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Saito K, Saito Y, Muramatsu T, Kitahara H, Fujimoto Y, Isono S, Kobayashi Y. Impact of perioperative interruption of antithrombotic therapy on thrombotic and bleeding events in non-cardiac surgery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.159] [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
Funding Acknowledgements
Type of funding sources: None.
Introduction
Antithrombotic therapy including antiplatelet agents and anticoagulants are prescribed for secondary prevention in patients with established cardiovascular disease. Although antithrombotic therapy is often interrupted before non-cardiac surgery with or without perioperative bridging anticoagulation, the impact on thrombotic and bleeding events remains uncertain.
Purpose
The aim of this study was to clarify the impact of perioperative interruption of anticoagulants on thrombotic and bleeding events in patients with established CVD undergoing elective non-cardiac surgery.
Methods
A total of 330 patients chronically treated with antithrombotic therapy for secondary prevention underwent elective non-cardiac surgery under general anesthesia, with the complete interruption of antithrombotic agents. The study endpoints included all-cause death, thrombotic events, and major bleeding complications after surgical procedures.
Results
Of 330 patients, 171 (51.8%) and 159 (48.2%) received antiplatelet agents and anticoagulants perioperatively. Atrial fibrillation (31.8%) and coronary artery disease (20.3%) were the major indications for antithrombotic regimens. Antithrombotic therapy was interrupted from 5 [2, 7] days before the surgery to 4 [2, 7] days postoperatively. Perioperative bridging therapy with unfractionated heparin was employed in 99 (30.0%) patients. During the hospitalization, 3 (0.9%) patients died due to non-cardiovascular causes. Thrombotic events and major bleeding occurred in 2 (0.6%) and 9 (2.7%) patients. Bridging therapy with heparin was non-significantly associated with an increased risk of bleeding events (5.1% vs. 1.7%, p = 0.09). In univariable and multivariable analyses, pre-operative hemoglobin level and operative duration were significantly associated with bleeding complications.
Conclusions
In the present study, complete interruption of antithrombotic therapy resulted in a few thrombotic events with a numerically higher rate of bleeding events in patients undergoing elective non-cardiac surgery. Pre-operative hemoglobin level and operative duration were significantly associated with post-operative bleeding complications.
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Affiliation(s)
- K Saito
- Chiba University Hospital, Chiba, Japan
| | - Y Saito
- Chiba University Hospital, Chiba, Japan
| | | | | | | | - S Isono
- Chiba University Hospital, Chiba, Japan
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2
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Shugurov AI, Bodrov SB, Mashkovich EA, Kitahara H, Abramovsky NA, Tani M, Bakunov MI. Noncollinear electro-optic sampling detection of terahertz pulses in a LiNbO 3 crystal while avoiding the effect of intrinsic birefringence. Opt Express 2022; 30:3741-3748. [PMID: 35209626 DOI: 10.1364/oe.446281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
We propose and experimentally prove efficient high-resolution electro-optic sampling measurement of broadband terahertz waveforms in a LiNbO3 crystal in the configuration with the probe laser beam propagating along the optical axis of the crystal. This configuration allows one to avoid the detrimental effect of strong intrinsic birefringence of LiNbO3 without any additional optical elements. To achieve velocity matching of the terahertz wave and the probe beam, the terahertz wave is introduced into the crystal through a Si prism at the Cherenkov angle to the probe beam. The workability of the scheme at different wavelengths of the probe optical beam (800 and 1550 nm) is demonstrated.
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Tateishi K, Kondo Y, Saito Y, Kitahara H, Kobayashi Y. Implantable cardioverter-defibrillator therapy after resuscitation from cardiac arrest in vasospastic angina. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0690] [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
Patients with vasospastic angina (VSA) who are resuscitated from sudden cardiac arrest (SCA) are at high risk of recurrent cardiovascular events. However, there are no recommendations for implantable cardioverter-defibrillator (ICD) therapy in the VSA and SCA patient guidelines.
Purpose
This study investigated the prognostic impact of ICD therapy on patients with VSA and SCA.
Methods
The present multi-center registry included 280 patients who were resuscitated from SCA and received ICD implantation as secondary prophylaxis. The patients were divided into two groups according to the presence of VSA. The primary endpoint was a composite of all-cause death and appropriate ICD therapy, including appropriate anti-tachycardia pacing and shock for recurrent ventricular arrhythmias.
Results
Of 280 patients, 51 (18%) had VSA. Among those without VSA, ischemic cardiomyopathy was the leading cause of SCA (38%), followed by non-ischemic cardiomyopathies and Brugada syndrome (Table 1). During the median follow-up period of 3.8 years, 23 (8%) patients died, and 72 (26%) underwent appropriate ICD therapy. The incidence of the primary endpoint was not significantly different between patients with and without VSA (24% vs 33%, p=0.19). Further, the incidence of the primary endpoint was not significantly different among the etiologies (Figure 1)
Conclusions
In a cohort of patients who underwent ICD implantation as secondary prophylaxis, long-term clinical outcomes were comparable between those with VSA and those with other cardiac diseases after SCA. The results suggest that ICD therapy may be considered in patients with VSA and those with other etiologies after resuscitation from SCA.
Funding Acknowledgement
Type of funding sources: None. Table 1. Patient characteristics and outcomesFigure 1. Incidence of the primary endpoint
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Affiliation(s)
- K Tateishi
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kondo
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Saito
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - H Kitahara
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kobayashi
- Chiba University Hospital, Cardiology, Chiba, Japan
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Sakakibara N, Ijuin T, Horinouchi T, Yamamura T, Nagano C, Okada E, Ishiko S, Aoto Y, Rossanti R, Ninchoji T, Awano H, Nagase H, Minamikawa S, Tanaka R, Matsuyama T, Nagatani K, Kamei K, Jinnouchi K, Ohtsuka Y, Oka M, Araki Y, Tanaka T, Harada MS, Igarashi T, Kitahara H, Morisada N, Nakamura SI, Okada T, Iijima K, Nozu K. Identification of novel OCRL isoforms associated with phenotypic differences between Dent disease-2 and Lowe syndrome. Nephrol Dial Transplant 2021; 37:262-270. [PMID: 34586410 DOI: 10.1093/ndt/gfab274] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Although Lowe syndrome and Dent disease-2 are both caused by OCRL mutations, their clinical severities differ substantially, and their molecular mechanisms remain unclear. Truncating mutations in OCRL exons 1 through 7 lead to Dent disease-2, whereas those in exons 8 through 24 lead to Lowe syndrome. Herein, we identified the mechanism underlying the action of novel OCRL protein isoforms. METHODS mRNA samples extracted from cultured urine-derived cells from a healthy control and the Dent disease-2 patient were examined to detect the 5' end of the OCRL isoform. For protein expression and functional analysis, vectors containing (1) the full-length OCRL transcripts, (2) the isoform transcripts, and (3) transcripts with truncating mutations detected in Lowe syndrome and Dent disease-2 patients were transfected into HeLa cells. RESULTS We successfully cloned the novel isoform transcripts from OCRL exons 6-24, including the translation-initiation codons present in exon 8. In vitro protein-expression analysis detected proteins of two different sizes (105 and 80 kDa) translated from full-length OCRL, whereas only one protein (80 kDa) was found from the isoform and Dent disease-2 variants. No protein expression was observed for the Lowe syndrome variants. The isoform enzyme activity was equivalent to that of full-length OCRL; the Dent disease-2 variants retained > 50% enzyme activity, whereas the Lowe syndrome variants retained < 20% activity. CONCLUSIONS We elucidated the molecular mechanism underlying the two different phenotypes in OCRL-related diseases; the functional OCRL isoform translated starting at exon 8 was associated with this mechanism.
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Affiliation(s)
- Nana Sakakibara
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Ijuin
- Division of Biochemistry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoko Horinouchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomohiko Yamamura
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Eri Okada
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Nephrology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shinya Ishiko
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuya Aoto
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Rini Rossanti
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takeshi Ninchoji
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Awano
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shogo Minamikawa
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryojiro Tanaka
- Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | | | - Koji Nagatani
- Department of Pediatrics, Uwajima City Hospital, Uwajima, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Kumiko Jinnouchi
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Yasufumi Ohtsuka
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Masafumi Oka
- Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan
| | - Yoshinori Araki
- Department of Pediatrics, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Toju Tanaka
- Department of Pediatrics, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan
| | - Mari S Harada
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Toru Igarashi
- Department of Pediatrics, Nippon Medical School Hospital, Tokyo, Japan
| | - Hikaru Kitahara
- Department of Pediatrics, Osaka Medical College, Takatsuki, Japan
| | - Naoya Morisada
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.,Department of Clinical Genetics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
| | - Shun-Ichi Nakamura
- Division of Biochemistry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taro Okada
- Division of Biochemistry, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
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Shadman S, Ahmed S, Nawaz A, Hofmeyer M, Kadakkal A, Lam P, Rao S, Rodrigo M, Elliott T, Kitahara H, Najjar S, Molina E, Sheikh F. Destination LVAD Therapy in African American (AA) Recipients: A Single Center Experience. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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6
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Shah H, Papolos A, Molina E, Najjar S, Kadakkal A, Hofmeyer M, Kenigsberg B, Sheikh F, Lam P, Kitahara H, Cohen J, Peters L, Wllis C, Barnett C. Argatroban as an Alternative Anticoagulant in Impella Supported Patients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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7
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Saito Y, Mori N, Saito K, Matsuoka T, Tateishi K, Kitahara H, Fujimoto Y, Kobayashi Y. Greater coronary lipid core plaque assessed by near-infrared spectroscopy intravascular ultrasound in patients with elevated xanthine oxidoreductase: a mechanistic insight. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1297] [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
Elevated serum uric acid level was reportedly associated with greater coronary lipid plaque. Xanthine oxidoreductase (XOR) is a rate-limiting enzyme in purine metabolism and believed to play important roles in coronary atherosclerosis. However, the relation of XOR to coronary lipid plaque and its mechanism are unclear.
Purpose
The aim of this study was to assess the impact of XOR on coronary lipid plaque and the associated factors with XOR in coronary artery disease (CAD).
Methods
Patients with stable CAD undergoing elective percutaneous coronary intervention under near-infrared spectroscopy intravascular ultrasound (NIRS-IVUS) guidance were prospectively enrolled. They were divided into three groups according to serum XOR activities; low, normal, and high. Coronary lipid core plaques in non-target vessels were evaluated by NIRS-IVUS with lipid core burden index (LCBI) and a maximum LCBI in 4 mm (maxLCBI4mm). Systemic endothelial function and inflammation were assessed with reactive hyperemia index (RHI) and high-sensitivity C-reactive protein, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio.
Results
Of 68 patients, 26, 31, and 11 were classified as low, normal, and high XOR activity groups. LCBI (474.4±171.6 vs. 347.4±181.6 vs. 294.0±155.9, p=0.04) and maxLCBI4mm (102.1±56.5 vs. 65.6±48.5 vs. 55.6±37.8, p=0.04) were significantly higher in high XOR group than in normal and low XOR groups. Although RHI was significantly correlated with body mass index, diabetes, current smoking, and high-density lipoprotein cholesterol, no relation was found between XOR activity and RHI (Figure). There were also no relations between XOR activity and high-sensitivity C-reactive protein, neutrophil-to-lymphocyte ratio, or platelet-to-lymphocyte ratio (Figure).
Conclusion
Elevated XOR activity was associated with greater coronary lipid plaque in patients with stable CAD, without significant relations to systemic endothelial function and inflammation.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Saito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - N Mori
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Saito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Matsuoka
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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8
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Kato K, Tateishi K, Saito Y, Kitahara H, Fujimoto Y, Kobayashi Y. Comparison of clinical characteristics between patients with microvascular and epicardial coronary artery spasm. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1281] [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
Coronary functional abnormalities including both epicardial and microvascular coronary artery spasm represent an important role responsible for myocardial ischemia in patients with angina and nonobstructive coronary artery disease. However, clinical characteristics associated with microvascular spasm (MVS) have not been fully evaluated.
Purpose
The aim of this study was to assess differences in clinical features between patients with MVS and epicardial coronary spasm.
Methods
A total of 732 consecutive patients with suspected angina who presented nonobstructive coronary arteries and underwent intracoronary acetylcholine provocation test were retrospectively enrolled in this study. Epicardial coronary spasm was defined as total or subtotal occlusion of epicardial coronary arteries accompanied by chest pain and/or ischemic electrocardiographic changes in response to acetylcholine provocation test. MVS was diagnosed when chest pain and/or ischemic electrocardiographic changes developed after administration of acetylcholine in the absence of epicardial coronary spasm. Clinical characteristics were compared between patients with MVS and epicardial coronary spasm.
Results
Of all patients, 83 patients (11%) had MVS, 367 (50%) had epicardial coronary spasm, and the other patients (39%) showed neither MVS nor epicardial coronary spasm. Patients with MVS tended to be older (65.6±12.7 vs. 63.0±12.3 years, P=0.088) and were more frequently female (60.2% vs. 41.1%, P=0.0016) in comparison with patients with epicardial coronary spasm. Patients with MVS were less likely to be smokers (8.6% vs. 22.9%, P=0.0018), while there were no significant differences in the other coronary risk factors such as hypertension, dyslipidemia, and diabetes mellitus. Serum uric acid were significantly lower in patients with MVS (4.9±1.1 vs. 5.4±1.3 mg/dl, P=0.0018).
Conclusion
Our study demonstrated that patients with MVS had distinctive clinical background from those with epicardial coronary spasm, suggesting different mechanisms may involve the development of MVS.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Kato
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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Satou T, Kitahara H, Ishikawa K, Nakayama T, Fujimoto Y, Sano K, Kobayashi Y. Short-term risk stratification using CADILLAC risk score in patients with ST elevation myocardial infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1352] [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
The recent reperfusion therapy for ST-elevation myocardial infarction (STEMI) has made the length of hospital stay shorter without adverse events. CADILLAC risk score is reportedly one of the risk scores predicting the long-term prognosis in STEMI patients.
Purpose
To invenstigate the usefulness of CADILLAC risk score for predicting short-term outcomes in STEMI patients.
Methods
Consecutive patients admitted to our university hospital and our medical center with STEMI (excluding shock, arrest case) who underwent primary PCI between January 2012 and April 2018 (n=387) were enrolled in this study. The patients were classified into 3 groups according to the CADILLAC risk score: low risk (n=176), intermediate risk (n=87), and high risk (n=124). Data on adverse events within 30 days after hospitalization, including in-hospital death, sustained ventricular arrhythmia, recurrent myocardial infarction, heart failure requiring intravenous treatment, stroke, or clinical hemorrhage, were collected.
Results
In the low risk group, adverse events within 30 days were significantly less observed, compared to the intermediate and high risk groups (n=13, 7.4% vs. n=13, 14.9% vs. n=58, 46.8%, p<0.001). In particular, all adverse events occurred within 3 days in the low risk group, although adverse events, such as heart failure (n=4), recurrent myocardial infarction (n=1), stroke (n=1), and gastrointestinal bleeding (n=1), were substantially observed after day 4 of hospitalization in the intermediate and high risk groups.
Conclusions
In STEMI patients with low CADILLAC risk score, better short-term prognosis was observed compared to the intermediate and high risk groups, and all adverse events occurred within 3 days of hospitalization, suggesting that discharge at day 4 might be safe in this study population. CADILLAC risk score may help stratify patient risk for short-term prognosis and adjust management of STEMI patients.
Initial event occurrence timing
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Satou
- Chiba University Hospital, Chiba, Japan
| | | | - K Ishikawa
- Eastern Chiba Medical Center, Cardiology, Chiba, Japan
| | | | | | - K Sano
- Eastern Chiba Medical Center, Cardiology, Chiba, Japan
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10
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Kato K, Tateishi K, Saito Y, Kitahara H, Fujimoto Y, Kobayashi Y. Age-related differences and vascular function test findings in patients with vasospastic angina. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1575] [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
Vasospastic angina (VSA) accounts for the majority of angina cases with no epicardial stenosis and develops amongawide range of age, which is reportedly induced by coronary functional abnormalities including endothelial dysfunction and smooth muscle hypercontraction. However, the relation of noninvasive vascular function tests to VSA remains to be fully elucidated.
Purpose
The aim of this study was to assess differences in clinical characteristics and findings from noninvasive vascular function tests among groups by age in patients with VSA.
Methods
We enrolled a total of 732 patients with angina who underwent intracoronary acetylcholine provocation test. VSA was defined as total or subtotal occlusion of epicardial coronary arteries accompanied by chest pain and/or ischemic electrocardiographic changes in response to acetylcholine administration. Patients with VSA were divided into 3 groups by age (young [<50 years], intermediate [50–64 years], and elderly group [≥65 years]). Noninvasive vascular function test findings such as ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), andpercentage of mean arterial pressure (%MAP) were compared among groups by age in patients with VSA.
Results
Of all patients, 367 (50.1%) were diagnosed as VSA with intracoronary acetylcholine test, including 66 (18.0%), 113 (30.8%), and 188 (51.2%) patients in the young, intermediate, and elderly groups. Among groups by age, there was no significant difference in gender (female, 31.8% vs. 40.7% vs. 44.7%, P=0.19). Patients in the young group were more often smokers and alcohol drinkers than those in the intermediate and elderly groups, while the prevalence of hypertension, dyslipidemia, and diabetes were lower in younger patients. A history of percutaneous coronary intervention was less frequently found in the young group compared tothe intermediate and elderly groups (7.6% vs. 16.8% vs. 20.7%, P=0.033). The baPWV was higher in the elderly group (1424±232 vs. 1537±247 vs. 1774±358 cm/s, P<0.0001), while there was no difference in ABI between the 3 groups. %MAP at arms was significantly and progressively decreased with an increase in age (54.0±4.5% vs. 53.0±2.6% vs. 51.2±2.8%, P<0.0001).
Conclusion
Our study demonstrated that there were distinct age-related differences in clinical characteristics of patients with VSA. The higher %MAP in younger patients suggests that more impaired endothelial dysfunction may play a role in the development of VSA in this age group.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Kato
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - H Kitahara
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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11
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Kudo-Kubo A, Shimakawa S, Odanaka Y, Ikeda N, Kitahara H, Toshikawa H, Ashida A, Fukui M, Ozaki N, Kishi K, Wanibuchi M, Ashida A. Multiple brain abscesses with good prognosis in an infant with cyanotic congenital heart disease: a case report. J Med Case Rep 2020; 14:111. [PMID: 32690062 PMCID: PMC7372864 DOI: 10.1186/s13256-020-02436-3] [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: 04/22/2020] [Accepted: 06/08/2020] [Indexed: 11/19/2022] Open
Abstract
Background Brain abscesses are relatively rare, but they are a potentially life-threatening condition. Predictive factors for poor outcome are a young age and the presence of multiple abscesses. We report a case of a 15-month-old girl with cyanotic congenital heart disease who developed multiple brain abscesses caused by Streptococcus intermedius. The patient was treated with a combination of surgical aspiration and antimicrobial therapy without apparent neurological sequelae. To the best of our knowledge, this is the youngest such patient to have been reported in the literature. We explore the possible causes of her good outcome. Case presentation At the age of 15 months, the Japanese patient initially was presented to our hospital with transient eye deviation to the left and vomiting. In a blood examination, her white blood cell count (12,720 per mm3 with a left shift) and C-reactive protein level (1.23 mg/ml) were slightly elevated. Magnetic resonance imaging of the brain showed three mass lesions. These were 1.5-cm, 1.9-cm, and 1.2-cm rim-enhancing lesions with extensive surrounding edema. Brain abscesses were diagnosed, and vancomycin (50 mg every 12 hours) and meropenem (40 mg every 8 hours) were started empirically. However, because each brain abscess was enlarged at 8 days after admission, surgical aspiration was performed at 10 days after admission, and cultures of the aspirated pus grew S. intermedius. Penicillin G (0.7 million units every 4 hours) and ceftriaxone (280 mg every 12 hours), to which this isolate is susceptible, were then administered, and the brain abscesses reduced in size. After 1 month of ceftriaxone and 3 months of penicillin G treatment, all of the brain abscesses disappeared. Apparent neurological sequelae were not observed at 6 months after onset. Conclusions A good outcome can be obtained if multiple brain abscesses develop in infancy or early childhood in cases without unconsciousness at admission, meningitis, or sepsis. Appropriate antimicrobial therapy should be started immediately after diagnosis, with surgical aspiration performed to identify the causative pathogen and avoid intraventricular rupture of the brain abscesses.
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Affiliation(s)
- Atsuko Kudo-Kubo
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Shuichi Shimakawa
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan.
| | - Yutaka Odanaka
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Naokado Ikeda
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hikaru Kitahara
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Hiromitsu Toshikawa
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Atsuko Ashida
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Miho Fukui
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Noriyasu Ozaki
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Kanta Kishi
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
| | - Masahiko Wanibuchi
- Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Akira Ashida
- Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Takatsuki, Osaka, 569-8686, Japan
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Kitahara H, Najjar S, Ahmed S, Lam P, Kadakkal A, Mohammed S, Rodrigo M, HOfmeyer M, Sheikh F, Molina E. One-Year Survival Rate after Thoracotomy for Left Ventricular Assist Device Implantation Compared with Sternotomy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sheikh F, Peters L, Grinstein J, Ahmed S, Rodrigo M, Hofmeyer M, Kadakkal A, Mohammed S, Kitahara H, Najjar S, Molina E. Feasibility of Delayed Parenteral Heparin Initiation after HM3 Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Molina E, Najjar S, Ahmed S, Rodrigo M, Hofmeyer M, Kadakkal A, Mohammed S, Lam P, Kitahara H, Sheikh F. Real World Experience with the HeartMate 3 (HM3) Left Ventricular Assist Device (LVAD): Analysis of the First 125 Consecutive Patients at a Single Institution. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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15
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Molina E, Sheikh F, Ahmed S, Rodrigo M, Hofmeyer M, Kadakkal A, Mohammed S, Lam P, Kitahara H, Najjar S. Outcomes in Patients with Smaller Left Ventricular End Diastolic Diameter Following HeartMate 3 (HM3) Left Ventricular Assist Device (LVAD) Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Sheikh F, Babola N, Ahmed S, Rodrigo M, Hofmeyer M, Kadakkal A, Kitahara H, Molina E, Mohammed S, Najjar S, Elliott T. Admissions Due to HeartMate 3 (HM3) Alarms. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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17
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Tateishi K, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P5538Safety and efficacy of acetylcholine provocation test for diagnosis of vasospastic angina in young patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0484] [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
Vasospastic angina (VSA) is considered as a cause of myocardial infarction with nonobstructive coronary arteries. Given the previous reports of higher incidence of cardiovascular events in young VSA patients, early diagnosis and optimal treatment are important for these patients. While acetylcholine provocation test (ACh test) for VSA diagnosis is well reported, ACh test among young patients is not as commonly performed, therefore its safety and usefulness for this patient subset have not been fully evaluated.
Purpose
The purpose of this study was to evaluate the safety and the proportion of positive results of ACh test for young patients.
Methods
Data from patients who underwent ACh test in our institution from May 2012 to September 2018 were retrospectively analyzed. A total of 669 patients were enrolled and divided into 2 groups according to age: Young group (Age≤50, n=106); and Senior group (Age>50, n=563).
Results
The senior group had a higher incidence of hypertension, dyslipidemia, diabetes mellitus, and coronary artery disease. On the other hand, the young group had a significantly higher incidence of current smoker and tendency of daily alcohol. The rate of positive ACh test was similar, and there were no significant differences in major or minor complications between the 2 groups.
Patient characteristics and outcome Young group Senior group p (n=106) (n=563) Age (years) 42.8±7.3 68.0±9.0 <0.001 Male (%) 56.6 52.2 0.407 Current smoker (%) 34.9 15.4 <0.001 Daily alcohol (%) 31.1 22.9 0.070 Hypertension (%) 33.0 66.6 <0.001 Dyslipidemia (%) 50.0 68.4 <0.001 Diabetes (%) 12.3 20.8 0.047 ACh positive (%) 52.8 49.9 0.581 Minor adverse event (%) 4.7 5.9 0.820 Major adverse event (%) 0.9 1.4 1.000 Major adverse event: composite of death, ventricular fibrillation, sustained ventricular tachycardia (VT), myocardial infarction and stroke. Minor adverse event: non-sustained VT and paroxysmal atrial fibrillation.
Conclusion
ACh provocation test for young patients can be safely performed, and the rate of positive results was similar to that of senior patients. In young patients suspected of having VSA, ACh test should be actively performed to identify optimal medical therapy for prevention of cardiovascular events.
Acknowledgement/Funding
None
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Affiliation(s)
- K Tateishi
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - H Kitahara
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - T Nakayama
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Fujimoto
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kobayashi
- Chiba University Hospital, Cardiology, Chiba, Japan
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Yamamoto T, Imaizumi T, Yamamoto-Shimojima K, Lu Y, Yanagishita T, Shimada S, Chong PF, Kira R, Ueda R, Ishiyama A, Takeshita E, Momosaki K, Ozasa S, Akiyama T, Kobayashi K, Oomatsu H, Kitahara H, Yamaguchi T, Imai K, Kurahashi H, Okumura A, Oguni H, Seto T, Okamoto N. Genomic backgrounds of Japanese patients with undiagnosed neurodevelopmental disorders. Brain Dev 2019; 41:776-782. [PMID: 31171384 DOI: 10.1016/j.braindev.2019.05.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 11/26/2018] [Revised: 05/08/2019] [Accepted: 05/21/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Recently, many genes related to neurodevelopmental disorders have been identified by high-throughput genomic analysis; however, a comprehensive understanding of the mechanism underlying neurodevelopmental disorders remains to be established. To further understand these underlying mechanisms, we performed a comprehensive genomic analysis of patients with undiagnosed neurodevelopmental disorders. METHODS Genomic analysis using next-generation sequencing with a targeted panel was performed for a total of 133 Japanese patients (male/female, 81/52) with previously undiagnosed neurodevelopmental disorders, including developmental delay (DD), intellectual disability (ID), autism spectrum disorder (ASD), and epilepsy. Genomic copy numbers were also analyzed using the eXome Hidden Markov Model (XHMM). RESULTS Thirty-nine patients (29.3%) exhibited pathogenic or likely pathogenic findings with single-gene variants or chromosomal aberrations. Among them, 20 patients were presented here. Pathogenic or likely pathogenic variants were identified in 18 genes, including ACTG1, CACNA1A, CHD2, CDKL5, DNMT3A, EHMT1, GABRB3, GABRG2, GRIN2B, KCNQ3, KDM5C, MED13L, SCN2A, SHANK3, SMARCA2, STXBP1, SYNGAP1, and TBL1XR1. CONCLUSION A diagnostic yield of 29.3% in this study was nearly the same as that previously reported from other countries. Thus, we suggest that there is no difference in genomic backgrounds in Japanese patients with undiagnosed neurodevelopmental disabilities. Although most of the patients possessed de novo variants, one of the patients showed an X-linked inheritance pattern. As X-linked recessive disorders exhibit the possibility of recurrent occurrence in the family, comprehensive molecular diagnosis is important for genetic counseling.
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Affiliation(s)
- Toshiyuki Yamamoto
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Tokyo Women's Medical University Institute of Integrated Medical Sciences, Tokyo, Japan.
| | - Taichi Imaizumi
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Department of Pediatrics, St. Mariannna University School of Medicine, Kawasaki, Japan
| | - Keiko Yamamoto-Shimojima
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Tokyo Women's Medical University Institute of Integrated Medical Sciences, Tokyo, Japan
| | - Yongping Lu
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomoe Yanagishita
- Institute of Medical Genetics, Tokyo Women's Medical University, Tokyo, Japan; Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Shino Shimada
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Pin Fee Chong
- Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Ryutaro Kira
- Department of Pediatric Neurology, Fukuoka Children's Hospital, Fukuoka, Japan
| | - Riyo Ueda
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Akihiko Ishiyama
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Eri Takeshita
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Ken Momosaki
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Shiro Ozasa
- Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomoyuki Akiyama
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Katsuhiro Kobayashi
- Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroo Oomatsu
- Department of Pediatrics, National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Hikaru Kitahara
- Department of Pediatrics, National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Tokito Yamaguchi
- Department of Pediatrics, National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Katsumi Imai
- Department of Pediatrics, National Epilepsy Center, NHO Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | | | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Hirokazu Oguni
- Department of Pediatrics, Tokyo Women's Medical University, Tokyo, Japan
| | - Toshiyuki Seto
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Nobuhiko Okamoto
- Department of Medical Genetics, Osaka Women's and Children's Hospital, Izumi, Japan
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Saito K, Kondo Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P4453Predictors of sustained ventricular arrhythmias during late phase in patients with reduced left ventricular ejection fraction after myocardial infarction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0852] [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
Sustained ventricular arrhythmias (VAs) and death are feared events post myocardial infarction (post-MI). Patients with heart failure post-MI have higher risk of VAs, compared to those without heart failure. Although the risk of sudden cardiac arrest and death post-MI isn't small, previous clinical trials have failed to demonstrate the benefit of early use of implantable cardioverter defibrillators. Moreover, little is known about the relationship between the acute phase and the late phase VAs in patients with heart failure post-MI.
Purpose
The aim of this study was to determine the predictors of the late phase VAs in patients with heart failure post MI.
Methods
We retrospectively analyzed our database of MI patients from January 2012 to September 2016.
Results
A total of consecutive 460 post-MI patients were included in this study (age, 67±12 year-old; male, 336 (73%); STEMI, 281 (61%)). All the patients underwent primary percutaneous coronary intervention. Of those, 90 patients (20%) had depressed left ventricular ejection fraction (LVEF) ≤35%. After a mean follow up period of 30±16 months, 45 patients (50%) had VAs after MI. Among them, 35 patients (78%) had VAs within 48 hours after MI onset, 8 patients (18%) within 7 days 48 hours later, and 21 patients (47%) more than 7 days. Cox-regression analysis showed that VAs within 7 days 48 hours later after MI onset was significantly related to sustained VAs more than 7 days after MI onset (Hazard Ratio, 4.97; 95% Confidence Interval, 1.31–18.9; p=0.019).
Conclusions
VAs in the sub-acute phase after MI predicted sustained VAs in the late phase in this population. Prompt initiation of aggressive antiarrhythmic therapies, including catheter ablation, after MI should be considered to reduce the mortality.
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Affiliation(s)
- K Saito
- Chiba University Hospital, Chiba, Japan
| | - Y Kondo
- Chiba University Hospital, Chiba, Japan
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Koda Y, Kitahara H, Kim G, Sarswat N, Kalantari S, Smith B, Raikhelkar J, Sayer G, Onsager D, Song T, Uriel N, Jeevanandam V, Ota T. Surgical Device Exchange is Favorable to Treat Device Thrombosis Compared to Medical Therapy. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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21
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Hirai M, Kobayashi Y, Miyazawa M, Kitahara H, Kawashiri S, Nakamura H. Matrix metalloproteinase-mediated regulation of programmed-death ligand in the human head and neck squamous cell carcinoma microenvironment. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy268.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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22
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Kitahara H, Kobayashi Y, Hirai M, Kawashiri S, Nakamura H. Eribulin demonstrate selectively high sensitivity to recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC) cells and xenograft tumors. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy268.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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23
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Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P6411Achilles tendon thickening as an independent predictor for advanced coronary artery disease in patients without diagnosed familial hypercholesterolemia undergoing percutaneous coronary intervention. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6411] [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: 11/12/2022] Open
Affiliation(s)
- H Kitahara
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - T Nakayama
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Fujimoto
- Chiba University Graduate School of Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Chiba, Japan
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24
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Saito K, Saito Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P5130In-hospital blood pressure variability as a novel prognostic factor in patients with stable coronary artery disease. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5130] [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)
- K Saito
- Chiba University Hospital, Chiba, Japan
| | - Y Saito
- Chiba University Hospital, Chiba, Japan
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25
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Kitahara H, Hirai M, Kawashiri S, Nakamura H. Oral squamous cell carcinoma cells were sensitized to cetuximab by Eribulin via induction of the mesenchymal-to-epithelial transition. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx361.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Saito Y, Kitahara H, Shoji T, Tokimasa S, Nakayama T, Sugimoto K, Fujimoto Y, Kobayashi Y. P859Relation between severity of myocardial bridge and vasospasm. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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27
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Okuya Y, Saito Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P2364Usefulness of blood speckle intensity on intravascular ultrasound for prediction of periprocedural myocardial injury. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Saito Y, Kitahara H, Nakayama T, Fujimoto Y, Kobayashi Y. P2382Baseline and post-stent physiological assessment during percutaneous coronary intervention by intraluminal intensity of blood speckle on intravascular ultrasound. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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29
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Tokimasa S, Kitahara H, Nakayama T, Fujimoto Y, Shiba T, Shikama N, Nameki M, Himi T, Fukushima K, Kobayashi Y. P3694Multicenter research of bleeding risk between low dose prasugrel and standard dose clopidogrel in patients with coronary artery disease undergoing percutaneous coronary intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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30
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Song T, Wombacher T, Kitahara H, Onsager D, Ota T, Uriel N, Jeevanandam V. A New Cannulation Technique for Ambulatory Percutaneous RVAD. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.1254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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31
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Jokaji R, Ooi K, Ide K, Ishimiya M, Kobayashi Y, Kitahara H, Noguchi N, Katoh K, Nakamura H, Takamichi S, Nakata M, Kasahara K, Kawashiri S. Perioperative evaluation and management of obstructive sleep apnoea after mandibular setback by sagittal split ramus osteotomy. Int J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.ijom.2017.02.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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32
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Kitahara H, Hirai M, Nakamura H, Kawashiri S. Eribulin differentiates cetuximab resistant oral squamous cell carcinoma cells to sensitive by inducing mesenchymal–epithelial transition (MET). Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61183-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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33
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Nakamura H, Kimura I, Kitahara H, Kawashiri S. 179 Loss of EGFR expression in oral squamous cell carcinoma is associated with invasiveness and epithelial-mesenchymal transition. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30076-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Kitahara H, Ye Z, Aoyagi K, Ross PD, Abe Y, Honda S, Kanagae M, Mizukami S, Kusano Y, Tomita M, Shindo H, Osaki M. Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study. Osteoporos Int 2013; 24:907-15. [PMID: 22836277 PMCID: PMC3572384 DOI: 10.1007/s00198-012-2038-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [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] [Received: 12/22/2011] [Accepted: 04/30/2012] [Indexed: 01/02/2023]
Abstract
UNLABELLED We examined the spinal distribution of the types of vertebral deformities and the associations of vertebral deformities and osteoarthritis with back pain in Japanese women. Midthoracic and upper lumbar vertebrae were more susceptible to deformity. Vertebral deformity and osteoarthritis were frequent and were associated with back pain. INTRODUCTION Vertebral fractures due to osteoporosis and osteoarthritis are both common and significant health problems in aged people. However, little is known about the descriptive epidemiology of the individual deformity types and the relative clinical impact in women in Japan. METHODS Lateral radiographs were obtained from 584 Japanese women ages 40 to 89 years old. Deformities were defined as vertebral heights of more than 3 standard deviations (SDs) below the normal mean. Osteoarthritis was defined as Kellgren-Lawrence (KL) grade 2 or higher. Information on upper or low back pain during the previous month was collected by questionnaire. We compared the spinal distribution of the three types of vertebral deformities (wedge, endplate, and crush) typical of fractures and examined the associations of number and type of vertebral deformities and osteoarthritis with back pain. RESULTS Fifteen percent of women had at least one vertebral deformity and 74% had vertebral osteoarthritis. The prevalence of upper or low back pain was 30.1%. Deformities were most common in the midthoracic and upper lumbar regions and wedge was the frequent type, followed by endplate and crush. Multiple logistic regression analysis showed that the odds of back pain was 3.0 (95% CI 1.5-6.3) times higher for women with a single wedge deformity and 3.2 (95% CI 1.0--0.6) times higher for women with two or more wedge deformities, compared to women with no wedge deformity. Vertebral osteoarthritis was associated with back pain (OR 1.8, 95% CI 1.1-2.9), independent of other covariates including age and deformities. CONCLUSION Our results in this group of Japanese women are similar to and consistent with results reported previously in other populations of Japanese and Caucasians.
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Affiliation(s)
- H. Kitahara
- Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Z. Ye
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K. Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Y. Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S. Honda
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M. Kanagae
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - S. Mizukami
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - Y. Kusano
- Department of Community Development, Nagasaki Wesleyan University, Isahaya, Japan
| | - M. Tomita
- Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H. Shindo
- Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - M. Osaki
- Department of Orthopaedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Seya K, Kanemaru K, Matsuki M, Hongo K, Kitahara H, Kikuchi H, Oshima Y, Kubohara Y, Okumura K, Motomura S, Furukawa KI. Br-DIF-1 accelerates dimethyl sulphoxide-induced differentiation of P19CL6 embryonic carcinoma cells into cardiomyocytes. Br J Pharmacol 2012; 165:870-9. [PMID: 21671902 DOI: 10.1111/j.1476-5381.2011.01541.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE Stem cell transplantation therapy is a promising option for treatment of severe ischaemic heart disease. Dimethyl sulphoxide (DMSO) differentiates P19CL6 embryonic carcinoma cells into cardiomyocyte-like cells, but with low differentiation capacity. To improve the degree of this differentiation, we have assessed several derivatives of the differentiation-inducing factor-1 (DIF-1), originally found in the cellular slime mould Dictyostelium discoideum, on P19CL6 cells. EXPERIMENTAL APPROACH P19CL6 cells were cultured with each derivative and 1% DMSO for up to 16 days. Differentiation was assessed by measuring the number of beating and non-beating aggregates, and the expression of genes relevant to cardiac tissue. The mechanism of action was investigated using a T-type Ca(2+) channel blocker. KEY RESULTS Of all the DIF-1 derivatives tested only Br-DIF-1 showed any effects on cardiomyocyte differentiation. In the presence of 1% DMSO, Br-DIF-1 (0.3-3 µM) significantly and dose-dependently increased the number of spontaneously beating aggregates compared with 1% DMSO alone, by day 16. Expression of mRNA for T-type calcium channels was significantly increased by Br-DIF-1 + 1% DMSO compared with 1% DMSO alone. Mibefradil (a T-type Ca(2+) channel blocker; 100 nM) and a small interfering RNA for the T-type Ca(2+) channel both significantly decreased the beating rate of aggregates induced by Br-DIF-1 + 1% DMSO. CONCLUSIONS AND IMPLICATIONS Br-DIF-1 accelerated the differentiation, induced by 1% DMSO, of P19CL6 cells into spontaneously beating cardiomyocyte-like cells, partly by enhancing the expression of the T-type Ca(2+) channel gene.
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Affiliation(s)
- K Seya
- Department of Pharmacology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Kawashiri S, Yamamoto E, Noguchi N, Kato K, Yoshizawa K, Kitahara H, Okamune A, Sugiura S, Kimura I, Yagi M, Yoshimoto T. Evaluation of prognostic factors in squamous cell carcinoma of oral cavity. Int J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.ijom.2011.07.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoshizawa K, Kawashiri S, Kitahara H, Kato K, Noguchi N, Yamamoto E. UPA, UPAR AND MASPIN EXPRESSION AS A BIOMARKER IN INVASIVE ORAL SQUAMOUS CELL CARCINOMA. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70064-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Katayama Y, Kitajima I, Niimi H, Kitahara H, Kawai H. Diagnosis of cerebral cortical vein thrombosis with T2* weighted magnetic resonance imaging. Case Reports 2009; 2009:bcr03.2009.1651. [DOI: 10.1136/bcr.03.2009.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Kato K, Kawashiri S, Yoshizawa K, Kitahara H, Okamune A, Sugiura S, Noguchi N, Yamamoto E. 8571 Correlation of p53 and PCNA expression with the invasion and prognosis of oral squamous cell carcinoma. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Umezawa K, Branch J, Yamagami H, Ofuchi H, Ohta B, Uchida Y, Kitahara H. 255: The Outcome of Out-of-Hospital Cardiopulmonary Arrest in the Over 85-Year-Old Japanese Population Taken to the Emergency Department. Ann Emerg Med 2009. [DOI: 10.1016/j.annemergmed.2009.06.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zhang Z, Fukushima T, Shi P, Tao F, Onda Y, Gomi T, Mizugaki S, Asano Y, Kosugi K, Hiramatsu S, Kitahara H, Kuraji K, Terajima T, Matsushige K. Baseflow concentrations of nitrogen and phosphorus in forested headwaters in Japan. Sci Total Environ 2008; 402:113-122. [PMID: 18538826 DOI: 10.1016/j.scitotenv.2008.04.045] [Citation(s) in RCA: 7] [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] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 04/25/2008] [Accepted: 04/26/2008] [Indexed: 05/26/2023]
Abstract
A comprehensive investigation on all dissolved nitrogen and phosphorus components at both local and regional scales in the headwaters from forested watersheds is valuable to improve our understanding of the factors controlling water quality. Here, we investigated the baseflow concentrations of dissolved nitrogen and phosphorus components, N:P ratio, and their associations with region and vegetation type in forested headwaters in fives regions of Japan. We found that inorganic nitrogen and phosphorus were the dominant components in the 26 temperate forested streams, rather than organic forms. There were significant positive correlations between the concentrations of N and P components. Furthermore, the regional patterns of the concentrations of nitrate, dissolved inorganic P (DIP), and dissolved total N (DTN) and P (DTP) were similar. Our results suggest that the regional patterns of the concentrations of N and P components should be related to the regional atmospheric deposition of both N and P nutrients. We also found that the nitrate and DTN concentrations were higher in man-made evergreen conifer (EC) than those in the natural deciduous broadleaf (DB). In contrast, the DIP and DTP concentrations in EC were lower than those in DB. The uniformly higher N:P ratio in EC- than in DB-forested streams for each region suggest that EC-forested streams could be more affected by P-limited than DB-forested streams when N inputs from atmospheric sources increased.
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Affiliation(s)
- Zhao Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beiing Normal University, Beijing 100875, China.
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Zhang Z, Fukushima T, Onda Y, Mizugaki S, Gomi T, Kosugi K, Hiramatsu S, Kitahara H, Kuraji K, Terajima T, Matsushige K, Tao F. Characterisation of diffuse pollutions from forested watersheds in Japan during storm events - its association with rainfall and watershed features. Sci Total Environ 2008; 390:215-226. [PMID: 18022217 DOI: 10.1016/j.scitotenv.2007.09.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Revised: 09/27/2007] [Accepted: 09/28/2007] [Indexed: 05/25/2023]
Abstract
Forest areas have been identified as important sources of nonpoint pollution in Japan. The managers must estimate stormwater quality and quantities from forested watersheds to develop effective management strategies. Therefore, stormwater runoff loads and concentrations of 10 constituents (total suspended solids, dissolved organic carbon, PO(4)-P, dissolved total phosphorus, total phosphorus, NH(4)-N, NO(2)-N, NO(3)-N, dissolved total nitrogen, and total nitrogen) for 72 events across five regions (Aichi, Kochi, Mie, Nagano, and Tokyo) were characterised. Most loads were significantly and positively correlated with stormwater variables (total event rainfall, event duration, and rainfall intensity), but most discharge-weighted event concentrations (DWECs) showed negative correlations with rainfall intensity. Mean water quality concentration during baseflow was correlated significantly with storm concentrations (r=0.41-0.77). Although all pollutant load equations showed high coefficients of determination (R(2)=0.55-0.80), no models predicted well pollutant concentrations, except those for the three N constituents (R(2)=0.59-0.67). Linear regressions to estimate stormwater concentrations and loads were greatly improved by regional grouping. The lower prediction capability of the concentration models for Mie, compared with the other four regions, indicated that other watershed or storm characteristics should be included in the prediction models. Significant differences among regions were found more frequently in concentrations than in loads for all constituents. Since baseflow conditions implied available pollutant sources for stormwater, the similar spatial characteristics of pollutant concentrations between baseflow and stormflow conditions were an important control for stormwater quality.
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Affiliation(s)
- Zhao Zhang
- Graduate School of Life and Environmental Science, University of Tsukuba, Tsukuba, 305-8572, Japan.
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Tomita M, Motomura Y, Kitahara H, Yoshiki Y, Okubo K. Isomers and homologues of L-glutamic acid 5-n-butyl ester as promoters of sediment formation in raw soy sauce. J Biosci Bioeng 2005; 87:357-60. [PMID: 16232481 DOI: 10.1016/s1389-1723(99)80045-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/1998] [Accepted: 11/30/1998] [Indexed: 11/22/2022]
Abstract
Soy sauce was found to contain promoters of sediment formation at 60 degrees C, one of which has previously been identified as L-glutamic acid 5-n-butyl ester. Isomers and homologues of L-glutamic acid 5-n-butyl ester (n-propyl, isopropyl, n-butyl, isobutyl, and sec-butyl esters of L-glutamic acid) were synthesized using 80% (w/w) sulfuric acid as a catalyst and identified by 1H-NMR and the ninhydrin test. The yields of L-glutamic acid 5-n-propyl, isopropyl, n-butyl, isobutyl, and sec-butyl esters from 10 g L-glutamic acid were 25, 101, 72, 130, and 134 micromol, respectively. For maximum sediment formation in 1 ml soy sauce, 1.2, 8.6, 22.0, 22.0, and 26.5 micromol/ml of n-butyl, n-propyl, isobutyl, sec-butyl, and isopropyl esters were respectively required. Sediment-forming activity was not observed with L-glutamic acid and L-glutamic acid 5-methyl, ethyl and tert-butyl esters.
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Affiliation(s)
- M Tomita
- Tohoku Women's Junior College, Hirosaki, Aomori 036-8503, Japan
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Abstract
We undertook a radiographic analysis with pre-operative computed tomographic myelography in 78 patients with idiopathic scoliosis in order to analyse rotation of the spinal cord and to investigate its clinical significance. The angle of rotation of the cord had a statistically significant relationship to both that of the apical vertebra and the size of the primary curve. The relationship between the rotation of the cord and that of the apical vertebra was divided into three types. The cord rotated in the same direction as the apical vertebra in 55 patients and rotated in the opposite direction in the remaining 23 patients. In the first group, the angle of rotation of the cord was more than that of the vertebra in six patients, but less than it in 49 patients. These results suggest that the neuraxis in idiopathic scoliosis may be under tension in the axial dimension.
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Ito T, Tokunaga K, Maruyama H, Kawashima H, Kitahara H, Horikoshi T, Ogose A, Hotta Y, Kuwano R, Katagiri H, Endo N. Coxsackievirus and adenovirus receptor (CAR)-positive immature osteoblasts as targets of adenovirus-mediated gene transfer for fracture healing. Gene Ther 2003; 10:1623-8. [PMID: 12907955 DOI: 10.1038/sj.gt.3302060] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [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: 11/09/2022]
Abstract
Adenovirus vectors are expected to be a powerful tool for gene therapy to treat severe fractures. Adenovirus invades cells through binding to the coxsackievirus and adenovirus receptor (CAR) on the cell membrane. CAR expression is low in normal adult animals, but it is induced on regenerating cells in some experimental models. We made a rib fracture model in mice and evaluated the histological changes and CAR mRNA expression by RT-PCR 1, 5, 10, 14, and 21 days after the fracture. CAR mRNA was expressed exclusively in the fractured ribs at each time point, but not in the normal ribs. We detected the CAR protein immunohistochemically in fibroblast-like cells in the fracture callus on days 10 and 14 after fracture. In situ hybridization showed that these fibroblast-like cells expressed mRNA of type I collagen and osteopontin, but not osteocalcin, defining the cells as immature osteoblasts. We then transferred small doses (10(4)-10(8) PFU) of lacZ-expressing adenovirus vector into immature osteoblasts on day 14. beta-galactosidase was detected only on the immature osteoblasts at every dose. Immature osteoblasts play an important role in the matrix replacement step in fracture healing. CAR-mediated gene transfer into immature osteoblasts can be reasonable for adenovirus-mediated treatment of fracture healing.
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Affiliation(s)
- T Ito
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Fujisawa H, Koide N, Kono T, Takayama K, Tsukioka K, Wada Y, Zhang T, Kitahara H, Nakano H, Suzuki JI, Isobe M, Amano J. Expression of basic fibroblast growth factor and its receptor-1 in cardiac myxoma. J Cardiovasc Surg (Torino) 2002; 43:589-94. [PMID: 12386568] [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: 02/26/2023]
Abstract
BACKGROUND To clarify the significance of basic fibroblast growth factor (bFGF) in angiogenesis or proliferative activity in cardiac myxoma, the expression of bFGF and its receptor (FGFR-1) were immunohistochemically examined. METHODS Formalin-embedded tissues of cardiac myxomas were obtained by surgical resection from 15 patients and analyzed by immunostaining of bFGF and FGFR-1. The microvessel density was measured in the 15 myxomas using platelet derived endothelial cell adhesion molecule-1. For evaluation of proliferative activity of the cardiac myxomas, proliferating cell nuclear antigen (PCNA) immunostaining was performed, and the PCNA labeling index was measured in each section. RESULTS bFGF and FGFR-1 were observed in 73.3% and 67.7% of the myxomas, respectively. There was a close correlation between the expression of bFGF and FGFR-1. This co-expression was frequently observed in the myxoma cells around the microvessels appearing as a ring structure. Regarding possible relationships between the expression of bFGF or FGFR-1 and the clinicopathologic features, there were no parameters excluding the macroscopic type of myxoma. The microvessel density in the myxomas with bFGF or FGFR-1 expression was higher than that in myxomas without it. The PCNA labeling index in myxomas with bFGF expression was higher than that in myxomas without it, and the PCNA labeling index tended to be higher in myxomas with FGFR-1 expression than that in myxomas without it. CONCLUSIONS bFGF and/or FGFR-1 was expressed in some of cardiac myxoma, and may be an important role for tumor angiogenesis and proliferative activity.
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Affiliation(s)
- H Fujisawa
- Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
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Hasegawa R, Kitahara H, Watanabe K, Kuroda H, Amano J. Mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome. Jpn J Thorac Cardiovasc Surg 2001; 49:711-3. [PMID: 11808093 DOI: 10.1007/bf02913510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cases of valvular disease accompanied by systemic lupus erythematosus and antiphospholipid antibody syndrome are uncommon. Here, we present a surgical case of mitral stenosis and regurgitation with systemic lupus erythematosus and antiphospholipid antibody syndrome. Mitral valve replacement was performed, and the postoperative course was uneventful. Pathohistological findings of the mitral valve showed degenerative change due to chronic inflammation, proliferative fibrous change and calcification without thrombus formation.
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Affiliation(s)
- R Hasegawa
- Second Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan
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Abstract
STUDY DESIGN Cineradiography was used to analyze continuous dynamic motion in the lumbar spine. OBJECTIVES To identify motion patterns of the lumbar spine in asymptomatic volunteers and symptomatic patients with L4 degenerative spondylolisthesis, and to use the findings to discuss segmental instability in this disorder. SUMMARY OF BACKGROUND DATA The use of radiographic findings to assess lumbar spine instability remains controversial. Although some studies have reported on lumbar kinematics during actual movement, the motion patterns in asymptomatic volunteers and symptomatic patients with L4 degenerative spondylolisthesis have not been fully clarified. METHODS While asymptomatic volunteers (n=20; mean age, 27; control group) and symptomatic patients with L4 degenerative spondylolisthesis (n=41; mean age, 63; degenerative spondylolisthesis [DS] group) flexed from a sitting neutral position and back to the neutral position (flexion course), cineradiography was used to record lateral segmental lumbar motions. Twelve frames were selected during the flexion course, and flexion-extension angle (f-e angle) and translation in the sagittal plane were measured at each motion segment (L2-L3, L3-L4, L4-L5, and L5-S1). The DS group was classified into 2 subgroups according to percentage of slip: DS group I, with a slip equal to or less than 15%; and DS group II, with a slip of more than 15%. The motion pattern was compared between the groups. RESULTS In the control group, f-e angle and translation at the L2-L3, L3-L4, and L4-L5 segments moved simultaneously, although the L5-S1 segment showed an initial delay. The amount of f-e angle and translation changed almost symmetrically. In both f-e angle and translation, the L4-L5 segment showed a large motion pattern. In DS group I (n=21), the L4-L5 segment showed a large motion pattern in f-e angle and an intermediate motion pattern in translation. In DS group II (n=20), the L4-L5 segment showed an intermediate motion pattern in f-e angle, and a small motion pattern in translation. The relative range of f-e angle at the L4-L5 segment had the largest range in DS group I, and the relative translation showed a serial decrease from the control group through DS group II. A significant correlation between f-e angle and translation (harmonious motion pattern) was noted at the L2-L3, L3-L4, and L4-L5 segments in the control group. The harmonious motion pattern at the L4-L5 segment was significantly less in the DS group than in the control group. The loss of harmonious motion pattern (disordered motion pattern) at L4-L5 was well-revealed in the DS group II. CONCLUSIONS Motion analyses using cineradiography helped to explain the phenomena of lumbar spine kinematics. Based on continuous dynamic-motion analysis with cineradiography, large f-e angle and disordered motion pattern during the flexion-backward course in the DS group I was considered to be caused by segmental instability. The decreased translation and disordered motion pattern throughout the flexion course in the DS group II was considered to be caused by restabilization.
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Affiliation(s)
- K Takayanagi
- Department of Orthopaedic Surgery, Chiba Social Insurance Hospital, Japan.
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Ohta M, Isobe K, Kuyama J, Uchida Y, Nakano K, Goto S, Uno T, Yasuda S, Shigematsu N, Kawata T, Kitahara H, Ito H. Clinical role of Tc-99m-MIBI scintigraphy in non-Hodgkin's lymphoma. Oncol Rep 2001; 8:841-5. [PMID: 11410795 DOI: 10.3892/or.8.4.841] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This study was designed to investigate the relationship between Tc-99m-hexakis-2-methoxyisobutylisonitrile (MIBI) scintigraphy and outcome of treatment in patients with non-Hodgkin's lymphoma (NHL). Forty-five patients with NHL were studied with Tc-99m-MIBI before any treatment. Images of the lesions were obtained at 20 min and 2 h after radionuclide administration. Visual semi-quantitative interpretation was performed for Tc-99m-MIBI (grade 0-4) scintigraphy. Patients underwent 3-5 cycles of CHOP chemotherapy with/without involved field radiotherapy for large tumors. Their responses to treatment were evaluated at the end of chemotherapy and during the follow-up period. Forty of 45 patients (89%) showed abnormal uptake of Tc-99m-MIBI. There was no correlation between intensity of MIBI accumulation and response to chemotherapy. However, patients with negative or decreased MIBI activity 2 h after radionuclide administration showed worse response to chemotherapy compared to those with continued MIBI activity. MIBI activity could not predict the development of relapse in the follow-up study. In this study, the number of patients was small and we could not reach definite conclusions. However, we think that MIBI scintigraphy is not valuable for predicting the chemotherapy outcome in patients with NHL.
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Affiliation(s)
- M Ohta
- Department of Radiology, School of Medicine, Chiba University, 1-8-2 Inohana Chuoku, Chiba City 260-8670, Japan
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Abstract
We performed a retrospective review of 27 scoliotic patients with syringomyelia using MRI. Their mean age at the first MRI examination was 10.9 years, and at the final review 15.8 years. The mean ratio of the diameter of the syrinx to the cord on the midsagittal MRI (S/C ratio) decreased from 0.49 to 0.24; 14 patients showed a decrease of 50% or more (reduction group). In this reduction group, the cerebellar tonsillar herniation decreased from a mean of 11.3 mm to 6.0 mm, and some improvement in dissociated sensory disturbance was seen in nine of 13 patients. The scoliosis improved by 5° or more in six patients in the reduction group. Our results indicate that spontaneous shrinkage of syringomyelia in children is not unusual and is associated with improvement in the tonsillar herniation, the scoliosis and the neurological deficit.
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Affiliation(s)
| | | | - K. Isobe
- Department of Orthopaedic Surgery
| | | | - H. Kitahara
- Department of Clinical Radiology, School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8677, Japan
| | - Y. Nakata
- Department of Orthopaedic Surgery, National Sanatorium, Chiba Higashi Hospital, 673 Nitona, Chuo-ku, Chiba 260-0801, Japan
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