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This study aimed to elucidate the prognostic influence of statins in relation to the degree of inflammation at the time of endovascular therapy (EVT) for patients with peripheral artery disease (PAD). This observational study included patients with PAD who underwent EVT, including 285 statin users and 275 statin non-users. They were assigned into four groups depending on C-reactive protein (CRP) level at the time of EVT: low CRP (0.1 mg/dL), intermediate-low CRP (0.1-0.3 mg/dL), intermediate-high CRP (0.3-1.0 mg/dL), and high CRP (1.0 mg/dL). A composite of death and major amputation as the primary endpoint was compared between statin users and non-users in each CRP category. Overall, statin users showed a lower event rate than non-users (log-rank, p=0.02). However, the event rates did not differ significantly between statin users and non-users in the low, intermediate-low, and intermediate-high CRP categories. In the high CRP category, statin users showed a lower event rate than non-users (p=0.002). In this population, multivariate Cox regression analysis revealed that statin use was independently associated with the primary endpoint (hazard ratio: 0.28 [95% confidence interval: 0.14-0.55]). Statins may exert favorable prognostic effects in PAD patients with highly elevated CRP levels, but not in those with low-to-moderate CRP levels.

Heterozygous familial hypercholesterolemia (HeFH) is a common, autosomal dominant, genetic disease that results in premature atherosclerotic cardiovascular disease secondary to high-level low-density lipoprotein cholesterol (LDL-C) exposure. We present a 68-year-old male patient with HeFH who was diagnosed with acute coronary syndrome at 9 months after coronary artery bypass grafting, although his LDL-C level was decreased to 77 mg/dL from 213 mg/dL. The emergency coronary angiography revealed that all bypass grafts were occluded, and the large atherosclerotic plaque burden was observed even in right internal thoracic artery (RITA) by intravascular ultrasound examination. Emergency percutaneous coronary intervention (PCI) was performed to his RITA bypass graft. After strict LDL-C management with proprotein convertase subtilisin/kexin 9 (PCSK-9) inhibitors, re-stenosis was not observed at the PCI site and the atherosclerotic plaque burden in his graft drastically disappeared. The high-risk HeFH patients, including those suffering from coronary bypass graft stenosis despite receiving medical therapy, might need stricter management of lipid profile with PCSK-9 inhibitors.

Data on the mid-term clinical outcomes after endovascular treatment (EVT) using a Crosser catheter (C. R. Bard, Inc.) as a crossing or flossing device for a heavily calcified lesion in the common femoral artery (CFA) or popliteal artery (PA) are lacking. The aim of this study was to investigate the safety and efficacy of EVT using a Crosser catheter for isolated and heavily calcified CFA or PA disease. We retrospectively analyzed 64 consecutive patients (72 lesions; CFA 30, PA 42) who underwent EVT for heavily calcified CFA or PA lesions with Crosser catheters between April 2015 and April 2019. The primary endpoint was clinically driven target lesion revascularization (CD-TLR). The median follow-up was 18.5 months. The mean age of the study population was 70 ± 9.5 years, with a male prevalence of 73.6%. The mean Proposed Peripheral Artery Calcification Scoring System grade was 2.9 ± 0.9. Procedure success, defined as 50% or less residual stenosis without suboptimal results, was achieved in 94.4% of lesions. There were no cases of bailout stenting or target lesion-related complications. After EVT, the 1-year CD-TLR-free rate for CFA and PA lesions was 87.4 and 76.8%, respectively. The corresponding rates at 2 years were 82.2 and 62.8%, respectively. In the multivariate analysis used to define CD-TLR predictors for CFA and PA lesions, hemodialysis was the only independent predictor (HR 3.35, 95% CI 1.02-13.95, P = 0.045). EVT with a Crosser device for heavily calcified CFA and PA lesions seems to be safe and feasible.

Symptomatic central venous obstruction (CVO) is sometimes observed in patients undergoing hemodialysis. Angioplasty is generally performed for salvage purposes, and stent implantation is performed as a last resort to prevent permanent venous occlusion. However, published reports about the clinical outcomes of stenting for CVO have been limited by the small number of included patients and the relatively old generation of analyzed stents. This study aimed to clarify the safety and efficacy of endovascular therapy (EVT) using stents for symptomatic CVO in contemporary practice.This retrospective review was performed between May 2012 and August 2021. We retrospectively analyzed consecutive 31 lesions (31 patients, 64 ± 10.7 years old) treated with a vascular stent for elastic recoil after balloon angioplasty or recurrent stenosis3 months after angioplasty. The primary outcome was primary patency, defined as freedom from target lesion revascularization. The secondary outcome was assisted primary patency, defined as freedom from permanent occlusion of the target stents.In all cases, stents were successfully deployed on the target lesions. No EVT-related complications were observed. Self-expandable and balloon-expandable stents were used in 26 and 5 lesions, respectively. The median follow-up period was 18 months (interquartile range, 7-40). Kaplan-Meier analysis revealed that the primary patency rates were 66.1 % at 6 months, 61.7 % at 12 months, and 38.4 % at 24 months after EVT. The assisted primary patency rate was 70.3 % 24 months after EVT. In the multivariate analysis, younger age was the only independent predictor of target lesion revascularization (hazard ratio: 0.92, 95 % CI: 0.85-0.99, p = 0.04).Stent implantation for CVO that is resistant to standard angioplasty seems safe and effective.

Renal transplantation (RT) can improve life expectancy in hemodialysis (HD) patients. However, little is known about the outcomes of renal transplant recipients after percutaneous coronary intervention (PCI). This study aimed to elucidate the effect of RT on clinical outcomes after PCI. Renal transplant recipients who underwent PCI from 2002 to 2017 were enrolled. To evaluate the effectiveness of RT, we retrospectively reviewed HD patients who underwent PCI. Propensity-score matching was performed using logistic regression to control for differences in baseline characteristics. The primary outcome was the incidence of major adverse cardiac events. After propensity matching, patients were classified into the RT (n = 50) group and HD (n = 50) group. Kaplan-Meier analysis revealed that the incidence of major adverse cardiac events was significantly lower in the RT group than in the HD group (p0.0001). Moreover, RT was associated with a lower risk for all-cause death (odds ratio 0.04; 95% confidence interval 0.002 to 0.03; p = 0.0054) and target vessel revascularization (OR 0.27; 95% CI 0.07 to 0.79; p = 0.015). RT may improve clinical outcomes after PCI, and it is encouraged for HD patients to increase life expectancy and reduce the occurrence of adverse events after PCI. Further research would be warranted to support this finding.

Background There is little knowledge about clinical outcomes after the percutaneous coronary intervention (PCI) in hemodialysis patients with long lesions. The objective of the present study was to examine the long-term prognosis after PCI in hemodialysis patients in the second-generation drug-eluting stents (DES) era. Methods We retrospectively enrolled 270 consecutive hemodialysis patients who underwent PCI using second-generation DES from January 2010 to July 2015. We defined long lesions as the total stent length >30 mm. In total, 96 hemodialysis patients (35.6%) underwent PCI for long lesions. The median follow-up period was 2.7 years. The endpoints of this study were cardiac death, target lesion revascularization (TLR), and major adverse cardiovascular events (MACE), including cardiac death, non-fatal myocardial infarction, non-fatal stroke, stent thrombosis, and TLR. Results The patients’ baseline characteristics were similar between the long lesion and the non-long lesion groups, except for prior PCIs (long-lesion vs. non-long lesion = 30.2% vs. 46.0%; p = 0.01). Kaplan–Meier analyses revealed that the incidence of cardiac death, TLR, and MACE were comparable between the two groups (long lesion vs. non-long lesion; 5.2% vs. 5.7%, log-rank p = 0.84, 26.0% vs. 23.0%, log-rank p = 0.29, and 43.8% vs. 40.2%; log-rank p = 0.49, respectively). Conclusions Clinical outcomes of PCI for long lesions in hemodialysis patients were similar to that of non-long lesions. Long-stenting in hemodialysis patients, who were considered high-risk subset of adverse cardiovascular events, might be acceptable in the second-generation DES era.

The present study aimed to clarify the current status, therapeutic strategy, and 1-year outcome in acute limb ischemia (ALI) patients in Japan. The EnDOvascular treatment (Edo) registry database includes 324 patients from 10 institutes who were registered between November 2011 and October 2013. A total of 70 ALI patients (mean age 74.0 years) from the Edo registry database were enrolled in this study. Of the 70 included patients, 72.9% were male and 35.7% had embolism. Of patients, 38.6%, 42.9%, and 18.6% underwent EVT, surgery, and hybrid thrombectomy, respectively, in primary revascularization strategy. Limb ischemia was categorized into four classes at initial evaluation: SVS/ISCVS class I (n = 13, 18.6%), SVS/ISCVS class IIa (n = 36, 51.4%), SVS/ISCVS class IIb (n = 21, 30%), and SVS/ISCVS class III (n = 0, 0%). Three patients with SVS/ISCVS class IIb limb ischemia developed myonephropathic metabolic syndrome. No catheter-directed thrombolysis was employed as a primary revascularization strategy. The 1-year rates of all-cause death, major amputation, and a composite of perioperative death or major adverse limb event were 28.6%, 5.7%, and 40.0%, respectively. Lower age, male sex, dyslipidemia, high estimated glomerular filtration rate, high albumin level, and low C-reactive protein level were independent positive predictors of all-cause death. In this registry, SVS/ISCVS class IIa ALI was predominant. Approximately 40% of primary revascularization strategy was surgery and EVT, followed by hybrid therapy. All-cause death and major amputation rates at 1 year were less than 30% and 6%, respectively.

This report presents the successful repair of an iatrogenic brachial artery pseudoaneurysm in a 72-year-old man who had peripheral artery disease and received endovascular treatment. A novel interventional method for treating iatrogenic femoral pseudoaneurysms with Perclose Proglide (Abbott Vascular Devices, Redwood City, CA, USA) has been reported; however, since a direct sheath insertion into the lumen of the pseudoaneurysm is initially required at the first step of this procedure, this strategy may prove limited in cases with small pseudoaneurysms. We describe the complete hemostasis of the pseudoaneurysm that was successfully achieved with endovascular treatment using the Perclose ProGlide suture-mediated closure system without using direct sheath insertion into the lumen of pseudoaneurysm. Our method may be effective in the repair of refractory pseudoaneurysms, in which direct sheath insertion is challenging.

Background Using the standard maintenance dose of prasugrel (10 mg/day) as part of triple therapy with aspirin and an oral anticoagulant (OAC) is not recommended in the current guidelines because it increases the risk of bleeding compared with clopidogrel. However, the safety and efficacy of low-dose prasugrel (3.75 mg/day) as part of triple therapy has not been reported. Methods and Results: We registered 816 consecutive patients with atrial fibrillation (AF) who underwent percutaneous coronary intervention (PCI) from January 2011 to June 2016 at 8 hospitals in Japan. We examined the clinical outcomes of patients who received either low-dose prasugrel (n=57) or clopidogrel (n=451) as part of triple therapy after PCI. The incidences of bleeding (TIMI major and minor) and major adverse cerebrocardiovascular events (MACCE; all-cause death, nonfatal myocardial infarction, stent thrombosis, unplanned revascularization, and stroke) were evaluated. The cumulative 1-year incidence of bleeding was not significantly different (prasugrel 5.6% vs. clopidogrel 8.1%, log-rank P=0.55). In addition, the cumulative 1-year incidence of MACCE was also not significantly different (prasugrel 11.5% vs. clopidogrel 12.3%, log-rank P=0.88). Conclusions Low-dose prasugrel, as part of triple therapy, did not increase the risk of bleeding compared with clopidogrel. Therefore, it can be an alternative to clopidogrel for patients with AF undergoing PCI.

To identify the risk factors for major adverse cardiovascular events (MACEs) in real-world practice for symptomatic peripheral artery disease in Japan.Data on Japanese patients (N = 880) from the Observational Prospective Multicenter Registry Study on Outcomes of Peripheral Arterial Disease Patients Treated by Angioplasty Therapy for Aortoiliac Artery who underwent de novo aortoiliac stent placement. The 3-year risk of incident MACEs was investigated.The median age of the patients was 72.6 years (range, 34-97 years), and 83.1% of the patients were men. The patients had the following conditions: smoking (35.6%), hypertension (94.1%), dyslipidemia (81.7%), diabetes (48.0%), renal failure on dialysis (12.6%), myocardial infarction (12.7%), stroke (15.8%), and chronic limb-threatening ischemia (7.1%). Femoropopliteal lesions were present in 38.8% of the limbs with aortoiliac lesions. The 3-year rate of freedom from MACEs was 89.1%. Baseline characteristics, such as age, renal failure on dialysis, myocardial infarction, stroke, and femoropopliteal lesions, were independently associated with the risk of incident MACEs. When the study population was stratified according to these risk factors, the rate of MACEs was highest in patients with at least 3 risk factors (32.9% at 3 years).The 3-year rate of freedom from MACEs was reported. Baseline characteristics, such as age, renal failure on dialysis, myocardial infarction, stroke, and femoropopliteal lesions, are independent risk factors for MACEs after aortoiliac stent placement.

The present study aimed to clarify the current status, therapeutic strategy, and 1-year outcome in acute limb ischemia (ALI) patients in Japan. The EnDOvascular treatment (Edo) registry database includes 324 patients from 10 institutes who were registered between November 2011 and October 2013. A total of 70 ALI patients (mean age 74.0 years) from the Edo registry database were enrolled in this study. Of the 70 included patients, 72.9% were male and 35.7% had embolism. Of patients, 38.6%, 42.9%, and 18.6% underwent EVT, surgery, and hybrid thrombectomy, respectively, in primary revascularization strategy. Limb ischemia was categorized into four classes at initial evaluation: SVS/ISCVS class I (n = 13, 18.6%), SVS/ISCVS class IIa (n = 36, 51.4%), SVS/ISCVS class IIb (n = 21, 30%), and SVS/ISCVS class III (n = 0, 0%). Three patients with SVS/ISCVS class IIb limb ischemia developed myonephropathic metabolic syndrome. No catheter-directed thrombolysis was employed as a primary revascularization strategy. The 1-year rates of all-cause death, major amputation, and a composite of perioperative death or major adverse limb event were 28.6%, 5.7%, and 40.0%, respectively. Lower age, male sex, dyslipidemia, high estimated glomerular filtration rate, high albumin level, and low C-reactive protein level were independent positive predictors of all-cause death. In this registry, SVS/ISCVS class IIa ALI was predominant. Approximately 40% of primary revascularization strategy was surgery and EVT, followed by hybrid therapy. All-cause death and major amputation rates at 1 year were less than 30% and 6%, respectively.

The outcomes of stent implantation in managing May-Thurner syndrome (MTS) are not well understood. To clarify the acute and long-term outcomes of stent implantation in patients with MTS having acute deep venous thrombosis (DVT), we retrospectively investigated consecutive 59 patients from 10 hospitals in Japan who were treated with stents for left iliac vein stenosis with acute DVT. Stents were considered successful if the stent was patent at discharge, which in turn was defined as patient success. The primary endpoint for the study was stent patency, and the secondary endpoint was recurrence of DVT and development of post-thrombotic syndrome (PTS) during follow-up. The patient success was achieved in 56 patients (95%). Clinical follow-up was conducted for 50 patients (89%) for a median duration of 40 months (range 8-165 months). Among them, 44 patients (79%) were followed up using imaging modalities. During this period, stent occlusion was revealed in four patients (9%), and one patient was successfully treated using balloon angioplasty. Primary and secondary patency rates were 84% at 19 months and 93% at 20 months, respectively. Recurrence of DVT was documented in 3 (8%) patients. PTS was evaluated from 36 patients. Three patients (8%) had PTS; however, none of the patients had severe PTS. This multicenter retrospective study of the use of stents for treating patients with MTS having acute DVT demonstrated good acute and long-term outcomes and long-term stent patency.

Background The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. In a recent study, iFR was found to be more closely linked to coronary flow reserve (CFR) than fractional flow reserve (FFR). E/e′ is a surrogate marker of left ventricular (LV) filling pressure and LV diastolic dysfunction. Coronary resting flow was found to be increased in patients with elevated E/e′, and higher coronary resting flow was associated with lower CFR. Higher baseline coronary flow induces a greater loss of translesional pressure and may affect iFR. However, no reports have examined the impact of E/e′ on iFR. The purpose of this study was to assess the relationship between iFR and E/e′ compared with FFR. Methods and results We retrospectively examined 103 consecutive patients (142 with stenosis) whose iFR, FFR, and E/e′ were measured simultaneously. The mean age, LV mass index, and systolic blood pressure of patients with elevated E/e′ were higher than those of patients with normal E/e′. Although no significant differences were observed in mean FFR values and % diameter stenosis, the mean iFR value in patients with elevated E/e′ was significantly lower than that in patients with normal E/e′. The iFR was negatively correlated with E/e′, while there was no correlation between FFR and E/e′. Multivariate analysis showed that E/e′ and % diameter stenosis were independent determinants of iFR. Conclusion E/e′ ratio affects iFR values. Our results suggest that FFR mainly reflects the functional severity of the epicardial stenosis whereas iFR could potentially be influenced by not only epicardial stenosis but also other factors related to LV filling pressure or LV diastolic dysfunction. Further research is needed to understand the underlying mechanisms that influence the evaluation of iFR in patients with elevated E/e′.

Introduction: Peripheral artery disease (PAD) occurs at an advanced stage of atherosclerosis and its comorbidities are associated with poor prognoses. Malnutrition is related to the severity of atherosclerosis in patients with cardiovascular disease and it predicts mortality. The Controlling Nutritional Status (CONUT) score is calculated from serum albumin concentration, peripheral lymphocyte count and total cholesterol concentration, and it robustly represents the nutritional status of hospitalized patients. This study aimed to determine the prognostic value of the CONUT score in patients with peripheral artery disease (PAD) who were undergoing endovascular therapy (EVT). METHODS and RESULTS: This study included 628 PAD patients who underwent EVT between 2013 and 2017 and were assigned to low (CONUT score 0: n = 81), mild (CONUT score 1&ndash, 2: n = 250), moderate (CONUT score 3&ndash, 4: n = 169), and high (CONUT score &ge, 5: n = 128) risk groups. The study&rsquo, s primary endpoint was any death. Patients in the groups with higher CONUT scores were more likely to have chronic kidney disease (p &lt, 0.001), impaired left ventricular ejection fractions (p &lt, 0.001), and critical limb ischemia (p &lt, 0.001) on admission. During follow-up, 95 patients (15%) died. Kaplan&ndash, Meier analyses revealed that the patients with higher CONUT scores had lower survival rates (p &lt, 0.001, log-rank trend test). Multivariate Cox regression analyses showed that following adjustments for the confounding factors, a higher CONUT score was significantly associated with any death (hazard ratio, 1.15, 95% confidence interval, 1.03&ndash, 1.30). CONCLUSION: The simple index CONUT score at the time of EVT may predict long-term mortality in PAD patients.

Background. The instantaneous wave-free ratio (iFR) is an invasive coronary physiological index that is not inferior to fractional flow reserve- (FFR-) guided revascularization. The indexes of iFR and FFR are similar and closely correlated, but there are a few key differences. Previous studies suggested that patient characteristics and lesion severity could induce discordance between iFR and FFR. This study aimed to clarify the hemodynamics and lesion characteristics that influence discordance between iFR and FFR. Methods. In this retrospective study, we enrolled 225 patients (304 lesions) who underwent clinically indicated invasive coronary angiography and both iFR and FFR examinations between 2012 and 2017. We included only patients who underwent right heart catheterization and had blood pressure and heart rates recorded immediately prior to iFR and FFR. Results. Discordance (iFR ≤0.89 and FFR >0.8 or iFR >0.89 and FFR ≤0.8) was observed in 80 lesions (26.3%). The heart rate, rate-pressure product, and cardiac index tended to be higher in the iFR ≤0.89 group than in the iFR >0.89 group. These trends were not seen between the FFR ≤0.8 group and FFR >0.8 group. A multivariate analysis showed that independent predictors of iFR ≤0.89 and FFR >0.8 discordance were female sex and higher rate-pressure product. iFR >0.89 and FFR ≤0.8 discordance was rare in hemodialysis patients. Conclusion. Even if iFR is functionally significant in intermediate stenosis, additional FFR evaluations should be considered for women, especially those with a high rate-pressure product, to avoid unnecessary percutaneous coronary intervention. If iFR is not functionally significant with intermediate stenosis in hemodialysis patients, then further FFR evaluations are unnecessary.

We aimed to clarify the relationships between angiographic lesion characteristics and values of fractional flow reserve (FFR) on intermediate coronary artery stenosis. The clinical meaning and assessment for "visual-functional mismatches," including regular-mismatches [defined as angiographic percent diameter stenosis (%DS) ≥50 % and FFR >0.80] and reverse-mismatches (defined as angiographic %DS

Fe2O3-Bi2O3-B2O3 (FeBiB) glasses were developed as novel pH responsive hydrophobic glasses. The influence of the glass composition on the pH sensitivity of FeBiB glasses was investigated. The pH sensitivity drastically decreased with decreasing B2O3 content. A moderate amount of Fe2O3 and a small amount of B2O3 respectively produces bulk electronic conduction and a pH response on glass surfaces. Because the remaining components of the glass can be selected freely, this discovery could prove very useful in developing novel pH glass electrodes that are self-cleaning and resist fouling.

In recent years, improvements in endovascular equipment and the technical skills of operators have led to an increasing number of percutaneous common femoral artery (CFA) interventions. However, there are few reports of the detailed treatment strategy for CFA intervention and its subsequent clinical outcomes. We evaluated the safety and efficacy of endovascular therapy (EVT) with a high-pressure balloon for CFA disease. Fifty-five consecutive patients (59 lesions) who underwent EVT with high-pressure ballooning were analyzed retrospectively. The primary endpoint was clinically driven target lesion revascularization (TLR). The median follow-up was 34.0 months. The mean age was 68.0 ± 10.1 years, and 70.1% were men. The procedural success rate was 98.3%. All patients underwent high-pressure balloon angioplasty (mean pressure 17.7 atm). Clinically driven TLR-free rates at 2, 3, and 4 years were 88.7%, 77.9%, and 74.2%, respectively. Endovascular interventions with high-pressure ballooning for CFA showed an acceptable mid-term freedom rate from TLR.

A recent national study in Japan indicated that 5.8 % of deep venous thrombosis (DVT) patients were treated using endovascular procedures, 83 % of which included catheter-directed thrombolysis (CDT). However, the details of these endovascular procedures and their outcomes have not yet been fully evaluated. Using DVT data from the EDO registry (EnDOvascular treatment registry) database, a total of 35 symptomatic iliac or femoral DVT patients who received endovascular treatment (54.3 % male, age 64.7 ± 15.1) were analyzed. The dominant patient risks were being bedridden (22.9 %) and May-Thurner syndrome (25.7 %). Approximately 77.1 % of patients were treated using an antegrade approach, and CDT and other endovascular procedures were performed in 82.9 and 57.1 % of patients, respectively. A periprocedural inferior vena cava (IVC) filter was used in 94.1 % of patients, which remained implanted in 37.1 and 20.0 % of patients after discharge and 6 months after hospitalization, respectively. After 6 months of treatment, 2.9 % of patients experienced a recurrence of DVT and 5.7 % suffered revascularization, but no patient had a recurrence of pulmonary embolism. Subjective symptoms improved in 80.0 % of patients, while 2.9 % of patients felt worse at 6 months after treatment. Postthrombotic syndrome-related symptoms were observed in seven patients (19.4 %), and edema was most frequently observed (71.4 %). The details of CDT procedures, such as approach site and the removal of the IVC filter, varied among hospitals. Despite improved symptoms, further procedural standardization and data collection should be conducted to reduce complications and improve outcomes.

The aim of this study was to examine the clinical value of iFR for AS patients. Functional evaluation of coronary stenosis in patients with aortic valve stenosis (AS) is challenging because the stress-induced test is often thought to be a contraindication. AS patients have a unique coronary flow pattern dependent on the diastolic phase. The instantaneous wave-free ratio (iFR) is a vasodilator-free, invasive pressure wire index of the functional severity of coronary stenosis and is calculated under resting conditions. And iFR calculated during a specific period of diastole may have the potential benefit to assess the functional severity of coronary stenosis in AS patients. We examined 158 consecutive patients (217 stenoses) whose iFR and fractional flow reserve (FFR) were measured simultaneously. Among the 158 patients, AS was observed in 13 (8.2%). The iFR showed good correlation with FFR in AS patients. The best cut-off value of iFR for the receiver-operator curve analysis to predict FFR of 0.8 was 0.9 for non-AS patients. However, it was 0.73 for AS patients. The present study demonstrated good correlation between iFR and FFR for AS patients. Vasodilator-free assessment using iFR may provide potential benefits when evaluating coronary stenosis in patients with AS. In AS patients, the best cut-off of iFR value predicting FFR value of 0.8 was lower than 0.9 that is the standard predictive value of iFR.

Sub-micron wide Si rib patterns with a smooth sidewall and a high aspect ratio have been successfully formed using originally developed dry-etching apparatus with a high-density inductive coupled plasma source. The developed technique is applied for MEMS and X-ray devices.

Objectives This study aimed to examine prognosis and causes of death in hemodialysis (HD) patients with critical limb ischemia (CLI) after endovascular therapy (EVT). Background EVT is becoming a first-line treatment in patients with CLI. Nonetheless, only a few studies have examined prognosis and its predictors in HD patients with CLI undergoing EVT, who are known to be at high-risk. Moreover, causes of death in this population are not clarified to date. Methods We examined 175 consecutive patients who underwent EVT for CLI between March 2009 and March 2014. Results Among these, 126 patients were dependent on HD and their 2-year all-cause death and 2-year major amputation rates were 28% and 14%, respectively. Cox proportional hazards analyses revealed that lower body mass index (hazard ratio [HR] = 0.89, 95% confidence interval [CI] = 0.82-0.98, P = 0.03) and prior stroke (HR = 2.34, 95%CI = 1.10-4.85, P = 0.03) were independent predictors of all-cause death, and lower serum albumin (HR = 0.44, 95%CI = 0.22-0.92, P = 0.03) along with currently smoking (HR = 4.73, 95%CI = 1.43-14.1, P = 0.01) were independent predictors of major amputation in HD patients. The leading cause of death in this population was infections, most of which were lower extremity infections. Conclusions The incidences of all-cause death and major amputation seemed acceptable in HD patients undergoing EVT for CLI. In this high-risk subset, management of infection might be a potential therapeutic target.

Renal transplantation (RTx) is one of the great options for hemodialysis (HD) patients to improve their life expectancy, however, little is known about outcomes of renal transplantation patients who underwent percutaneous coronary intervention (PCI). The purpose of the present study was to elucidate

Background: Instantaneous wave-free ratio (iFR) is a vasodilator free index calculated using trans-lesional pressure ratio during a specific period of diastole that is called “wave-free period”, and reported to have a good correlation with fractional flow reserve (FFR). In patients with severe aortic valve stenosis (AS), evaluation of intermediate coronary stenosis by FFR using vasodilators is thought to be a contraindication in some situations. Moreover, previous studies reported unique coronary flow pattern during diastolic phase in patients with AS. To date, there is no report claiming the correlation of iFR and FFR in this population. The purpose of the present study was to examine the clinical value of iFR in patients with AS. Method and Results: We examined consecutive 154 patients (with 214 stenosis) whose iFR and FFR were measured simultaneously. The mean age of AS patients (n=10, mean aortic valve area: 0.75 ± 0.42cm2) was higher than non-AS patients (n=144). Other patients’ characteristics are shown in Table 1. The mean iFR value in AS patients was significantly lower than that of non-AS patients, despite no significant difference was observed in the mean FFR value and % diameter stenosis (Table 2). iFR showed a good correlation with FFR in AS patients (Figure 1) and the best cut-off value of iFR in receiver operator curve analysis to predict FFR ≤ 0.8 was 0.73 in AS patients (AUC 0.84, sensitivity 0.8, specificity 0.86, p=0.016; Figure 2), whereas, 0.90 in non-AS patients. Conclusion: The present study demonstrated the good correlation between iFR and FFR in AS patients. Besides, the value below 0.73 of iFR was thought to be a predictor of myocardial ischemia in AS patients, which was lower than standard predictive range of ischemia in iFR. Vasodilator-free assessment by iFR may have potential benefits in evaluating intermediate coronary stenosis in patients with AS.

Backgrounds: Critical limb ischemia (CLI) is a severe clinical presentation of patients with peripheral artery disease, and their limb salvage and survival rates are extremely poor. However, there is still only limited evidence from observational studies for contemporary outcomes in CLI patients who underwent endovascular treatment (EVT) including both above and below the knee lesion. Therefore, this study aimed to evaluate the prognostic and predictive factors for patients with CLI who underwent EVT. Methods: Cumulative total number of 192 patients with CLI who underwent EVT between March 2009 and April 2014 was prospectively enrolled. After the exclusion of patients who were lost to follow-up within 6 months, 175 patients were retrospectively analyzed for clinical and angiographic parameters. The primary endpoints of this study were all-cause death and major amputation above the ankle joint. Results: The study population was typically elderly (average age: 68 year-old) and 76% male with a normal body mass index (BMI: 23 kg/m2) and diverse comorbidities, including 34% diabetes and 72% maintenance hemodialysis. Target lesions consisted of 23% aortoiliac, 56% femoropopliteal and 67% below-the-knee arteries, including 37% isolated below-the-knee lesion. Median follow-up period was 23.9 months. Survival rate and major amputation free rate at 1-year were 87% and 95%, respectively (Figure). Multivariate analysis elucidated that low BMI and cerebrovascular disease were independent predictors for all-cause mortality (Table 1). Interestingly, infection was the leading cause of death (23 patients (46%), and main focus of infection was lower extremities (15 patients (30%)). As for major limb amputation, current smoking was the only independent predictor (Table 2). Conclusion: This study demonstrates that low BMI and cerebrovascular disease predict all-cause mortality, and current smoking does major amputation after EVT in patients with CLI.

We describe here the synthesis of [14C]-2-(3-chlorophenyloxy)-3-[3-(3-hydroxy)pyridin-4-yl propoxy]pyridine (1), a phosphodiesterase 4 inhibitor. [14C]-Labeled 1 was prepared in three steps from [14C]-2-bromopyridin-3-ol in an overall yield of 32%. Preparation of [14C]-labeled 2 and 3, two metabolites of 1, is also described. Copyright © 2014 John Wiley & Sons, Ltd.

Imprinted molds which are contaminated by organic substances such as UV-resins through many times of imprinting processes are successfully cleaned with irradiation of a vacuum ultraviolet (VUV, λ = 172 nm) light. Substrate temperature, radiation distance, and ambient oxygen concentration are also revealed as important factors to clean the molds.

We investigated a method for controlling the regularity of a single-domain triangular array of nanoholes in anodic aluminum oxide (AAO); the method is a combination of a nanoimprinting method and self-organization. We found that it was possible to reduce a nanohole pitch of AAO to 1/3 of the pitch of the nanoimprinting mold, by the choice of an appropriate anodic voltage. The regularity of the nanohole array was quantitatively evaluated using the FFT method, and the best regularity was obtained at 46V; at this voltage, the pitch of the nanohole array was decreased to 115nm from 200nm of the nanoimprinting mold. This method suggests the possibility of decreasing the nanohole pitch by using a top-down technique such as nanoimprinting and an appropriate choice of the anodic voltage.

The CONUT (CONtrolling NUTritional) score is simple index calculated from the following factors; serum albumin concentration, total peripheral lymphocyte count and total cholesterol concentration, and has been reported to well represent nutritional status in hospitalized patients. We aimed to

The purpose of this study was to determine whether feeding cultured bluefin tuna with feed fish containing low levels of mercury results in a concomitant reduction in the total mercury levels in tuna. The control group was fed spotted mackerel with average mercury concentrations of 0.052 ppm, and the experimental group was fed horse mackerel in combination with Japanese sand lance, whose mercury concentrations were 0.016 ppm and 0.037 ppm (0.019 ppm in average), respectively. Mercury intake in the control and experimental groups' tunas decreased from 124 to 53 µg/kg body weight/month and from 60 to 19 µg/kg body weight/month over the duration of the 19- and 18 month rearing period, respectively. Three specimens from each group were harvested at approximately monthly intervals initially, and then less frequently as the tuna increased in size, and muscle tissue, internal organs, gill filaments, and blood samples were collected for analysis. In the control group, total mercury concentrations increased from 0.25 to 0.55 ppm in all muscle samples except the front ventral one. In contrast, total mercury concentrations in muscle tissues from the experimental group were less than 0.25 ppm, with no marked increases observed over time. The mercury concentrations of the internal organs in the experimental samples were also lower than those of the control. The study showed that feeding bluefin tuna horse mackerel supplemented with sand lance can decrease the accumulated total mercury levels lower than the maximum permitted level of mercury in fish in Japan (0.4 µg/g). This study is the first report to describe the production of bluefin tuna with such low levels of mercury.

A fabrication method of uniform gratings on composite semiconductors using ultraviolet nanoimprint lithography (UV-NIL) is described. Since the grating pattern was batch transferred to the resin on substrates in this process, a high throughput fabrication process is expected. Both the dry etching process and the wet etching process can be performed for composite semiconductors patterning. The uniformity of the pattern height on a 3 inch GaAs substrate is better than the standard deviation of 2.6.

金沢大学理工研究域電子情報学系, This paper describes a 158 MS/s JPEG 2000 codec with an embedded block coder (EBC) based on bit-plane and pass-parallel architecture. The EBC contains bit-plane coders (BPCs) corresponding to each bit-plane in a code-block. The upper and the lower bit-plane coding overlap in time with a 1-stripe and 1-column gap. The bit-modeling passes in the bit-plane coding also overlap in time with the same gap. These methods increase throughput by 30 times in comparison with the conventional. In addition, the methods support not only vertically causal mode, but also regular mode, which enhances the image quality. Furthermore, speculative decoding is adopted to increase throughput. This codec LSI was designed using 0.18/Limprocess. The core area is 4.7 x 4.7 mm2 and the frequency is 160 MHz. A system including the codec enables image transmission of PC desktop with 8 ms delay. Copyright © 2008 The Institute of Electronics, Information and Communication Engineers.

The bluefin tuna tested were reared for 22 months from eggs before the beginning of the experiment, and sampling was performed every 3 months over the following year. The experimental results showed that the mercury concentration in the muscle ranged from 0.32 to 0.85 μg/g, which is lower than that found in wild bluefin tuna of a similar size. Increase in the mercury concentration corresponding to the increase in body weight was not shown, and it was quite different with wild bluefin tuna. Furthermore, no significant relationship was found between the lipid concentration and the mercury concentration in muscle. Among the internal organs of cultured bluefin tuna, the heart (0.32–0.66 μg/g), liver (0.43–0.99 μg/g) and spleen (0.59–1.0 μg/g) contained higher concentrations of mercury. It was estimated that the full-cycle cultured bluefin tuna had been fed small fish containing lower concentrations of mercury, and that the mercury concentration of tuna would be almost equal throughout the year because the effect of mercury accumulation would be weakened by body growth. Therefore, it was concluded that selecting diet fish species might decrease mercury contents in cultured bluefin tuna.

Based on the software model proposed at SID 2006 [5], we've developed a prototype hardware of real-time image transmission system supporting environments where both computer desktop images requiring interactive responsiveness and real-time motion picture images coexist. The architecture of the prototype is described in detail

A prototype of image transmission system which can be used for the wireless PC monitor has been developed. The high memory consumption and the high computation complexity are got rid of by optimizing the image quality control and adopting the efficient network protocol. Experimental results show that the system maintains high image quality comparable to the JPEG 2000 conventional method and eliminates the delay in comparison to MPEG-2.

Shoseiryuto (TJ-19) contains eight herbal components, including Ephedra sinica, and has been used for treating asthma and allergic rhinitis in Asian countries for several centuries. In this study, we investigated the potential herb–drug interaction of TJ-19 in healthy volunteers and attempted to ascertain whether or not the interaction might be affected by the cytochrome P450 (CYP) 2D6 genotype. We assessed the effect of TJ-19 on the activities of CYP1A2, CYP2D6, CYP3A, xanthine oxidase (XO), and N-acetyltransferase 2 (NAT2) in 37 healthy subjects. The subject pool consisted of 19 extensive metabolizers (EMs) with CYP2D6*Wild/*Wild, and 18 intermediate metabolizers (IMs) with CYP2D6*10/*10. The baseline activities of five enzymes were ascertained by their respective urinary metabolic ratios from an 8-h urine sample, after an oral 150-mg and 30-mg dose of caffeine and dextromethorphan were administrated, respectively. Thereafter, the subjects received 4.5 g of TJ-19 twice daily for 7 days, and underwent the same phenotyping test on postdose day 7. The activities of all enzymes examined did not differ before or after the 7-day administration of TJ-19. Consequently, the influence of the CYP2D6 genotype on the herb–drug interaction remained unsolved. Our results indicate that TJ-19 at the generally recommended dosage is unlikely to cause pharmacokinetic interaction with co-administered medications primarily dependent on the CYP1A2, CYP2D6, CYP3A, XO, and NAT2 pathways for elimination.

BACKGROUND Hemodialysis (HD) patients are reported to show poor clinical outcomes after percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES) compared with non-HD patients and their long-term prognosis remains unclear. METHODS AND RESULTS We prospectively enrolled 489 consecutive patients undergoing PCI with SES and performed a retrospective analysis focusing on HD patients. Median follow-up was 7.0 years (interquartile range, 4.2-7.9) and the follow-up rate was 100%. At the 7-year follow-up, the cumulative incidences of all-cause death, target lesion revascularization (TLR) and major adverse cardiac events (MACE) were significantly higher in HD patients than in non-HD patients (HD vs. non-HD=34.7% vs. 9.6%, 42.6% vs. 10.2% and 75.3% vs. 24.4%, respectively; log-rank P

Pyridinoline (Pyr), one of the mature crosslinks of collagen, was determined in muscular collagen of three species of fish. The amounts of muscular Pyr in red sea bream, yellowtail, and tiger puffer were 3.4, 8.8, and 50.3 mmol/mol collagen, respectively, indicating that the Pyr concentration in muscular collagen differs greatly among fish species. The Pyr concentration in tiger puffer muscular collagen was the greatest, but it was only one-fourth that in rabbit muscle. As in mammalian skin collagen, Pyr was not detected in skin collagen of red sea bream and yellowtail. However, tiger puffer skin contained Pyr (3.75 mmol/mol collagen). The presence of Pyr would have a relationship to some features of tiger puffer skin, such as mechanical strength and thickness. Pyr concentrations in acid-soluble collagen (ASC), pepsin-solubilized collagen (PSC), and insoluble collagen (ISC) in muscles of three species of fish were determined. Pyr was found in ISC > PSC > ASC, from the highest to the lowest concentration, and the concentration in ISC was 45–200 times that in ASC. Therefore, Pyr crosslinks that are formed between collagen molecules would have a close relationship to collagen solubility.