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Tanaka K, Suzuki T, Kobayashi J, Yasukawa T. [Early Structural Valve Deterioration of Trifecta Aortic Bioprosthesis:Report of a Case]. Kyobu Geka 2023; 76:949-952. [PMID: 38056954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Trifecta, an externally mounted bovine pericardial bioprosthetic aortic valve, provides excellent hemodynamic performance;however, early structural deterioration of this valve has been reported. A 60-year-old man with progressive dyspnea was admitted to the emergency unit of our institution. Seven years prior, he underwent aortic valve replacement with 23-mm Trifecta valve. Severe aortic valve regurgitation and stenosis due to structural valve deterioration was diagnosed and redo aortic valve replacement using an Inspiris valve was performed. Intraoperative findings revealed a large laceration in the left coronary cusp adjacent to the non coronary-left coronary commissure and leaflet calcification. Further, circumferential fibrous pannus ingrowth at the inflow portion was also noted. To avoid anticoagulation therapy and repeat surgery, mitral valve plasty and left atrial appendage clipping were performed simultaneously. Postoperative course was uneventful, and he was transferred to a rehabilitation facility on 36th postoperative day.
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Affiliation(s)
- Keita Tanaka
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
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2
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Sakahashi Y, Higashisaka K, Izutani R, Seo J, Kitahara G, Kobayashi J, Nakamoto Y, Yamamoto R, Tsujino H, Haga Y, Tsutsumi Y. P06-02 Silver nanoparticles inhibit intercellular fusion in the BeWo syncytialization process. Toxicol Lett 2022. [DOI: 10.1016/j.toxlet.2022.07.320] [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: 10/14/2022]
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Fujioka T, Asakawa N, Suzuki T, Kobayashi J, Takahashi K, Tsuchiya K. Giant coronary artery aneurysm associated with Kawasaki disease showing progressive dilation over 30 years. J Cardiol Cases 2021; 23:281-284. [PMID: 34093908 PMCID: PMC8165665 DOI: 10.1016/j.jccase.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/20/2020] [Accepted: 01/20/2021] [Indexed: 10/22/2022] Open
Abstract
A 33-year-old pregnant woman with a history of a giant coronary artery aneurysm (CAA) of the right coronary artery owing to Kawasaki disease (KD) was referred to our hospital for the management of pregnancy and delivery. The CAA was detected when she was 10 months old on the 24th day from the onset of KD and showed transient regression followed by progressive dilation and reached a size of 25 mm when she was 30 years old. The baby was delivered at 38 weeks of gestational age. Resection of the CAA and coronary artery bypass grafting were performed 5 months after the delivery. Pathological results suggest that progressive dilation of the CAA was owing to a reduction in elastic recoiling force caused by partial destruction of the internal elastic lamina and degenerated tunica media against an increase in blood pressure that accompanied the growth of the patient. The pathophysiology of CAAs with atypical clinical course may be different from that of typical CAAs owing to KD. .
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Affiliation(s)
- Tao Fujioka
- Department of Pediatrics, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
| | - Nanae Asakawa
- Department of Pathology, Toho University Ohashi Medical Center, Japan
| | - Toshihiko Suzuki
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Japan
| | - Jotaro Kobayashi
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Japan
| | - Kei Takahashi
- Department of Pathology, Toho University Ohashi Medical Center, Japan
| | - Keiji Tsuchiya
- Department of Pediatrics, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo 150-8935, Japan
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Nakai R, Fujioka T, Okamura K, Suzuki T, Nakao A, Kobayashi J, Tsuchiya K. Survival Outcomes of Two-Stage Intracardiac Repair in Large Ventricular Septal Defect and Trisomy 18. Pediatr Cardiol 2021; 42:821-831. [PMID: 33515091 DOI: 10.1007/s00246-021-02546-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Surgical management has not been encouraged in patients with trisomy 18 (T18) and congenital heart diseases due to poor survival. This study aimed to investigate (1) the appropriateness of palliative surgeries followed by intracardiac repair (ICR) (i.e., two-stage ICR) for patients with a large ventricular septal defect (VSD) and T18, and (2) its impact on their long-term outcomes. METHODS Medical charts of patients with VSD and T18 who underwent two-stage ICR at the Japanese Red Cross Medical Center between January 2005 and December 2019 were retrospectively reviewed. Demographic data, timing, and types of palliative surgeries, information related to ICR, peri- and postoperative clinical information, postoperative survival, and cause of death were collected. The long-term prognosis of patients treated with two-stage ICR was compared with that of patients treated with primary ICR and palliative surgery without ICR. RESULTS Overall, 18 (2 male, 16 female) patients underwent two-stage ICR. Pulmonary artery banding was the initial palliative surgery in all patients after a median duration of 19.5 (range 6-194) days of life. The median age and the mean body weight at the time of ICR were 18.2 (7.6-50.7) months and 6.0 ± 1.0 kg, respectively. The mean pulmonary artery pressure and pulmonary vascular resistance index before ICR were 19.1 ± 7.3 mmHg and 3.4 ± 2.0 U m2, respectively. Overall, 17/18 (94%) patients were discharged after ICR. Fourteen (78%) patients were alive during data collection. None of the patients died of cardiac insufficiency, and the median duration of survival was 46.3 (14.3-186.4) months since birth. Most patients required cardiac medications rather than pulmonary vasodilators at the last follow-up. During the study period, three patients underwent primary ICR, and 46 underwent palliative surgery without ICR. Of those who underwent primary ICR, two died in the hospital on the first and 48th day following ICR, and the third died 179 days after the ICR. The Log-rank test revealed a significantly longer survival for the patients treated with two-stage ICR compared with those treated with palliative surgery without ICR (P = 0.003). CONCLUSION Two-stage ICR improves the long-term survival of patients with VSDs and T18. This safe surgical strategy can also prevent pulmonary hypertension in such patients.
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Affiliation(s)
- Ryosuke Nakai
- Department of Pediatrics, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Tao Fujioka
- Department of Pediatrics, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
| | - Kenichi Okamura
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Toshihiko Suzuki
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Atsushi Nakao
- Department of Neonatology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Jotaro Kobayashi
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Keiji Tsuchiya
- Department of Pediatrics, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
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5
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Shibata M, Saito M, Kobayashi J. P22.08 Paraganglioma of the Anterior Mediastinum. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.605] [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: 10/21/2022]
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Yanagida Y, Amano T, Akai R, Toyoshima A, Kobayashi J, Hashimoto T, Sunami E, Kumasaka T, Sasaki S. Treatment of tumor thrombus in the superior mesenteric vein due to advanced colon cancer with complete surgical resection and chemotherapy: a case report. Surg Case Rep 2020; 6:320. [PMID: 33315157 PMCID: PMC7736432 DOI: 10.1186/s40792-020-01091-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 12/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Tumor thrombus in the superior mesenteric vein secondary to colon cancer is rare. We report a case of tumor thrombus in the superior mesenteric vein and liver metastasis due to advanced colon cancer that was treated with chemotherapy and complete surgical resection. CASE PRESENTATION A 72-year-old man after transverse colectomy with lymph node dissection for advanced colon cancer was diagnosed with tumor thrombus in the superior mesenteric vein and liver metastasis. He underwent adjuvant chemotherapy and had complete surgical tumor resection involving tumor thrombectomy and hepatectomy. There has been no recurrence at 36 months after surgery. CONCLUSION Herein, we report a rare case of tumor thrombus in the superior mesenteric vein related to advanced colon cancer. The combination of chemotherapy and complete surgical tumor resection may provide long-term survival.
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Affiliation(s)
- Yoshitsugu Yanagida
- Department of Coloproctological Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan.
| | - Takahiro Amano
- Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
| | - Ryuji Akai
- Department of Coloproctological Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Akira Toyoshima
- Department of Coloproctological Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Jotaro Kobayashi
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
| | - Takuya Hashimoto
- Department of Hepato-Biliary-Pancreatic and Transplantation Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo , Shibuya-ku, Tokyo, 150-8935, Japan
| | - Eiji Sunami
- Department of Surgery, Kyorin University Hospital, 6-20-2, Shinkawa, Mitaka City, Tokyo, 181-8611, Japan
| | - Toshio Kumasaka
- Department of Pathology, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8953, Japan
| | - Shin Sasaki
- Department of Coloproctological Surgery, Japanese Red Cross Medical Center, 4-1-22, Hiroo, Shibuya-ku, Tokyo, 150-8935, Japan
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Suzuki T, Tanaka K, Kobayashi J. [Hybrid Two-stage Repair of Syphilitic Aortic Aneurysm, Total Arch Replacement and Thoracic Endovascular Aortic Repair;Report of a Case]. Kyobu Geka 2020; 73:1023-1026. [PMID: 33268755] [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: 06/12/2023]
Abstract
Syphilitic aortic aneurysm is seldom seen in the antibiotic era. Statistically the number of patients is increasing today and 10% of them seem to develop syphilitic aortitis. A 59-year-old male visited the emergency room due to chest discomfort and general fatigue. Treponema pallidum latex agglutination (TPLA) and rapid plasma reagin (RPR) were both strongly positive on blood tests. White blood cell counts and C-reactive protein elevation were also found. He couldn't figure out how or when he was suffering from syphilis. He needed to undergo a hybrid 2-stage surgery urgently, Total arch replacement and thoracic endovascular aortic repair (TEVAR), because his thoracic aortic aneurysm was growing more rapidly. No complication has occurred during or after surgery. Computed tomography after surgery showed successful exclusion of the thoracic aneurysm. It is important not to forget that syphilis is one of the causes of aortic aneurysm.
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Affiliation(s)
- Toshihiko Suzuki
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
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Okamoto C, Okada A, Moriuchi K, Amano M, Takahama H, Amaki M, Hasegawa T, Kanzaki H, Fujita T, Kobayashi J, Yasuda S, Izumi C. Prognostic differences between atrial functional mitral regurgitation and ventricular functional mitral regurgitation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Atrial functional mitral regurgitation (A-FMR) has been under-recognized until recently as a cause of FMR, and the prognostic difference between A-FMR and ventricular FMR (V-FMR) has not been fully elucidated. As there has been different mechanisms of FMR suggested in A-FMR and V-FMR, we hypothesized that prognosis and prognostic predictors of A-FMR may differ from those of V-FMR.
Purpose
To investigate the prognosis and prognostic predictors of A-FMR in comparison with V-FMR.
Methods
Among 1312 consecutive patients with grade 3+ (moderate to severe) or 4+ (severe) MR, 378 consecutive FMR patients were identified by excluding patients with degenerative MR, previous cardiac surgery, or concomitant aortic valve disease and/or mitral stenosis. FMR with ejection fraction (EF) <40% or FMR due to regional wall motion abnormalities with leaflet tethering were classified as V-FMR (N=288), and FMR due to left atrial (LA) and/or annular dilatation with preserved or mid-range EF (≥40%) were classified as A-FMR (N=90). All-cause death and heart failure hospitalization were analyzed as cardiovascular (CV) events in this study. Surgical or percutaneous mitral valve intervention without CV events was handled as not reaching an endpoint and these cases were censored.
Results
A-FMR were significantly older (76 [69–82] vs. 70 [58–77] years), higher rates of female (64 vs. 35%) and atrial fibrillation (88 vs. 42%), and lower B-type natriuretic peptide (BNP) values (169 [101–318] vs. 447 [213–952] pg/ml) compared to V-FMR (all P<0.05). On echocardiography, LV end-diastolic and end-systolic dimensions (52 [48–57] vs. 64 [58–72] mm, 34 [31–37] vs. 55 [48–64] mm), respectively) were smaller, and EF (55 [50–60] vs. 28 [19–35] %) and LA volume (99 [73–137] vs. 73 [57–91] ml/m2) were larger in A-FMR (all P<0.05). Effective regurgitant orifice area (32 [26–40] vs. 31 [24–45] mm2) and regurgitant volume (50±15 vs. 52±16 ml) were similar (both n.s.). During a median follow up of 1407 days, 206 (54%) patients developed CV events. Kaplan-Meier analysis revealed that V-FMR had a significantly higher rates of CV events compared to A-FMR (Figure) with adjusted hazard ratio (HR) of 1.762 [1.168–2.660], P=0.007 after adjusted for variables including age, sex, New York Heart Association functional class, previous heart failure hospitalization, estimated glomerular filtration rate (eGFR) and BNP. Further, stepwise multivariate analysis showed that independent prognostic predictors of A-FMR were LA volume and eGFR, while those for V-FMR were LA volume, age, and LV end-systolic dimension.
Conclusions
A-FMR had relatively better prognosis compared to V-FMR, and there were different prognostic predictors between A-FMR and V-FMR. Our results suggest that different treatment strategies need to be considered between A-FMR and V-FMR.
The Kaplan-Meier life table
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- C Okamoto
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - A Okada
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - K Moriuchi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Amano
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Takahama
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Amaki
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Hasegawa
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Kanzaki
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Surgery, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center Hospital, Department of Cardiovascular Medicine, Osaka, Japan
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Fukushima N, Yanase M, Watanabe T, Kuroda K, Nakajima S, Iwasaki K, Fujita T, Fukushima S, Tadokoro N, Kobayashi J. Mid-Term Effectiveness of Everolimus on Heart Transplant Recipients with Renal Dysfunction or Transplant Coronary Artery Atherosclerosis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.602] [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: 11/27/2022] Open
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Watanabe T, Yanase M, Fujita T, Fukushima S, Nakajima S, Kuroda K, Iwasaki K, Yajima S, Tadokoro N, Mochizuki H, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Kobayashi J, Fukushima N. Donor-Transmitted Atherosclerosis and the Occurrence of Cardiac Antibody-Mediated Rejection Influenced on the Development of Cardiac Allograft Vasculopathy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.537] [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: 10/24/2022] Open
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11
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Tadokoro N, Fukushima S, Taguchi T, Shimahara Y, Fujita T, Kobayashi J. How Does Double Tunnel Driveline Derivation Technique Contributes to Treatment of Driveline Infection? J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.052] [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: 11/27/2022] Open
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Iwasaki K, Yoshitake K, Yagi N, Sujino Y, Anegawa E, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Seguchi O, Yanase M, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Incidence, Factors and Prognostic Impact of Re-Exploration for Bleedings after Continuous Flow Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.520] [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: 10/24/2022] Open
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13
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Tanaka K, Suzuki T, Kobayashi J. [Bentall Procedure for Annuloaortic Ectasia in a Patient with Systemic Lupus Erythematosus;Report of a Case]. Kyobu Geka 2020; 73:131-134. [PMID: 32393722] [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
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease, rarely complicated with cardiac valvular abnormality or aortic aneurysm. An asymptomatic 40-year-old woman with a 15-year history of SLE developed annuloaortic ectasia and aortic valve regurgitation. She had long been maintained on steroid therapy for the treatment of SLE. Her serum anti-phospholipid antibodies were positive. An enhanced computed tomography revealed a dilated aortic root and ascending aorta (57 mm in diameter). Cardiac ultrasonography demonstrated severe aortic regurgitation. We performed the Bentall procedure using a composite graft with the Carrel patch technique. Histopathological examination of the aortic wall showed cystic medial necrosis without any evidence of vascu-litis. Careful long-term follow-up is mandatory for assessing the risk of later anastomotic dehiscence and pseudoaneurysm formation.
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Affiliation(s)
- Keita Tanaka
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
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Makino H, Tanaka A, Asakura K, Koezuka R, Tochiya M, Ohata Y, Tamanaha T, Son C, Shimabara Y, Fujita T, Miyamoto Y, Kobayashi J, Hosoda K. Addition of low-dose liraglutide to insulin therapy is useful for glycaemic control during the peri-operative period: effect of glucagon-like peptide-1 receptor agonist therapy on glycaemic control in patients undergoing cardiac surgery (GLOLIA study). Diabet Med 2019; 36:1621-1628. [PMID: 31335979 DOI: 10.1111/dme.14084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 01/20/2023]
Abstract
AIM To test the hypothesis that the addition of a glucagon-like peptide-1 receptor agonist that can decrease glucose levels without increasing the hypoglycaemia risk will achieve appropriate glycaemic control during the peri-operative period. METHODS We studied 70 people with Type 2 diabetes who underwent elective cardiac surgery. Participants were randomized to either an insulin-alone or an insulin plus liraglutide 0.6 mg/day group. We evaluated average M values, which indicated the proximity index of the target glucose level from day 1 to day 10. RESULTS The average M value in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (liraglutide plus insulin 5.8 vs insulin-alone 12.3; P < 0.001). The frequency of insulin dose modification in the liraglutide plus insulin group was significantly lower than that in the insulin-alone group (odds ratio 0.19, 95% CI 0.08-0.49; P < 0.001). The frequency of hypoglycaemia in the liraglutide plus insulin group tended to be lower than that in the insulin-alone group (odds ratio 0.57, 95% CI 0.15-2.23; P = 0.21). CONCLUSIONS The results of this study showed that the addition of low-dose liraglutide to insulin achieved lower M values than insulin alone, suggesting that the addition of low-dose liraglutide may achieve better glycaemic control during the peri-operative period. (Clinical trials registry no.: UMIN 000008003).
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Affiliation(s)
- H Makino
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - A Tanaka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Asakura
- Department of, Data Science, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - R Koezuka
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - M Tochiya
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Ohata
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Tamanaha
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - C Son
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Shimabara
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - T Fujita
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - Y Miyamoto
- Department of, Preventive Cardiology, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - J Kobayashi
- Department of, Adult Cardiac Surgery, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
| | - K Hosoda
- Departments of, Department of, Endocrinology and Metabolism, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. P1671Subclinical persistent hemolysis may affect late renal function deterioration after HeartMateII implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Late renal function dysfunction is an increasingly recognized complication in continuous flow left ventricular assist device (CF-LVAD) patients. Although hemolysis is prevalent in CF-LVAD patients and hemolysis may deteriorate renal function, the influence of persistent hemolysis on renal function in CF-LVAD patients remains to be investigated.
Purpose
To investigate the influence of persistent hemolysis on renal function in CF-LVAD patients, using lactate dehydrogenase (LDH) as a sensitive marker of hemolysis.
Methods
Excluding patients who died or underwent pump exchange for pump thrombosis, we retrospectively reviewed 65 consecutive adults who underwent HeartMateII implantation in our center from May 2011 to October 2017. Patient characteristics, chronotropic change of estimated glomerular filtration rate (eGFR) and LDH values weekly for 4 weeks and every 4 weeks between 4 and 48 weeks after implantation were collected. Then, calculating mean LDH during 48 weeks after implantation, study population was divided into low and high mean LDH groups at the median value of mean LDH.
Results
The median value of mean LDH was 304 U/l. Compared with low LDH patients, though high LDH patients were more likely female and had smaller body surface area, there were no significant difference in pre-operative eGFR between the groups (66.0±23.7 vs. 70.2±25.7 ml/min/1.73m2, p=0.495). After 40 weeks after implantation, high LDH patients had significantly lower eGFR than low LDH patients (71.0±23.7 vs. 87.1±31.4 ml/min/1.73m2, p=0.024). In multivariate linear regression analysis, mean LDH [parameter estimate: −0.10 (95% CI: −0.17 to −0.04), p=0.003] and post-operative pulse pressure [parameter estimate: 0.71 (95% CI: 0.05 to 1.37), p=0.036] were significantly associated with eGFR change during 48 weeks after HeartMateII implantation.
Univariate and multivariate linear regression analysis for eGFR change Univariate parameter estimate 95% CI p value Multivariate parameter estimate 95% CI p value Bilirubin, mg/dl 9.97 3.82 to 16.13 0.002 6.55 −0.43 to 13.53 0.065 BNP, pg/ml 0.01 0.00 to 0.02 0.044 0.00 −0.01 to 0.01 0.528 Mean LDH during 4 to 48 weeks, U/l −0.11 −0.18 to −0.05 <0.001 −0.10 −0.17 to −0.04 0.003 Pre-operative right atrial pressure, mmHg 1.43 0.35 to 2.51 0.010 −0.06 −1.52 to 1.40 0.935 Post-operative pulse pressure, mmHg 0.77 0.03 to 1.52 0.042 0.71 0.05 to 1.37 0.036
Conclusions
High mean LDH and low pulse pressure were associated with a significant decrease in eGFR late after HeartMateII implantation. Subclinical persistent hemolysis may be associated with late renal function deterioration in CF-LVAD patients.
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Affiliation(s)
- K Iwasaki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - O Seguchi
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - H Mochizuki
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kimura
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Kumai
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - K Kuroda
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - S Nakajima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - T Watanabe
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - M Yanase
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
| | - Y Matsumoto
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - S Fukushima
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center, Cardiovascular surgery, Osaka, Japan
| | - N Fukushima
- National Cerebral and Cardiovascular Center, Transplant medicine, Osaka, Japan
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16
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Takata Y, Nakajima S, Kobayashi J, Ono K, Amano Y, Takahashi Y. Current-feedback-stabilized laser system for quantum simulation experiments using Yb clock transition at 578 nm. Rev Sci Instrum 2019; 90:083002. [PMID: 31472606 DOI: 10.1063/1.5110037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 07/28/2019] [Indexed: 06/10/2023]
Abstract
We developed a laser system for the spectroscopy of the clock transition in ytterbium (Yb) atoms at 578 nm based on an interference-filter stabilized external-cavity diode laser (IFDL) emitting at 1156 nm. Owing to the improved frequency-to-current response of the laser-diode chip and the less sensitivity of the IFDL to mechanical perturbations, we succeeded in stabilizing the frequency to a high-finesse ultra-low-expansion glass cavity with a simple current feedback system. Using this laser system, we performed high-resolution clock spectroscopy of Yb and found that the linewidth of the stabilized laser was less than 320 Hz.
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Affiliation(s)
- Y Takata
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - S Nakajima
- The Hakubi Center for Advanced Research, Kyoto University, Kyoto 606-8501, Japan
| | - J Kobayashi
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - K Ono
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Amano
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - Y Takahashi
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
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17
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Ezura M, Kikuchi A, Ishiki A, Okamura N, Hasegawa T, Harada R, Watanuki S, Funaki Y, Hiraoka K, Baba T, Sugeno N, Oshima R, Yoshida S, Kobayashi J, Kobayashi M, Tano O, Nakashima I, Mugikura S, Iwata R, Taki Y, Furukawa K, Arai H, Furumoto S, Tashiro M, Yanai K, Kudo Y, Takeda A, Aoki M. Longitudinal changes in 18 F-THK5351 positron emission tomography in corticobasal syndrome. Eur J Neurol 2019; 26:1205-1211. [PMID: 30980575 DOI: 10.1111/ene.13966] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 04/04/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Corticobasal syndrome (CBS) is pathologically characterized by tau deposits in neuronal and glial cells and by reactive astrogliosis. In several neurodegenerative disorders, 18 F-THK5351 has been observed to bind to reactive astrocytes expressing monoamine oxidase B. In this study, the aim was to investigate the progression of disease-related pathology in the brains of patients with CBS using positron emission tomography with 18 F-THK5351. METHODS Baseline and 1-year follow-up imaging were acquired using magnetic resonance imaging and positron emission tomography with 18 F-THK5351 in 10 subjects: five patients with CBS and five age-matched normal controls (NCs). RESULTS The 1-year follow-up scan images revealed that 18 F-THK5351 retention had significantly increased in the superior parietal gyrus of the patients with CBS compared with the NCs. The median increases in 18 F-THK5351 accumulation in the patients with CBS were 6.53% in the superior parietal gyrus, 4.34% in the precentral gyrus and 4.33% in the postcentral gyrus. In contrast, there was no significant increase in the regional 18 F-THK5351 retention in the NCs. CONCLUSIONS Longitudinal increases in 18 F-THK5351 binding can be detected over a short interval in the cortical sites of patients with CBS. A monoamine oxidase B binding radiotracer could be useful in monitoring the progression of astrogliosis in CBS.
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Affiliation(s)
- M Ezura
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Kikuchi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - A Ishiki
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - N Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.,Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - T Hasegawa
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Harada
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Watanuki
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Y Funaki
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - K Hiraoka
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - T Baba
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - N Sugeno
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Oshima
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Yoshida
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - J Kobayashi
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - M Kobayashi
- Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - O Tano
- Department of Neurology, Sendai Medical Center, Sendai, Japan
| | - I Nakashima
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Neurology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - S Mugikura
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - R Iwata
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - Y Taki
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - K Furukawa
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan.,Division of Community of Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - H Arai
- Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - S Furumoto
- Division of Radiopharmaceutical Chemistry, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - M Tashiro
- Division of Cyclotron Nuclear Medicine, Cyclotron and Radioisotope Center, Tohoku University, Sendai, Japan
| | - K Yanai
- Department of Pharmacology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Y Kudo
- Division of Neuroimaging, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - A Takeda
- Department of Neurology, National Hospital Organization, Sendai Nishitaga Hospital, Sendai, Japan
| | - M Aoki
- Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
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18
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Seguchi O, Fujita T, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Tsukiya T, Mizuno T, Katagiri N, Kakuta Y, Takewa Y, Hamasaki T, Yamamoto H, Tatsumi E, Kobayashi J, Fukushima N. Novel Extracorporeal Continuous-Flow Ventricular Assist System for Patients with Advanced Heart Failure. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.871] [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: 10/27/2022] Open
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19
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Kimura Y, Seguchi O, Mochizuki H, Iwasaki K, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Matsumoto Y, Fukushima S, Yanase M, Fujita T, Kobayashi J, Fukushima N. Role of Gallium-SPECT-CT in Predicting Outcomes of Patients with Ventricular Assist Device-Specific Percutaneous Driveline Infection. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.800] [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] Open
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20
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Koga A, Fukushima S, Matsumoto Y, Otani K, Fukushima N, Ishibashi-Ueda H, Harada-Shiba M, Kobayashi J, Suzuki K, Fukui T, Fujita T. Role of Immunocompetent Cells in Functional Recovery Post-Implantation of Ventricular Assist Device in Non-Ischemic Dilated Cardiomyopathy. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.892] [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: 12/01/2022] Open
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21
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Miko K, Kobayashi J, Ono Y, Tanino T, Uchida N. EP-1751 Topical skin agent application-thickness influence on surface dose in external radiation therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32171-1] [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: 10/26/2022]
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22
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Iwasaki K, Seguchi O, Mochizuki H, Kimura Y, Toda K, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Terminal Ileac Ulcers Mimicked Post-transplantation Lymphoproliferative Disorder in a Heart Recipient Treated With Everolimus: A Case Report. Transplant Proc 2018; 50:4053-4056. [PMID: 30577313 DOI: 10.1016/j.transproceed.2018.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/29/2018] [Indexed: 02/07/2023]
Abstract
Post-transplant lymphoproliferative disorder (PTLD) is a well-recognized and potentially fatal complication of cardiac transplantation that commonly involves the gastrointestinal tract. Herein, we report a case of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers mimicking PTLD in a heart recipient treated with everolimus (EVL). A 40-year-old man underwent heart transplantation for dilated cardiomyopathy 3 years prior to the current admission and was treated with tacrolimus and EVL. He was admitted to a local hospital because of fever, abdominal pain, and diarrhea. His symptoms persisted and, 3 weeks later, hematochezia occurred; thus, he was transferred to our hospital. As computed tomography and 18F-fluorodeoxyglucose positron emission tomography showed bowel-wall thickening of the terminal ileum, gastrointestinal PTLD was initially suspected. However, although colonoscopy- performed after switching EVL to mycophenolate mofetil (MMF)-showed terminal ileac ulcers, the histologic examination revealed no findings corresponding to PTLD. As EVL may delay ulcer healing, MMF was maintained for 3 months. After repeated colonoscopy showed ulcer healing, MMF was switched back to EVL for cardiac allograft vasculopathy prevention. Three weeks later, he was emergently admitted to a local hospital for life-threatening gastrointestinal bleeding from a recurrent terminal ileal ulcer, which required hemostatic forceps hemostasis. As EVL is suspected to be associated with recurrent ileal ulcers, EVL was again switched back to MMF. The ileal ulcers resolved, without recurrence in 3 months of clinical follow-up. This case demonstrates that cases of life-threatening gastrointestinal bleeding from recurrent terminal ileac ulcers can mimic PTLD in a heart recipient treated with EVL.
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Affiliation(s)
- K Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - O Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - H Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - K Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - M Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - N Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
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23
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Kobayashi J, Luo S, Haranal M, Parker M, Wang J, Haller C, Honjo O. PRESSURE-TARGETED PERFUSION IS THE OPTIMAL STRATEGY OF THE PEDIATRIC EX-VIVO HEART PERFUSION FOR DONATION AFTER CARDIAC DEATH IN PORCINE MODEL. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.140] [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: 11/27/2022] Open
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24
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Kobayashi M, Watanabe H, Hasegawa H, Tsukamoto K, Suzuki R, Kyoya T, Saito S, Kobayashi J. Morphokinetic parameters assessed by time-lapse monitoring associate with clinical outcomes in morphologically good quality frozen-thawed blastocyst transfer. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1037] [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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25
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Okamoto C, Okada A, Kanzaki H, Hamatani Y, Takahama H, Amaki M, Hasegawa T, Sugano Y, Fujita T, Kobayashi J, Yasuda S, Izumi C. P2577Peak E wave velocity may predict cardiovascular events in asymptomatic degenerative mitral regurgitation in sinus rhythm. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Okamoto
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - A Okada
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Kanzaki
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Hamatani
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - H Takahama
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - M Amaki
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Hasegawa
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - Y Sugano
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - T Fujita
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - J Kobayashi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - S Yasuda
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
| | - C Izumi
- National Cerebral and Cardiovascular Center, Department of Cardiovascular Medicine, Osaka, Japan
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26
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Kumai Y, Seguchi O, Sato T, Wada K, Shiozawa M, Yokota C, Kuroda K, Nakajima S, Sato T, Yanase M, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Reversible Cerebral Vasoconstriction Syndrome After Heart Transplantation: A Case Report. Transplant Proc 2018; 49:2415-2418. [PMID: 29198694 DOI: 10.1016/j.transproceed.2017.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Reversible cerebral vasoconstriction syndrome (RCVS) is a transient cerebrovascular disorder putatively caused by some immunosuppressive agents. CASE REPORT We recently encountered a 47-year-old female patient diagnosed with dilated cardiomyopathy who developed RCVS after heart transplantation. A triple-drug regimen consisting of tacrolimus, mycophenolate mofetil, and a corticosteroid was started after surgery. On postoperative day (POD) 11, the patient developed a severe headache, although computed tomography of the head demonstrated no signs of hemorrhage or infarction. At first, both a painkiller and migraine drugs were regularly administered to the patient. On POD 21, however, she developed an unbearable headache with a visual field defect and mild hemiparesis of the right hand. Magnetic resonance imaging (MRI) of the brain revealed a cerebral infarction in the left occipital lobe with diffuse vasoconstriction of both the middle and posterior cerebral arteries. A diagnosis of RCVS was made and tacrolimus, a drug suspected to cause RCVS, was discontinued. In its place, two doses of basiliximab followed by everolimus, both of which are alternatives for tacrolimus, were given. The corticosteroid dose was also increased. Furthermore, to release vasoconstriction, both verapamil and diltiazem were administered. On POD 27, cerebrovascular constrictions were shown to be relieved on brain MRI and the patient's neurological symptoms subsequently almost completely diminished. CONCLUSION RCVS should always be considered as a cause of headache in heart transplant recipients because tacrolimus, an immunosuppressive agent, may trigger RCVS. This will allow rapid intervention that is essential for avoiding irreversible neurological deficits.
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Affiliation(s)
- Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - T Sato
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Shiozawa
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - C Yokota
- Department of Stroke and Cerebrovascular Diseases, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Sato
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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27
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Wakamiya A, Seguchi O, Shionoiri A, Kumai Y, Kuroda K, Nakajima S, Yanase M, Matsuda S, Wada K, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Paradoxical Reaction of Tuberculosis in a Heart Transplant Recipient During Antituberculosis Therapy: A Case Report. Transplant Proc 2018; 50:947-949. [PMID: 29661467 DOI: 10.1016/j.transproceed.2018.01.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Tuberculous paradoxical reactions (PRs) are excessive immune reactions occurring after antituberculosis (TB) treatment and are commonly observed in immunocompromised hosts such as patients infected with the human immunodeficiency virus. CASE REPORT We recently encountered a 63-year-old male heart transplant recipient who developed tuberculous PR after treatment for miliary TB. The patient had been receiving immunosuppressive therapy with cyclosporine and mycophenolate mofetil for over 15 years. The diagnosis of miliary TB was made based on the presence of intermittent fever and fatigue; thus, anti-TB treatments (isoniazid, levofloxacin, ethambutol, and pyrazinamide) were started, which led to rapid defervescence and regression of the granular shadow and pleural effusion. However, a new persistent fever and confused state developed 1 month after the anti-TB therapy was started. After excluding possible etiologies of the patient's symptom, a PR was suspected, and anti-TB drugs were continued; corticosteroids were added as anti-inflammatory agents. After that, he has shown a favorable course with long-term anti-TB chemotherapy. CONCLUSION A PR should always be considered when the patients' symptoms of tuberculosis re-exacerbate after an appropriate anti-TB therapy. A PR commonly occurs in patients with various immunologic conditions including heart transplant recipients.
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Affiliation(s)
- A Wakamiya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - A Shionoiri
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Matsuda
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
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28
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Iwasaki K, Kimura Y, Toda K, Kikuchi N, Kumai Y, Kuroda K, Seguchi O, Yanase M, Matsumoto Y, Fujita T, Kobayashi J, Fukushima N. Impact of Creatinine Excretion Rate, a Maker of Sarcopenia, on Prediction of Mortality and Neurological Events in Advanced Heart Failure Patients With Left Ventricular Assist Device. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.700] [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: 10/17/2022] Open
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29
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Matsumoto Y, Fujita T, Fukushima S, Shimahara Y, Kume Y, Yamashita K, Kawamoto N, Kobayashi J. Impact of Late Aortic Regurgitation in Patients with HeartMate II. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.952] [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: 10/17/2022] Open
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Matsumoto Y, Fujita T, Fukushima S, Shimahara Y, Kume Y, Yamashita K, Kawamoto N, Kobayashi J. Early Postoperative Heparinization is Crucial for Prevention of Cerebral Vascular Accident in Patients with HeartMate II. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.951] [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: 10/17/2022] Open
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Tomokawa S, Kaewviset S, Saito J, Akiyama T, Waikugul J, Okada K, Kobayashi J, Jimba M. Key factors for school health policy implementation in Thailand. Health Educ Res 2018; 33:186-195. [PMID: 29509891 DOI: 10.1093/her/cyy008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 02/09/2018] [Indexed: 06/08/2023]
Abstract
Thailand formulated a National School Health Policy (NSHP) in 1998, and it has been widely implemented but has not been evaluated. This case study aimed to identify factors that have influenced the implementation of NSHP in Thailand. For this purpose, we conducted a document review and key informant interviews. We selected key interviewees, from NSHP implementers at national, provincial and school levels in four geographical areas. We adopted a content analysis method, using a framework of 12 influential components of successful policy implementation and triangular policy framework. This study showed that NSHP was well-disseminated and implemented at whole country. We identified seven positive factors influencing NSHP implementation, namely matching with ongoing educational strategy, competition and encouragement by an awarding system, sustainable human capacity building at school level, participation of multiple stakeholders, sufficient understanding and acceptance of school health concepts, sharing information and collaboration among schools in the same clusters and functional fund raising activities. In addition, we identified three negative factors, namely lack of institutional sustainability, vague role of provincial officers and diverse health problems among Thai children. The government should clarify the role of provincial level and set up institutionalized capacity-building system as measures to strengthen monitoring and evaluation activities.
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Affiliation(s)
- S Tomokawa
- Department of Sports and Health Sciences, Faculty of Education, Shinshu University, 6-Ro Nishi Nagano, Nagano City, Nagano 380-8544, Japan
- Japanese Consortium for Global School Health and Research, Japan
| | - S Kaewviset
- Office of International Cooperation Faculty of Science, Mahidol University, 272 Rama 6 Road, Bangkok 10400, Thailand
| | - J Saito
- Japanese Consortium for Global School Health and Research, Japan
- Department of Health and Social Behavior/Health Education and Health Sociology, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - T Akiyama
- Japanese Consortium for Global School Health and Research, Japan
- Department of Health Science, Nagano College of Nursing, 1694 Akaho, Komagane, Nagano 399-4117, Japan
| | - J Waikugul
- School Health Promotion Unit, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchawithi Road, Bangkok 10400, Thailand
| | - K Okada
- Japanese Consortium for Global School Health and Research, Japan
- Department of School Health Nursing, Faculty of Education, Chiba University, 1-33 Yayoi, Inage-ku, Chiba 263-8522, Japan
| | - J Kobayashi
- Japanese Consortium for Global School Health and Research, Japan
- Department of Global Health, School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan
| | - M Jimba
- Japanese Consortium for Global School Health and Research, Japan
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Kakuta T, Fujita T, Fukushima S, Kawamoto N, Matsumoto Y, Yamashita K, Kume Y, Shimahara Y, Fukushima N, Kitamura S, Kobayashi J. Benefit of Modified Bicaval Anastomosis Technique for Orthotopic Heart Transplantation From Size-mismatch Marginal Donor. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1114] [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: 10/17/2022] Open
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Seguchi O, Kuroda K, Kumai Y, Nakajima S, Yanase M, Wada K, Matsumoto Y, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Clinical Outcomes of Patients With the HeartMate II Left Ventricular Assist Device: A Single-center Experience From Japan. Transplant Proc 2018; 50:2726-2732. [PMID: 30401385 DOI: 10.1016/j.transproceed.2018.03.091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 03/02/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Left ventricular assist device (LVAD) therapy is the "gold standard" alternative therapy for patients with advanced heart failure. However, LVAD therapy is still uncommon in the Asia-Pacific region. Therefore, we aimed to elucidate the clinical outcomes of patients from Japan supported with the HeartMate II (HM-II) LVAD at our institution. METHODS Ninety-two patients (mean 44.3 ± 12.1 years, 68 men, average body mass index 1.65 ± 0.28 m2; 81 with nonischemic cardiomyopathy) who underwent HM-II implantation for bridge to transplantation (n = 91) or for destination therapy in a clinical study (n = 1) at the National Cerebral and Cardiovascular Center between April 2013 and October 2017 were enrolled in this analysis. Preoperatively, most patients (n = 73, 79%) had an INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) profile of between level 2 and 4. Postoperatively, the average pump speed was 8602 ± 258 rpm and the hemodynamics were well compensated. RESULTS Adverse events consisted of 38 (41.3%) hemolysis, 30 (32.6%) major infection, 27 (29.3%) major bleeding (6 [6.5%] with gastrointestinal bleeding), and 18 (19.6%) neurologic dysfunction events. Eighteen patients underwent heart transplantation (HTx) after an average of 32.9 ± 8.9 months of VAD support, and overall survival at both 6 months and 3 years was 96.3%. CONCLUSION Clinical outcome among patients with HM-II at our institution is satisfactory for both survival and adverse events. The HM-II can provide effective hemodynamic support during the extremely long waiting period for HTx in Japan.
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Affiliation(s)
- O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Kumai
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - K Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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Kobayashi J, Yanagisawa R, Ono T, Tatsuzawa Y, Tokutake Y, Kubota N, Hidaka E, Sakashita K, Kojima S, Shimodaira S, Nakamura T. Administration of platelet concentrates suspended in bicarbonated Ringer's solution in children who had platelet transfusion reactions. Vox Sang 2017; 113:128-135. [DOI: 10.1111/vox.12608] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/19/2017] [Accepted: 09/24/2017] [Indexed: 02/06/2023]
Affiliation(s)
- J. Kobayashi
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
| | - R. Yanagisawa
- Life Science Research Center; Nagano Children's Hospital; Azumino Japan
- Division of Blood Transfusion; Shinshu University Hospital; Matsumoto Japan
- Center for Advanced Cell Therapy; Shinshu University Hospital; Matsumoto Japan
| | - T. Ono
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
| | - Y. Tatsuzawa
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
| | - Y. Tokutake
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
| | - N. Kubota
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
- Life Science Research Center; Nagano Children's Hospital; Azumino Japan
| | - E. Hidaka
- Department of Laboratory Medicine; Nagano Children's Hospital; Azumino Japan
- Life Science Research Center; Nagano Children's Hospital; Azumino Japan
| | - K. Sakashita
- Department of Hematology/Oncology; Nagano Children's Hospital; Azumino Japan
| | - S. Kojima
- Division of Blood Transfusion; Shinshu University Hospital; Matsumoto Japan
| | - S. Shimodaira
- Department of Regenerative Medicine; Kanazawa Medical University; Uchinada-Cho Kahoku-Gun Japan
| | - T. Nakamura
- Life Science Research Center; Nagano Children's Hospital; Azumino Japan
- Division of Neonatology; Nagano Children's Hospital; Azumino Japan
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Harada R, Endo K, Nakamura T, Kobayashi J, Higuchi J. Acute ischemic stroke caused by reversible cerebral vasoconstriction syndrome combined with moyamoya disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3648] [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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Hasegawa T, Yoshida S, Suzuki M, Sugeno N, Kobayashi J, Ezura M, Kikuchi A, Takeda A, Mochizuki H, Nagai Y, Aoki M. Parkinson’s disease-linked DNAJC13 mutation aggravates alpha-synuclein-induced neurotoxicity through alteration of endosomal trafficking. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.656] [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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37
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Ikenouchi H, Suzuki Y, Nakamura N, Watanabe G, Tsukita K, Nakamura T, Kobayashi J, Ohshima R, Sugeno N, Kuroda H, Aoki M. Paradoxical cerebral embolism after gastrointestinal endoscopy in a patient with Crohn’s disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3676] [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: 11/28/2022]
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38
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Goda T, Kobayashi J, Watanabe A, Takahashi D, Hazama T. Thrombolysis in patients with mild ischemic strokes. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3641] [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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39
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Ishizuka M, Yamada S, Maemura S, Yamamoto K, Takizawa M, Uozumi H, Minegishi S, Kobayashi J, Ikenouchi H. Axillofemoral Bypass Markedly Improved Acute Decompensated Heart Failure and Kidney Injury in a Patient with Severely Calcified Stenosis of Thoracoabdominal Aorta (Atypical Aortic Coarctation). Int Heart J 2017; 58:820-823. [PMID: 28966318 DOI: 10.1536/ihj.16-463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Atypical aortic coarctation (AAC) has been reported to occur anywhere along the aorta, except for the ascending aorta. The associated symptoms include hypotension in the lower half of the body, secondary hypertension in the upper half of the body, and heart failure. Here we present an 80-year-old Asian woman complaining of progressive exertional dyspnea. She was diagnosed with acute decompensated heart failure and kidney injury due to severely calcified stenosis of the thoracoabdominal aorta, the so called AAC. She received hemodiafiltration, and pulmonary congestion improved in part. Generally, surgical treatments are quite invasive in elderly patients. Endovascular stent graft placement is less invasive, however, fracture and rupture should be considered at severely calcified lesions like this case. Therefore, we selected extra-anatomical axillofemoral bypass. Her recovery after the surgery was remarkable. In a few days, she became free from hemodiafiltration, intravenous diuretics, and oxygen administration. We thought the contributive factors are the increase in kidney blood flow and the correction of afterload mismatch. The decrease in pulse pressure may reflect the reduction in systemic arterial compliance by axillofemoral bypass. The operative mortality of axillofemoral bypass was reported to be acceptable, although the patency of the axillofemoral bypass graft was not high enough. In conclusion, axillofemoral bypass is effective and feasible for elderly patients with acute decompensated heart failure and kidney injury due to AAC.
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Affiliation(s)
| | | | - Sonoko Maemura
- Department of Cardiology, Japanese Red Cross Medical Center
| | | | | | - Hiroki Uozumi
- Department of Cardiology, Japanese Red Cross Medical Center
| | - Sachito Minegishi
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center
| | - Jotaro Kobayashi
- Department of Cardiovascular Surgery, Japanese Red Cross Medical Center
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Kikumoto A, Watanabe H, Hasegawa H, Suzuki R, Tsukamoto K, Kyoya T, Kobayashi M, Saito S, Kobayashi J. Clinical evaluation of two generations of time lapse imaging systems. Fertil Steril 2017. [DOI: 10.1016/j.fertnstert.2017.07.483] [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: 11/27/2022]
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41
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Kobayashi J, Tahara T, Matsuzaki Y, Ono Y, Matsumoto J, Sato H, Onko K, Kishimoto Y, Tanino T, Sakaguchi H, Uchida N. PO-0999: Control of rectal volume with Kampo formula during prostate radiotherapy: A prospective study. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31435-4] [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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42
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Kuroda K, Sunami H, Matsumoto Y, Nakajima S, Sato T, Seguchi O, Hata H, Yanase M, Fujita T, Kobayashi J, Fukushima N. Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in Heart Transplant Recipients With Transplant Coronary Arterial Vasculopathy. Transplant Proc 2017; 49:130-134. [PMID: 28104120 DOI: 10.1016/j.transproceed.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Transplant coronary arterial vasculopathy (TCAV) is a major cause of death after heart transplantation (HTx). Palliative coronary revascularization has been attempted in patients with severe TCAV; however, the outcome has not been fully elucidated. METHODS Ninety-six patients who were treated after HTx at our institute between 1999 and 2015 were screened for TCAV. TCAV was defined as >70% stenosis on coronary angiography (CAG) or a maximal intimal thickness of >0.5 mm in the right or left coronary arteries on intracoronary ultrasonography (IVUS). In the present study, the outcomes of patients with severe TCAV who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) were investigated. RESULTS TCAV containing donor-transmitted atherosclerosis was cumulatively found in 69 patients (71.9% of the total; mean age, 34.6 ± 13.1 years; 52 men; mean follow-up duration, 83.0 ± 60.4 months). Five (7.2%) and 64 (92.8%) of the 69 patients were diagnosed as having TCAV by use of CAG and IVUS, respectively. All 5 patients diagnosed by with the use of CAG underwent coronary revascularization between 1 and 236 months after HTx. Three patients underwent PCI with drug-eluting stents, with a primary success rate of 100%. No angiographic restenosis occurred in 2 patients at 31 and 36 months after PCI, respectively. Meanwhile, 2 patients underwent CABG. No peri-operative complications occurred, and all grafts were patent as assessed by use of CAG at 34 and 5 months after CABG. CONCLUSIONS Coronary revascularization was feasible and effective for severe TCAV with middle-term follow-up.
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Affiliation(s)
- K Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - H Sunami
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - S Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Sato
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - O Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Hata
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - M Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - T Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - J Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - N Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Osaka, Japan
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Kato K, Wang Y, Kobayashi J, Julienne PS, Inouye S. Isotopic Shift of Atom-Dimer Efimov Resonances in K-Rb Mixtures: Critical Effect of Multichannel Feshbach Physics. Phys Rev Lett 2017; 118:163401. [PMID: 28474928 DOI: 10.1103/physrevlett.118.163401] [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] [Received: 10/25/2016] [Indexed: 06/07/2023]
Abstract
Multichannel Efimov physics is investigated in ultracold heteronuclear admixtures of K and Rb atoms. We observe a shift in the scattering length where the first atom-dimer resonance appears in the ^{41}K-^{87}Rb system relative to the position of the previously observed atom-dimer resonance in the ^{40}K-^{87}Rb system. This shift is well explained by our calculations with a three-body model including van der Waals interactions, and, more importantly, multichannel spinor physics. With only minor differences in the atomic masses of the admixtures, the shift in the atom-dimer resonance positions can be cleanly ascribed to the isolated and overlapping Feshbach resonances in the ^{40}K-^{87}Rb and ^{41}K-^{87}Rb systems, respectively. Our study demonstrates the role of multichannel Feshbach physics in determining Efimov resonances in heteronuclear three-body systems.
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Affiliation(s)
- K Kato
- Graduate School of Science, Osaka City University, Sumiyoshi-ku, Osaka 558-8585, Japan
| | - Yujun Wang
- Department of Physics, Kansas State University, 116 Cardwell Hall, Manhattan, Kansas 66506, USA
| | - J Kobayashi
- Department of Physics, Graduate School of Science, Kyoto University, Kyoto 606-8502, Japan
| | - P S Julienne
- Joint Quantum Institute, University of Maryland and NIST, College Park, Maryland 20742, USA
| | - S Inouye
- Graduate School of Science, Osaka City University, Sumiyoshi-ku, Osaka 558-8585, Japan
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44
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Kuroda K, Kumai Y, Sunami H, Nakajima S, Sato T, Seguchi O, Yanase M, Matsumoto Y, Hata H, Fujita T, Kobayashi J, Fukushima N. Ventricular Assist Device Support for Ischemic Cardiomyopathy: A Single-Center Experience in Japan. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.952] [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: 11/29/2022] Open
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45
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Suzuki R, Watanabe H, Hasegawa H, Tsukamoto K, Kobayashi M, Kyoya T, Saito S, Kobayashi J. Time-lapse observation can help improve workflow and ensure the correct observation of fertilized embryos. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.996] [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: 11/15/2022]
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46
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Nakajima K, Usui S, Shinohata R, Miyashita K, Imamura S, Kobayashi J, Machida T, Sumino H, Murakami M. Most of the hepatic triglyceride lipase (HTGL) is bound to apoE-rich HDL in post-heparin plasma. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.563] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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47
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Nakajima S, Okada N, Kuroda K, Hisamatsu E, Sunami H, Sato T, Seguchi O, Yanase M, Hata H, Fujita T, Fukushima N, Kobayashi J, Nakatani T. The Role of Biventricular Assist Device on Patients with Multiorgan Failure Due to Fulminant Myocarditis: Single-Center Experience. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.1146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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48
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Watanabe T, Seguchi O, Yanase M, Fujita T, Sato T, Sunami H, Nakajima S, Nishimura K, Hisamatsu E, Kuroda K, Okada N, Wada K, Hata H, Ishibashi-Ueda H, Miyamoto Y, Kobayashi J, Fukushima N, Nakatani T. Relationship Between Brachial Artery Flow-Mediated Dilation and Clinical Characteristics of Heart Transplant Recipients. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.578] [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] Open
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49
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Hata H, Fujita T, Ishibashi-Ueda H, Fukushima N, Nakatani T, Kobayashi J. Primary Graft Dysfunction after Heart Transplantation with High Frequency of Marginal Donor Hearts. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.849] [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: 11/27/2022] Open
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50
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Sato T, Seguchi O, Kanaumi Y, Yanase M, Okada N, Kuroda K, Hisamatsu E, Sunami H, Nakajima S, Hata H, Fujita T, Ishibashi-Ueda H, Fukushima N, Kobayashi J, Nakatani T. Clinical Implication of Non-Complement-Binding De Novo Donor-Specific Anti-HLA Antibodies in Heart Transplant Recipients: Do We Really Have to Care All the DSA Positive Patients? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.585] [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: 11/28/2022] Open
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