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Tomomori S, Suenari K, Sairaku A, Higaki T, Dai K, Oi K, Kawase T, Ohashi N, Nishioka K, Masaoka Y, Shiode N, Nakano Y. Prolonged PR intervals are associated with epicardial adipose tissue and recurrence after catheter ablation in persistent atrial fibrillation. Heart Vessels 2024; 39:232-239. [PMID: 37813984 DOI: 10.1007/s00380-023-02323-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: 05/31/2023] [Accepted: 09/20/2023] [Indexed: 10/11/2023]
Abstract
Epicardial adipose tissue (EAT) has been reported to promote myocardial fibrosis and to affect intracardiac conduction. The PR interval reflects the conduction from the atria to the Purkinje fibers and may be associated with the EAT volume, especially in persistent atrial fibrillation (AF) patients. We aimed to investigate the relationship between the EAT and PR interval in patients with persistent AF. We enrolled 268 persistent AF patients who underwent catheter ablation (CA) and divided the patients into two groups: the normal PR interval group (PR interval less than 200 ms: Group N) and long PR interval group (PR interval 200 ms or more: Group L). We then analyzed the association between the total EAT volume around the heart and PR interval and calculated the ratio of the duration of the P wave (PWD) to the PR interval (PWD/PR interval). Moreover, we investigated whether a long PR interval was associated with the outcomes after ablation. The total EAT volume was significantly larger in Group L than Group N (Group N: 131.4 ± 51.8 ml vs. Group L: 151.3 ± 63.3 ml, p = 0.039). A positive correlation was also observed between the PWD/PR interval and EAT volume in Group L (r = 0.345, p = 0.039). A multivariate analysis also revealed that a long PR interval was independently associated with AF recurrence after CA (hazard ratio [HR] 2.071, p = 0.032). The total EAT volume was associated with a long PR interval, and a long PR interval was a significant risk factor for recurrence after ablation in persistent AF patients.
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Affiliation(s)
- Shunsuke Tomomori
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan.
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Akinori Sairaku
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Kuniomi Oi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Tomoharu Kawase
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Norihiko Ohashi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Yoshiko Masaoka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Motomachi, Nakaku, Hiroshima, 730-8518, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Katoh N, Nakazato K, Uchinami Y, Kanehira T, Takahashi S, Koizumi F, Taguchi H, Nishioka K, Yasuda K, Tamura M, Takao S, Miyamoto N, Matsuura T, Kobashi K, Aoyama H. Evaluation of the Possibility of Dose Realignment Adaptation by Shifting the Isocenter in Proton Beam Therapy for Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e307. [PMID: 37785114 DOI: 10.1016/j.ijrobp.2023.06.2330] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In pancreatic cancer, a tumor is surrounded by the gastrointestinal (GI) tract, which is subject to changes in location, shape, and contents. Due to these inter-fractional changes, proton beam therapy (PBT) for pancreatic cancer may result in unintentionally high doses to the GI tract. Daily adaptive re-planning can solve this problem, but is not yet established with PBT due to its resource intensive characteristics. This study aims to evaluate the GI tract dose using weekly computed tomography (CTw) and the possibility of dose realignment adaptation by shifting the isocenter (IC) of the PBT plan, which does not require re-planning. MATERIALS/METHODS We retrospectively analyzed 6 consecutive patients with unresectable pancreatic cancer treated with real-time-image gated PBT using a fiducial marker. The planning CT was scanned at the natural expiration of respiration and a PBT plan of 60 GyE in 25 fractions (baseline plan, PLANbase) was created. The CTw images were acquired the day before start of PBT and once a week during the PBT course thereafter. The PLANbase was rigidly transferred to the CTw based on the relationship between the three-dimensional coordinates of the fiducial marker and those of the IC in the PLANbase. The PLANeval was created by recalculating the PLANbase on the CTw. We evaluated the doses to the stomach, duodenum, and intestines in the PLANeval according to the following criteria: Dmax of the stomach < 60 GyE, duodenum and intestines < 55 GyE, and D1cc of the stomach < 55 GyE, duodenum and intestines < 54 GyE. In addition, we investigated the GI tract dose realignment adaptation for the PLANeval with its IC shifted 2mm, 4mm, and 6mm in each of 6 directions (right, left, ventral, dorsal, cranial, and caudal), respectively. RESULTS A total of 35 PLANeval were created for the CTw. In the PLANbase of the 6 patients, the average of Dmax and D1cc of the stomach, duodenum and intestines were 50.7 GyE (range, 46.7-53.6) and 50.0 GyE (45.0-53.2), 49.2 GyE (44.3-51.7) and 48.8 GyE (43.7-51.5), and 49.2 GyE (44.8-52.0) and 48.9 GyE (44.6-51.8), respectively. In the PLANeval, the average of Dmax and D1cc of the stomach, duodenum, and intestines were 53.3GyE (43.8-61.4) and 52.8 GyE (43.2-61.1), 51.0 GyE (36.1-60.0) and 50.3 GyE (35.4-59.8), and 52.5 GyE (36.6-61.0) and 51.9 (34.4-60.9) GyE, respectively. Twenty-two of the 35 PLANeval (63 %) did not meet at least one of the GI tract dose criteria. In 11 of 22 PLANeval with higher doses to the GI tract, the IC shift resulted in GI dose reductions and all dose criteria were met. The minimum amount of the IC shift required to meet the criteria was 2 mm for 8 plans and 4 mm for 3 plans. The remaining 11 PLANeval did not meet the criteria using dose realignment adaptation by shifting the isocenter. CONCLUSION Adaptive replanning is necessary for PBT for pancreatic cancers due to excessive GI tract doses in more than 60% of the plans. Dose realignment adaptation by shifting the IC, which does not require re-planning, may be an option in adaptive treatment strategies.
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Affiliation(s)
- N Katoh
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Nakazato
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Y Uchinami
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Kanehira
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - S Takahashi
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - F Koizumi
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Taguchi
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - K Nishioka
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - K Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - M Tamura
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - S Takao
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - N Miyamoto
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - T Matsuura
- Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - K Kobashi
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - H Aoyama
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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Koizumi F, Katoh N, Kanehira T, Kawamoto Y, Nakamura T, Kakisaka T, Uchinami Y, Taguchi H, Fujita Y, Takahashi S, Higaki H, Nishioka K, Yasuda K, Kinoshita R, Suzuki R, Miyamoto N, Yokota I, Kobashi K, Aoyama H. A Risk Prediction Model for Severe Radiation Induced Lymphopenia in Patients with Pancreatic Cancer Treated with Concurrent Chemoradiotherapy. Int J Radiat Oncol Biol Phys 2023; 117:e309. [PMID: 37785118 DOI: 10.1016/j.ijrobp.2023.06.2334] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) In pancreatic cancer, radiation induced lymphopenia (RIL) is associated with a poor prognosis. However, normal tissue complication probability (NTCP) models predicting RIL in pancreatic cancer treated with concurrent chemoradiotherapy (CCRT) have yet to be developed. This study aims to develop a least absolute shrinkage and selection operator (LASSO)-based multivariate NTCP model to predict severe RIL in patients with pancreatic cancer during CCRT and to validate the model internally. MATERIALS/METHODS We retrospectively reviewed patients with localized pancreatic cancer who underwent CCRT using three-dimensional conformal radiation therapy from 2013 to 2021. The exclusion criteria were patients with distant metastasis; patients who did not complete RT due to tumor progression; patients who did not have absolute lymphocyte count (ALC) data available before or during RT. An ALC of < 0.5 K/μL during CCRT was defined as severe RIL. A NTCP model of severe RIL was developed by LASSO-based multivariate analysis. We used age, sex, Karnofsky performance status, maximum tumor size, carbohydrate antigen 19-9 level before RT, ALC before RT, volume of planning target volume (PTV), and dosimetric parameters for surrounding organs (including spleen, vertebrae, liver, bilateral kidneys, gastrointestinal tracts) as variables for LASSO. In addition, internal validation was performed by the bootstrap method. The predictive performance of the model was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve and scaled Brier score. RESULTS Of the 131 patients included in the study, the median age was 68 years (range, 42-84), and 55% were male. The median ALC before RT was 1.37 K/µL (0.52-3.50). The median PTV volume was 315.4 ml (86.3-1079.3). The median dose of radiotherapy was 50.4 Gy (16.2-50.4), with 1.8 Gy per fraction. Combination chemotherapy was S-1 in 99 cases (75.6%) and gemcitabine in 32 cases (24.4%). Induction chemotherapy before CCRT was performed in 39 patients (29.8%). Severe RIL was observed in 84 (63.6%) patients. The LASSO showed that low baseline ALC (p = 0.0002), large PTV volume (p < 0.0001), and a large kidney V5 defined as the percentage of bilateral kidneys receiving 5 Gy or more (p = 0.0338) were selected as parameters of the prediction model for severe RIL (AUC = 0.917) and scaled Brier score was 0.511. As a result of internal validation by the bootstrap method, the average AUC was 0.918 (95% confidence interval, 0.849-0.954). CONCLUSION Severe RIL occurred frequently during CCRT for pancreatic cancer, and a NTCP model for severe RIL developed and validated internally in this study showed good predictive performance. External validation is needed before this NTCP model can be used as a benchmark for treatment planning to reduce the risk of severe RIL and for considering future treatment approaches.
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Affiliation(s)
- F Koizumi
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Katoh
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - T Kanehira
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Y Kawamoto
- Division of Cancer Center, Hokkaido University Hospital, Sapporo, Japan
| | - T Nakamura
- Department of Gastroenterological Surgery Ⅱ, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - T Kakisaka
- Department of Gastroenterological Surgery Ⅰ, Hokkaido University Hospital, Sapporo, Japan
| | - Y Uchinami
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Taguchi
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Y Fujita
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Takahashi
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - H Higaki
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - K Nishioka
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - K Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - R Kinoshita
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - R Suzuki
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - N Miyamoto
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - I Yokota
- Department of Biostatistics, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - K Kobashi
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - H Aoyama
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
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Dai K, Shiode N, Yoshii K, Kimura Y, Matsuo K, Jyuri Y, Tomomori S, Higaki T, Oi K, Kawase T, Sairaku A, Ohashi N, Suenari K, Nishioka K, Masaoka Y, Nakano Y. Impact of Lipoprotein (a) on Long-Term Outcomes in Patients With Acute Myocardial Infarction. Circ J 2023; 87:1356-1361. [PMID: 37258219 DOI: 10.1253/circj.cj-23-0221] [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: 06/02/2023]
Abstract
BACKGROUND Lipoprotein (a) (Lp(a)) is a complex circulating lipoprotein, and there is increasing evidence it is a risk factor for atherosclerotic cardiovascular disease (ASCVD). This study aimed to investigate the influence of Lp(a) serum levels on long-term outcomes after acute myocardial infarction (AMI).Methods and Results: Between January 2015 and January 2018, we enrolled 262 patients with AMI who underwent coronary angiography within 24 h of the onset of chest pain and had available Lp(a) data enabling subdivision into 2 groups: high Lp(a) (≥32 mg/dL: n=76) and low Lp(a) (<32 mg/dL: n=186). The primary endpoint was major adverse cardiac events (MACE), which was defined as a composite of cardiac death, nonfatal MI, and readmission for heart failure. Multivariate Cox regression analysis was performed to identify the predictors of MACE. The incidence of MACE was significantly higher in the high Lp(a) group than in the low Lp(a) group (32.8% vs. 19.6%, P=0.004). Multivariate analysis showed that Lp(a) ≥32 mg/dL was an independent predictor of MACE (hazard ratio 2.84, 95% confidence interval 1.25-6.60, P=0.013). CONCLUSIONS High Lp(a) levels were associated with worse long-term outcomes after AMI, so Lp(a) may be useful for risk assessment.
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Affiliation(s)
- Kazuoki Dai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Kanade Yoshii
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Yuka Kimura
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Keita Matsuo
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Yusuke Jyuri
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Shunsuke Tomomori
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Kuniomi Oi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Tomoharu Kawase
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Akinori Sairaku
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Norihiko Ohashi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Yoshiko Masaoka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences
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Ichikawa Y, Matsumoto S, Fujinaka W, Takatori M, Nishioka K, Namera A. Left Stellate Ganglion Blockade for Refractory Ventricular Arrhythmias With Aconitine Poisoning: A Case Report. A A Pract 2023; 17:e01666. [PMID: 36805572 DOI: 10.1213/xaa.0000000000001666] [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: 02/22/2023]
Abstract
Aconitine poisoning causes refractory ventricular arrhythmias (VAs). In a 20-year-old man, VAs of unknown etiology did not respond to drugs and electrical defibrillation. However, left stellate ganglion blockade (SGB) dramatically decreased arrhythmias without complications. At a later date, we found that refractory VAs were caused by aconitine poisoning. Left SGB is effective for treating refractory VAs with aconitine poisoning and can be easily performed with few complications for VAs of unknown etiology even if patients are receiving anticoagulant therapy. Also, left SGB can be performed to diagnose refractory VAs.
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Affiliation(s)
- Yasuko Ichikawa
- From the Departments of Anesthesiology and Intensive Care Medicine
| | | | - Waso Fujinaka
- From the Departments of Anesthesiology and Intensive Care Medicine
| | - Makoto Takatori
- From the Departments of Anesthesiology and Intensive Care Medicine
| | - Kenji Nishioka
- Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Akira Namera
- Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Yamada R, Yoshimura T, Mori T, Nishioka K, Koizumi F, Nishikawa N, Fujita Y, Takahashi S, Kanehira T, Yokokawa K, Yamazaki R, Horita K, Tamura H, Wakabayashi Y, Ichiu Y, Aoyama H. Evaluation of Margin for Intra-Fractional Patient Motion during Single-Isocenter Multi Targets Volumetric Modulated Arc Therapy Stereotactic Radiation Therapy for Brain Metastases Using Actual Target Coordinates. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.814] [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: 11/26/2022]
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7
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Dai K, Oi K, Hyodo Y, Jyuri Y, Takayama S, Shigehara M, Tomomori S, Higaki T, Kawase T, Suenari K, Nishioka K, Otsuka M, Masaoka Y, Shiode N, Nakano Y. Low-molecular-weight dextran-induced anaphylactic shock immediately after intracoronary imaging. J Cardiol Cases 2022; 26:229-231. [DOI: 10.1016/j.jccase.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 11/29/2022] Open
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8
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Nakano T, Suenari K, Okada A, Hyodo Y, Tomomori S, Higaki T, Oi K, Dai K, Kawase T, Nakama Y, Nishioka K, Otsuka M, Masaoka Y, Shiode N, Nakano Y. New Minimally Invasive and Tailor-Made Strategy for Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation. Heart Lung Circ 2021; 31:530-536. [PMID: 34753660 DOI: 10.1016/j.hlc.2021.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 09/14/2021] [Accepted: 10/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The optimal dosage for cryoballoon ablation (CBA) of atrial fibrillation (AF) is still unknown. OBJECTIVE This study aimed to evaluate the clinical implications of a reduction in the freezing duration to <180 seconds during CBA guided by the time to the target temperature. METHODS This study enrolled 325 consecutive paroxysmal AF patients who underwent CBA. It was a retrospective observational study in a single centre. It compared 164 patients who underwent a tailor-made CBA procedure (group T) with 161 who had a standard CBA procedure (group S). In group T, the freezing duration was reduced to 150 seconds when the temperature reached ≤ -40 °C within 40 seconds. Furthermore, it was reduced to 120 seconds when it reached ≤ -50 °C within 60 seconds. In the other patients, the freezing duration was 180 seconds, except for excessive freezing of ≤ -60 °C and/or emergent situations while monitoring the oesophageal temperature, and for phrenic nerve injury, as in group S. RESULTS In group T, 89 patients (83%) underwent CBA with a reduction in the freezing duration. The total freezing time for each pulmonary vein was significantly shorter in group T than group S, and the total procedure time in group T decreased by an average of 4 minutes compared with group S. The rate of requiring additional radio frequency ablation following the CBA was significantly lower in group T than group S. The AF-free survival rate during the follow-up period (median, 366 days) was similar between the two groups. CONCLUSION The safety and efficacy of the new CBA strategy were non-inferior to the standard procedure.
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Affiliation(s)
- Takayuki Nakano
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan; Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
| | - Akira Okada
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yohei Hyodo
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Shunsuke Tomomori
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kuniomi Oi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Tomoharu Kawase
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yasuharu Nakama
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Masaya Otsuka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yoshiko Masaoka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yukiko Nakano
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Yoshimura T, Nishioka K, Hashimoto T, Kogame S, Seki K, Sugimori H, Yamashina H, Kato F, Aoyama H, Kudo K, Shimizu S. Evaluation of Visualizing the Prostatic Urinary Tract in MRI With a Super Resolution Deep Learning Model for Urethra Sparing Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Fujita Y, Katoh N, Uchinami Y, Taguchi H, Nishioka K, Mori T, Yasuda K, Minatogawa H, Koizumi F, Otsuka M, Takao S, Tamura M, Tanaka S, Sutherland K, Tha K, Ito Y, Shimizu S, Aoyama H. Pre-Treatment Apparent Diffusion Coefficient Histogram Metrics as a Predictor of Local Tumor Control After Proton Beam Therapy in Patients With Hepatocellular Carcinomas. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Okuda T, Nishimura Y, Nishioka K, Kishimoto S, Kikuchi Y, Nakamura T. A 5-kV pulse generator with a 100-kV/µs slew rate based on series-connected 1700-V SiC MOSFETs for electrical insulation tests. Rev Sci Instrum 2021; 92:114705. [PMID: 34852512 DOI: 10.1063/5.0058083] [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] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/20/2021] [Indexed: 06/13/2023]
Abstract
This study demonstrates a high-slew-rate 5-kV pulse generator for electrical insulation tests. Electrical equipment, such as electrical actuators and traction drive motors, are exposed to severe electrical stress because recent switching inverters have high-frequency outputs with high supply voltages using wide-bandgap power devices. For an advanced electrical insulation test, a high-voltage pulse generator is required with a high slew rate; however, such generators suffer from large switching noise, followed by measurement noise, such as ground voltage fluctuations and radiation noise, hindering the detection of partial discharge (PD) phenomena. In this study, we propose a 5-kV pulse generator based on series-connected 1700-V silicon carbide (SiC) metal-oxide-semiconductor field-effect transistors (MOSFETs). Four 1700-V SiC MOSFETs are connected in series as a 5-kV SiC switching module, constituting a half-bridge configuration for the pulse generator. The obtained switching waveforms exhibit fast rise times of 48 ns under 5 kV and 6.2 ns under 400 V with a low voltage overshoot and ringing owing to superior device characteristics and reduced parasitic inductances. Because of the low switching noise, we detect a clear PD signal with a 1500-V pulse when using the fabricated pulse generator for a PD test of a twisted pair. The proposed pulse generator uses a hard switching configuration such that the pulse generator can vary the pulse width from 150 ns to DC and increase the switching pulse cycle beyond 1 MHz by changing the control signals of the SiC MOSFETs.
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Affiliation(s)
- T Okuda
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - Y Nishimura
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - K Nishioka
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
| | - S Kishimoto
- Graduate School of Engineering, University of Hyogo, Hyogo 671-2280, Japan
| | - Y Kikuchi
- Graduate School of Engineering, University of Hyogo, Hyogo 671-2280, Japan
| | - T Nakamura
- Graduate School of Engineering, Osaka University, Osaka 565-0871, Japan
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12
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Tahara Y, Noguchi T, Yonemoto N, Nakashima T, Yasuda S, Kikuchi M, Hashiba K, Arimoto H, Nishioka K, Kokubu N, Atsumi T, Kashiwase K, Kasaoka S, Kuroda Y, Kada A, Yokoyama H, Nonogi H. Cluster Randomized Trial of Duration of Cooling in Targeted Temperature Management After Resuscitation for Cardiac Arrest. Circ Rep 2021; 3:368-374. [PMID: 34250277 PMCID: PMC8258184 DOI: 10.1253/circrep.cr-21-0062] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 11/09/2022] Open
Abstract
Background: The 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that comatose patients with return of spontaneous circulation after cardiac arrest have targeted temperature management (TTM). However, the duration of TTM remains to be elucidated. Methods and Results: We conducted a cluster randomized trial in 10 hospitals to compare 12-24 vs. 36 h of cooling in patients with cardiac arrest who received TTM. The primary outcome was the incidence, within 1 month, of complications including bleeding requiring transfusion, infection, arrhythmias, decreasing blood pressure, shivering, convulsions, and major adverse cardiovascular events. Secondary outcomes were mortality and favorable neurological outcome (Cerebral Performance Categories 1-2) at 3 months. Random-effects models with clustered effects were used to calculate risk ratios (RR). Data of 185 patients were analyzed (12- to 24-h group, n=100 in 5 hospitals; 36-h group, n=85 in 5 hospitals). The incidence of complications within 1 month did not differ between the 2 groups (40% vs. 34%; RR 1.04, 95% confidence interval [CI] 0.67-1.61, P=0.860). Favorable neurological outcomes at 3 months were comparable between the 2 groups (64% vs. 62%; RR 0.91, 95% CI 0.72-1.14, P=0.387). Conclusions: TTM at 34℃ for 12-24 h did not significantly reduce the incidence of complications. This study did not show superiority of TTM at 34℃ for 12-24 h for neurologic outcomes.
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Affiliation(s)
- Yoshio Tahara
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Naohiro Yonemoto
- Department of Public Health, Juntendo University School of Medicine Tokyo Japan.,Department of Psychoneuropharmacology, National Center of Neurology and Psychiatry Kodaira Japan
| | - Takahiro Nakashima
- Department of Emergency Medicine, University of Michigan Ann Arbor, MI USA
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan.,Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine Sendai Japan
| | - Migaku Kikuchi
- Department of Cardiovascular Medicine/Emergency and Critical Care Center, Dokkyo Medical University Tochigi Japan
| | - Katsutaka Hashiba
- Department of Cardiology, Saiseikai Yokohama-shi Nanbu Hospital Yokohama Japan
| | - Hideki Arimoto
- Department of Emergency Medicine and Critical Care, Iseikai Hospital Osaka Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital Hiroshima Japan
| | - Nobuaki Kokubu
- Advanced Critical Care and Emergency Center, Sapporo Medical University Hospital Sapporo Japan
| | - Takahiro Atsumi
- Department of Emergency Medicine, Seirei Hamamatsu General Hospital Hamamatsu Japan
| | | | - Shunji Kasaoka
- Disaster Medical Education and Research Center, Kumamoto University Hospital Kumamoto Japan
| | - Yasuhiro Kuroda
- Department of Emergency, Disaster, and Critical Care Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Akiko Kada
- National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Hiroyuki Yokoyama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Hiroshi Nonogi
- Faculty of Health Science, Osaka Aoyama University Osaka Japan
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13
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Higaki T, Tomomori S, Dai K, Oi K, Kawase T, Suenari K, Nishioka K, Otsuka M, Shiode N. Left Main Trunk Occlusion Caused by In-Stent Neointimal Dissection. JACC Cardiovasc Interv 2020; 13:e175-e176. [PMID: 32950421 DOI: 10.1016/j.jcin.2020.06.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Shunsuke Tomomori
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kuniomi Oi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Tomoharu Kawase
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Masaya Otsuka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.
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14
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Nakano T, Suenari K, Suruga K, Takemoto H, Hashimoto Y, Tomomori S, Higaki T, Ooi K, Dai K, Nakama Y, Kawase T, Nishioka K, Otsuka M, Masaoka Y, Shiode N. P4760New minimally invasive and tailor-made strategy for cryoballoon ablation in patients with paroxysmal atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1136] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Currently, cryoballoon ablation (CBA) has proven to be highly effective in achieving free from atrial fibrillation (AF), especially paroxysmal AF. However, the optimal freezing protocol for each patient to achieve successful pulmonary vein isolation by only CBA is still uncertain. The aim of this study was to evaluate the clinical implications of a reduction in the freezing duration (<180s) during CBA guided by the time to target temperature.
Methods
From November 2015 to August 2018, 286 consecutive paroxysmal AF patients undergoing CBA were enrolled. We compared 107 patients undergoing a tailor-made CBA procedure (Group A; August 2017-August 2018) to 179 patients with a standard CBA procedure (Group B; November 2015–July 2017). In Group A, the freezing duration was reduced to 150s when the temperature reached ≤−40°C within 40s. Furthermore, we reduced it to 120s when it reached ≤−50°C within 60s. In the other patients, the freezing time was 180s except for excessive freezing over −60°C and/or emergent situations while monitoring the esophageal temperature and for phrenic nerve injury as in Group B.
Results
The baseline clinical characteristics were similar between two groups. In Group A, 89 patients (83%) underwent CBA with a reduction in the freezing time. The rate of having reduction time in left inferior PV (LIPV) and right inferior PV (RIPV) was lower compared with left superior PV (LSPV) and right superior PV (RSPV) (respectively 17%, 29%, 56%, and 63.5%). However, for right inferior PV, in 31 patients having the reduced freezing time, none of them required touch-up ablation. Although the procedure time and frequency of touch-up ablation did not differ between the 2 groups, total freezing time for each PV was significantly shorter in Group A than Group B as shown in figure (LSPV: 164±28s vs. 216±67s; p<0.001, LIPV: 187±44s vs. 218±69s; p<0.001, RSPV: 147±31s vs. 192±51s; p<0.001, RIPV: 180±50 vs. 218±73s; p<0.001). The AF free survival rate during the follow-up period (356±167 days) was similar between the 2 groups (log-rank test, p=0.38). Furthermore, the complication rate was similar 2 groups.
The freezing time for each PV
Conclusion
The safety and efficacy of the new tailor-made CBA strategy were non-inferior to the standard procedure. This study showed that the unnecessary freezing time could be reduced in most of paroxysmal AF patients.
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Affiliation(s)
- T Nakano
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Suenari
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Suruga
- Hiroshima City Hospital, Hiroshima, Japan
| | - H Takemoto
- Hiroshima City Hospital, Hiroshima, Japan
| | | | - S Tomomori
- Hiroshima City Hospital, Hiroshima, Japan
| | - T Higaki
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Ooi
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Dai
- Hiroshima City Hospital, Hiroshima, Japan
| | - Y Nakama
- Hiroshima City Hospital, Hiroshima, Japan
| | - T Kawase
- Hiroshima City Hospital, Hiroshima, Japan
| | - K Nishioka
- Hiroshima City Hospital, Hiroshima, Japan
| | - M Otsuka
- Hiroshima City Hospital, Hiroshima, Japan
| | - Y Masaoka
- Hiroshima City Hospital, Hiroshima, Japan
| | - N Shiode
- Hiroshima City Hospital, Hiroshima, Japan
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15
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Higaki T, Nishioka K, Suruga K, Takemoto H, Nakano T, Hashimoto Y, Tomomori S, Oi K, Dai K, Kawase T, Nakama Y, Suenari K, Otsuka M, Masaoka Y, Shiode N. P2694Early and late restenosis after excimer laser coronary angioplasty and paclitaxel-coated balloon combination therapy for drug-eluting stent restenosis. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Drug-eluting stent restenosis (DES-ISR) is associated with poorer outcomes than those of bare-metal stent restenosis after treatment with paclitaxel-coated balloon (PCB), and late restenosis after PCB angioplasty for DES-ISR is a residual problem. Excimer laser coronary angioplasty (ELCA) is thought to be advantageous for ISR treatment by removing neointima. However, whether the combination of ELCA and PCB angioplasty is more effective than the use of PCB only angioplasty in DES-ISR has not been studied so far.
Purpose
We evaluated the efficacy of ELCA and PCB combination therapy for DES-ISR at mid-and late-term after revascularization.
Methods
From January 2014 to March 2016, 166 DES-ISR lesions were treated with ELCA and no-ELCA prior to PCB. Two serial angiographic follow-ups were planned for the patients (at 6–12 and 18–24 months after procedure). Acute procedural and follow-up angiographic results were assessed by quantitative coronary angiography. ELCA and no-ELCA group included 74 lesions and 92 lesions, respectively.
Results
There was no significant difference between the two groups in the clinical characteristics except the prevalence of hemodialysis, the rate of first-generation DES (37.9% vs 36.8%, p=0.897), previous stent size (2.90±0.39 mm vs 2.77±0.39 mm, p=0.063), and reference vessel diameter (2.65±0.46 mm vs 2.60±0.65 mm, p=0.593). Early follow-up angiography was performed in 66 lesions (89.1%) of ELCA group, and was done in 76 lesions (82.6%) of no-ELCA group. In the ELCA group, percentage diameter stenosis (%DS) just after procedure and at 6–12 months later were significantly smaller than those of no-ELCA group. Besides, target lesion revascularization (TLR) rate at 6–12 months after procedure was tended to be lower in the ELCA group. Late follow-up angiography was performed for 93 lesions (81.6%) of the remaining 114 lesions (excluding TLR lesion), late restenosis was found 9 lesions (18.6%) in the ELCA group and 11 lesions (24.4%) in the no-ELCA group (p=0.504). Late luminal loss was similar in both groups (0.37±0.71 mm vs 0.24±0.82 mm, p=0.438), and %DS at 12–18 months after revascularization was not different between the two groups.
Changes of %DS and TLR rate
Conclusions
%DS in the ELCA group was smaller at just after procedure and the advantage was kept even after 1-year. However, late restenosis and TLR at 2-year after revascularization for DES-ISR could not be reduced by ELCA and PCB combination therapy.
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Affiliation(s)
- T Higaki
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Nishioka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Suruga
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - H Takemoto
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - T Nakano
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Hashimoto
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - S Tomomori
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Oi
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Dai
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - T Kawase
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Nakama
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Suenari
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - M Otsuka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Masaoka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - N Shiode
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
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16
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Nakao Y, Higaki T, Nakama Y, Morito T, Suenari K, Nishioka K, Masaoka Y, Yoshida H, Shiode N. Primary pericardial abscess caused by Staphylococcus aureus infection without a predisposing condition. J Cardiol Cases 2019; 20:73-76. [PMID: 31497168 DOI: 10.1016/j.jccase.2019.04.004] [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: 01/21/2019] [Revised: 03/18/2019] [Accepted: 04/05/2019] [Indexed: 10/26/2022] Open
Abstract
A 75-year-old man presented to the hospital with a low-grade fever and worsening dyspnea. Transthoracic echocardiogram and contrast-enhanced computed tomography revealed a 20 × 20 mm lesion adjacent to the left ventricle with pericardial effusion. We suspected pericardial abscess, but no bacteria were detected even after 6 consecutive blood cultures. Ultimately, we drained 500 mL serosanguinous fluid from the pericardial effusion on the 4th hospital day; a subsequent culture grew methicillin-sensitive Staphylococcus aureus. Although we performed percutaneous and surgical drainage and intravenous administration of antibiotics, he developed constrictive pericarditis, and died due to multi-organ failure on the 21st hospital day. On histological examination, neutrophil infiltration was noted in the thickened pericardium and the myocardium. To our knowledge, a purulent pericarditis complicated pericardial abscess can occur without bacteremia, and early diagnosis and aggressive management are necessary for a good prognosis. <Learning objective: Pericardial abscess (PA) is a rare but serious life-threatening illness. We report the case of a patient with primary PA induced by S. aureus infection without a predisposing condition. A purulent pericarditis complicated PA can occur without bacteremia being detected from sequential blood cultures. Early diagnosis and aggressive management are vital to ensure a good prognosis.>.
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Affiliation(s)
- Yasuhisa Nakao
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yasuharu Nakama
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Toshiaki Morito
- Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan.,Department of Pathology, NHO Iwakuni Clinical Center, Yamaguchi, Japan
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Yoshiko Masaoka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Hideo Yoshida
- Department of Cardiovascular Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
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17
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Hifumi T, Inoue A, Kokubu N, Hase M, Yonemoto N, Kuroda Y, Kawakita K, Sawano H, Tahara Y, Nishioka K, Shirai S, Hazui H, Arimoto H, Kashiwase K, Kasaoka S, Motomura T, Yasuga Y, Yokoyama H, Nagao K, Nonogi H. Association between rewarming duration and neurological outcome in out-of-hospital cardiac arrest patients receiving therapeutic hypothermia. Resuscitation 2019; 146:170-177. [PMID: 31394154 DOI: 10.1016/j.resuscitation.2019.07.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 04/22/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 02/08/2023]
Abstract
AIM The European Resuscitation Council guidelines recommend a slow rate of rewarming of 0.25 °C/h-0.5 °C/h for out-of-hospital cardiac arrest (OHCA) patients receiving therapeutic hypothermia (TH). Conversely, a very slow rewarming of 1 °C/day is generally applied in Japan. The rewarming duration ranged from less than 24 h up to more than 50 h. No randomized control trials have examined the optimal rewarming speed for TH in OHCA patients. Therefore, we examined the association between the rewarming duration and neurological outcomes in OHCA patients who received TH. METHODS This study was a secondary analysis of the Japanese Population-based Utstein-style study with defibrillation and basic/advanced Life Support Education and implementation-Hypothermia (J-PULSE-HYPO) study registry, a multicenter prospective cohort study. Patients suffering from OHCA who received TH (target temperature, 34 °C) after the return of spontaneous circulation from 2005 to 2011 in 14 hospitals throughout Japan were enrolled. The rewarming duration was defined as the time from the beginning of rewarming at a target temperature of 34 °C until reaching 36 °C. The primary outcome was an unfavorable neurological outcome at hospital discharge, i.e., a cerebral performance category of 3-5. RESULTS The J-PULSE-HYPO study enrolled 452 OHCA patients. Of these, 328 were analyzed; 79.9% survived to hospital discharge, of which 56.4% had a favorable neurological outcome. Multivariable logistic regression analysis revealed that the rewarming duration was independently associated with unfavorable neurological outcomes [odds ratio (per 5 h), 0.89; 95% confidence interval, 0.79-0.99; p = 0.032]. CONCLUSION A longer rewarming duration was significantly associated with and was an independent predictor of favorable neurological outcomes in OHCA patients who received TH.
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Affiliation(s)
- Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Japan; Emergency Medical Center, Kagawa University Hospital, Japan.
| | - Akihiko Inoue
- Emergency Medical Center, Kagawa University Hospital, Japan; Department of Emergency and Critical Care Medicine, Hyogo Emergency Medical Center, Japan
| | - Nobuaki Kokubu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University, Japan
| | | | - Naohiro Yonemoto
- Department of Biostatistics, Kyoto University School of Public Health, Japan
| | | | - Kenya Kawakita
- Emergency Medical Center, Kagawa University Hospital, Japan
| | - Hirotaka Sawano
- Senri Critical Care Medical Center, Saiseikai Senri Hospital, Japan
| | - Yoshio Tahara
- Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hospital, Japan
| | | | - Hiroshi Hazui
- Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Japan
| | - Hideki Arimoto
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Japan
| | - Kazunori Kashiwase
- Department of Internal Medicine, Division of Coronary Heart Disease, Hyogo College of Medicine, Japan
| | - Shunji Kasaoka
- Department of Emergency and General Medicine, Kumamoto University Hospital, Japan
| | - Tomokazu Motomura
- Shock & Trauma Center, Chiba Hokusoh Hospital, Nippon Medical School, Japan
| | - Yuji Yasuga
- Department of Cardiology, Sumitomo hospital, Japan
| | | | - Ken Nagao
- Cardiovascular Center, Nihon University Hospital, Japan
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18
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Dai K, Suruga K, Nakano T, Takemoto H, Hashimoto Y, Tomomori S, Higaki T, Oi K, Kawase T, Nakama Y, Suenari K, Nishioka K, Otsuka M, Masaoka Y, Shiode N, Kihara Y. VERY LOW PREVALENCE OF NORMAL GLUCOSE METABOLISM IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION IN THE CURRENT ERA. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)30719-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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19
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Shimizu S, Yoshimura T, Katoh N, Inoue T, Hashimoto T, Nishioka K, Takao S, Matsuura T, Miyamoto N, Ito Y, Umegaki K, Shirato H. Analysis of Beam Delivery Times and Dose Rates for the Treatment of Mobile Tumors Using Real Time Image Gated Spot-Scanning Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.062] [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: 10/28/2022]
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20
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Inoue A, Hifumi T, Yonemoto N, Kuroda Y, Kawakita K, Sawano H, Tahara Y, Hase M, Nishioka K, Shirai S, Hazui H, Arimoto H, Kashiwase K, Kasaoka S, Motomura T, Yasuga Y, Yokoyama H, Nagao K, Nonogi H. The Impact of Heart Rate Response During 48-Hour Rewarming Phase of Therapeutic Hypothermia on Neurologic Outcomes in Out-of-Hospital Cardiac Arrest Patients. Crit Care Med 2018; 46:e881-e888. [DOI: 10.1097/ccm.0000000000003254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Suruga K, Dai K, Kobayashi Y, Ikegami Y, Nakao Y, Takemoto H, Higaki T, Ooi K, Kawase T, Nakama Y, Suenari K, Nishioka K, Otsuka M, Masaoka Y, Shiode N. P2275Are cholesterol crystals findings predictors for progression of non-culprit coronary plaque after acute myocardial infarction? (From optical coherence tomography study). Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Suruga
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Dai
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Kobayashi
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Ikegami
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Nakao
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - H Takemoto
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - T Higaki
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Ooi
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - T Kawase
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Nakama
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Suenari
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - K Nishioka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - M Otsuka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - Y Masaoka
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
| | - N Shiode
- Hiroshima City Hospital, Cardiology, Hiroshima, Japan
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Kasai J, Okamoto Y, Nishioka K, Takagi T, Sasaki Y. Chiral Domain Structure in Superfluid ^{3}He-A Studied by Magnetic Resonance Imaging. Phys Rev Lett 2018; 120:205301. [PMID: 29864362 DOI: 10.1103/physrevlett.120.205301] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/05/2017] [Indexed: 06/08/2023]
Abstract
The existence of a spatially varying texture in superfluid ^{3}He is a direct manifestation of the complex macroscopic wave function. The real space shape of the texture, namely, a macroscopic wave function, has been studied extensively with the help of theoretical modeling but has never been directly observed experimentally with spatial resolution. We have succeeded in visualizing the texture by a specialized magnetic resonance imaging. With this new technology, we have discovered that the macroscopic chiral domains, of which sizes are as large as 1 mm, and corresponding chiral domain walls exist rather stably in ^{3}He-A film at temperatures far below the transition temperature.
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Affiliation(s)
- J Kasai
- Department of Physics, Graduate School of Science, Kyoto University, Kitashirakawa-Oiwake-Cho, Sakyo-ku, Kyoto 606-8502, Japan
| | - Y Okamoto
- Department of Physics, Graduate School of Science, Kyoto University, Kitashirakawa-Oiwake-Cho, Sakyo-ku, Kyoto 606-8502, Japan
| | - K Nishioka
- Department of Physics, Graduate School of Science, Kyoto University, Kitashirakawa-Oiwake-Cho, Sakyo-ku, Kyoto 606-8502, Japan
| | - T Takagi
- Department of Applied Physics, University of Fukui, Bunkyo 3-9-1, Fukui 910-8507, Japan
| | - Y Sasaki
- Department of Physics, Graduate School of Science, Kyoto University, Kitashirakawa-Oiwake-Cho, Sakyo-ku, Kyoto 606-8502, Japan
- Research Center for Low Temperature and Materials Sciences, Kyoto University, Yoshida-honmachi, Sakyo-ku, Kyoto 606-8501, Japan
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Harima A, Sairaku A, Inoue I, Nishioka K, Oka T, Nakama Y, Dai K, Ohi K, Hashimoto H, Kihara Y. Real-life experience of a stent-less revascularization strategy using a combination of excimer laser and drug-coated balloon for patients with acute coronary syndrome. J Interv Cardiol 2018; 31:284-292. [PMID: 29464846 DOI: 10.1111/joic.12495] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/09/2018] [Accepted: 01/18/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES We aimed to test a novel stent-less revascularization strategy using a combination of excimer laser coronary angioplasty (ELCA) and drug-coated balloon (DCB) for patients with acute coronary syndrome (ACS). BACKGROUND Percutaneous coronary intervention with drug eluting stents is a standard invasive treatment for ACS. Some unsolved issues however remain, such as stent thrombosis and bleeding risks associated with dual antiplatelet therapy. METHODS Consecutive ACS patients were planned to receive either a DCB application following ELCA without a stent implantation or conventional revascularization with a coronary stent. The endpoints were (i) major cardiac adverse events (MACEs), defined as the composite of cardiac death, myocardial infarctions, and target lesion revascularization; (ii) target vessel revascularization (TVR); and (iii) angiographic outcome. RESULTS Since a greater than expected number of patients allocated to the stent-less treatment arm eventually received a bailout stenting, the following 3 as-treated groups were compared; DCB with ELCA group (N = 60), Stent with ELCA group (N = 23), and Stent without ELCA group (N = 85). During a mean follow-up period of 420 ± 137 days, and with angiographic 6- and 12-month-follow-up rates of 96.7%, 87%, and 81.2%, and 50%, 65.2%, and 45.9%, respectively, the MACE rate did not differ across the groups (10%, 4.3%, and 3.5%; P = 0.22) while an incidence of TVR was more common (15%, 0, and 4.7%; P = 0.02) and the diameter stenosis at 6-months of follow-up was greater (25.7 ± 18.2, 14.9 ± 13.1 and 16.2 ± 15.4%; P = 0.002) in the DCB with ELCA group. CONCLUSIONS The stent-less revascularization strategy with DCB and ELCA was associated with a higher occurrence of restenosis in ACS patients.
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Affiliation(s)
- Ayako Harima
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Akinori Sairaku
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Ichiro Inoue
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Toshiharu Oka
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Yasuharu Nakama
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Kuniomi Ohi
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Haruki Hashimoto
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan.,Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yasuki Kihara
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
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Maniwa T, Shintani Y, Okami J, Ohta M, Takeuchi Y, Takami K, Yokouchi H, Kurokawa E, Kanzaki R, Sakamaki Y, Shiono H, Iwasaki T, Nishioka K, Kodama K, Okumura M. MA 17.04 Initial Surgery in Patients with Clinical N2 Non-Small Cell Lung Cancer: A Multi-Institution Retrospective Study. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.612] [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: 11/29/2022]
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25
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Yoshino H, Nishioka K, Li Y, Ikeda A, Shibagaki Y, Hosaka A, Iwanaga H, Fujitake J, Ohi T, Miyazaki D, Sekijima Y, Oki M, Kusaka H, Ugawa Y, Funayama M, Hattori N. Clinical hetrogeneity of gch1 mutations in parkinsonism with or without dystonia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.472] [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: 11/26/2022]
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26
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Nishioka K, Hirano M, Stoessl A, Yoshino H, Imamichi Y, Ikeda A, Li Y, Funayama M, Yamada I, Yusaku N, Sossi V, Farrer M, Hattori N. Homozygous alpha-synuclein a53v in familial parkinson's disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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27
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Dai K, Suruga K, Nakao Y, Kobayashi Y, Ikegami Y, Takemoto H, Higaki T, Oi K, Kawase T, Nakama Y, Suenari K, Nishioka K, Sakai K, Otsuka M, Shimatani Y, Masaoka Y, Shiode N. Cauliflower-Like Appearance of Calcified Nodules Observed by Coronary Angioscopy. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.117.005722. [PMID: 28916607 DOI: 10.1161/circinterventions.117.005722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kazuoki Dai
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan.
| | - Kazuki Suruga
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yasuhisa Nakao
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yusuke Kobayashi
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yuki Ikegami
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Hajime Takemoto
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Tadanao Higaki
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Kuniomi Oi
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Tomoharu Kawase
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yasuharu Nakama
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Kazuyoshi Suenari
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Kenji Nishioka
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Koyu Sakai
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Masaya Otsuka
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yuji Shimatani
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Yoshiko Masaoka
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
| | - Nobuo Shiode
- From the Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, Japan
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Higaki T, Shiode N, Nishioka K, Takeuchi A, Harima A, Oi K, Dai K, Kawase T, Nakama Y, Suenari K, Otsuka M, Sakai K, Shimatani Y, Masaoka Y, Inoue I. P524Angiographic outcomes after the combined use of paclitaxel-coated balloon and excimer laser coronary angioplasty for drug-eluting stent in-stent restenosis. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Oiwa H, Araki K, Nishioka K. P1_163 Aneurysm of the Left Main Coronary Trunk in Cogan's Syndrome. Rheumatology (Oxford) 2017. [DOI: 10.1093/rheumatology/kex099] [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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31
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Okuda Y, Moe HH, Moe KK, Shimizu Y, Nishioka K, Shimogiri T, Mannen H, Kanemaki M, Kunieda T. Genotype distribution and allele frequencies of the genes associated with body composition and locomotion traits in Myanmar native horses. Anim Sci J 2016; 88:1198-1203. [DOI: 10.1111/asj.12756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 10/18/2016] [Accepted: 10/20/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Yu Okuda
- Graduate School of Environmental and Life Science; Okayama University; Okayama Japan
| | - Hla Hla Moe
- University of Veterinary Science; Nay Pyi Taw Myanmar
| | - Kyaw Kyaw Moe
- University of Veterinary Science; Nay Pyi Taw Myanmar
| | - Yuki Shimizu
- Graduate School of Environmental and Life Science; Okayama University; Okayama Japan
| | - Kenji Nishioka
- Graduate School of Environmental and Life Science; Okayama University; Okayama Japan
| | | | - Hideyuki Mannen
- Graduate School of Agricultural Science; Kobe University; Kobe Japan
| | | | - Tetsuo Kunieda
- Graduate School of Environmental and Life Science; Okayama University; Okayama Japan
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Kikuchi Y, Uchida Y, Kanauchi H, Niwa T, Nishioka K, Tada K, Hashimoto M, Yasuda H, Kawabata H, Seto Y, Ogawa T. 135P A multicenter retrospective observation study about overall survival benefit of eribulin mesylate in comparison with taxane regimens for metastatic cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw577.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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33
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Kikuchi Y, Uchida Y, Kanauchi H, Niwa T, Nishioka K, Tada K, Hashimoto M, Yasuda H, Kawabata H, Seto Y, Ogawa T. 135P A multicenter retrospective observation study about overall survival benefit of eribulin mesylate in comparison with taxane regimens for metastatic cancer patients. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00293-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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34
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Otsuka M, Shiode N, Nakao Y, Ikegami Y, Kobayashi Y, Takeuchi A, Harima A, Higaki T, Oi K, Dai K, Kawase T, Nakama Y, Suenari K, Nishioka K, Sakai K, Shimatani Y, Masaoka Y, Inoue I. Comparison of radial, brachial, and femoral accesses using hemostatic devices for percutaneous coronary intervention. Cardiovasc Interv Ther 2016; 33:62-69. [PMID: 27830459 DOI: 10.1007/s12928-016-0439-4] [Citation(s) in RCA: 14] [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: 07/21/2016] [Accepted: 11/04/2016] [Indexed: 11/25/2022]
Abstract
Some studies have suggested that radial access (RA) for percutaneous coronary intervention (PCI) reduces vascular complications and bleeding compared to femoral access (FA). The purpose of this study was to investigate the routine use of hemostatic devices and bleeding complications among RA, brachial access (BA), and FA. Between January 2015 and December 2015, 298 patients treated for PCI with RA were compared with 158 patients using BA and 206 patients using FA. The radial sheath was routinely removed with ADAPTY, the brachial sheath with BLEED SAFE, and the femoral sheath with Perclose ProGlide. In-hospital bleeding complications were investigated. Cardiogenic shock was most frequent in patients in the femoral group (RA 1.3%, BA 2.5%, FA 9.2%, p < 0.0001). The rate of major bleeding was highest in the femoral group (RA 1.0%, BA 2.5%, FA 5.3%, p = 0.01). Blood transfusion rates were highest in the femoral group (RA 0.7%, BA 1.3%, FA 4.4%, p = 0.01). Retroperitoneal bleeding was observed in 1.9% of patients in the femoral group. Patients in the brachial group had large hematomas (RA 0.7%, BA 4.4%, FA 1.5%, p = 0.01). Pseudoaneurysm formation needing intervention occurred most frequently in the brachial group (RA 0%, BA 1.3%, FA 0%, p = 0.04). In conclusion, compared to the brachial and femoral approaches, the radial approach appears to be the safest technique to avoid local vascular bleeding complications. The brachial approach has the highest risk of large hematoma and pseudoaneurysm formation among the three groups.
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Affiliation(s)
- Masaya Otsuka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan.
| | - Nobuo Shiode
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yasuhisa Nakao
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yuki Ikegami
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yusuke Kobayashi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Arinori Takeuchi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Ayako Harima
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Tadanao Higaki
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Kuniomi Oi
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Kazuoki Dai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Tomoharu Kawase
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yasuharu Nakama
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Kazuyoshi Suenari
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Koyu Sakai
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yuji Shimatani
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Yoshiko Masaoka
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
| | - Ichiro Inoue
- Department of Cardiology, Hiroshima City Hiroshima Citizens Hospital, 7-33 Moto-machi, Naka-ku, Hiroshima, 730-8518, Japan
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Shimizu S, Katoh N, Hashimoto T, Nishioka K, Yoshimura T, Takao S, Matsuura T, Miyamoto N, Umegaki K, Shirato H. Analysis of Durations and Dose Rates for Treatment of Moving Liver Tumors Using Real-Time Image Gated Spot Scanning Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.526] [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: 11/29/2022]
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36
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Kinoshita R, Shimizu S, Nishikawa Y, Nishioka K, Hashimoto T, Suzuki R, Shirato H. Radiation Dose to Internal Mammary Lymph Node in Standard Tangential Breast Irradiation. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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37
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Affiliation(s)
- Hiroshi Oiwa
- Department of Rheumatology, Hiroshima City Hiroshima Citizens Hospital, Japan
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Kuroiwa Y, Nishioka K, Yokota S, Hirai T, Nishioka K, Fujino K, Iguchi Y. Subacute autonomic, endocrine, and cognitive disorders in Japanese girls at puberty after human papillomavirus vaccination. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.430] [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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39
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Hirai T, Iguchi Y, Uchiyama M, Kuroiwa Y, Nakamura I, Yokota S, Nishioka K. Single photon emission computed tomography findings after human papillomavirus (HPV) vaccination in Japan. Auton Neurosci 2015. [DOI: 10.1016/j.autneu.2015.07.407] [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: 11/27/2022]
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40
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Matsuo H, Tomiyama H, Satake W, Chiba T, Onoue H, Kawamura Y, Nakayama A, Sakiyama M, Funayama M, Nishioka K, Shimizu T, Kaida K, Kamakura K, Toda T, Hattori N, Shinomiya N. Onset age of Parkinson’s disease is delayed by a common dysfunctional variant of ABCG2, a major causative gene for early-onset gout. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.977] [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: 12/01/2022]
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41
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Hattori N, Nishioka K, Matsushima T, Li Y, Yoshino H, Takanashi M, Funayama M. Clinicogenetic study of CHCHD2 in patients with autosomal dominant familial Parkinson's disease. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.226] [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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42
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Kikuchi Y, Shirakawa K, Kanauchi H, Wakeda T, Niwa T, Nishioka K, Tada K, Uchida Y, Seto Y. 1873 A retrospective multicenter observation study about comparative analysis on efficacy of eribulin mesylate with taxane regimens (including combination with bevacizumab) in metastatic breast cancer patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30823-1] [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: 10/22/2022]
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43
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Hifumi T, Kuroda Y, Kawakita K, Sawano H, Tahara Y, Hase M, Nishioka K, Shirai S, Hazui H, Arimoto H, Kashiwase K, Kasaoka S, Motomura T, Yasuga Y, Yonemoto N, Yokoyama H, Nagao K, Nonogi H. Effect of Admission Glasgow Coma Scale Motor Score on Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Therapeutic Hypothermia. Circ J 2015. [PMID: 26212234 DOI: 10.1253/circj.cj-15-0308] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [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: 11/09/2022]
Abstract
BACKGROUND Because the initial (on admission) Glasgow Coma Scale (GCS) examination has not been fully evaluated in comatose survivors of cardiac arrest (CA) who receive therapeutic hypothermia (TH), the aim of the present study was to determine any association between the admission GCS motor score and neurologic outcomes in patients with out-of-hospital CA who receive TH. METHODS AND RESULTS In the J-PULSE-HYPO study registry, patients with bystander-witnessed CA were eligible for inclusion. Patients were divided into 3 groups based on GCS motor score (1, 2-3, and 4-5) to assess various effects on neurologic outcome. Univariate and multivariate analyses were performed to identify independent predictors of good neurologic outcome at 90 days. Of 452 patients, 302 were enrolled. There was a significant difference among the 3 patient groups with regard to neurologic outcome at 90 days in the univariate analysis. Multiple logistic regression analyses showed that the GCS motor score on admission, age >65 years, bystander cardiopulmonary resuscitation, the time from collapse to return of spontaneous circulation, and pupil size <4 mm were independent predictors of a good neurologic outcome at 90 days in cases of CA (GCS motor score, 4-5: odds ratio, 8.18; 95% confidence interval: 1.90-60.28; P<0.01). CONCLUSIONS GCS motor score is an independent predictor of good neurologic outcome at 90 days in patients sustaining out-of-hospital CA who receive TH.
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Affiliation(s)
- Toru Hifumi
- Emergency Medical Center, Kagawa University Hospital
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Kaneko T, Kasaoka S, Nakahara T, Sawano H, Tahara Y, Hase M, Nishioka K, Shirai S, Hazui H, Arimoto H, Kashiwase K, Motomura T, Kuroda Y, Yasuga Y, Yonemoto N, Yokoyama H, Nagao K, Nonogi H. Effectiveness of lower target temperature therapeutic hypothermia in post-cardiac arrest syndrome patients with a resuscitation interval of ≤30 min. J Intensive Care 2015; 3:28. [PMID: 26097741 PMCID: PMC4474339 DOI: 10.1186/s40560-015-0095-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/10/2015] [Indexed: 11/16/2022] Open
Abstract
Background Therapeutic hypothermia (TH) is a standard strategy to reduce brain damage in post-cardiac arrest syndrome (PCAS) patients. However, it is unknown whether the target temperature should be adjusted for PCAS patients in different states. Methods Participants in the J-PULSE-Hypo study database were divided into lower (32.0–33.5 °C; Group L) or moderate (34.0–35.0 °C; Group M) temperature groups. Primary outcome was a favourable neurological outcome (proportion of patients with a Glasgow-Pittsburgh Cerebral Performance Category [CPC] of 1–2 on day 30). We compared between the two groups and in subgroups of patients divided by age and resuscitation interval (interval from collapse to return of spontaneous circulation) by propensity score (PS) analysis. Results Overall, 467 participants were analysed. The proportions of patients with favourable neurological outcomes were as follows (Group L vs. Group M) (OR; Odds ratio): all patients, 64 % (n = 42) vs. 55 % ((n = 424) (PS; OR 1.381 (0.596–3.197)), P = 0.452) and resuscitation interval ≤ 30 min, 88 % (n = 24) vs. 64 % ((n = 281) (PS; OR 7.438 (1.769–31.272)), P = 0.007). Conclusions PCAS patients with a resuscitation interval of <30 min may be candidates for TH with a target temperature of <34 °C. Trial registration University Hospital Medical Information Network (UMIN) Clinical Trials Registry UMIN000001935; available at: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000002348&language=J.
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Affiliation(s)
- Tadashi Kaneko
- Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 Japan
| | - Shunji Kasaoka
- Emergency and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556 Japan
| | - Takashi Nakahara
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Ube, Japan
| | - Hirotaka Sawano
- Senri Critical Care Medical Center, Saiseikai Senri Hospital, Osaka, Japan
| | - Yoshio Tahara
- Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Mamoru Hase
- Department of Emergency Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kenji Nishioka
- Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan
| | - Shinichi Shirai
- Division of Cardiology, Kokura Memorial Hospital, Kokura, Japan
| | - Hiroshi Hazui
- Emergency Medicine, Osaka Mishima Emergency and Critical Care Center, Osaka, Japan
| | - Hideki Arimoto
- Emergency and Critical Care Medical Center, Osaka City General Hospital, Osaka, Japan
| | | | - Tomokazu Motomura
- Department of Emergency and Critical Care Medicine, Chiba Hokusoh Hospital, Nippon Medical School, Inzai, Japan
| | - Yasuhiro Kuroda
- Emergency and Critical Care Center, Kagawa University Hospital, Kagawa, Japan
| | - Yuji Yasuga
- Department of Cardiology, Sumitomo Hospital, Osaka, Japan
| | - Naohiro Yonemoto
- Department of Psychopharmacology, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hiroyuki Yokoyama
- Division of Cardiovascular Care Unit, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Ken Nagao
- Department of Cardiology, Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, Surugadai Nihon University Hospital, Tokyo, Japan
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Abstract
To break the vicious circle between malnutrition and severe infection which has been linked to the great magnitude of infant deaths worldwide, we have been searching by means of clinical and experimental studies for measures which provide for rapid enhancement of body defenses. Based on clinical observations of malnourished children and the sequence of recovery during nutritional rehabilitation, it is suggested that the complement system is a more important factor during the early stage of nutritional recovery than CMI. In animal experiments using malnourished rats, nutritional deprivation affected various components of the body defense system to various extents, CMI being the most susceptible to influence. The complement system acted to maintain host defense even when CMI was impaired. Also observed was the earlier recovery of serum complement to normal or higher levels as compared with that of CMI. The complement system responded to bacterial infection much earlier than other immunologic responses, even in malnourished rats with depressed CMI. The infected rats showed a much higher rate of de novo synthesis of complement proteins than noninfected rats, and this effect was predominant in the malnourished group. Based on these animal experiments, we attempted to induce rapid heightened resistance to infection in malnourished rats by enhancing the complement system. After administration of proper doses of lentinan or Zn-chlorophyllin, which are known to activate C3 in vitro, to malnourished rats, heightened resistance against bacterial infection was induced together with a heightened complement response. In contrast, after administration of cobra venom factor, which is known to reduce C3 activity both in vitro and in vivo, resistance against bacterial infection was reduced, even in well-nourished rats. In summary, we have analyzed in the malnourished state the mechanism of heightened resistance against bacterial infection after activation of C3 by lentinan or Zn-chlorophyllin. These C3 activators enhanced C3b formation and iC3b formation in vivo, eventually resulting in enhanced interaction of iC3b present on invaders with CR3 on phagocytic cells.
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Affiliation(s)
- M Sakamoto
- Department of Home Economics, Wayo Womens University, Chiba, Japan
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46
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Ohtsubo T, Nishioka K, Imaiso Y, Iwai S, Shimokawa H, Oda H, Fujiwara T, Nakabeppu Y. Identification of human MutY homolog (hMYH) as a repair enzyme for 2-hydroxyadenine in DNA and detection of multiple forms of hMYH located in nuclei and mitochondria. Nucleic Acids Res 2015; 43:3870-1. [PMID: 25800745 PMCID: PMC4402549 DOI: 10.1093/nar/gkv264] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Katsunuma T, Fujisawa T, Mizuho N, Akira A, Nomura I, Yamaoka A, Kondo H, Masuda K, Yamaguchi K, Terada A, Ikeda M, Nishioka K, Adachi Y, Kurihara K. Effects of Transdermal Tulobuterol in Pediatric Asthma Patients on Long-Term Leukotriene Receptor Antagonist Therapy: Results of a Randomized, Open-Label, Multicenter Clinical Trial in Japanese Children Aged 4-12 Years. Allergol Int 2015; 62:37-43. [PMID: 28942989 DOI: 10.2332/allergolint.12-oa-0437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 05/31/2012] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Few studies have examined the efficacy or safety of a transdermal β2 agonist as add-on medicationto long-term leukotriene receptor antagonist (LTRA) therapy in pediatric asthma patients. METHODS In this randomized, open-label, multicenter clinical trial, children aged 4-12 years on long-term LTRA therapy were treated with tulobuterol patches (1-2 mg daily) or oral sustained-release theophylline (usual dose, 4-5 mg_kg daily) for 4 weeks. LTRAs were continued throughout the trial. Outcomes included volume peak expiratory flow (% PEF), fractional exhaled nitric oxide (FeNO), clinical symptoms and adverse events. RESULTS Thirty-three and 31 patients were treated with tulobuterol patches and theophylline, respectively. % PEF measured in the morning and before bedtime was significantly higher at all times in the treatment period compared with baseline in the tulobuterol patch group (p < 0.001), and was significantly higher in the tulobuterol patch group compared with the theophylline group. FeNO was similar and unchanged from baseline in both groups. There were no drug-related adverse events in either group. CONCLUSIONS These results suggest that short-term use of a transdermal β2 agonist is an effective therapy for pediatric asthma without inducing airway inflammation in children on long-term LTRA therapy.
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Affiliation(s)
- Toshio Katsunuma
- Department of Pediatrics, Jikei Daisan Hospital, University of Toyama, Toyama, Japan..
| | - Takao Fujisawa
- National Hospital Organization Mie Hospital, University of Toyama, Toyama, Japan
| | - Nagao Mizuho
- National Hospital Organization Mie Hospital, University of Toyama, Toyama, Japan
| | - Akasawa Akira
- National Center for Child Health and Development, University of Toyama, Toyama, Japan
| | - Ichiro Nomura
- National Hospital Organization Kanagawa Hospital, University of Toyama, Toyama, Japan
| | | | - Hisashi Kondo
- Kondo Children's Hospital, Mie, University of Toyama, Toyama, Japan
| | - Kei Masuda
- International University of Health and Welfare, Mita Hospital, University of Toyama, Toyama, Japan
| | | | - Akihiko Terada
- Daido Hospital, Aichi, University of Toyama, Toyama, Japan
| | - Masanori Ikeda
- Department of Pediatrics, Fukuyama Medical center, Hiroshima University of Toyama, Toyama, Japan
| | | | - Yuichi Adachi
- Department of Pediatrics, University of Toyama, Toyama, Japan
| | - Kazuyuki Kurihara
- Kanagawa Children's Medical center, Kanagawa, University of Toyama, Toyama, Japan
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Ohtsuka Y, Higashimoto K, Sasaki K, Jozaki K, Yoshinaga H, Okamoto N, Takama Y, Kubota A, Nakayama M, Yatsuki H, Nishioka K, Joh K, Mukai T, Yoshiura KI, Soejima H. Autosomal recessive cystinuria caused by genome-wide paternal uniparental isodisomy in a patient with Beckwith-Wiedemann syndrome. Clin Genet 2014; 88:261-6. [PMID: 25171146 DOI: 10.1111/cge.12496] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 01/08/2023]
Abstract
Approximately 20% of Beckwith-Wiedemann syndrome (BWS) cases are caused by mosaic paternal uniparental disomy of chromosome 11 (pUPD11). Although pUPD11 is usually limited to the short arm of chromosome 11, a small minority of BWS cases show genome-wide mosaic pUPD (GWpUPD). These patients show variable clinical features depending on mosaic ratio, imprinting status of other chromosomes, and paternally inherited recessive mutations. To date, there have been no reports of a mosaic GWpUPD patient with an autosomal recessive disease caused by a paternally inherited recessive mutation. Here, we describe a patient concurrently showing the clinical features of BWS and autosomal recessive cystinuria. Genetic analyses revealed that the patient has mosaic GWpUPD and an inherited paternal homozygous mutation in SLC7A9. This is the first report indicating that a paternally inherited recessive mutation can cause an autosomal recessive disease in cases of GWpUPD mosaicism. Investigation into recessive mutations and the dysregulation of imprinting domains is critical in understanding precise clinical conditions of patients with mosaic GWpUPD.
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Affiliation(s)
- Y Ohtsuka
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Higashimoto
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Sasaki
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - K Jozaki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - H Yoshinaga
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - N Okamoto
- Department of Medical Genetics, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Y Takama
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - A Kubota
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - M Nakayama
- Department of Pathology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - H Yatsuki
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Nishioka
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - K Joh
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
| | - T Mukai
- Nishikyushu University, Saga, Japan
| | - K-i Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - H Soejima
- Division of Molecular Genetics and Epigenetics, Department of Biomolecular Sciences, Faculty of Medicine, Saga University, Saga, Japan
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Teragawa H, Nishioka K, Fujii Y, Idei N, Hata T, Kurushima S, Shokawa T, Kihara Y. Worsening of coronary spasm during the perioperative period: A case report. World J Cardiol 2014; 6:685-688. [PMID: 25068030 PMCID: PMC4110618 DOI: 10.4330/wjc.v6.i7.685] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Revised: 02/20/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023] Open
Abstract
We present the case of a 65-year-old male with vasospastic angina (VSA) whose condition worsened during the perioperative period. He had been diagnosed with VSA 10 years prior. He was treated with two types of vasodilators and had not experienced any chest symptoms for 5 years. At this juncture, he underwent surgery for relapsed maxillary sublingual carcinoma. He had taken two vasodilators one day prior to surgery. Intravenous infusion of nitroglycerin (NTG) was initiated immediately before the surgery and continued the following day. Instead of stopping NTG, a dermal isosorbide dinitrate tape was applied on post-operative day 1. Two days later, a complete atrioventricular block with pulseless electrical activity appeared. After cardiopulmonary resuscitation, emergent coronary angiography showed severe coronary spasm in both the left and right coronary arteries. Intracoronary infusion of nitroglycerin and epinephrine with percutaneous cardiopulmonary support relieved the coronary spasm. During the perioperative period, several factors can trigger coronary vasospasm, including the discontinuation of vasodilators. Thus, surgeons, anesthetists, and cardiologists should watch for coronary vasospasm during this period and for worsening coronary spasm when discontinuing vasodilators in patients at risk for VSA.
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50
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Judex M, Neumann E, Fleck M, Pap T, Mountz JD, Gay RE, Schölmerich J, Nishioka K, Gay S, Müller-Ladner U. "Inverse wrap": an improved implantation technique for virus-transduced synovial fibroblasts in the SCID mouse model for rheumatoid arthritis. Mod Rheumatol 2014; 11:145-50. [PMID: 24383692 DOI: 10.3109/s101650170027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract The SCID mouse model for rheumatoid arthritis (RA) is an established and reliable approach to examining the distinct mechanisms operative in RA synovium, and evaluating novel gene therapy strategies. However, serum concentrations of circulating gene therapy products following gene transfer are frequently too low to allow detection. This problem stimulated us to develop a novel implantation technique to improve the yield of these soluble gene products. Synovial fibroblasts from patients with RA were cultured, passaged, and transduced with Ad5 sTNFRp55:Ig. sTNFRp55:Ig production was confirmed by ELISA, and then cells were implanted into SCID mice using a novel implantation strategy in which pieces of human cartilage were engrafted into a fibroblast-saturated inert sponge. Thereafter, the sponges were implanted under the skin of the mice instead of under the kidney capsule, as in the original approach, allowing co-implantation of larger pieces of cartilage together with higher numbers of adenovirus-transduced RA synovial fibroblasts. The improved implantation technique not only resulted in a reduction in the number of mice needed in each experiment by approximately 60%, and a reduction of the time taken for surgery by about 50%, but also considerably enhanced the serum concentrations of the gene product sTNFRp55-Ig, allowing detection of the soluble TNF receptor p55 by standard ELISA. In summary, the improved implantation technique for the SCID mouse model for RA results in more economic animal treatment, and facilitates the detection and quantification of circulating gene products following adenovirus-based gene transfer into synovial fibroblasts.
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Affiliation(s)
- M Judex
- Department of Internal Medicine I, University of Regensburg , FJS-Allee 11, D-93042 Regensburg , Germany
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