journal article

Background The lipid-lowering therapy by statins may stabilize and reduce coronary plaques. We compare the effect of strong or moderate statins on the coronary plaque characteristics by using 64-slice multidetector computed tomography (MDCT). Methods and Results We analyzed 13 subjects with non-calcified coronary plaques(NCP)as determined by MDCT. Pitavastatin(PTV:2mg/day)or pravastatin(PRA:10mg/day)were randomly administered. MDCT were performed at 0, 6 and 12 months after lipid-lowering therapy. In PTV group(n=6),CT density of NCP increased by 35.6 ± 28.8 HU after 6 months(p=0.037)and by 30.6 ± 29.8 HU after 12 months(NS).NCP area was decreased by 35.9 ± 15.2 % after 6 months and by 41.0 ± 16.5 % after 12 months(both P=0.001).In PRA group(n=7),CT density of NCP did not significantly increased after 6 months(NS)and after 12 months(NS).NCP area was not significantly decreased at 6 months(NS),but decreased by 23.1 ± 16.7 % at 12 months(P=0.001). Conclusions Serial CT angiography revealed that the regression of NCP occurs rapidly by strong lipid lowering therapy compared to the moderate statin therapy.

A 78-year-old man underwent distal partial gastrectomy and Billroth I reconstruction for early gastric cancer in May 1995, then was followed up by us. In March 2005, he was found in upper gastrointestinal endoscopy to have an elevated Isp lesion of the duodenum. Histological examination of biopsy specimens showed on inflammatory polyp and no malignancy. After one year of observation, the lesion became a IIa+IIc lesion in upper gastrointestinal endoscopy. Biopsy specimens showed group V and suspected signet-ring cell carcinoma. After further examination, we conducted partial resection of the duodenum. Macroscopically, the 8×6 mm tumor appeared to be a IIa+IIc lesion located in the second portion of the duodenum. The histological diagnosis was signet-ring cell carcinoma, within the membrane, ly0 and v0. The surgical margin was negative. We conducted curative surgery. He is alive without recurrence almost 10years after the operation. Billroth I reconstruction enabled us to diagnose duodenal cancer early in this case.