Percutaneous Transluminal Angioscopy During Coronary Intervention

To investigate the feasibility of angioscopic-guided percutaneous transluminal coronary angioplasty and to elucidate the mechanism of efficacy of coronary stenting for acute myocardial infarction, we performed coronary angioscopy in 102 patients with stable angina or acute myocardial infarction. Thrombi and intimal flaps were observed in most patients after coronary angioplasty. Large intimal splits were seen in one third of patients. Stents were inserted in 10 patients who were revealed to have a large flap or protruding split to the inner lumen. Thrombolytic agents were administered in 2 patients with large thrombi. Additional treatments were required in 32% of patients. No acute myocardial infarction or unstable angina occurred in patients during hospitalization. Thus, angioscopy of the coronary lumen enables clinicians to determine the most appropriate and least risky coronary intervention strategy. In patients with acute myocardial infarction, angioscopy revealed occlusive or protruding thrombi in 34 of 35 patients. The protruding thrombi disappeared after stenting. The frequency of large intimal flaps increased after predilatation with balloon, but these disappeared after stenting. The present angioscopic study demonstrates that the coronary stent compresses the occlusive or protruding thrombi and covers the ruptured thrombogenic plaque Consequently, smooth-surfaced and wide vessel lumen are obtained

Regional variation in hemoglobin distribution among individuals with chronic kidney disease: the ISN International Network of Chronic Kidney Disease (iNET-CKD) Cohorts

Introduction: Despite recognized geographic and sex-based differences in hemoglobin in the general population, these factors are typically ignored in patients with chronic kidney disease (CKD) in whom a single therapeutic range for hemoglobin is recommended. We sought to compare the distribution of hemoglobin across international nondialysis CKD populations and evaluate predictors of hemoglobin.Methods: In this cross-sectional study, hemoglobin distribution was evaluated in each cohort overall and stratified by sex and estimated glomerular filtration rate (eGFR). Relationships between candidate predictors and hemoglobin were assessed from linear regression models in each cohort. Estimates were subsequently pooled in a random effects model.Results: A total of 58,613 participants from 21 adult cohorts (median eGFR range of 17–49 ml/min) and 3 pediatric cohorts (median eGFR range of 26–45 ml/min) were included with broad geographic representation. Hemoglobin values varied substantially among the cohorts, overall and within eGFR categories, with particularly low mean hemoglobin observed in women from Asian and African cohorts. Across the eGFR range, women had a lower hemoglobin compared to men, even at an eGFR of 15 ml/min (mean difference 5.3 g/l, 95% confidence interval [CI] 3.7–6.9). Lower eGFR, female sex, older age, lower body mass index, and diabetic kidney disease were all independent predictors of a lower hemoglobin value; however, this only explained a minority of variance (R2 7%–44% across cohorts).Conclusion: There are substantial regional differences in hemoglobin distribution among individuals with CKD, and the majority of variance is unexplained by demographics, eGFR, or comorbidities. These findings call for a renewed interest in improving our understanding of hemoglobin determinants in specific CKD populations.</p

High-resolution seismic reflection profiling across the Shiraiwa fault, eastern margin of the Yokote basin fault zone, northeast Japan : data acquisition and processing

The eastern margin of the Yokote basin fault zone extends about 56km at the western foot of the Ou Backbone Range, northeast Japan. The Rikuu earthquake (M=7.2) occurred in the Ou Backbone Range (Mahiru Range) on 31st August, 1896. Associated with this earthquake, four thrust faults-Obonai, Shiraiwa, Ota, and Senya fault3 appeared on the surface of the western foot of the Mahiru Range. These faults were highly sinuous with numerous gaps and en echelon steps. We conducted a high-resolution seismic reflection profiling survey across the Shiraiwa fault. The obtained seismic reflection data were processed by conventional common mid-point methods, post-stack migration, and depth conversion. The subsurface structure across the Shraiwa fault is characterized by branched low-angle reverse faults and conjugate back-thrust. The emergent thrust associated with the 1896 earthquake is regarded to be a subsidiary reverse fault

High-resolution seismic reflection profiling across the Senya fault at Hanaoka, northern Honshu, Japan: Data acquisition and processing

The Senya fault, northern Honshu, Japan, which generated the Rikuu earthquake (Mj 7.2) 1896, is a typical intra-arc active thrust. Subsurface geometry provides essential information for better understanding strong ground motions and crustal deformation processes. A high-resolution seismic reflection survey was conducted along the 63km long seismic line across the toe of the thrust to reveal the subsurface geometry. The seismic source was a Mini-vibrator truck and the receiver interval was 10 m. The seismic data were processed by the standard common mid-point method. The Senya fault is clearly identified as a boundary between horizontal reflectors of the basin fill in the Yokote basin and moderately dipping reflectors beneath the Senya hills. The thrust occurred in late Miocene mudstone, and shows a flat and ramp geometry. The emergent thrust dips 30 degrees down to 500m, and changes its dip to subhorizontal following the distribution of the mudstone