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Aoyagi S, Tobinaga S, Wada K, Nata SI, Yasunaga H. Streptococcus Mitis Endocarditis Associated with Early Gastric Carcinoma. Kurume Med J 2023; 69:111-114. [PMID: 37544751 DOI: 10.2739/kurumemedj.ms6912003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
We report a case of Streptococcus mitis endocarditis associated with early gastric carcinoma. A 71-year-old man who had been diagnosed with aortic regurgitation (AR) two years previously was referred for valve surgery and evaluation of elevated inflammatory markers. Four months previously, atrophic gastritis, early gastric adenocarcinoma, and colon polyp had been identified in the patient during endoscopy. However, Helicobacter pylori testing was negative. On admission, he had no dental diseases or recent oral procedures. Echocardiography demonstrated severe AR and mobile vegetation on the aortic valve. Magnetic resonance imaging revealed cerebral embolism and spondylodiscitis. Blood cultures grew Streptococcus mitis. At surgery, destruction of the left cusp with vegetation and a perforation of the non-coronary cusp were found; in addition, aortic valve replacement was performed. Although the association between Streptococcus bovis bacteremia and colon neoplasm is well recognized, the association between Streptococcus mitis endocarditis and gastrointestinal carcinoma should also be kept in mind.
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Affiliation(s)
| | | | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital
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Aoyagi S, Tobinaga S, Wada K, Nata SI, Yasunaga H. Rothia Aeria Endocarditis Complicated with Multiple Systemic Embolisms. Kurume Med J 2023; 68:259-263. [PMID: 37316288 DOI: 10.2739/kurumemedj.ms6834009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Rothia aeria is part of the normal flora in the human oral cavity and rarely causes serious systemic infection in healthy hosts. We report a case of infective endocarditis of the mitral valve due to Rothia aeria. A 53-year-old man suffered a cut on his left thumb. At the time, the patient licked the wound as a conventional way to accelerate its cure. Thereafter, he developed a recurrent fever, which was temporarily lysed with treatment using an intravenous antibiotic, over a period of 2 months after the injury. On admission, the patient had no dental caries and denied any dental procedures before onset of the fever. Auscultation revealed a systolic cardiac murmur. Echocardiography showed torn chordae of the posterior mitral leaflet with a small vegetation and severe mitral regurgitation. Two sets of blood cultures were positive for Rothia aeria. Computed tomography revealed splenic and left renal infarctions but no cerebral infarction. After resolution of the inflammation by 6 weeks of penicillin treatment, mitral valve repair was successfully performed.
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Affiliation(s)
| | | | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital
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Aoki R, Kozai T, Ono Y, Tanaka F, Ueda Y, Ikeda J, Matsuo A, Hori H, Hosokawa Y, Okazaki T, Kosuga T, Yoshitake K, Kosuga K, Aoyagi S, Tayama K. Right Coronary Artery with an Intramural and Interarterial Course as a Unique Cause of Myocardial Ischemia: The Unroofing Method Might Still Be the Best Solution. Intern Med 2023; 62:745-749. [PMID: 35908964 PMCID: PMC10037012 DOI: 10.2169/internalmedicine.0127-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 39-year-old man was admitted because of cardiac arrest. Emergent coronary angiography revealed a preserved coronary blood flow; however, multiple-row detector computed tomography (MDCT) revealed that the proximal right coronary artery (RCA) was running inside the aortic wall, creating proximal stenosis without atherosclerotic changes. Surgical intervention with unroofing was performed; however, postoperative stenosis of the proximal RCA required additional coronary artery bypass grafting (CABG). Intraoperative findings during CABG did not reveal hematoma or coronary dissection. However, MDCT one year after CABG depicted improvement of the RCA and graft stenoses, suggesting that the post-unroof stenosis may have been caused by an inflammatory reaction after surgical intervention.
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Affiliation(s)
- Ryota Aoki
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Toshiyuki Kozai
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Yoshiyasu Ono
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Fumiaki Tanaka
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Yoko Ueda
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Jiro Ikeda
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Atsutoshi Matsuo
- Department of Cardiology, Munakata Suikokai General Hospital, Japan
| | - Hidetsugu Hori
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
| | - Yukio Hosokawa
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
| | - Teiji Okazaki
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
| | - Tomokazu Kosuga
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
| | | | - Kenichi Kosuga
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
| | - Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Japan
| | - Keiichiro Tayama
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Japan
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Aoyagi S, Tobinaga S, Wada K, Nata SI, Yasunaga H. Acute Mitral Regurgitation After Blunt Chest Trauma: A Case Report. Kurume Med J 2023; 68:39-42. [PMID: 36754381 DOI: 10.2739/kurumemedj.ms681002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Myocardial contusion is the most common cardiac injury from blunt chest trauma (BCT), whereas isolated valve injury is uncommon. We report a case of acute mitral regurgitation (MR) due to isolated valve injury after BCT. A 60-year-old man received an impact on his left chest by a car wheel three weeks prior to visiting our hospital. At the time a diagnosis of contusion of the chest wall without rib and sternal fractures was made. Thereafter, the patient had progressive worsening of heart failure symptoms. Eventually he developed dyspnea on slight exertion but echocardiographic evaluation was not performed at the time of diagnosis or during the three weeks prior to admission. At admission a holosystolic murmur was heard. Transthoracic echocardiography revealed prolapse of the posterior mitral leaflet due to torn chordae tendineae with severe MR and normal left ventricular wall motion. At surgery, torn chordae tendineae and a leaflet tear of the posterior leaflet were detected, and mitral valve repair was achieved without residual MR. Pathological examination of the torn chordae showed no findings of endocarditis or myxomatous degeneration. Echocardiography may play an important role for accurate and prompt diagnosis of cardiac lesions in patients with recent or a history of high-energy BCT.
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Affiliation(s)
| | | | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital
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Aoyagi S, Tobinaga S, Wada K, Nata SI, Yasunaga H. Anomalous Aortic Origin of the Right Coronary Artery Incidentally Detected In a Patient with Degenerative Mitral Valve Disease. Kurume Med J 2022; 67:131-135. [PMID: 36123028 DOI: 10.2739/kurumemedj.ms6723010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Anomalous aortic origin of a coronary artery from the opposite sinus of Valsalva is known as a cause of sudden cardiac death. However, it is often asymptomatic and incidentally diagnosed during evaluation for other cardiac diseases. We report a case of anomalous aortic origin of the right coronary artery (RCA) from the left sinus of Valsalva (ARCA) detected incidentally in a patient with degenerative mitral regurgitation (MR). A 47-year-old man, who had no history of myocardial ischemic symptoms on exertion, was admitted for sudden orthopnea. ECG revealed no ischemic changes and arrhythmias. Echocardiography demonstrated MR due to torn chordae of the posterior mitral leaflet. Computed tomography (CT) revealed the RCA arising from the left sinus of Valsalva at an acute angle and taking an interarterial course between the great arteries. The proximal RCA showed a circular shaped cross-section on CT, suggesting no presence of an intramural segment. Considering refractory heart failure and no history of myocardial ischemic symptoms on exertion as well as the findings of the CT angiography, urgent mitral valve repair was undertaken without surgical intervention for the anomalous RCA, and without evaluating myocardial ischemia. The patient recovered uneventfully. Postoperatively, myocardial perfusion scintigraphy demonstrated no exercise-induced myocardial ischemia. Patients with ARCA who are asymptomatic and whose coronary course is not intramural can be managed without surgical intervention for an anomalous coronary artery.
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Affiliation(s)
| | | | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital
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Kwon E, Matsukawa T, Hoshikawa A, Ishigaki T, Aoyagi S, Kawachi K, Kasama Y. Direct observation of nucleus of lithium in a C60 fullerene cage by neutron diffraction study. Chem Phys Lett 2022. [DOI: 10.1016/j.cplett.2022.139678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Aoyagi S, Tobinaga S, Wada K, Nata SI, Yasunaga H. Aortic valve replacement for dextrocardia with situs inversus totalis. J Card Surg 2021; 36:3378-3380. [PMID: 34148254 DOI: 10.1111/jocs.15759] [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: 01/27/2021] [Accepted: 05/23/2021] [Indexed: 11/26/2022]
Abstract
Dextrocardia is a rare congenital cardiac positional anomaly. A 74-year-old woman was referred for aortic regurgitation (AR). Chest X-ray revealed a mildly enlarged heart that directed to the right side. Transthoracic echocardiography showed AR due to cusp prolapse with a dilated left ventricle and reduced wall motion. Computed tomography demonstrated the heart and great vessels in a mirror image of their normal positions. A median sternotomy performed by the surgeon standing on the right side of the patient. After establishing a cardiopulmonary bypass, the surgeon moved to the left side of the patient, and then performed aortic valve replacement.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Satoru Tobinaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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Schneider P, Verloh F, Portz A, Aoyagi S, Rohnke M, Dürr M. Direct Analysis of Ion-Induced Peptide Fragmentation in Secondary-Ion Mass Spectrometry. Anal Chem 2020; 92:15604-15610. [PMID: 33170642 DOI: 10.1021/acs.analchem.0c03765] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Primary-ion-induced fragmentation in organic molecules can strongly influence the results in secondary-ion mass spectrometry (SIMS) of organic and biomolecular samples. In order to characterize this ion-induced fragmentation, oligopeptide samples irradiated in SIMS experiments were investigated by means of desorption/ionization induced by neutral SO2 clusters (DINeC). The latter is a nondestructive desorption method for mass spectrometry of biomolecules, which gives direct access to the fragments induced in the sample. Comparison of TOF-SIMS and DINeC mass spectra revealed qualitative differences between the fragments, which remain in the sample and the fragments sputtered during ion bombardment. The fragmentation strength and its spatial distribution were found to be quantitatively different for Bi1+, Bi3+, and Ar1000+ primary ions, leading to different distributions of the degree of fragmentation in the samples as directly measured by means of DINeC depth profiles.
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Affiliation(s)
- P Schneider
- Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, D-35392 Giessen, Germany
| | - F Verloh
- Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, D-35392 Giessen, Germany.,Physikalisch-Chemisches Institut and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 17, D-35392 Giessen, Germany
| | - A Portz
- Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, D-35392 Giessen, Germany
| | - S Aoyagi
- Department of Materials and Life Science, Seikei University, 3-3-1, Kichijyoji-kitamachi, Musashino-shi, Tokyo 180-8633, Japan
| | - M Rohnke
- Physikalisch-Chemisches Institut and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 17, D-35392 Giessen, Germany
| | - M Dürr
- Institut für Angewandte Physik and Zentrum für Materialforschung, Justus-Liebig-Universität Giessen, Heinrich-Buff-Ring 16, D-35392 Giessen, Germany
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Abstract
A male patient developed acute type B aortic dissection (AD) extending to the right external iliac artery (EIA) and left common femoral artery at the age of 56 years. Two months after the diagnosis of AD, he developed right renal infarction suggesting embolism, as the right renal artery arose from a false lumen containing a mural thrombus. Seven years later, at the age of 63 years, the patient was readmitted for acute onset of intermittent claudication in the right leg. On admission, arterial pulses distal to the right femoral artery were absent. The right ankle-brachial pressure index (ABI) was 0.66, while the left ABI was 1.06. Computed tomography (CT) confirmed chronic type B AD and revealed a localized occlusion of the right EIA and disappearance of a small protruding thrombus in the false lumen that was found on the previous CT, suggesting a second embolism. Since recovery of antegrade blood flow was insufficient after catheter embolectomy, femorofemoral bypass was performed with resolution of ischemic symptoms. Postoperatively, the ABI recovered to 0.99 in the right and 1.12 in the left, and CT showed a patent bypass graft and restoration of blood flow to the right leg. This case indicates that embolism should be recognized as one of the possible causes of acute organ ischemia in patients with AD, even in patients with chronic AD.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Mau Amako
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Tomokazu Kosuga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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Aoyagi S, Oda T, Kanamoto R, Nakamura E, Yasunaga H. Aortic Dissection Associated with Autosomal Dominant Polycystic Kidney Disease. Heart Surg Forum 2019; 22:E032-E034. [PMID: 30806618 DOI: 10.1532/hsf.2027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/14/2018] [Indexed: 11/20/2022]
Abstract
A 78-year-old man who had been diagnosed with autosomal dominant polycystic kidney disease (ADPKD) and hypertension presented with chest pain. His family history was positive for ADPKD. Chest computed tomography (CT) revealed a type A aortic dissection with thrombotic occlusion of a false lumen and an ulcer-like projection in the ascending aorta, an aneurysm of the ascending aorta, and pericardial effusion. Abdominal CT showed multiple renal and hepatic cysts. At surgery, aortic dissection with thrombotic occlusion of the false lumen and an intimal tear in the distal ascending aorta were observed. Hemiarch replacement including the intimal tear was performed. The patient is doing well without requiring dialysis and without recurrence of aortic dissection or aneurysm under strict antihypertensive therapy 3 years after the operation. Pathological examination of aortic wall specimens revealed no degenerative abnormality. ADPKD should be kept in mind as one of the causative disorders of aortic dissection.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Ryo Kanamoto
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Eiji Nakamura
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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Aoyagi S, Kosuga T, Wada K, Nata SI, Yasunaga H. Pericardial injury from chest compression: a case report of incidental release of cardiac tamponade. J Intensive Care 2018; 6:54. [PMID: 30181879 PMCID: PMC6114880 DOI: 10.1186/s40560-018-0325-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although chest compression is a standard technique in cardiopulmonary resuscitation, it is well recognized that manual chest compression causes various internal injuries, of which major injuries are often fatal. Similarly, when cardiac tamponade occurs in patients with type A acute aortic dissection, many patients die before reaching the hospital. We report a rare case in which chest compressions caused pericardial laceration that may have inadvertently played a life-saving role in releasing cardiac tamponade induced by acute aortic dissection. Case presentation A 67-year-old woman developed cardiac arrest soon after complaining of epigastric pain, and after successful resuscitation by manual chest compression, she was transferred to our hospital. On arrival, the patient was 14 on the Glasgow Coma Scale. An ECG showed a normal sinus rhythm, and no arrhythmias or signs of myocardial ischemia were observed. A chest X-ray revealed left pleural effusion, while cardiomegaly and pneumothorax were not identified. Computed tomography revealed type A aortic dissection, mild pericardial effusion, and massive left pleural effusion. No pulmonary embolus was found on the CT. After drainage of bloody effusion from the left pleural space, an emergency operation was begun. During surgery, a pericardial laceration with communication to the left pleural space and a hemothorax were found; however, no cardiac injury was identified. No other intra-thoracic injuries or rupture of the aortic dissection causing the hemothorax were detected. Hemiarch replacement was performed without difficulty, but the patient died of multi-organ failure 30 days after surgery. Conclusions We report a case of pericardial injury without skeletal fracture caused by chest compression. The pericardial laceration may have inadvertently served to release the cardiac tamponade induced by the acute aortic dissection, resulting in the hemothorax, and provided time to receive surgery.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, 830-8543 Japan
| | - Tomokazu Kosuga
- Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, 830-8543 Japan
| | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, 830-8543 Japan
| | - Shin-Ichi Nata
- Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, 830-8543 Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhonmachi, Kurume, 830-8543 Japan
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Abstract
We report a case of aortic valve infective endocarditis (IE) in a 24-year-old man with atopic dermatitis (AD). He had a history of balloon valvuloplasty for a stenotic bicuspid aortic valve, and had dental caries but no invasive dental procedure before the onset of IE. On admission, skin lesions of AD with itching and scratches were found on the neck, trunk, and extremities. Echocardiography showed a vegetation on the aortic valve with mild steno-regurgitation, but extension of IE to the annulus was not detected. Magnetic resonance imaging identified fresh cerebral infarction without neurological dysfunction, leading us to suspect an embolism. Blood cultures grew methicillin-sensitive Staphylococcus aureus. During emergency surgery, a vegetation attached to the conjoined cusp was observed, and the aortic valve was replaced with a mechanical valve. The patient recovered uneventfully without any complications such as recurrent IE or mediastinitis. We also review previously reported cases of IE associated with AD.
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Affiliation(s)
| | - Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Kumiko Wada
- Department of Cardiovascular Surgery, St. Mary's Hospital
| | - Eiji Nakamura
- Department of Cardiovascular Surgery, St. Mary's Hospital
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13
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Sakai K, Fukui S, Yabuuchi S, Aoyagi S, Tsumura Y. Expression of theSaccharomyces Diastaticus STA1Gene in Brewing Yeasts. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-47-0087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- K. Sakai
- Central Research Laboratories, Asahi Breweries Ltd., Ohmore-kita 2-13-1, Ohta-ku, Tokyo 143, Japan
| | | | - S. Yabuuchi
- Central Research Laboratories, Asahi Breweries Ltd., Ohmore-kita 2-13-1, Ohta-ku, Tokyo 143, Japan
| | - S. Aoyagi
- Central Research Laboratories, Asahi Breweries Ltd., Ohmore-kita 2-13-1, Ohta-ku, Tokyo 143, Japan
| | - Y. Tsumura
- Central Research Laboratories, Asahi Breweries Ltd., Ohmore-kita 2-13-1, Ohta-ku, Tokyo 143, Japan
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Aoyagi S, Kosuga T, Wada K, Nakamura E, Yasunaga H. Coexistence of Right Ventricular Myxoma and Atrioventricular Septal Defect. World J Pediatr Congenit Heart Surg 2018; 9:95-97. [PMID: 29310556 DOI: 10.1177/2150135117731726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although a small number of atrial myxomas are found in association with congenital cardiac defects, ventricular myxomas coexisting with congenital cardiac anomalies are extremely rare. We report a case of right ventricular (RV) myxoma coexistent with atrioventricular septal defect in an adolescent. Echocardiography showed an RV mass, a small ostium primum atrial septal defect, and a cleft of the left atrioventricular valve. Magnetic resonance imaging revealed a mass, suggesting a myxoma. The mass was excised simultaneously with repair of the anomalies and was histologically confirmed as a myxoma.
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Affiliation(s)
- Shigeaki Aoyagi
- 1 Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Tomokazu Kosuga
- 1 Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Kumiko Wada
- 1 Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Eiji Nakamura
- 1 Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- 1 Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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15
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Aoyagi S, Tobinaga S, Saisho H. Enlargement of the Excluded Left Atrial Appendage With Thrombus. Int Heart J 2017; 58:144-146. [PMID: 28077818 DOI: 10.1536/ihj.16-113] [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: 11/18/2022]
Abstract
We report progressive enlargement of the excluded left atrial appendage (LAA) with a thrombus in a patient who had undergone valve surgery and endocardial suture closure of the LAA previously. Echocardiography and CT detected no communication between the LAA and the left atrium. Magnetic resonance imaging showed the LAA was filled with fresh and old thrombi. Coronary arteriography demonstrated small left coronary artery-LAA fistulae. At surgery, successful exclusion of the LAA was confirmed after removal of the thrombi. Persistent inflow of blood through the coronary artery fistulae to the excluded LAA may be the primary mechanism of this pathology.
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16
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Chihara S, Sawada K, Tomoeda H, Aoyagi S. Pulsatile Varicose Veins Secondary to Severe Tricuspid Regurgitation: Report of a Case Successfully Managed by Endovenous Laser Treatment. Ann Vasc Surg 2017; 39:286.e11-286.e14. [DOI: 10.1016/j.avsg.2016.06.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 06/15/2016] [Indexed: 11/28/2022]
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17
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Oda T, Yasunaga H, Zaima Y, Arimura A, Imai S, Kanamoto R, Fukuda H, Nakamura E, Tashiro H, Aoyagi S. Usefulness of three-dimensional transesophageal echocardiography for diagnosis of hemolytic anemia due to inverted internal felt strip after surgery for aortic dissection. J Med Ultrason (2001) 2016; 44:211-214. [PMID: 27858229 DOI: 10.1007/s10396-016-0759-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 10/21/2016] [Indexed: 10/20/2022]
Abstract
Felt strips are widely used for reinforcement of the aortic stump in surgery for aortic dissection (AD). Postoperative hemolytic anemia (HA) due to an inverted internal felt strip at the aortic stump fixation for AD is extremely rare. A 70-year-old woman underwent ascending aorta replacement for acute type A AD, where both proximal and distal anastomotic sites were reinforced with Teflon felt strips. A week later, macroscopic hematuria and HA emerged. Three-dimensional transesophageal echocardiography (3D-TEE) demonstrated that the proximal inner felt strip turned up and protruded into the aortic inner lumen. At redo surgery, which was performed 2 weeks after the initial surgery, the findings of 3D-TEE were confirmed, and the inverted internal felt strip was replaced with a bovine pericardial strip. The findings of HA disappeared immediately after the second surgery. 3D-TEE is a very informative, valuable modality for accurate diagnosis that leads to a safe surgery.
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Affiliation(s)
- Takeshi Oda
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan. .,, 133-22 Kogashima-machi, Omura, Nagasaki, 856-8561, Japan.
| | - Hiroshi Yasunaga
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Yasuyuki Zaima
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Akiko Arimura
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Shinichi Imai
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Ryo Kanamoto
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Hayato Fukuda
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Eiji Nakamura
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Hideki Tashiro
- Division of Cardiology, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
| | - Shigeaki Aoyagi
- Division of Cardiovascular Surgery, St. Mary's Hospital, 422 Tsubukuhon-machi, Kurume, Fukuoka, 830-8543, Japan
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Aoyagi S, Tayama E, Oda T, Kosuga T, Yasunaga H. Intra-Atrial Excision of the Left Atrial Appendage: A Simple and Easy Technique. Heart Lung Circ 2016; 26:413-415. [PMID: 27769756 DOI: 10.1016/j.hlc.2016.08.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 08/02/2016] [Indexed: 11/24/2022]
Abstract
In patients with atrial fibrillation, closure of the left atrial appendage (LAA) is recommended to prevent thromboembolic events, however, conventional exclusion or excision techniques have potential drawbacks such as persistent blood flow into the appendage and a residual stump. We propose a simple and easy technique for LAA closure consisting of intra-atrial excision of the LAA, which is invaginated into the left atrium (LA), and direct suture closure of the orifice from inside the LA. In this technique, complete elimination of the LAA was achieved without leaving a residual stump because the LAA was excised at the orifice and was closed at the base of the LAA.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan.
| | - Eiki Tayama
- Department of Cardiovascular Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Tomokazu Kosuga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Japan
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Aoyagi S, Matsumoto T, Shima Y, Ishikawa T. Usefulness of SDS-Minislab Method in Electrophoretic Analyses of Photographic Gelatin. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/00223638.1987.11738456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Doppler echocardiographic characteristics of 29 normally functioning prosthetic valves (23 mechanical, 6 biological) and 8 obstructed mechanical prostheses in the tricuspid position are reported. In normally functioning prostheses, peak velocity, mean pressure gradient, and pressure-half time were 1.25 ± 0.18 m·sec−1, 2.6 ± 1.1 mm Hg, and 122.6 ± 30.7 msec, respectively. Although no significant differences were seen in peak velocity and mean pressure gradient between mechanical and biological valves, the pressure half-time was significantly greater in biological valves. All normally functioning prostheses had a mean pressure gradient ⩽5.5 mm Hg and pressure half-time < 200 msec. In obstructed bileaflet valves, peak velocity was 1.66 ± 0.28 m·sec−1, mean pressure gradient was 6.1 ± 2.8 mm Hg, and pressure half-time was 265.8 ± 171.7 msec. These Doppler data were significantly greater than those in normally functioning valves where the mean pressure gradient was ⩽5.1 mm Hg and the pressure half-time was ⩽156 msec in all except one patient. Pathological obstruction of a tricuspid prosthesis can be strongly suspected in patients with a mean pressure gradient > 5.5 mm Hg and a pressure half-time > 200 msec on Doppler echocardiography.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
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22
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Aoyagi S, Akashi H, Tayama K, Hanamoto Y, Yamana K, Oryoji A, Kosuga K, Oishi K. Reoperations for Aneurysmal Disease of the Ascending Aorta, Aortic Arch, and Descending Aorta: Their Causes and Operative Results. Asian Cardiovasc Thorac Ann 2016. [DOI: 10.1177/021849239400200209] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Between 1984 and 1993, 20 patients underwent reoperation for the thoracic aorta or ascending aorta and aortic valve. There were 14 male and 6 female patients who ranged in age from 28 to 70 years with a mean of 53.2 years. The mean interval between initial operation and the 2nd operation was 70.4 months. Of the 20 patients, 6 had stigmata of Marfan's syndrome. The primary aortic pathology requiring initial operation was annuloaortic ectasia in 10 patients, aortic valvular disease in 5, aortic dissection in 3, and mega aorta syndrome, aortic aneurysm in multiple segments, or aortic arch aneurysm in 1 each. Cause of reoperation was pseudoaneurysm formation at suture lines in the ascending aorta in 6 patients, new or progressive dilatation in the remaining aortic segment in 5, new or persistent aortic dissection in 4, graft infection in 2, and recurrent aortic arch aneurysm in 1. The remaining 2 patients received a planned two-stage operation for multiple aneurysms or mega aorta syndrome. Six patients died early after reoperation, yielding a hospital mortality rate of 30%; however, 3 of the 6 deaths were related to a compromised preoperative clinical condition and 1 to perioperative contamination. Two operative deaths (10%) were related to operative techniques. Results suggest application of separate grafts for coronary artery reattachment, as in the Cabrol or Piehler techniques, or the aortic button technique for aortic root replacement, may help eliminate pseudoaneurysm formation, which is one of the major complications after operations on the ascending aorta. It is also suggested that early diagnosis and prompt operative treatment for recurrent or residual aneurysmal diseases of the aorta may be essential for successful definitive treatment.
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Affiliation(s)
- Shigeaki Aoyagi
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Hidetoshi Akashi
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Keiichiro Tayama
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Yuji Hanamoto
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Kazunari Yamana
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Atsushige Oryoji
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Kenichi Kosuga
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
| | - Kiroku Oishi
- The Second Department of Surgery Kurume University School of Medicine Kurume, Japan
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Abstract
We retrospectively reviewed 41 patients with isolated iliac artery aneurysms presenting over a 21-year period. The mean age was 72 years. Mean aneurysmal diameter was 6.0 cm (range, 3.2–13 cm). The aneurysms were located in the common iliac artery in 31 patients, internal iliac artery in 7, and both arteries in 3. Rupture occurred in 20 patients (49%). The frequency of rupture of isolated iliac artery aneurysms was significantly higher than that of abdominal aortic aneurysms (8%) during the same period. The 30-day mortality was 9.8%; death in all 4 patients was due to rupture of the aneurysm. The surgical procedure was aneurysmectomy and replacement with a bifurcated prosthetic graft in 24 patients (59%), closure of the common iliac artery with a femorofemoral crossover in 7, minilaparotomy in 3, thromboexclusion in 6, and endoluminal stent-graft repair in one. In contrast to abdominal aortic aneurysms, isolated iliac artery aneurysms can be treated by various methods other than replacement with a bifurcated prosthetic graft. When selecting a strategy for such aneurysms, it is important to choose an approach appropriate to the location and risk, because of the frequency of rupture.
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Affiliation(s)
- Shinichi Hiromatsu
- Department of Surgery Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka-ken, 830-0011 Japan.
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Aoyagi S, Fukunaga S, Tayama E, Nakamura E, Egawa N, Hosokawa Y. Benefits of a β-Blocker for Intractable Hemolysis Due to Paraprosthetic Leakage. Asian Cardiovasc Thorac Ann 2016; 15:441-3. [PMID: 17911077 DOI: 10.1177/021849230701500518] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a 58-year-old man who was successfully treated with a β-adrenergic receptor blocking agent for intractable hemolysis due to paraprosthetic leakage. After replacement of a mitral prosthetic valve with another mechanical valve, the patient suffered intractable intravascular hemolysis resulting from recurrent paraprosthetic leakage. With oral administration of a β-adrenergic receptor blocker, betaxolol hydrochloride, for 3 months, the hemoglobin value increased from 9.7 g·dL−1 to 12.4 g·dL−1, although glutamic oxaloacetic transaminase and lactic dehydrogenase values remained elevated.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
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Nakamura E, Oda T, Yasunaga H, Aoyagi S. A Case of Femoral Arterial Bleeding by an Unknown Origin Metastatic Groin Lymph Nodes Carcinoma. Ann Vasc Dis 2016; 9:62-5. [PMID: 27087877 DOI: 10.3400/avd.cr.15-00107] [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: 10/12/2015] [Accepted: 12/14/2015] [Indexed: 11/13/2022] Open
Abstract
We report a case of femoral arterial bleeding complicated with hemorrhagic shock caused by bacterial infection attributed to an inguinal lymph node metastasis of carcinoma of unknown primary. Because of severe preoperative condition, a venous patch plasty of ruptured artery, and omentopexy for the groin was performed as a less invasive surgery. But the recurrence of bleeding was occurred postoperatively. A staged operation, hemostasis with a venous patch plasty at a first stage, and an extra-anatomical bypass soon after improvement of shock condition in a second stage, can be one of surgical procedures to save the lives and salvage limbs.
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Affiliation(s)
- Eiji Nakamura
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
| | - Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume, Fukuoka, Japan
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Imafuku K, Natsuga K, Aoyagi S, Shimizu H. Mucosal hyperpigmentation from prophylactic minocycline for EGFR inhibitor. J Eur Acad Dermatol Venereol 2016; 30:690-2. [PMID: 25627561 DOI: 10.1111/jdv.12978] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K Imafuku
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Natsuga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Aoyagi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Abstract
Sjogren's syndrome (SS) is an autoimmune disease characterized by dryness of the mouth and the eyes. Systemic involvement in SS is well known, however, obvious cardiac manifestations, particularly significant valve disorders, are extremely rare and only three cases of significant valve disease associated with SS that required surgical intervention have been previously described. We report a case of aortic stenosis (AS) associated with SS in an elderly patient. The diagnosis of primary SS had been made based on clinical features, positive ocular signs, and positive serologic findings. Echocardiography showed severe calcification, elevated mean pressure gradient (57 mmHg), and a small orifice area (0.45 cm(2)) of the aortic valve. At surgery, severe calcification of the aortic cusps and the annulus was the mechanism of AS, and the aortic valve was replaced with a bioprosthetic valve. Valve pathology showed nodular calcification and hyaline degeneration, but lymphocyte infiltration was not evident. The etiologic relation of SS to the valve lesions is not clear pathologically in this case, however, chronic inflammation related to immunologic reactions in SS could have some effect on exacerbation for degeneration of the valve tissue.
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Affiliation(s)
- Michitaka Kono
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital
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Aoyagi S, Oda T, Fukuda H, Zaima Y, Nakamura E, Yasunaga H. Isolated Tricuspid Valve Endocarditis Caused by Infection of an Implanted Central Venous Access Port Device. Kurume Med J 2016; 62:37-40. [PMID: 26935569 DOI: 10.2739/kurumemedj.ms65009] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 70-year-old man was referred to our hospital for an intermittent high fever attributed to subcutaneous pocket infection of an implanted central venous access port device caused by methicillin-resistant staphylococcus aureus and subsequent bloodstream infection. Echocardiography revealed a large vegetation on the posterior tricuspid leaflet, annular dilatation and moderate-to-severe tricuspid regurgitation. Valve surgery was performed for persistent infection despite 8 weeks of antibiotics therapy. At operation, vegetations and torn chordae tendineae were found on the posterior tricuspid leaflet. After total resection of the posterior tricuspid leaflet, bicuspidalization valvuloplasty with prosthetic ring annuloplasty was achieved without relapse of the infection or residual regurgitation.
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Hata H, Abe R, Suto A, Homma E, Fujita Y, Aoyagi S, Shimizu H. MMP13 can be a useful differentiating marker between squamous cell carcinoma and benign hyperkeratotic lesions in recessive dystrophic epidermolysis bullosa. Br J Dermatol 2015; 172:769-73. [PMID: 25066310 DOI: 10.1111/bjd.13302] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2014] [Indexed: 02/02/2023]
Abstract
Recessive dystrophic epidermolysis bullosa (RDEB) is a severe hereditary mechanobullous disease resulting from mutations in the COL7A1 gene, coding for type VII collagen. Patients with RDEB tend to develop squamous cell carcinomas (SCCs) at sites of chronic ulceration or scarring on the whole body. Distinguishing SCC from benign hyperkeratotic lesions is often difficult, not only clinically but also histologically in patients with RDEB. We investigated several matrix metallopeptidase (MMP) subtypes by comparing the DNA amplification microarray findings between evident SCCs and benign hyperkeratotic lesions in the same patient with RDEB. We report that MMP13 was found to be strongly positive in SCCs but negative in benign hyperkeratotic lesions. We found that there is an evident difference in the transitional area between SCCs and benign hyperkeratotic lesions. We propose that MMP13 may be a useful differentiating marker between SCC and benign hyperkeratotic lesions in RDEB.
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Affiliation(s)
- H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, North 15 West 7, Sapporo, 060-8638, Japan
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Kitamura S, Natsuga K, Imafuku K, Homma E, Yamane N, Aoyagi S, Matsumura T, Shimizu H. Metal implant-induced skin ulcer mimicking scrofuloderma. J Eur Acad Dermatol Venereol 2014; 30:449-50. [PMID: 25371032 DOI: 10.1111/jdv.12825] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S Kitamura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Natsuga
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - K Imafuku
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - E Homma
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - N Yamane
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Aoyagi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - T Matsumura
- Motomachi Dermatology Clinic, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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31
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Oda T, Aoyagi S, Yoshida S, Zaima Y, Fukuda H, Nakamura E, Yasunaga H. A surgical case of papillary fibroelastoma originating from the left atrial ridge. J Cardiol Cases 2014; 11:18-20. [PMID: 30546527 DOI: 10.1016/j.jccase.2014.09.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/18/2014] [Accepted: 09/10/2014] [Indexed: 10/24/2022] Open
Abstract
Papillary fibroelastomas are benign cardiac tumors with high embolic tendency, and usually originate from the cardiac valve. We report the case of a 49-year-old man who experienced sudden right hemiplegia and aphasia. Transesophageal echocardiography indicated a swinging tumor originating from the left atrial ridge between the orifice of the left atrial appendage and the anterolateral mitral annulus. Urgent tumor resection was performed to prevent further embolization. The histological findings of resected tumor were consistent with those of papillary fibroelastoma. To the best of our knowledge, all cases of papillary fibroelastomas that originate from the left atrial ridge are associated with cerebral vascular accidents. Therefore, prompt surgical resection is strongly recommended to prevent embolic events for those patients. <Learning objective: Papillary fibroelastomas are benign cardiac tumors and typically originate from valvular surfaces with high potential of embolization. To avoid embolic events, urgent excision of the tumor tends to be performed. All previously reported cases with papillary fibroelastoma at the left atrial ridge accompanied embolic events, therefore surgical excision should be under consideration in all such patients, regardless of the symptom, size, or configuration.>.
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Affiliation(s)
- Takeshi Oda
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Shigeaki Aoyagi
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Shohei Yoshida
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Yasuyuki Zaima
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Hayato Fukuda
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Eiji Nakamura
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
| | - Hiroshi Yasunaga
- Department of Cardiovascular Surgery, St. Mary's Hospital, Kurume City, Fukuoka, Japan
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Hata H, Natsuga K, Aoyagi S, Homma E, Shimizu H. Solitary fibrous tumour fluctuating in size with menstrual cycle. Clin Exp Dermatol 2014; 39:753-5. [PMID: 24986672 DOI: 10.1111/ced.12387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
Affiliation(s)
- H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, N15W7, Kita-Ku, Sapporo, 060-8638, Japan.
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Homma E, Hata H, Tsujiwaki M, Aoyagi S, Shimizu H. Nanoparticle albumin-bound paclitaxel can be useful agent to advanced primary mucinous carcinoma of the skin. J Eur Acad Dermatol Venereol 2014; 29:2271-3. [PMID: 24910079 DOI: 10.1111/jdv.12574] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E Homma
- Department of Dermatology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
| | - H Hata
- Department of Dermatology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
| | - M Tsujiwaki
- Department of Dermatology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
| | - S Aoyagi
- Department of Dermatology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
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Hata H, Aoyagi S, Homma E, Shimizu H. Lessons from 28 cases of reconstruction by lenticular island pedicle flap at a single institution. J Eur Acad Dermatol Venereol 2014; 29:1015-8. [PMID: 24911929 DOI: 10.1111/jdv.12575] [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: 03/25/2014] [Accepted: 04/29/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Lenticular island pedicle flap (LIPF) has been reported to be one of the most useful techniques for reconstructing middle cheek skin defects. LIPF may have been used all over the world on a daily basis; however, no reports have examined a large number of LIPF cases at a single institution. MATERIALS AND METHODS A total of 28 cases of reconstruction by LIPF at the Hokkaido University Hospital from 2005 to 2013 were analysed. We examined the tumour type, location, area of defect and presence/absence of antithrombotic treatment and complications, including transient circulatory impairment, damage to facial nerves and eyelid ectropion. RESULTS We found that nine patients had transiently impaired circulation. This complication was statistically more frequent in the patients without antithrombotic treatment than in the patients with antithrombotic treatment (0/8 vs. 10/20, P = 0.0292; Fisher's exact test). CONCLUSION We revelled that LIPF have been safely performed even under antithrombotic treatment, so, when patients are taking antithrombotic agents, we should choose LIPF rather than conventional flap including cheek flap, island pedicle flap and so on.
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Affiliation(s)
- H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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35
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Tsujiwaki M, Hata H, Miyauchi T, Homma E, Aoyagi S, Shimizu H. Warty intralymphatic histiocytosis successfully treated with topical tacrolimus. J Eur Acad Dermatol Venereol 2014; 29:2267-9. [DOI: 10.1111/jdv.12570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Tsujiwaki
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Hata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - T. Miyauchi
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - E. Homma
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - S. Aoyagi
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - H. Shimizu
- Department of Dermatology; Hokkaido University Graduate School of Medicine; Sapporo Japan
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36
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Aoyagi S. Reply to letter to the editor. J Card Surg 2014; 29:805. [PMID: 24750517 DOI: 10.1111/jocs.12338_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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37
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Homma E, Hata H, Aoyagi S, Shimizu H. Primary mucinous carcinoma of the skin with in-transit metastasis. J Eur Acad Dermatol Venereol 2014; 29:1655-7. [PMID: 24750401 DOI: 10.1111/jdv.12533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 03/28/2014] [Indexed: 12/01/2022]
Affiliation(s)
- E Homma
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - S Aoyagi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Hata H, Natsuga K, Aoyagi S, Homma E, Shimizu H. Ultrasound B-mode and elastographic findings of angiomatoid fibrous histiocytoma. Clin Exp Dermatol 2014; 39:538-9. [PMID: 24758358 DOI: 10.1111/ced.12314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- H. Hata
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Sapporo 060-8638 Japan
| | - K. Natsuga
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Sapporo 060-8638 Japan
| | - S. Aoyagi
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Sapporo 060-8638 Japan
| | - E. Homma
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Sapporo 060-8638 Japan
| | - H. Shimizu
- Department of Dermatology; Hokkaido University Graduate School of Medicine; North 15 West 7 Sapporo 060-8638 Japan
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Kitamura S, Hata H, Homma E, Aoyagi S, Shimizu H. Pigmented skin metastasis of breast cancer showing dermoscopic features of malignant melanoma. J Eur Acad Dermatol Venereol 2014; 29:1034-6. [PMID: 24641177 DOI: 10.1111/jdv.12459] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Kitamura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Abstract
Ebstein's anomaly (EA) is a rare congenital heart disease of the tricuspid valve, and less than 5% of patients with EA survive beyond the age of 50. We report two unoperated cases of EA in adult patients aged over 50 years. Two patients, a 70-year-old Japanese woman and a 59-year-old Chinese woman, were referred to us for tachyarrhythmias. Transthoracic echocardiography demonstrated apical displacement (>8 mm/m(2) body surface area) of the septal leaflet of the tricuspid valve from the atrioventricular ring with tricuspid regurgitation in both patients. The former suddenly expired 20 months later after suffering from repetitive supraventricular tachyarrhythmias and/or heart failure, and the latter is alive with minimal signs of heart failure 12 months after the diagnosis of EA. Although the natural history of EA is extremely variable, these two patients are exceptional in that they tolerated EA well for over 50 years without any surgical intervention.
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital
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Aoyagi S, Tayama K, Otsuka H, Okazaki T, Shintani Y, Wada K, Kosuga K. Sutureless Repair for Left Ventricular Free Wall Rupture After Acute Myocardial Infarction. J Card Surg 2014; 29:178-80. [DOI: 10.1111/jocs.12286] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Keiichiro Tayama
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Hiroyuki Otsuka
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Teiji Okazaki
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Yusuke Shintani
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Kumiko Wada
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
| | - Kenichi Kosuga
- Department of Cardiovascular Surgery; Cardiovascular Center, Munakata Suikokai General Hospital; Fukuoka Japan
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Teshima H, Akasu K, Arinaga K, Aoyagi S, Tanaka H. Diagnosis of Structural Deterioration in an Aortic Bioprosthetic Valve by Multidetector Row Computed Tomography: Report of a Case. Ann Thorac Cardiovasc Surg 2014; 20 Suppl:697-701. [DOI: 10.5761/atcs.cr.12.01988] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Hideki Teshima
- Cardiovascular Surgery, Chikamori Hospital Heart Center, Kochi, Japan
| | - Koji Akasu
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kouichi Arinaga
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shigeaki Aoyagi
- Cardiovascular Surgery, Munakata Suikokai General Hospital, Fukuoka, Japan
| | - Hiroyuki Tanaka
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Koguchi H, Ujiie H, Aoyagi S, Osawa R, Shimizu H. Characteristic findings of handprint and dermoscopy in reticulate acropigmentation of Kitamura. Clin Exp Dermatol 2013; 39:85-7. [PMID: 23746125 DOI: 10.1111/ced.12191] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2013] [Indexed: 11/28/2022]
Affiliation(s)
- H Koguchi
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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44
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Nomura Y, Nomura T, Sakai K, Sasaki K, Ohguchi Y, Mizuno O, Hata H, Aoyagi S, Abe R, Itaya Y, Akiyama M, Shimizu H. A novel splice site mutation in NCSTN underlies a Japanese family with hidradenitis suppurativa. Br J Dermatol 2013; 168:206-9. [PMID: 22834455 DOI: 10.1111/j.1365-2133.2012.11174.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic follicular occlusive disease with characteristic recurrent draining sinuses, skin abscesses and disfiguring scars, mainly involving the axilla, groin, perianal and perineal regions. While most HS cases are nonfamilial, familial cases showing autosomal dominant inheritance have been reported. Recently, loss-of-function mutations in the genes encoding γ-secretase have been identified as a cause of familial HS in the Chinese and British populations. OBJECTIVES To identify mutations in the genes encoding γ-secretase in Japanese patients with familial and nonfamilial HS. METHODS Two affected and three unaffected individuals from a Japanese family with familial HS and nine patients with nonfamilial HS were recruited. We conducted mutation analysis of the γ-secretase genes in Japanese patients with familial and nonfamilial HS. RESULTS A novel splice site mutation in the nicastrin gene NCSTN, one of the six key component genes encoding γ-secretase, was identified in the patients with familial HS. Neither unaffected individuals in the family nor 100 ethnically matched control alleles carry this mutation. None of the nine patients with nonfamilial HS carry nonsense, frameshift or splice site mutations in this gene. CONCLUSIONS A novel splice site mutation, c.582+1delG, in NCSTN was identified in the familial patients with HS. We also reveal for the first time that a γ-secretase gene mutation is not linked to the development of nonfamilial HS. These results would further pave the way to a better understanding of the contribution of γ-secretase and other genes to the pathogenesis of HS and to the development of a new therapeutic strategy for HS.
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Affiliation(s)
- Y Nomura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Morinaga K, Kiyokawa K, Rikimaru H, Aoyagi S, Tayama K, Akashi H. Results of intra-wound continuous negative pressure irrigation treatment for mediastinitis. J Plast Surg Hand Surg 2013; 47:297-302. [DOI: 10.3109/2000656x.2013.765885] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Amako M, Yamamoto Y, Nakamura K, Tobinaga S, Nakamura E, Hosokawa Y, Ohno T, Akashi H, Aoyagi S, Tanaka H. Preoperative visualization of the artery of Adamkiewicz by dual-phase CT angiography in patients with aortic aneurysm. Kurume Med J 2013; 58:117-25. [PMID: 23047141 DOI: 10.2739/kurumemedj.58.117] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To improve our ability to visualize the Adamkiewicz artery (AKA), we developed a modified intravenous CT angiography technique, which we refer to as right atrial CT (RA-CT) angiography. In this study, AKA detection rate and visualization of the arterial continuity from the aorta to the anterior spinal cord artery (ASA) was evaluated using RA-CT angiography.We performed RA-CT angiography in 110 patients with abdominal, thoracic descending, or thoracoabdominal aortic aneurysms. In RA-CT angiography, contrast medium with a high iodine concentration (370 mg/dl) was injected twice into the right atrium at a high injection rate (8.0 ml/sec), and two CT scans, starting at 20 sec after the first injection and at 35 sec after the second injection, respectively, were performed. All CT images were obtained using an 8- or 16-detector CT scanner at a slice thickness of 0.625 mm. The AKA was defined as the largest radiculomedullary artery with a characteristic hairpin turn, and with continuity from the aorta to the ASA.The AKA with hairpin turn was detected in all patients (100%), and continuity from the aorta to the ASA was confirmed in 99 of the 110 patients (90.0%). The AKA arose between Th8 and L1 in 86 of these patients (86.8%), and originated from the left side in 71 patients (71.7%).RA-CT angiography may be useful for visualizing the AKA and the arterial continuity from the aorta to the ASA in patients with aortic aneurysm, although the use of more advanced CT machines will provide safe and easy identification of the AKA and arterial continuity with a small amount of contrast medium and a single scan.
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Affiliation(s)
- Mau Amako
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan.
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Hata H, Abe R, Hoshina D, Saito N, Homma E, Aoyagi S, Shimizu H. MUC5AC expression correlates with invasiveness and progression of extramammary Paget's disease. J Eur Acad Dermatol Venereol 2013; 28:727-32. [PMID: 23581859 DOI: 10.1111/jdv.12156] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Accepted: 03/15/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Patients with in situ extramammary Paget's disease (EMPD) tend to have a good prognosis, although dermal invasion and metastasis are associated with significantly increased morbidity and mortality. Previous studies have addressed mechanisms underlying the EMPD pathogenesis; however, no molecular markers that reflect invasiveness or progression have been established. OBJECTIVE This study aims to identify a reliable marker for predicting the risk of invasion and metastasis in EMPD. METHODS We performed an initial microarray screening for in situ, invasive or metastatic lymph node lesions of EMPD. We analysed 44 specimens from 38 primary EMPD cases by immunohistochemical staining. RESULTS We found that expressions of MUC5AC directly correlate with invasion and prognosis. Labelling rates of tumour cells were scored by staining intensity on a four-tiered scale (- to 3+) to investigate the correlation between the expression score of these molecular markers and the type of EMPD lesion. All the specimens scored positive (3+) for MUC1 and negative (-) for MUC6. MUC5AC expression was detected in 19 of 44 (43.2%) specimens. Invasive lesions and metastatic lymph nodes tended to express MUC5AC significantly higher than in situ lesions (P < 0.01). MUC2 was positive in 10 specimens (22.7%). There was no significant difference between the degree of MUC2 expression and invasiveness. CONCLUSION The degree of MUC5AC expression may correlate with the invasiveness and progression of EMPD, and may be a useful marker for identifying high-risk EMPD cases.
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Affiliation(s)
- H Hata
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Ueda T, Teshima H, Fukunaga S, Aoyagi S, Tanaka H. Evaluation of Prosthetic Valve Obstruction on Electrocardiographically Gated Multidetector-Row Computed Tomography. Circ J 2013; 77:418-23. [DOI: 10.1253/circj.cj-12-0290] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tomohiro Ueda
- Department of Surgery, Kurume University School of Medicine
| | - Hideki Teshima
- Department of Cardiovascular Surgery, Chikamori Hospital Heart Center
| | - Shuji Fukunaga
- Department of Surgery, Kurume University School of Medicine
| | - Shigeaki Aoyagi
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital
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Aoyagi S, Tayama KI, Okazaki T, Shintani Y, Kono M, Wada K, Kosuga KI, Mori R, Tanaka H. Structural valve deterioration in a starr-edwards mitral caged-disk valve prosthesis. Circ J 2012; 77:105-8. [PMID: 23001071 DOI: 10.1253/circj.cj-12-0906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The durability of the Starr-Edwards (SE) mitral caged-disk valve, model 6520, is not clearly known, and structural valve deterioration in the SE disk valve is very rare. METHODS AND RESULTS Replacement of the SE mitral disk valve was performed in 7 patients 23-40 years after implantation. Macroscopic examination of the removed disk valves showed no structural abnormalities in 3 patients, in whom the disk valves were removed at <26 years after implantation. Localized disk wear was found at the sites where the disk abutted the struts of the cage, in disk valves excised >36 years after implantation in 4 patients. Disk fracture, a longitudinal split in the disk along its circumference at the site of incorporation of the titanium ring, was detected in the valves removed 36 and 40 years after implantation, respectively, and many cracks were also observed on the outflow aspect of the disk removed 40 years after implantation. CONCLUSIONS Disk fracture and localized disk wear were found in the SE mitral disk valves implanted >36 years previously. The present results suggest that SE mitral caged-disk valves implanted >20 years previously should be carefully followed up, and that those implanted >30 years previously should be electively replaced with modern prosthetic valves
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Affiliation(s)
- Shigeaki Aoyagi
- Department of Cardiovascular Surgery, Munakata Suikokai General Hospital, Fukutsu, Japan.
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Kishimoto S, Tsunoda A, Sugimoto T, Yano T, Tanaka K, Aoyagi S, Kawano Y. Facial Dismasking Approach for Craniofacial Lesion. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1313980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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