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Anegawa T, Sasaki KI, Ishizaki Y, Negoto S, Oryoji A, Nakamura E, Otsuka H, Hiromatsu S, Fukumoto Y, Tayama E. Effects of Pemafibrate on Reducing Oxidative Stress and Augmenting Angiogenesis in Ischemic Limb Tissue. Kurume Med J 2024:MS6934006. [PMID: 38233183 DOI: 10.2739/kurumemedj.ms6934006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Oxidative damage is observed in the ischemic limbs of patients with arteriosclerosis obliterans. We investigated whether pemafibrate, a selective peroxisome proliferator-activated receptor alpha modulator, reduced oxidative stress in ischemic limbs and consequently rescued limb damage in model mice. MATERIALS AND METHODS We surgically induced hind-limb ischemia in mice and orally administered pemafibrate solution (P-05 group, 0.5 mg/kg/day; P-10 group, 1.0 mg/kg/day) or control solution (control group). Seven days after the surgery, differences in reactive oxygen species (ROS) contents, antioxidative enzyme and transcription factor expression, blood flow, and capillary density in ischemic limbs were assessed. RESULTS Tissue ROS levels were lower in the P-05 and P-10 groups compared with those in the control group. Although the tissue expression levels of nuclear factor-erythroid 2-related factor 2 increased in the P-10 group compared with that in the control group, no corresponding changes were observed in the tissue expression of four antioxidative enzymes. The limb salvage rates and capillary densities in ischemic limbs were higher in the P-05 and P-10 groups than that in the control group. CONCLUSION Pemafibrate treatment reduced oxidative stress and augmented angiogenesis in ischemic limbs, contributing to prevention of limb damage in mice.
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Affiliation(s)
- Tomoyuki Anegawa
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yuta Ishizaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Shinya Negoto
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Atsunobu Oryoji
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Eiji Nakamura
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Hiroyuki Otsuka
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Shinichi Hiromatsu
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Eiki Tayama
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine
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Takaseya T, Itaya N, Sasaki KI, Sasaki M, Yokomizo M, Honda A, Oshita K, Azuma J, Fukumoto Y, Tayama E. Cusp overlap technique decreases paravalvular leakage in self-expandable transcatheter aortic valve replacement. Heart Vessels 2024; 39:48-56. [PMID: 37606754 DOI: 10.1007/s00380-023-02307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
The cusp overlap technique allows greater visual separation between the basal annular plane and the conduction system and decreases the permanent pacemaker implantation rate. We assessed the impact of the cusp overlap technique on conduction disturbance and paravalvular leakage after transcatheter aortic valve replacement. A total of 97 patients underwent transfemoral transcatheter aortic valve replacement with self-expandable valves at our institution from November 2018 to January 2023. The mean age of the patients was 85 years, and 23% were male. The patients were divided into two groups: the cusp overlap technique group and the non-cusp overlap technique group. We compared the clinical results between the two groups. The 30-day permanent pacemaker implantation rate was similar between the two groups (cusp overlap technique: 6.3% vs. non-cusp overlap technique: 10.2%, p = 0.48). The rate of new-onset conduction disturbance was slightly lower in the cusp overlap than non-cusp overlap technique group (18.8% vs. 34.7%, respectively; p = 0.08). The implanted valve function was similar between the two groups, but the rate of trivial or less paravalvular leakage (PVL) was significantly higher in the cusp overlap technique group on echocardiography (69% vs. 45%, p = 0.02). On multidetector computed tomography, the implantation depth at the membranous septum was significantly shorter in the cusp overlap technique group (2.0 ± 2.3 vs. 2.9 ± 1.5 mm, p = 0.02). The degree of canting was slightly smaller in the cusp overlap technique group (1.0 ± 2.2 vs. 1.7 ± 1.9 mm, p = 0.07). The relative risk of PVL equal to or greater than mild was 1.76 times higher for valve implantation without the cusp overlap technique (adjusted odds ratio, 3.74; 95% confidence interval, 1.45-9.69; p < 0.01). Transcatheter aortic valve replacement using the cusp overlap technique is associated with an optimized implantation depth, leading to fewer conduction disturbances. Optimal deployment may also maximize the radial force of self-expanding valves to reduce paravalvular leakage.
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Affiliation(s)
- Tohru Takaseya
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-Shi, Fukuoka, 830-0011, Japan.
| | - Naoki Itaya
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Masahiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Michiko Yokomizo
- Department of Anesthesiology, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Akihiro Honda
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Kensuke Oshita
- Department of Anesthesiology, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Junpei Azuma
- Division of Radiology, Kurume University Hospital, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume-Shi, Fukuoka, 830-0011, Japan
| | - Eiki Tayama
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-Shi, Fukuoka, 830-0011, Japan
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Yoshikawa T, Sasaki KI, Adachi H, Kakuma T, Hatada-Katakabe S, Takata Y, Fukumoto Y. Weakened Grip Strength Over 40 Years in a Community-Dwelling Cohort in Tanushimaru, Japan. Kurume Med J 2023; 68:191-200. [PMID: 37316292 DOI: 10.2739/kurumemedj.ms6834005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND An epidemiological survey has been periodically performed since 1977 among the adult population in Tanushimaru, a typical farming town in Japan. We aimed in this study to retrospectively investigate changes of grip strength (GS) and its correlates over 40 years in the same cohort of community-dwelling adults. We used pooled data from the survey to deduce essential correlates of GS in community-dwelling adults. METHODS We retrospectively compared serial correlates of GS in the adult population in Tanushimaru between a population tested in 1977 and 1979 (Cohort A, n=2,452) and another population tested in 2016 and 2018 (Cohort B, n=1,505), to identify essential correlates of GS for investigating changes in GS during the past 40 years in community-dwelling adults. RESULTS Age, height, weight, and the occupation of the subjects remained as correlates of GS in both genders during the past 40 years. In males, abdominal circumference also remained as a correlate of GS. Serum albumin levels in males and systolic blood pressure in females were identified as new correlates. GS after adjustment for the above correlates weakened in both genders, and the serial change in GS was particularly remarkable in subjects whose occupations were Class-1 and Class-2, which were defined as moderately hard work. CONCLUSIONS From a periodically-performed epidemiological survey of a community-dwelling cohort in a Japanese typical farming town, age, height, weight, and occupation were deduced as essential correlates of GS. GS in the community dwelling cohort weakened in both genders over 40 years, possibly affected by their occupation.
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Affiliation(s)
- Takahiro Yoshikawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Hisashi Adachi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | | | - Sachiko Hatada-Katakabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yuuki Takata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
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Fujioka A, Yanishi K, Yukawa A, Imai K, Yokota I, Fujikawa K, Yamada A, Naito A, Shoji K, Kawamata H, Higashi Y, Ishigami T, Sasaki KI, Tara S, Kuwahara K, Teramukai S, Matoba S. A Multicenter Prospective Interventional Trial of Therapeutic Angiogenesis Using Bone Marrow-Derived Mononuclear Cell Implantation for Patients With Critical Limb-Threatening Ischemia Caused by Thromboangiitis Obliterans. Circ J 2023; 87:1229-1237. [PMID: 36908168 DOI: 10.1253/circj.cj-23-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
BACKGROUND Thromboangiitis obliterans (TAO) can lead to the development of critical limb-threatening ischemia (CLTI). Despite conventional treatments, such as smoking cessation or revascularization, young patients (<50 years) still require limb amputation. Therapeutic angiogenesis using bone marrow-derived mononuclear cell (BM-MNC) implantation has been tested and shown to have reasonable efficacy in CLTI. In this multicenter prospective clinical trial, we evaluated the safety and efficacy of BM-MNC implantation in CLTI patients with TAO.Methods and Results: We enrolled 22 CLTI patients with skin perfusion pressure (SPP) <30 mmHg. The primary endpoint of this trial is the recovery of SPP in the treated limb after a 180-day follow-up period. Secondary endpoints include the pain scale score and transcutaneous oxygen pressure (TcPO2). One patient dropped out during follow-up, leaving 21 patients (mean age 48 years, 90.5% male, Fontaine Class IV) for analysis. BM-MNC implantation caused no serious adverse events and increased SPP by 1.5-fold compared with baseline. Surprisingly, this effect was sustained over the longer term at 180 days. Secondary endpoints also supported the efficacy of this novel therapy in relieving pain and increasing TcPO2. Major amputation-free and overall survival probabilities at 3 years among all enrolled patients were high (95.5% and 89.5%, respectively). CONCLUSIONS BM-MNC implantation showed safety and significant efficacy in CLTI patients with TAO.
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Affiliation(s)
- Ayumu Fujioka
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Kenji Yanishi
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Arito Yukawa
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Kojiro Imai
- Department for Medical Innovation and Translational Medical Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Isao Yokota
- Department of Biostatistics, Graduate School of Medicine, Hokkaido University
| | - Kei Fujikawa
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Ayumu Yamada
- The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine
| | - Akari Naito
- The Clinical and Translational Research Center, University Hospital, Kyoto Prefectural University of Medicine
| | - Keisuke Shoji
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Hirofumi Kawamata
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Tomoaki Ishigami
- Department of Stem Cell and Immune Regulation, Yokohama City University Graduate School of Medicine
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Syuhei Tara
- Department of Cardiovascular Medicine, Nippon Medical School of Medicine
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine
| | - Satoshi Teramukai
- Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine
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Sasaki M, Sasaki KI, Ishizaki Y, Ushijima S, Kamori-Kurokawa Y, Hamasaki K, Yoshikawa T, Hatada-Katakabe S, Takata Y, Ohtsuka M, Fukumoto Y. Safety and Efficacy of a Bodyweight Exercise Training Program in Symptomatic Patients With Severe Aortic Valve Stenosis. Am J Cardiol 2023; 186:163-169. [PMID: 36273954 DOI: 10.1016/j.amjcard.2022.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/06/2022] [Accepted: 09/28/2022] [Indexed: 11/01/2022]
Abstract
Conventional exercise therapy including aerobic and resistance training is desirable for cardiovascular disease, whereas it is generally considered contraindicated for symptomatic severe aortic valve stenosis (AS). This study aimed to evaluate the safety and efficacy of bodyweight resistance exercise training (BRET), which is low-intensity exercise training in symptomatic patients with severe AS. A BRET program consisting of 8 exercises was performed 3 times a week by patients with AS with physical therapists. For the 78 symptomatic patients with severe AS, the median aortic valve area and mean transaortic valve pressure gradient were 0.56 cm2 and 48.9 mm Hg, respectively; none showed any harmful changes in blood pressure or heart rate in 11 sessions of the BRET program. There were no adverse events during hospitalization. Meanwhile, Barthel's Index score significantly improved at the time of hospital discharge. In conclusion, the BRET program in this study did not appear to cause harmful changes in hemodynamics during the program or adverse events during hospitalization, and it improved activities of daily living in symptomatic patients with severe AS, allowing doctors and physical therapists to conduct it safely, with less emotional stress, for cardiac rehabilitation for such patients.
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Affiliation(s)
- Motoki Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Yuta Ishizaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shigeki Ushijima
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | | | - Kumiko Hamasaki
- Division of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takahiro Yoshikawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Hatada-Katakabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yuki Takata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masanori Ohtsuka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Ishizaki Y, Sasaki KI, Yoshikawa T, Nakayoshi T, Sasaki M, Ohtsuka M, Hatada-Katakabe S, Takata Y, Fukumoto Y. RTA-dh404 decreased oxidative stress in mice ischemic limbs and augmented efficacy of therapeutic angiogenesis by intramuscular injection of adipose-derived regenerative cells in the limbs. Eur J Pharmacol 2022; 938:175422. [PMID: 36442622 DOI: 10.1016/j.ejphar.2022.175422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/07/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Although an intramuscular injection of angiogenic cells to ischemic limbs with peripheral artery disease is a therapeutic option to rescue patients by augmenting neovascularization in the limbs, oxidative stress in the limbs may accelerate apoptosis of the injected cells and thereby reduce the therapeutic effect. In this study involving mice with ischemic lower limbs, whether daily oral administration of RTA-dh404, which is an activator of nuclear factor erythroid 2-related factor 2 (Nrf2) with antioxidant activity, could reduce oxidative stress in the limbs and suppress apoptosis of adipose-derived regenerative cells (ADRCs) injected in the limbs, eventually augmenting neovascularization in the limbs, was evaluated. The tissue expression of Nrf2 and concentrations of total antioxidant capacity and superoxide dismutase in the mice ischemic limbs were higher in the RTA-dh404-treated mice than in the control treated mice, and oxidative stress in the limbs of the RTA-dh404 treated mice was decreased. The day after an intramuscular injection of human ADRCs into ischemic lower limbs of immunodeficient mice, the number of apoptotic ADRCs in the ischemic limbs was decreased by approximately 25% in the RTA-dh404-treated mice compared to the control mice. Fourteen days after cell injection, neovascularization and the salvage ratio were increased by approximately 10% and 63%, respectively, in the ischemic limbs in the RTA-dh404-treated mice compared to the control mice. Pretreatment of ischemic limbs by daily oral administration of RTA-dh404 may augment the effect of therapeutic angiogenesis using an intramuscular injection of ADRCs into the ischemic limbs.
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Affiliation(s)
- Yuta Ishizaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Takahiro Yoshikawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takaharu Nakayoshi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Motoki Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masanori Ohtsuka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Hatada-Katakabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yuki Takata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Kario K, Yokoi Y, Okamura K, Fujihara M, Ogoyama Y, Yamamoto E, Urata H, Cho JM, Kim CJ, Choi SH, Shinohara K, Mukai Y, Ikemoto T, Nakamura M, Seki S, Matoba S, Shibata Y, Sugawara S, Yumoto K, Tamura K, Yoshihara F, Nakamura S, Kang WC, Shibasaki T, Dote K, Yokoi H, Matsuo A, Fujita H, Takahashi T, Kang HJ, Sakata Y, Horie K, Inoue N, Sasaki KI, Ueno T, Tomita H, Morino Y, Nojima Y, Kim CJ, Matsumoto T, Kai H, Nanto S. Catheter-based ultrasound renal denervation in patients with resistant hypertension: the randomized, controlled REQUIRE trial. Hypertens Res 2022; 45:221-231. [PMID: 34654905 PMCID: PMC8766280 DOI: 10.1038/s41440-021-00754-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 02/07/2023]
Abstract
Renal denervation is a promising new non-pharmacological treatment for resistant hypertension. However, there is a lack of data from Asian patients. The REQUIRE trial investigated the blood pressure-lowering efficacy of renal denervation in treated patients with resistant hypertension from Japan and South Korea. Adults with resistant hypertension (seated office blood pressure ≥150/90 mmHg and 24-hour ambulatory systolic blood pressure ≥140 mmHg) with suitable renal artery anatomy were randomized to ultrasound renal denervation or a sham procedure. The primary endpoint was change from baseline in 24-hour ambulatory systolic blood pressure at 3 months. A total of 143 patients were included (72 renal denervation, 71 sham control). Reduction from baseline in 24-hour ambulatory systolic blood pressure at 3 months was not significantly different between the renal denervation (-6.6 mmHg) and sham control (-6.5 mmHg) groups (difference: -0.1, 95% confidence interval -5.5, 5.3; p = 0.971). Reductions from baseline in home and office systolic blood pressure (differences: -1.8 mmHg [p = 0.488] and -2.0 mmHg [p = 0.511], respectively), and medication load, did not differ significantly between the two groups. The procedure-/device-related major adverse events was not seen. This study did not show a significant difference in ambulatory blood pressure reductions between renal denervation and a sham procedure in treated patients with resistant hypertension. Although blood pressure reduction after renal denervation was similar to other sham-controlled studies, the sham group in this study showed much greater reduction. This unexpected blood pressure reduction in the sham control group highlights study design issues that will be addressed in a new trial. CLINICAL TRIAL REGISTRATION: NCT02918305 ( http://www.clinicaltrials.gov ).
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Yoshiaki Yokoi
- Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
| | - Keisuke Okamura
- Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
| | - Yukako Ogoyama
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Eiichiro Yamamoto
- Department of Cardiovascular Medicine, Kumamoto University Graduate School of Medical Science, Kumamoto, Japan
| | - Hidenori Urata
- Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Fukuoka, Japan
| | - Jin-Man Cho
- Division of Cardiology, Department of Internal Medicine, KyungHee University Hospital at Gangdong, Seoul, South Korea
| | - Chong-Jin Kim
- Division of Cardiology, Department of Internal Medicine, CHA Gangnam Medical Center, Seoul, South Korea
| | - Seung-Hyuk Choi
- Division of Cardiology Heart Vascular and Stroke Institute, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Keisuke Shinohara
- Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Yasushi Mukai
- Division of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Tomokazu Ikemoto
- Division of Cardiology, Kumamoto Red Cross Hospital, Kumamoto, Japan
| | - Masato Nakamura
- Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Shuichi Seki
- Department of Cardiology, Chikamori Hospital, Kochi, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshisato Shibata
- Department of Cardiology, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Shigeo Sugawara
- Department of Cardiology, Nihonkai General Hospital, Yamagata, Japan
| | - Kazuhiko Yumoto
- Department of Cardiology, Yokohama Rosai Hospital, Kanagawa, Japan
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Medical Center, Kanagawa, Japan
| | - Fumiki Yoshihara
- Division of Nephrology and Hypertension, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satoko Nakamura
- Department of Nutritional Science for Well-being, Kansai University of Welfare Sciences, Osaka, Japan
| | - Woong Chol Kang
- Department of Cardiology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Taro Shibasaki
- Department of Cardiology, Saitama Sekishinkai Hospital, Saitama, Japan
| | - Keigo Dote
- Department of Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Hiroyoshi Yokoi
- Cardiovascular Center, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Akiko Matsuo
- Department of Cardiology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hiroshi Fujita
- Department of Cardiology, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Hyun-Jae Kang
- Department of Internal Medicine, Seoul National University Hospital and University College of Medicine, Seoul National University, Seoul, South Korea
| | - Yasushi Sakata
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Naoto Inoue
- Cardiovascular Center, Tokyo Kamata Hospital, Tokyo, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Takafumi Ueno
- Division of Cardiology, Fukuoka Kinen Hospital, Fukuoka, Japan
| | - Hirofumi Tomita
- Department of Cardiology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan
| | - Yuhei Nojima
- Department of Cardiovascular Medicine, Nishinomiya Municipal Central Hospital, Hyogo, Japan
| | - Chan Joon Kim
- Division of Cardiology, Department of Internal Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | - Hisashi Kai
- Department of Cardiology, Kurume University Medical Center, Fukuoka, Japan
| | - Shinsuke Nanto
- Department of Cardiovascular Medicine, Nishinomiya Municipal Central Hospital, Hyogo, Japan
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Abstract
Sarcopenia, the lowered skeletal muscle mass, weakened skeletal muscle strength, and reduced physical performance with aging, is a component of frailty and high-risk factor for falls, resulting in an increase in mortality. In cardiovascular disease (CVD) patients, systemic inflammation, oxidative stress, overactivation of ubiquitin-proteasome system, endothelial dysfunction, lowering muscle blood flow, impaired glucose tolerance, hormonal changes, and physical inactivity possibly contribute to CVD-related sarcopenia. Prevalence of sarcopenia and osteosarcopenia, which is osteopenia and sarcopenia coexisting together, seems to be higher in CVD patients than in community-dwelling adults, suggesting the necessity of early diagnosis and prevention of CVD-related sarcopenia. Atrial stiffness, coronary artery calcification score, and serum vitamin D levels may be of help as the biomarkers to suspect sarcopenia, and renin-angiotensin-aldosterone system inhibitors may play a role in the medical prevention and treatment of CVD-related sarcopenia. There are few reports to convince the efficacies of dietary and antioxidant supplementation on sarcopenia at present, whereas aerobic and resistance training exercises have been recognized as an effective strategy to prevent and treat sarcopenia.
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Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
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9
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Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
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10
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Kagiyama K, Mitsutake Y, Ueno T, Sakai S, Nakamura T, Yamaji K, Ishimatsu T, Sasaki M, Chibana H, Itaya N, Sasaki KI, Fukumoto Y. Successful introduction of robotic-assisted percutaneous coronary intervention system into Japanese clinical practice: a first-year survey at single center. Heart Vessels 2021; 36:955-964. [PMID: 33502572 PMCID: PMC7839282 DOI: 10.1007/s00380-021-01782-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/08/2021] [Indexed: 12/22/2022]
Abstract
In Japan, a robotic-assisted PCI (R-PCI) system, the CorPath GRX System (Corindus Inc.), has been approved for clinical use in 2018, which is the first introduction of R-PCI into Japan. In this study, the clinical performance of the R-PCI system in the initial year at Kurume University Hospital was evaluated comparing with conventional manual PCI (M-PCI). A total of 30 R-PCI and 77 M-PCI procedures performed between April 2019 and March 2020, were retrospectively included. The primary outcome was the rate of clinical success defined as < 30% residual stenosis without in-hospital major adverse cardiovascular events (MACE). The secondary outcomes were fluoroscopy time, dose area product (DAP), amount of radiation exposure to operators and assistants, procedural time, and contrast volume. Propensity-matching technique was used to match each R-PCI lesion to the nearest M-PCI lesion without replacement. After propensity score matching, 30 R-PCI procedures in 28 patients and 37 M-PCI procedures in 35 patients were analyzed. Clinical success rate with R-PCI was favorable and comparable to M-PCI (93.3 vs. 94.6%, p = 0.97), without any in-hospital MACE. The operator radiation exposure was significantly lower in R-PCI (0 vs. 24.5 µSV, p < 0.0001). Radiation exposure to the patients was tended to be reduced by R-PCI (DAP: 77.6 vs. 100.2 Gycm2, p = 0.07). There were no statistically significant differences in radiation exposure to the assistant, fluoroscopy time, procedural time and contrast volume between the two groups (radiation exposure to the assistant: 10.5 vs. 10.0 µSV, p = 0.64, fluoroscopy time: 27.5 vs. 30.1 min, p = 0.55, procedural time: 72.4 vs. 61.6 min, p = 0.23, and contrast volume: 93.2 vs. 102.0 ml, p = 0.36). R-PCI in selected patients demonstrated favorable clinical outcomes with dramatical reduction of radiation exposure to operators.
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Affiliation(s)
- Kotaro Kagiyama
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Yoshiaki Mitsutake
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
| | - Takafumi Ueno
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
- Fukuoka Memorial Hospital, Fukuoka, Japan
| | - Shinji Sakai
- Center of Diagnostic Imaging, Kurume University Hospital, Kurume, Japan
| | - Takuya Nakamura
- Center of Clinical Engineering, Kurume University Hospital, Kurume, Japan
| | - Kazunori Yamaji
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Takashi Ishimatsu
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Masahiro Sasaki
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Hidetoshi Chibana
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Naoki Itaya
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
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11
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Ishimatsu T, Sasaki KI, Kakuma T, Harada A, Hirakawa Y, Fukumoto Y, Ueno T. Serum interleukin-18 levels as a predictor for patients with genetic dysfunction of cytochrome P450 2C19 in dual antiplatelet therapy with clopidogrel. J Cardiol 2020; 76:479-486. [PMID: 32616329 DOI: 10.1016/j.jjcc.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND P2Y12 reaction unit (PRU) is an index of platelet activity upon treatment with clopidogrel. In spite of suitable P2Y12 reactions in dual antiplatelet therapy (DAPT) with clopidogrel after percutaneous coronary intervention (PCI), cardiovascular events actually occur in some patients, possibly due to a genetic dysfunction of cytochrome P450 2C19 (CYP2C19), which is a major metabolic enzyme of clopidogrel. As testing the CYP2C19 phenotypes to predict such patients may lack general versatility in daily clinical practice, the aim of this study was to examine whether measuring the blood levels of some cytokines in patients showing desirable PRUs in DAPT with clopidogrel could be a substitute for testing the CYP2C19 phenotypes. METHODS We analyzed relationships among PRU, serum levels of 51 cytokines, and CYP2C19 phenotypes in 22 patients receiving DAPT with aspirin and clopidogrel after PCI. RESULTS Seventeen, 18, and 19 of 22 patients indicated PRU ≤ 208, PRU ≤ 230, and PRU ≤ 262, respectively. Approximately 60% of the patients had a genetically metabolic dysfunction of CYP2C19, and the serum levels of interleukin-18 were independently increased in those patients (p = 0.024 in patients with PRU ≤ 208, p = 0.021 with PRU ≤ 230, and p = 0.020 with PRU ≤ 262). The area under the curves in plot receiver operating characteristics curves for the serum levels of interleukin-18 were 0.94, 0.96, and 0.90 in the non-extensive metabolizer patients with PRU ≤ 208, PRU ≤ 230, and PRU ≤ 262, respectively. CONCLUSIONS The serum levels of interleukin-18 may be a predictor to diagnose patients who receive undesirable DAPT with clopidogrel, possibly due to the genetic dysfunction of CYP2C19 in spite of suitable P2Y12 reactions after PCI.
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Affiliation(s)
- Takashi Ishimatsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
| | | | | | | | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takafumi Ueno
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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12
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Shimamatsu J, Sasaki KI, Katsuki Y, Kawasaki T, Murasato Y, Ajisaka H, Yokoi H, Tashiro H, Harada A, Hirakawa Y, Ishizaki Y, Ishimatsu T, Kagiyama K, Fukumoto Y, Kakuma T, Ueno T. Prasugrel effectively reduces the platelet reactivity units in patients with genetically metabolic dysfunction of cytochrome P450 2C19 who are treated with long-term dual antiplatelet therapy after undergoing drug-eluting stent implantation. Heart Vessels 2020; 35:312-322. [PMID: 31549178 PMCID: PMC7026273 DOI: 10.1007/s00380-019-01499-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/06/2019] [Indexed: 12/20/2022]
Abstract
Dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitor is administered following percutaneous coronary intervention (PCI) with coronary stent implantation. Several studies have reported the effects of switching between P2Y12 inhibitors on platelet reactivity (P2Y12 reaction units: PRU), from acute to late phase after PCI. However, the effect of switching at very late phase is unknown. This study examined the effect on PRU in Japanese coronary heart disease patients with long-term DAPT (aspirin + clopidogrel) when switching from clopidogrel to prasugrel. Ninety-six patients were enrolled in this study. The median DAPT duration at enrollment was 1824.0 days. Twenty-three patients with PRU ≥ 208 at enrollment were randomly assigned into either continuing to receive clopidogrel (Continued Group; n = 11) or switching to prasugrel (Switched Group; n = 12). The primary endpoint was the rate of patients who achieved PRU < 208 at the end of 12 weeks of treatment, which was significantly higher in Switched Group relative to Continued Group (90.0% vs. 36.4%; P = 0.024). The secondary endpoint was the PRU at week 12 in groups subdivided according to cytochrome P450 (CYP) 2C19 genotypes. At week 12, extensive metabolizers (EM Group) had 202.3 ± 60.0 and 174.5 ± 22.3 in Continued Group and Switched Group (P = 0.591), respectively; intermediate and poor metabolizers (non-EM Group) had 229.4 ± 36.9 and 148.4 ± 48.4 in Continued Group and Switched Group (P = 0.002), respectively. The PRU for non-EM Group was significantly reduced in Switched Group. Thus, for patients with long-term DAPT (aspirin + clopidogrel) after PCI with coronary stent implantation, switching from clopidogrel to prasugrel resulted in a stable reduction in PRU, regardless of CYP2C19 polymorphism.
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Affiliation(s)
- Junichiro Shimamatsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
- Division of Cardiovascular Internal Medicine, Tanushimaru Chuo Hospital, Kurume, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | | | - Tomohiro Kawasaki
- Department of Cardiology, Cardiovascular Center, Shin Koga Hospital, Kurume, Japan
| | - Yoshinobu Murasato
- Department of Cardiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hidehiko Ajisaka
- Division of Cardiovascular Internal Medicine, Asakura Medical Association Hospital, Asakura, Japan
| | - Hiroyoshi Yokoi
- Division of Cardiovascular Internal Medicine, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - Hideki Tashiro
- Division of Cardiovascular Internal Medicine, St. Mary's Hospital, Kurume, Japan
| | | | | | - Yuta Ishizaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | - Takashi Ishimatsu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | - Kotaro Kagiyama
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | | | - Takafumi Ueno
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan.
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13
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Abstract
In 2018, the CorPath GRX system (Corindus) was approved for use in Japan, marking the introduction of the first robotic-assisted system for percutaneous coronary intervention (PCI) in the country. The present report describes the first experience of robotic-assisted PCI for four coronary lesions in two cases in a single center. All procedures succeeded without any complications, although one procedure was converted to manual PCI by the operator's decision. Post-marketing surveillance to assess the impact of this novel system on both Japanese patients and physicians is currently ongoing in Japan.
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Affiliation(s)
- Koutaro Kagiyama
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Takafumi Ueno
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Yoshiaki Mitsutake
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Kazunori Yamaji
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Takashi Ishimatsu
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
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14
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Sasaki KI, Ishizaki Y, Sasaki M, Nakayoshi T, Ohtsuka M, Matsuse H, Shiba N, Ueno T, Fukumoto Y. Hybrid training system-induced myokine secretion in healthy men. Cytokine 2018; 111:178-181. [PMID: 30172114 DOI: 10.1016/j.cyto.2018.08.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/07/2018] [Accepted: 08/22/2018] [Indexed: 10/28/2022]
Abstract
The hybrid training system (HTS) is a special and compact system for effective skeletal muscle training by a combined application of volitional and electrical muscle contraction. Lower limbs' muscle training using HTS has been reported to increase not only muscle strength but also plasma interleukin-6 levels; however, little is known in other cytokines. In this study, we measured 52 cytokines and creatine phosphokinase-MM in the serum of 16 healthy men before and after lower limbs' muscle training by the knee flexion and extension using HTS. Skeletal muscle volume-corrected serum concentrations of cutaneous T-cell-attracting chemokine, erythropoietin, and tumor necrosis factor-related apoptosis-inducing ligand increased immediately after the training. These increased cytokines have been reported to play important roles in wound healing, neuroprotection, and cardiovascular protection.
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Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Yuta Ishizaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Motoki Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Takaharu Nakayoshi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Masanori Ohtsuka
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroo Matsuse
- Department of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Naoto Shiba
- Department of Rehabilitation, Kurume University Hospital, Kurume, Japan
| | - Takafumi Ueno
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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15
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Sasaki KI, Fukumoto Y. Pretreatment of Endothelial Progenitor Cells for Effective Cell Therapy. Circ J 2018; 82:2248-2249. [PMID: 30033949 DOI: 10.1253/circj.cj-18-0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
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16
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Sasaki KI, Fukumoto Y. Mesoangioblasts - A Newcomer in Cell-Based Treatment Strategy for Cardiovascular Disease? Circ J 2018; 82:1260-1261. [PMID: 29459536 DOI: 10.1253/circj.cj-18-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ken-Ichiro Sasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine
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17
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Sasaki KI, Chibana H, Ueno T, Itaya N, Sasaki M, Fukumoto Y. Successful Endovascular Treatment of Aortoiliac Bifurcation Stenosis Using an Empirically Based T and Protrude-Stenting with Self- and Balloon-Expandable Stents. Kurume Med J 2017; 63:39-43. [PMID: 28163269 DOI: 10.2739/kurumemedj.ms6300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 73-year-old woman with arteriosclerosis obliterans (ASO) was underwent a crossover stenting for an aortoiliac bifurcation from the right common iliac artery (CIA) with a self-expandable bare-metal stent (SE-BMS); however, a new stenosis later occurred just behind the bifurcation of the left CIA. An ex vivo experiment demonstrated that culotte-stenting by additional implantation of a balloon-expandable bare-metal stent (BE-BMS) through stent struts of the SE-BMS would be empirically infeasible. Although we had initially planned a T-stenting for the additional implantation of a BE-BMS in the left CIA, we finally deployed the stent in the CIA with the proximal end protruding into the previously-implanted SE-BMS through the stent struts to avoid incomplete coverage of the stenosis by reference to the ex vivo experiments. The patient has had no recurrence for 36 months.
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Affiliation(s)
- Ken-Ichiro Sasaki
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
| | - Hidetoshi Chibana
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
| | - Takafumi Ueno
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
| | - Naoki Itaya
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
| | - Masahiro Sasaki
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
| | - Yoshihiro Fukumoto
- Department of Cardio-Vascular Medicine, Kurume University School of Medicine
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18
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Nakayoshi T, Ueno T, Sasaki KI, Yokoyama S, Ohtsuka M, Mitsutake Y, Itaya N, Chibana H, Sasaki M, Ishimatsu T, Kimura T, Fukumoto Y. Differential angioscopic findings of neointimal coverage among first-, second-, and next generation drug-eluting stents. Int J Cardiol 2016; 223:450-451. [PMID: 27544603 DOI: 10.1016/j.ijcard.2016.08.175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 08/07/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Takaharu Nakayoshi
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan.
| | - Takafumi Ueno
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Ken-Ichiro Sasaki
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Shinji Yokoyama
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Masanori Ohtsuka
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Yoshiaki Mitsutake
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Naoki Itaya
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Hidetoshi Chibana
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Masahiro Sasaki
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takashi Ishimatsu
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Japan
| | - Yoshihiro Fukumoto
- Division of Cardio-Vascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
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19
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Koiwaya H, Kai H, Ueno T, Niiyama H, Takeuchi T, Ueda SI, Gondo T, Kumagai E, Miyamoto M, Yokoyama S, Sasaki KI, Toyama Y, Ohtsuka M, Mitsutake Y, Anegawa T, Nakayoshi T, Kudo Y, Suda K, Imaizumi T. Stent-anchored coil embolotherapy--novel treatment procedure for huge pulmonary arterio-venous malformation in hereditary hemorrhagic telangiectasia. Int J Cardiol 2012; 157:122-4. [PMID: 22459369 DOI: 10.1016/j.ijcard.2012.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 03/03/2012] [Indexed: 10/28/2022]
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20
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Niiyama H, Kai H, Yamamoto T, Shimada T, Sasaki KI, Murohara T, Egashira K, Imaizumi T. Roles of endogenous monocyte chemoattractant protein-1 in ischemia-induced neovascularization. J Am Coll Cardiol 2004; 44:661-6. [PMID: 15358037 DOI: 10.1016/j.jacc.2004.04.046] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [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: 01/07/2004] [Revised: 03/18/2004] [Accepted: 04/20/2004] [Indexed: 11/27/2022]
Abstract
OBJECTIVES We sought to investigate the role of endogenous monocyte chemoattractant protein (MCP)-1 in ischemia-induced neovascularization. BACKGROUND Roles of inflammatory changes including macrophage infiltration are suggested in ischemic neovascularization. METHODS Unilateral hindlimb ischemia was induced by excising surgically the entire femoral artery and vein in mice. Immediately after operation, plasmid deoxyribonucleic acid encoding a dominant negative mutant of MCP-1 (7ND) or the empty plasmid (mock) was injected into the ipsilateral thigh adductor muscle. RESULTS In mock-treated mice, MCP-1 was upregulated transiently in ischemic hindlimb peaking at day 3. Serial laser Doppler blood flow (LDBF) analysis showed an abrupt decrease in blood flow, followed by a recovery to the near-normal levels in mock-treated mice; 7ND treatment had no effects on the initial decrease in LDBF but deteriorated the recovery. At day 3, macrophage infiltration and inductions of tumor necrosis factor (TNF)-alpha and vascular endothelial growth factor (VEGF) were prominent in the ischemic adductor muscle in mock-treated mice; 7ND treatment significantly reduced macrophage infiltration and suppressed TNF-alpha and VEGF inductions in response to ischemia. At day 21, postmortem angiography and anti-CD31 immunohistostaining revealed well-developed collateral vessels and capillary formation, respectively, in the ischemic muscle of mock-treated mice; 7ND overexpression remarkably suppressed the collateral vessel formation and capillary formation. CONCLUSIONS Endogenous MCP-1 may play a role in ischemia-induced neovascularization by recruiting macrophages that activate TNF-alpha and VEGF inductions.
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Affiliation(s)
- Hiroshi Niiyama
- Third Department of Internal Medicine and Cardiovascular Research Institute, Kurume University, Kurume, Japan
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21
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Egami K, Murohara T, Shimada T, Sasaki KI, Shintani S, Sugaya T, Ishii M, Akagi T, Ikeda H, Matsuishi T, Imaizumi T. Role of host angiotensin II type 1 receptor in tumor angiogenesis and growth. J Clin Invest 2003; 112:67-75. [PMID: 12840060 PMCID: PMC162282 DOI: 10.1172/jci16645] [Citation(s) in RCA: 248] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Although the renin angiotensin system (RAS) is a major regulator of vascular homeostasis, the role of the RAS in tumor angiogenesis is little understood. Here we show that host angiotensin II (ATII) type 1 (AT1) receptor plays an important role in angiogenesis and growth of tumor cells engrafted in mice. Subcutaneous B16-F1 melanoma-induced angiogenesis as assessed by tissue capillary density and microangiography was prominent in WT mice but was reduced in AT1a receptor-deficient (AT1a-/-) mice. Consequently, tumor growth rate was significantly slower, and the mouse survival rate was greater, in AT1a-/- mice than in WT mice. Tumor growth was also reduced in WT mice treated with TCV-116, a selective blocker of AT1 receptor. Because the beta-galactosidase gene was inserted into the AT1a gene locus in AT1a-/- mice, the site of beta-galactosidase expression represents the AT1a receptor expression in these mutant mice. In tumor-implanted AT1a-/- mice, the major site of the beta-galactosidase expression was macrophages in tissues surrounding tumors. Moreover, the number of infiltrated macrophages was significantly lower in AT1a-/- mice than in WT mice, and double-immunofluorescence staining revealed that these macrophages expressed VEGF protein intensively. Therefore, the host ATII-AT1 receptor pathway supports tumor-associated macrophage infiltration, which results in enhanced tissue VEGF protein levels. The host ATII-AT1 receptor pathway thereby plays important roles in tumor-related angiogenesis and growth in vivo.
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MESH Headings
- Animals
- Benzimidazoles/pharmacology
- Biphenyl Compounds/pharmacology
- Cyclohexanes
- Endothelial Growth Factors/analysis
- Intercellular Signaling Peptides and Proteins/analysis
- Lymphokines/analysis
- Melanoma, Experimental/blood supply
- Melanoma, Experimental/pathology
- Mice
- Mice, Inbred C57BL
- Neoplasms, Experimental/blood supply
- Neoplasms, Experimental/pathology
- Neovascularization, Pathologic/etiology
- O-(Chloroacetylcarbamoyl)fumagillol
- Receptor, Angiotensin, Type 1
- Receptors, Angiotensin/analysis
- Receptors, Angiotensin/physiology
- Sesquiterpenes/pharmacology
- Tetrazoles
- Vascular Endothelial Growth Factor A
- Vascular Endothelial Growth Factors
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Affiliation(s)
- Kimiyasu Egami
- Department of Cardiology, Nagoya University Graduate School of Medicine, Kurume, Japan
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22
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Akita T, Murohara T, Ikeda H, Sasaki KI, Shimada T, Egami K, Imaizumi T. Hypoxic preconditioning augments efficacy of human endothelial progenitor cells for therapeutic neovascularization. J Transl Med 2003; 83:65-73. [PMID: 12533687 DOI: 10.1097/01.lab.0000050761.67879.e4] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
A subset of human peripheral blood mononuclear cells (PB-MNCs) differentiate into endothelial progenitor cells (EPCs) that participate in postnatal neovascularization. Although tissue ischemia can mobilize EPCs from bone marrow, the effects of hypoxia on differentiation and angiogenic function of EPCs are little known. We examined whether hypoxic conditioning would modulate differentiation and function of human PB-MNC-derived EPCs. A subset of PB-MNCs gave rise to EPC-like attaching (AT) cells under either normoxic or hypoxic conditions. However, hypoxia much enhanced the differentiation of AT cells from PB-MNCs compared with normoxia. AT cells released vascular endothelial growth factor (VEGF) protein and expressed CD31 and kinase insert domain receptor/VEGFR-2, endothelial lineage markers, on their surface, which were also enhanced by hypoxia. Both a neutralizing anti-VEGF mAb and a KDR-specific receptor tyrosine kinase inhibitor, SU1498, suppressed PB-MNC differentiation into EPC-like AT cells in a dose-dependent manner. Migration of AT cells in response to VEGF as examined by a modified Boyden chamber apparatus was also enhanced by hypoxia. Finally, in vivo neovascularization efficacy was significantly enhanced by in vitro hypoxic conditioning of AT cells when cells were transplanted into the ischemic hindlimb of immunodeficient nude rats. In conclusion, hypoxia directly stimulated differentiation of EPC-like AT cells from human PB-MNC culture. Moreover, hypoxic preconditioning of AT cells before in vivo transplantation is a useful means to enhance therapeutic vasculogenesis.
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Affiliation(s)
- Takako Akita
- The Cardiovascular Research Institute and Department of Internal Medicine III, Kurume University School of Medicine, Kurume, Japan
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Kojima S, Imanaka T, Takada J, Mitsugashira T, Nakanishi T, Seki R, Kondo M, Sasaki KI, Saito T, Yamaguchi Y, Furukawa M. Determination of radionuclides induced by fast neutrons from the JCO criticality accident in Tokai-mura, Japan for estimating neutron doses. J Radiat Res 2001; 42 Suppl:S45-S53. [PMID: 11791753 DOI: 10.1269/jrr.42.s45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A criticality accident occurred at a uranium conversion facility in Tokai-mura, Japan on September 30, 1999, and fission neutrons were continuously emitted for about 20 hours. Materials of stainless steel or iron, and chemical reagents were collected at places between 2 m and 270 m from the criticality accident site on October 25 and 26, 1999, November 27, 1999 and February 11, 2000. Neutron-induced radionuclides. such as 54Mn and 58Co, in the materials exposed to fast neutrons from the accident were measured to estimate the neutron fluences and energy distributions. Highly sensitive y-ray spectrometry with a well-type Ge detector was performed after radiochemical separation of Mn and Co from the materials. An instrumental neutron activation analysis was mainly applied for determinations of the target elements and chemical yields. The concentrations of 54Mn and 58Co in a mesh screen of stainless steel collected at a location 2.0 m from the accident site were determined. The total number of fission events was evaluated to be 2.5 x 10(18) by Monte-Carlo calculations of neutron transfer by considering the observed values of 54Mn and 58Co. The results presented here are fundamental to estimate the neutron doses at various distances.
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Affiliation(s)
- S Kojima
- School of Medicine, Aichi Medical University, Nagakute, Japan.
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Furusawa S, Nakano S, Wu J, Sakaguchi S, Takayanagi M, Sasaki KI, Satoh S. Apoptosis induced by doxorubicin and cinchonine in P388 multidrug-resistant cells. J Pharm Pharmacol 2001; 53:1029-39. [PMID: 11480538 DOI: 10.1211/0022357011776289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Acquired drug resistance is a major factor in the failure of doxorubicin-based cancer chemotherapy. We determined the ability of cinchonine to reverse doxorubicin drug resistance in a doxorubicin-resistant leukaemia cell line (mouse P388/DOX). A non-cytotoxic concentration of cinchonine (10 microM) increased the sensitivity to doxorubicin of multidrug-resistant P388/DOX cells and significantly enhanced the doxorubicin-induced apoptosis and DNA fragmentation in resistant cells, but had no effect in parent cells. Time-course studies demonstrated that DNA fragmentation was present 24 h after incubation with doxorubicin and cinchonine, indicating that DNA degradation was a preceding event. In cultured cells, cinchonine increased the intracellular accumulation of doxorubicin in the resistant cells in a dose-dependent manner. Using flow cytometry to measure the inhibition of the P-glycoprotein (P-gp) dependent efflux of rhodamine 123, cinchonine was found to be considerably more effective than quinine. The results with cinchonine suggest that there may be quinine derivatives with a similar capacity to inhibit drug transport by P-gp. Additionally, the G2/M phase cell population in resistant cells is increased by doxorubicin/cinchonine treatment. Exposure of resistant cells to 1 microM doxorubicin and 10 microM cinchonine resulted in the expression of Fas (APO-1/CD95) in cells after 6 h. These studies demonstrate that the cell killing effects of doxorubicin and cinchonine in resistant cells
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Affiliation(s)
- S Furusawa
- Department of Pharmacology and Toxicology, Cancer Research Institute, Tohoku Pharmaceutical University, Sendai, Japan.
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Sasaki KI, Saitoh M, Kawauchi H, Takayanagi G. [Antitumor activity of egg lectin from frog. I. Inhibitory effects of egg lectins from Rana Japonica and Rana catesbiana on growth of Ehrlich solid tumor in mice (author's transl)]. Nihon Yakurigaku Zasshi 1977; 73:571-8. [PMID: 303601 DOI: 10.1254/fpj.73.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Sasaki KI. [Inflammatory activities of synthetic bradykinin fragments on the rat's paw]. YAKUGAKU ZASSHI 1970; 90:1494-8. [PMID: 5531671 DOI: 10.1248/yakushi1947.90.12_1494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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