Background:Polaprezinc is clinically used for the treatment of gastric ulcers. It induces the mobilization of mesenchymal stem cells and the mRNA expression of insulin-like growth factor-1 in vascular endothelial cells in order to protect injured gastric tissue or skin.Methods:The current study population included 50 patients with primary acute myocardial infarction (AMI). After percutaneous coronary intervention, the subjects were randomly divided into 2 groups, namely, the nonpolaprezinc and polaprezinc groups. Peripheral blood and urinary samples were collected in a specific time to analyze zinc concentration, cardiac enzymes, and the levels of the inflammation marker interleukin-6. To evaluate the cardiac function, echocardiography was performed upon admission to the hospital and at 9 months post-AMI.Results:The urine and blood zinc levels of the polaprezinc group were higher compared with those of the non-polaprezinc group at 8 days after percutaneous coronary intervention. The mean interleukin-6/maximal creatine phosphokinase level was significantly reduced in the polaprezinc group (0.024 [0.003–0.066] vs. 0.076 [0.015–0.212], respectively; P = .045). In addition, echocardiography revealed that the ejection fraction of the nonpolaprezinc group was not significantly increased between day 3 and 9 months post-AMI (53 [49–60.8] vs. 59.5 [52–69.3], respectively; P = .015). However, a significant increase was detected in the ejection fraction of the polaprezinc group at the 2 time points (54 [51–57] vs. 62 [55–71], respectively; P < .01).Conclusions:The results of the present study suggest that polaprezinc has an anti-inflammatory effect and improves cardiac function after AMI.

Immunoglobulin light-chain (AL) amyloidosis is characterized by the deposition of insoluble fibrils composed of immunoglobulin light chains secreted by monoclonal plasma cells. Given the recent advances in the therapy of AL amyloidosis, it is important to diagnose this disease as early as possible. Herein, we describe the case of a 62-year-old man with hepatitis C virus (HCV)-related cirrhosis presenting with hematochezia. Colonoscopy showed multiple submucosal hematomas within the region ranging from the transverse colon to the sigmoid colon. Kappa immunoglobulin light-chain amyloid deposition was also detected. Bone marrow examination revealed a monoclonal abnormal plasma cell population. Thus, the patient was diagnosed with systemic immunoglobulin light-chain amyloidosis. The hematochezia was conservatively managed. However, because of liver failure caused by liver cirrhosis, the patient developed massive pleural effusion and died of respiratory failure. Postmortem examination revealed amyloid deposition in the esophagus, stomach, duodenum, ileum, descending colon, pancreas, heart, and lung. In these organs, amyloid deposition was limited to the vascular wall. We concluded that AL amyloidosis can present hematochezia arising from submucosal hematoma in the large colon before other systemic symptoms appear.

Background: Intracoronary thrombus followed by a rupture of unstable vulnerable plaque is a well-known cause of acute coronary syndrome (ACS). The no reflow/slow flow phenomenon is sometimes observed during a primary percutaneous coronary intervention (PCI) against ACS. It has already been shown that long inflation using a perfusion balloon (PB) is useful to remediate a coronary perforation. Thus, we investigated the usefulness of a PB for treating ACS. Methods: This study was a retrospective, single-center, observational study. One hundred-seven patients with ACS underwent PCI from January 2015 to December 2017 in our hospital. Fifty patients were treated by PB directly (PB group) and the remaining 57 patients were treated by another conventional balloon (C group). We used the Ryusei  balloon (Kaneka, Japan) as a PB. The clinical outcome was the incidence of the no reflow or slow flow phenomenon, the incidence of using IABP. Results: One patient in the PB group demonstrated slow flow phenomenon temporarily, and the coronary flow was quickly restored by thromboaspiration. In contrast, nine patients in the C group had occurrences of no reflow/slow flow phenomenon. Although all patients in the C group required stenting, some patients (24%) of the PB group did not require stenting. Conclusion: We found that the use of PB had a favorable effect on the treatment of ACS. Some patients completed PCI without a need for stenting.

An 89-year-old woman was introduced and followed up at our hospital office after being treated by antibiotics including ampicillin (ABPC) against infective endocarditis (IE) in another hospital. Although her CRP was in the negative range at first, her procalcitonin (PCT) was slightly positive in her blood exam. Then, she had a recurrence with high fever 1 week after the ABPC medication was stopped, and the patient was admitted into our hospital. Immediately, we started to administrate some antibiotics based on a result of blood culture of bacteria. Finally, both the CRP and the PCT showed negative 28 days after the beginning of the treatment. The feverish state was not observed even after the medication was finished. In the second case, a 77-yearold man with high fever was admitted in our hospital and diagnosed with IE by transesophageal echocardiography. The antibiotic therapy was started and the fever was gradually declined. The only CRP became negative 14 days after the beginning of the medication. Finally both the CRP and the PCT was completely negative at 21 days. It is possible that the PCT should be an appropriate marker for the treatment of IE compared to CRP.

<p><span style="font-size: medium;"><strong>Background:</strong> The fractional flow reserve (FFR) has been established as a physiological tool for the assessment of coronary ischemia. The instantaneous wave-free ratio (iFR) is an alternative pressure-derived physiologic index from the diastolic wave-free period in stable conditions. The hyperemic iFR (h-iFR) may represent a diagnostic tool; however, its diagnostic performance is unclear. Thus, we aimed to assess the diagnostic performance of the h-iFR compared with the conventional whole-cycle FFR. </span></p><p><span style="font-size: medium;"><strong>Methods:</strong> Fifty consecutive lesions, which were diagnosed as 50-75% stenosis by coronary angiography, were analyzed regarding the h-iFR and FFR during the intravenous administration of adenosine using a pressure wire. The h-iFR and FFR were calculated via automated algorithms.</span></p><p><span style="font-size: medium;"><strong>Results:</strong> Twenty-two stenoses were positive (FFR ≦0.8), and 28 stenoses were negative (FFR &gt;0.8). The slope of the regression line was 1.28 in the positive group and 1.61 in the negative group. The FFR and h-iFR values ranged from 0.64 to 0.80 (0.75±0.04) and 0.52 to 0.82 (0.66±0.07), respectively, in the positive group and 0.81 to 1.02 (0.90±0.05) and 0.69 to 1.02 (0.87±0.08), respectively, in the negative group. The means of the differences between the FFR and h-iFR were 0.027 and 0.090 in the FFR positive and negative groups, respectively. </span></p><p><span style="font-size: medium;"><strong>Conclusions:</strong> The hyperemic iFR, which is calculated using the diastolic phase and exhibited a larger dynamic range than the FFR, especially in FFR-positive stenosis, may be a better physiological tool than the cardiac full-cycle FFR in the evaluation of coronary ischemia.</span></p><strong><br clear="all" /> </strong>