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Kagawa S, Matsumura Y, Matsumoto R, Abe Y, Terada A, Ishiguro T, Naruko T. Large Tissue Debris Causing Cerebral Embolism After Transcatheter Aortic Valve Replacement. Int Heart J 2024; 65:152-154. [PMID: 38296569 DOI: 10.1536/ihj.23-337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Cerebral vascular embolism is one of the complications of transcatheter aortic valve replacement (TAVR). Thrombolytic therapy is not expected to be effective when embolic material consists of a large tissue fragment. Instead, mechanical aspiration may be more effective therapy for acute cerebral infarction after TAVR. Here, we describe the case of an 87-year-old woman with aortic valve stenosis and heart failure who underwent TAVR using a self-expandable valve. Acute cerebral infarction with left middle cerebral artery occlusion caused by a large tissue fragment developed after the procedure.
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Affiliation(s)
| | | | - Ryo Matsumoto
- Department of Cardiology, Osaka City General Hospital
| | - Yukio Abe
- Department of Cardiology, Osaka City General Hospital
| | - Aiko Terada
- Department of Neuro-Intervention, Osaka City General Hospital
| | - Tomoya Ishiguro
- Department of Neuro-Intervention, Osaka City General Hospital
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Kobayashi M, Hayashi M, Yamada R, Ishiguro T, Fujiwara W, Ishii H, Naruse H, Watanabe E, Ozaki Y, Izawa H. Predictors of in-hospital mortality in elderly patients with heart failure treated with tolvaptan. Fujita Med J 2023; 9:80-83. [PMID: 37234387 PMCID: PMC10206904 DOI: 10.20407/fmj.2021-027] [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] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/26/2022] [Indexed: 05/28/2023]
Abstract
Objectives We conducted an analysis of first-time tolvaptan users (≥80 years old) to determine the factors associated with the prognosis of elderly patients with heart failure. Methods We retrospectively analyzed 66 consecutive patients with worsening heart failure (aged ≥80 years) who were admitted to Fujita Health University Bantane Hospital from 2011 to 2016 and treated with tolvaptan. Differences between the in-hospital death and survival groups were evaluated. Multivariate logistic regression analysis was also performed to identify the risk factors for mortality. Results Sixty-six patients were included, and 26 patients died during the index hospitalization. The patients who died had a significantly higher prevalence of ischemic heart disease; a higher heart rate; higher levels of plasma C-reactive protein, blood urea nitrogen (BUN), and creatinine; a lower serum albumin level; and a lower estimated glomerular filtration rate than surviving patients. The proportion of patients requiring early initiation of tolvaptan treatment (within 3 days of admission) was significantly higher in surviving patients. On the basis of multivariate logistic regression analysis, although a high heart rate and high BUN levels were independent factors for in-hospital prognosis, they were not significantly associated with the early use of tolvaptan (≤3 days vs. ≥4 days; odds ratio=0.39; 95% confidence interval=0.07-2.21; p=0.29). Conclusions This study revealed that a higher heart rate and higher BUN levels were independent factors for in-hospital prognosis in elderly patients who received tolvaptan and that early tolvaptan use may not always be effective in elderly patients.
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Affiliation(s)
- Masakazu Kobayashi
- Department of Medicine, Division of Cardiology, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Ryo Yamada
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Hideki Ishii
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Hiroyuki Naruse
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Eiichi Watanabe
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Yukio Ozaki
- Department of Medicine, Division of Cardiology, Fujita Health University Okazaki Medical Center, Okazaki, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
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Fujiwara W, Ishii H, Sobue Y, Shimizu S, Ishiguro T, Yamada R, Ueda S, Nishimura H, Niwa Y, Miyazaki A, Miyagi W, Takahara S, Naruse H, Ishii J, Kiyono K, Watanabe E, Izawa H. A simple proteinuria-based risk score predicts contrast-associated acute kidney injury after percutaneous coronary intervention. Sci Rep 2022; 12:12331. [PMID: 35853998 PMCID: PMC9296582 DOI: 10.1038/s41598-022-16690-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/13/2022] [Indexed: 11/09/2022] Open
Abstract
Contrast-associated acute kidney injury (CA-AKI) is a complication of percutaneous coronary intervention (PCI). Because proteinuria is a sentinel marker of renal dysfunction, we assessed its role in predicting CA-AKI in patients undergoing PCI. A total of 1,254 patients undergoing PCI were randomly assigned to a derivation (n = 840) and validation (n = 414) dataset. We identified the independent predictors of CA-AKI where CA-AKI was defined by the new criteria issued in 2020, by a multivariate logistic regression in the derivation dataset. We created a risk score from the remaining predictors. The discrimination and calibration of the risk score in the validation dataset were assessed by the area under the receiver-operating characteristic curves (AUC) and Hosmer–Lemeshow test, respectively. A total of 64 (5.1%) patients developed CA-AKI. The 3 variables of the risk score were emergency procedures, serum creatinine, and proteinuria, which were assigned 1 point each based on the correlation coefficient. The risk score demonstrated a good discriminative power (AUC 0.789, 95% CI 0.766–0.912) and significant calibration. It was strongly associated with the onset of CA-AKI (Cochran-Armitage test, p < 0.0001). Our risk score that included proteinuria was simple to obtain and calculate, and may be useful in assessing the CA-AKI risk before PCI.
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Affiliation(s)
- Wakaya Fujiwara
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan.
| | - Hideki Ishii
- Department of Cardiovascular Medicine, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - Yoshihiro Sobue
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Shinya Shimizu
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Tomoya Ishiguro
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Ryo Yamada
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Sayano Ueda
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Hideto Nishimura
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Yudai Niwa
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Akane Miyazaki
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Wataru Miyagi
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Shuhei Takahara
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Hiroyuki Naruse
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Junichi Ishii
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Ken Kiyono
- Division of Bioengineering, Graduate School of Engineering Science, Osaka University, Suita, Japan
| | - Eiichi Watanabe
- Division of Cardiology, Department of Internal Medicine, Fujita Health University Bantane Hospital, 3-6-10 Otobashi, Nakagawa, Nagoya, 454-8509, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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Ishiguro T, Hayashi M, Fujiwara W, Okumura S, Yoshinaga M, Yamada R, Ueda S, Ito T, Niwa Y, Miyazaki A, Harada M, Naruse H, Ishii J, Ozaki Y, Izawa H. Circulating miR-489 as a potential new biomarker for idiopathic dilated cardiomyopathy. Fujita Med J 2022; 7:18-22. [PMID: 35111539 PMCID: PMC8749486 DOI: 10.20407/fmj.2020-001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/20/2020] [Indexed: 01/15/2023]
Abstract
Objectives:
MicroRNAs (miRNA) are functional RNAs that have emerged as pivotal gene expression
regulators in cardiac disease. Although several cardiomyocyte miRNAs have been reported to
play roles in heart failure progression among patients with idiopathic dilated cardiomyopathy
(DCM), the role of circulating miRNAs has not yet been well-examined. Methods:
After total RNA extraction from the peripheral blood samples of three control
participants and six patients with DCM, miRNA profiling was performed using miRNA arrays.
Based on the results of this initial screening, real-time polymerase chain reaction (RT-PCR)
was used to perform a quantitative analysis of blood samples from a larger number of matched
patients (DCM, n=20; controls, n=5). Finally, the
correlations between specific miRNA expression levels and hemodynamic parameters were
analyzed. Results:
A primary screening of 2,565 miRNAs resulted in the identification of nine miRNA
candidates. Quantitative RT-PCR results revealed significantly increased miR-489 expression
levels in the DCM group. Moreover, there was a significant positive correlation between
miR-489 expression level and left ventricular ejection fraction. Conclusions:
Our results suggest that circulating miR-489 could be a potential noninvasive
diagnostic biomarker for DCM. Additionally, the quantification of circulating miR-489 may have
value as a potential prognostic marker for patients with DCM.
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Affiliation(s)
- Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Satoshi Okumura
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Ryo Yamada
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Sayano Ueda
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Takehiro Ito
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Yudai Niwa
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Akane Miyazaki
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Masahide Harada
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Hiroyuki Naruse
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Junnichi Ishii
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, School of Medicine, Toyoake, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
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Kitayama K, Ishiguro T, Komiyama M, Morisaki T, Morisaki H, Minase G, Hamanaka K, Miyatake S, Matsumoto N, Kato M, Takahashi T, Yorifuji T. Mutational and clinical spectrum of Japanese patients with hereditary hemorrhagic telangiectasia. BMC Med Genomics 2021; 14:288. [PMID: 34872578 PMCID: PMC8647423 DOI: 10.1186/s12920-021-01139-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/29/2021] [Indexed: 12/28/2022] Open
Abstract
Background Hereditary hemorrhagic telangiectasia (HHT) is a dominantly inherited vascular disorder characterized by recurrent epistaxis, skin/mucocutaneous telangiectasia, and organ/visceral arteriovenous malformations (AVM). HHT is mostly caused by mutations either in the ENG or ACVRL1 genes, and there are regional differences in the breakdown of causative genes. The clinical presentation is also variable between populations suggesting the influence of environmental or genetic backgrounds. In this study, we report the largest series of mutational and clinical analyses for East Asians. Methods Using DNAs derived from peripheral blood leukocytes of 281 Japanese HHT patients from 150 families, all exons and exon–intron boundaries of the ENG, ACVRL1, and SMAD4 genes were sequenced either by Sanger sequencing or by the next-generation sequencing. Deletions/amplifications were analyzed by the multiplex ligation-dependent probe amplification analyses. Clinical information was obtained by chart review. Results In total, 80 and 59 pathogenic/likely pathogenic variants were identified in the ENG and ACVRL1 genes, respectively. No pathogenic variants were identified in the SMAD4 gene. In the ENG gene, the majority (60/80) of the pathogenic variants were private mutations unique to a single family, and the variants were widely distributed without any distinct hot spots. In the ACVRL1 gene, the variants were more commonly found in exons 5–10 which encompasses the serine/threonine kinase domain. Of these, 25/59 variants were unique to a single family while those in exons 8–10 tended to be shared by multiple (2–7) families. Pulmonary and cerebral AVMs were more commonly found in ENG-HHT (69.1 vs. 14.4%, 34.0 vs. 5.2%) while hepatic AVM was more common in ACVRL1-HHT (31.5 vs. 73.2%). Notable differences include an increased incidence of cerebral (34.0% in ENG-HHT and 5.2% in ACVRL1-HHT), spinal (2.5% in ENG-HHT and 1.0% in ACVL1-HHT), and gastric AVM (13.0% in ENG-HHT, 26.8% in ACVRL1-HHT) in our cohort. Intrafamilial phenotypic heterogeneity not related to the age of examination was observed in 71.4% and 24.1% of ENG- and ACVRL1-HHT, respectively. Conclusions In a large Japanese cohort, ENG-HHT was 1.35 times more common than ACVRL1-HHT. The phenotypic presentations were similar to the previous reports although the cerebral, spinal, and gastric AVMs were more common. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-01139-y.
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Affiliation(s)
- Kana Kitayama
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima, Osaka, 534-0021, Japan
| | - Tomoya Ishiguro
- Department of Neuro-Intervention, Osaka City General Hospital, Osaka, Japan
| | - Masaki Komiyama
- Department of Neuro-Intervention, Osaka City General Hospital, Osaka, Japan
| | - Takayuki Morisaki
- Division of Molecular Pathology, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroko Morisaki
- Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Gaku Minase
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kohei Hamanaka
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Masaru Kato
- Department of Genetic Medicine, Osaka City General Hospital, Osaka, Japan
| | - Toru Takahashi
- Department of Genetic Medicine, Osaka City General Hospital, Osaka, Japan
| | - Tohru Yorifuji
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima, Osaka, 534-0021, Japan. .,Department of Genetic Medicine, Osaka City General Hospital, Osaka, Japan.
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6
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Kono Y, Izawa H, Aoyagi Y, Yamada R, Ishiguro T, Yoshinaga M, Okumura S, Fujiwara W, Hayashi M, Otaka Y. Impact of heart failure severity on bone mineral density among older patients with heart failure. Heart Vessels 2021; 36:1856-1860. [PMID: 34085103 DOI: 10.1007/s00380-021-01884-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/28/2021] [Indexed: 11/25/2022]
Abstract
The study aimed to identify factors related to bone mineral density (BMD) among older patients with heart failure (HF). A total of 70 consecutive patients with HF aged 65 years or older who were admitted to an acute hospital due to worsening condition were enrolled before discharge. BMD of the femoral neck was evaluated using the DEXA method. Physical function, as well as echocardiographic and laboratory findings including biomarker of HF severity were collected. Bivariate and multiple regression analyses were employed to determine the association between BMD and the clinical variables. Bivariate analysis determined that age, grip strength, walking speed, serum albumin, and N-terminal pro B-type natriuretic peptide (NT-proBNP) were significantly correlated with BMD (P < 0.01), whereas other clinical parameters were not. The multiple regression analysis identified NT-proBNP as an independent related factor for BMD after adjusting with confounding clinical variables. NT-proBNP was independently related to BMD among older patients with HF. Our results suggest the inclusion of bone fracture prevention strategies in disease management programs, especially for older patients with HF.
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Affiliation(s)
- Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hideo Izawa
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan.
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ryo Yamada
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Satoshi Okumura
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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Shimohira M, Kiyosue H, Osuga K, Gobara H, Kondo H, Nakazawa T, Matsui Y, Hamamoto K, Ishiguro T, Maruno M, Sugimoto K, Koganemaru M, Kitagawa A, Yamakado K. Location of embolization affects patency after coil embolization for pulmonary arteriovenous malformations: importance of time-resolved magnetic resonance angiography for diagnosis of patency. Eur Radiol 2021; 31:5409-5420. [PMID: 33449178 DOI: 10.1007/s00330-020-07669-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 09/01/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess the diagnostic accuracy of computed tomography (CT) and time-resolved magnetic resonance angiography (TR-MRA) for patency after coil embolization of pulmonary arteriovenous malformations (PAVMs) and identify factors affecting patency. METHODS Data from the records of 205 patients with 378 untreated PAVMs were retrospectively analyzed. Differences in proportional reduction of the sac or draining vein on CT between occluded and patent PAVMs were examined, and receiver operating characteristic analysis was performed to assess the accuracy of CT using digital subtraction angiography (DSA) as the definitive diagnostic modality. The accuracy of TR-MRA was also assessed in comparison to DSA. Potential factors affecting patency, including sex, age, number of PAVMs, location of PAVMs, type of PAVM, and location of embolization, were evaluated. RESULTS The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of CT were 82%, 81%, 77%, 85%, and 82%, respectively, when the reduction rate threshold was set to 55%, which led to the highest diagnostic accuracy. The sensitivity, specificity, PPV, NPV, and accuracy of TR-MRA were 89%, 95%, 89%, 95%, and 93%, respectively. On both univariable and multivariable analyses, embolization of the distal position to the last normal branch of the pulmonary artery was a factor that significantly affected the prevention of patency. CONCLUSIONS TR-MRA appears to be an appropriate method for follow-up examinations due to its high accuracy for the diagnosis of patency after coil embolization of PAVMs. The location of embolization is a factor affecting patency. KEY POINTS • Diagnosis of patency after coil embolization for pulmonary arteriovenous malformations (PAVMs) is important because a patent PAVM can lead to neurologic complications. • The diagnostic accuracies of CT with a cutoff value of 55% and TR-MRA were 82% and 93%, respectively. • The positioning of the coils relative to the sac and the last normal branch of the artery was significant for preventing PAVM patency.
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Affiliation(s)
- Masashi Shimohira
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.
| | - Hiro Kiyosue
- Department of Radiology, Oita University, Yufu, Japan
| | - Keigo Osuga
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diagnostic Radiology, Osaka Medical College, Takatsuki, Japan
| | - Hideo Gobara
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Hiroshi Kondo
- Department of Radiology, Teikyo University School of Medicine, Itabashi, Tokyo, Japan
| | - Tetsuro Nakazawa
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diagnostic Imaging, Osaka General Medical Center, Osaka, Japan
| | - Yusuke Matsui
- Department of Radiology, Okayama University Medical School, Okayama, Japan
| | - Kohei Hamamoto
- Department of Radiology, Jichi Medical University, Saitama Medical Center, Saitama, Japan
| | - Tomoya Ishiguro
- Department of Neuro-Intervention, Osaka City General Hospital, Osaka, Japan
| | - Miyuki Maruno
- Department of Radiology, Oita University, Yufu, Japan
| | - Koji Sugimoto
- Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Akira Kitagawa
- Department of Radiology, Aichi Medical University, Nagakute, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
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8
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Yamada R, Okumura S, Kono Y, Miyazaki A, Niwa Y, Ito T, Ueda S, Ishiguro T, Yoshinaga M, Fujiwara W, Hayashi M, Ozaki Y, Saitoh E, Izawa H. Effect of cardiac rehabilitation on circulating microRNA expression in heart failure: a preliminary study. Fujita Med J 2021; 7:76-82. [PMID: 35111549 PMCID: PMC8749499 DOI: 10.20407/fmj.2020-010] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 07/02/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES There are benefits of exercise-based cardiac rehabilitation (CR) in patients with heart failure (HF), but their underlying molecular mechanisms remain elusive. The effect of CR on the expression profile of circulating microRNAs (miRNAs), which are short noncoding RNAs that regulate posttranscriptional expression of target genes, is unknown. If miRNAs respond to changes following CR for HF, then serum profiling of miRNAs may reveal cardioprotective mechanisms of CR. METHODS This study enrolled three hospitalized patients with progressed systolic HF and three normal volunteer controls. In patients, CR was initiated after improvement of HF, which included 2 weeks of bicycle ergometer and resistance exercises. Genome-wide expression profiling of circulating miRNAs was performed using microarrays for the patients (mean±SD age, 60.0±12.2 years) and controls (58.7±0.58 years). Circulating miRNA expression profiles were compared between patients with HF before and after CR and the controls. RESULTS Expression levels of two miRNAs were significantly different in patients before CR compared with controls and patients after CR. The expression of hsa-miR-125b-1-3p was significantly downregulated and that of hsa-miR-1290 was significantly upregulated in patients before CR. CONCLUSIONS When performing CR, expression of certain circulating miRNAs in patients with HF is restored to nonpathological levels. The benefits of CR for HF may result from regulation of miRNAs through multiple effects of gene expression.
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Affiliation(s)
- Ryo Yamada
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Satoshi Okumura
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane
Hospital, Nagoya, Aichi, Japan
| | - Akane Miyazaki
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yudai Niwa
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Takehiro Ito
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Sayano Ueda
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, School of
Medicine, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, Fujita Health University, School of
Medicine, Toyoake, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital,
Nagoya, Aichi, Japan
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9
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Ueda S, Kono Y, Yamada R, Ishiguro T, Yoshinaga M, Okumura S, Fujiwara W, Hayashi M, Aoyagi Y, Saitoh E, Otaka Y, Izawa H. Impact of physical function on indeterminable anaerobic threshold in patients with heart failure. Fujita Med J 2021; 7:65-69. [PMID: 35111547 PMCID: PMC8749534 DOI: 10.20407/fmj.2020-015] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Anaerobic threshold (AT) during cardiopulmonary exercise testing (CPET) is not always determinable in patients with heart failure (HF). However, little is known about the clinical features of patients with HF who have indeterminable AT. Therefore, the present study aimed to clarify the clinical features of such patients. METHODS A total of 70 patients with HF (58 males; age: 68±12 years) who underwent CPET during hospitalization were divided into two groups: determinable AT (n=50) and indeterminable AT (n=20). Physical function, echocardiographic results, and laboratory findings were subsequently determined. RESULTS Univariate analyses showed that the indeterminable AT group had significantly higher age and left ventricular ejection fraction, and significantly lower body mass index, calf circumference, handgrip strength, walking speed, serum hemoglobin, and serum albumin than the determinable AT group. Multiple logistic regression analysis identified handgrip strength and walking speed as independent predictive factors for indeterminable AT. Receiver-operating characteristic analyses revealed that handgrip strength of 21.2 kg and walking speed of 0.97 m/s were optimal cutoff values for differentiating patients who were likely to experience indeterminable AT. CONCLUSIONS The present study identified handgrip strength and walking speed as powerful predictors for indeterminable AT with HF.
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Affiliation(s)
- Sayano Ueda
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yuji Kono
- Department of Rehabilitation, Fujita Health University Hospital,
Toyoake, Aichi, Japan
| | - Ryo Yamada
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Satoshi Okumura
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
| | - Hideo Izawa
- Department of Cardiology, School of Medicine, Fujita Health
University, Toyoake, Aichi, Japan
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10
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Namba K, Niimi Y, Ishiguro T, Higaki A, Toma N, Komiyama M. Cauda Equina and Filum Terminale Arteriovenous Fistulas: Anatomic and Radiographic Features. AJNR Am J Neuroradiol 2020; 41:2166-2170. [PMID: 33033040 DOI: 10.3174/ajnr.a6813] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/01/2020] [Indexed: 11/07/2022]
Abstract
Intradural AVF below the conus medullaris may develop either on the filum terminale or the cauda equina (lumbosacral and coccygeal radicular nerves). Although not a few filum terminale AVFs are found in the literature, only 3 detailed cauda equina AVFs have been reported. Here, we analyze the angiographic and MR imaging findings of our cauda equina and filum terminale AVF cases, supplemented with literature research to characterize the radiologic features of the 2 entities. On angiography, filum terminale AVFs were invariably supplied by the extension of the anterior spinal artery accompanied by a closely paralleling filum terminale vein. Cauda equina AVFs were fed by either a radicular or a spinal artery or both arteries, often with a characteristic wavy radicular-perimedullary draining vein. On thin-section axial MR imaging, the filum terminale AVF draining vein joined the spinal cord at the conus medullaris apex, but that of the cauda equina AVF joined above the conus medullaris apex.
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Affiliation(s)
- K Namba
- From the Center for Endovascular Therapy (K.N., A.H.), Division of Neuroendovascular Surgery, Jichi Medical University, Tochigi, Japan
| | - Y Niimi
- Department of Neuroendovascular Therapy (Y.N.), St. Luke's International Hospital, Tokyo, Japan
| | - T Ishiguro
- Department of Neurointervention (T.I., M.K.), Osaka City General Hospital, Osaka, Japan
| | - A Higaki
- From the Center for Endovascular Therapy (K.N., A.H.), Division of Neuroendovascular Surgery, Jichi Medical University, Tochigi, Japan
| | - N Toma
- Department of Neurosurgery (N.T.), Mie University Graduate School of Medicine, Mie, Japan
| | - M Komiyama
- Department of Neurointervention (T.I., M.K.), Osaka City General Hospital, Osaka, Japan
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11
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Higuchi N, Uda K, Mizokami T, Mitsumizo S, Ishiguro T, Komiyama M, Nishimura S, Matsuo M. [A Suspected Case of Hemorrhagic Hereditary Telangiectasia Presented with Cerebral Hemorrhage in Infancy]. Brain Nerve 2020; 72:907-911. [PMID: 32741772 DOI: 10.11477/mf.1416201618] [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: 06/11/2023]
Abstract
Hereditary hemorrhagic telangiectasia (HHT) is characterized by telangiectasias in multiple organs. We experienced an infant with cerebral hemorrhaging and suspected HHT based on his family history of HHT. Computed tomography angiography confirmed a cerebral arteriovenous fistula. The onset of cerebral arteriovenous fistulas associated with HHT is relatively early, and the incidence of bleeding is relatively common. When HHT is suspected based on a family history, early imaging screening is recommended to improve the neurological prognosis, even in asymptomatic cases. (Received April 7, 2020; Accepted May 7, 2020; Published August 1, 2020).
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Affiliation(s)
- Naoya Higuchi
- Department of Pediatrics, Saga-ken Medical Centre Koseikan
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12
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Ishiguro T, Hatase T, Nishino K, Godo C, Nishikawa N, Umezu H, Motoyama T, Fukuchi T, Enomoto T. Cancer-associated retinopathy in a patient with synchronous fallopian tubal and uterine corpus cancers. EUR J GYNAECOL ONCOL 2019. [DOI: 10.12892/ejgo4778.2019] [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: 11/13/2022]
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13
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Tanaka K, Morita S, Ando M, Yokoyama T, Nakamura A, Yoshioka H, Ishiguro T, Miura S, Toyozawa R, Oguri T, Daga H, Ko R, Bessho A, Tachihara M, Iwamoto Y, Hirano K, Nakanishi Y, Nakagawa K, Yamamoto N, Okamoto I. MA13.06 Ph3 Study of Maintenance Therapy with S-1 vs BSC After Induction Therapy with Carboplatin + S-1 for Advanced Squamous Cell Lung Cancer (WJOG7512L). J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.605] [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: 10/25/2022]
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14
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Kono Y, Izawa H, Aoyagi Y, Ishikawa A, Sugiura T, Mori E, Yanohara R, Ishiguro T, Yamada R, Okumura S, Fujiwara W, Hayashi M, Saitoh E. Predictive impact of early mobilization on rehospitalization for elderly Japanese heart failure patients. Heart Vessels 2019; 35:531-536. [PMID: 31559458 PMCID: PMC7222093 DOI: 10.1007/s00380-019-01517-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/20/2019] [Indexed: 01/27/2023]
Abstract
The aim of this study was to determine whether early mobilization was associated with rehospitalization among elderly heart failure patients. We measured the time from admission to mobilization and other clinical characteristics for 190 heart failure patients (mean age, 80.7 years). The primary outcome was heart failure rehospitalization. Kaplan-Meier survival curves were plotted and the hazard ratios for rehospitalization were determined using Cox proportional hazards regression models. During a median follow-up period of 750 days, 58 patients underwent rehospitalization. The time from admission to mobilization was significantly longer for these patients than for those who were not rehospitalized. Univariate and multivariate Cox proportional hazards analyses showed that the time from admission to mobilization was an independent predictor of rehospitalization, and receiver-operating characteristic analysis determined an optimal cutoff value of 3 days for differentiating the patients more likely to experience a subsequent cardiac event (sensitivity, 76%; specificity, 69%; area under the curve, 0.667). Kaplan-Meier survival curve analysis showed a significantly lower event rate in the ≤ 3-day group (p = 0.001, log-rank test). In conclusion, the time from admission to mobilization may be one of the strongest predictors of rehospitalization in elderly heart failure patients. Early mobilization within 3 days may be an initial target for the acute phase treatment of heart failure.
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Affiliation(s)
- Yuji Kono
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan.
| | - Yoichiro Aoyagi
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ayako Ishikawa
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Tsubasa Sugiura
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Etsuko Mori
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Ryuzo Yanohara
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan
| | - Ryo Yamada
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan
| | - Satoshi Okumura
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan
| | - Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Bantane Hospital, 3-6-10, Otobashi, Nakagawa-ku, Nagoya, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
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15
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Ishiguro T, Chihara M, Nishikawa N, Enomoto T. Superficial cervical scar endometriosis following cone biopsy. CLIN EXP OBSTET GYN 2019. [DOI: 10.12891/ceog4482.2019] [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: 11/01/2022]
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16
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Kumagai Y, Hatano S, Sobajima J, Ishiguro T, Fukuchi M, Ishibashi KI, Mochiki E, Nakajima Y, Ishida H. Indocyanine green fluorescence angiography of the reconstructed gastric tube during esophagectomy: efficacy of the 90-second rule. Dis Esophagus 2018; 31:5036207. [PMID: 29897432 DOI: 10.1093/dote/doy052] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
By examining the reconstructed gastric tube during esophagectomy using indocyanine green fluorescence (ICG) angiography, we have established a '90-second rule' to confirm good blood perfusion at the anastomosis site. We examined the surgical outcome (rate of anastomotic leakage) of 70 consecutive patients who underwent esophagectomy with gastric tube reconstruction using ICG fluorescence angiography. All of the anastomoses were made in the area where less than 90 seconds was needed for enhancement using ICG fluorescence angiography (i.e. within the 90-second rule). In 18 cases for which the time until enhancement of the gastric tube tip exceeded 60 seconds, the anastomosis site was decided by reference to the ICG fluorescence angiogram, and the hypoperfused area was excised, and this significantly shortened the median time until enhancement of the gastric tube tip from 95.5 (60.0-204.0) seconds to 41.0 (9.0-77.0) seconds (P < 0.001). In three cases, the anastomosis was made at the site where more than 60 seconds was needed for ICG enhancement. In one case where ICG enhancement had taken 77 seconds, minor anastomotic leakage occurred. The overall rate of anastomotic leakage in this series was 1.4%. Blood flow in the reconstructed gastric tube is sufficient if the anastomosis is made in the area where ICG fluorescence angiography demonstrates enhancement within 60 seconds. Gastric tube necrosis can be avoided if the area showing an enhancement time exceeding 90 seconds is excised. The 90-second rule is a safe and effective method for deciding the site of anastomosis.
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Affiliation(s)
- Y Kumagai
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - S Hatano
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - J Sobajima
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - T Ishiguro
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - M Fukuchi
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - K-I Ishibashi
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - E Mochiki
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
| | - Ya Nakajima
- Department of Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - H Ishida
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama
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17
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Dote K, Takahashi N, Niki T, Ishiguro T, Shiojima I. A case of vertebral arteriovenous fistula in a patient undergoing maintenance hemodialysis. Ren Replace Ther 2018. [DOI: 10.1186/s41100-018-0185-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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18
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Terada A, Komiyama M, Ishiguro T, Niimi Y, Oishi H. Nationwide survey of pediatric intracranial arteriovenous shunts in Japan: Japanese Pediatric Arteriovenous Shunts Study (JPAS). J Neurosurg Pediatr 2018; 22:550-558. [PMID: 30052118 DOI: 10.3171/2018.5.peds18123] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/10/2018] [Indexed: 11/06/2022]
Abstract
The authors performed a nationwide study in Japan to evaluate the annual detected rate of pediatric intracranial arteriovenous (AV) shunts such as brain AV malformations (BAVMs), pial AV fistulas (PAVFs), vein of Galen aneurysmal malformations (VGAMs), and dural AV fistulas (DAVFs). These rates were revealed for the first time and showed that VGAM, DAVF, and PAVF were relatively common but that BAVMs were extremely rare in neonates and infants.
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Affiliation(s)
- Aiko Terada
- Departments of1Neurosurgery and.,2Neurointervention, Osaka City General Hospital, Osaka
| | | | | | - Yasunari Niimi
- 3Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo; and
| | - Hidenori Oishi
- Departments of4Neuroendovascular Therapy and.,5Neurosurgery, Juntendo University Faculty of Medicine, Tokyo, Japan
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19
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Sawa T, Yoshida T, Ishiguro T, Horiba A, Futamura Y, Hosogi S, Nakahari T. P3.03-04 Is the Ciliary Function of the Lesion Bronchus Maintained in Patients with Lung Cancer? J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1681] [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: 11/30/2022]
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20
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Fujiwara W, Kato Y, Hayashi M, Sugishita Y, Okumura S, Yoshinaga M, Ishiguro T, Yamada R, Ueda S, Harada M, Naruse H, Ishii J, Ozaki Y, Izawa H. Serum microRNA-126 and -223 as new-generation biomarkers for sarcoidosis in patients with heart failure. J Cardiol 2018; 72:452-457. [PMID: 30054123 DOI: 10.1016/j.jjcc.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Received: 03/29/2018] [Revised: 05/30/2018] [Accepted: 06/18/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Although cardiac sarcoidosis is associated with poor prognosis, diagnosis of the disease is challenging and the sensitivity and specificity of diagnostic modalities are limited. This study was performed to evaluate the potential of serum microRNAs (miRNAs) as diagnostic biomarkers for cardiac sarcoidosis. METHODS We performed genome-wide expression profiling for 2565 miRNAs (Human-miRNA ver.21) using peripheral blood samples from 5 patients with cardiac sarcoidosis (61±9 years) and 3 healthy controls (54±7 years). From this screening study, we selected 12 miRNAs that were significantly related to cardiac sarcoidosis. Next, we performed real-time polymerase chain reaction (PCR) on blood samples from 15 new patients with cardiac sarcoidosis and 4 healthy controls to quantify the expression of these 12 miRNAs. RESULTS In the screening study, 12 miRNAs were differentially expressed (p<0.01) in all 5 patients with cardiac sarcoidosis, showing greater fold-change values (>4 or <0.25) compared with the expression in the 3 healthy controls. Analysis of the real-time PCR for blood samples from the other 15 patients and 4 controls using Mann-Whitney U tests revealed that the expression of miR-126 and miR-223 was significantly higher in the patients than in the healthy individuals. However, there were no differences in the expressions of miRNA-126 and miR-223 between patients with only cardiac lesions and those with extra-cardiac lesions. CONCLUSIONS Our results demonstrate the potential of serum miR-126 and miR-223 as new-generation biomarkers for the differential diagnosis of cardiac sarcoidosis in patients with heart failure.
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Affiliation(s)
- Wakaya Fujiwara
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Yasuchika Kato
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Mutsuharu Hayashi
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Yoshinori Sugishita
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Satoshi Okumura
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Masataka Yoshinaga
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Tomoya Ishiguro
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Ryo Yamada
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Sayano Ueda
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Masahide Harada
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Hiroyuki Naruse
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Junnichi Ishii
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Yukio Ozaki
- Department of Cardiology, Fujita Health University, Nagoya, Japan
| | - Hideo Izawa
- Department of Cardiology, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan.
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21
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Maekawa H, Terada A, Ishiguro T, Komiyama M, Lenck S, Renieri L, Krings T. Recurrent periventricular hemorrhage in cerebral proliferative angiopathy: Case report. Interv Neuroradiol 2018; 24:713-717. [PMID: 29991310 DOI: 10.1177/1591019918787265] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cerebral proliferative angiopathy (CPA) is a rare vascular lesion. Bleeding from CPA is uncommon, but the risk of rebleeding is high once it bleeds. We describe a case of CPA with multiple intra- and periventricular hemorrhages during 30-year follow-up. Recurrent bleeding in these areas are common in moyamoya disease. These lesions may share the cause of bleeding: proliferation of the periventricular vessels functioning as collateral pathways. Revascularization surgery for CPA may attenuate the vascular proliferation in the vicinity of the ventricle, which may prevent rebleeding.
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Affiliation(s)
- Hidetsugu Maekawa
- 1 Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Canada
| | - Aiko Terada
- 2 Department of Neurointervention, Osaka City General Hospital, Japan
| | - Tomoya Ishiguro
- 2 Department of Neurointervention, Osaka City General Hospital, Japan
| | - Masaki Komiyama
- 2 Department of Neurointervention, Osaka City General Hospital, Japan
| | - Stephanie Lenck
- 1 Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Canada
| | - Leornardo Renieri
- 1 Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Canada
| | - Timo Krings
- 1 Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network, Toronto Western Hospital, Canada
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22
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Yamauchi S, Kawakami T, Murata K, Ishiguro T, Ikeda H, Nishio A. Choroid plexus AVM with anomalous origin of the capsulothalamic artery: A case report. Interv Neuroradiol 2017; 24:76-81. [PMID: 29125025 DOI: 10.1177/1591019917739841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and importance Traditionally, it has been believed that the plexal segment of the anterior choroidal artery (AChoA) can be sacrificed safely. Here, we present a case of choroid plexus arteriovenous malformation (AVM) in which the capsulothalamic artery originated from distal plexal segment of the AChoA. Clinical presentation A 45-year-old man was diagnosed with arteriovenous malformation involving the left inferior horn in screening MRI. Preceding stereotactic radiosurgery, transarterial target embolization was performed. In this procedure, 20% n-butyl-2-cyanoacrylate (NBCA) was successfully injected from the lateral plexal branch of the AChoA. After embolization, right homonymous hemianopsia developed due to cerebral infarction on the left optic radiation. This infarction was considered to be within the territory of the capsulothalamic artery. Conclusion This anomalous capsulothalamic artery might be formed by hemodynamic compromise of the brain surrounding AVM in early gestation. We must be aware of this unusual anatomical variation to avoid ischemic complication in embolization of the AChoA.
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Affiliation(s)
- Shigeru Yamauchi
- 1 Department of Neurosurgery, Hokuto Social Medical Corporation Hokuto Hospital, Obihiro, Japan.,2 Department of Neurosurgery, Shimada Municipal Hospital, Shimada, Japan
| | - Taichiro Kawakami
- 3 Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Keiji Murata
- 2 Department of Neurosurgery, Shimada Municipal Hospital, Shimada, Japan
| | - Tomoya Ishiguro
- 4 Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Hidetoshi Ikeda
- 1 Department of Neurosurgery, Hokuto Social Medical Corporation Hokuto Hospital, Obihiro, Japan.,4 Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Akimasa Nishio
- 1 Department of Neurosurgery, Hokuto Social Medical Corporation Hokuto Hospital, Obihiro, Japan
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23
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Kiyosue H, Matsumaru Y, Niimi Y, Takai K, Ishiguro T, Hiramatsu M, Tatebayashi K, Takagi T, Yoshimura S. Angiographic and Clinical Characteristics of Thoracolumbar Spinal Epidural and Dural Arteriovenous Fistulas. Stroke 2017; 48:3215-3222. [PMID: 29114089 PMCID: PMC5704665 DOI: 10.1161/strokeaha.117.019131] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/18/2017] [Accepted: 09/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The purpose of this study is to compare the angiographic and clinical characteristics of spinal epidural arteriovenous fistulas (SEAVFs) and spinal dural arteriovenous fistulas (SDAVFs) of the thoracolumbar spine. METHODS A total of 168 cases diagnosed as spinal dural or extradural arteriovenous fistulas of the thoracolumbar spine were collected from 31 centers. Angiography and clinical findings, including symptoms, sex, and history of spinal surgery/trauma, were retrospectively reviewed. Angiographic images were evaluated, with a special interest in spinal levels, feeders, shunt points, a shunted epidural pouch and its location, and drainage pattern, by 6 readers to reach a consensus. RESULTS The consensus diagnoses by the 6 readers were SDAVFs in 108 cases, SEAVFs in 59 cases, and paravertebral arteriovenous fistulas in 1 case. Twenty-nine of 59 cases (49%) of SEAVFs were incorrectly diagnosed as SDAVFs at the individual centers. The thoracic spine was involved in SDAVFs (87%) more often than SEAVFs (17%). Both types of arteriovenous fistulas were predominant in men (82% and 73%) and frequently showed progressive myelopathy (97% and 92%). A history of spinal injury/surgery was more frequently found in SEAVFs (36%) than in SDAVFs (12%; P=0.001). The shunt points of SDAVFs were medial to the medial interpedicle line in 77%, suggesting that SDAVFs commonly shunt to the bridging vein. All SEAVFs formed an epidural shunted pouch, which was frequently located in the ventral epidural space (88%) and drained into the perimedullary vein (75%), the paravertebral veins (10%), or both (15%). CONCLUSIONS SDAVFs and SEAVFs showed similar symptoms and male predominance. SDAVFs frequently involve the thoracic spine and shunt into the bridging vein. SEAVFs frequently involve the lumbar spine and form a shunted pouch in the ventral epidural space draining into the perimedullary vein.
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Affiliation(s)
- Hiro Kiyosue
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.).
| | - Yuji Matsumaru
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Yasunari Niimi
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Keisuke Takai
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Tomoya Ishiguro
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Masafumi Hiramatsu
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Kotaro Tatebayashi
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Toshinori Takagi
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
| | - Shinichi Yoshimura
- From the Department of Radiology, Oita University Hospital, Yufu, Japan (H.K.); Department of Neurosurgery, Tsukuba University, Japan (Y.M.); Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan (Y.N.); Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital, Japan (K.T.); Department of Neurosurgery, Osaka City General Hospital, Japan (T.I.); Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan (M.H.); and Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Japan (K.T., T.T., S.Y.)
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Fujiwara W, Yamada R, Ishiguro T, Okumura S, Yoshinaga M, Sugishita Y, Hayashi M, Kato Y, Ozaki Y, Izawa H. Serum Micro-ribonucleic Acid-126 and -223 as a New Generation Biomarker for Cardiac Sarcoidosis. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.08.298] [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: 10/18/2022]
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Ishiguro T, Kasuga K, Saito K, Mezaki N, Miura T, Onodera O, Ikeuchi T. The effect of neuronal activity on β-amyloid precursor protein (APP) processing in cultured cells. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1868] [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: 11/25/2022]
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Tokutake T, Kasuga K, Ishiguro T, Miura T, Mezaki N, Hirai K, Onodera O, Ikeuchi T. Characteristic clinical presentations and CSF biomarker features in patients with semantic dementia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2888] [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: 10/18/2022]
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Ueyama M, Ishiguro T, Konno T, Koyama A, Wada K, Ishikawa K, Onodera O, Nagai Y. Repeat associated non-atg translation and its regulation in C9orf72-associated amyotrophic lateral sclerosis/frontotemporal dementia model fly. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2021] [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]
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Ishiguro T, Sato N, Ueyama M, Fujikake N, Sellier C, Tokuda E, Zamiri B, Gall-Duncan T, Mirceta M, Furukawa Y, Yokota T, Wada K, Taylor P, Pearson C, Charlet-Berguerand N, Mizusawa H, Nagai Y, Ishikawa K. Balance between RNA binding proetin TDP-43 and an RNA UGGAA repeat underlies pathogenesis of spinocerebellar ataxia type 31 (SCA31) and motor neuron disease fly models. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.218] [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]
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Kanki R, Komiyama M, Ishiguro T, Terada A. The effect of embolization of pulmonary arteriovenous malformations on migraine among patients with hereditary hemorrhagic telangiectasia. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3431] [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: 10/18/2022]
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30
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Hiramatsu M, Sugiu K, Ishiguro T, Kiyosue H, Sato K, Takai K, Niimi Y, Matsumaru Y. Angioarchitecture of arteriovenous fistulas at the craniocervical junction: a multicenter cohort study of 54 patients. J Neurosurg 2017; 128:1839-1849. [PMID: 28862546 DOI: 10.3171/2017.3.jns163048] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The aim of this retrospective multicenter cohort study was to assess the details of the angioarchitecture of arteriovenous fistulas (AVFs) at the craniocervical junction (CCJ) and to determine the associations between the angiographic characteristics and the clinical presentations and outcomes. METHODS The authors analyzed angiographic and clinical data for patients with CCJ AVFs from 20 participating centers that are members of the Japanese Society for Neuroendovascular Therapy (JSNET). Angiographic findings (feeding artery, location of AV shunt, draining vein) and patient data (age, sex, presentation, treatment modality, outcome) were tabulated and stratified based on the angiographic types of the lesions, as diagnosed by a member of the CCJ AVF study group, which consisted of a panel of 6 neurointerventionalists and 1 spine neurosurgeon. RESULTS The study included 54 patients (median age 65 years, interquartile range 61-75 years) with a total of 59 lesions. Five angiographic types were found among the 59 lesions: Type 1, dural AVF (22 [37%] of 59); Type 2, radicular AVF (17 [29%] of 59); Type 3, epidural AVF (EDAVF) with pial feeders (8 [14%] of 59); Type 4, EDAVF (6 [10%] of 59); and Type 5, perimedullary AVF (6 [10%] of 59). In almost all lesions (98%), AV shunts were fed by radiculomeningeal arteries from the vertebral artery that drained into intradural or epidural veins through AV shunts on the dura mater, on the spinal nerves, in the epidural space, or on the spinal cord. In more than half of the lesions (63%), the AV shunts were also fed by a spinal pial artery from the anterior spinal artery (ASA) and/or the lateral spinal artery. The data also showed that the angiographic characteristics associated with hemorrhagic presentations-the most common presentation of the lesions (73%)-were the inclusion of the ASA as a feeder, the presence of aneurysmal dilatation on the feeder, and CCJ AVF Type 2 (radicular AVF). Treatment outcomes differed among the angiographic types of the lesions. CONCLUSIONS Craniocervical junction AVFs commonly present with hemorrhage and are frequently fed by both radiculomeningeal and spinal pial arteries. The AV shunt develops along the C-1 or C-2 nerve roots and can be located on the spinal cord, on the spinal nerves, and/or on the inner or outer surface of the dura mater.
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Affiliation(s)
- Masafumi Hiramatsu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Kenji Sugiu
- 1Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - Tomoya Ishiguro
- 2Department of Neuro-Intervention, Osaka City General Hospital, Osaka
| | - Hiro Kiyosue
- 3Department of Radiology, Oita University Faculty of Medicine, Oita
| | - Kenichi Sato
- 4Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai
| | - Keisuke Takai
- 5Department of Neurosurgery, Tokyo Metropolitan Neurological Hospital
| | - Yasunari Niimi
- 6Department of Neuroendovascular Therapy, St. Luke's International Hospital; and
| | - Yuji Matsumaru
- 7Department of Endovascular Neurosurgery, Toranomon Hospital, Tokyo, Japan
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Ura C, Okamura T, Yamazaki S, Ishiguro T, Miyazaki M, Ibe M, Kubota A, Kawamuro Y. RICE-FARMING CARE FOR PEOPLE WITH DEMENTIA; A NOVEL WAY OF SOCIAL PARTICIPATION FOR THE ELDERLY. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- C. Ura
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
| | - T. Okamura
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan,
- University of Tokyo, Tokyo, Japan,
| | | | | | | | - M. Ibe
- Kawamuro Memorial Hospital, Niigata, Japan
| | - A. Kubota
- Kawamuro Memorial Hospital, Niigata, Japan
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Nakajima H, Ishiguro T, Terada A, Komiyama M. Dural Arteriovenous Fistula of the Sinus of the Lesser Sphenoid Wing Presenting with Pontine Hemorrhage. World Neurosurg 2016; 98:871.e17-871.e21. [PMID: 27931945 DOI: 10.1016/j.wneu.2016.11.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 11/28/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dural arteriovenous fistulas (DAVFs) of the sinus of the lesser sphenoid wing (SLSW) with leptomeningeal drainage are rare. We report a patient with a DAVF of the SLSW draining into the basal vein of Rosenthal (BVR) presenting with pontine hemorrhage. CASE DESCRIPTION A 71-year-old man presented with sudden right hemisensory disturbance of the arm and leg. Brain computed tomography scan showed left pontine hemorrhage, and cerebral angiography revealed a DAVF of the left SLSW. The fistula drained solely into the left BVR, which had an anastomosis to the left lateral mesencephalic vein, which had a varix invaginated into the left pons. The diagnosis was a DAVF of the left SLSW drained into the lateral mesencephalic vein via the bridging vein of the left SLSW, the deep middle cerebral vein, and the BVR, and a varix of the lateral mesencephalic vein caused pontine hemorrhage. The fistula was occluded by clipping through frontotemporal craniotomy. The postoperative course was uneventful, and postoperative cerebral angiography confirmed disappearance of the fistula. CONCLUSIONS A DAVF of the SLSW presenting with pontine hemorrhage is extremely rare, and DAVFs with deep leptomeningeal drainage should be included among a variety of etiologies of pontine hemorrhage.
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Affiliation(s)
- Hideki Nakajima
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
| | - Tomoya Ishiguro
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan
| | - Aiko Terada
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan
| | - Masaki Komiyama
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan
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Ishiguro T, Hayashi M, Sugishita Y, Fujiwara W, Kamada T, Naruse H, Ishii J, Kato Y, Ozaki Y, Izawa H. Circulating miR-489 Could be a New Generation Biomarker for Dilated Cardiomyopathy. J Card Fail 2016. [DOI: 10.1016/j.cardfail.2016.07.144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nishikawa K, Fujitani K, Inagaki H, Akamaru Y, Tokunaga S, Takagi M, Tamura S, Sugimoto N, Shigematsu T, Yoshikawa T, Ishiguro T, Nakamura M, Yamane T, Yamada M, Imano M, Iijima S, Nashimoto A, Morita S, Miyashita Y, Tsuburaya A, Sakamoto J, Tsujinaka T. PD-035 Efficacy and safety of second-line irinotecan based chemotherapy in early relapse patients with gastric cancer after adjuvant chemotherapy: exploratory subgroup analysis of TRICS trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.35] [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: 11/14/2022] Open
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Komiyama M, Miyatake S, Terada A, Ishiguro T, Ichiba H, Matsumoto N. Vein of Galen Aneurysmal Malformation in Monozygotic Twin. World Neurosurg 2016; 91:672.e11-5. [PMID: 27102351 DOI: 10.1016/j.wneu.2016.04.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 04/07/2016] [Accepted: 04/08/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Vein of Galen aneurysmal malformation (VGAM) is a rare pediatric vascular malformation of the brain. Genetic backgrounds are not well elucidated. We report on a monozygotic twin with VGAM and his endovascular treatment, and the genetic analyses of the twins and their parents. CASE DESCRIPTION In a monochorionic, diamniotic pregnancy of a 28-year-old healthy woman, monozygotic twins were born by emergency caesarian section because of fetal distress of the smaller twin at 25 weeks' and 4 days' gestation. Although a postnatal cranial ultrasound failed to detect VGAM in the smaller twin, mild heart failure persisted. A brain magnetic resonance (MR) examination of this twin on day 82 revealed choroidal VGAM. The twin was treated successfully by two sessions of embolization at 6 and 8 months of age. An MR examination at 1 year showed minimal residual arteriovenous shunts. He developed normally similar to the normal co-twin, with a follow-up period of 1 year and 6 months. As for the affected twin, no germline mutation or copy number variations were identified in ENG, ALK1, SMAD4, BMPR2, PTEN, RASA1, KRIT1, Marcavernin, or PDCD10 through whole-exome sequencing (WES). CONCLUSION We have reported a rare combination of a monozygotic twin and VGAM and the successful endovascular treatment. Phenotypic discordance in monozygotic twins established early in embryogenesis could be attributable to environmental or epigenetic factors.
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Affiliation(s)
- Masaki Komiyama
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan.
| | - Satoko Miyatake
- Department of Neonatology, Osaka City General Hospital, Osaka, Japan
| | - Aiko Terada
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan
| | - Tomoya Ishiguro
- Department of Neurointervention, Osaka City General Hospital, Osaka, Japan
| | - Hiroyuki Ichiba
- Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Ishiguro T, Takayanagi T, Ikarashi H. Multiple metastatic liver abscesses and intravenous thrombosis due to pelvic actinomycosis. Eur J Obstet Gynecol Reprod Biol 2015; 198:166-167. [PMID: 26726122 DOI: 10.1016/j.ejogrb.2015.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 11/19/2015] [Indexed: 11/17/2022]
Affiliation(s)
- T Ishiguro
- Department of Obstetrics and Gynaecology, Tsuruoka Municipal Shonai Hospital, Izumi-machi, Tsuruoka-city, Yamagata, Japan.
| | - T Takayanagi
- Department of Obstetrics and Gynaecology, Tsuruoka Municipal Shonai Hospital, Izumi-machi, Tsuruoka-city, Yamagata, Japan
| | - H Ikarashi
- Department of Obstetrics and Gynaecology, Tsuruoka Municipal Shonai Hospital, Izumi-machi, Tsuruoka-city, Yamagata, Japan
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Nakajima H, Ishiguro T, Komiyama M. Basilar Artery Dissection Presenting with Subarachnoid Hemorrhage: Report of Two Cases. NMC Case Rep J 2015; 2:97-100. [PMID: 28663975 PMCID: PMC5364892 DOI: 10.2176/nmccrj.2014-0450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/01/2015] [Indexed: 12/25/2022] Open
Abstract
Basilar artery dissection (BAD) presenting with subarachnoid hemorrhage (SAH) is life-threatening, but its treatment has not been established yet. We treated two patients with ruptured BAD. They were 40-year-old and 41-year-old women. Both of them were treated conservatively during the acute stage. In one patient, radiological abnormality of BAD improved spontaneously. In another patient, reconstructive endovascular treatment (stent with coiling) was required in the chronic stage because the lesion deteriorated morphologically. Neither of them suffered from rebleeding and both had favorable outcome. We reported two patients with ruptured BAD treated conservatively during the acute stage and their outcomes were favorable. We reviewed the literature of BAD presenting with SAH and discussed the management for these lesions.
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Affiliation(s)
- Hideki Nakajima
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka
| | - Tomoya Ishiguro
- Department of Neurointervention, Osaka City General Hospital, Osaka, Osaka
| | - Masaki Komiyama
- Department of Neurointervention, Osaka City General Hospital, Osaka, Osaka
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Komiyama M, Terada A, Ishiguro T, Watanabe Y, Nakajima H, Yamada O, Morisaki H. Neuroradiological Manifestations of Hereditary Hemorrhagic Telangiectasia in 139 Japanese Patients. Neurol Med Chir (Tokyo) 2015; 55:479-86. [PMID: 26041630 PMCID: PMC4628199 DOI: 10.2176/nmc.oa.2015-0040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study is to report the neuroradiological manifestations of hereditary hemorrhagic telangiectasia (HHT). One hundred and thirty-nine Japanese HHT patients (73 men and 66 women, aged 2–78 years) were included in this study. Diagnosis of HHT was based on genetic analysis and/or clinical diagnosis of Curaçao. They included 68 HHT1 and 37 HHT2 patients. Essentially, all patients underwent brain magnetic resonance imaging (MRI) and pulmonary computed tomography (CT). Contrast enhanced studies of brain MRI and hepatic CT were performed in a subset of patients. Catheter cerebral angiography was performed when indicated. Their neuroradiological features were reviewed retrospectively. Various imaging abnormalities were found. Brain arteriovenous malformations (AVMs) were observed in 27/136 patients (19.9%, 21 patients with HHT1 and 1 patient with HHT2). Pulmonary arteriovenous fistulas (AVFs) were found in 73/137 patients (65.2%, 45 patients with HHT1 and 6 patients with HHT2). Cerebral infarction and brain abscess were found in 17 patients and 3 patients with pulmonary AVFs, respectively. T1 high lesions in the basal ganglia suggestive of porto-venous shunts were observed in 51/136 patients (37.5%, 9 patients with HHT1 and 28 patients with HHT2). Hepatic AVMs were observed in 61/136 patients (44.9%, 15 patients in HHT1 and 29 patients in HHT2). Brain AVMs and pulmonary AVFs were more common in HHT1 than in HHT2 (both p < 0.01), but hepatic AVMs were conversely more common in HHT2 than in HHT1 (p < 0.01). In conclusion, HHT patients present with a variety of neuroradiological manifestations, which are related to substantial causes of morbid-mortality in HHT.
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Affiliation(s)
- Masaki Komiyama
- Department of Neuro-intervention, Osaka City General Hospital
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Nomura T, Ishiguro T, Ohira M, Ikeda Y, Watanabe M. The establishment of reference standard values for the lower extremity strength in diabetic patients: study design and an interim report. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.2001] [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: 11/30/2022]
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Kumagai Y, Kawada K, Higashi M, Ishiguro T, Sobajima J, Fukuchi M, Ishibashi K, Baba H, Mochiki E, Aida J, Kawano T, Ishida H, Takubo K. Endocytoscopic observation of various esophageal lesions at ×600: can nuclear abnormality be recognized? Dis Esophagus 2015; 28:269-75. [PMID: 24467464 DOI: 10.1111/dote.12183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Endocytoscopy (ECS) is a novel endoscopic technique that allows detailed diagnostic examination of the gastrointestinal tract at the cellular level. We previously reported that use of ECS at ×380 magnification (GIF-Y0002) allowed a pathologist to diagnose esophageal squamous cell carcinoma (ESCC) with high sensitivity (94.9%) but considerably low specificity (46.7%) because this low magnification did not reveal information about nuclear abnormality. In the present study, we used the same magnifying endoscope to observe various esophageal lesions, but employed digital 1.6-fold magnification to achieve an effective magnification of ×600, and evaluated whether this improved the diagnostic accuracy in distinguishing neoplastic from non-neoplastic lesions.We examined the morphology of surface cells using vital staining with toluidine blue and compared the histological features of 40 cases, including 19 case of ESCC and 21 non-neoplastic esophageal lesions (18 cases of esophagitis, 1 case of glycogenic acanthosis, 1 case of leiomyoma, and 1 case of normal squamous epithelium). One endoscopist classified the lesions using the type classification, and we consulted one pathologist for judgment of the ECS images as 'neoplastic', 'borderline', or 'non-neoplastic'. At ×600 magnification, the pathologist confirmed that nuclear abnormality became evident, in addition to the information about nuclear density provided by observation at ×380. The overall sensitivity and specificity with which the endoscopist was able to predict neoplastic lesions using the type classification was 100% (19/19) and 90.5% (19/21), respectively, in comparison with values of 94.7% (18/19 cases) and 76.2% (16/21), respectively, for the pathologist using a magnification of ×600. The pathologist diagnosed two non-neoplastic lesions and one case of ESCC showing an apparent increase of nuclear density with weak nuclear abnormality as 'borderline'. Among the 21 non-cancerous lesions, two cases of esophagitis that were misdiagnosed by the endoscopist were also misinterpreted as 'neoplastic' by the pathologist. We have shown, by consultation with a pathologist, that an ECS magnification of ×600 (on a 19-inch monitor) is adequate for recognition of nuclear abnormality. We consider that it is feasible to diagnose esophageal neoplasms on the basis of ECS images, and that biopsy histology can be omitted if a combination of increased nuclear density and nuclear abnormality is observed.
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Affiliation(s)
- Y Kumagai
- Department of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan
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Nakano Y, Fujisaki H, Ishiguro T, Manabe T, Inoue T, Park YD, Nakamura T, Hara J. Isolated diffuse hemangiomatosis of the spleen with disseminated intravascular coagulation: successful treatment with embolization and splenectomy. J Pediatr 2015; 166:1093-e1. [PMID: 25648291 DOI: 10.1016/j.jpeds.2014.12.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 12/15/2014] [Indexed: 02/02/2023]
Affiliation(s)
- Yoshiko Nakano
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Hiroyuki Fujisaki
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
| | - Tomoya Ishiguro
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takao Manabe
- Department of Radiology, Osaka City General Hospital, Osaka, Japan
| | - Takeshi Inoue
- Department of Pathology, Osaka City General Hospital, Osaka, Japan
| | - Young-Dong Park
- Department of Pediatrics, Osaka Red Cross Hospital, Osaka, Japan
| | - Tetsuro Nakamura
- Department of Pediatric Surgery, Osaka City General Hospital, Osaka, Japan
| | - Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital, Osaka, Japan
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Ishiguro T, van Rooijen W, Shimazu Y, Mochizuki H. Design of a passive residual heat removal system for the FUJI-233Um molten salt reactor system. ANN NUCL ENERGY 2014. [DOI: 10.1016/j.anucene.2013.08.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Affiliation(s)
| | - Tomoya Ishiguro
- Departments of Neurointervention, Osaka City General Hospital
| | - Masaki Komiyama
- Departments of Neurointervention, Osaka City General Hospital
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Komiyama M, Ishiguro T, Yamada O, Morisaki H, Morisaki T. Hereditary hemorrhagic telangiectasia in Japanese patients. J Hum Genet 2013; 59:37-41. [DOI: 10.1038/jhg.2013.113] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/20/2013] [Accepted: 10/11/2013] [Indexed: 11/09/2022]
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Komiyama M, Ishiguro T, Umaba R, Suzuki T. Transcardiac Retrograde Transvenous Embolization of Proximally Occluded Pulmonary Arteriovenous Malformation. Cardiovasc Intervent Radiol 2013; 37:791-4. [DOI: 10.1007/s00270-013-0755-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 08/31/2013] [Indexed: 11/28/2022]
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Ishiguro T, Komiyama M. [Required knowledge for neuroendovascular surgeon (12) pediatric neurointervention]. No Shinkei Geka 2013; 41:731-742. [PMID: 23907481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Tomoya Ishiguro
- Department of Neurointervention, Osaka City General Hospital
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Abstract
The authors present a case in which transfemoral venous, transcardiac cerebral angiography was performed. In this 5-year-old girl with PHACE syndrome, both transfemoral and transbrachial arterial routes could not be used due to aortic interruption and aneurysmal dilation and small looping of the proximal portion of bilateral subclavian arteries. A 5-F balloon-tipped double-lumen catheter was advanced to the right atrium of the heart from the femoral vein. The catheter was then advanced to the left atrium through the patent foramen ovale and was further advanced to the left ventricle and then to the ascending aorta. The balloon catheter was exchanged for a 4-F catheter. Bilateral common carotid angiography was performed without difficulty. This transcardiac approach is useful in the unusual situation in which both femoral and brachial arterial routes are not available.
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Affiliation(s)
- Masaki Komiyama
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
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Yoshimura M, Matsusaka Y, Terada A, Ishiguro T, Nakajima H, Yamanaka K, Iwai Y, Komiyama M, Sakamoto H. [Spontaneous cerebrospinal fluid rhinorrhea associated with long-standing overt ventriculomegaly in adults (LOVA)]. No Shinkei Geka 2012; 40:897-902. [PMID: 23045404] [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: 06/01/2023]
Abstract
OBJECTIVE Spontaneous cerebrospinal fluid rhinorrhea associated with aqueductal stenosis is rare. CSF diversion is reported to be a failure in the majority of cases. The combination of the repair of the skull base and CSF diversion is reported to be successful. We describe a case successfully treated by intradural repair with ventricular drainage followed by endoscopic third ventriculostomy. CLINICAL PRESENTATION A 28-year-old woman presented with rhinorrhea, and occasional attacks of headache, vomiting, and unconsciousness for two years. She had been diagnosed as arrested hydrocephalus for 10 years. Magnetic resonance imaging revealed triventriculomegaly with ballooning of the floor of the third ventricle, tonsilar herniation, right anterior horn herniation into the cribriform plate, and bilateral temporal lobe herniation into the temporal base. INTERVENTION A ventricular drain was inserted followed by dissection of the herniated brain and repair of the enlarged cribriform foramen with periosteal flap. Make sure that the bacterial culture negative, endoscopic third ventriculostomy has been performed. There is no recurrence of hydrocephalus and rhinorrhea for two years. CONCLUSION Direct communication between the lateral ventricle and the nasal/paranasal sinus is a rare complication of aqueductal stenosis and LOVA. Surgical repair of the skull base followed by cerebrospinal fluid diversion with endoscopic third ventriculostomy was a safe and reliable method.
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Affiliation(s)
- Masaki Yoshimura
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
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Onuma T, Kagamitani Y, Hazu K, Ishiguro T, Fukuda T, Chichibu SF. Femtosecond-laser-driven photoelectron-gun for time-resolved cathodoluminescence measurement of GaN. Rev Sci Instrum 2012; 83:043905. [PMID: 22559547 DOI: 10.1063/1.3701368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A rear-excitation femtosecond-laser-driven photoelectron gun (PE-gun) is developed for measuring time-resolved cathodoluminescence (TRCL) spectrum of wide bandgap materials and structures such as semiconductors and phosphors. The maximum quantum efficiency of a 20-nm-thick Au photocathode excited using a frequency-tripled Al(2)O(3):Ti laser under a rear-excitation configuration is 3.6×10(-6), which is a reasonable value for a PE-gun. When the distance between the front edge of the PE-gun and the observation point is 10 mm, the narrowest electron-beam (e-beam) diameter is 19 μm, which corresponds to one tenth of the laser-beam diameter and is comparable to the initial e-beam diameter of a typical W hair-pin filament of thermionic electron-gun. From the results of TRCL measurements on the freestanding GaN grown by the ammonothermal method and a GaN homoepitaxial film grown by metalorganic vapor phase epitaxy, overall response time for the present TRCL system is estimated to be 8 ps. The value is the same as that of time-resolved photoluminescence measurement using the same excitation laser pulses, meaning that the time-resolution is simply limited by the streak-camera, not by the PE-gun performance. The result of numerical simulation on the temporal e-beam broadening caused by the space-charge-effect suggests that the present PE-gun can be used as a pulsed e-beam source for spatio-time-resolved cathodoluminescence, when equipped in a scanning electron microscope.
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Affiliation(s)
- T Onuma
- Center for Advanced Nitride Technology (CANTech), Institute of Multidisciplinary Research for Advanced Materials, Tohoku University, 2-1-1 Katahira, Aoba, Sendai 980-8577, Japan
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Matsushita H, Ishiguro T, Kurabayashi T, Shibuya M. Acute generalized exanthematous pustulosis during the puerperal period: a case report. CLIN EXP OBSTET GYN 2012; 39:414-416. [PMID: 23157063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Acute generalized exanthematous pustulosis (AGEP) is an uncommon adverse cutaneous reaction, most commonly associated with drugs. CASE A 38-year-old primigravida whose labor had been induced developed erythema over her chest and abdomen. She was transferred to our department after a failed vacuum extraction, and delivered a mature infant by forceps. On day three postpartum she developed a 40.4 degrees C fever. Although ceftriaxone was administered, her fever persisted (>38 degreesC). On day six of the puerperium, diffuse non-follicular pustules appeared over her neck and trunk, and AGEP was suspected. Two days after ceftriaxone was withdrawn, the eruptions started to resolve without any medical intervention. CONCLUSION Once the diagnosis of AGEP has been made, the antibiotics being administered must be discontinued. If continued treatment is required, pharmacologically distinct antibiotics must be used instead to aid the rapid self-limitation of the disease.
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Affiliation(s)
- H Matsushita
- Department of Obstetrics & Gynecology, Niigata City General Hospital, Shumoku, Chuo-ku, Niigata, Japan.
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