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Advances in Intravascular Imaging: New Insights into the Vulnerable Plaque from Imaging Studies
Taishi Yonetsu,장익경 대한심장학회 2018 Korean Circulation Journal Vol.48 No.1
The term “vulnerable plaque” denotes the plaque characteristics that are susceptible to coronary thrombosis. Previous post-mortem studies proposed 3 major mechanisms of coronary thrombosis: plaque rupture, plaque erosion, and calcified nodules. Of those, characteristics of rupture-prone plaque have been extensively studied. Pathology studies have identified the features of rupture-prone plaque including thin fibrous cap, large necrotic core, expansive vessel remodeling, inflammation, and neovascularization. Intravascular imaging modalities have emerged as adjunctive tools of angiography to identify vulnerable plaques. Multiple devices have been introduced to catheterization laboratories to date, including intravascular ultrasound (IVUS), virtual-histology IVUS, optical coherence tomography (OCT), coronary angioscopy, and near-infrared spectroscopy. With the use of these modalities, our understanding of vulnerable plaque has rapidly grown over the past several decades. One of the goals of intravascular imaging is to better predict and prevent future coronary events, for which prospective observational data is still lacking. OCT delineates microstructures of plaques, whereas IVUS visualizes macroscopic vascular structures. Specifically, plaque erosion, which has been underestimated in clinical practice, is gaining an interest due to the potential of OCT to make an in vivo diagnosis. Another potential future avenue for intravascular imaging is its use to guide treatment. Feasibility of tailored therapy for acute coronary syndromes (ACS) guided by OCT is under investigation. If it is proven to be effective, it may potentially lead to major shift in the management of millions of patients with ACS every year
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PE-133: Fate of Potential Living Donors for Liver Transplantation
( Taishi Fang ),( Ok-kyung Kim ),( Sanghee Song ),( Ok Soo Kim ),( Curi Ahn ),( Hyeyoung Kim ),( Suk Kyun Hong ),( Kyung Chul Yoon ),( Hyo-sin Kim ),( Hyeyoung Kim ),( Youngrok Choi ),( Hae Won Lee ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: In this study, we aimed to elucidate the fate of potential live liver donors. Methods: From July of 2011 to June of 2013, 372 potential donors were evaluated for 302 matched recipients. Data was prospectively collected. Results: Among 302 recipients, 209 patients received LDLT finally. Among 302 recipients, 53 recipients (17.5%) had more than 1 potential donor. 64.8% of donors was male and 53.5% was children of the recipients. Among 372 potential donors, 209 donors (56.2%) finally received donor hepatectomy for living donation. 159 cases (42.7%) were excluded for various reasons. Among 159 excluded cases, 87 cases were excluded due to donor reasons. The other 72 cases could not donate due to recipient reasons e.g. death, infection or Deceased donor LT. Donor reasons for exclusion consisted of withdrawal of consents (n=25, 28.7%), medical problems (n=24, 27.6%), small remnant volume (n=17, 19.5%), and others (n=21, 24.1%). The main reasons for donor exclusion were medical problem and withdrawal of consent. Therefore, thorough medical clearing and careful examination for donor voluntarism are important in donor evaluation process. Conclusions: The main reasons for donor exclusion were medical problem and withdrawal of consent. Therefore, thorough medical clearing and careful examination for donor voluntarism are important in donor evaluation process.
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Evaluation of physical function in older adults at individual and community levels
( Taishi Tsuji ),( Katsunori Kondo ),( Kenji Tsunoda ),( Jieun Yoon ),( Tomohiro Okura ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1
Purpose: We aimed to develop a novel physical performance test to easily evaluate lower limb muscle function and risk of their functional disability in a clinical setting. Community-level evaluation is also needed to identify a “high-risk community” and to promote a community-level approach for the prevention of functional disability. In this presentation, we will share the outline of our research project evaluating physical function in older adults at individual and community levels. Method: To evaluate physical function, we measured ground reaction force (GRF) during a sit-to-stand movement and calculated two parameters: peak reaction force per body weight and rate of force development per body weight (RFD/w). We investigated the validity of these parameters using data from the Kasama Study. For community-level evaluation, we performed ecological analyses using data from the Japan Gerontological Evaluation Study (JAGES), a nationwide research project including a questionnaire survey on aging, with over 100,000 participants in 2010 and 2013. We calculated the prevalence of physical function decline in 31 municipalities from the JAGES 2010 survey and investigated relevant factors affecting the prevalence. Result: We found that in older adults, two GRF parameters negatively correlated with age, had good criterion-related validity with lower limb muscle strength and power, and had relationships with physical function, history of fall, and ability to perform mobility activities. Further, we found that RFD/w declined with increase in incidences of falls and could predict onset of mobility limitations. Community-level analyses revealed that the prevalence of physical function decline varied from 14.6% to 32.2% in the 31 municipalities. Higher frequencies of participation in sports and hobby groups in a municipality were found to negatively correlate with the prevalence of physical function decline (r = .0.58 and .0.74, respectively). Conclusion: Measuring the GRF parameters during a sit-to-stand movement might provide a better evaluation of an older individual’s physical function, with sufficient validity. Recently, we have developed a specialized weight scale for measuring GRF more easily in a clinical setting. Further, we found that regional variations exist in the physical function of older adults. Community intervention with increasing participation in sports or hobby groups in a community might be an effective way to reduce these variations.
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Yoshii, Taishi,Tomioka, Kenji Korean Society of Photoscience 2002 Journal of Photosciences Vol.9 No.2
In Drosophila melanogaster, it is known that the circadian clock consists of an autoregulatory feedback loop, which includes so-called clock genes, such as per, tim, dClk and cyc and produces periodical expression of per. It is recently suggested, however, that the circadian oscillation without the rhythmical expression of per is involved in the regulation of circadian locomotor rhythms. In the present study, we examined the existence and the property of the possible per-less oscillation using arrhythmic clock mutant flies carrying per$^{01}$, tim$^{01}$, dClk$^{Jrk}$ or cyc$^{01}$. When temperature cycles consisting of 25$^{\circ}$C and 30$^{\circ}$C with varying periods (T = 8~32 hr) were given, they showed rhythms synchronizing with the given cycle under constant darkness (DD). per$^{01}$ and tim$^{01}$ flies always showed a peak around 7 hr after the onset of thermophase irrespective of Ts of temperature cycles, while dClk$^{Jrk}$ and cyc$^{01}$ flies did not. In addition, several days were necessary to establish a clear temperature entrainment in per$^{01}$ and tim$^{01}$ flies, when they were transferred from a constant temperature to a temperature cycle under DD. These results suggest that per$^{01}$ and tim$^{01}$ flies have a temperature-entrainable weak oscillatory mechanism. The fact that dClk$^{Jrk}$ and cyc$^{01}$ flies did not show any sign of the endogenous oscillation suggests that the per-less oscillatory mechanism may require CLK and CYC.
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( Fang Taishi ),( Hong Suk Kyun ),( Lee Kwang-woong ),( Yoon Kyung Chul ),( Kim Hyo-sin ),( Nugroho Adianto ),( Murokawa Takahiro ),( Kim Hyeyoung ),( Yi Nam-joon ),( Suh Kyung-suk ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Mycophenolate mofetil is the most common auxiliary immunosuppressant after liver transplantation to relieve calcineurin inhibitor related complications. There is one type of Cellcept<sup>®</sup> available, but Myrept<sup>®</sup> produced by Chong Kun Dang Company in Korea is available as 500 mg tablet as well as 250 mg capsule. However, there has been no clinical study to assess the feasibility of this generic product. Therefore, we aimed to evaluate the feasibility, cost-effectiveness, and convenience of Myrept<sup>®</sup> 500 mg tablet in recipients after liver transplantation. Methods: A 24 week, phase 4, single center, open-label, non-comparative study was employed. A total of 50 patients were recruited. Acute rejection, changes in blood chemistry, white blood cell count, renal function, adverse drug reaction and other characteristics of the patients were recorded for 24 weeks Results: All enrolled patients and their grafts were survived within 24 weeks. Mean GFR was 119.61 ± 76.52 ml/min at beginning of the study and reached 85.20 ± 23.70 ml/min after 24 weeks and showed a significant decrease overall (p < 0.001).Nine patients (18.75%) had adverse drug reactions which had been commonly reported in other Mycophenolate mofetil generic products, and there was no serious one. These adverse reactions included gastrointestinal problems (nausea, vomiting, and abdominal discomfort), laboratory abnormality (mild increase of aspartate or alanine aminotransferase). The size of Myrept<sup>®</sup> 500 mg tablet is smaller than Myrept<sup>®</sup> 250 mg capsule (17.1 x 7.1 x 6.5 mm vs. 19.18 x 7.23 x 6.40 mm). When comparing the same dose, the cost is less expensive (1,344 Korean won vs. 1,792 Korean won for 500 mg). Conclusions: In conclusion, Myrept<sup>®</sup> 500 mg tablet is feasible, cost-effective, and convenient in recipients after liver transplantation.
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( Kenji Tsunoda ),( Taishi Tsuji ),( Jieun Yoon ),( Tomohiro Okura ) 한국체육학회 2016 국제스포츠과학 학술대회 Vol.2016 No.1
As reflected in the slogan of the American College of Sports Medicine, “Exercise is Medicine,” it is common knowledge that physical activity provides numerous health benefits. This session aims to reconfirm the various health benefits of physical activity and to think a way to encourage physical activity in older adults. Despite the fact that almost all older adults know that physical activity is effective in improving health, physical activity typically decreases with advancing age. A traditional exercise program is effective in improving the health of older adults; however, this type of high-risk approach can be provided to only a proportion of the population, and its effects are usually short lived. A super- aging society requires an intervention that can be expected to provide long-term results across a wide population. Growing evidence indicates that environmental characteristics, such as access to recreational facilities and public transportation, traffic safety, and esthetics, are associated with increased physical activity in older adults. The impact of environmental factors on an individual’s behavior is smaller than traditional high risk approaches, but the approach to environments could have long-term and wide effects. This session introduces recent researches on the relationships of environmental characteristics with physical activity and certain health parameters. As a way to enhance physical activity, the use of active transportation, such as walking and bicycling, has been encouraged. In contrast to Korea, older Japanese adults traditionally cycle, which together with walking is a necessary mode of everyday transport. However, the distances older adults are willing to travel by walking and bicycling is uncertain. This session presents our recent research data on the distances community-dwelling older adults are willing to travel by walking and bicycling.
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