a web-based randomization system. Conclusions The CHOICE trial will directly compare the efficacy and safety of EES, ZES-R, and BES in everyday clinical practice for long-term follow-up.

Objectives This study sought to assess the impact of intravascular ultrasound (IVUS) guidance on clinical outcomes following drug-eluting stent implantation when treating long lesions. Background The role of IVUS guidance when treating long lesions has been tested during bare-metal stent, but not during drug-eluting stent, implantation. Methods A total of 543 patients treated with stents ≥28 mm in length were randomly assigned to IVUS guidance (n = 269) versus angiography guidance (n = 274). The primary endpoint was a composite of major adverse cardiac events (MACE), including cardiovascular death, myocardial infarction, target vessel revascularization, or stent thrombosis at 1 year following intervention. Results In the intention-to-treat analysis, total stent length was 32.4 mm in the IVUS-guided arm versus 32.3 mm in angiography-guided arm (p = 0.84). Adjunct post-dilation was more frequently performed in the IVUS-guided arm (54.6% vs. 44.5%, p = 0.03); post-intervention minimal lumen diameters were similar (2.55 vs. 2.55 mm, respectively, p = 0.50); and MACE occurred in 12 (4.5%) patients in IVUS-guided arm and in 20 (7.3%) patients in the angiography-guided arm (p = 0.16). However, among the 269 patients assigned to IVUS guidance, IVUS was not used in 13 patients (4.8%); conversely, in 274 patients assigned to angiography alone, 41 patients (15.0%) were treated with IVUS guidance. Therefore, in a per-protocol analysis according to actual IVUS usage, minimum lumen diameter was larger (2.58 vs. 2.51 mm, p = 0.04), and MACE rates were lower: 4.0% in the IVUS-guided arm versus 8.1% in the angiography-guided arm (p = 0.048). Conclusions A strategy of routine IVUS for drug-eluting stent implantation in long lesions did not improve the 1-year MACE rates. The IVUS use per operator decision was associated with improved results. (A New Strategy Regarding Discontinuation of Dual Antiplatelet; NCT01145079 )

Background Hypertension and dyslipidemia are major risk factors of cardiovascular disease (CVD) events. The objective of this study was to evaluate the efficacy and safety of the co-administration of fimasartan and rosuvastatin in patients with hypertension and hypercholesterolemia. Methods We conducted a randomized double-blind and parallel-group trial. Patients who met eligible criteria after 4 weeks of therapeutic life change were randomly assigned to the following groups. 1) co-administration of fimasartan 120 mg/rosuvastatin 20 mg (FMS/RSV), 2) fimasartan 120 mg (FMS) alone 3) rosuvastatin 20 mg (RSV) alone. Drugs were administered once daily for 8 weeks. Results Of 140 randomized patients, 135 for whom efficacy data were available were analyzed. After 8 weeks of treatment, the FMS/RSV treatment group showed greater reductions in sitting systolic (siSBP) and diastolic (siDBP) blood pressures than those in the group receiving RSV alone (both p

Objectives The goal of this study was to evaluate shorter duration (3 months) dual antiplatelet therapy (DAPT) after drug-eluting stent (DES) implantation. Background There have been few published reports of prospective randomized clinical studies comparing the safety and efficacy of shorter duration DAPT after DES implantation. Methods We randomly assigned 2,117 patients with coronary artery stenosis into 2 groups according to DAPT duration and stent type: 3-month DAPT following Endeavor zotarolimus-eluting stent (E-ZES) implantation (E-ZES+3-month DAPT, n = 1,059) versus 12-month DAPT following the other DES implantation (standard therapy, n = 1,058). We hypothesized that the E-ZES+3-month DAPT would be noninferior to the standard therapy for the primary composite endpoint (cardiovascular death, myocardial infarction, stent thrombosis, target\vessel revascularization, or bleeding) at 1 year. Results The primary endpoint occurred in 40 (4.7%) patients assigned to E-ZES+3-month DAPT compared with 41 (4.7%) patients assigned to the standard therapy (difference: 0.0%; 95% confidence interval [CI]: −2.5 to 2.5; p = 0.84; p Conclusions E-ZES+3-month DAPT was noninferior to the standard therapy with respect to the occurrence of the primary endpoint. (REal Safety and Efficacy of a 3-month dual antiplatelet Therapy following E-ZES implantation [RESET]; NCT01145079 )

We investigated the effects of heat treatment and extraction method on the antioxidant activities of five medicinal plants: Cyperus rotundus, Eucommia ulmoides, Bupleurum falcatum, Achyranthes japonica Nakai, and Akebia quinata. Extraction was performed with only ultrasound, ultrasound after heating at for 2 hours, and reflux extraction with distilled water. The phenolic contents of reflux extraction and ultrasound extraction after heating were higher than only ultrasound extraction, and ultrasound extraction after heating samples was higher than reflux extraction except for Eucommia ulmoides and Cyperus rotundus. Total flavonoid content was higher in reflux and ultrasound extraction after heating samples than only ultrasound extraction, except for Cyperus rotundus. ABTS radical scavenging activity was higher in reflux extraction and ultrasound extraction after heating a sample, than only ultrasound extraction. DPPH radical scavenging activity was higher in reflux extraction except for Achyranthes japonica Nakai and Akebia quinata. The reducing power of ultrasound extraction after heating was higher with Achyranthes japonica Nakai. From the results of this study, we can expect to increase the antioxidant activity of medicinal plant extracts by applying suitable extraction and pretreatment conditions on the type of medicinal plant.

The saving of time, which is defined as the demand from passengers and the supply from the urban railway, must be balanced. The selected factors influencing on the balance are the traffic, customer contact facilities, the number of failures, customer complaints(VOC), passenger moving time and transfer stations. Also, the overall ratio of SMRT`s 4 lines is generated by differentiating the rate of each attribute in each factor. This is not only to differentiate the stations with peculiar factors but also to standardize criteria of the personalized services. Furthermore, as part of standardization, standard drawings of facility management are prepared for the improvement on the management of human resource and material. The drawings include passenger moving lines, location of safety incidents and also indicate the rating of the factors in each station and overall evaluation rating. In conclusion, this thesis aims to improve customer satisfaction constantly by reducing passenger moving time, through the differentiated management of each station.

Patient initials or identifier number LKT ### Relevant clinical history and physical exam An 82-years-old male suffered chest pain and dyspnea for 6 hours. He has the history of hypertension. Initial his EKG showed ST-segment elevation in II, III, aVF lead and ST-segment depression in other

Aortoiliac occlusive disease (AIOD) affects the systemic vascular resistance and increases the afterload because the left ventricle (LV) must work harder to eject blood into a smaller vascular bed. This study was to determine whether successful revascularization of AIOD is associated with improvement of left ventricular diastolic dysfunction (LVDD). A total of 37 patients with AIOD (34 men and 3 women; age 65.1 ± 7.2 years) were analyzed. The primary endpoint was defined as the change in the mitral E/E′ ratio. There were no significant changes in the E velocity (from 0.7 ± 0.2 to 0.7 ± 0.2 m/s, P-value = .153), A velocity (from 0.8 ± 0.2 to 0.9 ± 0.2 m/s, P-value = .169), LAVI (from 36.1 ± 18.7 to 33.9 ± 15.7 mL/m2, P-value = .176), E/A ratio (from 0.9 ± 0.4 to 0.8 ± 0.2, P-value = .091), and E′ velocity (from 6.5 ± 2.0 to 6.9 ± 2.1 m/s, P-value = .068). However, successful revascularization significantly reduced the E/E′ ratio (from 14.1 ± 5.7 to 11.7 ± 3.3, P-value = .015). Additionally, a significant increase in the A′ velocity (from 9.1 ± 1.9 to 10.0 ± 2.2 m/s, P-value = .029) and a decrease in the LA diameter (from 40.7 ± 6.4 to 38.6 ± 6.6 mm, P-value = .014) were noted. Our results show that a successful revascularization of AIOD was associated with an improved E/E′ ratio.

While second generation drug-eluting stents (DES) promote more favorable vascular healing, biodegradable polymer containing stents might have a yield in terms of duration of dual antiplatelet therapy (DAPT) than durable polymer stents. We aimed to test whether 6-month DAPT would be non-inferior 12

Germanium nanocrystals (NCs)-embedded silicon dioxide (SiO2) layers on top of Si substrates were prepared using the implantation of 74Ge+ ions into the SiO2 layers and the annealing of the implanted oxide layers. The distribution of Ge NCs embedded inside the SiO2 layers was examined by high resolution transmission electron microscopy, and optical properties of the embedded NCs were characterized by photoluminescence and micro-Raman spectroscopy. Capacitance versus voltage (C-V) measurements of Ge NCs-embedded MOS capacitors with single Al2O3 capping layers were performed in order to study memory characteristics of these MOS capacitors. The C-V curves exhibit large threshold voltage shifts originating from charging effect of the Ge NCs, revealing the possibility that the MOS structure is applicable to Nano Floating Gate Memory (NFGM) devices.

The growth behavior of ultrathin (∼5 nm) SrRuO3 films prepared by pulsed laser deposition (PLD) on SrTiO3 (001) was investigated particularly as a function of growth temperature mainly using synchrotron X-ray diffraction. At a critical growth temperature (~500 °C), below which no crystallization occurs, an epitaxial SrRuO3 film starts to grow with a broad distribution of single (110) domain along the film growth direction maintaining the epitaxial relationship of SrRuO3[001]/SrTiO3[100] and SrRuO3[−110] SrTiO3[010]. Its in-plane and out-of-plane crystal alignments improve sharply when a higher growth temperature of 600 °C is applied, presumably due to the more thermal energy supplied to the substrate. However, more increase of the growth temperature to 650 °C results in no enhancement of atomic ordering but a rougher surface, suggesting that a careful adjustment in the growth temperature is needed to grow an epitaxially well aligned SrRuO3 film possessing a smooth surface.

The formation of advanced glycation end products (AGEs), in various tissues has been known to enhance immunoinflammatory reactions and local oxidant stresses in long standing diabetes. Recently, AGEs have been reported to play a role in neointimal formation in animal models of arterial injury. We attempted to determine whether the serum levels of AGEs are associated with coronary restenosis in diabetic patients. Blood samples were collected from diabetic patients with coronary artery disease undergoing stent implantation and the serum levels of AGEs were analyzed by the fluorescent intensity method. The development of in-stent restenosis (ISR) was evaluated by a 6-month follow-up coronary angiography. A total of 263 target lesions were evaluated, in 203 patients. The ISR rate in the high-AGE (>170 U/ml) group (40.1%) was significantly higher than in the low-AGE group (≤170 U/ml) (19.6%) (p

We sought to determine whether insulin resistance (IR) is related to arterial stiffness in nondiabetic hypertensive patients, independent of metabolic status and gender. IR has been associated with increased arterial stiffness in patients with diabetes. In nondiabetic hypertensive patients, the correlation between IR and arterial stiffness has yet to be investigated. We enrolled 284 nondiabetic patients who were being treated for hypertension. At the time of enrollment, the patients underwent a baseline laboratory assessment including homeostatic model assessment (HOMA) IR index and pulse wave velocity (PWV). The HOMA IR index is used as a marker of IR, and brachial to ankle PWV (baPWV) was used as a marker of arterial stiffness. Of the 284 study subjects, 121 were classified as having metabolic syndrome. The patients with metabolic syndrome were older than the non-metabolic syndrome patients (55.4+/-10.7 vs. 52.1+/-11.6 years, p=0.013), but there was no gender difference between the two groups. The average baPWV was significantly higher in the patients with metabolic syndrome (1,506+/-235 vs. 1,435+/-211 cm/s, p=0.009). The HOMA index was independently associated with an increase in arterial stiffness (r=0.548, p

Europium doped yttrium oxide (Y 2 O 3 :Eu) luminescent thin films were grown on Si(0 0 1) substrates using a pulsed laser deposition technique and their microstructures and growth behavior were investigated by synchrotron X-ray scattering and atomic force microscopy. We observed that the surface morphology of the Y 2 O 3 :Eu films was very smooth with typically a 0.5-nm root mean square roughness for the films up to 750 nm in thickness and the film strain increased gradually with film thickness, suggesting that the Y 2 O 3 :Eu films are grown with a layer-like growth mode. Grown with the (1 1 1) preferred orientation, the Y 2 O 3 :Eu films significantly improved in crystallinity with film thickness, showing a characteristic red luminescence of Y 2 O 3 :Eu materials.

Previously, antihypertensive treatment in severe aortic stenosis was considered a relative contraindication. However, recent studies have shown that antihypertensive treatment may be safe and even beneficial in terms of reducing the progression of left ventricular pressure overload and even retarding the progression of valvular aortic stenosis. To date, no randomized clinical trials have been performed and no definite treatment guideline exist for the proper antihypertensive regimens. Antihypertensive treatment with β-blockers has generally been avoided in patients with severe aortic stenosis (AS) due to the concerns for inducing left ventricular dysfunction and hemodynamic compromise in the presence of severe outflow tract obstruction. Although it remains unclear whether antihypertensive treatment with a β-blocker is associated with increased risk of cardiovascular events in patients with AS, recent studies have shown that the use of β-blockers may be safe and may even be beneficial. Renin-angiotensin system (RAS) are upregulated in AS and have been shown to be involved in valve calcification and progression in both experimental models and in human trials. As such, theoretically, RAS inhibition would have benefit in retarding the progression of valvular stenosis as well as have benefit in left ventricle remodeling. Recent clinical studies are indeed showing that use of RAS inhibition may be beneficial in patients with AS. Future clinical trials to establish the ideal target blood pressure and antihypertensive regimens in severe AS is essential.

Korean Abstract: 2008년 9월 글로벌 금융위기 이후 저금리가 장기간 지속되는 과정에서 국제금융시장 가격변수들의 변동성도 낮게 유지되었다. 낮은 변동성의 지속은 리스크 프리미엄의 하락을 초래하고, 이로 인해 글로벌 투자자들이 위험을 감수하는 행위가 증가한다. 2009년 이후 신흥국으로 대규모 자금이 유입되는 국제자본 흐름의 큰 변화가 발생하였는데, 이는 글로벌 투자자들의 위험자산에 대한 선호도가 높아짐에 따라 신용위험이 상대적으로 높은 신흥국에 대한 투자가 증가한데 기인한다. 신흥국으로의 자본유입 증가는 국내신용 증가 및 자산가격 왜곡 등 금융시스템의 취약성을 증대시킨다. 이는 향후 자본유출 압력이 강해지면 국내 자산가격의 하락 및 경기위축 등이 초래될 수 있음을 시사한다. 2015년 말 이후 미국 연방준비제도이사회(Federal Reserve Board)가 통화정책을 정상화하면서 자산가격의 변동성과 리스크 프리미엄이 다시 상승(정상화) 할 경우 우리나라를 포함한 신흥국으로 유입된 외국인자금에 대한 유출압력이 증가할 것으로 예상된다. 이에 따라 본 보고서는 국제금융시장의 변동성과 자본 흐름의 변화를 살펴보고, 신흥국 자금유출입의 변동요인을 분석하였다. 또한 신흥국 및 우리나라의 자본이동관리정책을 살펴보았으며, 새로운 정책대응수단으로 자산지준제도의 효과를 분석하였다.English Abstract: Volatilities of price indicators have remained extremely stable during the period of low interest rates since the Global Financial Crisis (GFC) of September 2009. Low volatility pushes down the risk premium which could cause global investors’ risk appetite to increase. There has been a big change in global liquidity flows since 2009. Emerging market economies (EMEs), with relatively high credit risk, received huge capital inflows backed up by the increased risk appetite of global investors. US Federal Reserve is now trying to normalize its monetary policy by increasing the policy rate tied at zero low bound for about seven years. This will bring asset price volatility and risk premiums to normalize. We remain concerned about the downside risk to the capital outflows from EMEs, including Korea. And it may well potentially cause a decrease in asset price and a growth contraction in EMEs. Accordingly, we provide an overview of the volatility of financial market and new trends in capital flows, and identify the determinants of capital flows to/from EMEs. We also review the use of capital flow management policies in EMEs including Korea, and examine the effectiveness of Asset？Based Reserve Requirements (ABRR) as an alternative macro-prudential policy measure to manage capital flows.

Conductive LaNiO 3 (LNO) thin films were prepared on Si(001) by pulsed laser deposition and their microstructures were investigated using synchrotron X-ray scattering and atomic force microscopy. We observed that the surface morphology of the LNO thin films was extremely smooth with typically a 1.0-nm root-mean-squared roughness for films up to 360 nm in thickness and the film strain increased monotonically with the film thickness, suggesting that the LNO/Si(001) films be grown with a layer-like growth mode. Grown with the (00 l ) preferred orientation, the LNO films showed a significant anisotropic structural order; the coherence length of the out-of-plane stacking order was one order of magnitude larger than that of the in-plane atomic order.

Microstructural changes in epitaxial SrRuO3 thin films grown on SrTiO3(001) during the early stages of growth by pulsed laser deposition were studied using synchrotron x ray scattering. We find that at a very early stage of growth (⩽110 A), the film is composed of a single (110) domain only, in sharp contrast to double (110) domains reported previously for thick (⩾1000 A) films. As the film grows further (>110 A), another, 90° rotated, (110) domain starts to form, coexisting with the original (110) domain. This domain evolution is attributed to strain relaxation, eventually resulting in significant atomic ordering in the in-plane direction.

The thermal stability of RuO2/Si(100) films in air was studied using ex situ synchrotron x-ray scattering. The (110) textured RuO2 film showed good thermal stability due to the low surface and strain energies. However, the RuO2 films of high strain and surface energies were transformed to three-dimensional islands during annealing up to 800 °C. We also studied, during the post annealing process, the interface roughness of BaxSr1−xTiO3 (BST)/RuO2/Si(100) and BST/Pt/Ti/SiO2/Si(100) structures comparatively, using in situ synchrotron x-ray scattering. The interfaces of the BST/RuO2/Si were thermally stable up to 500 °C, and the deterioration of the interfaces above 500 °C was attributed to the crystallization of amorphous BST film. Meanwhile, the interfaces of the BST/Pt/Ti/SiO2/Si were significantly degraded even at the low temperature of 350 °C, mainly due to the formation of the Pt–Ti alloy and the Ti oxidation.

Advanced atherosclerosis is often associated with dystrophic calcification and remodeling of extracellular matrix of vascular wall. Recently many studies have documented a general relationship between calcification and severity of coronary disease, and discussed the feasibility of electron beam computed tomography for detecting and quantifying the coronary artery calcification in the patients. The present study investigated the expression and the localization of osteopontin, one of noncollagenous bone matrix protein, within the calcified coronary arteries. Autopsy-derived coronary artery specimens were scanned and reconstructed to visualize the pattern of coronary calcification using a novel microscopic computed tomography technique. The localization of the osteopontin were evaluated by immunohistochemial stain with LF7. The present study showed that the pattern of coronary calcification is variable and the expression of osteopontin is localized mainly to calcified lesion. The smooth muscle cells in addition to macrophage expressed osteopontin protein in human coronary atherosclerotic plaques. Soluble osteopontin released near to the sites of vascular calcification may represent an adaptive mechanism aimed at regulating the process of vascular calcification.

We demonstrate that the credit channel of transmission of monetary/financial shocks appears to have aggravated Korea's economic crisis. We use micro-data gathered at the individual bank level to identify this channel of transmission. Our major findings are as follows: i) consistent with banks' autonomous retrenchment in loan supply, monetary tightening broadens the spread between marginal bank lending rates and corporate commercial paper rates; ii) credit limits on overdrafts – arguably a proxy identifying shifts in loan supply – react negatively to the monetary squeeze; iii) large negative capital shocks induce banks to disproportionately slow-down both lending and deposit taking and to disproportionately raise their lending rates. Our findings lend unequivocal support to the hypothesis that banks' autonomous contraction restricted the availability of credit and magnified the increase in its cost. In turn, this compounded the Korean crisis by aggravating liquidity constraints for the vast majority of agents who rely only on bank credit as an external source of funds.

We studied the effects of plasma power on the epitaxial behavior of (Ba0.48Sr0.52)TiO3 (BST) film growth on MgO (001) substrates using synchrotron x-ray scattering experiments. The BST films were grown on MgO (001) by magnetron sputtering at sputtering powers up to 3 W/cm2. We found that stress in the epitaxial BST films grown at lower powers was mainly induced by lattice mismatch, but in films grown at higher powers, it was primarily intrinsic stress. The films grown at higher powers were much more strained and exhibited better epitaxial quality. This study suggests that it is feasible to control the epitaxial quality of BST films just by varying the plasma power in magnetron sputtering.

Epitaxial (Ba0.5Sr0.5) TiO3 thin films of two different thickness (∼25 and ∼134 nm) on MgO(001) prepared by a pulsed laser deposition method were studied by synchrotron x-ray scattering measurements. The film grew initially with a cube-on-cube relationship, maintaining it during further growth. As the film grew, the surface of the film became significantly rougher, but the interface between the film and the substrate did not. In the early stage of growth, the film was highly strained in a tetragonal structure (c/a = 1.04) with the longer axis parallel to the surface normal direction. As the growth proceeded further, it relaxed to a cubic structure with the lattice parameter near the bulk value, and the mosaic distribution improved significantly in both in- and out-of-plane directions. The thinner film (∼25 nm) showed only one domain limited mainly by the film thickness, but the thicker film (∼134 nm) exhibited three domains along the surface normal direction.

In this study, we examined the microstructure of Ag films grown on Si(001) substrates by radio frequency (rf) magnetron sputtering in a synchrotron x-ray scattering experiment. At a low rf power of 0.22 W/cm2, the film was initially nucleated in the form of fine-grained epitaxial film with the crystalline axes parallel to the substrate crystalline axes. As the growth proceeded further, it changed to nonepitaxial three dimensional island growth. The Ag islands were not epitaxial, but grew preferentially along the 〈111〉 direction. At a higher rf power of 0.44 W/cm2, the Ag film developed a nonepitaxial island growth from the early stage. Annealing the films at 500 °C increased the island size and enhanced the crystalline quality. The thin epitaxial film grown at the low rf power was recrystallized into islands during the annealing. This study suggests that it is feasible to grow heteroepitaxial Ag films on silicon substrates even by a sputtering process when the energy of the sputtered particles is minimized.

Extracorporeal Membrane Oxygenation (ECMO) is an increasingly used supportive measurement for patients with Acute coronary syndrome (ACS) complicated by cardiogenic shock. Despite its increasing use, clinical outcomes still remain very poor. We investigated the clinical features and predictors of 1

The thermal evolution of interface roughness during cobalt silicide formation in the Co/Ti/Si(001) and Co/Si(001) systems was investigated using real-time synchrotron x-ray scattering measurement. We find that the enhancement of the CoSi2/Si(001) interface roughness is caused by the retardation of silicide phase formation almost up to the CoSi2 nucleation temperature. In the Co(120 A)/Ti(50 A)/Si(001), the interface roughness increases only to 6 A during silicidation, by suppressing the reaction between the Co overlayer and Si substrate with a Ti diffusion barrier nearly up to the CoSi2 nucleation temperature of 660 °C. In the Co(120 A)/Si(001), however, the reaction already starts at a low temperature of 300 °C, resulting in a significant rise of the interface roughness up to 13 A, which is mainly attributed to the formation of Si{111} facets that act as the nucleation sites of misoriented CoSi2 grains.

A 32-year-old woman presented with severe left flank pain. On physical examination, the skin was so thin and pale that subcutaneous blood vessels were visible. An abdominal computed tomographic (CT) scan showed multiple renal infarctions in the left kidney and dissection with thrombus in aneurysmal dilated renal artery (diameter 8.1 mm) ( Panel A ). Stenting was performed using a 7 × 15 mm stent for the renal artery dissection ( Panel B ). The CT scan also showed multiple mesenteric artery aneurysms ( Panel …

Treatments of choice for cardiac implantable electronic device (CIED) infections are the removal of the entire CIED system, control of infection, and new device implantation. Occasionally, a complete CIED removal can not be performed for several reasons, such as very old age, severe comobidity, limited life expectancy, or refusal by a patient. We encountered a male patient who developed traumatic CIED infection five years after cardioverter-defibrillator implantation. An intravenous electrode could not be removed by a simple transvenous extraction procedure, and he refused surgical removal of the remnant electrode. After control of local infection, the tips of the electrode were separated and buried between muscles, and the wound was closed with a local flap. CIED infection did not recur for 12 months even without relying on long-term antimicrobial treatment.

Advanced glycation endproducts (AGEs) have been reported to play a role in neointimal formation and increase the rate of in-stent restenosis (ISR) in the diabetic coronary artery disease patients treated with stents, but the potential pathogenic mechanisms of AGEs in vascular smooth muscle cell proliferation remain unclear. We sought to determine the AGEs related pathobiological mechanism of diabetic vasculopathy. Rat aortic smooth muscle cell (RAoSMC) culture was done with different concentrations of AGEs and proliferation was assessed. Immunohistochemistry for receptor of AGEs (RAGE) was performed with human carotid atheroma. Western blotting was performed to assess the activation of MAP kinase system in the cultured RAoSMC. AGEs increased RAoSMC proliferation and were associated with increased phosphorylation of ERK and p38 kinase by time and dose dependent manner. The MAP kinase activity was decreased by RNA interference for RAGE. AGEs stimulation increased reactive oxygen species (ROS) generation in cultured RAoSMC. From this study it is concluded that AGEs played a key role in RAoSMC proliferation via MAP kinase dependent pathways. Activation of vascular smooth muscle cell (VSMC) proliferation by MAP kinase system and increased formation of ROS may be the possible mechanisms of AGEs induced diabetic vasculopathy.

Not only has credit card lending in Asia grown rapidly, but also several episodes of sharp booms and busts have been experienced, posing new risks to financial stability. Policymakers need to learn more about the risks arising from this type of consumer lending and respond with appropriate prudential measures.

Importance Use of intravascular ultrasound (IVUS) promotes better clinical outcomes for coronary intervention in complex coronary lesions. However, randomized data demonstrating the clinical usefulness of IVUS are limited for lesions treated with drug-eluting stents. Objective To determine whether the long-term clinical outcomes with IVUS-guided drug-eluting stent implantation are superior to those with angiography-guided implantation in patients with long coronary lesions. Design, Setting, and Participants The Impact of Intravascular Ultrasound Guidance on Outcomes of Xience Prime Stents in Long Lesions (IVUS-XPL) randomized, multicenter trial was conducted in 1400 patients with long coronary lesions (implanted stent ≥28 mm in length) between October 2010 and July 2014 at 20 centers in Korea. Interventions Patients were randomly assigned to receive IVUS-guided (n = 700) or angiography-guided (n = 700) everolimus-eluting stent implantation. Main Outcomes and Measures Primary outcome measure was the composite of major adverse cardiac events, including cardiac death, target lesion-related myocardial infarction, or ischemia-driven target lesion revascularization at 1 year, analyzed by intention-to-treat. Results One-year follow-up was complete in 1323 patients (94.5%). Major adverse cardiac events at 1 year occurred in 19 patients (2.9%) undergoing IVUS-guided and in 39 patients (5.8%) undergoing angiography-guided stent implantation (absolute difference, −2.97% [95% CI, −5.14% to −0.79%]) (hazard ratio [HR], 0.48 [95% CI, 0.28 to 0.83], P = .007). The difference was driven by a lower risk of ischemia-driven target lesion revascularization in patients undergoing IVUS-guided (17 [2.5%]) compared with angiography-guided (33 [5.0%]) stent implantation (HR, 0.51 [95% CI, 0.28 to 0.91], P = .02). Cardiac death and target lesion–related myocardial infarction were not significantly different between the 2 groups. For cardiac death, there were 3 patients (0.4%) in the IVUS-guided group and 5 patients (0.7%) in the angiography-guided group (HR, 0.60 [95% CI, 0.14 to 2.52], P = .48). Target lesion–related myocardial infarction occurred in 1 patient (0.1%) in the angiography-guided stent implantation group ( P = .32). Conclusions and Relevance Among patients requiring long coronary stent implantation, the use of IVUS-guided everolimus-eluting stent implantation, compared with angiography-guided stent implantation, resulted in a significantly lower rate of the composite of major adverse cardiac events at 1 year. These differences were primarily due to lower risk of target lesion revascularization. Trial Registration clinicaltrials.gov Identifier:NCT01308281

The crystallization of amorphous BaxSr1−xTiO3 (BST) thin films was studied in a synchrotron x-ray scattering experiment. In a 550 A thick film, the crystallization to perovskite phase was occurred at around 700 °C, while a 5500 A thick film became crystalline at 500 °C. The thickness dependence of the crystallization was attributed to the observed intermediate phase nucleated near 600 °C at the interface. In thin films, high annealing temperature was required due to the energy barrier between the perovskite phase and the intermediate phase. In the thick film, the perovskite phase was nucleated directly from the amorphous phase in the bulk of the film concurrent to the nucleation of the intermediate phase at the interface.

PURPOSE To investigate the feasibility and clinical outcomes of subintimal angioplasty combined with stent implantation in patients with long, multisegmental occlusive lesions unsuitable for surgical treatment. METHODS Between 2003 and 2005, 30 patients (23 men; mean age 68 years, range 49-82) with severe claudication (Rutherford category 3, n=12) or critical limb ischemia (CLI; Rutherford category 4 or 5, n=18) underwent subintimal angioplasty with primary stenting for long (mean 28+/-11 cm) total occlusion in the lower limb arteries. Bypass surgery was considered unsuitable owing to inappropriate anatomy or poor distal runoff in 14 (47%) patients, severe coronary artery disease 14 (47%), or poor general condition in 2 (6%). RESULTS Technical success was achieved in 27 (90%) of 30 cases. The 3 technical failures were due to inability to advance the wire, to re-enter the distal lumen, and vessel rupture, respectively. Three (10%) complications occurred (1 perforation, 2 hematomas) but did not require surgery. After a mean follow-up of 13+/-7 months (range 3-28), 10 (37%) cases of restenosis were found in 27 patients. At 12 months, the primary patency rate was 52%, and the limb salvage rate was 83%. CONCLUSION Combined use of subintimal angioplasty and stent implantation was performed safely, with a relatively high success rate and acceptable intermediate-term clinical outcomes in patients with multisegmental, long occlusions of the lower limb arteries. Therefore, this strategy can be considered an option for symptomatic relief and limb salvage in patients unsuitable for bypass surgery due to various reasons.

C-reactive protein (CRP) has been known to be associated with vascular inflammation and hypertension. Pulse wave velocity (PWV) increases according to the degree of the arterial stiffness in hypertension patients. Therefore, PWV may be correlated with CRP levels in treated hypertensive patients, irrespective of medication. We sought to determine whether there is a correlation between hsCRP and arterial stiffness in non-diabetic treated hypertensive patients, independent of cardiovascular risk factor. This study consisted of 424 non-diabetic patients at least 45-years-old who were being treated for hypertension. At the time of enrollment, the patients underwent a baseline laboratory assessment of C-reactive protein levels and pulse wave velocity (PWV). Heart to femoral PWV (hfPWV) and brachial to ankle PWV (baPWV) were used as a marker of arterial stiffness. Subjects were categorized according to tertiles of hsCRP level [Group 1: first tertile (0.20-0.46 mg/L), Group 2: second tertile (0.47-1.15 mg/L), Group 3: third tertile (1.17-9.71 mg/L)]. Group 1 consisted of 141 patients (mean age 58+/-8 years), Group 2 had 142 patients (mean age 60+/-9 years) and Group 3 had 141 patients (mean age 61+/-8 years). The hfPWV and baPWV increased significantly along with the hsCRP level. Group 1, Group 2 and Group 3 demonstrated hfPWV and baPWV of 965+/-199 and 1438+/-246, 975+/-174 and 1487+/-258 and 1043+/-215 and 1566+/-252 cm/s, respectively (p