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Noda A, Doi S, Kuwata S, Shiokawa N, Suzuki N, Kanamitsu Y, Sato Y, Shoji T, Okuno T, Kai T, Koga M, Tanabe Y, Izumo M, Ishibashi Y, Akashi YJ. CORRIGENDUM: Preprocedural Controlling Nutritional Status Score as a Predictor of Mortality in Patients Undergoing Transcatheter Mitral Valve Repair - A Single Center Experience in Japan. Circ Rep 2024; 6:97. [PMID: 38464993 PMCID: PMC10920021 DOI: 10.1253/circrep.cr-66-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
[This corrects the article DOI: 10.1253/circrep.CR-23-0055.].
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Okuno T, Terauchi K, Kai T, Sato Y, Kuwata S, Koga M, Izumo M, Akashi YJ. Enhanced Hemodynamic Performance of a New-Generation 23-mm Balloon-Expandable Transcatheter Heart Valve. JACC Cardiovasc Interv 2024; 17:454-456. [PMID: 37988052 DOI: 10.1016/j.jcin.2023.10.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/19/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
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Kai T, Izumo M, Okuno T, Kobayashi Y, Sato Y, Kuwata S, Koga M, Tanabe Y, Sakamoto M, Akashi YJ. Prevalence and Clinical Outcomes of Noncardiac Surgery After Transcatheter Aortic Valve Replacement. Am J Cardiol 2024; 210:259-265. [PMID: 37875233 DOI: 10.1016/j.amjcard.2023.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023]
Abstract
Aortic stenosis is a prevalent valvular heart disease, especially in the older people. They often coexist with other co-morbidities, and noncardiac surgery carries a higher risk because of the underlying valve condition. Despite the growing concern about the safety and optimal management of noncardiac surgery post-transcatheter aortic valve replacement (TAVR), there is limited evidence on this matter. This study aims to assess the clinical outcomes of noncardiac surgeries after TAVR. This retrospective study included 718 patients who underwent TAVR. Of these, 36 patients underwent noncardiac surgery after TAVR. The primary end point was the incidence of cardiovascular adverse events post-TAVR and the secondary end point was the incidence of structural valve deterioration. Composite end points included disabling stroke, heart failure requiring hospitalization, and cardiac death as defined by Valve Academic Research Consortium 3. Most of these surgeries were orthopedic and classified as intermediate risk. All noncardiac surgeries were performed without perioperative adverse events. There was no observed structural valve deterioration, and the incidence of composite end points did not significantly differ between the surgical and nonsurgical groups during the follow-up period. Noncardiac surgery after TAVR can be performed safely and does not have a negative impact on prognosis. Further studies are warranted to determine the optimal strategy for noncardiac surgery after TAVR.
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Affiliation(s)
- Takahiko Kai
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan.
| | - Masaki Izumo
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Taishi Okuno
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshikuni Kobayashi
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yukio Sato
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Shingo Kuwata
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masashi Koga
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasuhiro Tanabe
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Miki Sakamoto
- Department of Anesthesiology, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J Akashi
- Department ofCardiology, St. Marianna University School of Medicine, Kawasaki, Japan
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Koga M, Izumo M, Kobayashi Y, Kai T, Okuno T, Sato Y, Kuwata S, Okuyama K, Ishibashi Y, Tanabe Y, Akashi YJ. Safety and feasibility of zero-contrast transcatheter aortic valve implantation using balloon-expandable valves in patients with aortic stenosis and severe renal impairment: A single-center study. Cardiovasc Revasc Med 2024; 58:68-76. [PMID: 37500393 DOI: 10.1016/j.carrev.2023.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/23/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Aortic stenosis (AS) and chronic kidney disease (CKD) can coexist. Repeat exposure to contrast media in patients undergoing transcatheter aortic valve implantation (TAVI) has latent mortality risks and increased risk for acute kidney injury. We aimed to assess our "zero-contrast TAVI" protocol for patients with advanced CKD. METHODS Consecutive patients with severe AS who underwent TAVI at a single center registry were enrolled. Zero-contrast TAVI group included patients who underwent TAVI without contrast and who had an estimated glomerular filtration rate <30 mL/min/1.73 m2. Conventional TAVI group included patients who underwent the regular TAVI procedure. Patients using balloon-expandable valves via transfemoral approach were analyzed. Baseline clinical and procedural characteristics and clinical outcomes were compared between two groups. The primary outcome was early safety as defined by Valve Academic Research Consortium Criteria. Secondary outcomes included the presence of severe prosthesis-patient mismatch, moderate or greater perivalvular leakage, and requirement for new dialysis (within 3 months). RESULTS A total of 520 patients were analyzed. Among these, 32 (6 %) underwent zero-contrast TAVI and 488 (94 %) conventional TAVI. In the zero-contrast TAVI group, 12 patients (37.5 %) had to use 20.7 (11.0-31.2) mL of contrast media. There were no significant differences in the primary and secondary outcomes between zero-contrast TAVI and conventional TAVI groups (78.1 % vs. 86.8 %, P = 0.184 and 9.4 % vs. 8.1 %, P = 0.738 for the primary and secondary outcomes, respectively). CONCLUSIONS Zero-contrast TAVI is feasible, safe, and effective in patients with AS and stage 4 CKD.
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Affiliation(s)
- Masashi Koga
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan.
| | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yoshikuni Kobayashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Takahiko Kai
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Taishi Okuno
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yukio Sato
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Shingo Kuwata
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Kazuaki Okuyama
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yuki Ishibashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yasuhiro Tanabe
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Japan
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Noda A, Doi S, Kuwata S, Shiokawa N, Suzuki N, Kanamitsu Y, Sato Y, Tatsuro S, Okuno T, Kai T, Koga M, Tanabe Y, Izumo M, Ishibashi Y, Akashi YJ. Preprocedural Controlling Nutritional Status Score as a Predictor of Mortality in Patients Undergoing Transcatheter Mitral Valve Repair - A Single Center Experience in Japan. Circ Rep 2023; 5:442-449. [PMID: 38073869 PMCID: PMC10700033 DOI: 10.1253/circrep.cr-23-0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/07/2023] [Accepted: 10/12/2023] [Indexed: 03/12/2024] Open
Abstract
Background: A high score for controlling nutritional status (CONUT) due to poor nutritional status has been associated with adverse outcomes in patients with chronic heart failure. However, because little is known about the effect of CONUT score on mortality rates after transcatheter mitral valve repair, we evaluated nutrition screening tools for prognosis prediction in patients undergoing transcatheter mitral valve repair using the MitraClipTM system. Methods and Results: We retrospectively analyzed 148 patients with severe mitral regurgitation (MR) who underwent MitraClipTM implantation between April 2018 and April 2021. The preprocedural CONUT scores were assessed at the time of hospitalization, the primary outcome was all-cause death, and the analysis was of the mortality and incidence rates of cardiac events 1 year post-operation. Functional MR was of ischemic origin in the majority of patients (69.6%), with a mean left ventricular ejection fraction of 48.9±15.8%. Kaplan-Meier curves indicated that all-cause death was significantly worse in the high-CONUT score group than in the low-CONUT score group. Cox hazard analysis showed a significant association between all-cause death and CONUT score, as well as MitraScore. Conclusions: Preprocedural CONUT score, as well as MitraScore, in patients undergoing transcatheter edge-to-edge mitral valve repair may predict an increased risk of all-cause death. This knowledge should allow the heart team to accurately assess the clinical implications and prognostic benefits of the procedure in individual patients.
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Affiliation(s)
- Airi Noda
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Shunichi Doi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Shingo Kuwata
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Noriko Shiokawa
- Ultrasound Center, St. Marianna University School of Medicine Kawasaki Japan
| | - Norio Suzuki
- St. Marianna University Toyoko Hospital Kawasaki Japan
| | - Yoko Kanamitsu
- Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine Kawasaki Japan
| | - Yukio Sato
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Shoji Tatsuro
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Taishi Okuno
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Takahiko Kai
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Masashi Koga
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yasuhiro Tanabe
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yuki Ishibashi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yoshihiro J Akashi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
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Kobayashi Y, Izumo M, Okuyama K, Uenomachi N, Shoji T, Kai T, Okuno T, Sato Y, Kuwata S, Koga M, Ishibashi Y, Tanabe Y, Miyairi T, Akashi YJ. Feasibility of Transcatheter Aortic Valve Implantation in Patients With Very Severe Aortic Stenosis. Circ Rep 2023; 5:358-364. [PMID: 37693232 PMCID: PMC10483111 DOI: 10.1253/circrep.cr-23-0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 09/12/2023] Open
Abstract
Background: Very severe aortic stenosis (AS) has a poor prognosis even in asymptomatic patients, and asymptomatic very severe AS is a Class IIa indication for aortic valve replacement, although the safety and effectiveness of transcatheter aortic valve implantation (TAVI) for very severe AS is not well-established. Methods and Results: This study included 366 patients undergoing TAVI at a single center, with 85 and 281 patients in the very severe AS (peak velocity ≥5 m/s or mean pressure gradient (PG) ≥60 mmHg) and severe AS groups, respectively. Procedural and clinical outcomes at 1-year follow-up were compared between groups. The calcium scores were significantly higher in the very severe AS group (2,864.5 vs. 1,405.8 arbitrary units [AU] (P<0.001). Although the patient-prosthesis mismatch rate was higher in the very severe AS group (38.3% vs. 25.7%; P=0.029), there was no significant difference in the early safety and clinical efficacy between the groups (16.5% vs. 17.1% and 12.0% vs. 18.9%, respectively). Similarly, there was no significant difference in all-cause mortality at 1 year (4.8% vs. 9.8%). Conclusions: Despite a higher incidence of prosthesis-patient mismatch in those with very severe AS, the procedural and clinical outcomes were comparable to those in patients with severe AS. TAVI may be a reasonable treatment option for very severe AS.
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Affiliation(s)
- Yoshikuni Kobayashi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Masaki Izumo
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Kazuaki Okuyama
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Nina Uenomachi
- Ultrasound Center, St. Marianna University School of Medicine Kawasaki Japan
| | - Tatsuro Shoji
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Takahiko Kai
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Taishi Okuno
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yukio Sato
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Shingo Kuwata
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Masashi Koga
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yuki Ishibashi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Yasuhiro Tanabe
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St. Marianna University School of Medicine Kawasaki Japan
| | - Yoshihiro J Akashi
- Department of Cardiology, St. Marianna University School of Medicine Kawasaki Japan
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Sasaki K, Kuwata S, Izumo M, Koga M, Kai T, Sato Y, Okuno T, Kobayashi Y, Murata R, Tanabe Y, Akashi YJ. Three-Year Clinical Impacts of Permanence, Resolution, and Absence of Newly-Developed Left Bundle Branch Block After Transcatheter Aortic Valve Replacement. Am J Cardiol 2023; 202:166-168. [PMID: 37451061 DOI: 10.1016/j.amjcard.2023.06.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Kenichi Sasaki
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
| | - Shingo Kuwata
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masaki Izumo
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Masashi Koga
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takahiko Kai
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yukio Sato
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Taishi Okuno
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshikuni Kobayashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Risako Murata
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasuhiro Tanabe
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihiro J Akashi
- Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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Kai T, Oka S, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. Renal Dysfunction as a Predictor of Slow-Flow/No-Reflow Phenomenon and Impaired ST Segment Resolution After Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction With Initial Thrombolysis in Myocardial Infarction Grade 0. Circ J 2021; 85:1770-1778. [PMID: 34305099 DOI: 10.1253/circj.cj-21-0221] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The slow-flow/no-reflow phenomenon and impaired ST segment resolution (STR) following primary percutaneous coronary intervention (PCI) in ST-elevation myocardial infarction (STEMI) predict unfavorable prognosis and are characterized by obstruction of the coronary microvascular. Several predictors of slow-flow/no-reflow have been revealed, but few studies have investigated predictors of slow-flow/no-reflow and STR exclusively in acute myocardial infarction patients with initial Thrombolysis in Myocardial Infarction (TIMI) Grade 0.Methods and Results:In all, 279 STEMI patients with initial TIMI Grade 0 were enrolled in the study. Slow-flow/no-reflow was defined as TIMI Grade <3 by angiography after PCI, and impaired STR was defined as STR <50% on an electrocardiogram after PCI. Slow-flow/no-reflow was observed in 31 patients. In multivariate analysis, estimated glomerular filtration rate (eGFR; odds ratio [OR] 0.97; P=0.007), a history of cerebrovascular disease (OR 4.65, P=0.007), time to recanalization ≥4 h (OR 2.76, P=0.023), and systolic blood pressure ≤90 mmHg (OR 3.45, P=0.046) were independent predictors of slow-flow/no-reflow. Impaired STR was observed in 102 of 248 patients with TIMI Grade 3. In multivariate analysis, eGFR (OR 0.94, P<0.001) and occlusion of the left anterior descending artery (OR 4.48, P<0.001) were independent predictors of impaired STR; eGFR was the only independent predictor of both slow-flow/no-reflow and impaired STR. CONCLUSIONS Renal dysfunction may be related to coronary microvascular dysfunction and obstruction.
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Affiliation(s)
- Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital
| | | | | | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital
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Watanabe K, Oka S, Kai T, Hoshino K, Nakamura J, Abe M, Watanabe A. Tracheobronchial Obstruction Due to Blood Clots in Acute Pulmonary Embolism with Cardiac Arrest Managed with Extracorporeal Membrane Oxygenation. Intern Med 2021; 60:2811-2817. [PMID: 33716289 PMCID: PMC8479226 DOI: 10.2169/internalmedicine.6856-20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
A 66-year-old Japanese woman developed pulseless electrical activity following an acute pulmonary embolism and was treated with thrombolytic therapy. She remained hemodynamically unstable and therefore underwent extracorporeal membrane oxygenation (ECMO). While receiving treatment with ECMO, blood clots induced by endobronchial hemorrhage caused tracheobronchial airway obstruction, leading to ventilatory defect. Furthermore, her cardiac function improved, resulting in cerebral hypoxemia progression. Therefore, the blood clots were removed with a Fogarty balloon catheter and endobronchial urokinase administration, resulting in improvement in her respiratory condition. Finally, ECMO was decannulated, and the patient was discharged from our hospital without difficulties in her activities of daily living.
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Affiliation(s)
| | - Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Katsuomi Hoshino
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
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Oka S, Kai T, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. Effects of empagliflozin in different phases of diabetes mellitus-related cardiomyopathy: a prospective observational study. BMC Cardiovasc Disord 2021; 21:217. [PMID: 33926386 PMCID: PMC8086321 DOI: 10.1186/s12872-021-02024-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 04/19/2021] [Indexed: 12/31/2022] Open
Abstract
Background Diabetes mellitus-related cardiomyopathy (DMCMP), defined as left ventricular (LV) dysfunction caused by hyperglycemia in the absence of coronary artery disease, leads to heart failure (HF). Previous studies have shown that treatment with sodium-glucose co-transporter 2 inhibitor (SGLT2i) reduces the risk of exacerbation of HF. The beneficial effects of SGLT2i on HF depend not only on indirect actions such as osmotic diuresis but also on direct actions on the myocardium, leading to improvements in LV function. However, it remains unclear whether SGLT2i treatment is equally effective in any phase of DMCMP. The aim of this observational study was to compare the efficacy of SGLT2i treatment on LV dysfunction between early and advanced DMCMP. Methods Thirty-five symptomatic non-ischemic HF patients with LV ejection fraction > 40% and type 2 diabetes mellitus (T2DM) treated with empagliflozin (EMPA group) and 20 controls treated without SGLT2i were enrolled. According to the myocardial extracellular volume fraction (ECV), a reliable marker of cardiac fibrosis quantified by cardiac magnetic resonance, the EMPA group was further divided into early DMCMP (n = 16, ECV ≤ 30%) and advanced DMCMP (n = 19, ECV > 30%) groups and followed up prospectively. Echocardiography was performed at baseline and after 12 months. LV function assessed as LV global longitudinal strain (LVGLS) and the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity (E/e′) were compared. Results ECV was strongly correlated with T2DM duration (r2 = 0.65, p < 0.001). At baseline, each group had a similar background. After 12 months, the EMPA group, especially the early DMCMP group, showed remarkable improvements in LVGLS (ΔLVGLS: 2.9 ± 3.0% (EMPA) vs. 0.6 ± 2.2% (controls), p = 0.005, and 4.6 ± 1.5% (early DMCMP) vs. 1.6 ± 3.3% (advanced DMCMP), p = 0.003) and E/e′ (ΔE/e′: − 1.5 ± 4.7 vs. − 0.3 ± 3.0, p = 0.253, and − 3.4 ± 5.5 vs. − 0.1 ± 3.5, p = 0.043). Conclusions The positive effects of empagliflozin on LV dysfunction were more remarkable in early than in advanced DMCMP. Early intervention of SGLT2i for DMCMP may be preferable.
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Affiliation(s)
- Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan.
| | - Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
| | - Katsuomi Hoshino
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
| | - Kazunori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Surugadai 4-1-11, Fujieda, Shizuoka, 426-8677, Japan
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Oka S, Ito S, Kai T, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. Painful Left Bundle Branch Block Syndrome Complicated by Iron-Overload Cardiomyopathy. Intern Med 2021. [PMID: 33746171 DOI: 10.2169/internalmedicine.7052-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Painful left bundle branch block (LBBB) syndrome is a rare disease that presents as simultaneous chest pain and transient LBBB without myocardial ischemia. We diagnosed a 72-year-old Japanese man with painful LBBB syndrome complicated by iron-overload cardiomyopathy. Phlebotomy was initially performed to improve myocardial iron deposition and conductive disturbance. Ironically, his chest pain was fully improved by the completion of incessant LBBB and walk-through phenomenon. However, this case demonstrates a clinically significant therapeutic strategy for cardiomyopathy-induced painful LBBB syndrome. Due to the lack of treatment guidelines, individualized treatment is required for each case of painful LBBB.
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Affiliation(s)
- Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Shu Ito
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Katsuomi Hoshino
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | | | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
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Oka S, Kai T, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. Rate Versus Rhythm Control in Tachycardia-Induced Cardiomyopathy Patients with Persistent Atrial Flutter. Int Heart J 2021; 62:119-126. [PMID: 33518651 DOI: 10.1536/ihj.20-266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Tachycardia-induced cardiomyopathy (TIC) is a potentially reversible cardiomyopathy caused by tachyarrhythmia. For atrial flutter (AFL) -induced TIC, a rhythm control strategy, such as catheter ablation, has been recommended. However, the efficacy of rate control has remained unclear due to the difficulty of achieving control using arrhythmic medications.We prospectively assessed 47 symptomatic heart failure (HF) patients with left ventricular ejection fraction (LVEF) < 50% and suspected persistent AFL-induced TIC. Patients were divided into the rhythm control strategy (n = 22; treatment with catheter ablation or electrical cardioversion) and rate control strategy (n = 25; treatment with bisoprolol) groups. The latter was further divided into the strict rate control strategy (average heart rate < 80 bpm) and lenient rate control strategy (average heart rate < 110 bpm) subgroups. The primary outcome was left ventricular (LV) function recovery, which was defined as an increase in LVEF ≥ 20% or to a value of ≥ 55% after 6 months.In the rhythm control strategy group, more patients achieved LV function recovery after 6 months (95.2% versus 60.9%, P = 0.010). The cumulative incidence of worsening HF events was significantly higher in the rate control strategy group than in the rhythm control strategy group (hazard ratio, 4.66; 95% confidence interval, 1.01-21.57). The subgroup study revealed the advantage of the strict rate control strategy for achieving LV function recovery (83.3% versus 36.4%, P = 0.036).The rate control strategy was significantly inferior to the rhythm control strategy for the LV function recovery in TIC patients with persistent AFL. Our findings suggest that the strict rate control strategy should be aimed if the rhythm control strategy cannot be performed.
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Affiliation(s)
- Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital
| | | | | | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital
| | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital
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Oka S, Kai T, Hoshino K, Watanabe K, Nakamura J, Abe M, Watanabe A. A comparison of rate control and rhythm control in tachycardia induced cardiomyopathy patients with persistent atrial flutter. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0693] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background/Introduction
Tachycardia induced cardiomyopathy (TIC) is a potentially reversible dysfunction of the left ventricle (LV) caused by tachyarrhythmias. Early recognition of TIC and treatment of the culprit arrhythmia using pharmacological therapy or catheter ablation results in the recovery of LV function. For atrial flutter (AFL)-induced TIC, rhythm control strategy, such as catheter ablation has been recommended. On the other hand, the efficacy of rate control strategy has remained unclear due to the difficulty of control with arrhythmic medications. However, not all patients can take rhythm control treatments due to their backgrounds.
Purpose
The aim of this cohort study was to establish whether rate control strategy using β-blocker is as effective as invasive rhythm control strategy for the recovery of LV function in patients with TIC due to AFL.
Methods
We prospectively assessed 47 symptomatic non-ischaemic heart failure (HF) patients with left ventricular ejection fraction (LVEF) below 50% and suspected TIC induced by persistent AFL. Patients were divided into rhythm control strategy group (n=22, treatment: catheter ablation, electrical cardioversion) and rate control strategy group (n=25, treatment: bisoprolol). As a sub-group study, the rate control strategy group was divided into the strict rate control group (n=12, average heart rate below 80 bpm) and lenient rate control group (n=13, average heart rate below 110 bpm). The primary outcome was the recovery of LV function, defined as an increase of LVEF over 20% or to a value of 55% or greater after 6 months.
Results
There were no significant differences in baseline AFL heart rate, New York Heart Association class, LVEF, estimated glomerular filtration rate, and brain natriuretic peptide between the two groups. A greater proportion of patients who showed the recovery of LVEF after 6 months belonged to the rhythm control strategy group (90.9% vs. 52.0%, p=0.004). The cumulative incidence of HF re-hospitalization was significantly higher in the rate control strategy group than in the rhythm control strategy group (hazard ratio: 4.90, 95% CI: 1.06–22.69). As a result of sub-group study, LVEF recovery was greater in the strict rate control group compared to the lenient rate control group (75.0% vs. 30.8%, p=0.027)
Conclusion
Rate control strategy was significantly inferior to rhythm control strategy for the recovery of LVEF in TIC patients with persistent AFL. Rhythm control should be the first choice in the management of TIC with AFL, and strict rate control should be an alternative if rhythm control is not available.
Primary outcomes
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Oka
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - T Kai
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - K Hoshino
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - K Watanabe
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - J Nakamura
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - M Abe
- Fujieda Municipal General Hospital, Fujieda, Japan
| | - A Watanabe
- Fujieda Municipal General Hospital, Fujieda, Japan
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Oka S, Nakamura J, Kai T, Hoshino K, Watanabe K, Abe M, Yasuda K, Watanabe A. An autopsy case report of extensive intramyocardial hemorrhage complicated with acute myocardial infarction. J Cardiol Cases 2020; 22:121-124. [PMID: 32884593 DOI: 10.1016/j.jccase.2020.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/28/2020] [Accepted: 05/10/2020] [Indexed: 11/16/2022] Open
Abstract
Hemorrhagic myocardial infarction (HMI) is a complication associated with percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). We carried out a successful PCI for a 59-year old Japanese man presenting with chest pain due to AMI over 5 h. The onset to balloon time was 363 min. The next morning, he suffered cardiogenic shock, even with an auxiliary circulating device, which eventually resulted in death. An autopsy revealed extensive HMI. The necrotic myocardium showed not only coagulation necrosis but also contraction band necrosis which suggests myocardial injury due to late reperfusion. Although the intramyocardial hemorrhage was confined to the necrotic area, it was beyond the perfusion area of the culprit artery. Here, we describe a case of death with severe HMI. HMI can be a serious complication and worsen prognosis. <Learning objective: The aim of primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is to recanalize the infarct related artery and salvage the ischemic myocardium. However, late reperfusion sometimes leads to hemorrhagic myocardial infarction (HMI) as a result of myocardial injury. To avoid extensive HMI in AMI patients, primary PCI should be performed as soon as possible.>.
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Affiliation(s)
- Satoshi Oka
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Jun Nakamura
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Takahiko Kai
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Katsuomi Hoshino
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | | | - Makoto Abe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
| | - Kazuyo Yasuda
- Department of Pathology, Fujieda Municipal General Hospital, Japan
| | - Akinori Watanabe
- Department of Cardiology, Fujieda Municipal General Hospital, Japan
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Mizuki S, Kai T, Mishima K, Ikeuchi H, Oryoji K. AB0904 PERSISTENCE AND REASONS FOR DISCONTINUATION OF DENOSUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Denosumab, a fully human monoclonal antibody to receptor activator of nuclear factor kappa B ligand, which inhibits osteoclast differentiation, activation and survival, not only increases bone mineral density but also inhibits the progression of bone erosion in patients with rheumatoid arthritis (RA)1-3). Therefore, denosumab have been preferably prescribed for patients with RA recently. The persistence with denosumab, which is administered subcutaneously once every 6 months, was reported higher than with oral bisphosphonates4), and in the prospective cohort studies, the persistence rate for one year was reported to be 82-95%5-6). However, there have been no report about the persistence in patients with RA treated with denosumab, moreover the reasons for discontinuation of denosumab.Objectives:The aims of this single center retrospective cohort study were 1) to assess the persistence with denosumab in a routine clinical setting and 2) to identify the reasons of discontinuation in patients with RA. And we also reviewed the clinical outcomes of osteonecrosis of the jaw in patients with RA during denosumab treatment.Methods:The present study is based on databases from our hospital, which include age, gender, date of injection of denosumab, as well as information on patients’ characteristics. Patients were included in this study when denosumab were newly started at our department during the period from June 1, 2013 and September 30, 2017. In this study, persistence was defined as patients with an interval between injections of no longer than 6 months plus 8 weeks. Patients were followed until censoring (death, transferring to another hospital) or the end of the study (August 3, 2018).We investigated reasons for the discontinuation of denosumab. Major reasons for the discontinuation of denosumab were classified as adverse event, anxiety over adverse events, patient’s transfer or request, doctor’s careless lack of refilling an injection, and other reason.We identified patients who had been diagnosed as osteonecrosis of the jaw, and demographic, pharmacological, and clinical data were collected from medical records.Results:One hundred and seventy-five patients were identified. Kaplan–Meier analysis showed a slow decline of persistence after initiating denosumab therapy, dropping to 80.4 and 61.9 % after 1 and 2 years of follow-up. When analyzing the reason of discontinuation as adverse events, the persistence rate of denosumab was at 89.4, and 79.4% at 1, and 2 years of follow-up, respectively.During 2-year period, 72 patients discontinued denosumab. A total of 27 adverse events occurred, of which five events were osteonecrosis of the jaw. The other reasons for adverse event included death in four, fracture in three, and so on. Six patients discontinued due to anxiety over dental adverse event. Thirteen patients were in doctor’s careless lack of refilling an injectionAll five patients who were diagnosed as osteonecrosis of the jaw had received the treatment with prednisolone, and four were treated with biologic drugs. All patients stopped denosumab and switched to other drugs including teriparatide. All patients underwent surgical curettages of necrotic bone and cured.Conclusion:Persistence of denosumab in patients with RA is comparable to that in postmenopausal women with osteoporosis. Dental screening and care should be important to continue denosumab treatment.References:[1]Cohen SB.Arthritis Rheum. 2008;58:1299–1309.[2]Takeuchi T.Ann Rheum Dis. 2019;78:899–907.[3]Ebina K.Osteoporos Int. 2018;29:1627–1636.[4]Hadji P.Osteoporos Int. 2016;27:2967–2978.[5]Silverman SL.Arch Osteoporos. 2018;13:85. doi:10.1007/s11657-018-0491-z[6]Hadji P.Osteoporos Int. 2015;26:2479–2489.Disclosure of Interests:Shinichi Mizuki Speakers bureau: AbbVie, Asahi Kasei, Chugai, Eli Lilly, Janssen, Mitsubishi Tanabe, Ono, Tatsuya Kai: None declared, Koji Mishima: None declared, Hiroko Ikeuchi: None declared, Kensuke Oryoji: None declared
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Fukami K, Azumi N, Inoue S, Kai T, Kimura H, Kiuchi J, Matsui S, Takano S, Watanabe T, Zhang C. Performance verification of a precise vibrating-wire magnet alignment technique for next-generation light sources. Rev Sci Instrum 2019; 90:054703. [PMID: 31153263 DOI: 10.1063/1.5086505] [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] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
The high-accuracy alignment of magnets is a key issue in the development of next-generation light-source rings. To obtain adequate dynamic apertures, the magnets must be aligned to an accuracy of 10 µm or better. Recently, a new technique that utilizes a vibrating wire has attracted attention for this purpose as it can directly determine with high resolution the magnetic centers in a series of multipole magnets on a straight section between bending magnets. In conventional vibrating-wire alignment techniques, wire sag, which causes alignment errors, is determined from the theoretical catenary curve. By contrast, in the present study, we have measured the sag profiles of various wires in the longitudinal direction to micrometer-order accuracy. We concluded that we can reduce deviations of the actual wire sag from the theoretical curve by choosing a suitable wire. By setting up a test bench of a vibrating-wire alignment system for a series of multipole magnet on a straight section, we have achieved the total error of the magnetic-center measurements of micrometer-order in the standard deviation. Moreover, two systematic error factors, the drift of the magnetic centers due to thermal deformations of the magnets after they are excited and the change in the magnetic centers due to reassembly of the magnets after installing the vacuum chamber, are included in practical magnet alignments. We have experimentally investigated these error factors using the test bench.
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Affiliation(s)
- K Fukami
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - N Azumi
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - S Inoue
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - T Kai
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - H Kimura
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - J Kiuchi
- SPring-8 Service Co., Ltd., Hyogo 679-5165, Japan
| | - S Matsui
- RIKEN SPring-8 Center, Hyogo 679-5148, Japan
| | - S Takano
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - T Watanabe
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
| | - C Zhang
- Japan Synchrotron Radiation Research Institute, Hyogo 679-5198, Japan
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Kim Y, Kai T, Kawano K, Goto S, Kodama Y, Yasunaga F, Takeyama M, Akizuki S, Kamada N, Kobayashi M. Predictive value of liver tissue flow in assessment of the viability of liver grafts after extended preservation in pigs. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.382] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Goto S, Kim Y, Kawano K, Kai T, Kobayashi M. Efficacy of PGI2
analog in preventing ischemia reperfusion damage of liver grafts from living donors. Transpl Int 2018. [DOI: 10.1111/tri.1992.5.s1.366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Protic ionic liquids containing cyclic oligosiloxane frameworks, which were prepared by the hydrolytic condensation method, exhibited relatively high thermal stabilities.
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Affiliation(s)
- T. Hirohara
- Graduate School of Science and Engineering
- Kagoshima University
- Kagoshima 890-0065
- Japan
| | - T. Kai
- Graduate School of Engineering
- Hiroshima University
- Higashi-Hiroshima
- Japan
| | - J. Ohshita
- Graduate School of Engineering
- Hiroshima University
- Higashi-Hiroshima
- Japan
| | - Y. Kaneko
- Graduate School of Science and Engineering
- Kagoshima University
- Kagoshima 890-0065
- Japan
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Matsumoto Y, Segawa M, Kai T, Shinohara T, Nakatani T, Oikawa K, Hiroi K, Su Y, Hayashida H, Parker J, Zhang S, Kiyanagi Y. Recent Progress of Radiography and Tomography at the Energy-resolved Neutron Imaging System RADEN. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.phpro.2017.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Kai T. [On the present and future of National Sanatorium Tohokushinseien]. Nihon Hansenbyo Gakkai Zasshi 2015; 84:71-72. [PMID: 26630798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Kiyanagi Y, Shinohara T, Kai T, Kamiyama T, Sato H, Kino K, Aizawa K, Arai M, Harada M, Sakai K, Oikawa K, Ooi M, Maekawa F, Iikura H, Sakai T, Matsubayashi M, Segawa M, Kureta M. Present Status of Research on Pulsed Neutron Imaging in Japan. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.phpro.2013.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jianhui Z, Kai T, Xiankai L, Wenhui P, Yawei X. Predictive value of left atrial size for atrial fibrillation recurrence after single circumferential pulmonary vein isolation: a systematic review and meta-analysis of observational studies. Heart 2011. [DOI: 10.1136/heartjnl-2011-300867.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hailing L, Wenhui P, Kai T, Dongdong Z, Dong W, Weiming L, Yawei X. Genetic study of familial atrial standstill. Heart 2011. [DOI: 10.1136/heartjnl-2011-300867.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Takei H, Saito T, Ishikawa Y, Hayashi Y, Kurosumi M, Kai T, Tabei T. P308 Optimal duration of neoadjuvant exemestane treatment in elderly women with estrogen receptor-positive/HER2-negative breast cancer. Breast 2011. [DOI: 10.1016/s0960-9776(11)70248-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Higashiyama S, Kawabe J, Hashimoto H, Kataoka K, Kawamura E, Yoshida A, Kotani K, Kai T, Inoue K, Kiriike N, Shiomi S. P37-10 Detection of the dementia of the Alzheimer type using easy Z-score imaging system and voxel-based specific regional analysis system. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)61327-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kai T, Dongdong Z, Yawei X. e0563 Implantation of left ventricular epicardial lead guided by overlay ref for cardiac resynchronisation therapy. Heart 2010. [DOI: 10.1136/hrt.2010.208967.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Xiao Z, Guang Z, Yong X, Jing W, Kai T, Bei Z. e0706 Evaluation of intraventricular flow in DCM patients using vector flow mapping. Heart 2010. [DOI: 10.1136/hrt.2010.208967.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Inubushi Y, Okano Y, Nishimura H, Cai H, Nagatomo H, Kai T, Kawamura T, Batani D, Morace A, Redaelli R, Fourment C, Santos JJ, Malka G, Boscheron A, Bonville O, Grenier J, Canal P, Lacoste B, Lepage C, Marmande L, Mazataud E, Casner A, Koenig M, Fujioka S, Nakamura T, Johzaki T, Mima K. X-ray polarization spectroscopy to study anisotropic velocity distribution of hot electrons produced by an ultra-high-intensity laser. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 81:036410. [PMID: 20365885 DOI: 10.1103/physreve.81.036410] [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] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Revised: 03/02/2010] [Indexed: 05/29/2023]
Abstract
The anisotropy of the hot-electron velocity distribution in ultra-high-intensity laser produced plasma was studied with x-ray polarization spectroscopy using multilayer planar targets including x-ray emission tracer in the middle layer. This measurement serves as a diagnostic for hot-electron transport from the laser-plasma interaction region to the overdense region where drastic changes in the isotropy of the electron velocity distribution are observed. These polarization degrees are consistent with analysis of a three-dimensional polarization spectroscopy model coupled with particle-in-cell simulations. Electron velocity distribution in the underdense region is affected by the electric field of the laser and that in the overdense region becomes wider with increase in the tracer depth. A full-angular spread in the overdense region of 22.4 degrees -2.4+5.4 was obtained from the measured polarization degree.
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Affiliation(s)
- Y Inubushi
- Institute of Laser Engineering, Osaka University, Suita, Osaka, Japan.
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Wada-Isoe K, Kusumi M, Kai T, Awaki E, Shimoda M, Yano H, Suzuki K, Nakayasu H, Oota K, Kowa H, Nakashima K. Epidemiological study of acute encephalitis in Tottori Prefecture, Japan. Eur J Neurol 2008; 15:1075-9. [DOI: 10.1111/j.1468-1331.2008.02249.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kai T, Maki T, Takahashi S, Warner D. Perioperative tobacco use interventions in Japan: a survey of thoracic surgeons and anaesthesiologists. Br J Anaesth 2008; 100:404-10. [DOI: 10.1093/bja/aem400] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kai T. Quantitative EEG in dementia with Lewy bodies and Alzheimer’s disease. Clin Neurophysiol 2007. [DOI: 10.1016/j.clinph.2007.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Yamamura S, Morishima H, Kumano-go T, Suganuma N, Matsumoto H, Adachi H, Sigedo Y, Mikami A, Kai T, Masuyama A, Takano T, Sugita Y, Takeda M. The effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly subjects. Eur J Clin Nutr 2007; 63:100-5. [PMID: 17851460 DOI: 10.1038/sj.ejcn.1602898] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To study the effect of Lactobacillus helveticus fermented milk on sleep and health perception in elderly healthy subjects. SUBJECTS The study included 29 healthy elderly subjects aged 60-81 years. METHODS Prospective, randomized, double-blind and placebo-controlled, with a crossover design. The study included two intervention periods of 3 weeks each, separated by a 3-week washout period. Subjects took 100 g of fermented milk drink or a placebo drink (artificially acidified milk) daily in the first supplementary period and the other drink in the second supplementary period. For each period, we measured sleep quality by means of actigraphy and a sleep questionnaire, and assessed the quality of life (QOL) by SF-36 health survey. RESULTS There was a significant improvement in sleep efficiency (P=0.03) and number of wakening episodes (P=0.007) in actigraph data after intake of fermented milk, whereas no significant changes were observed for the placebo. Fermented milk did not improve the SF-36 scores significantly from the baseline period. In the GH domain (general health perception) of the SF-36, however, there was marginal improvement as compared to the baseline period. Although the difference between fermented milk and placebo was not statistically significant for any of the sleep or QOL parameters, fermented milk produced slightly greater mean values for many parameters. CONCLUSION This short-term (3-week) intervention study indicates that Lactobacillus helveticus fermented milk may have a more favorable effect on improving sleep in healthy elderly people as compared with placebo.
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Affiliation(s)
- S Yamamura
- Psychiatry, Department of Integrated Medicine, Division of Internal Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
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Inoue K, Takei H, Kurozumi M, Futsuhara K, Kai T, Kuroda T, Ueda S, Miyake H, Hakamada Y, Suemasu K, Tabei T. A phase II study of doxorubicin plus paclitaxel followed by weekly paclitaxel as neoadjuvant chemotherapy for breast cancer (SBCCSG-07). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11103 Background: The primary aim of this study was to estimate the rate of clinical and pathologic response to preoperative doxorubicin and paclitaxel followed by weekly paclitaxel in stage II /III breast cancer. Secondary objective included the determination of time to progression, over all survival, the rate of breast conservation surgery, feasibility and safty. Saitama breast cancer clinical study group-07 study (SBCCSG-07; CTR:UMIN000000504) Methods: Patients were treated with 50 mg/m2 of doxorubicin intravenously and 150 mg/m2 of paclitaxel both administered intravenously on day 1 every 21 days for 4 courses followed by 80 mg/m2 of paclitaxel administered intravenously on day 1 every week for 12 courses(AP-wP). The rate of pathological, clinical response and breast conserving surgery and adverse events (CTCAE ver.3.0) were analyzed in stage II /III breast cancer. Results: From December 2005 to August 2006, 40 planned patients have been enrolled. One patient canceled chemotherapy for interstitial pneumonia. 16 patients have finished their treatment, received surgery and are evaluable for response. Clinical response rate was 81.2% (50.0%CR; 31.2%PR). Stable disease and progressive disease occurred in 2 (12.5%) patients and 1 (6.3%) patient. Four patients (25%) had pathological complete response. Conclusions: Preliminary results indicate that the AP-wP regimen feasible and very active as induction chemotherapy of operable breast cancer. Updated data including evaluation of biological markers will be presented at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- K. Inoue
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - H. Takei
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - M. Kurozumi
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - K. Futsuhara
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - T. Kai
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - T. Kuroda
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - S. Ueda
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - H. Miyake
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - Y. Hakamada
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - K. Suemasu
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
| | - T. Tabei
- Saitama Cancer Center, Saitama, Japan; Jichi Medical School Omiya Medical Center, Saitama, Japan; Omiya kyoritsu Hospital, Saitama, Japan; Sekishindo Hospital, Saitama, Japan; National Defense Medical, Saitama, Japan; Kasukabe City Hospital, Saitama, Japan; Toda Chuo General Hospital, Saitama, Japan
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35
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Inubushi Y, Kai T, Nakamura T, Fujioka S, Nishimura H, Mima K. Analysis of x-ray polarization to determine the three-dimensionally anisotropic velocity distributions of hot electrons in plasma produced by ultrahigh intensity lasers. Phys Rev E Stat Nonlin Soft Matter Phys 2007; 75:026401. [PMID: 17358426 DOI: 10.1103/physreve.75.026401] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Indexed: 05/14/2023]
Abstract
A new polarization spectroscopy model has been developed to analyze energetic electrons distributed in a three-dimensional phase space. This model calculates the polarization degrees for a given line of sight. Time-dependent polarization degrees of Healpha line emitted from heliumlike chlorine ions was obtained for two different lines of sight by using three-dimensional electron velocity distributions provided with two-dimensional particle-in-cell simulations. These results demonstrate that the polarization degrees are sensitively dependent on the profile of the electron velocity distributions which are affected by the polarization of the laser pulse.
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Affiliation(s)
- Y Inubushi
- Institute of Laser Engineering, Osaka University, 2-6 Yamada-oka, Suita, Osaka 565-0871, Japan.
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36
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Kai T, Toriyama K, Nishie K, Takahashi T, Nakajima M. Effect of volume decrease on fluidization quality of fluidized catalyst beds. AIChE J 2006. [DOI: 10.1002/aic.10925] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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37
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Tabei T, Sato K, Inoue K, Nakano S, Kai T, Futsuhara K, Yamashita S, Saito T, Kuroda T, Suemasu K. Multicenter, prospective study of radiotherapy without surgery after AC followed by weekly paclitaxel for patients with inflammatory breast cancer: SBCCSG-04 study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10783 Background: Inflammatory breast cancer (IBC) is a rare and aggressive disease with a dismal outcome. It is still an open debate whether surgery is beneficial for patients with IBC. This study was conducted to evaluate treatment results when patients were treated by chemotherapy and radiotherapy (CRT) alone. Methods: 52 pts with nonmetastatic IBC were enrolled for a prospective registration trial from 9/01–11/04. A diagnosis required the presence of erythema, ridging, or peau d’orange, with or without dermal lymphatic invasion (DLI). All patients were invited to participate for an experimental protocol; 4 cycles of AC and 12 cycles of weekly paclitaxel (80 mg/m2) followed by radiotherapy. In patients who did not agree to the protocol, the decision about treatment was left to the patients/investigators. The primary endpoint was distant-disease-free survival, and the further endpoints were locoregional relapse (LR) and overall survival. Results: The mean follow-up was 25.7 months. 24 pts (46.2%) were planned for the protocol, but one pt (4%) was receipt surgery. Otherwise, 18 (64%) out of 28 pts have accepted mastectomy. The 2-year distant-disease-free, LR, and overall survival in patients treated with and without the protocol was 35.2 vs 61.0% (HR = 2.4, 1.1–5.3) and 55.2 vs 83.6% (HR = 2.9, 1.1–7.8), respectively. Surgery was not associated with the risk of LR (p = 0.48). There was marginally worse prognosis in patients with DLI. Conclusions: There was a limitation because this comparison had not been conducted a randomized fashion. However, CRT alone would be a feasible treatment schedule for a moderate percentage of patients with IBC. No significant financial relationships to disclose.
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Affiliation(s)
- T. Tabei
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - K. Sato
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - K. Inoue
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - S. Nakano
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - T. Kai
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - K. Futsuhara
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - S. Yamashita
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - T. Saito
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - T. Kuroda
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
| | - K. Suemasu
- Saitama Cancer Center, Kita-Adachi, Saitama, Japan; National Defense Medical College, Tokorozawa, Saitama, Japan; Kawaguchi Medical Center, Kawaguchi, Saitama, Japan; Jichi Medical School, Omiya Medical Center, Saitama, Japan; Fukaya Red Cross Hospital, Fukaya, Japan; Saitama Red Cross Hospital, Saitama, Saitama, Japan; Sekishindo Hospital, Kawagoe, Saitama, Japan
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Ikeda K, Shiga Y, Takahashi A, Kai T, Kimura H, Takeyama K, Noji H, Ogawa K, Nakamura A, Ohira H, Sato Y, Maruyama Y. Fatal hepatitis B virus reactivation in a chronic myeloid leukemia patient during imatinib mesylate treatment. Leuk Lymphoma 2006; 47:155-7. [PMID: 16321842 DOI: 10.1080/14639230500236818] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.7] [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: 12/18/2022]
Abstract
Reactivation of chronic hepatitis B virus (HBV) infection in patients undergoing chemotherapy is well-documented, but reactivation during imatinib mesylate treatment has not been reported. This study reports a 54-year-old man, without prior liver dysfunction but with chronic HBV infection, in whom fatal HBV reactivation occurred during treatment of chronic myeloid leukemia (CML) with imatinib mesylate. He developed fulminant hepatitis followed by marked elevation of HBV DNA polymerase, probably from the lymphocytopenic and immunosuppressive status induced by imatinib mesylate. Imatinib mesylate is widely used to treat CML patients. Although therapy with imatinib mesylate is generally well tolerated, the case presented here suggests that viral reactivation should be considered, even when using imatinib mesylate to treat CML.
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Affiliation(s)
- K Ikeda
- First Department of Internal Medicine, Fukushima Medical University, Fukushima, Japan
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Ohta T, Kai T, Ito S. Evidence for paracrine modulation of voltage-dependent calcium channels by amperometric analysis in cultured porcine adrenal chromaffin cells. Brain Res 2004; 1030:183-92. [PMID: 15571668 DOI: 10.1016/j.brainres.2004.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2004] [Indexed: 11/16/2022]
Abstract
We investigated the endogenous control through vesicular contents of voltage-dependent Ca2+ channels (VDCCs) in cultured porcine adrenal chromaffin cells. To examine paracrine regulation of VDCCs, catecholamine release was monitored amperometrically together with patch-clamp recording under culture conditions at different cell densities. A depolarizing pulse evoked Ca(2+)- (ICa) and Ba(2+)-currents (IBa) in Ca(2+)- and Ba(2+)-containing solutions, respectively. In cells cultured at high density, stop-flow of the external solution decreased the I(Ba) concomitant with a sustained increase of amperometric current (Iamp), but not in cells at low density, suggesting the endogenous modulation of VDCCs in a paracine fashion. The degree of the prepulse facilitation was similar regardless of the flow condition. Application of noradrenaline (NA), ATP, methionine-enkephalin (ENK) or protons decreased IBa. The extent of the prepulse facilitation of the endogenous VDCC inhibition was similar to those induced by NA and ATP. GDPbetaS, pertussis toxin (PTX), blockers for alpha-adrenoceptors and P2-purinoceptors significantly reduced the endogenous VDCC inhibition. These results suggest that VDCCs are regulated by vesicular substances in a paracrine fashion, at least by noradrenaline and ATP, through activation of alpha-adrenoceptors and P2-purinoceptors, respectively, in porcine adrenal chromaffin cells.
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Affiliation(s)
- Toshio Ohta
- Laboratory of Pharmacology, Department of Biomedical Science, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo 0600818, Japan.
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40
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Kai T, Uchiyama S, Nishi Y, Kobayashi Y, Tomiyama T. Two States of the Triple Helix in the Thermal Transition of the Collagen Model Peptide (Pro-Pro-Gly)10. J Biomol Struct Dyn 2004; 22:51-8. [PMID: 15214805 DOI: 10.1080/07391102.2004.10506980] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The collagen model peptide (Pro-Pro-Gly)10 is known to fold into a triple helix in solution. So far, the triple helix has been considered to exist as a single state. However, our previous study of (Pro-Pro-Gly)10 in solution has indicated the presence of two different states of the triple helix, a lower (HL) and a higher temperature state (HH). In the present study, these triple-helical states were investigated in more detail by NMR. Complete stereospecific assignments of the methylene protons of the proline residues were accomplished by the use of NOESY and TOCSY spectra. The temperature dependence of the 1H chemical shifts showed that the HL-to-HH thermal transition can be attributed to a conformational change of the first proline (Pro1) residues of the (Pro-Pro-Gly) triplets. Since TOCSY spectra with a 10 ms mixing-time confirmed a down puckering of these Pro residues in the HL state, but interconverting down and up puckerings in the HH state, the HL-to-HH thermal transition corresponds to conformational changes of the pyrrolidine rings of the Pro1 residues from an uniform down puckering to a more flexible state. The results confirm that thermal unfolding of the triple helix proceeds through the intermediate HH state.
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Affiliation(s)
- T Kai
- Department of Chemistry, Graduate School of Science, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, 464-8602, Japan
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Kitamura G, Ohta T, Kai T, Kon Y, Ito S. Inhibitory effects of opioids on voltage-dependent Ca(2+) channels and catecholamine secretion in cultured porcine adrenal chromaffin cells. Brain Res 2002; 942:11-22. [PMID: 12031848 DOI: 10.1016/s0006-8993(02)02648-3] [Citation(s) in RCA: 13] [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: 11/16/2022]
Abstract
The inhibitory effects of opioids on voltage-dependent calcium channels (VDCCs) were investigated in cultured porcine adrenal chromaffin cells using whole-cell patch clamp technique. The effects of the opioid on [Ca(2+)](i) increase and catecholamine secretion induced by high K(+) were also examined in single cells by fura-2 microfluorimetry and amperometry. A depolarizing pulse to 0 mV (test pulse) from a holding potential of -80 mV evoked an inward barium current (I(Ba)), which was reversibly inhibited by methionine-enkephalin. This inhibitory effect of methionine-enkephalin was abolished by naloxone. Selective agonists of opioid receptor subtypes (DAMGO: mu, DPDPE: delta, U50488: kappa) dose-dependently inhibited I(Ba). In inhibitory potency, the order was DAMGO>U50488>DPDPE. These agonists applied sequentially produced a reversible I(Ba) inhibition in the same cells. The inhibitory effect of DAMGO on I(Ba) almost disappeared in the presence of omega-conotoxin GVIA but not omega-agatoxin IVA plus nifedipine. Application of a conditioning prepulse to +100 mV prior to the test pulse partly retrieved the I(Ba) inhibition by DAMGO, suggesting the involvement of voltage-sensitive components in opioid-induced VDCC inhibition. Intracellular application of GDPbetaS or GTPgammaS as well as pretreatment with pertussis toxin significantly reduced the extent of I(Ba) inhibition induced by DAMGO. DAMGO reversibly inhibited the [Ca(2+)](i) increase and catecholamine release induced by high K(+). RT-PCR revealed the expression of mu-, delta- and kappa-opioid receptor mRNAs in cultured adrenal chromaffin cells. These results suggest that porcine adrenal chromaffin cells possess mu-, delta- and kappa-opioid receptors and activation of opioid receptors mainly inhibits N-type VDCCs via pertussis toxin-sensitive G-proteins.
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MESH Headings
- 3,4-Dichloro-N-methyl-N-(2-(1-pyrrolidinyl)-cyclohexyl)-benzeneacetamide, (trans)-Isomer/pharmacology
- Adrenal Medulla/drug effects
- Adrenal Medulla/metabolism
- Animals
- Barium/pharmacology
- Calcium Channel Blockers/pharmacology
- Calcium Channels/drug effects
- Calcium Channels/metabolism
- Calcium Channels, N-Type/drug effects
- Calcium Channels, N-Type/metabolism
- Calcium Signaling/drug effects
- Calcium Signaling/physiology
- Catecholamines/metabolism
- Chromaffin Cells/drug effects
- Chromaffin Cells/metabolism
- Dose-Response Relationship, Drug
- Electric Stimulation
- Enkephalin, Ala(2)-MePhe(4)-Gly(5)-/pharmacology
- Enkephalin, D-Penicillamine (2,5)-/pharmacology
- Enkephalin, Methionine/metabolism
- Enkephalin, Methionine/pharmacology
- GTP-Binding Proteins/drug effects
- GTP-Binding Proteins/metabolism
- Guanosine 5'-O-(3-Thiotriphosphate)/pharmacology
- Membrane Potentials/drug effects
- Membrane Potentials/physiology
- Narcotics/metabolism
- Narcotics/pharmacology
- Neural Inhibition/drug effects
- Neural Inhibition/physiology
- Potassium Chloride/pharmacology
- RNA, Messenger/drug effects
- RNA, Messenger/metabolism
- Receptors, Opioid/drug effects
- Receptors, Opioid/genetics
- Receptors, Opioid/metabolism
- Swine
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Affiliation(s)
- Go Kitamura
- Laboratory of Pharmacology, Department of Biomedical Science, Hokkaido University, Sapporo 0600818, Japan
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Iijima S, Kai T, Iwade K, Hasegawa M, Horiuchi M, Azuma M, Gotoh Y, Kudoh M, Kado H, Ohta Y, Suga K, Hatanaka T, Danno M. [The new portable system for home enteral nutrition, Portermate, made a patient possible go out for a long time: report of a case]. Gan To Kagaku Ryoho 2001; 28 Suppl 1:154-7. [PMID: 11787285] [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: 02/23/2023]
Abstract
The patient, who is received home enteral nutrition (HEN) for a long time in a day, has problems on moving all days. Now, we tried Portermate, which is new portable devices for HEN, in his clinical care. The patient is chronic pancreatitis, and his clinical problems becomes to be worse after he ate. He was under total enteral nutrition via jejunostomy. His clinical complications were almost controlled after HEN, but he has a few complains receiving enteral nutrition. He would not move easily, for an old HEN system was not compact to move. Portermate made him go everywhere he wanted any time. It extremely improved his QOL under HEN. He continues to use Portermate.
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Affiliation(s)
- S Iijima
- Dept. of Surgery, Shitennohji Hospital
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43
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Kasono K, Hikino H, Fujino S, Takemoto N, Kai T, Yamaguchi K, Konishi F, Kawakami M. Cross-reactive mechanism for the false elevation of free triiodothyronine in the patients treated with diclofenac. Endocr J 2001; 48:717-22. [PMID: 11873872 DOI: 10.1507/endocrj.48.717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report three cases of patients exhibiting a false elevation of serum free triiodothyronine (FT3) as a result of a cross-reaction with diclofenac. The first case is a 66-yr-old woman with a long history of rheumatoid arthritis (RA). The patient was receiving diclofenac for the treatment of her RA. The patient was subsequently diagnosed as having thyroid papillary adenocarcinoma and received a subtotal thyroidectomy. After the operation, the patient exhibited postoperative hypothyroidism except for a gradual elevation of FT3. The other two patients also exhibited an elevated serum FT3 level after the administration of diclofenac. Serum FT3 levels in these patients decreased to normal or below normal after diclofenac administration was discontinued. In the first case, the elimination of immunoglobulin from the sera using polyethylene glycol precipitation did not reduce the FT3 level. In our hospital, Vitros ECi (enhanced chemiluminescence enzyme immunoassay) system and Vitros FT3 kit were used for FT3 assay. The patient's FT3 levels were normal or below normal when they were measured using other FT3 kits. FT3 was also detected when diclofenac was dissolved in a phosphate buffered saline. Therefore, we concluded that a cross-reaction between FT3 and diclofenac was the mechanism causing the false elevation of FT3 in these patients.
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Affiliation(s)
- K Kasono
- Department of Endocrinology and Metabolism, Jichi Medical School, Omiya Medical Center, Saitama, Japan
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Abstract
The concept that stem cells are controlled by particular microenvironments known as 'niches' has been widely invoked. But niches have remained largely a theoretical construct because of the difficulty of identifying and manipulating individual stem cells and their surroundings. Technical advances now make it possible to characterize small zones that maintain and control stem cell activity in several organs, including gonads, skin and gut. These studies are beginning to unify our understanding of stem cell regulation at the cellular and molecular levels, and promise to advance efforts to use stem cells therapeutically.
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Affiliation(s)
- A Spradling
- HHMI/Department of Embryology, Carnegie Institution of Washington, Baltimore, Maryland 21210, USA
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45
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Yoshimura H, Jones KA, Perkins WJ, Kai T, Warner DO. Calcium sensitization produced by G protein activation in airway smooth muscle. Am J Physiol Lung Cell Mol Physiol 2001; 281:L631-8. [PMID: 11504690 DOI: 10.1152/ajplung.2001.281.3.l631] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We determined whether activation of G proteins can affect the force developed for a given intracellular Ca(2+) concentration ([Ca(2+)]; i.e., the Ca(2+) sensitivity) by mechanisms in addition to changes in regulatory myosin light chain (rMLC) phosphorylation. Responses in alpha-toxin-permeabilized canine tracheal smooth muscle were determined with Ca(2+) alone or in the presence of ACh, endothelin-1 (ET-1), or aluminum fluoride (AlF; acute or 1-h exposure). Acute exposure to each compound increased Ca(2+) sensitivity without changing the response to high [Ca(2+)] (maximal force). However, chronic exposure to AlF, but not to chronic ACh or ET-1, increased maximal force by increasing the force produced for a given rMLC phosphorylation. Studies employing thiophosphorylation of rMLC showed that the increase in force produced by chronic AlF exposure required Ca(2+) during activation to be manifest. Unlike the acute response to receptor agonists, which is mediated solely by increases in rMLC phosphorylation, chronic direct activation of G proteins further increases Ca(2+) sensitivity in airways by additional mechanisms that are independent of rMLC phosphorylation.
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Affiliation(s)
- H Yoshimura
- Department of Anesthesiology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA
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Abstract
OBJECTIVE Various types of defaecography have been reported for research purposes. A simplified method for clinical use has not been devised for the assessment of disordered defaecation. The aim of this study was to describe a simplified procedure of defaecography and evaluate its usefulness in the diagnosis of faecal incontinence or obstructed defaecation. PATIENTS AND METHODS Anorectal manometry and simplified defaecography were performed in 82 consecutive patients. The procedure of defaecography consisted of instillation into the rectum with a 100% weight per volume of barium in the sitting position through a Foley catheter with an inflated balloon, and several series of static radiograph at rest, during squeezing and straining according to deflation of the balloon. RESULTS Positive rate of barium leakage after barium insertion was significantly higher in incontinent patients than constipated or asymptomatic patients (P < 0.001, respectively). The degree of barium leakage was classified into mild in 18 patients with faecal incontinence, moderate in 4 and severe in 2. Constipated patients had more difficulty trying to expel a catheter than incontinent or asymptomatic patients (P=0.001, P=0.03). Twenty-four percent of patients with obstructed defaecation could not expel the balloon and 48% could not evacuate barium sulphate completely. The positive rate of morphological changes such as rectocele, internal intussusception and band formation was higher in constipated patients than incontinent or asymptomatic patients (P=0.01, P=0.04). CONCLUSION The grade of barium leakage or balloon prolapse reflected the severity of faecal incontinence. The ability in rectal emptying of the balloon or barium sulphate also correlated with the degree of outlet obstruction. The authors concluded that the present defaecographic technique was useful for the assessment of faecal incontinence or functional outlet obstruction, and recommend it due to its simplicity.
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Affiliation(s)
- R Mibu
- Division of Surgery, School of Health Sciences, and Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Yoshida T, Aramaki M, Matsumoto T, Morii Y, Bandah T, Kai T, Kawano K, Kitano S. Right hepatic artery interruption and prostaglandin E1 in total or proximal pancreatectomy for pancreatobiliary malignancy. Hepatogastroenterology 2001; 48:1166-9. [PMID: 11490825] [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: 02/21/2023]
Abstract
BACKGROUND/AIMS Advanced hepato-biliary-pancreatic malignancy can frequently involve the hepatic artery. We evaluated the use of prostaglandin E1 in total or proximal pancreatectomy with the right hepatic artery interruption. METHODOLOGY A Consecutive seven of 117 patients (6.0%) in whom the right hepatic artery was interrupted and not reconstructed were reviewed retrospectively. Four of them received prostaglandin E1 (10-20 ng/kg/min) until the fifth postoperative day, while, the remaining three did not. The effect of prostaglandin E1 was compared concerning complication and hepatic function. RESULTS The right hepatic artery was intentionally resected because of cancer invasion in five patients with biliary tract carcinoma, while, accidentally transected in two with pancreatic carcinoma. Operative deaths did not occur. The biliary leakage was identified in one patient treated without prostaglandin E1. Although a marked rise in glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, and lactate dehydrogenase levels was observed, hepatic dysfunction was successfully treated conservatively in all patients. The glutamic oxaloacetic transaminase and lactate dehydrogenase values were significantly lower (P < 0.05) in patients treated with prostaglandin E1 compared with those without prostaglandin E1. CONCLUSIONS The prostaglandin E1 infusion can be helpful for biliary anastomosis and hepatic function in radical hepato-biliary-pancreatic surgery with the right hepatic artery interruption.
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Affiliation(s)
- T Yoshida
- Department of Surgery I, Oita Medical University, 1-1 Idaigaoka, Hasama, Oita 879-5593, Japan
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Sakata M, Todokoro M, Kai T, Kunitake M, Hirayama C. Effect of cationic polymer adsorbent pK a on the selective removal of endotoxin from an albumin solution. Chromatographia 2001. [DOI: 10.1007/bf02493008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ishii T, Kim YI, Tatsuma T, Kawano K, Kai T, Kobayashi M. Immunodepressants ameliorate normothermic ischemia injury to the rat liver by down-regulating tumor necrosis factor, not by alleviation of lipid peroxidative injury. Transpl Int 2001; 7 Suppl 1:S507-11. [PMID: 11271294 DOI: 10.1111/j.1432-2277.1994.tb01431.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mechanisms by which immunodepressants (Cyclosporine, CsA; FK 506, FK; Azanthioprine, AZA) ameliorate warm ischemic injury of the liver were examined. Female Sprague-Dawley rats were subjected to 60-min of normothermic liver ischemia. Animals were assigned to one of four groups: group I, control with vehicle treatment; groups II, III, and IV, treatment with CsA (10 mg/kg), FK (1 mg/kg), and AZA (1 mg/kg), respectively. The immunosuppressive agents were given per os for 4 consecutive days prior to the induction of hepatic ischemia. In addition to a survival study, plasma levels of endotoxin, serum activities of tumor necrosis factor-alpha (TNF), plasma levels of phosphatidylcholine hydroperoxide (PCOOH) as a lipid peroxide, and serum alanine aminotransferase (ALT) were investigated in blood samples collected from the suprahepatic vena cava. A 7-day survival period was significantly higher in the immunosuppressed animals. Serum TNF levels were elevated and peaked at 3 h following reperfusion. When, the peak values were compared, the animals given immunodepressants had significantly lower levels of TNF (217.0 +/- 40.6 pg/ml for group I, 67.6 +/- 13.7 for group II, 87.9 +/- 28.3 for group III and 89.1 +/- 19.9 for group IV; Mean +/- SEM). Plasma PCOOH levels were also elevated following reperfusion, but with no statistical difference among the groups. Our data suggest that immunodepressants ameliorate warm ischemia/reperfusion injury through modulation of TNF production and not through a diminution of lipid peroxidative injury.
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Affiliation(s)
- T Ishii
- Department of Surgery I, Oita Medical University, Japan
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Noji H, Shichishima T, Saitoh Y, Kai T, Yamamoto T, Ogawa K, Okamoto M, Ikeda K, Maruyama Y. The distribution of PIG-A gene abnormalities in paroxysmal nocturnal hemoglobinuria granulocytes and cultured erythroblasts. Exp Hematol 2001; 29:391-400. [PMID: 11301179 DOI: 10.1016/s0301-472x(00)00684-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 11/21/2022]
Abstract
Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired hemolytic anemia that is characterized by a deficiency of glycosylphosphatidylinositol-anchored membrane proteins due to phosphatidylinositol glycan-class A (PIG-A) gene abnormalities in various lineages of peripheral blood cells and hematopoietic precursors. The purpose of our study was to clarify the distribution of PIG-A gene abnormalities among various cell lineages during differentiation and maturation in PNH patients. The expression of CD16b or CD59 in peripheral blood granulocytes or cultured erythroblasts from three Japanese PNH patients was analyzed using flow cytometry. PIG-A gene abnormalities in both cell types, including glycophorin A(+) bone marrow erythroblasts, were examined using nucleotide sequence analysis. The expression study of PIG-A genes from each patient was also performed using JY-5 cells.Flow cytometry revealed that the erythroblasts consisted of negative, intermediate, and positive populations in Cases 1 and 3 and negative and intermediate populations in Case 2. The granulocytes consisted of negative and positive populations in all three cases. DNA sequence analysis indicated that all the PNH cases had two or three types of PIG-A gene abnormalities, and that a predominant clone with an abnormal PIG-A gene was different in granulocytes and erythroblasts from Cases 2 and 3. Expression studies showed that all the mutations from the patients were responsible for the null phenotype.PIG-A gene abnormalities result in deficiencies of glycosylphosphatidylinositol-anchored proteins in PNH erythroblasts and granulocytes. The distribution of predominant PNH clones with PIG-A gene abnormalities is often heterogeneous between the cell types, suggesting that a clonal selection of PIG-A gene abnormalities occurs independently among various cell lineages during differentiation and maturation.
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Affiliation(s)
- H Noji
- First Department of Internal Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
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