chocardiography is now recognized as an integral diagnostic tool that enables noninvasive quantification of cardiac chamber size, ventricular mass, and function in the clinical setting. Furthermore, technological advancement in Doppler echocardiography enables quantitative assessment of ventricular diastolic function as well as systolic function. Thus, echocardiography has become an important cardiac imaging technique in a number of clinical trials evaluating the efficacy of drug treatments or new therapeutic strategies.A guideline for quantifying cardiac chamber size and function using echocardiography, and references values for Circulation Journal Vol.72, November 2008 these echocardiographic measurements, were provided by the American Society of Echocardiography in conjunction with the European Association of Echocardiography. 1 Likewise, Doppler echocardiographic criteria for assessing left ventricular (LV) diastolic function were provided by the Canadian Consensus, 2 European 3 and American Medical Association guidelines, 4 and diastolic function parameters were reported to decline gradually with age. 5 However, most of these data are derived from American and European populations and because physical 6,7 and racial 8-10 differences can influence cardiac chamber size and function, it is important to evaluate the echocardiographic parameters in other populations. Reference values based on a large Asian population have not been previously reported, although some investigators have reported these values in a small population. 11 In addition, most studies that have investigated the relationship between age and cardiac chamber size and function have focused on a few parameters and have not assessed all of them in a large population.Accordingly, we designed and conducted a multicenter study, the Japanese Normal Values for Echocardiographic Measurements Project (JAMP) study, to determine the normal values for echocardiographic measurements and evaluate the relationship between these parameters and age in a large, healthy Japanese population. J 2008; 72: 1859 -1866 (Received February 27, 2008 revised manuscript received June 11, 2008; accepted June 26, 2008; released online September 29, 2008) Circ

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Significant functional MR and TR are seen in a substantial proportion of patients with longstanding AF, despite preserved LVEF. This MR/TR combination predicts poor outcome for AF patients, who may have to be treated more intensively.

Adequate venous outflow is the most important factor for successful fingertip replantation. The authors have attempted venous anastomosis in all cases of fingertip replantation to overcome postoperative congestion. In this article, the significance of venous repair for fingertip replantation is described from the authors' results of 64 complete fingertip amputations in 55 consecutive patients, which were replanted from January of 1996 to June of 2001. The overall survival rate was 86 percent. Of the 44 replantations in zone I, 37 survived, and the success rate was 84 percent. Of the 20 replantations in zone II, 18 survived, and the success rate was 90 percent. Venous anastomosis was attempted in all cases, but it was possible in 39 zone I and in all zone II replantations. For arterial repair, vein grafts were necessary in 17 of the 44 zone I and in one of the 20 zone II replantations; for venous repair, they were necessary in six zone I replantations and one zone II replantation. Postoperative vascular complications occurred in 15 replantations. There were five cases of arterial thrombosis and 10 cases of venous congestion. Venous congestion occurred in nine zone I and one zone II replantations. In five of these 10 replantations, venous anastomosis was not possible. In another five replantations, venous outflow was established at the time of surgery, but occlusion occurred subsequently. Except for the five failures resulting from arterial thrombosis, successful venous repair was possible in 49 of 59 replantations (83 percent). Despite the demand for skillful microsurgical technique and longer operation time, the authors' results using venous anastomosis in successful fingertip replantations are encouraging. By performing venous anastomosis, external bleeding can be avoided and a higher survival rate can be achieved. Venous anastomosis for fingertip replantation is a reliable and worthwhile procedure.

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This study demonstrated that ART-123 inhibits the expression of inflammatory cytokines and decreases the plasma HMGB1 levels in experimental endotoxemia. In addition, ART-123 administration markedly reduced liver dysfunction and mortality even with delayed treatment of ART-123. The use of ART-123 may therefore be a beneficial treatment for septic patients.

Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ender-based differences in the management and outcomes of cardiovascular disease have been studied extensively. 1-4 In women, heart failure (HF) is associated more with left ventricular (LV) diastolic dysfunction than in men, whereas LV systolic dysfunction is the predominant cause of HF in men. 5-8 In particular, elderly women frequently have HF associated with a normal LV ejection fraction. 2 Recent studies have also emphasized the importance of gender differences in the management of cardiovascular disease. 1,8,9 Thus, recognition of gender difference in LV geometry and function has important implications for the optimal diagnosis and management of cardiovascular disease. Background: The purpose of the present study was to investigate gender differences in age-related changes of left ventricular (LV) and right ventricular (RV) geometries and functions throughout the entire adult age range using the Japanese Normal Values for Echocardiographic Measurements Project (JAMP) study database.

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