[Background] Percutaneous coronary intervention (PCI) is useful for the treatment of coronary artery disease (CAD). The clinical outcome of the follow-up PCI revealed that the incidence of CAD (de novo lesion) still remained. This new lesion is considered to be the atheroma caused by the intimal injury incurred during the PCI procedure. We evaluated the therapeutic effect of LDL-apheresis on CAD after PCI retrospectively. [Method] The subjects were 11 familial hyperchoresterolemic patients (FH) who underwent LDL-apheresis (LA-15) monthly for 5 years and whose stenotic lesions (AHA Type B and/or C) matched 32 patients (C) who underwent conventional therapy. All patients underwent the first PCI and, within the following 5 years, all of the segments were evaluated by coronary angiograpy. The atheromatous lesion was recognized as a minimal lesion in diameter and was defined according to the segment criteria by AHA. After a 5-year follow-up, the incidence of cardiac events such as angina, myocardial infarction and cardiac death, the incidence of de novo lesions and the incidence of restenotic lesions following PCI were evaluated between two groups. [Results] The incidence of the cardiac events was significantly lower in FH (27.3% vs 56.2%). In FH, de novo lesions were only 4 segments; however, in C, de novo lesions were 16 segments. [Conclusion] These clinical outcomes suggest that LDL-apheresis therapy may be useful for reducing CAD following PCI.

[Background and Purpose] Low density lipoprotein(LDL) apheresis is one type of therapy that is currently being used for the treatment of coronary arterial disease. However, there have been few studies made to clarify the effectiveness of LDL apheresis on arteriosclerosis obliterans (ASO). In this study, we evaluated the clinical features of ASO during consecutive LDL apheresis treatment. [Methods] Five patients who were excluded from the treatment of intervention and surgery, were introduced to treatment of LDL apheresis. For each of the those five patients, we measured the temperature of the toe next to the large toe by thermograph, popliteal arterial blood flow by the Doppler Method, and ankle pressure index(API) by Matsuo's Method, and then evaluated the results of those measurements. The patients received LDL apheresis therapy once a week for ten consecutive weeks. [Results] All five patients showed significant improvement in temperature and API (Table).Table[Conclusion] LDL apheresis therapy improved peripheral circulation markedly and, therefore, maybe a good therapeutic choice of treatment for ASO.

Low density lipoprotein (LDL) apheresis is one type of therapy currently being used for coronary artery disease; however, there has been no study to compare the effectiveness of this therapy with the effectiveness of other treatments, such as coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA). In this study, we evaluated the clinical results of these three therapies to compare their individual effectiveness for the treatment of coronary artery disease. Forty-four patients with two vessel disease (plasma cholesterol levels > 250 mg/dl) were divided into three groups (L, LDL apheresis; C, CABG; I, PTCA). After 2 years' observation, the coronary artery findings were evaluated by quantitative coronary angiography (QCA), frequency of cardiac events, changes in plasma lipids, and subjective symptoms, and the cost was examined. The symptoms of patients in Groups C and I showed significant improvement when compared with those of Group L. In Group L, the frequency of cardiac events was low (L, 0%; P, 44%; C, 14%), and lipid reduction was marked (L, 48%; P, 13%; C, 14%); however, the cost of this therapy is much more than the other therapies. There was no difference in the minimal luminal diameter evaluated by QCA in the three groups. LDL apheresis may be a good strategy for coronary disease, if its cost can be improved.

Primary hepatic actinomycosis is rare, and there have been few reports concerning its nuclear imaging findings. Two cases of actinomycosis, in which hypervascular hepatic masses were observed in the arterial phase of radionuclide angiography are reported. To the authors' knowledge, this finding has not been reported in the literature. In one of the two cases, intense Ga-67 uptake also was noted. Although the preoperative diagnosis based on the findings of nuclear imaging (liver scan, liver flow study, Ga-67 scan), ultrasound, CT, and angiography was hepatoma, hepatic masses in our cases proved to be hepatic actinomycosis. Because hepatic actinomycosis is rare, this disease is neglected often in the differential diagnosis of hepatic mass lesions. It should be included in the gamut of hypervascular hepatic mass lesions.

False-positive liver scans may occur due to intrinsic hepatic anatomy, extrinsic impression on the liver from adjacent structures, or external attenuation of gamma rays. However, reports of false-positive scans due to external attenuation by pulmonary nodules are very few, and postoperative changes in liver scintigraphy have not been reported. We experienced three such cases. In each case, a pulmonary mass was located in the right posterior basal segment. The preoperative liver scan showed a focal "cold" area in the upper portion of the right lobe. This "cold" area was seen only in the posterior view, and after resection of the tumor it usually disappeared promptly unless direct liver invasion was present.