1
|
Thirayan V, Kong VY, Uchino H, Clarke DL. Post-traumatic stress disorder in international surgeons undertaking trauma electives in a South African trauma centre. S AFR J SURG 2024; 62:14-17. [PMID: 38568120] [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: 04/05/2024]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a well-documented psychiatric outcome in patients who experience physical trauma. The phenomenon is less studied in the staff involved in caring for such patients. The aim was to investigate the prevalence of PTSD in visiting international surgeons undergoing elective trauma training and to compare to local and international rates. METHODS A trauma screening questionnaire (TSQ) survey was conducted among surgeons completing their elective trauma service placements in the Pietermaritzburg Metropolitan Trauma Service. RESULTS Nineteen surveys were completed (32% response rate). Mean age was 38.9 (SD 6.5). Median postgraduate working experience was 5 (2-10) years. Median time of stay in South Africa was 6 (1-72) months. Compared to preelective experience, there was a five-fold increase in the level of trauma resuscitation experience reported during elective placement. 10.5% of surgeons scored > 5 in the TSQ suggesting probable PTSD. No statistical differences in age, years of prior experience, prior trauma rotation, number of major resuscitations, or length of stay in South Africa were observed in those scoring positive versus negative screening in the TSQ questionnaire. CONCLUSION Despite being exposed to increased levels of trauma related injury, we observed low rates of positive screening for PTSD in our cohort of visiting international surgeons involved in elective trauma service placements. Investigation of potential protective factors against PTSD in this South African tertiary trauma centre is warranted.
Collapse
Affiliation(s)
- V Thirayan
- Mental Health and Addictions, Waikato Hospital, New Zealand
| | - V Y Kong
- Department of Surgery, University of KwaZulu-Natal, South Africa
- Department of Surgery, University of the Witwatersrand, South Africa
| | - H Uchino
- Trauma Centre, Montreal General Hospital, Canada
| | - D L Clarke
- Department of Surgery, University of KwaZulu-Natal, South Africa
- Department of Surgery, University of the Witwatersrand, South Africa
| |
Collapse
|
2
|
Sekiguchi S, Nakazawa K, Ishida Y, Uchino H. Intraoperative difficulty in cardiorespiratory management during anesthesia for retroperitoneal paraganglioma resection. SAGE Open Med Case Rep 2023; 11:2050313X231183881. [PMID: 37434894 PMCID: PMC10331333 DOI: 10.1177/2050313x231183881] [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: 02/27/2023] [Accepted: 06/06/2023] [Indexed: 07/13/2023] Open
Abstract
We report the anesthetic management of a case of paraganglioma, which was challenging because of intraoperative circulatory changes and difficult ventilatory management. A 52-year-old man with a history of chronic obstructive pulmonary disease was scheduled for paraganglioma resection under general anesthesia combined with epidural anesthesia. Since a marked increase in blood pressure was observed immediately after administration of rocuronium, antihypertensive agents were administered as necessary. The ventilatory settings were initially adjusted to deliver a tidal volume of 7 mL/kg, and the drive pressure was maintained at 13 cm H2O or less. However, despite increasing the minute volume, PETCO2 increased to 60 mmHg and PaCO2 to 76 mmHg before tumor removal. Blood pressure decreased immediately after tumor removal, and PETCO2 and PaCO2 gradually returned to normal. We speculated that the increases in PETCO2 and PaCO2 might have been due to both an increase in endogenous catecholamine secretion as well as chronic obstructive pulmonary disease. It is important to preoperatively evaluate the functionality of the tumor and to anticipate perioperative cardiorespiratory instability in the management of paragangliomas.
Collapse
Affiliation(s)
| | | | - Yusuke Ishida
- Yusuke Ishida, Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
| | | |
Collapse
|
3
|
Yoshitani K, Ogata S, Kato S, Tsukinaga A, Takatani T, Kin N, Ezaka M, Shimizu J, Furuichi Y, Uezono S, Kida K, Seo K, Kakumoto S, Miyawaki H, Kawamata M, Tanaka S, Kakinohana M, Izumi S, Uchino H, Kakinuma T, Nishiwaki K, Hasegawa K, Matsumoto M, Ishida K, Yamashita A, Yamakage M, Yoshikawa Y, Morimoto Y, Saito H, Goto T, Masubuchi T, Kawaguchi M, Tsubaki K, Mizobuchi S, Obata N, Inagaki Y, Funaki K, Ishiguro Y, Sanui M, Taniguchi K, Nishimura K, Ohnishi Y. Effect of cerebrospinal fluid drainage pressure in descending and thoracoabdominal aortic repair: a prospective multicenter observational study. J Anesth 2023; 37:408-415. [PMID: 36944824 DOI: 10.1007/s00540-023-03179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
PURPOSE Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. METHODS This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. RESULTS Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71-3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62-4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27-5.17, p = 0.009). CONCLUSION CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.
Collapse
Affiliation(s)
- Kenji Yoshitani
- Department of Transfusion, National Cerebral and Cardiovascular Center, 6-1 Kishibeshimmachi, Suita, Osaka, 564-8565, Japan.
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shinya Kato
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Akito Tsukinaga
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
- Department of Anesthesiology, School of Medicine, Yokohama City University, Yokohama, Japan
| | - Tsunenori Takatani
- Division of Central Clinical Laboratory, Nara Medical University, Kashihara, Nara, Japan
| | - Nobuhide Kin
- Department of Anesthesia, New Tokyo Hospital, Matsudo, Japan
| | - Mariko Ezaka
- Department of Anesthesia, New Tokyo Hospital, Matsudo, Japan
| | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute, Futyu, Japan
| | - Yuko Furuichi
- Department of Anesthesiology, Sakakibara Heart Institute, Futyu, Japan
| | - Shoichi Uezono
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
| | - Kotaro Kida
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
| | - Katsuhiro Seo
- Department of Emergency, Kokura Memorial Hospital, Fukuoka, Japan
| | - Shinichi Kakumoto
- Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Hiroshi Miyawaki
- Department of Anesthesiology, Kokura Memorial Hospital, Fukuoka, Japan
| | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Manabu Kakinohana
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Nishihara, Japan
| | - Shunsuke Izumi
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Nishihara, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Japan
| | - Takayasu Kakinuma
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Japan
| | - Kimitoshi Nishiwaki
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kazuko Hasegawa
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mishiya Matsumoto
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Kazuyoshi Ishida
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Atsuo Yamashita
- Department of Anesthesiology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yusuke Yoshikawa
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yuji Morimoto
- Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Hitoshi Saito
- Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Takahisa Goto
- Department of Anesthesiology, School of Medicine, Yokohama City University, Yokohama, Japan
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Tetsuhito Masubuchi
- Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Kosuke Tsubaki
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, Japan
| | - Satoshi Mizobuchi
- Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Norihiko Obata
- Division of Anesthesiology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshimi Inagaki
- Division of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Kazumi Funaki
- Division of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Tottori University, Yonago, Japan
| | - Yoshiki Ishiguro
- Department of Anesthesiology, The Jikei University School of Medicine, Minato-ku, Japan
- Department of Anesthesiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masamitsu Sanui
- Department of Anesthesiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | | | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| |
Collapse
|
4
|
Yajima R, Ishida Y, Kobayashi T, Uchino H. Anesthetic Management Using the Oxygen Reserve Index for Tracheal Resection and Tracheal End-to-End Anastomosis for a Malignant Thyroid Tumor With Tracheal Invasion. Cureus 2023; 15:e35728. [PMID: 37016655 PMCID: PMC10066925 DOI: 10.7759/cureus.35728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
When tracheal invasion of cancerous diseases such as thyroid cancer occurs, tracheal resection followed by end-to-end anastomosis is a treatment of choice. Anesthetic management of the patient during this procedure may pose challenges, such as maintaining ventilation during tracheal dissection, resection of the tracheal invasion, and tracheal end-to-end anastomosis. Here, we have presented a case of a woman in her 50s. Computed tomography of the head and neck displayed a 31-mm mass in the medial lobe of the thyroid gland, and irregularities in the trachea and right tracheoesophageal groove. We decided to perform total thyroidectomy followed by tracheal resection and end-to-end tracheal anastomosis, as a radical treatment. Anesthetic management was successfully performed without a decrease in the peripheral blood oxygen saturation level, due to managing oxygenation by using the oxygen reserve index (ORITM) monitoring during the tracheostomy, tracheal infiltration division resection, and tracheal end-to-end suturing. This case was a unique situation requiring two intraoperative tube exchanges, but the ORI monitoring of oxygenation enabled safe anesthetic management.
Collapse
|
5
|
Takahashi N, Akaike N, Nagamatsu T, Uchino H, Kudo Y. Effects of TND1128 (a 5-deazaflavin derivative), with self-redox ability, as a mitochondria activator on the mouse brain slice and its comparison with β-NMN. J Pharmacol Sci 2023; 151:93-109. [PMID: 36707184 DOI: 10.1016/j.jphs.2022.11.005] [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: 10/22/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
We have no definitive treatment for dementia characterized by prolonged neuronal death due to the enormous accumulation of foreign matter, such as β-amyloid. Since Alzheimer's type dementia develops slowly, we may be able to delay the onset and improve neuronal dysfunction by enhancing the energy metabolism of individual neurons. TND1128, a derivative of 5-deazaflavin, is a chemical known to have an efficient self-redox ability. We expected TND1128 as an activator for mitochondrial energy synthesis. We used brain slices prepared from mice 22 ± 2 h pretreated with TND1128 or β-NMN. We measured Ca2+ concentrations in the cytoplasm ([Ca2+]cyt) and mitochondria ([Ca2+]mit) by using fluorescence Ca2+ indicators, Fura-4F, and X-Rhod-1, respectively, and examined the protective effects of drugs on [Ca2+]cyt and [Ca2+]mit overloading by repeating 80K exposure. TND1128 (0.01, 0.1, and 1 mg/kg s.c.) mitigates the dynamics of both [Ca2+]cyt and [Ca2+]mit in a dose-dependent manner. β-NMN (10, 30, and 100 mg/kg s.c.) also showed significant dose-dependent mitigating effects on [Ca2+]cyt, but the effect on the [Ca2+]mit dynamics was insignificant. We confirmed the mitochondria-activating potential of TND1128 in the present study. We expect TND1128 as a drug that rescues deteriorating neurons with aging or disease.
Collapse
Affiliation(s)
- Nanae Takahashi
- Department of Anesthesiology, Tokyo Medical University Hachioji Medical Center 1163 Tatemachi,Hachioji, Tokyo 193-0998, Japan.
| | - Norio Akaike
- Research Division for Clinical Pharmacology, Medical Corporation, Juryou Group, Kumamoto Kinoh Hospital, 6-8-1 Yamamuro, Kita-ku, Kumamoto 860-8518, Japan.
| | - Tomohisa Nagamatsu
- Laboratory of Curative Creation Study for Geriatric-diseases Prevention, Faculty of Pharmacological Sciences, Sojo University, 4-22-1 Ikeda, Nishi-ku, Kumamoto, 860-0082, Japan.
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Sinjuku-ku, Tokyo 160-0023, Japan.
| | - Yoshihisa Kudo
- Department of Anesthesiology, Tokyo Medical University Hachioji Medical Center 1163 Tatemachi,Hachioji, Tokyo 193-0998, Japan.
| |
Collapse
|
6
|
Kurachi A, Ishida Y, Nakazawa K, Okada T, Kishida T, Uchino H. Necrotizing fasciitis and septic shock due to streptococcal toxic shock syndrome in an elderly patient: A case report. Clin Case Rep 2023; 11:e6846. [PMID: 36698511 PMCID: PMC9850853 DOI: 10.1002/ccr3.6846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023] Open
Abstract
Streptococcal toxic shock syndrome (STSS) has a high mortality rate, and most patients die within a few days of onset. We report an elderly patient with STSS, necrotizing fasciitis and septic shock caused by group G streptococcus who was successfully treated with multidisciplinary therapy.
Collapse
Affiliation(s)
- Akiko Kurachi
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| | - Yusuke Ishida
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| | - Koichi Nakazawa
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| | - Toshio Okada
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| | - Takumi Kishida
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| | - Hiroyuki Uchino
- Department of AnesthesiologyTokyo Medical UniversityTokyoJapan
| |
Collapse
|
7
|
Muto E, Okada T, Yamanaka T, Uchino H, Inazu M. Licochalcone E, a β-Amyloid Aggregation Inhibitor, Regulates Microglial M1/M2 Polarization via Inhibition of CTL1-Mediated Choline Uptake. Biomolecules 2023; 13:biom13020191. [PMID: 36830561 PMCID: PMC9953043 DOI: 10.3390/biom13020191] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/19/2023] Open
Abstract
Alzheimer's disease (AD) is thought to be a series of neuroinflammatory diseases caused by abnormal deposits of amyloid-β (Aβ) and tau protein in the brain as part of its etiology. We focused on Aβ aggregation and M1 and M2 microglial polarity in microglia to search for novel therapeutic agents. It has been reported that the inhibition of choline uptake via choline transporter-like protein 1 (CTL1) in microglia preferentially induces M2 microglial polarity. However, the role of the choline transport system on the regulation of microglial M1/M2 polarity in AD is not fully understood. Licochalcones (Licos) A-E, flavonoids extracted from licorice, have been reported to have immunological anti-inflammatory effects, and Lico A inhibits Aβ aggregation. In this study, we compared the efficacy of five Licos, from Lico A to E, at inhibiting Aβ1-42 aggregation. Among the five Licos, Lico E was selected to investigate the relationship between the inhibition of choline uptake and microglial M1/M2 polarization using the immortalized mouse microglial cell line SIM-A9. We newly found that Lico E inhibited choline uptake and Aβ1-42 aggregation in SIM-A9 cells in a concentration-dependent manner, suggesting that the inhibitory effect of Lico E on choline uptake is mediated by CTL1. The mRNA expression of tumor necrosis factor (TNF-α), a marker of M1 microglia, was increased by Aβ1-42, and its effect was inhibited by choline deprivation and Lico E in a concentration-dependent manner. In contrast, the mRNA expression of arginase-1 (Arg-1), a marker of M2 microglia, was increased by IL-4, and its effect was enhanced by choline deprivation and Lico E. We found that Lico E has an inhibitory effect on Aβ aggregation and promotes polarity from M1 to M2 microglia via inhibition of the CTL1 function in microglia. Thus, Lico E may become a leading compound for a novel treatment of AD.
Collapse
Affiliation(s)
- Eisuke Muto
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Toshio Okada
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Tsuyoshi Yamanaka
- Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Masato Inazu
- Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
- Correspondence: ; Tel.: +81-3-3351-6141
| |
Collapse
|
8
|
Kishida T, Ishida Y, Okada T, Tsuzuki Y, Kurita K, Uchino H. Successful Perioperative Management of Cochlear Implantation in a Patient With Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS). Cureus 2022; 14:e27761. [PMID: 36106294 PMCID: PMC9449252 DOI: 10.7759/cureus.27761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/29/2022] Open
Abstract
Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a type of mitochondrial disease that is characterized by stroke-like seizures. For these patients, serious, unexpected complications have occurred during and following anesthetic exposure. Provision of anesthesia is challenging, including the choice of anesthetic agents. We here report a case of general anesthesia management for a patient with MELAS. A 46-year-old woman was diagnosed with MELAS at the age of 40. She subsequently underwent cochlear implantation for hearing loss. Anesthesia was induced with midazolam and maintained with desflurane. In the present case, anesthesia was maintained with inhalation anesthetics to avoid the development of propofol infusion syndrome. Her intraoperative and postoperative courses were uneventful. The anesthesia management of patients with MELAS can be performed safely with carefully planned anesthesia and close monitoring at each step, including the postoperative period.
Collapse
|
9
|
Akao K, Ishida Y, Nakazawa K, Okada T, Fujiyoshi T, Kawachi A, Uchino H. Esophageal Submucosal Giant Hematoma Detected After Mitral Repair Using Transesophageal Echocardiography. Cureus 2022; 14:e27292. [PMID: 36039225 PMCID: PMC9403247 DOI: 10.7759/cureus.27292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2022] [Indexed: 12/04/2022] Open
Abstract
Transesophageal echocardiography (TEE) is a necessary diagnostic tool for cardiac surgery, including for intraoperative evaluation of the morphology and function of each structure. On the other hand, many complications caused by insertion and manipulation of the TEE probe have been reported, such as gastrointestinal injuries and hematoma, as well as esophageal perforation. Here, we report a case in which a large submucosal esophageal hematoma was found on the fourth postoperative day after surgery using TEE for mitral regurgitation. The patient was an 81-year-old man who underwent mitral valve replacement for mitral regurgitation. On the fourth postoperative day, anorexia and blood-tinged sputum were observed. A computed tomography (CT) scan of the chest displayed a giant esophageal submucosal hematoma. When performing TEE, to avoid complications, it is important to handle the TEE probe with care and to avoid leaving the device at the same site for long periods of time.
Collapse
|
10
|
Ishida Y, Okada T, Kobayashi T, Funatsu K, Uchino H. Pain Management of Acute and Chronic Postoperative Pain. Cureus 2022; 14:e23999. [PMID: 35547410 PMCID: PMC9086530 DOI: 10.7759/cureus.23999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2022] [Indexed: 12/04/2022] Open
Abstract
Inadequate management of acute postoperative pain is associated with effects related to both physiological and psychological function. Postoperative pain increases the risk of perioperative complications, so postoperative pain should be prevented. Postoperative pain management by sufficient analgesia is important while considering the use of various kinds of analgesics. Insufficient management of postoperative pain may lead to chronic postsurgical pain (CPSP). It is suggested that CPSP is dependent not only upon biological factors but also upon psychological factors, including the type of surgery, age, physical health, mental health, and preoperative pain. As CPSP is a severe complication that may prolong hospitalization and interferes with activities of daily living (ADL) and quality of life (QoL), its prevention of development is paramount. Therefore, in order to prevent the onset of CPSP, it is necessary to craft analgesic management to prevent CPSP during the perioperative period.
Collapse
|
11
|
Nakazawa K, Kodaira A, Matsumoto R, Matsushita T, Yoshikawa R, Ishida Y, Uchino H. Positive end-expiratory pressure setting based on transpulmonary pressure during robot-assisted laparoscopic prostatectomy: an observational intervention study. JA Clin Rep 2022; 8:10. [PMID: 35150377 PMCID: PMC8840948 DOI: 10.1186/s40981-022-00501-y] [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: 12/01/2021] [Revised: 01/22/2022] [Accepted: 02/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background In robot-assisted laparoscopic prostatectomy (RALP), concerns include the formation of atelectasis and reduced functional residual capacity. The present study aimed to examine the feasibility of positive end-expiratory pressure (PEEP) setting based on transpulmonary pressure (Ptp) as well as the effects of incremental PEEP on respiratory mechanics, blood gases, cerebral oxygenation (rSO2), and hemodynamics. Methods Fourteen male patients who were scheduled to receive RALP were recruited. Patients received mechanical ventilation (tidal volume of 6 mL kg−1) and were placed in Trendelenburg position with positive-pressure capnoperitoneum. PEEP levels were increased from 0 to 15 cmH2O (5 cmH2O per increase) every 30 min. PEEP levels were assessed where end-expiratory Ptp levels of ≥0 cmH2O were achieved (PtpEEP0). Airway pressure, esophageal pressure, cardiac index, and blood gas and rSO2 values were measured after 30 min at each PEEP step and respiratory mechanics were calculated. Results With increasing PEEP levels from 0 to 15 cmH2O or PtpEEP0, the values of PaO2 and respiratory system compliance increased, and the values of driving pressure decreased. The median PEEP level associated with PtpEEP0 was 15 cmH2O. Respiratory system compliance values were higher at PtpEEP0 than those at PEEP5 (P = 0.02). Driving pressure was significantly lower at PtpEEP0 than at PEEP5 (P = 0.0036). The cardiac index remained unchanged, and the values of rSO2 were higher at PtpEEP0 than at PEEP0 (right; P = 0.0019, left; P = 0.036). Conclusions PEEP setting determined by transpulmonary pressure can help achieve higher respiratory system compliance values and lower driving pressure without disturbing hemodynamic parameters.
Collapse
Affiliation(s)
- Koichi Nakazawa
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan.
| | - Ami Kodaira
- Department of Anesthesia, Mitsui Memorial Hospital, Kanda-Izumi-cho 1, Chiyoda-ku, Tokyo, 101-8643, Japan
| | - Rika Matsumoto
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan
| | - Tomoko Matsushita
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan
| | - Ryotaro Yoshikawa
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan
| | - Yusuke Ishida
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan
| | - Hiroyuki Uchino
- Department of Anesthesia, Tokyo Medical University Hospital, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo, 1600023, Japan
| |
Collapse
|
12
|
Kobayashi T, Uchino H, Elmér E, Ogihara Y, Fujita H, Sekine S, Ishida Y, Saiki I, Shibata S, Kawachi A. Disease Outcome and Brain Metabolomics of Cyclophilin-D Knockout Mice in Sepsis. Int J Mol Sci 2022; 23:961. [PMID: 35055146 PMCID: PMC8779771 DOI: 10.3390/ijms23020961] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 02/04/2023] Open
Abstract
Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction resulting from a systemic inflammatory response to infection, but the mechanism remains unclear. The mitochondrial permeability transition pore (MPTP) could play a central role in the neuronal dysfunction, induction of apoptosis, and cell death in SAE. The mitochondrial isomerase cyclophilin D (CypD) is known to control the sensitivity of MPTP induction. We, therefore, established a cecal ligation and puncture (CLP) model, which is the gold standard in sepsis research, using CypD knockout (CypD KO) mice, and analyzed the disease phenotype and the possible molecular mechanism of SAE through metabolomic analyses of brain tissue. A comparison of adult, male wild-type, and CypD KO mice demonstrated statistically significant differences in body temperature, mortality, and histological changes. In the metabolomic analysis, the main finding was the maintenance of reduced glutathione (GSH) levels and the reduced glutathione/oxidized glutathione (GSH/GSSG) ratio in the KO animals following CLP. In conclusion, we demonstrate that CypD is implicated in the pathogenesis of SAE, possibly related to the inhibition of MPTP induction and, as a consequence, the decreased production of ROS and other free radicals, thereby protecting mitochondrial and cellular function.
Collapse
Affiliation(s)
- Takayuki Kobayashi
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Eskil Elmér
- Mitochondrial Medicine, Department of Clinical Sciences, Lund University, 221 84 Lund, Sweden;
| | - Yukihiko Ogihara
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Hidetoshi Fujita
- Department of Biomedical Engineering, Osaka Institute of Technology, Osaka 535-8585, Japan;
| | - Shusuke Sekine
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Yusuke Ishida
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Iwao Saiki
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Shoichiro Shibata
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| | - Aya Kawachi
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan; (H.U.); (Y.O.); (S.S.); (Y.I.); (I.S.); (S.S.); (A.K.)
| |
Collapse
|
13
|
Hamada H, Tanoue T, Saito O, Endo M, Miyazaki K, Miyasato A, Iketani S, Sugimori A, Watanabe C, Uchino H. Dermatomyositis Identified During Palliative Care Management for Chemotherapy-Associated Pain: A Case Report. J Palliat Care 2021; 37:83-86. [PMID: 34823395 DOI: 10.1177/08258597211030382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Skin disorders and neuropathy often occur as side effects of chemotherapy. We encountered a patient who was treated for drug-induced skin symptoms, but the symptoms did not improve, and he was eventually diagnosed as having dermatomyositis. CASE PRESENTATION A 71-year-old man underwent chemotherapy with regorafenib in February 2020 for the postoperative recurrence of sigmoid colon cancer, but treatment was discontinued after about 2 months owing to the appearance of skin symptoms, which were thought to be side effects of regorafenib. Subsequently, his symptoms further worsened, and he was hospitalized 3 weeks after the appearance of the initial skin symptoms, and a palliative care team was asked to relieve his back pain caused by the drug-induced skin symptoms. Erythema was widely observed on the lower back and limbs, and he experienced needle stick-like pain. Furthermore, the patient demonstrated difficulty in lifting both upper limbs. As acetaminophen was effective for his pain, the dose was slowly increased with careful observation. The cause of the patient's muscle weakness was unclear, and after careful discussion of the possible causes among specialists in dermatology, neurology, and rheumatoid arthritis, a diagnosis of dermatomyositis associated with the malignant tumor was made about 10 days after his admission. The patient's symptoms gradually improved with steroid pulse treatment (methylprednisolone 1 g/day for 3 days) followed by high-dose gamma globulin treatment (2.5 g/day for 5 days), and the patient was discharged 48 days after admission. DISCUSSION Because this patient was referred to a palliative care team for the purpose of relieving pain caused by skin symptoms associated with chemotherapy, a crucial point is the symptoms were treated as side effects of the chemotherapy from the beginning. As neuropathy can occur as a result of chemotherapy, the pain and muscle weakness could be explained at the time; however, the symptoms continued to worsen even after the chemotherapy was stopped. Because the symptoms were not typical of polymyositis/dermatomyositis, diagnosis of the patient was delayed, even though he was treated in each specialized department. Our present case indicates that paraneoplastic syndrome should always be kept in mind when treating cancer patients.
Collapse
Affiliation(s)
- Hiroshi Hamada
- Department of Anesthesiology and Palliative Medicine, Tokyo Medical University, Tokyo, Japan
| | - Tadashi Tanoue
- Department of Anesthesiology and Palliative Medicine, Tokyo Medical University, Tokyo, Japan
| | - Osamu Saito
- Department of Anesthesiology and Palliative Medicine, Tokyo Medical University, Tokyo, Japan
| | - Mitsufumi Endo
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Kanako Miyazaki
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Akime Miyasato
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Sayaka Iketani
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Ayaka Sugimori
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Chiaki Watanabe
- Department of Palliative Medicine, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
14
|
Abstract
In the perioperative period, hypoxemia and hyperoxia are crucial factors that require attention, because they greatly affect patient prognoses. The pulse oximeter has been the only noninvasive monitor that can be used as a reference of oxygenation in current anesthetic management; however, in recent years, a new monitoring method that uses the oxygen reserve index (ORi™) has been developed by Masimo Corp. ORi is an index that reflects the state of moderate hyperoxia (partial pressure of arterial oxygen [PaO2] between 100 and 200 mmHg) using a non-unit scale between 0.00 and 1.00. ORi monitoring performed together with percutaneous oxygen saturation (SpO2) measurements may become an important technique in the field of anesthetic management, for measuring oxygenation reserve capacity. By measuring ORi, it is possible to predict hypoxemia and to detect hyperoxia at an early stage. In this review, we summarize the method of ORi, cautions for its use, and suitable cases for its use. In the near future, the monitoring of oxygen concentrations using ORi may become increasingly common for the management of respiratory function before, after, and during surgery.
Collapse
Affiliation(s)
- Yusuke Ishida
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Toshio Okada
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takayuki Kobayashi
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
15
|
Miyazaki N, Kobayashi T, Komiya T, Okada T, Ishida Y, Fukui H, Ogihara Y, Uchino H. Postoperative malignant hyperthermia confirmed by calcium-induced calcium release rate after breast cancer surgery, in which prompt recognition and immediate dantrolene administration were life-saving: a case report. J Med Case Rep 2021; 15:201. [PMID: 33863374 PMCID: PMC8052646 DOI: 10.1186/s13256-021-02681-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022] Open
Abstract
Background Malignant hyperthermia (MH) is a rare genetic disease characterized by the development of very serious symptoms, and hence prompt and appropriate treatment is required. However, postoperative MH is very rare, representing only 1.9% of cases as reported in the North American Malignant Hyperthermia Registry (NAMHR). We report a rare case of a patient who developed sudden postoperative hyperthermia after mastectomy, which was definitively diagnosed as MH by the calcium-induced calcium release rate (CICR) measurement test. Case presentation A 61-year-old Japanese woman with a history of stroke was hospitalized for breast cancer surgery. General anesthesia was introduced by propofol, remifentanil, and rocuronium. After intubation, anesthesia was maintained using propofol and remifentanil, and mastectomy and muscle flap reconstruction surgery was performed and completed without any major problems. After confirming her spontaneous breathing, sugammadex was administered and she was extubated. Thereafter, systemic shivering and masseter spasm appeared, and a rapid increase in body temperature (maximum: 38.9 °C) and end-tidal carbon dioxide (ETCO2) (maximum: 59 mmHg) was noted. We suspected MH and started cooling the body surface of the axilla, cervix, and body trunk, and administered chilled potassium-free fluid and dantrolene. After her body temperature dropped and her shivering improved, dantrolene administration was ended, and finally she was taken to the intensive care unit (ICU). Body cooling was continued within the target range of 36–37 °C in the ICU. No consciousness disorder, hypotension, increased serum potassium level, metabolic acidosis, or cola-colored urine was observed during her ICU stay. Subsequently, her general condition improved and she was discharged on day 12. Muscle biopsy after discharge was performed and provided a definitive diagnosis of MH. Conclusions The occurrence of MH can be life-threatening, but its frequency is very low, and genetic testing and muscle biopsy are required to confirm the diagnosis. On retrospective evaluation using the malignant hyperthermia scale, the present case was almost certainly that of a patient with MH. Prompt recognition and immediate treatment with dantrolene administration and body cooling effectively reversed a potentially fatal syndrome. This was hence a valuable case of a patient with postoperative MH that led to a confirmed diagnosis by CICR.
Collapse
Affiliation(s)
- Natsumi Miyazaki
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takayuki Kobayashi
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takako Komiya
- Department of Plastic Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, Japan
| | - Toshio Okada
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yusuke Ishida
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hidekimi Fukui
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yukihiko Ogihara
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Hiroyuki Uchino
- Department of Anesthesia, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
16
|
Ishida Y, Nakazawa K, Okada T, Tsuzuki Y, Kobayashi T, Yamada R, Uchino H. Anesthetic management of a morbidly obese patient with endometrial cancer during robot-assisted laparoscopic surgery. JA Clin Rep 2021; 7:30. [PMID: 33821374 PMCID: PMC8021672 DOI: 10.1186/s40981-021-00434-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/21/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022] Open
Abstract
Background The number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies. We here report the anesthetic management of a morbidly obese woman who underwent robot-assisted surgery. Case presentation A 44-year-old woman (height, 165 cm; weight, 147 kg; body mass index, 54 kg/m2) was scheduled to undergo robot-assisted laparoscopic hysterectomy for endometrial cancer. Preoperative weight loss and rehearsal of positioning during induction of anesthesia and surgical procedures greatly contributed to the surgical success. Monitoring of oxygen reserve index in combination with SpO2 was useful for appropriate airway and respiratory management. During anesthesia induction, the ramp position using a special commercially available cushion facilitated manual mask ventilation and tracheal intubation. Lung-protective ventilation using a limited tidal volume with moderate PEEP was applied during the robot-assisted surgical procedure. Conclusion We successfully managed anesthesia without any complications.
Collapse
Affiliation(s)
- Yusuke Ishida
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
| | - Koichi Nakazawa
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Toshio Okada
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Yumi Tsuzuki
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takayuki Kobayashi
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Rikako Yamada
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| |
Collapse
|
17
|
Yoshitani K, Kawaguchi M, Kawamata M, Kakinohana M, Kato S, Hasuwa K, Yamakage M, Yoshikawa Y, Nishiwaki K, Hasegawa K, Inagaki Y, Funaki K, Matsumoto M, Ishida K, Yamashita A, Seo K, Kakumoto S, Tsubaki K, Tanaka S, Ishida T, Uchino H, Kakinuma T, Yamada Y, Mori Y, Izumi S, Shimizu J, Furuichi Y, Kin N, Uezono S, Kida K, Nishimura K, Nakai M, Ohnishi Y. Cerebrospinal fluid drainage to prevent postoperative spinal cord injury in thoracic aortic repair. J Anesth 2020; 35:43-50. [PMID: 32980925 DOI: 10.1007/s00540-020-02857-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 09/15/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cerebrospinal fluid drainage (CSFD) is recommended as a spinal cord protective strategy in open and endovascular thoracic aortic repair. Although small studies support the use of CSFD, systematic reviews have not suggested definite conclusion and a large-scale study is needed. Therefore, we reviewed medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open and endovascular repair) at multiple institutions to assess the association between CSFD and postoperative motor deficits. METHODS Patients included in this study underwent descending or thoracoabdominal aortic repair between 2000 and 2013 at 12 hospitals belonging to the Japanese Association of Spinal Cord Protection in Aortic Surgery. We conducted a retrospective study to investigate whether motor-evoked potential monitoring is effective in reducing motor deficits in thoracic aortic aneurysm repair. We use the same dataset to examine whether CSFD reduces motor deficits after propensity score matching. RESULTS We reviewed data from 1214 patients [open surgery, 601 (49.5%); endovascular repair, 613 (50.5%)]. CSFD was performed in 417 patients and not performed in the remaining 797 patients. Postoperative motor deficits were observed in 75 (6.2%) patients at discharge. After propensity score matching (n = 700), mixed-effects logistic regression performed revealed that CSFD is associated with postoperative motor deficits at discharge [adjusted odds ratio (OR), 3.87; 95% confidence interval (CI), 2.30-6.51]. CONCLUSION CSFD may not be effective for postoperative motor deficits at discharge.
Collapse
Affiliation(s)
- Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan.
| | | | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Manabu Kakinohana
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Naha, Japan
| | - Shinya Kato
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan
| | - Kyoko Hasuwa
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yusuke Yoshikawa
- Department of Anesthesiology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kimitoshi Nishiwaki
- Department of Anesthesiology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Kazuko Hasegawa
- Department of Anesthesiology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshimi Inagaki
- Department of Anesthesiology and Critical Care, Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Kazumi Funaki
- Department of Anesthesiology and Critical Care, Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Mishiya Matsumoto
- Department of Anesthesiology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Kazuyoshi Ishida
- Department of Anesthesiology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Atsuo Yamashita
- Department of Anesthesiology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Katsuhiro Seo
- Department of Anesthesiology and Intensive Care Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Shinichi Kakumoto
- Department of Anesthesiology and Intensive Care Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Kosuke Tsubaki
- Department of Anesthesiology, Nara Medical University, Kashihara, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Ishida
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Shinjuku Ku, Japan
| | - Takayasu Kakinuma
- Department of Anesthesiology, Tokyo Medical University, Shinjuku Ku, Japan
| | - Yoshitsugu Yamada
- Department of Anesthesiology, Faculty of Vital Care Medicine, The Graduate School of Medicine, The University of Tokyo, Bunkyo Ku, Japan
| | - Yoshiteru Mori
- Department of Anesthesiology, Faculty of Vital Care Medicine, The Graduate School of Medicine, The University of Tokyo, Bunkyo Ku, Japan
| | - Shunsuke Izumi
- Department of Anesthesiology, Faculty of Medicine, University of Ryukyu, Naha, Japan
| | - Jun Shimizu
- Department of Anesthesiology, Sakakibara Heart Institute, Fuchu, Japan
| | - Yuko Furuichi
- Department of Anesthesiology, Sakakibara Heart Institute, Fuchu, Japan
| | - Nobuhide Kin
- Department of Anesthesiology, New Tokyo Hospital, Matsudo, Japan
| | - Shoichi Uezono
- Department of Anesthesiology, School of Medicine, The Jikei University, Minato Ku, Japan
| | - Kotaro Kida
- Department of Anesthesiology, School of Medicine, The Jikei University, Minato Ku, Japan
| | - Kunihiko Nishimura
- Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Michikazu Nakai
- Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, Osaka, Japan
| |
Collapse
|
18
|
Uchino H, Kong VY, Pantelides A, Anderson J, O'Neill H, Bruce JL, Laing GL, Clarke DL. The scourge of knife crime: trends in knife-related assault managed at a major centre in South Africa. S AFR J SURG 2020; 58:150-153. [PMID: 33231008] [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: 06/11/2023]
Abstract
BACKGROUND Knife wounds are common and represent a major burden to the South African healthcare system. This study reviews trends in spectrum, management and outcome of these injuries at a single trauma centre in KwaZulu-Natal(KZN). METHOD The regional hybrid electronic registry (HEMR) was reviewed for the period January 2013 - December 2018, and all patients who suffered a knife-related assault were identified and reviewed. RESULTS During the period under review, a total of 2117 patients suffered a knife-related assault. Regions injured were as follows: head 445, neck 572, face 258, chest 939, abdomen 649, pelvic/urogenital 49, upper limb 418, and lower limb 105. The median ISS was 9 (4-10). Imaging comprised 1242 chest X-rays, 315 abdominal X-rays, 162 abdominal ultrasounds/ FAST, and 929 CT scans of which 634 were CT angiograms. A total of 783 (37%) patients required an operation. The rate of laparotomy was 447/649 (69%) and of thoracotomy/sternotomy/thoracoscopy 95/939 (10%). The rate of vascular exploration for upper and lower limb vascular injury was 101/523 (19%). Mortality was 49/2117 (2.3%).. CONCLUSION Although our clinical outcomes over this period appear to be consistent, suggesting a familiarity with managing knife-related trauma, the persistently high rate of knife-related injury suggests that we have failed to develop a preventative strategy to try and reduce this scourge.
Collapse
Affiliation(s)
- H Uchino
- Department of Surgery, Department of Critical Care Medicine, Kurashiki Central Hospital, Okayama, Japan
| | - V Y Kong
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa and Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - A Pantelides
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - J Anderson
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - H O'Neill
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - J L Bruce
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - G L Laing
- Department of Surgery, University of KwaZulu-Natal, Durban, South Africa
| | - D L Clarke
- Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
19
|
Saiki I, Yara M, Yamanaka T, Uchino H, Inazu M. Functional Expression of Choline Transporter-Like Protein 1 in LNCaP Prostate Cancer Cells: A Novel Molecular Target. Biomol Ther (Seoul) 2020; 28:195-201. [PMID: 31693854 PMCID: PMC7059810 DOI: 10.4062/biomolther.2019.097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/12/2019] [Accepted: 10/01/2019] [Indexed: 11/18/2022] Open
Abstract
Prostate cancer is one of the most common cancers in men. Choline PET or PET/CT has been used to visualize prostate cancer, and high levels of choline accumulation have been observed in tumors. However, the uptake system for choline and the functional expression of choline transporters in prostate cancer are not completely understood. In this study, the molecular and functional aspects of choline uptake were investigated in the LNCaP prostate cancer cell line along with the correlations between choline uptake and cell viability in drug-treated cells. Choline transporter-like protein 1 (CTL1) and CTL2 mRNA were highly expressed in LNCaP cells. CTL1 and CTL2 were located in the plasma membrane and mitochondria, respectively. [3H]Choline uptake was mediated by a single Na+-independent, intermediate-affinity transport system in the LNCaP cells. The anticancer drugs, flutamide and bicalutamide, inhibited cell viability and [3H]choline uptake in a concentration-dependent manner. The correlations between the effects of these drugs on cell viability and [3H]choline uptake were significant. Caspase-3/7 activity was significantly increased by both flutamide and bicalutamide. Furthermore, these drugs decreased CTL1 expression in the prostate cancer cell line. These results suggest that CTL1 is functionally expressed in prostate cancer cells and are also involved in abnormal proliferation. Identification of this CTL1-mediated choline transport system in prostate cancer cells provides a potential new therapeutic target for the treatment of this disease.
Collapse
Affiliation(s)
- Iwao Saiki
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Miki Yara
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Tsuyoshi Yamanaka
- Department of Molecular Preventive Medicine, Tokyo Medical University, Tokyo 160-8402, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Masato Inazu
- Department of Molecular Preventive Medicine, Tokyo Medical University, Tokyo 160-8402, Japan.,Institute of Medical Science, Tokyo Medical University, Tokyo 160-8402, Japan
| |
Collapse
|
20
|
Ishikawa M, Aoyama T, Shibata S, Sone T, Miyoshi H, Watanabe H, Nakamura M, Morota S, Uchino H, Yoo AS, Okano H. miRNA-Based Rapid Differentiation of Purified Neurons from hPSCs Advancestowards Quick Screening for Neuronal Disease Phenotypes In Vitro. Cells 2020; 9:E532. [PMID: 32106535 PMCID: PMC7140514 DOI: 10.3390/cells9030532] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 12/12/2022] Open
Abstract
Obtaining differentiated cells with high physiological functions by an efficient, but simple and rapid differentiation method is crucial for modeling neuronal diseases in vitro using human pluripotent stem cells (hPSCs). Currently, methods involving the transient expression of one or a couple of transcription factors have been established as techniques for inducing neuronal differentiation in a rapid, single step. It has also been reported that microRNAs can function as reprogramming effectors for directly reprogramming human dermal fibroblasts to neurons. In this study, we tested the effect of adding neuronal microRNAs, miRNA-9/9*, and miR-124 (miR-9/9*-124), for the neuronal induction method of hPSCs using Tet-On-driven expression of the Neurogenin2 gene (Ngn2), a proneural factor. While it has been established that Ngn2 can facilitate differentiation from pluripotent stem cells into neurons with high purity due to its neurogenic effect, a long or indefinite time is required for neuronal maturation with Ngn2 misexpression alone. With the present method, the cells maintained a high neuronal differentiation rate while exhibiting increased gene expression of neuronal maturation markers, spontaneous calcium oscillation, and high electrical activity with network bursts as assessed by a multipoint electrode system. Moreover, when applying this method to iPSCs from Alzheimer's disease (AD) patients with presenilin-1 (PS1) or presenilin-2 (PS2) mutations, cellular phenotypes such as increased amount of extracellular secretion of amyloid β42, abnormal oxygen consumption, and increased reactive oxygen species in the cells were observed in a shorter culture period than those previously reported. Therefore, it is strongly anticipated that the induction method combining Ngn2 and miR-9/9*-124 will enable more rapid and simple screening for various types of neuronal disease phenotypes and promote drug discovery.
Collapse
Affiliation(s)
- Mitsuru Ishikawa
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Takeshi Aoyama
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Shoichiro Shibata
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Takefumi Sone
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiroyuki Miyoshi
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hirotaka Watanabe
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Mari Nakamura
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Saori Morota
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan
| | - Andrew S Yoo
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| |
Collapse
|
21
|
Uchino H, Kong VY, Pantelides A, Anderson J, O'Neill H, Bruce JL, Laing GL, Clarke DL. The scourge of knife crime: trends in knife-related assault managed at a major centre in South Africa. S AFR J SURG 2020. [DOI: 10.17159/2078-5151/2020/v58n3a3251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
22
|
Yoshitani K, Kawaguchi M, Ishida K, Maekawa K, Miyawaki H, Tanaka S, Uchino H, Kakinohana M, Koide Y, Yokota M, Okamoto H, Nomura M. Guidelines for the use of cerebral oximetry by near-infrared spectroscopy in cardiovascular anesthesia: a report by the cerebrospinal Division of the Academic Committee of the Japanese Society of Cardiovascular Anesthesiologists (JSCVA). J Anesth 2019; 33:167-196. [DOI: 10.1007/s00540-019-02610-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 01/02/2019] [Indexed: 11/29/2022]
|
23
|
Inazu M, Saiki I, Uchino H, Yamanaka T. Choline transporter-like protein 1 (CTL1/SLC44A1) is a therapeutic target molecule for prostate cancer therapy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz029.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
24
|
Yoshitani K, Masui K, Kawaguchi M, Kawamata M, Kakinohana M, Kato S, Hasuwa K, Yamakage M, Yoshikawa Y, Nishiwaki K, Aoyama T, Inagaki Y, Yamasaki K, Matsumoto M, Ishida K, Yamashita A, Seo K, Kakumoto S, Hayashi H, Tanaka Y, Tanaka S, Ishida T, Uchino H, Kakinuma T, Yamada Y, Mori Y, Izumi S, Nishimura K, Nakai M, Ohnishi Y. Clinical Utility of Intraoperative Motor-Evoked Potential Monitoring to Prevent Postoperative Spinal Cord Injury in Thoracic and Thoracoabdominal Aneurysm Repair: An Audit of the Japanese Association of Spinal Cord Protection in Aortic Surgery Database. Anesth Analg 2018; 126:763-768. [PMID: 29283918 DOI: 10.1213/ane.0000000000002749] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Spinal cord ischemic injury is the most devastating sequela of descending and thoracoabdominal aortic surgery. Motor-evoked potentials (MEPs) have been used to intraoperatively assess motor tract function, but it remains unclear whether MEP monitoring can decrease the incidence of postoperative motor deficits. Therefore, we reviewed multicenter medical records of patients who had undergone descending and thoracoabdominal aortic repair (both open surgery and endovascular repair) to assess the association of MEP monitoring with postoperative motor deficits. METHODS Patients included in the study underwent descending or thoracoabdominal aortic repair at 12 hospitals belonging to the Japanese Association of Spinal Cord Protection in Aortic Surgery between 2000 and 2013. Using multivariable mixed-effects logistic regression analysis, we investigated whether intraoperative MEP monitoring was associated with postoperative motor deficits at discharge after open and endovascular aortic repair. RESULTS We reviewed data from 1214 patients (open surgery, 601 [49.5%]; endovascular repair, 613 [50.5%]). MEP monitoring was performed in 631 patients and not performed in the remaining 583 patients. Postoperative motor deficits were observed in 75 (6.2%) patients at discharge. Multivariable logistic regression analysis revealed that postoperative motor deficits at discharge did not have a significant association with MEP monitoring (adjusted odds ratio [OR], 1.13; 95% confidence interval [CI], 0.69-1.88; P = .624), but with other factors: history of neural deficits (adjusted OR, 6.08; 95% CI, 3.10-11.91; P < .001), spinal drainage (adjusted OR, 2.14; 95% CI, 1.32-3.47; P = .002), and endovascular procedure (adjusted OR, 0.45; 95% CI, 0.27-0.76; P = .003). The sensitivity and specificity of MEP <25% of control value for motor deficits at discharge were 37.8% (95% CI, 26.5%-49.5%) and 95.5% (95% CI, 94.7%-96.4%), respectively. CONCLUSIONS MEP monitoring was not significantly associated with motor deficits at discharge.
Collapse
Affiliation(s)
- Kenji Yoshitani
- From the Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenichi Masui
- Department of Anesthesiology, National Defense Medical College, Tokorozawa, Japan.,Department of Anesthesiology, Showa University School of Medicine, Tokyo, Japan
| | | | - Mikito Kawamata
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Manabu Kakinohana
- Department of Anesthesiology, University of Ryukyu, Faculty of Medicine, Nishihara, Japan
| | - Shinya Kato
- From the Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kyoko Hasuwa
- From the Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Yusuke Yoshikawa
- Department of Anesthesiology, Sapporo Medical University, School of Medicine, Sapporo, Japan
| | - Kimitoshi Nishiwaki
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Chikusa-ku, Nagoya
| | - Tadashi Aoyama
- Department of Anesthesiology, Nagoya University Graduate School of Medicine, Chikusa-ku, Nagoya
| | - Yoshimi Inagaki
- Department of Anesthesiology and Critical Care and Medicine, Tottori University, Faculty of Medicine, Tottori, Japan
| | - Kazumasa Yamasaki
- Department of Anesthesiology and Critical Care and Medicine, Tottori University, Faculty of Medicine, Tottori, Japan
| | - Mishiya Matsumoto
- Department of Anesthesiology, Yamaguchi University, Graduate School of Medicine, Ube, Japan
| | - Kazuyoshi Ishida
- Department of Anesthesiology, Yamaguchi University, Graduate School of Medicine, Ube, Japan
| | - Atsuo Yamashita
- Department of Anesthesiology, Yamaguchi University, Graduate School of Medicine, Ube, Japan
| | - Katsuhiro Seo
- Department of Anesthesiology and Intensive Care Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Shinichi Kakumoto
- Department of Anesthesiology and Intensive Care Medicine, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Hironobu Hayashi
- Department of Anesthesiology, Nara Medical University, Kashihara, Japan
| | - Yuu Tanaka
- Department of Anesthesiology, Nara Medical University, Kashihara, Japan
| | - Satoshi Tanaka
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takashi Ishida
- Department of Anesthesiology and Resuscitology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - Takayasu Kakinuma
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - Yoshitsugu Yamada
- Department of Anesthesiology, Faculty of Vital Care Medicine, The Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiteru Mori
- Department of Anesthesiology, Faculty of Vital Care Medicine, The Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Izumi
- Department of Anesthesiology, University of Ryukyu, Faculty of Medicine, Nishihara, Japan
| | - Kunihiro Nishimura
- Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Michikazu Nakai
- Department of Statistics and Data Analysis, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiko Ohnishi
- From the Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| |
Collapse
|
25
|
Ishida Y, Fujita H, Aratani S, Chijiiwa M, Taniguchi N, Yokota M, Ogihara Y, Uoshima N, Nagashima F, Uchino H, Nakajima T. The NRF2‑PGC‑1β pathway activates kynurenine aminotransferase 4 via attenuation of an E3 ubiquitin ligase, synoviolin, in a cecal ligation/perforation‑induced septic mouse model. Mol Med Rep 2018; 18:2467-2475. [PMID: 29916549 DOI: 10.3892/mmr.2018.9175] [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] [Received: 06/15/2017] [Accepted: 03/15/2018] [Indexed: 11/06/2022] Open
Abstract
Sepsis‑associated encephalopathy (SAE) is a systemic inflammatory response syndrome of which the precise associated mechanisms remain unclear. Synoviolin (Syvn1) is an E3 ubiquitin ligase involved in conditions associated with chronic inflammation, including rheumatoid arthritis, obesity, fibrosis and liver cirrhosis. However, the role of Syvn1 in acute inflammation is not clear. The aim of the present study was to investigate the role of Syvn1 in a septic mouse model induced by cecal ligation/perforation (CLP). Metabolome analysis revealed that kynurenine (KYN), a key factor for the development of neuroinflammation, was increased in CLP‑induced septic mice. Notably, KYN was not detected in CLP‑induced septic Syvn1‑deficient mice. KYN is converted to kynurenic acid (KYNA) by kynurenine aminotransferases (KATs), which has a neuroprotective effect. The expression of KAT4 was significantly increased in Syvn1‑deficient mice compared to that in wild‑type mice. Promoter analysis demonstrated that Syvn1 knockdown induced the KAT4 promoter activity, as assessed by luciferase reporter activity, whereas Syvn1 overexpression repressed this activity in a dose‑dependent manner. Furthermore, the KAT4 promoter was significantly activated by the transcriptional factors, NF‑E2‑related factor 2 and peroxisome proliferator‑activated receptor coactivator 1β, which are targets of Syvn1‑induced degradation. In conclusion, the results of the current study demonstrates that the repression of Syvn1 expression induces the conversion of neurotoxic KYN to neuroprotective KYNA in a CLP‑induced mouse model of sepsis, and that Syvn1 is a potential novel target for the treatment of SAE.
Collapse
Affiliation(s)
- Yusuke Ishida
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Hidetoshi Fujita
- Institute of Medical Science, Tokyo Medical University, Tokyo 160‑8402, Japan
| | - Satoko Aratani
- Institute of Medical Science, Tokyo Medical University, Tokyo 160‑8402, Japan
| | - Miyuki Chijiiwa
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Noboru Taniguchi
- Department of Medicine of Sensory and Motor Organs, Division of Orthopedic Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Miyazaki 889‑1692, Japan
| | - Maho Yokota
- Institute of Medical Science, Tokyo Medical University, Tokyo 160‑8402, Japan
| | - Yukihiko Ogihara
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Naomi Uoshima
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Fumiaki Nagashima
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University Hospital, Tokyo 160‑0023, Japan
| | - Toshihiro Nakajima
- Institute of Medical Science, Tokyo Medical University, Tokyo 160‑8402, Japan
| |
Collapse
|
26
|
Abstract
SummaryThe effects of etamsylate on human platelet aggregation and ATP release as well as on the arachidonate metabolism by the platelet have been studied. Etamsylate enhanced these platelet functions induced by arachidonic add (AA), thromboxane A2, collagen and caldum ionophore A23187 but not those induced by ADP and epinephrine. In experiments with cyclooxygenase-inhibited platelets, AA-induced platelet aggregation was completely inhibited and it was not enhanced by etamsylate, while A23187-induced aggregation was partially inhibited and this aggregation was enhanced by etamsylate. Platelet AA metabolism including thrombin-induced AA liberation from phospholipids as well as the lipoxygenase and cyclo-oxygenase pathways was not significantly affected by etamsylate. These results suggested that etamsylate enhanced platelet response to thromboxane A2 and calcium ionophore and that this could be included as a mechanism for its potentiating effect on platelet functions.
Collapse
Affiliation(s)
- M Okuma
- The First Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - H Takayama
- The First Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - T Sugiyama
- The First Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - S Sensaki
- The First Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - H Uchino
- The First Division, Department of Internal Medicine, Faculty of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
27
|
Nagashima F, Nishiyama R, Iwao B, Kawai Y, Ishii C, Yamanaka T, Uchino H, Inazu M. Molecular and Functional Characterization of Choline Transporter-Like Proteins in Esophageal Cancer Cells and Potential Therapeutic Targets. Biomol Ther (Seoul) 2018; 26:399-408. [PMID: 29223141 PMCID: PMC6029686 DOI: 10.4062/biomolther.2017.113] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/06/2017] [Accepted: 07/28/2017] [Indexed: 01/27/2023] Open
Abstract
In this study, we examined the molecular and functional characterization of choline uptake in the human esophageal cancer cells. In addition, we examined the influence of various drugs on the transport of [3H]choline, and explored the possible correlation between the inhibition of choline uptake and apoptotic cell death. We found that both choline transporter-like protein 1 (CTL1) and CTL2 mRNAs and proteins were highly expressed in esophageal cancer cell lines (KYSE series). CTL1 and CTL2 were located in the plasma membrane and mitochondria, respectively. Choline uptake was saturable and mediated by a single transport system, which is both Na+-independent and pH-dependent. Choline uptake and cell viability were inhibited by various cationic drugs. Furthermore, a correlation analysis of the potencies of 47 drugs for the inhibition of choline uptake and cell viability showed a strong correlation. Choline uptake inhibitors and choline deficiency each inhibited cell viability and increased caspase-3/7 activity. We conclude that extracellular choline is mainly transported via a CTL1. The functional inhibition of CTL1 by cationic drugs could promote apoptotic cell death. Furthermore, CTL2 may be involved in choline uptake in mitochondria, which is the rate-limiting step in S-adenosylmethionine (SAM) synthesis and DNA methylation. Identification of this CTL1- and CTL2-mediated choline transport system provides a potential new target for esophageal cancer therapy.
Collapse
Affiliation(s)
- Fumiaki Nagashima
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Ryohta Nishiyama
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Beniko Iwao
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Yuiko Kawai
- Institute of Medical Science, Tokyo Medical University, Tokyo 160-8402, Japan
| | - Chikanao Ishii
- Institute of Medical Science, Tokyo Medical University, Tokyo 160-8402, Japan
| | - Tsuyoshi Yamanaka
- Department of Molecular Preventive Medicine, Tokyo Medical University, Tokyo 160-8402, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Masato Inazu
- Institute of Medical Science, Tokyo Medical University, Tokyo 160-8402, Japan.,Department of Molecular Preventive Medicine, Tokyo Medical University, Tokyo 160-8402, Japan
| |
Collapse
|
28
|
Uchino H, Kong VY, Bruce JL, Oosthuizen GV, Bekker W, Laing GL, Clarke DL. Preparing Japanese surgeons for potential mass casualty situations will require innovative and systematic programs. Eur J Trauma Emerg Surg 2017; 45:139-144. [PMID: 29119221 DOI: 10.1007/s00068-017-0871-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/31/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The ongoing state of global geo-political instability means that it is prudent to prepare civilian surgeons to manage major military-type trauma. Japan has enjoyed a prolonged period of peace and consequently it is unlikely that surgeons will have been exposed to a sufficient volume of cases. This study reviews the state of trauma training and preparedness in Japan and reviews the trauma workload of a major Japanese emergency medical center and compared with a major South African trauma center with the intention of quantifying and comparing the time needed to gain adequate exposure to major trauma at the two centers. MATERIALS AND METHODS The literature describing the surgical burden from a number of recent military missions was reviewed and the core surgical skills to manage military-type injuries were identified. We then went on to review all patients admitted to both Kurashiki Central Hospital (KCH) and Pietermaritzburg Metropolitan Trauma Service (PMTS) following trauma between the period September 2015 and August 2016. The burden of trauma at each center was quantified and the number of core surgical competencies or procedures performed at each center was then reviewed. These were then compared with the number of the core procedures which were performed on the reported military missions. RESULTS Three reports on military surgical missions were reviewed. These came from the Dutch, French and British military surgical services. The average number of each core procedures performed on each reported military surgery mission are tabulated in the text. The most common procedures were wound debridement and orthopedic fixation, followed by trauma laparotomy, neck exploration and thoracotomy. During the 12 month study period, 309 trauma patients were admitted to KCH. Of which 206 (67%) were male, and the mean age was 57 years. There were 10 penetrating injuries and 299 blunt injuries. Of the penetrating injuries there were no gunshot wounds. The mechanisms of injury for blunt trauma were as follows: Road traffic accidents (RTAs); 141 (47%), fall; 136 (46%) and other injuries; 22 (7%). In the same period, 2887 trauma patients were admitted by the PMTS. There were 1244 cases (43%) of penetrating trauma and 1644 cases (57%) of blunt trauma in PMTS. The mechanisms of injury for penetrating trauma were as follows: stab wounds (SWs); 955 (77%), gunshot wounds (GSWs); 252 (20%), and other injuries; 37 (3%) and for blunt trauma were as follows: assault; 739 (45%), RTAs; 669 (41%), fall; 166 (10%), and other injuries; 70 (4%). The exposure to all the key competencies required to manage trauma is overwhelmingly greater in South Africa than in Japan. The length of time needed to obtain an equivalent trauma exposure to that achieved in South Africa, working in Japan is prohibitively long. CONCLUSION Trauma training in Japan is hamstrung by a lack of clinical material as well as by systematic factors. Training a trauma surgeon is difficult. Developing a trauma system in the country may help address some of these deficits. South Africa in contrast has a huge burden of trauma and sufficient infrastructure to ensure that surgeons working there have adequate exposure to major trauma. Developing an academic exchange program between Japan and South Africa may allow for the transfer of trauma experience and skills between the two countries.
Collapse
Affiliation(s)
- H Uchino
- Kurashiki Central Hospital, Emergency and Critical Care Center, 1-1-1 Miwa, Kurashiki, Okayama, Japan.
| | - V Y Kong
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
| | - J L Bruce
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
| | - G V Oosthuizen
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
| | - W Bekker
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
| | - G L Laing
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
| | - D L Clarke
- Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, 719 Umbilo Rd, Durban, South Africa
- Department of Surgery, University of the Witwatersrand, 7 York Rd, Johannesburg, South Africa
| |
Collapse
|
29
|
Kanoh T, Mizumoto T, Yasuda N, Koya M, Ohno Y, Uchino H, Yoshimura K, Ohkubo Y, Yamaguchi H. Selective IgA Deficiency in Japanese Blood Donors:
Frequency and Statistical Analysis. Vox Sang 2017. [DOI: 10.1159/000461396] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
30
|
Takahashi N, Omi A, Uchino H, Kudo Y. Different characteristics of cell volume and intracellular calcium ion concentration dynamics between the hippocampal CA1 and lateral cerebral cortex of male mouse brain slices during exposure to hypotonic stress. J Neurosci Res 2017; 96:117-127. [DOI: 10.1002/jnr.24086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/11/2017] [Accepted: 05/04/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Nanae Takahashi
- Department of Anesthesiology; Tokyo Medical University Hachioji Medical Center; 1163 Tatemachi, Hachioji Tokyo 193-0998 Japan
| | - Akibumi Omi
- Department of Anesthesiology; Tokyo Medical University Hachioji Medical Center; 1163 Tatemachi, Hachioji Tokyo 193-0998 Japan
| | - Hiroyuki Uchino
- Depatment of Anesthesiology; Tokyo Medical University; 6-7-1 Nishishinjuku, Shinjuku Tokyo 160-0023 Japan
| | - Yoshihisa Kudo
- Department of Anesthesiology; Tokyo Medical University Hachioji Medical Center; 1163 Tatemachi, Hachioji Tokyo 193-0998 Japan
| |
Collapse
|
31
|
Rob D, Špunda R, Lindner J, Šmalcová J, Šmíd O, Kovárník T, Linhart A, Bìlohlávek J, Marinoni MM, Cianchi G, Trapani S, Migliaccio ML, Gucci L, Bonizzoli M, Cramaro A, Cozzolino M, Valente S, Peris A, Grins E, Kort E, Weiland M, Shresta NM, Davidson P, Algotsson L, Fitch S, Marco G, Sturgill J, Lee S, Dickinson M, Boeve T, Khaghani A, Wilton P, Jovinge S, Ahmad AN, Loveridge R, Vlachos S, Patel S, Gelandt E, Morgan L, Butt S, Whitehorne M, Kakar V, Park C, Hayes M, Willars C, Hurst T, Best T, Vercueil A, Auzinger G, Adibelli B, Akovali N, Torgay A, Zeyneloglu P, Pirat A, Kayhan Z, Schmidbauer SS, Herlitz J, Karlsson T, Friberg H, Knafelj R, Radsel P, Duprez F, Bonus T, Cuvelier G, Mashayekhi S, Maka M, Ollieuz S, Reychler G, Mosaddegh R, Abbasi S, Talaee S, Zotzmann VZ, Staudacher DS, Wengenmayer TW, Dürschmied DD, Bode CB, Nelskylä A, Nurmi J, Jousi M, Schramko A, Mervaala E, Ristagno G, Skrifvars M, Ozsoy G, Kendirli T, Azapagasi E, Perk O, Gadirova U, Ozcinar E, Cakici M, Baran C, Durdu S, Uysalel A, Dogan M, Ramoglu M, Ucar T, Tutar E, Atalay S, Akar R, Kamps M, Leeuwerink G, Hofmeijer J, Hoiting O, Van der Hoeven J, Hoedemaekers C, Konkayev A, Kuklin V, Kondratyev T, Konkayeva M, Akhatov N, Sovershaev M, Tveita T, Dahl V, Wihersaari L, Skrifvars MB, Bendel S, Kaukonen KM, Vaahersalo J, Romppanen J, Pettilä V, Reinikainen M, Lybeck A, Cronberg T, Nielsen N, Friberg H, Rauber M, Steblovnik K, Jazbec A, Noc M, Kalasbail P, Garrett F, Kulstad E, Bergström DJ, Olsson HR, Schmidbauer S, Friberg H, Mandel I, Mikheev S, Podoxenov Y, Suhodolo I, Podoxenov A, Svirko J, Sementsov A, Maslov L, Shipulin V, Vammen LV, Rahbek SR, Secher NS, Povlsen JP, Jessen NJ, Løfgren BL, Granfeldt AG, Grossestreuer A, Perman S, Patel P, Ganley S, Portmann J, Cocchi M, Donnino M, Nassar Y, Fathy S, Gaber A, Mokhtar S, Chia YC, Lewis-Cuthbertson R, Mustafa K, Sabra A, Evans A, Bennett P, Eertmans W, Genbrugge C, Boer W, Dens J, De Deyne C, Jans F, Skorko A, Thomas M, Casadio M, Coppo A, Vargiolu A, Villa J, Rota M, Avalli L, Citerio G, Moon JB, Cho JH, Park CW, Ohk TG, Shin MC, Won MH, Papamichalis P, Zisopoulou V, Dardiotis E, Karagiannis S, Papadopoulos D, Zafeiridis T, Babalis D, Skoura A, Staikos I, Komnos A, Passos SS, Maeda F, Souza LS, Filho AA, Granjeia TAG, Schweller M, Franci D, De Carvalho Filho M, Santos TM, De Azevedo P, Wall R, Welters I, Tansuwannarat P, Sanguanwit P, Langer T, Carbonara M, Caccioppola A, Fusarini CF, Carlesso E, Paradiso E, Battistini M, Cattaneo E, Zadek F, Maiavacca R, Stocchetti N, Pesenti A, Ramos A, Acharta F, Toledo J, Perezlindo M, Lovesio L, Dogliotti A, Lovesio C, Schroten N, Van der Veen B, De Vries MC, Veenstra J, Abulhasan YB, Rachel S, Châtillon-Angle M, Alabdulraheem N, Schiller I, Dendukuri N, Angle M, Frenette C, Lahiri S, Schlick K, Mayer SA, Lyden P, Akatsuka M, Arakawa J, Yamakage M, Rubio J, Mateo-Sidron JAR, Sierra R, Celaya M, Benitez L, Alvarez-Ossorio S, Rubio J, Mateo-Sidron JAR, Sierra R, Fernandez A, Gonzalez O, Engquist H, Rostami E, Enblad P, Toledo J, Ramos A, Acharta F, Canullo L, Nallino J, Dogliotti A, Lovesio C, Perreault M, Talic J, Frenette AJ, Burry L, Bernard F, Williamson DR, Adukauskiene D, Cyziute J, Adukauskaite A, Malciene L, Luca L, Rogobete A, Bedreag O, Papurica M, Sarandan M, Cradigati C, Popovici S, Vernic C, Sandesc D, Avakov V, Shakhova I, Trimmel H, Majdan M, Herzer GH, Sokoloff CS, Albert M, Williamson D, Odier C, Giguère J, Charbonney E, Bernard F, Husti Z, Kaptás T, Fülep Z, Gaál Z, Tusa M, Donnelly J, Aries M, Czosnyka M, Robba C, Liu M, Ercole A, Menon D, Hutchinson P, Smielewski P, López R, Graf J, Montes JM, Kenawi M, Kandil A, Husein K, Samir A, Heijneman J, Huijben J, Abid-Ali F, Stolk M, Van Bommel J, Lingsma H, Van der Jagt M, Cihlar RC, Mancino G, Bertini P, Forfori F, Guarracino F, Pavelescu D, Grintescu I, Mirea L, Alamri S, Tharwat M, Kono N, Okamoto H, Uchino H, Ikegami T, Fukuoka T, Simoes M, Trigo E, Coutinho P, Pimentel J, Franci A, Basagni D, Boddi M, Cozzolino M, Anichini V, Cecchi A, Peris A, Markopoulou D, Venetsanou K, Papanikolaou I, Barkouri T, Chroni D, Alamanos I, Cingolani E, Bocci MG, Pisapia L, Tersali A, Cutuli SL, Fiore V, Palma A, Nardi G, Antonelli M, Coke R, Kwong A, Dwivedi DJ, Xu M, McDonald E, Marshall JC, Fox-Robichaud AE, Charbonney E, Liaw PC, Kuchynska I, Malysh IR, Zgrzheblovska LV, Mestdagh L, Verhoeven EF, Hubloue I, Ruel-laliberte J, Zarychanski R, Lauzier F, Bonaventure PL, Green R, Griesdale D, Fowler R, Kramer A, Zygun D, Walsh T, Stanworth S, Léger C, Turgeon AF, Baron DM, Baron-Stefaniak J, Leitner GC, Ullrich R, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Tarabrin O, Mazurenko A, Potapchuk Y, Sazhyn D, Tarabrin P, Pérez AG, Silva J, Artemenko V, Bugaev A, Tokar I, Konashevskaya S, Kolesnikova IM, Roitman EV, Kiss TR, Máthé Z, Piros L, Dinya E, Tihanyi E, Smudla A, Fazakas J, Ubbink R, Boekhorst te P, Mik E, Caneva L, Ticozzelli G, Pirrelli S, Passador D, Riccardi F, Ferrari F, Roldi EM, Di Matteo M, Bianchi I, Iotti GA, Zurauskaite G, Voegeli A, Meier M, Koch D, Haubitz S, Kutz A, Bargetzi M, Mueller B, Schuetz P, Von Meijenfeldt G, Van der Laan M, Zeebregts C, Christopher KB, Vernikos P, Melissopoulou T, Kanellopoulou G, Panoutsopoulou M, Xanthis D, Kolovou K, Kypraiou T, Floros J, Broady H, Pritchett C, Marshman M, Jannaway N, Ralph C, Lehane CL, Keyl CK, Zimmer EZ, Trenk DT, Ducloy-Bouthors AS, Jonard MJ, Fourrier F, Piza F, Correa T, Marra A, Guerra J, Rodrigues R, Vilarinho A, Aranda V, Shiramizo S, Lima MR, Kallas E, Cavalcanti AB, Donoso M, Vargas P, Graf J, McCartney J, Ramsay S, McDowall K, Novitzky-Basso I, Wright C, Medic MG, Bielen L, Radonic V, Zlopasa O, Vrdoljak NG, Gasparovic V, Radonic R, Narváez G, Cabestrero D, Rey L, Aroca M, Gallego S, Higuera J, De Pablo R, González LR, Chávez GN, Lucas JH, Alonso DC, Ruiz MA, Valarezo LJ, De Pablo Sánchez R, Real AQ, Wigmore TW, Bendavid I, Cohen J, Avisar I, Serov I, Kagan I, Singer P, Hanison J, Mirza U, Conway D, Takasu A, Tanaka H, Otani N, Ohde S, Ishimatsu S, Coffey F, Dissmann P, Mirza K, Lomax M, Dissmann P, Coffey F, Mirza K, Lomax M, Miner JR, Leto R, Markota AM, Gradišek PG, Aleksejev VA, Sinkovič AS, Romagnoli S, Chelazzi C, Zagli G, Benvenuti F, Mancinelli P, Boninsegni P, Paparella L, Bos AT, Thomas O, Goslar T, Knafelj R, Perreault M, Martone A, Sandu PR, Rosu VA, Capilnean A, Murgoi P, Frenette AJ, Lecavalier A, Jayaraman D, Rico P, Bellemare P, Gelinas C, Williamson D, Nishida T, Kinoshita T, Iwata N, Yamakawa K, Fujimi S, Maggi L, Sposato F, Citterio G, Bonarrigo C, Rocco M, Zani V, De Blasi RA, Alcorn D, Barry L, Riedijk MA, Milstein DM, Caldas J, Panerai R, Camara L, Ferreira G, Bor-Seng-Shu E, Lima M, Galas F, Mian N, Nogueira R, de Oliveira GQ, Almeida J, Jardim J, Robinson TG, Gaioto F, Hajjar LA, Zabolotskikh I, Musaeva T, Saasouh W, Freeman J, Turan A, Saseedharan S, Pathrose E, Poojary S, Messika J, Martin Y, Maquigneau N, Henry-Lagarrigue M, Puechberty C, Stoclin A, Martin-Lefevre L, Blot F, Dreyfuss D, Dechanet A, Hajage D, Ricard J, Almeida E, Almeida J, Landoni G, Galas F, Fukushima J, Fominskiy E, De Brito C, Cavichio L, Almeida L, Ribeiro U, Osawa E, Boltes R, Battistella L, Hajjar L, Fontela P, Lisboa T, Junior LF, Friedman GF, Abruzzi F, Primo JAP, Filho PM, de Andrade JS, Brenner KM, boeira MS, Leães C, Rodrigues C, Vessozi A, Machado AS, Weiler M, Bryce H, Hudson A, Law T, Reece-Anthony R, Molokhia A, Abtahinezhadmoghaddam F, Cumber E, Channon L, Wong A, Groome R, Gearon D, Varley J, Wilson A, Reading J, Wong A, Zampieri FG, Bozza FA, Ferez M, Fernandes H, Japiassú A, Verdeal J, Carvalho AC, Knibel M, Salluh JI, Soares M, Gao J, Ahmadnia E, Patel B, McCartney J, MacKay A, Binning S, Wright C, Pugh RJ, Battle C, Hancock C, Harrison W, Szakmany T, Mulders F, Vandenbrande J, Dubois J, Stessel B, Siborgs K, Ramaekers D, Soares M, Silva UV, Homena WS, Fernandes GC, Moraes AP, Brauer L, Lima MF, De Marco F, Bozza FA, Salluh JI, Maric N, Mackovic M, Udiljak N, Bosso CE, Caetano RD, Cardoso AP, Souza OA, Pena R, Mescolotte MM, Souza IA, Mescolotte GM, Bangalore H, Borrows E, Barnes D, Ferreira V, Azevedo L, Alencar G, Andrade A, Bierrenbach A, Buoninsegni LT, Bonizzoli M, Cecci L, Cozzolino M, Peris A, Lindskog J, Rowland K, Sturgess P, Ankuli A, Molokhia A, Rosa R, Tonietto T, Ascoli A, Madeira L, Rutzen W, Falavigna M, Robinson C, Salluh J, Cavalcanti A, Azevedo L, Cremonese R, Da Silva D, Dornelles A, Skrobik Y, Teles J, Ribeiro T, Eugênio C, Teixeira C, Zarei M, Hashemizadeh H, Eriksson M, Strandberg G, Lipcsey M, Larsson A, Lignos M, Crissanthopoulou E, Flevari K, Dimopoulos P, Armaganidis A, Golub JG, Markota AM, Stožer AS, Sinkovič AS, Rüddel H, Ehrlich C, Burghold CM, Hohenstein C, Winning J, Sellami W, Hajjej Z, Bousselmi M, Gharsallah H, Labbene I, Ferjani M, Sattler J, Steinbrunner D, Poppert H, Schneider G, Blobner M, Kanz KG, Schaller SJ, Apap K, Xuereb G, Xuereb G, Apap K, Massa L, Xuereb G, Apap K, Massa L, Delvau N, Penaloza A, Liistro G, Thys F, Delattre IK, Hantson P, Roy PM, Gianello P, Hadîrcă L, Ghidirimschi A, Catanoi N, Scurtov N, Bagrinovschi M, Sohn YS, Cho YC, Golovin B, Creciun O, Ghidirimschi A, Bagrinovschi M, Tabbara R, Whitgift JZ, Ishimaru A, Yaguchi A, Akiduki N, Namiki M, Takeda M, Tamminen JN, Reinikainen M, Uusaro A, Taylor CG, Mills ED, Mackay AD, Ponzoni C, Rabello R, Serpa A, Assunção M, Pardini A, Shettino G, Corrêa T, Vidal-Cortés PV, Álvarez-Rocha L, Fernández-Ugidos P, Virgós-Pedreira A, Pérez-Veloso MA, Suárez-Paul IM, Del Río-Carbajo L, Fernández SP, Castro-Iglesias A, Butt A, Alghabban AA, Khurshid SK, Ali ZA, Nizami IN, Salahuddin NS, Alshahrani M, Alsubaie AW, Alshamsy AS, Alkhiliwi BA, Alshammari HK, Alshammari MB, Telmesani NK, Alshammari RB, Asonto LP, Zampieri FG, Damiani LP, Bozza F, Salluh JI, Cavalcanti AB, El Khattate A, Bizrane M, Madani N, Belayachi J, Abouqal R, Ramnarain D, Gouw-Donders B, Benstoem C, Moza A, Meybohm P, Stoppe C, Autschbach R, Devane D, Goetzenich A, Taniguchi LU, Araujo L, Salgado G, Vieira JM, Viana J, Ziviani N, Pessach I, Lipsky A, Nimrod A, O´Connor M, Matot I, Segal E, Kluzik A, Gradys A, Smuszkiewicz P, Trojanowska I, Cybulski M, De Jong A, Sebbane M, Chanques G, Jaber S, Rosa R, Robinson C, Bessel M, Cavalheiro L, Madeira L, Rutzen W, Oliveira R, Maccari J, Falavigna M, Sanchez E, Dutra F, Dietrich C, Balzano P, Rezende J, Teixeira C, Sinha S, Majhi K, Gorlicki JG, Pousset FP, Kelly J, Aron J, Gilbert AC, Urankar NP, Knafelj R, Irazabal M, Bosque M, Manciño J, Kotsopoulos A, Jansen N, Abdo W, Casey ÚM, O’Brien B, Plant R, Doyle B. 37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3). Crit Care 2017. [PMCID: PMC5374552 DOI: 10.1186/s13054-017-1630-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
32
|
Kazumata K, Tha KK, Narita H, Ito YM, Shichinohe H, Ito M, Uchino H, Abumiya T. Characteristics of Diffusional Kurtosis in Chronic Ischemia of Adult Moyamoya Disease: Comparing Diffusional Kurtosis and Diffusion Tensor Imaging. AJNR Am J Neuroradiol 2016; 37:1432-9. [PMID: 27012294 DOI: 10.3174/ajnr.a4728] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 01/07/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Detecting microstructural changes due to chronic ischemia potentially enables early identification of patients at risk of cognitive impairment. In this study, diffusional kurtosis imaging and diffusion tensor imaging were used to investigate whether the former provides additional information regarding microstructural changes in the gray and white matter of adult patients with Moyamoya disease. MATERIALS AND METHODS MR imaging (diffusional kurtosis imaging and DTI) was performed in 23 adult patients with Moyamoya disease and 23 age-matched controls. Three parameters were extracted from diffusional kurtosis imaging (mean kurtosis, axial kurtosis, and radial kurtosis), and 4, from DTI (fractional anisotropy, radial diffusivity, mean diffusivity, and axial diffusivity). Voxelwise analysis for these parameters was performed in the normal-appearing brain parenchyma. The association of these parameters with neuropsychological performance was also evaluated. RESULTS Voxelwise analysis revealed the greatest differences in fractional anisotropy, followed, in order, by radial diffusivity, mean diffusivity, and mean kurtosis. In patients, diffusional kurtosis imaging parameters were decreased in the dorsal deep white matter such as the corona radiata and superior longitudinal fasciculus (P < .01), including areas without DTI abnormality. Superior longitudinal fasciculus fiber-crossing areas showed weak correlations between diffusional kurtosis imaging and DTI parameters compared with tissues with a single-fiber direction (eg, the corpus callosum). Diffusional kurtosis imaging parameters were associated with general intelligence and frontal lobe performance. CONCLUSIONS Although DTI revealed extensive white matter changes, diffusional kurtosis imaging additionally demonstrated microstructural changes in ischemia-prone deep white matter with abundant fiber crossings. Thus, diffusional kurtosis imaging may be a useful adjunct for detecting subtle chronic ischemic injuries.
Collapse
Affiliation(s)
- K Kazumata
- From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.)
| | - K K Tha
- Radiobiology and Medical Engineering (K.K.T.)
| | | | - Y M Ito
- Biostatistics (Y.M.I.), Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Shichinohe
- From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.)
| | - M Ito
- From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.)
| | - H Uchino
- From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.)
| | - T Abumiya
- From the Departments of Neurosurgery (K.K., H.S., M.I., H.U., T.A.)
| |
Collapse
|
33
|
Nishiyama R, Nagashima F, Iwao B, Kawai Y, Inoue K, Midori A, Yamanaka T, Uchino H, Inazu M. Identification and functional analysis of choline transporter in tongue cancer: A novel molecular target for tongue cancer therapy. J Pharmacol Sci 2016; 131:101-9. [DOI: 10.1016/j.jphs.2016.04.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 04/14/2016] [Accepted: 04/24/2016] [Indexed: 12/21/2022] Open
|
34
|
Uchino H, Ogihara Y, Fukui H, Chijiiwa M, Sekine S, Hara N, Elmér E. Brain injury following cardiac arrest: pathophysiology for neurocritical care. J Intensive Care 2016; 4:31. [PMID: 27123307 PMCID: PMC4847238 DOI: 10.1186/s40560-016-0140-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/04/2016] [Indexed: 11/27/2022] Open
Abstract
Cardiac arrest induces the cessation of cerebral blood flow, which can result in brain damage. The primary intervention to salvage the brain under such a pathological condition is to restore the cerebral blood flow to the ischemic region. Ischemia is defined as a reduction in blood flow to a level that is sufficient to alter normal cellular function. Brain tissue is highly sensitive to ischemia, such that even brief ischemic periods in neurons can initiate a complex sequence of events that may ultimately culminate in cell death. However, paradoxically, restoration of blood flow can cause additional damage and exacerbate the neurocognitive deficits in patients who suffered a brain ischemic event, which is a phenomenon referred to as “reperfusion injury.” Transient brain ischemia following cardiac arrest results from the complex interplay of multiple pathways including excitotoxicity, acidotoxicity, ionic imbalance, peri-infarct depolarization, oxidative and nitrative stress, inflammation, and apoptosis. The pathophysiology of post-cardiac arrest brain injury involves a complex cascade of molecular events, most of which remain unknown. Many lines of evidence have shown that mitochondria suffer severe damage in response to ischemic injury. Mitochondrial dysfunction based on the mitochondrial permeability transition after reperfusion, particularly involving the calcineurin/immunophilin signal transduction pathway, appears to play a pivotal role in the induction of neuronal cell death. The aim of this article is to discuss the underlying pathophysiology of brain damage, which is a devastating pathological condition, and highlight the central signal transduction pathway involved in brain damage, which reveals potential targets for therapeutic intervention.
Collapse
Affiliation(s)
- Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Yukihiko Ogihara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Hidekimi Fukui
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Miyuki Chijiiwa
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Shusuke Sekine
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Naomi Hara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023 Japan
| | - Eskil Elmér
- Mitochondrial Pathophysiology Unit, Department of Clinical Sciences, Lund University, Box 117, 221 00 Lund, Sweden
| |
Collapse
|
35
|
Bilotta F, Lauretta MP, Tewari A, Haque M, Hara N, Uchino H, Rosa G. Insulin and the Brain: A Sweet Relationship With Intensive Care. J Intensive Care Med 2015; 32:48-58. [PMID: 26168800 DOI: 10.1177/0885066615594341] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 01/20/2015] [Revised: 04/28/2015] [Accepted: 05/15/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Insulin receptors (IRs) in the brain have unique molecular features and a characteristic pattern of distribution. Their possible functions extend beyond glucose utilization. In this systematic review, we explore the interactions between insulin and the brain and its implications for anesthesiologists, critical care physicians, and other medical disciplines. METHODS A literature search of published preclinical and clinical studies between 1978 and 2014 was conducted, yielding 5996 articles. After applying inclusion and exclusion criteria, 92 studies were selected for this systematic review. RESULTS The IRs have unique molecular features, pattern of distribution, and mechanism of action. It has effects on neuronal function, metabolism, and neurotransmission. The IRs are involved in neuronal apoptosis and neurodegenerative processes. CONCLUSION In this systematic review, we present a close relationship between insulin and the brain, with discernible effects on memory, learning abilities, and motor functions. The potential therapeutic effects extend from acute brain insults such as traumatic brain injury, brain ischemia, and hemorrhage, to chronic neurodegenerative diseases such as Alzheimer and Parkinson disease. An understanding of the wider effects of insulin conveyed in this review will prompt anaesthesiologists and critical care physicians to consider its therapeutic potential and guide future studies.
Collapse
Affiliation(s)
- F Bilotta
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| | - M P Lauretta
- Anesthesia and Intensive Care Department, "La Sapienza" University of Rome, Rome, Italy .,Critical Care Department, University College London Hospital, London, United Kingdom
| | - A Tewari
- Department of Pediatric Neuroanesthesia and IONM, Cincinnati Children Hospital & Medical Center, Cincinnati, OH, USA
| | - M Haque
- Anesthesia and Critical Care Department, University College London Hospital, London, United Kingdom
| | - N Hara
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - H Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan
| | - G Rosa
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
36
|
Tomino M, Miyata K, Takeshita Y, Kaneko K, Kanazawa H, Uchino H. [A Case of Mitral Valvular Re-repair in a Patient with Hemolytic Anemia after Mitral Valvular Repair]. Masui 2015; 64:761-763. [PMID: 26422945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A 54-year-old woman was admitted for mitral valvular repair. After folding plasty to A3, a 30 mm Cosgrove-Edwards ring was placed. There was no mitral regurgitation jet observed by transesophageal echocardiography (TEE) during the operation. However, high blood pressure was monitored and treated in the intensive care unit, hemolytic anemia developed, and the serum lactate dehydrogenase level was elevated. Two weeks after the operation, serum lactate dehydrogenase was again elevated. TEE showed mild mitral regurgitation and the regurgitation jet colliding with the annuloplasty ring. Multiple transfusions of red blood cells were required. Repeat surgery was therefore undertaken. Lam and associates previously studying patients on hemolysis after mitral valvular repair noted high grade mitral regurgitation jets fragmented or accelerated. In the present case, mitral regurgitation was mild, but the high velocity and manner of regurgitation (collision with the annuloplasty ring) could cause hemolytic anemia. In the present case, high blood pressure might have caused chordae rupture. Furthermore, a flexible ring, such as the Cosgrove-Edwards ring, is likely to cause hemolytic anemia. As contributing factors to hemolysis after mitral valvular repair, perioperative blood pressure management and type of ring are significant.
Collapse
|
37
|
Yara M, Iwao B, Hara N, Yamanaka T, Uchino H, Inazu M. Molecular and functional characterization of choline transporter in the human trophoblastic cell line JEG-3 cells. Placenta 2015; 36:631-7. [PMID: 25896522 DOI: 10.1016/j.placenta.2015.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 03/23/2015] [Accepted: 03/31/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Choline is essential for the synthesis of the major membrane phospholipid phosphatidylcholine (PC), the methyl donor betaine and the neurotransmitter acetylcholine (ACh), which is involved in several vital biological functions that play key roles in fetal development. In this study, we examined the molecular and functional characteristics of choline uptake in the human trophoblastic cell line JEG-3. METHODS We examined [(3)H]choline uptake in the human trophoblastic cell line JEG-3. The expression of CTL1 and CTL2 was evaluated by quantitative real-time PCR, western blotting and immunocytochemistry. RESULTS We demonstrated that JEG-3 cells take up [(3)H] choline by a saturable process that is mediated by a Na(+)-independent and pH-dependent transport system. The cells have two different [(3)H] choline transport systems, high- and low-affinity, with Km values of 28.4 ± 5.0 μM and 210.6 ± 55.1 μM, respectively. Cationic compounds and hemicholinium-3 (HC-3) inhibited choline uptake. Choline transporter-like protein 1 (CTL1) and CTL2 mRNA and protein were highly expressed in JEG-3 cells and were localized to the plasma membrane. DISCUSSION The present results suggest that choline is mainly transported via a high-affinity choline transport system (CTL1) and a low-affinity choline transport system (CTL2) in human trophoblastic JEG-3 cells. These transporters play an important role in the growth of the fetus.
Collapse
Affiliation(s)
- M Yara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - B Iwao
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - N Hara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - T Yamanaka
- Department of Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - H Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - M Inazu
- Department of Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan.
| |
Collapse
|
38
|
Fujita H, Yagishita N, Aratani S, Saito-Fujita T, Morota S, Yamano Y, Hansson MJ, Inazu M, Kokuba H, Sudo K, Sato E, Kawahara KI, Nakajima F, Hasegawa D, Higuchi I, Sato T, Araya N, Usui C, Nishioka K, Nakatani Y, Maruyama I, Usui M, Hara N, Uchino H, Elmer E, Nishioka K, Nakajima T. The E3 ligase synoviolin controls body weight and mitochondrial biogenesis through negative regulation of PGC-1β. EMBO J 2015; 34:1042-55. [PMID: 25698262 DOI: 10.15252/embj.201489897] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [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: 08/26/2014] [Accepted: 01/19/2015] [Indexed: 12/26/2022] Open
Abstract
Obesity is a major global public health problem, and understanding its pathogenesis is critical for identifying a cure. In this study, a gene knockout strategy was used in post-neonatal mice to delete synoviolin (Syvn)1/Hrd1/Der3, an ER-resident E3 ubiquitin ligase with known roles in homeostasis maintenance. Syvn1 deficiency resulted in weight loss and lower accumulation of white adipose tissue in otherwise wild-type animals as well as in genetically obese (ob/ob and db/db) and adipose tissue-specific knockout mice as compared to control animals. SYVN1 interacted with and ubiquitinated the thermogenic coactivator peroxisome proliferator-activated receptor coactivator (PGC)-1β, and Syvn1 mutants showed upregulation of PGC-1β target genes and increase in mitochondrion number, respiration, and basal energy expenditure in adipose tissue relative to control animals. Moreover, the selective SYVN1 inhibitor LS-102 abolished the negative regulation of PGC-1β by SYVN1 and prevented weight gain in mice. Thus, SYVN1 is a novel post-translational regulator of PGC-1β and a potential therapeutic target in obesity treatment.
Collapse
Affiliation(s)
- Hidetoshi Fujita
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Naoko Yagishita
- Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Satoko Aratani
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Tomoko Saito-Fujita
- Department of Obstetrics and Gynecology University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Saori Morota
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Yoshihisa Yamano
- Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Magnus J Hansson
- Mitochondrial Pathophysiology Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Masato Inazu
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hiroko Kokuba
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Katsuko Sudo
- Animal Research Center, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Eiichi Sato
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Medical Research Center, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan
| | - Ko-Ichi Kawahara
- Department of Biomedical Engineering, Osaka Institute of Technology, Asahi-ku, 11Neurology and Geriatrics, Japan
| | - Fukami Nakajima
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Daisuke Hasegawa
- Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Itsuro Higuchi
- Neurology and Geriatrics, Faculty of Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Tomoo Sato
- Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Natsumi Araya
- Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Chie Usui
- Department of Psychiatry, Juntendo University Nerima Hospital, Nerima-ku, Tokyo, Japan
| | - Kenya Nishioka
- Department of Neurology, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yu Nakatani
- Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Ikuro Maruyama
- Laboratory and Vascular Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan
| | - Masahiko Usui
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Naomi Hara
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Eskil Elmer
- Mitochondrial Pathophysiology Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kusuki Nishioka
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan
| | - Toshihiro Nakajima
- Institute of Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Department of Future Medical Science, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan Institute of Medical Science, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan Medical Research Center, Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan Department of Biomedical Engineering, Osaka Institute of Technology, Asahi-ku, 11Neurology and Geriatrics, Japan integrated Gene Editing Section (iGES), Tokyo Medical University Hospital, Shinjuku-ku, Tokyo, Japan Bayside Misato Medical Center, Niida, Kōchi, Japan
| |
Collapse
|
39
|
Kato Y, Okamoto H, Uchino H, Fukuoka T. Comparison of video laryngoscopy with direct laryngoscopy in patients with good glottic visualization: an observational study of 348 emergency intubations. Crit Care 2015. [PMCID: PMC4470914 DOI: 10.1186/cc14287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
40
|
Sekine S, Imaizumi H, Masumoto K, Uchino H. Usefulness of endotoxin activity assay for early diagnosis of sepsis. Crit Care 2015. [PMCID: PMC4472523 DOI: 10.1186/cc14129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
41
|
Inazu M, Taguchi C, Yamanaka T, Uchino H. 175 Functional analysis of [methyl-3H]choline uptake in glioblastoma cells: Influence of anti-cancer and central nervous system drugs. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
42
|
Uchino H, Nagashima F, Nishiyama R, Ishida Y, Saiki I, Yara M, Hara N. [Pathophysiology and mechanisms of postoperative cognitive dysfunction]. Masui 2014; 63:1202-1210. [PMID: 25731051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Postoperative cognitive impairment is a recognized clinical phenomenon. Previously, such clinical findings were called "adverse cerebral effects of anesthesia on old people". POCD is transient disturbance that can affect patients of any age but is more common in elderly people. Its relevance with the immediate post-operative phase was made clear. The aging of the population and new developments in medicine both lead to the increasing number of elderly patietnts undergoing extensive surgery. Mechanism of POCD is considered to be due to the inflammatory response and Ca2+ dysregulation of the brain. For the diagnosis of POCD, pscychometric tests are applied. Risk factors for POCD are aging, extensive invasive operations, intra and postoperative complications, and anesthetics. To reduce POCD, it is necessary to provide preoperative screening and cognitive training, minimally invasive surgery, the use of short-acting agents, meticulous anesthetic technique to prevent perioperative disturbances of homeostasis and organ ischemia, tight volume balance, and EEG monitoring.
Collapse
|
43
|
Yara M, Tomino M, Miyata K, Ishida Y, Saiki I, Seta N, Hara N, Uchino H. [Perioperative management of off-pump CABG for a 93-year-old man]. Masui 2014; 63:1146-1148. [PMID: 25693348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In recent years, the aging population has been growing, and the operative techniques and anesthetic methods have advanced. With these developments and medical support, the number of operations on very elderly patients has been increasing. We report the perioperative management of off-pump CABG for a 93-year-old man. When the heart was displaced during the operation, hypotension was induced and a marked reduction of his bispectral index (BIS) to "1" appeared. During the perioperative period, the patient developed delirium that was difficult to manage, but he was discharged from the hospital without any complications on POD 21. As part of the perioperative management, intraoperative cerebral circulatory management with attention to cerebral perfusion and prevention of postoperative delirium is crucial.
Collapse
|
44
|
Taguchi C, Inazu M, Saiki I, Yara M, Hara N, Yamanaka T, Uchino H. Functional analysis of [methyl-(3)H]choline uptake in glioblastoma cells: Influence of anti-cancer and central nervous system drugs. Biochem Pharmacol 2014; 88:303-12. [PMID: 24530235 DOI: 10.1016/j.bcp.2014.01.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 01/18/2014] [Accepted: 01/23/2014] [Indexed: 11/25/2022]
Abstract
Positron emission tomography (PET) and PET/computed tomography (PET-CT) studies with (11)C- or (18)F-labeled choline derivatives are used for PET imaging in glioblastoma patients. However, the nature of the choline transport system in glioblastoma is poorly understood. In this study, we performed a functional characterization of [methyl-(3)H]choline uptake and sought to identify the transporters that mediate choline uptake in the human glioblastoma cell lines A-172 and U-251MG. In addition, we examined the influence of anti-cancer drugs and central nervous system drugs on the transport of [methyl-(3)H]choline. High- and low-affinity choline transport systems were present in A-172 cells, U-251MG cells and astrocytes, and these were Na(+)-independent and pH-dependent. Cell viability in A-172 cells was not affected by choline deficiency. However, cell viability in U-251MG cells was significantly inhibited by choline deficiency. Both A-172 and U-251MG cells have two different choline transporters, choline transporter-like protein 1 (CTL1) and CTL2. In A-172 cells, CTL1 is predominantly expressed, whereas in U-251MG cells, CTL2 is predominantly expressed. Treatment with anti-cancer drugs such as cisplatin, etoposide and vincristine influenced [methyl-(3)H]choline uptake in U-251MG cells, but not A-172 cells. Central nervous system drugs such as imipramine, fluvoxamine, paroxetine, reboxetine, citalopram and donepezil did not affect cell viability or [methyl-(3)H]choline uptake. The data presented here suggest that CTL1 and CTL2 are functionally expressed in A-172 and U-251MG cells and are responsible for [methyl-(3)H]choline uptake that relies on a directed H(+) gradient as a driving force. Furthermore, while anti-cancer drugs altered [methyl-(3)H]choline uptake, central nervous system drugs did not affect [methyl-(3)H]choline uptake.
Collapse
Affiliation(s)
- Chiaki Taguchi
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Masato Inazu
- Institute of Medical Science, Tokyo Medical University, 6-1-1 Shinjyuku, Shinjyuku-ku, Tokyo 160-8402, Japan; Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjyuku, Shinjyuku-ku, Tokyo 160-8402, Japan.
| | - Iwao Saiki
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Miki Yara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Naomi Hara
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan
| | - Tsuyoshi Yamanaka
- Department of Molecular Preventive Medicine, Tokyo Medical University, 6-1-1 Shinjyuku, Shinjyuku-ku, Tokyo 160-8402, Japan
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, 6-7-1 Nishishinjyuku, Shinjyuku-ku, Tokyo 160-0023, Japan
| |
Collapse
|
45
|
|
46
|
Miyata K, Uchino H. [Intensive care for CKD patients]. Masui 2013; 62:1336-1343. [PMID: 24364275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In Japan, the number of patients with chronic kidney disease (CKD) has increased. Hence, the opportunities for intensive care management of patients with CKD have also increased. Acute kidney injury (AKI) easily develops following CKD, and conversely, it can be a risk factor for CKD. At the time when CKD patients require ICU admission, their disease is already very severe, and the mortality rate tends to be high due to a number of associated complications. During the hemodynamic management of these patients, not only static indices such as CVP, but also dynamic indices such as stroke volume variation (SVV) should be used, since their circulation is very precariously balanced. While "goal-directed" hemodynamic management, which targets particular hemodynamic variables, might be useful in CKD patients, there is no evidence to prove its efficacy. Renal Replacement Therapy (RRT) is usually started after metabolic acidosis, hyperkalemia, ingestion of dialyzable toxin, volume overload and uremia have occurred. However, it is not clear whether continuous or intermittent RRT is beneficial in these patients.
Collapse
Affiliation(s)
- Kazuto Miyata
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023
| | - Hiroyuki Uchino
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-0023
| |
Collapse
|
47
|
Iwase N, Fukui H, Yuunaiyama Y, Kaneko K, Ohseto K, Uchino H. [The efficacy of ultrasound-guided infraorbital nerve block with hockey stick typed probe]. Masui 2013; 62:1210-1213. [PMID: 24228458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report a case of ultrasound-guided infraorbital nerve block with a hockey stick typed probe in plane approach. Individual difference of infraorbital anatomy makes it difficult to puncture the infraorbital for a man, and the risks include bleeding, double vision and paranasal sinus puncture. The advantage of ultrasound-guided nerve block has been reported. Compared with conventional land mark method approach, ultrasound technique is thought to be easy to perform, more quickly and safely without any complications. From our results, we have demonstrated that ultrasound-guided infraorbital nerve block assisted by hockey stick typed probe could become one of the safe methods for this purpose.
Collapse
Affiliation(s)
- Naoto Iwase
- Department of Anesthesiology, Tokyo Medical University, Tokyo 160-8402
| | | | | | | | | | | |
Collapse
|
48
|
Miyashita R, Chen L, Morizane Y, Takeshita Y, Fukui H, Ishizaki T, Hatakeyama K, Ohseto K, Shibasaki F, Uchino H. Cytokine marker measurement in human neuroblastoma cells with supersensitive and multiplex assay: MUSTag technology. Acta Neurochir Suppl 2013; 118:317-20. [PMID: 23564157 DOI: 10.1007/978-3-7091-1434-6_62] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Recently, various sets of protein -biomarkers have been discovered in important diseases such as cancers, brain stroke and heart attack. However, clinical validation is difficult and time-consuming by individual assays or because of very low concentrations at early stages of the diseases. We have developed assay technology through an innovative modification of the immuno-PCR method for the super-sensitive and multiplex detection of target biomarkers. METHODS In the assay technology, each different oligo-tag simultaneously detects multiplex protein targets with extremely high-level sensitivity in a dose-dependent manner by qRT-PCR (maximum: three plexes). In this study, we measured specific secreted protein concentrations in the culture supernatant of a 24-h culture of transfected SH-SY5Y cells with MUSTag. RESULTS There was a significant increase in the protein level of tumor necrosis factor (TNF)-α measured with extremely high-level sensitivity (≥10 pg/mL). Compared with negative controls, the levels of TNF-α increased from 16.9 to 28.1 pg/mL (p = 0.011). CONCLUSION We suggest that our assay technology might be of clinical value in treating patients with cancer, cerebral ischemia, or patients who need a prompt and predictive diagnosis for adequate treatment.
Collapse
Affiliation(s)
- Ryoichi Miyashita
- Department of Anesthesiology, Tokyo Medical University, Tokyo, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Takeshita Y, Hashimoto Y, Nawa M, Uchino H, Matsuoka M. SH3-binding protein 5 mediates the neuroprotective effect of the secreted bioactive peptide humanin by inhibiting c-Jun NH2-terminal kinase. J Biol Chem 2013; 288:24691-704. [PMID: 23861391 DOI: 10.1074/jbc.m113.469692] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Humanin is a secreted bioactive peptide that suppresses cell toxicity caused by a variety of insults. The neuroprotective effect of Humanin against Alzheimer disease (AD)-related death is mediated by the binding of Humanin to its heterotrimeric Humanin receptor composed of ciliary neurotrophic receptor α, WSX-1, and gp130, as well as the activation of intracellular signaling pathways including a JAK2 and STAT3 signaling axis. Despite the elucidation of the signaling pathways by which Humanin mediates its neuroprotection, the transcriptional targets of Humanin that behaves as effectors of Humanin remains undefined. In the present study, Humanin increased the mRNA and protein expression of SH3 domain-binding protein 5 (SH3BP5), which has been known to be a JNK interactor, in neuronal cells. Similar to Humanin treatment, overexpression of SH3BP5 inhibited AD-related neuronal death, while siRNA-mediated knockdown of endogenous SH3BP5 expression attenuated the neuroprotective effect of Humanin. These results indicate that SH3BP5 is a downstream effector of Humanin. Furthermore, biochemical analysis has revealed that SH3BP5 binds to JNK and directly inhibits JNK through its two putative mitogen-activated protein kinase interaction motifs (KIMs).
Collapse
Affiliation(s)
- Yuji Takeshita
- Department of Pharmacology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | | | | | | | | |
Collapse
|
50
|
Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J, Inoue M, Tsugane S, Sobue T, Hanaoka T, Ogata J, Baba S, Mannami T, Okayama A, K. Y, Miyakawa K, Saito F, Koizumi A, Sano Y, Hashimoto I, Ikuta T, Tanaba Y, Miyajima Y, Suzuki N, Nagasawa S, Furusugi Y, Nagai N, Sanada H, Hatayama Y, Kobayashi F, Uchino H, Shirai Y, Kondo T, Sasaki R, Watanabe Y, Miyagawa Y, Kobayashi Y, Machida M, Kishimoto Y, Takara E, Fukuyama T, Kinjo M, Irei M, Sakiyama H, Imoto K, Yazawa H, Seo T, Seiko A, Ito F, Shoji F, Saito R, Murata A, Minato K, Motegi K, Fujieda T, Abe T, Katagiri M, Suzuki M, Matsui K, Doi M, Terao A, Ishikawa Y, Tagami T, Doi H, Urata M, Okamoto N, Ide F, Sueta H, Sakiyama H, Onga N, Takaesu H, Uehara M, Horii F, Asano I, Yamaguchi H, Aoki K, Maruyama S, Ichii M, Takano M, Matsushima S, Natsukawa S, Akabane M, Konishi M, Okada K, Honda Y, Sakurai KYS, Tsuchiya N, Sugimura H, Tsubono Y, Kabuto M, Tominaga S, Iida M, Ajiki W, Ioka A, Sato S, Yasuda N, Nakamura K, Kono S, Suzuki K, Takashima Y, Yoshida M, Maruyama E, Yamaguchi M, Matsumura Y, Sasaki S, Watanabe S, Kadowaki T, Noda M, Mizoue T, Kawaguchi Y, Shimizu H. Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: the JPHC Study. Eur Heart J 2013; 34:1225-32. [DOI: 10.1093/eurheartj/eht043] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|