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Yamane N, Ikeda A, Tomooka K, Saito I, Maruyama K, Eguchi E, Suyama K, Fujii A, Shiba T, Tanaka K, Kooka A, Nakamura S, Kajita M, Kawamura R, Takata Y, Osawa H, Steptoe A, Tanigawa T. Salivary Alpha-Amylase Activity and Mild Cognitive Impairment among Japanese Older Adults: The Toon Health Study. J Prev Alzheimers Dis 2022; 9:752-757. [PMID: 36281680 DOI: 10.14283/jpad.2022.51] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is growing interest in examining objective markers for early identification and behavioral intervention to prevent dementia and mild cognitive impairment in clinical and community settings. OBJECTIVE To investigate the association between salivary alpha-amylase as an objective measure of psychological stress response and mild cognitive impairment for the implication of psychological stress in the development of mild cognitive impairment. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study involved 865 participants aged ≥ 65 years. A saliva sample was collected in the morning, and the levels of salivary alpha-amylase were assayed. Mild cognitive impairment was evaluated using the Japanese version of the Montreal Cognitive Assessment; a score < 26 was indicative of mild cognitive impairment. A multivariable logistic regression model was used to examine the association of salivary alpha-amylase and mild cognitive impairment after adjusting for age, sex, current drinking status, current smoking status, body mass index, hypertension, diabetes mellitus, physical activity, education, social support, social network, and heart rate variability. RESULTS Salivary alpha-amylase was associated with mild cognitive impairment (the multivariable-adjusted odds ratio [95% confidence interval] for the 1-standard deviation increment of log-transformed salivary alpha-amylase was 1.24 [1.07-1.44]). This significant association persisted after adjusting for various confounding factors. CONCLUSION Elevation of salivary alpha-amylase was associated with mild cognitive impairment among Japanese community-dwelling older adults. This suggests that salivary alpha-amylase is a useful objective marker of psychological stress responses associated with mild cognitive impairment.
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Affiliation(s)
- N Yamane
- Takeshi Tanigawa, MD, PhD, Department of Public Health, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. Phone: +81 (3) 5802-1049 Fax: +81 (3) 3814-0305,
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Kobayashi H, Joshita S, Akahane Y, Matsuzaki K, Yamada H, Aomura D, Joshita N, Midorikawa H, Suyama K, Ota M, Wakabayashi SI, Yamashita Y, Sugiura A, Yamazaki T, Misawa H, Umemura T. Protocol: Prospective observational study aiming for micro-elimination of hepatitis C virus in Nagawa town: The Nagawa Project. PLoS One 2021; 16:e0256711. [PMID: 34437651 PMCID: PMC8389441 DOI: 10.1371/journal.pone.0256711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The World Health Organization has set a goal of hepatitis C virus (HCV) elimination by the year 2030. However, no regions in Japan have succeeded in eradicating HCV. Micro-elimination is an approach to attain hepatitis C eradication in which national eradication goals are applied to specific populations so that viral treatment and control efforts can move forward quickly and efficiently. In order to eradicate HCV from Japan, this study aims to achieve HCV micro-elimination in the town of Nagawa. METHODS AND DESIGN The Nagawa Project is an ongoing, prospective, multiple-institution, observational study running from April 1, 2021, to March 31, 2024. All residents of Nagawa town, excluding those under 20 years of age, not consenting to the study, or unable to undergo health check-ups due to nursing care needs, will be included. If found to be HCV antibody-positive, the participant will be recommended to see a doctor in consideration of MAC-2 binding protein glycosylation isomer values. Then, the participant will undergo serum HCV RNA measurement with the real-time polymerase chain reaction by an attending physician. If the participant is HCV RNA-positive, he or she will be referred to a hepatologist for further evaluation. In the case of a definitive diagnosis of chronic hepatitis C, direct acting antiviral treatment will be initiated. Through this process, HCV will be systematically micro-eliminated from the region. DISCUSSION The Nagawa Project will reveal the prevalence of chronic HCV in addition to the HCV eradication rate in Nagawa town towards achieving HCV micro-elimination. TRIAL REGISTRATION This study is performed by Shinshu University School of Medicine and was registered as UMIN 000044114 on May 6, 2021.
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Affiliation(s)
- Hiroyuki Kobayashi
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Satoru Joshita
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- * E-mail:
| | - Yuki Akahane
- Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | | | - Hiromi Yamada
- Department of Clinical Laboratory, Yodakubo Hospital, Nagawa, Japan
| | - Daiki Aomura
- Department of Nephrology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Nao Joshita
- Health Care Center, Yodakubo Hospital, Nagawa, Japan
| | | | - Kazuhiro Suyama
- Department of Internal Medicine, Yodakubo Hospital, Nagawa, Japan
| | - Masao Ota
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shun-ichi Wakabayashi
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuki Yamashita
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ayumi Sugiura
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tomoo Yamazaki
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | | | - Takeji Umemura
- Division of Gastroenterology and Hepatology, Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- Department of Health Promotion Medicine, Shinshu University School of Medicine, Matsumoto, Japan
- Consultation Center for Liver Diseases, Shinshu University Hospital, Matsumoto, Japan
- Department of Life Innovation, Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan
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Ito Y, Takeichi T, Igari S, Mori T, Ono A, Suyama K, Takeuchi S, Muro Y, Ogi T, Hosoya M, Yamamoto T, Akiyama M. MEDNIK-like syndrome due to compound heterozygous mutations in AP1B1. J Eur Acad Dermatol Venereol 2020; 35:e345-e347. [PMID: 33349978 DOI: 10.1111/jdv.17098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Y Ito
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Takeichi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Igari
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - T Mori
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - A Ono
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - K Suyama
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - S Takeuchi
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Muro
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Ogi
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan
| | - M Hosoya
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - T Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - M Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Terayama H, Miyaki Y, Qu N, Katsuki S, Tanaka R, Umemoto K, Kosemura N, Suyama K, Tanaka O, Sakabe K. Variations in the gonadal artery with a single common trunk: embryological hypotheses by observation. Folia Morphol (Warsz) 2020; 80:324-330. [PMID: 32488854 DOI: 10.5603/fm.a2020.0063] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND A gonadal artery originates as a branch of the abdominal aorta and renal artery inferior to the level of origin of the renal arteries. Variations in multiple right testicular arteries (RTAs) arising from the abdominal aorta are common. We aimed to re-evaluate the unusual courses of gonadal arteries with a single common trunk in relation to the inferior vena cava and left renal vein and explain the developmental anatomy. MATERIALS AND METHODS The observational cross-sectional study was performed on 54 Japanese adult cadavers (29 men and 25 women). We examined the literature and developed embryological hypotheses on the single common trunk of the gonadal artery. RESULTS The gonadal artery, testicular artery, and ovarian artery arose from the abdominal aorta in 93.1%, 96.3%, and 89.6% of cases, respectively, and from the renal artery in 4.9%, 3.7%, and 6.3% of cases, respectively. We found two rare variations in the RTAs observed during the routine dissection of two male cadavers; in these two cases, a single common trunk of the RTAs originated from the abdominal aorta. A single common trunk was found in 3.7% of cadavers, 2.0% of sides, and 2.0% of arteries in the gonadal artery and in 6.9% of cadavers, 3.8% of sides, and 3.7% of arteries in the testicular artery. All cases of the single common trunk, including those in past reports, were observed only in men. CONCLUSIONS Knowledge of the variations in RTAs has important clinical consequences for invasive and non-invasive arterial procedures. In addition, this variation provides a new interpretation of the embryology of the gonadal artery. Variations similar to our findings have not been previously reported. Therefore, different variations concerning the RTA should be considered during surgical and non-surgical evaluations.
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Affiliation(s)
- H Terayama
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan.
| | - Y Miyaki
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - N Qu
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - S Katsuki
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan.,Department of Rehabilitation, Kanto Rosai Hospital, 1-1 Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki-si, Kanagawa, Japan
| | - R Tanaka
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan.,Department of Rehabilitation, Kanto Rosai Hospital, 1-1 Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki-si, Kanagawa, Japan
| | - K Umemoto
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - N Kosemura
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - K Suyama
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - O Tanaka
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
| | - K Sakabe
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Kanagawa, Japan
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Michel-Sendis F, Gauld I, Martinez J, Alejano C, Bossant M, Boulanger D, Cabellos O, Chrapciak V, Conde J, Fast I, Gren M, Govers K, Gysemans M, Hannstein V, Havlůj F, Hennebach M, Hordosy G, Ilas G, Kilger R, Mills R, Mountford D, Ortego P, Radulescu G, Rahimi M, Ranta-Aho A, Rantamäki K, Ruprecht B, Soppera N, Stuke M, Suyama K, Tittelbach S, Tore C, Winckel SV, Vasiliev A, Watanabe T, Yamamoto T, Yamamoto T. SFCOMPO-2.0: An OECD NEA database of spent nuclear fuel isotopic assays, reactor design specifications, and operating data. ANN NUCL ENERGY 2017. [DOI: 10.1016/j.anucene.2017.07.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Terayama H, Yi SQ, Tanaka O, Kanazawa T, Suyama K, Kosemura N, Tetsu S, Yamazaki H, Sakamoto R, Kawakami S, Suzuki T, Sakabe K. Common and separate origins of the left and right inferior phrenic artery with a review of the literature. Folia Morphol (Warsz) 2017; 76:408-413. [PMID: 28281724 DOI: 10.5603/fm.a2017.0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 08/18/2016] [Indexed: 11/25/2022]
Abstract
In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT), the common trunk of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA); the GPT arises from the abdominal aorta. A hepatosplenic trunk accompanied the variation. In this variation, the RIPA first branched from the GPT and then to the LIPA and LGA. Variations in the common trunk of the LIPA and RIPA in the GPT are common, but to our knowledge, a variation (separate inferior phrenic artery in the GPT) similar to our findings has not been previously reported. We discuss the incidence and developmental and clinical significance of this variation with a detailed review of the literature. Knowledge of such a case has important clinical significance for invasive and non-invasive arterial procedures. Therefore, different variations concerning the LGA and inferior phrenic artery should be considered during surgical and non-surgical evaluations.
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Affiliation(s)
- H Terayama
- Department of Anatomy, Division of Basic Medicine, Tokai University School of Medicine, Japan, Japan.
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Funakoshi T, Horimatsu T, Nakamura M, Suyama K, Mizukami T, Arita S, Ozaki Y, Yasui H, Satake H, Toyoda M, Yazumi S, Kirishima T, Nozaki A, Yoshioka A, Matsubara T, Yanagita M, Fukuhara S, Muto M. Chemotherapy in cancer patients undergoing hemodialysis: A multicenter study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yamazaki K, Nagase M, Tamagawa H, Ueda S, Tamura T, Murata K, Eguchi Nakajima T, Baba E, Tsuda M, Moriwaki T, Esaki T, Tsuji Y, Muro K, Taira K, Denda T, Funai S, Shinozaki K, Yamashita H, Sugimoto N, Okuno T, Nishina T, Umeki M, Kurimoto T, Takayama T, Tsuji A, Yoshida M, Hosokawa A, Shibata Y, Suyama K, Okabe M, Suzuki K, Seki N, Kawakami K, Sato M, Fujikawa K, Hirashima T, Shimura T, Taku K, Otsuji T, Tamura F, Shinozaki E, Nakashima K, Hara H, Tsushima T, Ando M, Morita S, Boku N, Hyodo I. Randomized phase III study of bevacizumab plus FOLFIRI and bevacizumab plus mFOLFOX6 as first-line treatment for patients with metastatic colorectal cancer (WJOG4407G). Ann Oncol 2016; 27:1539-46. [PMID: 27177863 DOI: 10.1093/annonc/mdw206] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/09/2016] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND FOLFIRI and FOLFOX have shown equivalent efficacy for metastatic colorectal cancer (mCRC), but their comparative effectiveness is unknown when combined with bevacizumab. PATIENTS AND METHODS WJOG4407G was a randomized, open-label, phase III trial conducted in Japan. Patients with previously untreated mCRC were randomized 1:1 to receive either FOLFIRI plus bevacizumab (FOLFIRI + Bev) or mFOLFOX6 plus bevacizumab (mFOLFOX6 + Bev), stratified by institution, adjuvant chemotherapy, and liver-limited disease. The primary end point was non-inferiority of FOLFIRI + Bev to mFOLFOX6 + Bev in progression-free survival (PFS), with an expected hazard ratio (HR) of 0.9 and non-inferiority margin of 1.25 (power 0.85, one-sided α-error 0.025). The secondary end points were response rate (RR), overall survival (OS), safety, and quality of life (QoL) during 18 months. This trial is registered to the University Hospital Medical Information Network, number UMIN000001396. RESULTS Among 402 patients enrolled from September 2008 to January 2012, 395 patients were eligible for efficacy analysis. The median PFS for FOLFIRI + Bev (n = 197) and mFOLFOX6 + Bev (n = 198) were 12.1 and 10.7 months, respectively [HR, 0.905; 95% confidence interval (CI) 0.723-1.133; P = 0.003 for non-inferiority]. The median OS for FOLFIRI + Bev and mFOLFOX6 + Bev were 31.4 and 30.1 months, respectively (HR, 0.990; 95% CI 0.785-1.249). The best overall RRs were 64% for FOLFIRI + Bev and 62% for mFOLFOX6 + Bev. The common grade 3 or higher adverse events were leukopenia (11% in FOLFIRI + Bev/5% in mFOLFOX6 + Bev), neutropenia (46%/35%), diarrhea (9%/5%), febrile neutropenia (5%/2%), peripheral neuropathy (0%/22%), and venous thromboembolism (6%/2%). The QoL assessed by FACT-C (TOI-PFC) and FACT/GOG-Ntx was favorable for FOLFIRI + Bev during 18 months. CONCLUSION FOLFIRI plus bevacizumab was non-inferior for PFS, compared with mFOLFOX6 plus bevacizumab, as the first-line systemic treatment for mCRC. CLINICAL TRIALS NUMBER UMIN000001396.
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Affiliation(s)
- K Yamazaki
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - M Nagase
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke
| | - H Tamagawa
- Department of Surgery, Osaka General Medical Center, Osaka
| | - S Ueda
- Department of Medical Oncology, Kinki University Faculty of Medicine, Higashiosaka
| | - T Tamura
- Department of Medical Oncology, Nara Hospital Kinki University Faculty of Medicine, Ikoma
| | - K Murata
- Department of Surgery, Suita Municipal Hospital, Suita
| | - T Eguchi Nakajima
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki
| | - E Baba
- Department of Comprehensive Clinical Oncology, Kyushu University Faculty of Medical Sciences, Fukuoka
| | - M Tsuda
- Department of Gastroenterological Oncology, Hyogo Cancer Center, Akashi
| | - T Moriwaki
- Division of Gastroenterology, University of Tsukuba, Tsukuba
| | - T Esaki
- Department of Gastrointestinal and Medical Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo
| | - K Muro
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Nagoya
| | - K Taira
- Clinical Oncology, Osaka City General Hospital, Osaka
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba
| | - S Funai
- Department of Surgery, Sakai Hospital Kinki University Faculty of Medicine, Sakai
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima
| | - H Yamashita
- Department of Gastroenterology and Hepatology, Okayama Medical Center, Okayama
| | - N Sugimoto
- Department of Clinical Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka
| | - T Okuno
- Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, National Hospital Organization Shikoku Cancer Center, Matuyama
| | - M Umeki
- Department of Surgery, Hyogo Prefectural Awaji Medical Center, Sumoto
| | - T Kurimoto
- Department of Gastrointestinal Oncology, Nagoya Kyoritsu Hospital, Nagoya
| | - T Takayama
- Department of Gastroenterology and Oncology, Tokushima University Graduate School, Tokushima
| | - A Tsuji
- Department of Medical Oncology, Kochi Health Sciences Center, Kochi
| | - M Yoshida
- Division of Cancer Chemotherapy Center, Osaka Medical College Hospital, Takatsuki
| | - A Hosokawa
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Toyama, Toyama
| | - Y Shibata
- Department of Chemotherapy, Miyazaki Prefectural Miyazaki Hospital, Miyazaki
| | - K Suyama
- Department of Medical Oncology, Toranomon Hospital, Tokyo
| | - M Okabe
- Department of Surgery, Kurashiki Central Hospital, Kurashiki
| | - K Suzuki
- Department of gastroenterology, Kushiro City General Hospital, Kushiro
| | - N Seki
- Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo
| | - K Kawakami
- Department of Gastroenterology, Muroran City General Hospital, Muroran
| | - M Sato
- Department of Gastroenterology and Hepatology, Ryuugasaki Saiseikai Hospital, Ryugasaki
| | - K Fujikawa
- Department of Gastroenterology, Hokkaido Cancer Center, Sapporo
| | - T Hirashima
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino
| | - T Shimura
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - K Taku
- Division of Medical Oncology, Shizuoka General Hospital, Shizuoka
| | - T Otsuji
- Department of Gastroenterology, Dongo Hospital, Yamatotakada
| | - F Tamura
- Department of Gastroenterology, Kumamoto Regional Medical Center, Kumamoto
| | - E Shinozaki
- Department of Gastroenterology, Cancer Institute Hospital of JFCR, Tokyo
| | - K Nakashima
- First Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki
| | - H Hara
- Department of Gastroenterology, Saitama Cancer Center, Saitama
| | - T Tsushima
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka
| | - M Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - N Boku
- Department of Clinical Oncology, St Marianna University School of Medicine, Kawasaki
| | - I Hyodo
- Division of Gastroenterology, University of Tsukuba, Tsukuba
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Tanaka T, Tanaka K, Suyama K, Honda S, Senjyu H, Kozu R. A Comparison of Objective Physical Activity, Muscle Strength, and Depression among Community-dwelling Older Women Living in Sloped Versus Non-sloped Environments. J Nutr Health Aging 2016; 20:520-4. [PMID: 27102790 DOI: 10.1007/s12603-015-0602-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To examine the relationship between the living location and outcomes of physical activity level and physical and psychological functioning in older women. The specific aim was to understand the association between living in a sloped versus non-sloped environment and these outcomes. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS 108 older women aged 65 years or older who resided in Nagasaki prefecture participated. MEASUREMENTS Physical activity, lung function, muscle strength (hand grip and quadriceps force) and depressive symptoms were assessed objectively. RESULTS In logistic regression, activity counts per day (OR 0.779, 95%CI 0.715-0.841, p<0.01), activity times per day (OR 0.821, 95%CI 0.801-0.913, p<0.01), hand grip force (OR 0.666, 95%CI 0.558-0.796, p<0.001), and depressed (Center for Epidemiological Studies Depression Scale score ≥16) (OR 1.093, 95%CI 1.019-1.427, p<0.05) showed statistically significant inverse associations with living in a sloped ground. CONCLUSIONS Since dwelling on sloped ground was associated with negative (lower physical activity levels, lower grip strength, and more depression) outcomes, a comprehensive geriatric assessment, related to all aspects of older women, is recommended. Planning of home exercise programs for the elderly should take such environmental factors into consideration.
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Affiliation(s)
- T Tanaka
- Takako Tanaka, Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8520, Japan, Tel: +81 95-819-7967, Fax: +81 95-819-7967, E-mail:
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Fujita Y, Yamazaki K, Oba M, Muro K, Negoro Y, Yoshida M, Suyama K, Kurimoto T, Sugimoto N, Seki N, Sato M, Ebi M, Tamagawa H, Ueda S, Tamura T, Boku N, Hyodo I, Yamanaka T, Tsurutani J, Nishio K. 2152 Exploratory analysis of predictive biomarkers of oxaliplatin versus irinotecan in combination with bevacizumab for patients with metastatic colorectal cancer in WJOG4407G study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31073-5] [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: 10/22/2022]
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Suyama K, Onishi H, Tanaka M, Katano M. Hedgehog Signaling is a Possible Therapeutic Target in Cd24-Negative Breast Cancer Cells. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu359.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Takeshita T, Hayashi K, Horie N, Morikawa M, Suyama K, Nagata I. Endovascular treatment of intractable bleeding from a traumatic pseudoaneurysm of the internal maxillary artery. Neuroradiol J 2013; 25:469-74. [PMID: 24029039 DOI: 10.1177/197140091202500409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/07/2012] [Indexed: 11/16/2022] Open
Abstract
Traumatic pseudoaneurysms of the internal maxillary artery (IMA) are rare and difficult to treat. A 58-year-old man with a traumatic pseudoaneurysm of the IMA presented with intractable nasal and oral hemorrhage during dual antiplatelet therapy. Transcatheter artery embolization with N-butyl cyanoacrylate (NBCA) completely occluded the pseudoaneurysm. Transcatheter artery embolization with NBCA is a feasible and effective treatment because of its shorter treatment time and lower incidence of recurrence.
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Affiliation(s)
- T Takeshita
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Science; Nagasaki, Japan -
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13
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Tada H, Kuroki Y, Funabashi T, Kamiya Y, Goto T, Suyama K, Sano A, Mitsushima D, Etgen AM, Takahashi T. Phasic synaptic incorporation of GluR2-lacking AMPA receptors at gonadotropin-releasing hormone neurons is involved in the generation of the luteinizing hormone surge in female rats. Neuroscience 2013; 248:664-9. [PMID: 23811398 DOI: 10.1016/j.neuroscience.2013.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 06/05/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022]
Abstract
Reproductive success depends on a robust and appropriately timed preovulatory luteinizing hormone (LH) surge, which is induced by the activation of gonadotropin-releasing hormone (GnRH) neurons in response to positive feedback from increasing estrogen levels. Here we document an increase in postsynaptic GluR2-lacking Ca2+ -permeable AMPA-type glutamate receptors (CP-AMPARs) at synapses on GnRH neurons on the day of proestrus in rats, coincident with the increase in estrogen levels. Functional blockade of CP-AMPARs depressed the synaptic responses only on the day of proestrus and concomitantly attenuated the LH surge. Thus, the phasic synaptic incorporation of postsynaptic CP-AMPARs on GnRH neurons is involved in the generation of the LH surge.
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Affiliation(s)
- H Tada
- Department of Physiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
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14
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Suyama K, Sasaki A, Oritani T, Hosono A. Identification of lactose ureide, a urea derivative of lactose, in milk and milk products. J Dairy Sci 2011; 94:5857-63. [DOI: 10.3168/jds.2011-4704] [Citation(s) in RCA: 4] [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: 07/07/2011] [Accepted: 08/16/2011] [Indexed: 11/19/2022]
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15
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Horie N, Morikawa M, Nozaki A, Hayashi K, Suyama K, Nagata I. "Brush Sign" on susceptibility-weighted MR imaging indicates the severity of moyamoya disease. AJNR Am J Neuroradiol 2011; 32:1697-702. [PMID: 21799039 DOI: 10.3174/ajnr.a2568] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE SWI is a high spatial resolution MR imaging technique showing magnetic inhomogeneity that could demonstrate increased oxygen extraction in focal cerebral ischemia. The aim of this study was to investigate the characteristics in the signal intensity of DMVs by using SWI and to determine whether this method could indicate the severity of the hemodynamics in MMD by evaluating the correlation between SWI stage and hemodynamics on SPECT. MATERIALS AND METHODS Consecutive MMD patients were prospectively analyzed before treatment. Routine MR imaging including SWI was performed, and the number of the conspicuous DMVs draining into the subependymal veins was classified: stage 1, mild (< 5); stage 2, moderate (5-10); and stage 3, severe (> 10). The SWI stage was evaluated in correlation with clinical presentations, and CBF and CVR were quantified by using a SPECT iodine 123 N-isopropyl-p-iodoamphetamine split-dose method. RESULTS Patients were 12 males and 21 females (range, 8-66 years), consisting of 4 asymptomatic patients, 13 patients with TIA, 9 patients with infarct, and 7 patients with hemorrhage. There was a significant difference in CVR among clinical presentations, though there was no difference in age, Suzuki stage, or CBF. Conversely, SWI stage was significantly higher in patients with TIA and infarct than asymptomatic patients (P < .01). Higher SWI stage significantly had lower CBF and CVR in the middle cerebral artery area (P < .05). CONCLUSIONS SWI stage strongly correlates with ischemic presentations in MMD and also correlates with hemodynamics on SPECT, especially CVR. Increased conspicuity of DMVs, known as "brush sign", could predict the severity of MMD.
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Affiliation(s)
- N Horie
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki, Japan.
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Makimoto H, Noda T, Kurita T, Nakajima I, Yokoyama T, Doi A, Yamada Y, Okamura H, Satomi K, Aiba T, Shimizu W, Suyama K, Aihara N, Kamakura S. Incessant monomorphic ventricular tachycardia induced by the proarrhythmic effect of amiodarone. Intern Med 2011; 50:2591-5. [PMID: 22041363 DOI: 10.2169/internalmedicine.50.5588] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This case report describes incessant monomorphic ventricular tachycardia (VT), not torsade de pointes, induced by intravenous amiodarone in a 48-year-old woman with dilated cardiomyopathy. VT was reproducibly triggered by short coupled premature ventricular complex (PVC) with different morphology from VT. After amiodarone infusion, the coupling interval of initiating PVC was prolonged, and moreover, the morphology of initiating PVC became the same as that of VT. Though amiodarone has become the first line drug to treat ventricular tachyarrhythmias in patients with cardiac dysfunction, it is important to be aware of its proarrhythmic effect, which may lead to an electrical storm of monomorphic VT.
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Affiliation(s)
- Hisaki Makimoto
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
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17
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Makimoto H, Nakagawa E, Takaki H, Yamada Y, Okamura H, Noda T, Satomi K, Suyama K, Aihara N, Kurita T, Kamakura S, Shimizu W. Augmented ST-Segment Elevation during Recovery from Exercise Predicts Cardiac Events in Patients with Brugada Syndrome. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.jaac_3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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18
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Itoh K, Mihara Y, Toshima Y, Suyama K. Characterization of microbial consortia that reductively dechlorinate 4-chlorophenol and transform phenol to benzoate enriched from estuarine sediment of Lake Shinji. J Environ Sci Health B 2011; 46:181-190. [PMID: 21328126 DOI: 10.1080/03601234.2011.539147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Monochlorophenols were degraded to benzoate via phenol by the initial dechlorination and the subsequent conversion of phenol to benzoate in anaerobic sediment samples of estuarine Lake Shinji under methanogenic conditions. To characterize bacteria that dechlorinate 4-chlorophenol and transform phenol to benzoate, we analyzed the microbial community structure of the enrichment culture with each 4-chlorophenol and phenol by the limiting dilution method with polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) of 16S rRNA gene. After serial dilution of the culture, the 4-chlorophenol-dechlorinating culture consisted of two dominant bacteria, one of which was most homologous with Dehalobacter sp. In the enriched culture with phenol, minor band homologous with Cryptanaerobacter phenolicass corresponded to the transformation activity.
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Affiliation(s)
- K Itoh
- Life and Environmental Science, Shimane University, Shimane, Japan.
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Kawata H, Suyama K, Yokoawa M, Yamagata K, Yokoyama T, Makimoto H, Doi A, Yamada Y, Okamura H, Noda T, Satomi K, Shimizu W, Aihara N, Kamakura S. Three Dimensional Electroanatomical Mapping of Lower Loop Reentry in Patients with Intracardiac Operation. J Arrhythm 2011. [DOI: 10.1016/s1880-4276(11)80006-2] [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: 11/25/2022] Open
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20
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Makimoto H, Nakagawa E, Takaki H, Yamada Y, Okamura H, Noda T, Satomi K, Suyama K, Aihara N, Kurita T, Kamakura S, Shimizu W. Augmented ST-segment elevation during recovery from exercise predicts cardiac events in patients with Brugada syndrome. J Am Coll Cardiol 2010; 56:1576-84. [PMID: 21029874 DOI: 10.1016/j.jacc.2010.06.033] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [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] [Received: 04/21/2010] [Revised: 06/08/2010] [Accepted: 06/15/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The goal of this study was to evaluate the prevalence and the clinical significance of ST-segment elevation during recovery from exercise testing. BACKGROUND During recovery from exercise testing, ST-segment elevation is reported in some patients with Brugada syndrome (BrS). METHODS Treadmill exercise testing was conducted for 93 patients (91 men), 46 ± 14 years of age, with BrS (22 documented ventricular fibrillation, 35 syncope alone, and 36 asymptomatic); and for 102 healthy control subjects (97 men), 46 ± 17 years of age. Patients were routinely followed up. The clinical end point was defined as the occurrence of sudden cardiac death, ventricular fibrillation, or sustained ventricular tachyarrhythmia. RESULTS Augmentation of ST-segment elevation ≥0.05 mV in V(1) to V(3) leads compared with baseline was observed at early recovery (1 to 4 min at recovery) in 34 BrS patients (37% [group 1]), but was not observed in the remaining 59 BrS patients (63% [group 2]) or in the 102 control subjects. During 76 ± 38 months of follow-up, ventricular fibrillation occurred more frequently in group 1 (15 of 34, 44%) than in group 2 (10 of 59, 17%; p = 0.004). Multivariate Cox regression analysis showed that in addition to previous episodes of ventricular fibrillation (p = 0.005), augmentation of ST-segment elevation at early recovery was a significant and independent predictor for cardiac events (p = 0.007), especially among patients with history of syncope alone (6 of 12 [50%] in group 1 vs. 3 of 23 [13%] in group 2) and among asymptomatic patients (3 of 15 [20%] in group 1 vs. 0 of 21 [0%] in group 2). CONCLUSIONS Augmentation of ST-segment elevation during recovery from exercise testing was specific in patients with BrS, and can be a predictor of poor prognosis, especially for patients with syncope alone and for asymptomatic patients.
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Affiliation(s)
- Hisaki Makimoto
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Takano K, Kawasaki Y, Imaizumi T, Ohara S, Takeyama A, Suyama K, Hashimoto K, Hosoya M. An 8-month-old boy with congenital fibromuscular dysplasia presenting with shock caused by sudden renal hemorrhage. Clin Nephrol 2010; 74:399-402. [PMID: 20979950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Fibromuscular dysplasia (FMD) is a non-atheromatous, non-inflammatory, multifocal segmental angiopathy. FMD is the most common cause of pediatric renovascular hypertension. Aneurysmal formation of the main renal artery and distal branches is a rare complication of FMD in infancy. We report an 8-month-old boy with FMD presenting with shock caused by sudden renal hemorrhage that necessitated removal of one kidney. A diagnosis of renovascular hypertension resulting from intimal type FMD with aneurysmal formation was made on the basis of the presence of hypertension, elevation of PRA and aldosterone activity, pathological findings and the results of renal angiography. Our findings suggest that it is therefore necessary to consider FMD with aneurysmal formation as a possible cause of hypertension and renal hemorrhage in infants.
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Affiliation(s)
- K Takano
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
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22
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Mohammad M, Itoh K, Suyama K. Effects of herbicides on Lemna gibba and recovery from damage after prolonged exposure. Arch Environ Contam Toxicol 2010; 58:605-612. [PMID: 20094883 DOI: 10.1007/s00244-010-9466-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2009] [Accepted: 01/02/2010] [Indexed: 05/28/2023]
Abstract
To determine the potential impact of contaminants on the aquatic vascular plants Lemna sp., toxicity tests are usually conducted for a 4- to 14-day exposure, and the toxicity is usually expressed as EC50. However, the effects of longer exposure and the recovery potential after exposure to chemicals are other important factors which should be considered. We present the relative risks of a variety of exposure scenarios and recovery potentials from damage, using herbicides with different modes of action. Toxicity was assessed on the basis of both EC50 and relative growth rate (RGR) compared with untreated controls in exposure and recovery. The EC50 of atrazine was found to be 89 ppb, and its phytostatic concentrations were 1600 and 800 ppb for exposure periods of 14 and 28 days, respectively, and no phytocidal effects were observed up to 3200 ppb for a 28-day exposure. The RGR in recovery was not affected by the RGR in exposure, and regrowth was possible even after complete inhibition of growth for 28 days at the highest concentration tested. Alachlor, with an EC50 of 31 ppb, was phytostatic at 400 ppb for a 14-day exposure and phytocidal at 200 ppb for 21- and 28-day exposures. Paraquat, with an EC50 of 31 ppb, showed phytocidal rather than phytostatic effects. All phytostatic fronds could not grow in the recovery period, and the phytocidal concentration decreased with exposure period, from 80 ppb for a 7-day exposure to 20 ppb for 21- and 28-day exposures. The RGR of alachlor and paraquat in recovery was dependent on the RGR in exposure. In the case of cyclosulfamuron, phytostatic concentrations were 100 and 50 ppb for 7- and 14-day exposures, respectively. In the case of exposures longer than 21 days, however, it exhibited phytocidal activity at 10 ppb. The results of this study suggest that it is important to examine the effects of chemicals over a longer exposure period as well as the recovery potential from damage for reliable ecological risk assessment.
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Affiliation(s)
- M Mohammad
- Faculty of Life and Environmental Science, Shimane University, 1060 Nishikawatsu, Matsue, Shimane, 690-8504, Japan
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23
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Matsuyama TA, Ishibashi-Ueda H, Ikeda Y, Yamada Y, Okamura H, Noda T, Satomi K, Suyama K, Shimizu W, Aihara N, Kamakura S, Inoue S. The positional relationship between the coronary sinus musculature and the atrioventricular septal junction. Europace 2010; 12:719-25. [PMID: 20228078 DOI: 10.1093/europace/euq067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS The atrioventricular (AV) septal junction includes the coronary sinus (CS) and the compact part of the AV node and its posterior extensions. It has been recognized as the target site for ablation therapy of the AV nodal reentrant tachycardia and its variant forms. Despite the clinical significance of this region, the arrangement of the musculature in the AV septal junction, including the CS, has not fully been elucidated. We tried to explore the histological muscular diversity within the AV septal junction. METHODS AND RESULTS Sixteen autopsied human hearts (seven women), mean age 59.8 years, without structural anomalies, were studied. We removed the whole AV septum, including the CS opening after the macroscopic measurements, and prepared serial sections parallel to mitral and tricuspid annuli (short-axis style) to elucidate the positional relationships between the compact AV node and the CS musculature. Out of 16 hearts, the CS musculature extended deeply into the AV septal junction in eight hearts. In the other eight hearts, the CS musculature was located above the AV septal junction. In the former group, we found that the offset of both annuli was wide (mean 3.8 +/- 1.4 vs. 2.4 +/- 1.1 mm), the distance between CS opening and membranous septum was long (mean 14.8 +/- 1.6 vs. 12.3 +/- 2.2 mm), and the CS opening level was lower and closer to the His bundle level (mean 2.8 +/- 1.9 vs. 5.8 +/- 2.9 mm) (P < 0.05). CONCLUSION The deep extension of CS musculature into the AV septal junction seems to increase the tissue non-uniformity in this area.
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Affiliation(s)
- Taka-aki Matsuyama
- Department of Pathology, National Cardiovascular Center, 5-7-1 Fujishirodai Suita-City, 565-8565 Osaka, Japan.
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Kawata H, Noda T, Kurita T, Yamagata K, Yamada Y, Okamura H, Satomi K, Shimizu W, Suyama K, Aihara N, Isobe M, Kamakura S. Clinical Effect of Implantable Cardioverter Defibrillator Replacements - When Should You Resume Driving After an Implantable Cardioverter Defibrillator Replacement? -. Circ J 2010; 74:2301-7. [DOI: 10.1253/circj.cj-10-0316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [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)
- Hiro Kawata
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Takashi Noda
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Takashi Kurita
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kenichiro Yamagata
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Yuko Yamada
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hideo Okamura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuhiro Satomi
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Wataru Shimizu
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Kazuhiro Suyama
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Naohiko Aihara
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Mitsuaki Isobe
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | - Shiro Kamakura
- Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
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Nagai T, Satomi K, Noda T, Okamura H, Yamada Y, Shimizu W, Suyama K, Aihara N, Kamakura S, Kurita T. Relationship Between Oral Amiodarone and Inappropriate Therapy From an Implantable Cardioverter Defibrillator. Circ J 2010; 74:1302-7. [DOI: 10.1253/circj.cj-09-0789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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)
- Takayuki Nagai
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Kazuhiro Satomi
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Hideo Okamura
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Yuko Yamada
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Kazuhiro Suyama
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Naohiko Aihara
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Shiro Kamakura
- Department of Cardiovascular Medicine, National Cardiovascular Center
| | - Takashi Kurita
- Department of Cardiovascular Medicine, National Cardiovascular Center
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Takigawa M, Noda T, Kurita T, Aihara N, Yamada Y, Okamura H, Satomi K, Suyama K, Shimizu W, Kamakura S. Predictors of Electrical Storm in Patients With Idiopathic Dilated Cardiomyopathy - How to Stratify the Risk of Electrical Storm -. Circ J 2010; 74:1822-9. [DOI: 10.1253/circj.cj-10-0092] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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)
- Masateru Takigawa
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Noda
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Kurita
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Naohiko Aihara
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Yuko Yamada
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Hideo Okamura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Satomi
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Suyama
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Wataru Shimizu
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Shiro Kamakura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
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Kurita T, Ueda S, Okamura H, Noda T, Satomi K, Suyama K, Shimizu W, Aihara N, Miyazaki S, Kamakura S. Destructive device removal - sparks and deletion of therapy history from an implantable cardioverter defibrillator. Int Heart J 2009; 50:823-7. [PMID: 19952478 DOI: 10.1536/ihj.50.823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 74-year-old female with a diagnosis of idiopathic dilated cardiomyopathy and ventricular tachycardia died suddenly 9 years after an implantation of an implantable cardioverter-defibrillator (ICD). The destructive removal of an ICD generator and the leads by an uninformed coroner resulted in the loss of the fragile electrograms during the terminal episodes of VT/VF and caused severe charring on the surface of the ICD generator. In order to observe the conditions in which the shock deliveries occurred during the noise detection, we programmed the ICD to deliver the maximum shock energy via a programmer while keeping continuous contact between the device surface and shock lead. The maximum shock energy of 31 Joules produced significant sparks from the surface of the ICD. To avoid the loss of data from an ICD and injury to the patient, widespread notification and education through appropriate scientific societies about the functions of ICDs are highly recommended.
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Affiliation(s)
- Takashi Kurita
- Division of Cardiology, Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan
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28
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Yokokawa M, Okamura H, Noda T, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S, Shimizu W. Neurally mediated syncope as a cause of syncope in patients with Brugada electrocardiogram. J Cardiovasc Electrophysiol 2009; 21:186-92. [PMID: 19793146 DOI: 10.1111/j.1540-8167.2009.01599.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [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: 12/17/2022]
Abstract
INTRODUCTION Patients with type 1 Brugada electrocardiogram (ECG) and an episode of syncope are diagnosed as symptomatic Brugada syndrome; however, all episodes of syncope may not be due to ventricular tachyarrhythmia. METHODS AND RESULTS Forty-six patients with type 1 Brugada ECG (all males, 51 +/- 13 years, 29 spontaneous, 17 Ic-drug induced), 20 healthy control subjects (all males, 35 +/- 11 years), and 15 patients with suspected neurally mediated syncope (NMS; 9 males, 54 +/- 22 years) underwent the head-up tilt (HUT) test. During the HUT test, 12-lead ECGs were recorded in all patients, and the heart rate variability was investigated in some patients. Sixteen (35%) of 46 patients with Brugada ECG, 2 (10%) of 20 control subjects, and 10 (67%) of 15 patients with suspected NMS showed positive responses to the HUT test. Although no significant differences were observed in HUT-positive rate among Brugada patients with documented VT (7/14; 50%), syncope (5/19; 26%) and asymptomatic patients (4/13; 31%), the HUT-positive rate was significantly higher in patients with documented VT (50%) and those with VT or no symptoms (11/27, 41%) compared to that in control subjects (10%) (P < 0.05). Augmentation of ST-segment amplitude (> or =0.05 mV) in leads V1-V3 was observed in 11 (69%) of 16 HUT-positive patients with Brugada ECG during vasovagal responses, and was associated with augmentation of parasympathetic tone following sympathetic withdrawal. CONCLUSION Thirty-five percent of patients with Brugada ECG showed vasovagal responses during the HUT test, suggesting that some Brugada patients have impaired balance of autonomic nervous system, which may relate to their syncopal episodes.
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Affiliation(s)
- Miki Yokokawa
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan
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Kamakura S, Ohe T, Nakazawa K, Aizawa Y, Shimizu A, Horie M, Ogawa S, Okumura K, Tsuchihashi K, Sugi K, Makita N, Hagiwara N, Inoue H, Atarashi H, Aihara N, Shimizu W, Kurita T, Suyama K, Noda T, Satomi K, Okamura H, Tomoike H. Long-term prognosis of probands with Brugada-pattern ST-elevation in leads V1-V3. Circ Arrhythm Electrophysiol 2009; 2:495-503. [PMID: 19843917 DOI: 10.1161/circep.108.816892] [Citation(s) in RCA: 198] [Impact Index Per Article: 13.2] [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: 11/16/2022]
Abstract
BACKGROUND The prognosis of patients with saddleback or noncoved type (non-type 1) ST-elevation in Brugada syndrome is unknown. The purpose of this study was to clarify the long-term prognosis of probands with non-type 1 ECG and those with coved (type 1) Brugada-pattern ECG. METHODS AND RESULTS A total of 330 (123 symptomatic, 207 asymptomatic) probands with a coved or saddleback ST-elevation > or = 1 mm in leads V(1)-V(3) were divided into 2 ECG groups-type 1 (245 probands) and non-type 1 (85 probands)-and were prospectively followed for 48.7+/-15.0 months. The absence of type 1 ECG was confirmed by drug provocation test and multiple recordings. The ratio of individuals with a family history of sudden cardiac death (14%) was lower than previous studies. Clinical profiles and outcomes were not notably different between the 2 groups (annual arrhythmic event rate of probands with ventricular fibrillation; type 1: 10.2%, non-type 1: 10.6%, probands with syncope; type 1: 0.6%, non-type 1: 1.2%, and asymptomatic probands; type 1: 0.5%, non-type 1: 0%). Family history of sudden cardiac death at age <45 years and coexistence of inferolateral early repolarization with Brugada-pattern ECG were independent predictors of fatal arrhythmic events (hazard ratio, 3.28; 95% confidence interval, 1.42 to 7.60; P=0.005; hazard ratio, 2.66; 95% confidence interval, 1.06 to 6.71; P=0.03, respectively, by multivariate analysis), although spontaneous type 1 ECG and ventricular fibrillation inducibility by electrophysiological study were not reliable parameters. CONCLUSIONS The long-term prognosis of probands in non-type 1 group was similar to that of type 1 group. Family history of sudden cardiac death and the presence of early repolarization were predictors of poor outcome in this study, which included only probands with Brugada-pattern ST-elevation.
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Affiliation(s)
- Shiro Kamakura
- Division of Cardiology, National Cardiovascular Center, Suita, Osaka 565-8565, Japan.
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Kwasniewski W, Filipecki A, Orszulak W, Urbanczyk D, Szydlo K, Trusz Gluza M, Borleffs CJW, Van Rees JB, Van Welsenes GH, Van Erven L, Van Bommel RJ, Van Der Velde ET, Bax JJ, Schalij MJ, Jimenez-Candil J, Ruiz M, Morinigo J, Martin A, Ledesma C, Martin-Luengo C, Cozar-Leon R, Diaz-Infante E, Prado-Gotor B, Nieto P, Maldonado J, Borrego I, Cruz JM, Satomi K, Yamada Y, Okamura H, Noda T, Shimizu W, Suyama K, Aihara N, Kamakura S, Hatzinikolaou-Kotsakou E, Moschos G, Beleveslis TH, Reppas E, Kotsakou M, Tsakiridis K, Nageh MF, Kim JJ, Yao J, Deering TF, Epstein A, Goldman D, Greenberg S, Dalal Y, Kreuz J, Balta O, Lickfett L, Nickenig G, Schwab J, Horlbeck FW, Bitzen A, Liliegren N, Jegorova A, Nickenig G, Schwab JO. Moderated Posters: Sudden cardiac death. Europace 2009. [DOI: 10.1093/europace/euq231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Nagai T, Kurita T, Satomi K, Noda T, Okamura H, Shimizu W, Suyama K, Aihara N, Kobayashi J, Kamakura S. QRS prolongation is associated with high defibrillation thresholds during cardioverter-defibrillator implantations in patients with hypertrophic cardiomyopathy. Circ J 2009; 73:1028-32. [PMID: 19359812 DOI: 10.1253/circj.cj-08-0744] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [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: 01/18/2023]
Abstract
BACKGROUND Although high defibrillation threshold (DFT) is a major and unavoidable clinical problem after implantation of an implantable cardioverter defibrillator (ICD), little is known about the cause and management of a high DFT in patients with hypertrophic cardiomyopathy (HCM). The purpose of this study was to assess the predictors of a high DFT in patients with HCM. METHODS AND RESULTS Twenty-three patients with non-dilated HCM who underwent ICD implantation were included. The DFT at the time of the device implantation was measured in all patients. The patients were divided into 2 groups, a high DFT group (DFT >or=15J, n=13) and a low DFT group (DFT <15J, n=10); and their baseline characteristics were compared. The QRS duration was longer in the high than in the low DFT group (128 +/-31 vs 103 +/-12 ms, respectively; P=0.02). QRS duration, left ventricular (LV) end-systolic diameter, and LV ejection fraction were significant predictors of DFT in univariate analysis. However, in multivariate analysis, the only factor significantly associated with DFT was QRS duration (P=0.002). CONCLUSIONS QRS duration is the most consistent predictor of a high DFT in HCM patients undergoing ICD implantation.
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Affiliation(s)
- Takayuki Nagai
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan
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Matsuyama TA, Kurita T, Suyama K, Okamura H, Noda T, Satomi K, Shimizu W, Aihara N, Ikeda Y, Inoue S, Kamakura S, Ishibashi-Ueda H. Mitral isthmus pathology of re-entrant ventricular tachycardia in a patient with idiopathic dilated cardiomyopathy. Europace 2009; 11:827-30. [PMID: 19351627 DOI: 10.1093/europace/eup067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A 68-year-old woman with idiopathic dilated cardiomyopathy suffered from drug-resistant monomorphic ventricular tachycardia (VT). Electrophysiological study revealed a re-entrant VT circuit located just beneath the inferior mitral valve annulus. The VT was considered to be related to the mitral valve isthmus and was abolished by radiofrequency ablation. The patient died 2 years after the ablation due to worsening of heart failure and an autopsy was performed. Pathological examination revealed ablation scar tissue on the localized myocardial bundle running parallel to the mitral valve annulus. Therefore, this bundle appeared to comprise the slow conduction area of the re-entrant VT in this case.
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Affiliation(s)
- Taka-aki Matsuyama
- Department of Pathology, National Cardiovascular Center, 5-7-1 Fujishirodai Suita-City, Osaka 565-8565, Japan.
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Hiu T, Kitagawa N, Morikawa M, Hayashi K, Horie N, Morofuji Y, Suyama K, Nagata I. Efficacy of DynaCT digital angiography in the detection of the fistulous point of dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30:487-91. [PMID: 19213824 DOI: 10.3174/ajnr.a1395] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Identifying the precise hemodynamic features, including the fistulous point, is essential for treatments of dural arteriovenous fistulas (DAVFs). This study illustrates the efficacy of DynaCT digital angiograms obtained from a 3D C-arm CT to directly visualize the location of the fistulous points in DAVFs. MATERIALS AND METHODS This retrospective study observed 14 consecutive patients with DAVFs, which included 7 cavernous sinuses, 4 transverse-sigmoid sinuses, 2 convexity-superior sagittal sinuses, and 1 tentorial sinus. In the assessment of the practical applicability for the diagnosis of DAVFs, images obtained from 2D digital subtraction angiography (DSA) and DynaCT were comparatively evaluated. RESULTS In all patients, DynaCT digital angiography could clearly demonstrate the feeding arteries, the fistulous points, and the draining veins. Significant anatomic landmarks for the fistulous points with relationships to osseous structures were also provided. Compared with 2D DSA, DynaCT digital angiograms demonstrated 12 additional findings in 8 patients (57%), including the detection of the fistulous points (n = 7), the feeders (n = 1), the retrograde leptomeningeal drainage (n = 1), the draining veins (n = 1), and the venous anomaly (n = 2). CONCLUSIONS In comparison with 2D DSA, DynaCT may provide more detailed information to evaluate DAVFs. DynaCT digital angiograms have a high contrast and isotropic spatial resolution, allowing a reliable visualization of small vessels and fine osseous structures. Such detailed information, especially for the location of the fistulous points, could be very useful for either the endovascular or the surgical treatments of DAVFs.
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Affiliation(s)
- T Hiu
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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Aiba T, Shimizu W, Noda T, Okamura H, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S. Noninvasive Characterization of Intra-Atrial Reentrant Tachyarrhythmias After Surgical Repair of Congenital Heart Diseases. Circ J 2009; 73:451-60. [DOI: 10.1253/circj.cj-08-0656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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)
- Takeshi Aiba
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Wataru Shimizu
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Noda
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Hideo Okamura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Satomi
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Suyama
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Kurita
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Naohiko Aihara
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Shiro Kamakura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
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Miyazaki A, Yamamoto M, Sakaguchi H, Tsukano S, Kagisaki K, Suyama K, Ohuchi H, Kurosaki KI, Yagihara T, Yamada O. Pulmonary Valve Replacement in Adult Patients With a Severely Dilated Right Ventricle and Refractory Arrhythmias After Repair of Tetralogy of Fallot. Circ J 2009; 73:2135-42. [DOI: 10.1253/circj.cj-09-0164] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [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)
- Aya Miyazaki
- Department of Pediatric Cardiology, National Cardiovascular Center
| | - Masaki Yamamoto
- Department of Pediatric Cardiology, National Cardiovascular Center
| | - Heima Sakaguchi
- Department of Pediatric Cardiology, National Cardiovascular Center
| | - Shinya Tsukano
- Department of Pediatric Cardiology, National Cardiovascular Center
| | - Koji Kagisaki
- Department of Cardiovascular Surgery, National Cardiovascular Center
| | - Kazuhiro Suyama
- Department of Internal Medicine, Division of Cardiology, National Cardiovascular Center
| | - Hideo Ohuchi
- Department of Pediatric Cardiology, National Cardiovascular Center
| | | | | | - Osamu Yamada
- Department of Pediatric Cardiology, National Cardiovascular Center
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Kurita T, Aiba T, Masukata Y, Yamagata K, Shimizu W, Okamura H, Noda T, Satomi K, Suyama K, Aihara N, Kamakura S. The role of antiarrhythmic drugs for the management of malignant ventricular tachyarrythmias in patients.with heart failure. J Card Fail 2008. [DOI: 10.1016/j.cardfail.2008.07.047] [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]
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Takigawa M, Noda T, Shimizu W, Miyamoto K, Okamura H, Satomi K, Suyama K, Aihara N, Kamakura S, Kurita T. Seasonal and circadian distributions of ventricular fibrillation in patients with Brugada syndrome. Heart Rhythm 2008; 5:1523-7. [PMID: 18984526 DOI: 10.1016/j.hrthm.2008.08.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 08/23/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND It is well-known that the incidence of ventricular tachyarrhythmias is the highest in winter and during the daytime in patients with structural heart disease. However, little is known about the seasonal and circadian distributions of ventricular fibrillation (VF) in patients with Brugada syndrome. OBJECTIVE The aim of this study was to investigate seasonal and circadian distributions of VF in patients with Brugada syndrome. METHODS We analyzed the data of appropriate shock episodes for VF recorded by an implantable cardioverter-defibrillator (ICD) in patients with Brugada syndrome. RESULTS Among 62 consecutive Brugada syndrome patients with an ICD (48 +/- 14 years, 58 males), 19 patients had at least one episode of an appropriate ICD shock due to VF during a mean follow-up of 70 +/- 36 months, and 98 episodes were evaluated as isolated VF. There was a significant peak between March and June (P = .03). As for the circadian variation, significantly more VF occurred from midnight to 6:00 (P <.0001). Electrical storms of VF occurred in seven patients. The seasonal and circadian variations of electrical storms were similar to those of the isolated VF episodes. CONCLUSIONS In patients with Brugada syndrome, there was a significant seasonal peak from spring to early summer and a significant circadian peak from midnight to early morning in terms of the occurrences of VF.
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Affiliation(s)
- Masateru Takigawa
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan
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Aiba T, Yamagata K, Shimizu W, Taguchi A, Satomi K, Noda T, Okamura H, Suyama K, Aihara N, Kamakura S, Kurita T. Electrophysiologic Study-Guided Amiodarone for Sustained Ventricular Tachyarrhythmias Associated With Structural Heart Diseases. Circ J 2008; 72:88-93. [DOI: 10.1253/circj.72.88] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [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)
- Takeshi Aiba
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kenichiro Yamagata
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Wataru Shimizu
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Atsushi Taguchi
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Satomi
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Noda
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Hideo Okamura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Kazuhiro Suyama
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Naohiko Aihara
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Shiro Kamakura
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
| | - Takashi Kurita
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center
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Takigawa M, Noda T, Kurita T, Okamura H, Suyama K, Shimizu W, Aihara N, Nakajima H, Kobayashi J, Kamakura S. Extremely Late Pacemaker-Infective Endocarditis due to Stenotrophomonas maltophilia. Cardiology 2007; 110:226-9. [DOI: 10.1159/000112404] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Accepted: 05/06/2007] [Indexed: 11/19/2022]
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Yokokawa M, Noda T, Okamura H, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S, Shimizu W. Comparison of long-term follow-up of electrocardiographic features in Brugada syndrome between the SCN5A-positive probands and the SCN5A-negative probands. Am J Cardiol 2007; 100:649-55. [PMID: 17697823 DOI: 10.1016/j.amjcard.2007.03.078] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Revised: 03/15/2007] [Accepted: 03/15/2007] [Indexed: 01/05/2023]
Abstract
To investigate changes of electrocardiographic parameters with aging and their relation to the presence of SCN5A mutation in probands with Brugada syndrome (BS), we measured several electrocardiographic parameters prospectively during long-term follow-up (10 +/- 5 years) in 8 BS probands with SCN5A mutation (SCN5A-positive group, all men; age 46 +/- 10 years) and 36 BS probands without SCN5A mutation (SCN5A-negative group, all men; age 46 +/- 13 years). Throughout the follow-up period, depolarization parameters, such as P-wave (lead II), QRS (leads II, V(2), V(5)), S-wave durations (leads II, V(5)), and PQ interval (leads II) were all significantly longer and S-wave amplitude (II, V(5)) was significantly deeper in the SCN5A-positive group than in the SCN5A-negative group. The SCN5A-positive group showed a significantly longer corrected QT interval (lead V(2)) and higher ST amplitude (lead V(2)) than those in the SCN5A-negative group. The depolarization parameters increased with aging during the follow-up period in both groups; however, the PQ interval (lead II) and QRS duration (lead V(2)) were prolonged more prominently and the QRS axis deviated more to the left with aging in the SCN5A-positive group than in the SCN5A-negative group. In conclusion, conduction slowing was more marked and more progressively accentuated in Brugada probands with SCN5A mutation than in those without SCN5A mutation.
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Affiliation(s)
- Miki Yokokawa
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan
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Yamagata K, Noda T, Kurita T, Okamura H, Shimizu W, Suyama K, Aihara N, Niwaya K, Kamakura S. A Novel Procedure for Left Side Implantation of CRT-D Generator in a Patient with Left Subclavian Vein Stenosis. J Card Fail 2007. [DOI: 10.1016/j.cardfail.2007.06.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Otomo K, Suyama K, Okamura H, Noda T, Satomi K, Shimizu W, Kurita T, Aihara N, Kamakura S. Implications of 2:1 atrioventricular block during typical atrioventricular nodal reentrant tachycardia. J Interv Card Electrophysiol 2007; 19:109-19. [PMID: 17668303 DOI: 10.1007/s10840-007-9147-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 06/26/2007] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The effects of 2:1 AV block (AVB) on AV nodal reentrant tachycardia (AVNRT) remain to be elucidated. This study was performed to localize the site of 2:1 AVB and elucidate the effects of 2:1 AVB on typical AVNRT. METHODS The His bundle (HB) electrograms during typical AVNRT with 2:1 AV block were reviewed in 24 patients. It was hypothesized that if 2:1 AVB at the HB or below changed tachycardia cycle length (TCL), the lower turnaround point of the reentrant circuit (RC) might be located within the HB and parts of the HB might be involved in the RC. RESULTS A HB potential was absent in blocked beats during 2:1 AVB in four patients (supra-Hisian block), and the maximal amplitude of the HB potential in blocked beats was the same as that in conducted beats in four patients (infra-Hisian block), and was significantly smaller than that in conducted beats (0.1 +/- 0.1 versus 0.5 +/- 0.2 mV, P < 0.05) in 16 patients (intra-Hisian block). Eight patients (33%) with intra-Hisian block had a nearly identical prolongation of the H-A and A-A intervals in blocked beats (12 +/- 3 and 13 +/- 2 ms, respectively) with unchanged A-H intervals, while the remaining 16 patients (67%) exhibited invariable A-A and/or H-A intervals. CONCLUSION The site of 2:1 AVB during typical AVNRT was estimated to be at the HB or below in 83% of the cases. Two-to-one intra-Hisian block transiently prolonged TCL, possibly indicating involvement of the proximal HB in the RC in one-third of typical the AVNRT cases with 2:1 AVB.
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Affiliation(s)
- Kiyoshi Otomo
- Division of Cardiology, National Cardiovascular Center, Suita, Japan.
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Otomo K, Suyama K, Okamura H, Noda T, Satomi K, Shimizu W, Kurita T, Aihara N, Kamakura S. Participation of a concealed atriohisian tract in the reentrant circuit of the slow–fast type of atrioventricular nodal reentrant tachycardia. Heart Rhythm 2007; 4:703-10. [PMID: 17556188 DOI: 10.1016/j.hrthm.2007.02.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2007] [Accepted: 02/12/2007] [Indexed: 11/20/2022]
Abstract
BACKGROUND The retrograde fast pathway in typical atrioventricular nodal reentrant tachycardia (AVNRT) exhibits marked variation in its electrophysiologic properties. OBJECTIVE The purpose of this study was to characterize the retrograde fast pathway and localize the lower turnaround site of the reentrant circuit in typical AVNRT. METHODS Seventy-four patients with typical AVNRT were divided into two groups according to the response of the retrograde fast pathway to intravenous administration of adenosine triphosphate (ATP) during ventricular pacing: ATP-S [n = 47 (63.5%)] with and ATP-R without [n = 27 (36.5%)] His-atrial (H-A) block. H-A intervals were measured from the most proximal His-bundle electrogram to the earliest atrial activation during the tachycardia (HAt) and entrainment pacing from the parahisian right ventricular region (HAe). It was postulated that the HAt was the difference in conduction time between the lower common pathway (x) and retrograde fast pathway (y) (HAt = y - x), whereas HAe was the sum of the two (HAe = y + x). Hence, x = (HAe-HAt)/2. x >0 suggested the presence of a lower common pathway, whereas x <0 suggested the absence of a lower common pathway and lower turnaround site within the His bundle. RESULTS x was significantly smaller in ATP-R than ATP-S (-6 +/- 5 vs 4 +/- 4 ms, P <.05) and was <0 in 23 (85%) of 27 ATP-R patients. The maximal increment in H-A interval during ventricular pacing was significantly longer in ATP-S than ATP-R (35 +/- 33 vs 2 +/- 2 ms, P <.05). CONCLUSION A concealed atriohisian tract totally bypassing the atrioventricular node constituted the retrograde fast pathway in one third of all typical AVNRT cases.
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Affiliation(s)
- Kiyoshi Otomo
- Division of Cardiology, National Cardiovascular Center, Suita, Japan.
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Shimizu W, Matsuo K, Kokubo Y, Satomi K, Kurita T, Noda T, Nagaya N, Suyama K, Aihara N, Kamakura S, Inamoto N, Akahoshi M, Tomoike H. Sex Hormone and Gender Difference?Role of Testosterone on Male Predominance in Brugada Syndrome. J Cardiovasc Electrophysiol 2007; 18:415-21. [PMID: 17394456 DOI: 10.1111/j.1540-8167.2006.00743.x] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The clinical phenotype is 8 to 10 times more prevalent in males than in females in patients with Brugada syndrome. Brugada syndrome has been reported to be thinner than asymptomatic normal controls. We tested the hypothesis that higher testosterone level associated with lower visceral fat may relate to Brugada phenotype and male predominance. METHODS AND RESULTS We measured body-mass index (BMI), body fat percentage (BF%), and several hormonal levels, including testosterone, in 48 Brugada males and compared with those in 96 age-matched control males. Brugada males had significantly higher testosterone (631 +/- 176 vs 537 +/- 158 ng/dL; P = 0.002), serum sodium, potassium, and chloride levels than those in control males by univariate analysis, and even after adjusting for age, exercise, stress, smoking, and medication of hypertension, diabetes, and hyperlipidemia, whereas there were no significant differences in other sex and thyroid hormonal levels. Brugada males had significantly lower BMI (22.1 +/- 2.9 vs 24.6 +/- 2.6 kg/m(2); P < 0.001) and BF% (19.6 +/- 4.9 vs 23.1 +/- 4.7%; P < 0.001) than control males. Testosterone level was inversely correlated with BMI and BF% in both groups, even after adjusting for the confounding variables. Conditional logistic regression models analysis showed significant positive and inverse association between Brugada syndrome and hypertestosteronemia (OR:3.11, 95% CI:1.22-7.93, P = 0.017) and BMI (OR:0.72, 95% CI:0.61-0.85, P < 0.001), respectively. CONCLUSIONS Higher testosterone level associated with lower visceral fat may have a significant role in the Brugada phenotype and male predominance in Brugada syndrome.
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Affiliation(s)
- Wataru Shimizu
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan.
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Ohgo T, Okamura H, Noda T, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S, Ohe T, Shimizu W. Acute and chronic management in patients with Brugada syndrome associated with electrical storm of ventricular fibrillation. Heart Rhythm 2007; 4:695-700. [PMID: 17556186 DOI: 10.1016/j.hrthm.2007.02.014] [Citation(s) in RCA: 162] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2006] [Accepted: 02/10/2007] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some patients with Brugada syndrome experience an electrical storm of ventricular fibrillation (VF). OBJECTIVE The purpose of this study was to investigate the clinical, laboratory, electrocardiographic, and electrophysiologic characteristics, acute and subsequent chronic treatment, and follow-up data of patients with Brugada syndrome associated with electrical storm of VF. METHODS Sixty-seven patients with Brugada syndrome (65 men and 2 women, age 46 +/- 14 years) were divided into three groups: 7 patients with a history of electrical storm of VF (group I), 39 symptomatic patients with documented VF and/or syncope (group II), and 21 asymptomatic patients (group III). Electrical storm was defined as three or more episodes of VF per day recorded by the memory of an implantable cardioverter-defibrillator. RESULTS No significant differences were observed among the three groups with regard to clinical (age at diagnosis, familial history of sudden cardiac death), laboratory (SCN5A mutation and serum potassium level), electrocardiographic and electrophysiologic characteristics, and follow-up duration after diagnosis. However, arrhythmic events during follow-up after diagnosis and number of arrhythmic events per patient were significantly higher in group I compared with groups II and III. Isoproterenol infusion (0.003 +/- 0.003 microg/kg/min for 24 +/- 13 days) completely suppressed electrical storm of VF in all five patients treated and was successfully replaced with oral medications, including denopamine, quinidine, isoproterenol, cilostazol, and bepridil alone or in combination. CONCLUSION No specifically clinical, laboratory, electrocardiographic, and electrophysiologic characteristics were recognized in patients with Brugada syndrome associated with electrical storm of VF. Isoproterenol infusion was effective as an acute treatment in suppressing electrical storm of VF and was successfully replaced with chronic oral medications.
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Affiliation(s)
- Takeshi Ohgo
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan
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Miyamoto K, Yokokawa M, Tanaka K, Nagai T, Okamura H, Noda T, Satomi K, Suyama K, Kurita T, Aihara N, Kamakura S, Shimizu W. Diagnostic and prognostic value of a type 1 Brugada electrocardiogram at higher (third or second) V1 to V2 recording in men with Brugada syndrome. Am J Cardiol 2007; 99:53-7. [PMID: 17196462 DOI: 10.1016/j.amjcard.2006.07.062] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 07/25/2006] [Accepted: 07/25/2006] [Indexed: 11/24/2022]
Abstract
To evaluate the diagnostic and prognostic value of an electrocardiogram (ECG) recorded at a higher (third or second) intercostal space, 98 men (17 to 76 years of age, mean +/- SD 47 +/- 13; with documented ventricular fibrillation [VF] in 22 and syncope in 32) were categorized into 3 groups; 68 men had a spontaneous type 1 ECG in standard leads V(1) and V(2) (S group), 19 had a spontaneous type 1 ECG only in the higher V(1) and V(2) leads (H group), and 11 had a type 1 ECG only after receiving class Ic sodium channel blockers (Ic group). There were no significant differences in baseline clinical characteristics, including VF episodes, syncope, atrial fibrillation, family history, late potentials, and inducibility of VF during electrophysiologic study across the 3 groups. During prospective follow-up periods (779 +/- 525, 442 +/- 282, and 573 +/- 382 days, respectively), subsequent cardiac events occurred in 11 men (16%) within the S group, in 2 men (11%) in the H group, and in 0 men (0%) in the Ic group (p = NS, S vs H group). In men with previous episodes of VF, subsequent cardiac events occurred in 7 (44%) within the S group and in 2 (50%) in the H group (p = NS). In conclusion, men with a spontaneous type 1 Brugada ECG recorded only at higher leads V(1) and V(2) showed a prognosis similar to that of men with a type 1 ECG in using standard leads V(1) and V(2).
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Affiliation(s)
- Koji Miyamoto
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan
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Satomi K, Kurita T, Suyama K, Noda T, Okamura H, Otomo K, Shimizu W, Aihara N, Kamakura S. Catheter ablation of stable and unstable ventricular tachycardias in patients with arrhythmogenic right ventricular dysplasia. J Cardiovasc Electrophysiol 2006; 17:469-76. [PMID: 16684016 DOI: 10.1111/j.1540-8167.2006.00434.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION A reentrant circuit within an area of abnormal myocardium is suspected as the origin of ventricular tachycardia (VT) in patients with arrhythmogenic right ventricular dysplasia (ARVD). OBJECTIVES To examine the relationship between the reentrant circuits of VT and the abnormal electrograms in ARVD, and to assess the feasibility of a block line formation in the reentrant circuit isthmus utilizing electroanatomical mapping system (CARTO) guidance. METHODS AND RESULTS An electrophysiological study and catheter ablation (CA) were performed in 17 ARVD patients (13 men, 47 +/- 17 year) using CARTO. Endocardial mapping during sinus rhythm demonstrated electrogram abnormalities extended from the tricuspid annulus (TA) or the right ventricular outflow tract in 16 of 17 patients. In 13 hemodynamically stable VTs, the reentrant circuits and critical slow conduction sites for the CA were investigated during VTs. The entire macro-reentrant pathway was identified in 6/13 stable VTs (figure-of-8 in 4, single loop in 2). In the remaining seven VTs, a focal activation pattern was found in four and an unidentifiable pattern in three. CA successfully abolished all the macro-reentrant and focal tachycardias, however, not effective in three unidentifiable VTs. In the 13 cases with unstable VT, the linear conduction block zone was produced between the sites with abnormal electrograms and the TA. Ultimately, 23/26 VTs (88%) became noninducible after the CA. During follow-up (26 +/- 15 months), 13/17 patients remained free from any VT episodes. CONCLUSIONS CARTO is useful for characterizing the anatomical and electrophysiological substrates, and for identifying the optimal ablation sites for VT associated with ARVD.
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Affiliation(s)
- Kazuhiro Satomi
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan.
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Yokokawa M, Takaki H, Noda T, Satomi K, Suyama K, Kurita T, Kamakura S, Shimizu W. Spatial Distribution of Repolarization and Depolarization Abnormalities Evaluated by Body Surface Potential Mapping in Patients with Brugada Syndrome. Pacing Clin Electro 2006; 29:1112-21. [PMID: 17038144 DOI: 10.1111/j.1540-8159.2006.00505.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Mutations in sodium channel gene, SCN5A, have been identified in Brugada syndrome, but it is still unclear as to how sodium channel dysfunction relates to arrhythmogenesis. We examined spatial distribution of both repolarization and depolarization abnormalities in patients with Brugada syndrome by using 87-leads body surface potential mapping (BSPM). METHODS BSPM was recorded under baseline condition and after pharmacological interventions in 28 patients with Brugada syndrome (27 males, 49 +/- 14 years). The ST-segment amplitude 20 ms after the end of QRS (ST20), QRS duration, and corrected recovery time (RTc) were measured in all 87-leads, and averaged among 6-leads (D-F, 5-6) reflecting right ventricular outflow tract (RVOT) potentials and the other 81-leads. RESULTS The ST20 was elevated at baseline, normalized by isoproterenol, and augmented by pilsicainide in only the RVOT. The RTc was longer at baseline and increased by pilsicainide in only the RVOT. On the other hand, the QRS duration was slightly widened at baseline, further increased by pilsicainide, but not changed by isoproterenol in both leads. CONCLUSIONS The ST-segment elevation and the RTc prolongation were localized and modulated by agents only in the RVOT region, while the slight QRS widening at baseline and further increase by pilsicainide were observed homogeneously. Our data suggest that depolarization abnormalities are distributed homogeneously, whereas repolarization abnormalities are localized in the RVOT.
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Affiliation(s)
- Miki Yokokawa
- Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Osaka, Japan
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Otomo K, Okamura H, Noda T, Satomi K, Shimizu W, Suyama K, Kurita T, Aihara N, Kamakura S. "Left-variant" atypical atrioventricular nodal reentrant tachycardia: electrophysiological characteristics and effect of slow pathway ablation within coronary sinus. J Cardiovasc Electrophysiol 2006; 17:1177-83. [PMID: 16978247 DOI: 10.1111/j.1540-8167.2006.00598.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Recent anatomical and electrophysiological studies have demonstrated the presence of leftward posterior nodal extension (LPNE); however, its role in the genesis of atrioventricular nodal reentrant tachycardia (AVNRT) is poorly understood. This study was performed to characterize successful slow pathway (SP) ablation site and to elucidate the role of LPNE in genesis of atypical AVNRT with eccentric activation patterns within the coronary sinus (CS). METHODS AND RESULTS Among 45 patients with atypical AVNRT (slow-slow/fast-slow/both = 20/22/3 patients) with concentric (n = 37, 82%) or eccentric CS activation (n = 8, 18%), successful ablation site was evaluated. Among 35/37 patients (95%) with concentric CS activation, ablation at the conventional SP region outside CS eliminated both retrograde SP conduction and AVNRT inducibility. Among eight patients with eccentric CS activation, the earliest retrograde atrial activation was found at proximal CS 16 +/- 4 mm distal to the ostium during AVNRT. The earliest retrograde activation site was located at inferior to inferoseptal mitral annulus, consistent with the presumed location of LPNE. Ablation at the conventional SP region with electroanatomical approach only rendered AVNRT nonsustained without elimination of retrograde SP conduction in seven of eight patients (88%). Ablation targeted to the earliest retrograde atrial activation site within proximal CS (15 +/- 4 mm distal to the ostium); however, eliminated retrograde SP conduction and rendered AVNRT noninducible in six of eight patients (75%). CONCLUSION In 75% of "left-variant" atypical AVNRT, ablation within proximal CS was required to eliminate eccentric retrograde SP conduction and render AVNRT noninducible, suggesting LPNE formed retrograde limb of reentrant circuit.
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Affiliation(s)
- Kiyoshi Otomo
- Department of Cardiovascular Medicine, Cardiovascular Center, Tsuchiura Kyodo Hospital, 11-7 Manabe-shin-machi, Tsuchiura, Ibaraki prefecture, 300-0053, Japan.
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Otomo K, Okamura H, Noda T, Satomi K, Shimizu W, Suyama K, Kurita T, Aihara N, Kamakura S. Site-Specific Influence of Transversal Conduction Across Crista Terminalis on Recognition of Isthmus Block. Pacing Clin Electro 2006; 29:589-99. [PMID: 16784424 DOI: 10.1111/j.1540-8159.2006.00383.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Transversal conduction across crista terminalis (CT) is commonly observed during low-rate coronary sinus (CS) pacing after isthmus ablation and sometimes mimics incomplete clockwise isthmus block (IB). Site-specific influence of trans-cristal conduction gap on recognition of clockwise IB has been poorly understood. METHODS Forty-five patients with common-type atrial flutter underwent mapping of CT and free wall lateral to CT during CS pacing of 100 ppm using CARTO after verification of IB, while duodecapolar catheter was positioned along tricuspid annulus to map periannular activation. RESULTS A total of 43 gaps were demonstrated at upper (n = 15, 35%), middle (n = 17, 40%), and lower one-thirds of CT (n = 11, 25%) in 36 of 45 patients (80%). Gaps were single in 31 (69%) and multiple in 5 patients (11%). Activation patterns of free wall lateral to CT in CARTO maps were descending pattern without gaps (n = 9, 20%), collision pattern with a single gap (n = 31, 69%), and simultaneous pattern with multiple gaps (n = 5, 11%). Activation sequence of duodecapolar catheter was complete block pattern in 41 (91%) and incomplete block pattern in 4 patients (9%), masquerading as persistent clockwise isthmus conduction. The incomplete block pattern in duodecapolar catheter was exclusively associated with a gap at the lower CT (0/15, 0/17, and 4/11 gaps at upper, middle, and lower CT, respectively; P < 0.01) and was attributable to faster conduction across CT gaps than in complete block pattern. CONCLUSIONS Trans-cristal conduction was commonly observed during low-rate CS pacing. Rapid transversal conduction exclusively across lower CT masqueraded as incomplete clockwise IB.
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Affiliation(s)
- Kiyoshi Otomo
- Division of Cardiology, National Cardiovascular Center, Suita, Japan.
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