[The drug use results survey of Adenoscan injection 60 mg].

To investigate the safety and efficacy of Adenoscan injection 60 mg (adenosine), a pharmacologic stress agent that can be used for coronary vasodilation in patients unable to exercise adequately, the drug use results survey was conducted by consecutive patients-survey method in 166 nationwide medical institutes from 2006 to 2008. Adverse drug reactions (ADRs) occurred at the rate of 16.0% (343/2,150 patients), most of which disappeared shortly with no need for treatment. Major ADRs were chest discomfort at the rate of 4.9%, chest pain 2.0%, atrioventricular block 1.8% and dyspnea 1.4%. There were no differences in the incidences of ADRs between the elderly and the non-elderly. The overall efficacy rate was 97.9% (2,104/2,150 patients) according to the efficacy judgment of each primary physician. The sensitivity, specificity and diagnostic accuracy of myocardial perfusion scintigraphy in 608 patients who underwent coronary angiography were 70.8%, 58.1% and 65.0%, respectively. We conclude that adenosine stress is safe and useful for myocardial perfusion scintigraphy to detect ischemic heart disease for patients who are unable to exercise adequately.

Multicenter prospective investigation on efficacy and safety of carperitide as a first-line drug for acute heart failure syndrome with preserved blood pressure: COMPASS: Carperitide Effects Observed Through Monitoring Dyspnea in Acute Decompensated Heart Failure Study.

BACKGROUND: Recently, vasodilators have been increasingly being recognized as useful for the treatment of acute heart failure syndromes (AHFS). Although carperitide (alpha-human atrial natriuretic peptide) has vasodilatory, diuretic and organ-protective effects, its efficacy and safety for the first-line drug treatment of AHFS have not been reported. METHODS AND RESULTS: A prospective observational study was performed in AHFS patients with preserved systolic blood pressure (SBP >or=120 mmHg), pulmonary congestion and dyspnea who were receiving carperitide monotherapy. The analysis was conducted in 1,832 patients (male: 52.7%; mean age: 75.1+/-12.7 years). The initial SBP was 151.1+/-25.7 mmHg; 62.0% were diagnosed as having acutely decompensated chronic heart failure and 78.8% were assessed as functional class III-IV according to New York Heart Association classification. Carperitide was administered at an initial dosage of 0.025-0.05 microg x kg(-1) x min(-1) in 50.4% of patients. In 1,524 patients (83.2%), carperitide monotherapy restored the acute phase and improved the degree of dyspnea as assessed using the modified Borg scale. The incidence of adverse drug reactions was 4.64%; the most frequently reported adverse reaction was hypotension (3.55%). CONCLUSION: In the present study, following carperitide monotherapy, 83.2% of AHFS patients recovered from the acute phase. Based on these findings, carperitide seems useful for the first-line drug treatment of AHFS in patients with pulmonary congestion and preserved blood pressure.

Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. A detailed evaluation with comparison of single- and double-tendon harvest.

BACKGROUND: The advantages of hamstring tendon autografts for anterior cruciate ligament reconstruction are well known; however, concerns have arisen regarding the influence of hamstring tendon harvest on postoperative weakness in knee flexion. PURPOSE: To evaluate the influence of hamstring tendon harvest on knee flexion strength in patients undergoing anterior cruciate ligament reconstruction. STUDY DESIGN: Prospective randomized study. METHODS: Ninety patients were randomly assigned at surgery to undergo anterior cruciate ligament reconstruction with either a semitendinosus tendon autograft or a semitendinosus and gracilis tendon autograft. Quadriceps and hamstring muscle strength was tested before surgery and at 6, 12, and 18 months after surgery. RESULTS: There was no significant difference in clinical results between the groups and neither group showed a significant decrease in isokinetic hamstring muscle strength. However, when the subjects' knees were at positions of 70 degrees or more of flexion, both isokinetic and isometric measurements revealed a significant decrease in hamstring muscle strength in both groups. The strength in the group with semitendinosus and gracilis tendons was considerably less than that in the group with semitendinosus tendon alone at 18 months. CONCLUSIONS: Tendon harvest causes significant weakness of hamstring muscle strength at high knee flexion angles, but such weakness can be minimized if the gracilis tendon is preserved.