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Takasaki A, Hashimoto M, Fukuhara R, Sakuta S, Koyama A, Ishikawa T, Boku S, Ikeda M, Takebayashi M. Gesture imitation performance in community-dwelling older people: assessment of a gesture imitation task in the screening and diagnosis of mild cognitive impairment and dementia. Psychogeriatrics 2024; 24:404-414. [PMID: 38290836 DOI: 10.1111/psyg.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Gesture imitation, a simple tool for assessing visuospatial/visuoconstructive functions, is reportedly useful for screening and diagnosing dementia. However, gesture imitation performance in healthy older adults is largely unknown, as are the factors associated with lower performance. To address these unknowns, we examined the gesture imitation performance of a large number of community-dwelling older adults aged ≥65 years in Arao City, Kumamoto Prefecture (southern Japan). METHODS The examiner presented the participants with eight gesture patterns and considered it a success if they could imitate them within 10 s. The success rate of each gesture imitation was calculated for three diagnostic groups: cognitively normal (CN) (n = 1184), mild cognitive impairment (MCI) (n = 237), and dementia (n = 47). Next, we reorganised the original gesture imitation battery by combining six selected gestures with the following scoring method: if the participants successfully imitated the gestures, immediately or within 5 s, two points were assigned. If they succeeded within 5-10 s, one point was assigned. The sensitivity and specificity of the battery were investigated to detect the dementia and MCI groups. Factors associated with gesture imitation battery scores were examined. RESULTS Except one complex gesture, the success rate of imitation in the CN group was high, approximately 90%. The sensitivity and specificity of the gesture imitation battery for discriminating between the dementia and CN groups and between the MCI and CN groups were 70%/88%, and 45%/75%, respectively. Ageing, male sex, and a diagnosis of dementia or MCI were associated with lower scores on the gesture imitation battery. CONCLUSION Gesture imitation tasks alone may not be sufficient to detect MCI. However, by combining gestures with set time limits, gesture imitation tasks can be a low-burden and effective method for detecting dementia, even in community medicine, such as during health check-ups.
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Affiliation(s)
- Akihiro Takasaki
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Ryuji Fukuhara
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shizuka Sakuta
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Asuka Koyama
- Faculty of Social Welfare, Kumamoto Gakuen University, Kumamoto, Japan
| | | | - Shuken Boku
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Taomoto D, Sato S, Kanemoto H, Suzuki M, Hirakawa N, Takasaki A, Akimoto M, Satake Y, Koizumi F, Yoshiyama K, Takahashi R, Shigenobu K, Hashimoto M, Miyagawa T, Boeve B, Knopman D, Mori E, Ikeda M. Utility of the Japanese version of the Clinical Dementia Rating® plus National Alzheimer's Coordinating Centre Behaviour and Language Domains for sporadic cases of frontotemporal dementia in Japan. Psychogeriatrics 2024; 24:281-294. [PMID: 38152057 DOI: 10.1111/psyg.13072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/07/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND We aimed to validate the Clinical Dementia Rating (CDR®) dementia staging instrument plus the National Alzheimer's Coordinating Centre Behaviour and Language Domains (CDR® plus NACC FTLD) for use in clinical settings in Japan and in the Japanese language. METHODS This prospective observational study enrolled 29 patients with frontotemporal dementia (FTD) and 21 patients with Alzheimer's disease (AD) dementia from the Departments of Psychiatry at Osaka University Hospital and Asakayama General Hospital and the Brain Function Centre at Nippon Life Hospital. CDR® plus NACC FTLD, CDR®, Mini-Mental State Examination (MMSE), Western Aphasia Battery (WAB), Neuropsychiatric Inventory-plus (NPI-plus), Stereotypy Rating Inventory (SRI), and frontal behavioural symptom scores obtained from items of NPI-plus and SRI, were conducted to assess inter- and intra-rater reliability, validity, and responsiveness. We performed receiver operating characteristic (ROC) curve analysis to evaluate the discriminating power of the Behaviour/Comportment/Personality (BEHAV) and Language (LANG) domains of the CDR® plus NACC FTLD and the MEMORY domain of the CDR® in patients AD dementia and FTD. RESULTS The CDR® plus NACC FTLD showed good inter- and intra-rater reliabilities. In patients with FTD, the BEHAV domain of the CDR® plus NACC FTLD was significantly correlated with all clinical measures except for the SRI total score, while the LANG domain of the CDR® plus NACC FTLD was significantly correlated with the MMSE and the WAB-Aphasia quotient. In addition, the CDR® plus NACC FTLD sum of boxes significantly changed after 6 months and after 1 year. ROC curve analysis showed that the BEHAV and LANG domains of the CDR® plus NACC FTLD distinguished between patients with AD dementia and FTD better than the MEMORY domain of the CDR®. CONCLUSIONS This study validated the Japanese version of the CDR® plus NACC FTLD with good reliability, validity, and responsiveness.
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Affiliation(s)
- Daiki Taomoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunsuke Sato
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Psychiatry, Esaka Hospital, Suita, Japan
| | - Hideki Kanemoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Maki Suzuki
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Natsuho Hirakawa
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Akihiro Takasaki
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Miu Akimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuto Satake
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fuyuki Koizumi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Yoshiyama
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Rei Takahashi
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
| | - Kazue Shigenobu
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Department of Psychiatry, Asakayama General Hospital, Sakai, Japan
| | - Mamoru Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley Boeve
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Etsuro Mori
- Department of Behavioural Neurology and Neuropsychiatry, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
- Brain Function Centre, Nippon Life Hospital, Osaka, Japan
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Kirii Y, Kurita T, Morita K, Kasai Y, Unno K, Takasaki A, Ishiyama M, Terashima M, Emi Y, Dohi K. Unique Case of Coronary Artery Rupture and Acute Myocardial Infarction Triggered by a Karate Punch: Evaluation of the Hit Site by CT Imaging. Circ Cardiovasc Imaging 2024; 17:e016343. [PMID: 38436111 DOI: 10.1161/circimaging.123.016343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Affiliation(s)
- Yosuke Kirii
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
| | - Kae Morita
- Department of Cardiology, Ise Municipal General Hospital, Ise, Japan (K.M., K.U., Y.E.)
| | - Yosuke Kasai
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
| | - Kohei Unno
- Department of Cardiology, Ise Municipal General Hospital, Ise, Japan (K.M., K.U., Y.E.)
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
| | - Masaki Ishiyama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
| | | | - Yoshiharu Emi
- Department of Cardiology, Ise Municipal General Hospital, Ise, Japan (K.M., K.U., Y.E.)
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan (Y. Kirii, T.K., Y. Kasai, A.T., M.I., K.D.)
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4
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Takasaki A, Terashima M, Suzuki T. The importance of accurate diagnosis of myocardial infarction with nonobstructive coronary arteries to prevent unnecessary coronary intervention. Cardiovasc Revasc Med 2024; 59:109-110. [PMID: 37775454 DOI: 10.1016/j.carrev.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Akihiro Takasaki
- Toyohashi Heart Center, 21-1 Gobutori Ooyamacho, Toyohashi, Aichi, Japan
| | | | - Takahiko Suzuki
- Toyohashi Heart Center, 21-1 Gobutori Ooyamacho, Toyohashi, Aichi, Japan.
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5
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Takasaki A, Kurita T, Hirota Y, Uno K, Kirii Y, Ichikawa M, Ishiyama M, Terashima M, Nakajima A, Dohi K. Isolated Coronary Arteritis Treated With FDG-PET/CT-Guided Immunosuppressant to Break the Vicious Cycle of In-Stent Restenosis. JACC Case Rep 2023; 28:102102. [PMID: 38204559 PMCID: PMC10774826 DOI: 10.1016/j.jaccas.2023.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 01/12/2024]
Abstract
Recurrent in-stent restenosis of the coronary artery is a rare but intractable problem. In this situation, coronary arteritis should be considered as an etiology. This case highlights the use of immunosuppressive drugs, including tocilizumab, and follow-up F-18-fluorodeoxyglucose positron emission tomography/computed tomography to break the vicious circle of recurrent stenosis caused by isolated coronary arteritis of unknown cause.
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Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yumi Hirota
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kenta Uno
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yosuke Kirii
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Mizuki Ichikawa
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masaki Ishiyama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | | | - Ayako Nakajima
- Center for Rheumatic Diseases, Mie University Hospital, Tsu, Mie, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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6
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Mori H, Kurita T, Takasaki A, Dohi K. Plaque characterization of a saphenous vein graft by near-infrared spectroscopy and histopathology in a patient with a percutaneous coronary intervention. Catheter Cardiovasc Interv 2023; 101:1071-1073. [PMID: 36950828 DOI: 10.1002/ccd.30641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/12/2023] [Accepted: 02/25/2023] [Indexed: 03/24/2023]
Abstract
Near-infrared spectroscopy (NIRS) is an intravascular imaging (IVUS) modality that detects lipid core plaques in the vessel wall, which are regarded as high-risk plaques for distal embolization in percutaneous coronary interventions (PCI). Saphenous vein graft (SVG) lesions have friable lipid-rich plaques and thrombus prone to distal embolization. The plaque characterization of SVG by NIRS was confirmed herein for the first time with histopathology before and after PCI. The present case was a man in his 60 s with a history of coronary artery bypass graft surgery. Coronary angiography revealed severe stenosis in multiple segments of the SVG to left circumflex artery (LCX). NIRS IVUS showed large amounts of lipidic materials at each segment before PCI. After balloon dilatation, NIRS IVUS revealed a marked reduction in yellow signals on chemography. A histopathological analysis of the captured specimen showed that it was mainly composed of fibrin and contained numerous histiocytes with foam cells, lymphocytes, and other cells, which was consistent with the histopathological findings of plaque rupture.
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Affiliation(s)
- Hiroki Mori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
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7
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Takasaki A, Kurita T, Yanagisawa M, Ino A, Hiramatsu D, Ikmi A, Ito H, Kato T, Fukuoka S, Sugimoto T, Nakata T, Masuda J, Tanabe M, Kakimoto H, Dohi K. Impact of in-hospital medical management for COVID-19 pandemic on door-to-balloon time in patients with ST-elevation myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Delayed door-to-balloon (DTB) time and deterioration of in-hospital mortality during the coronavirus disease 2019 (COVID-19) pandemic have been reported. Little is known about the impact of changes in in-hospital medical management before primary percutaneous coronary intervention (PCI) for COVID-19 such as screening test (antigen or polymerase chain reaction (PCR) tests, chest CT for excluding the pneumoniae) and primary PCI under full personal protective equipment (PPE) on DTB time and in-hospital mortality.
Purpose
The purpose of this study was to evaluate the impact of in-hospital medical management for COVID-19 on DTB time and in-hospital mortality during COVID-19 pandemic period.
Methods
We compared DTB time and in-hospital mortality of 502 ST-elevation myocardial infarction (STEMI) patients during COVID-19 pandemic (February 2020 and January 2021) with 2035 STEMI patients before pandemic (February 2016 and January 2020) using date from Mie ACS registry, a retrospective and multicenter registry.
Results
The COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was performed on 173/502 (34.5%) patients (antigen or PCR tests; 39 (7.8%), chest CT; 156 (31.3%), full PPE; 11 (2.2%)). These patients had lower rate of achievement of DTB time ≤90 min compared with others (Figure 1A). Moreover, In-hospital management of COVID-19 screening tests and/or primary PCI under full PPE was an independent factor of DTB time>90 min with odds ratio of 1.94 (95% confidential interval: 1.37–2.76, p<0.001). In addition, in-hospital mortality of those patients was higher compared with others (Figure 1B).
Conclusion
In-hospital medical management for COVID-19 screening tests before primary PCI and/or primary PCI under full PPE was the independent factor of DTB time>90 min. This study reinforces the need to focus efforts on shortening DTB time, while controlling the epidemic of infection.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital , Tsu , Japan
| | | | - A Ino
- Ise City Red Cross Hospital, cardiology , Ise , Japan
| | - D Hiramatsu
- Matsusaka chuo general hospital , matsusaka , Japan
| | - A Ikmi
- Suzuka chuo general hospital , Suzuka , Japan
| | - H Ito
- Mie University Hospital , Tsu , Japan
| | - T Kato
- Mie prefectural general medical center , yokkaichi , Japan
| | - S Fukuoka
- mie chuo medical center , tsu , Japan
| | | | | | - J Masuda
- Mie prefectural general medical center , yokkaichi , Japan
| | - M Tanabe
- Mie University Hospital , Tsu , Japan
| | - H Kakimoto
- saiseikai matsusaka general hospital , matsusaka , Japan
| | - K Dohi
- Mie University Hospital , Tsu , Japan
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8
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Takasaki A, Kurita T, Yanagisawa M, Ino A, Hiramatsu D, Ikami A, Ito H, Kato T, Fukuoka S, Sugimoto T, Nakata T, Masuda J, Tanabe M, Kakimoto H, Dohi K. Demographic Trends and Changes in the Pre- and In-Hospital Medical Management of Acute Myocardial Infarction During the First 12 Months of the COVID-19 Pandemic in Mie Prefecture ― Report From the Mie ACS Registry ―. Circ Rep 2022; 4:412-421. [PMID: 36120481 PMCID: PMC9437476 DOI: 10.1253/circrep.cr-22-0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/09/2022] Open
Abstract
Background: Even though hospital admissions for acute myocardial infarction (AMI) decreased globally during the COVID-19 pandemic in early 2020, limited information is available on subsequent demographic trends in the number of cases and management of AMI through the first 12 months of the COVID-19 pandemic. Methods and Results: We assessed demographic trends, patient characteristics, and AMI outcomes (n=730) during the first 12 months of the COVID-19 pandemic and compared them with corresponding months during the control period (February 2016–January 2020; n=2,742) using data from the Mie ACS Registry. Although a 25.8% reduction in hospitalizations for AMI was observed in the 3 months following the declaration of a state of emergency (47.7 vs. 64.3/month; P=0.002), the total number of AMI patients was similar between the 12-month COVID-19 and control periods (60.8 vs. 57.2/month; P=0.58). The number of patients requiring direct ambulance transport was lower in the first half of the COVID-19 than control period (44.4% vs. 51.5; P=0.028). In-hospital mortality was higher in the second half of the COVID-19 than control period (8.9% vs. 5.8%; P=0.032). Conclusions: Through the first 12 months of the COVID-19 pandemic, the number of AMI cases was similar to that in previous years. The COVID-19 pandemic changed the behavior of AMI patients and both pre- and in-hospital medical management, which significantly affected the severity and prognosis of AMI.
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Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Ayaka Ino
- Department of Cardiology, Ise Red Cross Hospital
| | | | | | - Hiromasa Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Takashi Kato
- Department of Cardiology, Mie Prefecture General Medical Center
| | | | - Tadafumi Sugimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Jun Masuda
- Department of Cardiology, Mie Prefecture General Medical Center
| | - Masaki Tanabe
- Department of Infection Control and Prevention, Mie University Hospital
| | | | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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Mizutani H, Fujimoto N, Ito H, Sato T, Moriwaki K, Takasaki A, Ogihara Y, Kasuya S, Mori T, Tanimura M, Goto I, Ichikawa K, Masuda J, Sawai T, Kurita T, Tanigawa T, Dohi K. Prognostic Impact of Peak Aortic Jet Velocity on Patients With Acute Myocardial Infarction. Circ J 2022; 86:1539-1546. [DOI: 10.1253/circj.cj-22-0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Hana Mizutani
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Naoki Fujimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Hiromasa Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Toru Sato
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Keishi Moriwaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Yoshito Ogihara
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Shogo Kasuya
- Department of Cardiology, Kuwana City Medical Center
| | - Tatsuya Mori
- Department of Cardiology, Japanese Red Cross Ise Hospital
| | | | - Itaru Goto
- Department of Cardiology, Matsusaka Chuo General Hospital
| | | | - Jun Masuda
- Department of Cardiology, Mie Prefectural General Medical Center
| | | | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | | | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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Hiramatsu D, Ogihara Y, Matsumoto T, Sato K, Takasaki A, Kurita T, Okamoto R, Wada H, Dohi K. Endovascular Treatment for Lower-extremity Arterial Thrombosis in a Patient with Congenital Afibrinogenemia and a History of Bleeding Complications. Intern Med 2022; 61:361-364. [PMID: 34334565 PMCID: PMC8866793 DOI: 10.2169/internalmedicine.7542-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Congenital afibrinogenemia is a rare autosomal recessive blood disorder that accompanies thrombotic complications and is associated with bleeding tendency. The management of these opposing complications remains a challenge. Endovascular treatment (EVT) for peripheral arterial thrombosis has not been described in previous studies. A 57-year-old man with congenital afibrinogenemia developed back pain and left lower leg pain. The cause of the pain was confirmed to be renal infarction and lower extremity arterial thrombosis by Doppler ultrasound and contrast-enhanced computed tomography. He was treated with EVT for the lower extremity arterial thrombosis, leading to an excellent short-term improvement without bleeding.
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Affiliation(s)
- Daisuke Hiramatsu
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Yoshito Ogihara
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Takeshi Matsumoto
- Department of Transfusion Medicine and Cell Therapy, Mie University Hospital, Japan
| | - Kei Sato
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Ryuji Okamoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
| | - Hideo Wada
- Department of General and Laboratory Medicine, Mie Prefectural General Medical Center, Japan; Associated Department with Mie Graduate School of Medicine, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Japan
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Ishiyama M, Kurita T, Takasaki A, Takamura T, Masuda J, Ishikura K, Seko T, Setsuda M, Kasai A, Imai H, Dohi K. Impact of Helicopter Transport on Reperfusion Times and Long-Term Outcomes in Acute Myocardial Infarction Patients in Rural Areas: A Report From the Mie Acute Coronary Syndrome Registry. Air Med J 2021; 40:337-343. [PMID: 34535242 DOI: 10.1016/j.amj.2021.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/14/2021] [Accepted: 05/03/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Helicopter emergency medical services (HEMS) are effective for time-sensitive conditions, such as stroke and trauma. However, prognostic data on helicopter transport for acute myocardial infarction (AMI) patients are insufficient. METHODS We registered 2,681 AMI patients in the Mie Acute Coronary Syndrome Registry and enrolled 163 patients from rural areas to HEMS base hospitals with HEMS or ground emergency medical services (GEMS). They were categorized into 4 groups according to the transportation method for interhospital transfer (direct HEMS: n = 52, direct GEMS: n = 54, interhospital HEMS: n = 32, and interhospital GEMS: n = 25). The primary end point was the emergency medical services (EMS) call-to-balloon time. The secondary end point was 2-year major adverse cardiac and cerebrovascular events. RESULTS The direct HEMS group was younger than the direct GEMS group (P = .029). The EMS call-to-balloon time was shorter in the direct HEMS and interhospital HEMS groups than in each GEMS group (P = .015 and P = .046). The incidence of 2-year major adverse cardiac and cerebrovascular events tended to be lower in both HEMS groups than in each GEMS group. CONCLUSION Direct HEMS for AMI in rural areas shortens the time from the EMS call to reperfusion when the transport distance is expected to exceed 30 km, which may result in a better patient prognosis. In addition, prehospital diagnostic modalities, such as 12-lead electrocardiography and echocardiography, may shorten the duration from the EMS call to reperfusion.
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Affiliation(s)
- Masaki Ishiyama
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Takeshi Takamura
- Department of Cardiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Jun Masuda
- Department of Cardiology, Mie Prefectural General Medical Center, Yokkaichi, Mie, Japan
| | - Ken Ishikura
- Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Tetsuya Seko
- Department of Cardiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Morimichi Setsuda
- Emergency and Critical Care Center, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Atsunobu Kasai
- Department of Cardiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Hiroshi Imai
- Emergency Critical Care Center, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Takasaki A, Okamoto R, Sugimoto H, Dohi K. Fatal myopericarditis complicated with coronary vein perforation under the triple antithrombotic therapy: a case report. Eur Heart J Case Rep 2021; 5:ytab098. [PMID: 34124546 PMCID: PMC8188861 DOI: 10.1093/ehjcr/ytab098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 11/25/2020] [Accepted: 02/26/2021] [Indexed: 01/04/2023]
Abstract
Background Acute pericarditis generally follows a mild clinical course and is rarely fatal. Coronary vein involvement is rarely reported. Case summary We report an autopsy case of cardiac tamponade from idiopathic myopericarditis due to coronary venous perforation under the triple antithrombotic therapy. A 69-year-old man was admitted to our hospital with abnormal findings on electrocardiography, bloody pericardial effusion, and mild elevation of troponin I. Oral anti-inflammatories were started and the patient followed a benign course. However, on hospital Day 5, he suddenly suffered cardiogenic shock with pulseless electric activity due to cardiac tamponade under the combination use of the dual antiplatelet drugs and an anticoagulant drug. He died despite intense medical treatment. Autopsy revealed cardiac tamponade caused by perforation in the coronary venous wall. To the best of our knowledge, this is the first description of fatal myopericarditis as a complication of coronary venous perforation. Discussion The aetiology and mechanism remain unknown; however, we should take care for this rare complication in patients with acute myopericarditis and bloody effusion under the triple antithrombotic therapy.
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Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.,Department of Cardiology, Matsusaka Central Hospital, Kobo 102, Kawai-machi, Matsusaka, Mie 515-8566, Japan
| | - Ryuji Okamoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hiroko Sugimoto
- Department of Pathology, Matsusaka Central Hospital, Kobo 102, Kawai-machi, Matsusaka, Mie 515-8566, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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13
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Ito H, Masuda J, Kurita T, Ida M, Yamamoto A, Takasaki A, Takeuchi T, Sato Y, Omura T, Sawai T, Tanigawa T, Ito M, Dohi K. Effect of left ventricular ejection fraction on the prognostic impact of chronic total occlusion in a non-infarct-related artery in patients with acute myocardial infarction. Int J Cardiol Heart Vasc 2021; 33:100738. [PMID: 33718588 PMCID: PMC7933260 DOI: 10.1016/j.ijcha.2021.100738] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/31/2021] [Accepted: 02/06/2021] [Indexed: 11/04/2022]
Abstract
Background Chronic total occlusion (CTO) in a non-infarct-related artery (IRA) in patients with acute coronary syndrome (ACS) is associated with a poor prognosis. However, whether the prognostic impact of non-IRA CTO differs according to left ventricular ejection fraction (LVEF) is unclear. Methods and results A total of 2060 consecutive acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention (PCI) were classified into 2 groups according to their LVEF (reduced EF: LVEF < 50%, preserved EF: LVEF ≥ 50%) and further subdivided according to the presence of concomitant non-IRA CTO. In the reduced EF group, patients with CTO had a higher 1-year all-cause death rate (20.3% vs. 34.3%, P = 0.001) and major adverse cardiac event rate (MACE: 19.6% vs. 39.6%, P < 0.001) compared to those without CTO, but they were similar between patients with and without CTO in the preserved EF group. Non-IRA CTO was an independent predictor of all-cause death (HR 1.58, 95% CI 1.06–2.33, P = 0.02) and MACE (HR 1.67, 95% CI 1.14–2.46, P = 0.009) only in the reduced EF group. In addition, the outcomes of successful CTO-PCI seemed to be similar to those without CTO in the reduced EF group. Conclusions CTO in a non-IRA may contribute to a poor prognosis only in AMI patients with reduced LVEF.
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Affiliation(s)
- Hiromasa Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Jun Masuda
- Department of Cardiology, Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Mizuki Ida
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Ayato Yamamoto
- Department of Cardiology, Suzuka Chuo General Hospital, Suzuka, Japan
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | | | - Yuichi Sato
- Department of Cardiology, Matsusaka Chuo General Hospital, Matsusaka, Japan
| | - Takashi Omura
- Department of Cardiology, Kuwana City Medical Center, Kuwana, Japan
| | - Toshiki Sawai
- Department of Cardiology, Mie Heart Center, Meiwa, Japan
| | - Takashi Tanigawa
- Department of Cardiology, Matsusaka Chuo General Hospital, Matsusaka, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan
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14
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Sakuta S, Hashimoto M, Ikeda M, Koyama A, Takasaki A, Hotta M, Fukuhara R, Ishikawa T, Yuki S, Miyagawa Y, Hidaka Y, Kaneda K, Takebayashi M. Clinical features of behavioral symptoms in patients with semantic dementia: Does semantic dementia cause autistic traits? PLoS One 2021; 16:e0247184. [PMID: 33600474 PMCID: PMC7891790 DOI: 10.1371/journal.pone.0247184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the behavioral characteristics of semantic dementia (SD) using an instrument originally developed for patients with autism spectrum disorder. Methods The behavioral symptoms of 20 patients with SD and 20 patients with Alzheimer’s disease (AD) in both the preclinical state and the dementia state were evaluated using the Pervasive Developmental Disorders Autism Society Japan Rating Scale (PARS). Results The SD group showed high prevalence in four behaviors related to stereotypy and social impairment: eating very few food items, selfishness, difficulty in recognizing others’ feeling and thoughts, and interpreting language literally. Scores on the PARS short version, which is sensitive for diagnosis of autism spectrum disorder, were significantly higher in the dementia state than in the preclinical state in both the SD (11.5 ± 6.0 and 1.7 ± 2.5, respectively; t (19) = 6.7, p < 0.001) and AD (6.9 ± 4.6 and 1.7 ± 2.0, respectively; t (19) = 5.1, p < 0.001) groups. PARS short version scores after dementia onset increased in both the SD and AD groups, although the increase was significantly larger in the SD group (F = 5.6, p = 0.023). Additionally, a significantly higher rate of patients exceeded the cutoff score for autism diagnosis in the dementia state in the SD group (75%) than in the AD group (40%; χ2 = 5.0, p = 0.025). PARS scores in the dementia state were significantly correlated with illness duration (r = 0.46, p = 0.04) and Mini-Mental State Examination scores (r = −0.75, p < 0.001) in the SD group only. Conclusions Although SD and autism spectrum disorder are etiologically distinct diseases, patients with semantic dementia behave like those with autism spectrum disorder. Our findings suggest the symptomatic similarity of the two disorders.
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Affiliation(s)
- Shizuka Sakuta
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mamoru Hashimoto
- Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- * E-mail:
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Asuka Koyama
- Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Akihiro Takasaki
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Maki Hotta
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Osaka, Japan
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Tomohisa Ishikawa
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Seiji Yuki
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Yusuke Miyagawa
- Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan
| | - Yosuke Hidaka
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Minoru Takebayashi
- Faculty of Life Sciences, Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
- Division of Psychiatry and Neuroscience, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan
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15
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Takasaki A, Kurita T, Masuda J, Hoshino K, Seko T, Tanigawa T, Kitamura T, Ichikawa T, Ito M, Dohi K. Prevalence and Prognosis of Familial Hypercholesterolemia in Patients With Acute Coronary Syndrome in Mie Prefecture, Japan ― Report From Mie ACS Registry ―. Circ J 2020; 85:9-18. [DOI: 10.1253/circj.cj-20-0112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Jun Masuda
- Department of Cardiology, Mie Prefectural General Medical Center
| | | | - Tetsuya Seko
- Department of Cardiology, Japanese Red Cross Ise Hospital
| | | | | | | | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine
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16
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Hirota Y, Moriwaki K, Takasaki A, Takamura T, Kurita T, Fujii E, Saito Y, Yamada N, Ito M, Dohi K. Prognostic impacts of prehospital age shock index in patients with acute myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Early identification of high-risk patients is the cornerstone of managing patients with acute myocardial infarction (AMI). Age Shock index (ASI; age multiplied by the ratio of heart rate/systolic blood pressure) has been reported to be similar to Global Registry of Acute Coronary Events (GRACE) risk score for predicting mortality in patients with AMI. However, prognostic impacts of prehospital ASI (pre-ASI) in patients with AMI remain unknown.
Methods
We analyzed of 2578 AMI patients who underwent emergency primary percutaneous coronary intervention (PCI) from January 2013 to March 2018, using data from Mie ACS Registry, a prospective and multicenter registry in Japan. Pre-ASI was recorded by emergency medical services at the first contact with the patient before admission, and in-hospital ASI (in-ASI) was recorded prior to PCI at admission. The primary end point was defined as all-cause death.
Results
Median follow-up duration was 753 days (497–838 days). All-cause death was observed in 230 (8.9%) patients. The ROC-AUC (Receiver operating characteristic-area under the curve) of pre-ASI for all- cause death was 0.76 (p<0.001), which was similar to that of in-ASI (0.78, p<0.001) (p=0.25 for pre-ASI versus in-ASI). The cut-off value for pre-ASI and in-ASI was for the prediction of all-cause death was both 45 with a sensitivity of 0.66 and a specificity of 0.78, with a sensitivity of 0.68 and a specificity of 0.76 respectively. According to the Kaplan-Meier survival analysis by combination of pre-ASI≥45 and in-ASI≥45, the patients with pre-ASI≥45 and in-ASI≥45 showed significantly higher all-cause mortality compared to the patients with pre-ASI≥45 and in-ASI<45, the patients with pre-ASI<45 and in-ASI≥45, and the patients with pre-ASI<45 and in-ASI<45 (p<0.001) (Figure). The addition of pre-ASI≥45 to in-ASI≥45 (global chi-squared score: 205) resulted in a significantly increased global chi-squared score, suggesting the incremental prognostic value of pre-ASI (267; p<0.001). Multivariate cox proportional hazard regression analysis for all-cause mortality demonstrated pre-ASI≥45 was a significant independent predictor (HR: 4.86; 95% CI: 3.36 to 7.02, p<0.001). It was strongest predictor compared to left ventricular ejection fraction<40% (HR: 2.45; 95% CI 1.67 to 3.58, p<0.001), hemodialysis (HR: 3.45; 95% CI 1.66 to 7.17, p=0.001), door to balloon time>90 minutes (HR: 1.66; 95% CI 1.18 to 2.34, p=0.004).
Conclusions
High pre-ASI predict increase mortality and assessment of both high pre-ASI and high in-ASI enhance risk stratification in patients with AMI. Early recognizing high pre-ASI may help us make better strategies and improve prognosis for high-risk AMI patients.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Hirota
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - K Moriwaki
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - A Takasaki
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - T Takamura
- Ise City Red Cross Hospital, Department of Cardiology, Ise, Japan
| | - T Kurita
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - E Fujii
- Nabari City Hospital, Department of Cardiology, Nabari, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Department of Cardiology, suzuka, Japan
| | - N Yamada
- Kuwana City Medical Center, Department of Cardiology, Kuwana, Japan
| | - M Ito
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - K Dohi
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
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Mizutani H, Kurita T, Takasaki A, Nakata T, Konishi K, Izumi D, Omura T, Masuda J, Ito M, Dohi K. Premature acute coronary syndrome patients do not have a better prognosis for their age than mature ACS patients by propensity score match analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Acute coronary syndrome (ACS) is the most important cardiovascular (CV) disease with a prevalence that increases with age. There is no data which compared the prognosis with premature ACS and mature ACS using propensity score matched analysis
Purpose
The purpose of this study was to compare the prognosis of premature ACS patients and mature ACS patients using propensity score matched analysis.
Methods
We analyzed of 4249 ACS patients (69.1±12.6, male 77%) including 773 premature ACS patients (50.1±6.8, male 78%) and 3476 mature ACS (73.3±9.3, male 77%) from January 2013 to December 2018, using data from Mie ACS Registry, a prospective and multicenter registry in Japan.
Premature onset of ACS was defined as younger than 65 years old in male and 55 years old in female.
Primary end point was as major adverse cardiac event (MACE) including cardiovascular death, non-fetal myocardial infarction, heart failure requiring admission and unstable angina.
Results
During median follow duration of 742 days ranging from409 to 828 days, 502 MACE were occurred. Premature ACS patients were younger and showed higher body mass index compared to mature ACS patients (50.1±6.8 vs 73.3±9.3 y.o., 25.5 vs 23.0, P<0.001, respectively). However, premature ACS patients were more likely to be associated with ST elevation myocardial infarction, dyslipidemia, family history of coronary artery disease (CAD) and lower Killip classification compared to mature ACS patients (P<0.01, respectively). Common CAD risk factors such as hypertension, diabetes mellitus and past history of CAD were less associated with premature ACS patients compared to mature ACS patients (P<0.01, respectively). Unadjusted Kaplan-Meier survival curves demonstrated the favorable prognosis in premature ACS patients compared to mature ACS patients with hazard ratio of 0.57 (95% CI 0.45–0.71, P<0.001, see Figure 1A). We compared a 1:1 propensity score-matched cohort of 1208 patients with or without premature onset of ACS adjusting the several factors mentioned above (n=604, respectively). Age could not be introduced as a factor of propensity score match when comparing premature and mature ACS patients. After propensity score-match, premature ACS patients is about 18 years younger than mature ACS patients (50.7±6.5 vs 68.5±8.2 y.o., P<0.001). The average age of premature ACS was younger than that of mature ACS, but MACE by Kaplan-Meier survival analysis for premature ACS patients was equivalent to mature ACS patients (P=0.77, see Figure 1B).
Conclusion
Premature ACS patients are required very careful management because they might have factors with unfavorable prognosis, such as lifestyle habit and genetics, that may be beyond age.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - T Kurita
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - A Takasaki
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | | | - K Konishi
- Suzuka General Hospital, Suzuka, Japan
| | - D Izumi
- Ise Red Cross Hospital, Cardiology, Ise, Japan
| | - T Omura
- Kuwana City Medical Center, Kuwana, Japan
| | - J Masuda
- Mie prefectural general medical center, Yokkaichi, Japan
| | - M Ito
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
| | - K Dohi
- Mie University Graduate School of Medicine, Department of Cardiology and Nephrology, Tsu, Japan
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18
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Sato T, Ogihara Y, Kurita T, Mizutani H, Takasaki A, Moriwaki K, Tanimura M, Sawai T, Ito M, Dohi K. Prognostic impact of right ventricular overload in patients with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Right ventricular (RV) overload is associated with adverse outcome in patients with chronic heart failure. However, its prognostic value in acute coronary syndrome (ACS) patients remains unknown.
Purpose
The purpose of this study was to investigate the prevalence and prognostic impact of right ventricular overload in ACS patients.
Methods
We studied 2797 ACS patients from Mie ACS registry, a prospective and multicenter registry in Japan. They were divided into 4 subgroups according to the severity of RV overload and the extent of Left Ventricle Ejection Fraction (LVEF) assessed by echocardiography before hospital discharge. High RV overload was defined as trans-tricuspid pressure gradient (TRPG) ≥40mmHg and preserved LVEF was defined as ≥50%. The primary outcome was defined as 2-year all-cause mortality. Median follow up duration was 730 days (1–2215 days).
Results
High RV overload was detected in 76 patients (2.7%). In basic patients characteristics, high RV overload patients were significantly older and higher killip classification than low RV overload patients (P<0.01, respectively). Laboratory data in high RV overload patients showed lower hemoglobin level and higher serum creatinine level than those in low RV overload patients (P<0.01, respectively).
Echocardiographic findings in high RV overload represented lower LVEF, higher rate of moderate or severe mitral regurgitation and left atrial enlargement than those in low RV overload patients (P<0.01, respectively).
During the follow-up periods (median 730 days), 260 (9.3%) patients experienced all-cause death. Multivariate cox hazard regression analysis for all-cause mortality demonstrated that high RV overload was an independent poor prognostic factor in the entire study population. Among patients with preserved LVEF, high RV overload resulted in an increased risk of all-cause mortality compared to low RV overload (P<0.0001).
Conclusion
In ACS patients, high RV overload strongly contributes to worsening of prognosis regardless of the extent of LVEF.
Kaplan-Meier survival curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Sato
- Mie University Hospital, Tsu, Japan
| | | | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - H Mizutani
- Suzuka chuo general hospital, Suzuka, Japan
| | | | | | - M Tanimura
- Yokkaichi Hazu Medical Center, Yokkaichi, Japan
| | - T Sawai
- Mie Heart Center, Meiwa, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
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19
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Fukuoka S, Kurita T, Takasaki A, Nakata T, Fujimoto N, Masuda J, Hoshino K, Tanigawa T, Koyabu S, Ito M, Dohi K. Clinical usefulness of instantaneous wave-free ratio for the evaluation of coronary artery lesion with prior myocardial infarction: A multi-center study. IJC Heart & Vasculature 2020; 26:100431. [PMID: 31890864 PMCID: PMC6931066 DOI: 10.1016/j.ijcha.2019.100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/23/2019] [Accepted: 10/08/2019] [Indexed: 01/10/2023]
Abstract
Background Fractional flow reserve (FFR) is useful for assessing the functional significance of coronary artery stenosis, even in lesions with prior myocardial infarction (pMI). Instantaneous wave-free ratio (iFR) is a vasodilator-free alternative for the physiological assessment of coronary artery stenosis. In addition, iFR shows good diagnostic agreement with FFR and an iFR-guided revascularization strategy was non-inferior to an FFR-guided revascularization strategy. However, the clinical usefulness of iFR for the evaluation of a coronary artery lesions with pMI has not been evaluated. Methods and Results A total of 200 lesions from 200 patients (44 pMI territories lesions and 156 non-pMI coronary artery lesions) were analyzed retrospectively. Major adverse cardiac events (MACE) were defined as cardiovascular death, non-fatal MI, unstable angina pectoris, fatal arrhythmia and heart failure during 12 months follow-up after the physiological assessment of coronary artery stenosis. iFR was closely correlated with FFR in pMI and non-pMI lesions (r = 0.81 and 0.72; P < 0.001, respectively). In pMI lesions, an iFR cut-off of 0.89 was optimal against a clinical FFR cut-off of 0.80 according to receiver operating characteristics (ROC) curve analysis, whereas in non-pMI lesions, the iFR cut-off value was 0.92 without statistical significance. In addition, the event rate of MACE was similar between pMI and non-pMI patients during follow-up even in the presence or absence of an PCI procedure. Conclusions iFR may be a useful alternative method compared with FFR for clinical decision-making even in pMI patients.
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Takasaki A, Sugiura E, Dohi K, Ito M. Marked changes in bioprosthetic valve thrombosis by anticoagulation therapy. Eur Heart J Case Rep 2019; 3:1-3. [PMID: 32099959 PMCID: PMC7026594 DOI: 10.1093/ehjcr/ytz207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/25/2019] [Accepted: 10/29/2019] [Indexed: 11/14/2022]
Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan
| | - Emiyo Sugiura
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P1717The clinical impact of intra-aortic balloon pumping for acute coronary syndrome from Mie ACS registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Intra-Aortic Balloon Pumping (IABP) was widespread used in cases of Acute Coronary Syndrome (ACS) at daily clinical situation in Japan, even though the efficacy of IABP in AMI patients with cardiogenic shock was not proved. The aim of this study was to investigate the efficacy of IABP use in ACS patients in Japan.
Methods
We investigated 2-year all-cause-mortality of 2,660 enrolled ACS patients including 358 patients with IABP and 2,302 patients without IABP from Mie ACS registry.
Results
We compared a 1:1 propensity score-matched cohort of 426 ACS patients with or without IABP (n=213, respectively). 2-year mortality was significantly higher in patients with IABP than without IABP (p=0.02, Figure A). In addition, IABP usage was independent predictor of mortality with hazard ratio of 1.6 by multivariate analysis. However, 2-year mortality was not statistically different between 2 groups only when analyzed patients with shock (p=0.60, Figure B).
Figure 1
Conclusion
IABP was not commonly recommended in ACS patients. However, IABP was might as well used in some situation especially in shock.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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22
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Takasaki A, Kurita T, Masuda J, Dohi K, Hoshino K, Tanigawa T, Saito Y, Kitamura T, Kakimoto H, Setsuda M, Makino K, Ichikawa T, Ito M. P2659Difference of prognostic impact of Killip classification in ACS patients with or without hemodialysis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Cardiovascular deaths are more frequently in hemodialysis (HD) patients compared to general population. However, difference of prognosis of acute coronary syndrome (ACS) patients with or without HD were not well evaluated.
Purpose
The purpose of this study was to evaluate the clinical and prognostic characteristics of ACS patients with HD compared to that of ACS patients without HD.
Methods
We investigated 3427 ACS patients including 63 HD and 3364 non-HD patients between 2013 and 2017 using date from Mie ACS registry, a retrospective and multicenter registry. The primary outcome was defined as all-cause mortality.
Results
HD patients showed significantly higher prevalence of diabetes mellitus, past treatment of coronary artery disease, history of myocardial infarction and Killip ≥2 compared to non-HD patients (p<0.05, respectively). During the follow-up periods (median 719 days), 425 (12.4%) patients experienced all-cause death. HD patients demonstrated the higher all-cause mortality rate compared to that of non-HD patients during the follow-up (11.9% versus 38.1%, p<0.001, chi square). Kaplan Meier survival curves demonstrated that HD and non-HD patients with Killip 1 showed similar 30-day mortality, and Killip ≥2 patients also showed similar prognosis (Left side of figure). On the other hand, all cause mortality at 2 years were higher in Killip 1 HD patients compared to Killip 1 non-HD patients and similar between Killip 1 HD patients and Killip ≥2 non-HD patients in the 30 days landmark analysis (Right side of figure). In addition, cox regression analyses for all cause mortality demonstrated that HD was a strongest independent prognostic factor not of 30-day mortality but of after 30-day mortality with hazard ratio of 4.09 (95% confidential interval: 2.32–7.21, p<0.001).
Figure 1
Conclusion
Careful management are required in chronic phase for ACS patients with HD even in Killip 1 classification.
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Affiliation(s)
| | - T Kurita
- Mie University Hospital, Tsu, Japan
| | - J Masuda
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - K Dohi
- Mie University Hospital, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka Chuo General Hospital, Cardiology, Matsusaka, Japan
| | - Y Saito
- Suzuka Kaisei Hospital, Suzuka, Japan
| | - T Kitamura
- Suzuka Chuo General Hospital, Cardiology, Suzuka, Japan
| | - H Kakimoto
- Saiseikai Matsusaka General Hospital, Matsusaka, Japan
| | | | - K Makino
- Mie Prefectural General Medical Center, Yokkaichi, Japan
| | - T Ichikawa
- Kuwana City Medical Center, Kuwana, Japan
| | - M Ito
- Mie University Hospital, Tsu, Japan
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Affiliation(s)
- Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Shiro Nakamori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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24
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Omori T, Kurita T, Dohi K, Takasaki A, Nakata T, Nakamori S, Fujimoto N, Kitagawa K, Hoshino K, Tanigawa T, Sakuma H, Ito M. Prognostic impact of unrecognized myocardial scar in the non-culprit territories by cardiac magnetic resonance imaging in patients with acute myocardial infarction. Eur Heart J Cardiovasc Imaging 2018; 19:108-116. [PMID: 28950314 DOI: 10.1093/ehjci/jex194] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/10/2017] [Indexed: 11/14/2022] Open
Abstract
Aims Unrecognized myocardial scar by late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) is strongly associated with cardiac event in patients with stable coronary artery disease. The purpose of this study was to evaluate the prognostic impact of unrecognized non-infarct-related LGE (non-IR-LGE) in patients with acute myocardial infarction (AMI). Methods and results We studied 269 patients with a first clinical episode of AMI underwent cardiac MRI within 6 weeks after onset (209 men; age, 66 ± 12 years). LGE, cine MRI and T2-weighted imaging were obtained to evaluate the presence and extent of LGE and to evaluate cardiac function. Major adverse cardiac events (MACE) were defined as cardiovascular death, non-fatal AMI, unstable angina requiring revascularization, fatal arrhythmia, and heart failure. Unrecognized non-IR LGE was observed in 13.0% of patients. During follow-up periods (median, 22 months; range, 3-95 months), 8.9% of patients experienced MACE in this study. In addition, 22.9% of patients with unrecognized non-IR LGE and 6.8% of patients without unrecognized non-IR-LGE experienced MACE (P < 0.01). The presence of unrecognized non-IR LGE predicted MACE with a hazard ratio of 3.45 (95% confidential interval, 1.03-11.47; P < 0.01). In addition, unrecognized non-IR LGE was the strongest independent predictors of MACE with a hazard ratio of 3.30 by the Cox proportional hazards model (P < 0.01). In contrast, angiography-proven multi-vessel disease and transmural extent of infarct-related LGE were not independently associated with MACE. Conclusion Among patients with a first clinical episode of AMI, unrecognized non-IR myocardial scar provides incremental prognostic value for predicting MACE beyond that of common clinical, angiographic and functional variables.
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Affiliation(s)
- Taku Omori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Tairo Kurita
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Kaoru Dohi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Akihiro Takasaki
- Department of Cardiology, Matsusaka Central Hospital, 102 Kawai, Matsusaka 515-8566, Japan
| | - Tomoyuki Nakata
- Department of Cardiology, Nagai Hospital, 29-29 Nishimarunouchi, Tsu 514-8508, Japan
| | - Shiro Nakamori
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Naoki Fujimoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Kakuya Kitagawa
- Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi Tsu 514-8507, Japan
| | - Kozo Hoshino
- Department of Cardiology, Nagai Hospital, 29-29 Nishimarunouchi, Tsu 514-8508, Japan
| | - Takashi Tanigawa
- Department of Cardiology, Matsusaka Central Hospital, 102 Kawai, Matsusaka 515-8566, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi Tsu 514-8507, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
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25
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Sugiura S, Matsuoka K, Ikami A, Shioji H, Takasaki A, Koji T, Tanigawa T, Ito M. An incomplete pacemaker lead fracture causing inappropriate pacing inhibition due to oversensing of the minute ventilation sensor pulses. J Cardiol Cases 2018; 18:47-51. [PMID: 30279909 DOI: 10.1016/j.jccase.2018.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 04/09/2018] [Accepted: 04/11/2018] [Indexed: 11/24/2022] Open
Abstract
Cardiac pacemakers using rate response technologies represent the effectiveness of increasing the heart rate and cardiac output during exercise. Minute ventilation (MV) sensors are popular and estimate rates using transthoracic impedance by emitting very low amperage short electrical current pulses between the pacemaker lead tip and pulse generator. We present a case of an incomplete pacemaker lead fracture developing inappropriate pacing inhibition due to oversensing caused by the electrical current emitted by the MV sensor. A permanent pacemaker replacement was performed, resulting in no further abnormal findings such as inappropriate pacing inhibition. <Learning objective: The minute ventilation (MV) sensor is estimated using the transthoracic impedance by emitting a very low amperage and short pulses of electrical current between the pacemaker lead tip and pulse generator. Therefore, if a fractured lead occurs, the voltage from the current pulses emitted for the MV sensor might be high enough to be oversensed as ventricular waves. We recommend that it is necessary to keep in mind the possibility of a fractured lead if oversensing of the thoracic impedance measurement current is observed.>.
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Affiliation(s)
- Shinya Sugiura
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Koji Matsuoka
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Akiyoshi Ikami
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Hirokazu Shioji
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Akihiro Takasaki
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Takafumi Koji
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Takashi Tanigawa
- Department of Cardiology, Matsusaka Chuo Hospital, Matsusaka, Mie, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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26
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Sumitomo-Kondo M, Ukai Y, Iba Y, Ohshima N, Miura K, Takasaki A, Kurosawa Y, Kurosawa G. Isolation of human monoclonal antibodies that bind to two different antigens and are encoded by germline V H and V L genes. Biochem Biophys Res Commun 2018; 503:1141-1147. [PMID: 29944883 DOI: 10.1016/j.bbrc.2018.06.132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 06/23/2018] [Indexed: 10/28/2022]
Abstract
This paper reports isolation of two monoclonal antibodies (mAbs) that bind to both a membrane protein and a cytoplasmic protein. Most Abs established as markers for autoimmune disease bind to cytoplasmic or nuclear substances. However, it remains unknown how these Abs are produced. On the other hand, there were examples where clones originally isolated as Abs that bind to membrane proteins also showed binding activity to cytoplasmic or nuclear substances. Based on these results, the following hypothesis has been proposed. The Abs that had been originally produced against a membrane protein showed cross-reactivity against cytoplasmic or nuclear substances. In the present study we reported isolation of Abs that bound to both a membrane protein, CADM1, and a cytoplasmic protein, α-actinin-4. The method adopted in the present study could be generally applicable to isolation of Abs showing such dual specificity. Firstly, we constructed a huge human Ab library using various organs including naïve B-cell-rich organs such as bone marrow and umbilical cords. Then, we developed a comprehensive screening method for isolation of Abs that bound to cell surface antigens. Through extensive screenings with many kinds of cell we newly obtained a library composed of around 4000 independent clones that bind to membrane proteins. We screened this library with α-actinin-4 and succeeded in isolating two Abs. They bound to α-actinin-4 and a membrane protein CADM1. Furthermore, they are encoded by naïve heavy and light chain variable genes (VH & VL). These results suggested that cross-reactive Abs to both a membrane protein and a cytoplasmic protein could be present in germline repertoire of Ab in humans. This methodology adopted in the present study could be applied to isolation of cross-reactive Abs possibly involved in autoimmune diseases.
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Affiliation(s)
- M Sumitomo-Kondo
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan; Perseus Proteomics Inc., Tokyo, Japan
| | - Y Ukai
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan; Perseus Proteomics Inc., Tokyo, Japan
| | - Y Iba
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - N Ohshima
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - K Miura
- School of Health Sciences Fujita Health University, Toyoake, Japan
| | - A Takasaki
- Department of Medical Technology School of Health Sciences, Gifu University of Medical Science, Gifu, Japan
| | - Y Kurosawa
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan
| | - G Kurosawa
- Center for Research Promotion and Support, Fujita Health University, Toyoake, Aichi, Japan.
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27
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Ito H, Masuda J, Takasaki A, Ichikawa K, Sato Y, Takeuchi T, Kakuta K, Matsuda A, Nakajima H, Omura T, Sawai T, Hoshino K, Seko T, Kitamura T, Ito M. P6043Prognostic impact of a chronic total occlusion in a non-infarct-related artery and left ventricular ejection fraction in patients with acute myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Ito
- Ise Red Cross Hospital, cardiology, Ise, Japan
| | | | | | | | - Y Sato
- Mie CCU Network, Tsu, Japan
| | | | | | | | | | | | | | | | - T Seko
- Mie CCU Network, Tsu, Japan
| | | | - M Ito
- Mie CCU Network, Tsu, Japan
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28
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Fukuoka S, Kurita T, Dohi K, Takasaki A, Nakata T, Fujimoto N, Masuda J, Hoshino K, Tanigawa T, Fujii E, Koyabu S, Ito M. P3660Clinical usefulness of instantaneous wave-free ratio for evaluation of coronary artery lesion with prior myocardial infarction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Fukuoka
- Mie University Hospital, Cardiology, Tsu, Japan
| | - T Kurita
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Dohi
- Mie University Hospital, Cardiology, Tsu, Japan
| | - A Takasaki
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - T Nakata
- Mie Prefecture General Medical Center, Cardiology, Yokkaichi, Japan
| | - N Fujimoto
- Mie University Hospital, Cardiology, Tsu, Japan
| | - J Masuda
- Mie University Hospital, Cardiology, Tsu, Japan
| | - K Hoshino
- Nagai Hospital, Cardiology, Tsu, Japan
| | - T Tanigawa
- Matsusaka General Hospital, Cardiology, Matsusaka, Japan
| | - E Fujii
- Mie University Hospital, Cardiology, Tsu, Japan
| | - S Koyabu
- Owase General Hospital, Cardiology, Owase, Japan
| | - M Ito
- Mie University Hospital, Cardiology, Tsu, Japan
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29
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Koyama A, Hashimoto M, Fukuhara R, Ichimi N, Takasaki A, Matsushita M, Ishikawa T, Tanaka H, Miyagawa Y, Ikeda M. Caregiver Burden in Semantic Dementia with Right- and Left-Sided Predominant Cerebral Atrophy and in Behavioral-Variant Frontotemporal Dementia. Dement Geriatr Cogn Dis Extra 2018; 8:128-137. [PMID: 29706989 PMCID: PMC5921212 DOI: 10.1159/000487851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 02/16/2018] [Indexed: 12/13/2022] Open
Abstract
Background Caregiver burden is a serious concern for family caregivers of dementia patients, but its nature is unclear in patients with semantic dementia (SD). This study aimed to clarify caregiver burden for right- (R > L) and left-sided (L > R) predominant SD versus behavioral-variant frontotemporal dementia (bvFTD) patients. Methods Using the Japanese version of the Zarit Burden Interview (ZBI) and the Neuropsychiatric Inventory, we examined caregiver burden and behavioral and psychological symptoms of dementia (BPSD) in 43 first-visit outpatient/family caregiver dyads (bvFTD, 20 dyads; SD [L > R], 13 dyads; SD [R > L], 10 dyads). Results We found a significant difference in ZBI score between the 3 diagnostic groups. Post hoc tests revealed a significantly higher ZBI score in the bvFTD than in the SD (L > R) group. The ZBI scores in the SD (L > R) and SD (R > L) groups were not significantly different, although the effect size was large. Caregiver burden was significantly correlated with BPSD scores in all groups and was correlated with activities of daily living and instrumental activities of daily living decline in the bvFTD and SD (R > L) groups. Conclusion Caregiver burden was highest in the bvFTD group, comparatively high in the SD (R > L) group, and lowest in the SD (L > R) group. Adequate support and intervention for caregivers should be tailored to differences in caregiver burden between these patient groups.
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Affiliation(s)
- Asuka Koyama
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Naoko Ichimi
- Department of Medical Quality and Safety Management, Kumamoto University Hospital, Kumamoto, Japan
| | - Akihiro Takasaki
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Masateru Matsushita
- Center for Medical Education and Research, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomohisa Ishikawa
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hibiki Tanaka
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yusuke Miyagawa
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
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30
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Sugiura S, Matsuoka K, Noda H, Kurata N, Uemori M, Shioji H, Takasaki A, Koji T, Tanigawa T, Ito M. The utility of atrial pacing for identifying the electrical breakthrough sites between the left atrium and pulmonary veins. J Arrhythm 2017; 33:92-98. [PMID: 28416973 PMCID: PMC5388039 DOI: 10.1016/j.joa.2016.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 07/26/2016] [Accepted: 08/08/2016] [Indexed: 11/26/2022] Open
Abstract
Background Circumferential pulmonary vein (PV) isolation for atrial fibrillation (AF) is occasionally difficult to achieve because electrical breakthrough sites (EBSs) between the left atrium (LA) and PVs cannot be identified during ablation especially in the carina regions. Methods The left PVs (Lt.PVs) of 60 AF patients and the right PVs (Rt.PVs) of 37 patients undergoing PV isolation were studied. When PV isolation was not achieved after the initial circumferential PV isolation, atrial pacing was repeatedly performed from the distal coronary sinus (CSd) and high right atrium (HRA), and the time interval from the stimulus to the earliest PV potential (stimulus-PV interval) was measured using circular mapping catheters at each PV until PV isolation was achieved. When PV isolation was achieved via local Radiofrequency (RF) deliveries, those regions were diagnosed as final EBSs. We classified the final EBSs into six segments for each PV (anterior and posterior PV walls of the roof, carina, and bottom) and investigated the relationship between the final EBSs and stimulus-PV intervals. Results For Lt.PVs, the stimulus-PV intervals during CSd pacing were significantly shorter than during HRA pacing at the Lt.PV anterior carina and bottom (90±28 ms vs. 125±26 ms, P<0.001 and 84±20 ms vs. 148±24 ms, P=0.028, respectively), but there was no significant difference in the Lt.PV roof and any posterior segments. For Rt.PVs, the stimulus-PV interval from both pacing sites exhibited no significant difference between either segment. Conclusions This pacing method may help to identify whether EBSs are located in the anterior Lt.PVs. Improved recognition of EBSs through pacing from different sites would be helpful for achieving PV isolation.
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Affiliation(s)
- Shinya Sugiura
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
- Corresponding author. Fax: +81 59 821 9555.
| | - Koji Matsuoka
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Hideki Noda
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Naoya Kurata
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Misa Uemori
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Hirokazu Shioji
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Akihiro Takasaki
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Takafumi Koji
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Takashi Tanigawa
- Department of Cardiology, Matsusaka Chuo Hospital, 102 KawaimachiKobou, Matsusaka, Mie 515-8566, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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31
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Goto I, Okamoto R, Sawai T, Takasaki A, Takeuchi T, Matsuo H, Miyahara M, Nakamura M, Ito M. A case of aortic thrombosis and embolism preceding the progression of early esophageal cancer. J Cardiol Cases 2013; 7:e123-e125. [PMID: 30533142 DOI: 10.1016/j.jccase.2012.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 12/19/2012] [Indexed: 11/15/2022] Open
Abstract
Aortic thrombosis is rare, especially in non-atherosclerotic aortae. A 51-year-old woman presented with intermittent claudication in the right lower extremity. She was diagnosed as having peripheral artery disease on ultrasound. A computed tomography scan showed a large, sessile, aortic mural thrombus from the infrarenal abdominal aorta to the right common iliac artery. An arteriogram showed an abrupt occlusion of the right superficial femoral artery with collateral arteries. She had no risk factors for atherosclerosis. Interestingly, this occurred before early esophageal cancer progressed. Heparin was administered intravenously and later changed to warfarin. In the follow-up period, the thrombus disappeared, and her symptoms improved. A careful investigation for malignant disease is needed when aortic thrombus occurs in patients with no atherosclerosis risk factors. <Learning objective: Aortic thrombosis is rare, especially in non-atherosclerotic aortae. A patient who presented with descending aortic thrombosis and peripheral embolism complicating early esophageal carcinoma is presented. Interestingly, this occurred before the cancer progressed. A careful investigation for malignant disease is needed when aortic thrombus occurs in patients with no atherosclerosis risk factors.>.
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Affiliation(s)
- Itaru Goto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Ryuji Okamoto
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Toshiki Sawai
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Akihiro Takasaki
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Tetsushiro Takeuchi
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hiroshi Matsuo
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masatoshi Miyahara
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Mashio Nakamura
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masaaki Ito
- Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Johansson M, Takasaki A, Lenner L, Arstrand K, Kågedal B. Quantitative relationships between pigment-related mRNA and biochemical melanoma markers in melanoma cell lines. Melanoma Res 2002; 12:193-200. [PMID: 12140375 DOI: 10.1097/00008390-200206000-00002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The use of reverse transcription polymerase chain reaction (RT-PCR) analysis of melanoma-specific transcripts for the identification of circulating melanoma cells has shown very variable results in different studies on melanoma patients. We have therefore developed quantitative methods to study both analytical and biological variations as possible causes of this phenomenon. Pigment-related and S-100 beta transcripts were quantified in 12 different melanoma cell lines and related to the amounts of 5-S-cysteinyldopa, pigment and S-100B protein. A real-time PCR method was used and the results were expressed as absolute number of transcripts per cell. Tyrosinase, tyrosinase-related protein (TRP)-1, TRP-2 and MART-1/Melan-A mRNA varied from undetectable (< 10(-4) transcripts/cell) to 10(3) transcripts/cell, i.e. by a factor > 10(7) in the different cell lines. S-100 beta mRNA varied from 2.8 to 165 transcripts/cell, i.e. by a factor of 60. Tyrosinase, TRP-1 and TRP-2 mRNA correlated significantly with the amount of 5-S-cysteinyldopa, an intermediate pigment metabolite (P < 0.001, P < 0.001 and P < 0.01, respectively). The amount of S-100 beta mRNA correlated significantly with the amount of S-100B protein (P < 0.001). No cross-correlations were seen between the pigment-related and S-100-related analytes. We conclude that one reason behind the negative results of RT-PCR measurement of pigment-related mRNA may be that these transcripts are not always expressed in the particular cells present in the patient's blood. Furthermore, variation in the expression of the order of 10(7) must have great impact on the diagnostic sensitivity. Measurement of S-100 beta mRNA would be more sensitive, but the use of this transcript is hampered by its presence in the blood cells.
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Affiliation(s)
- M Johansson
- Department of Biomedicine and Surgery, Division of Clinical Chemistry, Linköping University, S-581 85 Linköping, Sweden
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Abstract
l-Leucyl l-leucine methyl ester (LeuLeuOMe) is a lysosomotropic agent which is converted to a membranolytic compound by dipeptidyl peptidase I and kills human leukocytes such as CD8+ T cells and monocytes but not B cells. The reagent has also been used in mice on the assumption that the cell-type specificity to murine leukocytes is the same as that to human leukocytes. During study on the effect of LeuLeuOMe on antigen-driven IL-2 production using murine splenocytes as antigen-presenting cells, however, we noticed that murine B cells were sensitive to LeuLeuOMe. We therefore examined the cell-type specificity using murine splenocytes and peritoneal macrophages. Flow cytometric analysis revealed that the most sensitive cells to LeuLeuOMe were CD8+ cells and that CD19+ cells (B cells) were as sensitive as CD3+ cells (T cells). Murine splenic B cells, which were either positively or negatively sorted with a cell sorter, were also sensitive to LeuLeuOMe, whereas human peripheral blood B cells, which were positively sorted, were not. Peritoneal macrophages were the most insensitive to LeuLeuOMe. Thus, this study demonstrated that the cell-type specificity to murine leukocytes is different from that to human leukocytes.
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Affiliation(s)
- Y Kobayashi
- Department of Biomolecular Science, Faculty of Science, Toho University, Chiba, Japan.
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Tobari A, Teshima M, Koyanagi J, Kawase M, Miyamae H, Yoza K, Takasaki A, Nagamura Y, Saito S. Spirostanols obtained by cyclization of pseudosaponin derivatives and comparison of anti-platelet agglutination activities of spirostanol glycosides. Eur J Med Chem 2000; 35:511-27. [PMID: 10889330 DOI: 10.1016/s0223-5234(00)00151-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Naturally occurring saponins 3 and 4 have a normal type F ring and alpha-arranged CH(3)-21 group. Treatments of pseudosaponin peracetates 18 and 19 derived from 3 and 4, respectively, with alcoholic KOH, followed by acidification with acetic acid, gave spirostanols 20 and 22 having iso type F rings as major products. Structural analyses of sapogenins and saponins derived from pseudo derivatives 11, 12, 18 and 19 were performed by comparisons of their 1H-NMR spectral data and the X-ray analytical data of 3-O-p-bromobenzoyl sarsasapogenin 7, 3-O-acetyl diosgenin 13 and saponin 20. The mechanisms of ring-closure reaction of the side chain at C-22 of pseudosapogenins and pseudosaponins were deduced using stereomodels of the spirostanols derived from 11 under various reaction conditions. Inhibitory activities of saponin diglycosides 3, 4, 20, 21 and 25 on human platelet agglutinations induced by ADP and ristocetin were compared.
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Affiliation(s)
- A Tobari
- Faculty of Pharmaceutical Sciences, Josai University, Keyakidai 1-1, Sakado, 350-0295, Saitama, Japan
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Nakamura K, Jung YM, Era S, Sogami M, Ozaki Y, Takasaki A. 1H-NMR and raman studies on perforating trauma-induced cataract formation in a mouse lens. Biochim Biophys Acta 2000; 1474:23-30. [PMID: 10699486 DOI: 10.1016/s0304-4165(99)00220-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In order to provide new insight into the molecular mechanism of perforating trauma-induced cataract formation in an 8-week-old ddY mouse lens, we performed an in situ investigation into changes in the water-protein and/or protein-protein interactions by using 500 MHz (1)H-NMR spectroscopy, and into structural alterations in lens proteins by using Raman spectroscopy. Cross-relaxation times of water protons in the perforated opaque lens were considerably shorter than those in the intact transparent lens, whereas there was no significant difference in water content, suggesting a drastic change in water-protein and protein-protein interactions in the perforated lens. In addition, there was no significant difference in the intensity ratios of several key Raman bands between intact and perforated lenses, indicating that no significant local and overall conformational changes in lens protein itself occur in the perforated lens. The present (1)H-NMR and Raman results lead us to the conclusion that changes leading to lens opacification in the perforating trauma-induced cataract appear to involve the rapid formation of immobile large lens protein aggregates without formation of intra- and intermolecular disulfide linkages, and rapid increase in a fraction of bound water associated with large protein aggregates.
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Affiliation(s)
- K Nakamura
- Department of Physiology, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu, Japan
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Tanonaka K, Takasaki A, Kajiwara H, Takeo S. Contribution of sodium channel and sodium/hydrogen exchanger to sodium accumulation in the ischemic myocardium. Gen Pharmacol 2000; 34:167-74. [PMID: 11120378 DOI: 10.1016/s0306-3623(00)00057-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Contribution of sodium channels and sodium/hydrogen exchangers (NHEs) to sodium accumulation during ischemia in the ischemic/reperfused heart was examined. Ischemia increased the myocardial sodium. Reperfusion elicited a further increase in the myocardial sodium, which was associated with little recovery of the left ventricular developed pressure (LVDP) of the perfused heart. Treatment with tetrodotoxin or dimethylamirolide (DMA) dose-dependently attenuated the ischemia- and reperfusion-induced increase in myocardial sodium and enhanced the post-ischemic recovery of the LVDP. There was an inverse relationship between the increase in myocardial sodium during ischemia and the post-ischemic recovery of the LVDP.The myocardial sodium accumulation during ischemia is mainly attributed to sodium influx through sodium channels and NHEs.
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Affiliation(s)
- K Tanonaka
- Department of Pharmacology, Tokyo University of Pharmacy and Life Science, 1432-1 Horinouchi, Tokyo 192-0392, Hachioji, Japan
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Tanonaka K, Kajiwara H, Kameda H, Takasaki A, Takeo S. Relationship between myocardial cation content and injury in reperfused rat hearts treated with cation channel blockers. Eur J Pharmacol 1999; 372:37-48. [PMID: 10374713 DOI: 10.1016/s0014-2999(99)00172-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A role for K+ and Ca2+ channel blockers in cardiac contractile dysfunction and myocardial ionic imbalance was examined in isolated rat hearts with 35-min ischemia and 60-min reperfusion. The K+ channel blockers glibenclamide (1-30 microM) and sematilide (1-30 microM), Ca2+ channel blockers diltiazem (0.1-3 microM) and nicardipine (0.03-1 microM) and fast Na+ channel blocker tetrodotoxin (0.01-0.3 microM) were delivered for the last 3-min pre-ischemia. Ischemia-induced increase in Na+ content was attenuated by diltiazem and tetrodotoxin at all concentrations employed and by nicardipine at 0.3 microM, whereas the ischemia-induced loss of K+ was suppressed partially by glibenclamide and sematilide and almost completely by the two drugs in combination. Left ventricular developed pressure of untreated hearts did not recover upon reperfusion, which was associated with increases in myocardial Na+ and Ca2+ contents and decreases in K+ and Mg2+ contents. Glibenclamide and sematilide neither enhanced the post-ischemic recovery of left ventricular developed pressure nor affected cation changes during reperfusion. Diltiazem enhanced the recovery of left ventricular developed pressure and attenuated imbalance of the myocardial Na+ during ischemia and of all myocardial cations examined during reperfusion. The effects of nicardipine on these parameters were small. Tetrodotoxin enhanced the recovery of left ventricular developed pressure and reversed the imbalance of all myocardial cations examined during reperfusion in a concentration-dependent manner. The results suggest that blockade of transmembrane flux of K+ during ischemia plays a minor role in the improvement of post-ischemic contractile recovery, rather blockade of transmembrane flux of Na+ attenuates the ischemia and reperfusion injury.
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Affiliation(s)
- K Tanonaka
- Department of Pharmacology, Tokyo University of Pharmacy and Life Science, Hachioji, Japan
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Takasaki A, Hayashi N, Matsubara M, Yamauchi E, Taniguchi H. Identification of the calmodulin-binding domain of neuron-specific protein kinase C substrate protein CAP-22/NAP-22. Direct involvement of protein myristoylation in calmodulin-target protein interaction. J Biol Chem 1999; 274:11848-53. [PMID: 10207003 DOI: 10.1074/jbc.274.17.11848] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Various proteins in the signal transduction pathways as well as those of viral origin have been shown to be myristoylated. Although the modification is often essential for the proper functioning of the modified protein, the mechanism by which the modification exerts its effects is still largely unknown. Brain-specific protein kinase C substrate, CAP-23/NAP-22, which is involved in the synaptogenesis and neuronal plasticity, binds calmodulin, but the protein lacks any canonical calmodulin-binding domain. In the present report, we show that CAP-23/NAP-22 isolated from rat brain is myristoylated and that the modification is directly involved in its interaction with calmodulin. Myristoylated and non-myristoylated recombinant proteins were produced in Escherichia coli, and their calmodulin-binding properties were examined. Only the former bound to calmodulin. Synthetic peptides based on the N-terminal sequence showed similar binding properties to calmodulin, only when they were myristoylated. The calmodulin-binding site narrowed down to the myristoyl moiety together with a nine-amino acid N-terminal basic domain. Phosphorylation of a single serine residue in the N-terminal domain (Ser5) by protein kinase C abolished the binding. Furthermore, phosphorylation of CAP-23/NAP-22 by protein kinase C was also found myristoylation-dependent, suggesting the importance of myristoylation in protein-protein interactions.
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Affiliation(s)
- A Takasaki
- Division of Biomedical Polymer Science, Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi 470-1192, Japan
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Hayashi N, Matsubara M, Takasaki A, Titani K, Taniguchi H. An expression system of rat calmodulin using T7 phage promoter in Escherichia coli. Protein Expr Purif 1998; 12:25-8. [PMID: 9473453 DOI: 10.1006/prep.1997.0807] [Citation(s) in RCA: 128] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An efficient expression system of rat calmodulin in Escherichia coli is presented. To express rat calmodulin cDNA, we employed a pET expression vector which contains the T7 phage promoter and terminator. After transformation of E. coli BL21(DE3) strain which carries T7 phage RNA polymerase inducible with isopropyl-beta-D-thiogalactopyranoside, induction of the expression, and chromatography of soluble proteins on a phenyl-Sepharose column, about 250 mg of recombinant rat calmodulin was obtained from 1 liter of E. coli culture. The recombinant calmodulin lacked the N-terminal methionine, and posttranslational modifications such as Nalpha-acetylation and methylation. This system facilitates the large amount preparation of calmodulin and the mutant proteins required for the structural analysis by NMR spectrometry and/or X-ray crystallography.
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Affiliation(s)
- N Hayashi
- Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Aichi, 470-11, Japan.
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Yakabe A, Sugino N, Hayashi K, Yamashita S, Ito T, Takasaki A. [Effect of vaginal antibiotics suppository on retroperitoneal-space infection after hysterectomy and lymphadenectomy for uterine cancer]. Nihon Gan Chiryo Gakkai Shi 1989; 24:2499-503. [PMID: 2614187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Effects of vaginal antibiotics suppository on the retroperitoneal-space infection were studied in 42 patients who had hysterectomy and lymphadenectomy with diagnosis of uterine cancer stage I or II. All patients received intravenous administration of 1 g LMOX (3 times/day) for 7 days after operation. One group of patients (21 cases) received 0.5 g of ABPC vaginal suppository (twice/day) for 10 days immediately after operation. Another group of 21 patients did not received vaginal suppository. The LMOX concentrations in the exudate decreased rapidly from the 3rd day to the 7th day. The frequencies of bacterial appearance in the retroperitoneal-space in the vaginal suppository group were 33% on 5th day, 33% on 7th day and 20% on 9th day, while those in the control group were 100%, 100% and 76%, respectively. It was concluded that the administration of vaginal antibiotics suppository was easy to handle and effective for preventing the retroperitoneal-space infection after hysterectomy and lymphadenectomy.
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Miyauchi F, Inoguchi H, Takasaki A, Tamura H, Kato H, Torigoe T. [Regulation of progesterone accumulation in dissociated luteal cells on day 15 of pregnancy in rats]. Nihon Sanka Fujinka Gakkai Zasshi 1989; 41:383-9. [PMID: 2746064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Luteal cells from the corpora lutea of rats on day 15 of pregnancy were suspended in DMEM-F12 and progesterone accumulation was measured by radioimmunoassay. Progesterone accumulation increased steadily over eight hours and then gradually decreased. Progesterone accumulation was seen to increase with the addition of BSA and 25-hydroxycholesterol. At doses of 12 ng/ml and 600 ng/ml hCG, progesterone accumulation increased, but was seen to decrease at a dose of 30 micrograms/ml hCG. However, the addition of cyclohexamide alone had no effect on progesterone accumulation, but the simultaneous addition of cyclohexamide and hCG blocked the effects of hCG in a dose related manner. These data indicate that progesterone production by rat luteal cells depends on cholesterol availability. The results reveal that hCG stimulates progesterone production by a process requiring new protein synthesis.
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Affiliation(s)
- F Miyauchi
- Department of Obstetrics and Gynecology, Yamaguchi University School of Medicine
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Yakabe A, Sugino N, Yamashita S, Kinashi N, Ito T, Kamei T, Takasaki A. [Treatment of advanced cervical cancer with sequential administration of OK-432]. Nihon Sanka Fujinka Gakkai Zasshi 1988; 40:1911-4. [PMID: 3209918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- A Yakabe
- Division of Obstetrics and Gynecology, Tokuyama Chuo General Hospital, Yamaguchi
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Nagasawa K, Takenaka Y, Takasaki A. [Experimental study of methanol poisoning. 3. Distribution and conversion of 14C-methanol in rabbits]. Eisei Shikenjo Hokoku 1966; 84:35-39. [PMID: 6008590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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