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Soeda M, Ohka S, Nishizawa D, Iseki M, Yamaguchi K, Arita H, Hanaoka K, Kato J, Ogawa S, Hiranuma A, Hasegawa J, Nakayama K, Ebata Y, Hayashida M, Ichinohe T, Fukuda KI, Ikeda K. Single-Nucleotide Polymorphisms of the PAR2 and IL-17A Genes Are Significantly Associated with Chronic Pain. Int J Mol Sci 2023; 24:17627. [PMID: 38139455 PMCID: PMC10744199 DOI: 10.3390/ijms242417627] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Patients with chronic pain are affected psychologically and socially. There are also individual differences in treatment efficacy. Insufficient research has been conducted on genetic polymorphisms that are related to individual differences in the susceptibility to chronic pain. Autoimmune disorders can lead to inflammation and chronic pain; therefore, we focused on the autoimmune-related protease-activated receptor 2 (PAR2/F2RL1) and interleukin 17A (IL-17A/IL17A) genes. PAR2 and IL-17A are associated with autoimmune diseases that lead to chronic pain, and PAR2 regulates T-helper (Th) cell activation and differentiation. We hypothesized that the PAR2 and IL-17A genes are associated with chronic pain. The present study used a case-control design to statistically examine associations between genetic polymorphisms and the vulnerability to chronic pain. The rs2243057 polymorphism of the PAR2 gene and rs3819025 polymorphism of the IL-17A gene were previously reported to be associated with pain- or autoimmune-related phenotypes. Thus, these polymorphisms were investigated in the present study. We found that both rs2243057 and rs3819025 were significantly associated with a susceptibility to chronic pain. The present findings revealed autoimmune-related genetic factors that are involved in individual differences in chronic pain, further aiding understanding of the pathomechanism that underlies chronic pain and possibly contributing to future personalized medicine.
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Affiliation(s)
- Moe Soeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
- Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Seii Ohka
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
| | - Masako Iseki
- Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431, Japan; (M.I.)
| | - Keisuke Yamaguchi
- Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431, Japan; (M.I.)
| | - Hideko Arita
- Department of Anesthesiology, Pain Relief Center, JR Tokyo General Hospital, Tokyo 151-8528, Japan; (H.A.); (K.H.)
| | - Kazuo Hanaoka
- Department of Anesthesiology, Pain Relief Center, JR Tokyo General Hospital, Tokyo 151-8528, Japan; (H.A.); (K.H.)
| | - Jitsu Kato
- Department of Anesthesiology, Nihon University School of Medicine, Tokyo 173-8610, Japan
| | - Setsuro Ogawa
- University Research Center, Nihon University, Tokyo 173-8610, Japan
| | - Ayako Hiranuma
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
- Department of Surgery, Toho University Sakura Medical Center, Chiba 285-8741, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
| | - Kyoko Nakayama
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
| | - Yuko Ebata
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
| | - Masakazu Hayashida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
- Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431, Japan; (M.I.)
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Tatsuya Ichinohe
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Ken-ichi Fukuda
- Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo 101-0061, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (M.S.); (S.O.); (D.N.)
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Imai E, Fukuda M, Kochiyama T, Yamaguchi A, Sugasawa Y, Hayashida M, Kawagoe I. Successful one-lung ventilation in a patient after laryngectomy by inserting a long spiral single-lumen tube into the left main bronchus: a case report. AME Case Rep 2023; 8:16. [PMID: 38234342 PMCID: PMC10789889 DOI: 10.21037/acr-23-108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/02/2023] [Indexed: 01/19/2024]
Abstract
Background Patients who have had laryngectomy require a thorough preoperative assessment for potential stomal stenosis, and an action plan for possible inadvertent displacement of the voice prosthesis (VP) must be considered. We report the anesthetic management of a post-laryngectomy patient undergoing lung resection surgery. The patient had both a laryngectomy and a VP in situ. Case Description A 66-year-old man with Parkinson's disease, who had previously undergone total laryngectomy for supraglottic laryngeal cancer, had a cuffed tracheostomy tube and a VP inserted into the tracheoesophageal fistula below it. He was scheduled for segmentectomy combined with lymph node dissection under combined epidural-general anesthesia due to lung cancer in the apical segment of the right lung. Following induction of general anesthesia, instead of using a double-lumen endotracheal tube, we inserted a long spiral single-lumen tube (SLT) (6 mm inner diameter, 8.7 mm outer diameter) through the tracheostoma under the guidance of a 4 mm bronchoscope because of concerns about airway injury due to the narrowed diameter of the stoma and potential dislodgement of the VP. The tube was carefully advanced and smoothly placed into the left main bronchus, and the surgery was completed using one-lung ventilation (OLV). Conclusions For post-total laryngectomy patients, it is important to assess the size and condition of the tracheostoma and the usage of a VP, and choose an appropriate endotracheal tube. A long spiral SLT might be an option for OLV in patients after laryngectomy with a tracheoesophageal VP.
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Affiliation(s)
- Emi Imai
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Tsukasa Kochiyama
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Ai Yamaguchi
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Sugasawa
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan
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Satoh D, Takeuchi K, Kawagoe I, Kisii J, Kudoh O, Hayashida M. Prognosis for major abdominal surgeries based on intraoperative low-dose nutrition: A metabolic perspective. Clin Nutr ESPEN 2023; 58:208-212. [PMID: 38057007 DOI: 10.1016/j.clnesp.2023.09.926] [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: 02/05/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND & AIMS The optimal nutrition intake during surgery is unknown. This study aimed to investigate the prognosis of low-dose nutrition during laparoscopic colorectal cancer surgery. METHODS In the glucose and amino acids (GA) group, 20 patients were infused with glucose (75 g/L) and amino acids (30 g/L) at 60 mL/h and bicarbonate Ringer's solution. However, 20 patients in the control (C) group were infused with bicarbonate Ringer's solution without GA. The length of hospital stay was determined, and measurements were taken before (TI) and after (T2) the surgery under general anesthesia. RESULTS The lengths of hospital stay were comparable between the GA (13 days) and C (16 days) groups. Ketone body levels were 294 (C group) and 33 (GA group) μmol/L at T2. Nitrogen balance was 0.32 g (GA group) and -1.60 g (C group) at T2. CONCLUSIONS Although the lengths of hospital stay were comparable, ketone body levels, and nitrogen balance were significantly different (P < 0.01) between the two groups after surgery.
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Affiliation(s)
- Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | - Kazuyo Takeuchi
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | - Jun Kisii
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | - Osamu Kudoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan.
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Fukuda M, Sakai H, Koh K, Sakuraba S, Ando N, Hayashida M, Kawagoe I. Unusual severe hypoxemia due to unilateral pulmonary edema after conventional cardiopulmonary bypass salvaged by veno-venous extracorporeal membrane oxygenation: a case report. JA Clin Rep 2023; 9:65. [PMID: 37803183 PMCID: PMC10558410 DOI: 10.1186/s40981-023-00656-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND We report a case in which veno-venous extracorporeal membrane oxygenation (V-V ECMO) saved the life of a patient who developed severe hypoxemia due to unusual unilateral pulmonary edema (UPE) after cardiopulmonary bypass (CPB). CASE PRESENTATION A 69-year-old man underwent aortic valve replacement and coronary artery bypass grafting. Following uneventful weaning off CPB, he developed severe hypoxemia. The ratio of arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2) decreased from 301 mmHg 5 min after CPB to 42 mmHg 90 min after CPB. A chest X-ray revealed right-sided UPE. Immediately established V-V ECMO increased PaO2/FiO2 to 170 mmHg. Re-expansion pulmonary edema (REPE) was likely, as the right lung remained collapsed during CPB following the accidental opening of the right chest cavity during graft harvesting. CONCLUSIONS V-V ECMO was effective in improving oxygenation and saving the life of a patient who had fallen into unilateral REPE unusually developing after conventional CPB.
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Affiliation(s)
- Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - Hiroaki Sakai
- Department of Anesthesia, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - Keito Koh
- Department of Anesthesiology and Pain Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Sonoko Sakuraba
- Department of Anesthesiology and Pain Medicine, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Nozomi Ando
- Department of Anesthesiology and Pain Medicine, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Hospital, Tokyo, 113-8431, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University Hospital, Tokyo, 113-8431, Japan.
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Mitaka C, Teranishi K, Wakita M, Misawa S, Nojiri S, Satoh D, Hayashida M. Incidences of and risk factors for clinical and subclinical contrast-associated acute kidney injury in patients who underwent neuroendovascular surgery. Neuroradiol J 2023; 36:601-609. [PMID: 37106524 PMCID: PMC10569205 DOI: 10.1177/19714009231173104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Contrast-associated acute kidney injury (CA-AKI) can develop after intravascular administration of iodinated contrast media. Neutrophil gelatinase-associated lipocalin (NGAL) is an early marker for AKI that helps to detect subclinical CA-AKI. We investigated the incidence of and risk factors for clinical and subclinical CA-AKI in patients who underwent neuroendovascular surgery. METHODS We retrospectively investigated 228 patients who underwent neuroendovascular surgery in 2020. Changes in serum creatinine and urine output were used to detect clinical CA-AKI. Urine NGAL concentration was used to detect subclinical CA-AKI in 67 out of 228 patients. RESULTS In 228 patients, serum creatinine, hemoglobin, hematocrit, total protein, and blood urea nitrogen (BUN) decreased significantly (p < 0.001) after surgery. However, serum creatinine decreased less significantly (p < 0.05) than hemoglobin, hematocrit, total protein, and BUN on postoperative Day 3. Two patients out of 228 developed clinical CA-AKI, and seven patients out of 67 with urine NGAL measurements developed subclinical CA-AKI. Multivariate regression analysis revealed that diabetes mellitus and carotid artery stenosis were significantly (p < 0.05) associated with the development of clinical and/or subclinical CA-AKI. CONCLUSION There was a large difference between the incidences of clinical CA-AKI (0.88%) and subclinical CA-AKI (10.4%). The difference might have primarily resulted from the different sensitivities between serum creatinine and urine NGAL and possibly from underestimation of the incidence of clinical AKI due to a postoperative decrease in serum creatinine caused by hemodilution. In addition to diabetes mellitus, carotid artery stenosis could also be a risk factor for CA-AKI.
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Affiliation(s)
- Chieko Mitaka
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kohsuke Teranishi
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mitsuru Wakita
- Department of Clinical Laboratory, Juntendo University Hospital, Tokyo, Japan
| | - Shigeki Misawa
- Department of Clinical Laboratory Technology, Faculty Medical Science, Juntendo University, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Tokyo, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Nishizawa D, Morino R, Inoue R, Ohka S, Kasai S, Hasegawa J, Ebata Y, Nakayama K, Sumikura H, Hayashida M, Yokota M, Ikeda K. Genome-Wide Association Study Identifies Novel Candidate Variants Associated with Postoperative Nausea and Vomiting. Cancers (Basel) 2023; 15:4729. [PMID: 37835423 PMCID: PMC10571790 DOI: 10.3390/cancers15194729] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023] Open
Abstract
Considerable individual differences are widely observed in the incidence of postoperative nausea and vomiting (PONV). We conducted a genome-wide association study (GWAS) to identify potential candidate single-nucleotide polymorphisms (SNPs) that contribute to PONV by utilizing whole-genome genotyping arrays with more than 950,000 markers. The subjects were 806 patients who provided written informed consent and underwent elective surgery under general anesthesia with propofol or desflurane. The GWAS showed that two SNPs, rs2776262 and rs140703637, in the LOC100506403 and CNTN5 gene regions, respectively, were significantly associated with the frequency of nausea. In another GWAS conducted only on patients who received propofol, rs7212072 and rs12444143 SNPs in the SHISA6 and RBFOX1 gene regions, respectively, were significantly associated with the frequency of nausea as well as the rs2776262 SNP, and the rs45574836 and rs1752136 SNPs in the ATP8B3 and LOC105370198 gene regions, respectively, were significantly associated with vomiting. Among these SNPs, clinical and SNP data were available for the rs45574836 SNP in independent subjects who underwent laparoscopic gynecological surgery, and the association was replicated in these subjects. These results indicate that these SNPs could serve as markers that predict the vulnerability to PONV. Our findings may provide valuable information for achieving satisfactory prophylactic treatment for PONV.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Ryozo Morino
- Division of Anesthesiology, Koujinkai Daiichi Hospital, Tokyo 125-0041, Japan
| | - Rie Inoue
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Seii Ohka
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Yuko Ebata
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Kyoko Nakayama
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
| | - Hiroyuki Sumikura
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Masakazu Hayashida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Miyuki Yokota
- Department of Anesthesiology, Cancer Institute Hospital, Tokyo 135-8550, Japan
- Department of Anesthesiology, East Hokkaido Hospital, Kushiro 085-0036, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.)
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Ishikawa S, Shirakawa K, Kuroda Y, Yube Y, Mine S, Hayashida M, Kawagoe I. Persistent bilateral pneumothorax after robotic-assisted inguinal hernia repair: possible relevance to recent esophageal cancer surgery - a case report. JA Clin Rep 2023; 9:37. [PMID: 37347313 DOI: 10.1186/s40981-023-00630-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Postoperative pneumothorax is a well-known but relatively rare complication after laparoscopic surgery. There has been no report describing pneumothorax that persisted for a week or more after laparoscopic surgery. Herein, we report a case of bilateral pneumothorax after laparoscopic surgery, which appears to have occurred by a different mechanism than previously described. CASE PRESENTATION A 65-year-old male, with a past history of esophagectomy and retrosternal gastric tube reconstruction 4 months earlier, underwent a robotic-assisted inguinal hernia repair. Postoperative chest x-rays revealed the development of bilateral pneumothorax, which became worse on postoperative day (POD) 1 and took more than 9 days to resolve spontaneously. We assumed that intra-abdominal gas replaced by the air after pneumoperitoneum might have migrated into thoracic cavities through an opened esophageal hiatus or along the retrosternal route. CONCLUSIONS Laparoscopic surgery after radical esophagectomy may be associated with an increased risk of postoperative pneumothorax.
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Affiliation(s)
- Seiji Ishikawa
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Kaori Shirakawa
- Clinical Training Center, Juntendo University Hospital, 3-1-3, Hongo, Bunkyo-Ku, Tokyo, 113-8431, Japan
| | - Yui Kuroda
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Yukinori Yube
- Department of Esophageal and Gastroenterological Surgery, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Shinji Mine
- Department of Esophageal and Gastroenterological Surgery, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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Hasegawa A, Niimi N, Mitaka C, Hayashida M. Negative pressure pulmonary edema due to upper airway obstruction after general anesthesia in a patient with Parkinson's disease: A case report. Clin Case Rep 2023; 11:e7444. [PMID: 37266349 PMCID: PMC10229746 DOI: 10.1002/ccr3.7444] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/29/2023] [Accepted: 05/19/2023] [Indexed: 06/03/2023] Open
Abstract
In a patient with Parkinson's disease (PD) who underwent spine surgery 13 h after the last anti-Parkinson medications, negative pressure pulmonary edema from upper airway obstruction developed immediately after extubation. Although oxygenation improved with high-flow nasal cannula therapy, such complications might develop due to abrupt discontinuation of medication for PD.
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Affiliation(s)
- Ayaka Hasegawa
- Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
| | - Naoko Niimi
- Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
| | - Chieko Mitaka
- Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
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Egerton R, Hayashida M, Malac M. Transmission electron microscopy of thick polymer and biological specimens. Micron 2023; 169:103449. [PMID: 37001476 DOI: 10.1016/j.micron.2023.103449] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
We explore the properties of elastic and inelastic scattering in a thick organic specimen, together with the mechanisms that provide contrast in a transmission electron microscope (TEM) and scanning-transmission electron microscope (STEM). Experimental data recorded from amorphous carbon are used to predict the bright-field image intensity, mass-thickness contrast and dose-limited resolution as a function of thickness, objective-aperture size, and primary-electron energy E0. Combining this information with estimates of chromatic aberration, objective-aperture diffraction and beam broadening in the specimen, we calculate the achievable TEM and STEM resolution to be around 4 nm at E0 = 300 keV (or below 3 nm at MeV energies) for a 10 µm-diameter objective aperture and 1 - 2 µm thickness of hydrated biological tissue. The 3 MeV resolution for a 10-μm tissue sample is probably closer to 10 nm. We also comment on the error involved in quadrature addition of resolution factors, when one or more of the point-spread functions are non-Gaussian.
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Nishizawa D, Mieda T, Tsujita M, Nakagawa H, Yamaguchi S, Kasai S, Hasegawa J, Nakayama K, Ebata Y, Kitamura A, Shimizu H, Takashima T, Hayashida M, Ikeda K. Genome-Wide Association Study Identifies Genetic Polymorphisms Associated with Estimated Minimum Effective Concentration of Fentanyl in Patients Undergoing Laparoscopic-Assisted Colectomy. Int J Mol Sci 2023; 24:ijms24098421. [PMID: 37176129 PMCID: PMC10179231 DOI: 10.3390/ijms24098421] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/29/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Sensitivity to opioids varies widely among individuals. To identify potential candidate single-nucleotide polymorphisms (SNPs) that may significantly contribute to individual differences in the minimum effective concentration (MEC) of an opioid, fentanyl, we conducted a three-stage genome-wide association study (GWAS) using whole-genome genotyping arrays in 350 patients who underwent laparoscopic-assisted colectomy. To estimate the MEC of fentanyl, plasma and effect-site concentrations of fentanyl over the 24 h postoperative period were estimated with a pharmacokinetic simulation model based on initial bolus doses and subsequent patient-controlled analgesia doses of fentanyl. Plasma and effect-site MECs of fentanyl were indicated by fentanyl concentrations, estimated immediately before each patient-controlled analgesia dose. The GWAS revealed that an intergenic SNP, rs966775, that mapped to 5p13 had significant associations with the plasma MEC averaged over the 6 h postoperative period and the effect-site MEC averaged over the 12 h postoperative period. The minor G allele of rs966775 was associated with increases in these MECs of fentanyl. The nearest protein-coding gene around this SNP was DRD1, encoding the dopamine D1 receptor. In the gene-based analysis, the association was significant for the SERP2 gene in the dominant model. Our findings provide valuable information for personalized pain treatment after laparoscopic-assisted colectomy.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Tsutomu Mieda
- Department of Anesthesiology, Saitama Medical University Hospital, Saitama 350-0495, Japan
| | - Miki Tsujita
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Hideyuki Nakagawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Shigeki Yamaguchi
- Division of Colorectal Surgery, Department of Surgery, Tokyo Women's Medical University, Tokyo 162-8666, Japan
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Kyoko Nakayama
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Yuko Ebata
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
| | - Akira Kitamura
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
| | - Hirotomo Shimizu
- Laboratory for Safety Assessment and ADME, Asahi Kasei Pharma Corporation, Shizuoka 410-2321, Japan
| | - Tadayuki Takashima
- Laboratory for Safety Assessment and ADME, Asahi Kasei Pharma Corporation, Shizuoka 410-2321, Japan
| | - Masakazu Hayashida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan
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Uezono E, Mizobuchi Y, Miyano K, Ohbuchi K, Murata H, Komatsu A, Manabe S, Nonaka M, Hirokawa T, Yamaguchi K, Iseki M, Uezono Y, Hayashida M, Kawagoe I. Distinct Profiles of Desensitization of µ-Opioid Receptors Caused by Remifentanil or Fentanyl: In Vitro Assay with Cells and Three-Dimensional Structural Analyses. Int J Mol Sci 2023; 24:ijms24098369. [PMID: 37176075 PMCID: PMC10179353 DOI: 10.3390/ijms24098369] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Remifentanil (REM) and fentanyl (FEN) are commonly used analgesics that act by activating a µ-opioid receptor (MOR). Although optimal concentrations of REM can be easily maintained during surgery, it is sometimes switched to FEN for optimal pain regulation. However, standards for this switching protocol remain unclear. Opioid anesthetic efficacy is decided in part by MOR desensitization; thus, in this study, we investigated the desensitization profiles of REM and FEN to MOR. The efficacy and potency during the 1st administration of REM or FEN in activating the MOR were almost equal. Similarly, in β arrestin recruitment, which determines desensitization processes, they showed no significant differences. In contrast, the 2nd administration of FEN resulted in a stronger MOR desensitization potency than that of REM, whereas REM showed a higher internalization potency than FEN. These results suggest that different β arrestin-mediated signaling caused by FEN or REM led to their distinct desensitization and internalization processes. Our three-dimensional analysis, with in silico binding of REM and FEN to MOR models, highlighted that REM and FEN bound to similar but distinct sites of MOR and led to distinct β arrestin-mediated profiles, suggesting that distinct binding profiles to MOR may alter β arrestin activity, which accounts for MOR desensitization and internalization.
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Affiliation(s)
- Eiko Uezono
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Yusuke Mizobuchi
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-0194, Japan
| | - Kanako Miyano
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo 104-0045, Japan
- Department of Dentistry, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Katsuya Ohbuchi
- Tsumura Research Laboratories, Tsumura and Co., Ibaraki 300-1192, Japan
| | - Hiroaki Murata
- Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan
| | - Akane Komatsu
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Sei Manabe
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-0194, Japan
| | - Miki Nonaka
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Takatsugu Hirokawa
- Chemical Biology and In Silico Drug Design, Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
| | - Keisuke Yamaguchi
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo 136-0075, Japan
| | - Masako Iseki
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Yasuhito Uezono
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo 104-0045, Japan
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Supportive and Palliative Care Research Support Office, National Cancer Center Hospital East, Chiba 277-8577, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
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12
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Kusano Y, Kawagoe I, Yamaguchi A, Kishii J, Morita Y, Fukuda M, Kochiyama T, Hayashida M. Postoperative analgesia following robot-assisted thoracic surgery for mediastinal disease: retrospective comparative study of general anesthesia alone, combined with epidural analgesia, and with ultrasound-guided thoracic paraspinal block. Ann Transl Med 2023; 11:206. [PMID: 37007544 PMCID: PMC10061470 DOI: 10.21037/atm-22-4258] [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] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/08/2023] [Indexed: 03/11/2023]
Abstract
Background Recently, robot-assisted thoracic surgery has been increasingly performed for mediastinal disease. However, appropriate postoperative analgesic methods have not been evaluated. Methods We retrospectively studied patients who underwent robot-assisted thoracic surgery for mediastinal disease at a single university hospital between January 2019 and December 2021. Patients were performed either general anesthesia alone, general anesthesia combined with thoracic epidural anesthesia, or general anesthesia combined with ultrasound-guided thoracic block. Patients were divided into three groups [non-block (NB), thoracic epidural analgesia (TEA), and thoracic paraspinal block (TB)] according to postoperative analgesic methods, and they compared with terms of postoperative pain scores by using numerical rating scale (NRS) at 0, 3, 6, 12, 18, 24, and 48 h. Additionally, rescue supplemental analgesic within 24 h, side effects of anesthesia such as respiratory depression, hypotension, postoperative nausea and vomiting, pruritus and urinary retention, time to ambulation after surgery, and hospital stay after surgery were also compared among the three groups. Results Data from 169 patients (Group NB: 25, Group TEA: 102, and Group TB: 42) were progressed to the analysis. Postoperative pain scale at 6 and 12 h was significantly lower in Group TEA than NB (1.2±1.6 vs. 2.4±1.8, P<0.01; and 1.2±1.5 vs. 2.2±1.7, P=0.018, respectively). There were no differences in pain scores between Groups TB and TEA at any point. The incidence of patients using rescue analgesics within 24 h was significantly different between groups [Group NB: 15/25 (60%), Group TEA: 30/102 (29.4%), Group TB: 25/42 (59.5%), P=0.01]. For postoperative side effects, only the number of patients complaining of postoperative nausea and vomiting for 24 h after surgery differed significantly between groups [Group NB: 7/25 (28%), Group TEA: 19/102 (18.6%), Group TB: 1/42 (2.4%), P=0.01]. Conclusions TEA provided better analgesia after robot-assisted thoracic surgery for mediastinal disease than NB as indicated by lower pain scores and fewer rescue analgesic requirements. However, the frequency of postoperative nausea and vomiting was lowest in Group TB of all the groups. Thus, TBs might also provide adequate postoperative analgesia following robot-assisted thoracic surgery for mediastinal disease.
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Miyake Y, Fujiwara K, Kataoka K, Ochi T, Seo S, Koga H, Lane GJ, Nishimura K, Hayashida M, Yamataka A. Retroperitoneoscopic Surgery in Children Does Not Cause Pathological Desaturation in Cerebral/Renal Oxygenation on Near-Infrared Spectroscopy Compared with Laparoscopic and Thoracoscopic Surgery. J Laparoendosc Adv Surg Tech A 2022; 32:1260-1264. [PMID: 35904967 DOI: 10.1089/lap.2022.0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Introduction: Cerebral and renal regional oxygen saturation (C-rSO2 and R-rSO2, respectively) were monitored using near-infrared spectroscopy in pediatric patients (range: 0.3-14.3 years) during minimally invasive surgery (MIS) taking at least 3 hours performed by laparoscopy (Lap), thoracoscopy (Tho), or retroperitoneoscopy (Ret) from January 2019 to December 2021. Materials and Methods: Criteria compared were operative time, preoperative/intraoperative hemoglobin, blood loss, mean arterial pressure, arterial partial pressure of carbon dioxide (PaCO2), peripheral oxygen saturation (SpO2), C-rSO2, and R-rSO2. Pathological desaturation (PD) was defined as >20% decrease from baseline, and statistical significance as P < .05. Results: Subjects (n = 79) were similar for gender, age, and body mass index. MIS procedures were: Lap = 45, Tho = 20, Ret = 14; one Lap case required conversion for severe adhesions, not PD. Intraoperative PaCO2 (mmHg) was significantly higher in Tho (maximum: 59.5 ± 17.0, minimum: 39.9 ± 7.5) versus Lap (maximum: 39.9 ± 5.1, minimum: 34.6 ± 3.9) and Ret (maximum: 37.8 ± 4.2, minimum: 35.0 ± 3.3); P < .0001 (maximum), P = .0013 (minimum). Minimum intraoperative SpO2 was significantly lower in Tho (P < .0001). Mean operative times were significantly shorter in Tho (259 ± 114 minutes) versus Lap (433 ± 154 minutes) and Ret (342 ± 100 minutes); P < .0001, respectively. PD was absent during Ret (C-rSO2: 0/14 = 0% and R-rSO2: 0/14 = 0%). Differences in PD for Lap (C-rSO2: 7/45 = 15.6% and R-rSO2: 10/45 = 22.2%) and Tho (C-rSO2: 9/20 = 45.0%, and R-rSO2: 7/20 = 35.0%) were significant; P = .0028 for C-rSO2 and P = .0497 for R-rSO2. Hemoglobin and blood loss were similar. Conclusions: PD was absent during Ret, despite longer operative times. If Ret is indicated for a procedure, neurodevelopmental sequelae of MIS could be minimized.
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Affiliation(s)
- Yuichiro Miyake
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kentaro Fujiwara
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kumi Kataoka
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Takanori Ochi
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Shogo Seo
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hiroyuki Koga
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Geoffrey J Lane
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Kinya Nishimura
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Atsuyuki Yamataka
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
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14
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Yamazaki S, Yamaguchi K, Someya A, Nagaoka I, Hayashida M. Anti-Inflammatory Action of Dexmedetomidine on Human Microglial Cells. Int J Mol Sci 2022; 23:ijms231710096. [PMID: 36077505 PMCID: PMC9455981 DOI: 10.3390/ijms231710096] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 12/03/2022] Open
Abstract
Neuroinflammation, where inflammatory cytokines are produced in excess, contributes to the pathogenesis of delirium. Microglial cells play a central role in neuroinflammation by producing and releasing inflammatory cytokines in response to infection, tissue damage and neurodegeneration. Dexmedetomidine (DEX) is a sedative, which reduces the incidence of delirium. Thus, we hypothesized that DEX may alleviate delirium by exhibiting anti-inflammatory action on microglia. In the present study, we investigated the anti-inflammatory action of DEX on human microglial HMC3 cells. The results indicated that DEX partially suppressed the IL-6 and IL-8 production by lipopolysaccharide (LPS)-stimulated HMC3 cells as well as the phosphorylation of p38 MAPK and IκB and the translocation of NF-κB. Furthermore, DEX substantially suppressed IL-6 and IL-8 production by unstimulated HMC3 cells as wells as the phosphorylation of p38 MAPK and IκB and the translocation of NF-κB. These observations suggest that DEX exhibits anti-inflammatory action on not only LPS-stimulated but also unstimulated microglial cells via the suppression of inflammatory signaling and cytokine production.
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Affiliation(s)
- Sho Yamazaki
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
| | - Keisuke Yamaguchi
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
- Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric Medical Center, 3-3-20 Shinsuna, Koto-Ku, Tokyo 136-0075, Japan
- Correspondence:
| | - Akimasa Someya
- Department of Biochemistry and Systems Biomedicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
| | - Isao Nagaoka
- Department of Biochemistry and Systems Biomedicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
- Faculty of Medical Science, Juntendo University, 6-8-1 Hinode, Urayasu 279-0013, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421, Japan
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15
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Inada M, Kawagoe I, Kudoh O, Satoh D, Mitaka C, Hayashida M. Dilutional acidosis during whole lung lavage under general anesthesia due to excessive absorption of normal saline. JA Clin Rep 2022; 8:30. [PMID: 35420327 PMCID: PMC9010487 DOI: 10.1186/s40981-022-00520-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/30/2022] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
Background Whole lung lavage (WLL) is an effective therapy for pulmonary alveolar proteinosis. We report a rare dilutional acidosis following WLL in a female patient. Case presentation Under general anesthesia, a left-sided double-lumen tube was inserted with its bronchial lumen connected to the saline delivery system. Preoperatively, arterial blood gases were within normal limits. During 14 l of fluid was instilled into the lung for 2.5 hours, a decrease in pH, K+, and base excess, alongside an increase in Na+ and Cl−, indicated a strong ion difference; the diagnosis was dilutional hyperchloremic metabolic acidosis. Although she remained hemodynamically stable and had no indicators of massive absorption, she stayed in the ICU for mechanical ventilation for one night out of concern of pulmonary edema. Conclusions Inappropriate irrigating fluid pressure might lead to absorption of normal saline. Continuous monitoring and careful observation during WLL can help prevent intraoperative dilutional acidosis.
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Affiliation(s)
- Mikako Inada
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Osamu Kudoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Chieko Mitaka
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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16
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Nishizawa D, Nagashima M, Kasai S, Hasegawa J, Nakayama K, Ebata Y, Fukuda KI, Ichinohe T, Hayashida M, Ikeda K. Associations between the C3orf20 rs12496846 Polymorphism and Both Postoperative Analgesia after Orthognathic and Abdominal Surgeries and C3orf20 Gene Expression in the Brain. Pharmaceutics 2022; 14:pharmaceutics14040727. [PMID: 35456561 PMCID: PMC9028963 DOI: 10.3390/pharmaceutics14040727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 02/05/2023] Open
Abstract
Considerable individual differences are widely observed in the sensitivity to opioid analgesics. We focused on rs12496846, rs698705, and rs10052295 single-nucleotide polymorphisms (SNPs) in the C3orf20, SLC8A2, and CTNND2 gene regions that we previously identified as possibly associated with postoperative analgesia after orthognathic surgery. We investigated associations between these SNPs and postoperative analgesia in 112 patients who underwent major open abdominal surgery in hospitals and were treated with analgesics, including opioids, after surgery. Total genomic DNA was extracted from peripheral blood or oral mucosa samples for genotyping each SNP. Effects of these potent SNPs on gene expression in the brain were also investigated in samples that were provided by the Stanley Foundation Brain Bank. In the association studies, carriers of the G allele of the rs12496846 SNP in the C3orf20 gene region were significantly associated with greater 24 h postoperative analgesic requirements among the three SNPs that were investigated (p = 0.0015), which corroborated a previous study of orthognathic patients (p < 0.0001). In the gene expression analysis, carriers of the G allele of the rs12496846 SNP were significantly associated with lower mRNA expression of the C3orf20 gene (p < 0.0001). These results indicate that this SNP could serve as a marker that predicts analgesic requirements.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura 143-8541, Japan;
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
| | - Kyoko Nakayama
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
| | - Yuko Ebata
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
| | - Ken-ichi Fukuda
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Tatsuya Ichinohe
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo 101-0061, Japan;
| | - Masakazu Hayashida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8421, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo 156-8506, Japan; (D.N.); (S.K.); (J.H.); (K.N.); (Y.E.); (M.H.)
- Correspondence: ; Tel.: +81-3-6834-2379
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17
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Takeuchi K, Hayashida M, Kudoh O, Niimi N, Kataoka K, Kakemizu-Watanabe M, Yamamoto M, Hara A, Kawagoe I, Yamaguchi K. Continuing versus withholding angiotensin receptor blocker (ARB)/calcium channel blocker (CCB) combination tablets during perioperative periods in patients undergoing minor surgery: a single-blinded randomized controlled trial. J Anesth 2022; 36:374-382. [PMID: 35247102 PMCID: PMC9156462 DOI: 10.1007/s00540-022-03053-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/20/2022] [Indexed: 11/30/2022]
Abstract
Purpose This trial was conducted to compare effects of continuing versus withholding single-pill combination tablets consisting of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) on perioperative hemodynamics and clinical outcomes. Methods Patients undergoing minor abdominal or urological surgery (n = 106) were randomly assigned to Group C, in which ARB/CCB combination tablets were continued until surgery, or Group W, in which they were withheld within 24 h of surgery. Perioperative hemodynamics and clinical outcomes were compared between the Groups. Results The incidence of hypotension during anesthesia requiring repeated treatment with vasoconstrictors was higher in Group C than Group W (p = 0.0052). Blood pressure during anesthesia was generally lower in Group C than Group W (p < 0.05) despite significantly more doses of ephedrine and phenylephrine administrated in Group C (p = 0.0246 and p = 0.0327, respectively). The incidence of postoperative hypertension did not differ between Groups (p = 0.3793). Estimated glomerular filtration rate (eGFR) on the preoperative day did not differ between Groups (p = 0.7045), while eGFR was slightly lower in Group C than Group W on the first and third postoperative days (p = 0.0400 and p = 0.0088, respectively), although clinically relevant acute kidney injury did not develop. Conclusions Continuing ARB/CCB combination tablets preoperatively in patients undergoing minor surgery increased the incidence of hypotension during anesthesia, increased requirements of vasoconstrictors to treat hypotension, and might deteriorate postoperative renal function, albeit slightly. These results suggest that withholding ARB/CCB tablets preoperatively is preferable to continuing them. Clinical trial registration This trial is registered with the Japan Registry of Clinical Trials (jRCT) at Japanese Ministry of Health, Labour, and Welfare (Trial ID: jRCT1031190027).
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Affiliation(s)
- Kazuyo Takeuchi
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Osamu Kudoh
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Naoko Niimi
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kumi Kataoka
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Maho Kakemizu-Watanabe
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Makiko Yamamoto
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsuko Hara
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Keisuke Yamaguchi
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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18
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Kasai S, Nishizawa D, Hasegawa J, Fukuda KI, Ichinohe T, Nagashima M, Hayashida M, Ikeda K. Short Tandem Repeat Variation in the CNR1 Gene Associated With Analgesic Requirements of Opioids in Postoperative Pain Management. Front Genet 2022; 13:815089. [PMID: 35360861 PMCID: PMC8963810 DOI: 10.3389/fgene.2022.815089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/02/2022] [Indexed: 11/25/2022] Open
Abstract
Short tandem repeats (STRs) and variable number of tandem repeats (VNTRs) that have been identified at approximately 0.7 and 0.5 million loci in the human genome, respectively, are highly multi-allelic variations rather than single-nucleotide polymorphisms. The number of repeats of more than a few thousand STRs was associated with the expression of nearby genes, indicating that STRs are influential genetic variations in human traits. Analgesics act on the central nervous system via their intrinsic receptors to produce analgesic effects. In the present study, we focused on STRs and VNTRs in the CNR1, GRIN2A, PENK, and PDYN genes and analyzed two peripheral pain sensation-related traits and seven analgesia-related traits in postoperative pain management. A total of 192 volunteers who underwent the peripheral pain sensation tests and 139 and 252 patients who underwent open abdominal and orthognathic cosmetic surgeries, respectively, were included in the study. None of the four STRs or VNTRs were associated with peripheral pain sensation. Short tandem repeats in the CNR1, GRIN2A, and PENK genes were associated with the frequency of fentanyl use, fentanyl dose, and visual analog scale pain scores 3 h after orthognathic cosmetic surgery (Spearman’s rank correlation coefficient ρ = 0.199, p = 0.002, ρ = 0.174, p = 0.006, and ρ = 0.135, p = 0.033, respectively), analgesic dose, including epidural analgesics after open abdominal surgery (ρ = −0.200, p = 0.018), and visual analog scale pain scores 24 h after orthognathic cosmetic surgery (ρ = 0.143, p = 0.023), respectively. The associations between STRs in the CNR1 gene and the frequency of fentanyl use and fentanyl dose after orthognathic cosmetic surgery were confirmed by Holm’s multiple-testing correction. These findings indicate that STRs in the CNR1 gene influence analgesia in the orofacial region.
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Affiliation(s)
- Shinya Kasai
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Ken-ichi Fukuda
- Department of Oral Health Science, Tokyo Dental College, Tokyo, Japan
| | - Tatsuya Ichinohe
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- *Correspondence: Kazutaka Ikeda,
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19
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Umeno Y, Ishikawa S, Kudoh O, Hayashida M. Effects of the Multidisciplinary Preoperative Clinic on the Incidence of Elective Surgery Cancellation. J Med Syst 2022; 46:95. [PMID: 36374361 PMCID: PMC9660193 DOI: 10.1007/s10916-022-01883-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/25/2022] [Indexed: 11/16/2022]
Abstract
To evaluate effects of the multidisciplinary preoperative clinic (POC) consisting of anesthesiologists, dentists, pharmacists, and nurses on elective surgery cancellation, we retrospectively investigated patients who underwent elective non-cardiac, non-obstetric surgeries between October, 2018 and March, 2019 (before the POC establishment: Group 1) and between October, 2019 and March, 2020 (after the POC establishment: Group 2). Among reasons for surgery cancellation allocated into eight categories, three reasons for cancellation (related to consent authorization, medication, and significant comorbidities) were considered preventable. We compared incidences of overall and preventable cancellations of surgeries between 4,198 patients in Group 1 and 4,664 patients in Group 2, who had significantly different clinical backgrounds, including the ASA-PS class. There was no significant difference in the incidence of overall cancellation between Group 1 and Group 2 (4.1% vs. 4.1%, p = 0.96). However, the incidence of preventable cancellation was significantly lower in Group 2 than in Group 1 (0.4% vs. 0.7%, p = 0.045). In addition, the incidence of overall cancellation was significantly lower in 3,741 Group 2 patients visiting the POC than in 5,121 patients not visiting the POC in both Groups (3.2% vs. 4.7%, p < 0.001). Further, in 3,423 pairs of patients with comparable clinical backgrounds created from both Groups using propensity score matching, incidences of overall cancellation (2.2% vs. 3.1%) and preventable cancellation (0.1% vs. 0.6%) were significantly lower in Group 2 than in Group 1 (p = 0.036 and 0.008, respectively). In conclusion, the multidisciplinary POC was effective in reducing elective surgery cancellation.
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Affiliation(s)
- Yuki Umeno
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Seiji Ishikawa
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan.
| | - Osamu Kudoh
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-Ku, Tokyo, 113-8421, Japan
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20
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Takenaka T, Matsuzaki M, Fujiwara S, Hayashida M, Suyama H, Kawamoto M. Myeloperoxidase anti-neutrophil cytoplasmic antibody positive optic perineuritis after mRNA coronavirus disease-19 vaccine. QJM 2021; 114:737-738. [PMID: 34432055 PMCID: PMC8499787 DOI: 10.1093/qjmed/hcab227] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- T Takenaka
- From the Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - M Matsuzaki
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - S Fujiwara
- From the Department of Neurology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
- Address correspondence to Satoru Fujiwara, Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan.
| | - M Hayashida
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Hyogo, Japan
- Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - H Suyama
- Department of Ophthalmology, Suyama Eye Clinic, Kobe, Hyogo 655-0047, Japan
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21
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Ohka S, Yamada S, Nishizawa D, Fukui Y, Arita H, Hanaoka K, Iseki M, Kato J, Ogawa S, Hiranuma A, Kasai S, Hasegawa J, Hayashida M, Fukushi S, Saijo M, Ikeda AK. Heparan sulfate 3- O-sulfotransferase 4 is genetically associated with herpes zoster and enhances varicella-zoster virus-mediated fusogenic activity. Mol Pain 2021; 17:17448069211052171. [PMID: 34904858 PMCID: PMC8733353 DOI: 10.1177/17448069211052171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Acute pain that is associated with herpes zoster (HZ) can become long-lasting
neuropathic pain, known as chronic post-herpetic neuralgia (PHN), especially in
the elderly. HZ is caused by the reactivation of latent varicella-zoster virus
(VZV), whereas PHN is not attributed to ongoing viral replication. Although VZV
infection reportedly induces neuronal cell fusion in humans, the pathogenesis of
PHN is not fully understood. A genome-wide association study (GWAS) revealed
significant associations between PHN and the rs12596324 single-nucleotide
polymorphism (SNP) of the heparan sulfate 3-O-sulfotransferase
4 (HS3ST4) gene in a previous study. To further examine whether
this SNP is associated with both PHN and VZV reactivation, associations between
rs12596324 and a history of HZ were statistically analyzed using GWAS data. HZ
was significantly associated with the rs12596324 SNP of HS3ST4,
indicating that HS3ST4 is related to viral replication. We investigated the
influence of HS3ST4 expression on VZV infection in cultured cells. Fusogenic
activity after VZV infection was enhanced in cells with HS3ST4 expression by
microscopy. To quantitatively evaluate the fusogenic activity, we applied
cytotoxicity assay and revealed that HS3ST4 expression enhanced cytotoxicity
after VZV infection. Expression of the VZV glycoproteins gB, gH, and gL
significantly increased cytotoxicity in cells with HS3ST4 expression by
cytotoxicity assay, consistent with the fusogenic activity as visualized by
fluorescence microscopy. HS3ST4 had little influence on viral genome
replication, revealed by quantitative real-time polymerase chain reaction. These
results suggest that HS3ST4 enhances cytotoxicity including fusogenic activity
in the presence of VZV glycoproteins without enhancing viral genome
replication.
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Affiliation(s)
- Seii Ohka
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Virology I, 13511National Institute of Infectious Diseases, Tokyo, Japan
| | - Souichi Yamada
- Department of Virology I, 13511National Institute of Infectious Diseases, Tokyo, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Yoshiko Fukui
- Department of Virology I, 13511National Institute of Infectious Diseases, Tokyo, Japan
| | - Hideko Arita
- Department of Anesthesiology and Pain Relief Center, 13622JR Tokyo General Hospital, Tokyo, Japan
| | - Kazuo Hanaoka
- Department of Anesthesiology and Pain Relief Center, 13622JR Tokyo General Hospital, Tokyo, Japan
| | - Masako Iseki
- Department of Anesthesiology and Pain Medicine, 175793Juntendo University School of Medicine, Tokyo, Japan
| | - Jitsu Kato
- Department of Anesthesiology, 38113Nihon University School of Medicine, Tokyo, Japan
| | - Setsuro Ogawa
- Nihon University University Research Center, Tokyo, Japan
| | - Ayako Hiranuma
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Clinical Oncology, Graduate School of Medicine, 38138Toho University, Tokyo, Japan
| | - Shinya Kasai
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Hasegawa
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Masakazu Hayashida
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Anesthesiology and Pain Medicine, 175793Juntendo University School of Medicine, Tokyo, Japan.,Department of Anesthesiology, 12277Saitama Medical University International Medical Center, Saitama, Japan
| | - Shuetsu Fukushi
- Department of Virology I, 13511National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, 13511National Institute of Infectious Diseases, Tokyo, Japan
| | - And Kazutaka Ikeda
- Addictive Substance Project, 13931Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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22
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Mitaka C, Kawagoe I, Satoh D, Hayashida M. Effect of Recombinant Human Soluble Thrombomodulin on Coagulation-Related Variables in Patients With Sepsis-Induced Disseminated Intravascular Coagulation: A Retrospective Observational Study. Clin Appl Thromb Hemost 2021; 27:10760296211050356. [PMID: 34859680 PMCID: PMC8646186 DOI: 10.1177/10760296211050356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To evaluate associations among coagulation-related variables, resolution of disseminated intravascular coagulation (DIC) and mortality, we retrospectively investigated 123 patients with sepsis-induced DIC treated with recombinant human soluble thrombomodulin (rTM). Changes in coagulation-related variables before and after treatment with rTM were examined. Further, associations between coagulation-related variables and DIC resolution were evaluated. The platelet count, prothrombin international normalized ratio (PT-INR), and fibrin/fibrinogen degradation products (FDP) significantly (p < .001) improved after rTM administration in survivors (n = 98), but not in nonsurvivors (n = 25). However, the DIC score significantly (p < .001) reduced in survivors and in nonsurvivors. Among coagulation-related variables examined before rTM, only PT-INR was significantly (p = .0395) lower in survivors than in nonsurvivors, and PT-INR before rTM was significantly (p = .0029) lower in patients attaining than not attaining DIC resolution (n = 87 and 36, respectively). The 28-day mortality was significantly lower in patients attaining than not attaining DIC resolution (11.5% vs 41.7%, p = .0001). In conclusion, the initiation of rTM administration before marked PT-INR elevation may be important to induce DIC resolution and thus to decrease mortality in patients with sepsis-induced DIC. Conversely, the treatment with rTM in patients with marked PT-INR elevation may be not so effective in achieving such goals.
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23
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Yamaguchi A, Kawagoe I, Inoue S, Kochiyama T, Fukuda M, Saito M, Hayashida M. Propofol decreases CD8+ T cells and sevoflurane increases regulatory T cells after lung cancer resection: a randomized controlled trial. J Thorac Dis 2021; 13:5430-5438. [PMID: 34659809 PMCID: PMC8482331 DOI: 10.21037/jtd-21-878] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/30/2021] [Indexed: 01/07/2023]
Abstract
Background Anaesthetics generally have an immunosuppressive effect, which may be related to prognosis. We conducted to clarify the relationship between peri-operative immunosuppression and anaesthetic agents in patients undergoing lung cancer surgery, resulting in better selection of intraoperative anaesthesia. Methods Prospective randomized controlled study was performed in single-University hospital. Patients with lung cancer who were scheduled to undergo lung cancer resection between June 2018 and July 2019. Patients were randomly divided to three groups: desflurane (group D), sevoflurane (group S), and propofol (group P) groups. Peripheral blood mononuclear cells were separated from the blood samples. CD4+ and CD8+ T cells, programmed death 1 (PD-1) on CD4+ and CD8+ T cells, and regulatory T cells were measured by flow cytometry. The Wilcoxon signed rank sum test was used to compare pre- and post-operative values for each anaesthesia. Results Eighty-two patients were enrolled; samples from 64 individuals (20 in group D, 22 in group S, and 22 in group P) were analysed after exclusion. The number of CD8+ T cells was significantly lower after the operation than before the operation in the group P (P<0.05). The proportion of regulatory T cells was significantly increased after surgery, compared with before surgery in the group S (P<0.05). There was no difference in PD-1 on CD4+ and CD8+ T cells after lung surgery among the three groups. Conclusions Propofol decreased the number of CD8+ T cells, while sevoflurane increased the proportion of regulatory T cells in patients after lung surgery; however, propofol, sevoflurane, and desflurane did not increase the proportion of PD-1 on CD4+ and CD8+ T cells after lung surgery. Sevoflurane and propofol may cause immunosuppression via different mechanisms after lung cancer surgery. Trial Registration UMIN-CTR: UMIN000031911.
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Affiliation(s)
- Ai Yamaguchi
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Shigeaki Inoue
- Department of Disaster and Emergency and Critical Care Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tsukasa Kochiyama
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Masafumi Saito
- Department of Disaster and Emergency and Critical Care Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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24
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Karasawa Y, Miyano K, Fujii H, Mizuguchi T, Kuroda Y, Nonaka M, Komatsu A, Ohshima K, Yamaguchi M, Yamaguchi K, Iseki M, Uezono Y, Hayashida M. In Vitro Analyses of Spinach-Derived Opioid Peptides, Rubiscolins: Receptor Selectivity and Intracellular Activities through G Protein- and β-Arrestin-Mediated Pathways. Molecules 2021; 26:molecules26196079. [PMID: 34641621 PMCID: PMC8513079 DOI: 10.3390/molecules26196079] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022] Open
Abstract
Activated opioid receptors transmit internal signals through two major pathways: the G-protein-mediated pathway, which exerts analgesia, and the β-arrestin-mediated pathway, which leads to unfavorable side effects. Hence, G-protein-biased opioid agonists are preferable as opioid analgesics. Rubiscolins, the spinach-derived naturally occurring opioid peptides, are selective δ opioid receptor agonists, and their p.o. administration exhibits antinociceptive effects. Although the potency and effect of rubiscolins as G-protein-biased molecules are partially confirmed, their in vitro profiles remain unclear. We, therefore, evaluated the properties of rubiscolins, in detail, through several analyses, including the CellKeyTM assay, cADDis® cAMP assay, and PathHunter® β-arrestin recruitment assay, using cells stably expressing µ, δ, κ, or µ/δ heteromer opioid receptors. In the CellKeyTM assay, rubiscolins showed selective agonistic effects for δ opioid receptor and little agonistic or antagonistic effects for µ and κ opioid receptors. Furthermore, rubiscolins were found to be G-protein-biased δ opioid receptor agonists based on the results obtained in cADDis® cAMP and PathHunter® β-arrestin recruitment assays. Finally, we found, for the first time, that they are also partially agonistic for the µ/δ dimers. In conclusion, rubiscolins could serve as attractive seeds, as δ opioid receptor-specific agonists, for the development of novel opioid analgesics with reduced side effects.
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Affiliation(s)
- Yusuke Karasawa
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
- Medical Affairs, Viatris Pharmaceuticals Japan Inc., 5-11-2, Toranomon, Minato-ku, Tokyo 105-0001, Japan
| | - Kanako Miyano
- Division of Cancer Pathophysiology, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Hideaki Fujii
- Laboratory of Medicinal Chemistry and Medicinal Research Laboratories, School of Pharmacy, Kitasato University, 5-9-1, Shirokane, Minato-ku, Tokyo 108-8641, Japan; (H.F.); (T.M.)
| | - Takaaki Mizuguchi
- Laboratory of Medicinal Chemistry and Medicinal Research Laboratories, School of Pharmacy, Kitasato University, 5-9-1, Shirokane, Minato-ku, Tokyo 108-8641, Japan; (H.F.); (T.M.)
| | - Yui Kuroda
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Miki Nonaka
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
| | - Akane Komatsu
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Kaori Ohshima
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
| | - Masahiro Yamaguchi
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
- Medical Affairs, Pfizer Japan Inc., 3-22-7, Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan
| | - Keisuke Yamaguchi
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Masako Iseki
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yasuhito Uezono
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Pain Control Research, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan; (M.N.); (K.O.)
- Correspondence:
| | - Masakazu Hayashida
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan; (Y.K.); (Y.K.); (A.K.); (M.Y.); (K.Y.); (M.I.); (M.H.)
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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25
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Kawagoe I, Hayashida M, Satoh D, Kudoh O, Fukuda M, Kochiyama T, Kishii J, Mitaka C. Unique strategy using a standard double lumen tube during one lung ventilation for successful intraoperative airway management in patients with a giant bulla on the ventilated side: case series. J Anesth 2021; 35:761-766. [PMID: 34436685 PMCID: PMC8387664 DOI: 10.1007/s00540-021-02991-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/20/2021] [Indexed: 11/29/2022]
Abstract
Giant lung bullae are usually seen in patients with severe chronic obstructive pulmonary disease. Over time, air trapping leads to severe dyspnea and CO2 accumulation. In severe cases, overinflation and rupture of the bulla can cause secondary life-threatening tension pneumothorax. Since positive pressure ventilation exerts deleterious effects on the bulla, general anesthesia is always challenging in patients with giant bullae. We encountered remarkable intraoperative hypercapnia and decreased tidal volume in a 58-year-old male patient with bilateral bullae who underwent right upper bullectomy, due to overinflation of a bulla located in the upper lobe of the ventilated side. Through this experience, to avoid further overinflation, we devised an original, unique and simple airway management strategy using a standard double lumen tube (DLT), which only requires slightly deeper advancement of the DLT to achieve selective lobar blockade during one lung ventilation (OLV). Following the first case, we used this strategy in a 48-year-old male patient who underwent left giant bullectomy, resulting in successful airway management without overinflation during OLV. We recommend our strategy as an option for successful intraoperative airway management during OLV in select bullectomy patients with bilateral giant bullae.
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Affiliation(s)
- Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Osamu Kudoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tsukasa Kochiyama
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Jun Kishii
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Chieko Mitaka
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Kuroda Y, Nonaka M, Kamikubo Y, Ogawa H, Murayama T, Kurebayashi N, Sakairi H, Miyano K, Komatsu A, Dodo T, Nakano-Ito K, Yamaguchi K, Sakurai T, Iseki M, Hayashida M, Uezono Y. Inhibition of endothelin A receptor by a novel, selective receptor antagonist enhances morphine-induced analgesia: Possible functional interaction of dimerized endothelin A and μ-opioid receptors. Biomed Pharmacother 2021; 141:111800. [PMID: 34175819 DOI: 10.1016/j.biopha.2021.111800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 03/01/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The misuse of opioids has led to an epidemic in recent times. The endothelin A receptor (ETAR) has recently attracted attention as a novel therapeutic target to enhance opioid analgesia. We hypothesized that endothelin A receptors may affect pain mechanisms by heterodimerization with μ opioid receptors. We examined the mechanisms of ETAR-mediated pain and the potential therapeutic effects of an ETAR antagonist, Compound-E, as an agent for analgesia. METHODS Real-time in vitro effect of Compound-E on morphine response was assessed in HEK293 cells expressing both endothelin A and μ opioid receptors through CellKey™ and cADDis cAMP assays. Endothelin A/μ opioid receptor dimerization was assessed by immunoprecipitation and live cell imaging. The in vivo effect of Compound-E was evaluated using a morphine analgesia mouse model that observed escape response behavior, body temperature, and locomotor activity. RESULTS In CellKey™ and cAMP assays, pretreatment of cells with endothelin-1 attenuated morphine-induced responses. These responses were improved by Compound-E, but not by BQ-123 nor by bosentan, an ETAR and endothelin B receptor antagonist. Dimerization of ETARs and μ opioid receptors was confirmed by Western blot and total internal reflection fluorescence microscopy in live cells. In vivo, Compound-E potentiated and prolonged the analgesic effects of morphine, enhanced hypothermia, and increased locomotor activity compared to morphine alone. CONCLUSION The results suggest that attenuation by endothelin-1 of morphine analgesia may be caused by dimerization of Endothelin A/μ opioid receptors. The novel ETAR antagonist Compound-E could be an effective adjunct to reduce opioid use.
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Affiliation(s)
- Yui Kuroda
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Miki Nonaka
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuji Kamikubo
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Haruo Ogawa
- Institute of Molecular and Cellular Biosciences, The University of Tokyo, Tokyo, Japan
| | - Takashi Murayama
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nagomi Kurebayashi
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hakushun Sakairi
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kanako Miyano
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan; Division of Cancer Pathophysiology, National Cancer Center Research Institute, Tokyo, Japan
| | - Akane Komatsu
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Tetsushi Dodo
- Strategy Planning & Operations, Medicine Development Center, Eisai Co., Ltd., Ibaraki, Japan
| | - Kyoko Nakano-Ito
- Global Drug Safety, Medicine Development Center, Eisai Co., Ltd., Ibaraki, Japan
| | - Keisuke Yamaguchi
- Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takashi Sakurai
- Department of Cellular and Molecular Pharmacology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masako Iseki
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yasuhito Uezono
- Department of Pain Control Research, The Jikei University School of Medicine, Tokyo, Japan; Department of Pain Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Supportive and Palliative Care Research Support Office, National Center Hospital East, Chiba, Japan; Project for Supportive Care Research, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Tokyo, Japan.
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27
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Kadokura Y, Hayashida M, Kakemizu-Watanabe M, Yamamoto M, Endo D, Oishi A, Nakanishi K, Hata H. Cerebral oxygen saturation (rSO 2) during cardiopulmonary bypass (CPB) measured using the INVOS oximeter closely correlates with baseline rSO 2. J Artif Organs 2021; 24:433-441. [PMID: 33826034 DOI: 10.1007/s10047-021-01263-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/17/2021] [Indexed: 11/28/2022]
Abstract
Baseline cerebral regional saturation (rSO2) measured using the INVOS 5100C (Medtronic, MN, USA) varies widely among patients with cardiac and/or renal diseases. To identify significant correlates of baseline rSO2 and to investigate intraoperative rSO2 changes, we conducted a retrospective study in 494 patients undergoing on-pump cardiovascular surgery. Correlations between preoperative blood laboratory test variables and baseline rSO2 before anesthesia were examined. Intraoperative rSO2 changes were analyzed. Of all the variables examined, log-transformed B-type natriuretic peptide (BNP) most significantly and negatively correlated with baseline rSO2 (r = - 0.652, p < 0.0001). Intraoperatively, rSO2 showed the lowest value during cardiopulmonary bypass (CPB) (median rSO2: 56.2% during CPB vs. 63.9% at baseline, p < 0.0001). Although rSO2 during CPB correlated positively with hemoglobin concentration and oxygen delivery during CPB (r = 0.192, p < 0.0001; and r = 0.172, p = 0.0001, respectively), it correlated much more closely with baseline rSO2 (r = - 0.589, p < 0.0001). Thus, patients showing low baseline rSO2 primarily associated with preoperatively high BNP continued to show low rSO2 even during CPB independent of hemodynamics artificially controlled by CPB. Our findings suggest that low baseline rSO2 in patients with high BNP due to cardiac and/or renal diseases is more likely to result from tissue edema causing alterations in optical pathlength and thus in calculated rSO2 values, not readily modifiable with CPB, rather than actual cerebral hemodynamic alterations readily modifiable with CPB. These may partly explain why the INVOS oximeter is a trend monitor requiring baseline measures.
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Affiliation(s)
- Yumiko Kadokura
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Maho Kakemizu-Watanabe
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Makiko Yamamoto
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Atsumi Oishi
- Department of Cardiovascular Surgery, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Keisuke Nakanishi
- Department of Cardiovascular Surgery, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Hiroaki Hata
- Department of Cardiovascular Surgery, Graduate School of Medicine, Juntendo University, Tokyo, Japan
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Nishizawa D, Iseki M, Arita H, Hanaoka K, Yajima C, Kato J, Ogawa S, Hiranuma A, Kasai S, Hasegawa J, Hayashida M, Ikeda K. Genome-wide association study identifies candidate loci associated with chronic pain and postherpetic neuralgia. Mol Pain 2021; 17:1744806921999924. [PMID: 33685280 PMCID: PMC8822450 DOI: 10.1177/1744806921999924] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Human twin studies and other studies have indicated that chronic pain has heritability that ranges from 30% to 70%. We aimed to identify potential genetic variants that contribute to the susceptibility to chronic pain and efficacy of administered drugs. We conducted genome-wide association studies (GWASs) using whole-genome genotyping arrays with more than 700,000 markers in 191 chronic pain patients and a subgroup of 89 patients with postherpetic neuralgia (PHN) in addition to 282 healthy control subjects in several genetic models, followed by additional gene-based and gene-set analyses of the same phenotypes. We also performed a GWAS for the efficacy of drugs for the treatment of pain. RESULTS Although none of the single-nucleotide polymorphisms (SNPs) were found to be genome-wide significantly associated with chronic pain (p ≥ 1.858 × 10-7), the GWAS of PHN patients revealed that the rs4773840 SNP within the ABCC4 gene region was significantly associated with PHN in the trend model (nominal p = 1.638 × 10-7). In the additional gene-based analysis, one gene, PRKCQ, was significantly associated with chronic pain in the trend model (adjusted p = 0.03722). In the gene-set analysis, several gene sets were significantly associated with chronic pain and PHN. No SNPs were significantly associated with the efficacy of any of types of drugs in any of the genetic models. CONCLUSIONS These results suggest that the PRKCQ gene and rs4773840 SNP within the ABCC4 gene region may be related to the susceptibility to chronic pain conditions and PHN, respectively.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Masako Iseki
- Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Hideko Arita
- Department of Anesthesiology and Pain Relief Center, JR Tokyo General Hospital, Tokyo, Japan
| | - Kazuo Hanaoka
- Department of Anesthesiology and Pain Relief Center, JR Tokyo General Hospital, Tokyo, Japan
| | - Choku Yajima
- Department of Anesthesiology and Pain Relief Center, JR Tokyo General Hospital, Tokyo, Japan
| | - Jitsu Kato
- Department of Anesthesiology, Nihon University School of Medicine, Tokyo, Japan
| | - Setsuro Ogawa
- Nihon University, University Research Center, Tokyo, Japan
| | - Ayako Hiranuma
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Surgery, Toho University Sakura Medical Center, Sakura, Japan
| | - Shinya Kasai
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Masakazu Hayashida
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Inoue R, Nishizawa D, Hasegawa J, Nakayama K, Fukuda KI, Ichinohe T, Mieda T, Tsujita M, Nakagawa H, Kitamura A, Sumikura H, Ikeda K, Hayashida M. Effects of rs958804 and rs7858836 single-nucleotide polymorphisms of the ASTN2 gene on pain-related phenotypes in patients who underwent laparoscopic colectomy and mandibular sagittal split ramus osteotomy. Neuropsychopharmacol Rep 2021; 41:82-90. [PMID: 33476460 PMCID: PMC8182957 DOI: 10.1002/npr2.12159] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/10/2023] Open
Abstract
Background Opioids are widely used as effective analgesics, but opioid sensitivity varies widely among individuals. The underlying genetic and nongenetic factors are not fully understood. Based on the results of our previous genome‐wide association study, we investigated the effects of single nucleotide polymorphisms (SNPs) of the astrotactin 2 (ASTN2) gene on pain‐related phenotypes in surgical patients. Methods We investigated the effects of two SNPs, rs958804 T/C and rs7858836 C/T, of the ASTN2 gene on eight and seven pain‐related phenotypes in 350 patients who underwent laparoscopic colectomy (LAC) and 358 patients who underwent mandibular sagittal split ramus osteotomy (SSRO), respectively. In both surgical groups, intravenous fentanyl patient‐controlled analgesia (PCA) was used for postoperative analgesia, and 24‐hour postoperative PCA fentanyl use was the primary endpoint. Results The association analyses among the two SNPs and pain‐related traits showed that 24‐hour fentanyl use was significantly associated with the two SNP genotypes in both surgical groups. The Mann‐Whitney test showed that 24‐hour fentanyl use was lower in patients with the C allele than in patients with the TT genotype of the rs958804 T/C SNP (P = .0019 and .0200 in LAC and SSRO patients, respectively), and it was lower in patients with the T allele than in patients with the CC genotype of the rs7858836 C/T SNP (P = .0017 and .0098 in LAC and SSRO patients, respectively). Conclusion The two SNPs of the ASTN2 gene were consistently associated with fentanyl requirements after two different types of surgery. These findings may contribute to personalized pain control. We investigated the effects of two SNPs, rs958804 T/C and rs7858836 C/T, which are located in the same LD block of the ASTN2 gene, on pain‐related phenotypes in two groups of patients who underwent laparoscopic colectomy and mandibular sagittal split ramus osteotomy. We found that these SNPs consistently reduced fentanyl requirements for postoperative analgesia, possibly by enhancing the analgesic effect of fentanyl.![]()
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Affiliation(s)
- Rie Inoue
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kyoko Nakayama
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Ken-Ichi Fukuda
- Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Tatsuya Ichinohe
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Tsutomu Mieda
- Department of Anesthesiology, Saitama Medical University Hospital, Saitama, Japan
| | - Miki Tsujita
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hideyuki Nakagawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akira Kitamura
- Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroyuki Sumikura
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Graduate School of Medicine, Juntendo University, Tokyo, Japan.,Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Anesthesiology, Saitama Medical University International Medical Center, Saitama, Japan
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Kawagoe I, Hayashida M, Satoh D, Kochiyama T, Fukuda M, Kishii J. Postoperative analgesia in patients undergoing robot-assisted thoracic surgery: a comparison between thoracic epidural analgesia and intercostal nerve block combined with intravenous patient-controlled analgesia. Ann Palliat Med 2021; 10:1985-1993. [PMID: 33440971 DOI: 10.21037/apm-20-1607] [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] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/02/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND Recently, robot-assisted thoracic surgery (RATS) is increasingly applied to lung or mediastinal tumor surgery. However, appropriate methods of postoperative analgesia for RATS have not been studied. METHODS Patients who underwent RATS at a single university hospital between January, 2017 and March, 2018 were studied retrospectively. Patients were anesthetized with either general anesthesia alone or combined general and thoracic epidural anesthesia. Accordingly, postoperative analgesia was managed with either intravenous patient-controlled analgesia (PCA) with fentanyl or thoracic epidural analgesia (TEA) with morphine and levobupivacaine. Patients were thus divided into 2 groups (PCA and TEA) according to methods of postoperative analgesia, and analgesic efficacies were compared between the groups with regard to pain scores evaluated on a 11-point numerical rating scale (NRS) at 0, 3, 6, 12, 18, 24, and 48 h postoperatively, rescue analgesic requirements within 24 h, side effects of anesthesia and analgesia, including respiratory depression, hypotension, nausea, pruritus, and urinary retention, time to ambulation after surgery, and hospital stay after surgery. RESULTS Data from 107 patients (76 in Group PCA and 31 in Group TEA) were analyzed. NRS pain scores at 6, 18, and 48 h were significantly less or tended to be less in Group TEA than in Group PCA (1.8±2.0 vs. 2.6±1.8, P=0.045; 1.7±1.5 vs. 2.4±1.8, P=0.047; and 1.9±1.4 vs. 2.5±1.6, P=0.063, respectively). The number of patients who required rescue analgesics within 24 h was significantly less in Group TEA than in Group PCA [4/31 (12%) vs. 32/76 (42%), P=0.004]. The other parameters were not significantly different between the groups. CONCLUSIONS Compared with PCA, TEA provided better analgesia after RATS in terms of less pain scores, less rescue analgesic requirements, and similar side effect profiles. TEA with a hydrophilic opioid and local anesthetic seemed an appropriate method of postoperative analgesia in patients undergoing RATS.
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Affiliation(s)
- Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan.
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Tsukasa Kochiyama
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Jun Kishii
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Kawagoe I, Hayashida M, Satoh D, Mitaka C. Comparison of desflurane and propofol in the speed and the quality of emergence from anesthesia in patients undergoing lung cancer surgery—a prospective, randomized study. Transl Cancer Res 2021; 11:736-744. [PMID: 35571644 PMCID: PMC9091024 DOI: 10.21037/tcr-21-2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Chieko Mitaka
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Yamamoto A, Ito K, Yasokawa K, Kanki A, Tanimoto D, Hayashida M, Tamada T. Morphologic changes in hepatitis virus-related liver cirrhosis: Relationship to hemodynamics of portal vein on dynamic contrast-enhanced CT. Radiography (Lond) 2020; 27:598-604. [PMID: 33358531 DOI: 10.1016/j.radi.2020.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The morphologic changes in the compensated stage of liver cirrhosis (cLC) are not diffuse atrophic changes. With cLC lobar or segmental changes combined with atrophy of the right lobe and medial segment together with hypertrophy of the caudate lobe and lateral segment are commonly seen. The purpose of this study was to evaluate the morphologic changes in hepatitis virus-related liver cirrhosis in relationship to haemodynamics of the portal vein on dynamic contrast-enhanced computed tomography (DCE-CT) METHODS: This study included 72 patients, 46 with hepatitis virus-related cirrhosis and 26 with a normally functioning liver, who underwent DCE-CT. In cirrhosis patients, the morphologic change index (MCI) of the liver was calculated and categorised into two groups, high-MCI (MCI ≥ 0.4) (n = 21) and low-MCI (MCI < 0.4) (n = 25). Cross-sectional areas of the main, right and left portal veins and the intra-portal distribution from splenic venous flow were evaluated for their relationships with the MCI and compared among three groups (normal-control, low MCI and high MCI). RESULTS There was a significant difference in the cross-sectional area of the left portal vein between the high-MCI group and the low-MCI group (p = 0.013) and the control group (p = 0.008). A significant correlation was identified between the cross-sectional area of the left portal vein and the MCI (r = 0.508, p < 0.001). CONCLUSION Cross-sectional area of the left portal vein may be a factor related to morphologic changes in hepatitis virus-related liver cirrhosis and could be a possible index of the left portal venous flow volume. IMPLICATIONS FOR PRACTICE This study may be useful for predicting the degree of hepatic morphologic changes and the condition of cirrhosis in association with regional hepatic morphologic changes.
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Affiliation(s)
- A Yamamoto
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan.
| | - K Ito
- Department of Radiology, Yamaguchi University, Japan
| | - K Yasokawa
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - A Kanki
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - D Tanimoto
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - M Hayashida
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - T Tamada
- Department of Radiology, Kawasaki Medical School, Kurashiki, Japan
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Kawagoe I, Satoh D, Mitaka C, Fukuda M, Kochiyama T, Hayashida M. Specific airway management for SVC replacement during giant anterior mediastinal tumor resection. JA Clin Rep 2020; 6:70. [PMID: 32929663 PMCID: PMC7490311 DOI: 10.1186/s40981-020-00377-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 09/02/2020] [Indexed: 12/04/2022] Open
Abstract
Background Giant anterior mediastinal tumor (GAMT) resection is a challenging procedure, for which anesthesiologist might take to need special precautions. Case presentation A 48-year-old male patient had been scheduled to undergo GAMT resection and superior vena cava (SVC) replacement. The tumor spread surrounding SVC and left main bronchus (LMB), resulting in small volume of his left lung. A soft left-sided double lumen tube (DLT) was selected to keep the patency of LMB during left one lung ventilation (OLV) against the tumor weight. Semi-awake intubation with spontaneous breathing was selected for DLT insertion to avoid lower airway occlusion. During left OLV after right open thoracotomy, his SPO2 decreased below to 90%. We performed selective right upper lobe bronchial blockade using the combination of DLT and bronchial blocker. The surgery was successfully completed with this strategy. Conclusions Although such cases are rare, they are informative for anesthesiologists, providing optional strategies.
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Affiliation(s)
- Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Chieko Mitaka
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masataka Fukuda
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tsukasa Kochiyama
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Niimi N, Kataoka K, Hayashida M, Inada E. The dynamic collapse of the trachea during anesthesia for a pediatric patient with a large anterior mediastinal mass: A case report. Clin Case Rep 2020; 8:1814-1815. [PMID: 32983502 PMCID: PMC7495815 DOI: 10.1002/ccr3.3005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/06/2020] [Accepted: 05/15/2020] [Indexed: 12/17/2022] Open
Abstract
Anesthesia for patient with large anterior mediastinal mass might induce life-threatening complication. Maintaining the spontaneous breathing throughout the procedure and finding rescue position are the cornerstones of anesthetic management.
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Affiliation(s)
- Naoko Niimi
- Department of AnesthesiaJuntendo University HospitalBunkyo‐kuJapan
| | - Kumi Kataoka
- Department of AnesthesiaJuntendo University HospitalBunkyo‐kuJapan
| | | | - Eiichi Inada
- Department of AnesthesiaJuntendo University HospitalBunkyo‐kuJapan
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Tsukuda F, Yutaka H, Hayashida M, Ogata A, Noboru S, Shoji K. IMRT by Helical Tomotherapy for prostate cancer increases the risk of bladder cancer at single institution. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33524-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Ikeda K, Nishizawa D, Hayashida M, Fukuda KI. Personalized opioid use for controlling pain and drug abuse. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kawagoe I, Hayashida M, Satoh D, Inada E. Intercostal misplacement of a thoracic epidural catheter discovered during lung cancer surgery: a case report. JA Clin Rep 2019; 5:44. [PMID: 32026055 PMCID: PMC6966728 DOI: 10.1186/s40981-019-0264-8] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 06/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blind epidural catheter placement can lead to inadvertent misplacement. We present a case of intercostal misplacement of a thoracic epidural catheter. CASE PRESENTATION A 67-year-old male underwent left lung cancer surgery via thoracotomy with epidural analgesia via the Th 5-6 intervertebral space, although with some difficulty. We detected dermatomal cold sensory loss around Th five min after initial administration of local anesthetics through the catheter before general anesthesia induction. However, the epidural catheter was intraoperatively found below the fifth rib, running along the course of the intercostal nerve. The catheter was successfully withdrawn via his back, and we postoperatively performed paravertebral block under ultrasound guidance. He did not complain of complications at discharge. CONCLUSIONS Detailed bilateral assessment of sensory loss after initial local anesthetic administration might have facilitated preoperative detection of the misplacement. In cases requiring multiple catheter insertion attempts, switching to another analgesic method should be considered.
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Affiliation(s)
- Izumi Kawagoe
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Daizoh Satoh
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Eiichi Inada
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
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Kawagoe I, Hayashida M, Satoh D, Suzuki K, Inada E. Ventilation failure after lateral jackknife positioning for robot-assisted lung cancer surgery in a patient after lingula-sparing left upper lobectomy. JA Clin Rep 2018; 4:51. [PMID: 32025970 PMCID: PMC6966923 DOI: 10.1186/s40981-018-0188-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/13/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ventilation failure commonly occurs when a standard left-sided double-lumen tube is used in patients after left upper lobectomy having remarkable angulation of the left main bronchus. We present a female without remarkable angulation, in whom ventilation failure occurred after lateral jackknife positioning. CASE PRESENTATION A 73-year-old female after lingula-sparing left upper lobectomy without remarkable angulation was scheduled for robot-assisted right upper lobectomy. Ventilation failure with a standard left-sided double-lumen tube occurred when she was placed not in the lateral position but in the lateral jackknife position required for robotic surgery. After replacement by the Silbroncho® left-sided double-lumen tube, adequate one-lung ventilation became possible. CONCLUSIONS Ventilation failure with a standard tube may occur more easily when patients with bronchial angulation are placed in the lateral jackknife than lateral position due to posture-induced exacerbations of bronchial angulation. The Silbroncho® tube seems useful in such situations.
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Affiliation(s)
- Izumi Kawagoe
- Division of General Thoracic Anesthesia, Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan. .,, Tokyo, Japan.
| | - Masakazu Hayashida
- Division of Cardiovascular Anesthesia, Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Daizoh Satoh
- Division of Intensive Care Medicine, Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
| | - Kenji Suzuki
- Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Eiichi Inada
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, Japan
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Aoki Y, Nishizawa D, Yoshida K, Hasegawa J, Kasai S, Takahashi K, Koukita Y, Ichinohe T, Hayashida M, Fukuda KI, Ikeda K. Association between the rs7583431 single nucleotide polymorphism close to the activating transcription factor 2 gene and the analgesic effect of fentanyl in the cold pain test. Neuropsychopharmacol Rep 2018; 38:86-91. [PMID: 30106255 PMCID: PMC7292331 DOI: 10.1002/npr2.12012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 01/20/2018] [Accepted: 01/29/2018] [Indexed: 11/19/2022] Open
Abstract
Background Activating transcription factor 2 (ATF2) is a member of the leucine zipper family of DNA binding proteins and is widely distributed in tissues. Several recent studies have demonstrated that this protein is involved in mechanisms that are related to pain and inflammation. However, unclear is whether polymorphisms of the ATF2 gene, which encodes the human ATF2 protein, influence pain or analgesic sensitivity. This study examined associations between the analgesic effect of fentanyl in the cold pressor‐induced pain test and polymorphisms in the ATF2 gene in 355 Japanese subjects. Results In this study, 33 single nucleotide polymorphisms (SNPs) were selected, and a total of 2 linkage disequilibrium blocks with 6 Tag SNPs (rs1153702, rs7583431, rs2302663, rs3845744, rs268214, and rs1982235) were observed in the region within and around the ATF2 gene. We further analyzed associations between these Tag SNPs and clinical data. Even after multiple testing with Bonferroni adjustments, an increase in the analgesic effect of fentanyl in the cold pressor‐induced pain test was significantly associated with a greater number of the A allele of the rs7583431 SNP (linear regression, P = .001). Conclusions The present findings may contribute to adequate pain relief in individual patients. Although more research on the genetic factors that influence opioid sensitivity is needed, analgesic requirements may be predicted by analyzing ATF2SNPs, together with other polymorphisms of genes that are reportedly associated with opioid sensitivity, such as CREB1,OPRM1, and GIRK2. In this study, 33 single nucleotide polymorphisms (SNPs) were selected, and a total of 2 linkage disequilibrium blocks with 6 Tag SNPs (rs1153702, rs7583431, rs2302663, rs3845744, rs268214, and rs1982235) were observed in the region within and around the ATF2 gene. We further analyzed associations between these Tag SNPs and clinical data. Even after multiple testing with Bonferroni adjustments, an increase in the analgesic effect of fentanyl in the cold pressor‐induced pain test was significantly associated with a greater number of the A allele of the rs7583431 SNP (linear regression, P = .001).
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Affiliation(s)
- Yoshinori Aoki
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kaori Yoshida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kaori Takahashi
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Yoshihiko Koukita
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | - Tatsuya Ichinohe
- Department of Dental Anesthesiology, Tokyo Dental College, Tokyo, Japan
| | | | - Ken-Ichi Fukuda
- Department of Oral Health Science, Tokyo Dental College, Tokyo, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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40
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Yamamoto M, Hayashida M, Kakemizu-Watanabe M, Ando N, Mukaida H, Kawagoe I, Yusuke S, Inada E. B-Type Natriuretic Peptide and Hemoglobin are Two Major Factors Significantly Associated With Baseline Cerebral Oxygen Saturation Measured Using the INVOS Oximeter in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery. J Cardiothorac Vasc Anesth 2018; 32:187-196. [DOI: 10.1053/j.jvca.2017.04.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Indexed: 12/14/2022]
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Nishizawa D, Mieda T, Tsujita M, Nakagawa H, Yamaguchi S, Kasai S, Hasegawa J, Fukuda KI, Kitamura A, Hayashida M, Ikeda K. Genome-wide scan identifies candidate loci related to remifentanil requirements during laparoscopic-assisted colectomy. Pharmacogenomics 2017; 19:113-127. [PMID: 29207912 DOI: 10.2217/pgs-2017-0109] [Citation(s) in RCA: 4] [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] [Indexed: 12/24/2022] Open
Abstract
AIM Opioids are widely used as effective analgesics, but opioid sensitivity is well known to vary widely among individuals. We explored the genetic factors that contribute to individual differences in intraoperative opioid sensitivity by performing a genome-wide association study. PATIENTS & METHODS We conducted a multistage genome-wide association study in subjects who underwent laparoscopic-assisted colectomy. RESULTS A nonsynonymous SNP, rs199670311, within the TMEM8A gene region and intronic SNPs, including rs4839603, within the SLC9A9 gene region were significantly associated with intraoperative opioid requirements (p = 3.409 × 10-8 in the dominant model for rs199670311; p = 4.162 × 10-6 and p = 4.229 × 10-6 in the additive and recessive models, respectively, for rs4839603). The A and T alleles of the rs199670311 and rs4839603 SNPs, respectively, were associated with lower opioid sensitivity in patients. CONCLUSION Our findings provide valuable information for personalized pain treatment during laparoscopic-assisted colectomy.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Tsutomu Mieda
- Department of Anesthesiology, Saitama Medical University Hospital, 38, Morohongo Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
| | - Miki Tsujita
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hideyuki Nakagawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Ken-Ichi Fukuda
- Department of Oral Health & Clinical Science, Tokyo Dental College, 2-9-18, Misaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Akira Kitamura
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masakazu Hayashida
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.,Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, 2-1-1, Hongou, Bunkyou-ku, Tokyo 113-8421, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
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42
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Tayama J, Saigo T, Ogawa S, Takeoka A, Hamaguchi T, Hayashida M, Fukudo S, Shirabe S. Effect of attention bias modification on brain function and anxiety in patients with irritable bowel syndrome: A preliminary electroencephalogram and psycho-behavioral study. Neurogastroenterol Motil 2017; 29. [PMID: 28612504 DOI: 10.1111/nmo.13131] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/17/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Gastrointestinal symptoms of irritable bowel syndrome (IBS) show a reciprocal relationship with anxiety. In this intervention-based study, we investigated the utility of attention bias modification (ABM) therapy in patients with IBS. We hypothesized that IBS-related electroencephalographic abnormalities would be normalized after ABM therapy. METHODS Seventeen patients with IBS and 13 healthy subjects completed five ABM intervention sessions over a 2-month period. Each session included 128 ABM trials, resulting in a total of 640 trials across the intervention period. For each trial, subjects viewed a pair of facial expression images and were instructed to indicate the position of the neutral face as quickly and accurately as possible by pressing one of two buttons on a button box. Electroencephalography data (alpha and beta power percentages) were collected during the 1st and 5th sessions. KEY RESULTS Generalized estimating equations of relative alpha power revealed a significant effect of period was identified at O2 (P=.036). Paired t tests revealed that ABM significantly increased relative alpha power at O2 in patients with IBS. Generalized estimating equation of relative beta power revealed a significant effect of the group × period interaction was identified at Pz (P=.035). Paired t tests revealed that ABM significantly decreased relative beta power at Pz in patients with IBS. CONCLUSIONS & INFERENCES Attention bias modification may normalize brain function related to attention and anxiety in patients with IBS.
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Affiliation(s)
- J Tayama
- Graduate School of Education, Nagasaki University, Nagasaki, Japan.,Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan
| | - T Saigo
- Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Ogawa
- Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - A Takeoka
- Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - T Hamaguchi
- Department of Occupational Therapy, School of Health and Social Services Saitama Prefectural University, Saitama, Japan
| | - M Hayashida
- Unit of Preventive Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Fukudo
- Department of Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Shirabe
- Center for Health and Community Medicine, Nagasaki University, Nagasaki, Japan
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Mukaida H, Hayashida M, Matsushita S, Yamamoto M, Nakamura A, Amano A. Brain natriuretic peptide (BNP) may play a major role in risk stratification based on cerebral oxygen saturation by near-infrared spectroscopy in patients undergoing major cardiovascular surgery. PLoS One 2017; 12:e0181154. [PMID: 28704502 PMCID: PMC5507540 DOI: 10.1371/journal.pone.0181154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/27/2017] [Indexed: 01/08/2023] Open
Abstract
Purpose A previous study reported that low baseline cerebral oxygen saturation (ScO2) (≤50%) measured with near-infrared spectroscopy was predictive of poor clinical outcomes after cardiac surgery. However, such findings have not been reconfirmed by others. We conducted the current study to evaluate whether the previous findings would be reproducible, and to explore mechanisms underlying the ScO2-based outcome prediction. Methods We retrospectively investigated 573 consecutive patients, aged 20 to 91 (mean ± standard deviation, 67.1 ± 12.8) years, who underwent major cardiovascular surgery. Preanesthetic baseline ScO2, lowest intraoperative ScO2, various clinical variables, and hospital mortality were examined. Results Bivariate regression analyses revealed that baseline ScO2 correlated significantly with plasma brain natriuretic peptide concentration (BNP), hemoglobin concentration (Hgb), estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) (p < 0.0001 for each). Baseline ScO2 correlated with BNP in an exponential manner, and BNP was the most significant factor influencing ScO2. Logistic regression analyses revealed that baseline and lowest intraoperative ScO2 values, but not relative ScO2 decrements, were significantly associated with hospital mortality (p < 0.05), independent of the EuroSCORE (p < 0.01). Receiver operating curve analysis of ScO2 values and hospital mortality revealed an area under the curve (AUC) of 0.715 (p < 0.01) and a cutoff value of ≤50.5% for the baseline and ScO2, and an AUC of 0.718 (p < 0.05) and a cutoff value of ≤35% for the lowest intraoperative ScO2. Low baseline ScO2 (≤50%) was associated with increases in intubation time, intensive care unit stay, hospital stay, and hospital mortality. Conclusion Baseline ScO2 was reflective of severity of systemic comorbidities and was predictive of clinical outcomes after major cardiovascular surgery. ScO2 correlated most significantly with BNP in an exponential manner, suggesting that BNP plays a major role in the ScO2-based outcome prediction.
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Affiliation(s)
- Hiroshi Mukaida
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Clinical Engineering, Juntendo University Hospital, Tokyo, Japan
- * E-mail:
| | - Masakazu Hayashida
- Department of Anesthesiology & Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Makiko Yamamoto
- Department of Anesthesiology & Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsushi Nakamura
- Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
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Kawagoe I, Hayashida M, Nozumi Y, Banno T, Hirayama S, Suzuki K, Satoh D, Naito Y, Inada E. A Combination of a Partial Anomalous Pulmonary Venous Connection (PAPVC) and a Lung Tumor Requiring Pulmonary Resection. J Cardiothorac Vasc Anesth 2017; 31:274-278. [DOI: 10.1053/j.jvca.2016.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Indexed: 11/11/2022]
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Kawagoe I, Hayashida M, Suzuki K, Kitamura Y, Oh S, Satoh D, Inada E. Anesthetic Management of Patients Undergoing Right Lung Surgery After Left Upper Lobectomy: Selection of Tubes for One-Lung Ventilation (OLV) and Oxygenation During OLV. J Cardiothorac Vasc Anesth 2016; 30:961-6. [DOI: 10.1053/j.jvca.2015.10.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Indexed: 11/11/2022]
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Sudarman A, Hayashida M, Miralestari M. In vitro rumen fermentation characteristics and microbes of thin tail sheep given sweet potato (Ipomoea batatas L) biomass. JITV 2016. [DOI: 10.14334/jitv.v21i2.1355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
<p class="abstrak2">Sweet potato plant is produced in Indonesia in large quantities. Sweet potato leaves and stems can be used as a source of protein and the tuber can be used as an energy source. This study was aimed to analyze the effect of feeding of sweet potato biomass on the rumen fermentation characteristics, digestibility of dry matter and organic matter as well as rumen microbial population of thin tail sheep. This study used a randomized block design by applying four feed treatments, i.e., T0 (100% Napier grass), T1 (70% of Napier grass + 30% concentrate), T2 (50% of Napier grass + 50% sweet potato leaves), and T3 (70% sweet potato leaves + 30% sweet potato tuber) with three replicates. Rumen fluid samples were taken with stomach tube method using a vacuum pump. Results showed that the T3 diet has higher (P<0.05) digestibility of dry matter and organic matter, concentration of NH<sub>3</sub> and VFA, and rumen bacterial population than those of T0 and T1diets but similar to that of T2 diet. Rumen pH and protozoa population was not different among the treatments. It can be concluded that the use of sweet potato biomass can improve the quality of rumen fermentation of sheep.</p>
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Kawagoe I, Kohchiyama T, Hayashida M, Satoh D, Suzuki K, Inada E. [Successful One-lung Ventilation with a Right-sided Double-lumen Tube in a Patient with a Right Upper Tracheal Bronchus, who Underwent Left Pneumonectomy for Left Hilar Lung Cancer]. Masui 2016; 65:594-598. [PMID: 27483653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
A 60-year-old male patient with left hilar lung cancer was scheduled to undergo left pneumonectomy or left sleeve lower lobectomy. Preoperative computer tomographic and bronchoscopic examinations revealed that the bronchus (B1) to the right apical segment (S1) was a tracheal bronchus (TB) originating from the trachea approximately 10 mm above the carina. Because the left main bronchus was to be dissected, a right-sided double-lumen tube (DLT) was selected to completely protect the right lung from spillage of secretions or cancer cells from the left lung. The right-sided DLT was placed so as to fit its lateral opening of the bronchial lumen to normal upper branches (B2, B3), while sacrificing ventilation of S1 with an abnormal branch (B1). However, one-lung ventilation (OLV) of the right lung could not be achieved, since a gas leakage from the opened tracheal lumen occurred, most probably due to intra-lobar micro-airway communications between S1 and S2/S3. The DLT was withdrawn until the blue bronchial cuff occluded the orifice of the TB (B1). Although the upper half of the blue bronchial cuff appeared above the tracheal carina, OLV through the two bronchial lumen openings could be achieved due to a specific, slanted doughnut shape of the blue bronchial cuff and the location of the abnormal branch (B1) approximate to the carina. Left pneumonectomy using successful OLV was completed safely without hypoxemia or hypercapnea. Our experience indicates that management of OLV for patients with a thoracheal bronchus needs special considerations of the exact location of the TB and intra-lobar micro-airway communications, in addition to types of scheduled surgical procedures.
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Mieda T, Nishizawa D, Nakagawa H, Tsujita M, Imanishi H, Terao K, Yoshikawa H, Itoh K, Amano K, Tashiro J, Ishii T, Ariyama J, Yamaguchi S, Kasai S, Hasegawa J, Ikeda K, Kitamura A, Hayashida M. Genome-wide association study identifies candidate loci associated with postoperative fentanyl requirements after laparoscopic-assisted colectomy. Pharmacogenomics 2015; 17:133-45. [PMID: 26566055 DOI: 10.2217/pgs.15.151] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIMS Opioids are widely used as effective analgesics, but opioid sensitivity is well known to vary widely among individuals and the underlying genetic factors are not fully understood, thus hampering efficient pain treatment. We explored the genetic factors that contribute to individual differences in opioid sensitivity by performing a genome-wide association study. METHODS We conducted a multistage genome-wide association study in subjects who underwent laparoscopic-assisted colectomy (LAC). RESULTS A nonsynonymous SNP in the LAMB3 gene region, rs2076222, was strongly associated with postoperative opioid requirements. The C allele of this best-candidate SNP was associated with lower opioid sensitivity and/or higher pain sensitivity in the patient subjects. CONCLUSION Our findings provide valuable information for personalized pain treatment after LAC, in which the C allele of the rs2076222 SNP is associated with lower opioid sensitivity and requires more opioid analgesic after LAC.
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Affiliation(s)
- Tsutomu Mieda
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Hideyuki Nakagawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Miki Tsujita
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hirokazu Imanishi
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kazuhisa Terao
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hiroaki Yoshikawa
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kazushi Itoh
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kojiro Amano
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Jo Tashiro
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Toshimasa Ishii
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Jun Ariyama
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shigeki Yamaguchi
- Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6, Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan
| | - Akira Kitamura
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan
| | - Masakazu Hayashida
- Department of Anesthesiology, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, Saitama 350-1298, Japan.,Department of Anesthesiology & Pain Medicine, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Nishizawa D, Kasai S, Hasegawa J, Sato N, Yamada H, Tanioka F, Nagashima M, Katoh R, Satoh Y, Tagami M, Ujike H, Ozaki N, Inada T, Iwata N, Sora I, Iyo M, Yamada M, Kondo N, Won MJ, Naruse N, Uehara-Aoyama K, Itokawa M, Ohi K, Hashimoto R, Tanisawa K, Arai T, Mori S, Sawabe M, Naka-Mieno M, Yamada Y, Yamada M, Sato N, Muramatsu M, Tanaka M, Irukayama-Tomobe Y, Saito YC, Sakurai T, Hayashida M, Sugimura H, Ikeda K. Associations between the orexin (hypocretin) receptor 2 gene polymorphism Val308Ile and nicotine dependence in genome-wide and subsequent association studies. Mol Brain 2015; 8:50. [PMID: 26289589 PMCID: PMC4546081 DOI: 10.1186/s13041-015-0142-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/12/2015] [Indexed: 11/29/2022] Open
Abstract
Background Many genetic and environmental factors are involved in the etiology of nicotine dependence. Although several candidate gene variations have been reported by candidate gene studies or genome-wide association studies (GWASs) to be associated with smoking behavior and the vulnerability to nicotine dependence, such studies have been mostly conducted with subjects with European ancestry. However, genetic factors have rarely been investigated for the Japanese population as GWASs. To elucidate genetic factors involved in nicotine dependence in Japanese, the present study comprehensively explored genetic contributors to nicotine dependence by using whole-genome genotyping arrays with more than 200,000 markers in Japanese subjects. Results The subjects for the GWAS and replication study were 148 and 374 patients, respectively. A two-stage GWAS was conducted using the Fagerström Test for Nicotine Dependence (FTND), Tobacco Dependence Screener (TDS), and number of cigarettes smoked per day (CPD) as indices of nicotine dependence. For the additional association analyses, patients who underwent major abdominal surgery, patients with methamphetamine dependence/psychosis, and healthy subjects with schizotypal personality trait data were recruited. Autopsy specimens with various diseases were also evaluated. After the study of associations between more than 200,000 marker single-nucleotide polymorphisms (SNPs) and the FTND, TDS, and CPD, the nonsynonymous rs2653349 SNP (located on the gene that encodes orexin [hypocretin] receptor 2) was selected as the most notable SNP associated with FTND, with a p value of 0.0005921 in the two-stage GWAS. This possible association was replicated for the remaining 374 samples. This SNP was also associated with postoperative pain, the initiation of methamphetamine use, schizotypal personality traits, and susceptibility to goiter. Conclusions Although the p value did not reach a conventional genome-wide level of significance in our two-stage GWAS, we obtained significant results in the subsequent analyses that suggest that the rs2653349 SNP (Val308Ile) could be a genetic factor that is related to nicotine dependence and possibly pain, schizotypal personality traits, and goiter in the Japanese population. Electronic supplementary material The online version of this article (doi:10.1186/s13041-015-0142-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daisuke Nishizawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan.
| | - Shinya Kasai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan.
| | - Junko Hasegawa
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan.
| | - Naomi Sato
- Department of Clinical Nursing, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan. .,Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan.
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan.
| | - Fumihiko Tanioka
- Department of Pathology, Iwata City Hospital, Iwata, 438-8550, Japan.
| | - Makoto Nagashima
- Department of Surgery, Toho University Sakura Medical Center, Sakura, 285-8741, Japan.
| | - Ryoji Katoh
- Department of Surgery, Toho University Sakura Medical Center, Sakura, 285-8741, Japan.
| | - Yasuo Satoh
- Department of Anesthesiology, Toho University Sakura Medical Center, Sakura, 285-8741, Japan.
| | - Megumi Tagami
- Department of Anesthesiology, Toho University Sakura Medical Center, Sakura, 285-8741, Japan.
| | - Hiroshi Ujike
- Ujike Nishiguchi Clinic, Okayama, 700-0024, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Toshiya Inada
- Department of Psychiatry, Seiwa Hospital, Institute of Neuropsychiatry, Tokyo, 162-0851, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, 470-1192, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Ichiro Sora
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan. .,Department of Psychiatry, Kobe University Graduate School of Medicine, Kobe, 650-0017, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, 260-8670, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, 187-8553, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Naoki Kondo
- Seimei Hospital, Fuji City, 417-0801, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Moo-Jun Won
- Koujin Hospital, Nagoya, 463-8530, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Nobuya Naruse
- Saitama Seishin-iryo Center, Kita-adachi, Saitama, 362-0806, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Kumi Uehara-Aoyama
- Kanagawa Psychiatric Center, Serigaya Hospital, Kanagawa, 233-0006, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
| | - Masanari Itokawa
- Schizophrenia and Depression Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, 156-8506, Japan.
| | - Kazutaka Ohi
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. .,National Hospital Organization, Yamato Mental-Medical Center, Nara, 639-1042, Japan.
| | - Ryota Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan. .,Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University, Chiba University, and Fukui University School of Medicine, Osaka, 565-0871, Japan.
| | - Kumpei Tanisawa
- Department of Genomics for Longevity and Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, 173-0015, Japan. .,Graduate School of Sport Sciences, Waseda University, Tokyo, 359-1192, Japan.
| | - Tomio Arai
- Department of Pathology, Tokyo Metropolitan Geriatric Hospital, Tokyo, 173-0015, Japan.
| | - Seijiro Mori
- Center for Promotion of Clinical Investigation, Tokyo Metropolitan Geriatric Hospital, Tokyo, 173-0015, Japan.
| | - Motoji Sawabe
- Molecular Pathophysiology, Department of Molecular-genetic Sciences, Division of Biomedical Laboratory Sciences, Graduate School of Health Care Sciences, Tokyo Medical and Dental University, Tokyo, 101-0062, Japan.
| | - Makiko Naka-Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University, Shimotsuke, 329-0498, Japan.
| | - Yoshiji Yamada
- Department of Human Functional Genomics, Life Science Research Center, Mie University, Tsu, 514-8507, Japan.
| | - Miki Yamada
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, 101-0062, Japan.
| | - Noriko Sato
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, 101-0062, Japan.
| | - Masaaki Muramatsu
- Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, 101-0062, Japan.
| | - Masashi Tanaka
- Department of Genomics for Longevity and Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, 173-0015, Japan. .,Department of Clinical Laboratory, Tokyo Metropolitan Geriatric Hospital, Tokyo, 173-0015, Japan.
| | | | - Yuki C Saito
- Department of Molecular Neuroscience and Integrative Physiology, Faculty of Medicine, Kanazawa University, Ishikawa, 920-8640, Japan.
| | - Takeshi Sakurai
- Department of Molecular Neuroscience and Integrative Physiology, Faculty of Medicine, Kanazawa University, Ishikawa, 920-8640, Japan.
| | - Masakazu Hayashida
- Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo, 113-8421, Japan.
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, Hamamatsu, 431-3192, Japan.
| | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo, 156-8506, Japan. .,Japanese Genetics Initiative for Drug Abuse (JGIDA), Tokyo, Japan.
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50
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Ide S, Nishizawa D, Fukuda KI, Kasai S, Hasegawa J, Hayashida M, Minami M, Ikeda K. Haplotypes of P2RX7 gene polymorphisms are associated with both cold pain sensitivity and analgesic effect of fentanyl. Mol Pain 2014; 10:75. [PMID: 25472448 PMCID: PMC4265416 DOI: 10.1186/1744-8069-10-75] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/18/2014] [Indexed: 12/12/2022] Open
Abstract
Background The P2X7 receptor is a member of the P2X family of adenosine 5′-triphosphate-gated cation channels. Several recent studies have demonstrated that this receptor is involved in mechanisms related to pain and inflammation. However, unknown is whether polymorphisms of the P2RX7 gene that encodes the human P2X7 receptor influence pain sensitivity and analgesic effects of opioids. The P2RX7 gene is known to be highly polymorphic. Thus, the present study examined associations between fentanyl sensitivity and polymorphisms in the P2RX7 gene in 355 Japanese patients who underwent painful orofacial cosmetic surgery. Results We first conducted linkage disequilibrium (LD) analyses for 55 reported single-nucleotide polymorphisms (SNPs) in the region within and around the P2RX7 gene using genomic samples from 100 patients. In our samples, 42 SNPs were polymorphic, and a total of five LD blocks with six Tag SNPs (rs2708092, rs1180012, rs1718125, rs208293, rs1718136, and rs7132846) were observed. Thus, we further analyzed associations between genotypes/haplotypes of these Tag SNPs and clinical data using a total of 355 samples. In the genotype-based association study, only the rs1718125 G > A SNP tended to be associated with higher pain scores on a visual analog scale 24 h after surgery (VAS24). The haplotype-based association study showed that subjects with homozygous haplotype No.3 (GTAAAC; estimated frequency: 15.0%) exhibited significantly higher cold pain sensitivity and lower analgesic effects of fentanyl for acute cold pain in the cold pressor test. Conversely, subjects who carried haplotype No.1 (ACGGAC; estimated frequency: 24.5%) tended to exhibit lower cold pain sensitivity and higher analgesic effects of fentanyl. Furthermore, subjects with homozygous haplotype No.2 (GCGGAC; estimated frequency: 22.9%) exhibited significantly lower VAS24 scores. Conclusions Cold pain sensitivity and analgesic effects of fentanyl were related to the SNP and haplotypes of the P2RX7 gene. The patients with the rs1718125 G>A SNP tended to show higher VAS24 scores. Moreover, the combination of polymorphisms from the 5′-flanking region to exon 5 recessively affected cold pain sensitivity and analgesic effects of opioids for acute cold pain. The present findings shed light on the involvement of P2RX7 gene polymorphisms in naive cold pain sensitivity and analgesic effects of fentanyl. Electronic supplementary material The online version of this article (doi:10.1186/1744-8069-10-75) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | | | | | | | - Kazutaka Ikeda
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, 2-1-6 Kamikitazawa, Setagaya-ku, Tokyo 156-8506, Japan.
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