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Sakai H, Kikuchi K, Masuda K, Sai Y, Yoshino K, Ito J, Fukita K. Adjunctive Technique for Proximal Anastomosis via Right Anterior Small Thoracotomy in Minimally Invasive Coronary Artery Bypass Grafting. Innovations (Phila) 2024:15569845241237541. [PMID: 38504143 DOI: 10.1177/15569845241237541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Hiroki Sakai
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Keita Kikuchi
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Kaito Masuda
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Yoshun Sai
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Kunihiko Yoshino
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Kouji Fukita
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
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Noguchi M, Tabata M, Ito J, Kato N, Obunai K, Watanabe H, Yashima F, Watanabe Y, Naganuma T, Yamawaki M, Yamanaka F, Shirai S, Ueno H, Tada N, Yamamoto M, Hayashida K. Midterm outcomes of transcatheter aortic valve replacement in patients with active cancer. Open Heart 2024; 11:e002573. [PMID: 38417913 PMCID: PMC10900309 DOI: 10.1136/openhrt-2023-002573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/15/2024] [Indexed: 03/01/2024] Open
Abstract
OBJECTIVES The clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS) and concomitant active cancer remain insufficiently explored. This study aimed to assess the midterm outcomes of TAVR in patients diagnosed with AS and active cancer. METHODS Data from the OCEAN-TAVI, a prospective Japanese registry of TAVR procedures, was analysed to compare prognoses and clinical outcomes in patients with and without active cancer at the time of TAVR. RESULTS Of the 2336 patients who underwent TAVR from October 2013 to July 2017, 89 patients (3.8%) had active cancer, whereas 2247 did not. Among patients with active cancer, 49 had limited-stage cancer (stage 1 or 2). The prevalent cancers identified before TAVR were colon (21%), prostate (18%), lung (15%), liver (11%) and breast (9%). Although the periprocedural complications and 30-day mortality rates were comparable between the groups, the 3-year survival rate after TAVR was notably lower in patients with active cancer (64.7%) than in those without active cancer (74.7%; p=0.016). Nevertheless, the 3-year survival rate of patients with limited-stage cancer (stage 1 or 2) did not significantly differ from those without cancer (70.6% vs 74.7%, p=0.50). CONCLUSIONS The patients with active cancer exhibited significantly reduced midterm survival rates. However, no distinct disparity existed in those with limited-stage cancer (stage 1 or 2). Although TAVR is a viable treatment in patients with AS with active cancer, the type and stage of cancer and prognosis should be carefully weighed in the decision-making process.
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Affiliation(s)
- Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Nahoko Kato
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Hiroshi Ueno
- Second Department of Internal Medicine, Toyama University Hospital, Toyama, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan
- Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Asano K, Noguchi M, Hara R, Sakai H, Kikuchi K, Ito J, Obunai K, Watanabe H. A case of ECPELLA-supported treatment for post-infarction cardiac rupture. J Cardiol Cases 2024; 29:23-26. [PMID: 38188318 PMCID: PMC10770099 DOI: 10.1016/j.jccase.2023.09.003] [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: 05/03/2023] [Revised: 08/31/2023] [Accepted: 09/06/2023] [Indexed: 01/09/2024] Open
Abstract
The efficacy and risk of a combination of veno-arterial extracorporeal membrane oxygenation and Impella (Abiomed, Inc., Danvers, MA, USA), an approach known as ECPELLA, for post-infarction cardiac rupture is unclear. We describe the case of a 72-year-old man who presented with acute myocardial infarction. The patient was managed with ECPELLA because of hemodynamic compromise. One week later, there was a sudden increase in venous oxygen saturation. Transthoracic echocardiography revealed ventricular septal rupture, and free wall rupture. Intraventricular thrombus was also observed despite standard anticoagulation therapy. Even with double cardiac rupture, ECPELLA could facilitate left ventricular unloading and sustain hemodynamics. However, because of the risk of device failure due to thrombus aspiration into the Impella, the patient underwent repair surgery. Postoperatively, the patient was temporarily weaned off ECPELLA, and his hemodynamics deteriorated again, and he finally died. Learning objectives ECPELLA can effectively stabilize the hemodynamics in cases of post-infarction cardiac rupture. However, there are still challenges to address, such as determining optimal ventricular reloading and ECPELLA management for intraventricular thrombus prevention. When using ECPELLA to delay surgery for post-infarction cardiac rupture, it is crucial to strike a balance between hemodynamic stabilization and avoiding potential serious complications.
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Affiliation(s)
- Kazuhiro Asano
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Ryota Hara
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroki Sakai
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Keita Kikuchi
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
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Muraishi M, Nakama T, Amano H, Fukita K, Noguchi M, Obunai K, Ito J, Watanabe H. A Case of Successful Balloon Aortic Valvuloplasty for Transcatheter Aortic Valve Distortion Following Cardiopulmonary Resuscitation. JACC Cardiovasc Interv 2023; 16:3036-3038. [PMID: 37999705 DOI: 10.1016/j.jcin.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/28/2023] [Accepted: 10/10/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Makio Muraishi
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan; Jikei University Hospital, Department of Surgery, Division of Vascular Surgery, Tokyo, Japan.
| | - Hidewo Amano
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Koji Fukita
- Department of Cardiovascular Surgery, Tokyo Bay Medical Center, Urayasu, Japan
| | - Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Medical Center, Urayasu, Japan
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Hiramatsu Y, Hiraoka E, Ito H, Iwanami K, Ito J, Tabata M. Immune-Mediated Non-Infectious Periaortitis After Aortic Graft Replacement Surgery: A Case Report Highlighting the Need for Immunosuppressive Therapy. Am J Case Rep 2023; 24:e941428. [PMID: 38058124 DOI: 10.12659/ajcr.941428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND A non-infectious inflammatory reaction against replaced aortic graft for aortic dissection often manifests as fever, malaise, and peri-graft effusion. It usually lasts less than 1 month and subsides spontaneously without immunosuppressive treatment. CASE REPORT A 49-year-old man underwent ascending aorta and total arch replacement for acute thoracic aortic dissection. He had fever, malaise, nausea, and elevated serum C-reactive protein for 1 month postoperatively. Pathological examination of the aorta revealed no aortitis, and repeated blood cultures were negative. We also noted periaortic graft fluid collection, and a small amount of pleural and pericardial effusions. We suspected post-pericardiotomy syndrome. Colchicine and prednisolone were administered, with an excellent clinical response. Three weeks after discontinuation of a 7-week prednisolone treatment, the same symptoms recurred and gradually worsened. Prednisolone was restarted 6 months after the first surgery, with good clinical response. Thereafter, he developed left-sided weakness and dysarthria, being diagnosed as ischemic stroke. Contrast-enhanced computed tomography revealed fluid collection with contrast leak around the aortic grafts, suggesting peel dehiscence, and thrombus formation in anastomotic pseudoaneurysm. He underwent surgical repair. He was diagnosed with non-infectious periaortitis, likely due to an immune reaction to the grafts, based on an excellent clinical response to immunosuppressive therapy. CONCLUSIONS We report a case of non-infectious periaortitis around a thoracic aortic graft, probably with an immune-mediated mechanism, requiring immunosuppressive treatment. When fever persists after aortic graft replacement surgery, non-infectious periaortitis should be considered and immunosuppressive treatment should be considered to prevent critical complications of anastomotic pseudoaneurysm and graft dehiscence.
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Affiliation(s)
- Yuki Hiramatsu
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Eiji Hiraoka
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Hikaru Ito
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Keiichi Iwanami
- Department of Rheumatology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Takafuji H, Ito J, Kobayashi T, Obunai K. Acute ischaemic stroke attributed to multiple atrial cardioembolic sources. Eur Heart J Case Rep 2023; 7:ytad522. [PMID: 37942355 PMCID: PMC10630091 DOI: 10.1093/ehjcr/ytad522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/31/2023] [Accepted: 10/16/2023] [Indexed: 11/10/2023]
Affiliation(s)
- Hiroya Takafuji
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu-city, Chiba 279-0001, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu-city, Chiba 279-0001, Japan
| | - Tetsuya Kobayashi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu-city, Chiba 279-0001, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu-city, Chiba 279-0001, Japan
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Yoshino K, Kikuchi K, Tamaki R, Sakai H, Hara R, Sai Y, Ito J, Abe K. A Novel Technique of No-Touch Endoscopic Saphenous Vein Harvesting. Innovations (Phila) 2023; 18:589-591. [PMID: 37994624 DOI: 10.1177/15569845231210299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
No-touch saphenous vein harvesting is considered an ideal procedure for harvesting good-quality veins, whereas endoscopic vein harvesting (EVH) is considered ideal for decreasing wound complications. The no-touch EVH (NT-EVH) technique, which was developed in 2018, is one of the best vein-harvesting procedures. We have improved this method in several aspects since our initial experience. Herein, we present the details of this technique.
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Affiliation(s)
- Kunihiko Yoshino
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Keita Kikuchi
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Rihito Tamaki
- Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Hiroki Sakai
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Ryota Hara
- Department of Cardiovascular Surgery, Itabashi Chuo Medical Center, Tokyo, Japan
| | - Youshun Sai
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Japan
| | - Kohei Abe
- Department of Cardiovascular Surgery, Itabashi Chuo Medical Center, Tokyo, Japan
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Sueda K, Hiraoka E, Kitamura K, Norisue Y, Suzuki T, Takahashi O, Ito J, Tabata M. Validation study of EuroSCORE II for dialysis patients: A single-center study in Japan. J Cardiol 2023:S0914-5087(23)00241-1. [PMID: 37802204 DOI: 10.1016/j.jjcc.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 08/17/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II is a predictive model for in-hospital mortality after cardiac surgery. Although it has good performance among the general population undergoing cardiac surgery, it has not been validated among dialysis patients, who have a higher rate of mortality after cardiac surgery. This study aimed to evaluate the performance of the model in predicting in-hospital mortality in maintenance dialysis patients undergoing cardiac surgery. METHODS This retrospective, single-center study included adult patients on maintenance dialysis who underwent open cardiac surgery at our institution. Calibration performance of EuroSCORE II for in-hospital death was determined based on the comparison between expected and observed mortalities for low- (EuroSCORE II <4 %), intermediate- (4-8 %), and high-risk (>8 %) groups. The area under receiver operating characteristic curve (AUROC) was investigated to determine the model's discrimination performance. RESULTS A total of 163 patients (male, 73.6 %; median age, 70 years; median dialysis vintage, 9 years; median EuroSCORE II, 3.3 %) were included. The mortality rate was 9.2 %. The observed mortality rates (vs. mean expected mortality) rates were 2.1 % (vs. 2.4 %), 7.5 % (vs. 5.5 %), and 34.5 % (vs. 21.1 %) in the low-, intermediate-, and high-risk groups, respectively. Its AUROC was 0.825 (95 % confidence interval, 0.711-0.940). CONCLUSIONS Although EuroSCORE II model adequately estimated in-hospital mortality in the low-and intermediate-risk groups (EuroSCORE II <8 %), it underestimated in-hospital mortality in the high-risk group (EuroSCORE II >8 %) among maintenance dialysis patients. The discrimination performance of the model for in-hospital death was good among maintenance dialysis patients.
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Affiliation(s)
- Keishiro Sueda
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Eiji Hiraoka
- Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
| | - Koichi Kitamura
- Department of Nephrology, Endocrinology, and Diabetes, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Yasuhiro Norisue
- Department of Pulmonary and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Toshihiko Suzuki
- Department of Nephrology, Endocrinology, and Diabetes, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Osamu Takahashi
- Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Joji Ito
- Department of Cardiothoracic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Minoru Tabata
- Department of Cardiothoracic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan; Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Kato T, Sato M, Takamura C, Ito J, Ito M, Watanabe Y, Terashima M. Transverse and Longitudinal Right Ventricular Fractional Parameters Derived from Four-Chamber Cine Mri are Associated with Right Ventricular Dysfunction Etiology. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.514] [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: 04/05/2023] Open
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Ito J, Nakanaga H, Fujii H, Tabata M. Endoscopically assisted selective antegrade cardioplegia in minimally invasive aortic valve replacement for patients with aortic insufficiency. JTCVS Tech 2023; 18:28-36. [PMID: 37096103 PMCID: PMC10122126 DOI: 10.1016/j.xjtc.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/04/2022] [Accepted: 01/04/2023] [Indexed: 01/18/2023] Open
Abstract
Objective In minimally invasive aortic valve replacement via a right minithoracotomy for patients with significant aortic insufficiency, optimal cardioplegia delivery procedures remain controversial. This study aimed to describe and evaluate endoscopically assisted selective cardioplegia delivery in minimally invasive aortic valve replacement for aortic insufficiency. Methods Between September 2015 and February 2022, 104 patients (mean age, 66.0 ± 14.3 years) with moderate or greater aortic insufficiency underwent endoscopically assisted minimally invasive aortic valve replacement at our institutions. For myocardial protection, potassium chloride and landiolol were systemically administered before aortic crossclamping, and cold crystalloid cardioplegia was delivered selectively to the coronary arteries using step-by-step endoscopic procedures. The early clinical outcomes were also evaluated. Results Eighty-four patients (80.7%) had severe aortic insufficiency, and 13 patients (12.5%) had aortic stenosis and moderate or greater aortic insufficiency. A regular prosthesis was used in 97 cases (93.3%), and a sutureless prosthesis was used in 7 cases (6.7%). The mean operative, cardiopulmonary bypass, and aortic crossclamping times were 169.3 ± 36.5, 102.4 ± 25.4, and 72.5 ± 21.8 minutes, respectively. No patients underwent a conversion to full sternotomy or required mechanical circulatory support during or after surgery. No operative deaths or perioperative myocardial infarctions occurred. The median intensive care unit and hospital stays were 1 and 5 days, respectively. Conclusions Endoscopically assisted selective antegrade cardioplegia delivery is safe and feasible for treating minimally invasive aortic valve replacement in patients with significant aortic insufficiency.
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Affiliation(s)
- Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Hiroshi Nakanaga
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Cardiovascular Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Hiromi Fujii
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Chiba, Japan
- Department of Cardiovascular Surgery, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Cardiovascular Surgery, Toranomon Hospital, Minato-ku, Tokyo, Japan
- Address for reprints: Minoru Tabata, MD, PhD, MPH, Department of Cardiovascular Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
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Hoffmann DC, Hai L, Wagener R, Mandelbaum H, Xie R, Hausmann D, Dominguez Azorín D, Weil S, Sievers P, Cebulla G, Ito J, Warnken U, Venkataramani V, Ernst K, Reibold D, Will R, Suvà ML, Herold-Mende C, Sahm F, Winkler F, Schlesner M, Wick W, Kessler T. JS08.6.A A connectivity signature for glioblastoma. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Tumor cell extensions called tumor microtubes (TMs) in glioma resemble neurites during neurodevelopment and connect glioma cells to a network that has considerable relevance for tumor progression and therapy resistance. The determination of interconnectivity in individual tumors has been challenging and the impact of tumor cell connectivity on patient survival remained unresolved so far.
Material and Methods
A connectivity signature was derived by single-cell RNA-sequencing (scRNA-Seq) of highly and lowly connected cells obtained from an SR101 dye transfer xenograft model of primary glioblastoma (GB). The signature was validated in different in vitro models of cell-to-cell connectivity and could be translated to GB clinical specimens.
Results
34 of 40 connectivity genes were related to neurogenesis, neural tube development or glioma progression, including the TM-network-relevant GAP43 gene. Astrocytic-like and mesenchymal-like GB cells had the highest connectivity signature scores in scRNA-Seq data of patient-derived xenografts and patient samples. In 230 human GBs, high connectivity correlated with the mesenchymal expression subtype, TP53 wildtype, and with dismal patient survival. CHI3L1 was identified and validated as a robust molecular marker of connectivity with a functional relevance.
Conclusion
The connectivity signature gives novel insights into brain tumor biology, provides a proof-of-principle that tumor cell connectivity is relevant for patients’ prognosis, and serves as a robust biomarker that can be used for future clinical trials
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Affiliation(s)
- D C Hoffmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Faculty of Biosciences, Heidelberg University , Heidelberg , Germany
| | - L Hai
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Bioinformatics and Omics Data Analytics, DKFZ , Heidelberg , Germany
| | - R Wagener
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - H Mandelbaum
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - R Xie
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - D Hausmann
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - D Dominguez Azorín
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - S Weil
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - P Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg , Heidelberg , Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ , Heidelberg , Germany
| | - G Cebulla
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - J Ito
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - U Warnken
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - V Venkataramani
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
- Department of Neuroanatomy, Institute for Anatomy and Cell Biology, Heidelberg University , Heidelberg , Germany
| | - K Ernst
- Hopp Children's Cancer Center at the NCT Heidelberg (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, DKTK, DKFZ , Heidelberg , Germany
| | - D Reibold
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - R Will
- Genomics and Proteomics Core Facility, DKTK, DKFZ , Heidelberg , Germany
| | - M L Suvà
- Broad Institute of Harvard and MIT, Cambridge, MA, United States; Department of Pathology and Center for Cancer Research, Massachusetts General Hospital and Harvard Medical School , Boston, MA , United States
| | - C Herold-Mende
- Department of Neurosurgery, Heidelberg University Hospital , Heidelberg , Germany
| | - F Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg , Heidelberg , Germany
- Clinical Cooperation Unit Neuropathology, DKTK, DKFZ , Heidelberg , Germany
| | - F Winkler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - M Schlesner
- Bioinformatics and Omics Data Analytics, DKFZ , Heidelberg , Germany
- Biomedical Informatics, Data Mining and Data Analytics, Faculty of Applied Computer Science and Medical Faculty, University of Augsburg , Augsburg , Germany
| | - W Wick
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
| | - T Kessler
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ) , Heidelberg , Germany
- Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital , Heidelberg , Germany
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12
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Omiya S, Ito J, Otsu K. Labile iron derived from autophagy-mediated ferritin degradation in cardiomyocytes under pressure overload increases myocardial oxidative stress and develops heart failure in mice. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Heart failure is the leading cause of morbidity and mortality in developed countries, and abnormal iron metabolism is common in patients with heart failure. While iron is essential for metabolic homeostasis, it can increase oxidative stress, such as lipid peroxidation resulting from the generation of harmful reactive hydroxyl radicals through the Fenton reaction. Iron is stored in ferritin, which consists of ferritin heavy (FTH1) and light chains. FTH1 has ferroxidase activity and sequestrates labile ferrous iron. Its protein expression is mediated through nuclear receptor coactivator 4 (NCOA4)-mediated autophagic degradation, known as ferritinophagy. However, the role of ferritinophagy in the stressed heart remains unclear.
Methods
Cardiomyocyte-specific NCOA4-deficient (KO) mice were generated and subjected to pressure overload by transverse aortic constriction to induce heart failure. Cardiac remodelling was assessed by echocardiography and histological and molecular analyses four weeks after the operation. Furthermore, lipid peroxidation was inhibited by its potent inhibitor, ferrostatin-1.
Results
Deletion of NCOA4 in mouse hearts did not affect cardiac phenotypes and FTH1 protein level at baseline but improved cardiac systolic function (Fractional shortening, control littermates 21.9% vs KO 45.9%) accompanied by the attenuation of ferritin degradation (The protein level of FTH1, controls 42.9% vs. KO 67.2% of sham-operated hearts) 4 weeks after pressure overload compared to the control littermates. The number of LC3B (a marker of an autophagosome)- and FTH1-positive dots (controls 2.64/103μm2 vs KO 0.30/103μm2) and that of LAMP2a (a marker of a lysosome)- and FTH1-positive dots (controls 3.68/103μm2 vs KO 1.77/103μm2) increased in TAC-operated control hearts, which was attenuated in TAC-operated NCOA4-deficient hearts. The ratio of ferrous iron to the FTH1 protein level, which represents the non-binding fraction of labile ferrous iron to FTH1, was higher in TAC-operated control hearts than in the sham-operated controls and TAC-operated NCOA4–deficient hearts. Although pressure overload increased the level of malondialdehyde, a marker for lipid peroxidation in control hearts, its level was reduced by deletion of NCOA4 (controls 1.12 nmol/mg vs KO 0.68 nmol/mg). Ferrostatin-1 significantly mitigated the development of pressure overload-induced dilated cardiomyopathy in wild-type mice (Fractional shortening, saline 21.4% vs ferrostatin-1 41.7%).
Conclusions
Pressure overload-induced ferritinophagy in cardiomyocytes increases myocardial labile iron pool and oxidative stress resulting in the development of heart failure in mice.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): British heart foundation
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Affiliation(s)
- S Omiya
- King's College London, The School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation, London, United Kingdom
| | - J Ito
- King's College London, The School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation, London, United Kingdom
| | - K Otsu
- King's College London, The School of Cardiovascular Medicine and Sciences, King's College London British Heart Foundation, London, United Kingdom
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13
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Kawamura M, Nakahara R, Ishihara S, Oie Y, Takase Y, Okumura M, Ito J, Ono T, Itoh Y, Naganawa S. PO-1291 Can we safely lower the RT dose with the use of high dose PF for advanced cervical cancer? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07742-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Kawabata A, Funakoshi H, Ito J, Santanda T, Norisue Y, Watanabe H. Diagnostic delay of acute mitral regurgitation during the coronavirus disease 2019 pandemic: a case report. Int J Emerg Med 2021; 14:38. [PMID: 34281499 PMCID: PMC8287556 DOI: 10.1186/s12245-021-00365-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diagnostic errors or delays can cause serious consequences for patient safety, especially in the emergency department. Anchoring bias is one of the major factors leading to diagnostic error. During the coronavirus disease 2019 (COVID-19) pandemic, the high probability of COVID-19 in febrile patients could be a major cause of anchoring bias leading to diagnostic error. In addition, certain evaluations such as auscultation are difficult to perform on a casual basis due to the increased risk of contact infection, which lead to inadequate assessment of the patients with valvular disease. Acute mitral regurgitation (MR) could be a fatal disease in the emergency department, especially if there is a diagnostic error or delay in diagnosis. It is often reported that diagnosis can be difficult even though there is no treatment other than emergent surgery. The diagnosis of acute MR has become more difficult because coronavirus disease 2019 (COVID-19) pandemic could affect our daily practice especially in febrile patients. We report a case of a diagnostic delay of a febrile patient because of anchoring bias during the COVID-19 pandemic. CASE PRESENTATION A 45-year-old man presented to the emergency department complaining of acute dyspnea and fever. Based on vital signs and computed tomography of the chest, acute pneumonia due to COVID-19 was suspected. Auscultation was avoided because of facility rule based on concern of contact infection. After admission to the intensive care unit, Doppler echocardiography revealed acute mitral regurgitation, and transesophageal echocardiography revealed mitral valve tendon rupture. After confirming the negative result for the polymerase chain reaction of severe acute respiratory syndrome coronavirus 2, mitral valvuloplasty was performed on the third day after admission. The patient was discharged 14 days after admission without complications. CONCLUSIONS In COVID-19 pandemic, anchoring bias suspecting COVID-19 among febrile patients becomes a strong heuristic factor. A thorough history and physical examination is still important in febrile patients presenting with dyspnea to ensure the correct diagnosis of acute mitral regurgitation.
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Affiliation(s)
- Azumi Kawabata
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Hiraku Funakoshi
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan.
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Takushi Santanda
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Yasuhiro Norisue
- Department of Emergency and Critical Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
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15
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Rahman I, Alibrahim A, Zahrani M, Ito J, Connelly K, Buller C, Peterson M, Latter D. TAVR for severe aortic stenosis and papillary fibroelastoma in a high-risk setting. Br J Cardiol 2021; 28:23. [PMID: 35747452 PMCID: PMC8822510 DOI: 10.5837/bjc.2021.023] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Papillary fibroelastomas (PFE) are rare benign cardiac tumours mainly originating on aortic and mitral valvular surfaces. Management is individualised, but most recommend surgical excision due to thromboembolic risk. We report a 75-year-old man with symptomatic severe aortic stenosis compounded by PFE. Redo sternotomy aortic valve replacement was deferred in favour of the trans-apical (TAVR) approach. This report highlights, for the first time, the application of TAVR as a strategy for aortic valve stenosis and PFE to mitigate risk posed by injury to patent internal mammary arterial graft in close proximity to the manubrium, and complications due to the patient's multiple comorbidities.
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Affiliation(s)
- Ishtiaq Rahman
- International SCTS/Ethicon Fellow St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Ammar Alibrahim
- Clinical Fellow St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Mohammad Zahrani
- Clinical Fellow St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Joji Ito
- Clinical Fellow St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Kim Connelly
- Cardiologist St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Chris Buller
- Cardiologist and Director, Cardiac Catheterization and Intervention St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - Mark Peterson
- Cardiac and Aortic Surgeon, and Medical Director, Brain and Hear St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
| | - David Latter
- Cardiac Surgeon, and Division Head, Division of Cardiac Surgery St. Michael's Hospital and Li Ka Shing Knowledge Institute, University of Toronto, Toronto, Ontario, M5B 1W8, Canada
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16
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Ito J, Tabata M. What Is the Best Treatment for Severe Aortic Stenosis Patients With Small Aortic Annulus? Circ J 2021; 85:977-978. [PMID: 33828029 DOI: 10.1253/circj.cj-21-0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center.,Department of Cardiovascular Surgery, Toranomon Hospital
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17
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Sato M, Kato T, Ito M, Takakuwa Y, Ito J, Takamura C, Terashima M. Assessment of Right Ventricular Contractile Patterns Using Cardiac Magnetic Resonance Imaging Would Reflect the Underlying Mechanism of Right Ventricular Dysfunction. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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18
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Matsuo T, Mori N, Mizuno A, Sakurai A, Kawai F, Starkey J, Ohkushi D, Abe K, Yamasaki M, Ito J, Yoshino K, Mikami Y, Uehara Y, Furukawa K. Infected aortic aneurysm caused by Helicobacter cinaedi: case series and systematic review of the literature. BMC Infect Dis 2020; 20:854. [PMID: 33203370 PMCID: PMC7670619 DOI: 10.1186/s12879-020-05582-7] [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: 07/02/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022] Open
Abstract
Background Helicobacter cinaedi is rarely identified as a cause of infected aneurysms; however, the number of reported cases has been increasing over several decades, especially in Japan. We report three cases of aortic aneurysm infected by H. cinaedi that were successfully treated using meropenem plus surgical stent graft replacement or intravascular stenting. Furthermore, we performed a systematic review of the literature regarding aortic aneurysm infected by H. cinaedi. Case presentation We present three rare cases of infected aneurysm caused by H. cinaedi in adults. Blood and tissue cultures and 16S rRNA gene sequencing were used for diagnosis. Two patients underwent urgent surgical stent graft replacement, and the other patient underwent intravascular stenting. All three cases were treated successfully with intravenous meropenem for 4 to 6 weeks. Conclusions These cases suggest that although aneurysms infected by H. cinaedi are rare, clinicians should be aware of H. cinaedi as a potential causative pathogen, even in immunocompetent patients. Prolonged incubation periods for blood cultures are necessary for the accurate detection of H. cinaedi.
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Affiliation(s)
- Takahiro Matsuo
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.
| | - Nobuyoshi Mori
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan
| | - Atsushi Mizuno
- Department of Cardiology, St. Luke's International Hospital, Tokyo, Japan.,Penn Medicine Nudge Unit, University of Pennsylvania, Philadelphia, USA.,Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia, USA
| | - Aki Sakurai
- Department of Infectious Diseases, Fujita Health University, Aichi, Japan
| | - Fujimi Kawai
- St. Luke's International University Library, Tokyo, Japan
| | - Jay Starkey
- Department of Diagnostic Radiology, Division of Neuroradiology, Oregon Health & Science University, Portland, OR, USA
| | - Daisuke Ohkushi
- Department of Infectious Diseases, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kohei Abe
- Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Manabu Yamasaki
- Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Kunihiko Yoshino
- Department of Cardiovascular Surgery, St. Luke's International Hospital, Tokyo, Japan
| | - Yumiko Mikami
- Department of Clinical Laboratory, St. Luke's International Hospital, Tokyo, Japan
| | - Yuki Uehara
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.,Department of Clinical Laboratory, St. Luke's International Hospital, Tokyo, Japan
| | - Keiichi Furukawa
- Department of Infectious Diseases, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, Japan.,Department of Infectious Diseases, Asahi General Hospital, Chiba, Japan
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19
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Hibino M, Tabata M, Ito J, Shibayama K, Obunai K, Watanabe H, Tada N, Naganuma T, Araki M, Yamanaka F, Ueno H, Mizutani K, Higashimori A, Takagi K, Watanabe Y, Shirai S, Yamamoto M, Hayashida K. Midterm outcomes after the rescue THV-in-THV procedure: Insights from the multicenter prospective OCEAN-TAVI registry. Catheter Cardiovasc Interv 2020; 97:701-711. [PMID: 32790158 DOI: 10.1002/ccd.29175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/05/2020] [Accepted: 07/19/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To confirm whether the rescue transcatheter heart valve in the transcatheter heart valve (THV-in-THV) procedure is effective and feasible, we aimed to assess the midterm outcomes following rescue THV-in-THV procedures. The trends in the usage of the rescue THV-in-THV procedure at the time of transcatheter aortic valve implantation (TAVI) have also been explored. BACKGROUND Midterm outcomes of the rescue THV-in-THV procedure have been poorly defined, though it is popular as an effective method to bail-out some complications in TAVI. METHODS We reviewed data from the Optimized transCathEter vAlvular iNtervention-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry and compared the outcomes of TAVI with rescue THV-in-THV and TAVI without rescue THV-in-THV. We also examined the annual rates of rescue THV-in-THV procedures in all the TAVI procedures between 2013 and 2017. RESULTS Among 2,588 patients who underwent TAVI, 26 patients have required rescue THV-in-THV for valve malposition (n = 23) or severe transvalvular regurgitation because of stuck THV leaflets (n = 3). Three cases needed an open conversion, and two died in the hospital. The rates of new permanent pacemaker implantation, acute kidney injury, and stroke were higher in the THV-in-THV group. A two-year cumulative survival and echocardiographic outcomes succeeding rescue THV-in-THV procedure were comparable to non-THV-in-THV cases. The rate of rescue THV-in-THV procedure lessened from 2.6% in 2013 to 0.6% in 2017. CONCLUSIONS The rescue THV-in-THV procedure is an effective and feasible option for THV malpositioning and stuck valve. It has given a comparable survival and a stable valve function over midterm observation periods.
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Affiliation(s)
- Makoto Hibino
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Kentaro Shibayama
- Department of Cardiology, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan
| | - Norio Tada
- Cardiovascular Center, Sendai Kosei Hospital, Sendai, Japan
| | - Toru Naganuma
- Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan
| | - Motoharu Araki
- Department of Cardiovascular Medicine, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Futoshi Yamanaka
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Hiroshi Ueno
- Department of Cardiovascular Medicine, Toyama University School of Medicine, Toyama, Japan
| | - Kazuki Mizutani
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Kensuke Takagi
- Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan
| | - Yusuke Watanabe
- Division of Cardiology, Department of Internal Medicine, Teikyo University, Tokyo, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Kokura, Japan
| | - Masanori Yamamoto
- Division of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.,Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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20
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Miyamoto S, Ito J, Naruse H, Sugiura R, Yamamoto Y, Hatanaka K, Kinoshita K, Higashino M, Hayasaka S, Tsuchida N, Shimoyama N, Sakamoto N. Gastrointestinal: Endoscopic myotomy for a large rectal tumor with severe fibrosis after treatment of hemorrhoids. J Gastroenterol Hepatol 2020; 35:1097. [PMID: 31884711 DOI: 10.1111/jgh.14931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/13/2019] [Indexed: 12/09/2022]
Affiliation(s)
- S Miyamoto
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan.,Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - J Ito
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - R Sugiura
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan.,Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - Y Yamamoto
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Kinoshita
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Higashino
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Hayasaka
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Tsuchida
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Shimoyama
- Department of Pathology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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21
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Kohada Y, Hayashi T, Hsi R, Yukihiro K, Sentani K, Goto K, Inoue S, Ohara S, Teishima J, Kajiwara M, Nishisaka T, Mikami J, Anan G, Ito J, Kaiho Y, Sato M, Yasui W, Akio M. Recurrence and progression free survival of intermediate risk NMIBC: The impact of conditional evaluation and sub-classification. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33546-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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22
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Noguchi M, Tabata M, Obunai K, Shibayama K, Ito J, Watanabe H, Yashima F, Watanabe Y, Naganuma T, Araki M, Yamanaka F, Shirai S, Ueno H, Mizutani K, Higashimori A, Takagi K, Tada N, Yamamoto M, Hayashida K. Clinical outcomes of transcatheter aortic valve implantation (TAVI) in nonagenarians from the optimized catheter valvular intervention-TAVI registry. Catheter Cardiovasc Interv 2020; 97:E113-E120. [PMID: 32333724 DOI: 10.1002/ccd.28935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/24/2020] [Accepted: 04/12/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate 30-day and 2-year clinical outcomes, and predictors of 2-year mortality in nonagenarians undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND TAVI has been applied to nonagenarians. However, sufficient clinical data in nonagenarians who could benefit from TAVI are limited. METHODS We evaluated the data from the optimized catheter valvular intervention-TAVI registry. Clinical outcomes were compared between patients' age ≥90 years and age <90 years. Predictive factors of 2-year mortality were assessed by multivariable Cox regression analyses. RESULTS From October 2013 to May 2017, a total of 375 nonagenarians (age ≥90 years) and 2,213 younger patients (age <90 years) were included. Although nonagenarians had a higher surgical risk score, 30-day clinical outcomes were similar between two groups. There were no significant differences in 2-year mortality (22.0% vs. 17.3%; p = .11) and stroke (5.5% vs. 3.9%; p = .31); however, 2-year heart failure readmission was higher in nonagenarians (13.3% vs. 9.0%; p = .03). After adjusting covariates, age ≥90 years was not independent predictor for 2-year outcomes. In nonagenarians, female sex (hazard ratio [HR] = 0.43; 95% confidence interval [CI] = 0.26-0.74; p = .002), chronic kidney disease grade ≥4 (HR = 2.14; 95% CI = 1.21-3.64; p = .01), and Clinical Frailty Scale ≥4 (HR = 1.82; 95% CI = 1.02-3.42; p = .04) were independently associated with 2-year mortality. CONCLUSIONS Clinical outcomes of TAVI in selected nonagenarians were favorable. Severe renal dysfunction and frailty may be important factors to predict mid-term mortality after TAVI in nonagenarians.
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Affiliation(s)
- Masahiko Noguchi
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Kentaro Shibayama
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan
| | - Fumiaki Yashima
- Department of Cardiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Yusuke Watanabe
- Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan
| | - Toru Naganuma
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shinichi Shirai
- Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
| | - Hiroshi Ueno
- Department of Cardiovascular Medicine, Toyama University Hospital, Toyama, Japan
| | - Kazuki Mizutani
- Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Kensuke Takagi
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Norio Tada
- Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan
| | - Masanori Yamamoto
- Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.,Department of Cardiology, Nagoya Heart Center, Nagoya, Japan
| | - Kentaro Hayashida
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
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Sato M, Kato T, Takamura C, Ito J, Takakuwa Y, Terashima M. Right Ventricular Morphology in Patients with Left-Sided Heart Failure: Analysis Based on Cardiac Magnetic Resonance Imaging. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Kato T, Kawamura A, Takakuwa Y, Ito J, Takamura C, Terashima M. Cost-Effectiveness of Cardiac Magnetic Resonance Imaging in the Diagnosis of Cardiac Allograft Vasculopathy as Well as the Detection of Myocardial Inflammation Associated with Treatment-Requiring Cellular Rejection. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Ito J, Shirasuna K, Kuwayama T, Iwata H. Resveratrol treatment increases mitochondrial biogenesis and improves viability of porcine germinal-vesicle stage vitrified-warmed oocytes. Cryobiology 2020; 93:37-43. [DOI: 10.1016/j.cryobiol.2020.02.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/28/2020] [Accepted: 02/29/2020] [Indexed: 12/24/2022]
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26
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Sugiura R, Kinoshita K, Naruse H, Yamamoto Y, Hatanaka K, Ito J, Miyamoto S, Higashino M, Hayasaka S, Tsuchida N, Nakanishi K, Ueki S, Umehara M, Shimoyama N, Mitsuhashi T, Sakamoto N. Hepatobiliary and Pancreatic: Hemosuccus pancreaticus due to an intraductal papillary mucinous neoplasm: A rare cause of obscure gastrointestinal bleeding. J Gastroenterol Hepatol 2020; 35:363. [PMID: 31958167 DOI: 10.1111/jgh.14881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 09/15/2019] [Indexed: 12/13/2022]
Affiliation(s)
- R Sugiura
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan.,Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Kinoshita
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - J Ito
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Miyamoto
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Higashino
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Hayasaka
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Tsuchida
- Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakanishi
- Department of Gastrointestinal Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Ueki
- Department of Gastrointestinal Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Umehara
- Department of Gastrointestinal Surgery, Hakodate Municipal Hospital, Hakodate, Japan
| | - N Shimoyama
- Department of Pathology, Hakodate Municipal Hospital, Hakodate, Japan
| | - T Mitsuhashi
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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Elisofon SA, Magee JC, Ng VL, Horslen SP, Fioravanti V, Economides J, Erinjeri J, Anand R, Mazariegos GV, Martin A, Mannino D, Flynn L, Mohammad S, Alonso E, Superina R, Brandt K, Riordan M, Lokar J, Ito J, Elisofon S, Zapata L, Jain A, Foristal E, Gupta N, Whitlow C, Naik K, Espinosa H, Miethke A, Hawkins A, Hardy J, Engels E, Schreibeis A, Ovchinsky N, Kogan‐Liberman D, Cunningham R, Malik P, Sundaram S, Feldman A, Garcia B, Yanni G, Kohli R, Emamaullee J, Secules C, Magee J, Lopez J, Bilhartz J, Hollenbeck J, Shaw B, Bartow C, Forest S, Rand E, Byrne A, Linguiti I, Wann L, Seidman C, Mazariegos G, Soltys K, Squires J, Kepler A, Vitola B, Telega G, Lerret S, Desai D, Moghe J, Cutright L, Daniel J, Andrews W, Fioravanti V, Slowik V, Cisneros R, Faseler M, Hufferd M, Kelly B, Sudan D, Mavis A, Moats L, Swan‐Nesbit S, Yazigi N, Buranych A, Hobby A, Rao G, Maccaby B, Gopalareddy V, Boulware M, Ibrahim S, El Youssef M, Furuya K, Schatz A, Weckwerth J, Lovejoy C, Kasi N, Nadig S, Law M, Arnon R, Chu J, Bucuvalas J, Czurda M, Secheli B, Almy C, Haydel B, Lobritto S, Emand J, Biney‐Amissah E, Gamino D, Gomez A, Himes R, Seal J, Stewart S, Bergeron J, Truxillo A, Lebel S, Davidson H, Book L, Ramstack D, Riley A, Jennings C, Horslen S, Hsu E, Wallace K, Turmelle Y, Nadler M, Postma S, Miloh T, Economides J, Timmons K, Ng V, Subramonian A, Dharmaraj B, McDiarmid S, Feist S, Rhee S, Perito E, Gallagher L, Smith K, Ebel N, Zerofsky M, Nogueira J, Greer R, Gilmour S, Robert C, Cars C, Azzam R, Boone P, Garbarino N, Lalonde M, Kerkar N, Dokus K, Helbig K, Grizzanti M, Tomiyama K, Cocking J, Alexopoulos S, Bhave C, Schillo R, Bailey A, Dulek D, Ramsey L, Ekong U, Valentino P, Hettiarachchi D, Tomlin R. Society of pediatric liver transplantation: Current registry status 2011-2018. Pediatr Transplant 2020; 24:e13605. [PMID: 31680409 DOI: 10.1111/petr.13605] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/08/2019] [Accepted: 09/27/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND SPLIT was founded in 1995 in order to collect comprehensive prospective data on pediatric liver transplantation, including waiting list data, transplant, and early and late outcomes. Since 2011, data collection of the current registry has been refined to focus on prospective data and outcomes only after transplant to serve as a foundation for the future development of targeted clinical studies. OBJECTIVE To report the outcomes of the SPLIT registry from 2011 to 2018. METHODS This is a multicenter, cross-sectional analysis characterizing patients transplanted and enrolled in the SPLIT registry between 2011 and 2018. All patients, <18 years of age, received a first liver-only, a combined liver-kidney, or a combined liver-pancreas transplant during this study period. RESULTS A total of 1911 recipients from 39 participating centers in North America were registered. Indications included biliary atresia (38.5%), metabolic disease (19.1%), tumors (11.7%), and fulminant liver failure (11.5%). Greater than 50% of recipients were transplanted as either Status 1A/1B or with a MELD/PELD exception score. Incompatible transplants were performed in 4.1%. Kaplan-Meier estimates of 1-year patient and graft survival were 97.3% and 96.6%. First 30 days of surgical complications included reoperation (31.7%), hepatic artery thrombosis (6.3%), and portal vein thrombosis (3.2%). In the first 90 days, biliary tract complications were reported in 13.6%. Acute cellular rejection during first year was 34.7%. At 1 and 2 years of follow-up, 39.2% and 50.6% had normal liver tests on monotherapy (tacrolimus or sirolimus). Further surgical, survival, allograft function, and complications are detailed.
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Affiliation(s)
- Scott A Elisofon
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts
| | - John C Magee
- Division of Surgery, University of Michigan Transplant Center, Ann Arbor, Michigan
| | - Vicky L Ng
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Transplant and Regenerative Medicine Center, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Simon P Horslen
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington
| | - Vicki Fioravanti
- Section of Hepatology and Liver Transplantation, Children's Mercy Hospital, Kansas City, Missouri
| | | | | | | | - George V Mazariegos
- Division of Pediatric Transplant Surgery, Hillman Center for Pediatric Transplantation, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
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Sakata K, Mitsuda H, Ito J, Isaka A, Gouda A, Soejima K. P942 Outcome prediction by exercise stress echocardiography and cardiopulmonary exercise testing assessment in patients with heart failure. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiopulmonary exercise testing (CPX) is essential to the assessment of functional impairment and prognosis in patients with heart failure (HF). Peak oxygen consumption (peak VO2) continues to be considered the gold standard for assessing prognosis in HF. The minute ventilation-carbon dioxide production (VE-VCO2) slope has recently demonstrated prognostic significance in patients with HF. Ergometer stress echocardiography (Erg-Echo) is useful to evaluate the exercise-induced pulmonary hypertension and the potential cardiac dysfunction that are difficult to evaluate in the resting state.
Objective
The aim of this study is to evaluate the relationship between CPX and Erg-echo indices, and the usefulness of Erg-echo to determine the severity of cardiac dysfunction and the prognosis in patients with HF.
Methods
We studied 58 patients with HF (age 65.2 ± 11.9 years) and performed CPX and Erg-Echo. The peak VO2 and the VE-VCO2 slope were measured by CPX. Cardiac output (CO) and estimated mean pulmonary artery pressure (mPAP) were measured by Erg-Echo at rest and peak exercise load, and the change ratio (ΔmPAP / ΔCO) were calculated. We evaluated the clinical outcome during a1 year period.
Results
The ΔmPAP / ΔCO was significantly correlated with the peak VO2 (R = -0.6767, P <0.0001) and the VE-VCO2 slope (R = 0.6809, P <0.0001). Cardiovascular events (1 patient of cardiovascular death, 8 patients of re-hospitalization due to HF, 4 patients of myocardial ischemia, 2 patients of Cardiac Resynchronization Therapy (CRT) devices implantation, 1 patient of ventricular tachycardia) developed in 16 of the 58 patients (27.5%: Group CE) during the 1 year. The peak VO2 was significantly lower (12.1 ± 2.5 vs. 16.1 ± 3.1ml/min/kg, P <0.0001) and the VE-VCO2 slope was significantly higher (41.1 ±. 12.3 vs. 31.8 ± 6.1ml/ml, P <0.0001) in Group CE compared to the other 42 patients (Group N). The ΔmPAP was significantly higher (19.1 ± 4.4 vs. 14.9 ± 6.4, P = 0.0408) and the ΔCO was significantly lower (2.4 ± 1.2 vs. 4.1 ± 2.0, P = 0.0078), and the ΔmPAP / ΔCO was significantly higher (9.7 ± 4.6 vs. 4.4 ± 2.4, P <0.0001) in Group CE compared to Group N.
Conclusions
The ΔmPAP/ ΔCO by Erg-Echo is useful to evaluate the severity of cardiac dysfunction and the prognosis of HF patients.
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Affiliation(s)
- K Sakata
- Kyorin University School of Medicine, Tokyo, Japan
| | - H Mitsuda
- Kyorin University School of Medicine, Tokyo, Japan
| | - J Ito
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Isaka
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Gouda
- Kyorin University School of Medicine, Tokyo, Japan
| | - K Soejima
- Kyorin University School of Medicine, Tokyo, Japan
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Sakata K, Mitsuda H, Ito J, Isaka A, Furuya M, Minamishima T, Matsushita K, Soejima K. P1802 Prevalence and prognostic significance of pulmonary artery aneurysms in patients with pulmonary artery hypertension. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Pulmonary artery aneurysm (PAA) occurs in some patients with pulmonary arterial hypertension (PAH) and can be accompanied by various complications.
Objective
The aim of the this study is to evaluate the characteristics of cardiac dysfunction and the prognostic impact of PAA by analysing the outcome of patients with PAH complicated by PAA.
Methods
We performed echocardiography and right-heart catheterization in 130 PAH patients. We measured the maximum dimensions of the main pulmonary artery (MPA) trunk. We evaluated the right ventricular (RV) function and the five-year prognosis of patients with PAA.
Results
The maximum MPA trunk diameter of >40 mm by echocardiography was defined as PAA. PAA appeared in 32 of the 130 PAH patients (24.6%: Group PAA), other 98 patients were defined as Group non-PAA. Systolic pulmonary artery pressure (76 ±18 vs. 61 ± 21 mmHg, P = 0.0008) and mean right atrial pressure (10.0 ± 8.1 vs. 5.4 ± 3.8 mmHg, P < 0.0001) were significantly higher in Group PAA than in Group non-PAA. RV end-diastolic area index was significantly larger (37.3 ± 8.8 vs. 32.3 ± 7.8 mmHg, P = 0.0048), and RV fractional area change (32 ± 8 vs. 36 ± 9 %, P = 0.0176) and RV longitudinal strain amplitude (-16 ±5 vs. -20 ± 6, P = 0.0017) were significantly lower in Group PAA than those in Group non-PAA. During the five-year follow-up period, 20 patients (15%) died. The five-year mortality rate was significantly higher in Group PAA compared to Group non-PAA (30% vs. 10%, P = 0.007).
Conclusion
In PAH patients with PAA, RV dysfunction was more severe and the prognosis was poor. Assessment of PAA can be a useful index for the extraction of high-risk PAH patients.
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Affiliation(s)
- K Sakata
- Kyorin University School of Medicine, Tokyo, Japan
| | - H Mitsuda
- Kyorin University School of Medicine, Tokyo, Japan
| | - J Ito
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Isaka
- Kyorin University School of Medicine, Tokyo, Japan
| | - M Furuya
- Kyorin University School of Medicine, Tokyo, Japan
| | | | - K Matsushita
- Kyorin University School of Medicine, Tokyo, Japan
| | - K Soejima
- Kyorin University School of Medicine, Tokyo, Japan
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Shimura A, Takaesu Y, Ito J, Katayose Y, Nieda K, Kawashima K, Hashimoto M, Kunoki K, Toumei K, Inoue T. A randomized controlled trial: tailored sleep hygiene intervention reduced high school students' sleep disturbance, absenteeism, presenteeism, and dropout. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kawamura M, Yoshiyuki I, Kamomae T, Ito J, Oie Y, Ohtakara K, Naganawa S. PO-143: A phase I/II trial of intraoperative breast radiotherapy in an Asian population: 10-year results. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(20)30485-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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32
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Oie Y, Itoh Y, Kawamura M, Takase Y, Murao T, Ishihara S, Nomoto Y, Hirasawa N, Asano A, Yamakawa K, Ito J, Naganawa S. Clinical Results of T1 Glottic Cancer Treated with Radiotherapy Using 2.25 Gy per Fractions: A Multicenter Survey in Clinical Practice. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ito J, Tabata M. [How to Implant a Prosthetic Valve in the Aortic and Mitral Valve Positions]. Kyobu Geka 2019; 72:789-793. [PMID: 31582697] [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: 06/10/2023]
Abstract
We surgeons have to achieve a good result for surgical valve replacement which is not inferior to trans-catheter heart valve treatments. This column aimed to learn fundamental skills for surgical valve implantation and to learn types of suturing techniques. For updated information, we mentioned about choice of valve and suturing technique for valve-in-valve procedure into surgical valve. We should take into consideration valve type, size, and how-to implantation of surgical valve which would affect the future valve-in-valve procedure.
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Affiliation(s)
- Joji Ito
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Tokyo, Japan
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Batsuli G, Ito J, Mercer R, Baldwin WH, Cox C, Parker ET, Healey JF, Lollar P, Meeks SL. Anti-C1 domain antibodies that accelerate factor VIII clearance contribute to antibody pathogenicity in a murine hemophilia A model. J Thromb Haemost 2018; 16:1779-1788. [PMID: 29981270 PMCID: PMC6123829 DOI: 10.1111/jth.14233] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Indexed: 01/06/2023]
Abstract
Essentials Inhibitor formation remains a challenging complication of hemophilia A care. The Bethesda assay is the primary method used for determining bleeding risk and management. Antibodies that block factor VIII binding to von Willebrand factor can increase FVIII clearance. Antibodies that increase clearance contribute to antibody pathogenicity. SUMMARY Background The development of neutralizing anti-factor VIII (FVIII) antibodies remains a challenging complication of modern hemophilia A care. In vitro assays are the primary method used for quantifying inhibitor titers, predicting bleeding risk, and determining bleeding management. However, other mechanisms of inhibition are not accounted for in these assays, which may result in discrepancies between the inhibitor titer and clinical bleeding symptoms. Objectives To evaluate FVIII clearance in vivo as a potential mechanism for antibody pathogenicity and to determine whether increased FVIII dosing regimens correct the associated bleeding phenotype. Methods FVIII-/- or FVIII-/- /von Willebrand factor (VWF)-/- mice were infused with anti-FVIII mAbs directed against the FVIII C1, C2 or A2 domains, followed by infusion of FVIII. Blood loss via the tail snip bleeding model, FVIII activity and FVIII antigen levels were subsequently measured. Results Pathogenic anti-C1 mAbs that compete with VWF for FVIII binding increased the clearance of FVIII-mAb complexes in FVIII-/- mice but not in FVIII-/- /VWF-/- mice. Additionally, pathogenic anti-C2 mAbs that inhibit FVIII binding to VWF increased FVIII clearance in FVIII-/- mice. Anti-C1, anti-C2 and anti-A2 mAbs that do not inhibit VWF binding did not accelerate FVIII clearance. Infusion of increased doses of FVIII in the presence of anti-C1 mAbs partially corrected blood loss in FVIII-/- mice. Conclusions A subset of antibodies that inhibit VWF binding to FVIII increase the clearance of FVIII-mAb complexes, which contributes to antibody pathogenicity. This may explain differences in the bleeding phenotype observed despite factor replacement in some patients with hemophilia A and low-titer inhibitors.
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MESH Headings
- Animals
- Antibodies, Heterophile/administration & dosage
- Antibodies, Heterophile/immunology
- Antibodies, Heterophile/toxicity
- Antibodies, Monoclonal/administration & dosage
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/toxicity
- Antibodies, Neutralizing/administration & dosage
- Antibodies, Neutralizing/immunology
- Antibodies, Neutralizing/toxicity
- Epitopes/immunology
- Factor VIII/antagonists & inhibitors
- Factor VIII/immunology
- Factor VIII/pharmacokinetics
- Hemophilia A/drug therapy
- Hemophilia A/immunology
- Hemorrhage/etiology
- Inhibitory Concentration 50
- Mice
- Mice, 129 Strain
- Mice, Inbred C57BL
- Models, Animal
- Phenotype
- Protein Domains
- von Willebrand Diseases
- von Willebrand Factor/metabolism
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Affiliation(s)
- G Batsuli
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - J Ito
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - R Mercer
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - W H Baldwin
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - C Cox
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - E T Parker
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - J F Healey
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - P Lollar
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
| | - S L Meeks
- Department of Pediatrics, Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA
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Taniai S, Ito J, Yorozu T, Yoshino H. 2171Cardiovascular preoperative screening system for non-cardiac surgery modified from ACC/AHA guideline can provide effective evaluation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Taniai
- Kyorin University, Second department of Internal Medicine, Mitaka, Japan
| | - J Ito
- Kyorin University, Second department of Internal Medicine, Mitaka, Japan
| | - T Yorozu
- Kyorin University School of Medicine, anesthesiology, Tokyo, Japan
| | - H Yoshino
- Kyorin University, Second department of Internal Medicine, Mitaka, Japan
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Taniai S, Ito J, Yorozu T, Yoshino H. P1537Is exercise capacity above 4METs good enough to screen pre-operative patients with non-cardiac surgery? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Taniai
- Kyorin University, Second Department of Internal Medicine, Mitaka, Japan
| | - J Ito
- Kyorin University, Second Department of Internal Medicine, Mitaka, Japan
| | - T Yorozu
- Kyorin University, Second Department of Internal Medicine, Mitaka, Japan
| | - H Yoshino
- Kyorin University, Second Department of Internal Medicine, Mitaka, Japan
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37
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Kinoshita R, Ganaha F, Ito J, Ohyama N, Abe N, Yamazato T, Munakata H, Mabuni K, Kugai T. Multiple Re-entry Closures After TEVAR for Ruptured Chronic Post-dissection Thoraco-abdominal Aortic Aneurysm. EJVES Short Rep 2018; 38:15-18. [PMID: 29780894 PMCID: PMC5956622 DOI: 10.1016/j.ejvssr.2018.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/09/2018] [Accepted: 01/17/2018] [Indexed: 11/21/2022] Open
Abstract
Introduction Although thoracic endovascular aortic repair (TEVAR) has become a promising treatment for complicated acute type B dissection, its role in treating chronic post-dissection thoraco-abdominal aortic aneurysm (TAA) is still limited owing to persistent retrograde flow into the false lumen (FL) through abdominal or iliac re-entry tears. Report A case of chronic post-dissection TAA treatment, in which a dilated descending FL ruptured into the left thorax, is described. The primary entry tear was closed by emergency TEVAR and multiple abdominal re-entries were closed by EVAR. In addition, major re-entries at the detached right renal artery and iliac bifurcation were closed using covered stents. To close re-entries as far as possible, EVAR was carried out using the chimney technique, and additional aortic extenders were placed above the coeliac artery. A few re-entries remained, but complete FL thrombosis of the rupture site was achieved. Follow-up computed tomography showed significant shrinkage of the FL. Discussion In treating post-dissection TAA, entry closure by TEVAR is sometimes insufficient, owing to persistent retrograde flow into the FL from abdominal or iliac re-entries. Adjunctive techniques are needed to close these distal re-entries to obtain complete FL exclusion, especially in rupture cases. Recently, encouraging results of complete coverage of the thoraco-abdominal aorta with fenestrated or branched endografts have been reported; however, the widespread employment of such techniques appears to be limited owing to technical difficulties. The present method with multiple re-entry closures using off the shelf and immediately available devices is an alternative for the endovascular treatment of post-dissection TAA, especially in the emergency setting. A case of ruptured post-dissection thoraco-abdominal aneurysm was treated. Following entry closure by TEVAR, EVAR was performed to close multiple re-entries. Re-entries at the renal artery ostium and iliac artery were closed by covered stents. Complementary re-entry closure techniques are essential to treat false lumen rupture. This report demonstrates successful re-entry closure techniques following TEVAR.
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Affiliation(s)
- R Kinoshita
- Department of Radiology, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - F Ganaha
- Department of Radiology, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - J Ito
- Department of Radiology, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - N Ohyama
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - N Abe
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - T Yamazato
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - H Munakata
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - K Mabuni
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
| | - T Kugai
- Cardiovascular Surgery, Okinawa Prefectural Nanbu Medical Centre, Okinawa, Japan
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Marx M, Younes E, Chandrasekhar S, Ito J, Plontke S, O’Leary S, Sterkers O. International consensus (ICON) on treatment of sudden sensorineural hearing loss. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S23-S28. [DOI: 10.1016/j.anorl.2017.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 12/10/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
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Shimura A, Ito J, Takaesu Y. A pilot study: a priority oriented tailored sleep hygiene intervention reduced sleep disturbance and absenteeism among correspondence high school students. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kawagishi N, Suda G, Onozawa M, Kimura M, Maehara O, Ohara M, Izumi T, Umemura M, Ito J, Nakai M, Sho T, Natsuizaka M, Morikawa K, Ogawa K, Sakamoto N. Comparing the risk of hepatitis B virus reactivation between direct-acting antiviral therapies and interferon-based therapies for hepatitis C. J Viral Hepat 2017. [PMID: 28632923 DOI: 10.1111/jvh.12737] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) reactivation has been reported during antihepatitis C treatment in patients with hepatitis C virus (HCV) and HBV co-infection. We aimed to evaluate the frequency and risk factors of HBV reactivation during anti-HCV therapy and compared those between interferon (IFN)-free direct-acting antiviral (DAA) therapies and IFN-based therapies. Three hundred and twenty-two patients with HCV infection receiving anti-HCV therapy were retrospectively screened. The baseline HBV infection statuses of all eligible patients and the HBV-DNA level of all patients with current or previous HBV infection were examined at the end of treatment. In patients with baseline anti-HBs positivity, changes in anti-HBs titre were evaluated. Of 287 patients who met the inclusion criteria, 157 had current (n=4) or previous (n=153) HBV infection; 85 were treated with IFN-free DAA therapies and 72 were treated with IFN-based therapies. Six patients experienced HBV reactivation (n=2) or HBV reappearance (n=4) after IFN-free DAA therapies, while no patient developed HBV reactivation after IFN-based therapies. The risk factors of HBV reactivation or reappearance were DAA therapies and a reduction in anti-HBs titre to <12 mIU mL-1 by the end of treatment. The decline changes of anti-HBs titre were significantly higher in patients treated with DAA therapies. Although HBV reactivation hepatitis was not observed, three of four patients with HBV reactivation or reappearance after achieving HCV eradication had viremia 8 weeks after completion of therapy. A significant proportion of patients develop HBV reactivation or reappearance without hepatitis after IFN-free DAA therapies. Low levels of anti-HBs and their decrease to <12 mIU mL-1 after treatment are significant risk factors for HBV reactivation or reappearance.
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Affiliation(s)
- N Kawagishi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Onozawa
- Department of Hematology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Kimura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - O Maehara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Ohara
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Izumi
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Umemura
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - J Ito
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Nakai
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Natsuizaka
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Morikawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - K Ogawa
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
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Ohta K, Ito J, Shimizu H, Takahashi H, Kakita A, Tobinaga M, Endo H, Ikeda T, Aida I, Yonemoti Y, Ozawa T, Nakajima T. A case of sporadic amyotrophic lateral sclerosis presenting with chorea as the initial symptom. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Yamaguchi S, Sato S, Horio N, Yoshida K, Shimodaira M, Taneda A, Ikebuchi E, Nishio M, Ito J. Cost-effectiveness of cognitive remediation and supported employment for people with mental illness: a randomized controlled trial. Psychol Med 2017; 47:53-65. [PMID: 27654902 DOI: 10.1017/s0033291716002063] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Little is known about the economic benefits of cognitive remediation and supported employment (CR + SE). The present study aimed to investigate the cost-effectiveness of CR + SE compared with traditional vocational services (TVS). METHOD Individuals with mental illness and low cognitive function were recruited at six sites in Japan. A total of 111 participants were randomly allocated to the CR + SE group or the TVS group. Clinical and vocational outcomes were assessed at baseline and 12-month follow-up. Service utilization data were collected monthly. The data on outcomes and costs were combined to examine cost-effectiveness. RESULTS The data were obtained from a total of 92 participants. The CR + SE group resulted in better vocational and clinical outcomes (employment rate, 62.2%; work tenures, 78.6 days; cognitive improvement, 0.5) than the TVS group (19.1%, 24.9 days and 0.2). There was no significant difference in mean total costs between the groups (CR + SE group: $9823, s.d. = $6372, TVS group: $11 063, s.d. = $11 263) with and without adjustment for covariates. However, mean cost for medical services in the CR + SE group was significantly lower than that in the TVS group after adjusting covariates (Β = -$3979, 95% confidence interval -$7816 to -$143, p = 0.042). Cost-effectiveness acceptability curves for vocational outcomes illustrated the high probabilities (approximately 70%) of the CR + SE group being more cost-effective than TVS when society is not willing to pay additional costs. CONCLUSIONS CR + SE appears to be a cost-effective option for people with mental illness who have low cognitive functioning when compared with TVS.
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Affiliation(s)
- S Yamaguchi
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
| | - S Sato
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
| | - N Horio
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
| | - K Yoshida
- Department of Social Welfare, Faculty of Human and Social Sciences,Showa Women's University,Setagaya,Tokyo,Japan
| | - M Shimodaira
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
| | - A Taneda
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
| | - E Ikebuchi
- Department of Psychiatry,School of Medicine, Teikyo University,Itabashi, Tokyo,Japan
| | - M Nishio
- School of Social Welfare, Tohoku Fukushi University,Sendai,Japan
| | - J Ito
- Department of Psychiatric Rehabilitation,National Institute of Mental Health, National Center of Neurology and Psychiatry,Kodaira,Japan
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Kawano H, Nakata K, Kamoshita M, Ito J, Kashiwazaki N, Yamashita N. Affixing labels on culture dishes decrease the development rate of mouse embryos. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ohyama Y, Ito J, Hakeda Y, Shimada J. Sudachitin, a Polymethoxyflavone Derived From Citrus Sudachi, Suppresses Lipopolysaccharide-Induced Inflammatory Bone Resorption Because of Inhibiting Osteoclast Formation in Mice. J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.joms.2016.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Katada Y, Ito J, Shibayama K, Nakatsuka D, Kawano Y, Watanabe H, Tabata M. Transapical Transcatheter Closure of the Pseudoaneurysm in the Left Ventricular Outflow Tract After Aortic Valve Replacement. JACC Cardiovasc Interv 2016; 9:e181-3. [DOI: 10.1016/j.jcin.2016.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/06/2016] [Accepted: 06/20/2016] [Indexed: 10/21/2022]
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Takakubo Y, Ota D, Naganuma Y, Oki H, Narita A, Ito J, Sasaki K, Takagi M. THU0118 Trend of Atypical Femoral Fractures in Rheumatic Patients in The Highly Super Aging Area of North Japan. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Taura A, Taura K, Koyama Y, Yamamoto N, Nakagawa T, Ito J, Ryan AF. Hair cell stereociliary bundle regeneration by espin gene transduction after aminoglycoside damage and hair cell induction by Notch inhibition. Gene Ther 2016; 23:415-23. [PMID: 26886463 PMCID: PMC4860107 DOI: 10.1038/gt.2016.12] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 09/27/2015] [Accepted: 10/23/2015] [Indexed: 12/20/2022]
Abstract
Once inner ear hair cells (HCs) are damaged by drugs, noise or aging, their apical structures including the stereociliary arrays are frequently the first cellular feature to be lost. Although this can be followed by progressive loss of HC somata, a significant number of HC bodies often remain even after stereociliary loss. However, in the absence of stereocilia they are nonfunctional. HCs can sometimes be regenerated by Atoh1 transduction or Notch inhibition, but they also may lack stereociliary bundles. It is therefore important to develop methods for the regeneration of stereocilia, in order to achieve HC functional recovery. Espin is an actin-bundling protein known to participate in sterociliary elongation during development. We evaluated stereociliary array regeneration in damaged vestibular sensory epithelia in tissue culture, using viral vector transduction of two espin isoforms. Utricular HCs were damaged with aminoglycosides. The utricles were then treated with a γ-secretase inhibitor, followed by espin or control transduction and histochemistry. Although γ-secretase inhibition increased the number of HCs, few had stereociliary arrays. In contrast, 46 h after espin1 transduction, a significant increase in hair-bundle-like structures was observed. These were confirmed to be immature stereociliary arrays by scanning electron microscopy. Increased uptake of FM1-43 uptake provided evidence of stereociliary function. Espin4 transduction had no effect. The results demonstrate that espin1 gene therapy can restore stereocilia on damaged or regenerated HCs.
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Affiliation(s)
- A Taura
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Taura
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Koyama
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - N Yamamoto
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Nakagawa
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - J Ito
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - A F Ryan
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Divison of Otolaryngology, Department of Surgery, UCSD School of Medicine, La Jolla, CA, USA.,VA Medical Center, San Diego, CA, USA.,Department of Neurosciences, UCSD School of Medicine, La Jolla, CA, USA
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Nakai M, Ito J, Kashiwazaki N, Men N, Tanihara F, Noguchi J, Kaneko H, Onishi A, Kikuchi K. Treatment with protein kinase C activator is effective for improvement of male pronucleus formation and further embryonic development of sperm-injected oocytes in pigs. Theriogenology 2016; 85:703-8. [DOI: 10.1016/j.theriogenology.2015.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 10/05/2015] [Accepted: 10/07/2015] [Indexed: 11/26/2022]
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Ito J, Kawasaki Y, Shibao Y, Matsumura K, Hyon SH, Kashiwazaki N. 29 THE NOVEL CRYOPROTECTIVE AGENT CARBOXYLATED ε-POLY-L-LYSINE IS EFFECTIVE FOR VITRIFICATION OF PRE-IMPLANTATION MOUSE EMBRYOS AT THE DIFFERENT STAGES. Reprod Fertil Dev 2016. [DOI: 10.1071/rdv28n2ab29] [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] [Indexed: 11/23/2022] Open
Abstract
Embryo cryopreservation is one of the important technologies in various research and clinical areas. Very recently, carboxylated ε-poly-L-lysine (COOH-PLL) has been developed as a new cryoprotective regent, and we previously demonstrated that combined treatment of COOH-PLL with ethylene glycol (EG), which is a commonly used cryoprotective regent, is effective for vitrification of unfertilized mouse oocytes and pronuclear embryos. In this study, we examined different concentration of COOH-PLL and tried to vitrify the embryos at the different stages beyond the 2-cell stage using the same protocol. Embryos at the pronuclear, 2-cell, 4-cell, 8-cell, morulae, and blastocyst stages were treated with 7.5% (vol/vol) EG and 7.5% (vol/vol) COOH-PLL for 3 min and then vitrified with 15% EG (vol/vol) and 15% (vol/vol) COOH-PLL (E15P15) for 1 min by the Cryotop. The embryos except for pronuclear embryos showed low rates of survival, blastocyst, and hatched blastocysts. To improve the survival and developmental ability of the vitrified embryos, blastocysts were vitrified with different concentrations of COOH-PLL. At the results, the survival and developmental rates of vitrified blastocyst in E20P10 group were higher (98.0 ± 2.5% and 93.3 ± 4.0%) than those of the E30, E25P5, and E15P15 groups (P < 0.05). When 2-cell, 4-cell, and 8-cell embryos or morulae were vitrified with E20P10, survival, blastocyst, and hatched blastocyst rates were dramatically improved (more than 86.0%). Taken together, vitrification with 20% COOH-PLL and 10% EG is available for vitrification of mouse pre-implantation embryos at the different stages.
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Kamoshita M, Fujiwara K, Matsumura K, Hyon SH, Ito J, Kashiwazaki N. 48 CARBOXYLATED ε-POLY-L-LYSINE (COOH-PLL) IMPROVES DEVELOPMENTAL ABILITY AND REDUCES MITOCHONDRIAL DAMAGE OF VITRIFIED PORCINE EMBRYOS AT THE PRONUCLEAR STAGE. Reprod Fertil Dev 2016. [DOI: 10.1071/rdv28n2ab48] [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] [Indexed: 11/23/2022] Open
Abstract
Although cryopreservation of pronuclear-stage embryos has increasing importance in the production of genetically modified animals via microinjection, it is well known that cryopreserved porcine embryos show low developmental ability. Cryopreservation causes damage to organelles such as mitochondria that are involved in metabolism and play important roles in embryonic development. To reduce the damage in embryo cryopreservation, we focused on carboxylated ε-poly-l-lysine (COOH-PLL), which has been recently developed as a new cryoprotective agent. Carboxylated ε-poly-l-lysine has antifreeze protein properties, such as inhibition of ice recrystallization (Matsumura and Hyon 2009). In this study, we examined the effect of COOH-PLL on development and mitochondrial damage of vitrified porcine embryos at the pronuclear stage. Porcine follicular oocytes were matured (in vitro) and then fertilized (IVF) in vitro. At 10 h after IVF, the presumptive embryos were centrifuged to visualise the pronuclei. Embryos with 2 or 3 pronuclei (PN embryos) were used for vitrification. The PN embryos were exposed to equilibration solution for 10 min and then exposed to vitrification solution for 1 min before being plunged into LN on Cryotop®. Vitrification solution was phosphate buffered saline supplemented with 30% (vol/vol) ethylene glycol + 0.5 M sucrose + 20% (vol/vol) fetal calf serum + 0 or 20% (wt/vol) COOH-PLL (P0 or P20). Development to the blastocyst stage of the vitrified PN embryos was observed after in vitro culture for 158 h. Nonvitrified embryos were used as a control (fresh). Fresh and vitrified with P0 or P20 PN embryos were stained with MitoTracker® Red CMXRos. The embryos stained with MitoTracker® Red CMXRos were investigated by using a laser-scanning confocal microscope. Mitochondrial fluorescent intensity of embryos was evaluated by measuring the mean numbers of pixels in the fluorescent area (mean/area) using the NIH ImageJ software. The blastocyst rate of embryos vitrified with P20 (19.4%) was significantly (P < 0.05) higher than that of P0 (1.3%), and there were no significant differences in blastocyst rates between P20 and fresh group (28.4%; P > 0.05). The mitochondrial fluorescent intensity of embryos vitrified with P20 (2.8 mean/area) was significantly higher than that of P0 (1.5 mean/area), but the intensity of embryos vitrified with P20 was significantly lower than that of fresh (4.2 mean/area; P < 0.05). Our results suggest that supplementation of COOH-PLL with vitrification solution improved development and also reduced mitochondrial damage of vitrified porcine embryos at the pronuclear stage. Further studies are required to clarify the effect of COOH-PLL on various kinds of damage caused by cryopreservation such as other organelles, including endoplasmic reticulum damage, cytoskeleton damage, or DNA fragmentation of vitrified or warmed embryos in pigs.
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