直接的に可溶性グアニル酸シクラーゼ（soluble guanylate cyclase：sGC）を活性化させるsGC刺激薬であるベルイシグアトはNO-sGC-cGMP（nitric oxide-sGC-cyclic guanosine monophosphate）系を標的とする新規慢性心不全治療薬である．第III相臨床試験において主要評価項目である心血管死または心不全入院の複合エンドポイントの発現を有意に減少させた．一方，リスク軽減比が小さい等，予後改善効果について慎重な見方もある．今後，導入に適したタイミングや患者像等について使用経験の蓄積とさらなる検討が期待される．

introduction: tyrosine kinase inhibitors (tkis) were the first drugs to use an intracellular signaling molecule as a therapeutic target. unresponsiveness to tkis limits therapeutic options, making allogeneic hematopoietic stem cell transplantation (hsct) the only option leading to molecular remission. objectives: to characterize cml patients unresponsive to first- and/or second-generation tki t...

hemophiliac patients carry a high risk for blood born viruses particularly hepatitis c virus (hcv) infection. with introducing the new therapeutic modalities for hiv infection, the role of hcv in mortality and morbidity has been more prominent. hiv co-infection is a wellknown factor that accelerates the progression of liver injury leading to end stage liver failure. screening of hemophiliacs ha...

Diastolic dysfunction, which is increasingly viewed as being influential in precipitating heart failure and determining prognosis, is often unrecognized and has therapeutic implications distinct from those that occur with systolic dysfunction. In this review, several therapeutic modalities including pharmacologic, nonpharmacologic, and surgical approaches for primary diastolic dysfunction and h...