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Sakaida H, Ichikawa Y, Yamazaki A, Sakuma H, Takeuchi K. Ultra-High Spatial Resolution Images of the Temporal Bone Obtained With a Newly Released Photon-Counting Detector Computed Tomography. Ear Nose Throat J 2024:1455613241235551. [PMID: 38656190 DOI: 10.1177/01455613241235551] [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] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yasutaka Ichikawa
- Department of Radiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Akio Yamazaki
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Kobayashi M, Takeuchi K. Usefulness of endoscopic endonasal underwater surgery using a combination of coblation and a lens-cleaning system for hemostasis in hereditary hemorrhagic telangiectasia. Auris Nasus Larynx 2024; 51:512-516. [PMID: 38522355 DOI: 10.1016/j.anl.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 03/26/2024]
Abstract
Hemostatic procedures for controlling nasal bleeding in refractory diseases such as hereditary hemorrhagic telangiectasia (HHT) can be challenging. In this report, we present a novel technique for underwater endoscopic endonasal hemostatic surgery, which was performed on a 69-year-old man with HHT. The patient had been experiencing frequent episodes of nasal bleeding and had many telangiectasias in the nasal cavity, which were the cause of the bleeding. These telangiectasias were effectively treated using a coblation device in combination with an endoscope lens-cleaning system that supplied saline to create stable underwater conditions. There are several advantages to this technique, including provision of a stable and clear endoscopic field of view, allowing for better visualization of the surgical site. This makes it easier to identify bleeding points and ensure accurate hemostasis. Additionally, the hydrostatic pressure created by the underwater environment helps to reduce bleeding during the procedure. However, it is important to take careful precautions to prevent water from entering the lower airway. With this precautionary measure, this technique is particularly useful in managing bleeding in patients with HHT.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
| | - Masayoshi Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Nishida E, Sakaida H, Kitano M, Takeuchi K. Quantification of Mastoid Air Cells and Opacification of the Middle Ear in Primary Ciliary Dyskinesia. Otol Neurotol 2024; 45:e102-e106. [PMID: 38013495 DOI: 10.1097/mao.0000000000004059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE To evaluate pneumatization and opacification of the temporal bone on computed tomography (CT) images in patients with primary ciliary dyskinesia (PCD). STUDY DESIGN Retrospective case-control study. SETTING Tertiary referral center. PATIENTS Fifteen patients with PCD (30 ears) and 45 age-matched individuals without PCD (90 ears) as controls. INTERVENTION Diagnostic only. MAIN OUTCOME MEASURES Quantification of mastoid air cells in the PCD and control groups and comparison between them. Degree of middle ear opacification on CT images of the temporal bone in the PCD group. RESULTS The volume of the mastoid air cells was 30% smaller in the PCD group than in the control group ( p < 0.05). The suppression ratio, which is defined to indicate how much the average volume of mastoid air cells in the PCD group is suppressed relative to the control group, was 64% lower in the PCD group ( p < 0.05). Opacification was noted in 47% of the mastoid air cells and 63% of the tympanic cavity on CT images of the temporal bone in the PCD group, which were significantly higher frequencies than in the control group (1.1% and 1.1%, respectively). CONCLUSIONS Compared with individuals without PCD, those with PCD showed a significantly smaller volume of mastoid air cells and a significantly higher frequency of opacification of mastoid air cells and tympanic cavity on temporal bone CT. Otitis media raises suspicion for PCD, and the otological manifestations of PCD reported here could help to narrow the differential diagnosis and facilitate early treatment.
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Affiliation(s)
- Eri Nishida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Takeuchi K. Allergic Fungal Otomastoiditis: A Case Report. Cureus 2023; 15:e45446. [PMID: 37727842 PMCID: PMC10506369 DOI: 10.7759/cureus.45446] [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] [Accepted: 09/18/2023] [Indexed: 09/21/2023] Open
Abstract
Otomastoiditis caused by an allergic reaction to fungi in the middle ear is rare, with only four cases reported in the English literature. We report the case of a patient with allergic fungal otomastoiditis. A 28-year-old man presented with otalgia, hearing loss, and vertigo. Exploratory tympanotomy revealed mucin with a peanut butter-like consistency and containing eosinophils and Candida parapsilosis, but no evidence of direct tissue invasion by fungi. The patient was treated with a combination of surgery and medication. Subtotal petrosectomy was finally performed to remove the middle ear mucosa and separate the middle ear from the external environment. Short-term prednisolone and long-term fluconazole were administered without satisfactory therapeutic results. The inflammatory condition has improved but continues without complete remission. Allergic fungal otomastoiditis is an extremely rare condition that may share pathophysiological features with allergic fungal rhinosinusitis, so a thorough examination combining bacterial cultures, histopathological examination with fungal staining, and serum antigen-specific immunoglobulin E against multiple fungi is essential. Optimal treatment probably comprises appropriate surgery and long-term administration of systemic corticosteroids. Definitive diagnostic criteria and therapeutic strategies need to be established, based on the accumulation of similar cases.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, JPN
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, JPN
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Sakaida H, Takeuchi K. Doppler sonography in diagnosis of Bow Hunter's syndrome. Clin Case Rep 2023; 11:e7783. [PMID: 37554574 PMCID: PMC10405235 DOI: 10.1002/ccr3.7783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023] Open
Abstract
Bow Hunter's syndrome is a rare condition in which vertebrobasilar circulatory insufficiency develops because of neck rotation. We report a patient with Bow Hunter's syndrome diagnosed by Doppler sonography. This report demonstrates the important role of Doppler sonography in diagnosis of Bow Hunter's syndrome.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology‐Head and Neck SurgeryMie University Graduate School of MedicineTsuMieJapan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology‐Head and Neck SurgeryMie University Graduate School of MedicineTsuMieJapan
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Sakaida H, Kitano M, Takeuchi K. Giant Cell Tumor of the Temporal Bone. Ear Nose Throat J 2023:1455613231182677. [PMID: 37381666 DOI: 10.1177/01455613231182677] [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] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masako Kitano
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Goto F, Yamamoto A, Hamada K, Kuroki K, Furuta T, Odachi K, Sasaki R, Furukawa K, Nakajima Y, Arikawa S. Initial Result of Stroke Care at the Stroke Center in a New Hospital Opened by the Merger of Three Facilities with Different Management Bases: Effect of Stroke Center on Mechanical Thrombectomy. J Neuroendovasc Ther 2021; 15:712-718. [PMID: 37502269 PMCID: PMC10371006 DOI: 10.5797/jnet.oa.2020-0128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 02/09/2021] [Indexed: 07/29/2023]
Abstract
Objective The most important function required for the stroke center is prompt treatment for acute stroke. We report the initial results of stroke care under the new medical care system of stroke center in a new hospital that merges three hospitals with different management bases to verify the effect of stroke center on mechanical thrombectomy. Methods We investigated changes in the number of inpatients and surgical treatments compared with the past 3 years (Stages I, II, and III) with stage IV one year after the new hospital was opened, and examined the effect of establishing a stroke center on mechanical thrombectomy for acute main cerebral artery occlusion. Results From stage I to stage IV, the number of hospitalized patients increased from 396, 485, 482 to 630, respectively, and the proportion of patients with cerebrovascular disease increased from 57.6%, 55.7%, 60.4% to 68.3%, respectively. Total surgical treatment increased from 137, 195, 224 to 297, respectively, especially endovascular therapy increased markedly from 22, 36, 68 to 118, respectively. The main treatment contents of endovascular treatment in stage IV were ruptured cerebral aneurysm embolization 22 cases, unruptured cerebral aneurysm embolization 13 cases, carotid artery stenting 23 cases, other intracranial or extracranial artery angioplasty/stenting 9 cases, and mechanical thrombectomy 34 cases. In particular, mechanical thrombectomy was significantly increased to 34 in stage IV, compared to 4 in stage I, 4 in stage II, and 17 in stage III (degree of contribution [DC] 25.0%, contribution ratio [CR] 34.0%). Conclusion With the establishment of the stroke center, the number of cases of acute cerebral infarction within the adaptation time who received mechanical thrombectomy remarkably increased. It is considered that the effect and validity of function aggregation by establishing stroke center are shown.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Neurosurgery, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Fuki Goto
- Department of Neurosurgery, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Atsushi Yamamoto
- Department of Neurosurgery, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Kazuhide Hamada
- Department of Neurosurgery, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Katsura Kuroki
- Department of Neurosurgery, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Tomoyuki Furuta
- Department of Neurology, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Kiyomi Odachi
- Department of Neurology, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Ryogen Sasaki
- Department of Neurology, Stroke Center, Kuwana City Medical Center, Kuwana, Mie, Japan
| | - Kazuhiro Furukawa
- Department of Neurosurgery, Hisai Neurosurgery Clinic, Tsu, Mie, Japan
| | - Yuki Nakajima
- Department of Neurology, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | - Shigeo Arikawa
- Department of Neurology, Ise Municipal General Hospital, Ise, Mie, Japan
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Nampei M, Shiba M, Sakaida H, Nakatsuka Y, Yasuda R, Toma N, Suzuki H. Successful Balloon-assisted Coil Embolization of Right Subclavian Artery Aneurysm: A Case Report. J Neuroendovasc Ther 2020; 14:255-262. [PMID: 37502620 PMCID: PMC10370521 DOI: 10.5797/jnet.cr.2019-0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/12/2020] [Indexed: 07/29/2023]
Abstract
Objective Subclavian artery aneurysms are relatively rare, and have been treated by open surgery and/or endovascular treatment using a stent graft. In this article, we report a case of unruptured right subclavian artery aneurysm successfully treated using balloon-assisted coil embolization. Case Presentation A 77-year-old man was diagnosed with an asymptomatic unruptured right subclavian artery aneurysm of 8 mm in diameter by follow-up CTA after surgery for thoracoabdominal aortic aneurysms. He also had a history of cerebral infarction and clipping of an unruptured cerebral aneurysm. The subclavian artery aneurysm was treated by balloon-assisted coil embolization because its diameter increased to 17.6 mm in 2 years. Balloon assistance was mainly used to prevent protrusion of the framing coil into the parent artery, and satisfactory framing was achieved. Subsequently, the aneurysm was obliterated using filling and finishing coils. The postoperative course was uneventful, and the follow-up MRI at 18 months after treatment revealed no recanalization of the aneurysm. Conclusion Balloon-assisted coil embolization may be an effective treatment for subclavian artery aneurysms, but further long-term follow-up and case accumulation are needed.
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Affiliation(s)
- Mai Nampei
- Department of Neurosurgery, Saiseikai Matsusaka General Hospital, Matsusaka, Mie, Japan
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masato Shiba
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hiroshi Sakaida
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yoshinari Nakatsuka
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Ryuta Yasuda
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Hidenori Suzuki
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Tanioka S, Ishida F, Yamamoto A, Shimizu S, Sakaida H, Toyoda M, Kashiwagi N, Suzuki H. Machine Learning Classification of Cerebral Aneurysm Rupture Status with Morphologic Variables and Hemodynamic Parameters. Radiol Artif Intell 2020; 2:e190077. [PMID: 33937812 DOI: 10.1148/ryai.2019190077] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/31/2019] [Accepted: 09/18/2019] [Indexed: 12/11/2022]
Abstract
Purpose To construct a classification model of rupture status and to clarify the importance of morphologic variables and hemodynamic parameters on rupture status by applying a machine learning (ML) algorithm to morphologic and hemodynamic data of cerebral aneurysms. Materials and Methods Between 2011 and 2019, 226 (112 ruptured and 114 unruptured) cerebral aneurysms in 188 consecutive patients were retrospectively analyzed with computational fluid dynamics (CFD). A random forest ML algorithm was applied to the results to create three classification models consisting of only morphologic variables (model 1), only hemodynamic parameters (model 2), and both morphologic variables and hemodynamic parameters (model 3). The accuracy of rupture status classification and the importance of each variable or parameter in the models were computed. Results The accuracy was 77.0% in model 1, 71.2% in model 2, and 78.3% in model 3. The three most important features were projection ratio, size ratio, and aspect ratio in model 1; low shear area ratio, oscillatory shear index, and oscillatory velocity index in model 2; and projection ratio, irregular shape, and size ratio in model 3. Conclusion Classification models of rupture status of cerebral aneurysms were constructed by applying an ML algorithm to morphologic variables and hemodynamic parameters. The model worked with relatively high accuracy, in which projection ratio, irregular shape, and size ratio were important for the discrimination of ruptured aneurysms.Supplemental material is available for this article.© RSNA, 2020.
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Affiliation(s)
- Satoru Tanioka
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Fujimaro Ishida
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Atsushi Yamamoto
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Shigetoshi Shimizu
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Hiroshi Sakaida
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Mitsuru Toyoda
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Nobuhisa Kashiwagi
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
| | - Hidenori Suzuki
- Department of Neurosurgery, Mie Chuo Medical Center, 2158-5 Myojin-cho, Hisai, Tsu, Mie 514-1101, Japan (S.T., F.I.); Department of Neurosurgery, Kuwana City Medical Center, Kuwana, Japan (A.Y., H. Sakaida); Department of Neurosurgery, Suzuka Central General Hospital, Suzuka, Japan (S.S.); School of Statistical Thinking, The Institute of Statistical Mathematics, Tachikawa, Japan (M.T., N.K.); and Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Japan (H. Suzuki)
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Nakamura S, Tsunoda S, Sakaida H, Masuda S, Said AS, Takeuchi K. Analysis of factors associated with cedar pollen sensitization and development of pollinosis in a young Japanese adult population. Allergol Int 2019; 68:39-45. [PMID: 29908674 DOI: 10.1016/j.alit.2018.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 05/02/2018] [Accepted: 05/13/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Genetic and environmental factors are proposed to be involved in cedar pollen allergy sensitization and onset. The impact of these factors will provide key information for the prevention of cedar pollen sensitization and allergy onset, which we investigated in this cross-sectional study. METHODS Subjects were 382 young adult volunteers who completed a self-administered questionnaire on self-reported subjective symptoms of pollinosis, physician-diagnosed pollinosis, and background factors. We also measured their serum IgE antibody titers specific for cedar, cypress, and mites. Factors associated with subjective symptoms, physician diagnosis, and the three specific antigens were determined using both univariate and multivariate analyses. RESULTS Sensitization to cedar, cypress, and mites, defined as specific IgE levels of class 1 or above, was found in 78.8%, 64.4%, and 56.0% of subjects, respectively. The prevalence of cedar pollinosis was 41.2% based on subjective symptoms and 22.2% based on physician diagnosis. Factors associated with increased cedar pollen sensitization were mite sensitization, comorbid allergic rhinitis, and family history of cedar pollinosis. Risk-reducing factors for cedar pollen sensitization were keeping a cat, number of common colds, and hours of sleep. Risk-increasing factors for both subjective pollinosis symptoms and physician-diagnosed pollinosis were comorbid allergic rhinitis and family history of cedar pollinosis. CONCLUSIONS Sensitization to cedar pollen in this population was extremely high. Both common and distinct factors were associated with sensitization to pollen and with the development of pollinosis. The distinct factors were associated with sensitization to cedar and cypress antigens.
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Shiba M, Toma N, Tanioka S, Yasuda R, Sakaida H, Suzuki H. Significance of novel subcortical low intensity score on transient neurological events after revascularization surgery for moyamoya disease. Clin Neurol Neurosurg 2018; 167:70-75. [DOI: 10.1016/j.clineuro.2018.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 02/04/2018] [Accepted: 02/11/2018] [Indexed: 12/14/2022]
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Sakaida H, Matsuda Y, Takeuchi K. Sonographic appearance of pyomyositis of the sternocleidomastoid muscle: A case report. J Clin Ultrasound 2017; 45:520-523. [PMID: 27874219 DOI: 10.1002/jcu.22428] [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] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
Pyomyositis in the neck has rarely been described. We present the sonographic findings in a case of pyomyositis of the sternocleidomastoid muscle. A 62-year-old man with poorly controlled diabetes presented with an induration of the neck and fever. On gray-scale sonography, a part of the sternocleidomastoid muscle appeared swollen and contained irregularly shaped hypoechoic areas. Power Doppler imaging showed increased vascularity in the muscle. Sonographic-guided aspiration confirmed abscesses in the sternocleidomastoid muscle. Surgical drainage was successfully performed along with antibiotic treatment. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:520-523, 2017.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yasunori Matsuda
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Usui S, Matsuda Y, Masuda S, Takeuchi K. Sonographic diagnosis of acute mastoiditis and subsequent retroauricular abscess in a pediatric cochlear implant recipient: A case report. J Clin Ultrasound 2017; 45:515-519. [PMID: 28369924 DOI: 10.1002/jcu.22442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/15/2016] [Accepted: 12/04/2016] [Indexed: 06/07/2023]
Abstract
When acute mastoiditis occurs in cochlear implant recipients, it can progress to subsequent retroauricular abscess due to the absence of the external mastoid cortex resulting from mastoidectomy performed for cochlear implantation. The management goal is to control infection while preserving the implanted device. A 2-year-old boy with cochlear implants developed acute mastoiditis and a subsequent retroauricular abscess. The patient underwent a surgical intervention based on the diagnosis made utilizing gray-scale and power Doppler sonography. This case illustrates the diagnostic usefulness of sonography in this rare situation. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:515-519, 2017.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Satoko Usui
- Department of Otorhinolaryngology, National Mie Hospital, Tsu, Mie, Japan
| | - Yasunori Matsuda
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Sawako Masuda
- Department of Otorhinolaryngology, National Mie Hospital, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Kitagami M, Yasuda R, Toma N, Shiba M, Nampei M, Yamamoto Y, Nakatsuka Y, Sakaida H, Suzuki H. Impact of Hypertriglyceridemia on Carotid Stenosis Progression under Normal Low-Density Lipoprotein Cholesterol Levels. J Stroke Cerebrovasc Dis 2017; 26:1793-1800. [PMID: 28495179 DOI: 10.1016/j.jstrokecerebrovasdis.2017.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 04/06/2017] [Accepted: 04/09/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dyslipidemia is a well-known risk factor for carotid stenosis progression, but triglycerides have attracted little attention. The aim of this study was to assess if serum triglycerides affect progression of carotid stenosis in patients with well-controlled low-density lipoprotein cholesterol (LDL-C) levels. METHODS This is a retrospective study in a single hospital consisting of 71 Japanese patients with internal carotid artery stenosis greater than or equal to 50% and normal serum LDL-C levels who underwent angiographic examination with or without the resultant carotid artery stenting or endarterectomy from 2007 to 2011, and were subsequently followed up for 4 years. Clinical factors including fasting serum triglyceride values were compared between the progression (≥10% increase in degree of carotid stenosis on ultrasonography) and the nonprogression groups. RESULTS During 4 years, 15 patients (21.1%) had carotid stenosis progression on either side. Cox regression analysis demonstrated that symptomatic cases (hazard ratio [HR], 4.327; P = .019), coexisting intracranial arteriosclerotic stenosis (HR, 5.341; P = .005), and hypertriglyceridemia (HR, 6.228; P = .011) were associated with subsequent progression of carotid stenosis. Kaplan-Meier plots demonstrated that the progression-free survival rate was significantly higher in patients without hypertriglyceridemia and intracranial arteriosclerotic stenosis at baseline. CONCLUSIONS Among patients with moderate to severe carotid stenosis and well-controlled LDL-C, hypertriglyceridemia was an important risk factor for progression of carotid stenosis irrespective of surgical treatments. It would be worthwhile to test if triglyceride-lowering medications suppress carotid stenosis progression.
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Affiliation(s)
- Masayuki Kitagami
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Ryuta Yasuda
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Masato Shiba
- Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan; Vascular and Heart Center, Mie University Hospital, Mie, Japan
| | - Mai Nampei
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Yoko Yamamoto
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Yoshinari Nakatsuka
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan
| | - Hiroshi Sakaida
- Department of Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan; Vascular and Heart Center, Mie University Hospital, Mie, Japan
| | - Hidenori Suzuki
- Department of Neurosurgery, Mie University Graduate School of Medicine, Mie University Hospital, Mie, Japan.
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Sakaida H, Akeda K, Sudo A, Takeuchi K. Atlantoaxial rotatory fixation as a rare complication from head positioning in otologic surgery: Report of two cases in young children. Patient Saf Surg 2017; 11:5. [PMID: 28184249 PMCID: PMC5289022 DOI: 10.1186/s13037-016-0116-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 12/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atlantoaxial rotatory fixation is a condition in which the first and second vertebrae of the cervical spine become interlocked in a rotated position. This condition can result in serious consequences and thus have a significant impact on patients, especially when diagnosis and treatment are delayed. Some cases of atlantoaxial rotatory fixation have been described in association with otologic surgery or plastic surgery involving the ear. We present the cases of two pediatric patients who developed atlantoaxial rotatory fixation following otologic surgery and we review the relevant literature. CASE PRESENTATION One patient was a 7-year-old boy who underwent tympanoplasty for cholesteatoma. The other patient was a 5-year-old girl with profound sensorineural hearing loss who underwent cochlear implantation. Both patients developed atlantoaxial rotatory fixation on the day after surgery, and they were treated conservatively. Our literature search using relevant terms identified 12 similar published cases. Thus, a total of 14 patients, including our 2 patients, were evaluated. Most of the patients were children and typically they complained of painful torticollis and exhibited a characteristic posture called the "cock-robin" position on the day after surgery. Mostly, the direction of torticollis was opposite to the side of surgery. Most of the patients received conservative treatment alone, but three underwent surgical treatment. CONCLUSION The correlation between the direction of torticollis and the side of surgery suggests that rotation of the head during surgery has an impact on development of postoperative atlantoaxial rotatory fixation. Thus, children undergoing otologic surgery are thought to be at a risk of postoperative atlantoaxial rotatory fixation. Although rare, the surgical team needs to be aware of this adverse event and pay close attention to this possibility throughout the perioperative period. Perioperative management should include informed consent, preoperative assessment of the range of head and neck motion, proper intraoperative positioning and monitoring of the position, and postoperative follow-up. Postoperative atlantoaxial rotatory fixation is not completely preventable, but good perioperative management can minimize the damage resulting from this condition.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
| | - Koji Akeda
- Department of Orthopaedic surgery, Mie University Graduate School of Medicine, Tsu, Mie Japan
| | - Akihiro Sudo
- Department of Orthopaedic surgery, Mie University Graduate School of Medicine, Tsu, Mie Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
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16
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
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17
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Sakaida H, Yuasa H, Fukutome K, Takeuchi K. Pharyngolaryngeal ulcers associated with the improper use of alendronate. Auris Nasus Larynx 2016; 44:762-765. [PMID: 27956102 DOI: 10.1016/j.anl.2016.11.002] [Citation(s) in RCA: 3] [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: 09/29/2016] [Revised: 11/07/2016] [Accepted: 11/16/2016] [Indexed: 10/20/2022]
Abstract
Bisphosphonates can cause mucosal irritation. Although esophageal ulceration is a well-recognized adverse effect of bisphosphonates, pharyngolaryngeal ulcers associated with the improper use of oral bisphosphonates have rarely been described. A previously healthy 78-year-old woman presented with refractory pharyngolaryngeal ulcers. Extensive evaluation, including biopsy, bacterial culture, and blood tests did not identify any findings that indicated a specific disease diagnosis. Antibiotics and oral prednisolone were ineffective. Ultimately, it was found that the patient regularly took a tablet of alendronate, a type of bisphosphonate, by dissolving it in the oral cavity. Within 2 weeks after withdrawal of the use of the medication, her symptoms were eliminated, and the lesions were completely healed. This case illustrates the importance of correct administration of bisphosphonates. Given the widespread use of bisphosphonates, physicians need to be aware that their improper use can cause pharyngolaryngeal ulcers.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
| | - Hiroto Yuasa
- Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuo Fukutome
- Department of Oncologic Pathology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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18
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
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19
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Yasuda R, Maeda M, Umino M, Nakatsuka Y, Umeda Y, Toma N, Sakaida H, Suzuki H. Suspected Metallic Embolism following Endovascular Treatment of Intracranial Aneurysms. AJNR Am J Neuroradiol 2016; 37:1696-9. [PMID: 27102315 DOI: 10.3174/ajnr.a4804] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 03/03/2016] [Indexed: 11/07/2022]
Abstract
We describe a case series of suspected metallic embolism after coil embolization for intracranial aneurysms. Between January 2012 and December 2014, 110 intracranial aneurysms had been treated by coil embolization in our institution. In 6 cases, the postprocedural MR imaging revealed abnormal spotty lesions not detected on the preprocedural MR imaging. The lesions were also undetectable on the postprocedural CT scan. They were demonstrated as low-intensity spots on T1WI, T2WI, DWI, and T2*-weighted imaging. On DWI, they were accompanied by bright "halo," and on T2*-weighted imaging, they showed a "blooming" effect. In 3 of the 6 cases, follow-up MR imaging was available and all the lesions remained and demonstrated no signal changes. Although histologic examination had not been performed, these neuroradiologic findings strongly supported the lesions being from metallic fragments. No specific responsible device was detected after reviewing all the devices used for the neuroendovascular treatment in the 6 cases.
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Affiliation(s)
- R Yasuda
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
| | - M Maeda
- Radiology (M.U., M.M.), Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - M Umino
- Radiology (M.U., M.M.), Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Y Nakatsuka
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
| | - Y Umeda
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
| | - N Toma
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
| | - H Sakaida
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
| | - H Suzuki
- From the Departments of Neurosurgery (R.Y., Y.N., Y.U., N.T., H.Sakaida, H.Suzuki)
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Takeuchi K, Kitano M, Sakaida H, Masuda S. Novel syndrome with conductive hearing loss and congenital glaucoma in three generations. Auris Nasus Larynx 2016; 44:493-497. [PMID: 27552829 DOI: 10.1016/j.anl.2016.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 07/27/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
The objective of this paper was to describe the clinical and otological findings in multiple members of a family with congenital glaucoma, cardiac anomaly, and conductive hearing loss due to ossicular chain anomalies. We performed a retrospective review of the medical charts and otological materials of multiple members of the same family. Congenital glaucoma and hearing loss were inherited by the proband and her daughter, son, and mother, suggesting autosomal dominant inheritance. The son and daughter also showed atrial septal defects. Exploratory tympanotomies revealed anomalies of the long process of the incus in the proband and her daughter, and tympanoplasty improved hearing loss in both patients. This represents the first description of coexisting congenital glaucoma and conductive hearing loss due to ossicular chain anomalies in multiple members of a single family.
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Affiliation(s)
- Kazuhiko Takeuchi
- Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
| | - Masako Kitano
- Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Sakaida
- Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Sawako Masuda
- Department of Otorhinolaryngology, Mie National Hospital, Tsu, Japan
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21
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Nakatsuka Y, Kawakita F, Yasuda R, Umeda Y, Toma N, Sakaida H, Suzuki H. Preventive effects of cilostazol against the development of shunt-dependent hydrocephalus after subarachnoid hemorrhage. J Neurosurg 2016; 127:319-326. [PMID: 27494819 DOI: 10.3171/2016.5.jns152907] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 11/06/2022]
Abstract
OBJECTIVE Chronic hydrocephalus develops in association with the induction of tenascin-C (TNC), a matricellular protein, after aneurysmal subarachnoid hemorrhage (SAH). The aim of this study was to examine if cilostazol, a selective inhibitor of phosphodiesterase Type III, suppresses the development of chronic hydrocephalus by inhibiting TNC induction in aneurysmal SAH patients. METHODS The authors retrospectively reviewed the factors influencing the development of chronic shunt-dependent hydrocephalus in 87 patients with Fisher Grade 3 SAH using multivariate logistic regression analyses. Cilostazol (50 or 100 mg administered 2 or 3 times per day) was administered from the day following aneurysmal obliteration according to the preference of the attending neurosurgeon. As a separate study, the effects of different dosages of cilostazol on the serum TNC levels were chronologically examined from Days 1 to 12 in 38 SAH patients with Fisher Grade 3 SAH. RESULTS Chronic hydrocephalus occurred in 12 of 36 (33.3%), 5 of 39 (12.8%), and 1 of 12 (8.3%) patients in the 0 mg/day, 100 to 200 mg/day, and 300 mg/day cilostazol groups, respectively. The multivariate analyses showed that older age (OR 1.10, 95% CI 1.13-1.24; p = 0.012), acute hydrocephalus (OR 23.28, 95% CI 1.75-729.83; p = 0.016), and cilostazol (OR 0.23, 95% CI 0.05-0.93; p = 0.038) independently affected the development of chronic hydrocephalus. Higher dosages of cilostazol more effectively suppressed the serum TNC levels through Days 1 to 12 post-SAH. CONCLUSIONS Cilostazol may prevent the development of chronic hydrocephalus and reduce shunt surgery, possibly by the inhibition of TNC induction after SAH.
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Affiliation(s)
| | | | | | - Yasuyuki Umeda
- Center for Vessels and Heart, Mie University Hospital, Tsu, Japan
| | | | - Hiroshi Sakaida
- Innovative Neuro-Intervention Radiology, Mie University Graduate School of Medicine; and
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Sakaida H, Miyamura T, Matsuda Y, Takeuchi K. Dual-incision approach for excision of postauricular sinus. Eur J Plast Surg 2016; 39:159-160. [PMID: 27069313 PMCID: PMC4803812 DOI: 10.1007/s00238-015-1159-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 09/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
| | - Tomotaka Miyamura
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
| | - Yasunori Matsuda
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507 Japan
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Yamamoto A, Suzuki K, Sakaida H, Suzuki H, Imai H. Management of inadvertent vertebral artery injury due to central venous catheterization in a coagulopathic patient. Acute Med Surg 2015; 3:265-267. [PMID: 29123795 DOI: 10.1002/ams2.177] [Citation(s) in RCA: 6] [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: 08/31/2015] [Accepted: 10/19/2015] [Indexed: 11/07/2022] Open
Abstract
Case A 72-year-old man was admitted to the intensive care unit for severe pancreatitis with coagulopathy. He underwent hemodialysis catheter insertion into the internal jugular vein that subsequently leaked arterial blood; vertebral artery cannulation was suspected following a computed tomography scan. Outcome Under angiographic guidance, the catheter was removed, and an arteriovenous fistula was identified. The patient was successfully treated with endovascular embolization of the affected vertebral artery with detachable coils and N-butyl-2-cyanoacrylate. Conclusion Despite ultrasound guidance, vertebral cannulation can occur, which can result in serious complications. Prompt management is needed to prevent further sequelae. Endovascular embolization with detachable coils and N-butyl-2-cyanoacrylate appears to be an effective option for vertebral artery injury in patients with coagulopathy.
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Affiliation(s)
- Akitaka Yamamoto
- Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan
- Department of Neurosurgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Kei Suzuki
- Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan
| | - Hiroshi Sakaida
- Department of Innovative Neuro-Intervention Radiology Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hidenori Suzuki
- Department of Neurosurgery Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hiroshi Imai
- Emergency and Critical Care Center Mie University Hospital Tsu Mie Japan
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Tokunaga T, Sakashita M, Haruna T, Asaka D, Takeno S, Ikeda H, Nakayama T, Seki N, Ito S, Murata J, Sakuma Y, Yoshida N, Terada T, Morikura I, Sakaida H, Kondo K, Teraguchi K, Okano M, Otori N, Yoshikawa M, Hirakawa K, Haruna S, Himi T, Ikeda K, Ishitoya J, Iino Y, Kawata R, Kawauchi H, Kobayashi M, Yamasoba T, Miwa T, Urashima M, Tamari M, Noguchi E, Ninomiya T, Imoto Y, Morikawa T, Tomita K, Takabayashi T, Fujieda S. Novel scoring system and algorithm for classifying chronic rhinosinusitis: the JESREC Study. Allergy 2015; 70:995-1003. [PMID: 25945591 PMCID: PMC5032997 DOI: 10.1111/all.12644] [Citation(s) in RCA: 385] [Impact Index Per Article: 42.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2015] [Indexed: 01/22/2023]
Abstract
Background Chronic rhinosinusitis (CRS) can be classified into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). CRSwNP displays more intense eosinophilic infiltration and the presence of Th2 cytokines. Mucosal eosinophilia is associated with more severe symptoms and often requires multiple surgeries because of recurrence; however, even in eosinophilic CRS (ECRS), clinical course is variable. In this study, we wanted to set objective clinical criteria for the diagnosis of refractory CRS. Methods This was a retrospective study conducted by 15 institutions participating in the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC). We evaluated patients with CRS treated with endoscopic sinus surgery (ESS), and risk of recurrence was estimated using Cox proportional hazard models. Multiple logistic regression models and receiver operating characteristics curves were constructed to create the diagnostic criterion for ECRS. Results We analyzed 1716 patients treated with ESS. To diagnose ECRS, the JESREC scoring system assessed unilateral or bilateral disease, the presence of nasal polyps, blood eosinophilia, and dominant shadow of ethmoid sinuses in computed tomography (CT) scans. The cutoff value of the score was 11 points (sensitivity: 83%, specificity: 66%). Blood eosinophilia (>5%), ethmoid sinus disease detected by CT scan, bronchial asthma, aspirin, and nonsteroidal anti‐inflammatory drugs intolerance were associated significantly with recurrence. Conclusion We subdivided CRSwNP in non‐ECRS, mild, moderate, and severe ECRS according to our algorithm. This classification was significantly correlated with prognosis. It is notable that this algorithm may give useful information to clinicians in the refractoriness of CRS before ESS or biopsy.
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Hou B, Murata M, Said AS, Sakaida H, Masuda S, Takahashi T, Zhang Z, Takeuchi K. Changes of micro-RNAs in asymptomatic subjects sensitized to Japanese cedar pollen after prophylactic sublingual immunotherapy. Allergy Rhinol (Providence) 2015; 6:33-8. [PMID: 25675113 PMCID: PMC4388874 DOI: 10.2500/ar.2015.6.0107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Japanese cedar pollinosis is the predominant seasonal allergic rhinitis in Japan, and it has increased in prevalence during the past 10 years. Sublingual immunotherapy (SLIT) is considered a safe and effective treatment for pollinosis. Micro-RNAs (miRNAs) are a class of short single-stranded RNA molecules that posttranscriptionally silence gene expression and may mediate allergic immune responses. The aim of this study was to investigate the miRNA alteration in asymptomatic subjects sensitized to Japanese cedar pollen under prophylactic SLIT under part of a randomized, double-blind, placebo-controlled, multiple-center trial. Analysis was undertaken in 15 asymptomatic subjects sensitized to Japanese cedar pollen–specific IgE (ImmunoCAP class ≥2) who participated in 2013. The SLIT group (n = 6) received standardized Japanese cedar pollen extract and the placebo group (n = 9) received an inactive placebo for 5 months covering the cedar pollen season. Changes in serum miRNAs were measured by real-time quantitative polymerase chain reaction to determine whether SLIT had effects on profiles of circulating miRNA. Seven subjects in the placebo group developed pollinosis symptoms, whereas no subjects in the SLIT group did (p = 0.007). Serum hsa-miR-223 was significantly up-regulated in postseason compared with preseason samples. The hsa-let-7b was significantly more down-regulated in postseason than in preseason samples from the placebo group; however, no significant differences were observed in those from the SLIT group. A significant decrease in circulating let-7b was also observed in the subjects who developed symptoms. Prophylactic SLIT was effective in preventing the development of pollinosis. Alterations in miRNA expression occurred in asymptomatic, sensitized subjects during cedar pollen season.
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Affiliation(s)
- Bo Hou
- Department of Otorhinolaryngology, Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Japan
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26
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Fujieda S, Sakashita M, Tokunaga T, Okano M, Haruna T, Yoshikawa M, Ohtori N, Asaka D, Haruna S, Nakayama T, Ishitoya J, Sakuma Y, Hirakawa K, Takeno S, Himi T, Seki N, Iino Y, Yoshida N, Kobayashi M, Sakaida H, Kondo K, Yamasoba T, Miwa T, Yamada K, Kawata R, Terada T, Kawauchi H, Morikura I, Ikeda K, Murata J, Ikeda H, Noguchi E, Tamari M, Hirota T, Imoto Y, Takabayashi T, Tomita K, Ninomiya T, Morikawa T, Urashima M. [Eosinophilic chronic rhinosinusitis]. Arerugi 2015; 64:38-45. [PMID: 25779061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Shigeharu Fujieda
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | - Masafumi Sakashita
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | - Takahiro Tokunaga
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | - Mitsuhiro Okano
- Department of Otolaryngology Head & Neck Surgery, Okayama University Graduate School of Medicine
| | - Takenori Haruna
- Department of Otolaryngology Head & Neck Surgery, Okayama University Graduate School of Medicine
| | | | - Nobuyoshi Ohtori
- Department of Otorhinolaryngology, Jikei University School of Medicine
| | - Daiya Asaka
- Department of Otorhinolaryngology, Jikei University School of Medicine
| | - Shinichi Haruna
- Department of Otorhinolaryngology Head & Neck Surgery, Dokkyo Medical University
| | - Tsuguhisa Nakayama
- Department of Otorhinolaryngology Head & Neck Surgery, Dokkyo Medical University
| | | | - Yasunori Sakuma
- Department of Otorhinolaryngology, Yokohama City Medical Center
| | - Katsuhiro Hirakawa
- Department of Otorhinolaryngology-Head & Neck Surgery, Hiroshima University
| | - Sachio Takeno
- Department of Otorhinolaryngology-Head & Neck Surgery, Hiroshima University
| | - Tetsuo Himi
- Department of Otolaryngology, Sapporo Medical University
| | - Nobuhiko Seki
- Department of Otolaryngology, Sapporo Medical University
| | - Yukiko Iino
- Department of Otolaryngology, Jichi Medical University Saitama Medical Center
| | - Naohiro Yoshida
- Department of Otolaryngology, Jichi Medical University Saitama Medical Center
| | - Masayoshi Kobayashi
- Department of Otorhinolaryngology Head & Neck Surgery, Mie University Graduate School of Medicine
| | - Hiroshi Sakaida
- Department of Otorhinolaryngology Head & Neck Surgery, Mie University Graduate School of Medicine
| | - Kenji Kondo
- Department of Otolaryngology, University of Tokyo
| | | | - Takaki Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University
| | - Kanako Yamada
- Department of Otorhinolaryngology, Kanazawa Medical University
| | - Ryo Kawata
- Department of Otolaryngology Head & Neck Surgery, Osaka Medical College
| | - Tetsuya Terada
- Department of Otolaryngology Head & Neck Surgery, Osaka Medical College
| | | | | | | | - Junko Murata
- Department of Otorhinolaryngology, Juntendo University
| | - Hiroki Ikeda
- Department of Otorhinolaryngology, Japanese Red Cross Society, Wakayama Medical Center
| | - Emiko Noguchi
- Department of Medical Genetics, University of Tsukuba
| | - Mayumi Tamari
- Laboratory for Respiratory Diseases. Center for Genomic Medicine, Institute of Physical and Chemical Research (RIKEN)
| | - Tomomitsu Hirota
- Laboratory for Respiratory Diseases. Center for Genomic Medicine, Institute of Physical and Chemical Research (RIKEN)
| | - Yoshimasa Imoto
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | | | - Kaori Tomita
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | - Takahiro Ninomiya
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
| | - Taiyo Morikawa
- Department of Otorhinolaryngology Head & Neck Surgery, University of Fukui
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27
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
| | - Masayoshi Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Ai Ito
- Department of Neurology, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Masuda S, Takeuchi K. Measurement of Japanese cedar pollen-specific IgE in nasal secretions. Allergol Int 2014; 63:467-73. [PMID: 24957114 DOI: 10.2332/allergolint.13-oa-0668] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 03/01/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Japanese cedar pollen (JCP) is the most common allergen for seasonal allergic rhinitis in Japan. Little is known about local production of immunoglobulin (Ig)E in people with or without Japanese cedar pollinosis. The aims of this study were to measure levels of JCP-specific IgE in nasal secretions and determine correlations with levels in serum. METHODS Forty-six subjects were enrolled in this study, comprising 24 symptomatic subjects, 9 asymptomatic subjects sensitized to JCP, and 13 subjects not sensitized to JCP. Nasal secretions were obtained during a period of Japanese cedar dispersal, and levels of JCP-specific IgE were measured with CAP-fluorescent enzyme immunoassay. Serum JCP-specific IgE and total IgE were also measured using the same method. RESULTS Among the 46 subjects enrolled, JCP-specific IgE in nasal secretions was measureable in 43 subjects. Irrespective of symptom development, sensitized subjects showed higher levels of JCP-specific IgE in nasal secretions than non-sensitized subjects. A significant moderate correlation was observed between JCP-specific IgE levels in nasal secretions and serum in all 43 subjects. With stratification by subject group, only symptomatic subjects showed a substantial correlation between JCP-specific IgE levels in nasal secretions and serum. CONCLUSIONS Our results imply a certain association between JCP-specific IgE in nasal secretions and sensitization of Japanese cedar pollinosis. Therefore, levels of allergen-specific IgE in nasal secretions can be used as an alternative diagnostic marker for allergic rhinitis patients.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Sawako Masuda
- Department of Otorhinolaryngology, Mie National Hospital, Mie, Japan
| | - Kazuhiko Takeuchi
- Department of Otorhinolaryngology, Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
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Suzuki H, Sano T, Umeda Y, Yamamoto A, Toma N, Sakaida H, Taki W. Valsartan prevents neointimal hyperplasia after carotid artery stenting by suppressing endothelial cell injuries. Neurol Res 2014; 37:35-42. [PMID: 24938321 DOI: 10.1179/1743132814y.0000000408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Restenosis or neointimal hyperplasia remains an important complication after carotid artery stenting (CAS) for carotid artery stenosis. The purpose of this study was to examine if an anti-hypertensive drug, angiotensin receptor blocker (ARB), prevents post-CAS neointimal hyperplasia during the first 1-year period after CAS, and to clarify the possible mechanisms. METHODS Hypertension had been treated with a calcium channel blocker (CCB) and/or an ARB, valsartan, by the preference of the neurosurgeon in charge in our department. At admission to perform CAS, patients were assigned to normotensive, valsartan (hypertensive patients treated with valsartan with/without any kind of CCBs), and non-valsartan (hypertensive patients treated with any kind of CCBs without ARBs) groups. Post-CAS neointimal hyperplasia was evaluated by carotid duplex ultrasound imaging in terms of intima-media thickening (IMT), which was performed at pre-CAS and at 90, 180, 270, and 360 days post-CAS. Biomarkers of oxidative stress (8-hydroxy-2'-deoxyguanosine), inflammation (C-reactive protein, tenascin-C) and endothelial cell injury (von Willebrand factor [vWF] antigen) were measured at pre-CAS and at 1, 7, and 180 days post-CAS. RESULTS The non-valsartan group (n = 8) had a higher incidence of maximum in-stent IMT ≧ 1.1 mm compared with the normotensive group (n = 6). Valsartan (n = 9) significantly suppressed plasma vWF levels at 7 days post-CAS and decreased the incidence of maximum in-stent IMT ≧ 1.1 mm compared with the non-valsartan group, although clinical parameters were similar between the two groups. Other biomarkers were not significantly different among the three groups. CONCLUSIONS These findings suggest that valsartan may prevent post-CAS neointimal hyperplasia possibly by suppressing endothelial cell injury.
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Shindo A, Tanemura H, Yata K, Hamada K, Shibata M, Umeda Y, Asakura F, Toma N, Sakaida H, Fujisawa T, Taki W, Tomimoto H. Inflammatory biomarkers in atherosclerosis: pentraxin 3 can become a novel marker of plaque vulnerability. PLoS One 2014; 9:e100045. [PMID: 24936646 PMCID: PMC4061039 DOI: 10.1371/journal.pone.0100045] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Accepted: 05/21/2014] [Indexed: 12/03/2022] Open
Abstract
Inflammation is crucially involved in the development of carotid plaques. We examined the relationship between plaque vulnerability and inflammatory biomarkers using intraoperative blood and tissue specimens. We examined 58 patients with carotid stenosis. Following carotid plaque magnetic resonance imaging, 41 patients underwent carotid artery stenting (CAS) and 17 underwent carotid endarterectomy (CEA). Blood samples were obtained from the femoral artery (systemic) and common carotid artery immediately before and after CAS (local). Seventeen resected CEA tissue samples were embedded in paraffin, and histopathological and immunohistochemical analyses for IL-6, IL-10, E-selectin, adiponectin, and pentraxin 3 (PTX3) were performed. Serum levels of IL-6, IL-1β, IL-10, TNFα, E-selectin, VCAM-1, adiponectin, hs-CRP, and PTX3 were measured by multiplex bead array system and ELISA. CAS-treated patients were classified as stable plaques (n = 21) and vulnerable plaques (n = 20). The vulnerable group showed upregulation of the proinflammatory cytokines (IL-6 and TNFα), endothelial activation markers (E-selectin and VCAM-1), and inflammation markers (hs-CRP and PTX3) and downregulation of the anti-inflammatory markers (adiponectin and IL-10). PTX3 levels in both systemic and intracarotid samples before and after CAS were higher in the vulnerable group than in the stable group. Immunohistochemical analysis demonstrated that IL-6 was localized to inflammatory cells in the vulnerable plaques, and PTX3 was observed in the endothelial and perivascular cells. Our findings reveal that carotid plaque vulnerability is modulated by the upregulation and downregulation of proinflammatory and anti-inflammatory factors, respectively. PTX3 may thus be a potential predictive marker of plaque vulnerability.
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Affiliation(s)
- Akihiro Shindo
- Department of Neurology, Mie University Graduate School of Medicine, 2–174 Edobasih, Tsu, Mie, Japan
- * E-mail:
| | - Hiroshi Tanemura
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Kenichiro Yata
- Department of Neurology, Mie University Graduate School of Medicine, 2–174 Edobasih, Tsu, Mie, Japan
| | - Kazuhide Hamada
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Masunari Shibata
- Department of Neurology, Mie University Graduate School of Medicine, 2–174 Edobasih, Tsu, Mie, Japan
| | - Yasuyuki Umeda
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Fumio Asakura
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Naoki Toma
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Hiroshi Sakaida
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Takao Fujisawa
- Institute for Clinical Research, Mie National Hospital, 357 Ozatokubota, Tsu, Mie, Japan
| | - Waro Taki
- Department of Neurosurgery, Mie University Graduate School of Medicine, 2–174 Edobashi, Tsu, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Mie University Graduate School of Medicine, 2–174 Edobasih, Tsu, Mie, Japan
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Sakaida H, Nagao K, Higa K, Shirouchi B, Inoue N, Hidaka F, Kai T, Yanagita T. Effect ofVaccinium ashei readeLeaves on Angiotensin Converting Enzyme Activityin Vitroand on Systolic Blood Pressure of Spontaneously Hypertensive Ratsin Vivo. Biosci Biotechnol Biochem 2014; 71:2335-7. [PMID: 17827680 DOI: 10.1271/bbb.70277] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The hypotensive effects of Vaccinium ashei reade (blueberry) leaves were studied in vitro and in vivo. Blueberry leaf showed a strong inhibitory effect on angiotensin-converting enzyme activity in vitro. Additionally, feeding of blueberry leaf suppressed the development of essential hypertension in spontaneously hypertensive rats in vivo. These results promise the use of blueberry leaf as a source of dietary hypotensive components.
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Affiliation(s)
- Hiroshi Sakaida
- Research Institute, Unkai Shuzo Co., Ltd, 1800-5 Oaza Minamimata, Miyazaki 880-1303, Japan
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Tanemura H, Ishida F, Miura Y, Umeda Y, Fukazawa K, Suzuki H, Sakaida H, Matsushima S, Shimosaka S, Taki W. Changes in hemodynamics after placing intracranial stents. Neurol Med Chir (Tokyo) 2014; 53:171-8. [PMID: 23524501 DOI: 10.2176/nmc.53.171] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Stent-assisted coil embolization has enabled the endovascular treatment of wide-necked cerebral aneurysms. Moreover, recent reports demonstrated that stent-assisted coil embolization was associated with a significant decrease in angiographic recurrences of coiled cerebral aneurysms. One of the possible explanations for this adjunctive effect of stent-assisted coil embolization is changes in the local hemodynamics caused by placing intracranial stents. This study investigated the hemodynamic effect of intracranial stents using computational fluid dynamics (CFD) analysis. The geometry of the intracranial stent, Enterprise(TM) VRD, was acquired by using micro computed tomography and virtually placed across the aneurysm orifice of a saccular aneurysm model (saccular model) and a blister-like aneurysm model (blister-like model) constructed from patient-specific three-dimensional (3D) rotational angiography data. Transient CFD analysis was performed with these models with and without stents. Stent placement induced no significant changes in the 3D streamline in the saccular model and slight changes in the blister-like model. Both saccular and blister-like models with stents had lower wall shear stress (WSS) and flow velocity, and higher oscillatory shear index, WSS gradient, and relative residence time than the equivalent models without stents, indicating the possibility that stent placement induced stagnant and disturbed blood flow. Cross-sectional vector velocity around the stent strut revealed complex blood flow patterns with variable direction and velocity. Although this study was a simulation under limited conditions, similar hemodynamic changes might be induced in the neck remnants treated with stent-assisted coil embolization.
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Affiliation(s)
- Hiroshi Tanemura
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Sakaida H, Masuda S, Takeuchi K. Analysis of factors influencing sensitization of Japanese cedar pollen in asymptomatic subjects. Auris Nasus Larynx 2013; 40:543-7. [DOI: 10.1016/j.anl.2013.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2012] [Revised: 01/27/2013] [Accepted: 04/05/2013] [Indexed: 12/28/2022]
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Yuji K, Sakaida H, Kai T, Fukuda N, Yukizaki C, Sakai M, Tsubouchi H, Kataoka H. Effect of dietary blueberry (Vaccinium ashei Reade) leaves on serum and hepatic lipid levels in rats. J Oleo Sci 2013; 62:89-96. [PMID: 23391532 DOI: 10.5650/jos.62.89] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The serum and liver lipid-lowering effects of dietary freeze-dried blueberry leaf powder (BL) and its hydrothermal extract (BLHE) were examined in rats fed diets with or without cholesterol supplementation. Administration of 1% and 3% BL had no adverse effects on food intake or growth; however, relative liver weights were reduced in rats fed diets with and without dietary cholesterol. In the absence of dietary cholesterol, a dose-dependent reduction was evident. The effects of dietary BL on the concentration of serum lipids were marginal; however, the effects on liver triacylglycerol (TG) and cholesterol levels were apparently dose-dependent when the animals were fed diets free of cholesterol. Further, BL significantly attenuated dietary cholesterol-dependent accumulation of hepatic cholesterol, but not of TG. Hydrothermal treatment studies suggested that the active component of BL in terms of its liver lipid-lowering activity is relatively stable at high temperatures. Histopathological analysis of hepatic tissues revealed that BL administration suppresses fatty infiltrations induced by an AIN 76-based high-sucrose diet. The results of this study suggest that some of the active components of BL extracts, which are incorporated into the liver, prevent fatty liver in rats. These results provide further support for the investigation of dietary BL and derivatives thereof as functional human foods.
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Affiliation(s)
- Kumiko Yuji
- Miyazaki Prefectural Industrial Support Foundation, Miyakazi, Japan
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SHINDO A, Tanemura H, Yata K, Asakura F, Toma N, Sakaida H, Hamada K, Fujisawa T, Taki W, Tomimoto H. Abstract 64: Mechanism Of Carotid Plaque Vulnerability: Associations Of Pro-and Anti-inflammatory Molecules. Stroke 2013. [DOI: 10.1161/str.44.suppl_1.a64] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
Inflammation plays an important role in the development, progression, and rupture of carotid plaques. We examined the relationship between plaque vulnerability and inflammatory molecules using blood samples and histological specimens.
Methods:
We examined 58 patients with symptomatic or asymptomatic carotid stenosis, among which 41 underwent carotid artery stenting (CAS) and 17 underwent carotid endarterectomy (CEA). All of these patients were recruited in Mie University Hospital from Sept. 2009 to Mar. 2012 and underwent carotid plaque imaging with MRI. In the 41 patients with CAS, blood samples were obtained in the femoral artery as controls and in the carotid artery just before and after the operation. Emboli attached to the distal protection devices in CAS, or resected tissues after CEA were embedded in paraffin. The serum concentrations of IL-6, IL-10, E-selectin, adiponectin, hs-CRP and pentraxin 3 (PTX3) levels were measured by ELISA. Paraffin-embedded tissues were subjected to histopathologic and immunohistochemical analysis on IL-6, IL-10, E-selectin, PTX3.
Results:
The patients with CAS were classified to 22 with stable plaque (stable group) and 19 with vulnerable plaque (vulnerable group). The values of IL-6, E-selectin, hs-CRP and PTX3 in the vulnerable group were higher than those in the stable group, whereas adiponectin and IL-10 were decreased in the vulnerable group as compared to the stable group. The values of PTX3 in the control and intracarotid samples before and after CAS were higher from the vulnerable group than those from the stable group. Pathologically, IL-6 was immunostained in the vulnerable plaques with infiltration of inflammatory cells, and PTX3 was expressed in the endothelial and perivascular cells in the unstable plaques.
Conclusions:
The vulnerability of carotid plaques was modulated by upregulation of pro-inflammatory factors and downregulation of anti-inflammatory ones. In addition, PTX3 may be a novel determinant for plaque vulnerability.
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Affiliation(s)
| | | | | | | | - Naoki Toma
- Mie Univ Graduate Sch of Medicine, Tsu, Japan
| | | | | | | | - Waro Taki
- Mie Univ Graduate Sch of Medicine, Tsu, Japan
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Matsuura Y, Kaneko M, Hirabaru H, Hidaka F, Sakaida H, Kai T, Yukizaki C, Sakono M. Antihypertensive Effect of Blueberry Leaves on Spontaneously Hypertensive Rats. J JPN SOC FOOD SCI 2013. [DOI: 10.3136/nskkk.60.689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ishinaga H, Otsu K, Sakaida H, Miyamura T, Nakamura S, Kitano M, Tenpaku H, Takao M, Kobayashi M, Takeuchi K. Descending necrotizing mediastinitis from deep neck infection. Eur Arch Otorhinolaryngol 2012; 270:1463-6. [DOI: 10.1007/s00405-012-2182-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 09/06/2012] [Indexed: 11/30/2022]
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Ishinaga H, Shah SA, Sakaida H, Takeuchi K. The role of transforming growth factor-α on mucin overproduction in eosinophilic chronic rhinosinusitis. Pharmacology 2011; 88:302-8. [PMID: 22104252 DOI: 10.1159/000333794] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 09/26/2011] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Eosinophilic chronic rhinosinusitis (ECRS) is considered a refractory and intractable disease with thick mucus production, long-term nasal congestion, loss of sense of smell and intermittent acute exacerbations secondary to bacterial infections. In this study, we investigated which growth factor is deeply involved in the mucin overproduction in ECRS. METHOD We employed fluorescence immunohistochemical analysis to evaluate whether or not TGF-α expression was upregulated in the nasal tissue of ECRS patients. We also examined MUC5AC transcription using a luciferase reporter plasmid in HM3-MUC5AC cells and A549 cells in order to assess the role of TGF-α in human epithelial cells. RESULTS TGF-α immunoreactivity was found markedly increased in the submucosal tissue in the ECRS patient compared with that of a normal patient and with noneosinophilic CRS. TGF-α synergized with TNF-α to upregulate MUC5AC expression in human epithelial cells through the ERK signaling pathway. CONCLUSION Our results demonstrated that TGF-α was highly expressed in the upper airway tract in ECRS patients and is deeply involved in mucus hypersecretion.
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Affiliation(s)
- Hajime Ishinaga
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Japan. hajime @ clin.medic.mie-u.ac.jp
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Taha MM, Sakaida H, Asakura F, Maeda M, Toma N, Yamamoto A, Kawaguchi K, Matsushima S, Taki W. Endovascular management of vertebral artery dissecting aneurysms: review of 25 patients. Turk Neurosurg 2010; 20:126-35. [PMID: 20401839 DOI: 10.5137/1019-5149.jtn.2790-09] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
AIM Management of Vertebral Artery (VA) dissections remains controversial. The clinical and angiographic variables of VA dissections were evaluated to demonstrate the safety and efficacy of endovascular intervention in treatment of VA dissecting aneurysms. MATERIAL AND METHODS 25 patients with 27 VAdissecting aneurysms were treated with endovascular intervention during the last 10 years.17 patients were admitted with subarachnoid hemorrhage. 23 aneurysms treated using destructive endovascular trapping, while reconstructive techniques were used in 3 aneurysms treated with stent-assisted coiling and one aneurysm treated with false lumen embolization. RESULTS The right VA was involved in 14 patients, the left VA in 9 patients, while 2 patients had bilateral VA dissection. The pearl and string sign was the commonest angiographic sign in 12 aneurysms. Perioperative complications included; rebleeding in one patient, symptomatic brain stem infarction in two patients and silent cerebellar ischemic lesion in one patient. Afavorable outcome was evident more in patients with unruptured VA dissection (100%) versus (76.5%) in patients presented with SAH. CONCLUSION The endovascular technique should be individualized according to the clinical status of the patient, angiographic variables, condition of the posterior circulation and the available supplies.
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Affiliation(s)
- Mahmoud M Taha
- Department of Neurosurgery, Zagazig University, Zagazig, Egypt.
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Hamada K, Matsushima S, Toma N, Totani T, Toda M, Ogawa S, Asakura F, Sakaida H, Iwata H, Taki W. Simple immersion of filter devices into an urokinase solution prevents fibrin net formation during carotid artery stenting. J Biomed Mater Res B Appl Biomater 2010; 95:171-6. [PMID: 20737433 DOI: 10.1002/jbm.b.31699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Slow-flow phenomenon is frequently observed during carotid artery stenting (CAS) with a filter embolic protection device. It results in technical difficulties and can lead to adverse neurological events. Flow impairment is thought to be caused by plaque entrapped by the filter and/or blood coagulation on the filter. Characteristics of heparin- or urokinase-treated polyurethanes were analyzed by surface plasmon resonance, and the fibrinolytic activity of the urokinase-treated filter of Angioguard XP was estimated by the fibrin plate assay. A filter membrane of Angioguard XP protection device was treated with a heparin or urokinase solution. In clinical studies, six and nine patients were treated by CAS using Angioguard XP modified with heparin and urokinase, respectively. Filter membranes were examined by scanning electron microscopy (SEM). From in vitro studies, it appeared that urokinase adsorbed and remained on the Angioguard XP filter, and its fibrinolytic activity was demonstrated even after washing with saline; heparin, however, was easily washed out from the surface. From clinical study, some filter pores were obstructed in all six patients in the heparin group and in three patients in the urokinase group. Fibrin net was found on the filter in five of six patients in the heparin group and in one of nine patients in the urokinase group. Treatment of an Angioguard XP filter with a urokinase solution is effective in preventing pore occlusion and may reduce occurrence of the slow-flow phenomenon.
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Affiliation(s)
- Kazuhide Hamada
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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Matsuo Y, Fujita Y, Ohnishi S, Tanaka T, Hirabaru H, Kai T, Sakaida H, Nishizono S, Kouno I. Chemical constituents of the leaves of rabbiteye blueberry (Vaccinium ashei) and characterisation of polymeric proanthocyanidins containing phenylpropanoid units and A-type linkages. Food Chem 2010. [DOI: 10.1016/j.foodchem.2010.01.052] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Taha MM, Sakaida H, Asakura F, Maeda M, Toma N, Yamamoto A, Kawaguchi K, Matsushima S, Taki W. Endovascular management of vertebral artery dissecting aneurysms: review of 25 patients. Turk Neurosurg 2010. [DOI: 10.5137/1019-5149.jtn.2790-09.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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44
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Taha MM, Maeda M, Sakaida H, Kawaguchi K, Toma N, Yamamoto A, Hirose T, Miura Y, Fujimoto M, Matsushima S, Taki W. Cerebral ischemic lesions detected with diffusion-weighted magnetic resonance imaging after carotid artery stenting: Comparison of several anti-embolic protection devices. Neurol Med Chir (Tokyo) 2009; 49:386-93. [PMID: 19779282 DOI: 10.2176/nmc.49.386] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Distal embolism is an important periprocedural technical complication with carotid angioplasty and carotid artery stenting (CAS). We evaluated the safety and efficacy of protection devices used during CAS by detecting new cerebral ischemic lesions using diffusion-weighted magnetic resonance imaging in 95 patients who underwent 98 CAS procedures: 34 using single PercuSurge GuardWire, 31 using double balloon protection, 15 using proximal flow reverse protection devices, 14 using Naviballoon, and 4 using filter anti-embolic devices. Diffusion-weighted imaging was performed preoperatively and postoperatively to evaluate the presence of any new embolic cerebral lesions. Postoperative diffusion-weighted imaging revealed 117 new ischemic lesions. Three patients had new ischemic stroke, two minor and one major, all ipsilateral to the treated carotid artery. The remaining patients had clinically silent ischemia. The incidence of new embolic lesions was lower using the proximal flow reverse protection device than with the double balloon protection (33% vs. 48.4%), but the volume of ipsilateral new ischemic lesions per patient was 136.6 mm(3) vs. 86.9 mm(3), respectively. Neuroprotection with Naviballoon yielded ipsilateral lesions of large volume (86.6 mm(3)) and higher number (5.7 lesions per patient) than using the filter anti-embolic device (34.8 mm(3) and 1 lesion per patient). New cerebral ischemic lesions after neuroprotected CAS are usually silent. The lower incidence of distal ischemia using proximal flow reverse and double balloon protection devices is limited by the larger volume and higher number of ischemic lesions.
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Affiliation(s)
- Mahmoud M Taha
- Department of Neurosurgery, Mie University School of Medicine, Tsu, Mie
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45
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Sakaida H, Taki W. [Current status and future of recombinant tissue plasminogen activator for acute ischemic stroke]. No Shinkei Geka 2009; 37:1067-1083. [PMID: 19938663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Hiroshi Sakaida
- Department of Innovative Neuro-Interventional Radiology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-shi, Mie 514-8507, Japan
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She W, Takeuchi K, Suzuki S, Sakaida H, Ishinaga H, Majima Y. Remodeling of nasal mucosa by allergen exposure in guinea pigs is suppressed by steroid and pranlukast. Rhinology 2009; 47:199-206. [PMID: 19593979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND It is unclear whether remodeling exists in allergic rhinitis in man. The aim of this study was to establish a guinea pig model of allergic rhinitis with remodeling and to examine the effects of dexamethasone and pranlukast on nasal mucosa remodeling. METHODS In the first experiment, three groups of ovalbumin-sensitized Hartley guinea pigs received intranasal challenges with ovalbumin for 1, 8, 12 weeks, respectively. In the second experiment, to examine the effect of dexamethasone and pranlukast, the animals were divided into 4 groups: negative control group; ovalbumin-sensitized group; ovalbumin + dexamethasone group; and ovalbumin + pranlukast group. During 12 weeks of intranasal exposure to ovalbumin, the latter two groups received daily intraperitoneal injections of dexamethasone and pranlukast, respectively. RESULTS In the first experiment, in contrast to the negative control group, the ovalbumin-sensitized group exhibited significant goblet cell hyperplasia, epithelial damage and deposition of extracellular matrix in the nasal septal mucosa and conchae. In the second experiment, these changes were significantly inhibited by dexamethasone and pranlukast, respectively. CONCLUSIONS We have established a model of upper airway remodeling in guinea pigs. The tissue remodeling was inhibited by early intervention with the antiallergic-inflammatory agents dexamethasone and pranlukast.
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Affiliation(s)
- Wenyu She
- Department of Otorhinolaryngology, Head and Neck Surgery, Mie University Graduate School of Medicine, Edobashi, Tsu, Mie, Japan
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Kitano M, Kobayashi M, Imanishi Y, Sakaida H, Majima Y. [Clinical analysis of hyposmia-associated taste dysfunction]. Nihon Jibiinkoka Gakkai Kaiho 2009; 112:110-5. [PMID: 19364046 DOI: 10.3950/jibiinkoka.112.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We clarified the clinical features of "flavor dysfunction," defined as olfactory dysfunction with self-reported hypogeusia but normal taste function in gustatory tests compared to those of "smell and taste dysfunction" hyposmia and hypogeusia in olfactory and gustatory tests. Patients with flavor dysfunction reported significantly milder taste loss than those with other smell and taste dysfunction. The major smell and taste loss etiology was upper respiratory tract infection (URI) in the flavor dysfunction group and the URI rate was significantly higher in the flavor dysfunction group than in the smell and taste dysfunction group. Smell identification thresholds in T & T olfactometry were not different between groups. Flavor dysfunction, hyposmia was treated medically but not with conventional hypogeusia medication. Medication including zinc was administered for other smell and taste dysfunction. Both groups significantly recovered from taste dysfunction. Our results indicate that treating olfactory dysfunction effectively improves flavor dysfunction but hypogeusia need not necessarily be treated. Hyposmia and hypogeusia must be treated together for other smell and taste dysfunction, making it vital that we conduct appropriate gustatory testing to correctly differentiate between flavor and other smell and taste dysfunctions.
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Affiliation(s)
- Masako Kitano
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu
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Takeuchi K, Hattori T, Masuda S, Usui S, Oka K, Sakaida H, Majima Y. Cochlear implantation in complete remission in a patient with leukemia. Acta Otolaryngol 2008; 128:821-3. [PMID: 18568527 DOI: 10.1080/00016480701714301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Patients with leukemia have an increased risk of developing sensorineural hearing loss. This is a retrospective review of a profoundly deafened patient with acute myelogenous leukemia who underwent cochlear implantation. The 26-year-old patient was successfully implanted with a Nucleus cochlear implant in the complete remission after peripheral blood stem cell transplantation. To date, with a follow-up of 1 year, the patient has not experienced any complication and has regained useful open-set speech perception. To our knowledge, this is the first reported case of successful cochlear implantation in a patient deafened by acute myelogenous leukemia.
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Sakaida H, Kobayashi M, Yuta A, Imanishi Y, Majima Y. Squamous cell carcinoma of the nasolacrimal duct. Eur Arch Otorhinolaryngol 2008; 266:455-8. [PMID: 18488243 DOI: 10.1007/s00405-008-0677-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2007] [Accepted: 04/03/2008] [Indexed: 10/22/2022]
Abstract
Tumors originating from the nasolacrimal duct are exceedingly rare. Only a few cases have been reported previously. In advanced cases with extended tumor, differential diagnosis from lacrimal sac tumor is difficult. A 68-year-old Japanese man with intractable dacryocystitis was examined with intranasal endoscopy, computed tomography (CT) and magnetic resonance imaging (MRI). Squamous cell carcinoma extended from a medial site in the left orbit to the lacrimal orifice. En bloc resection was performed and histopathological examination of the surgical specimen using serial section suggested that the origin of the tumor was located in the nasolacrimal duct. This is the first case in nasolacrimal duct carcinoma whose differential diagnosis of origin has been studied in detail. We showed that pathological study using serial section along the duct provides useful information for diagnosing the tumor origin in addition to that obtained from imaging studies.
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Affiliation(s)
- Hiroshi Sakaida
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
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Kobayashi M, Imanishi Y, Ishikawa M, Nishida K, Oishi M, Nakamura S, Sakaida H, Maeda T, Tsunoda T, Matsuura T, Majima Y. Influence of visual information and test paradigm on clinical olfactory test results. Auris Nasus Larynx 2008; 35:53-60. [PMID: 17869045 DOI: 10.1016/j.anl.2007.04.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2007] [Revised: 03/28/2007] [Accepted: 04/04/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The goal of this study was to determine if visual information and test paradigms affect clinical olfactory test results. METHODS Three hundred and ninety-seven Japanese patients with complaints of olfactory dysfunction were administered both a new clinical olfactory test, the Odor Stick Identification Test for Japanese (OSIT-J), and the Japanese benchmark olfactory test, T&T olfactometry. Four different methods were used to administer the OSIT-J combining paradigms using word or picture-word alternatives with the four-plus alternative method based on a top-down strategy or the two-step identification method based on a bottom-up strategy. OSIT-J scores were compared for the different methods, referring to benchmark scores obtained with T&T olfactometry. RESULTS OSIT-J scores using picture-word alternatives and the four-plus alternative method showed a stronger correlation with T&T olfactometry test scores than those using word alternatives and the two-step identification method, respectively. The average OSIT-J scores of the four-plus alternative method using picture-word alternatives were significantly higher than those using word alternatives in anosmic and severely hyposmic patients. The time required to administer the OSIT-J using both picture-word alternatives and the four-plus alternative method was the shortest of the four OSIT-J methods. CONCLUSIONS Visual information and test paradigms may affect clinical olfactory test results. The OSIT-J method using picture-word alternatives and the four-plus alternative method may be the most suitable for clinical practice.
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Affiliation(s)
- Masayoshi Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
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