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Hashiguchi N, Chiang CH, Rottner L, Reißmann B, Rillig A, Maurer T, Lemes C, Kuck KH, Ouyang F, Mathew S. Reverse structural left atrial remodeling and atrial tachycardia in patients with repeat ablation for atrial fibrillation. Pacing Clin Electrophysiol 2023; 46:11-19. [PMID: 36356298 DOI: 10.1111/pace.14619] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Catheter ablation has been evolved to a cornerstone in the therapy of atrial fibrillation (AF); however, atrial tachycardias (AT) after AF ablation are still an important issue. Besides the electrical recurrence of atrial tachyarrhythmia after ablation, left atrial (LA) remodeling has received attention as a consequence of AF. OBJECTIVE The aim of this study is to evaluate predictors for AT recurrence and LA remodeling in patients with repeat AF ablation procedures. METHODS AND RESULTS One hundred thirteen patients who underwent repeat AF ablation with 3D electro-anatomical mapping system were evaluated. Mean age was 63.1 ± 9.3 years, and 2.3 ± 0.5 ablation procedures were performed during a time period of 22 [IQR 7;48] months. Reverse structural LA remodeling (LA volume decreased more than 15%) was observed in 25 (22.1%) patients. LA volume index (LAVI) during first procedure was the only predictor for positive reverse structural LA remodeling (hazard ratio (HR): 1.03, 95% CI: 1.00-1.07, p = .036) in multivariate analysis. Fifty-nine (52.2%) patients experienced only AF and 54 (47.8%) patients AT after first procedure. Female gender (HR: 5.21, 95% CI: 1.66-18.08, p = .006), LAVI (HR: 1.06, 95% CI: 1.02-1.11, p = .008) and LA scar percentage (HR: 1.08, 95% CI: 1.02-1.17, p = .019) were independent significant predictors for AT recurrence in multivariate analysis. CONCLUSIONS Reverse structural LA remodeling occurred in a quarter of patients with repeat ablation procedures for AF. Only larger LAVI during first procedure predicted reverse structural LA remodeling. Half of the patients experienced AT between first and last ablation procedure. Female gender, larger LAVI and larger scar area were significant predictors for AT after catheter ablation for AF.
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Affiliation(s)
| | - Cheng-Hung Chiang
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Bruno Reißmann
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Tilman Maurer
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Christine Lemes
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Fuwai Hospital, The Chinese Academy of Medical Sciences & National Center of Cardiovascular Diseases, Beijing, China
| | - Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department of Cardiology, University of Giessen, Giessen, Germany
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Hashiguchi N, Schenker N, Rottner L, Reißmann B, Rillig A, Maurer T, Lemes C, Kuck KH, Ouyang F, Mathew S. Absence of detectable effect of radiotherapy and chemotherapy for breast cancer on the presence of low voltage areas in patients receiving left atrial catheter ablation. Acta Cardiol 2021; 76:1061-1068. [PMID: 32914694 DOI: 10.1080/00015385.2020.1812892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE Radiation and chemotherapy for breast cancer are known to cause side effects to the heart. However, it still remains unclear whether those therapies affect left atrium fibrosis. We sought to examine the effects of radiation and chemotherapy on the electroanatomic features of the left atrium (LA) in patients who received catheter ablation for LA arrhythmias and underwent radiation and/or chemotherapy prior to the procedure. METHODS AND RESULTS We compared 38 patients who underwent catheter ablation for LA arrhythmias and had a previous diagnosis of breast cancer with 38 patients without breast cancer. LA low voltage zones (LVZ) were analysed during the electrophysiological (EP) study. The existence of LA LVZ did not differ significantly between both groups (71.1% vs. 76.3%, p = .602; 13.7cm2 (IQR 0;20.6cm2) vs. 7.0cm2 (IQR 1.6;21.1cm2), p = .690). Also scar distribution revealed no difference between both groups. However, an involvement of the anterior wall was common in both groups (65.8% vs. 73.7%, p = .454). Patients with breast cancer and persistent AF showed a trend towards greater LA scar areas 14.5% vs. 6.9%, p = .383) compared to the control group. Age and LA volume index were the only independent predictors for greater LA scarring. CONCLUSIONS Thoracic irradiation and chemotherapy for breast cancer do not lead to an increase in LA scar area or a changed distribution of LA scarring. However, patient with breast cancer showed a tendency towards greater LA scar areas. Patient's age and LA volume index were identified as independent predictors for LA scar development.
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Affiliation(s)
| | - Niklas Schenker
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Bruno Reißmann
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Department for Cardiology, University of Hamburg Eppendorf, Hamburg, Germany
| | - Tilman Maurer
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Christine Lemes
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Fuwai Hospital, The Chinese Academy of Medical Sciences & National Center of Cardiovascular Diseases, Beijing, China
| | - Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Department of Cardiology, University of Giessen, Giessen, Germany
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Mathew S, Rottner L, Warneke L, Maurer T, Lemes C, Hashiguchi N, Reißmann B, Goldmann B, Ouyang F, Kuck KH, Metzner A, Rillig A. Initial experience and procedural efficacy of pulmonary vein isolation using the fourth-generation cryoballoon - a step forward? Acta Cardiol 2020; 75:754-759. [PMID: 31630633 DOI: 10.1080/00015385.2019.1677373] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Cryoballoon (CB)-based pulmonary vein isolation (PVI) is an established treatment modality for patients suffering from paroxysmal or persistent atrial fibrillation (AF). Recently, the novel fourth-generation cryoballoon (CB4) was introduced which mainly provides a 40% shorter distal tip as compared to the second-generation cryoballoon (CB2). This two-centre analysis sought to assess the primary efficacy of the 28 mm CB4 for PVI and the feasibility of real-time signal recordings from the PVs considering the time-to-isolation (TTI).Methods and results: Eighty-four patients with paroxysmal or short-standing persistent AF underwent CB4-based PVI at two different hospitals. Individual freeze-cycle duration was set at TTI + 120 seconds. No bonus freeze was applied. A total of 331 pulmonary veins (PVs) including five left common PVs were identified and all PVs were successfully isolated. Mean freeze-cycle duration was 165.7 ± 31.5 seconds. The mean minimal CB temperature was -45.6 ± 7.6 °C with a real-time PVI visualisation rate of 78% (67/84 (79.8%) RSPVs, 55/84 (65.5%) RIPVs, 67/79 (84.8%) LSPVs, 66/79 (83.5%) LIPVs and 2/5 (40%) LCPV). Transient phrenic nerve palsy occurred in 2/84 (2.4%) patients during cryo-application along the RSPV.Conclusions: The novel CB4 provides both, a high acute efficacy and a high rate of real time electrical PV-recordings, thus facilitating individual ablation strategies based on TTI.
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Affiliation(s)
- Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Laura Warneke
- Department of Cardiology, Asklepios Klinikum Harburg, Hamburg, Germany
| | - Tilman Maurer
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Christine Lemes
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | | | - Bruno Reißmann
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Britta Goldmann
- Department of Cardiology, Asklepios Klinikum Harburg, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, Asklepios Klinikum Harburg, Hamburg, Germany
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik St. George, Hamburg, Germany
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Mathew S, Feickert S, Fink T, Rillig A, Reissmann B, Rottner L, Hashiguchi N, Wohlmuth P, Maurer T, Lemes C, Metzner A, Kuck KH, Ouyang F. Epicardial access for VT ablation: analysis of two different puncture techniques, incidence of adhesions and complication management. Clin Res Cardiol 2020; 110:810-821. [PMID: 32719917 PMCID: PMC8166684 DOI: 10.1007/s00392-020-01711-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/10/2020] [Indexed: 12/11/2022]
Abstract
Introduction Pericardial access for ablation of ventricular arrhythmias (VA) can be gained either by an anterior-oriented or inferior-oriented epicardial puncture under fluoroscopical guidance. We retrospectively sought to assess the safety of these two puncture techniques and the incidence of epicardial adhesions and introduce our algorithm for management of pericardial tamponade. Methods and results In 211 patients (61.4 ± 15.6 years, 179 males; 84.8%) 271 epicardial ablation procedures of VA were performed using either an anterior- or inferior-oriented approach for epicardial access. Puncture-related complications were systematically analyzed. Furthermore, the incidence of adhesions was evaluated during first and repeated procedures. A total of 34/271 (12.5%) major complications occurred and 23/271 (8.5%) were directly related to epicardial puncture. The incidence of puncture-related major complications in the anterior and inferior group was 4/82 (4.9%) and 19/189 (10.1%), respectively. Pericardial tamponade was the most common major complication (15/271; 5.5%). Collateral damages of adjacent structures such as liver, colon, gastric vessels and coronary arteries occurred in 6/189 (3.2%) patients and only within the inferior epicardial access group. Adhesions were documented in 19/211 (9%) patients during the first procedure and in 47.1% if patients had 2 or more procedures involving epicardial access. Conclusion Anterior-oriented epicardial puncture shows an observed association to a reduced incidence of pericardial tamponades and overall puncture-related complications in epicardial ablation of VA. In cases of repeated epicardial access adhesions increase significantly and may lead to ablation failure.
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Affiliation(s)
- Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
- Department of Cardiology, University Hospital of Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
| | | | - Thomas Fink
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- University Heart Center Lübeck, Medical Clinic II, University Hospital Schleswig Holstein, Lübeck, Germany
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- University Heart Center Hamburg, Department of Electrophysiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Bruno Reissmann
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- University Heart Center Hamburg, Department of Electrophysiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Laura Rottner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- University Heart Center Hamburg, Department of Electrophysiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | | | | | - Tilman Maurer
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Christine Lemes
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- University Heart Center Hamburg, Department of Electrophysiology, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
- Fuwai Hospital/National Centers of Cardiovascular Diseases, The Chinese Academy of Medical Sciences and National Center of Cardiovascular Diseases, Beijing, China
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Schenker N, Hashiguchi N, Maurer T, Lemes C, Rottner L, Reissmann B, Rillig A, Kuck KH, Ouyang F, Mathew S. P1361Impact of radiation/chemotherapy for breast cancer on the electroanatomic features in patients receiving catheter ablation for left atrial arrhythmia. Europace 2020. [DOI: 10.1093/europace/euaa162.177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a common cardiac arrhythmia and catheter ablation a viable treatment option for patients with AF. Extensive left atrial (LA) scars, frequently seen in patients with persistent AF, can limit its efficacy. Radiation for breast cancer treatment is known to have serious long-term effects (e.g. fibrosis) on the targeted tissue. At the same time, chemotherapy often leads to organ dysfunction. We sought to examine the effects of radiation and chemotherapy on the electroanatomic features of the LA in patients who received catheter ablation for left atrial arrhythmias with prior breast cancer treatment.
Methods and Results
We compared 38 patients (mean age 68.4 ± 7.1 years) who underwent catheter ablation for LA arrhythmia and had a previous diagnosis of breast cancer with 38 patients (mean age 65.4 ± 7.3 years) without breast cancer who formed our control group. LA scar area, as well as its distribution was measured during the electrophysiology (EP) study and graded according to the Utah classification.
The existence of LA scarring did not differ significantly between both groups (71.1% vs. 76.3%, p = 0.602). LA scar area (excluding PVs) was 107.5cm2 ± 19.0cm2 in the breast cancer group compared to 110.1cm2 ± 18.5cm2 in the control group (p = 0.536). The distribution of the scar area revealed no significant difference between both groups, however an involvement of the anterior wall was common (65.8% vs. 73.7%; p = 0.454). We further investigated whether the location of breast cancer had an impact on the LA scar development of the patients in our study cohort. Here, we found no significant difference in the amount of LA scarring when comparing patients with left-sided breast cancer to patients with right-sided breast cancer (66.7% vs. 73.9%). In a sub-analysis patients with breast cancer and persistent AF showed a non-significant trend towards greater LA scar areas (17.4cm2 vs. 6.8cm2) in comparison to patients of the control group with similar LA volumes.
The patient’s age (>65 years) was the only independent predictor for greater LA scarring we could identify. Neither former radiotherapy, nor chemotherapy showed a positive correlation with greater LA scarring.
Conclusion
There is no change in the distribution as well as an increase of the extent of LA scars after thoracic irradiation and/or chemotherapy. A trend towards greater LA scar areas was seen in patients with breast cancer and persistent AF. The patient’s age was identified as an independent predictor for LA scar development.
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Affiliation(s)
- N Schenker
- Asklepios Clinic St. Georg, Hamburg, Germany
| | | | - T Maurer
- Asklepios Clinic St. Georg, Hamburg, Germany
| | - C Lemes
- Asklepios Clinic St. Georg, Hamburg, Germany
| | - L Rottner
- University Heart Center Hamburg, Hamburg, Germany
| | - B Reissmann
- University Heart Center Hamburg, Hamburg, Germany
| | - A Rillig
- University Heart Center Hamburg, Hamburg, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Hamburg, Germany
| | - F Ouyang
- Fuwai Hospital, CAMS and PUMC, Beijing, China
| | - S Mathew
- Justus-Liebig University of Giessen, Giessen, Germany
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Inaba O, Metzner A, Rottner L, Mathew S, Lemes C, Maurer T, Heeger C, John A, Hashiguchi N, Wohlmuth P, Ouyang F, Kuck K, Rillig A, Reissmann B. Radiofrequency or cryoballoon ablation for index pulmonary vein isolation: What is the impact on long‐term clinical outcomes after repeat ablation? J Cardiovasc Electrophysiol 2020; 31:1068-1074. [DOI: 10.1111/jce.14432] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Osamu Inaba
- Department of CardiologySaitama Red Cross Hospital Saitama Japan
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Andreas Metzner
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
- Department of CardiologyUniversity Heart Center Hamburg Hamburg Germany
| | - Laura Rottner
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
- Department of CardiologyUniversity Heart Center Hamburg Hamburg Germany
| | - Shibu Mathew
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Christine Lemes
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Tilman Maurer
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Christian Heeger
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
- University Heart Centre Lübeck Germany
| | - Alexander John
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | | | | | - Feifan Ouyang
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Karl‐Heinz Kuck
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
| | - Andreas Rillig
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
- Department of CardiologyUniversity Heart Center Hamburg Hamburg Germany
| | - Bruno Reissmann
- Department of CardiologyAsklepios Klinik St. Georg Hamburg Germany
- Department of CardiologyUniversity Heart Center Hamburg Hamburg Germany
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Santoro F, Rillig A, Sohns C, Pott A, Brunetti ND, Reissmann B, Lemeš C, Maurer T, Fink T, Hashiguchi N, Sano M, Mathew S, Dahme T, Ouyang F, Kuck KH, Tilz RR, Metzner A, Heeger CH. Second-Generation Cryoballoon Atrial Fibrillation Ablation in Patients With Persistent Left Superior Caval Vein. JACC Clin Electrophysiol 2019; 5:590-598. [DOI: 10.1016/j.jacep.2019.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 11/24/2022]
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Maruyama M, Kurita T, Kotake Y, Hashiguchi N, Yasuoka R, Ueno M, Iwanaga Y, Miyazaki S. Early transient recurrence of ventricular fibrillation after catheter ablation of premature ventricular contraction from Purkinje fibers in two patients with myocardial infarction. J Cardiol Cases 2018; 19:66-69. [PMID: 31193704 DOI: 10.1016/j.jccase.2018.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/11/2018] [Accepted: 10/22/2018] [Indexed: 01/08/2023] Open
Abstract
Catheter ablation (CA) targeting premature ventricular contraction (PVC) from Purkinje fibers can be an effective therapy for refractory ventricular fibrillation (VF) after myocardial infarction (MI). We experienced two cases in which catheter ablation targeting PVC initiating VF after percutaneous coronary intervention (PCI) in post-MI patients was effective despite transient early recurrences of VF. The first patient (a 68-year-old woman with MI) developed drug-refractory VF 3 days after PCI to the left anterior descending artery (LAD) and left circumflex artery. CA targeting Purkinje potential preceding PVC at the infarcted area eliminated both the PVCs and VF. Three days after the procedure, the VF attacks relapsed by a different type of PVC. However, the VF responded to conventional treatments and disappeared thereafter. In the second patient (an 83-year-old woman with old MI), refractory VF attacks occurred after PCI to the LAD. CA targeting Purkinje potential preceding two distinct types of PVC successfully suppressed the VF. Although the VF relapsed 2 days after CA, it was suppressed by conventional treatment and disappeared the next day. <Learning objective: We report two patients with MI in whom VF attacks were treated by CA targeting triggering PVCs, and these completely disappeared after the process of transient early VF recurrences. Two cases demonstrate that additional CA may not always be necessary even if VF has relapsed within several days after PVC elimination. When recurrences of VF attacks after the first CA are not so frequent, we will be able to observe patient for several days without performing additional CA.>.
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Affiliation(s)
- Masahiro Maruyama
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Takashi Kurita
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Yasuhito Kotake
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Naotaka Hashiguchi
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Ryobun Yasuoka
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Masafumi Ueno
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Yoshitaka Iwanaga
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Shunichi Miyazaki
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University, Osaka, Japan
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Santoro F, Metzner A, Scholz L, Brunetti ND, Heeger CH, Rillig A, Reissmann B, Lemeš C, Maurer T, Fink T, Inaba O, Hashiguchi N, Kuck KH, Ouyang F, Mathew S. Prognostic significance of ventricular tachycardia clustering after catheter ablation in non-ischemic dilated cardiomyopathy. Clin Res Cardiol 2018; 108:539-548. [PMID: 30350253 DOI: 10.1007/s00392-018-1384-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Ventricular tachycardia clustering (VTc) is associated with a worse clinical outcome in patients with non-ischemic dilated cardiomyopathy (NI-DCM) and implantable cardioverter defibrillator (ICD); however, its role after catheter ablation (CA) has still not been investigated. Aim of this study was to evaluate the prognostic significance of VTc after CA. METHODS 96 consecutive patients (59 ± 13 years, 82% males) with NI-DCM underwent CA for drug-refractory VT. After CA, patients with VT recurrence were divided into two groups: (1) patients that presented with VTc defined as the occurrence of three or more appropriate ICD interventions within 2 weeks, and (2) patients without VTc. RESULTS At 56-months follow-up after ablation 52/96 (54%) patients had recurrent VT, 28/52 (54%) patients experienced VTc and 24/52 (46%) no VTc. When comparing patients with VTc after CA with those without, no differences in terms of age, sex, ejection fraction and cardiovascular risk factors were found. However, patients with VTc showed higher mortality rates at follow-up (54% vs 21% p = 0.04; log-rank p ≤ 0.01). No survival differences were found between patients without VT recurrence and those with VT recurrence but without VTc (29% vs 21% p = 0.77). Predictors of VTc were LVEF < 30% at follow-up and endo-epicardial scar at 3D voltage mapping. At stepwise multivariate analysis VTc and NHYA class were the only independent predictors of death (respectively, RR 3.4, CI 95% 1.16-10.3, p = 0.02; RR 4.18, CI 95% 1.3-12.6, p = 0.01). CONCLUSIONS VTc after CA is an independent predictor of survival and is associated with reduced LVEF at follow-up and endo-epicardial scar at 3D voltage mapping.
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Affiliation(s)
- Francesco Santoro
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany. .,Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Andreas Metzner
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Leonie Scholz
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | | | - Christian-H Heeger
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany.,University Heart Center Lübeck, Lübeck, Germany
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Bruno Reissmann
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Christine Lemeš
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Tilmann Maurer
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Thomas Fink
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Osamu Inaba
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Naotaka Hashiguchi
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
| | - Shibu Mathew
- Department of Cardiology, Asklepios Klinik, St Georg, Lohmühlenstraße 5, 20099, Hamburg, Germany
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Heeger CH, Schuette C, Seitelberger V, Wissner E, Rillig A, Mathew S, Reissmann B, Lemes C, Maurer T, Fink T, Inaba O, Hashiguchi N, Santoro F, Ouyang F, Kuck KH, Metzner A. Time-to-effect guided pulmonary vein isolation utilizing the third-generation versus second generation cryoballoon: One year clinical success. Cardiol J 2018; 26:368-374. [PMID: 29924380 DOI: 10.5603/cj.a2018.0056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 02/13/2018] [Revised: 06/05/2018] [Accepted: 04/02/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The second-generation cryoballoon (CB2) provides effective and durable pulmonary vein isolation (PVI) associated with encouraging and reproducible clinical outcome data. The latest- -generation cryoballoon (CB3) incorporates a 40% shorter distal tip, thus allowing for an increased rate of PVI real-time signal recording and facilitating individualized ablation strategies taking the time-to- -effect (TTE) into account. However, whether this characteristic translates into favorable clinical success has not been evaluated yet. Herein was investigated 1-year clinical success after CB3 in comparison to CB2 based-PVI. METHODS One hundred and ten consecutive patients with paroxysmal or short-standing persistent atrial fibrillation (AF) underwent CB2 (n = 55 patients) -or CB3 (n = 55 patients) -based PVI. The freeze-cycle duration was set to TTE + 120 s if TTE could be recorded, otherwise a fixed freeze-cycle duration of 180 s was applied. RESULTS A total of 217/218 (99%, CB3) and 217/217 (100%, CB2) pulmonary veins (PV) were successfully isolated. The real-time PVI visualization rate was 69.2% (CB3) and 54.8% (CB2; p = 0.0392). The mean freeze-cycle duration was 194 ± 77 s (CB3) and 206 ± 85 s (CB2; p = 0.132), respectively. During a median follow-up of 409 days (interquartile range [IQR] 378-421, CB3) and 432 days (IQR 394-455, CB2) 73.6% (CB3) and 73.1% of patients (CB2) remained in stable sinus rhythm after a single procedure (p = 0.806). CONCLUSIONS A higher rate of real-time electrical PV recordings was seen using the CB3 as compared to CB2. There was no difference in 1-year clinical follow-up.
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Affiliation(s)
- Christian-Hendrik Heeger
- University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), Sektion Elektropjysiologie, University Hospital Schleswig-Holstein, Germany. .,Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany. .,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Berlin, Germany.
| | | | | | - Erik Wissner
- Division of Cardiology, University of Illinois at Chicago, United States
| | - Andreas Rillig
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department of Cardiology-Electrophysiology, University Hospital Hamburg, University Heart Center Hamburg, Hamburg, Germany
| | - Shibu Mathew
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Bruno Reissmann
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Christine Lemes
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Tilman Maurer
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Thomas Fink
- University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), Sektion Elektropjysiologie, University Hospital Schleswig-Holstein, Germany.,Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Berlin, Germany
| | - Osamu Inaba
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | | | - Francesco Santoro
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Feifan Ouyang
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Fuwai Hospital / National Center of Cardiovascular Diseases, Beijing, China
| | - Karl-Heinz Kuck
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Andreas Metzner
- Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.,Department of Cardiology-Electrophysiology, University Hospital Hamburg, University Heart Center Hamburg, Hamburg, Germany
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Moriyama N, Sawatari H, Chishaki A, Rahmawati A, Nishizaka M, Hashiguchi N, Kuroda H, Ando S. 0772 Age And Sex Impact On Symptoms Of Sleep-disordered Breathing In People With Down Syndrome -a Nation-wide Study In Japan-. Sleep 2018. [DOI: 10.1093/sleep/zsy061.771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Moriyama
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Sawatari
- Department of Health Care for Adults, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, JAPAN
| | - A Chishaki
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - A Rahmawati
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - M Nishizaka
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Fufuoka, JAPAN
- Department of Cardiovascular Medicine, Kimura Hospital, Fukuoka, JAPAN
| | - N Hashiguchi
- Kyushu University Graduate School of Medical Sciences, Fukuoka, JAPAN
| | - H Kuroda
- Faculty of Fundamentals of Nursing, Japanese Red Cross Kyushu International College of Nursing, Fukuoka, JAPAN
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, JAPAN
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12
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Kajiyama T, Ueda M, Ishimura M, Hashiguchi N, Nakano M, Kondo Y, Kobayashi Y. A novel technique for ligation of the cephalic vein reduces hemorrhaging during a two-in-one insertion of dual cardiac device leads. Indian Pacing Electrophysiol J 2018; 18:152-154. [PMID: 29660446 PMCID: PMC6090004 DOI: 10.1016/j.ipej.2018.04.002] [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: 02/20/2018] [Revised: 03/23/2018] [Accepted: 04/12/2018] [Indexed: 11/06/2022] Open
Abstract
The cutdown technique for the cephalic vein is a common access route for transvenous cardiac device leads (TVLs), and sometimes one cephalic vein can accomodate two TVLs. We examined a novel ligation technique to balance the hemostasis and lead maneuverability for this two-in-one insertion. A total of 22 patients scheduled for cardiac device implantations with two or more leads were enrolled. The ipsilateral cephalic vein was identified for inserting the TVLs with a cutdown. If two TVLs could be introduced into one cephalic vein, hemostasis was established by ligating the venous wall between the TVLs. We measured the amount of hemorrhaging per minute and the operators assessed the lead maneuverability before and after the ligation. We successfully implanted cardiac devices in 15 patients (68%) with this novel method, whereas only one TVL could be introduced via the cephalic vein in 7 patients. As for the successful patients, hemorrhaging from the gap was significantly reduced (5.6 ± 7.3 to 0.41 ± 0.36g/min, p = 0.016) after the novel ligation. The lead maneuverability was well maintained so there was no difficulty placing the leads into the cardiac chambers in all cases. No major complications were observed. In the present study, the novel ligation method provided significant hemostasis as well as a preserved maneuverability. It could be an optional choice for insertion of multiple TVLs.
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Affiliation(s)
- Takatsugu Kajiyama
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan.
| | - Marehiko Ueda
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Masayuki Ishimura
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Naotaka Hashiguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Masahiro Nakano
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
| | - Yusuke Kondo
- Department of Advanced Cardiovascular Therapeutics, Chiba University Graduate School of Medicine, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Japan
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13
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Kuroda H, Sawatari H, Ando S, Ohkusa T, Rahmawati A, Ono J, Nishizaka M, Hashiguchi N, Matsuoka F, Chishaki A. A nationwide, cross-sectional survey on unusual sleep postures and sleep-disordered breathing-related symptoms in people with Down syndrome. J Intellect Disabil Res 2017; 61:656-667. [PMID: 28378398 DOI: 10.1111/jir.12379] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 01/04/2017] [Accepted: 03/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with Down syndrome (DS) often have sleep-disordered breathing (SDB). Unusual sleep postures, such as leaning forward and sitting, are observed in people with DS. This study aimed to clarify the prevalence of unusual sleep postures and their relationships with SDB-related symptoms (SDB-RSs), such as snoring, witnessed apnoea, nocturnal awakening and excessive daytime sleepiness. METHODS A questionnaire, including demographic characteristics and the presence of unusual sleep postures, as well as SDB-RSs, was completed by 1149 parents of people with DS from Japan. RESULTS Unusual sleep postures were recorded in 483 (42.0%) people with DS. These participants were significantly younger and had a history of low muscle tone more frequently than people without unusual sleep postures. In all ages, the leaning forward posture was more frequent than sitting. People with DS with unusual sleep postures suffered from SDB-RSs. Those who slept in the sitting posture had more frequent SDB-RSs than did those who slept with the leaning forward posture. Snoring, witnessed apnoea and nocturnal awakening were observed in 73.6, 27.2 and 58.2% of participants, respectively. Snoring increased with aging. Witnessed apnoea was more common in males and in those with hypothyroidism than in females and in those without hypothyroidism. CONCLUSIONS Our study shows that there is a close relationship between unusual sleep postures and SDB-RSs. We recommend that all people with DS with unusual sleep postures should be checked for the presence of SDB.
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Affiliation(s)
- H Kuroda
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - H Sawatari
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - S Ando
- Sleep Apnea Center, Kyushu University Hospital, Fukuoka, Japan
| | - T Ohkusa
- Faculty of Health Sciences, Ube Frontier University, Ube, Japan
| | - A Rahmawati
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - J Ono
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - M Nishizaka
- Kirameki Projects Career Support Center, Kyushu University Hospital, Fukuoka, Japan
| | - N Hashiguchi
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - F Matsuoka
- Department of Medicine, Kyushu University School of Medicine, Fukuoka, Japan
| | - A Chishaki
- Department of Health Sciences, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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Hashiguchi N, Kurita T, Miyazaki S. Catheter ablation for atrial fibrillation in a patient with unilateral left pulmonary artery agenesis: an enlarged right pulmonary vein caused arrhythmogenicity of atrial fibrillation. Europace 2017; 19:733. [PMID: 27733460 DOI: 10.1093/europace/euw188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yasuoka R, Kurita T, Kotake Y, Hashiguchi N, Motoki K, Kobuke K, Iwanaga Y, Miyazaki S. Particular Morphology of Inferior Pulmonary Veins and Difficulty of Cryoballoon Ablation in Patients With Paroxysmal Atrial Fibrillation. Circ J 2017; 81:668-674. [DOI: 10.1253/circj.cj-16-1161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ryobun Yasuoka
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Takashi Kurita
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Yasuhito Kotake
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Naotaka Hashiguchi
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Koichiro Motoki
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Kazuhiro Kobuke
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Yoshitaka Iwanaga
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
| | - Shunichi Miyazaki
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Kindai University
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Yasuoka R, Kurita T, Kotake Y, Hashiguchi N, Motoki K, Miyazaki S. Cardiac memory-induced T wave change during complete atrioventricular block in a patient with inferior acute myocardial infarction. J Cardiol Cases 2016; 14:133-135. [DOI: 10.1016/j.jccase.2016.06.008] [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] [Received: 05/25/2016] [Revised: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 11/15/2022] Open
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17
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Yabuuchi H, Murayama S, Murakami J, Sakai S, Hashiguchi N, Soeda H, Masuda K. Correlation of immunologic status with high-resolution CT and distributions of pulmonary tuberculosis. Acta Radiol 2016; 43:44-7. [PMID: 11972461 DOI: 10.1080/028418502127347637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate the correlation of cluster of differentiation (CD)4 lymphocyte counts with high-resolution CT (HRCT) findings and distribution of pulmonary tuberculosis. Material and Methods: Thirty-seven bacteriologically proven pulmonary tuberculosis, clinically non-AIDS, patients underwent HRCT and CD4 lymphocyte counts in peripheral blood cells were obtained within 3 days after the CT examinations. Patients were categorized into four groups according to CD4 lymphocyte counts (A >800; B 800-500; C 500-200; D <200). HRCT findings analyzed were as follows: typical, atypical, and mixed findings of post-primary tuberculosis, common, uncommon, and mixed distribution, and number of lobes involved. Results: CD4 lymphocyte counts correlated with the degree of the mixture of atypical CT findings (ρ=0.565, p<0.001) and the degree of the mixture of uncommon distribution (ρ=0.431, p<0.01). Number of involved lobes showed no statistically significant correlation (ρ=0.209, p=0.21). Conclusion: In patients with low CD4 levels, atypical HRCT findings co-exist with typical findings, and uncommon sites are involved in addition to common sites.
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Affiliation(s)
- Hidetaki Yabuuchi
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Notame 3-1-1, Minami-ku, Fukuoka 811-1395, Japan
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Magota C, Ando S, Nishizaka M, Horikoshi K, Tanaka K, Miyazono M, Hashiguchi N, Ohkusa T, Chishaki A. A study on the meteorological analysis of nocturnal falls during sleep in hospital. Sleep Med 2015. [DOI: 10.1016/j.sleep.2015.02.1413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kanaeda T, Ueda M, Arai M, Ishimura M, Kajiyama T, Hashiguchi N, Nakano M, Kondo Y, Hiranuma Y, Oyamada A, Yokosuka O, Kobayashi Y. Evaluation of periesophageal nerve injury after pulmonary vein isolation using the (13)C-acetate breath test. J Arrhythm 2015; 31:364-70. [PMID: 26702316 PMCID: PMC4672080 DOI: 10.1016/j.joa.2015.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/25/2015] [Accepted: 06/08/2015] [Indexed: 01/30/2023] Open
Abstract
Background Pulmonary vein isolation (PVI) has become an important option for treating patients with atrial fibrillation (AF). Periesophageal nerve (PEN) injury after PVI causes pyloric spasms and gastric hypomotility. This study aimed to clarify the impact of PVI on gastric motility and assess the prevalence of gastric hypomotility after PVI. Methods Thirty consecutive patients with AF underwent PVI under luminal esophageal temperature (LET) monitoring. The 13C-acetate breath test was conducted before and after the procedure for all patients (PVI group). Gastric emptying was evaluated using the time to peak concentration of 13CO2 (Tmax). This test was also conducted in another 20 patients who underwent catheter ablation procedures other than PVI (control group). Results The number of patients with abnormal Tmax (≥75 min) increased from seven (23%) to 13 (43%) and from three (15%) to five (25%) after the procedure in the PVI group and control group, respectively. The mean Tmax was longer after PVI than before PVI (64±14 min vs. 57±15 min, p=0.006), whereas there was no significant difference before and after the procedure in the control group. However, no significant difference in ΔTmax was observed between the two groups (p=0.27). No patients suffered from symptomatic gastric hypomotility. Conclusions Asymptomatic gastric hypomotility occurred more often after PVI. However, the average impact of PVI on gastric motility was minimal.
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Affiliation(s)
- Tomonori Kanaeda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Marehiko Ueda
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Makoto Arai
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masayuki Ishimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takatsugu Kajiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naotaka Hashiguchi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Masahiro Nakano
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yusuke Kondo
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yasunori Hiranuma
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Arata Oyamada
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Osamu Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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Ishimura M, Ueda M, Miyazawa K, Kajiyama T, Hashiguchi N, Nakano M, Kondo Y, Kanaeda T, Hiranuma Y, Kobayashi Y. Unexpected and unmanageable malfunctions of current co-radial pacemaker leads. Europace 2015; 17:166. [DOI: 10.1093/europace/euu187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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21
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Nakano M, Ueda M, Ishimura M, Kajiyama T, Hashiguchi N, Kanaeda T, Kondo Y, Hiranuma Y, Kobayashi Y. Estimation of the origin of ventricular outflow tract arrhythmia using synthesized right-sided chest leads. Europace 2013; 16:1373-8. [PMID: 24284987 DOI: 10.1093/europace/eut355] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS For successful ablation of ventricular outflow tract arrhythmia, estimation of its origin prior to the procedure can be useful. Morphology and lead placement in the right thoracic area may be useful for this purpose. Electrocardiography using synthesized right-sided chest leads (Syn-V3R, Syn-V4R, and Syn-V5R) is performed using standard leads without any additional leads. This study evaluated the usefulness of synthesized right-sided chest leads in estimating the origin of ventricular outflow tract arrhythmia. METHODS AND RESULTS This retrospective study included 63 patients in whom successful ablation of ventricular outflow tract arrhythmia was performed. Numbers of arrhythmias originating from the left ventricle, the septum of the right ventricle, and the free wall of the right ventricle were 11, 40, and 13, respectively. In one patient, two different left ventricular outflow tract origins were found. Electrocardiographic recordings from right-sided chest leads were divided into three types as follows: those in which an R > S concordance, a transitional zone, or an R < S concordance were detected. In all left arrhythmia cases, R > S concordance was observed. A transitional zone was evident in 34 of 40 cases of right ventricular outflow tract arrhythmia originating in the ventricular septum, and an R < S concordance was observed in 6 of the 40 cases. However, an R < S concordance was found in all cases of right ventricular outflow tract arrhythmia originating in the free wall. CONCLUSION Synthesized right-sided chest lead electrocardiography may be useful for estimating the origin of ventricular outflow tract arrhythmia.
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Affiliation(s)
- Masahiro Nakano
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Marehiko Ueda
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Masayuki Ishimura
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Takatsugu Kajiyama
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Naotaka Hashiguchi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Tomonori Kanaeda
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Yusuke Kondo
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Yasunori Hiranuma
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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Hashiguchi N, Takeda A, Yasuyama Y, Chishaki A, Tochihara Y. Effects of 6-h exposure to low relative humidity and low air pressure on body fluid loss and blood viscosity. Indoor Air 2013; 23:430-436. [PMID: 23464811 DOI: 10.1111/ina.12039] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 02/21/2013] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to investigate the effects of 6-h exposure to low relative humidity (RH) and low air pressure in a simulated air cabin environment on body fluid loss (BFL) and blood viscosity. Fourteen young healthy male subjects were exposed to four conditions, which combined RH (10% RH or 60% RH) and air pressure (NP: sea level or LP: equivalent to an altitude of 2000 m). Subjects remained seated on a chair in the chamber for 6 h. Their diet and water intake were restricted before and during the experiment. Insensible water loss (IWL) in LP10% condition was significantly greater than in NP60% condition; thus, combined 10%RH and LP conditions promoted a greater amount of IWL. The BFL under the LP condition was significantly greater than that under the NP condition. Blood viscosity significantly increased under LP conditions. Increases in red blood cell counts (RBCs) and BFL likely contributed to the increased blood viscosity. These findings suggest that hypobaric-induced hypoxia, similar to the conditions in the air cabin environment, may cause increased blood viscosity and that the combined low humidity and hypobaric hypoxia conditions increase IWL.
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Affiliation(s)
- N Hashiguchi
- Department of Health Science, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Kondo Y, Ueda M, Watanabe M, Kajiyama T, Hashiguchi N, Kanaeda T, Nakano M, Ishizaka T, Matsumiya G, Kobayashi Y. Identification of left atrium ganglionated plexi by dense epicardial mapping as ablation targets for the treatment of concomitant atrial fibrillation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kondo Y, Ueda M, Kajiyama T, Hashiguchi N, Kanaeda T, Nakano M, Sato Y, Inagaki M, Kurita T, Kobayashi Y. The factors affecting psychological quality of life of implantable cardioverter-defibrillator patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sawatari H, Chishaki A, Nishizaka M, Matsuoka F, Kuroda H, Hashiguchi N, Anita R, Ono J, Miyazono M, Ando S. Cross-sectional general survey on the relationship between congenital heart diseases and sleep disordered breathing in patients with Down syndrome. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p2138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kondo Y, Ueda M, Watanabe M, Ishimura M, Kajiyama T, Hashiguchi N, Kanaeda T, Nakano M, Hiranuma Y, Ishizaka T, Matsumiya G, Kobayashi Y. Identification of left atrial ganglionated plexi by dense epicardial mapping as ablation targets for the treatment of concomitant atrial fibrillation. Pacing Clin Electrophysiol 2013; 36:1336-41. [PMID: 23742214 PMCID: PMC4285812 DOI: 10.1111/pace.12169] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/06/2013] [Accepted: 03/17/2013] [Indexed: 11/29/2022]
Abstract
Background Autonomic ganglionated plexi (GPs) play a significant role in the initiation and maintenance of atrial fibrillation (AF). GPs are key targets for a maze procedure. The purpose of this study was to identify the location of the left atrial GPs based on dense epicardial mapping during a maze procedure in patients with concomitant AF. Methods Sixteen patients (age, 68 ± 10 years; 11 males, 69%) with heart failure and concomitant AF (duration 55 ± 86 months) underwent intraoperative epicardial electrophysiological mapping and a GP ablation using the maze procedure at our institution. Twenty-four-site, high-frequency stimulation (1,000/min; output, 18 V; pulse width, 0.75 ms) was performed by placing tweezers directly onto the potential GP sites on the left atrial epicardium. Results Active GPs were found in 13 (81%) of the 16 patients, and 12 (92%) of 13 patients had active GPs between the right pulmonary veins (PVs) and the interatrial groove. For those patients with active locations, a 7-day event-loop recording demonstrated that 12 (92%) of 13 patients were maintained in sinus rhythm 3 months after the operation. Conclusion Dense epicardial mapping in the potential GP areas identified active GP locations in a high percentage of patients. GPs between the PVs and interatrial groove have a high potential as ablation targets for treatment of concomitant AF.
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Murata S, Hashiguchi N, Shimizu M, Endo A, Omura N, Morita E. Skin disorders and the role of dermatologists after the tsunami in Japan. J Eur Acad Dermatol Venereol 2011; 26:923-4. [PMID: 21711469 DOI: 10.1111/j.1468-3083.2011.04168.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Hiranuma Y, Ueda M, Kajiyama T, Hashiguchi N, Kanaeda T, Kondo Y, Nakano M, Kobayashi Y. Neurally Mediated Syncope in a Patient with Long QT Syndrome. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj2_101] [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: 11/11/2022] Open
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Hiranuma Y, Ueda M, Kajiyama T, Hashiguchi N, Kanaeda T, Kondo Y, Nakano M, Kobayashi Y. P-Wave Dispersion in Synthesized 18-Lead ECG of Paroxysmal Atrial Fibrillation Patients. J Arrhythm 2011. [DOI: 10.4020/jhrs.27.pj3_037] [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: 11/11/2022] Open
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Hashiguchi N, Ogura H, Tanaka H, Koh T, Nakamori Y, Noborio M, Shiozaki T, Nishino M, Kuwagata Y, Shimazu T, Sugimoto H. Enhanced expression of heat shock proteins in activated polymorphonuclear leukocytes in patients with sepsis. J Trauma 2001; 51:1104-9. [PMID: 11740261 DOI: 10.1097/00005373-200112000-00015] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Heat shock proteins (HSPs) in cells, as molecular chaperons, have been reported to regulate cell functions. The objective of this study was to investigate the HSP expression in polymorphonuclear leukocytes (PMNLs) from severe septic patients and the relation between the expression of HSPs and PMNL function. METHODS In blood samples from 21 patients with sepsis and serum C-reactive protein levels more than 10 mg/dL, we used flow cytometry to measure expressions of HSP27, HSP60, HSP70, and HSP90; oxidative activity; and levels of apoptosis in PMNLs during sepsis. In in vitro studies, we used cells from 14 healthy volunteers to examine the relation between the expression of HSP70 and PMNL function. Quercetin (30 microM), a suppressor of HSP, and sodium arsenite (100 microM), an inducer of HSP, were used to regulate the expression of HSP70 in PMNLs, and oxidative activity and apoptosis in these cells were measured. RESULTS In patients with sepsis, the expressions of HSP27, HSP60, HSP70, and HSP90 and oxidative activity in PMNLs were significantly increased. Apoptosis of these PMNLs was markedly inhibited. In the in vitro studies, administration of sodium arsenite enhanced the expression of HSP70, significantly increased oxidative activity, and inhibited apoptosis. Administration of quercetin before sodium arsenite prevented the expression of HSP70, the increase in oxidative activity, and the inhibition of apoptosis. CONCLUSION Sepsis causes the enhanced expression of HSPs in activated PMNLs. In PMNLs with enhanced expression of HSP70, oxidative activity is increased and apoptosis is inhibited. The enhanced expression of HSPs may play a role in regulating PMNL function in patients with sepsis.
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Affiliation(s)
- N Hashiguchi
- Department of Traumatology, Osaka University Medical School, Suita-shi, Osaka, Japan.
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Osumi T, Imamura A, Tsukamoto T, Fujiwara C, Hashiguchi N, Shimozawa N, Suzuki Y, Kondo N. Temperature sensitivity in peroxisome assembly processes characterizes milder forms of peroxisome biogenesis disorders. Cell Biochem Biophys 2001; 32 Spring:165-70. [PMID: 11330043 DOI: 10.1385/cbb:32:1-3:165] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Peroxisome biogenesis disorders (PBDs) contain various clinical phenotypes; Zellweger syndrome (ZS), neonatal adrenoleukodystrophy (NALD), and infantile Refsum disease (IRD), decreasing in the clinical severity in this order. We found that all IRD cell lines and some NALD lines belonging to several different complementation groups are temperature-sensitive in peroxisome assembly; that is, they lacked catalase-positive peroxisomes at 37 degrees C, but do gain the peroxisomes at 30 degrees C. We identified heterozygous mutations E55K/R119Stop in the PEX2 gene of an IRD patient of complementation group F. The E55K mutation was the direct cause of the temperature-sensitivity because similar phenotypes could be transferred to PEX2-defective CHO cells by transfecting the mutant gene. Thus, temperature-sensitive peroxisome assembly is representative of milder forms of PBDs.
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Affiliation(s)
- T Osumi
- Department of Life Science, Himeji Institute of Technology, Kamigori, Hyogo 678-1297, Japan.
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Shiozaki T, Hayakata T, Taneda M, Nakajima Y, Hashiguchi N, Fujimi S, Nakamori Y, Tanaka H, Shimazu T, Sugimoto H. A multicenter prospective randomized controlled trial of the efficacy of mild hypothermia for severely head injured patients with low intracranial pressure. Mild Hypothermia Study Group in Japan. J Neurosurg 2001; 94:50-4. [PMID: 11147897 DOI: 10.3171/jns.2001.94.1.0050] [Citation(s) in RCA: 165] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECT The criteria for the use of mild hypothermia (34 degrees C) in severely head injured patients have not been standardized. A prospective randomized controlled trial was conducted to determine whether mild hypothermia is essential in the treatment of severely head injured patients with low intracranial pressure (ICP). METHODS At 11 medical centers, 91 severely head injured patients with an admission Glasgow Coma Scale score of 8 or less in whom ICP could be maintained below 25 mm Hg by conventional therapies were divided randomly into two groups: the mild hypothermia group (HT group, 45 patients) and the normothermia group (NT group, 46 patients). Patients in the HT group were exposed to mild hypothermia (34 degrees C) for 48 hours, followed by rewarming at 1 degrees C per day for 3 days, whereas patients in the NT group were exposed to normothermia (37 degrees C) for 5 days. The two groups were similar with respect to prognostic factors, and there was no difference in clinical outcome at 3 months postinjury. During treatment, there was a significantly greater use of neuromuscular blocking agents in the HT group (p = 0.011). During the initial 2 weeks postinjury, the incidences of pneumonia, meningitis, leukocytopenia, thrombocytopenia, hypernatremia, hypokalemia, and hyperamylasemia were significantly higher in the HT than in the NT group (p < 0.05). CONCLUSIONS Mild hypothermia should not be used for the treatment of severely head injured patients with low ICP because this therapy conveys no advantage over normothermia in such patients.
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Affiliation(s)
- T Shiozaki
- Department of Traumatology, Osaka University Medical School, Kinki University School of Medicine, Japan.
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Hashiguchi N, Ogura H, Tanaka H, Koh T, Aoki M, Shiozaki T, Matsuoka T, Shimazu T, Sugimoto H. Enhanced expression of heat shock proteins in leukocytes from trauma patients. J Trauma 2001; 50:102-7. [PMID: 11231678 DOI: 10.1097/00005373-200101000-00018] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Heat shock proteins (HSPs) play essential roles as molecular chaperones in cells to assist in the repair of degenerated proteins. The expression of HSPs in polymorphonuclear leukocytes (PMNLs) following insult has not been delineated. The objective of this study was to clarify the serial changes in HSP expression in PMNLs from trauma patients. METHODS Fifty severely injured patients (mean Injury Severity Score of 31.8 +/- 10.8) and 17 healthy volunteers were included as study subjects. Blood samples were serially obtained at three time points: days 0 to 1, days 2 to 5, and days 6 to 14 after the trauma event. We measured expressions of HSP27, HSP60, HSP70, and HSP90 in permeabilized PMNLs by flow cytometry using a monoclonal antibody generated against each HSP and fluorescein isothiocyanate-conjugated antimouse immunoglobulins as secondary reagents. We also evaluated the expression of HSP70 mRNA in PMNLs by Northern blot hybridization and the expression of HSP70 in PMNLs by fluorescence microscopy. RESULTS Expressions of HSP27, HSP70, and HSP90 in PMNLs from trauma patients were significantly greater than in PMNLs from healthy volunteers in all three periods (days 0-1, days 2-5, and days 6-14). The expression of HSP60 in PMNLs from trauma patients was significantly greater than normal expression on days 2 to 5 and days 6 to 14. The values for HSP27, HSP60, and HSP70 on days 2 to 5 were significantly higher than those on days 0 to 1. The expression of HSP70 mRNA in PMNLs was significantly enhanced for as long as 2 weeks after trauma compared with that in normal volunteers. CONCLUSION Severe trauma causes demonstrated enhanced expression of HSPs in PMNLs during the acute phase. This enhanced expression of HSPs may regulate PMNL functions.
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Affiliation(s)
- N Hashiguchi
- Department of Traumatology, Osaka University Medical School, 2-15 Yamadaoka, Suita-shi, Osaka 565-0871, Japan. hashi!hp-emerg.med.osaka-u.ac.jp
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Abstract
Chromatin structure is thought to play a critical role in gene expression. Using the lac operator/repressor system and two colour variants of green fluorescent protein (GFP), we developed a system to visualize a gene and its protein product directly in living cells, allowing us to examine the spatial organization and timing of gene expression in vivo. Dynamic morphological changes in chromatin structure, from a condensed to an open structure, were observed upon gene activation, and targeting of the gene product, cyan fluorescent protein (CFP) reporter to peroxisomes was visualized directly in living cells. We found that the integrated gene locus was surrounded by a promyelocytic leukaemia (PML) nuclear body. The association was transcription independent but was dependent upon the direct in vivo binding of specific proteins (EYFP/lac repressor, tetracycline receptor/VP16 transactivator) to the locus. The ability to visualize gene expression directly in living cells provides a powerful system with which to study the dynamics of nuclear events such as transcription, RNA processing and DNA repair.
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Affiliation(s)
- T Tsukamoto
- Cold Spring Harbor Laboratory, One Bungtown Road, Cold Spring Harbor, New York 11724, USA
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Fujiwara C, Imamura A, Hashiguchi N, Shimozawa N, Suzuki Y, Kondo N, Imanaka T, Tsukamoto T, Osumi T. Catalase-less peroxisomes. Implication in the milder forms of peroxisome biogenesis disorder. J Biol Chem 2000; 275:37271-7. [PMID: 10960480 DOI: 10.1074/jbc.m006347200] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We established a Chinese hamster ovary cell line having a temperature-sensitive phenotype in peroxisome biogenesis. This mutant (65TS) was produced by transforming a PEX2-defective mutant, Z65, with a mutant PEX2 gene, PEX2(E55K), derived from a patient with infantile Refsum disease, a milder form of peroxisome biogenesis disorder. In 65TS, catalase was found in the cytosol at a nonpermissive temperature (39 degrees C), but upon the shift to a permissive temperature (33 degrees C), catalase gradually localized to the structures containing a 70-kDa peroxisomal membrane protein, PMP70. In contrast to catalase, other matrix proteins containing typical peroxisome targeting signals, acyl-CoA oxidase and peroxisomal 3-ketoacyl-CoA thiolase, were co-localized with PMP70 in most cells, even at 39 degrees C. We found that these structures are partially functional peroxisomes and named them "catalase-less peroxisomes." Catalase-less peroxisomes were also observed in human fibroblasts from patients with milder forms of peroxisome biogenesis disorder, including the one from which the mutant PEX2 gene was derived. We suggest that these structures are the causes of the milder phenotypes of the patients. Temperature-dependent restoration of the peroxisomes in 65TS occurred even in the presence of cycloheximide, a protein synthesis inhibitor. Thus, we conclude that in 65TS, catalase-less peroxisomes are the direct precursors of peroxisomes.
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Affiliation(s)
- C Fujiwara
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, 3-2-1 Koto, Kamigori, Hyogo 678-1297, Japan
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Yabuuchi H, Murayama S, Murakami J, Hashiguchi N, Soeda H, Sugio K, Masuda K. High-resolution CT characteristics of poorly differentiated adenocarcinoma of the peripheral lung: comparison with well differentiated adenocarcinoma. Radiat Med 2000; 18:343-7. [PMID: 11153686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE The purpose of this study was to elucidate the characteristic high-resolution CT (HRCT) findings of poorly differentiated adenocarcinoma (PDA) in comparison with those of well differentiated adenocarcinoma (WDA). MATERIALS AND METHODS We investigated the HRCT features of surgically resected PDAs (n=21) and WDAs (n=31). We analyzed the margin, CT attenuation, and internal architecture of the tumor and findings in the surrounding lung field, comparing them with the corresponding pathologic findings. RESULTS Smoothness of the greater part (full-1/2 round) of the tumor and solid appearance were more prevalent in PDAs than WDAs (81% vs. 32%, 100% vs. 35%) [p<0.01]. Air-bronchogram was prevalent in WDAs (58%), but was never seen in PDAs [p<0.01]. Ground-glass opacity in PDAs pathologically corresponded to inflammation and edema in the alveolar space. CONCLUSIONS Smoothness of the tumor margin and solid appearance without air-bronchogram were more commonly found in PDA than in WDA. HRCT may predict the histological differentiation of adenocarcinoma in selected cases in which differentiation is inconclusive by sputum cytology and transbronchial or CT-guided biopsy.
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Affiliation(s)
- H Yabuuchi
- Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Kuwagata Y, Oda J, Matsuyama S, Nishino M, Hashiguchi N, Ogura H, Tanaka H, Sugimoto H. Interleukin-1beta alters the oxygen delivery-oxygen consumption relationship in rabbits by increasing the slope of the supply-independent line. Shock 2000; 14:193-9. [PMID: 10947166 DOI: 10.1097/00024382-200014020-00020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
When systemic oxygen delivery (DO2) is reduced, oxygen consumption (VO2) is maintained until a critical level is reached (DO2crit). Sepsis is thought to shift DO2crit to the right and lengthen the supply-dependent portion. We tested the effect of interleukin (IL)-1beta, which is one of the key cytokines related to sepsis, on the DO2-VO2 relationship. Fifteen rabbits were subjected to stepwise cardiac tamponade to reduce DO2 to 10% by inflating a handmade balloon placed into the pericardial sac. Seven rabbits were given 10 microg/kg of IL-1beta intravenously (IL-1beta group) prior to the graded cardiac tamponade. The remainder received saline alone (control group). The DO2-VO2 relationship was analyzed by the dual-line method. IL-1beta significantly decreased mean arterial pressure (65 +/- 11 mmHg from baseline 85 +/- 7 mmHg) without altering cardiac output. The IL-1beta group showed significantly steeper supply-independent line slopes than did the control group (0.19 +/- 0.02 vs. 0.11 +/- 0.02, respectively), which resulted in a DO2crit shift to the left (IL-1beta group, 8.7 +/- 1.7 ml/kg x min vs. control, 11.7 +/- 0.7 ml/kg x min). The IL-1beta group also showed greater PO2 and plasma lactate levels in the portal vein than did the control group. These results indicate that IL-1beta impairs systemic oxygen uptake even before VO2 becomes supply-dependent, presumably due to maldistribution of the blood flow including the splanchnic circulation.
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Affiliation(s)
- Y Kuwagata
- Department of Acute Critical Medicine, Osaka University Medical School, Suita, Japan
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Dote T, Kono K, Usuda K, Nishiura H, Tagawa T, Miyata K, Shimahara M, Hashiguchi N, Senda J, Tanaka Y. Toxicokinetics of intravenous fluoride in rats with renal damage caused by high-dose fluoride exposure. Int Arch Occup Environ Health 2000; 73 Suppl:S90-2. [PMID: 10968567 DOI: 10.1007/pl00014633] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Fluoride (F) complexes are used in some fields of industry and medicine. F excretion mainly depends on kidney function. Urinary F concentration is measured to monitor the health of workers exposed to F. The toxicokinetics of F were studied by analyzing plasma concentration of F after intravenous injection of 2.86, 5.71 and 8.57 mg/kg into male Wistar rats. A dose-response relationship was recognized between these F doses and renal tissue injury. Blood samples were removed at 0, 10, 20, and 30 min, and after 1, 2, 3, 4, 5, and 6 h after injection. Plasma concentration-vs-time profiles were evaluated by a nonlinear least-squares method for fitting data to polyexponential equations and calculation of relevant pharmacokinetic parameters. Results indicated that a two-compartment model could describe the elimination of F from plasma. The beta rate constant, total plasma clearance (C1) and first-order rate constants (K21, Kel) decreased, and the half-time of the beta-phase (t1/2beta) was significantly prolonged with increasing dose. The kidney is the main target organ for F toxicity. Acute exposure to high doses of F damages renal tissue and causes renal dysfunction. The C1 of F is mainly dependent on renal F excretion. Since severe kidney damage markedly affected the toxicokinetics of F and decreased its elimination, other nephrotoxic indicators and measurement of plasma F concentration are necessary for monitoring high-dose F exposure.
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Affiliation(s)
- T Dote
- Department of Hygiene and Public Health, Osaka Medical College, Takatsuki City, Japan
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Yamasaki M, Hashiguchi N, Fujiwara C, Imanaka T, Tsukamoto T, Osumi T. Formation of peroxisomes from peroxisomal ghosts in a peroxisome-deficient mammalian cell mutant upon complementation by protein microinjection. J Biol Chem 1999; 274:35293-6. [PMID: 10585391 DOI: 10.1074/jbc.274.50.35293] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Most mammalian cell strains genetically deficient in peroxisome biogenesis have abnormal membrane structures called ghosts, containing integral peroxisomal membrane protein, PMP70, but lacking the peroxisomal matrix proteins. Upon genetic complementation, these mutants regain the ability of peroxisome biogenesis. It is postulated that, in this process, the ghosts act as the precursors of peroxisomes, but there has been no evidence to support this. In the present study, we investigated this issue by protein microinjection to a mutant Chinese hamster ovary cell line defective of PEX5, encoding a peroxisome-targeting signal receptor. When recombinant Pex5p and green fluorescent protein (GFP) carrying a peroxisome-targeting signal were co-injected into the mutant cells, the GFP fluorescence gathered over time to particulate structures where PMP70 was co-localized. This process was dependent on both Pex5p and the targeting signal, and, most importantly, occurred even in the presence of cycloheximide, a protein synthesis inhibitor. These findings suggest that the ghosts act as acceptors of matrix proteins in the peroxisome recovery process at least in the PEX5 mutant, and support the view that peroxisomes can grow by incorporating newly synthesized matrix proteins.
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Affiliation(s)
- M Yamasaki
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, 3-2-1 Koto, Kamigori, Hyogo 678-1297, Japan
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Shiozaki T, Kato A, Taneda M, Hayakata T, Hashiguchi N, Tanaka H, Shimazu T, Sugimoto H. Little benefit from mild hypothermia therapy for severely head injured patients with low intracranial pressure. J Neurosurg 1999; 91:185-91. [PMID: 10433305 DOI: 10.3171/jns.1999.91.2.0185] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT This study was performed to determine whether mild hypothermia therapy is essential for the treatment of severely head injured patients in whom intracranial pressure (ICP) can be maintained below 20 mm Hg by using conventional therapies. METHODS Sixteen consecutive severely head injured patients fulfilled the following criteria: the patient's ICP was maintained below 20 mm Hg by using fluid restriction, hyperventilation, and high-dose barbiturate therapy; and the patient had a Glasgow Coma Scale score of 8 or less on admission. After conventional therapies had been applied, the patients were divided randomly into two groups: the mild hypothermia group (HT group; eight patients) and the normothermia group (NT group; eight patients). The HT group received mild hypothermia (intracranial temperature 34 degrees C) therapy for 48 hours followed by rewarming at 1 degree C per day for 3 days, whereas the NT group received normothermia (intracranial temperature 37 degrees C) therapy for 5 days. Specimens of cerebrospinal fluid (CSF) taken from an intraventricular catheter every 24 hours were analyzed for the presence of excitatory amino acids ([EAAs] glutamate, aspartate, and glycine) and cytokines (tumor necrosis factor-alpha, interleukin [IL]-1beta, IL-6, IL-8, and IL-10). The two groups did not differ significantly in patient age, neurological status, or level of ICP. There were no significant differences in daily changes in CSF concentrations of EAAs and cytokines between the two groups. The incidence of pneumonia was slightly higher in the HT group compared with the NT group (p = 0.059). The incidence of diabetes insipidus associated with hypernatremia was significantly higher in the HT group compared with that in the NT group (p < 0.01). The two groups did not differ with respect to their clinical outcomes. CONCLUSIONS The authors recommend normothermia therapy for the treatment of severely head injured patients in whom ICP can be maintained at lower than 20 mm Hg by using conventional therapies, because mild hypothermia therapy does not convey any advantage over normothermia therapy in such patients.
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Affiliation(s)
- T Shiozaki
- Department of Traumatology, Osaka University Medical School, Japan
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Ogura H, Tanaka H, Koh T, Hashiguchi N, Kuwagata Y, Hosotsubo H, Shimazu T, Sugimoto H. Priming, second-hit priming, and apoptosis in leukocytes from trauma patients. J Trauma 1999; 46:774-81; discussion 781-3. [PMID: 10338393 DOI: 10.1097/00005373-199905000-00004] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Polymorphonuclear leukocytes (PMNL) play important roles in both host defenses and systemic inflammatory responses after insults. The objectives of this study are to examine the serial changes in PMNL priming and apoptosis in severely injured patients and to evaluate the impact of second hits on primed PMNL function and systemic vascular endothelial damage. METHODS Twenty-four severely injured patients (mean Injury Severity Score, 31.1 +/- 9.7) were included. Infections were seen as second hits after trauma in seven patients. Oxidative activity, phagocytosis, and apoptosis of PMNL from serial blood samples were measured by flow cytometry. Oxidative activity with no stimulus and with formylmethionyl-leucyl-phenylalanine (FMLP) were analyzed as the priming index and FMLP response, respectively. Interleukin (IL)-6, IL-10, PMNL elastase, and thrombomodulin concentrations in blood were also measured before and after the second hit. RESULTS The PMNL priming index was elevated from days 2 to 13, especially days 2 to 5 after injury. FMLP response was enhanced from days 2 to 21 after injury. Apoptosis of PMNL was inhibited for as long as 3 weeks after injury. Infections as second hits after trauma enhanced both the priming index and the FMLP response within 24 hours after diagnosis of infection and increased serum IL-6 concentrations. However, serum thrombomodulin levels were not affected by second hits. All patients with second hits survived. CONCLUSION Severe trauma stimulated acute-phase priming in PMNL and inhibited apoptosis. Infections after trauma induced second-hit priming in PMNL, but the unchanged serum levels of thrombomodulin suggest that priming per se may not cause systemic vascular endothelial damage.
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Affiliation(s)
- H Ogura
- Department of Traumatology, Osaka University Medical School, Suita City, Japan
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Yabuuchi H, Murayama S, Sakai S, Hashiguchi N, Murakami J, Muranaka T, Soeda H, Sugio K, Nagashima A, Masuda K. Resected peripheral small cell carcinoma of the lung: computed tomographic-histologic correlation. J Thorac Imaging 1999; 14:105-8. [PMID: 10210482 DOI: 10.1097/00005382-199904000-00007] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In order to clarify the characteristic computed tomographic findings of peripheral small cell lung cancer, the authors investigated 12 patients with surgically resected and histologically proven peripheral small cell lung cancer. Conventional computed tomography was performed on all, and additional high-resolution computed tomographic images were obtained for nine patients. Marginal, internal, and surrounding features of the tumors were analyzed, and these findings were correlated with histologic findings. All 12 tumors appeared as homogenous masses, and eight had well-defined margins. Lobulation was found in seven, marginal ground-glass opacity in three, fine spiculation in two, and both ground-glass opacity and spiculation in one. Cut specimens showed whitish medullary masses without large areas of necrosis, and microscopic specimens showed small areas of necrosis in 11 patients. Marginal ground-glass opacities corresponded to focal edema and hemorrhage in two patients and to intraalveolar invasion in one. Fine spiculation corresponded to vascular/lymphatic invasion in one patient and to irregular intraalveolar spread in another. The authors concluded that a homogenous mass without necrosis is the most characteristic feature of peripheral small cell carcinoma on computed tomography.
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Affiliation(s)
- H Yabuuchi
- Department of Radiology, Kyushu University, Fukuoka, Japan
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Shimazu T, Tanaka R, Hashiguchi N, Sugimoto H. [Clostridial myonecrosis]. Ryoikibetsu Shokogun Shirizu 1999:593-6. [PMID: 10088481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- T Shimazu
- Department of Traumatology, Osaka University Medical School
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Kobayashi I, Toda H, Koyama E, Hasegawa M, Hashiguchi N, Arai H, Fukami T, Watanabe A. [Evaluation of mycobacteria growth indicator tube (MGIT), an automated culture system for detection of mycobacteria from clinical specimens]. Kansenshogaku Zasshi 1999; 73:172-8. [PMID: 10213995 DOI: 10.11150/kansenshogakuzasshi1970.73.172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We compared the Mycobacteria Growth Indicator Tube 960 (MGIT 960) and Ogawa medium (OM) for the detection of mycobacteria (acid fast bacteria: AFB) using 882 sputum specimens. Overall, 120 strains of AFB were isolated by the MGIT 960 system and 99 strains of AFB were isolated by using OM. As far as Mycobacterium tuberculosis is concerned, 88 and 71 isolates were achieved by the MGIT 960 and OM respectively. A total of 28 isolates (18 isolates of M. tuberculosis and 10 isolates of nontuberculous mycobacteria: NTM) were detected by the MGIT 960 only whereas only 2 isolates (1 M. tuberculosis and 1 NTM) were detected by OM only. Of these sputum specimens, 72 were smear positive for AFB. The rates of smear negative but culture positive specimens were 8.0% (65 out of 809) for the MGIT 960 system and 6.2% (50 out of 809) for OM. The contamination rate for MGIT 960 was only 1.2%. The average time required for detection of M. tuberculosis was 14.1 days by the MGIT 960 system and 24.6 days by OM. For the NTM, the average detection time were 8.3 days for the MGIT 960 system and 22.8 days for OM. These results indicate that the MGIT 960 system allows detection of mycobacteria significantly faster than OM.
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Affiliation(s)
- I Kobayashi
- Department of Clinical Microbiology, Mitsubishi Kagaku Bio-Clinical Laboratories, Inc
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Murayama S, Murakami J, Tanaka J, Sakai S, Hashiguchi N, Masuda K. Adaptive spatial filtering technique for storage phosphor radiography in portable chest radiographs: parameter optimization. Radiat Med 1998; 16:405-10. [PMID: 9929139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE To investigate the optimal parameters of adaptive spatial filtering (ASF) in storage phosphor radiography for processing portable chest radiographs. MATERIALS AND METHODS Two types of weighting factor curves starting at 383 digital pixel values (PV) (type B) and at 511 PV (type C) were selected for the optimization of ASF. The PV of 27 areas of apparent pulmonary lesions and seven retrocardiac areas were measured for original unprocessed and ASF-processed images. Three radiologists compared 30 ASF-processed portable chest radiographs with apparent pulmonary or pleural lesions with unprocessed images. RESULTS PV measurements revealed no significant change in pulmonary densities in type B, and an increase in PV of lower pulmonary densities in type C. Densities of retrocardiac areas were more enhanced in type C than in type B. Observer testing showed that pulmonary densities were evaluated as unchanged in 90% of type B images and 76% of type C images. Changes in mediastinal densities were evaluated as adequate in 80% of type B and 90% of type C images. CONCLUSION The starting point of the weighting factor curve of ASF in portable chest radiographs should be set the same as in chest radiographs in the upright posteroanterior position with high kVp.
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Affiliation(s)
- S Murayama
- Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Buadu AA, Buadu LD, Murakami J, Murayama S, Hashiguchi N, Masuda K. Enhancement of the Nipple-Areolar-Complex on Contrast-Enhanced MR Imaging of the Breast. Breast Cancer 1998; 5:285-289. [PMID: 11091660 DOI: 10.1007/bf02966709] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE: To evaluate patterns of enhancement in the nipple-areolar-complex (NAC) on contrast-enhanced MRI. METHODS: We reviewed the MR images of 37 patients in which enhancement of the NAC was demonstrated on gadolinium-enhanced dynamic fast radiofrequency spoiled gradient recalled echo (fast-SPGR) images. Time intensity profiles derived from signal intensity values were constructed, and findings correlated with histological results. RESULTS: Three types of curve were observed. In the first type seen in adenoma of the nipple, rapid initial increase in signal intensity with an early peak (1 min) occurred followed by gradual washout. In the second type seen in direct invasion from carcinoma, subareolar intracystic papilloma, or Paget's disease, rapid initial increase in signal intensity followed by a more gradual increase or plateau was seen. In the third type seen in carcinoma without nipple invasion, fibrocystic disease and fibroadenoma, a gradual increase in signal intensity was observed throughout the examination period. CONCLUSION: Early and prominent enhancement of the NAC on contrast-enhanced MRImay indicate the presence of a primary lesion in the NAC or secondary involvement by a primary tumor elsewhere in the breast.
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Affiliation(s)
- AA Buadu
- Department of Radiology, Facutly of Medicine, Kyushu University, 3-1-1 Higashi-ku, Fukuoka 812-8582, Japan
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Buadu LD, Murakami J, Murayama S, Hashiguchi N, Toyoshima S, Sakai S, Yabuuchi H, Masuda K, Kuroki S, Ohno S. Colour Doppler sonography of breast masses: a multiparameter analysis. Clin Radiol 1997; 52:917-23. [PMID: 9413965 DOI: 10.1016/s0009-9260(97)80224-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To evaluate signals from breast lesions on both colour and spectral Doppler US, and to correlate findings with angiographic and histopathological features including microvessel density. MATERIALS AND METHODS One hundred and sixteen breast lesions in 113 patients were evaluated with colour Doppler ultrasonography. Subjective and semi-quantitative assessment of colour signals as well as spectral Doppler analysis were performed and compared. Comparison of colour Doppler features with angiographic and histopathological findings were also carried out. RESULTS Subjective evaluation revealed that colour signals were more commonly found in malignant (89%) than benign (56%) lesions. Malignant lesions demonstrated a more elaborate vascular network (51%) compared to 12.5% in benign lesions. Spectral Doppler analysis revealed slightly higher specificity values for the pulsatility and resistivity indices, respectively, but lower sensitivity and accuracy values compared to qualitative assessment. Colour Doppler patterns corresponded well with angiograhic images, however, the correlation between colour Doppler parameters and microvessel density was not significant. CONCLUSION Despite the increased examination time required, spectral analysis does not appear to contribute significantly to the differentiation between malignant and benign breast tumours. Features such as the density, pattern and predominant site of colour signals may be more useful for the evaluation of breast lesions on colour Doppler imaging.
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MESH Headings
- Adolescent
- Adult
- Aged
- Angiography
- Breast Neoplasms/blood supply
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/blood supply
- Carcinoma, Ductal, Breast/diagnostic imaging
- Diagnosis, Differential
- Female
- Humans
- Magnetic Resonance Angiography
- Middle Aged
- Sensitivity and Specificity
- Ultrasonography, Doppler, Color/methods
- Ultrasonography, Doppler, Pulsed
- Ultrasonography, Mammary/methods
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Affiliation(s)
- L D Buadu
- Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Hamano K, Ohta A, Masamura K, Hashiguchi N, Takekuma A, Ushiyama O, Suzuki N, Inoue E, Inoue N, Nagasawa K. [Relationship between the experience of steroids side effects and noncompliance with oral steroids treatment in collagen disease patients]. Kango Kenkyu 1997; 30:47-54. [PMID: 9543990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE To analyze the relationship between the experience of side effect and the compliance with oral steroids drug treatment of the patients in Collagen Disease Clinic. METHODS A questionnaire survey through interview was conducted on 165 outpatients with various collagen disease at Saga Medical School Hospital. RESULTS 94 patients (57%) had a history of noncompliance to the steroids drug. 49 patients (52.1%) adventitiously had forgotten to take the steroids as ordered and 45 patients (47.9%) intentionally had regulated their steroids dose or had discontinued the steroids drug treatment. Over 80% of the patients had experienced side effects of the steroids. The patients who experienced one or more of the following side effects, osteoporosis, bone fractures, menstrual disorders, moon face, central obesity, alopecia, acnelike eruption, manic-depressive state, and insomnia, intentionally regulated, or discontinued the steroids therapy. In addition, the patients who were not made cognizance about side effects of the steroids by their physicians and nurse tended to noncompliance group. CONCLUSION To increase the compliance rate with oral steroids drug treatment, we must make conscious efforts to inform the patients on the condition of their medical states, the efficacy of the prescribed drugs, and the side effects and risk concerning discontinuation of the steroids. It is Also necessary to establish "Drug information and counseling day" in outpatient Department.
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Affiliation(s)
- K Hamano
- Department of Fundation of Nursing, Faculty of Medicine, Saga Medical School
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Abdolmaleki P, Buadu LD, Murayama S, Murakami J, Hashiguchi N, Yabuuchi H, Masuda K. Neural network analysis of breast cancer from MRI findings. Radiat Med 1997; 15:283-293. [PMID: 9445150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
PURPOSE To evaluate how much the experience of radiologists affects the performance of an artificial neural network (ANN) trained by two highly experienced radiologists. MATERIALS AND METHODS Before biopsy two experienced radiologists reviewed the MR images of 100 adult patients with suspicious breast lesions and evaluated their findings based on six features. This database was then used to train a three-layered feed-forward neural network. The network's generalizing ability was then tested to predict the outcome of biopsy in 56 new patients' records which were extracted by 10 participating radiologists. The MRI findings of each reader were presented to the ANN to evaluate the effect of various levels of experience on the output of the ANN. The performance of the ANN was then compared with that of attendant physicians in terms of sensitivity, specificity, and accuracy as well as ROC analysis. RESULTS The best ANN outcome offered a correct diagnosis in 40 of 41 of the patients with malignant breast cancer and 10 of 15 with benign entity presented in the testing set. The output of the trained ANN outperformed the attendant radiologists with low levels of experience and showed comparable performance with radiologists with higher levels of experience. CONCLUSIONS The ANN is able to work as a backup system to assist radiologists in the diagnosis of breast cancer.
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Affiliation(s)
- P Abdolmaleki
- Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Sakai S, Murayama S, Murakami J, Hashiguchi N, Masuda K. Bronchogenic carcinoma invasion of the chest wall: evaluation with dynamic cine MRI during breathing. J Comput Assist Tomogr 1997; 21:595-600. [PMID: 9216765 DOI: 10.1097/00004728-199707000-00013] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Our goal was to assess the utility of breathing dynamic cine MR (BDCMR) in the evaluation of tumor invasion to the chest wall in bronchogenic carcinomas. METHOD BDCMR imaging was performed preoperatively in 25 patients with bronchogenic carcinomas adjacent to the chest wall. Twelve sequential images were obtained in the same coronal and/or sagittal planes during one respiratory cycle with fast spoiled GRASS sequence, and analysis with cine-loop display was performed. RESULTS In all 14 cases in which free movement of tumor along the parietal pleura on BDCMR was demonstrated, no chest wall invasion was evident at thoracotomy. However, of 11 patients with fixation of the tumor on BDCMR, 5 had benign pleural adhesions, 5 had chest wall invasion at thoracotomy, and 1 with an apical tumor had no benign pleural adhesion or chest wall invasion. CONCLUSION Although BDCMR cannot distinguish benign pleural adhesions from chest wall invasion by tumor, this method accurately estimated the free movement of lung tumors with no invasion of chest wall from bronchogenic carcinomas prior to surgery.
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Affiliation(s)
- S Sakai
- Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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