チシセイ フセイミャク ノ ヒヤクブツ リョウホウ

The majority of sudden cardiac death （SCD） is caused by fatal arrhythmias （brady-and tachyarrhythmia）, most of leading to SCD are tachy-arrhythmias like ventricular tachycardia （VT） or ventricular fibrillation （VF）. Implantable cardioverter defibrillator （ICD） therapy to VT and VF is dramatically demonstrating improved survival from SCD by randomized clinical trials. Today’s ICD devices are implanted pectorally with transvenous lead in most patients, so procedures can be done by physician （duration of procedure １-２ hrs）. We had performed ICD therapy to forty-two patients including with low left ventricular function. Although all patients could leave hospital, several patients died of heart failure and suffered from inappropriate therapy. In patients with advanced heart failure, cardiac-resynchronization therapy may decrease the risk of death from heart failure, when combined with ICD. Resynchronization therapy may have clinical benefit, especially when combined with an implantable defibrillator

Functional Polymorphisms in the Promoter Regions of Matrix Metalloproteinase-2, -3, -7, -9 and TNF-alpha Genes, and the Risk of Colorectal Neoplasm in Japanese

Colorectal carcinogenesis involves environmental factors and genetic predispositions. Recent studies have suggested the associations between colorectal neoplasm and functional polymorphism of matrix metalloproteinases (MMPs) and cytokine genes. In this study, we analyzed polymorphisms of MMPs and tumor necrosis factor (TNF)-alpha genes, focusing on the susceptibility to colorectal neoplasm and the tumor progression. The subjects were 186 patients (95 men and 91 women) who underwent total colonoscopy, and were classified into cancer, adenoma and non-neoplasm (control) groups of 47, 72 and 67 patients, respectively. The polymorphisms at the MMP-2 ?1306C/T, MMP-3 ?1171 5A/6A, MMP-7 ?181A/G, MMP-9 ?1562C/T and TNF-alpha ?308G/A loci were analyzed. Regarding background factors, significant differences were found in the age, sex ratio and alcohol-drinking and cigarette-smoking histories in the adenoma and cancer groups, compared to those in the control group. On these factors-adjusted logistic regression analysis of polymorphisms and disease susceptibility, no significant difference was noted in the frequency of any polymorphism in the adenoma and cancer groups, compared to those in the control group. The analysis of the involvement of polymorphisms in tumor progression in the adenoma and cancer groups revealed that the odds ratio for the MMP-3 5A allele was significantly higher in the cancer group (2.74; 95% confidence interval = 1.11?6.74, P = 0.02). The polymorphisms of MMP genes and TNF-alpha genes were not associated with the susceptibility to colorectal neoplasm, but the involvement of the MMP-3 5A allele in the progression of adenoma to cancer was suggested

Association of Functional Gene Polymorphisms of Interleukin-1β and Transforming Growth Factor-β1 with the Progression of Liver Fibrosis in Japanese Patients with Hepatitis C Virus-Related Chronic Liver Disease

Interleukin-1β (IL-1β) and interleukin-1 receptor antagonist (IL-1RN) are key cytokines in an inflammatory response, and transforming growth factor β1 (TGF-β1) promotes hepatic fibrogenesis. The association of polymorphisms in the genes for these cytokines with liver fibrosis is controversial. The aim of this study was to examine the possible association of IL-1β, IL-1RN and TGF-β1 polymorphisms with the progression of liver fibrosis in the Japanese population using cross-sectional and longitudinal study designs. We examined 183 patients with hepatitis C virus (HCV)-related chronic liver disease (93 chronic hepatitis and 90 with cirrhosis). Some of the chronic hepatitis cases were divided into progressive fibrosis and non-progressive fibrosis. IL-1β ?31T/C, IL-1RN variable number of tandem repeats (VNTR) and TGF-β1 +869 T/C polymorphisms were analyzed using a polymerase-chain reaction-based assay. In the cross-sectional study, there were no significant differences in the genotype distributions of IL-1β, IL-1RN and TGF-β1 between chronic hepatitis and liver cirrhosis. No significant differences were found among Child-Pugh grades in cirrhosis patients. In the longitudinal study, there were no significant differences in the genotype distributions of IL-1β, IL-1RN and TGF-β1 between progressive fibrosis and non-progressive fibrosis. No significant differences in the speed at which liver fibrosis develop were found among the genotypes of IL-1β, IL-1RN and TGF-β1. In disagreement with other studies, the functional gene polymorphisms of IL-1β, IL-1RN and TGF-β1 were not associated with the progression of liver fibrosis in Japanese patients with HCV-related chronic liver disease

A Comparative Study between CT and Histopathologic Findings of Amyloid Goiter

There are only a few reports describing the imaging features of amyloid goiter with adequate histopathologic correlation. We present a case of amyloid goiter, focusing the correlation between CT and autopsy specimen findings. CT showed diffuse low attenuation areas (40-50 H.U. ) which corresponded to the tissue with dense amyloid deposits. There was also focal areas of very low attenuation which contained the adipose tissue. The latter finding is relatively characteristic for amyloid goiter, because fatty infiltration is known to be frequently associated with amyloid goiter : a rare finding in other disorders