Genetic Polymorphisms of Angiotensin Converting Enzyme (I/D) and Endothelial Nitric Oxide Synthase (T(-788)C) Genes in Japanese Patients with Myocardial Infarction -
A 64-year-old patient with chronic renal failure underwent coronary artery bypass grafting (CABG) because of the frequent severe angina during hemodialysis. Intraoperative hemodialysis and extra-corporeal ultrafiltration method (ECUM) was used during cardiopulmonary bypass. Postoperative management was successfully performed by continuous ambulatory peritoneal dialysis (CAPD), which made hemodynamics stable and prevented postoperative bleeding, providing with adequate fluid removal and satisfactory control of serum chemistry.
From 1969 to 1980, 83 patients with herpes zoster and postherpetic neuralgia were referred to our clinic. They consisted of 36 male and 47 female, whose ages ranged from 18 to 91 years. They were tested mainly with stellate ganglion block or epidural block. Patients with postherpetic neuralgia received imipramine 60 mg per day in addition. About half of the patients were relieved of pain or considerably improved after treatment. Other half of the patients somewhat improved excluding those patients whose therapeutic effect could not be assessed. More favourable results were obtained in patients whose treatment was instituted within 2 weeks from onset of herpes zoster than patients over 2 weeks from onset. Duration of treatment was shorter in younger patients (approximately 59 years) than older patients (60 years approximately), but results were same in both age groups. About 10% of the patients had concomitant malignant disease or autoimmune disease. No relationship between the localization of herpes zoster and the site of malignant disease was found.
Objective: In the REDUCE-IT trial, high doses of eicosapentaenoic acid (EPA) demonstrated a significant absolute risk reduction in its primary endpoint among patients with hypertriglyceridemia and high cardiovascular risk. However, the mechanism of action of long-chain N-3 polyunsaturated fatty acids, EPA and docosahexaenoic acid (DHA), has not been fully investigated. The AQUAMARINE EPA/DHA study aims to investigate the effect of EPA/DHA on high-risk coronary plaques after 12 months, using cardiac magnetic resonance imaging (CMR), in patients with coronary artery disease on statin therapy. Methods: This is a single-centre, triple-arm, parallel-group, randomized controlled, open-label, superiority trial. Eligible patients were randomly assigned to the following three groups: no-treatment group, 2 g/day EPA/DHA group, and 4 g/day EPA/DHA group. The primary endpoint was the change in the plaque-to-myocardial ratio (PMR) of coronary high-intensity plaques using CMR. Coronary plaque assessment using computed tomography angiography (CTA) was also investigated. Results: Overall, 84 patients (mean age; 68.2 years, male; 85%) who achieved low-density lipoprotein-cholesterol levels <100 mg/dL were enrolled. In the primary analysis, there were no significant differences in PMR changes among the three groups. Difference with changes in CTA parameters were not detected. In a post-hoc subgroup analysis of patients with high triglyceride levels (>150 mg/dL), a dose-dependent reduction in PMR was observed in the EPA/DHA group. Conclusion: EPA/DHA therapy did not significantly reduce PMR in the primary analysis. A further study to investigate the anti-atherosclerotic effect of EAP/DHA using CMR is warranted for statin-treated patients with residual hypertriglyceridemia.
