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Houkin K, Osanai T, Uchiyama S, Minematsu K, Taguchi A, Maruichi K, Niiya Y, Asaoka K, Kuga Y, Takizawa K, Haraguchi K, Yoshimura S, Kimura K, Tokunaga K, Aoyama A, Ikawa F, Inenaga C, Abe T, Tominaga A, Takahashi S, Kudo K, Fujimura M, Sugiyama T, Ito M, Kawabori M, Hess DC, Savitz SI, Hirano T. Allogeneic Stem Cell Therapy for Acute Ischemic Stroke: The Phase 2/3 TREASURE Randomized Clinical Trial. JAMA Neurol 2024; 81:154-162. [PMID: 38227308 PMCID: PMC10792497 DOI: 10.1001/jamaneurol.2023.5200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/15/2023] [Indexed: 01/17/2024]
Abstract
Importance Cell therapy is a promising treatment approach for stroke and other diseases. However, it is unknown whether MultiStem (HLCM051), a bone marrow-derived, allogeneic, multipotent adult progenitor cell product, has the potential to treat ischemic stroke. Objective To assess the efficacy and safety of MultiStem when administered within 18 to 36 hours of ischemic stroke onset. Design, Setting, and Participants The Treatment Evaluation of Acute Stroke Using Regenerative Cells (TREASURE) multicenter, double-blind, parallel-group, placebo-controlled phase 2/3 randomized clinical trial was conducted at 44 academic and clinical centers in Japan between November 15, 2017, and March 29, 2022. Inclusion criteria were age 20 years or older, presence of acute ischemic stroke (National Institutes of Health Stroke Scale [NIHSS] score of 8-20 at baseline), confirmed acute infarction involving the cerebral cortex and measuring more than 2 cm on the major axis (determined with diffusion-weighted magnetic resonance imaging), and a modified Rankin Scale (mRS) score of 0 or 1 before stroke onset. Data analysis was performed between May 9 and August 15, 2022. Exposure Patients were randomly assigned to either intravenous MultiStem in 1 single unit of 1.2 billion cells or intravenous placebo within 18 to 36 hours of ischemic stroke onset. Main Outcomes and Measures The primary end points were safety and excellent outcome at day 90, measured as a composite of a modified Rankin Scale (mRS) score of 1 or less, a NIHSS score of 1 or less, and a Barthel index score of 95 or greater. The secondary end points were excellent outcome at day 365, mRS score distribution at days 90 and 365, and mRS score of 0 to 1 and 0 to 2 at day 90. Statistical analysis of efficacy was performed using the Cochran-Mantel-Haenszel test. Results This study included 206 patients (104 received MultiStem and 102 received placebo). Their mean age was 76.5 (range, 35-95) years, and more than half of patients were men (112 [54.4%]). There were no between-group differences in primary and secondary end points. The proportion of excellent outcomes at day 90 did not differ significantly between the MultiStem and placebo groups (12 [11.5%] vs 10 [9.8%], P = .90; adjusted risk difference, 0.5% [95% CI, -7.3% to 8.3%]). The frequency of adverse events was similar between treatment groups. Conclusions and Relevance In this randomized clinical trial, intravenous administration of allogeneic cell therapy within 18 to 36 hours of ischemic stroke onset was safe but did not improve short-term outcomes. Further research is needed to determine whether MultiStem therapy for ischemic stroke has a beneficial effect in patients who meet specific criteria, as indicated by the exploratory analyses in this study. Trial Registration ClinicalTrials.gov Identifier: NCT02961504.
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Affiliation(s)
| | - Toshiya Osanai
- Department of Neurosurgery, Hokkaido University, Sapporo, Japan
| | - Shinichiro Uchiyama
- Clinical Research Center for Medicine, International University of Health and Welfare, Tokyo, Japan
- Center for Brain and Cerebral Vessels, Sanno Medical Center, Tokyo, Japan
| | | | - Akihiko Taguchi
- Department of Regenerative Medicine Research, Foundation for Biomedical Research and Innovation at Kobe, Kobe, Japan
| | - Katsuhiko Maruichi
- Department of Neurosurgery, Kashiwaba Neurosurgical Hospital, Sapporo, Japan
| | - Yoshimasa Niiya
- Department of Neurosurgery, Otaru General Hospital, Otaru, Japan
| | - Katsuyuki Asaoka
- Department of Neurosurgery, Teine Keijinkai Medical Center, Sapporo, Japan
| | - Yoshihiro Kuga
- Department of Neurosurgery, Ohnishi Neurological Center, Akashi, Japan
| | - Katsumi Takizawa
- Department of Neurosurgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan
| | - Koichi Haraguchi
- Department of Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan
| | - Shinichi Yoshimura
- Department of Neurosurgery, Hyogo Medical University, Nishinomiya, Japan
| | - Kazumi Kimura
- Department of Neurology, Nippon Medical School Hospital, Tokyo, Japan
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, Okayama City, Japan
| | - Atsuo Aoyama
- Department of Neurology, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Fusao Ikawa
- Department of Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan
| | - Chikanori Inenaga
- Department of Neurosurgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Saga University, Nabeshima, Japan
| | - Atsushi Tominaga
- Department of Neurosurgery and Neuroendovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima City, Japan
| | - Shinichi Takahashi
- Department of Neurology and Stroke, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Kohsuke Kudo
- Department of Diagnostic Imaging, Hokkaido University, Sapporo, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Hokkaido University, Sapporo, Japan
| | - Taku Sugiyama
- Department of Neurosurgery, Hokkaido University, Sapporo, Japan
| | - Masaki Ito
- Department of Neurosurgery, Hokkaido University, Sapporo, Japan
| | | | - David C. Hess
- Department of Neurology, Medical College of Georgia, Augusta University, Augusta
| | - Sean I. Savitz
- Department of Neurology Institute for Stroke and Cerebrovascular Disease, UTHealth, Houston, Texas
| | - Teruyuki Hirano
- Department of Stroke and Cerebrovascular Medicine, Kyorin University, Mitaka, Japan
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2
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Takasugi Y, Hishikawa T, Shimizu T, Murai S, Haruma J, Hiramatsu M, Tokunaga K, Takeda Y, Sugiu K, Morimatsu H, Date I. Power suppression in EEG after the onset of SAH is a significant marker of early brain injury in rat models. Sci Rep 2024; 14:2277. [PMID: 38280926 PMCID: PMC10821948 DOI: 10.1038/s41598-024-52527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
We analyzed the correlation between the duration of electroencephalogram (EEG) recovery and histological outcome in rats in the acute stage of subarachnoid hemorrhage (SAH) to find a new predictor of the subsequent outcome. SAH was induced in eight rats by cisternal blood injection, and the duration of cortical depolarization was measured. EEG power spectrums were given by time frequency analysis, and histology was evaluated. The appropriate frequency band and recovery percentage of EEG (defined as EEG recovery time) to predict the neuronal damage were determined from 25 patterns (5 bands × 5 recovery rates) of receiver operating characteristic (ROC) curves. Probit regression curves were depicted to evaluate the relationships between neuronal injury and duration of depolarization and EEG recovery. The optimal values of the EEG band and the EEG recovery time to predict neuronal damage were 10-15 Hz and 40%, respectively (area under the curve [AUC]: 0.97). There was a close relationship between the percentage of damaged neurons and the duration of depolarization or EEG recovery time. These results suggest that EEG recovery time, under the above frequency band and recovery rate, may be a novel marker to predict the outcome after SAH.
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Affiliation(s)
- Yuji Takasugi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Tomohito Hishikawa
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tomohisa Shimizu
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Satoshi Murai
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Jun Haruma
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masafumi Hiramatsu
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Tokunaga
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Yoshimasa Takeda
- Department of Anesthesiology, Faculty of Medicine, Toho University, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Kenji Sugiu
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroshi Morimatsu
- Department of Anesthesiology and Resuscitology, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Cutler G, Cocco D, Bentley B, Cervantes M, Chavez P, Chrzan J, DiMaggio S, Hussey R, Ilmberger J, Lindsay J, Lizotte E, McCombs K, Morton S, Paulovits G, Pearson K, Redding C, Smith N, Tokunaga K, Zehm D, DiMasi E, Padmore H. Experimental testing of a prototype cantilevered liquid-nitrogen-cooled silicon mirror. J Synchrotron Radiat 2023; 30:76-83. [PMID: 36601928 PMCID: PMC9814055 DOI: 10.1107/s1600577522010700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/08/2022] [Indexed: 06/17/2023]
Abstract
This report presents testing of a prototype cantilevered liquid-nitrogen-cooled silicon mirror. This mirror was designed to be the first mirror for the new soft X-ray beamlines to be built as part of the Advanced Light Source Upgrade. Test activities focused on fracture, heat transfer, modal response and distortion, and indicated that the mirror functions as intended.
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Affiliation(s)
- G. Cutler
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - D. Cocco
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - B. Bentley
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - M. Cervantes
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - P. Chavez
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - J. Chrzan
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - S. DiMaggio
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - R. Hussey
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - J. Ilmberger
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - J. Lindsay
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - E. Lizotte
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - K. McCombs
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - S. Morton
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - G. Paulovits
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - K. Pearson
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - C. Redding
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - N. Smith
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - K. Tokunaga
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - D. Zehm
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - E. DiMasi
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - H. Padmore
- Lawrence Berkeley National Laboratory, Berkeley, California, USA
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Ohto H, Uchikawa M, Ito S, Wada I, Nollet KE, Omae Y, Ogasawara K, Tokunaga K. The KANNO blood group system. Immunohematology 2022; 38:119-122. [PMID: 36789458 DOI: 10.21307/immunohematology-2022-053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
The KANNO blood group system (International Society of Blood Transfusion [ISBT] 037) includes one high-prevalence antigen, KANNO1, across ethnic groups. Sporadic KANNO1- cases among East and South Asians are theoretically estimated by the DNA database library. Anti-KANNO1 has been found most often among Japanese women with current or prior pregnancy. Thus far, there are no reported cases of hemolytic transfusion reaction or hemolytic disease of the fetus and newborn due to anti-KANNO1.
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Affiliation(s)
- H Ohto
- Fukushima Medical University, Fukushima City, 960-1295 Fukushima, Japan
| | - M Uchikawa
- Makoto Uchikawa, Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - S Ito
- Japanese Red Cross Tohoku Block Blood Center, Sendai, Japan
| | - I Wada
- Fukushima Medical University Institute of Biomedical Sciences, Fukushima, Japan
| | - K E Nollet
- Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Y Omae
- Research Institute National Center for Global Health and Medicine, Tokyo, Japan
| | - K Ogasawara
- Japanese Red Cross Central Blood Institute, Tokyo, Japan
| | - K Tokunaga
- Research Institute National Center for Global Health and Medicine, Tokyo, Japan
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Yoshihara H, Otani T, Nishiyama T, Omae Y, Tokunaga K, Fumiko O, Goto S, Kitaori T, Sugiura-Ogasawara M. O-301 Genome-wide association study identified meiotic variant associated with aneuploid pregnancy loss. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Which single nucleotide variant (SNVs) are associated with aneuploid pregnancy loss?
Summary answer
We identified a SNV on MEIG1 gene, which are associated with meiosis/spermiogenesis.
What is known already
Recurrent pregnancy loss (RPL) refers to the loss of two or more pregnancies, with a frequency of 5%. Chromosomal abnormalities in embryos are found in 80% of first trimester miscarriages, 86% of which are aneuploid. Recently, embryonic aneuploidy was found to be the most common cause of RPL, with a frequency of 40-50%. Most trisomy miscarriages are of maternal origin, with errors occurring during meiosis of the oocyte. Chromosome segregation abnormalities in oocytes are thought to be an event associated with increasing maternal age, but in addition, maternal genetic causes are thought to contribute.
Study design, size, duration
A Genome wide association study (GWAS) was performed on a clinically well characterized cohort of 189 women with RPL whose previous aborted conceptus was ascertained to be an aneuploid embryo. Samples were mainly collected from 2007 to 2018 mainly at Nagoya City University Hospital. For control samples, we used 1157 samples from the population-based prospective cohorts that included fertile women.
Participants/materials, setting, methods
All patients underwent a systematic examination. Patients with antiphospholipid syndrome, an abnormal chromosome in either partner, or uterine anomaly were excluded. Patients whose previously miscarried POC exhibited triploidy or 45, X were excluded. DNA was isolated from stored EDTA-blood samples and genotyped by Axiom Japonica-array v2659,503 SNVs). For the GWAS, a chi-squared test was applied to a two-by-two contingency table in allele frequency model.
Main results and the role of chance
The mean (SD) ages and number of previous miscarriages of the patients were 36.8 (4.3) and 3.09 (1.13). GWAS data revealed 5 SNVs with suggestive significance (p < 9.46e-06). The SNVs that showed the most significant associations (P = 1.06E-06, OR = 1.72) was located on meiosis/spermiogenesis associated 1 (MEIG1) gene under an allelic model after Bonferroni correction considering the number of analyzed SNVs. The SNV rs7908491 was reported as a splicing QTL in the MEIG1 gene, which is a meiosis/meiosis-associated factor and is plausibly associated with chromosome aneuploidy. This is the first GWAS in patients with RPL caused by aneuploidy.
Limitations, reasons for caution
Since this study was conducted in a single center and had a small sample size, it needs to be replicated in different centers with more subjects and on an international scale. Whole genome imputation analysis will be performed to detect SNVs with more significant associations.
Wider implications of the findings
Our findings demonstrate that a specific genotype of MEIG1 gene can be a risk factor for aneuploid pregnancy loss. The establishment of clinically applicable maternal germ cell markers could identify groups for whom PGT would be more useful or provide patients with counseling that provides prognostic information about pregnancy.
Trial registration number
not applicable
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Affiliation(s)
- H Yoshihara
- Nagoya City University Graduate School of Medical Sciences, Obstetrics and Gynecology , Nagoya, Japan
| | - T Otani
- Nagoya City University Graduate School of Medical Sciences , Public Health , Nagoya, Japan
| | - T Nishiyama
- Nagoya City University Graduate School of Medical Sciences , Public Health , Nagoya, Japan
| | - Y Omae
- National Center for Global Health and Medicine Genome Medical Science, Project-Toyama , Tokyo, Japan
| | - K Tokunaga
- National Center for Global Health and Medicine Genome Medical Science, Project-Toyama , Tokyo, Japan
| | - O Fumiko
- Nagoya City University Graduate School of Medical Sciences, Obstetrics and Gynecology , Nagoya, Japan
| | - S Goto
- Nagoya City University Graduate School of Medical Sciences, Obstetrics and Gynecology , Nagoya, Japan
| | - T Kitaori
- Nagoya City University Graduate School of Medical Sciences, Obstetrics and Gynecology , Nagoya, Japan
| | - M Sugiura-Ogasawara
- Nagoya City University Graduate School of Medical Sciences, Obstetrics and Gynecology , Nagoya, Japan
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Sasaki F, Nakamoto R, Tokunaga K, Ishida A, Umeoka S. 18F-FDG PET/CT Findings of G-CSF-Producing Gallbladder Cancer. Clin Nucl Med 2022; 47:e368-e369. [PMID: 35044962 DOI: 10.1097/rlu.0000000000004054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT We report a case of granulocyte colony-stimulating factor (G-CSF)-producing gallbladder cancer in a 64-year-old man. Contrast-enhanced CT showed an exophytic hypoattenuation mass with peripheral enhancement in the gallbladder. 18F-FDG PET/CT showed avid FDG uptake in the gallbladder mass and diffuse FDG uptake in the bone marrow. The patient was diagnosed with G-CSF-producing gallbladder cancer based on an elevated serum level of G-CSF and histological findings. G-CSF-producing tumors are associated with a poor prognosis because of rapid progression. Early and accurate diagnosis of G-CSF-producing tumors based on characteristic PET/CT findings is important to determine treatment strategies and improve prognosis of patients.
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Affiliation(s)
- Fumi Sasaki
- From the Departments of Diagnostic Radiology
| | | | | | - Ayami Ishida
- Diagnostic Pathology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
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Kidani N, Sugiu K, Terasaka K, Nakashima H, Tokunaga K, Kobayashi K, Kambara H, Hishikawa T, Hiramatsu M, Date I. Mobile endovascular therapy for acute treatment of ruptured vertebral artery dissecting aneurysm in multiple hospitals. Acta Neurochir (Wien) 2022; 164:517-523. [PMID: 34146152 DOI: 10.1007/s00701-021-04885-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/14/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The patients with ruptured vertebral artery dissecting aneurysm (rVADA) should be treated as early as possible because VADA carries extremely high risk of rebleeding in the acute phase. We have established a mobile endovascular strategy for the patients with rVADA between our flagship center and its affiliated local hospitals. We introduced and reviewed our mobile endovascular therapy in this study. METHODS We retrospectively evaluated 98 consecutive patients who underwent endovascular surgery for rVADA from 2000 to 2018 at our institution or five affiliated hospitals. When each patient was initially transported to the local affiliated hospitals, neuroendovascular surgeons traveled directly to the affiliated hospital from the flagship center in order to treat the patient there. Clinical outcomes using modified Rankin Scale at 6 months after treatment, radiological results, and procedure-related complications were reviewed to justify our mobile endovascular strategy. RESULTS All aneurysms were cured successfully by internal trapping. Favorable outcome was achieved in 61 patients (62.2%) even though 53 patients (54.1%) had presented with severe subarachnoid hemorrhage. Overall mortality rate, treatment-related mortality rate, and treatment related complication rate were 18.4% (18/98), 0%, and 16% (16/98), respectively. There were no differences in clinical and radiological outcomes between the patients treated in the flagship center and those who treated in the affiliated hospitals. Treatment in the affiliated hospital was not a predictive factor of unfavorable outcome in our multivariate analysis, and elderly age (≥ 60) was negatively associated with favorable outcome. CONCLUSIONS Our results prove the efficacy and safety of mobile endovascular therapy for the treatment of rVADA in the ultra-acute stage. Mobile endovascular therapy may work well in the acute treatment of rVADAs in the certain circumstance.
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Affiliation(s)
- Naoya Kidani
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Kenji Sugiu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan.
| | - Kaoru Terasaka
- Department of Neurosurgery, Kure Kyosai Hospital, Kure, Hiroshima, Japan
| | | | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Municipal Hospital, Okayama, Japan
| | - Kazuki Kobayashi
- Department of Neurosurgery, Tsuyama Chuo Hospital, Tsuyama, Okayama, Japan
| | - Hirokazu Kambara
- Department of Neurosurgery, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Tomohito Hishikawa
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Masafumi Hiramatsu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, Okayama, 700-8558, Japan
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Hiramatsu M, Ishibashi R, Suzuki E, Miyazaki Y, Murai S, Takai H, Takasugi Y, Yamaoka Y, Nishi K, Takahashi Y, Haruma J, Hishikawa T, Yasuhara T, Chin M, Matsubara S, Uno M, Tokunaga K, Sugiu K, Date I. Incidence and clinical characteristics of spinal arteriovenous shunts: hospital-based surveillance in Okayama, Japan. J Neurosurg Spine 2021; 36:670-677. [PMID: 34715647 DOI: 10.3171/2021.7.spine21233] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 07/01/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE There have been no accurate surveillance data regarding the incidence rate of spinal arteriovenous shunts (SAVSs). Here, the authors investigate the epidemiology and clinical characteristics of SAVSs. METHODS The authors conducted multicenter hospital-based surveillance as an inventory survey at 8 core hospitals in Okayama Prefecture between April 1, 2009, and March 31, 2019. Consecutive patients who lived in Okayama and were diagnosed with SAVSs on angiographic studies were enrolled. The clinical characteristics and the incidence rates of each form of SAVS and the differences between SAVSs at different spinal levels were analyzed. RESULTS The authors identified a total of 45 patients with SAVSs, including 2 cases of spinal arteriovenous malformation, 5 cases of perimedullary arteriovenous fistula (AVF), 31 cases of spinal dural AVF (SDAVF), and 7 cases of spinal epidural AVF (SEAVF). The crude incidence rate was 0.234 per 100,000 person-years for all SAVSs including those at the craniocervical junction (CCJ) level. The incidence rate of SDAVF and SEAVF combined increased with advancing age in men only. In a comparative analysis between upper and lower spinal SDAVF/SEAVF, hemorrhage occurred in 7/14 cases (50%) at the CCJ/cervical level and in 0/24 cases (0%) at the thoracolumbar level (p = 0.0003). Venous congestion appeared in 1/14 cases (7%) at the CCJ/cervical level and in 23/24 cases (96%) at the thoracolumbar level (p < 0.0001). CONCLUSIONS The authors reported detailed incidence rates of SAVSs in Japan. There were some differences in clinical characteristics of SAVSs in the upper spinal levels and those in the lower spinal levels.
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Affiliation(s)
- Masafumi Hiramatsu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Ryota Ishibashi
- 2Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki
| | - Etsuji Suzuki
- 3Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Yuko Miyazaki
- 4Department of Neurosurgery, Kawasaki Medical School, Kurashiki; and
| | - Satoshi Murai
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Hiroki Takai
- 4Department of Neurosurgery, Kawasaki Medical School, Kurashiki; and
| | - Yuji Takasugi
- 5Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Japan
| | - Yoko Yamaoka
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Kazuhiko Nishi
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Yu Takahashi
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Jun Haruma
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Tomohito Hishikawa
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Takao Yasuhara
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Masaki Chin
- 2Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki
| | - Shunji Matsubara
- 4Department of Neurosurgery, Kawasaki Medical School, Kurashiki; and
| | - Masaaki Uno
- 4Department of Neurosurgery, Kawasaki Medical School, Kurashiki; and
| | - Koji Tokunaga
- 5Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Japan
| | - Kenji Sugiu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
| | - Isao Date
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama
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Tokunaga K, Furuta A, Iizuka Y, Isoda H, Togashi K. Utility of real-time image fusion technology in ultrasonography-guided fiducial marker implantation for stereotactic body radiation therapy for liver tumors. Acta Radiol 2021; 62:567-573. [PMID: 32586122 DOI: 10.1177/0284185120934479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ultrasonography (US) is useful when implanting fiducial markers in the liver. However, the implant position is sometimes lost. Recently, real-time image fusion technology (Volume Navigation [V-navi]; GE Healthcare, Milwaukee, WI, USA) has been introduced as a technique for using images from different modalities, and its utility for fiducial marker implantation has been hypothesized. PURPOSE To evaluate the utility of US-guided fiducial marker implantation in the liver using V-navi compared to conventional US. MATERIAL AND METHODS We retrospectively reviewed 35 patients who underwent fiducial marker implantation for stereotactic body radiation therapy of liver tumors in 2013-2018. To avoid artifacts obscuring the tumor, the target point of implantation was set 10 mm cranial or caudal to the tumor. Marker implantation was then performed using US alone (US group, n = 24) or V-navi with computed tomography (CT) or magnetic resonance imaging (V-navi group, n = 11). Postprocedural CT was evaluated to determine technical success, distances between marker and either tumor surface or target point, and whether marker-induced artifacts obscured the tumor. Complications were also evaluated. Results were compared between groups. RESULTS Technical success was obtained in 33 patients. Distance between the tumor and marker showed no significant difference between groups. Distance between target point and marker was shorter in the V-navi group (P = 0.0093). Tumor-obscuring artifacts were seen in 12 patients (V-navi group, n = 1; US group, n = 11; P = 0.055). The only complication was minor bleeding in the US group (n = 1). CONCLUSION V-navi appears useful for US-guided fiducial marker implantation in the liver compared with conventional US.
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Affiliation(s)
- Koji Tokunaga
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihiro Furuta
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yusuke Iizuka
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Murai S, Hiramatsu M, Suzuki E, Ishibashi R, Takai H, Miyazaki Y, Takasugi Y, Yamaoka Y, Nishi K, Takahashi Y, Haruma J, Hishikawa T, Yasuhara T, Chin M, Matsubara S, Uno M, Tokunaga K, Sugiu K, Date I. Trends in Incidence of Intracranial and Spinal Arteriovenous Shunts: Hospital-Based Surveillance in Okayama, Japan. Stroke 2021; 52:1455-1459. [PMID: 33596673 DOI: 10.1161/strokeaha.120.032052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE To date, the incidence of intracranial and spinal arteriovenous shunts has not been thoroughly investigated. We aimed to clarify recent trends in the rates of intracranial and spinal arteriovenous shunts in Japan. METHODS We conducted multicenter hospital-based surveillance at 8 core hospitals in Okayama Prefecture between April 1, 2009 and March 31, 2019. Patients who lived in Okayama and were diagnosed with cerebral arteriovenous malformations, dural arteriovenous fistulas (DAVFs), or spinal arteriovenous shunts (SAVSs) were enrolled. The incidence and temporal trends of each disease were calculated. RESULTS Among a total of 393 cranial and spinal arteriovenous shunts, 201 (51.1%) cases of DAVF, 155 (39.4%) cases of cerebral arteriovenous malformation, and 34 (8.7%) cases of SAVS were identified. The crude incidence rates between 2009 and 2019 were 2.040 per 100 000 person-years for all arteriovenous shunts, 0.805 for cerebral arteriovenous malformation, 1.044 for DAVF, and 0.177 for SAVS. The incidence of all types tended to increase over the decade, with a notable increase in incidence starting in 2012. Even after adjusting for population aging, the incidence of nonaggressive DAVF increased 6.0-fold while that of SAVS increased 4.4-fold from 2010 to 2018. CONCLUSIONS In contrast to previous studies, we found that the incidence of DAVF is higher than that of cerebral arteriovenous malformation. Even after adjusting for population aging, all of the disease types tended to increase in incidence over the last decade, with an especially prominent increase in SAVSs and nonaggressive DAVFs. Various factors including population aging may affect an increase in DAVF and SAVS.
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Affiliation(s)
- Satoshi Murai
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Masafumi Hiramatsu
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Etsuji Suzuki
- Department of Epidemiology (E.S.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Ryota Ishibashi
- Department of Neurosurgery, Kurashiki Central Hospital, Japan (R.I., M.C.)
| | - Hiroki Takai
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan (H.T., Y.M., S.M., M.U.)
| | - Yuko Miyazaki
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan (H.T., Y.M., S.M., M.U.)
| | - Yuji Takasugi
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan.,Department of Neurosurgery, Okayama City Hospital Okayama City General Medical Center, Japan (Y. Takasugi, K.T.)
| | | | - Kazuhiko Nishi
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Yu Takahashi
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Jun Haruma
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Tomohito Hishikawa
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Takao Yasuhara
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Masaki Chin
- Department of Neurosurgery, Kurashiki Central Hospital, Japan (R.I., M.C.)
| | - Shunji Matsubara
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan (H.T., Y.M., S.M., M.U.)
| | - Masaaki Uno
- Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Japan (H.T., Y.M., S.M., M.U.)
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital Okayama City General Medical Center, Japan (Y. Takasugi, K.T.)
| | - Kenji Sugiu
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
| | - Isao Date
- Department of Neurological Surgery (S.M., M.H., Y.Y., K.N., Y. Takahashi, J.H., T.H., T.Y., K.S., I.D.), Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
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Osakada Y, Yamashita T, Morihara R, Matsumoto N, Sasaki R, Tadokoro K, Nomura E, Kawahara Y, Omote Y, Hishikawa N, Takemoto M, Ohta Y, Suruga Y, Nagase T, Takasugi Y, Inoue S, Watanabe K, Deguchi K, Tokunaga K, Sasada S, Kobayashi K, Maeoka R, Fukutome K, Takahashi K, Ohnishi H, Kuga Y, Ohnishi H, Abe K. 4-Hydroxyl-2-Nonenal Localized Expression Pattern in Retrieved Clots is Associated with Large Artery Atherosclerosis in Stroke Patients. J Stroke Cerebrovasc Dis 2021; 30:105583. [PMID: 33412400 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/09/2020] [Accepted: 12/22/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The relationship between stroke etiology and clot pathology remains controversial. MATERIALS AND METHODS We performed histological analysis of clots retrieved from 52 acute ischemic stroke patients using hematoxylin and eosin staining and immunohistochemistry (CD42b and oxidative/hypoxic stress markers). The correlations between clot composition and the stroke etiological group (i.e., cardioembolic, cryptogenic, or large artery atherosclerosis) were assessed. RESULTS Of the 52 clots analyzed, there were no significant differences in histopathologic composition (e.g., white blood cells, red blood cells, fibrin, and platelets) between the 3 etiological groups (P = .92). By contrast, all large artery atherosclerosis clots showed a localized pattern with the oxidative stress marker 4-hydroxyl-2-nonenal (P < .01). From all 52 clots, 4-hydroxyl-2-nonenal expression patterns were localized in 28.8% of clots, diffuse in 57.7% of clots, and no signal in 13.5% of clots. CONCLUSIONS A localized pattern of 4-hydroxyl-2-nonenal staining may be a novel and effective marker for large artery atherosclerosis (sensitivity 100%, specificity 82%).
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Affiliation(s)
- Yosuke Osakada
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan; Department of Neurology, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan
| | - Toru Yamashita
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Ryuta Morihara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Namiko Matsumoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Ryo Sasaki
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Koh Tadokoro
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Emi Nomura
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Yuko Kawahara
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Yoshio Omote
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Nozomi Hishikawa
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Mami Takemoto
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
| | - Yasuyuki Ohta
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan
| | - Yasuki Suruga
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan.
| | - Takayuki Nagase
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan.
| | - Yuji Takasugi
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan
| | - Satoshi Inoue
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan
| | - Kyoichi Watanabe
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan.
| | - Kentaro Deguchi
- Department of Neurology, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan.
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, 3-20-1 Kitanagase Omotecho, Kita-ku, Okayama 700-8557, Japan.
| | - Susumu Sasada
- Department of Neurosurgery, Tsuyama Chuo Hospital, 1756 Kawasaki Tsuyama, Okayama 708-0841, Japan
| | - Kazuki Kobayashi
- Department of Neurosurgery, Tsuyama Chuo Hospital, 1756 Kawasaki Tsuyama, Okayama 708-0841, Japan
| | - Ryosuke Maeoka
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Kenji Fukutome
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Kenkichi Takahashi
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Hiroyuki Ohnishi
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Yoshihiro Kuga
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Hideyuki Ohnishi
- Department of Neurosurgery, Ohnishi Neurological Center, 1661-1 Eigashima Okubocho, Akashi, Hyogo 674-0064, Japan.
| | - Koji Abe
- Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikatacho, Kita-ku, Okayama 700-8558, Japan.
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Tokunaga K, Furuta A, Isoda H, Uemoto S, Togashi K. Feasibility and mid- to long-term results of endovascular treatment for portal vein thrombosis after living-donor liver transplantation. Diagn Interv Radiol 2020; 27:65-71. [PMID: 33252338 DOI: 10.5152/dir.2020.19469] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE We aimed to evaluate mid- to long-term results of endovascular treatment for portal vein thrombosis (PVT) after living-donor liver transplantation (LDLT). METHODS Thirty cases (14 males, 16 females; age range, 0.67-65 years) who underwent endovascular treatment including thrombolysis, angioplasty, stent placement, and/or collateral embolization for PVT after LDLT from 2001 to 2017 were retrospectively reviewed. Clinical and procedural data were collected and analyzed regarding the patency of the PVT site at the last follow-up date (PVT-free persistency) using Log-rank test. Results were considered statistically significant at P < 0.05. RESULTS Median follow-up was 120 months. The technical success rate was 80% (n=24). Patency rates at 1 week and 1, 3, 6, 12, 36, and 60 months were 73%, 59%, 55%, 51%, 51%, 51%, and 51% for primary patency and 80%, 70%, 66%, 66%, 66%, 61%, and 61% for assisted patency after secondary endovascular treatment. PVT-free persistency rates regarding the subgroups were as follows: children under 12 years vs. adults, 50% vs. 68% (P = 0.42); acute vs. nonacute, 76% vs. 46% (P = 0.10); localized vs. extensive, 90% vs. 50% (P = 0.035); transileocolic approach vs. percutaneous-transhepatic approach, 71% vs. 54% (P = 0.39); and thrombolysis-based treatment vs. non-thrombolysis-based treatment, 71% vs. 44% (P = 0.12), respectively. Among technically successful cases, PVT-free persistency rate was 94% for those with hepatopetal flow in the peripheral portal vein vs. 17% for those without hepatopetal flow (P < 0.001). The only major complication occurring was pleural hemorrhage (n=1). Minor complications (i.e., fever) occurred in 18 patients (60%). CONCLUSION In conclusion, mid- to long-term portal patency following endovascular treatment was approximately 50%-60% in PVT patients after LDLT. PVT site patency over three months after the first endovascular treatment, localized PVT, and hepatopetal flow in the peripheral portal vein were identified as key prognostic factors for mid- to long-term portal patency.
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Affiliation(s)
- Koji Tokunaga
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Japan
| | - Akihiro Furuta
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Japan
| | - Shinji Uemoto
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Transplantation, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Shogoin, Sakyo-ku, Japan
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Nagase T, Tokunaga K, Watanabe K, Umeda T, Suruga Y, Takasugi Y, Inoue S, Kiriyama H, Matsumoto K. A Patient with a Cavernous Sinus Dural Arteriovenous Fistula in Whom an Approach through the Jugular Venous Arch Involving Facial Vein Return Was Adopted. J Neuroendovasc Ther 2020; 15:164-169. [PMID: 37502728 PMCID: PMC10370671 DOI: 10.5797/jnet.cr.2020-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/24/2020] [Indexed: 07/29/2023]
Abstract
Objective We report the case of a cavernous sinus dural arteriovenous fistula (CSdAVF) treated by transvenous embolization (TVE) via the jugular venous arch (JVA) connecting bilateral superficial cervical veins. Case Presentation A male patient in his 50s presenting with diplopia and headache was diagnosed with a CSdAVF. The first session of TVE resulted in incomplete obliteration of the fistula due to poor accessibility through the inferior petrosal sinus (IPS), and postoperative computed tomography angiography (CTA) disclosed a newly developed drainage route into the facial vein (FV) connecting to the anterior jugular vein (AJV) and the JVA. The patient underwent the second session of TVE through the JVA, FV, and the superior ophthalmic vein (SOV), and obliteration was achieved. Conclusion There is a considerable variation in the anatomy of facio-cervical veins in patients with CSdAVF. Meticulous preoperative evaluation of the venous drainage route using modern diagnostic tools is indispensable to achieve successful results in patients with CSdAVF.
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Affiliation(s)
- Takayuki Nagase
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kyoichi Watanabe
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Tsuyoshi Umeda
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yasuki Suruga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yuji Takasugi
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Satoshi Inoue
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Hideki Kiriyama
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kengo Matsumoto
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
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Tokunaga K, Inoue S, Suruga Y, Nagase T, Takagi Y, Watanabe K, Kiriyama H, Deguchi S, Deguchi K, Matsumoto K. Practical Use of a Communication Application on Mobile Devices by Our Stroke Team. J Neuroendovasc Ther 2020; 14:339-344. [PMID: 37501671 PMCID: PMC10370912 DOI: 10.5797/jnet.oa.2020-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/23/2020] [Indexed: 07/29/2023]
Abstract
Objective To describe our 1-year experience of the practical use of a mobile communication application by our stroke team. Methods The mobile Join application (Allm Inc., Tokyo, Japan) was introduced into our stroke team for the purpose of immediate sharing of the patient information. We analyzed the usage situation for 1 year after the introduction of Join, particularly its efficacy in improving the door-to-puncture time (D2P) for thrombectomy cases, and reported our inter-hospital collaboration with the use of Join. Results The total number of events notified by Join was 337, and they included acute stroke potentially leading to reperfusion therapy in 23% (76 events), head trauma in 14%, brain hemorrhage in 12%, other infarction in 10%, subarachnoid hemorrhage in 8%, and the others in 34%. The information of the patients was shared among the team members before arrival to our hospital in 42% of acute stroke cases. Of 31 patients undergoing mechanical thrombectomy, the median interval between arrival and groin puncture for the directly transported patients with/without pre-hospital information was 77.5 min/87 min, respectively, whereas that of the patients transferred from primary hospitals with/without pre-hospital information was 19 min/71 min (p <0.0001), respectively, demonstrating the efficacy of information sharing in advance through Join in improving the timing of endovascular therapy. For inter-hospital collaboration using the telestroke system, we concluded the partnership agreement with three local primary hospitals by communication via Join at a reasonable cost. Conclusion Active and effective utilization of the mobile Join application for communication by our stroke team was demonstrated, and it is expected to promote inter-hospital collaboration in stroke treatment.
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Affiliation(s)
- Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Satoshi Inoue
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yasuki Suruga
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Takayuki Nagase
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Yuji Takagi
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kyoichi Watanabe
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Hideki Kiriyama
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Shoko Deguchi
- Department of Neurology, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kentaro Deguchi
- Department of Neurology, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
| | - Kengo Matsumoto
- Department of Neurosurgery, Okayama City Hospital, Okayama City General Medical Center, Okayama, Okayama, Japan
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Tokunaga K, Matsui K, Oshikawa H, Matsui T, Tohma S. SAT0124 RISK OF SERIOUS INFECTION, MALIGNANCY, OR DEATH IN JAPANESE RHEUMATOID ARTHRITIS PATIENTS TREATED WITH A COMBINATION OF ABATACEPT AND TACROLIMUS: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Both Abatacept (ABT) and Tacrolimus (Tac) suppress T cell immunity, but it is unknown whether combinations of these will increase the risk of adverse events.Objectives:To evaluate whether combining ABT and Tac increases the risk of infection and malignancy compared to their individual use in Japanese rheumatoid arthritis (RA) patients.Methods:We conducted a retrospective cohort study of RA patients using the multicenter database in Japan (NinJa). The dataset was clinical information at a certain point within each year, and the point was any point selected by a registered physician. RA was clinically diagnosed in the dataset. (1)We analyzed the data from RA patients registered in NinJa during the period from April 2010 to March 2019. In this study, we compared three groups who received Tac, ABT or a combination of both. We included patients who had just begun initiating treatment with ABT or Tac, and we excluded patients who used TNF inhibitors, IL-6 inhibitors, and Jak inhibitors in the first year. The primary outcome was defined the composite events including infections that require hospitalization, newly diagnosed malignancy, and death from any cause after initiation of ABT or Tac. We assessed whether the combination contributed to increase the risk of outcome by performing a Cox regression analysis.Results:Among the 27032 RA patients in the registry, 2009 patients were included. The Tac, ABT and combination groups consisted of 1328, 563 and 118 patients, respectively. (Figure 1) (Table 1) Primary outcomes occurred in 149 (13.4%), 62 (13.5%), 14 (13.9%) patients, of the Tac, ABT and combination groups, respectively. The incidence between groups was not significantly different (p= 0.638). (Figure 2) A Cox regression analysis was adjusted for the following parameters: age, sex, disease duration, modified health assessment questionnaire, disease activity score 28-CRP, CRP, use of prednisolone, and use of methotrexate. The analysis revealed no significant differences between groups. The hazard ratio (95% confidence interval) was as follows: Tac 1.00 (Ref), ABT 1.02 (0.74-1.40), and combination 1.15 (0.65-2.05).Table 1.baseline characteristicsTacrolimusAbataceptCombinationp valueN (person-year)1328 (2505)563 (944)118 (193)age (median [IQR])69.00 [60.00, 76.00]70.00 [61.00, 76.00]67.00 [59.00, 74.00]0.169*sex female (%)1038 (78.2)468 (83.1)97 (82.2)0.039†disease duration (yr) (median [IQR])9.00 [4.00, 18.00]11.00 [5.00, 21.00]11.00 [7.00, 20.00]0.002*Steinbrocker stage (%)I285 (23.5)82 (15.6)12 (12.1)<0.001†II361 (29.8)125 (23.8)25 (25.3)III232 (19.1)150 (28.5)31 (31.3)IV334 (27.6)169 (32.1)31 (31.3)mHAQ (median [IQR])0.25 [0.00, 0.75]0.38 [0.00, 1.00]0.50 [0.00, 1.13]<0.001*DAS28CRP (median [IQR])2.58 [1.88, 3.40]2.77 [2.09, 3.62]3.01 [2.27, 3.98]<0.001*CRP (mg/dL) (median [IQR])0.30 [0.10, 1.02]0.35 [0.13, 1.10]0.30 [0.14, 0.82]0.590*RF positivity (%)708/895 (79.1)331/400 (82.8)57/71 (80.3)0.314†Tacrolimus (mg/d) (median [IQR])1.50 [1.00, 2.00]0.00 [0.00, 0.00]2.00 [1.00, 2.50]<0.001*MTX use (%)619 (46.6)264 (46.9)32 (27.1)<0.001†PSL use (%)749 (56.4)299 (53.1)71 (60.2)0.253†Abbreviations: anti-CCP, anti-cyclic citrullinated peptide; mHAQ, modified Health Assessment Questionnaire; MTX, methotrexate; PSL, prednisolone; RF, rheumatoid factor * Kruskal-Wallis test; † chi square test; ‡ analysis of variance (ANOVA)Conclusion:The combination of ABT and Tac does not increase the risk of adverse events in patients with rheumatoid arthritis in Japan when compared to the use ABT or Tac alone. Further evaluation is needed.References:[1]Matsui T, et al. Ann Rheum Dis 2007;66:1221–6.Disclosure of Interests:Kenichiro Tokunaga: None declared, Kunihiko Matsui: None declared, Hideto Oshikawa: None declared, Toshihiro Matsui Paid instructor for: Chugai Pharmaceutical Co., LTD., Janssen Pharmaceutical K,K,, Shigeto Tohma: None declared
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Smittipat N, Miyahara R, Juthayothin T, Billamas P, Dokladda K, Imsanguan W, Intralawan D, Rukseree K, Jaitrong S, Chaiyasirinroje B, Wongjai J, Disratthakit A, Chaiprasert A, Nedsuwan S, Mahasirimongkol S, Toyo-Oka L, Tokunaga K, Yamada N, Palittapongarnpim P, Yanai H. Indo-Oceanic Mycobacterium tuberculosis strains from Thailand associated with higher mortality. Int J Tuberc Lung Dis 2020; 23:972-979. [PMID: 31615603 DOI: 10.5588/ijtld.18.0710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING: This study was conducted among tuberculosis (TB) patients in a highly endemic Thai province.OBJECTIVE: To evaluate the association between different Mycobacterium tuberculosis lineages and clinical characteristics, especially mortality.DESIGN: We enrolled 1,304 TB patients registered from 2002-2011 with culture isolates whose lineages were identified by specific regions of deletion. Data on mortality within 1 year of follow-up were extracted from the registration system and hospital records. Mortality-associated risk factors, including bacterial lineages, as independent variables were analysed using Cox regression models.RESULTS: Of 1,304 isolates, 521 (40.0%) and 582 (44.6%) belonged to Indo-Oceanic and East-Asian lineages, respectively. Indo-Oceanic strains significantly increased the mortality risk compared with East-Asian strains (adjusted hazard ratio [aHR] 1.42, 95%CI 1.02-1.99) or modern lineages (aHR 1.49, 95%CI 1.08-2.06) in the 172 patients who died within 1 year after TB diagnosis. The former also caused significantly higher mortality than modern lineages among patients who died within 6 months after TB diagnosis (aHR 1.62, 95%CI 1.12-2.35). No significant association was found between drug resistance and death.CONCLUSION: In Thailand, the Indo-Oceanic lineage of M. tuberculosis increased mortality risk compared with modern lineages or the East-Asian lineage, the latter being considered highly virulent in previous studies.
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Affiliation(s)
- N Smittipat
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - R Miyahara
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Juthayothin
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - P Billamas
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - K Dokladda
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - W Imsanguan
- Chiang Rai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai
| | - D Intralawan
- Chiang Rai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai
| | - K Rukseree
- Mahidol University Amnatcharoen Campus, Amnatcharoen
| | - S Jaitrong
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | | | - J Wongjai
- TB/HIV Research Foundation, Chiang Rai
| | - A Disratthakit
- Medical Genetics Center, Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi
| | - A Chaiprasert
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Nedsuwan
- Chiang Rai Prachanukroh Hospital, Ministry of Public Health, Chiang Rai
| | - S Mahasirimongkol
- Medical Genetics Center, Medical Life Sciences Institute, Department of Medical Sciences, Ministry of Public Health, Nonthaburi
| | - L Toyo-Oka
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - N Yamada
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Japan
| | - P Palittapongarnpim
- National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand, Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - H Yanai
- Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Kiyose, Japan, Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose, Japan
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Tokunaga K, Arizono S, Shimizu H, Fujimoto K, Kurata M, Minamiguchi S, Isoda H, Togashi K. Optimizing b-values for accurate depiction of pancreatic cancer with tumor-associated pancreatitis on computed diffusion-weighted imaging. Clin Imaging 2020; 61:20-26. [PMID: 31954347 DOI: 10.1016/j.clinimag.2020.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/05/2019] [Accepted: 01/07/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To determine the optimal b-value for accurate depiction of pancreatic cancer (PC) in patients with active tumor-associated pancreatitis (TAP), using computed diffusion-weighted imaging (cDWI) with a range of b-values up to 3000 s/mm2. METHODS The study protocol was approved by the institutional review board. We retrospectively analyzed 34 consecutive PC cases with active TAP who underwent pancreatectomy without preoperative therapy. Four cDWI datasets with b-values of 1500-3000 s/mm2 (cDWI1500-cDWI3000) were generated from the original DWI datasets with b-values of 0 and 1000 s/mm2 obtained using a 3-T scanner. Two board-certified radiologists evaluated images qualitatively (tumor conspicuity and total image quality), and another two board-certified radiologists placed regions of interest for quantitative evaluations (apparent diffusion coefficient [ADC] values of both lesions, contrast ratio [CR] of PC to active TAP, and volume ratio [VR] of PC to surgical specimen). RESULTS As the b-value increased, tumor conspicuity improved significantly in cDWI2000 and cDWI2500 (P = 0.0121 and 0.0015, respectively), although total image quality decreased in all cDWIs compared with DWI1000 (P < 0.0001). Significantly lower ADC values were seen in PC (P < 0.0001). All cDWI groups showed positive correlation between the tumor conspicuity and ADC difference between PC and TAP. CR increased with the b-value, while VR decreased. Significant equivalence of VR to the surgical specimen was seen on cDWI2000 (P = 0.0031). CONCLUSION Accurate depiction of PC was optimal with cDWI2000 in the presence of active TAP.
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Affiliation(s)
- Koji Tokunaga
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Shigeki Arizono
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hironori Shimizu
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Koji Fujimoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Mariyo Kurata
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Sachiko Minamiguchi
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
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Tokunaga K, Furuta A, Yoshimura M, Togashi K. Superior Mesenteric Artery Stent-Graft Migration into the Duodenum. J Vasc Interv Radiol 2019; 30:1614. [DOI: 10.1016/j.jvir.2019.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/17/2019] [Accepted: 05/19/2019] [Indexed: 10/26/2022] Open
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Nakamura K, Alam M, Jiang Y, Mitarai O, Takechi M, Hasegawa M, Tokunaga K, Hanada K, Idei H, Nagashima Y, Onchi T, Kuroda K, Watanabe O, Higashijima A, Nagata T, Shimabukuro S, Kawasaki S, Fukuyama A. Plasma equilibrium based on EC-driven current profile with toroidal rotation on QUEST. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.04.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tokunaga K, Furuta A, Arizono S, Teramoto Y, Negoro H, Kido A, Isoda H, Togashi K. Duodenal obstruction induced by retroperitoneal progression of bladder cancer: a report of two cases. Abdom Radiol (NY) 2019; 44:1223-1229. [PMID: 30600382 DOI: 10.1007/s00261-018-1874-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Bladder cancer usually forms a papillary structure. Progression along the cavity or membranous structures surrounding the bladder, rectum, or retroperitoneum without formation of a discrete mass is rare. We here present two patients with duodenal obstruction caused by retroperitoneal progression of bladder cancer, in both of whom computed tomography revealed bladder and rectal wall thickening with a malignant target sign, thickened mesorectal fascia with abnormal tissue stranding, and increased perirectal fat density. Both cancers progressed despite treatment, as indicated by faint abnormal tissue stranding and increased retroperitoneal fat density along the retromesenteric plane from the pelvis to the duodenum. Subsequently, both patients developed obstruction in the horizontal portion of the duodenum, still without formation of a mass lesion. These two patients highlight the challenges associated with retroperitoneal invasion by bladder cancer in the absence of a mass lesion and underscore the importance of considering cancer progression in patients with bowel obstruction, even when there is no obvious mass lesion and/or only minor retroperitoneal findings. Progression along the retromesenteric plane may be the key pathway via which progressive bladder cancer results in duodenal obstruction without or with a minor mass lesion.
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Affiliation(s)
- Koji Tokunaga
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Akihiro Furuta
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Shigeki Arizono
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuki Teramoto
- Department of Diagnostic Pathology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiromitsu Negoro
- Department of Urology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Aki Kido
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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Affiliation(s)
- P. Palittapongarnpim
- Department of Microbiology, Faculty of Science, Mahidol University and the National Science and Technology Development Agency, Bangkok
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Ibano K, Sabau A, Tokunaga K, Akiyoshi M, Kiggans J, Schaich C, Katoh Y, Ueda Y. Surface morphology of Tungsten-F82H after high-heat flux testing using plasma-arc lamps. Nuclear Materials and Energy 2018. [DOI: 10.1016/j.nme.2018.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ikeda M, Takahashi A, Kamatani Y, Okahisa Y, Kunugi H, Mori N, Sasaki T, Ohmori T, Okamoto Y, Kawasaki H, Shimodera S, Kato T, Yoneda H, Yoshimura R, Iyo M, Matsuda K, Akiyama M, Ashikawa K, Kashiwase K, Tokunaga K, Kondo K, Saito T, Shimasaki A, Kawase K, Kitajima T, Matsuo K, Itokawa M, Someya T, Inada T, Hashimoto R, Inoue T, Akiyama K, Tanii H, Arai H, Kanba S, Ozaki N, Kusumi I, Yoshikawa T, Kubo M, Iwata N. A genome-wide association study identifies two novel susceptibility loci and trans population polygenicity associated with bipolar disorder. Mol Psychiatry 2018; 23:639-647. [PMID: 28115744 PMCID: PMC5822448 DOI: 10.1038/mp.2016.259] [Citation(s) in RCA: 114] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/29/2016] [Accepted: 12/13/2016] [Indexed: 11/09/2022]
Abstract
Genome-wide association studies (GWASs) have identified several susceptibility loci for bipolar disorder (BD) and shown that the genetic architecture of BD can be explained by polygenicity, with numerous variants contributing to BD. In the present GWAS (Phase I/II), which included 2964 BD and 61 887 control subjects from the Japanese population, we detected a novel susceptibility locus at 11q12.2 (rs28456, P=6.4 × 10-9), a region known to contain regulatory genes for plasma lipid levels (FADS1/2/3). A subsequent meta-analysis of Phase I/II and the Psychiatric GWAS Consortium for BD (PGC-BD) identified another novel BD gene, NFIX (Pbest=5.8 × 10-10), and supported three regions previously implicated in BD susceptibility: MAD1L1 (Pbest=1.9 × 10-9), TRANK1 (Pbest=2.1 × 10-9) and ODZ4 (Pbest=3.3 × 10-9). Polygenicity of BD within Japanese and trans-European-Japanese populations was assessed with risk profile score analysis. We detected higher scores in BD cases both within (Phase I/II) and across populations (Phase I/II and PGC-BD). These were defined by (1) Phase II as discovery and Phase I as target, or vice versa (for 'within Japanese comparisons', Pbest~10-29, R2~2%), and (2) European PGC-BD as discovery and Japanese BD (Phase I/II) as target (for 'trans-European-Japanese comparison,' Pbest~10-13, R2~0.27%). This 'trans population' effect was supported by estimation of the genetic correlation using the effect size based on each population (liability estimates~0.7). These results indicate that (1) two novel and three previously implicated loci are significantly associated with BD and that (2) BD 'risk' effect are shared between Japanese and European populations.
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Affiliation(s)
- M Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Takahashi
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Laboratory for Omics Informatics, Omics Research Center, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Y Okahisa
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - H Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - N Mori
- Department of Psychiatry and Neurology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Sasaki
- Laboratory of Health Education, Graduate School of Education, the University of Tokyo, Tokyo, Japan
| | - T Ohmori
- Department of Psychiatry, Course of Integrated Brain Sciences, Medical Informatics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan
| | - Y Okamoto
- Department of Psychiatry and Neurosciences, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - H Kawasaki
- Department of Psychiatry, Fukuoka University, Faculty of Medicine, Fukuoka, Japan
| | - S Shimodera
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan
| | - T Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Brain Science Institute, Wako, Japan
| | - H Yoneda
- Department of Neuropsychiatry, Osaka Medical College, Takatsuki, Japan
| | - R Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyusyu, Japan
| | - M Iyo
- Department of Psychiatry, Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Matsuda
- Laboratory of Clinical Sequence, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - M Akiyama
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - K Ashikawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Japan
| | - K Kashiwase
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Kondo
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Saito
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Shimasaki
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - K Kawase
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Kitajima
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - K Matsuo
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - M Itokawa
- Center for Medical Cooperation, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - T Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Inada
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan
| | - T Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - K Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - H Tanii
- Department of Neuropsychiatry, Mie University, Graduate School of Medicine, Tsu, Japan
| | - H Arai
- Department of Psychiatry and Behavioral Sciences, Juntendo Graduate School of Medicine, Tokyo, Japan
| | - S Kanba
- Department of Neuropsychiatry, Kyushu University, Graduate School of Medical Sciences, Fukuoka, Japan
| | - N Ozaki
- Department of Psychiatry, Nagoya University, Graduate School of Medicine, Nagoya, Japan
| | - I Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Yoshikawa
- Laboratory for Molecular Psychiatry, RIKEN Brain Science Institute, Wako, Japan
| | - M Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - N Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
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Ueta M, Hamuro J, Nishigaki H, Nakamura N, Shinomiya K, Mizushima K, Hitomi Y, Tamagawa-Mineoka R, Yokoi N, Naito Y, Tokunaga K, Katoh N, Sotozono C, Kinoshita S. Mucocutaneous inflammation in the Ikaros Family Zinc Finger 1-keratin 5-specific transgenic mice. Allergy 2018; 73:395-404. [PMID: 28914974 DOI: 10.1111/all.13308] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our genomewide association study documented an association between cold medicine-related Stevens-Johnson syndrome/toxic epidermal necrolysis (CM-SJS/TEN) and Ikaros Family Zinc Finger 1 (IKZF1). Few studies examined biological and pathological functions of IKZF1 in mucosal immunity. We hypothesized that IKZF1 contributes to the mucocutaneous inflammation. METHODS Human skin and conjunctival tissues were obtained for immunohistological studies. Primary human conjunctival epithelial cells (PHCjECs) and adult human epidermal keratinocytes (HEKa) also used for gene expression analysis. We also generated K5-Ikzf1-EGFP transgenic mice (Ikzf1 Tg) by introducing the Ik1 isoform into cells expressing keratin 5, which is expressed in epithelial tissues such as the epidermis and conjunctiva, and then examined them histologically and investigated gene expression of the epidermis. Moreover, Ikzf1 Tg were induced allergic contact dermatitis. RESULTS We found that human epidermis and conjunctival epithelium expressed IKZF1, and in PHCjECs and HEKa, the expression of IKZF1 mRNA was upregulated by stimulation with polyI:C, a TLR3 ligand. In Ikzf1 Tg, we observed dermatitis and mucosal inflammation including the ocular surface. In contact dermatitis model, inflammatory infiltrates in the skin of Ikzf1 Tg were significantly increased compared with wild type. Microarray analysis showed that Lcn2, Adh7, Epgn, Ifi202b, Cdo1, Gpr37, Duoxa1, Tnfrsf4, and Enpp5 genes were significantly upregulated in the epidermis of Ikzf1 Tg compared with wild type. CONCLUSION Our findings support the hypothesis that Ikaros might participate in mucocutaneous inflammation.
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Affiliation(s)
- M. Ueta
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - J. Hamuro
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - H. Nishigaki
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - N. Nakamura
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Shinomiya
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Mizushima
- Department of Molecular Gastroenterology and Hepatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Y. Hitomi
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - R. Tamagawa-Mineoka
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - N. Yokoi
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - Y. Naito
- Department of Molecular Gastroenterology and Hepatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Tokunaga
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - N. Katoh
- Department of Dermatology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - C. Sotozono
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - S. Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
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Nakamura K, Alam M, Jiang Y, Mitarai O, Kurihara K, Kawamata Y, Sueoka M, Takechi M, Hasegawa M, Tokunaga K, Araki K, Zushi H, Hanada K, Fujisawa A, Idei H, Nagashima Y, Kawasaki S, Nakashima H, Higashijima A, Nagata T, Fukuyama A. Plasma equilibrium based on RF-driven current profile without assuming nested magnetic surfaces on QUEST. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.05.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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26
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Koge J, Matsumoto S, Nakahara I, Ishii A, Hatano T, Sadamasa N, Kai Y, Ando M, Saka M, Chihara H, Takita W, Tokunaga K, Kamata T, Nishi H, Hashimoto T, Tsujimoto A, Kira J, Nagata I. Reduction in stroke alert response time for patients with in-hospital stroke using a standardized protocol. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2454] [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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27
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Matsumoto S, Koyama H, Hatano T, Sadamasa N, Kai Y, Saka M, Ando M, Hashimoto T, Chihara H, Takita W, Tokunaga K, Kamata T, Tujimoto A, Nagata I, Kira J. The development of visual task management ICT system for acute stroke care. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1745] [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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28
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Hiramatsu M, Hishikawa T, Tokunaga K, Kidoya H, Nishihiro S, Haruma J, Shimizu T, Takasugi Y, Shinji Y, Sugiu K, Takakura N, Date I. Combined gene therapy with vascular endothelial growth factor plus apelin in a chronic cerebral hypoperfusion model in rats. J Neurosurg 2017; 127:679-686. [DOI: 10.3171/2016.8.jns16366] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVEThe aim of this study was to evaluate whether combined gene therapy with vascular endothelial growth factor (VEGF) plus apelin during indirect vasoreconstructive surgery enhances brain angiogenesis in a chronic cerebral hypoperfusion model in rats.METHODSA chronic cerebral hypoperfusion model induced by the permanent ligation of bilateral common carotid arteries (CCAs; a procedure herein referred to as “CCA occlusion” [CCAO]) in rats was employed in this study. Seven days after the CCAO procedure, the authors performed encephalo-myo-synangiosis (EMS) and injected plasmid(s) into each rat's temporal muscle. Rats were divided into 4 groups based on which plasmid was received (i.e., LacZ group, VEGF group, apelin group, and VEGF+apelin group). Protein levels in the cortex and attached muscle were assessed with enzyme-linked immunosorbent assay (ELISA) on Day 7 after EMS, while immunofluorescent analysis of cortical vessels was performed on Day 14 after EMS.RESULTSThe total number of blood vessels in the cortex on Day 14 after EMS was significantly larger in the VEGF group and the VEGF+apelin group than in the LacZ group (p < 0.05, respectively). Larger vessels appeared in the VEGF+apelin group than in the other groups (p < 0.05, respectively). Apelin protein on Day 7 after EMS was not detected in the cortex for any of the groups. In the attached muscle, apelin protein was detected only in the apelin group and the VEGF+apelin group. Immunofluorescent analysis revealed that apelin and its receptor, APJ, were expressed on endothelial cells (ECs) 7 days after the CCAO.CONCLUSIONSCombined gene therapy (VEGF plus apelin) during EMS in a chronic cerebral hypoperfusion model can enhance angiogenesis in rats. This treatment has the potential to be a feasible option in a clinical setting for patients with moyamoya disease.
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Affiliation(s)
- Masafumi Hiramatsu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Tomohito Hishikawa
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Koji Tokunaga
- 2Department of Neurosurgery, Okayama City Hospital, Okayama; and
| | - Hiroyasu Kidoya
- 3Department of Signal Transduction, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Shingo Nishihiro
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Jun Haruma
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Tomohisa Shimizu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yuji Takasugi
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Yukei Shinji
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Kenji Sugiu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Nobuyuki Takakura
- 3Department of Signal Transduction, Research Institute for Microbial Diseases, Osaka University, Suita, Japan
| | - Isao Date
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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29
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Skoda U, Bertrams J, Dykes D, Eiberg H, Hobart M, Hummel K, Kühnl P, Mauff G, Nakamura S, Nishimukai H, Raum D, Tokunaga K, Widinger S. Proposal for the Nomenclature of Human Plasminogen (PLG)
Polymorphism. Vox Sang 2017. [DOI: 10.1159/000461502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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30
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Toyo‐oka L, Mahasirimongkol S, Yanai H, Mushiroda T, Wattanapokayakit S, Wichukchinda N, Yamada N, Smittipat N, Juthayothin T, Palittapongarnpim P, Nedsuwan S, Kantipong P, Takahashi A, Kubo M, Sawanpanyalert P, Tokunaga K. Strain‐based
HLA
association analysis identified
HLA‐DRB1
*09:01
associated with modern strain tuberculosis. HLA 2017; 90:149-156. [DOI: 10.1111/tan.13070] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 01/08/2023]
Affiliation(s)
- L. Toyo‐oka
- Medical Genetics Center, Medical Life Science Institute Department of Medical Sciences, Ministry of Public Health Nonthaburi Thailand
- Department of Human Genetics, Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - S. Mahasirimongkol
- Medical Genetics Center, Medical Life Science Institute Department of Medical Sciences, Ministry of Public Health Nonthaburi Thailand
| | - H. Yanai
- Fukujuji Hospital Japan Anti‐Tuberculosis Association (JATA) Kiyose Japan
- Research Institute of Tuberculosis Japan Anti‐Tuberculosis Association (JATA) Kiyose Japan
| | - T. Mushiroda
- Laboratory for Pharmacogenomics RIKEN Center for Integrative Medical Sciences Yokohama Japan
| | - S. Wattanapokayakit
- Medical Genetics Center, Medical Life Science Institute Department of Medical Sciences, Ministry of Public Health Nonthaburi Thailand
| | - N. Wichukchinda
- Medical Genetics Center, Medical Life Science Institute Department of Medical Sciences, Ministry of Public Health Nonthaburi Thailand
| | - N. Yamada
- Research Institute of Tuberculosis Japan Anti‐Tuberculosis Association (JATA) Kiyose Japan
| | - N. Smittipat
- Tuberculosis Research Laboratory, National Center for Genetic Engineering and Biotechnology National Science and Technology Development Agency, Thailand Science Park (TSP) Pathum Thani Thailand
| | - T. Juthayothin
- Tuberculosis Research Laboratory, National Center for Genetic Engineering and Biotechnology National Science and Technology Development Agency, Thailand Science Park (TSP) Pathum Thani Thailand
| | - P. Palittapongarnpim
- Department of Microbiology, Faculty of Science Mahidol University Bangkok Thailand
| | - S. Nedsuwan
- Chiangrai Prachanukroh Hospital Ministry of Public Health Chiang Rai Thailand
| | - P. Kantipong
- Chiangrai Prachanukroh Hospital Ministry of Public Health Chiang Rai Thailand
| | - A. Takahashi
- Laboratory for Statistical Analysis RIKEN Center for Integrative Medical Sciences Yokohama Japan
| | - M. Kubo
- Laboratory for Genotyping Development RIKEN Center for Integrative Medical Sciences Yokohama Japan
| | - P. Sawanpanyalert
- Health Technical Office Ministry of Public Health Nonthaburi Thailand
| | - K. Tokunaga
- Department of Human Genetics, Graduate School of Medicine The University of Tokyo Tokyo Japan
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31
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Suzuki S, Ueda Y, Tokunaga K, Sato K, Akiba M. Present Research Status on Divertor and Plasma Facing Components for Fusion Power Plants. Fusion Science and Technology 2017. [DOI: 10.13182/fst03-a308] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- S. Suzuki
- Japan Atomic Energy Research Institute, 801-1 Naka-machi, Naka-gun, Ibaraki-ken, 311-0193 Japan, (0)29-270-7551
| | - Y. Ueda
- Osaka University, 2-1 Yamadaoka, Suita-shi, Osaka-fu, 565-0871 Japan (0)6-6879-7236
| | - K. Tokunaga
- Kyushu University, 6-1 Kasuga-koen, Kasuga-shi, Fukuoka-ken, 816-8580 Japan, (0)92-583-7986
| | - K. Sato
- Japan Atomic Energy Research Institute, 801-1 Naka-machi, Naka-gun, Ibaraki-ken, 311-0193 Japan, (0)29-270-7488
| | - M. Akiba
- Japan Atomic Energy Research Institute, 801-1 Naka-machi, Naka-gun, Ibaraki-ken, 311-0193 Japan, (0)29-270-7581
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32
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Ueda Y, Ohno N, Kajita S, Kurishita H, Iwakiri H, Tokunaga K, Yoshida N. Development of Tungsten Materials for Plasma Facing Components in Japan. Fusion Science and Technology 2017. [DOI: 10.13182/fst07-a1540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Ueda
- Graduate School of Engineering, Osaka University: Suita, Osaka 565-0871,Japan
| | - N. Ohno
- EcoTopia Science Institute, Nagoya University, Nagoya 464-8603, Japan
| | - S. Kajita
- Graduate School of Engineering, Nagoya University, Nagoya 464-8603, Japan
| | - H. Kurishita
- International Research Center for Nuclear Materials Science, IMR, Tohoku University, Oarai, Ibaragi311-1313, Japan
| | - H. Iwakiri
- Research Institute for Applied Mechanics, Kyushu University,6-1 Kasuga, Fukuoka 816-8580, Japan
| | - K. Tokunaga
- Research Institute for Applied Mechanics, Kyushu University,6-1 Kasuga, Fukuoka 816-8580, Japan
| | - N. Yoshida
- Research Institute for Applied Mechanics, Kyushu University,6-1 Kasuga, Fukuoka 816-8580, Japan
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33
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Muroga T, Sze DK, Okuno K, Terai T, Kimura A, Kurtz RJ, Sagara A, Nygren R, Ueda Y, Doerner RP, Sharpe JP, Kunugi T, Morley NB, Hatano Y, Sokolov MA, Yamamoto T, Hasegawa A, Katoh Y, Ohno N, Tokunaga K, Konishi S, Fukada S, Calderoni P, Yokomine T, Messadek K, Oya Y, Hashimoto N, Hinoki T, Hashizume H, Norimatsu T, Shikama T, Stoller RE, Tanaka KA, Tillack MS. Midterm Summary of Japan-US Fusion Cooperation Program TITAN. Fusion Science and Technology 2017. [DOI: 10.13182/fst11-a12373] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - K. Okuno
- Shizuoka University, Shizuoka, Japan
| | - T. Terai
- University of Tokyo, Tokyo, Japan
| | | | | | | | | | - Y. Ueda
- Osaka University, Suita, Japan
| | | | | | | | | | | | | | | | | | | | - N. Ohno
- Nagoya University, Nagoya, Japan
| | | | | | | | | | | | | | - Y. Oya
- Shizuoka University, Shizuoka, Japan
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34
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Higaki M, Otsuka T, Tokunaga K, Hashizume K, Ezato K, Suzuki S, Enoeda M, Akiba M. Determination of Hydrogen Diffusion Coefficients in F82H by Hydrogen Depth Profiling with a Tritium Imaging Plate Technique. Fusion Science and Technology 2017. [DOI: 10.13182/fst14-t33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Higaki
- Interdisciplinary Graduate School of Engineering and Sciences, Kyushu University
| | - T. Otsuka
- Interdisciplinary Graduate School of Engineering and Sciences, Kyushu University
| | - K. Tokunaga
- Research Institute of Applied Mechanics, Kyushu University, 6-1 Kasuga-Kouen, Kasuga, Fukuoka 816-8580, Japan
| | - K. Hashizume
- Interdisciplinary Graduate School of Engineering and Sciences, Kyushu University
| | - K. Ezato
- Japan Atomic Energy Agency, Naka, Ibaraki 311-0193, Japan
| | - S. Suzuki
- Japan Atomic Energy Agency, Naka, Ibaraki 311-0193, Japan
| | - M. Enoeda
- Japan Atomic Energy Agency, Naka, Ibaraki 311-0193, Japan
| | - M. Akiba
- Japan Atomic Energy Agency, Naka, Ibaraki 311-0193, Japan
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35
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Wattanapokayakit S, Mushiroda T, Yanai H, Wichukchinda N, Chuchottawon C, Nedsuwan S, Rojanawiwat A, Denjanta S, Kantima T, Wongyai J, Suwankesawong W, Rungapiromnan W, Kidkeukarun R, Bamrungram W, Chaiwong A, Suvichapanich S, Mahasirimongkol S, Tokunaga K. NAT2 slow acetylator associated with anti-tuberculosis drug-induced liver injury in Thai patients. Int J Tuberc Lung Dis 2016; 20:1364-1369. [DOI: 10.5588/ijtld.15.0310] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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36
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Otani Y, Tokunaga K, Kawauchi S, Inoue S, Watanabe K, Kiriyama H, Sakane K, Maekawa K, Date I, Matsumoto K. Cerebral Infarction Arising from Takotsubo Cardiomyopathy: Case Report and Literature Review. NMC Case Rep J 2016; 3:119-123. [PMID: 28664012 PMCID: PMC5386162 DOI: 10.2176/nmccrj.cr.2016-0034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/29/2016] [Indexed: 11/20/2022] Open
Abstract
Although most patients with takotsubo cardiomyopathy have a favorable outcome, complications are not uncommon. Recent studies have reported an increase in incidence of cardioembolic complications; however, the association between takotsubo cardiomyopathy and stroke, in particular thromboembolic cerebral infarction, remains unclear. We reported a 44-year-old woman who had a cerebral infarction resulting from takotsubo cardiomyopathy. She had felt chest discomfort a few days prior to infarction, and later developed left hemiparesis. Head magnetic resonance imaging (MRI) revealed acute infarction in the right insular cortex and occlusion of the right middle cerebral artery at the M2 segment. Echocardiogram revealed a takotsubo-like shape in the motion of the left ventricular wall, and coronary angiography showed neither coronary stenosis nor occlusion. Cerebral infarction resulting from takotsubo cardiomyopathy was diagnosed and treatment with anticoagulant was started. MRI on the eighth day after hospitalization showed recanalization of the right middle cerebral artery and no new ischemic lesions. The findings of the 19 previously published cases who had cerebral infarction resulting from takotsubo cardiomyopathy were also reviewed and showed the median interval between takotsubo cardiomyopathy and cerebral infarction was approximately 1 week and cardiac thrombus was detected in 9 of 19 patients. We revealed that thromboembolic events occurred later than other complications of takotsubo cardiomyopathy and longer observation might be required due to possible cardiogenic cerebral infarction. Anticoagulant therapy is recommended for patients with takotsubo cardiomyopathy with cardiac thrombus or a large area of akinetic left ventricle.
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Affiliation(s)
- Yoshihiro Otani
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan.,Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Tokunaga
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Satoshi Kawauchi
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Satoshi Inoue
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Kyoichi Watanabe
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Hideki Kiriyama
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
| | - Kosuke Sakane
- Department of Cardiology, Okayama City Hospital, Okayama, Japan
| | - Kiyoaki Maekawa
- Department of Cardiology, Okayama City Hospital, Okayama, Japan
| | - Isao Date
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Kengo Matsumoto
- Department of Neurosurgery, Okayama City Hospital, Okayama, Japan
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37
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Tokunaga K, Shiraishi A, Takenouchi S, Yokochi R, Muranaka K, Shinozaki M, Hagino N, Nishino J, Tohma S. FRI0085 Forefoot Disease Activity Has The Impact on Boolean Remission in Japanese Rheumatoid Arthritis Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2482] [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: 11/03/2022]
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38
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Miyadera H, Bungener LB, Kusano S, Yokoyama S, Tokunaga K, Hepkema BG. Questionable expression of unstable DQ heterodimer containing HLA-DQA1*01:07. ACTA ACUST UNITED AC 2015; 86:413-8. [PMID: 26555242 DOI: 10.1111/tan.12686] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 08/24/2015] [Accepted: 09/28/2015] [Indexed: 01/23/2023]
Abstract
Human leukocyte antigens (HLA)-DQA1*01:07 was identified as an HLA-DQ blank specificity that segregated with the serological HLA-A2, -B7, -DR14, -DR52 haplotype, which carried DQB1*05:03. The blank specificity of DQA1*01:07-DQB1*05:03 may be because of lack of reactivity of available typing sera, or disruption of proper assembly of DQ heterodimer. The cDNA sequence of DQA1*01:07 is nearly identical to DQA1*01:04 except for a variant at position 304, which results in the replacement of an arginine with a cysteine at 79α. To determine whether the DQA1*01:07 product can be expressed on cell-surface, we co-expressed DQA1*01:07 with various DQB1*05 or *06 alleles in fibroblast cells. Cell-surface expression of DQ was detectable when DQA1*01:07 was co-expressed with DQB1*06:04 but undetectable with other DQB1*05 and DQB1*06 alleles, including DQB1*05:03, to which DQA1*01:07 was encoded in cis. These data suggest that DQA1*01:07 may act as a phenotypically null allele in the DQA1*01:07-DQB1*05:03 haplotype, while it can be expressed at a low level in the presences of certain DQB1*06 alleles, such as DQB1*06:04, in trans. Based on the null or low expression of DQA1*01:07 as shown in the previous and present studies, DQA1*01:07 has recently been renamed to DQA1*01:07Q, indicating its questionable expression.
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Affiliation(s)
- H Miyadera
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - L B Bungener
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S Kusano
- RIKEN Structural Biology Laboratory, Yokohama, Japan
| | - S Yokoyama
- RIKEN Structural Biology Laboratory, Yokohama, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - B G Hepkema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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39
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Hishikawa T, Date I, Tokunaga K, Tominari S, Nozaki K, Shiokawa Y, Houkin K, Murayama Y, Ishibashi T, Takao H, Kimura T, Nakayama T, Morita A. Risk of rupture of unruptured cerebral aneurysms in elderly patients. Neurology 2015; 85:1879-85. [PMID: 26511450 PMCID: PMC4662696 DOI: 10.1212/wnl.0000000000002149] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 07/28/2015] [Indexed: 11/25/2022] Open
Abstract
Objectives: The aim of this study was to identify risk factors for rupture of unruptured cerebral aneurysms (UCAs) in elderly Japanese patients aged 70 years or older. Methods: The participants included all patients 70 years of age or older in 3 prospective studies in Japan (the Unruptured Cerebral Aneurysm Study of Japan [UCAS Japan], UCAS II, and the prospective study at the Jikei University School of Medicine). A total of 1,896 patients aged 70 years or older with 2,227 UCAs were investigated. The median and mean follow-up periods were 990 and 802.7 days, respectively. Results: The mean aneurysm size was 6.2 ± 3.9 mm. Sixty-eight patients (3.6%) experienced subarachnoid hemorrhage during the follow-up period. Multivariable analysis per patient revealed that in patients aged 80 years or older (hazard ratio [HR], 2.02; 95% confidence interval [CI], 1.16–3.49, p = 0.012), aneurysms 7 mm or larger (HR, 3.08; 95% CI, 1.35–7.03, p = 0.007 for 7–9 mm; HR, 7.82; 95% CI, 3.60–16.98, p < 0.001 for 10–24 mm; and HR, 43.31; 95% CI, 12.55–149.42, p < 0.001 for ≥25 mm) and internal carotid–posterior communicating artery aneurysms (HR, 2.45; 95% CI, 1.23–4.88, p = 0.011) were independent predictors for UCA rupture in elderly patients. Conclusions: In our pooled analysis of prospective cohorts in Japan, patient age and aneurysm size and location were significant risk factors for UCA rupture in elderly patients.
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Affiliation(s)
- Tomohito Hishikawa
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.
| | - Isao Date
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Koji Tokunaga
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Shinjiro Tominari
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kazuhiko Nozaki
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiaki Shiokawa
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Kiyohiro Houkin
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yuichi Murayama
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshihiro Ishibashi
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiroyuki Takao
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Toshikazu Kimura
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Takeo Nakayama
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Akio Morita
- From the Department of Neurological Surgery (T.H., I.D., K.T.), Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama; Department of Health Informatics (S.T., T.N.), Kyoto University School of Public Health, Kyoto; Department of Neurosurgery (K.N.), Shiga University of Medical Science, Shiga; Department of Neurosurgery (Y.S.), Kyorin University School of Medicine, Tokyo; Department of Neurosurgery (K.H.), Hokkaido University Graduate School of Medicine, Sapporo; Division of Endovascular Neurosurgery (Y.M., T.I., H.T.), Department of Neurosurgery, The Jikei University School of Medicine, Tokyo; Department of Neurosurgery (T.K.), NTT Medical Center Tokyo; and UCAS Coordinating Office (A.M.), University of Tokyo, Department of Neurological Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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Nishida N, Ohashi J, Sugiyama M, Tsuchiura T, Yamamoto K, Hino K, Honda M, Kaneko S, Yatsuhashi H, Koike K, Yokosuka O, Tanaka E, Taketomi A, Kurosaki M, Izumi N, Sakamoto N, Eguchi Y, Sasazuki T, Tokunaga K, Mizokami M. Effects of HLA-DPB1 genotypes on chronic hepatitis B infection in Japanese individuals. ACTA ACUST UNITED AC 2015; 86:406-12. [PMID: 26449183 DOI: 10.1111/tan.12684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/04/2015] [Accepted: 09/15/2015] [Indexed: 01/26/2023]
Abstract
Significant associations of HLA-DP alleles with chronic hepatitis B (CHB) infection are evident in Asian and Arabian populations, including Japanese, Han Chinese, Korean, and Saudi Arabian populations. Here, significant associations between CHB infection and five DPB1 alleles (two susceptibility alleles, DPB1(*) 05:01 and (*) 09:01, and three protective alleles, DPB1(*) 02:01, (*) 04:01, and (*) 04:02) were confirmed in a population comprising of 2582 Japanese individuals. Furthermore, odds ratios for CHB were higher for those with both DPB1 susceptibility alleles than for those with only one susceptibility allele; therefore, effects of susceptibility alleles were additive for risk of CHB infection. Similarly, protective alleles showed an additive effect on protection from CHB infection. Moreover, heterozygotes of any protective allele showed stronger association with CHB than did homozygotes, suggesting that heterozygotes may bind a greater variety of hepatitis B-derived peptides, and thus present these peptides more efficiently to T-cell receptors than homozygotes. Notably, compound heterozygote of the protective allele (any one of DPB1*02:01, *04:01, and *04:02) and the susceptible allele DPB1*05:01 was significantly associated with protection against CHB infection, which indicates that one protective HLA-DPB1 molecule can provide dominant protection. Identification of the HLA-DPB1 genotypes associated with susceptibility to and protection from CHB infection is essential for future analysis of the mechanisms responsible for immune recognition of hepatitis B virus antigens by HLA-DPB1 molecules.
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Affiliation(s)
- N Nishida
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - J Ohashi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - M Sugiyama
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - T Tsuchiura
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - K Yamamoto
- Department of Medical Chemistry, Kurume University School of Medicine, Kurume, Japan
| | - K Hino
- Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki, Japan
| | - M Honda
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - S Kaneko
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - H Yatsuhashi
- Clinical Research Center, National Nagasaki Medical Center, Nagasaki, Japan
| | - K Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - O Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - E Tanaka
- Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - A Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Kurosaki
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - N Izumi
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Y Eguchi
- Division of Hepatology, Saga Medical School, Saga, Japan
| | - T Sasazuki
- Institute for Advanced Study, Kyushu University, Fukuoka, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Mizokami
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
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Ueta M, Tokunaga K, Sotozono C, Sawai H, Yoon K, Kim M, Seo K, Joo C, Kinoshita S. HLA-A*02:06 and PTGER3 polymorphism exerts additive effects in cold medicine-related Stevens-Johnson syndrome with severe ocular complications in Japanese and Korean populations. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. Ueta
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - K. Tokunaga
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - C. Sotozono
- Department of Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
| | - H. Sawai
- Department of Human Genetics; Graduate School of Medicine; University of Tokyo; Tokyo Japan
| | - K.C. Yoon
- Department of Ophthalmology; Chonnam National University; Gwangju South-Korea
| | - M.K. Kim
- Department of Ophthalmology; Seoul National University College of Medicine; Seoul South-Korea
| | - K.Y. Seo
- Department of Ophthalmology; Severance Hospital; Institute of Vision Research; Yonsei University College of Medicine; Seoul South-Korea
| | - C.K. Joo
- Department of Ophthalmology and Visual Science; Seoul St. Mary's Hospital; College of Medicine; The Catholic University of Korea; Seoul South-Korea
| | - S. Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology; Kyoto Prefectural University of Medicine; Kyoto Japan
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Omura K, Watanabe T, Okada Y, Okumura H, Tokunaga K. SUN-PP088: Supplementation of Leucine and Vitamin D Following Rising Training May Reinforce the Muscle Strength of Old Inpatients. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30239-9] [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: 11/30/2022]
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Deguchi K, Kawahara Y, Deguchi S, Morimoto N, Kurata T, Ikeda Y, Ichikawa T, Tokunaga K, Kawai N, Sugiu K, Abe K. A patient develops transient unique cerebral and cerebellar lesions after unruptured aneurysm coiling. BMC Neurol 2015; 15:49. [PMID: 25884179 PMCID: PMC4387739 DOI: 10.1186/s12883-015-0303-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 03/12/2015] [Indexed: 12/27/2022] Open
Abstract
Background We describe a case of a very unusual complication following a coiling procedure in which the patient developed transient unique cerebral and cerebellar lesions. Lesions were examined not only by magnetic resonance imaging (MRI) but also by positron emission tomography-computed tomography (PET-CT) and proton magnetic resonance spectroscopy (1H-MRS). Case presentation A 33-year-old woman presented an incidental 3.7 × 3.3-mm unruptured cerebral aneurysm (CAn) in her basilar artery, which was successfully coiled with balloon assistance. A follow-up brain MRI at 1 and 2 months showed a gradual increase in several white matter hyperintense lesions in the left cerebellar, bilateral occipitotemporal and left parietoccipital lobe during fluid-attenuated inversion recovery (FLAIR). These were the only lesions associated with perfused CAn. However, the patient did not show any additional symptoms such as visual disturbance throughout the entire course. 11C-methionine-PET (MET-PET) showed an obvious increase in methionine uptake in the lesion corresponding to enhanced areas with gadolinium-enhanced MRI. MRS showed a decrease in the N-acetylaspartate/creatine (NAA/cr) ratio and a slight elevation of the choline/creatine (cho/cr) ratio and a lactate peak in the lesion. A follow-up MRI at 6 and 12 months showed a gradual decrease in the initial hyperintense lesions in FLAIR without any treatment. Conclusion We present a case of an unusual complication after a coiling procedure. Although it is difficult to identify this etiology without a pathological examination, it is importance to increase awareness of such a potential complication arising from coiling procedures, because interventional procedures have become the first choice of treatment for cerebrovascular diseases in many countries.
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Affiliation(s)
- Kentaro Deguchi
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Yuko Kawahara
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Shoko Deguchi
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Nobutoshi Morimoto
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Tomoko Kurata
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Yoshio Ikeda
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Tomotsugu Ichikawa
- Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Koji Tokunaga
- Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Nobuyuki Kawai
- Department of Neurological Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, 761-0793, Japan.
| | - Kenji Sugiu
- Departments of Neurosurgery, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
| | - Koji Abe
- Departments of Neurology, Graduate School of Medicine and Dentistry, Okayama University, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
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Otani Y, Inoue S, Kawauchi S, Uneda A, Kajitani T, Watanabe K, Deguchi K, Kiriyama H, Tokunaga K, Matsumoto K. [Multiple brain abscesses in the territory of the vertebral-basilar artery resulting from an infected aortic arch graft]. No Shinkei Geka 2015; 43:235-40. [PMID: 25748809 DOI: 10.11477/mf.1436202993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 62-year-old man with high fever and in a state of disorientation was transferred to our hospital. One year before this transfer, he had undergone total arch replacement surgery for thoracic aortic dissection. On admission to our hospital, head MRI revealed multiple brain abscesses in the territory of the vertebral-basilar artery, and chest CT showed gas around the aortic graft, in particular, at the origin of the left subclavian artery. We diagnosed him with brain abscesses in the left vertebral-basilar artery resulting from an infected aortic graft. We immediately began administration of intravenous antibiotics. Although his blood, urine, and cerebrospinal fluid cultures were negative, fortunately, the brain abscesses and ectopic gas disappeared. Since reports of only antibiotic use for treating brain abscesses due to aortic graft infection are rare, the appropriate duration of antibiotic administration has not been established yet. Therefore, careful observation is required in this case.
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Hishikawa T, Tokunaga K, Sugiu K, Date I. Long-term outcomes in adult patients with ischemic-type moyamoya disease involving posterior circulation. Acta Neurochir (Wien) 2014; 156:1745-51. [PMID: 24866473 DOI: 10.1007/s00701-014-2136-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 05/16/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The object of this study was to compare the long-term outcomes in adult patients with moyamoya disease (MMD) with posterior circulation involvement (PCi) treated through surgical revascularization with those in adult patients without PCi. METHODS The records of 32 consecutive adult patients with ischemic-type MMD who were treated with revascularization were reviewed. Twelve of these patients (38 %) had PCi at initial onset. Clinical characteristics of the patients with PCi were compared to those without PCi. Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the preoperative and postoperative follow-up periods. A five-year Kaplan-Meier stroke risk was calculated. RESULTS The frequency of presenting with infarction was significantly higher among patients with PCi than among those without PCi (p = 0.006). mRS scores in the preoperative period were significantly higher in patients with PCi than in patients without PCi (p = 0.0004). There were no significant differences in mRS scores between the preoperative and postoperative follow-up period in patients with PCi (p = 0.3), nor were there any between the preoperative and postoperative follow-up periods in patients without PCi (p = 0.2). The five-year Kaplan-Meier risk of surgical morbidity and ipsilateral stroke was 14.3 % in surgically treated hemispheres with PCi versus 14.9 % in surgically treated hemispheres without PCi (p = 0.96). CONCLUSIONS PCi at initial onset was significantly correlated with poor outcome. Revascularization for the middle cerebral artery territory in patients with PCi was effective at preventing recurrent ischemic stroke.
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Affiliation(s)
- Tomohito Hishikawa
- Department of Neurological Surgery, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan,
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Oshikawa H, Kishimoto M, Yoshida K, Takizawa N, Tokunaga K, Nakano H, Minoda M, Kobayashi T, Matsui K. THU0287 Parvovirus B19 Infection Mimics Various Rheumatic Diseases: Clinical Features and Frequency of Fulfilling the Criteria for Rheumatoid Arthritis or Systemic Lupus Erythematosus. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kobayashi T, Kishimoto M, Ohara Y, Tokunaga K, Takizawa N, Nakano H, Minoda M, Oshikawa H, Yoshida K, Okada M, Matsui K. THU0405 A Strong Association between Hla-A*26 and BehÇEt's Syndrome in Japanese Patients without Diagnostic Bias; Two-Center Cohort Study of BehÇEt's Syndrome: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2801] [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: 11/03/2022]
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48
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Tokunaga K, Hishikawa T, Sugiu K, Date I. [Spontaneous indirect revascularization through the failed radial artery bypass in a patient with a giant intracavernous internal carotid artery aneurysm]. No Shinkei Geka 2014; 42:59-64. [PMID: 24388942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Koji Tokunaga
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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Hiramatsu M, Sugiu K, Hishikawa T, Haruma J, Tokunaga K, Date I, Kuwayama N, Sakai N. Epidemiology of Dural Arteriovenous Fistula in Japan: Analysis of Japanese Registry of Neuroendovascular Therapy (JR-NET2). Neurol Med Chir (Tokyo) 2014; 54 Suppl 2:63-71. [PMID: 26236817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
We developed the Japanese Registry of Neuroendovascular Therapy 2 (JR-NET2) database and used the information for a retrospective, nation-wide multicenter, observational study to clarify the clinical characteristics, current status of procedures, and outcome of patients treated by neuroendovascular therapy in Japan. In this report, we analyzed the clinical characteristics of dural arteriovenous fistulas (dAVFs) in the JR-NET2 database. All patients with dAVFs treated with endovascular therapy in 150 Japanese hospitals were included. Patient characteristics, clinical presentations, and imaging characteristics were analyzed. A total of 1,075 patients with dAVFs underwent 1,520 endovascular procedures. Of 1,075 patients, 45% were men and 55% were women. The mean age was 65±13 years. The most frequent location of dAVFs was the cavernous sinus (43.6%), followed by the transverse-sigmoid sinus (TSS) (33.4%). Twelve percent of the patients had intracranial hemorrhage, 9% had venous infarction, and 3% had convulsion. The statistically significant independent risk factors of intracranial hemorrhage were TSS, superior sagittal sinus (SSS), tentorium, anterior cranial fossa, cranio-cervical junction, cortical venous reflux (CVR), and varix. Risk factors of venous infarction were age older than 60 years, male sex, TSS, SSS, and CVR. Risk factors of convulsion were male sex, SSS, and CVR. This is the largest nationwide report, to date, of the clinical characteristics of dAVFs treated by neuroendovascular therapy. CVR was a major risk factor of aggressive symptoms.
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Hiramatsu M, Sugiu K, Hishikawa T, Haruma J, Tokunaga K, Date I, Kuwayama N, Sakai N. Epidemiology of dural arteriovenous fistula in Japan: Analysis of Japanese Registry of Neuroendovascular Therapy (JR-NET2). Neurol Med Chir (Tokyo) 2013. [PMID: 24390192 PMCID: PMC4508691 DOI: 10.2176/nmc.st.2013-0172] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We developed the Japanese Registry of Neuroendovascular Therapy 2 (JR-NET2) database and used the information for a retrospective, nation-wide multicenter, observational study to clarify the clinical characteristics, current status of procedures, and outcome of patients treated by neuroendovascular therapy in Japan. In this report, we analyzed the clinical characteristics of dural arteriovenous fistulas (dAVFs) in the JR-NET2 database. All patients with dAVFs treated with endovascular therapy in 150 Japanese hospitals were included. Patient characteristics, clinical presentations, and imaging characteristics were analyzed. A total of 1,075 patients with dAVFs underwent 1,520 endovascular procedures. Of 1,075 patients, 45% were men and 55% were women. The mean age was 65 ± 13 years. The most frequent location of dAVFs was the cavernous sinus (43.6%), followed by the transverse-sigmoid sinus (TSS) (33.4%). Twelve percent of the patients had intracranial hemorrhage, 9% had venous infarction, and 3% had convulsion. The statistically significant independent risk factors of intracranial hemorrhage were TSS, superior sagittal sinus (SSS), tentorium, anterior cranial fossa, cranio-cervical junction, cortical venous reflux (CVR), and varix. Risk factors of venous infarction were age older than 60 years, male sex, TSS, SSS, and CVR. Risk factors of convulsion were male sex, SSS, and CVR. This is the largest nationwide report, to date, of the clinical characteristics of dAVFs treated by neuroendovascular therapy. CVR was a major risk factor of aggressive symptoms.
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Affiliation(s)
- Masafumi Hiramatsu
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
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