1
|
Kadoguchi T, Shimada K, Fukui N, Tanaka N, Tsuno H, Shiozawa T, Fukao K, Nishitani-Yokoyama M, Isoda K, Matsushita S, Yokoyama N, Daida H. Accumulation of polyunsaturated fatty acid-derived metabolites in the sarcopenic muscle of aging mice. Geriatr Gerontol Int 2023; 23:297-303. [PMID: 36811314 DOI: 10.1111/ggi.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 12/26/2022] [Accepted: 01/27/2023] [Indexed: 02/24/2023]
Abstract
AIM Although it is known that advanced age alters skeletal muscle lipid metabolism, the role(s) of polyunsaturated fatty acid-derived metabolites (mostly eicosanoids and docosanoids) in sarcopenia are not clear. We therefore examined the changes in the metabolites of arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid in the sarcopenic muscle of aged mice. METHODS We used 6- and 24-month-old male C57BL/6J mice as healthy and sarcopenic muscle models, respectively. Skeletal muscles were removed from the lower limb and subjected to a liquid chromatography-tandem mass spectrometry analysis. RESULTS The liquid chromatography-tandem mass spectrometry analysis detected distinct changes of metabolites in the muscles of the aged mice. Of the 63 metabolites identified, nine were significantly higher in the sarcopenic muscle of aged mice compared with the healthy muscle of young mice. In particular, prostaglandin E2 , prostaglandin F2a , thromboxane B2 , 5-hydroxyeicosatetraenoic acid, and 15-oxo-eicosatetraenoic acid (arachidonic acid-derived metabolites), 12-hydroxy-eicosapentaenoic acid and 14,15-epoxy-eicosatetraenoic acid (eicosapentaenoic acid-derived metabolites) and 10-hydroxydocosa-hexaenoic acid and 14-hydroxyoctadeca-pentaenoic acid (docosahexaenoic acid-derived metabolites) were significantly higher in aged tissue compared with young tissue (all P < 0.05). CONCLUSIONS We observed the accumulation of metabolites in the sarcopenic muscle of aged mice. Our results may provide new insights into the pathogenesis and progression of aging- or disease-related sarcopenia. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2023; ••: ••-••.
Collapse
Affiliation(s)
- Tomoyasu Kadoguchi
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazunori Shimada
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Naoshi Fukui
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan.,Clinical Research Center, National Hospital Organization Sagamihara Hospital, Sagamihara, Japan
| | - Nobuho Tanaka
- Clinical Research Center, National Hospital Organization Sagamihara Hospital, Sagamihara, Japan
| | - Hirotaka Tsuno
- Clinical Research Center, National Hospital Organization Sagamihara Hospital, Sagamihara, Japan
| | - Tomoyuki Shiozawa
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiovascular Medicine, Juntendo University Shizuoka Hospital, Izunokuni, Japan
| | - Kosuke Fukao
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Miho Nishitani-Yokoyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Norihiko Yokoyama
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Faculty of Health Science, Juntendo University, Tokyo, Japan
| |
Collapse
|
2
|
Yamamoto T, Matsushita S, Endo D, Shimada A, Dohi S, Kajimoto K, Yokoyama Y, Sato Y, Machida Y, Asai T, Amano A. Management of cardiovascular surgery in patients with systemic lupus erythematosus including thromboembolism and multiple organ failure prevention: A retrospective observational study. Medicine (Baltimore) 2023; 102:e32979. [PMID: 36800570 PMCID: PMC9936021 DOI: 10.1097/md.0000000000032979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Systemic lupus erythematosus is a chronic autoimmune disease that affects most tissues. Cardiovascular events are critical, life-threatening, long-term complications of systemic lupus erythematosus (SLE). We report our single-center experience of performing cardiovascular surgery in patients with SLE while avoiding postoperative complications. We also suggest a new approach for cardiopulmonary bypass and perioperative management. We applied the antiphospholipid antibody syndrome (APS) severity classification published by the Japan Intractable Disease Information Center to patients with SLE for perioperative management. Patients with Grade III or higher severity are treated with a slightly relaxed version of catastrophic APS therapy. This treatment modality includes glucocorticoids, anticoagulation, intravenous immunoglobulin, and plasma exchange. Between April 2010 and January 2021, 26 patients (2 males, 24 females) with SLE underwent cardiovascular surgery. The mean age was 74.2 ± 13.0 years (38-84 years). The primary outcomes were in-hospital mortality and long-term results, and the secondary outcomes were related to bleeding/embolization and coagulation function/platelet count. A subset analysis was performed to examine treatment efficacy in the APS Grade III or higher group. Of the 26 patients, 17 underwent valve surgery, 4 underwent isolated coronary artery bypass grafting, and 5 underwent thoracic aortic aneurysm surgery. There were no in-hospital deaths or associated bleeding/embolic complications. Postoperative antithrombin III decreased in patients who underwent valvular and aortic surgery, and platelet counts recovered to preoperative levels within 7 to 10 days. The 5- and 10-year survival rates were 80.5% and 53.7%, respectively. In addition, there were 10 patients with APS Grade III or higher, but there was no significant difference in the frequency of complications other than platelet recovery after treatment. The surgical outcome of open-heart surgery in patients with SLE was good. Surgical treatment of cardiovascular disease in these patients is difficult and complex. We focused on blood coagulation abnormalities and treated each patient by selecting the best individual treatment protocol according to the severity of the disease, taking into account the risk of bleeding and thrombosis. Management of blood coagulation function in these patients is essential, and careful therapeutic management should be considered during open-heart surgery.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
- * Correspondence: Taira Yamamoto, Department of Cardiovascular Surgery, Juntendo University Nerima Hospital, 3-1-10 Koyadai, Nerima-ku, Tokyo 177-8521, Japan (e-mail: )
| | | | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Shizuyuki Dohi
- Department of Cardiovascular Surgery, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Kan Kajimoto
- Department of Cardiovascular Surgery, Juntendo University Shizuoka Hospital, Shizuoka, Japan
| | - Yasutaka Yokoyama
- Department of Cardiovascular Surgery, Toda Chuo Hospital, Saitama, Japan
| | - Yuichiro Sato
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Yoichiro Machida
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
3
|
Mukaida H, Matsushita S, Yamamoto T, Minami Y, Sato G, Asai T, Amano A. Oxygen delivery-guided perfusion for the prevention of acute kidney injury: A randomized controlled trial. J Thorac Cardiovasc Surg 2023; 165:750-760.e5. [PMID: 33840474 DOI: 10.1016/j.jtcvs.2021.03.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES The reduction of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass surgery using an oxygen delivery-guided perfusion strategy (oxygen delivery strategy) for cardiopulmonary bypass management compared with a fixed flow perfusion (conventional strategy) remains controversial. The purpose of this study was to determine whether a oxygen delivery strategy would reduce the incidence of postoperative acute kidney injury in patients undergoing cardiopulmonary bypass surgery. METHODS We randomly enrolled 300 patients undergoing cardiopulmonary bypass surgery. Patients were randomly assigned to a oxygen delivery strategy (maintaining a oxygen delivery index value >300 mL/min/m2 through pump flow adjustments during cardiopulmonary bypass) or a conventional strategy (a target pump flow was determined on the basis of the body surface area). The primary end point was the development of acute kidney injury. Secondary end points were the red blood cell transfusion rate and number of red blood cell units, intubation time, postoperative length of stay in the intensive care unit and the hospital, predischarge estimated glomerular filtration rate, and hospital mortality. RESULTS Acute kidney injury occurred in 20 patients (14.6%) receiving the oxygen delivery strategy and in 42 patients (30.4%) receiving the conventional strategy (relative risk, 0.48; 95% confidence interval, 0.30-0.77; P = .002). The secondary end points were not significantly different between strategies. In a prespecified subgroup analysis of patients who had nadir hematocrit less than 23% or body surface area less than 1.40 m2, the oxygen delivery strategy seemed to be superior to the conventional strategy and the existence of quantitative interactions was suggested. CONCLUSIONS An oxygen delivery strategy for cardiopulmonary bypass management was superior to a conventional strategy with respect to preventing the development of acute kidney injury.
Collapse
Affiliation(s)
- Hiroshi Mukaida
- Department of Clinical Engineering, Juntendo University Hospital, Tokyo, Japan; Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan.
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Yuki Minami
- Department of Clinical Engineering, Juntendo University Hospital, Tokyo, Japan
| | - Go Sato
- Department of Clinical Engineering, Juntendo University Hospital, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Oishi A, Matsushita S, Dohi S, Yamamoto T, Kajimoto K, Amano A. Endovascular repair for iliac artery aneurysms. Surgery in Practice and Science 2022. [DOI: 10.1016/j.sipas.2022.100141] [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
|
5
|
Mukaida H, Matsushita S, Minami Y, Sato G, Usuba M, Kondo R, Asai T, Amano A. Risk factors for postoperative delirium on oxygen delivery-guided perfusion. J Cardiothorac Surg 2022; 17:193. [PMID: 35987682 PMCID: PMC9392930 DOI: 10.1186/s13019-022-01938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Studies have demonstrated the efficacy of oxygen delivery-guided perfusion (ODGP) in preventing postoperative acute kidney injury, but the benefit of ODGP for delirium has not been confirmed. We retrospectively investigated the risk factors for postoperative delirium in patients who underwent ODGP (with oxygen delivery index [DO2i] > 300 mL/min/m2).
Methods
Consecutive patients who underwent on-pump cardiovascular surgery with ODGP from January 2018 to December 2020 were retrospectively analyzed. In addition to examining patients’ DO2i during cardiopulmonary bypass (CPB), we quantified the two primary DO2 components-hematocrit (Hct) and pump flow. Delirium was defined based on the Intensive Care Delirium Screening Checklist (ICDSC). Patients were divided into three groups: no delirium (ICDSC score = 0), subsyndromal delirium (ICDSC score = 1–3), and clinical delirium (ICDSC score ≥ 4).
Results
Multivariate analysis identified only the number of red blood cell (RBC) units transfused, intubation time, and the cumulative time below the Hct threshold of 25% as predictive factors of postoperative delirium. Although patients with higher ICDSC scores had greater hemodilution during CPB, ODGP resulted in a higher pump flow, and DO2i was maintained above 300 mL/min/m2, with no significant difference between the three groups.
Conclusions
A low Hct level during CPB with ODGP, the number of RBC units transfused, and intubation time were associated with postoperative delirium. Further investigations are needed to determine the ability of ODGP to prevent low Hct during CPB.
Collapse
|
6
|
Kawamoto T, Amano H, Matsushita S, Minowa K, Matsushita M, Yamaji K, Amano A, Tamura N. OP0238 CLINICAL ANALYSIS OF 34 CASES OF CARDIAC COMPLICATIONS REQUIRING SURGICAL INTERVENTION IN SYSTEMIC LUPUS ERYTHEMATOSUS AND ASSESSMENT ABOUT MECHANISM OF DEVELOPMENT WITH IMMUNOLOGICAL ANALYSIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIn cases of systematic lupus erythematosus (SLE) that lead to surgery due to the development of heart diseases such as valvular disease, ischemic heart disease and aortic aneurysm, early detection and careful monitoring are important. An absence of background diseases or immunopathological examination of the myocardial tissue in SLE cases with cardiovascular lesions demonstrates the lack of knowledge in this area. In recent years, however, there have been reports of neutrophil extracellular traps being involved in the fulminant onset of SLE.ObjectivesThis study aimed to analyze clinically and immunohistopathologically the pathophysiology of heart diseases associated with SLE.MethodsWe performed left atrial appendage resection in 34 patients, including patients with cardiovascular lesions, who underwent heart surgery for SLE complications from 2012 to 2021. Tissue analysis was conducted in 9 cases. The left atrial appendage, in cases of non-collagen valvular disease, was used as the control. Tissue staining of cardiomyocytes was carried out by adding anti-neutrophil extracellular(NE) antibodies(Abs) to anti-human IgG antibody (Ab), anti-IgM Ab and anti-C3 Ab.ResultsOf the 34 SLE patients 14 had valvular disease, 8 had ischemic heart disease and 12 had aneurysms. Preoperative SLE activity was relatively stable with only 1 patient below the CH50 standard and 6 patients above the anti-DNA Ab standard. The Ab positivity rate for the patients in this study was higher than that of the 687 SLE patients who were previously tested in 2019. The presence of anti-CL Abs was 55.6%, which was higher than the 25.5% observed in previous SLE patients. In this study, anti-SS-A and anti-RNP Abs tended to be relatively numerous. An example of immunohistochemical staining of IgG in the left atrial appendage is presented (Figure 1a). IgG deposits were not observed on the left side of the myocardial fibers in the control group, whereas IgG deposits were observed on the right side in the SLE group. Deposits were also observed in tissues that were not located in the affected areas. The presence or absence of tissue deposition in the myocardial fibers and clinical findings in 2 cases of the control group and 9 cases of the SLE complication group are reported in Table 1. IgG deposits were found in the myocardial fibers of 6 of the 9 patients in the SLE complication group, and deposits were found in the left atrial appendage tissue regardless of the type of heart disease, suggesting a potential change in the heart tissue. In the SLE group, 5 cases were positive for antiphospholipid (APS) Abs, while 7 cases were positive for either anti-SS-A or anti-RNP Abs. Only 2 cases had elevated preoperative anti-DNA Ab and complement reduction. Of the SLE complication group, 2 of the 9 cases were negative for all Abs but IgG deposits were observed in a case. Of these 4 cases were selected and stained with anti-IgM, anti-C3 and anti-NE Abs. However IgM and C3 deposits were only observed in one patient who developed myocardial infarction at the age of 39 and was triple positive for APS, anti-SS-A and anti-RNP Abs (Figure 1b). There were also no NE deposits in any of the cases. Even if complement and anti-DNA Ab levels in the serum are normal, attention should be paid to heart disease complications during the long-term observation of SLE patients. In particular, attention should be paid to various autoantibody-positive cases such as APS, anti-SS-A Ab and anti-RNP Ab. The anti-NE Ab was not stained in this study because the tissue was different from the lesion site and because it occurred during the chronic course.ConclusionIn SLE patients who developed cardiovascular lesions and required surgery, immunological abnormalities may occur in the myocardial tissue even if serum complement and anti-DNA Ab levels are stable.References[1]Stephane Zuily et al. Valvular Curr Rheumatol Rep (2013) 15:320.[2]Zawadowski GM et al. Lupus. 2012;21(13):1378-84.[3]Daniel Appelgren et al. Autoimmunity 2018,vol51,No.6,310-318.Disclosure of InterestsNone declared
Collapse
|
7
|
Yamamoto T, Endo D, Shimada A, Matsushita S, Asai T, Amano A. Surgical treatment of acute aortic dissection in a patient with SLE and prior antiphospholipid syndrome on therapy for over 30 years: a case report. BMC Cardiovasc Disord 2022; 22:216. [PMID: 35562652 PMCID: PMC9103044 DOI: 10.1186/s12872-022-02659-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 05/02/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In patients with systemic lupus erythematosus (SLE), lengthy treatment and long-term steroid use are the main risk factors for developing aortic aneurysms or aortic dissections. In patients with cardiac tamponade, hemodynamic collapse may lead to acute renal and hepatic failure. CASE PRESENTATION We report the successful treatment of a 55-year-old woman with SLE since the age of 21. She suddenly felt chest pain approximately 2 weeks before developing fever and vomiting and was admitted to our hospital. Initially, she had severe liver dysfunction and was admitted to the hepatology department, where treatment for fulminant hepatitis was initiated. However, computed tomography (CT) showed an acute aortic dissection (DeBakey type II) and severe bloody pericardial effusion. Therefore, we performed emergency pericardial drainage. Plasma exchange therapy was initiated as emergency aortic surgery was deemed impossible due to impaired liver function tests and coagulation. Ten days later, the patient developed peritonitis due to small bowel perforation, and laparotomy was performed for abscess drainage and perforation closure. She had received steroid pulse therapy at the age of 21. At 40 years of age, she developed deep vein thrombosis due to antiphospholipid antibodies and was prescribed prednisolone. She was ambulatory at 3 months after the onset of acute aortic dissection, and CT revealed a rapidly enlarging true aneurysm in the distal arch. We performed elective aortic surgery. Although there were no antiphospholipid antibodies, surgery could have led to a devastating antiphospholipid syndrome. Therefore, we decided to treat the patient with triple therapy. Methylprednisolone was intravenously administered intraoperatively and at 1 day postoperatively. The patient was discharged without complications after returning to her usual oral prednisolone regimen. CONCLUSIONS The patient described herein had a systemic circulatory failure due to cardiac tamponade, accompanied by liver failure. This condition is a significant cause of death in patients with aortic dissection-associated SLE and is extremely dangerous. However, multi-specialty intervention helped the patient recover, and she has been attending the outpatient clinic. Aortic surgery requiring hypothermia in SLE patients with antiphospholipid syndrome and a history of thrombocytopenia or thrombosis requires a multi-disciplinary treatment team, including cardiac surgeons and medical experts.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo Nerima Hospital, Takanodai 3-1-10, Nerima- Ku, Tokyo, 177-8521, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo Nerima Hospital, Takanodai 3-1-10, Nerima- Ku, Tokyo, 177-8521, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Hongo 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
8
|
Shimada A, Yamamoto T, Endo D, Nishida K, Matsushita S, Asai T, Amano A. Pseudoaneurysm with a fistula to the right ventricle late after surgical repair of type A aortic dissection in a patient with systemic lupus erythematosus. J Cardiothorac Surg 2022; 17:83. [PMID: 35477534 PMCID: PMC9044762 DOI: 10.1186/s13019-022-01827-5] [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: 06/11/2021] [Accepted: 04/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Pseudoaneurysm with a shunt to the right ventricle after aortic repair for acute aortic dissection is an extremely rare and life-threatening condition. Surgical treatment is unavoidable, but surgery is complicated, and there are some pitfalls. This study describes the reoperation performed in a patient at a high surgical risk by clarifying the shunt site using multimodality imaging before surgery. Case presentation A 69-year-old woman with a history of systemic lupus erythematosus (SLE) and Sjogren’s syndrome presented with a pseudoaneurysm 1 year after emergency surgery for acute type A aortic dissection. Eight years after the first surgery, she experienced sudden chest pain and presented to the emergency department. Her dyspnea worsened; therefore, echocardiography and three-dimensional computed tomography (3DCT) were performed, and a pseudoaneurysm and shunt to the right ventricle were identified. The medical team attempted to close the shunt with a percutaneous catheter but was unsuccessful, and she was referred to our department for surgical treatment. The pseudoaneurysm originating from the proximal side of the aorta was large (diameter = 55 mm), and echocardiography-gated 3DCT identified the shunt from the pseudoaneurysm to the right ventricle. First, extracorporeal circulation was initiated, and resternotomy was performed. We could not insert the left ventricular venting tube from the right side because of the pseudoaneurysm size. Instead, the tube was inserted from the left atrial appendage. We found a half-circumferential disengaged anastomosis around the proximal anastomosis, which formed the large pseudoaneurysm leading to a fistula in the right ventricle. We closed the fistula and performed a Bentall operation. The patient had a good postoperative course and was discharged on postoperative day 21. She continued treatment for SLE and Sjogren’s syndrome, and her inflammatory reaction improved. Conclusions We performed a Bentall operation and fistula closure with resternotomy in a patient with type A aortic dissection with SLE and Sjogren’s syndrome. Multimodal imaging is essential in defining the pseudoaneurysm and the fistula surrounding the anatomy while ensuring their resolution and guiding the approach for operation.
Collapse
Affiliation(s)
- Akie Shimada
- Department of Cardiovascular Surgery, Nerima Hospital, Juntendo University, 3-1-10, Takanodai, Nerima-ku, Tokyo, 177-8521, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Nerima Hospital, Juntendo University, 3-1-10, Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| | - Kousuke Nishida
- Department of Cardiovascular Surgery, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Bunkyo-Ku, Tokyo, Japan
| |
Collapse
|
9
|
Nakamura Y, Namikawa K, Yoshikawa S, Kiniwa Y, Maekawa T, Yamasaki O, Isei T, Matsushita S, Nomura M, Nakai Y, Fukushima S, Saito S, Takenouchi T, Tanaka R, Kato H, Otsuka A, Matsuya T, Baba N, Nagase K, Inozume T, Fujimoto N, Kuwatsuka Y, Onishi M, Kaneko T, Onuma T, Umeda Y, Ogata D, Takahashi A, Otsuka M, Teramoto Y, Yamazaki N. Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study). ESMO Open 2021; 6:100325. [PMID: 34839104 PMCID: PMC8633880 DOI: 10.1016/j.esmoop.2021.100325] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 09/21/2021] [Accepted: 10/29/2021] [Indexed: 01/14/2023] Open
Abstract
Background Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients. Patients and methods We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan–Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4. Results Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001). Conclusions First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events. Anti-PD-1 plus anti-CTLA-4 antibody therapy (PD1 + CTLA4) is an option for patients with advanced mucosal melanoma (MCM). Data on the efficacy of PD1 + CTLA4 compared with PD-1 monotherapy (PD1) for MCM, however, are limited. We retrospectively analyzed data from 329 Japanese patients with advanced MCM treated with PD1 or PD1 + CTLA4. No significant differences in objective response rate, progression-free survival, or overall survival were observed. Immune-related adverse events resulting in treatment cessation were higher in the PD1 + CTLA4 group.
Collapse
Affiliation(s)
- Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan.
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - S Yoshikawa
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Y Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - T Maekawa
- Department of Dermatology, Jichi Medical University, Tochigi, Japan
| | - O Yamasaki
- Department of Dermatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - T Isei
- Department of Dermatologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - M Nomura
- Department of Clinical Oncology, Kyoto University, Kyoto, Japan
| | - Y Nakai
- Department of Dermatology, Mie University, Tsu, Japan
| | - S Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - S Saito
- Department of Dermatology, Gunma University, Maebashi, Japan
| | - T Takenouchi
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - R Tanaka
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - H Kato
- Department of Geriatric and Environmental Dermatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - T Matsuya
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - N Baba
- Department of Dermatology, Fukui University, Fukui, Japan
| | - K Nagase
- Division of Dermatology, Department of Internal Medicine, Saga University, Saga, Japan
| | - T Inozume
- Department of Dermatology, Chiba University, Chiba, Japan
| | - N Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu, Japan
| | - Y Kuwatsuka
- Department of Dermatology, Nagasaki University, Nagasaki, Japan
| | - M Onishi
- Department of Dermatology, Iwate Medical University, Morioka, Japan
| | - T Kaneko
- Department of Dermatology, Juntendo University Urayasu Hospital, Urayasu, Japan
| | - T Onuma
- Department of Dermatology, Yamanashi University, Kofu, Japan
| | - Y Umeda
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan; Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - D Ogata
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - A Takahashi
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - M Otsuka
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Y Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - N Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
10
|
Matsushita S, Shimada A, Yamamoto T, Minematsu K, Inaba H, Kuwaki K, Amano A. Nutritional supplement drink reduces inflammation and postoperative depression in patients after off-pump coronary artery bypass surgery. World J Cardiol 2021; 13:348-360. [PMID: 34589170 PMCID: PMC8436681 DOI: 10.4330/wjc.v13.i8.348] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/13/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronary artery bypass grafting is a surgical treatment for ischemic heart disease. Although development in surgical technique and improvement of perioperative management reduced the postoperative complications, some patients still delayed in progress of postoperative rehabilitation. In this study, we aimed to investigate the effect of daily intake of an herbal medicine-containing drink for rehabilitation after surgery in patients with ischemic heart disease.
AIM To investigate the effect of taking an herbal medicine-containing, commercially available drink for postoperative rehabilitation in those patients.
METHODS Patients who underwent isolated off-pump coronary artery bypass (OPCAB) surgery were divided into two groups depend on the timing of the admission to the hospital: the Yunker (YKR) group, that consumed one bottle of a caffeine-free nutritional supplement drink on a daily basis and the control group (CTL) that underwent regular rehabilitation.
RESULTS A total of 229 patients (CTL = 130, YKR = 99) were enrolled. No significant differences were observed in the baseline characteristics between the two groups. The YKR group had a significantly increased number of daily steps postoperatively (P < 0.05) and had significantly lower postoperative serum tumor necrosis factor-alpha levels (P < 0.01), while no significant differences were observed in the levels of other inflammatory or stress-related cytokines (interleukin-6, adiponectin, superoxide dismutase, and urine 8-hydroxy-2′-deoxyguanosine) between the two groups. Also, the YKR group showed a significant improvement in the Hospital Anxiety and Depression Score (P < 0.05). Moreover, there were no differences in postoperative complications and the duration of postoperative hospital stay between the two groups.
CONCLUSION Our results demonstrated that the daily intake of an herbal medicine-containing drink after OPCAB surgery may have beneficial effects on cardiac rehabilitation by reducing inflammation markers and depression.
Collapse
Affiliation(s)
- Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Kazuo Minematsu
- Department of School Health, Graduate School of Education, Nagasaki University, Nagasaki 852-8521, Japan
| | - Hirotaka Inaba
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
- Department of Cardiovascular Surgery, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan
| | - Kenji Kuwaki
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
- Department of Cardiovascular Surgery, Tokai University Hachioji Hospital, Tokyo 192-0032, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| |
Collapse
|
11
|
Yamamoto T, Endo D, Shimada A, Yamaoka H, Ooishi A, Dohi S, Matsushita S, Asai T, Amano A. Surgical 5-year Outcomes of Extra-Anatomical Bypass for Middle Aortic Syndrome: A Case Series. Vasc Endovascular Surg 2021; 56:85-94. [PMID: 34407713 DOI: 10.1177/15385744211038892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Middle aortic syndrome is a rare disease. Several surgical treatments are available; however, the optimal treatment strategy and long-term outcomes remain unelucidated. We herein report the 5-year outcomes of six patients treated with extra-anatomical bypass surgery for middle aortic syndrome. CASE PRESENTATIONS Between 2013 and 2016, six patients underwent extra-anatomical bypass for middle aortic syndrome at our institute: three had Takayasu's arteritis, one had vessel vasculitis, and two had middle aortic hypoplastic syndrome of unknown origin. The patients included five women and one man, with a mean age of 59.7 years. Four patients had uncontrolled hypertension and were receiving antihypertensive medications. The mean ankle-brachial pressure index was .61. The three patients with Takayasu's arteritis were hospitalized for congestive heart failure. These patients underwent bypass surgery from the descending aorta to the infrarenal abdominal aorta, and one also underwent concomitant heart surgery. The patient with microscopic polyangiitis underwent Y-grafting with an aortic aneurysmectomy. Subsequently, bypass surgery was performed from the descending aorta to the graft via the diaphragm. The two patients with unknown causes underwent bypass surgery from the proximal descending aorta to the distal descending thoracic aorta. There were no early or late deaths at the 5-year follow-up. We did not observe any changes in anastomotic site stenosis or new aneurysmal changes during the follow-up period. The number of antihypertensive medications was reduced in all cases, and critical symptoms, including headache, severe abdominal pain, claudication, and heart failure, improved in all patients. The ankle-brachial pressure index increased to 1.11 and did not change for five years. Renal function remained stable, and the brain natriuretic peptide level decreased from 302.8 to 74.5 pg/mL at follow-up. CONCLUSION Extra-anatomical bypass for middle aortic syndrome is safe and effective, and can help prevent renal failure, and relieve critical ischemic symptoms.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Daisuke Endo
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Hironobu Yamaoka
- Department of Cardiovascular Surgery, 158026Edogawa Hospital, Tokyo, Japan
| | - Atsumi Ooishi
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Shizuyuki Dohi
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, 12847Juntendo University, Tokyo, Japan
| |
Collapse
|
12
|
Abstract
This review aimed to discuss the anatomical properties of the left atrial appendage (LAA), its relationship with atrial fibrillation (AF), effectiveness of LAA occlusion (LAAO), techniques, and new devices used to perform this procedure. An electronic search was performed to identify studies, in the English language, on LAA management. Searches were performed on PubMed Central, Scopus, and Medline from the dates of database inception to February 2020. For the assessed papers, data were extracted from the reviewed text, tables, and figures, by two independent authors. Anticoagulant therapy for patients with AF has proven beneficial and is highly recommended, but it is challenging for many patients to maintain optimal treatment. Surgery is the most cost-effective option; surgical methods include simple LAA resection, thoracoscopic surgery, and catheter treatment. Each procedure has its advantages and disadvantages, and many prospective studies have been conducted to evaluate various treatment methods. In managing the LAA, dissection of the LAA, such as changes in its shape and size due to remodeling during AF, changes in autonomic nerve function, and thrombosis, must be understood anatomically and physiologically. We believe that early treatment intervention for the LAA should be considered particularly in cases of recurrent AF. Conclusion: SLET under artificial pneumothorax is feasible and safe in minimally invasive McKeown esophagectomy.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | | | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Keisuke Nakanishi
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
13
|
Nagasawa H, Ueda S, Otsuka T, Kaifu K, Ono S, Okuma T, Kobayashi T, Matsushita S, Kasai T, Dohi T, Fukushima Y, Amano A, Suzuki Y. Safety and efficacy of using cereal food (Frugra®) to improve blood pressure and bowel health in patients undergoing chronic hemodialysis: A pilot study. J Pharmacol Sci 2021; 147:132-137. [PMID: 34294364 DOI: 10.1016/j.jphs.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/28/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022] Open
Abstract
Hypertension and constipation are major hemodialysis complications. Salt restriction is one of the most important nonpharmacological interventions in managing hypertension. In patients undergoing hemodialysis, nonpharmacological strategies to manage constipation are extremely difficult to develop owing to the presence of excess dietary potassium and fluids. Frugra®, which is a cereal food that has a low salt content of 0.5 g per serving, may help reduce salt intake. Additionally, Frugra is rich in dietary fiber, thereby beneficial for such patients. In this study, we evaluated the safety and efficacy of Frugra in patients undergoing hemodialysis, focusing mainly on blood pressure and bowel health by changing the usual breakfast meal to Frugra for 8 weeks. We enrolled 11 patients undergoing hemodialysis. Despite the absence of changes in the patients' dry weight levels, their systolic blood pressure levels decreased from 155.5 ± 20.9 mmHg to 137.9 ± 10.3 mmHg after 2 months (P < 0.05). All participants reported improvements in bowel movement, and the levels of indoxyl sulfate, a representative gut-derived uremic toxin, were decreased from 49.3 μg/ml to 33.4 μg/ml. Furthermore, adverse events including electrolyte abnormalities were not observed. Therefore, Frugra may be useful to manage the health of patients undergoing hemodialysis.
Collapse
Affiliation(s)
- Hajime Nagasawa
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Seiji Ueda
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
| | - Tomoyuki Otsuka
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | | | | | - Teruyuki Okuma
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takashi Kobayashi
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Tomotaka Dohi
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yoshifumi Fukushima
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Cardiovascular Biology and Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Granola Health Care and Preventive Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan; Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yusuke Suzuki
- Department of Nephrology, Juntendo University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Yamamoto T, Endo D, Yamaoka H, Shimada A, Matsushita S, Amano A. Rapid-Deployment Aortic Valve Replacement for a Hemodialysis Patient with Prior Coronary Artery Bypass Grafting. Heart Surg Forum 2021; 24:E530-E533. [PMID: 34173768 DOI: 10.1532/hsf.3535] [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] [Received: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Aortic valve reoperation increases the risk of mortality and morbidity. The 2017 European Society of Cardiology guidelines for managing valvular heart disease with a previous heart surgery and intact bypass grafts consider patients with high surgical risk to be injury-prone during sternotomy. In high-risk patients with prior coronary artery bypass grafting, several authors have reported the noninferiority or superiority of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement; however, in Japan, TAVR cannot be performed for patients on hemodialysis. In this study, we report a case of successful implantation of the new rapid-deployment bioprosthesis in a 65-year-old Japanese man on dialysis with prior coronary artery bypass grafting. METHODS The rapid-deployment aortic valve system has demonstrated excellent hemodynamic performance, durability, and safety. However, implantation requires specific training and the analysis of preoperative 3D computed tomographic imaging. The cineangiography revealed patency of all grafts, and the saphenous vein graft (SVG) had overlapped the planned aortotomy position. By avoiding the anastomotic part of the SVG, we could perform rapid-deployment aortic valve replacement efficiently even if the aortic incision was repositioned, and the incision was smaller than planned. RESULTS We used the 23-mm Intuity valve without an additional stitch, and the cardiopulmonary bypass and aortic cross-clamp times were only 52 and 39 minutes, respectively. CONCLUSION This novel valve may be beneficial in complex combinational procedures for hemodialysis patients with prior coronary artery bypass grafting.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
| | - Hironobu Yamaoka
- Department of Cardiovascular Surgery, Edogawa Hospital, Tokyo, Japan.
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan.
| |
Collapse
|
15
|
Yamaoka H, Yamamoto T, Endo D, Shimada A, Matsushita S, Asai T, Amano A. Rapid decline in cardiac function in diabetic patients with calcified coronary artery disease undergoing hemodialysis: two case reports. BMC Cardiovasc Disord 2021; 21:271. [PMID: 34082711 PMCID: PMC8173516 DOI: 10.1186/s12872-021-02076-5] [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: 10/23/2020] [Accepted: 05/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical symptoms of patients on dialysis do not match the signs of coronary disease progression, making the prediction of the true progression of their medical condition in clinical settings difficult. Emergency and concomitant surgeries are significant risk factors of mortality following open-heart surgery in patients on hemodialysis. CASE PRESENTATION We report two cases of successful coronary artery bypass grafting (CABG) in patients on dialysis with a history of cardiac surgery. The first case describes a 65-year-old woman who had undergone aortic valve replacement 2 years ago and was hospitalized urgently, because of a sudden decline in heart function and hypotension. She had moderate mitral regurgitation with right ventricular pressure of 66 mmHg and poor left ventricular function [left ventricular ejection fraction (LVEF), 40%]. Cineangiography revealed an increase in the rate of stenosis in the left main trunk, from 25 to 99% at admission, in addition to 100% occlusion in proximal left anterior descending artery (LAD) and 99% stenosis in the proximal left circumflex artery (LCX). We inserted an intra-aortic balloon pump preoperatively and performed emergency surgery (Euro II risk score, 61.7%; Society of Thoracic Surgeons (STS) risk score, 56.3%). The second case described a 78-year-old man who had undergone surgery for left atrial myxoma 4 years ago and was hospitalized urgently due to dyspnea, chest discomfort, and an LVEF of 44% (Euro II risk score, 40.7%; STS risk score, 33.2%). Cineangiography revealed an increase in the rate of stenosis in the proximal LAD, from 25% (4 years ago) to 90% at admission, in addition to 99% stenosis in proximal LCX and 95% stenosis in the posterolateral branch of LCX. Both patients underwent emergency CABG due to unstable hemodynamics and decreased left ventricular function despite regular dialysis. The surgeries were successful, and the patients were discharged without any complications. CONCLUSIONS In patients with multiple comorbidities and those who undergo dialysis treatment, calcified lesions in coronary arteries can progress severely and rapidly without any symptoms, including chest pain. Close outpatient management involving nephrologists and the cardiovascular team is necessary for patients on dialysis.
Collapse
Affiliation(s)
- Hironobu Yamaoka
- Department of Cardiovascular surgery, Edogawa Hospital, Higashi Koiwa 2-24-18, Edogawa-ku, Tokyo, 133-0052, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
16
|
Minoda S, Sada R, Matsushita S, Nakayama Y, Akebo H, Tsugihashi Y, Ishimaru H, Hatta K. POS0516 REDEFINING THE CLINICAL AND LABORATORY FEATURES OF RHEUMATIC PLEURAL EFFUSION: A 30-CASE SERIES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid pleural effusion (RPE) is a common extra-articular complication in patients with rheumatoid arthritis (RA). Previous studies have shown that RPE usually occurs in middle-aged men with rheumatoid factor (RF)-positive RA. RPE usually has features of pleural fluid acidosis, high lactate dehydrogenase (LDH) levels, and very low glucose levels(1). However, to the best of our knowledge, these findings were based on very few case series and reports, and most of these reports were published by the early 2000s(1, 2).Objectives:To investigate the clinical and laboratory characteristics and typical clinical courses of patients with RPE in a single centre of Japan since the beginning of the 21st century.Methods:Medical records of RPE patients were retrospectively reviewed between May 2006 and September 2020. RPE was identified by fulfilling these five conditions: (1) confirmation of the RA diagnosis; (2) having an exudative pleural effusion according to Light’s criteria; (3) negative results of pleural fluid culture; (4) negative results of pleural fluid cytology; and (5) exclusion of a parapneumonic effusion or empyema defined as no antibiotic use or ineffectiveness of antibiotics during the clinical course. Patients were divided into two groups according to their age at diagnosis: <60 years (Group A) and ≥60 years (Group B).Results:A total of 30 cases of RPE were included in the study. The median age was 71 years (interquartile range [IQR], 66–78 years). Of these patients, 16 (53%) were women. The median disease duration of RA was 98 months (IQR, 8–162 months). The two groups comprised six patients aged <60 years old and 24 patients ≥60 years. The median age was 54 years (IQR, 49–56 years) in Group A and 74 years (IQR, 69–78 years) in Group B. The median disease duration of RA was longer in Group B than that in Group A (132 vs. 3 months, p=0.008). Compared with Group A, Group B had fewer patients with fever (14% vs. 83%, p=0.003), and had lower serum C-reactive protein levels (3.3 vs. 11.1 mg/dL, p=0.03). Moreover, Group B was more likely to show mild inflammatory pleural fluids with higher pH (7.5 vs. 7.2, p=0.005) and lower LDH levels (155 vs. 1810 IU/L, p=0.046). Corticosteroids were started or increased in five (83%) and nine (38%) patients, and biologic disease-modifying anti-rheumatic drugs were started in one (17%) and two (8%) patients in groups A and B, respectively. One patient (16%) died within 5-years in Group A, and seven patients (29%) died in Group B.Conclusion:In contrast to previous studies, RPE was seen in older patients as well as middle-aged adults, and the pleural fluid analysis in older patients with RPE showed milder inflammation than the middle-aged patients.References:[1]Balbir-Gurman A, et al. Semin Arthritis Rheum. 2006 Jun; 35(6): 368-78.[2]Faurschou P, et al. Thorax. 1985 May; 40(5): 371-5.Table 1.Comparison of clinical and laboratory findings between Group A and Group B.Group A (n=6)Group B (n=24)P valueAge (years)54 [49-56]74 [69-78]Female2 (n=6, 33.3)14 (n=24, 58.3)0.38Disease duration of RA (months)3 [1-9]132 [44-199]0.008Fever ≥37.0°C5 (n=6, 83.3)3 (n=22, 13.6)0.003SerumCRP (mg/dL)11.1 [5.6-1.4]3.3 [0.9-10.5]0.03 RF (IU/mL)100 [19-816]63 [23-193]0.95 Anti-CCP ab positive5 (n=6, 83.3)12 (n=15, 80)1.00Pleural fluid analysispH7.2 [7.2-7.2]7.5 [7.4-7.5]0.005LDH (IU/L)1810 [594-2932]155 [123-346]0.046Glu (mg/dL)59 [10-123]105 [91-122]0.42Tp (g/dL)5.1 [4.9-5.6]4.6 [3.6-5.2]0.21Number of cells (/μL)5235 [3353-9300]3300 [1490-5008]0.27 Glu/serum Glu0.41 [0.09-0.99]1.05 [0.85-1.15]0.71Started or increased CS5 (n=6, 83.3)9 (n=24, 37.5)0.18Started bDMARDs1 (n=6, 16.6)2 (n=24, 8.3)0.50Died within 5 years1 (n=6, 16.6)7 (n=24, 29.1)1.00Data are median [interquartile range], or number (total number, percent).Abbreviations: RA, rheumatoid arthritis; CRP, C-reactive protein; RF, rheumatoid factor; Anti-CCP ab, anti-cyclic citrullinated peptide antibodies; LDH, lactate dehydrogenase; Glu, glucose; Tp, total protein; CS, corticosteroid; bDMARDs, biologic disease-modifying anti-rheumatic drugsDisclosure of Interests:None declared
Collapse
|
17
|
Matsushita S, Fujii K, Kajihara I, Aoki M, Yamamura K, Tada K, Kanekura T, Aoi J, Fukushima S. Efficacy of S-1 plus docetaxel in the treatment of metastatic extramammary Paget's disease: a multicentre retrospective study. Br J Dermatol 2021; 185:458-460. [PMID: 33829494 DOI: 10.1111/bjd.20135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - K Fujii
- Department of Dermatology, Field of Sensory Organology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - I Kajihara
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - M Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - K Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - K Tada
- Department of Dermatology, Field of Sensory Organology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - T Kanekura
- Department of Dermatology, Field of Sensory Organology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - J Aoi
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - S Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| |
Collapse
|
18
|
Yamamoto T, Endo D, Yamaoka H, Matsushita S, Kajimoto K, Asai T, Amano A. A new technique that prevents paravalvular leakage after aortic valve replacement using a rapid-deployment valve system. J Card Surg 2021; 36:2225-2232. [PMID: 33783050 DOI: 10.1111/jocs.15513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 01/31/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND We report our 1-year single-center experience of a new technique of aortic valve replacement using a rapid-deployment valve (RD-AVR) to avoid postoperative complications. We also report the unexpected pitfalls and handling techniques that we have seen in past cases. METHODS We performed aortic valve replacement on 38 patients between May 2019 and April 2020. Their mean age was 74 years. The primary outcomes were in-hospital mortality and short-term results during a 1-year follow-up period, while the secondary outcomes were related to prosthetic valve function, especially paravalvular leakage (PVL). We further analyzed the relationship between the new technique and its outcomes. RESULTS The mean operative time was 196 min. There were no in-hospital deaths, and the mean duration of postoperative hospital stay was 11.8 days. Valvular measurements using three-dimensional computed tomography were larger and more accurate than those measured using ultrasonic echocardiography. Postoperative RD-AVR prosthetic valve function was excellent. However, PVL occurred in four cases 1 week and 1 year postoperatively and regurgitation did not improve. A gap associated with PVL was identified below the right-noncoronary commissure. To prevent PVL, we additionally stitched this gap in the later 18 cases; there was no case of PVL and no new pacemaker implantation in these cases. CONCLUSIONS PVL is more likely to occur if there is a gap below the R-N commissure, especially in cases with a large annulus; therefore, applying an additional stitch to the R-N commissure is extremely useful.
Collapse
Affiliation(s)
- Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Daisuke Endo
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Hironobu Yamaoka
- Department of Cardiovascular Surgery, Edogawa Hospital, Tokyo, Japan
| | | | - Kan Kajimoto
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Tohru Asai
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Tokyo, Japan
| |
Collapse
|
19
|
Kim KH, Lara-Avila S, Kang H, He H, Eklӧf J, Hong SJ, Park M, Moth-Poulsen K, Matsushita S, Akagi K, Kubatkin S, Park YW. Author Correction: Apparent Power Law Scaling of Variable Range Hopping Conduction in Carbonized Polymer Nanofibers. Sci Rep 2020; 10:6471. [PMID: 32277080 PMCID: PMC7148298 DOI: 10.1038/s41598-020-62904-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
20
|
Shiozawa T, Shimada K, Lee-Okada H, Kadoguchi T, Aikawa T, Hayashi H, Miyazaki T, Matsushita S, Suwa S, Yokomizo T, Amano A, Nakazato Y, Daida H. Levels of phospholipids and triacylglycerol-containing omega 3 fatty acids in myocardial tissue of patients with myocardial infarction: analyzed by a lipidomics profiling method. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
According to population-based studies, low omega 3 fatty acid (omega3FA) intake and high levels of serum triacylglycerol (TAG) are associated with cardiovascular diseases. Recent advances in mass spectrometry allow molecular lipid (lipidomics) profiling, which may enhance cardiovascular risk prediction. In this study, we assessed the levels of omega3FA-containing phospholipids (PL) and TAG in myocardial tissues of patients with and without myocardial infarction (MI) using a lipidomics profiling method.
Methods
We performed lipidomics profiling of human left atrial appendage (LAA) tissue of 29 consecutive patients receiving off-pump coronary bypass surgery with standard LAA resection. The patients were divided into the MI group (n=7) and an age- and gender-matched non-MI group (n=7).
Results
Lipidomics profiling revealed that the MI group tended to have low levels of phosphatidylcholines (PC), phosphatidylethanolamine (PE), lysophosphatidylethanolamine (LPE), and plasmalogen, and high levels of TAG species. Individual molecular species containing omega3FA, such as PC (18:0/20:5; 3,200±1,200 vs. 4,500±910 pmol/g tissue, p=0.04) and plasmalogen (18:1/20:5; 57,000±21,000 vs. 91,000±28,000 pmol/g tissue, p=0.02), were significantly lower in the MI group than in the non-MI group.
Conclusions
To our knowledge, this is the first study to determine the levels of omega3FA-containing PL and TAG in myocardial tissue using lipidomics profiling. We discovered that lower levels of omega3FA-containing PL and higher levels of TAG existed in myocardial tissues of patients with MI than in those of patients without MI. Accordingly, the lipidomics profiling method for human myocardial tissue may be useful for developing therapy targets for cardiovascular diseases.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): MEXT/JSPS KAKENHI Grant
Collapse
Affiliation(s)
- T Shiozawa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Shizuoka, Japan
| | - K Shimada
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Lee-Okada
- Juntendo University School of Medicine, Department of Biochemistry, Tokyo, Japan
| | - T Kadoguchi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Aikawa
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Hayashi
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Miyazaki
- Juntendo University Urayasu Hospital, Department of Cardiology, Chiba, Japan
| | - S Matsushita
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - S Suwa
- Juntendo University Shizuoka Hospital, Department of Cardiology, Shizuoka, Japan
| | - T Yokomizo
- Juntendo University School of Medicine, Department of Biochemistry, Tokyo, Japan
| | - A Amano
- Juntendo University School of Medicine, Department of Cardiovascular Surgery, Tokyo, Japan
| | - Y Nakazato
- Juntendo University Urayasu Hospital, Department of Cardiology, Chiba, Japan
| | - H Daida
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|
21
|
Ghazawi FM, Iga N, Tanaka R, Fujisawa Y, Yoshino K, Yamashita C, Yamamoto Y, Fujimura T, Yanagi T, Hata H, Matsushita S, Le M, Roy SF, Lagacé F, Ishida Y, Kabashima K, Otsuka A. Demographic and clinical characteristics of extramammary Paget's disease patients in Japan from 2000 to 2019. J Eur Acad Dermatol Venereol 2020; 35:e133-e135. [PMID: 32780877 DOI: 10.1111/jdv.16868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- F M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, ON, Canada
| | - N Iga
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - R Tanaka
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Fujisawa
- Department of Dermatology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - K Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - C Yamashita
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan
| | - Y Yamamoto
- Department of Dermatology, Wakayama Medical University Graduate School of Medicine, Wakayama, Japan
| | - T Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Yanagi
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Hata
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - M Le
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - S F Roy
- Department of Pathology and Cell Biology, University of Montreal, Montreal, QC, Canada
| | - F Lagacé
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Y Ishida
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| |
Collapse
|
22
|
Matsushita S, Kishida A, Wakamatsu Y, Mukaida H, Yokokawa H, Yamamoto T, Amano A. Factors influencing activated clotting time following heparin administration for the initiation of cardiopulmonary bypass. Gen Thorac Cardiovasc Surg 2020; 69:38-43. [PMID: 32656705 DOI: 10.1007/s11748-020-01435-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Initiation of cardiopulmonary bypass (CPB) for open-heart surgery requires that heparin be administered and reach an adequate value of activated clotting time (ACT). We previously introduced a new heparin formula that considered the preoperative ACT. In this study, we determined other factors affecting ACT. METHODS Adult patients who underwent cardiac surgery using CPB were divided into two groups according to their ACT value after the initial administration of heparin during surgery. ACT above 450 s was defined as "Reach", and this group was compared to the "Short" group with ACT below 450 s. RESULTS The Reach and Short groups included 334 (64.7%) and 182 (35.3%) cases, respectively. Univariate analysis indicated that preoperative heparin use, age ≥ 80 years, New York Heart Association classification 4, white blood cell counts above the higher limit, hematocrit below the lower limit, platelet cell counts below the lower limit, low albumin levels, moderate renal dysfunction, high C-reactive protein levels, high brain natriuretic peptide levels, and moderate deterioration of left ventricular ejection fraction were associated with the effects of heparin. Multivariate analysis revealed that age ≥ 80 years (odds ratio [OR] 2.53, 95% confidence interval [95%CI] 1.41-5.24), New York Heart Association classification 4 (OR = 4.44, 95%CI 1.59-15.35), and platelet count below the lower limit (OR 0.37, 95%CI 0.31-0.85) were associated with the effects of heparin. CONCLUSION Old age, heart failure, and lower platelet counts affected heparin activity. The dose of heparin should be considered in those patients to reach the target ACT.
Collapse
Affiliation(s)
- Satoshi Matsushita
- Faculty of Medicine, Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Akinori Kishida
- Department of Medical Engineer, Juntendo Hospital, Tokyo, Japan
| | | | - Hiroshi Mukaida
- Department of Medical Engineer, Juntendo Hospital, Tokyo, Japan
| | - Hirohide Yokokawa
- Faculty of Medicine, Department of General Medicine, Juntendo University, Tokyo, Japan
| | - Taira Yamamoto
- Faculty of Medicine, Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Faculty of Medicine, Department of Cardiovascular Surgery, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
23
|
Kim JD, Matsushita S, Tamura K. Crosslinked Sulfonated Polyphenylsulfone-Vinylon (CSPPSU-vinylon) Membranes for PEM Fuel Cells from SPPSU and Polyvinyl Alcohol (PVA). Polymers (Basel) 2020; 12:polym12061354. [PMID: 32560108 PMCID: PMC7361900 DOI: 10.3390/polym12061354] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/13/2020] [Accepted: 06/14/2020] [Indexed: 11/16/2022] Open
Abstract
A crosslinked sulfonated polyphenylsulfone (CSPPSU) polymer and polyvinyl alcohol (PVA) were thermally crosslinked; then, a CSPPSU-vinylon membrane was synthesized using a formalization reaction. Its use as an electrolyte membrane for fuel cells was investigated. PVA was synthesized from polyvinyl acetate (PVAc), using a saponification reaction. The CSPPSU-vinylon membrane was synthesized by the addition of PVA (5 wt%, 10 wt%, 20 wt%), and its chemical, mechanical, conductivity, and fuel cell properties were studied. The conductivity of the CSPPSU-10vinylon membrane is higher than that of the CSPPSU membrane, and a conductivity of 66 mS/cm was obtained at 120 °C and 90% RH (relative humidity). From a fuel cell evaluation at 80 °C, the CSPPSU-10vinylon membrane has a higher current density than CSPPSU and Nafion212 membranes, in both high (100% RH) and low humidification (60% RH). By using a CSPPSU-vinylon membrane instead of a CSPPSU membrane, the conductivity and fuel cell performance improved.
Collapse
Affiliation(s)
- Je-Deok Kim
- Polymer Electrolyte Fuel Cell Group, Global Research Center for Environmental and Energy Based on Nanomaterials Science (GREEN),Tsukuba Ibaraki 305-0044, Japan;
- Hydrogen Production Materials Group, Center for Green Research on Energy and Environmental Materials, Tsukuba Ibaraki 305-0044, Japan
- Functional Clay Materials Group, Research Center for Functional Materials, National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan;
- Correspondence: ; Tel.: +81-29-860-4764; Fax: +81-29-860-4984
| | - Satoshi Matsushita
- Polymer Electrolyte Fuel Cell Group, Global Research Center for Environmental and Energy Based on Nanomaterials Science (GREEN),Tsukuba Ibaraki 305-0044, Japan;
| | - Kenji Tamura
- Functional Clay Materials Group, Research Center for Functional Materials, National Institute for Materials Science (NIMS), 1-1 Namiki, Tsukuba, Ibaraki 305-0044, Japan;
| |
Collapse
|
24
|
Shahi HA, Kadoguchi T, Shimada K, Fukao K, Matsushita S, Aikawa T, Ouchi S, Shiozawa T, Takahashi S, Sato-Okabayashi Y, Akita K, Isoda K, Miyazaki T, Daida H. Voluntary exercise and cardiac remodeling in a myocardial infarction model. Open Med (Wars) 2020; 15:545-555. [PMID: 33313409 PMCID: PMC7706131 DOI: 10.1515/med-2020-0109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/01/2020] [Accepted: 03/10/2020] [Indexed: 02/04/2023] Open
Abstract
We investigated the effects of voluntary exercise after myocardial infarction (MI) on cardiac function, remodeling, and inflammation. Male C57BL/6J mice were divided into the following four groups: sedentary + sham (Sed-Sh), sedentary + MI (Sed-MI), exercise + sham (Ex-Sh), and exercise + MI (Ex-MI). MI induction was performed by ligation of the left coronary artery. Exercise consisting of voluntary wheel running started after the operation and continued for 4 weeks. The Ex-MI mice had significantly increased cardiac function compared with the Sed-MI mice. The Ex-MI mice showed significantly reduced expression levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6, and IL-10 in the infarcted area of the left ventricle compared with the Sed-MI mice. In the Ex-MI mice, the expression levels of fibrosis-related genes including collagen I and III were decreased compared to the Sed-MI mice, and the expression levels of IL-1β, IL-6, follistatin-like 1, fibroblast growth factor 21, and mitochondrial function-related genes were significantly elevated in skeletal muscle compared with the Sed mice. The plasma levels of IL-6 were also significantly elevated in the Ex-MI group compared with the Sed-MI groups. These findings suggest that voluntary exercise after MI may improve in cardiac remodeling associated with anti-inflammatory effects in the myocardium and myokine production in the skeletal muscles.
Collapse
Affiliation(s)
- Hamad Al Shahi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoyasu Kadoguchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kazunori Shimada
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kosuke Fukao
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Graduate School of Health and Sports Science, Juntendo University, Chiba, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tatsuro Aikawa
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shohei Ouchi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tomoyuki Shiozawa
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shuhei Takahashi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yayoi Sato-Okabayashi
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Akita
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kikuo Isoda
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Tetsuro Miyazaki
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroyuki Daida
- Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Faculty of Health Science, Juntendo University, Tokyo, Japan
| |
Collapse
|
25
|
Nakamura Y, Namikawa K, Yoshino K, Yoshikawa S, Uchi H, Goto K, Nakamura Y, Fukushima S, Kiniwa Y, Takenouchi T, Uhara H, Kawai T, Hatta N, Funakoshi T, Teramoto Y, Otsuka A, Doi H, Ogata D, Matsushita S, Isei T, Hayashi T, Shibayama Y, Yamazaki N. Anti-PD1 checkpoint inhibitor therapy in acral melanoma: a multicenter study of 193 Japanese patients. Ann Oncol 2020; 31:1198-1206. [PMID: 32522691 DOI: 10.1016/j.annonc.2020.05.031] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/04/2020] [Accepted: 05/28/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Acral melanoma (AM) is an epidemiologically and molecularly distinct entity that is underrepresented in clinical trials on immunotherapy in melanoma. We aimed to analyze the efficacy of anti-programmed cell death 1 (anti-PD-1) antibodies in advanced AM. PATIENTS AND METHODS We retrospectively evaluated unresectable stage III or stage IV AM patients treated with an anti-PD-1 antibody in any line at 21 Japanese institutions between 2014 and 2018. The clinicobiologic characteristics, objective response rate (ORR, RECIST), survival estimated using Kaplan-Meier analysis, and toxicity (Common Terminology Criteria for Adverse Events 4.0.) were analyzed to estimate the efficacy of the anti-PD-1 antibodies. RESULTS In total, 193 patients (nail apparatus, 70; palm and sole, 123) were included in the study. Anti-PD-1 antibody was used as first-line therapy in 143 patients (74.1%). Baseline lactate dehydrogenase (LDH) was within the normal concentration in 102 patients (52.8%). The ORR of all patients was 16.6% (complete response, 3.1%; partial response, 13.5%), and the median overall survival (OS) was 18.1 months. Normal LDH concentrations showed a significantly stronger association with better OS than abnormal concentrations (median OS 24.9 versus 10.7 months; P < 0.001). Although baseline characteristics were similar between the nail apparatus and the palm and sole groups, ORR was significantly lower in the nail apparatus group [6/70 patients (8.6%) versus 26/123 patients (21.1%); P = 0.026]. Moreover, the median OS in this group was significantly poorer (12.8 versus 22.3 months; P = 0.03). CONCLUSIONS Anti-PD-1 antibodies have limited efficacy in AM patients. Notably, patients with nail apparatus melanoma had poorer response and survival, making nail apparatus melanoma a strong candidate for further research on the efficacy of novel combination therapies with immune checkpoint inhibitors.
Collapse
Affiliation(s)
- Y Nakamura
- Department of Skin Oncology/Dermatology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan.
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - K Yoshino
- Department of Dermatologic Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - S Yoshikawa
- Department of Dermatology, Shizuoka Cancer Center, Shizuoka, Japan
| | - H Uchi
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - K Goto
- Department of Dermatology, Nagoya University, Nagoya, Japan
| | - Y Nakamura
- Department of Dermatology, University of Tsukuba, Tsukuba, Japan
| | - S Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Y Kiniwa
- Department of Dermatology, Shinshu University, Matsumoto, Japan
| | - T Takenouchi
- Department of Dermatology, Niigata Cancer Center, Niigata, Japan
| | - H Uhara
- Department of Dermatology, Sapporo Medical University, Sapporo, Japan
| | - T Kawai
- Department of Dermatology, University of Tokyo, Tokyo, Japan
| | - N Hatta
- Department of Dermatology, Toyama Prefectural Central Hospital, Toyama, Japan
| | - T Funakoshi
- Department of Dermatology, Keio University, Tokyo, Japan
| | - Y Teramoto
- Department of Skin Oncology/Dermatology, Comprehensive Cancer Center, Saitama Medical University International Medical Center, Saitama, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - H Doi
- Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan
| | - D Ogata
- Department of Dermatology, Saitama Medical University, Saitama, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - T Isei
- Department of Dermatological Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - T Hayashi
- Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Y Shibayama
- Department of Dermatology, Fukuoka University, Fukuoka, Japan
| | - N Yamazaki
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
26
|
Fujisawa Y, Fujimura T, Matsushita S, Yamamoto Y, Uchi H, Otsuka A, Funakoshi T, Miyagi T, Hata H, Gosho M, Kambayashi Y, Aoki M, Yanagi T, Ohira A, Nakamura Y, Maeda T, Yoshino K. The efficacy of eribulin mesylate for patients with cutaneous angiosarcoma previously treated with taxane: a multicentre prospective observational study. Br J Dermatol 2020; 183:831-839. [PMID: 32198756 DOI: 10.1111/bjd.19042] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Taxanes are the current first-line treatment for advanced cutaneous angiosarcoma (CAS) for patients who are considered difficult to treat with doxorubicin owing to advanced age or comorbidity. However, no effective second-line therapy for such patients has been established. METHODS We designed a single-arm prospective observational study of eribulin mesylate (ERB) administered at a dose of 1·4 mg m-2 on days 1 and 8 in a 21-day cycle. Patients with advanced CAS who were previously treated with a taxane and were scheduled to begin ERB treatment were enrolled. The primary endpoint was overall survival (OS) and the secondary endpoints were response rate (RR), progression-free survival (PFS) and toxicity assessment. RESULTS We enrolled a total of 25 patients. The median OS and PFS were 8·6 months and 3·0 months, respectively. The best overall RR was 20% (five of 25). In total, 16 grade 3/4 severe adverse events (SAEs) occurred; however, all patients recovered. Patients who achieved partial response or stable disease as best response had longer OS than those with progressive disease (median OS not reached and 3·3 months, respectively; P < 0·001). Patients who did not experience SAEs showed longer OS than those who did (median OS 18·8 months and 7·5 months, respectively; P < 0·05). Patients with distant metastasis had shorter median OS than those with locoregional disease, but without statistically significant difference. CONCLUSIONS ERB showed a promising RR and is a potential candidate for second-line treatment for patients with CAS, after treatment with taxanes. However, owing to the occurrence of SAEs in over half of the participants, caution should be exercised regarding ERB use in elderly patients. What is already known about this topic? Taxanes are the current first-line treatment for patients with advanced cutaneous angiosarcoma (CAS) who are considered difficult to treat with doxorubicin owing to advanced age or comorbidity. No effective therapy for taxane-resistant CAS has been established thus far. Eribulin suppresses microtubule polymerization and elicits an antitumour effect similar to that of taxanes. What does this study add? In our single-arm prospective observational study to evaluate the efficacy of eribulin for treating patients with advanced CAS who previously received taxanes, the median overall survival and progression-free survival were 8·6 and 3·0 months, respectively. Response rates at weeks 7, 13 and 25 were 20%, 17% and 14%, respectively. Although 16 grade 3/4 severe adverse events occurred, all patients recovered. Eribulin showed a promising response rate and is a potential candidate for second-line treatment in CAS after taxane treatment. Linked Comment: Smrke and Benson. Br J Dermatol 2020; 183:797-798.
Collapse
Affiliation(s)
- Y Fujisawa
- Dermatology Division, University of Tsukuba, Tsukuba, Japan
| | - T Fujimura
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Y Yamamoto
- Department of Dermatology, Wakayama Prefectural Medical School, Wakayama, Japan
| | - H Uchi
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - T Funakoshi
- Department of Dermatology, Keio University, Tokyo, Japan
| | - T Miyagi
- Department of Dermatology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - H Hata
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - M Gosho
- Department of Clinical Trial and Clinical Epidemiology, University of Tsukuba, Tsukuba, Japan
| | - Y Kambayashi
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - T Yanagi
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - A Ohira
- Department of Dermatology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Y Nakamura
- Dermatology Division, University of Tsukuba, Tsukuba, Japan
| | - T Maeda
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - K Yoshino
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| |
Collapse
|
27
|
Nakamura Y, Matsushita S, Tanaka R, Saito S, Araki R, Teramoto Y, Aoki M, Yamamura K, Nakamura Y, Fujisawa Y, Brinker TJ, Yamamoto A. 2-mm surgical margins are adequate for most basal cell carcinomas in Japanese: a retrospective multicentre study on 1000 basal cell carcinomas. J Eur Acad Dermatol Venereol 2020; 34:1991-1998. [PMID: 31954082 DOI: 10.1111/jdv.16200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Surgery is the gold standard for basal cell carcinomas (BCC). Current recommended surgical margins for BCCs are determined from studies in Caucasian populations. However, the appropriate surgical margins for BCCs in non-white races are unclear. OBJECTIVES To investigate the accuracy of preoperative determination of clinical tumour borders and appropriate surgical margins in Japanese patients with BCC. METHODS The maximum calculated differences in distance between the preoperatively determined surgical margins and the actual histologic tumour side margins were considered as 'accuracy gaps' of clinical tumour borders. Estimated side margin positivity rates (ESMPRs) with narrower (2 and 3 mm) surgical margins were calculated on the basis of the accuracy gaps. RESULTS Overall, 1000 surgically excised BCCs from 980 Japanese patients were included. The most frequent histologic subtype was nodular BCC (67%). The median accuracy gap was 0.3 mm [interquartile range (IQR): -0.5 to +1 mm]. The ESMPRs with 2- and 3-mm surgical margins were 3.8% and 1.4%, respectively. Only the ESMPRs between the well-defined (n = 921) and poorly defined clinical tumour border groups (n = 79) showed statistical difference [2-mm margin: 3.1% vs. 11.7%, OR: 3.89, 95% confidential interval (CI): 1.41-10.71, P <0.01; 3-mm margin: 0.97% vs. 6.3%, OR: 6.58, 95% CI: 1.67-25.99, P <0.01]. No significant differences in ESMPRs were noted in other subgroups including risk classifications. CONCLUSIONS The determined clinical tumour border accuracy gaps in this Japanese cohort were negligible. Dermatologic surgeons may use narrower surgical margins with acceptable margin positivity rates. The clarity of clinical tumour borders could be an appropriate guide for selection of different surgical margins in the Japanese cohort.
Collapse
Affiliation(s)
- Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - R Tanaka
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - S Saito
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - R Araki
- Community Health Science Center, Saitama Medical University, Saitama, Japan
| | - Y Teramoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - M Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - K Yamamura
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - Y Nakamura
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Y Fujisawa
- Department of Dermatolgy, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - T J Brinker
- Department of Dermatology, University of Heidelberg, Heidelberg, Germany
| | - A Yamamoto
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| |
Collapse
|
28
|
Fujimura T, Tanita K, Sato Y, Lyu C, Kambayashi Y, Fujisawa Y, Uchi H, Yamamoto Y, Otsuka A, Yoshino K, Matsushita S, Funakoshi T, Fukushima S, Hata H, Hashimoto A, Aiba S. Immune checkpoint inhibitor‐induced vitiligo in advanced melanoma could be related to increased levels of CCL19. Br J Dermatol 2019; 182:1297-1300. [DOI: 10.1111/bjd.18721] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- T. Fujimura
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - K. Tanita
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - Y. Sato
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - C. Lyu
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - Y. Kambayashi
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | | | - H. Uchi
- National Kyushu Cancer Center Fukuoka Japan
| | | | - A. Otsuka
- Kyoto University Graduate School of Medicine Kyoto Japan
| | - K. Yoshino
- Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital Tokyo Japan
| | - S. Matsushita
- National Hospital Organization Kagoshima Medical Center Kagoshima Japan
| | | | | | - H. Hata
- Hokkaido University Graduate School of Medicine Sapporo Japan
| | - A. Hashimoto
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| | - S. Aiba
- Department of Dermatology Tohoku University Graduate School of Medicine Sendai Japan
| |
Collapse
|
29
|
Miyosawa K, Iwata H, Takano A, Hayashi H, Funamizu T, Doi S, Tabuchi H, Sekita G, Matsushita S, Amano A, Daida H. P2861Elevated cc chemokine receptor 2 expression and higher migratory activity of monocytes in atrial fibrillation patients with progressive structural remodeling. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Inflammation in atrial tissue underlies structural remodeling of left atrium, which is a hallmark of atrial fibrillation (AF). Activated monocytes mediate inflammation; however, the role of monocytes in AF pathogenesis has not been extensively examined. In this study, we thus investigated the association between structural remodeling of left atrium, represented by left atrial dimension (LAD), and characteristics of peripheral monocytes in patients with AF.
Methods
Blood samples were collected from patients undergone catheter ablation between July 2017 and October 2018, including AF patients (n=152) and paroxysmal supraventricular tachycardia (PSVT) patients, which serves as a control non-AF group (n=22). AF patients were further divided into two groups by the median of LAD (normal LAD group: LAD <40 mm, n=77, large LAD group: LAD ≥40 mm, n=75). Peripheral blood mononuclear cells (PBMC) were isolated to analyze monocyte subsets by flow cytometry. In a subset of patients, we further isolated monocytes from PBMC by using magnetic bead-based negative selection method then gene products associated with inflammation or monocyte functions were evaluated. We also examined migratory activity of monocytes toward monocyte chemotactic protein-1, a ligand for CC chemokine receptor 2 (CCR2), using a modified Boyden chamber method. Finally, we performed immunofluorescence staining of monocytes and macrophages in left atrial appendages resected from patients underwent coronary bypass graft surgery (CABG) complicated by AF.
Results
There were no differences in age, body mass index and high-sensitivity C-reactive protein levels among three groups, including non-AF, normal LAD and large LAD groups, except that more female subjects were included in non-AF group. We found that proportions of classical CD14++CD16- and nonclassical CD14+CD16++ monocytes were higher (non-AF: 71.2±7.3% vs. AF: 75.5±8.3%, p<0.05) and lower (non-AF: 16.4±5.9% vs. AF: 13.2±5.5%, p<0.05), respectively, in all AF patients compared with those in non-AF group, while no significant difference was observed between normal and large LAD groups. In monocytes from large LAD group, mRNA levels of CCR2, a receptor to mediate monocyte chemotaxis, were significantly higher compared to those in normal LAD group (Figure A, p<0.05). Furthermore, monocytes isolated from large LAD group exhibited higher migratory capacity compared to normal LAD group (Figure B, p<0.01). Finally, higher monocyte/macrophage infiltrations to left atrial appendages were implicated in patients with large LAD, shown by immunofluorescence staining.
Conclusions
Monocytes in AF patients with enlarged left atrium expressed higher CCR2 mRNA and were more active in chemotaxis to MCP-1, suggesting the proactive roles of activated monocytes in the pathogenesis of arterial remolding in AF.
Collapse
Affiliation(s)
- K Miyosawa
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - H Iwata
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - A Takano
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - H Hayashi
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - T Funamizu
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - S Doi
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - H Tabuchi
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - G Sekita
- Juntendo University, Cardiovascular Medicine, Tokyo, Japan
| | - S Matsushita
- Juntendo University, Cardiac Surgery, Tokyo, Japan
| | - A Amano
- Juntendo University, Cardiac Surgery, Tokyo, Japan
| | - H Daida
- Juntendo University, Cardiac Surgery, Tokyo, Japan
| |
Collapse
|
30
|
Kadoguchi T, Shimada K, Hamad A, Aikawa T, Ouchi S, Kitamura K, Kunimoto M, Fukao K, Yokoyama M, Sugita Y, Shiozawa T, Matsushita S, Miyazaki T, Isoda K, Daida H. P629Voluntary exercise associated with myokine production ameliorates cardiac remodeling and inflammation in a myocardial infarction mouse model. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) remodeling, through excessive inflammation, leads to heart failure. Exercise (Ex) training is associated with a risk reduction in heart failure through direct and indirect mechanisms by which Ex contributes an anti-inflammatory effect. During Ex, contracting muscle fibers release myokines, including interleukins (ILs), tumor necrosis factor α (TNF-α), follistatin-like protein 1 (FSTL-1), and fibroblast growth factor 21 (FGF-21), into the bloodstream. These myokines may have beneficial effects on other damaged organs, such as an infarcted myocardium, through anti-inflammatory effects. However, the exact mechanisms of the anti-inflammatory effects of voluntary Ex in myocardial infarction (MI) are poorly understood. Therefore, we investigated the effect of voluntary Ex on cardiac remodeling and inflammation, the relationship between cardiac remodeling and skeletal muscle (SKM) response, and circulating myokine levels in a mouse model of MI.
Methods
Twelve-week-old male C57BL/6J mice were used and divided into the following 4 groups: sham operation (Sham), MI, Sham+Ex, and MI+Ex. MI was induced by ligation of the left anterior descending coronary artery. Ex groups began voluntary wheel running for 4 weeks after the operation. An echocardiography was performed at baseline and 4 weeks after the operation. The mRNA levels in the LV infarcted area and SKM were measured with RT-PCR and western blot analysis. Plasma levels of myokines were also measured with immunoassays.
Results
Four weeks after MI induction, echocardiographic evaluation showed that the MI mice had a larger LV end-diastolic diameter (LVEDD) and end-systolic diameter (LVESD) than the Sham mice. The MI mice also showed higher mRNA levels of TNF-α, IL-1β, IL-6, and IL-10 in the LV tissue when compared to the Sham mice. These changes were significantly ameliorated in the MI+Ex mice. Interestingly, in the MI+Ex mice, mRNA levels of IL-6, IL-1β, FSTL-1, and FGF-21 in the SKM were significantly higher than in the MI mice, while there were no significant differences in TNF-α and IL-10 levels in all groups. Similarly, protein expression levels of peroxisome proliferator-activated receptor gamma coactivator 1-alpha, sirtuin-1, and mitochondrial transcriptional factor A of mitochondrial function markers in SKM were also significantly higher in the MI+Ex mice than in the MI mice. Furthermore, there were significant correlations between plasma levels of IL-1β, but not other myokines, and LVEDD, and LVESD. In addition, there was also a significant correlation between the SKM IL-1β level and LVESD in the Sham+Ex mice (all, P<0.05).
Conclusions
Amelioration of cardiac remodeling and inflammation by voluntary Ex is associated with increased myokines, especially IL-1β, in a MI mouse model. These results suggest that increased myokine levels, through voluntary exercise, may play an important role in the prevention of cardiac remodeling after MI.
Collapse
Affiliation(s)
- T Kadoguchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Shimada
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - A Hamad
- Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - T Aikawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Ouchi
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Kitamura
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Kunimoto
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Fukao
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Yokoyama
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Sugita
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Shiozawa
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Matsushita
- Juntendo University, Cardiovascular Surgery, Tokyo, Japan
| | - T Miyazaki
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Isoda
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - H Daida
- Juntendo University, Department of Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|
31
|
Fujisawa Y, Yoshino K, Fujimura T, Matsushita S, Uchi H, Yamamoto Y, Hata H, Otsuka A, Miyagi T, Ishii M, Funakoshi T. The efficacy of eribulin for patients with taxane-resistant cutaneous angiosarcoma: Interim result of multi-center, prospective observational study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
32
|
Yan B, Matsushita S, Suzuki S, Kitamura S, Kaiho T, Akagi K. Low-density graphitic films prepared from iodine-doped enzymatically synthesized amylose films as carbonization precursors. Carbohydr Polym 2018; 196:332-338. [PMID: 29891304 DOI: 10.1016/j.carbpol.2018.05.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 05/11/2018] [Accepted: 05/16/2018] [Indexed: 10/16/2022]
Abstract
We have developed a novel approach for preparing low-density graphitic films using iodine-doped enzymatically synthesized amyloses (ESAs) with strictly controlled molecular weights as carbonization precursors. All of the iodine-doped ESA films retained their film structures and morphologies, even after the heat-treatment at 800 °C and 2600 °C. Therefore, iodine doping plays an indispensable role in retaining film structure and morphology during the carbonization of ESA polysaccharides. It was also elucidated that the carbonization yields of the ESA films can be controlled by changing the conditions of iodine doping process. The bulk densities of the graphitic films are varied from 0.08 to 0.42 g/cm3 dependent on the doping level. In addition, the capacitance performances of the graphite films prepared from the ESAs are investigated using cyclic voltammetry and galvanostatic charge/discharge procedures. The potential utility of the carbonized and graphitized ESA films for supercapacitors was revealed. This approach may broaden the application and even the swill processing of polysaccharides.
Collapse
Affiliation(s)
- Bairu Yan
- Department of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan
| | - Satoshi Matsushita
- Department of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan
| | - Shiho Suzuki
- Graduate School of Life & Environmental Sciences, Osaka Prefecture University, Sakai, Osaka 599-8531, Japan
| | - Shinichi Kitamura
- Graduate School of Life & Environmental Sciences, Osaka Prefecture University, Sakai, Osaka 599-8531, Japan
| | - Tatsuo Kaiho
- Godo Shigen Co. Ltd., Chuo-ku, Tokyo 104-0031, Japan
| | - Kazuo Akagi
- Department of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan.
| |
Collapse
|
33
|
Miyazaki S, Kuwaki K, Kajimoto K, Matsushita S, Dohi S, Yamamoto T, Hata H, Amano A. Independent Effect of Low Flow on Outcomes in Patients Undergoing Aortic Valve Replacement for Severe Aortic Stenosis. Circ J 2018; 82:2199-2205. [PMID: 29806622 DOI: 10.1253/circj.cj-17-0900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Low flow (LF; i.e., reduced left ventricular stroke volume index <35 mL/m2) can occur with severe aortic stenosis (AS). However, few studies have investigated the effects of LF on early and late outcomes after aortic valve replacement (AVR) for severe AS.Methods and Results:In all, 285 severe AS patients undergoing isolated AVR at Juntendo University Hospital between August 2002 and August 2015 were enrolled in the study. In this cohort, 52 patients (18%) had LF. Compared with patients with normal flow (NF) severe AS, early postoperative mortality (9.6% vs. 1.2%; P=0.006), gastrointestinal complications (5.7% vs. 0.8%; P=0.04), and the duration of the intensive care unit (ICU) stay (81.7 vs. 35.3 h; P=0.02) were increased in LF patients with severe AS. LF was an independent predictor of early mortality (Model A, odds ratio [OR] 6.81, P=0.01; Model B, OR 6.69, P=0.01) and composite complications (Model A, OR 2.44, P=0.02). In propensity score-matched comparisons, early mortality (12.8% vs. 0%; P=0.02), composite complications (28.2% vs. 10.2%; P=0.04), and duration of ICU stay (97.4 vs. 22.1 h; P=0.006) were significantly increased in LF than NF patients. CONCLUSIONS LF, as an important independent risk factor for postoperative mortality and morbidity, should be included in risk stratification and assessment in severe AS patients.
Collapse
Affiliation(s)
| | - Kenji Kuwaki
- Department of Cardiovascular Surgery, Juntendo University
| | - Kan Kajimoto
- Department of Cardiovascular Surgery, Juntendo University
| | | | - Shizuyuki Dohi
- Department of Cardiovascular Surgery, Juntendo University
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University
| | - Hiroaki Hata
- Department of Cardiovascular Surgery, Juntendo University
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University
| |
Collapse
|
34
|
Fujisawa Y, Yoshino K, Otsuka A, Funakoshi T, Fujimura T, Yamamoto Y, Hata H, Tanaka R, Yamaguchi K, Nonomura Y, Hirai I, Furudate S, Okuhira H, Imafuku K, Aoki M, Matsushita S. Baseline neutrophil to lymphocyte ratio combined with serum lactate dehydrogenase level associated with outcome of nivolumab immunotherapy in a Japanese advanced melanoma population. Br J Dermatol 2018; 179:213-215. [PMID: 29405254 DOI: 10.1111/bjd.16427] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Y Fujisawa
- Department of Dermatology, University of Tsukuba, Japan
| | - K Yoshino
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - A Otsuka
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - T Funakoshi
- Department of Dermatology, Keio University, Tokyo, Japan
| | - T Fujimura
- Department of Dermatology, Tohoku University, Sendai, Japan
| | - Y Yamamoto
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - H Hata
- Department of Dermatology, Hokkaido University, Sapporo, Japan
| | - R Tanaka
- Department of Dermatology, University of Tsukuba, Japan
| | - K Yamaguchi
- Department of Dermatology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan
| | - Y Nonomura
- Department of Dermatology, Kyoto University, Kyoto, Japan
| | - I Hirai
- Department of Dermatology, Keio University, Tokyo, Japan
| | - S Furudate
- Department of Dermatology, Tohoku University, Sendai, Japan
| | - H Okuhira
- Department of Dermatology, Wakayama Medical University, Wakayama, Japan
| | - K Imafuku
- Department of Dermatology, Hokkaido University, Sapporo, Japan
| | - M Aoki
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| | - S Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima, Japan
| |
Collapse
|
35
|
Kim KH, Lara-Avila S, He H, Kang H, Hong SJ, Park M, Eklöf J, Moth-Poulsen K, Matsushita S, Akagi K, Kubatkin S, Park YW. Probing variable range hopping lengths by magneto conductance in carbonized polymer nanofibers. Sci Rep 2018; 8:4948. [PMID: 29563568 PMCID: PMC5862887 DOI: 10.1038/s41598-018-23254-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 03/08/2018] [Indexed: 11/14/2022] Open
Abstract
Using magneto transport, we probe hopping length scales in the variable range hopping conduction of carbonized polyacetylene and polyaniline nanofibers. In contrast to pristine polyacetylene nanofibers that show vanishing magneto conductance at large electric fields, carbonized polymer nanofibers display a negative magneto conductance that decreases in magnitude but remains finite with respect to the electric field. We show that this behavior of magneto conductance is an indicator of the electric field and temperature dependence of hopping length in the gradual transition from the thermally activated to the activation-less electric field driven variable range hopping transport. This reveals magneto transport as a useful tool to probe hopping lengths in the non-linear hopping regime.
Collapse
Affiliation(s)
- Kyung Ho Kim
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden. .,Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea.
| | - Samuel Lara-Avila
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden.,National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, UK
| | - Hans He
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Hojin Kang
- Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea
| | - Sung Ju Hong
- Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea.,Institut für Festkörperphysik, Leibniz Universität Hannover, Appelstraße 2, 30167, Hannover, Germany
| | - Min Park
- Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea.,KIST Jeonbuk Institute of Advanced Composite Materials, Jeonbuk, 565-905, Korea
| | - Johnas Eklöf
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Kasper Moth-Poulsen
- Department of Chemistry and Chemical Engineering, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Satoshi Matsushita
- Department of Polymer Chemistry, Kyoto University, Katsura, Kyoto, 615-8510, Japan
| | - Kazuo Akagi
- Department of Polymer Chemistry, Kyoto University, Katsura, Kyoto, 615-8510, Japan
| | - Sergey Kubatkin
- Department of Microtechnology and Nanoscience, Chalmers University of Technology, SE-412 96, Gothenburg, Sweden
| | - Yung Woo Park
- Department of Physics and Astronomy, Seoul National University, Seoul, 08826, Korea. .,Institute of Applied Physics, Seoul National University, Seoul, 08826, Korea. .,Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| |
Collapse
|
36
|
Mukaida H, Matsushita S, Inotani T, Nakamura A, Amano A. Continuous renal replacement therapy with a polymethyl methacrylate membrane hemofilter suppresses inflammation in patients after open-heart surgery with cardiopulmonary bypass. J Artif Organs 2018; 21:188-195. [DOI: 10.1007/s10047-018-1025-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/28/2018] [Indexed: 01/25/2023]
|
37
|
Matsushita S, Yan B, Matsui T, Kim JD, Akagi K. Conjugated polymer-based carbonaceous films as binder-free carbon electrodes in supercapacitors. RSC Adv 2018; 8:19512-19523. [PMID: 35540988 PMCID: PMC9080771 DOI: 10.1039/c8ra00267c] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 05/18/2018] [Indexed: 11/28/2022] Open
Abstract
We present a facile preparation method for carbonaceous film electrodes using poly(3,4-ethylenedioxythiophene) (PEDOT) and polyacetylene (PA) films as precursors via a morphology-retaining carbonization process. Carbonization was performed on acceptor-doped conjugated polymer films in the temperature range of 600–1100 °C. The obtained carbonaceous films had similar surface morphologies to those of the original conjugated polymer films. The carbonaceous film prepared from the electrochemically synthesized PEDOT film and the carbon film prepared from the chemically synthesized PA film showed hierarchical porous structures consisting of granular and fibril morphologies, respectively. The PEDOT and PA films carbonized at 1100 °C exhibited average electrical conductivities of 2.1 × 100 S cm−1 and 9.9 × 101 S cm−1, respectively. The carbonaceous films could be used as binder-free carbon electrodes in supercapacitors, and the PEDOT-based carbonaceous film prepared in the range of 1000–1100 °C exhibited the most efficient performance on the basis of the electrochemical capacitance in neutral and alkaline aqueous solutions determined from cyclic voltammograms and galvanostatic charge/discharge curves. This approach requires no binders/additives and no further activation processes or additional treatments for the enhancement of the capacities of the carbon materials, enabling one-step fabrication and their direct use as carbon electrodes for energy-storage devices. This is the first report of PEDOT- and PA-based carbonaceous films being used as carbon electrodes in supercapacitors. A facile preparation method for carbonaceous film electrodes was developed using conjugated polymer films as precursors via a morphology-retaining carbonization process.![]()
Collapse
Affiliation(s)
- Satoshi Matsushita
- Polymer Electrolyte Fuel Cell Group
- Global Research Center for Environmental and Energy Based on Nanomaterials Science (GREEN)
- National Institute for Materials Science (NIMS)
- Tsukuba
- Japan
| | - Bairu Yan
- Department of Polymer Chemistry
- Kyoto University
- Kyoto 615-8510
- Japan
| | - Takanori Matsui
- Department of Polymer Chemistry
- Kyoto University
- Kyoto 615-8510
- Japan
| | - Je-Deok Kim
- Polymer Electrolyte Fuel Cell Group
- Global Research Center for Environmental and Energy Based on Nanomaterials Science (GREEN)
- National Institute for Materials Science (NIMS)
- Tsukuba
- Japan
| | - Kazuo Akagi
- Department of Polymer Chemistry
- Kyoto University
- Kyoto 615-8510
- Japan
| |
Collapse
|
38
|
Kyotani M, Hiratani K, Okada T, Matsushita S, Akagi K. Preparation of 2D Carbon Materials by Chemical Carbonization of Cellulosic Materials to Avoid Thermal Decomposition. Glob Chall 2017; 1:1700061. [PMID: 31565290 PMCID: PMC6607140 DOI: 10.1002/gch2.201700061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 07/11/2017] [Indexed: 06/10/2023]
Abstract
Cellulosic materials, including regenerated cellulose, are promising precursors for a variety of carbon materials. However, thermal decomposition, typically accompanying carbonization at high temperatures, hinders cellulosic materials from being efficiently carbonized (i.e., very low carbon yields). Herein, this study presents a new and efficient method for the preparation of porous 2D carbon materials from sheet-like cellulosic materials, such as papers and fabrics, involving a catalyzed chemical reaction at high temperatures without thermal decomposition. Thus, cellulosic materials are treated with sulfonic acid solutions and significantly dehydrated at high temperatures via evaporation of water. As a result, black materials are obtained at a weight near the theoretical carbon content of cellulose and remain in the carbonized materials. The as-obtained porous 2D carbon materials are flexible and suitable for a wide range of applications such as in electrodes and gas absorbents.
Collapse
Affiliation(s)
- Mutsumasa Kyotani
- Conjugated Polymer Super‐Hierarchical Control LabKatsura Int'tech Center 2F‐212Kyoto UniversityKatsuraKyoto615‐8510Japan
| | - Kazuhisa Hiratani
- Department of Applied ChemistryUtsunomiya UniversityUtsunomiya321‐8582Japan
| | - Tatsuhiro Okada
- Tsukuba Fuel Cell Laboratory, Inc.Shimotakatsu 2‐14‐3TsuchiuraIbaraki300‐0812Japan
| | - Satoshi Matsushita
- Department of Polymer ChemistryKyoto UniversityKatsuraKyoto615‐8510Japan
| | - Kazuo Akagi
- Department of Polymer ChemistryKyoto UniversityKatsuraKyoto615‐8510Japan
| |
Collapse
|
39
|
Abstract
Objective Resident cardiac stem cells are expected to be a therapeutic option for patients who suffer from severe heart failure. However, uncertainty remains over whether sorting cells for c-kit, a stem cell marker, improves therapeutic outcomes. Materials and methods Cardiac outgrowth cells cultured from explants of rat heart atrium were sorted according to their positivity (+) or negativity (−) for c-kit. These cells were exposed to hypoxia for 3 d, and subsequently harvested for mRNA expression measurement. The cell medium was also collected to assess cytokine secretion. To test for a functional benefit in animals, myocardial infarction (MI) was induced in rats, and c-kit+ or c-kit− cells were injected. The left ventricular ejection fraction (LVEF) was measured for up to 4 weeks, after which the heart was harvested for biological and histological analyses. Results and conclusion Expression of the angiogenesis-related genes, VEGF and ANGPTL2, was significantly higher in c-kit+ cells after 3 d of hypoxic culture, although we found no such difference prior to hypoxia. Secretion of VEGF and ANGPTL2 was greater in the c-kit+ group than in the c-kit− group, while hypoxia tended to increase cytokine expression in both groups. In addition, IGF-1 was significantly increased in the c-kit+ group, consistent with the relatively low expression of cleaved-caspase 3 revealed by western blot assay, and the relatively low count of apoptotic cells revealed by histochemical analysis. Administration of c-kit+cells into the MI heart improved the LVEF and increased neovascularization. These results indicate that c-kit+cells may be useful in cardiac stem cell therapy.
Collapse
Affiliation(s)
- Chuan Li
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Zhengqing Li
- Department of Materials Science and Engineering, Ohio State University, Columbus, USA
| | - Jianjun Guan
- Department of Materials Science and Engineering, Ohio State University, Columbus, USA
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
40
|
Mukaida H, Hayashida M, Matsushita S, Yamamoto M, Nakamura A, Amano A. Brain natriuretic peptide (BNP) may play a major role in risk stratification based on cerebral oxygen saturation by near-infrared spectroscopy in patients undergoing major cardiovascular surgery. PLoS One 2017; 12:e0181154. [PMID: 28704502 PMCID: PMC5507540 DOI: 10.1371/journal.pone.0181154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/27/2017] [Indexed: 01/08/2023] Open
Abstract
Purpose A previous study reported that low baseline cerebral oxygen saturation (ScO2) (≤50%) measured with near-infrared spectroscopy was predictive of poor clinical outcomes after cardiac surgery. However, such findings have not been reconfirmed by others. We conducted the current study to evaluate whether the previous findings would be reproducible, and to explore mechanisms underlying the ScO2-based outcome prediction. Methods We retrospectively investigated 573 consecutive patients, aged 20 to 91 (mean ± standard deviation, 67.1 ± 12.8) years, who underwent major cardiovascular surgery. Preanesthetic baseline ScO2, lowest intraoperative ScO2, various clinical variables, and hospital mortality were examined. Results Bivariate regression analyses revealed that baseline ScO2 correlated significantly with plasma brain natriuretic peptide concentration (BNP), hemoglobin concentration (Hgb), estimated glomerular filtration rate (eGFR), and left ventricular ejection fraction (LVEF) (p < 0.0001 for each). Baseline ScO2 correlated with BNP in an exponential manner, and BNP was the most significant factor influencing ScO2. Logistic regression analyses revealed that baseline and lowest intraoperative ScO2 values, but not relative ScO2 decrements, were significantly associated with hospital mortality (p < 0.05), independent of the EuroSCORE (p < 0.01). Receiver operating curve analysis of ScO2 values and hospital mortality revealed an area under the curve (AUC) of 0.715 (p < 0.01) and a cutoff value of ≤50.5% for the baseline and ScO2, and an AUC of 0.718 (p < 0.05) and a cutoff value of ≤35% for the lowest intraoperative ScO2. Low baseline ScO2 (≤50%) was associated with increases in intubation time, intensive care unit stay, hospital stay, and hospital mortality. Conclusion Baseline ScO2 was reflective of severity of systemic comorbidities and was predictive of clinical outcomes after major cardiovascular surgery. ScO2 correlated most significantly with BNP in an exponential manner, suggesting that BNP plays a major role in the ScO2-based outcome prediction.
Collapse
Affiliation(s)
- Hiroshi Mukaida
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
- Department of Clinical Engineering, Juntendo University Hospital, Tokyo, Japan
- * E-mail:
| | - Masakazu Hayashida
- Department of Anesthesiology & Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Makiko Yamamoto
- Department of Anesthesiology & Pain Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Atsushi Nakamura
- Department of Clinical Engineering, Kyorin University Faculty of Health Sciences, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
41
|
Matsushita S, Minematsu K, Yamamoto T, Inaba H, Kuwaki K, Shimada A, Yokoyama Y, Amano A. Factors for C-Kit Expression in Cardiac Outgrowth Cells and Human Heart Tissue. Int Heart J 2017; 58:962-968. [DOI: 10.1536/ihj.16-559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/18/2022]
Affiliation(s)
- Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Kazuo Minematsu
- Department of Public Health, Juntendo University Faculty of Medicine
- School Health Unit, Faculty of Education, Nagasaki University
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Hirotaka Inaba
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Kenji Kuwaki
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Yasutaka Yokoyama
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine
| |
Collapse
|
42
|
San Jose BA, Matsushita S, Akagi K. Liquid Crystallinity Enforced Chirality Transfer from Chiral Monosubstituted Polyacetylene Copolymer to Poly(p-phenylene ethynylene). Macromolecules 2016. [DOI: 10.1021/acs.macromol.6b01952] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Benedict A. San Jose
- Department
of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan
| | - Satoshi Matsushita
- Department
of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan
| | - Kazuo Akagi
- Department
of Polymer Chemistry, Kyoto University, Katsura, Kyoto 615-8510, Japan
| |
Collapse
|
43
|
Suzuki K, Matsumaru D, Matsushita S, Murashima A, Ludwig M, Reutter H, Yamada G. Epispadias and the associated embryopathies: genetic and developmental basis. Clin Genet 2016; 91:247-253. [PMID: 27649475 DOI: 10.1111/cge.12871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/13/2016] [Accepted: 09/16/2016] [Indexed: 12/25/2022]
Abstract
The abnormalities in the urogenital organs are frequently observed as human developmental diseases. Among such diseases, the defects in the upper part of external genitalia are rather rare named epispadias. The cleft in the dorsal part of external genitalia often reaches to the urethra. In general, the urogenital abnormalities accompany defects in the adjacent tissues and organs. The ventral body wall and bladder can also be affected in the patients with dorsal defects of the external genitalia. Therefore, such multiple malformations are often classified as bladder exstrophy and epispadias complex (BEEC). Because of the lower frequency of such birth defects and their early embryonic development, animal models are required to analyze the pathogenic mechanisms and the functions of responsible genes. Mutant mouse analyses on various signal cascades for external genitalia and body wall development are increasingly performed. The genetic interactions between growth factors such as bone morphogenetic proteins (Bmp) and transcription factors such as Msx1/2 and Isl1 have been suggested to play roles for such organogenesis. The significance of epithelial-mesenchymal interaction (EMI) is suggested during development. In this review, we describe on such local interactions and developmental regulators. We also introduce some mutant mouse models displaying external genitalia-body wall abnormalities.
Collapse
Affiliation(s)
- K Suzuki
- Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, Japan
| | - D Matsumaru
- Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, Japan
| | - S Matsushita
- Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, Japan
| | - A Murashima
- Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, Japan.,Division of Human Embryology, Department of Anatomy, Iwate Medical University, Yahaba, Japan
| | - M Ludwig
- Department of Clinical Chemistry and Clinical Pharmacology, University Hospital of Bonn, Bonn, Germany
| | - H Reutter
- Institute of Human Genetics, University Hospital of Bonn, Bonn, Germany.,Department of Neonatology and Pediatric Intensive Care, University Hospital of Bonn, Bonn, Germany
| | - G Yamada
- Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, Japan
| |
Collapse
|
44
|
Suzuki H, Matsushita S, Suzuki K, Yamada G. 5α-Dihydrotestosterone negatively regulates cell proliferation of the periurethral ventral mesenchyme during urethral tube formation in the murine male genital tubercle. Andrology 2016; 5:146-152. [DOI: 10.1111/andr.12241] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 05/20/2016] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Affiliation(s)
- H. Suzuki
- Department of Developmental Genetics; Institute of Advanced Medicine; Wakayama Medical University; Wakayama Japan
| | - S. Matsushita
- Department of Developmental Genetics; Institute of Advanced Medicine; Wakayama Medical University; Wakayama Japan
| | - K. Suzuki
- Department of Developmental Genetics; Institute of Advanced Medicine; Wakayama Medical University; Wakayama Japan
| | - G. Yamada
- Department of Developmental Genetics; Institute of Advanced Medicine; Wakayama Medical University; Wakayama Japan
| |
Collapse
|
45
|
Hirako Y, Yamauchi T, Matsushita S, Hashimoto T. Major cleavage-dependent epitopes for linear IgA bullous dermatosis are formed at the boundary between the NC16A and C15 domains of BP180. J Dermatol Sci 2016. [DOI: 10.1016/j.jdermsci.2016.08.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
46
|
Kato TS, Nakamura H, Murata M, Kuroda K, Suzuki H, Yokoyama Y, Shimada A, Matsushita S, Yamamoto T, Amano A. The effect of tolvaptan on renal excretion of electrolytes and urea nitrogen in patients undergoing coronary artery bypass surgery. BMC Cardiovasc Disord 2016; 16:181. [PMID: 27624603 PMCID: PMC5022266 DOI: 10.1186/s12872-016-0341-0] [Citation(s) in RCA: 7] [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: 04/06/2016] [Accepted: 07/30/2016] [Indexed: 12/02/2022] Open
Abstract
Background Adequate fluid management is an important component of patient care following cardiac surgery. Our aim in this study was to determine the benefits of tolvaptan, an oral selective vasopressin-2 receptor antagonist that causes electrolyte-free water diuresis, in postoperative fluid management. We prospectively examined the effect of tolvaptan on renal excretion of electrolytes and urea nitrogen in cardiac surgery patients. Methods Patients undergoing coronary artery bypass surgery were randomized to receive conventional loop diuretics (Group C, n = 30) or conventional loop diuretic therapy plus tolvaptan (Group T, n = 27). Fractional excretions of sodium (FENA), potassium (FEK) and urea nitrogen (FEUN) were measured in both groups during post-surgical hospitalization. Results Urine output was greater with tolvaptan (Group T) than without it (Group C), and some patients in Group C required intravenous as well as oral loop diuretics. Serum sodium concentrations decreased after surgery in Group C, but were unchanged in Group T (postoperative day [POD] 3, 139.8 ± 3.5 vs. 142.3 ± 2.6 mEq/L, p = 0.006). However, postoperative FENA values in Group C did not decrease, and the values were similar in both groups. Serum potassium levels remained lower and FEK values remained higher than the preoperative values, but only in Group C (all p < 0.05). BUN increased postoperatively in both groups, but it remained higher than its preoperative value only in Group C (all p < 0.01). Group T showed an initial increase in BUN, which peaked and then returned to its preoperative value within a week. The FEUN increased postoperatively in both groups, but the change was more pronounced in Group T (POD7, 52.7 ± 9.3 vs. 58.2 ± 6.5 %, p = 0.025). Conclusions Renal excretion of sodium and potassium reflects the changes in serum concentration in patients treated with tolvaptan. Patients treated only with loop diuretics showed a continuous excretion of sodium and potassium that led to electrolyte imbalance, whereas the combination of loop diuretics and tolvaptan increased renal urea nitrogen elimination. Tolvaptan therefore appears to be an effective diuretic that minimally affects serum electrolytes while adequately promoting the elimination of urea nitrogen from the kidneys in patients undergoing coronary artery bypass surgery. Trial registration The present study is registered with the UMIN Clinical Trials Registry (ID: UMIN000011039)
Collapse
Affiliation(s)
- Tomoko S Kato
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
| | - Hiroshi Nakamura
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Mai Murata
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Kishio Kuroda
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Hitoshi Suzuki
- Division of Nephrology, Department of Internal Medicine, Juntendo University School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yasutaka Yokoyama
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Heart Center, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan
| |
Collapse
|
47
|
Ono S, Kato T, Nakamura H, Kajimoto K, Matsushita S, Dohi S, Kuwaki K, Morita T, Yamamoto T, Amano A. The Effect of Tolvaptan on Renal Excretion of Electrolytes and Urea Nitrogen in Patients Undergoing Coronary Artery Bypass Surgery. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
48
|
Shinohara D, Matsushita S, Yamamoto T, Inaba H, Kuwaki K, Shimada A, Amano A. Reduction of c-kit positive cardiac stem cells in patients with atrial fibrillation. J Cardiol 2016; 69:712-718. [PMID: 27499271 DOI: 10.1016/j.jjcc.2016.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/21/2016] [Accepted: 07/11/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND We aimed to determine expression patterns of cardiac stem cells in the left atrium (LA) tissue from patients with atrial fibrillation. METHODS LA appendages were obtained during open-heart surgery and processed for explant cell culture and tissue analysis (n=319). The total number of grown cells and c-kit positive cells were analyzed by flow cytometry after 4 weeks of culture. The remaining tissue was used for Masson's trichrome staining to determine the area of the fibrosis. RESULTS The diameter of the LA, as measured by echocardiography, was significantly larger in the AF group than in the sinus rhythm group. Reverse transcription polymerase chain reaction analysis revealed higher expression of collagen in the AF group and an increase in the expression of basic fibrosis growth factor and transforming growth factor-2 and -3. Masson's trichrome staining showed progression of fibrosis in the AF tissue. In addition, the expression of apoptosis-related genes were significantly higher in AF group. There was no difference in the expression of connexin-40 between groups, while the expression of connexin-43 was decreased and that of connexin-45 was increased in the AF group. The total numbers of grown cells as well as c-kit positive cells after 4 weeks of cardiac tissue culture were significantly lower in the AF group. CONCLUSION Progression of remodeling in LA tissue was observed in AF patients. The number of c-kit positive cells cultured from LA appendages was reduced in AF patients, suggesting impairments in self-renewal.
Collapse
Affiliation(s)
- Daisuke Shinohara
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Satoshi Matsushita
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan.
| | - Taira Yamamoto
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Hirotaka Inaba
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Kenji Kuwaki
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Akie Shimada
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| | - Atsushi Amano
- Department of Cardiovascular Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
49
|
Yamaoka H, Kuwaki K, Inaba H, Yamamoto T, Kato TS, Dohi S, Matsushita S, Amano A. Comparison of modern risk scores in predicting operative mortality for patients undergoing aortic valve replacement for aortic stenosis. J Cardiol 2016; 68:135-40. [DOI: 10.1016/j.jjcc.2015.08.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 08/01/2015] [Accepted: 08/24/2015] [Indexed: 01/11/2023]
|
50
|
Suzuki Y, Matsushita S, Kubota H, Kobayashi M, Murauchi K, Higuchi Y, Kato R, Hirai A, Sadamasu K. Identification and functional activity of a staphylocoagulase type XI variant originating from staphylococcal food poisoning isolates. Lett Appl Microbiol 2016; 63:172-7. [PMID: 27227969 DOI: 10.1111/lam.12595] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 11/26/2022]
Abstract
UNLABELLED Staphylocoagulase, an extracellular protein secreted by Staphylococcus aureus, has been used as an epidemiological marker. At least 12 serotypes and 24 genotypes subdivided on the basis of nucleotide sequence have been reported to date. In this study, we identified a novel staphylocoagulase nucleotide sequence, coa310, from staphylococcal food poisoning isolates that had the ability to coagulate plasma, but could not be typed using the conventional method. The protein encoded by coa310 contained the six fundamental conserved domains of staphylocoagulase. The full-length nucleotide sequence of coa310 shared the highest similarity (77·5%) with that of staphylocoagulase-type (SCT) XIa. The sequence of the D1 region, which would be responsible for the determination of SCT, shared the highest similarity (91·8%) with that of SCT XIa. These results suggest that coa310 is a novel variant of SCT XI. Moreover, we demonstrated that coa310 encodes a functioning coagulase, by confirming the coagulating activity of the recombinant protein expressed from coa310. This is the first study to directly demonstrate that Coa310, a putative SCT XI, has coagulating activity. These findings may be useful for the improvement of the staphylocoagulase-typing method, including serotyping and genotyping. SIGNIFICANCE AND IMPACT OF THE STUDY This is the first study to identify a novel variant of staphylocoagulase type XI based on its nucleotide sequence and to demonstrate coagulating activity in the variant using a recombinant protein. Elucidation of the variety of staphylocoagulases will provide suggestions for further improvement of the staphylocoagulase-typing method and contribute to our understanding of the epidemiologic characterization of Staphylococcus aureus.
Collapse
Affiliation(s)
- Y Suzuki
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - S Matsushita
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - H Kubota
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - M Kobayashi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - K Murauchi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - Y Higuchi
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - R Kato
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - A Hirai
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| | - K Sadamasu
- Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|