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Harada T, Hirata Y, Kawamura H, Yamamoto Y, Kobayashi Y, Kumai D, Adachi A, Nagura Y, Ikeuchi H, Hayashi N, Takada H, Sobue S, Yoshida M. A Case of Adult-onset Still's Disease (AOSD) with Gastrointestinal Lesions. Intern Med 2024:3412-23. [PMID: 38631856 DOI: 10.2169/internalmedicine.3412-23] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
A 51-year-old woman with fever was admitted to our hospital. A computed tomography (CT) scan showed thickened colonic walls. Colonoscopy revealed erosion in the ileum and colon. Adult-onset Still's disease (AOSD) was diagnosed due to a subsequent sore throat and skin rash. Following AOSD treatment, methylprednisolone pulse therapy, followed by prednisolone and cyclosporine, was initiated. Despite achieving a temporary improvement, relapse occurred with fever, abdominal pain, with worsening CT and endoscopic findings. The reappearance of a skin rash confirmed an exacerbation of AOSD. Tocilizumab treatment alleviated the symptoms and improved the endoscopic findings. Considering their correlation with the symptoms and endoscopic findings, the observed gastrointestinal lesions may be linked to AOSD.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Hiroki Takada
- Gastroenterology, Kasugai municipal hospital, Japan
- Endoscopy Center, Kasugai municipal hospital, Japan
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Sakae Y, Takada H, Ichinose S, Nakajima M, Sakai A, Ogawa R. Treatment with YIGSR peptide ameliorates mouse tail lymphedema by 67 kDa laminin receptor (67LR)-dependent cell-cell adhesion. Biochem Biophys Rep 2023; 35:101514. [PMID: 37521371 PMCID: PMC10372372 DOI: 10.1016/j.bbrep.2023.101514] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
Impaired microcirculation can cause lymphatic leakage which leads to a chronic swelling in the tissues of the body. However, no successful treatment gives any protection against lymphedema due to the lack of well-revealed pathophysiology of secondary lymphedema. Binary image of laminin immunohistochemical expression revealed that distribution of laminin expression localized during surgically induced lymphedema. 67 kDa laminin receptor (67LR) mRNA expression showed a peak at during lymphedema exacerbation. Since the response of 67LR molecules may affect the prevention of inflammation and edema, here we have hypothesized that 67LR ligand of YIGSR peptide could permit reconstructive environment for amelioration of lymphedema and evaluated the effect of YIGSR in a mouse tail model of lymphedema. Indeed, intra-abdominal injections of YIGSR for the first 3 days after inducing lymphedema in the mouse tail model reduced the tail lymphedema on day 14 by 27% (P = 0.035). Histology showed that YIGSR treatment protected lymphedema impairment in epidermis and dermis, and it also inhibited the expansion of intercellular spaces and enhanced especially cell adhesion in the basement membrane as revealed by transmission electron microscopy. Interestingly, the treatment also reduced the local expression of transforming growth factor (TGF)β. Further elucidation of the mechanisms of 67LR-facilitated lymphangiogenesis contributes to find potential targets for the treatment of lymphedema.
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Affiliation(s)
- Y. Sakae
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
| | - H. Takada
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
- Department of Anti-Aging and Preventive Medicine, Nippon Medical School, Japan
| | - S. Ichinose
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
| | - M. Nakajima
- Department of Pharmacology, Nippon Medical School, Japan
| | - A. Sakai
- Department of Pharmacology, Nippon Medical School, Japan
| | - R. Ogawa
- Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Japan
- Department of Anti-Aging and Preventive Medicine, Nippon Medical School, Japan
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Kato A, Naitoh I, Naiki-Ito A, Hayashi K, Okumura F, Fujita Y, Sano H, Nishi Y, Miyabe K, Inoue T, Hirano A, Takada H, Yoshida M, Hori Y, Natsume M, Kato H, Takahashi S, Kataoka H. Class III β-Tubulin Expression Is of Value in Selecting nab -Paclitaxel and Gemcitabine as First-Line Therapy in Unresectable Pancreatic Cancer. Pancreas 2022; 51:372-379. [PMID: 35695793 DOI: 10.1097/mpa.0000000000002032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Nab -paclitaxel and gemcitabine (GnP) or FOLFIRINOX (a combination of leucovorin, fluorouracil, irinotecan, and oxaliplatin [FFX]) is currently recognized as the standard first-line regimen for unresectable pancreatic ductal adenocarcinoma (PDAC). Class III β-tubulin (TUBB3) has the potential to predict resistance to taxane in various tumors; therefore, this study aimed to clarify whether TUBB3 is a predictive marker for GnP response. METHODS We retrospectively reviewed 113 patients with PDAC who received GnP or FFX as first-line chemotherapy and examined immunohistochemically the TUBB3 expression in specimens obtained by endoscopic ultrasound-guided fine-needle aspiration. RESULTS High TUBB3 expression was associated with a significantly lower disease control rate ( P = 0.017) and shorter progression-free survival (PFS) ( P = 0.019), and multivariate analysis revealed that TUBB3 expression was an independent variable for PFS in the GnP first-line group ( P = 0.045). In addition, in the FFX first-line group, TUBB3 expression was not correlated with PFS or overall survival (OS). In all 113 patients, TUBB3 expression was not also associated with OS. CONCLUSIONS Class III β-tubulin might be a predictive factor for the response of GnP, but not a prognostic factor for OS, helping the selection of an optimized first-line chemotherapy regimen for unresectable PDAC.
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Affiliation(s)
- Akihisa Kato
- From the Departments of Gastroenterology and Metabolism
| | - Itaru Naitoh
- From the Departments of Gastroenterology and Metabolism
| | - Aya Naiki-Ito
- Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | | | - Fumihiro Okumura
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi
| | - Yasuaki Fujita
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi
| | - Hitoshi Sano
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa
| | - Yuji Nishi
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa
| | - Katsuyuki Miyabe
- Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya
| | - Tadahisa Inoue
- Department of Gastroenterology, Aichi Medical University School of Medicine, Nagakute
| | - Atsuyuki Hirano
- Department of Gastroenterology, Nagoya City West Medical Center, Nagoya
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | | | - Yasuki Hori
- From the Departments of Gastroenterology and Metabolism
| | | | - Hiroyuki Kato
- Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - Satoru Takahashi
- Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya
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Tanaka Y, Tanaka H, Hatazawa K, Yamashita K, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Minami H, Hirata KI. Effect of hypertension on the optimal anthracycline cumulative dose for developing left ventricular dysfunction in patients with malignant lymphoma. Int J Cardiovasc Imaging 2022. [DOI: 10.1007/s10554-021-02233-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abstract
BACKGROUND Few studies have assessed depression in healthcare workers (HCWs) in Japan owing to the coronavirus disease 2019 (COVID-19) pandemic, and no studies have proposed effective interventions to help support their mental health. AIMS To test the hypothesis that enhancing access to mental healthcare professionals helps to improve HCWs' mental health. METHODS This cross-sectional study assessed depressive symptoms in HCWs at three hospitals in Osaka prefecture between May and July, 2020. The survey obtained information on HCWs' mental state and related situations/perceptions. Multivariable logistic regression analysis was performed to identify factors associated with depressive symptoms. RESULTS Of the 3291 eligible HCWs, 1269 (39%) completed the survey. Of all HCWs, 87 (7%) were physicians, and 700 (55%) were nurses. A total of 181 (14%) HCWs had moderate-to-severe symptoms of depression. Being a frontline worker was not significantly associated with depressive symptoms (odds ratio: 0.86 [95% confidence intervals: 0.54-1.37], P = 0.50). The unwillingness to consult with anyone was significantly associated with more severe depressive symptoms (1.70 [1.10-2.63], P < 0.01). HCWs who had no opportunity to confide in family/friends (1.66 [1.10-2.52], P < 0.01) or colleagues/supervisors (3.19 [2.22-4.58], P < 0.001) were significantly more likely to have depressive symptoms. CONCLUSIONS Being a frontline HCW in a Japanese hospital treating patients with COVID-19 was not significantly associated with having depressive symptoms. The study highlights that encouraging daily communication with close persons (family, friends, colleagues and supervisors), rather than improving access to mental health professionals, might help to prevent depression in HCWs during the COVID-19 pandemic.
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Affiliation(s)
- H Takada
- Osaka Prefectural Mental Health Centre, Bandai-higashi 3-1-46, Sumiyoshi, Osaka, Japan
| | - R Ae
- Division of Public Health, Centre for Community Medicine, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi, Japan
| | - M Ogawa
- Health Service Centre, Jichi Medical University, Yakushiji 3311-1, Shimotsuke, Tochigi, Japan
| | - T Kagomoto
- Osaka Prefectural Mental Health Centre, Bandai-higashi 3-1-46, Sumiyoshi, Osaka, Japan
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Abstract
OBJECTIVE The confirmation of abnormal behavior during video monitoring in polysomnography (PSG) and the frequency of rapid eye movement (REM) sleep without atonia (RWA) during REM sleep based on physiological indicators are essential diagnostic criteria for the diagnosis of REM sleep behavior disorder (RBD). However, no clear criteria have been established for the determination of the tonic and phasic activities of RWA. In this study, we investigated an RWA decision program that simulates visual inspection by clinical laboratory technicians. METHODS We used the measurement data of 25 men and women (average age±standard deviation: 72.7±1.7 years) who visited the Sleep Treatment Center for PSG inspection due to suspected RBD. The chin electromyography (EMG) during REM sleep was divided into 30 s intervals, and RWA decisions were made on the basis of visual inspection by a clinical laboratory technician. We compared and investigated two machine-learning methods namely support vector machine (SVM) and convolutional neural network (CNN) for RWA decisions. RESULTS When comparing SVM and CNN, the highest discrimination accuracy for RWA decisions was obtained when using the average rectified value (ARV) processed chin EMG images using CNN as a feature. We also estimated the prevalence of RBD on the basis of the Mahalanobis distance measure using the frequency of occurrence of both tonic and phasic activities calculated from a total of 25 subjects in the patient and healthy groups. Consequently, estimation of RBD prevalence using CNN resulted in misclassification of none of the subjects in the patient group and two subjects in the healthy group. CONCLUSIONS In this study, we investigated the automatic analysis of PSG results focusing on RBD, which is a parasomnia. As a result, there were no misclassifications of patients in the 25 subjects in the patient or healthy groups based on the estimates of RBD prevalence using CNN. The prevalence estimation based on our proposed automated algorithm is considered effective for the primary screening for RBD.
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Affiliation(s)
| | - Meiho Nakayama
- Department of Otolaryngology & Good Sleep Center, Nagoya City University
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Fujikake K, Ono R, Takada H. [Development of Visually Induced Motion Sickness Evaluation Index Using Gaze Data of Elderly People]. Nihon Eiseigaku Zasshi 2022; 77:n/a. [PMID: 35314574 DOI: 10.1265/jjh.21001] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES The benefit of using a noncontact eye-tracking system is its low a burden on individuals for measuring biological signals. The goal of this study was to develop a visually induced motion sickness (VIMS) evaluation index using data collected with a noncontact eye-tracking system for driving simulator (DS) experiments. METHODS The participants included nine elderly people with visual and balance functions that did not interfere with their daily life. The gaze data of the participants were measured at rest-both before and after DS trials. The participants answered followed up the simulator sickness questionnaire (SSQ) before and after each trial. The participants were divided into two groups on the basis of their SSQ results. One group experienced VIMS during the DS trial (four people; average age, 79.0 years), whereas the other group did not experience it (five people; average age, 71.2 years). RESULTS The results of VIMS symptoms were confirmed: data concerning the locus of eye-tracking were lengthened, the eye-tracking data were diffused. This experiment demonstrated the usefulness of sparse density as a quantification index based on eye-tracking data in the evaluation of VIMS. CONCLUSIONS Regarding the application of the findings of this study, it is believed that it will be easier to detect VIMS symptoms induced by DS operations if the index can be used for an eye-tracking data-based evaluation of VIMS.
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Affiliation(s)
| | - Rentaro Ono
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui
| | - Hiroki Takada
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui
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Ono R, Matsuura Y, Miyao M, Takada H. [Pattern of Body Sway While Viewing 3D Video Clips in Various Age Groups]. Nihon Eiseigaku Zasshi 2022; 77:n/a. [PMID: 35314577 DOI: 10.1265/jjh.20009] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES These days, developments in graphical technology have resulted in an increase in the chance to view 3D video clips. Visually induced motion sickness (VIMS) has been widely reported as a negative result of viewing these clips. The onset of VIMS is explained by some hypotheses. However, the root causes of VIMS have not been elucidated yet, whereas dizziness and nausea are regarded as symptoms of VIMS. In this study, we focus on the difference in the pattern of body sway among age groups and examine whether the consistency between the background and the viewpoint motion depends on the severity of VIMS. METHODS This experiment was conducted with 116 subjects aged 15-89 years. They peripherally viewed a 3D video clip showing a sphere whose motion was consistent with their viewpoint (VC-I) and another 3D video clip of a sphere whose motion was inconsistent with their viewpoint (VC-II). Statokinesigrams (SKGs) were recorded with their eyes open and with their eyes closed for 60 s. The amount of sway was calculated from the SKGs. RESULTS Results showed that for all age groups, sway values were significantly higher when viewing the 3D video clip (VC-II) than in the Pre. However, for the elderly, there was no significant difference between the sway values while viewing the VC-I and those in the Pre. CONCLUSIONS Results suggest that VIMS might not occur in the elderly because of the deterioration of their visual function, such as visual acuity and accommodation, with advancing age.
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Affiliation(s)
- Rentaro Ono
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui
| | | | | | - Hiroki Takada
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui
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Takai E, Aoyagi T, Ichikawa K, Matsuura Y, Kinoshita F, Takada H. [Effect of Olfactory Stimulation with Vanilla Odor on Degree of Gastric Myoelectrical Activity]. Nihon Eiseigaku Zasshi 2022; 77:n/a. [PMID: 35314575 DOI: 10.1265/jjh.20012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Olfactory stimulation elicits various physiological responses. However, few reports exist on the changes in gastric motility during olfactory stimulation in humans. In this regard, we carried out electrogastrography (EGG) to non-invasively measure the gastric myoelectrical activity, which regulates gastric motility. Moreover, subjective sensory evaluation was performed to determine which characteristics of vanilla odor at two different concentrations affect the myoelectrical activity. METHODS The participants consisted of eight healthy young males. EGG and electrocardiography (ECG) recordings were obtained approximately 20 min prior to and during olfactory stimulation. Autonomic nervous system activity was evaluated in terms of heart rate variability (HRV) and mean heart rate (HR) from ECG signals. EGG signals were analyzed by spectral analysis. In addition, the translation error was estimated by the Wayland algorithm. Sensory evaluation was performed using the Visual Analog Scale (VAS). RESULTS There were no significant differences in HRV and HR values and results of spectral analyses of EGG signals in all sample presentations. The translation error of EGG signals and the rating of perceived odor intensity significantly increased in a concentration-dependent manner. There was a strong positive correlation between translation error and odor intensity. CONCLUSIONS The correlation found between translation error and odor intensity suggests that the higher the vanilla odor intensity was perceived, the greater the randomness of EGG signals was. Our results suggest that the application of the Wayland algorithm to EGG signals can be used as an objective indicator in odor evaluation.
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Affiliation(s)
- Eiji Takai
- Soda Aromatic Co., Ltd
- Graduate School of Engineering, University of Fukui
| | | | | | - Yasuyuki Matsuura
- Graduate School of Engineering, University of Fukui
- Department of Cross Cultural Studies, Gifu City Women's College
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Sugiura A, Ono R, Itazu Y, Sakakura H, Takada H. [Analysis of Characteristics of Eye Movement While Viewing Movies and Its Application]. Nihon Eiseigaku Zasshi 2022; 77:n/a. [PMID: 35314573 DOI: 10.1265/jjh.21004] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
In this article, we present the following: a background of visually induced motion sickness (VIMS), the goal of our study, and descriptions of three recent studies conducted by our group on the measurement and analysis of eye movement while viewing movies and the relationship of eye movement with VIMS. First, this study focuses on the relationship between eye movement and motion sickness susceptibility. We investigated the relationship between the motion sickness susceptibility and the frequency of optokinetic nystagmus (OKN) with peripheral viewing. It was revealed that susceptible participants showed a lower OKN frequency under conditions that strongly support the occurrence of OKN than insusceptible participants. Second, this study focuses on the relationship between visual information and postural variation such as visually evoked postural responses (VEPRs). In this study, both eye movement and the center of gravity while viewing a movie were measured. Additionally, we evaluated the difference in the transfer gain of the transfer function (vision as input and equilibrium function as output) due to the type of movie content or way of viewing. The gain for the three-dimensional movie with peripheral viewing exceeded that for the two-dimensional movie with central viewing. Third, this study focuses on eye movement and the application of deep-learning technology. In this study, we classified the eye movement as peripheral or central using a convolutional deep neural network with supervised learning. Then, cross validation was performed to test the classification accuracy. The use of >1-s eye movement data yielded an accuracy of >90%.
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Affiliation(s)
- Akihiro Sugiura
- Department of Radiological Technology, Gifu University of Medical Science
| | - Rentaro Ono
- Graduate School of Engineering, University of Fukui
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Kawamura H, Takada H, Narui T, Harada T, Aiba R, Yamamoto Y, Adachi A, Kojima Y, Shibata S, Ikeuchi H, Hayashi N, Hirata Y, Fujieda H, Yamaguchi R, Tateyama H, Sobue S. Eosinophilic pancreatitis presenting as rupture of a pancreatic cystic lesion into the chest cavity. Clin J Gastroenterol 2021; 15:228-236. [PMID: 34694599 DOI: 10.1007/s12328-021-01536-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
Abstract
A 71-year-old man was receiving follow-up examination because of a retention cyst in the pancreatic body that extended to the dorsal extrahepatic area, but presented to the Emergency Department at our hospital with dyspnea and cough. Chest X-ray showed a large amount of left-sided pleural effusion and abdominal computed tomography (CT) showed reduction in size of the cystic lesion. Biochemical testing of the pleural effusion revealed high levels of pancreatic enzymes. We, therefore, diagnosed rupture of the pancreatic cystic lesion into the chest cavity. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated stenosis of the pancreatic duct and leakage of contrast medium at the cystic lesion. CT after ERCP revealed leakage of contrast medium from the cystic lesion through the dorsal extrahepatic area into the chest cavity. Endoscopic naso-pancreatic drainage was performed, but the cystic lesion and pleural effusion remained unimproved. Distal pancreatectomy was, therefore, performed. Microscopic examination revealed eosinophilic infiltration of the pancreatic parenchyma, leading to a diagnosis of eosinophilic pancreatitis (EP). Pancreatic retention cyst secondary to chronic pancreatitis associated with eosinophilic infiltration was considered to have ruptured into the chest cavity. EP is a rare etiology of pancreatitis and few cases have been reported. This case was thus considered valuable.
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Affiliation(s)
- Hayato Kawamura
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan.
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Tatsuki Narui
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Takahito Harada
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Reika Aiba
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Yuki Yamamoto
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Akihisa Adachi
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Yuki Kojima
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Shunsuke Shibata
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Hirokazu Ikeuchi
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Noriyuki Hayashi
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Yoshikazu Hirata
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Hironori Fujieda
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, 4640021, Japan
| | - Ryuzo Yamaguchi
- Department of Gastroenterological Surgery, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Hisashi Tateyama
- Department of Pathology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, 1-1-1 Takagicho, Kasugai, Aichi, 4868510, Japan
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Naniwa S, Yamada S, Awano K, Yoshida A, Takami K, Tagashira T, Tsuda S, Terashita D, Takada H, Akita T, Takata K, Kunigita T, Nishijo K. Impact of wall shear stress affected by anatomical difference between acute and chronic coronary syndrome in patients with LAD proximal disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1075] [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
Recent hemodynamic studies have demonstrated that progression of coronary atherosclerosis occurs at low wall share-stress site, whereas plaque rupture frequently occurs at high share stress site. It is well recognized that wall shear stress is relatively low along the outer walls of the bifurcation.
We investigated consecutive 140 patients (77 with acute coronary syndrome (ACS) and 63 with chronic coronary syndrome (CCS) performed PCI for LAD proximal lesions (AHA seg.6) from January 2016 to December 2019. In CCS group, entry criteria included stenosis of at least 90% in the LAD proximal lesion or at least 70% in the LAD proximal lesion and objective evidence of myocardial ischemia (inducible ischemia with either exercise or pharmacologic vasodilator stress or with pressure wire). Exclusion criteria were patients with maintenance dialysis, chronic total occlusion lesions, in-stent restenosis, and clinically diagnosed unstable angina without troponin I elevation. We measured the distance from LMT distal carina to the culprit site (Distance) and plaque location (Location) with intravascular ultrasound and angle between LMT and LAD with cardiovascular angiography analysis system (CAAS) (Angle).
The two groups were generally well balanced with regard to baseline clinical characteristics. The mean (±SD) age of the patients was 69.0±11.8 years, and 75% were men. Medication at baseline was also similar between two groups except higher prevalence of statin prescription in CCS group. The Distance was shorter and Angle was steeper in CCS group than in ACS group. The number of patients with Angle less than 150 degrees and with Location in the lateral wall side was much more in CCS group.
In this study, plaques in CCS were frequently observed at low shear stress site, whereas those in ACS at high shear stress site. Plaque progression in CCS may be associated with low wall shear stress, and high shear stress may play key role in plaque rupture in ACS. This anatomical difference can partly explain the different mechanisms of onset between of ACS and CCS.
Funding Acknowledgement
Type of funding sources: None. Anatomical differenceCharacteristics and results
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Affiliation(s)
- S Naniwa
- Kita-Harima Medical Centre, Ono, Japan
| | - S Yamada
- Kita-Harima Medical Centre, Ono, Japan
| | - K Awano
- Kita-Harima Medical Centre, Ono, Japan
| | - A Yoshida
- Kita-Harima Medical Centre, Ono, Japan
| | - K Takami
- Kita-Harima Medical Centre, Ono, Japan
| | | | - S Tsuda
- Kita-Harima Medical Centre, Ono, Japan
| | | | - H Takada
- Kita-Harima Medical Centre, Ono, Japan
| | - T Akita
- Kita-Harima Medical Centre, Ono, Japan
| | - K Takata
- Kita-Harima Medical Centre, Ono, Japan
| | | | - K Nishijo
- Kita-Harima Medical Centre, Ono, Japan
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Hama M, Horie R, Kubota T, Matsumura T, Kimura E, Nakamura H, Takahashi M, Takada H. MYOTONIC DYSTROPHY. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.258] [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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Shimizu S, Naitoh I, Okumura F, Hirano A, Miyabe K, Nishi Y, Takada H, Haneda K, Anbe K, Yoshida M, Kondo H, Sano H, Hayashi K, Kataoka H. One-step versus two-step distal self-expandable metal stent placement: A multicenter prospective randomized trial. J Gastroenterol Hepatol 2021; 36:2015-2021. [PMID: 33382137 DOI: 10.1111/jgh.15393] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND AND AIM Two methods of transpapillary covered self-expandable metal stent (SEMS) placement are used for distal malignant biliary obstruction (MBO): after initial drainage by plastic stent (two-step method) and without previous drainage (one-step method). METHODS In total, 90 patients with unresectable pancreatic cancer and distal MBO were enrolled in this prospective multicenter randomized study and allocated to one-step (n = 45) and two-step (n = 45) groups. The main outcome was the time to recurrent biliary obstruction (TRBO). Secondary outcomes were the rates of early and late adverse events, survival time, the time required for bilirubin level reduction, and cost-effectiveness. RESULTS The median TRBO did not differ significantly between the one-step and two-step groups (not available vs 314 days, P = 0.134). SEMS migration occurred significantly more frequently in the two-step group (14.3% vs 0%, P = 0.026). No significant difference was observed between groups in early (7.3% vs 14.3%, P = 0.483) or late (12.2% and 11.9%, P = 1) adverse events other than RBO, survival time (P = 0.104), or the median number of days required to reach a bilirubin level considered to be acceptable for chemotherapy administration (<3 mg/dL; P = 0.881). The total costs of stent placement and reintervention were significantly lower in the one-step SEMS group (3347 vs 5465 US dollars, P < 0.001). CONCLUSIONS The superiority of TRBO with two-step SEMS placement was not demonstrated. One-step SEMS placement might be a promising method from the viewpoints of cost-effectiveness and less invasiveness (UMIN-CTR clinical trial registration number: UMIN000016010).
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Affiliation(s)
- Shuya Shimizu
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Itaru Naitoh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Fumihiro Okumura
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | - Atsuyuki Hirano
- Department of Gastroenterology, Nagoya City West Medical Center, Nagoya, Japan
| | - Katsuyuki Miyabe
- Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Yuji Nishi
- Department of Gastroenterology, Toyokawa Municipal Hospital, Toyokawa, Japan
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Kenichi Haneda
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | - Kaiki Anbe
- Department of Gastroenterology, Toyokawa Municipal Hospital, Toyokawa, Japan
| | - Michihiro Yoshida
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiromu Kondo
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hitoshi Sano
- Department of Gastroenterology, Toyokawa Municipal Hospital, Toyokawa, Japan
| | - Kazuki Hayashi
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiromi Kataoka
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Yamashita K, Tanaka H, Hatazawa K, Tanaka Y, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Minami H, Hirata K. Association between clinical risk factors and left ventricular function in patients with breast cancer following chemotherapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1155] [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
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD), which is often the result of the combined detrimental effect of the two therapies for breast cancer patients. For risk stratification to detect the development of CTRCD, the current position paper from the European Society of Cardiology (ESC) lists several factors associated with risk of cardiotoxicity following treatment with chemotherapy. However, the association between clinical risk factors and left ventricular (LV) function in breast cancer patients is currently unclear.
Purpose
Our purpose was to investigate the impact of baseline risk factors on LV function in patients with preserved LV ejection fraction (LVEF) who have undergone anthracycline or trastuzumab chemotherapy for breast cancer.
Methods
We studied 86 breast cancer patients treated with anthracyclines, trastuzumab, or both. Mean age was 59±13 years and LVEF was 67±5%. In accordance with the current definition, CTRCD was defined as a decline in LVEF of >10% to an absolute value of <53% after chemotherapy. Based on the 2016 ESC position paper, clinical risk factors for CTRCD were defined as: (1) a cumulative total doxorubicin dose of ≥240 mg/m2, (2) age ≥65-year-old, (3) body mass index ≥30 kg/m2, (4) a previous history of radiation therapy to chest or mediastinum, (5) B-type natriuretic peptide ≥100pg/mL, (6) a previous history of cardiovascular disease, (7) atrial fibrillation, (8) hypertension, (9) diabetes mellitus, (10) current or ex-smoker.
Results
The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without (−9.3±10.8% vs. −2.2±10.2%; p=0.02). However, this finding did not apply to patients with more than one, two or three risk factors. Patients with more than four risk factors also tended to show a higher prevalence of CTRCD than those without (14.3% vs. 2.8%, p=0.12). Moreover, patients with more than four risk factors were more likely to have higher LV mass index (109.3±29.0 g/m2 vs. 83.2±21.0g /m2, p<0.001), lower global longitudinal strain (18.4±2.8% vs. 20.0±2.6%, p=0.06) and higher E/e' (10.4 (8.9–13.0) vs. 9.0 (7.4–10.9), p=0.06) compared to those without.
Conclusions
Association between clinical risk factors and LV dysfunction following chemotherapy became stronger with an increase in the number of risk factors in breast cancer patients, and was especially strong for patients treated with chemotherapy who had more than four risk factors. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | - M Suto
- Kobe University, Kobe, Japan
| | - J Mukai
- Kobe University, Kobe, Japan
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Shiraki H, Tanaka H, Yamashita K, Tanaka Y, Sumimoto K, Shono A, Suzuki M, Yokota S, Suto M, Mukai J, Takada H, Matsumoto K, Fukuzawa K, Hirata K. Consideration of non-valvular atrial fibrillation with left atrial appendage thrombus formation despite under appropriate oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0071] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is the most frequently sustained cardiac arrhythmia, with a prevalence of about 2–3% in the general population. In accordance with CHADS2 or CHA2DS2-VASc score, appropriate oral anticoagulation therapy such as warfarin or direct oral anticoagulants (DOAC) significantly reduced the risk of thromboembolic events. However, left atrial (LA) thrombus can be detected in the LA appendage (LAA) in AF patients despite appropriate oral anticoagulation therapy.
Purpose
Our purpose was to investigate the associated factors of LAA thrombus formation in non-valvular atrial fibrillation (NVAF) patients despite under appropriate oral anticoagulation therapy.
Methods
We retrospectively studied consecutive 286 NVAF patients for scheduled catheter ablation or electrical cardioversion for AF in our institution between February 2017 and September 2019. Mean age was 67.1±9.4 years, 79 patients (29.5%) were female, and 140 (52.2%) were paroxysmal AF. All patients underwent transthoracic and transesophageal echocardiography before catheter ablation or electrical cardioversion. All patients received appropriate oral anticoagulation therapy including warfarin or DOAC for at least 3 weeks prior to transesophageal echocardiography based on the current guidelines. LAA thrombus was defined as an echodense intracavitary mass distinct from the underlying endocardium and not caused by pectinate muscles by at least three senior echocardiologists.
Results
Of 286 NVAF patients with under appropriate oral anticoagulation therapy, LAA thrombus was observed in 9 patients (3.3%). Univariate logistic regression analysis showed that age, paroxysmal AF, CHADS2 score ≥3, left ventricular end-diastolic volume index (LVEDVI), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), LA volume index (LAVI), mitral inflow E and mitral e' annular velocities ratio (E/e'), and LAA flow were associated with LAA thrombus formation. It was noteworthy that multivariate logistic regression analysis showed that LAA flow was independent predictor of LAA thrombus (OR: 0.72, 95% CI: 0.59–0.89, p<0.005) as well as LVEF. Furthermore, receiver operating characteristic (ROC) curve analysis identified the optimal cutoff value of LAA flow for predicting LAA thrombus as ≤15cm/s, with a sensitivity of 88%, specificity of 93%, and area under the curve (AUC) of 0.95.
Conclusions
LAA flow was strongly associated with LAA thrombus formation even in NVAF patients with appropriate oral anticoagulation therapy. According to our findings, further strengthen of oral anticoagulation therapy or percutaneous transcatheter closure of the LAA may be considered in NVAF patients with appropriate oral anticoagulation therapy but low LAA flow, especially <15cm/s.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | | | | | | | - A Shono
- Kobe University, Kobe, Japan
| | | | | | - M Suto
- Kobe University, Kobe, Japan
| | - J Mukai
- Kobe University, Kobe, Japan
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Shichiji M, Kihara Y, Ishiguro K, Sato T, Takahashi M, Komaki H, Takada H, Kuru S, Matsumura T, Ishigaki K. FSHD / OPMD / MYOTONIC DYSTROPHY. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.236] [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: 11/26/2022]
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18
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Suto M, Matsumoto K, Onishi A, Shibata N, Yokota S, Mukai J, Hisamatsu E, Takada H, Dokuni K, Hatazawa K, Tanaka H, Hirata KI. Noninvasive Leg-Positive Pressure Stress Echocardiography Reveals Preload Reserve in Adult Patients after Complete Repair of Tetralogy of Fallot. J Am Soc Echocardiogr 2020; 33:858-867. [PMID: 32336610 DOI: 10.1016/j.echo.2020.02.012] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Long-term sequelae such as right ventricular dysfunction and reduced hemodynamic reserve are the main determinants of cardiovascular outcomes after repair of tetralogy of Fallot (TOF). Echocardiographic parameters at rest offer only partial information on impaired hemodynamics in these patients, and data during stress testing are lacking. The leg-positive pressure (LPP) maneuver has recently been reported to be able to apply acute preload stress. The aim of this study was to test the hypothesis that preload reserve is impaired and ventricular interaction is exacerbated in patients with TOF. METHODS In this prospective cross-sectional study, we recruited 44 consecutive patients with TOF and 30 normal control subjects. Echocardiography was performed both at rest and during LPP stress, and preload reserve was defined as the change between baseline stroke volume (SV) and that obtained during LPP stress. The eccentricity index was calculated as the ratio of the left ventricular anteroposterior to septal-lateral dimensions to quantify ventricular interaction. RESULTS LPP stress significantly increased SV from 73 ± 14 to 83 ± 16 mL (P < .01) in control subjects, while the increase in SV was significantly blunted (from 75 ± 19 to 79 ± 18 mL; P < .01 for interaction) in patients with TOF. The eccentricity index significantly changed during LPP stress in patients with TOF only from 1.07 ± 0.13 to 1.13 ± 0.14 (P < .01 for interaction). Patients with TOF were subdivided into two subgroups on the basis of the median value of increased response in SV (22 with sufficient and 22 with insufficient preload reserve). Multivariate analysis identified significant pulmonary regurgitation as the only independent determinant factor for insufficient preload reserve (odds ratio, 4.57; 95% CI, 1.048-19.90; P = .04). CONCLUSIONS In patients after repair of TOF, ventricular interaction was exacerbated and preload reserve was impaired, especially in patients with significant pulmonary regurgitation. LPP stress testing may direct tailored treatment approaches, risk stratification, and clinical decision-making, such as more aggressive pharmacologic therapy, meticulous outpatient follow-up, or earlier reintervention.
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Affiliation(s)
- Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
| | - Akira Onishi
- Division of Rheumatology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nao Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shun Yokota
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Eriko Hisamatsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kumiko Dokuni
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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19
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Sumimoto K, Tanaka H, Mukai J, Yamashita K, Tanaka Y, Shono A, Suzuki M, Yokota S, Suto M, Takada H, Matsumoto K, Taniguchi Y, Emoto N, Hirata KI. IMPACT OF BALLOON PULMONARY ANGIOPLASTY ON RIGHT VENTRICULAR FUNCTION FOR CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32718-2] [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: 10/24/2022]
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20
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Tanaka Y, Tanaka H, Hatazawa K, Yamashita K, Sumimoto K, Shono A, Suzuki M, Shibata N, Yokota S, Suto M, Mukai J, Takada H, Dokuni K, Hisamatsu E, Matsumoto K, Hirata KI. IMPACT OF HYPERTENSION ON LEFT VENTRICULAR FUNCTION IN PATIENTS WITH MALIGNANT LYMPHOMA AFTER ANTHRACYCLINE CHEMOTHERAPY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31357-7] [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: 10/24/2022]
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21
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Sumimoto K, Tanaka H, Mukai J, Yamashita K, Tanaka Y, Shono A, Suzuki M, Yokota S, Suto M, Takada H, Matsumoto K, Taniguchi Y, Emoto N, Hirata KI. Effects of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension on remodeling in right-sided heart. Int J Cardiovasc Imaging 2020; 36:1053-1060. [PMID: 32086654 DOI: 10.1007/s10554-020-01798-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 12/07/2019] [Accepted: 02/14/2020] [Indexed: 12/21/2022]
Abstract
Remodeling in the right-sided heart plays an important role in the management of pulmonary hypertension (PH) patients. However, the effect of balloon pulmonary angioplasty (BPA) on right ventricular (RV) and right atrial (RA) morphology of patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains uncertain. This study involved 45 CTEPH patients who underwent BPA with mean pulmonary artery pressure (mPAP) of 37.0 mmHg (all ≥ 25 mmHg). All patients underwent echocardiography and right-heart catheterization at baseline and 3 months after BPA. RV and RA remodeling was assessed as RV and the RA area, and RV systolic function was calculated by averaging peak speckle-tracking longitudinal strain of the RV free-wall (RV free-wall strain). Significant reverse remodeling in the right-sided heart was observed after BPA, resulting in improvement of mPAP and pulmonary vascular resistance (RV area: from 15.0 ± 5.3 to 9.6 ± 3.0 cm2, p < 0.0001; RA area: from 17.3 ± 6.6 to 13.4 ± 3.8 cm2, p = 0.0002; RV free-wall strain: from 15.9 ± 5.6 to 21.2 ± 4.9%, p < 0.0001). Furthermore, multiple regression analysis showed that the baseline RV area was an independent predictor of post-BPA normalization of RV systolic function defined as RV free-wall strain ≥ 20% (odds ratio = 1.16, p = 0.0305). Interestingly, significant RV reverse remodeling was also observed after additional BPA even in 18 CTEPH patients with residual pulmonary arterial stenosis, whose mPAP was normalized after BPA (RV area: from 11.5 ± 3.8 to 9.2 ± 3.8 cm2, p = 0.0045; RV free-wall strain: from 17.2 ± 4.8 to 22.8 ± 7.4%, p = 0.0216). Significant reverse remodeling in the right-sided heart, as well as hemodynamic improvement, was observed in CTEPH patients after BPA.
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Affiliation(s)
- Keiko Sumimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kentaro Yamashita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yusuke Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ayu Shono
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Makiko Suzuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Shun Yokota
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Noriaki Emoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Hatani Y, Tanaka H, Mochizuki Y, Suto M, Yokota S, Mukai J, Takada H, Soga F, Hatazawa K, Matsuzoe H, Matsumoto K, Hirota Y, Ogawa W, Hirata KI. Association of body fat mass with left ventricular longitudinal myocardial systolic function in type 2 diabetes mellitus. J Cardiol 2020; 75:189-195. [DOI: 10.1016/j.jjcc.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/08/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
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Yokota S, Tanaka H, Mochizuki Y, Soga F, Yamashita K, Tanaka Y, Shono A, Suzuki M, Sumimoto K, Mukai J, Suto M, Takada H, Matsumoto K, Hirota Y, Ogawa W, Hirata KI. Association of glycemic variability with left ventricular diastolic function in type 2 diabetes mellitus. Cardiovasc Diabetol 2019; 18:166. [PMID: 31805945 PMCID: PMC6894492 DOI: 10.1186/s12933-019-0971-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 11/23/2019] [Indexed: 12/16/2022] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) is a major cause of heart failure (HF) with preserved ejection fraction (HFpEF), usually presenting as left ventricular (LV) diastolic dysfunction. Thus, LV diastolic function should be considered a crucial marker of a preclinical form of DM-related cardiac dysfunction. However, the impact of glycemic variability (GV) on LV diastolic function in such patients remains unclear. Methods We studied 100 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease (age: 60 ± 14 years, female: 45%). GV was evaluated as standard deviation of blood glucose level using continuous glucose monitoring system for at least 72 consecutive hours. LV diastolic function was defined as mitral inflow E and mitral e’ annular velocities (E/e’), and > 14 was determined as abnormal. Results E/e’ in patients with high GV (≥ 35.9 mg/dL) was significantly higher than that in patients with low GV (11.3 ± 3.9 vs. 9.8 ± 2.8, p = 0.03) despite similar age, gender-distribution, and hemoglobin A1c (HbA1c). Multivariate logistic regression analysis showed that GV ≥ 35.9 mg/dL (odds ratio: 3.67; 95% confidence interval: 1.02–13.22; p < 0.05) was an independently associated factor, as was age, of E/e’ > 14. In sequential logistic models for the associations of LV diastolic dysfunction, one model based on clinical variables including age, gender and hypertension was not improved by addition of HbA1c (p = 0.67) but was improved by addition of high GV (p = 0.04). Conclusion Since HFpEF is a syndrome caused by diverse agents, reducing GV may represent a potential new therapeutic strategy for the prevention of the development of HFpEF in T2DM patients.
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Affiliation(s)
- Shun Yokota
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yasuhide Mochizuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kentaro Yamashita
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yusuke Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Ayu Shono
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Makiko Suzuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Keiko Sumimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Shono A, Mori S, Nakamura K, Yatomi A, Takada H, Tanaka H, Okano T, Morinobu A, Hirata KI. Glucocorticoid-sensitive Paroxysmal Atrial Fibrillation, Sick Sinus Syndrome, and Mitral Regurgitation in a Patient with Malignant Rheumatoid Vasculitis. Intern Med 2019; 58:3093-3098. [PMID: 31292399 PMCID: PMC6875444 DOI: 10.2169/internalmedicine.3090-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 01/08/2023] Open
Abstract
An 80-year-old woman with rheumatoid arthritis presented with chest pain. Clinical examination revealed new-onset paroxysmal atrial fibrillation with symptomatic sinus pauses and worsening mitral regurgitation, which were both resistant to conventional therapies. Based on her skin lesions, an increase in pleural and pericardial effusion, possible myocardial involvement, and a positive finding for immune complex testing, rheumatoid vasculitis was diagnosed. Subsequent glucocorticoid therapy suppressed systemic inflammation, resulting in structural, functional, and electrical reverse remodeling of the left atrium with complete remission of atrial arrhythmias and also an improvement of mitral regurgitation. This case highlights the importance of evaluating the underlying disease activity in a case of de novo paroxysmal atrial fibrillation associated with systemic autoimmune disease.
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Affiliation(s)
- Ayu Shono
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Shumpei Mori
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Keita Nakamura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Atsusuke Yatomi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
| | - Takaichi Okano
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan
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Takada H, Tanaka H, Yokota S, Mukai J, Suto M, Soga F, Hatani Y, Matsuzoe H, Hatazawa K, Matsumoto K, Fukuzawa K, Hirata KI. Association of Relatively Short Posterior Mitral Leaflet With Mitral Regurgitation in Patients With Atrial Fibrillation. Circ J 2019; 83:2312-2319. [DOI: 10.1253/circj.cj-19-0529] [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)
- Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Shun Yokota
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yutaka Hatani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroki Matsuzoe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Koji Fukuzawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Ueno K, Takada H, Matsuo H, Kuru S, Goto K, Mitsui T, Ishizaki M, Sugimoto S, Ogata K, Matsumura T, Suwazono S, Furuya H, Watanabe A, Kawano Y, Yamamoto A, Sasagasako N, Arahata H. P.87Carnitine deficiency in patients with neuromuscular diseases on long-term tube feeding. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.116] [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: 11/29/2022]
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Adachi A, Hirata Y, Kawamura H, Harada T, Hattori R, Kumai D, Yamamoto Y, Kojima Y, Ikeuchi H, Hayashi N, Mochizuki H, Takada H, Yamaguchi R, Sobue S. Efficacy of Mucosal Cutting Biopsy for the Histopathological Diagnosis of Gastric Submucosal Tumors. Case Rep Gastroenterol 2019; 13:185-194. [PMID: 31123445 PMCID: PMC6514511 DOI: 10.1159/000499442] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/05/2019] [Indexed: 02/06/2023] Open
Abstract
Background Gastrointestinal stromal tumors occur frequently. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed commonly for diagnosis. However, the success rate of histological diagnosis is insufficient when the submucosal tumor (SMT) is small. Recently, another technique, mucosal cutting biopsy (MCB) has been reported. The aim of this study is to evaluate the efficacy and safety of MCB. Method Between January 2012 and August 2018, MCB and EUS-FNA were performed 16 and 31 times for diagnosing gastric SMT. The diagnostic rate, the rate of successful immunohistochemistry, and the safety were reviewed. Difficult locations for EUS-FNA were also evaluated. Results The mean SMT sizes measured on MCB and EUS-FNA were 21.2 and 36.2 mm. The diagnostic rates of MCB and EUS-FNA were almost the same (88 vs. 81%), but successful immunohistochemistry was significantly higher in the MCB group (93 vs. 59%, p = 0.03). In the subgroup of SMTs < 20 mm, the successful histological diagnosis rate from EUS-FNA was relatively low. There were no complications. Failures of EUS-FNA were more frequent in the middle third of the stomach. Conclusions MCB was an effective procedure for diagnosing gastric SMT, especially in the case of small SMTs located at the middle third of the stomach.
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Affiliation(s)
- Akihisa Adachi
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Yoshikazu Hirata
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Hayato Kawamura
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Takahito Harada
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Reika Hattori
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Daisuke Kumai
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Yuki Yamamoto
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Yuki Kojima
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Hirokazu Ikeuchi
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Noriyuki Hayashi
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Hisato Mochizuki
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Ryuzo Yamaguchi
- Department of Surgery, Kasugai Municipal Hospital, Kasugai, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
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Soga F, Tanaka H, Mochizuki Y, Mukai J, Suto M, Takada H, Hatani Y, Matsuzoe H, Hatazawa K, Sano H, Ooka J, Shimoura H, Matsumoto K, Fukuzawa K, Hirata KI. Combined assessment of left atrial volume parameters for predicting recurrence of atrial fibrillation following pulmonary vein isolation in patients with paroxysmal atrial fibrillation. Echocardiography 2019; 36:862-869. [PMID: 30908731 DOI: 10.1111/echo.14315] [Citation(s) in RCA: 2] [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: 02/14/2019] [Accepted: 02/24/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Our aim was to test the hypothesis that comprehensive simplified left atrial (LA) assessment derived from routine echocardiography may be more useful than assessment of LA volume alone for predicting atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). METHODS We studied 156 patients with paroxysmal AF (PAF) who had undergone PVI. Echocardiography was performed within two days before PVI. Maximum (Max-LAVi) and minimum LA volume index (Min-LAVi) were calculated with the biplane modified Simpson's method, and then normalized to the body surface area. On the basis of previous findings, the predefined cutoff value of Max-LAVi for AF recurrence was set at Max-LAVi ≥ 34 mL/m2 . ΔLA volume index (ΔLAVi) was also calculated as Max-LAVi minus Min-LAVi. The follow-up period after PVI was 24 months. RESULTS AF recurrence was observed in 35 patients. Multivariate logistic regression analysis showed that ΔLAVi (odds ratio [OR]: 1.131; 95% confidence interval [CI]: 1.057-1.221; P < 0.001) was an independent predictor of AF recurrence. Sequential logistic regression models for predicting AF recurrence revealed that a model based on clinical variables including age, gender and AF duration (χ2 = 1.65) was improved by the addition of Max-LAVi ≥ 34 mL/m2 (χ2 = 13.8; P < 0.001), and further improved by the addition of ΔLAVi (χ2 = 18.2; P = 0.036). Of note is that only 1.02 ± 0.10 minutes per patient was needed to obtain a comprehensive LA assessment that included Max-LAVi, Min-LAVi, and ΔLAVi. CONCLUSION This easy-to-use comprehensive simplified LA approach from routine echocardiography may well have clinical implications for better management of PAF patients.
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Affiliation(s)
- Fumitaka Soga
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidekazu Tanaka
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yasuhide Mochizuki
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Mukai
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makiko Suto
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Takada
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Hatani
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Matsuzoe
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiko Hatazawa
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Sano
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junichi Ooka
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Shimoura
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kensuke Matsumoto
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Fukuzawa
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Soga F, Tanaka H, Mochizuki Y, Yamashita K, Tanaka Y, Shono A, Suzuki M, Yoshikawa S, Sumimoto K, Shibata N, Yokota S, Mukai J, Suto M, Takada H, Dokuni K, Hatazawa K, Hisamatsu E, Matsumoto K, Fukuzawa K, Hirata KI. COMPREHENSIVE SIMPLIFIED LEFT ATRIAL ASSESSMENT FOR PREDICTING RECURRENCE OF ATRIAL FIBRILLATION FOLLOWING PULMONARY VEIN ISOLATION IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32111-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hatani Y, Tanaka H, Shibata N, Yokota S, Mukai J, Suto M, Takada H, Soga F, Dokuni K, Hatazawa K, Hisamatsu E, Matsumoto K, Hirata KI. A CASE OF SUDDEN ONSET OF PLATYPNEA ORTHODEOXIA SYNDROME CAUSED BY TRAUMATIC TRICUSPID REGURGITATION WITH RUPTURED CHORDAE TENDINEAE AFTER BLUNT CHEST TRAUMA. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32996-1] [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: 10/27/2022]
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31
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Hatani Y, Tanaka H, Mochizuki Y, Suto M, Takada H, Soga F, Dokuni K, Hatazawa K, Hisamatsu E, Matsumoto K, Hirata KI. ASSOCIATION OF BODY FAT MASS WITH LEFT VENTRICULAR MYOCARDIAL SYSTOLIC LONGITUDINAL DYSFUNCTION IN TYPE 2 DIABETES MELLITUS. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32104-7] [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: 10/27/2022]
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Abstract
Abstract
One aim of animal behaviour research is to explain why animals live in groups. The grouping behaviour of solitary mammals is important for understanding the ecological factors promoting the evolution of sociality. We present field data of Japanese serow, a primitive solitary ungulate, in forest and alpine meadow habitats. We found no differences in group size of all age–sex classes between the forest and alpine meadow habitats, and both populations were mainly solitary. The current findings suggest that group size in the serow is not affected by ecological conditions, including habitat structure, forage abundance, and population density. However, female associations involving up to three females occurred in the alpine meadow habitat throughout the year, whereas such groupings were not observed in the forest habitat. This finding suggests that abundant food supply in the alpine meadow promoted female associations by decreasing the cost of food resource competition.
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Affiliation(s)
- H. Takada
- aMount Fuji Research Institute Yamanashi Prefecture Government, 5597-1, Kenmarubi, Kamiyoshida, Fijiyoshida, Yamanashi 403-0005, Japan
- bLaboratory of Wildlife Ecology and Conservation, School of Veterinary Medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - M. Minami
- bLaboratory of Wildlife Ecology and Conservation, School of Veterinary Medicine, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
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Sano H, Tanaka H, Motoji Y, Mukai J, Suto M, Takada H, Soga F, Hatani Y, Matsuzoe H, Hatazawa K, Shimoura H, Ooka J, Nakayama K, Matsumoto K, Yamada H, Emoto N, Hirata KI. Echocardiography during preload stress for evaluation of right ventricular contractile reserve and exercise capacity in pulmonary hypertension. Echocardiography 2018; 35:1997-2004. [PMID: 30328154 DOI: 10.1111/echo.14161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 08/19/2018] [Revised: 09/07/2018] [Accepted: 09/12/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Pulmonary hypertension (PH) is characterized by marked and sustained elevation of pulmonary vascular resistance and pulmonary artery pressure, and subsequent right-sided heart failure. Right ventricular (RV) function and exercise capacity have been recognized as important prognostic factors for PH. Our aim was to investigate RV contractile reserve and exercise capacity during a leg-positive pressure (LPP) maneuver. METHODS The study population comprised 43 PH patients and 17 normal controls. All patients underwent echocardiography at rest and during LPP stress. Exercise capacity was assessed by 6-minute walk distance for PH patients. RV relative wall thickness was calculated from dividing by RV free wall thickness by basal RV linear dimensions at end-diastole. RV function was calculated by averaging peak speckle-tracking longitudinal strain from the RV free wall. RV contractile reserve was assessed as the difference in RV free wall strain at rest and during LPP stress. Changes in left ventricular stroke volume (ΔSV) during LPP stress were also calculated. RESULTS ΔSV and RV contractile reserve of PH patients were significantly lower than of controls (3.6 ± 6.0 mL vs 8.5 ± 2.3 mL, and 8.2 ± 11.9% vs 14.5 ± 6.6%; both P < 0.01). RV contractile reserve of PH patients with ΔSV <3.3 mL was significantly lower than of PH patients with ΔSV >3.3 mL (3.9 ± 13.2% vs 12.3 ± 8.9%; P = 0.02). ΔSV had also significant correlation with 6-minute walk distance (r = 0.42, P = 0.006). Multivariate regression analysis showed that RV relative wall thickness was an independent determinant parameter of ΔSV during LPP stress for PH patients (β = 3.2, P = 0.003). CONCLUSIONS Preload stress echocardiography in response to LPP maneuver, a noninvasive and easy-to-use procedure for routine clinical use, proved to be useful for the assessment of RV contractile reserve and exercise capacity of PH patients.
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Affiliation(s)
- Hiroyuki Sano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshiki Motoji
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yutaka Hatani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroki Matsuzoe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroyuki Shimoura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junichi Ooka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazuhiko Nakayama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotsugu Yamada
- Department of Community Medicine for Cardiology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Noriaki Emoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
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Ogata K, Kosuga M, Takeshita E, Matsumura T, Ishigaki K, Ozasa S, Arahata H, Sugie K, Takahashi T, Kuru S, Kobayashi M, Takada H, Hattori A, Takahashi M, Tanaka N, Kimura T, Funato M, Okuyama T, Komaki H. METABOLIC MYOPATHIES II. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.396] [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]
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Hatazawa K, Tanaka H, Nonaka A, Takada H, Soga F, Hatani Y, Matsuzoe H, Shimoura H, Ooka J, Sano H, Mochizuki Y, Matsumoto K, Hirata KI. Baseline Global Longitudinal Strain as a Predictor of Left Ventricular Dysfunction and Hospitalization for Heart Failure of Patients With Malignant Lymphoma After Anthracycline Therapy. Circ J 2018; 82:2566-2574. [DOI: 10.1253/circj.cj-18-0333] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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)
- Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | | | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yutaka Hatani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroki Matsuzoe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroyuki Shimoura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Junichi Ooka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroyuki Sano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yasuhide Mochizuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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36
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Matsuzoe H, Matsumoto K, Tanaka H, Tahara N, Izawa Y, Toba T, Mori S, Suto M, Mukai J, Takada H, Soga F, Hatani Y, Hatazawa K, Shimoyama S, Hirata K. P6483Integrated assessment of aortic valve resistance using multi-detector computed tomography and echocardiography reflects aortic valvular burden and has prognostic value in patients with aortic stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6483] [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)
- H Matsuzoe
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - N Tahara
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - Y Izawa
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - T Toba
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - S Mori
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - M Suto
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - J Mukai
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - H Takada
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - F Soga
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - Y Hatani
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - K Hatazawa
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
| | - S Shimoyama
- Kobe University, Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - K Hirata
- Kobe University, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
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37
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Suto M, Matsumoto K, Shibata N, Yokota S, Mukai J, Hisamatsu E, Takada H, Soga F, Dokuni K, Hatani Y, Hatazawa K, Matsuzoe H, Tanaka H, Hirata K. P1610Non-invasive assessment of preload reserve using the leg-positive pressure manoeuvre in patients with repaired tetralogy of Fallot. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1610] [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)
- M Suto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Matsumoto
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - N Shibata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - S Yokota
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - J Mukai
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - E Hisamatsu
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Takada
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - F Soga
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Dokuni
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - Y Hatani
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hatazawa
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Matsuzoe
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - H Tanaka
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
| | - K Hirata
- Kobe University, Division of Cardiovascular Medicine, Kobe, Japan
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Okayama K, Hirata Y, Kumai D, Yamamoto Y, Kojima Y, Kanno T, Ikeuchi H, Mochizuki H, Takada H, Sobue S. The Successful Treatment of Sodium Polystyrene Sulfonate-induced Enteritis Diagnosed by Small Bowel Endoscopy. Intern Med 2018; 57:1577-1581. [PMID: 29321412 PMCID: PMC6028675 DOI: 10.2169/internalmedicine.0088-17] [Citation(s) in RCA: 9] [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] [Indexed: 12/03/2022] Open
Abstract
Sodium polystyrene sulfonate (SPS: Kayexalate®) is an ion-exchange resin used to treat hyperkalemia in patients with chronic kidney disease. It is known that this resin sometimes causes colonic necrosis and perforation, but there are few reports about small bowel necrosis associated with SPS. We herein report the case of a patient who developed SPS-induced small bowel necrosis, which was diagnosed based on the examination of a small bowel endoscopic biopsy specimen. The SPS-induced small bowel necrosis was resistant to conservative treatment including the cessation of SPS, and finally required surgical bowel resection.
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Affiliation(s)
- Kohei Okayama
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Yoshikazu Hirata
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Daisuke Kumai
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Yuki Yamamoto
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Yuki Kojima
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Takuya Kanno
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Hirokazu Ikeuchi
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Hisato Mochizuki
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
| | - Satoshi Sobue
- Department of Gastroenterology, Kasugai Municipal Hospital, Japan
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Kato A, Naiki-Ito A, Naitoh I, Hayashi K, Nakazawa T, Shimizu S, Nishi Y, Okumura F, Inoue T, Takada H, Kondo H, Yoshida M, Takahashi S, Joh T. The absence of class III β-tubulin is predictive of a favorable response to nab-paclitaxel and gemcitabine in patients with unresectable pancreatic ductal adenocarcinoma. Hum Pathol 2018; 74:92-98. [DOI: 10.1016/j.humpath.2018.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 01/04/2018] [Accepted: 01/05/2018] [Indexed: 11/17/2022]
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Hori Y, Naitoh I, Hayashi K, Kondo H, Yoshida M, Shimizu S, Hirano A, Okumura F, Ando T, Jinno N, Takada H, Togawa S, Joh T. Covered duodenal self-expandable metal stents prolong biliary stent patency in double stenting: The largest series of bilioduodenal obstruction. J Gastroenterol Hepatol 2018; 33:696-703. [PMID: 28902972 DOI: 10.1111/jgh.13977] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 07/18/2017] [Revised: 08/14/2017] [Accepted: 08/28/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM Endoscopic biliary and duodenal stenting (DS; double stenting) is widely accepted as a palliation therapy for malignant bilioduodenal obstruction. The aim of the current study was to investigate the patency and adverse events of duodenal and biliary stents in patients with DS. METHODS Patients who underwent DS from April 2004 to March 2017 were analyzed retrospectively with regard to clinical outcomes and predictive factors of recurrent biliary and duodenal obstruction (recurrent biliary obstruction [RBO] and recurrent duodenal obstruction [RDO]). RESULTS A total of 109 consecutive patients was enrolled. Technical success of DS was achieved in 108 patients (99.1%). Symptoms due to biliary and duodenal obstruction were improved in 89 patients (81.7%). RBO occurred in 25 patients (22.9%) and RDO in 13 (11.9%). The median times to RBO and RDO from DS were 87 and 76 days, respectively. Placement of a duodenal uncovered self-expandable metal stent (U-SEMS) was significantly associated with RBO in the multivariable analysis (P = 0.007). Time to RBO was significantly longer in the duodenal covered self-expandable metal stent group than in the U-SEMS group (P = 0.003). No predictive factors of RDO were detected, and duodenal stent type was not associated with the time to RDO (P = 0.724). CONCLUSIONS Double stenting was safe and effective for malignant bilioduodenal obstruction. Duodenal U-SEMS is a risk factor for RBO. The covered self-expandable metal stent is the preferred type of duodenal SEMS in patients with DS (Clinical trial registration number: UMIN000027606).
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Affiliation(s)
- Yasuki Hori
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Itaru Naitoh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kazuki Hayashi
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiromu Kondo
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Michihiro Yoshida
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shuya Shimizu
- Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Atsuyuki Hirano
- Department of Gastroenterology, Nagoya City West Medical Center, Nagoya, Japan
| | - Fumihiro Okumura
- Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | - Tomoaki Ando
- Department of Gastroenterology, Gamagori City Hospital, Gamagori, Japan
| | - Naruomi Jinno
- Department of Gastroenterology, Toyokawa City Hospital, Toyokawa, Japan
| | - Hiroki Takada
- Department of Gastroenterology, Kasugai Municipal Hospital, Kasugai, Japan
| | - Shozo Togawa
- Department of Gastroenterology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan
| | - Takashi Joh
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Abstract
Polysomnography (PSG), which records physiological phenomena including brain waves, breathing status, and muscle tonus, is useful for the diagnosis of sleep disorders as a gold standard. However, measurement and analysis are complex for several specific sleep disorders, such as rapid eye movement (REM) sleep behavior disorder (RBD). Usually, brain waves during REM sleep indicate an awakening pattern under relaxed conditions of skeletal and antigravity muscles. However, these muscles are activated during REM sleep when patients suffer from RBD. These activated muscle movements during REM, so-called REM without atonia (RWA) recorded by PSG, may be related to a neurodegenerative disease such as Parkinson's disease. Thus, careful analysis of RWA is significant not only physically, but also clinically. Commonly, manual viewing measurement analysis of RWA is time-consuming. Therefore, quantitative studies on RWA are rarely reported. A software program, developed from Microsoft Office Excel®, was used to semiautomatically analyze the RWA ratio extracted from PSG to compare with manual viewing measurement analysis. In addition, a quantitative muscle tonus study was carried out to evaluate the effect of medication on RBD patients. Using this new software program, we were able to analyze RWA on the same cases in approximately 15 min as compared with 60 min in the manual viewing measurement analysis. This software program can not only quantify RWA easily but also identify RWA waves for either phasic or tonic bursts. We consider that this software program will support physicians and scientists in their future research on RBD. We are planning to offer this software program for free to physicians and scientists.
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Affiliation(s)
| | | | - Hiroki Takada
- Graduate School of Information Science, Nagoya University.,Department of Human and Artificial Intelligence Systems, Graduate School of Engineering, University of Fukui
| | - Meiho Nakayama
- Good Sleep Center Nagoya City University Hospital.,Department of Neuro-otolaryngology, Nagoya City University
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Mori Y, Kinoshita F, Takada H. [Study of Equilibrium Control System during a Lowering at Arousal Level]. Nihon Eiseigaku Zasshi 2018; 73:34-38. [PMID: 29386444 DOI: 10.1265/jjh.73.34] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Contingent negative variation (CNV) is an event-related potential proportional to vigilance degree. A CNV graph shows an inverted U-shape, and this bioreaction disappears after falling below a threshold of vigilance degree. Previous studies have shown that the event-related potential gained with time decreases with sleep deprivation, and a decrease in the vigilance degree has been confirmed using Flicker values (FV) and the Stanford Sleepiness Scale (SSS) score. The minimum integrated value was recorded 24 h after the onset of sleep deprivation. In a present study, we used 36-h sleep deprivation. The FVs, SSS scores, and stabilograms were obtained every 90 min for 52 h, except for the 12 h of sleep. We herein examine whether the biocontrol system is changed by sleep deprivation. RESULTS The time sequences in FV and SSS score showed that the degree of vigilance markedly decreased 22.5 h after the onset of this experiment, which supported CNV disappearance with sleep deprivation. The sway value with subjects' eyes closed was greatest 22.5 h after the onset of this experiment. Furthermore, there were no significant differences between the sway value during the above-mentioned sleep deprivation and that after 12 h of sleep. We considered that the equilibrium function and vigilance after 36-h sleep deprivation did not recover markedly well with sleep of sufficient duration. That is, the biocontrol process in the subconscious still proceeds after awakening. CONCLUSIONS In this study, we focused on bioprocessing, especially the equilibrium function, during sleep deprivation and investigated the relationship between the equilibrium function and sleep deprivation. We obtained evidence supporting CNV disappearance after sleep deprivation for 36 h. The equilibrium control system without CNV was compared with that with CNV.
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Affiliation(s)
- Yuki Mori
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui
| | - Fumiya Kinoshita
- Department of Information Engineering, Graduate School of Information Science, Nagoya University
| | - Hiroki Takada
- Department of Human and Artificial Intelligent Systems, Graduate School of Engineering, University of Fukui.,Department of Information Engineering, Graduate School of Information Science, Nagoya University
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Sugiura A, Eto T, Kinoshita F, Takada H. [Effect of Reading a Book on a Tablet Computer on Cerebral Blood Flow in the Prefrontal Cortex]. Nihon Eiseigaku Zasshi 2018; 73:39-45. [PMID: 29386445 DOI: 10.1265/jjh.73.39] [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] [Indexed: 11/09/2022]
Abstract
OBJECTIVES By measuring cerebral blood flow in the prefrontal cortex, we aimed to determine how reading a book on a tablet computer affects sleep. METHODS Seven students (7 men age range, 21-32 years) participated in this study. In a controlled illuminance environment, the subjects read a novel in printed form or on a tablet computer from any distance. As the subjects were reading, the cerebral blood flow in their prefrontal cortex was measured by near-infrared spectroscopy. The study protocol was as follows. 1) Subjects mentally counted a sequence of numbers for 30 s as a pretest to standardized thinking and then 2) read the novel for 10 min, using the printed book or tablet computer. In step 2), the use of the book or tablet computer was in a random sequence. Subjects rested between the two tasks. RESULTS Significantly increased brain activity (increase in regional cerebral blood flow) was observed following reading a novel on a tablet computer compared with that after reading a printed book. Furthermore, the region around Broca's area was more active when reading on a tablet computer than when reading a printed book. CONCLUSIONS Considering the results of this study and previous studies on physiological characteristics during nonrapid eye movement sleep, we concluded that reading a book on a tablet computer before the onset of sleep leads to the potential inhibition of sound sleep through mechanisms other than the suppression of melatonin secretion.
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Affiliation(s)
- Akihiro Sugiura
- Department of Radiological Technology, Gifu University of Medical Science
| | - Takuya Eto
- Graduate School of Engineering, University of Fukui
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Takada H. [Preface]. Nihon Eiseigaku Zasshi 2018; 73:21. [PMID: 29386441 DOI: 10.1265/jjh.73.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Teshigawara M, Ikeda Y, Ooi M, Harada M, Takada H, Kakishiro M, Noguchi G, Shimada T, Seita K, Murashima D, Fukatani K, Kanomata K, Teraoku T. Implementation of a low-activation Au-In-Cd decoupler into the J-PARC 1 MW short pulsed spallation neutron source. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Suto M, Tanaka H, Mochizuki Y, Mukai J, Takada H, Soga F, Dokuni K, Hatani Y, Hatazawa K, Matsuzoe H, Sano H, Shimoura H, Ooka J, Matsumoto K, Hirota Y, Ogawa W, Hirata KI. Impact of overweight on left ventricular function in type 2 diabetes mellitus. Cardiovasc Diabetol 2017; 16:145. [PMID: 29121924 PMCID: PMC5679500 DOI: 10.1186/s12933-017-0632-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/02/2017] [Indexed: 01/07/2023] Open
Abstract
Background Coexistence of left ventricular (LV) longitudinal myocardial systolic dysfunction with LV diastolic dysfunction could lead to heart failure with preserved ejection fraction (HFpEF). Diabetes mellitus (DM) is known as a significant factor associated with HFpEF. Although the mechanisms of DM-related LV myocardial injury are complex, it has been postulated that overweight contributes to the development of LV myocardial injury in type 2 diabetes mellitus (T2DM) patients. However, the precise impact of overweight on LV longitudinal myocardial systolic function in T2DM patients remains unclear. Methods We studied 145 asymptomatic T2DM patients with preserved LV ejection fraction (LVEF) without coronary artery disease. LV longitudinal myocardial systolic function was assessed by global longitudinal strain (GLS), which was defined as the average peak strain of 18-segments obtained from standard apical views. Overweight was defined as body mass index (BMI) ≥ 25 kg/m2. Ninety age-, gender- and LVEF-matched healthy volunteers served as controls. Results GLS of overweight T2DM patients was significantly lower than that of non-overweight patients (17.9 ± 2.4% vs. 18.9 ± 2.6%, p < 0.05), whereas GLS of both overweight and non-overweight controls was similar (19.8 ± 1.3% vs. 20.4 ± 2.1%, p = 0.38). Furthermore, multiple regression analysis revealed that for T2DM patients, BMI was the independent determinant parameters for GLS as well as LV mass index. Conclusions Overweight has a greater effect on LV longitudinal myocardial systolic function in T2DM patients than on that in non-DM healthy subjects. Our finding further suggests that the strict control of overweight in T2DM patients may be associated with prevention of the development of HFpEF.
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Affiliation(s)
- Makiko Suto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hidekazu Tanaka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
| | - Yasuhide Mochizuki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Jun Mukai
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Takada
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Fumitaka Soga
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kumiko Dokuni
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yutaka Hatani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Keiko Hatazawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroki Matsuzoe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroyuki Sano
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Hiroyuki Shimoura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Junichi Ooka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Kensuke Matsumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan
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Ogata K, Kosuga M, Takeshita E, Matsumura T, Ishigaki K, Ozasa S, Arahata H, Sugie K, Takahashi T, Kuru S, Hattori A, Takada H, Kobayashi M, Takahashi M, Tanaka N, Okuyama T, Komaki H. High-risk screening for late-onset Pompe disease in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2324] [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: 10/18/2022]
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Takada H, Odaira K, Konagaya M. Change over time in the treatment condition for patients with subacute myelo-optico-neuropathy in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2718] [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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49
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Saito T, Ogata K, Takahashi T, Kobayashi M, Takada H, Kuru S, Mikata T, Matsumura T, Arahata H, Fukudome T, Funato M, Yonemoto N, Kimura E. Study on factor related to general condition and prognosis of patients with duchenne muscular dystrophy. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2337] [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: 10/18/2022]
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50
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Takada H. Editor's Note. Nihon Eiseigaku Zasshi 2017; 72:195. [PMID: 28931800 DOI: 10.1265/jjh.72.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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