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Effects of Β‒Blocker Administration on Cardiac Function: A Coronary Computed Tomography Angiography Study. Curr Med Imaging 2022; 18:1517-1525. [PMID: 35593335 PMCID: PMC9903291 DOI: 10.2174/1573405618666220518104929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/30/2022] [Accepted: 04/07/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND β-blockers are widely used for lowering heart rate (HR) during coronary computed tomography angiography (CCTA); however, they should be used with caution for patients with heart failure as they may have a negative inotropic effect. OBJECTIVE To clarify the effects of β-blockers (oral and intravenous injection) on cardiac function using CCTA. METHODS A total of 244 patients (men: women = 166: 78; mean age, 64.4 years old) suspected of having ischemic cardiac disease and had undergone echocardiography within 3 months before and after CCTA were included in the study. Systematic errors in ejection fraction (EF) were corrected by calculating ΔEF from the EF difference between echocardiography and CCTA in patients not using β- blockers. Univariate and multivariate analyses were performed for factors affecting ΔEF. In addition, HR between, before, and during CCTA were compared by Wilcoxon's test. RESULTS Temporary oral or intravenous administration of β-blockers at the CCTA had no significant effects on EF (p = 0.70), whereas HR was significantly decreased (p < 0.001). However, regular administration of β-blockers increases the EF on CCTA. CONCLUSION The administration of β-blockers immediately before CCTA affects HR but not EF. Premedication with β-blockers can be safely used for patients who undergo CCTA, and CCTA is useful for EF evaluation, independent of the use of β-blockers.
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Ovarian reserve may influence the outcome of bone mineral density in patients with long-term use of dienogest. SAGE Open Med 2021; 9:20503121211005992. [PMID: 35154758 PMCID: PMC8826102 DOI: 10.1177/20503121211005992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: Long-term administration of dienogest, which is known to have effect on bone mineral density, is frequently done in patients with endometriosis and adenomyosis, but a few studies focused on the bone mineral density changes after finishing the long-term therapy. This study aimed to reveal the factors that adversely affect lumbar bone mineral density. Method: Fifty-seven premenopausal women who visited our hospital were diagnosed as either endometriosis or adenomyosis, and they were treated by dienogest for more than 115 weeks (26.5 months). Based on a previous report, bone mineral density changes less than 2% was categorized as the osteopenic group ( n = 30), and the others were assigned to the unchanged group ( n = 27). Bone mineral density was measured at the lumbar spine using dual-energy X-ray absorptiometry. A representative ovarian reserve marker, endogenous estradiol levels, and follicle-stimulating hormone levels were measured over time and were compared between the osteopenic and unchanged groups. Result: Duration of dienogest intake was 59.5 months (osteopenic group) versus 57.5 months (unchanged group). These patients experienced ovarian surgeries in a similar frequency, but the ovarian reserve in osteopenic group was impaired as suggested by the decline of endogenous estradiol level during intake of dienogest compared to that of unchanged group ( p = 0.0146). Endogenous follicle-stimulating hormone level between osteopenic group and unchanged group did not reach statistically significant difference, although the osteopenic group showed relatively higher level. Conclusion: This study might suggest that decreased ovarian reserve as judged by endogenous estradiol level is a factor that negatively affect bone mineral density, and measurement of endogenous estradiol level during intake of dienogest could have a predictive meaning of future decreased bone mineral density level.
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Overcoming the ceiling effects of experts' motor expertise through active haptic training. SCIENCE ADVANCES 2020; 6:6/47/eabd2558. [PMID: 33219034 PMCID: PMC7679166 DOI: 10.1126/sciadv.abd2558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Abstract
One of the most challenging issues among experts is how to improve motor skills that have already been highly trained. Recent studies have proposed importance of both genetic predisposition and accumulated amount of practice for standing at the top of fields of sports and performing arts. In contrast to the two factors, what is unexplored is how one practices impacts on experts' expertise. Here, we show that training of active somatosensory function (active haptic training) enhances precise force control in the keystrokes and somatosensory functions specifically of expert pianists, but not of untrained individuals. By contrast, training that merely repeats the task with provision of error feedback, which is a typical training method, failed to improve the force control in the experts, but not in the untrained. These findings provide evidence that the limit of highly trained motor skills could be overcome by optimizing training methods.
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MITOCHONDRIAL DISEASES & METABOLIC MYOPATHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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MITOCHONDRIAL DISEASES & METABOLIC MYOPATHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Clinical features and progression of dysphagia in bulbar-onset or limb-onset amyotrophic lateral sclerosis between patients with genetic mutations and those without mutations. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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CTA/CTG repeat sizes in the atxn8os gene afefct age at onset and phenotype in spinocerebellar ATAXIA type8. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Structure-activity relationships of Baikal seal estrogen receptors and environmental phenols. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Coronary plaque characteristics in computed tomography and 2-year outcomes: The PREDICT study. J Cardiovasc Comput Tomogr 2018; 12:436-443. [DOI: 10.1016/j.jcct.2018.07.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/03/2018] [Accepted: 07/06/2018] [Indexed: 02/07/2023]
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2435Important roles of cardiac lymphatic vessels in the regulation of coronary vasomotion after DES implantation in pigs in vivo. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.2435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Coronary arterial spasm detected by coronary computed tomography angiography and confirmed by intravascular ultrasound. Radiol Case Rep 2018; 13:14-17. [PMID: 29552237 PMCID: PMC5850873 DOI: 10.1016/j.radcr.2017.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 11/18/2022] Open
Abstract
A 40-year-old man was admitted to our hospital for chest pain after smoking. Coronary computed tomography angiography showed severe stenosis in the left anterior descending artery. The stenosis site had no plaque on stretched curved multiplanar reconstruction and short-axis images. Coronary angiography revealed improvement of the severe stenosis after the intracoronary administration of isosorbide dinitrate in the left anterior descending artery. Intravascular ultrasound demonstrated negative remodeling without a plaque and diffuse intima with media thickening at the stenosis site. The chest pain was likely caused by coronary spastic angina, which was treated with diltiazem hydrochloride.
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Cerebral Mitochondrial Microangiopathy Leads to Leukoencephalopathy in Mitochondrial Neurogastrointestinal Encephalopathy. AJNR Am J Neuroradiol 2018; 39:427-434. [PMID: 29348134 DOI: 10.3174/ajnr.a5507] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 10/30/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Mitochondrial neurogastrointestinal encephalopathy is a rare disorder due to recessive mutations in the thymidine phosphorylase gene, encoding thymidine phosphorylase protein required for mitochondrial DNA replication. Clinical manifestations include gastrointestinal dysmotility and diffuse asymptomatic leukoencephalopathy. This study aimed to elucidate the mechanisms underlying brain leukoencephalopathy in patients with mitochondrial neurogastrointestinal encephalopathy by correlating multimodal neuroradiologic features to postmortem pathology. MATERIALS AND METHODS Seven patients underwent brain MR imaging, including single-voxel proton MR spectroscopy and diffusion imaging. Absolute concentrations of metabolites calculated by acquiring unsuppressed water spectra at multiple TEs, along with diffusion metrics based on the tensor model, were compared with those of healthy controls using unpaired t tests in multiple white matters regions. Brain postmortem histologic, immunohistochemical, and molecular analyses were performed in 1 patient. RESULTS All patients showed bilateral and nearly symmetric cerebral white matter hyperintensities on T2-weighted images, extending to the cerebellar white matter and brain stem in 4. White matter, N-acetylaspartate, creatine, and choline concentrations were significantly reduced compared with those in controls, with a prominent increase in the radial water diffusivity component. At postmortem examination, severe fibrosis of brain vessel smooth muscle was evident, along with mitochondrial DNA replication depletion in brain and vascular smooth-muscle and endothelial cells, without neuronal loss, myelin damage, or gliosis. Prominent periependymal cytochrome C oxidase deficiency was also observed. CONCLUSIONS Vascular functional and histologic alterations account for leukoencephalopathy in mitochondrial neurogastrointestinal encephalopathy. Thymidine toxicity and mitochondrial DNA replication depletion may induce microangiopathy and blood-brain-barrier dysfunction, leading to increased water content in the white matter. Periependymal cytochrome C oxidase deficiency could explain prominent periventricular impairment.
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COQ2 gene analyses in multiple system atrophy and other neurodegenerative diseases and treatment of patients’ cells with coenzyme Q10. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Homozygous alpha-synuclein a53v in familial parkinson's disease. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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P002 Abnormal surround inhibition of finger tapping task and cerebellar hyper-activation of functional MRI in patients with focal hand dystonia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Should total gastrectomy and total colectomy be considered for selected patients with severe tumor burden of pseudomyxoma peritonei in cytoreductive surgery? Eur J Surg Oncol 2016; 42:1018-23. [DOI: 10.1016/j.ejso.2016.04.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/24/2016] [Accepted: 04/18/2016] [Indexed: 01/26/2023] Open
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Examination of Visceral Perception and Gastric Tone by Gastric Stimulation Using Air Inflation during Endoscopy. J Int Med Res 2016; 33:160-9. [PMID: 15790127 DOI: 10.1177/147323000503300203] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study investigated the assessment of visceral perception and gastric tone using insufflation during endoscopy. The intragastric pressure was measured during insufflation in 16 patients with gastro-oesophageal reflux disease, 25 patients with functional dyspepsia and 24 normal controls, using a pressure transducer inserted through the forceps aperture until gastric symptoms appeared. The intragastric pressure at the visceral perception threshold, the time to threshold and the time-pressure curve gradient were measured. The visceral perception threshold was significantly reduced in the functional dyspepsia group compared with the normal controls. Balloons were also inserted into the duodenal bulbs of 10 normal controls to investigate the effect of efflux of air into the duodenum; the measured parameters were not influenced by inflation and deflation. These results suggest that it is possible to assess visceral perception and gastric tone by measuring changes in intragastric pressure, using gastric stimulation by insufflation during endoscopy.
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Radiation-Dose-Lowering Effects of Landiolol Hydrochloride in Coronary Angiography Using Computed Tomography (DELIGHT) – A Prospective Multicenter Study –. Circ J 2016; 80:1225-31. [DOI: 10.1253/circj.cj-15-0962] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Detection of Left Ventricular Regional Dysfunction and Myocardial Abnormalities Using Complementary Cardiac Magnetic Resonance Imaging in Patients with Systemic Sclerosis without Cardiac Symptoms: A Pilot Study. Intern Med 2016; 55:237-43. [PMID: 26831016 DOI: 10.2169/internalmedicine.55.4441] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective We sought to detect the presence of left ventricular regional dysfunction and myocardial abnormalities in systemic sclerosis (SSc) patients without cardiac symptoms using a complementary cardiac magnetic resonance (CMR) imaging approach. Methods Consecutive patients with SSc without cardiac symptoms and healthy controls underwent CMR on a 1.5 T scanner. The peak systolic regional function in the circumferential and radial strain (Ecc, % and Err, %) were calculated using a feature tracking analysis on the mid-left ventricular slices obtained with cine MRI. In addition, we investigated the myocardial characteristics by contrast MRI. Pharmacological stress and rest perfusion scans were performed to assess perfusion defect (PD) due to micro- or macrovascular impairment, and late gadolinium enhancement (LGE) images were obtained for the assessment of myocarditis and/or fibrosis. Results We compared 15 SSc patients with 10 healthy controls. No statistically significant differences were observed in the baseline characteristics between the patients and healthy controls. The mean peak Err and Ecc of all segments was significantly lower in the patients than the controls (p=0.011 and p=0.003, respectively). Four patients with LGE (28.6%) and seven patients with PD (50.0%) were observed. PD was significantly associated with digital ulcers (p=0.005). Utilizing a linear regression model, the presence of myocardial LGE was significantly associated with the peak Ecc (p=0.024). After adjusting for age, the association between myocardial LGE and the peak Ecc was strengthened. Conclusion A subclinical myocardial involvement, as detected by CMR, was prevalent in the SSc patients without cardiac symptoms. Regional dysfunction might predict the myocardial abnormalities observed in SSc patients without cardiac symptoms.
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Liposome chaperon in cell-free membrane protein synthesis: one-step preparation of KcsA-integrated liposomes and electrophysiological analysis by the planar bilayer method. Biomater Sci 2016; 4:258-64. [DOI: 10.1039/c5bm00285k] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Chaperoning functions of liposomes were investigated using cell-free membrane protein synthesis.
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Left ventricular morphology and function in rheumatoid arthritis patients without cardiac symptoms, using a cardiac magnetic resonance imaging. J Cardiovasc Magn Reson 2015. [PMCID: PMC4328281 DOI: 10.1186/1532-429x-17-s1-p378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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303P The diagnostic splenectomy: a review of 12 years' experience of the procedure at our institution. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv526.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Association of tocilizumab treatment with changes in measures of regional left ventricular function in rheumatoid arthritis, as assessed by cardiac magnetic resonance imaging. Int J Rheum Dis 2015; 19:1169-1174. [PMID: 26480957 DOI: 10.1111/1756-185x.12632] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The goal of this study was to determine whether the powerful anti-inflammatory effect of anti-interleukin-6 with tocilizumab (TCZ) might lead to a reduction in left ventricular (LV) dysfunction in patients with rheumatoid arthritis (RA). METHODS Consecutive RA patients with active disease and healthy control subjects without a clinical diagnosis of cardiovascular disease were enrolled. The RA patients each had inadequate clinical response to non-biologic disease-modifying anti-rheumatic drugs and were prescribed TCZ therapy. All subjects underwent baseline evaluation of LV function, as measured by cardiac magnetic resonance imaging (CMRI). Peak systolic regional radial strain (Err, %) was calculated by feature tracking of cine CMRI. After baseline (BL) CMRI measurements, treatment with TCZ was initiated, and patients were followed for 52 weeks. We compared peak Err of RA patients at BL and at 52 weeks. RESULTS Thirteen RA patients (mean age 52.6 ± 5.4 years) were assessed at BL and at 52 weeks, and these patients were compared with 10 non-RA controls (mean age 55.7 ± 4.6 years). Disease Activity Score of 28 joints - erythrocyte sedimentation rate and Simple Disease Activity Index were significantly lower in RA patients at 52 weeks than at BL. Mean peak Err at BL in RA patients was significantly lower than in normal subjects (P = 0.03). Mean peak Err was significantly higher at 52 weeks than at BL (P = 0.028) in RA patients. CONCLUSION We showed that TCZ was associated with left ventricular dysfunction in RA patients which correlated with a reduction in RA disease activity.
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A multicenter, open-label study of an intravenous short-acting β1-adrenergic receptor antagonist landiolol hydrochloride for coronary computed tomography angiography by 16-slice multi-detector computed tomography in Japanese patients with suspected ischemic cardiac disease. Drugs R D 2015; 14:185-94. [PMID: 25091378 PMCID: PMC4153968 DOI: 10.1007/s40268-014-0056-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background During coronary computed tomography (CT) angiography (CCTA), β-blockers (β-adrenergic receptor antagonists) have commonly been used to lower heart rate and improve image quality. Objectives The aim of this study was to investigate the image quality-improving effect as well as the heart rate-lowering effect of landiolol hydrochloride (an intravenous short-acting β1-adrenergic receptor antagonist) in CCTA by 16-slice multi-detector CT (MDCT). Methods A total of 39 subjects suspected of having ischemic cardiac disease and requiring CCTA received 0.125 mg/kg of landiolol hydrochloride to study the efficacy and safety of landiolol hydrochloride in a multicenter open-label clinical study. The endpoint was the diagnosable proportion (proportion of subjects whose coronary stenosis was diagnosable). Results The diagnosable proportions for the reconstruction images at mid-diastole were 56.0 %. The diagnosable proportions for the optimal reconstruction images were 65.4 %. The mean heart rate-lowering effect was observed soon after administration of landiolol hydrochloride; the peak of the effect was reached in 3–5 min, and the effect wore off in 30 min after completion of administration. The mean heart rate-lowering proportion at that time was −14.46 ± 8.4 %. Conclusions Landiolol hydrochloride was confirmed to reduce heart rate significantly and rapidly after intravenous injection and this suggests that the study drug is a safe and useful agent for improving the image quality of CCTA by 16-slice MDCT.
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Cytochemical studies of nuclear DNA and RNA in normal and abnormal keratinizing tissues. CURRENT PROBLEMS IN DERMATOLOGY 2015; 10:127-40. [PMID: 7238088 DOI: 10.1159/000396286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The distribution patterns of nuclear DNA and RNA in normal and abnormal keratinizing tissues of human skin were examined by electron microscopy, using an enzyme digestion technique. We found that the distribution of nucleic acids in the nuclei of epidermal cells during keratinization changes gradually. In the hair cells, particularly in the cells of hair cortex and Henle's layer of inner root sheath, essentially similar findings were observed. On the other hand, the distribution patterns observed in the tumor cells of calcifying epithelioma and the parakeratotic cells of psoriasis were different from each other and different from the distribution patterns of normal keratinizing tissue, hair, and epidermis. It seems that a similar pattern of reorganization of nucleic acids occurs in the nucleic of normal keratinizing cells as the cells keratinize. However, in abnormal tissue, it seems that the reorganization pattern of nucleic acids in the nuclei is different in each case.
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Pharmacokinetics of everolimus when combined with cyclosporine in Japanese de novo renal transplant recipients. Transplant Proc 2015; 46:1314-8. [PMID: 24935294 DOI: 10.1016/j.transproceed.2014.01.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Accepted: 01/16/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Currently, there are no published data on pharmacokinetics (PK) of everolimus in combination with cyclosporine in Japanese renal transplant patients. We evaluated the PK of everolimus in Japanese de novo renal transplant patients who received everolimus in combination with cyclosporine. METHODS In this phase 3, multicenter, randomized, open-label study, patients were randomized (1:1) to 1 of the 2 groups: everolimus 1.5 mg (targeted C0 of 3-8 ng/mL) plus reduced-dose cyclosporine or mycophenolate mofetil 2 g/d plus standard-dose cyclosporine. PK assessments for everolimus were performed on day 28 (month 1) in the PK subpopulation. RESULTS A total of 11 patients (7 men), mean age 47.5 ± 11.21 years, were enrolled for PK analysis of everolimus. Starting at 1.5 mg (0.75 mg twice a day), the mean dose over a period of 28 days was 0.705 ± 0.1011 mg. Everolimus mean trough concentration was 4.307 ± 1.2459 ng/mL and mean peak concentration was 13.539 ± 3.5330 ng/mL, which peaked at 1 to 2 hours postdose. The average concentration was 7.558 ± 1.4723 ng/mL, area under the concentration-time curve was 90.70 ± 17.667 ng·h/mL, and peak-trough fluctuation was 122.6%. The PK parameters of everolimus were comparable to those in the earlier phase 3 studies (A2306 and A2307). The mean everolimus trough levels were within the target ranges at all time points ranging from 3.4 to 5.5 ng/mL (everolimus 0.75 mg twice a day, safety population). The majority of patients (>85% from day 7 onward) were maintained within the targeted everolimus trough blood levels (safety population). These data were similar to a non-Japanese study (A2309). CONCLUSIONS The pharmacokinetic characteristics of everolimus in Japanese de novo renal transplant patients did not differ from those previously observed in non-Japanese patients, hence the same dosage of everolimus may be acceptable in Japanese patients.
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Left ventricular regional dysfunction using cardiac magnetic resonance imaging in rheumatoid arthritis patients without cardiac symptoms: comparison between methotrexate and biologics treatment groups. J Rheumatol 2015; 41:1560-2. [PMID: 24986967 DOI: 10.3899/jrheum.121363] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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A randomized, double-blind, placebo-controlled, phase III study of the short-acting β1-adrenergic receptor blocker landiolol hydrochloride for coronary computed tomography angiography in Japanese patients with suspected ischemic cardiac disease. Clin Drug Investig 2015; 34:53-62. [PMID: 24174275 PMCID: PMC3889825 DOI: 10.1007/s40261-013-0149-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objectives and Background The objective of this study was to investigate the image quality-improving and heart rate-lowering effects of landiolol hydrochloride (a short-acting β1-adrenergic receptor blocker) on coronary computed tomography angiography (CCTA). During CCTA, β-adrenergic receptor blockers have been commonly used to lower heart rate and improve image quality. Methods A total of 258 subjects suspected of having ischemic cardiac disease and requiring CCTA were randomized to either a landiolol hydrochloride 0.125 mg/kg group or placebo group to study the efficacy and safety of landiolol hydrochloride in a multicenter, double-blind, randomized parallel study. The primary endpoint was the diagnosable proportion (proportion of subjects whose coronary stenosis was diagnosable). Results The diagnosable proportions about the reconstruction images at mid-diastole were 68.2 and 38.2 % in the landiolol hydrochloride and placebo group, respectively, indicating significant superiority of landiolol hydrochloride over placebo (p < 0.0001). The diagnosable proportions about the optimal reconstruction images were 81.4 and 54.2 % in the landiolol hydrochloride and placebo group, respectively, indicating significant superiority of landiolol hydrochloride over placebo (p < 0.0001). The mean heart rate-lowering effect was first observed soon after administration of landiolol hydrochloride, was most marked at 3–5 min, and disappeared 30 min after completion of administration. The mean heart rate-lowering proportion at that time was −19.1 ± 8.1 % and −5.9 ± 9.7 % in the landiolol hydrochloride and placebo groups, respectively, showing a significantly higher proportion in the landiolol hydrochloride group. Conclusions Landiolol hydrochloride was confirmed to significantly and rapidly lower heart rate after intravenous injection, suggesting that it is a safe and useful agent for improving the image quality of CCTA.
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P686: A comparison between short and long latency interhemispheric inhibition from the active to resting primary motor cortex during a unilateral muscle contraction. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50780-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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P664: Plasticity in primary motor cortex innervating the ankle flexor in football juggling experts. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50757-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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P314: Excitability changes in spinal reciprocal inhibitory circuit induced by periodical sensory inputs. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50434-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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RADIATION-DOSE-LOWERING EFFECT OF LANDIOLOL HYDROCHLORIDE IN CORONARY ANGIOGRAPHY USING COMPUTED TOMOGRAPHY (DELIGHT): A PROSPECTIVE MULTICENTER STUDY. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61048-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Relationship between mindfulness and anger: Focusing on multidimensionality of mindfulness tendency. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2013.07.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
OBJECTIVES To conduct a cost-minimization analysis of landiolol for CT diagnosis of coronary heart diseases in patients with tachycardia in Japan. METHODS A decision-tree model was constructed to analyze costs from the healthcare payer's perspective. Drug costs and diagnosis costs, computer tomography coronary angiography (CTCA), and coronary angiography (CAG), are adopted to the model. Landiolol is administered only to slow the heart rate to take CT images appropriately. Since some trials proved that there was no difference between landiolol and placebo in terms of efficacy and safety, this study conducted cost-minimization analysis. Of those suspected of coronary heart diseases, 22.5% are thought to be taking beta-blockers. The success rates for CT scanning for landiolol and placebo, derived from domestic trial data, were 81.4% (96/118, 77.8-84.9%) and 54.2% (64/118, 49.7-58.8%). Patients who failed to take a CT image were thought to take CAG. The healthcare cost was derived from a Japanese fee schedule. Costs of landiolol, CT imaging, and CAG are JPY2634 (USD1 = JPY100, as of November 20, 2013), JPY38,116, and JPY101,322, respectively. The positive rate for CAG, derived from domestic trial data, was 37.1% (33/89, 32.0-42.2%). Various sensitivity analyses, both univariate and probabilistic ones, were conducted. RESULTS In the base case analysis, expected costs per patient for landiolol and placebo were JPY78,956 and JPY82,232, respectively. In budget impact analysis, 81,062 patients are eligible for landiolol and it can save JPY266million for whole patients. Sensitivity analyses suggested the robustness of the results. LIMITATIONS This study did not consider any adverse effects in the decision-tree model. This model was developed especially for measuring the cost-saving effect of landiolol, through decreasing the number of patients who require CAG, due to imaging failure. CONCLUSIONS Landiolol for CTCA diagnosis in patients suspected of coronary heart disease with tachycardia is thought to be cost saving.
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1306-km 20x124.8-Gb/s PM-64QAM transmission over PSCF with net SEDP 11,300 (b ∙ km)/s/Hz using 1.15 samp/symb DAC. OPTICS EXPRESS 2014; 22:1796-1805. [PMID: 24515188 DOI: 10.1364/oe.22.001796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We demonstrated the transmission of a Nyquist-WDM signal based on PM-64QAM modulation in an EDFA-only submarine configuration composed of 54.4 km-long fiber spans: 20 channels at 124.8-Gb/s were propagated over 1306 km of low-loss pure-silica-core fiber (PSCF). Thanks to an aggressive digital spectral shaping, we achieved a raw spectral efficiency (SE) of 10.4 b/s/Hz, corresponding to 8.67 b/s/Hz net SE when considering a 20% FEC overhead. Transmitter DACs are operated at a record-low 1.15 samples/symbol, enabled by the insertion of advanced anti-alias filters. The achieved SE-times-distance product was 11,327 (b ∙ km)/(s ∙ Hz), the highest reported so far for PM-64QAM. Combining the experimental results with the performance predictions obtained using an analytical model of nonlinear propagation in uncompensated coherent optical systems (the so-called "GN-model"), we show that PM-64QAM is a realistic option for ultra-high capacity systems in the 1,000 km range, carrying up 40 Tb/s in the C-band.
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Cardiac magnetic resonance imaging abnormalities in patients with systemic lupus erythematosus: a preliminary report. Mod Rheumatol 2014. [DOI: 10.3109/s10165-009-0268-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Detection of left ventricular regional dysfunction and myocardial abnormalities using complementary cardiac magnetic resonance imaging in patients with systemic sclerosis without cardiac symptoms. J Cardiovasc Magn Reson 2014. [PMCID: PMC4042342 DOI: 10.1186/1532-429x-16-s1-p337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Prediction of severe cardiac involvement by fundus lesion in sarcoidosis. Jpn J Ophthalmol 2013; 58:81-5. [PMID: 24212542 DOI: 10.1007/s10384-013-0288-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 09/26/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE We examined the relation between ocular sarcoidosis and severe cardiac sarcoidosis necessitating pacemaker implantation. METHODS In this retrospective, observational, cross-sectional study, we reviewed the clinical records of 108 patients diagnosed with ocular sarcoidosis based on new diagnostic criteria established in Japan. We examined and compared the relationship between fundus findings of ocular sarcoidosis and severe cardiac sarcoidosis necessitating pacemaker implantation. RESULTS Of 108 patients with ocular sarcoidosis, seven patients (6.5 %) with median age of 61 years (interquartile range 59-63 years) also had severe heart disease leading to implantation of a pacemaker. Median duration of ocular symptoms was 4.5 years (interquartile range 3.6-7.8 years). Of seven patients with severe cardiac involvement, six had multiple peripheral chorioretinal atrophic lesions (MPCAL), two had nodules in the angle and tent-like peripheral anterior synechia, and two had snowball vitreous opacity. The prevalence of atrophic MPCAL lesions was significantly higher than that of other ocular findings (P < 0.05). CONCLUSIONS In patients with concurrent ocular sarcoidosis and severe cardiac sarcoidosis, MPCAL atrophic lesions were observed significantly more frequently, suggesting that severe cardiac involvement may be predicted by specific fundus lesions.
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P.5.12 A mutation in TNPO3 causes LGMD1F and characteristic nuclear pathology. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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P17.19 Deoxypyrimidine monophosphates treatment for thymidine kinase 2 deficiency. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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P.5.19 Fhl1 W122S knock-in mice manifest late-onset mild myopathy. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Dose-finding study of landiolol hydrochloride: a short-acting β1-blocker for controlling heart rate during coronary computed-tomography angiography in Japan. Adv Ther 2013; 30:803-18. [PMID: 24062147 PMCID: PMC3824371 DOI: 10.1007/s12325-013-0053-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Coronary computed-tomography angiography (CCTA) has high diagnostic performance, but it sometimes does not allow evaluation because of artifacts. Currently, the use of a β-blocker is recommended to prevent motion artifacts, but the β-blocker (metoprolol, propranolol, etc.) commonly used has a slow onset and long duration of action. Landiolol hydrochloride is an intravenous β1-blocker with a very short half-life. We investigated the efficacy and optimal dose of this drug for reduction of heart rate in patients undergoing CCTA. METHODS Eighty-seven subjects with ischemic heart disease were divided into three groups to receive landiolol hydrochloride at a dose of 0.125 (Group L), 0.25 (Group M), or 0.5 mg/kg (Group H). CCTA was performed at 3-7 min after administration, and heart rate, blood pressure, and image quality were assessed. RESULTS Heart rate decreased rapidly after completion of landiolol hydrochloride administration in all groups, with a heart rate reduction of 15.55 ± 6.56% in Group L, 16.48 ± 7.80% in Group M, and 21.49 ± 6.13% in Group H (Group L vs Group H, P = 0.0008; Group M vs Group H, P = 0.0109). Since there was no significant difference in heart rate during imaging among the three groups, although there was a significant difference between groups L and H and groups M and H in terms of percent change in heart rate, coronary stenosis was diagnosable in all groups with no significant difference. CONCLUSION Landiolol hydrochloride showed a rapid onset and short β-blocking effect, and was most effective at a dose of 0.5 mg/kg. However, the diagnosable proportion had no significant differences among the three groups in CCTA. Therefore, the clinically recommended dose was 0.125 mg/kg or less, considering the heart rate of patients with suspected coronary stenosis during CCTA.
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In not only vertebroplasty but also kyphoplasty, the resolution of vertebral deformities depends on vertebral mobility. AJNR Am J Neuroradiol 2013; 34:1474-8. [PMID: 23391839 DOI: 10.3174/ajnr.a3424] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE It has not been clarified whether the postoperative resolution of vertebral deformities achieved by KP are superior to those achieved by VP. We compared the outcomes of KP and VP, taking into account the presence of vertebral mobility, to determine whether the balloon inflation in KP may contribute to postoperative resolution of the vertebral deformities in patients with VCFs. MATERIALS AND METHODS The subjects had 34 vertebral bodies treated by VP, and 43 vertebral bodies treated by KP. In all patients, preoperative dynamic imaging was performed to assess the presence of vertebral mobility. First, the vertebral height restoration and kyphotic change were compared between the VP and KP groups. Then, the patients were further divided into 2 groups on the basis of the presence of vertebral mobility, and they were compared within and between the VP and KP groups in relation to the presence of vertebral mobility. RESULTS Overall, no significant differences were observed in either the vertebral height restoration or kyphotic change between the VP and KP groups (P > .20). Preoperative dynamic imaging identified 19 vertebral bodies each with vertebral mobility in the VP (56%) and KP groups (44%) (P = .21). Within the VP and KP groups, the vertebral height restoration and kyphotic changes were significantly better in patients with vertebral mobility than in those without (P < .01). There were no significant differences between the 2 treatment groups after adjustment for the presence of vertebral mobility (P > .30). CONCLUSIONS In both the VP and KP groups, the vertebral height restoration and kyphotic change largely depended on the preoperative vertebral mobility. The use of the balloon itself contributed little to resolution of the vertebral deformities.
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Reconstructed glycan profile for evaluation of operating status of the endoplasmic reticulum glycoprotein quality control. Glycobiology 2012; 23:121-31. [DOI: 10.1093/glycob/cws130] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Validity of intervertebral bone cement infusion for painful vertebral compression fractures based on the presence of vertebral mobility. AJNR Am J Neuroradiol 2012; 34:228-32. [PMID: 22743643 DOI: 10.3174/ajnr.a3160] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND PURPOSE It is uncertain whether analgesic effects of vertebroplasty in patients with painful VCF are actually attributable to intervertebral cement infusion. This study aims to assess the validity of cement infusion performed for pain relief based on the presence or absence of pseudoarthrosis. MATERIALS AND METHODS We compared therapeutic effects between PVP and vertebral perforation without bone cement infusion in patients with painful VCF. The subjects were 64 patients undergoing PVP (PVP group) and 67 undergoing vertebral perforation (perforation group). In all patients, preoperative dynamic radiography was performed to assess the presence of vertebral mobility. Patients were classified into 2 groups, those with and those without vertebral mobility, and changes in VAS and ADL scores before and after surgery were compared between the PVP and perforation groups. RESULTS Regarding patients with vertebral mobility, VAS improved during the 3 months immediately after surgery in the PVP group compared with the perforation group (P < .05). Although no significant difference in postoperative ADL scores was observed between the 2 treatment groups, the scores 3 months after surgery were better in the PVP group than in the perforation group. Meanwhile, in the subgroup of patients without vertebral mobility, both treatments produced marked pain relief, but the difference was not significant (P > .05). Moreover, there was no difference in ADL scores between the 2 treatment groups. CONCLUSIONS Intervertebral cement infusion exerts analgesic effects in patients with VCF with pseudoarthrosis. However, in those without vertebral mobility, the analgesic effects of vertebroplasty are the same regardless of bone cement infusion.
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MERRF and Kearns-Sayre Overlap Syndrome Due to the Mitochondrial DNA M.3291T>C Mutation (P07.209). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Severe Infantile Encephaloneuromyopathy and Defective Mitochondrial Translation Due to a New Molecular Defect (P05.135). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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MitoExome Sequencing Reveals a Mutation in the Mitochondrial MRPL51 Gene Causing Infantile Encephalopathy (P05.139). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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MERRF and Kearns-Sayre Overlap Syndrome Due to the Mitochondrial DNA M.3291T>C Mutation (IN7-1.008). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in7-1.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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