A reliable noninvasive method for assessing plaque configuration would constitute an important tool for predicting myocardial injury following percutaneous coronary intervention (PCI) . Multislice computed tomography (MSCT) shows promise in differentiating coronary lesion configurations. However, it is not clear whether the characteristics of coronary artery plaques measured by MSCT can predict complications after PCI. The aim of this study was to investigate the relationship between plaque configuration and complications following coronary intervention in patients with stable angina pectoris. MSCT was performed prospectively in patients with angina pectoris who were scheduled for PCI. Twenty-six patients (age ; 70 ± 11 years, 18 male patients) with coronary artery plaque stenosis, as measured by MSCT, were recruited in this study. Thirty-five plaques forming stenotic coronary lesions were divided into 3 groups on the basis of their MSCT-calculated densities; soft, intermediate, and hard. We investigated the association between these groups and complications following PCI. The soft plaque group (n =11) was significantly associated with the appearance of slow flow (n = 4) or side branch compromise (n =1) following PCI, whereas the hard plaque group (n =17) was associated with the appearance of dissection (n = 2) or perforation (n =1) following PCI (P = 0.004) . The intermediate plaque group (n = 7) had only one complication of side branch compromise (n = 1) . Coronary arterial plaque characterized by MSCT can predict coronary events following PCI. Plaque configuration by MSCT may be important for risk stratification of patients prior to scheduled PCI.

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With an ever-increasing aged population in our society, the number of elderly patients with gastric cancer has not surprisingly been increasing. We conducted this study to evaluate the safety and efficacy of TS-1-based chemotherapy in elderly patients, i.e. those over 75 years of age, for whom little evidence had previously been collected. Between November 2002 and Novem-ber 2005, 11 elderly patients who received TS-1-based chemotherapy as the first-line treatment were divided into two groups : (1) TS-1 therapy group [One course consisting of consecutive administration for 4 weeks and 2 weeks rest.] and (2) the combined TS-1 + CDDP therapy group [One course consisting of consecutive administration for 3 weeks and 2 weeks rest, in combination with CDDP, 60 mg/m², on Day 8 of each course.] For each group, TS-1 was given orally, twice daily after meals, and the dose of TS-1 was determined on the basis of estimated creatinine clearance. The response rate was 45.5%. Adverse events with severity of grade 3 or higher were seen in only one case (anorexia) . The median survival time (MST) was 244 days. The MST for the group with a performance status of 0-1 (P50-1; 323 days) was significantly longer than that for the PS2-3 group (131 days) . TS-1-based chemotherapy for elderly patients with gastric cancer who have a good performance status has an efficacy comparable to that previously seen in adult patients.

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The ability to precisely characterize myocardial tissue using ultrasound would be of great diagnostic value. In this study we developed and tested a method for calculating sound speeds in biological tissues using reflecting ultrasound. This noncontact method avoids the modification of acoustic characteristics that can occur with tissue compression or deformation. We measured sound speeds in silicone rubber to evaluate precision and reproducibility. Sound speeds were also measured in freshly resected rat myocardia and in formalin-fixed samples. The technique was found to be precise and highly reproducible. Mean sound speeds in fresh rat myocardia ranged from 1583.2 to 1594.0 m/s. The standard deviations of individual samples ranged from 1.5 to 7.5 m/s. Formalin fixation had minimal influence on sound speed. These findings enabled us to establish standard sound speeds for normal rat myocardia, which could be used in further development of the technique for analysis of abnormal tissue.

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The ryanodine receptor type 1 (RyR1) is an intracellular calcium ion (Ca²⁺) release channel in the endoplasmic reticulum (ER) . Onefifth of the total 5, 037 amino acids of full-length RyR1 at the carboxyl (C) -terminus contains the transmembrane segments of the calcium ion channel, while the amino (N) -terminus is located in the cytoplasm and is referred to as the foot structure. In the present study the proposed structure of RyR1 was investigated by dividing the full-length cDNA of RyR1 into 11 cassettes (Csl-11) and expressing each cassette as a fusion protein with enhanced green fluorescent protein (EGFP) in Chinese hamster ovary (CHO) cells. Like full-length of RyR1, the C-terminal (4772 Asp to 5037 Ser), N-terminal (1st Met to 184 Thr encoded by Csl) and central regions (1743 Arg to 3224 Pro encoded by Cs5, 6 and 7) of RyRI remain in the cytoplasmic compartment following plasma membrane permeabilization. The remaining regions of RyR1, encoded by Cs2, 3, 4, 8, 9 and 10, leak out following membrane permeabiliza-tion. These results indicate the presence of at least four signaling sequences within the N-terminal, central or C-terminal regions of RyR1 responsible for ER retention.

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Cardiac sympathetic nervous system abnormality can predict sudden cardiac death due to arrhythmia. However, it is unknown whether the sympathetic nerve abnormality is related to the origin of tachyarrhythmia. We hypothesized that such a relationship exists and tested it by uptake of iodine-123 metaiodobenzylguanidine (¹²³I-MIBG) in 184 patients (mean ± standard deviation, age : 52.7 ± 18.8 years, 106 males) with a history of paroxysmal palpitation. Patients with organic heart disease or left ventricular dysfunction were excluded. Cardiac sympathetic nerve abnormality was assessed from the heart l mediastinum (H / M) later index and washout ratio (WR) . Sustained ventricular tachycardia (VT) in 46 patients and sustained supraventricular tachycardia (SVT) in 103 patients were diagnosed by ECG during onset of arrhythmia or by electrophysiologic tests employing programmed cardiac stimulation. The tachyarrhythmia was not proven in 35 patients (Control groups) . The H I M index was significantly lower and WR significantly higher in tachyarrhythmia groups compared to controls (H I M index : 2.75 ± 0.55 in VT group, 3.01 ± 0.78 in SVT group vs. 3.34 ± 0.48 in control group, p < 0.001 and p < 0.05, WR : 39.6 ± 12.1% in VT group, 38.1 ± 8.5% in SVT group vs. 34.2 ± 6.8% in Control group, p < 0.05 in each) . The mean H / M index was lower in the VT group than the SVT group (p < 0.05) . Cardiac sympathetic nerve abnormality thus predicts the origin of tachyarrhythmia, and we propose ¹²³I-MIBG scintigraphy as an important tool to discriminate the life-threatening tachyarrhythmia from benign episodes in patients with a history of palpitation.

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