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Yamashita Y, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M. Prophylactic Anticoagulation and Thrombosis in Hospitalized Patients with Clinically Stable COVID-19 at Admission: From the Practice-Based Observational Study. Ann Vasc Dis 2024; 17:1-8. [PMID: 38628927 PMCID: PMC11018098 DOI: 10.3400/avd.oa.23-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 10/29/2023] [Indexed: 04/19/2024] Open
Abstract
Objectives: The potential benefit of routine prophylactic anticoagulation for all hospitalized patients with clinically stable coronavirus disease 2019 (COVID-19) is still controversial. Method: The CLOT-COVID Study was a multicenter observational study enrolling 2894 consecutive hospitalized patients with COVID-19. The current study population consisted of 1738 hospitalized patients with mild COVID-19 at admission not requiring oxygen administration, who were divided into 2 groups: patients with prophylactic anticoagulation (n = 326) and those without (n = 1412). Results: Patients with prophylactic anticoagulation had more severe status of the worst severity of COVID-19 during hospitalization compared with those without (mild: 38% versus 82%, moderate: 55% versus 17%, and severe or death at discharge: 6.4% versus 0.7%, P <0.001). During hospitalization, 8 patients (0.5%) developed thrombosis, and the incidences of thrombosis were numerically higher in patients with more severe status of worst severity of COVID-19 during hospitalization (mild: 0.2%, moderate: 1.2%, and severe or death at discharge: 3.2%). Conclusions: Among hospitalized patients with clinically stable COVID-19 at admission, patients who did not worsen in COVID-19 severity after admission rarely developed thrombosis, although patients with worsening of COVID-19 severity after admission more often received prophylactic anticoagulation and might have a higher risk of thrombosis.
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Affiliation(s)
- Yugo Yamashita
- Department of Cardiovascular Medicine, Kyoto University Hospital, Kyoto, Kyoto, Japan
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yuji Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | | | | | | | - Hiroko Nakata
- Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
| | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | | | - Shizu Aikawa
- Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirono Satokawa
- Fukushima Medical University, School of Medicine, Fukushima, Fukushima, Japan
| | - Yoshinori Okuno
- Department of Cardiovascular Medicine, Kyoto University Hospital, Kyoto, Kyoto, Japan
| | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Oita, Japan
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
| | | | | | | | | | - Makoto Mo
- Yokohama Minami Kyosai Hospital, Yokohama, Kanagawa, Japan
| | - on behalf of the Clot-COVID Study Investigators
- Department of Cardiovascular Medicine, Kyoto University Hospital, Kyoto, Kyoto, Japan
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
- Hokkaido University Hospital, Sapporo, Hokkaido, Japan
- Hamamatsu Medical Center, Hamamatsu, Shizuoka, Japan
- Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
- Tohoku University Hospital, Sendai, Miyagi, Japan
- Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Osaka Metropolitan University Graduate School of Medicine, Suita, Osaka, Japan
- Fukushima Medical University, School of Medicine, Fukushima, Fukushima, Japan
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Oita, Japan
- Mie University Hospital, Tsu, Mie, Japan
- Toho University Ohashi Medical Center, Tokyo, Japan
- Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
- Tsukuba Vascular Center, Moriya, Ibaraki, Japan
- Kuwana City Medical Center, Kuwana, Mie, Japan
- Fukushima Daiich Hospital, Fukushima, Fukushima, Japan
- Yokohama Minami Kyosai Hospital, Yokohama, Kanagawa, Japan
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2
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Umetsu M, Kanamori H, Murakami K, Shiga T, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Clinical Features Comparing Arterial Thrombosis and Venous Thromboembolism in Hospitalized Patients with COVID-19: Result from the CLOT-COVID Study. Ann Vasc Dis 2023; 16:115-123. [PMID: 37359099 PMCID: PMC10288120 DOI: 10.3400/avd.oa.22-00112] [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: 10/21/2022] [Accepted: 03/24/2023] [Indexed: 06/28/2023] Open
Abstract
Objectives: This study aimed to investigate the clinical features of arterial thrombosis and venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19). Methods: The CLOT-COVID Study was a retrospective, multicenter cohort study that enrolled 2,894 consecutively hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We compared the clinical features of arterial thrombosis and VTE. Results: Thrombosis was observed in 55 patients (1.9%) during hospitalization. Arterial thrombosis and VTE occurred in 12 (0.4%) and 36 (1.2%) patients, respectively. Among the 12 patients with arterial thrombosis, 9 (75%), 2 (17%), and 1 developed ischemic cerebral infarction, myocardial infarction, and acute limb ischemia, respectively, and there were five patients (42%) without comorbidities. Among 36 patients with VTE, 19 (53%) and 17 (47%) developed pulmonary embolism (PE) and deep vein thrombosis (DVT), respectively. PE was common in the early stages of hospitalization; whereas, DVT was common beyond the early stages of hospitalization. Conclusion: Among patients with COVID-19, arterial thrombosis was less common than VTE, although ischemic cerebral infarction seemed to be relatively common, and a certain number of patients developed arterial thrombosis even in the absence of known atherosclerosis risk factors.
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Affiliation(s)
| | | | | | - Takuya Shiga
- Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yuji Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan
| | | | | | | | - Hiroko Nakata
- Yokosuka General Hospital Uwamachi, Yokosuka, Kanagawa, Japan
| | - Satoshi Ikeda
- Nagasaki University Hospital, Nagasaki, Nagasaki, Japan
| | - Shizu Aikawa
- Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine, Osaka, Osaka, Japan
| | - Hirono Satokawa
- Fukushima Medical University, School of Medicine, Fukushima, Fukushima, Japan
| | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Osaka, Japan
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
| | | | | | | | | | - Makoto Mo
- Yokohama Minami Kyosai Hospital, Yokohama, Kanagawa, Japan
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3
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Fukui Y, Hirota Y, Aikawa S, Sakashita A, Shimizu-Hirota R, Takeda N, Ishizawa C, Iida R, Kaku T, Hirata T, Hiraoka T, Akaeda S, Matsuo M, Osuga Y. The EZH2-PRC2-H3K27me3 axis governs the endometrial cell cycle and differentiation for blastocyst invasion. Cell Death Dis 2023; 14:320. [PMID: 37198149 DOI: 10.1038/s41419-023-05832-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023]
Abstract
Infertility occurs in 15% of couples worldwide. Recurrent implantation failure (RIF) is one of the major problems in in vitro fertilization and embryo transfer (IVF-ET) programs, and how to manage patients with RIF to achieve successful pregnancy outcomes remains unresolved. Here, a uterine polycomb repressive complex 2 (PRC2)-regulated gene network was found to control embryo implantation. Our RNA-seq analyses of the human peri-implantation endometrium obtained from patients with RIF and fertile controls revealed that PRC2 components, including its core enzyme enhancer of zeste homolog 2 (EZH2)-catalyzing H3K27 trimethylation (H3K27me3) and their target genes are dysregulated in the RIF group. Although fertility of uterine epithelium-specific knockout mice of Ezh2 (eKO mice) was normal, Ezh2-deleted mice in the uterine epithelium and stroma (uKO mice) exhibited severe subfertility, suggesting that stromal Ezh2 plays a key role in female fertility. The RNA-seq and ChIP-seq analyses revealed that H3K27me3-related dynamic gene silencing is canceled, and the gene expression of cell-cycle regulators is dysregulated in Ezh2-deleted uteri, causing severe epithelial and stromal differentiation defects and failed embryo invasion. Thus, our findings indicate that the EZH2-PRC2-H3K27me3 axis is critical to preparing the endometrium for the blastocyst invasion into the stroma in mice and humans.
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Affiliation(s)
- Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan.
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Akihiko Sakashita
- Department of Molecular Biology, Keio University School of Medicine, Tokyo, 160-0016, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center for Preventive Medicine, Keio University School of Medicine, Tokyo, 160-0016, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi, 329-0498, Japan
| | - Chihiro Ishizawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Rei Iida
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, 113-8655, Japan
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4
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Takeyama M, Yachi S, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Mortality-associated Risk Factors in Hospitalized COVID-19 Patients in Japan: Findings of the CLOT-COVID Study. J Epidemiol 2023; 33:150-157. [PMID: 36372435 PMCID: PMC9909175 DOI: 10.2188/jea.je20220201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Reports of mortality-associated risk factors in patients with the novel coronavirus disease 2019 (COVID-19) are limited. METHODS We evaluated the clinical features that were associated with mortality among patients who died during hospitalization (n = 158) and those who were alive at discharge (n = 2,736) from the large-scale, multicenter, retrospective, observational cohort CLOT-COVID study, which enrolled consecutively hospitalized COVID-19 patients from 16 centers in Japan from April to September 2021. Data from 2,894 hospitalized COVID-19 participants of the CLOT-COVID study were analyzed in this study. RESULTS Patients who died were older (71.1 years vs 51.6 years, P < 0.001), had higher median D-dimer values on admission (1.7 µg/mL vs 0.8 µg/mL, P < 0.001), and had more comorbidities. On admission, the patients who died had more severe COVID-19 than did those who survived (mild: 16% vs 63%, moderate: 47% vs 31%, and severe: 37% vs 6.2%, P < 0.001). In patients who died, the incidence of thrombosis and major bleeding during hospitalization was significantly higher than that in those who survived (thrombosis: 8.2% vs 1.5%, P < 0.001; major bleeding: 12.7% vs 1.4%, P < 0.001). Multivariable logistic regression analysis revealed that age >70 years, high D-dimer values on admission, heart disease, active cancer, higher COVID-19 severity on admission, and development of major bleeding during hospitalization were independently associated with a higher mortality risk. CONCLUSION This large-scale observational study in Japan identified several independent risk factors for mortality in hospitalized patients with COVID-19 that could facilitate appropriate risk stratification of patients with COVID-19.
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Affiliation(s)
- Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine
| | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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5
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Ikeda S, Ueno Y, Maemura K, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Association Between the Development of Thrombosis and Worsening of Disease Severity in Patients With Moderate COVID-19 on Admission - From the CLOT-COVID Study. Circ J 2023; 87:448-455. [PMID: 35786694 DOI: 10.1253/circj.cj-22-0252] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The worsening of coronavirus disease 2019 (COVID-19) severity is a critical issue in current clinical settings and may be associated with the development of thrombosis.Methods and Results: This study used patient data obtained in the CLOT-COVID study, a retrospective multicenter cohort study. The demographics of patients with moderate COVID-19 on admission with and without worsened severity during hospitalization were compared and predictors were identified. Of 927 patients with moderate COVID-19 on admission, 182 (19.6%) had worsened severity during hospitalization. Patients with worsening of severity were older, more likely to have hypertension, diabetes, heart disease, and active cancer, and more likely to use pharmacological thromboprophylaxis. Patients with worsening of severity had higher D-dimer levels on admission and were more likely to develop thrombosis and major bleeding during hospitalization than those without worsening. Increased age (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.03, P=0.005), diabetes (OR: 1.63, 95% CI: 1.11-2.33, P=0.012), D-dimer levels >1.0 μg/mL on admission (OR: 2.10, 95% CI: 1.45-3.03, P<0.001), and thrombosis (OR: 6.28, 95% CI: 2.72-14.53, P<0.001) were independently associated with worsening of COVID-19 severity. CONCLUSIONS Approximately 20% of patients with moderate COVID-19 had worsened severity during hospitalization. Increased age, diabetes, D-dimer levels >1.0 μg/mL on admission, and the development of thrombosis during hospitalization were significantly associated with worsened COVID-19 severity.
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Affiliation(s)
- Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Yuki Ueno
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | | | | | | | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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6
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Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Risk Factors and Impact on Outcomes of Thrombosis in Patients with COVID-19 in Japan: From the CLOT-COVID Study. Ann Vasc Dis 2023; 16:31-37. [PMID: 37006864 PMCID: PMC10064299 DOI: 10.3400/avd.oa.22-00071] [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: 06/28/2022] [Accepted: 11/06/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives: The relationship between the thrombotic event and prognosis in patients with coronavirus disease 2019 (COVID-19) has not yet been fully investigated in Japan. Our study aimed to investigate the clinical outcomes and risk factors for thrombosis in hospitalized patients with COVID-19 in Japan. Materials and Methods: We compared the patient characteristics and clinical outcomes among patients with thrombosis (N=55) and those without thrombosis (N=2839) by using a large-scale data of CLOT-COVID study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800). Thrombosis included venous thromboembolism, ischemic stroke, myocardial infarction, and systemic arterial thromboembolism. Results: Higher rates of mortality and bleeding events were shown in hospitalized patients with COVID-19 with thrombosis compared to those without thrombosis (all-cause mortality, 23.6% vs. 5.1%, P<0.001; major bleeding, 23.6% vs. 1.6%, P<0.001). Multivariable analysis revealed that the independent risk factors of thrombosis were male sex, D-dimer level on admission>1.0 µg/mL, and moderate and severe COVID-19 status on admission. Conclusions: The development of thrombosis in hospitalized patients with COVID-19 was related to higher mortality and major bleeding, and several independent risk factors for thrombosis could help determine the patient-appropriate treatment for COVID-19.
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Affiliation(s)
- Sen Yachi
- Japan Community Health care Organization Tokyo Shinjuku Medical Center
| | - Makoto Takeyama
- Japan Community Health care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine
| | | | | | - Eriko Iwata
- Japan Community Health care Organization Nankai Medical Center
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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7
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Ogihara Y, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Influence of obesity on incidence of thrombosis and disease severity in patients with COVID-19: From the CLOT-COVID study. J Cardiol 2023; 81:105-110. [PMID: 36096957 PMCID: PMC9420713 DOI: 10.1016/j.jjcc.2022.08.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND The influence of obesity on the development of thrombosis and severity of coronavirus disease 2019 (COVID-19) remains unclear. METHOD The CLOT-COVID study was a retrospective multicenter cohort study enrolling 2894 consecutive hospitalized patients with COVID-19 between April 2021 and September 2021 among 16 centers in Japan. The present study consisted of 2690 patients aged over 18 years with available body mass index (BMI), who were divided into an obesity group (BMI ≥30) (N = 457) and a non-obesity group (BMI <30) (N = 2233). RESULTS The obesity group showed more severe status of COVID-19 at admission compared with the non-obesity group. The incidence of thrombosis was not significantly different between the groups (obesity group: 2.6 % versus non-obesity group: 1.9 %, p = 0.39), while the incidence of a composite outcome of all-cause death, or requirement of mechanical ventilation or extracorporeal membrane oxygenation during hospitalization was significantly higher in the obesity group (20.1 % versus 15.0 %, p < 0.01). After adjusting confounders in the multivariable logistic regression model, the risk of obesity relative to non-obesity for thrombosis was not significant (adjusted OR, 1.39; 95 % CI, 0.68-2.84, p = 0.37), while the adjusted risk of obesity relative to non-obesity for the composite outcome was significant (adjusted OR, 1.85; 95 % CI, 1.39-2.47, p < 0.001). CONCLUSIONS In the present large-scale observational study, obesity was not significantly associated with the development of thrombosis during hospitalization; however, it was associated with severity of COVID-19.
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Affiliation(s)
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yuji Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | | | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Japan
| | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | | | | | | | | | - Makoto Mo
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
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8
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Hayashi H, Izumiya Y, Fukuda D, Wakita F, Mizobata Y, Fujii H, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. Real-World Management of Pharmacological Thromboprophylactic Strategies for COVID-19 Patients in Japan: From the CLOT-COVID Study. JACC Asia 2022; 2:897-907. [PMID: 36536621 PMCID: PMC9753959 DOI: 10.1016/j.jacasi.2022.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 12/23/2022]
Abstract
Background Data on prophylactic anticoagulation are important in understanding the current issues, unmet needs, and optimal management of Japanese COVID-19 patients. Objectives This study aimed to investigate the clinical management strategies for prophylactic anticoagulation of COVID-19 patients in Japan. Methods The CLOT-COVID study was a multicenter observational study that enrolled 2,894 consecutive hospitalized patients with COVID-19. The study population consisted of 2,889 patients (after excluding 5 patients with missing data); it was divided into 2 groups: patients with pharmacological thromboprophylaxis (n = 1,240) and those without (n = 1,649). Furthermore, we evaluated the 1,233 patients who received prophylactic anticoagulation-excluding 7 patients who could not be classified based on the intensity of their anticoagulants-who were then divided into 2 groups: patients receiving prophylactic anticoagulant doses (n = 889) and therapeutic anticoagulant doses (n = 344). Results The most common pharmacological thromboprophylaxis anticoagulant was unfractionated heparin (68.2%). The severity of COVID-19 at admission was a predictor of the implementation of pharmacological thromboprophylaxis in the multivariable analysis (moderate vs mild: OR: 16.6; 95% CI:13.2-21.0; P < 0.001, severe vs mild: OR: 342.6, 95% CI: 107.7-1090.2; P < 0.001). It was also a predictor of the usage of anticoagulants of therapeutic doses in the multivariable analysis (moderate vs mild: OR: 2.10; 95% CI: 1.46-3.02; P < 0.001, severe vs mild: OR: 5.96; 95% CI: 3.91-9.09; P < 0.001). Conclusions In the current real-world Japanese registry, pharmacological thromboprophylaxis, especially anticoagulants at therapeutic doses, was selectively implemented in COVID-19 patients with comorbidities and severe COVID-19 status at admission.
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Affiliation(s)
- Hiroya Hayashi
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan,Address for correspondence: Dr Hiroya Hayashi, Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Yasuhiro Izumiya
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Daiju Fukuda
- Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Fumiaki Wakita
- Department of Traumatology and Critical Care Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yasumitsu Mizobata
- Department of Traumatology and Critical Care Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Hiromichi Fujii
- Department of Intensive Care Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yuji Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | | | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Japan
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | | | | | | | | | - Makoto Mo
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
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9
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Yamashita Y, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M. Significant Impact of Age on Mortality and Non-significant Impact of Age on Thrombosis and Major Bleeding in Patients with COVID-19: From the CLOT-COVID Study. J Atheroscler Thromb 2022. [PMID: 35908882 DOI: 10.5551/jat.63702] [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: 01/08/2023] Open
Abstract
AIM There is scarce data on the impact of age on clinical outcomes in patients with coronavirus disease 2019 (COVID-19). METHOD The CLOT-COVID Study was a retrospective, multicenter cohort study enrolling 2894 consecutive hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We divided the entire cohort into five groups according to age strata; -19, 20-39, 40-59, 60-79, and 80- years. RESULTS Most patients under 19 had mild COVID-19 on admission (99%), while older patients had more severe COVID-19. The incidence rates of clinical outcomes during hospitalization in patients aged ≤ 19, 20-39, 40-59, 60-79, and 80 ≥ years were 0.0%, 0.5%, 2.2%, 2.7%, and 1.5% for thrombosis; 0.0%, 1.2%, 1.5%, 3.4%, and 2.0% for major bleeding; and 0.0%, 0.4%, 2.0%, 12.1%, and 16.8% for all-cause death, respectively. In the stratified analysis according to COVID-19 severity on admission, the incidences of thrombosis were generally higher among patients with more severe status, although those were not significantly different among age strata in all sub-types of COVID-19 severity. However, the incidences of all-cause death were significantly higher with increasing age in all sub-types of COVID-19 severity. CONCLUSIONS In the current large observational study of patients with COVID-19, the risk of mortality became markedly higher with increased age. However, the risks of thrombosis and major bleeding did not necessarily increase as age increases, which seemed to be consistent irrespective of COVID-19 severity on admission.
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Affiliation(s)
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine
| | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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10
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Yamashita Y, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M. Therapeutic-Dose vs. Prophylactic-Dose Anticoagulation Therapy for Critically Ill Patients With COVID-19 in a Practice-Based Observational Study. Circ J 2022; 86:1137-1142. [DOI: 10.1253/circj.cj-22-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences
| | | | | | - Hiroya Hayashi
- Osaka Metropolitan University Graduate School of Medicine
| | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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11
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Hiraoka T, Hirota Y, Aikawa S, Iida R, Ishizawa C, Kaku T, Hirata T, Fukui Y, Akaeda S, Matsuo M, Shimizu-Hirota R, Takeda N, Osuga Y. Constant Activation of STAT3 Contributes to the Development of Adenomyosis in Females. Endocrinology 2022; 163:6563397. [PMID: 35380652 DOI: 10.1210/endocr/bqac044] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/28/2021] [Indexed: 11/19/2022]
Abstract
Adenomyosis is a benign uterine disease that causes dysmenorrhea, heavy menstrual bleeding, and infertility; however, its pathophysiology remains unclear. Since signal transducer and activator of transcription 3 (STAT3) is crucial for endometrial regeneration, we hypothesized that STAT3 participates in adenomyosis pathophysiology. To investigate the influence of STAT3 on adenomyosis development, this study was performed using a novel mouse model of adenomyosis and human specimens of eutopic endometria and adenomyosis lesions. We established a novel mouse model of adenomyosis by puncturing entire mouse uterine layers with a thin needle. Mouse eutopic and ectopic endometria showed a positive immunoreactivity for phosphorylated STAT3 (pSTAT3), the active form of STAT3. Decreased numbers of adenomyotic lesions and reduced expression of Cxcl1, Icam1, and Spp1, which are associated with immune cell chemotaxis and tissue regeneration, were observed in uterine Stat3-deficient mice compared with the controls. In humans, pSTAT3 was intensely expressed at both the eutopic endometrium and the adenomyotic lesions regardless of the menstrual cycle phases. Conversely, it was limitedly expressed in the eutopic endometrium during the menstrual and proliferative phases in women without adenomyosis. Our findings indicate that continuous STAT3 activation promotes adenomyosis development. STAT3 inhibition can be a promising treatment strategy in patients with adenomyosis.
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Affiliation(s)
- Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rei Iida
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chihiro Ishizawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center for Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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12
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Yamashita Y, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M. Influence of sex on development of thrombosis in patients with COVID-19: From the CLOT-COVID study. Thromb Res 2022; 213:173-178. [PMID: 35390553 PMCID: PMC8970622 DOI: 10.1016/j.thromres.2022.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/21/2022] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 02/06/2023]
Abstract
Introduction There has been limited data on the influence of sex on development of thrombosis in patients with coronavirus disease 2019 (COVID-19). Materials and methods The CLOT-COVID Study was a retrospective, multicenter cohort study enrolling 2894 consecutive hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021. We divided the entire cohort into the men (N = 1885) and women (N = 1009) groups. Results There were no significant differences in D-dimer levels at admission between men and women. Men had more severe status of the COVID-19 at admission compared with women (Mild: 57% versus 66%, Moderate: 34% versus 29%, and Severe: 9.1% versus 5.7%, P < 0.001). Men more often received pharmacological thromboprophylaxis than women (47% versus 35%, P < 0.001). During the hospitalization, men more often developed thrombosis than women (2.5% [95%CI, 1.9–3.3%] versus 0.8% [95%CI, 0.4–1.6%], P = 0.001). Men had numerically higher incidences of thrombosis than women in all subgroups of the worst severity of COVID-19 during the hospitalization (Mild: 0.3% versus 0.0%, Moderate: 1.6% versus 1.0%, and Severe: 11.1% versus 4.3%). Even after adjusting confounders in the multivariable logistic regression model, the excess risk of men relative to women remained significant for thrombosis (adjusted OR, 2.51; 95%CI, 1.16–5.43, P = 0.02). Conclusions In the current large observational study of patients with COVID-19, men had more severe status of the COVID-19 than women, and the risk of development of thrombosis was higher in men compared with women, which could be helpful in determining the patient-specific optimal management strategies for COVID-19.
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Affiliation(s)
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Yuji Nishimoto
- Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | | | - Hiroya Hayashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hirono Satokawa
- Fukushima Medical University, School of Medicine, Fukushima, Japan
| | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization, Saiki, Japan
| | | | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults, Zentsuji, Japan
| | | | | | | | | | - Makoto Mo
- Yokohama Minami Kyosai Hospital, Yokohama, Japan
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13
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Nishimoto Y, Yachi S, Takeyama M, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Ikeda N, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. The current status of thrombosis and anticoagulation therapy in patients with COVID-19 in Japan: From the CLOT-COVID study. J Cardiol 2022; 80:285-291. [PMID: 35430141 PMCID: PMC8979768 DOI: 10.1016/j.jjcc.2022.03.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/15/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023]
Abstract
Background Data on thrombosis and current real-world management strategies for anticoagulation therapy are scarce but important for understanding current issues and unmet needs of an optimal management of patients with coronavirus disease 2019 (COVID-19). Method The CLOT-COVID Study (thrombosis and antiCoaguLatiOn Therapy in patients with COVID-19 in Japan Study: UMIN000045800) was a retrospective, multicenter cohort study enrolling consecutive hospitalized patients with COVID-19 among 16 centers in Japan from April 2021 to September 2021, and we tried to capture the status of the patients in the fourth and fifth waves of the COVID-19 infections in Japan. We enrolled consecutive hospitalized patients who were diagnosed with COVID-19 and had a positive polymerase chain reaction test obtained from the hospital databases. Results Among 2894 patients with COVID-19, 1245 (43%) received pharmacological thromboprophylaxis. The proportion of pharmacological thromboprophylaxis increased according to the severity of the COVID-19 in 9.8% with mild COVID-19, 61% with moderate COVID-19, and 97% with severe COVID-19. The types and doses of anticoagulants varied widely across the participating centers. During the hospitalization, 38 patients (1.3%) and 126 (4.4%) underwent ultrasound examinations for the lower extremities and contrast-enhanced computed tomography examinations, respectively, and 55 (1.9%) developed thrombosis, mostly venous thromboembolism (71%). The incidence of thrombosis increased according to the severity of the COVID-19 in 0.2% with mild COVID-19, 1.4% with moderate COVID-19, and 9.5% with severe COVID-19. Major bleeding occurred in 57 patients (2.0%) and 158 (5.5%) died, and 81% of them were due to respiratory failure from COVID-19 pneumonia. Conclusions In the present large-scale observational study, pharmacological thromboprophylaxis for hospitalized patients with COVID-19 was common especially in patients with severe COVID-19, and management strategies varied widely across the participating centers. The overall incidence of thrombosis was substantially low with an increased incidence according to the severity of the COVID-19.
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14
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Ikeda N, Yachi S, Takeyama M, Nishimoto Y, Tsujino I, Nakamura J, Yamamoto N, Nakata H, Ikeda S, Umetsu M, Aikawa S, Hayashi H, Satokawa H, Okuno Y, Iwata E, Ogihara Y, Kondo A, Iwai T, Yamada N, Ogawa T, Kobayashi T, Mo M, Yamashita Y. D-Dimer Values and Venous Thromboembolism in Patients With COVID-19 in Japan ― From the CLOT-COVID Study ―. Circ Rep 2022; 4:215-221. [PMID: 35600720 PMCID: PMC9072098 DOI: 10.1253/circrep.cr-22-0022] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background: To date, there are no large-scale data on the association between D-dimer levels at admission and the occurrence of venous thromboembolism (VTE) in Japanese patients with coronavirus disease 2019 (COVID-19). Methods and Results: The CLOT-COVID study was a retrospective, multicenter cohort study enrolling consecutive hospitalized patients with COVID-19 across 16 centers in Japan from April 2021 to September 2021. Among 2,894 enrolled patients, 2,771 (96%) had D-dimer levels measured at admission. Patients were divided into 3 groups based on tertiles of D-dimer levels at admission (1st tertile, D-dimer ≤0.5 μg/mL, n=949; 2nd tertile, D-dimer 0.51–1.09 μg/mL, n=894; 3rd tertile, D-dimer ≥1.1 μg/mL, n=928). The higher the tertile group, the more severe the COVID-19 status at admission. The incidence of VTE during hospitalization was highest in the 3rd tertile group (1st tertile, 0.3%; 2nd tertile, 0.3%; 3rd tertile, 3.6%; P<0.001). Even after adjusting for confounders in the multivariable logistic regression model, the higher D-dimer levels in the 3rd tertile (≥1.1 μg/mL) were independently associated with a higher risk of VTE during hospitalization (adjusted odds ratio 4.83 [95% confidence interval 1.93–12.11; P<0.001]; reference=1st tertile). Conclusions: Higher D-dimer levels at admission were associated with a higher risk of VTE events during hospitalization in Japanese patients with COVID-19. This could be helpful in determining patient-specific anticoagulation management strategies for COVID-19 in Japan.
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Affiliation(s)
| | - Sen Yachi
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | - Makoto Takeyama
- Japan Community Health Care Organization Tokyo Shinjuku Medical Center
| | | | | | | | | | | | - Satoshi Ikeda
- Nagasaki University Graduate School of Biomedical Sciences
| | | | | | | | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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15
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Hashimoto T, Aikawa S, Akaishi T, Asano H, Bazzi M, Bennett DA, Berger M, Bosnar D, Butt AD, Curceanu C, Doriese WB, Durkin MS, Ezoe Y, Fowler JW, Fujioka H, Gard JD, Guaraldo C, Gustafsson FP, Han C, Hayakawa R, Hayano RS, Hayashi T, Hays-Wehle JP, Hilton GC, Hiraiwa T, Hiromoto M, Ichinohe Y, Iio M, Iizawa Y, Iliescu M, Ishimoto S, Ishisaki Y, Itahashi K, Iwasaki M, Ma Y, Murakami T, Nagatomi R, Nishi T, Noda H, Noumi H, Nunomura K, O'Neil GC, Ohashi T, Ohnishi H, Okada S, Outa H, Piscicchia K, Reintsema CD, Sada Y, Sakuma F, Sato M, Schmidt DR, Scordo A, Sekimoto M, Shi H, Shirotori K, Sirghi D, Sirghi F, Suzuki K, Swetz DS, Takamine A, Tanida K, Tatsuno H, Trippl C, Uhlig J, Ullom JN, Yamada S, Yamaga T, Yamazaki T, Zmeskal J. Measurements of Strong-Interaction Effects in Kaonic-Helium Isotopes at Sub-eV Precision with X-Ray Microcalorimeters. Phys Rev Lett 2022; 128:112503. [PMID: 35363014 DOI: 10.1103/physrevlett.128.112503] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
We have measured the 3d→2p transition x rays of kaonic ^{3}He and ^{4}He atoms using superconducting transition-edge-sensor microcalorimeters with an energy resolution better than 6 eV (FWHM). We determined the energies to be 6224.5±0.4(stat)±0.2(syst) eV and 6463.7±0.3(stat)±0.1(syst) eV, and widths to be 2.5±1.0(stat)±0.4(syst) eV and 1.0±0.6(stat)±0.3(stat) eV, for kaonic ^{3}He and ^{4}He, respectively. These values are nearly 10 times more precise than in previous measurements. Our results exclude the large strong-interaction shifts and widths that are suggested by a coupled-channel approach and agree with calculations based on optical-potential models.
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Affiliation(s)
- T Hashimoto
- Advanced Science Research Center, Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - S Aikawa
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - T Akaishi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - H Asano
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Bazzi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - D A Bennett
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M Berger
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - D Bosnar
- Department of Physics, Faculty of Science, University of Zagreb, Zagreb 10000, Croatia
| | - A D Butt
- Politecnico di Milano, Dipartimento di Elettronica, Milano 20133, Italy
| | - C Curceanu
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - W B Doriese
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - M S Durkin
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Ezoe
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - J W Fowler
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - H Fujioka
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - J D Gard
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - C Guaraldo
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - F P Gustafsson
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - C Han
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - R Hayakawa
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - R S Hayano
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - T Hayashi
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Sagamihara 252-5210, Japan
| | - J P Hays-Wehle
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - G C Hilton
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Hiraiwa
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - M Hiromoto
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - Y Ichinohe
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - M Iio
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - Y Iizawa
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Iliescu
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - S Ishimoto
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - Y Ishisaki
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - K Itahashi
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Iwasaki
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - Y Ma
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - T Murakami
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - R Nagatomi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Nishi
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako 351-0198, Japan
| | - H Noda
- Department of Earth and Space Science, Osaka University, Toyonaka 560-0043, Japan
| | - H Noumi
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - K Nunomura
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - G C O'Neil
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - T Ohashi
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - H Ohnishi
- Research Center for Electron Photon Science (ELPH), Tohoku University, Sendai 982-0826, Japan
| | - S Okada
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
- Engineering Science Laboratory, Chubu University, Kasugai 487-8501, Japan
| | - H Outa
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - K Piscicchia
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - C D Reintsema
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - Y Sada
- Research Center for Electron Photon Science (ELPH), Tohoku University, Sendai 982-0826, Japan
| | - F Sakuma
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - M Sato
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - D R Schmidt
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - A Scordo
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - M Sekimoto
- High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - H Shi
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - K Shirotori
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - D Sirghi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - F Sirghi
- Laboratori Nazionali di Frascati dell' INFN, Frascati I-00044, Italy
| | - K Suzuki
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - D S Swetz
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - A Takamine
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - K Tanida
- Advanced Science Research Center, Japan Atomic Energy Agency (JAEA), Tokai 319-1184, Japan
| | - H Tatsuno
- Department of Physics, Tokyo Metropolitan University, Tokyo 192-0397, Japan
| | - C Trippl
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
| | - J Uhlig
- Chemical Physics, Lund University, Lund 22100, Sweden
| | - J N Ullom
- National Institute of Standards and Technology, Boulder, Colorado 80305, USA
| | - S Yamada
- Department of Physics, Rikkyo University, Tokyo 171-8501, Japan
| | - T Yamaga
- RIKEN Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - T Yamazaki
- Department of Physics, The University of Tokyo, Tokyo 113-0033, Japan
| | - J Zmeskal
- Stefan-Meyer-Institut für subatomare Physik, Vienna A-1030, Austria
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16
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Aikawa S, Hirota Y, Fukui Y, Ishizawa C, IIda R, Kaku T, Hirata T, Akaeda S, Hiraoka T, Matsuo M, Osuga Y. A gene network of uterine luminal epithelium organizes mouse blastocyst implantation. Reprod Med Biol 2022; 21:e12435. [PMID: 35386370 PMCID: PMC8967306 DOI: 10.1002/rmb2.12435] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 10/06/2021] [Revised: 11/27/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The receptive endometrium is critical for blastocyst implantation. In mice, after blastocysts enter the uterine cavities on day 4 of pregnancy (day 1 = vaginal plug), blastocyst attachment is completed within 24 h, accompanied by dynamic interactions between the uterine luminal epithelium and the blastocysts. Any failures in this process compromise subsequent pregnancy outcomes. Here, we performed comprehensive analyses of gene expression at the luminal epithelium in the peri‐implantation period. Methods RNA‐seq combined with laser microdissection (LMD) was used to reveal unique gene expression kinetics in the epithelium. Results We found that the prereceptive epithelium on day 3 specifically expresses cell cycle‐related genes. In addition, days 3 and 4 epithelia express glutathione pathway‐related genes, which are protective against oxidative stresses. In contrast, day 5 epithelium expresses genes involved in glycolysis and the regulation of cell proliferation. The genes highly expressed on days 3 and 4 compared to day 5 are related to progesterone receptor signaling, and the genes highly expressed on day 5 compared to days 3 and 4 are associated with the ones regulated by H3K27me3. Conclusions These results suggest that specific gene expression patterns govern uterine functions during early pregnancy, contributing to implantation success.
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Affiliation(s)
- Shizu Aikawa
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yamato Fukui
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Chihiro Ishizawa
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Rei IIda
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology Graduate School of Medicine The University of Tokyo Tokyo Japan
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17
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Tanaka K, Shimizu Y, Kamada H, Aikawa S, Mishima H, Kanamori A, Nishino T, Sakane M, Ochiai N, Yamazaki M. Feasibility and Safety of a Novel Leg Exercise Apparatus for Venous Thromboembolism Prophylaxis after Total Joint Arthroplasty of the Lower Extremities-A Pilot Study. Tomography 2021; 7:734-746. [PMID: 34842826 PMCID: PMC8628884 DOI: 10.3390/tomography7040061] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 12/18/2022] Open
Abstract
Venous thromboembolism (VTE) is a severe complication in orthopedic surgeries. Herein, we developed a novel leg exercise apparatus (LEX) to encourage postoperative limb movement in bedridden patients to prevent VTE. We aimed to evaluate its feasibility and safety in individuals at risk of VTE. Twenty patients (four men, 16 women) who underwent total joint arthroplasty in the lower extremity were enrolled in this prospective study. Exercise using the LEX was performed for 5 min at 30 cycles/min, four times/day during postoperative days 1–7. Clinical assessments included the evaluation of vital signs, venous ultrasonography, and blood tests within seven days postoperatively, and adverse events (pulmonary embolism and cerebral hemorrhage) were monitored. Overall, 16/20 (80%) patients completed the 7-day exercise regimen. There were no cases of severe adverse events, changes in vital signs, or lower-extremity deep vein thrombosis in patients who performed exercises with the LEX. Thus, the results of this pilot study show that this novel apparatus may be a safe and feasible tool for VTE prophylaxis after joint arthroplasty of the lower extremities.
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Affiliation(s)
- Kenta Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
- Department of Orthopaedic Surgery, Nogami Hospital, Tozakimachi 6-8, Tsuchiura 300-0031, Ibaraki, Japan
| | - Yukiyo Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
- Correspondence: ; Tel.: +81-29-853-3219
| | - Hiroshi Kamada
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
| | - Shizu Aikawa
- Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba 305-8558, Ibaraki, Japan;
| | - Hajime Mishima
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
| | - Akihiro Kanamori
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
| | - Tomofumi Nishino
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
| | - Masataka Sakane
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
- Department of Orthopaedic Surgery, Tsukuba Gakuen Hospital, 2573-1 Kamiyokoba, Tsukuba 305-0854, Ibaraki, Japan
| | - Naoyuki Ochiai
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
- Department of Orthopaedic Surgery, Kikkoman General Hospital, 100 Miyazaki, Noda 278-0005, Chiba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan; (K.T.); (H.K.); (H.M.); (A.K.); (T.N.); (M.S.); (N.O.); (M.Y.)
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18
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Fukui Y, Hirota Y, Saito-Fujita T, Aikawa S, Hiraoka T, Kaku T, Hirata T, Akaeda S, Matsuo M, Shimizu-Hirota R, Takeda N, Ikawa M, Osuga Y. Uterine Epithelial LIF Receptors Contribute to Implantation Chamber Formation in Blastocyst Attachment. Endocrinology 2021; 162:6353290. [PMID: 34402888 DOI: 10.1210/endocr/bqab169] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 12/28/2022]
Abstract
Recent studies have demonstrated that the formation of an implantation chamber composed of a uterine crypt, an implantation-competent blastocyst, and uterine glands is a critical step in blastocyst implantation in mice. Leukemia inhibitory factor (LIF) activates signal transducer and activator of transcription 3 (STAT3) precursors via uterine LIF receptors (LIFRs), allowing successful blastocyst implantation. Our recent study revealed that the role of epithelial STAT3 is different from that of stromal STAT3. However, both are essential for blastocyst attachment, suggesting the different roles of epithelial and stromal LIFR in blastocyst implantation. However, how epithelial and stromal LIFR regulate the blastocyst implantation process remains unclear. To investigate the roles of LIFR in the uterine epithelium and stroma, we generated Lifr-floxed/lactoferrin (Ltf)-iCre (Lifr eKO) and Lifr-floxed/antimüllerian hormone receptor type 2 (Amhr2)-Cre (Lifr sKO) mice with deleted epithelial and stromal LIFR, respectively. Surprisingly, fertility and blastocyst implantation in the Lifr sKO mice were normal despite stromal STAT3 inactivation. In contrast, blastocyst attachment failed, and no implantation chambers were formed in the Lifr eKO mice with epithelial inactivation of STAT3. In addition, normal responsiveness to ovarian hormones was observed in the peri-implantation uteri of the Lifr eKO mice. These results indicate that the epithelial LIFR-STAT3 pathway initiates the formation of implantation chambers, leading to complete blastocyst attachment, and that stromal STAT3 regulates blastocyst attachment without stromal LIFR control. Thus, uterine epithelial LIFR is critical to implantation chamber formation and blastocyst attachment.
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Affiliation(s)
- Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoko Saito-Fujita
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center for Preventive Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan
| | - Masahito Ikawa
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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19
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Yamashita Y, Maruyama Y, Satokawa H, Nishimoto Y, Tsujino I, Sakashita H, Nakata H, Okuno Y, Ogihara Y, Yachi S, Toya N, Shingaki M, Ikeda S, Yamamoto N, Aikawa S, Ikeda N, Hayashi H, Ishiguro S, Iwata E, Umetsu M, Kondo A, Iwai T, Kobayashi T, Mo M, Yamada N. Incidence and Clinical Features of Venous Thromboembolism in Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) in Japan. Circ J 2021; 85:2208-2214. [PMID: 34011824 DOI: 10.1253/circj.cj-21-0169] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [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: 12/15/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) reportedly causes venous thromboembolism (VTE), but the status of this complication in Japan was unclear.Methods and Results:The VTE and COVID-19 in Japan Study is a retrospective, multicenter cohort study enrolling hospitalized patients with COVID-19 who were evaluated with contrast-enhanced computed tomography (CT) examination at 22 centers in Japan between March 2020 and October 2020. Among 1,236 patients with COVID-19, 45 (3.6%) were evaluated with contrast-enhanced CT examination. VTE events occurred in 10 patients (22.2%), and the incidence of VTE in mild, moderate, and severe COVID-19 was 0%, 11.8%, and 40.0%, respectively. COVID-19 patients with VTE showed a higher body weight (81.6 vs. 64.0 kg, P=0.005) and body mass index (26.9 vs. 23.2 kg/m2, P=0.04), and a higher proportion had a severe status for COVID-19 compared with those without. There was no significant difference in the proportion of patients alive at discharge between patients with and without VTE (80.0% vs. 88.6%, P=0.48). Among 8 pulmonary embolism (PE) patients, all were low-risk PE. CONCLUSIONS Among a relatively small number of patients undergoing contrast-enhanced CT examination in Japanese real-world clinical practice, there were no VTE patients among those with mild COVID-19, but the incidence of VTE seemed to be relatively high among severe COVID-19 patients, although all PE events were low-risk without significant effect on mortality risk.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Eriko Iwata
- Nankai Medical Center Japan Community Health Care Organization
| | | | - Akane Kondo
- Shikoku Medical Center for Children and Adults
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20
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Akaeda S, Hirota Y, Fukui Y, Aikawa S, Shimizu-Hirota R, Kaku T, Gebril M, Hirata T, Hiraoka T, Matsuo M, Haraguchi H, Saito-Kanatani M, Takeda N, Fujii T, Osuga Y. Retinoblastoma protein promotes uterine epithelial cell cycle arrest and necroptosis for embryo invasion. EMBO Rep 2021; 22:e50927. [PMID: 33399260 DOI: 10.15252/embr.202050927] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/18/2020] [Accepted: 12/03/2020] [Indexed: 12/12/2022] Open
Abstract
Retinoblastoma protein (RB) encoded by Rb1 is a prominent inducer of cell cycle arrest (CCA). The hormone progesterone (P4 ) promotes CCA in the uterine epithelium and previous studies indicated that P4 activates RB by reducing the phosphorylated, inactive form of RB. Here, we show that embryo implantation is impaired in uterine-specific Rb1 knockout mice. We observe persistent cell proliferation of the Rb1-deficient uterine epithelium until embryo attachment, loss of epithelial necroptosis, and trophoblast phagocytosis, which correlates with subsequent embryo invasion failure, indicating that Rb1-induced CCA and necroptosis of uterine epithelium are involved in embryo invasion. Pre-implantation P4 supplementation is sufficient to restore these defects and embryo invasion. In Rb1-deficient uterine epithelial cells, TNFα-primed necroptosis is impaired, which is rescued by the treatment with a CCA inducer thymidine or P4 through the upregulation of TNF receptor type 2. TNFα is expressed in the luminal epithelium and the embryo at the embryo attachment site. These results provide evidence that uterine Rb1-induced CCA is involved in TNFα-primed epithelial necroptosis at the implantation site for successful embryo invasion.
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Affiliation(s)
- Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Frontier Outstanding Research for Clinical Empowerment (FORCE), Japan Agency for Medical Research and Development (AMED), Tokyo, Japan
| | - Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center of Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mona Gebril
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hirofumi Haraguchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mayuko Saito-Kanatani
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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21
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Gebril M, Hirota Y, Aikawa S, Fukui Y, Kaku T, Matsuo M, Hirata T, Akaeda S, Hiraoka T, Shimizu-Hirota R, Takeda N, Taha T, Balah OA, Elnoury MAH, Fujii T, Osuga Y. Uterine Epithelial Progesterone Receptor Governs Uterine Receptivity Through Epithelial Cell Differentiation. Endocrinology 2020; 161:5939206. [PMID: 33099617 DOI: 10.1210/endocr/bqaa195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Indexed: 01/25/2023]
Abstract
Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to the heightened levels of ovarian progesterone (P4) after ovulation and regulates uterine gene transcription for successful embryo implantation. Although epithelial and stromal P4-PGR signaling may interact with each other to form appropriate endometrial milieu for uterine receptivity and the subsequent embryo attachment, it remains unclear what the specific roles of epithelial P4-PGR signaling in the adult uterus are. Here we generated mice with epithelial deletion of Pgr in the adult uterus (Pgrfl/flLtfCre/+ mice) by crossing Pgr-floxed and Ltf-Cre mice. Pgrfl/flLtfCre/+ mice are infertile due to the impairment of embryo attachment. Pgrfl/flLtfCre/+ uteri did not exhibit epithelial growth arrest, suggesting compromised uterine receptivity. Both epithelial and stromal expressions of P4-responsive genes decreased in Pgrfl/flLtfCre/+ mice during the peri-implantation period, indicating that epithelial Pgr deletion affects not only epithelial but stromal P4 responsiveness. In addition, uterine LIF, an inducer of embryo attachment, was decreased in Pgrfl/flLtfCre/+ mice. The RNA-seq analysis using luminal epithelial specimens dissected out by laser capture microdissection revealed that the signaling pathways related to extracellular matrix, cell adhesion, and cell proliferation are altered in Pgr fl/flLtf Cre/+ mice. These findings suggest that epithelial PGR controls both epithelial and stromal P4 responsiveness and epithelial cell differentiation, which provides normal uterine receptivity and subsequent embryo attachment.
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Affiliation(s)
- Mona Gebril
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Reproductive Health Department, National Research Center of Egypt, Cairo, Egypt
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center for Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
| | - Tamer Taha
- Reproductive Health Department, National Research Center of Egypt, Cairo, Egypt
| | - Osama Al Balah
- Department of Medical Application of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Mohamed Amr H Elnoury
- Department of Medical Application of Laser, National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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22
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Hiraoka T, Hirota Y, Fukui Y, Gebril M, Kaku T, Aikawa S, Hirata T, Akaeda S, Matsuo M, Haraguchi H, Saito-Kanatani M, Shimizu-Hirota R, Takeda N, Yoshino O, Fujii T, Osuga Y. Differential roles of uterine epithelial and stromal STAT3 coordinate uterine receptivity and embryo attachment. Sci Rep 2020; 10:15523. [PMID: 32968170 PMCID: PMC7511330 DOI: 10.1038/s41598-020-72640-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 04/30/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023] Open
Abstract
Although it has been reported that uterine signal transducer and activator of transcription 3 (STAT3) is essential for embryo implantation, the exact roles of uterine epithelial and stromal STAT3 on embryo implantation have not been elucidated. To address this issue, we generated Stat3-floxed/Ltf-iCre (Stat3-eKO), Stat3-floxed/Amhr2-Cre (Stat3-sKO), and Stat3-floxed/Pgr-Cre (Stat3-uKO) mice to delete Stat3 in uterine epithelium, uterine stroma, and whole uterine layers, respectively. We found that both epithelial and stromal STAT3 have critical roles in embryo attachment because all the Stat3-eKO and Stat3-sKO female mice were infertile due to implantation failure without any embryo attachment sites. Stat3-eKO uteri showed indented structure of uterine lumen, indicating the role of epithelial STAT3 in slit-like lumen formation in the peri-implantation uterus. Stat3-sKO uteri exhibited hyper-estrogenic responses and persistent cell proliferation of the epithelium in the peri-implantation uterus, suggesting the role of stromal STAT3 in uterine receptivity. In addition, Stat3-uKO female mice possessed not only the characteristic of persistent epithelial proliferation but also that of indented structure of uterine lumen. These findings indicate that epithelial STAT3 controls the formation of slit-like structure in uterine lumen and stromal STAT3 suppresses epithelial estrogenic responses and cell proliferation. Thus, epithelial and stromal STAT3 cooperatively controls uterine receptivity and embryo attachment through their different pathways.
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Affiliation(s)
- Takehiro Hiraoka
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Department of Obstetrics and Gynecology, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Frontier Outstanding Research for Clinical Empowerment (FORCE), Japan Agency for Medical Research and Development (AMED), Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Yamato Fukui
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mona Gebril
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tetsuaki Kaku
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shizu Aikawa
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tomoyuki Hirata
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Shun Akaeda
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mitsunori Matsuo
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hirofumi Haraguchi
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Mayuko Saito-Kanatani
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ryoko Shimizu-Hirota
- Department of Internal Medicine, Center of Preventive Medicine, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Norihiko Takeda
- Center for Molecular Medicine, Jichi Medical University, Shimotuke, Tochigi, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, Kitasato University, Sagamihara, Kanagawa, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Aikawa S, Yuan J, Dewar A, Sun X, Dey SK. Scribble promotes alveologenesis in the pregnant mammary gland for milk production. Reproduction 2020; 159:719-731. [PMID: 32213656 DOI: 10.1530/rep-20-0108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/26/2020] [Indexed: 12/14/2022]
Abstract
Mammary glands are comprised of ducts and terminal lobules that form tree-like structures. Luminal epithelial cells in these lobules undergo differentiation into alveolar cells in pregnancy to support milk production. This study reveals that Scribble (SCRIB), a scaffold protein expressed in progesterone receptor (PGR)-positive cells, plays a critical role in mammary gland alveologenesis in mice. We conditionally deleted Scrib using a Pgr-Cre driver. PGR is heterogeneously expressed throughout the luminal epithelium. Scrib loss in mammary glands by Pgr-Cre (Scribf/fPgrCre/+) shows inefficient alveologenesis and terminal end bud (TEB)-like morphology during pregnancy, resulting in poor milk production and subsequent death of pups after delivery. The differentiation of PGR-positive epithelial cells into Elf5-expressing alveolar cells is defective in Scribf/fPgrCre/+ mice. These changes are reflected in reduced activation of JAK2 and PAK1, resulting in downregulation of pSTAT5, a critical transcriptional factor for alveologenesis. These results provide evidence that SCRIB impacts PGR-positive cell lineage during alveologenesis, which impacts milk production and the health of offspring.
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Affiliation(s)
- Shizu Aikawa
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jia Yuan
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Amanda Dewar
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Xiaofei Sun
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Sudhansu K Dey
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
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24
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Aikawa S, Deng W, Liang X, Yuan J, Bartos A, Sun X, Dey SK. Uterine deficiency of high-mobility group box-1 (HMGB1) protein causes implantation defects and adverse pregnancy outcomes. Cell Death Differ 2019; 27:1489-1504. [PMID: 31595043 DOI: 10.1038/s41418-019-0429-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/19/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022] Open
Abstract
A reciprocal communication between the implantation-competent blastocyst and the receptive uterus is essential to successful implantation and pregnancy success. Progesterone (P4) signaling via nuclear progesterone receptor (PR) is absolutely critical for pregnancy initiation and its success in most eutherian mammals. Here we show that a nuclear protein high-mobility group box-1 (HMGB1) plays a critical role in implantation in mice by preserving P4-PR signaling. Conditional deletion of uterine Hmgb1 by a Pgr-Cre driver shows implantation defects accompanied by decreased stromal cell Hoxa10 expression and cell proliferation, two known signatures of inefficient responsiveness of stromal cells to PR signaling in implantation. These mice evoke inflammatory conditions with sustained macrophage accumulation in the stromal compartment on day 4 of pregnancy with elevated levels of macrophage attractants Csf1 and Ccl2. The results are consistent with the failure of exogenous P4 administration to rescue implantation deficiency in the mutant females. These early defects are propagated throughout the course of pregnancy and ultimately result in substantial subfertility. Collectively, the present study provides evidence that nuclear HMGB1 contributes to successful blastocyst implantation by sustaining P4-PR signaling and restricting macrophage accumulation to attenuate harmful inflammatory responses.
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Affiliation(s)
- Shizu Aikawa
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA
| | - Wenbo Deng
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA.,Fujian Provincial Key Laboratory of Reproductive Health Research, Medical College of Xiamen University, Xiamen, 361102, Fujian, China
| | - Xiaohuan Liang
- College of Veterinary Medicine, South China Agricultural University, 483 Wushan Road, Tianhe District, Guangzhou, 510642, China
| | - Jia Yuan
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA
| | - Amanda Bartos
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA
| | - Xiaofei Sun
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA
| | - Sudhansu K Dey
- Division of Reproductive Sciences, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA. .,College of Medicine, University of Cincinnati, 2600 Clifton Avenue, Cincinnati, OH, 45221, USA.
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25
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Shimizu Y, Kamada H, Sakane M, Aikawa S, Mutsuzaki H, Tanaka K, Mishima H, Kanamori A, Nishino T, Ochiai N, Yamazaki M. A novel exercise device for venous thromboembolism prophylaxis improves venous flow in bed versus ankle movement exercises in healthy volunteers. J Orthop Surg (Hong Kong) 2018; 25:2309499017739477. [PMID: 29137566 DOI: 10.1177/2309499017739477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Venous thromboembolism prophylaxis is crucial. To facilitate active ankle movement in postoperative and bedridden patients, we developed a novel leg exercise apparatus (LEX). We investigated the effect of the LEX by comparing increases in lower extremity venous flow during different modes of exercise using the LEX. METHODS In eight healthy participants, we measured venous flow volume and velocity in the femoral vein using duplex ultrasonography at 1, 10, 20, and 30 min after completing three modes of 1-min LEX exercises. The exercises involved (1) rapid single motion (ankle dorsi-plantar flexion; 60 cycles/min); (2) slow single motion (30 cycles/min); and (3) slow combined leg motion. RESULTS Flow volumes after modes 1, 2, and 3 were 1.63-, 1.39-, and 1.53-fold above baseline at 30 min, respectively. Short periods of rapid single motion, with the LEX, improved postexercise lower extremity venous flow volumes at 30 min and mean venous flow velocity at 20 min, compared to slow single motion exercise. Even at slow speeds, combined-motion improved flow volume compared to single motion. CONCLUSION Short periods of rapid single motion exercise, with the LEX, improved postexercise venous flow volumes in the lower extremities at 30 min and mean venous flow velocity at 20 min. These effects were greater than those produced by slow single motion exercises. However, even at slow speeds, combined-motion exercises improved flow volume compared to single motion. Therefore, LEX may prove effective at preventing thromboembolism in postoperative and bedridden patients.
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Affiliation(s)
- Yukiyo Shimizu
- 1 Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan.,2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroshi Kamada
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Masataka Sakane
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,3 Department of Orthopaedic Surgery, Tsukuba Gakuen Hospital, Kamiyokoba, Tsukuba-shi, Ibaraki, Japan
| | - Shizu Aikawa
- 4 Department of Cardiovascular Surgery, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Hirotaka Mutsuzaki
- 5 Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, Ami-city, Inashiki-gun, Ibaraki, Japan
| | - Kenta Tanaka
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hajime Mishima
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Akihiro Kanamori
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tomofumi Nishino
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Naoyuki Ochiai
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,6 Department of Orthopaedic Surgery, Kikkoman General Hospital, Noda, Chiba, Japan
| | - Masashi Yamazaki
- 2 Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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26
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Aikawa S, Kano K, Inoue A, Wang J, Saigusa D, Nagamatsu T, Hirota Y, Fujii T, Tsuchiya S, Taketomi Y, Sugimoto Y, Murakami M, Arita M, Kurano M, Ikeda H, Yatomi Y, Chun J, Aoki J. Autotaxin-lysophosphatidic acid-LPA 3 signaling at the embryo-epithelial boundary controls decidualization pathways. EMBO J 2017; 36:2146-2160. [PMID: 28588064 PMCID: PMC5509998 DOI: 10.15252/embj.201696290] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/12/2017] [Accepted: 05/02/2017] [Indexed: 12/21/2022] Open
Abstract
During pregnancy, up-regulation of heparin-binding (HB-) EGF and cyclooxygenase-2 (COX-2) in the uterine epithelium contributes to decidualization, a series of uterine morphological changes required for placental formation and fetal development. Here, we report a key role for the lipid mediator lysophosphatidic acid (LPA) in decidualization, acting through its G-protein-coupled receptor LPA3 in the uterine epithelium. Knockout of Lpar3 or inhibition of the LPA-producing enzyme autotaxin (ATX) in pregnant mice leads to HB-EGF and COX-2 down-regulation near embryos and attenuates decidual reactions. Conversely, selective pharmacological activation of LPA3 induces decidualization via up-regulation of HB-EGF and COX-2. ATX and its substrate lysophosphatidylcholine can be detected in the uterine epithelium and in pre-implantation-stage embryos, respectively. Our results indicate that ATX-LPA-LPA3 signaling at the embryo-epithelial boundary induces decidualization via the canonical HB-EGF and COX-2 pathways.
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Affiliation(s)
- Shizu Aikawa
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Kuniyuki Kano
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan.,Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan
| | - Asuka Inoue
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan.,Japan Science and Technology Agency, Precursory Research for Embryonic Science and Technology (PRESTO), Kawaguchi, Saitama, Japan
| | - Jiao Wang
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
| | - Daisuke Saigusa
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Department of Integrative Genomics, Tohoku Medical Megabank, Tohoku University, Sendai, Miyagi, Japan
| | - Takeshi Nagamatsu
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yasushi Hirota
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Soken Tsuchiya
- Department of Pharmaceutical Biochemistry, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshitaka Taketomi
- Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan.,Center for Disease Biology and Integrative Medicine Graduate School of Medicine The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yukihiko Sugimoto
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Department of Pharmaceutical Biochemistry, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan
| | - Makoto Murakami
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan.,Center for Disease Biology and Integrative Medicine Graduate School of Medicine The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Makoto Arita
- RIKEN, Center for Integrative Medical Sciences, Yokohama, Kanagawa, Japan.,Graduate School of Pharmaceutical Sciences, Keio University, Minato-ku, Tokyo, Japan
| | - Makoto Kurano
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Hitoshi Ikeda
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Yutaka Yatomi
- Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan.,Department of Clinical Laboratory, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Jerold Chun
- Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Junken Aoki
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan .,Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Chiyoda-ku, Tokyo, Japan
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27
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Aikawa S, Kano K, Inoue A, Aoki J. Proliferation of mouse endometrial stromal cells in culture is highly sensitive to lysophosphatidic acid signaling. Biochem Biophys Res Commun 2017; 484:202-208. [PMID: 28073697 DOI: 10.1016/j.bbrc.2016.12.154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 12/22/2016] [Indexed: 01/01/2023]
Abstract
Endometrial stromal cells (ESCs) proliferate rapidly both in vivo and in vitro. Here we show that proliferation of ESCs in vitro is strongly dependent on lysophosphatidic acid (LPA) signaling. LPA is produced by autotaxin (ATX) and induces various kinds of cellular processes including migration, proliferation and inhibition of cell death possibly through six G protein-coupled receptors (LPA1-6). We found that ESCs proliferated rapidly in vitro in an autocrine manner and that the proliferation was prominently suppressed by either an ATX inhibitor (ONO-8430506) or an LPA1/3 antagonist (Ki16425). Among the cells lines tested, mouse ESCs were the most sensitive to these inhibitors. Proliferation of ESCs isolated from either LPA1- or LPA3-deficient mice was comparable to proliferation of ESCs isolated from control mice. An LPA receptor antagonist (AM095), which was revealed to be a dual LPA1/LPA3 antagonist, also suppressed the proliferation of ESCs. The present results show that LPA signaling has a critical role in the proliferation of ESCs, and that this role is possibly mediated redundantly by LPA1 and LPA3.
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Affiliation(s)
- Shizu Aikawa
- Graduate School of Pharmaceutical Sciences, Tohoku University, Miyagi, 980-8578, Japan
| | - Kuniyuki Kano
- Graduate School of Pharmaceutical Sciences, Tohoku University, Miyagi, 980-8578, Japan; Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Tokyo, 100-0004, Japan
| | - Asuka Inoue
- Graduate School of Pharmaceutical Sciences, Tohoku University, Miyagi, 980-8578, Japan; Japan Science and Technology Agency, Precursory Research for Embryonic Science and Technology (PRESTO), Saitama, 332-0012, Japan
| | - Junken Aoki
- Graduate School of Pharmaceutical Sciences, Tohoku University, Miyagi, 980-8578, Japan; Japan Agency for Medical Research and Development, Core Research for Evolutional Science and Technology (AMED-CREST), Tokyo, 100-0004, Japan.
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28
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Shimizu Y, Kamada H, Sakane M, Aikawa S, Mutsuzaki H, Tanaka K, Mishima H, Ochiai N, Yamazaki M. A novel apparatus for active leg exercise improves venous flow in the lower extremity. J Sports Med Phys Fitness 2016; 56:1592-1597. [PMID: 26609971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Venous thromboembolism is a serious complication associated with major orthopedic surgery to the lower extremities. Although active ankle exercise is recommended, patients with postoperative pain may have difficulty moving their ankles. Therefore, we developed a novel leg exercise apparatus (LEX) to facilitate active ankle movement during the early postoperative period. We describe how LEX facilitates active movement of the leg, and thereby increases venous flow in the lower extremities. METHODS The femoral venous flow volume and velocity in 8 healthy volunteers (5 men, 3 women; mean age 22.4 years; age range 22-26 years), were measured using duplex ultrasonography. Measurements were repeated 1, 3, 5, and 10 minutes after the completion of 1 minute of active ankle exercise using LEX, and during a 10-minute period of intermittent pneumatic compression (IPC) device use. RESULTS The flow volume after 1 minute of LEX exercise increased 2.63-fold from baseline; elevated values persisted for 10 minutes. Flow volume at 10 minutes was increased 1.71-fold from baseline. The corresponding values during IPC did not differ from resting values. The mean velocity 1 minute after LEX exercise increased 2.34-fold from baseline; in contrast, mean velocity 1 minute after the start of IPC had decreased 0.90-fold (P=0.009). CONCLUSIONS A 1-minute period of LEX exercise improved venous flow in the lower extremities, compared with continuous use of IPC. Use of LEX might facilitate improved ankle mobility, and therefore reduced risk of thromboembolism, in postoperative patients.
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Affiliation(s)
- Yukiyo Shimizu
- Department of Rehabilitation Medicine, University of Tsukuba Hospital, Tsukuba, Japan
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Hiroshi Kamada
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan -
| | - Masataka Sakane
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shizu Aikawa
- Department of Cardiovascular Surgery, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hirotaka Mutsuzaki
- Department of Orthopedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Japan
| | - Kenta Tanaka
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hajime Mishima
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naoyuki Ochiai
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Department of Orthopedic Surgery, Kikkoman General Hospital, Noda, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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29
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Tanaka K, Kamada H, Shimizu Y, Aikawa S, Nishino T, Ochiai N, Sakane M, Yamazaki M. The use of a novel in-bed active Leg Exercise Apparatus (LEX) for increasing venous blood flow. J Rural Med 2016; 11:11-6. [PMID: 27313797 PMCID: PMC4910027 DOI: 10.2185/jrm.2906] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/22/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The incidence of pulmonary embolism (PE) and leg deep vein thrombosis (DVT) has increased in recent years in association with aging and an increase in the number of bedridden individuals. We developed an active in-bed leg exercise apparatus labeled the Leg Exercise Apparatus (LEX) for DVT prevention. We compared the effect of leg exercises performed using the LEX to conventional active ankle exercises on increased blood flow. MATERIALS & METHODS The subjects were eight healthy adult volunteers [five men and three women, aged 20-34 (mean 27.0) years]. Subjects performed two types of exercise; exercise 1 consisted of leg exercises using the LEX, while exercise 2 consisted of in-bed active plantar flexion/dorsiflexion exercises without the device. Measurements were taken 1, 5, 10, 20, and 30 minutes after exercise including common femoral vein blood flow, mean blood flow velocity, maximum blood flow velocity, and vessel diameter using Doppler ultrasound. Statistical procedures included timed measurement data analysis using a linear mixed model. A Bonferroni correction was used for multiple comparisons. RESULTS Compared to resting levels, blood flow reached a maximum value 1 minute after exercise for both exercise types, with a significantly greater increase after exercise 1 (1.76-fold increase) compared to exercise 2 (1.44-fold increase) (p = 0.005). There was a significant difference (p = 0.03) between the two exercises for all values from 1 minute to 30 minutes following exercise. There was no significant difference between exercises for peak or mean blood flow velocity. Compared to resting levels, blood vessel diameter reached a maximum value of 1.47-fold greater at 5 minutes post-exercise for exercise 1 and a maximum value of 1.21-fold greater at 1 minute post-exercise for exercise 2. CONCLUSIONS Exercise using the LEX increased lower leg venous blood flow and vessel diameter. We propose that the LEX may serve as a new DVT prevention tool.
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Affiliation(s)
- Kenta Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Hiroshi Kamada
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Yukiyo Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan; Department of Rehabilitation Medicine, University of Tsukuba Hospital, Japan
| | - Shizu Aikawa
- Department of Cardiovascular Surgery, University of Tsukuba Hospital, Japan
| | - Tomofumi Nishino
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Naoyuki Ochiai
- Department of Orthopaedic Surgery, Kikkoman General Hospital, Japan
| | - Masataka Sakane
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba, Japan
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30
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Tanaka K, Kamada H, Shimizu Y, Aikawa S, Irie S, Ochiai N, Sakane M, Yamazaki M. Muscle activity in the lower limbs during push-down movement with a new active-exercise apparatus for the leg. J Phys Ther Sci 2016; 28:1050-4. [PMID: 27134410 PMCID: PMC4842422 DOI: 10.1589/jpts.28.1050] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/16/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Lower-limb deep vein thrombosis is a complication of orthopedic surgery. A
leg-exercise apparatus named “LEX” was developed as a novel active-exercise apparatus for
deep vein thrombosis prevention. Muscle activity was evaluated to assess the effectiveness
of exercise with LEX in the prevention. [Subjects] Eight healthy volunteers participated
in this study. [Methods] Muscle activities were determined through electromyography during
exercise with LEX [LEX (+)] and during active ankle movements [LEX (−)]. The end points
were peak % maximum voluntary contraction and % integrated electromyogram of rectus
femoris, vastus lateralis, biceps femoris, tibialis anterior, gastrocnemius, and soleus.
[Results] LEX (+) resulted in higher average values in all muscles except the tibialis
anterior. Significant differences were noted in the peak of the biceps femoris and
gastrocnemius and in the integrated electromyogram of the rectus femoris, vastus
lateralis, gastrocnemius, and soleus. The LEX (+)/LEX (−) ratio of the peak was 2.2 for
the biceps femoris and 2.0 for the gastrocnemius . The integrated electromyogram was 1.8
for the gastrocnemius, 1.5 for the rectus femoris, 1.4 for the vastus lateralis, and 1.2
for the soleus. [Conclusion] Higher muscle activity was observed with LEX (+). LEX might
be a good tool for increasing lower-limb blood flow and deep vein thrombosis
prevention.
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Affiliation(s)
- Kenta Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba city, Ibaraki 305-8575, Japan
| | - Hiroshi Kamada
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba city, Ibaraki 305-8575, Japan
| | - Yukiyo Shimizu
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba city, Ibaraki 305-8575, Japan; Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Japan
| | - Shizu Aikawa
- Department of Cardiovascular Surgery, University of Tsukuba Hospital, Japan
| | - Shun Irie
- Department of Integrative Physiology, Graduate School of Medicine, Kyorin University, Japan
| | - Naoyuki Ochiai
- Department of Orthopaedic Surgery, Kikkoman General Hospital, Japan
| | - Masataka Sakane
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba city, Ibaraki 305-8575, Japan
| | - Masashi Yamazaki
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Tsukuba: 1-1-1 Tennodai, Tsukuba city, Ibaraki 305-8575, Japan
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31
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Sakamoto H, Tsukada T, Tokunaga C, Matsubara M, Aikawa S, Enomoto Y, Sato F, Hiramatsu Y. Left Ventricular Perforation during Catheter Ablation in a Patient with Idiopathic Thrombocytopenic Purpura. Heart Surg Forum 2015; 18:E240-1. [PMID: 26726712 DOI: 10.1532/hsf.1484] [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] [Received: 12/09/2015] [Accepted: 12/09/2015] [Indexed: 11/20/2022]
Abstract
Preoperative gamma-globulin therapy was recently performed to prevent bleeding complications in a patient with concomitant idiopathic thrombocytopenic purpura undergoing cardiac surgery. Here we report the case of a 75-year-old male patient with idiopathic thrombocytopenic purpura, chronic aortic dissection, and funnel chest in whom a left ventricular perforation sustained during catheter ablation was repaired during emergent surgery. Despite preoperative gamma-globulin therapy not being performed, bleeding complications were prevented because platelets were preserved by avoidance of cardiopulmonary bypass use. Although the funnel chest made it difficult to secure the operative field, the deep pericardial sutures were effective in repairing the perforation without cardiopulmonary bypass.
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Affiliation(s)
- Hiroaki Sakamoto
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toru Tsukada
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Chiho Tokunaga
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Muneaki Matsubara
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shizu Aikawa
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshiharu Enomoto
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fujio Sato
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yuji Hiramatsu
- Department of Cardiovascular Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Abstract
Lysophosphatidic acid (LPA) is one of the simplest glycerophospholipids with one fatty acid chain and a phosphate group as a polar head. Although LPA had been viewed just as a metabolic intermediate in de novo lipid synthetic pathways, it has recently been paid much attention as a lipid mediator. LPA exerts many kinds of cellular processes, such as cell proliferation and smooth muscle contraction, through cognate G protein-coupled receptors. Because lipids are not coded by the genome directly, it is difficult to know their patho- and physiological roles. However, recent studies have identified several key factors mediating the biological roles of LPA, such as receptors and producing enzymes. In addition, studies of transgenic and gene knockout animals for these LPA-related genes, have revealed the biological significance of LPA. In this review we will summarize recent advances in the studies of LPA production and its roles in both physiological and pathological conditions.
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Affiliation(s)
- Shizu Aikawa
- Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-Ku, Sendai 980-8578, Japan and CREST, Japan Science and Technology Corporation, 4-1-8, Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Takafumi Hashimoto
- Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-Ku, Sendai 980-8578, Japan and CREST, Japan Science and Technology Corporation, 4-1-8, Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Kuniyuki Kano
- Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-Ku, Sendai 980-8578, Japan and CREST, Japan Science and Technology Corporation, 4-1-8, Honcho, Kawaguchi, Saitama 332-0012, Japan
| | - Junken Aoki
- Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-Ku, Sendai 980-8578, Japan and CREST, Japan Science and Technology Corporation, 4-1-8, Honcho, Kawaguchi, Saitama 332-0012, Japan Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aoba, Aramaki, Aoba-Ku, Sendai 980-8578, Japan and CREST, Japan Science and Technology Corporation, 4-1-8, Honcho, Kawaguchi, Saitama 332-0012, Japan
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Kitada K, Aikawa S, Aida S. Alu-Alu fusion sequences identified at junction sites of copy number amplified regions in cancer cell lines. Cytogenet Genome Res 2012; 139:1-8. [PMID: 22986581 DOI: 10.1159/000342885] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2012] [Indexed: 12/13/2022] Open
Abstract
Alu elements are short, ∼300-bp stretches of DNA and are the most abundant repetitive elements in the human genome. A large number of chromosomal rearrangements mediated by Alu-Alu recombination have been reported in germline cells, but only a few in somatic cells. Cancer development is frequently accompanied by various chromosomal rearrangements including gene amplification. To explore an involvement of Alu-Alu fusion in gene amplification events, we determined 20 junction site sequences of 5 highly amplified regions in 4 cancer cell lines. The amplified regions exhibited a common copy number profile: a stair-like increase with multiple segments, which is implicated in the breakage-fusion-bridge (BFB) cycle-mediated amplification. All of the sequences determined were characterized as head-to-head or tail-to-tail fusion of sequences separated by 1-5 kb in the genome sequence. Of these, 4 junction site sequences were identified as Alu-Alu fusions between inverted, paired Alu elements with relatively long overlapping sequences of 17, 21, 22, and 24 bp. Together with genome mapping data of Alu elements, these findings suggest that when breakages occur at or near inverted, paired Alu elements in the process of BFB cycle-mediated amplification, sequence homology of Alu elements is frequently used to repair the broken ends.
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Affiliation(s)
- K Kitada
- Kamakura Research Laboratories, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan.
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34
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Kitada K, Aida S, Aikawa S. Coamplification of multiple regions of chromosome 2, including MYCN, in a single patchwork amplicon in cancer cell lines. Cytogenet Genome Res 2011; 136:30-7. [PMID: 22123490 DOI: 10.1159/000334349] [Citation(s) in RCA: 4] [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: 07/28/2011] [Indexed: 11/19/2022] Open
Abstract
Coamplification of multiple segments of chromosome 2, including an MYCN-bearing segment, was examined in 2 cancer cell lines, NCI-H69 (lung cancer) and IMR-32 (neuroblastoma). High-resolution array-CGH analysis revealed 13 and 6 highly amplified segments located at different sites in chromosome 2 in NCI-H69 and IMR-32, respectively. FISH analysis demonstrated that these segments were co-localized in double minutes in NCI-H69 and in homogeneously staining regions in IMR-32. Connectivity of the segments was determined by a PCR assay using designed primer sets. It was found that all the segments were connected to each other irrespective of their order and orientation against the genome sequence, and a single chain-like cluster was configured in both cell lines. Such patchwork structures of the amplicons suggest the possibility that massive genomic rearrangements, explained by the single catastrophic event model, are involved in the formation of the amplicons, enabling the coamplification of different chromosomal regions including the MYCN locus. The model comprises massive fragmentation of chromosomes and random rejoining of the fragments.
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Affiliation(s)
- K Kitada
- Kamakura Research Laboratories, Chugai Pharmaceutical Co. Ltd., Kamakura, Japan.
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35
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Aikawa S, Ishii M, Yanagisawa M, Sakakibara Y, Sakurai T. Effect of neuropeptide B on feeding behavior is influenced by endogenous corticotropin-releasing factor activities. ACTA ACUST UNITED AC 2008; 151:147-52. [DOI: 10.1016/j.regpep.2008.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Revised: 07/09/2008] [Accepted: 08/05/2008] [Indexed: 11/25/2022]
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36
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Abstract
We cloned and sequenced two types (alpha and beta type) of cDNA from the porcine anterior pituitary cDNA library, encoding neuronatin that has been cloned as a gene expressed by the fetal developing brain. Nucleotide sequences of alpha and beta type were identical except for two gaps, suggesting that they were produced by an alternative splicing. The amino acid sequences showed a high homology (more than 94 %) compared to those of other mammals, including human, rat, and mouse. In this study, RT-PCR was performed for the RNA samples prepared from the porcine fetal and postnatal pituitaries. The results showed that two types of neuronatin are expressed through the fetal stages, from day 40 to day 110 in both sexes. The relative amounts of alpha to beta type reversed just after birth in both sexes, and both amounts increased further in the postnatal anterior pituitary. This increased expression after birth is quite different from the brain in which the expression of neuronatins decreased, indicating the distinct role of the neuronatin in pituitary and brain. Finally, we found a pituitary cell type specific localization, especially in gonadotroph cell lines LbetaT2, of beta-neuronatins.
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Affiliation(s)
- S Aikawa
- Laboratory of Molecular Biology and Gene Regulation, Department of Life Science, Faculty of Agriculture, Meiji University, 1-1-1 Higashi-Mita, Tama-ku, Kawasaki, Kanagawa, Japan.
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Matsubara M, Hiramatsu Y, Sato M, Aikawa S, Tokunaga C, Seita J, Imazuru T, Noma M, Atsumi N, Jikuya T, Sakakibara Y. [Management of mediastinitis after pediatric cardiac surgery with continuous closed irrigation method]. Kyobu Geka 2003; 56:761-4. [PMID: 12931586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Two cases are presented as a successful management for mediastinitis with the continuous closed irrigation method after pediatric cardiac surgery. The continuous closed irrigation method has significant advantages over conventional open irrigation method or muscle flap in pediatric cases, because the system is simple to handle and easy to wash out any infectious tissue debris without additional invasive intervention. However, adequate duration of the irrigation and subsequent antibiotic regimen is still unclear. We conclude that the continuous closed irrigation method is an effective management which is applicable to most of mediastinitis cases after pediatric cardiac surgery.
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Affiliation(s)
- M Matsubara
- Department of Cardiovascular Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
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38
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Aikawa S, Abe M, Yoshimura Y, Isobe T. [Surgical treatment in an infant with atrial septal defect and persistent left superior vena cava draining into the coronary sinus; report of a case]. Kyobu Geka 2003; 56:494-6. [PMID: 12795156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
A 8-month-old boy with ostium secundum atrial septal defect and persistent left superior vena cava draining into the coronary sinus underwent surgical treatment because he had required long-term ventilator support due to congestive heart failure and respiratory distress. The left superior vena cava and dilated coronary sinus produce a ridge in the left atrium, causing a subdivided left atrium. In this case, the early symptom could be explained by an obligatory left to right shunt at the level of the left atrium resulting from a ridge produced by the left superior vena cava and the colonary sinus, as a subdivided left atrium.
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Affiliation(s)
- S Aikawa
- Department of Cardiovascular Surgery, Ibaraki Children's Hospital, Mito, Japan
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39
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Affiliation(s)
- Ikuo Fukuda
- Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
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40
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Abstract
BACKGROUND We have screened 309,914 newborns in Yamagata prefecture, Japan, since 1977 and have detected four patients with phenylketonuria (PKU). We analyzed the phenylalanine hydroxylase (PAH) gene of the four patients to study the genetic background in this area and the genotype-phenotype relationship in these patients. METHODS Mutations of the PAH gene were screened by denaturing gradient gel electrophoresis analysis and the sequences were determined. RESULTS Three cases were compound heterozygotes of six different mutations of the PAH gene and the remaining case was a homozygote. Of the six detected mutations, K115fs is novel, whereas the others have been previously detected among Chinese and/or Japanese patients. CONCLUSIONS The incidence and genetic basis in Yamagata prefecture was similar to that of other parts of Japan. Analysis of the genotype is useful to understand the clinical variation in some families.
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Affiliation(s)
- T Kimura
- Department of Pediatrics, Yamagata University School of Medicine, Japan
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41
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Suzuki A, Doi H, Matsuzawa F, Aikawa S, Takiguchi K, Kawano H, Hayashida M, Ohno S. Bcl-2 antiapoptotic protein mediates verotoxin II-induced cell death: possible association between bcl-2 and tissue failure by E. coli O157:H7. Genes Dev 2000; 14:1734-40. [PMID: 10898788 PMCID: PMC316775] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Verotoxin II (VTII: or Shiga-like toxin 2) is a key factor for Escherichia coli O157:H7-induced multiple tissue failure and contains a pentameric sequence (NWGRI) similar to the Bcl-2 homolog domain, BH1. In the current study, we demonstrate that VTII, but not VTI, interacts with Bcl-2 through each BH1 domain pentameric sequence (NWGRI) and that the VTII/Bcl-2 complex is necessary for cell-death induction in target cells. VTII translocates to mitochondria and induces cell death only when target cells are expressing Bcl-2. In addition, interruption of VTII-Bcl-2 complex formation by a pentameric BH1 synthetic peptide suppresses VTII-induced cell death. In the present article, we propose that Bcl-2 mediates VTII-induced target cell death by the interaction with each pentameric sequence of BH1 domain.
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Affiliation(s)
- A Suzuki
- Project for the Cell Death Research, Basic Technology Research Laboratory, Daiichi Pharmaceutical Co., Ltd., Tokyo R&D Center, Tokyo 134-8630, Japan.
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42
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Saiki M, Saitoh T, Morimoto K, Kumagai T, Tanaka M, Aikawa S, Tsuboi I, Sawada U, Horie T, Amagai M. [Plasma cell leukemia presenting with circulating villous lymphocytes and an indolent clinical course]. Rinsho Ketsueki 2000; 41:186-91. [PMID: 10774246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A 73-year-old man was admitted to our hospital in July 1996 because of lymphoctyosis and lumbago. Physical examination revealed hepatomegaly and anemia. Hematologic examination showed a hemoglobin concentration of 9.6 g/dl and a leukocyte count of 32,700/microliter with 74% abnormal mononuclear cells. In Wright-Giemsa stained blood films, these cells had short villi arising from 1 or 2 poles. Immunophenotyping of peripheral mononuclear cells showed moderate to strong expression of CD10, CD24, CD38, and sIg lambda, but not of CD19, CD20, or CD25. Southern blot analysis of the peripheral mononuclear cells demonstrated rearranged monoclonal bands in the C lambda. Urine immunoelectrophoresis detected a monoclonal band identifiable as lambda-type Bence Jones protein. In addition, bone X-ray studies disclosed multiple osteolytic lesions. A diagnosis of plasma cell leukemia was made, and the patient was placed on chemotherapy consisting of cyclophosphamide and prednisolone. No notable improvement in laboratory findings was seen but the patient experienced an indolent clinical course. He died of pneumonia in January 1998. The morphological and clinical findings were unusual for a case of plasma cell leukemia. This case study suggested that signs of lymphocytosis require immunophenotypic and electron microscopic studies for the differential diagnosis of plasma cell leukemia.
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Affiliation(s)
- M Saiki
- First Department of Internal Medicine, Nihon University School of Medicine
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43
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Kumagai T, Morimoto K, Saitoh T, Tsuboi I, Aikawa S, Horie T. Age-related changes in myelopoietic response to lipopolysaccharide in senescence-accelerated (SAM) mice. Mech Ageing Dev 2000; 112:153-67. [PMID: 10690927 DOI: 10.1016/s0047-6374(99)00085-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The effects of in vivo lipopolysaccharide (LPS) administration on myelopoiesis were examined in senescence-accelerated (SAM) mice. Young mice injected with LPS exhibited: (a) increased femoral proliferative pool size; (b) transient reduction in femoral non-proliferative pool size and number of femoral colony forming unit-granulocyte macrophages (CFU-GMs); (c) marked increase in splenic CFU-GMs; and (d) transient increase in S-phase of femoral CFU-GMs. The responses of old mice after LPS administration differed from those of young mice in the following points: (a) no recovery of the femoral non-proliferative pool or femoral CFU-GMs, (b) less significant augmentation of the femoral proliferative pool and splenic CFU-GMs, and (c) prolonged reduction in S-phase of femoral CFU-GM. Injection of LPS into mice resulted in a hyperproduction of colony-stimulating activity (CSA) in bone followed by production of colony-inhibitory activity (CIA) in young mice and in contrast, an excessive CIA secretion from bone without an increase in CSA levels in old mice. These imbalances in the regulatory factors derived from non-hemopoietic cells in the bones may lead to an inappropriate response of myelopoiesis in aged SAM mice after LPS administration, which may play a key role in infections.
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Affiliation(s)
- T Kumagai
- First Department of Internal Medicine, Faculty of Medicine, Nihon University, Tokyo, Japan.
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44
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Saitoh T, Morimoto K, Kumagai T, Saiki M, Tanaka M, Aikawa S, Tsuboi I, Sawada U, Horie T. Therapy-related megakaryoblastic leukemia with pituitary involvement following treatment for non-Hodgkin's lymphoma. Intern Med 1999; 38:904-9. [PMID: 10563755 DOI: 10.2169/internalmedicine.38.904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A case of a 66-year-old Japanese man developed therapy-related megakaryoblastic leukemia with pituitary involvement after chemotherapy for non-Hodgkin's lymphoma. Alkylating agents had been administered for the treatment of non-Hodgkin's lymphoma and 6 years later, megakaryoblastic leukemia with myelofibrosis and myelodysplasia developed. The blast cells expressed CD41, and immature antigens also. These findings were compatible with therapy-related megakaryoblastic leukemia. An autopsy revealed blast-cell infiltration into multiple organs including the posterior pituitary lobe. Therapy-related megakaryoblastic leukemia is very rare, and pituitary involvement may be associated with immaturity of blast cells.
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Affiliation(s)
- T Saitoh
- First Department of Internal Medicine, Nihon University School of Medicine, Tokyo
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45
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Saitoh T, Morimoto K, Kumagai T, Tsuboi I, Aikawa S, Horie T. Comparison of erythropoietic response to androgen in young and old senescence accelerated mice. Mech Ageing Dev 1999; 109:125-39. [PMID: 10515662 DOI: 10.1016/s0047-6374(99)00032-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this study, to clarify whether the functional capacity of hemopoietic progenitor cells and the micro-environment of aged mice are identical with those of the young, we investigated the changes in the number of hemopoietic progenitor cells and the production of regulatory cytokines from splenic cells as well as changes in the serum levels of cytokine in senescence-accelerated mice (SAM) after administration of 19-nandrolone decanoate (19-ND), a synthetic androgenic anabolic steroid. 19-ND induced an increase in erythroid colony-forming units (CFU-E), erythroid burst-forming units (BFU-E), and granulocytic-macrophage committed progenitor cells (CFU-GM) in bone marrow and spleen; especially remarkable increases were observed in the splenic CFU-E in both young and old mice. Antigen expression analysis of hemopoietic organs revealed that total TER-119+ cells per spleen of young and old mice with androgen treatment rose 2.6- and 3.2-fold over their respective control values. The responsiveness of hemopoietic progenitor cells to androgen did not change with age. Injection of 19-ND into young and old mice markedly enhanced the erythropoietin levels but not IL3 and GM-CSF levels in the serum of both groups. Cytokine production assessed by pokeweed mitogen-stimulated spleen condition medium showed an age-related decline. Androgen treatment could not influence IL-3 and GM-CSF production of spleen. These findings suggest that the spleen of both old and young mice served as the major site of regenerative repopulation of hemopoietic progenitors, especially the late erythroid progenitors in 19-ND-treated mice. The proliferative reserve of erythropoiesis with androgen treatment in aged mice was not reduced more than that in treated-young mice.
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Affiliation(s)
- T Saitoh
- First Department of Internal Medicine, Nihon University, School of Medicine, Tokyo, Japan.
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46
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Kumagai T, Morimoto K, Tsuboi I, Saitoh T, Aikawa S, Kaneita Y, Ohsima T, Sawada U, Horie T. [A case of chronic myelogenous leukemia presenting multiple extramedullary tumors localized in cranial dura]. Rinsho Ketsueki 1999; 40:224-9. [PMID: 10222630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
A 64-year-old woman had been given a diagnosis of Ph-positive chronic myelogenous leukemia (Ph+ CML) in October 1992 and accordingly treated with interferon-alpha busulfan, and hydroxyurea. She was admitted to our hospital with a one-day history of consciousness disturbance on May 30, 1993. Two weeks before admission, she had received chemotherapy consisting of vincristine and predonisolone because of progressive thrombocytopenia, basophilia, and leukocytosis accompanied by a heightened degree of cell immaturity in peripheral blood and bone marrow. Cranial computerized tomography on admission disclosed tumoral masses in the left frontal lobe and the right temporal lobe. Moreover, lumbar puncture ezinkns disclosed blastoid cells in cerebrospinal fluid. Based on these laboratory findings, the diagnosis was blastic crisis CML, 46XX t(9; 22; 17) (q34; q11; q23), cytogenetic aberration and extramedulary brain disease Although the patient underwent the same combined chemotherapy again, her unconsciousness did not resolve. She died of cerebellar herniation on the 7th hospital day. Post mortem examination revealed three extramedullary tumors localized in cranial dura. This was a rare case of CML presenting multiple extramedullary tumors localized in cranial dura.
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Affiliation(s)
- T Kumagai
- First Department of Internal Medicine, Nihon University School of Medicine
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47
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Sakakibara Y, Aikawa S, Enomoto Y, Osaka M, Hiramatsu Y, Shigeta O, Terada Y, Atsumi N, Jikuya T, Mitsui T. Lower extremity hematoma as a complication of warfarinization in patients with artificial heart valves. Jpn Heart J 1999; 40:239-45. [PMID: 10420885 DOI: 10.1536/jhj.40.239] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Four cases of lower extremity hematoma in patients undergoing anticoagulant therapy after heart valve replacement are herein reported, with special emphasis on the comparative diagnostic value of ultrasonography and computerized tomography. Although conservative management is sufficient for patients with no neurological impairment, needle aspiration after autolysis of the hematoma, which can be confirmed by CT study, is also recommended.
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Affiliation(s)
- Y Sakakibara
- Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, Japan
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48
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Akaba K, Kimura T, Sasaki A, Tanabe S, Wakabayashi T, Hiroi M, Yasumura S, Maki K, Aikawa S, Hayasaka K. Neonatal hyperbilirubinemia and a common mutation of the bilirubin uridine diphosphate-glucuronosyltransferase gene in Japanese. J Hum Genet 1999; 44:22-5. [PMID: 9929972 DOI: 10.1007/s100380050100] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Neonatal hyperbilirubinemia, which is prevalent among Asian peoples, has been considered as a physiological phenomenon, and its metabolic basis has not been clearly explained. Gilbert syndrome is a common inherited disease of unconjugated hyperbilirubinemia due to decreased bilirubin uridine diphosphate-glucuronosyltransferase (B-UGT), and its role in neonatal jaundice has recently been considered. We have previously reported that the Gly71Arg mutation of the B-UGT gene associated with Gilbert syndrome is prevalent in Japanese, Korean, and Chinese populations and was more frequently detected in neonates with severe hyperbilirubinemia than in control subjects. We have studied 159 Japanese full-term neonates, evaluating the relationship between the B-UGT genotype and the severity of jaundice, as assessed with a transcutaneous bilirubinometer. The gene frequency of the Gly71Arg mutation in these neonates was 0.19, and neonates carrying the Gly71Arg mutation had significantly increased bilirubin levels on days 2-4, manifested in a gene dose-dependent manner. The frequency of the Gly71Arg mutation was 0.47 in the neonates who required phototherapy (i.e., those with more severe hyperbilirubinemia), significantly higher than 0.16 in the neonates who did not require the therapy. The gene frequency of the TA repeat promoter polymorphism, the (TA)7 mutation, was 0.07, and neonates carrying this mutation did not have an increase in bilirubin. These results suggested that the Gly71Arg mutation contributes to the high incidence of neonatal hyperbilirubinemia in Japanese.
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Affiliation(s)
- K Akaba
- Department of Pediatrics, Yamagata University School of Medicine, Japan
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49
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Kawahara S, Morimoto K, Nakazawa H, Kumagai T, Saito T, Aikawa S, Tsuboi I, Sawada U, Horie T. [Severe hemolytic anemia with tear drop red cells as initial manifestation of Wilson's disease]. Rinsho Ketsueki 1998; 39:665-9. [PMID: 9796400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
A 16-year-old girl was admitted for a detailed examination of hemolytic anemia in November 1995. Initial laboratory findings included a total bilirubin concentration of 1.46 mg/dl, hemoglobin of 9.1 g/dl, and a reticulocyte count of 89/1000 percent. The plasma haptoglobin concentration was below 10 mg/dl. A blood smear showed many dacryocytes and a few echinocytes and codocytes. GOT was 71 IU/l; GPT, 44 IU/l; and LDH, 812 IU/l; the results of a hepaplastin test were 45% of normal. On further investigation, the level of serum ceruloplasmin was found to be 4 mg/dl, and of serum copper, 43 micrograms/dl. Urinary copper excretion was markedly increased, at 345 micrograms per day. Slit-lamp examination of both corneas revealed obvious Kayser-Fleischer rings. A liver biopsy sample showed fibrosis histologically and an elevated copper concentration of 535 micrograms/g dry weight and 183 micrograms/g wet weight. In family studies, the patient's asymptomatic 5-year-old sister was observed to have metabolic abnormalities consistent with Wilson's disease. These findings suggested that the patient's hemolytic anemia with red cell deformities was due to abnormal copper metabolism associated with Wilson's disease.
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Affiliation(s)
- S Kawahara
- First Department of Internal Medicine, Nihon University School of Medicine
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50
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Aikawa S, Morimoto K, Kumagai T, Saitoh T, Tsuboi I, Sawada U, Horie T. [Plasma cell leukemia (IgG kappa) presenting bilateral neurosensory hearing loss and left sixth cranial nerve plasy]. Rinsho Ketsueki 1998; 39:506-11. [PMID: 9750458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 30-year-old man who had been given a diagnosis of IgG-kappa multiple myeloma by another hospital and treated with melphalan, prednisone, and cyclophosphamide 6 months earlier, was admitted to our hospitaly in July 1994 because of progressively impaired hearing in both ears, vertigo, and worsening fatigue. Peripheral blood examination showed a white blood cell count 25,000/microliter, with 77.5% atypical plasma cells. Examination at the time of hospitalization also revealed retinal hemorrhages and serum hyperviscosity. The diagnosis was plasma cell leukemia with hyperviscosity syndrome. Subsequent treatment consisted of vincristine, doxorubicine, and prednisone and repeated plasmapheresis. This resulted in a partial response and a reduction of serum viscosity but no reversal of hearing loss. One month after admission, left sixth cranial nerve plasy was demonstrated. Cranial computed tomography studies disclosed a tumoral mass in the sphenoid sinus. The patient received local radiotherapy and intensive chemotherapy, but exhibited no notable alleviation of his cranial nerve palsy. He died of septicemia and progressive disease in August 1994. This case was rare in that it involved plasma cell leukemia and bilateral neurosensory hearing loss associated with serum hyperviscosity and sixth cranial nerve plasy due to plasmacytoma within the sphenoid sinus.
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Affiliation(s)
- S Aikawa
- First Department of Internal Medicine, Nihon University School of Medicine
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