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Dainichi T, Nakano Y, Doi H, Nakamizo S, Nakajima S, Farkas T, Wong P, Narang V, Traspas RM, Kawakami E, Guttman-Yassky E, Dreesen O, Litman T, Reversade B, Kabashima K. 176 C10orf99/2610528A11Rik induces keratinocyte proinflammatory response and regulates lipid metabolism and barrier formation of the skin. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.187] [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: 11/19/2022]
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2
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Hirata K, Naruse H, Yamamoto Y, Hatanaka K, Kinoshita K, Abiko S, Suzuki K, Nakajima K, Katagiri M, Takano M, Ozasa M, Umemura M, Nakajima S, Aoyama K, Sasaki T, Kuwatani M, Sakamoto N, Tanikawa S, Okazaki N, Tanaka S. Gastrointestinal: Rare malignant biliary stricture with rapid progression. J Gastroenterol Hepatol 2022; 37:1839. [PMID: 35307882 DOI: 10.1111/jgh.15802] [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] [Received: 09/14/2021] [Revised: 12/21/2021] [Accepted: 01/12/2022] [Indexed: 12/09/2022]
Affiliation(s)
- K Hirata
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - H Naruse
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - Y Yamamoto
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Hatanaka
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Kinoshita
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - S Abiko
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Suzuki
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - K Nakajima
- Department of Gastroenterology, Hakodate Municipal Hospital, Hakodate, Japan
| | - M Katagiri
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Takano
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Ozasa
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Umemura
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - S Nakajima
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - K Aoyama
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - T Sasaki
- Department of Gastroenterology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - M Kuwatani
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan
| | - S Tanikawa
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - N Okazaki
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - S Tanaka
- Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan
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Hartley NJ, Grenzer J, Huang L, Inubushi Y, Kamimura N, Katagiri K, Kodama R, Kon A, Lu W, Makita M, Matsuoka T, Nakajima S, Ozaki N, Pikuz T, Rode A, Sagae D, Schuster AK, Tono K, Voigt K, Vorberger J, Yabuuchi T, McBride EE, Kraus D. Erratum: Using Diffuse Scattering to Observe X-Ray-Driven Nonthermal Melting [Phys. Rev. Lett. 126, 015703 (2021)]. Phys Rev Lett 2022; 128:169901. [PMID: 35522523 DOI: 10.1103/physrevlett.128.169901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Indexed: 06/14/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.126.015703.
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Kamiguchi N, Nakajima S, Miyashita T. FIRST TEST OF FLASH WITH CONTINUOUS LINE PROTON SCANNING. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01594-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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5
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Kumai Y, Seguchi O, Mochizuki H, Kimura Y, Iwasaki K, Kuroda K, Nakajima S, Matsumoto Y, Watanabe T, Yanase M, Sata M, Fukushima S, Fujita T, Chikamori T, Kobayashi J, Fukushima N. Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation. J Artif Organs 2022; 25:223-230. [PMID: 35022936 DOI: 10.1007/s10047-021-01307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
Abstract
Sleep-disordered breathing (SDB) is associated with an increased risk of adverse events in patients with heart failure (HF); however, its impact in patients implanted with a left ventricular assist device (LVAD) remains unclear. We aimed to investigate the prevalence of SDB in patients with LVAD and its impact on their clinical outcomes. Fifty consecutive patients with LVAD who underwent portable sleep monitoring between September 2017 and April 2018 were prospectively enrolled, and they were followed up for 170 ± 36 days. According to their respiratory disturbance indexes (RDIs), they were categorized into the SDB group (RDI ≥ 15, n = 12) and the non-SDB group (RDI < 15, n = 38). The incidence of adverse events during the follow-up period was investigated after enrollment. Multivariate logistic regression analysis revealed significant differences in SDB in LVAD-implanted patients in terms of the logarithmic transformation brain natriuretic peptide (BNP) values (p = 0.005). The optimal BNP cut-off value for SDB prediction in LVAD-implanted patients was 300 pg/mL (sensitivity: 58.3%, specificity: 94.7%). During follow-up, ventricular tachyarrhythmias (VTas) occurred significantly more frequently in the SDB group (4 [33%] vs. 2 [5%] patients, p = 0.02); Atrial tachyarrhythmia (ATa) also tended to occur more frequently in the SDB group (2 [25%] vs. 2 [2%] patients, p = 0.07). SBD was prevalent in 24% of the LVAD-implanted patients with advanced HF. Furthermore, SDB was significantly associated with high BNP levels and was also potentially associated with subsequent incidence of VTa in patients with LVAD.
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Affiliation(s)
- Yuto Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan.
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Yuki Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Yorihiko Matsumoto
- Department of Pulmonology and Infection Control, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan
| | - Makoto Sata
- Department of Pulmonology and Infection Control, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | | | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibeshinmachi, Suita, Osaka, 564-8565, Japan.
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6
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Yagi N, Seguchi O, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Yanase M, Tadokoro N, Fukushima S, Fujita T, Fukushima N. Implantation of ventricular assist devices in hypertrophic cardiomyopathy with left ventricular systolic dysfunction. ESC Heart Fail 2021; 8:5513-5522. [PMID: 34708560 PMCID: PMC8712821 DOI: 10.1002/ehf2.13653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/24/2021] [Accepted: 09/25/2021] [Indexed: 11/15/2022] Open
Abstract
Aims The outcomes of patients with hypertrophic cardiomyopathy with left ventricular systolic dysfunction (HCM‐LVSD) undergoing left ventricular assist device (LVAD) implantation remain unclear. We retrospectively evaluated the clinical impact of LVAD implantation on clinical outcomes, including haemodynamics and brain natriuretic peptide (BNP) levels, in patients with HCM‐LVSD, in comparison with those with dilated cardiomyopathy (DCM). Methods and results In this retrospective, single‐centre, observational study conducted in Japan, the medical records of patients who underwent LVAD implantation in the National Cerebral and Cardiovascular Center between 2011 and 2020 were reviewed. We enrolled 96 patients with DCM (average age: 43.5 years; 73 men) and 24 patients with HCM‐LVSD (average age: 48.3 years; 16 men). The HCM‐LVSD group had smaller left ventricles with thicker ventricular walls than the DCM group, which became more prominent after LVAD implantation. Preoperatively, BNP values were comparable between both groups; however, 3 months post‐implantation, they were significantly higher in the HCM‐LVSD group. Pulmonary artery pulsatility index, right ventricular stroke work index, and cardiac index were lower, and right atrial pressure was higher, in the HCM‐LVSD group, suggesting subclinical impairment of right ventricular function. The HCM‐LVSD group demonstrated equivalent outcomes, including overall survival, cerebrovascular accidents, right ventricular failure, LVAD‐related infections, arrhythmia, and aortic insufficiency, post‐implantation. Conclusions Despite a decreased right ventricular function with higher BNP values, patients with HCM‐LVSD and DCM showed comparable outcomes post‐LVAD implantation.
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Affiliation(s)
- Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan.,Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
| | - Naoki Tadokoro
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Satsuki Fukushima
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tomoyuki Fujita
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita-shi, Osaka, 564-8565, Japan
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7
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Sujino Y, Watanabe T, Iwasaki Y, Komeyama S, Yoshitake K, Yagi N, Anegawa E, Mochizuki H, Nakajima S, Kuroda K, Seguchi O, Yanase M, Fukushima S, Fujita T, Muramatsu T, Nishimura S, Nakano S, Fukushima N. The Predictive Value of Changes in Body Mass Index for the Incidence of Device-Specific Infections in Patients With Implantable Left Ventricular Assist Devices. Circ J 2021; 85:1460-1468. [PMID: 33867408 DOI: 10.1253/circj.cj-20-1197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Implantable left ventricular assist devices (LVAD) have improved quality of life and survival in patients with advanced heart failure. However, LVAD-specific infections and predicting which patients will develop infections remain challenging. This study investigated whether changes in body mass index (BMI) during hospitalization following LVAD implantation are associated with LVAD-specific infections within 1 year of implantation.Methods and Results:Patients (n=135) undergoing LVAD implantation were retrospectively divided into 2 groups based on changes in BMI from LVAD implantation to discharge: those with and without decreases in BMI. Each group was further subdivided according to baseline albumin concentrations (high [>3.7 g/dL] and low [≤3.7 g/dL]). Twenty patients developed LVAD-specific infections within 1 year. Receiver operating characteristic curve analysis resulted in a ∆BMI cut-off of less than -0.128 kg/m2. In multivariate analysis, younger patients and those with decreases in BMI had significantly higher rates of LVAD-specific infection (P=0.010 and P=0.035, respectively). LVAD-specific infection rates were significantly higher for patients with low albumin and decreases in BMI than for patients with low albumin but no decrease in BMI. CONCLUSIONS Decreases in BMI during hospitalization after LVAD implantation and younger age were independently associated with LVAD-specific infection within 1 year. Strict patient management may be needed to avoid decreases in BMI during hospitalization after LVAD implantation, particularly in patients with low baseline albumin concentrations.
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Affiliation(s)
- Yasumori Sujino
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiology, Saitama Medical University, International Medical Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yoichi Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Shotaro Komeyama
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Eiji Anegawa
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Toshihiro Muramatsu
- Department of Cardiology, Saitama Medical University, International Medical Center
| | - Shigeyuki Nishimura
- Department of Cardiology, Saitama Medical University, International Medical Center
| | - Shintaro Nakano
- Department of Cardiology, Saitama Medical University, International Medical Center
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiovascular Surgery, Saitama Medical University, International Medical Center
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Petersen SH, Kua LF, Nakajima S, Yong WP, Kono K. Chemoradiation induces upregulation of immunogenic cell death-related molecules together with increased expression of PD-L1 and galectin-9 in gastric cancer. Sci Rep 2021; 11:12264. [PMID: 34112882 PMCID: PMC8192931 DOI: 10.1038/s41598-021-91603-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/26/2021] [Indexed: 12/22/2022] Open
Abstract
Surgery alone or combined with chemo- and/or radiation therapy remains the primary treatment for gastric cancer (GC) to date and immunotherapeutic tools such as monoclonal antibodies are only slowly being implemented. This is partly due to the fact that the immune microenvironment in GC during chemoradiation and other treatment modalities is still poorly understood. 7 gastric cancer (GC) cell lines were tested for their response to chemoradiation using 5-FU in combination with X-ray irradiation. We conducted flow cytometric analysis to determine the cells’ ability to undergo immunogenic cell death (ICD) and their expression of the two immunosuppressive proteins programmed death-ligand 1 (PD-L1) and galectin-9 (Gal-9). We evaluated the overall immunogenicity of two cell lines (MKN7, MKN74) in co-culture experiments with human monocyte-derived dendritic cells (Mo-DCs). Chemoradiation induces distinct responses in different GC cell lines. We observe ICD in vitro in all tested GC cell lines in the form of calreticulin (CRT) translocation to the plasma membrane. As a resistance mechanism, these cells also upregulated Gal-9 and PD-L1. Mo-DC maturation experiments showed that GCs provoked the maturation of Mo-DCs after chemoradiation in vitro. The addition of α-PD-L1 blocking antibody further enhanced the immunogenicity of these cells while improving DC viability. Blocking Tim-3, as the main receptor for Gal-9, had no such effect. Our findings suggest that the benefits of chemoradiation can substantially depend on tumor subtype and these benefits can be offset by induced immune evasion in GC. Combination treatment using checkpoint inhibitors could potentially lead to enhanced immune responses and yield better patient outcomes.
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Affiliation(s)
- S H Petersen
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, 117599, Singapore.
| | - L F Kua
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, 117599, Singapore
| | - S Nakajima
- Department of Immunology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.,Department of Gastrointestinal Tract Surgery, Faculty of Medicine, Fukushima Medical University, Fukushima, Japan.,Department of Progressive DOHaD Research, Faculty of Medicine, Fukushima Medical University, Fukushima, 1 Hikariga-oka, Fukushima city, Fukushima, 960-1295, Japan
| | - W P Yong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore, 117599, Singapore.,Department of Haematology-Oncology, National University Hospital of Singapore, Singapore, 119228, Singapore
| | - K Kono
- Department of Gastrointestinal Tract Surgery, Faculty of Medicine, Fukushima Medical University, Fukushima, Japan.
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9
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Sakai H, Yamashita H, Nakajima S, Takahashi Y, Kaneko H. AB0391 LOW SERUM COMPLEMENT C3 LEVEL AS A RISK FACTOR FOR RELAPSE OF ANTINEUTROPHIL CYTOPLASMIC ANTIBODY-ASSOCIATED VASCULITIS: A RETROSPECTIVE COHORT STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The alternative pathway of complement activation has recently been recognized as a key pathogenic event in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Some previous studies have reported that low serum complement C3 level in AAV patients is associated with more severe renal disease, worse renal prognosis, or higher mortality. However, the correlation between low serum C3 level and AAV relapse remains unclear.Objectives:To analyze the clinical characteristics and outcomes of AAV patients with low serum C3 levels at the time of diagnosis.Methods:We conducted a retrospective observational cohort study including 83 consecutive patients diagnosed with AAV in our hospital from January 1999 to December 2020. Serum C3 levels were measured at diagnosis. AAV included microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), and eosinophilic granulomatosis with polyangiitis (EGPA); patients with ANCA-negative AAV were excluded. Patients were divided into low- and high-C3 groups (C3 < 100 and ≥ 100 mg/dL, respectively). We compared the clinical characteristics, and relapse-free and overall survival rates, of the two groups, and identified predictors of AAV relapse.Results:Of the 83 patients (MPA, n = 61; GPA, n = 18; EGPA, n = 4), 20 (24%) were in the low-C3 group. We found no significant group difference in sex, body mass index, disease type, ANCA subtype, Birmingham Vasculitis Activity Score (BVAS), or treatment. The low-C3 group patients were older (p=0.01), and had a higher Five Factor Score (FFS) (p=0.01) and a lower remission rate (p=0.02), than the high-C3 group. The generalized Wilcoxon test revealed that the relapse-free survival time was significantly shorter in the low-C3 group (29 months; 95% confidence interval [CI]: 15–49) than in the high-C3 group (82 months; 95% CI: 61–NA; p=0.01) (Figure 1A). The overall survival was also shorter in the low-C3 group (83 months; 95% CI: 8-121) than in the high-C3 group (112 months; 95% CI: 77-NA; p=0.03) (Figure 1B). In the Cox proportional hazards model, a low C3 level (< 100 mg/dL) (hazard ratio [HR], 3.01; 95% CI: 1.29–7.04], p=0.01) and GPA (HR, 3.04; 95% CI: 1.32–7.01; p=0.01) were independent predictors of AAV relapse.Figure 1.Kaplan-Meier estimates of the relapse-free (A) and overall (B) survival rates of AAV patients by baseline serum C3 levels. Eight patients who did not show remission were excluded in the relapse-free survival analysis. Black line: high-C3 group (≥ 100 mg/dL); red line: low-C3 group (< 100 mg/dL).Conclusion:AAV patients with low C3 levels at diagnosis were at higher risk of relapse. Larger prospective studies are required to confirm these findings.Disclosure of Interests:None declared
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Fukushima N, Yanase M, Seguchi O, Watanabe T, Kuroda K, Nakajima S, Mochizuki H, Fukushima S, Saito T, Tadokoro N, Fujita T, Iguchi A. Heart Transplantation from Donors with Heparin-Induced Thrombocytopenia. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.655] [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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11
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Anegawa E, Seguchi O, Iwasaki Y, Komeyama S, Yoshitake K, Sujino Y, Yagi N, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Yanase M, Fukushima S, Fujita T, Fukushima N. Pulmonary Vascular Reverse Remodeling in Combined Post and Pre Capillary Pulmonary Hypertension Occurs Over Time after Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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Hartley NJ, Grenzer J, Huang L, Inubushi Y, Kamimura N, Katagiri K, Kodama R, Kon A, Lu W, Makita M, Matsuoka T, Nakajima S, Ozaki N, Pikuz T, Rode AV, Sagae D, Schuster AK, Tono K, Voigt K, Vorberger J, Yabuuchi T, McBride EE, Kraus D. Using Diffuse Scattering to Observe X-Ray-Driven Nonthermal Melting. Phys Rev Lett 2021; 126:015703. [PMID: 33480771 DOI: 10.1103/physrevlett.126.015703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/09/2020] [Accepted: 12/07/2020] [Indexed: 06/12/2023]
Abstract
We present results from the SPring-8 Angstrom Compact free electron LAser facility, where we used a high intensity (∼10^{20} W/cm^{2}) x-ray pump x-ray probe scheme to observe changes in the ionic structure of silicon induced by x-ray heating of the electrons. By avoiding Laue spots in the scattering signal from a single crystalline sample, we observe a rapid rise in diffuse scattering and a transition to a disordered, liquidlike state with a structure significantly different from liquid silicon. The disordering occurs within 100 fs of irradiation, a timescale that agrees well with first principles simulations, and is faster than that predicted by purely inertial behavior, suggesting that both the phase change and disordered state reached are dominated by Coulomb forces. This method is capable of observing liquid scattering without masking signal from the ambient solid, allowing the liquid structure to be measured throughout and beyond the phase change.
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Affiliation(s)
- N J Hartley
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
| | - J Grenzer
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
| | - L Huang
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
| | - Y Inubushi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - N Kamimura
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - K Katagiri
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - R Kodama
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
- Photon Pioneers Center, Osaka University, Suita, Osaka 565-0087, Japan
| | - A Kon
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - W Lu
- European XFEL GmbH, Holzkoppel 4, D-22869 Schenefeld, Germany
| | - M Makita
- European XFEL GmbH, Holzkoppel 4, D-22869 Schenefeld, Germany
| | - T Matsuoka
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - S Nakajima
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - N Ozaki
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
- Photon Pioneers Center, Osaka University, Suita, Osaka 565-0087, Japan
| | - T Pikuz
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - A V Rode
- Laser Physics Centre, Research School of Physics, Australian National University, Canberra, ACT 2601, Australia
| | - D Sagae
- Graduate School of Engineering, Osaka University, Suita, Osaka 565-0087, Japan
| | - A K Schuster
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
| | - K Tono
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - K Voigt
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
| | - J Vorberger
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
| | - T Yabuuchi
- Japan Synchrotron Radiation Research Institute, Sayo, Hyogo 679-5198, Japan
- RIKEN SPring-8 Center, Sayo, Hyogo 679-5148, Japan
| | - E E McBride
- SLAC National Accelerator Laboratory, Menlo Park, California 94025, USA
| | - D Kraus
- Helmholtz-Zentrum Dresden-Rossendorf, Bautzner Landstraße 400, 01328 Dresden, Germany
- Institut für Physik, Universität Rostock, Albert-Einstein-Straße 23, 18059 Rostock, Germany
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13
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Watanabe T, Yanase M, Seguchi O, Fujita T, Hamasaki T, Nakajima S, Kuroda K, Kumai Y, Toda K, Iwasaki K, Kimura Y, Mochizuki H, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Wada K, Matsuda S, Takenaka H, Ikura M, Nakagita K, Yajima S, Matsumoto Y, Tadokoro N, Kakuta T, Fukushima S, Ishibashi-Ueda H, Kobayashi J, Fukushima N. Influence of Induction Therapy Using Basiliximab With Delayed Tacrolimus Administration in Heart Transplant Recipients - Comparison With Standard Tacrolimus-Based Triple Immunosuppression. Circ J 2020; 84:2212-2223. [PMID: 33148937 DOI: 10.1253/circj.cj-20-0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Appropriate indications and protocols for induction therapy using basiliximab have not been fully established in heart transplant (HTx) recipients. This study elucidated the influence of induction therapy using basiliximab along with delayed tacrolimus (Tac) initiation on the outcomes of high-risk HTx recipients.Methods and Results:A total of 86 HTx recipients treated with Tac-based immunosuppression were retrospectively reviewed. Induction therapy was administered to 46 recipients (53.5%) with impaired renal function, pre-transplant sensitization, and recipient- and donor-related risk factors (Induction group). Tac administration was delayed in the Induction group. Induction group subjects showed a lower cumulative incidence of acute cellular rejection grade ≥1R after propensity score adjustment, but this was not significantly different (hazard ratio [HR]: 0.63, 95% confidence interval [CI]: 0.37-1.08, P=0.093). Renal dysfunction in the Induction group significantly improved 6 months post-transplantation (P=0.029). The cumulative incidence of bacterial or fungal infections was significantly higher in the Induction group (HR: 10.6, 95% CI: 1.28-88.2, P=0.029). CONCLUSIONS These results suggest that basiliximab-based induction therapy with delayed Tac initiation may suppress mild acute cellular rejection and improve renal function in recipients with renal dysfunction, resulting in its non-inferior outcome, even in high-risk patients, when applied to the appropriate recipients. However, it should be carefully considered in recipients at a high risk of bacterial and fungal infections.
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Affiliation(s)
- Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | | | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yuto Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yuki Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Eiji Anegawa
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yasumori Sujino
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kyoichi Wada
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Sachi Matsuda
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Hiromi Takenaka
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Megumi Ikura
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Kazuki Nakagita
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Shin Yajima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Yorihiko Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Naoki Tadokoro
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Takashi Kakuta
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | | | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
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14
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Kase K, Saito M, Yamada L, Nakajima S, Ashizawa M, Kanke Y, Hanayama H, Onozawa H, Okayama H, Endo H, Fujita S, Sakamoto W, Saze Z, Momma T, Mimura K, Ohki S, Kono K. 152P ARID1A deficiency in EBV-positive gastric cancer is partially regulated by EBV-encoded miRNAs, but not by DNA promotor hypermethylation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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15
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Yamada L, Saito M, Kase K, Nakajima S, Endo E, Ujiie D, Min A, Ashizawa M, Matsumoto T, Kanke Y, Nakano H, Ito M, Onozawa H, Okayama H, Fujita S, Sakamoto W, Saze Z, Momma T, Mimura K, Kono K. 75P The evaluation of selective sensitivity of EZH2 inhibitors based on synthetic lethality in ARID1A-deficient gastric cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.095] [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: 11/16/2022] Open
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16
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Itoh T, Toda N, Osaki T, Maegawa Y, Yoshizawa R, Ishikawa Y, Nishiyama O, Yoshizawa M, Nakajima S, Nakamura M, Morino Y. Impact of east Japan earthquake disaster with massive tsunami for prevalence of Takotsubo syndrome – a multicenter regional registry before and after east Japan earthquake disaster. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1813] [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
Previous studies demonstrated Takotsubo syndrome (TS) was easy provoked by earthquake disaster. However, a previous other regional report demonstrated TS was not increased after 2011 east Japan earthquake disaster. The purpose of this study was to clarify incidence of TS after the earthquake disaster in Iwate prefecture during long term period.
Method
Consecutive hospitalized TS patients were registered during 8 years between 2009 and 2016 in our medical university and five Iwate prefecture hospitals. Moreover, patients were divided into two groups, i.e., those with the inland and those with tsunami-stricken area groups. Prevalence of TS were calculated by standard incidence ratio (SIR) before and after the earthquake disaster. Moreover, long-term prognosis in the both groups was compared using Kaplan-Meier analysis.
Results
A total of 112 TS (male 25 and female 87) were registered from acute coronary syndrome registry in each hospital (n=4,163). Averaged age was 75.3 year-old. A total number of TS just after the two months of the earthquake (March and April 2011) was nine and significance monthly variation was observed comparing with the other months (p=0.029). SIR before and after the disaster is as following Figure. There were no significant differences for long-term prognosis between the two groups (p=0.20).
Conclusion
Incidence of TS was increased in acute phase after east Japan earthquake disaster. However, significance increases were maintained during long-term period, although number of TS was decreased after acute phase. TS is increased not only acute but also chronic phase after the serious earthquake disaster.
Standard incidence ratio
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Itoh
- Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical Univ., Morioka, Japan
| | - N Toda
- Iwate Medical University, Morioka, Japan
| | - T Osaki
- Iwate Prefecture Kuji Hospital, Department of Cardiology, Kuji, Japan
| | - Y Maegawa
- Iwate prefecture Kuji Hospital, Department of Cardiology, Kuji, Japan
| | - R Yoshizawa
- Iwate Prefecture Kamaishi Hospital, Department of Cardiology, Kamaishi, Japan
| | - Y Ishikawa
- Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical Univ., Morioka, Japan
| | - O Nishiyama
- Iwate Prefecture Ninohe Hospital, Ninohe, Japan
| | - M Yoshizawa
- Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical Univ., Morioka, Japan
| | - S Nakajima
- Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical Univ., Morioka, Japan
| | - M Nakamura
- Iwate Medical University, Morioka, Japan
| | - Y Morino
- Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical Univ., Morioka, Japan
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17
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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, Ito H, Fukushima N. Incidence, Factors, and Prognostic Impact of Re-Exploration for Bleeding After Continuous-Flow Left Ventricular Assist Device Implantation - A Japanese Single-Center Study. Circ J 2020; 84:1949-1956. [PMID: 32999142 DOI: 10.1253/circj.cj-20-0238] [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] [Indexed: 11/09/2022]
Abstract
BACKGROUND Continuous-flow left ventricular assist device (CF-LVAD) substantially improves survival in endstage heart failure patients. However, bleeding complications are common after CF-LVAD implantation and in some cases, re-exploration for bleeding is needed. We aimed to investigate the incidence, timing, and risk factors of bleeding requiring re-exploration after CF-LVAD implantation.Methods and Results:We retrospectively reviewed 162 consecutive patients (age 43±13 years, 71% men) who underwent CF-LVAD implantation (HeartMateII 119, Jarvik2000 15, HVAD 13, EVAHEART 10, DuraHeart 5) from January 2012 to June 2019. During follow-up [median 662 days, interquartile range (IQR) 364-1,116 days], 35 (21.6%) experienced re-exploration for bleeding. The median timing of re-exploration was 6 (IQR 1-10) days. In the multivariate logistic regression analysis, postoperative platelet count was an independent predictor for re-exploration for bleeding after CF-LVAD implantation (per 104/μL: odds ratio 0.83, 95% confidence interval 0.74-0.93, P=0.002). Patients who experienced re-exploration for bleeding had a significantly worse survival rate than patients who did not (at 4 years, 73.6% vs. 90.1%, P=0.039). CONCLUSIONS Re-exploration for bleeding is prevalent after CF-LVAD implantation, especially in patients with low postoperative platelet counts. As bleeding requiring re-exploration is associated with poor prognosis, risk stratification using the postoperative platelet count may be beneficial for these patients.
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Affiliation(s)
- Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yasumori Sujino
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Eiji Anegawa
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
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18
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Sujino Y, Kuroda K, Yoshitake K, Yagi N, Anegawa E, Mochizuki H, Iwasaki K, Nakajima S, Watanabe T, Yanase M, Fukushima S, Fujita T, Kobayashi J, Fukushima N. Clinical potential of hemodynamic ramp test by simultaneous echocardiography and right heart catheterization for aortic insufficiency in a patient with continuous-flow left ventricular assist device. J Artif Organs 2020; 24:265-268. [PMID: 32940802 PMCID: PMC8154805 DOI: 10.1007/s10047-020-01210-y] [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: 04/02/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
Aortic insufficiency (AI) is an important adverse event in patients with continuous-flow (CF) left ventricular assist device (LVAD) support. AI is often progressive, resulting in elevated 2-year morbidity and mortality. The effectiveness of echocardiographic ramp studies in patients with AI has been unclear. Here, we describe a patient with a CF-LVAD implant who underwent aortic valve replacement (AVR), following assessment of AI using a hemodynamic ramp test with simultaneous echocardiography and right heart catheterization (RHC). The patient was a 21-year-old man with cardiogenic shock due to acute myocarditis, who underwent HeartWare CF-LVAD (HVAD) implantation. Heart failure persisted despite increased doses of diuretics and inotrope, as well as an increased HVAD pump rate. HVAD monitoring revealed a correlation between increased HVAD pump rate and flow at each speed step. A hemodynamic ramp test with simultaneous transthoracic echocardiography and RHC revealed a significant discrepancy between HVAD pump flow and cardiac output (CO) at each speed step; moreover, pulmonary capillary wedge pressure remained high. Therefore, the patient underwent AVR. Subsequently, his low CO symptoms disappeared and inotropes were successfully discontinued. A postoperative hemodynamic ramp test revealed that AVR had successfully closed the loop of blood flow and reduced the discrepancy between HVAD pump flow and CO, thereby increasing CO. The patient was then discharged uneventfully. In conclusion, a hemodynamic ramp test with simultaneous echocardiography and RHC was useful for the evaluation of the causal relationship between AI and low CO, and for selection of surgical treatment for AI in a patient with CF-LVAD.
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Affiliation(s)
- Yasumori Sujino
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Eiji Anegawa
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, 564-8564, Osaka, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, 564-8564, Osaka, Japan
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, 564-8564, Osaka, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shinmachi, Suita, Osaka, 564-8564, Japan.
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19
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Suwa K, Onda S, Yasuda J, Nakajima S, Okamoto T, Yanaga K. Single-blind randomized clinical trial of transinguinal preperitoneal repair using self-expanding mesh patch vs. Lichtenstein repair for adult male patients with primary unilateral inguinal hernia. Hernia 2020; 25:173-181. [PMID: 32926259 DOI: 10.1007/s10029-020-02301-8] [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] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 09/02/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of the study was to compare proportions of chronic postoperative inguinal pain (CPIP) and other surgical outcomes between transinguinal preperitoneal repair with modified Kugel patch (MK) and Lichtenstein repair (LR). METHODS Two-hundred adult male patients with primary unilateral inguinal hernia were randomized into MK or LR groups. The primary endpoint was CPIP, pain at 6 months after surgery. Secondary outcomes included recurrence rate, incidence of postoperative complications, time until return to activities, inguinal pain and sensory disturbances assessed at 1 week, 1 month, 3, 6, and 12 months after the operation using an 11-point numerical rating scale (NRS). The study was an intention-to-treat analysis. RESULTS In comparison of MK (n = 100) and LR (n = 100) with similar backgrounds, proportions of CPIP were similar (7.2 vs. 11.1%, p = 0.3452). Favorable outcomes for MK were duration of operation (32 vs. 40 min, p < 0.0001), NRS of foreign body sensation at 1 year (0 [0-1] vs. 0 [0-2], p = 0.0067), and NRS of numbness at 1 month (0 [0-1] vs. 0 [0-3], p = 0.0078) after the operation. CONCLUSIONS In regard to CPIP, the short-term results of MK and LR were similar.
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Affiliation(s)
- K Suwa
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1 Izumihoncho, Komae, Tokyo, 201-8601, Japan.
| | - S Onda
- Department of Surgery, The Jikei University Hospital, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - J Yasuda
- Department of Surgery, The Jikei University Hospital, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - S Nakajima
- Department of Surgery, The Jikei University Hospital, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - T Okamoto
- Department of Surgery, The Jikei University Daisan Hospital, 4-11-1 Izumihoncho, Komae, Tokyo, 201-8601, Japan
| | - K Yanaga
- Department of Surgery, The Jikei University Hospital, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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20
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Seguchi O, Fujita T, Kitahata N, Iwasaki K, Kuroda K, Nakajima S, Watanabe T, Yanase M, Fukushima S, Tsukiya T, Katagiri N, Mizuno T, Takewa Y, Hamasaki T, Onda K, Hayashi T, Yamamoto H, Tatsumi E, Kobayashi J, Fukushima N. A Novel Extracorporeal Continuous-Flow Ventricular Assist System for Patients With Advanced Heart Failure - Initial Clinical Experience. Circ J 2020; 84:1090-1096. [PMID: 32461539 DOI: 10.1253/circj.cj-19-1122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Bridge-to-decision (BTD) devices providing temporary mechanical circulatory support should be introduced to patients with advanced heart failure. This study evaluated the effectiveness and safety of a BTD device comprising an innovative extracorporeal continuous-flow temporary ventricular assist device (VAD) driven by a novel hydrodynamically levitated centrifugal flow blood pump.Methods and Results:Nine patients, comprising 3 with dilated cardiomyopathy, 3 with fulminant myocarditis, and 3 with ischemic heart disease, and 6 males, whose mean age was 47.7±8.1 years, were enrolled into the study. Six patients had Interagency Registry for Mechanically Assisted Circulatory Support profile 1, and 3 were profile 2. The primary endpoint was a composite of survival free from device-related serious adverse events and complications during circulatory support. Eight patients received left ventricular support, of whom 3 received concomitant right ventricular support using extracorporeal membrane oxygenation circuits, as a consequence of severe respiratory failure. One patient with fulminant myocarditis received biventricular support using the novel VAD system. After 19.0±13.5 days, 3 patients were weaned from circulatory support, because their native cardiac function recovered, and 6 patients required conversion to a durable device as a bridge-to-transplantation. One patient had non-disabling ischemic stroke episodes, and no patients died. CONCLUSIONS This novel extracorporeal VAD system with a hydrodynamically levitated centrifugal pump can safely and successfully bridge patients with advanced heart failure to subsequent therapeutic stages.
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Affiliation(s)
- Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Nana Kitahata
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tomonori Tsukiya
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | - Nobumasa Katagiri
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | - Toshihide Mizuno
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | - Yoshiaki Takewa
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | | | - Kaori Onda
- Department of Data Science, National Cerebral and Cardiovascular Center
| | - Teruyuki Hayashi
- Department of Clinical Engineering, National Cerebral and Cardiovascular Center
| | - Haruko Yamamoto
- Department of Advancing Clinical and Translational Sciences, National Cerebral and Cardiovascular Center
| | - Eisuke Tatsumi
- Department of Artificial Organs, National Cerebral and Cardiovascular Center
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
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21
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Yanase M, Iwasaki K, Watanabe T, Seguchi O, Nakajima S, Kuroda K, Mochizuki H, Matsuda S, Takenaka H, Ikura M, Tadokoro N, Fukushima S, Fujita T, Ishibashi-Ueda H, Nakatani T, Kitamura S, Kobayashi J, Tsujita K, Ogawa H, Fukushima N. Effect of Therapeutic Modification on Outcomes in Heart Transplantation Over the Past Two Decades - A Single-Center Experience in Japan. Circ J 2020; 84:965-974. [PMID: 32350231 DOI: 10.1253/circj.cj-19-1209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND During these 2 decades (1999-2019), many therapeutic strategies have been developed in the field of heart transplant (HTx) to improve post-HTx outcomes. In the present study, 116 consecutive HTx adults between 1999 and 2019 were retrospectively reviewed to evaluate the influences of a therapeutic modification on post HTx outcomes.Methods and Results:Patient survival, functional status and hemodynamics after HTx and modification of therapeutic strategies were reviewed. The overall cumulative survival rate at 10 and 20 years post-HTx was 96.4 and 76.7%, respectively. There were no significant differences in survival rate or exercise tolerance after HTx between extracorporeal and implantable continuous flow-LVAD. Post-HTx patient survival in patients, irrespective of the donor risk factors such as donor age, low LVEF, history of cardiac arrest, was equivalent across cohorts, while longer TIT and higher inotrope dosage prior to procurement surgery were significant risk factors for survival. In 21 patients given everolimus (EVL) due to renal dysfunction, serum creatinine significantly decreased 1 year after initiation. In 22 patients given EVL due to transplant coronary vasculopathy (TCAV), maximum intimal thickness significantly decreased 3 years after initiation. CONCLUSIONS The analysis of a 20-year single-center experience with HTx in Japan shows encouraging improved results when several therapeutic modifications were made; for example, proactive use of donor hearts declined by other centers and the use of EVL in patients with renal dysfunction and TCAV.
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Affiliation(s)
- Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Division of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Sachi Matsuda
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Hiromi Takenaka
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Megumi Ikura
- Department of Pharmacy, National Cerebral and Cardiovascular Center
| | - Naoki Tadokoro
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | | | | | - Soichiro Kitamura
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
| | | | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Division of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University
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22
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Iwasaki K, Seguchi O, Murata S, Nishimura K, Yoshitake K, Yagi N, Sujino Y, Anegawa E, Mochizuki H, Kuroda K, Nakajima S, Watanabe T, Yanase M, Fukushima S, Fujita T, Kobayashi J, Ito H, Fukushima N. Effect of the Creatinine Excretion Rate Index, a Marker of Sarcopenia, on Prediction of Intracranial Hemorrhage in Patients With Advanced Heart Failure and a Continuous-Flow Left Ventricular Assist Device. Circ J 2020; 84:949-957. [PMID: 32269201 DOI: 10.1253/circj.cj-19-0930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sarcopenia is characterized by progressive loss of skeletal muscle and has frequently been associated with poor clinical outcomes in patients with advanced heart failure (HF). The urinary creatinine excretion rate (CER) index is an easily measured marker of muscle mass, but its predictive capacity for mortality and cerebrovascular events has not been investigated in patients with a continuous-flow implantable left ventricular assist device (CF-iLVAD).Methods and Results:We retrospectively reviewed 147 patients (mean [±SD] age 43.7±12.5 years, 106 male) who underwent CF-iLVAD implantation between April 2011 and June 2019. CER indices in 24-h urine samples before CF-iLVAD implantation were determined. Over a median follow-up of 2.3 years, there were 10 (6.8%) deaths and 43 (29.3%) cerebrovascular events. Patients were divided into 2 groups (low and high CER index) according to the median CER index in men and women (i.e., 13.71 and 12.06 mg·kg-1·day-1, respectively). Mortality and intracranial hemorrhage rates after CF-iLVAD implantation were significantly higher in the low than high CER index group (mortality 12.3% vs. 1.4% [P<0.01]; intracranial hemorrhage 23.3% vs. 8.1% [P=0.01]). Multivariate Cox proportional hazard models revealed that a low CER index was an independent predictor of intracranial hemorrhage in patients receiving a CF-iLVAD (hazard ratio 3.63; 95% confidence interval 1.43-9.24; P<0.01). CONCLUSIONS A low preoperative CER index is an independent, non-invasive predictor of intracranial hemorrhage after CF-iLVAD implantation.
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Affiliation(s)
- Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center.,Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Shunsuke Murata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center
| | - Koichi Yoshitake
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Nobuichiro Yagi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yasumori Sujino
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Eiji Anegawa
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Hiroki Mochizuki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
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23
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Takeuchi S, Watanabe T, Anegawa E, Sujino Y, Yagi N, Yoshitake K, Mochizuki H, Iwasaki K, Nakajima S, Kuroda K, Seguchi O, Yanase M, Tadokoro N, Yajima S, Fukushima S, Fujita T, Ogawa H, Fukushima N. The Development of Cardiac Allograft Vasculopathy Occurs in Early Intimal Thickening and Constrictive Remodeling in Long-Term Period; Long-Term Serial Intravascular Ultrasound Study. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.532] [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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24
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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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25
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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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26
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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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27
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Zuo Y, Sakatsume K, Sasaki K, Nakajima S, Fukushima N, Horiuchi H, Saiki Y, Lvadavws I. Severity of vWF Degradation Depends on LVAD types: Preliminary Results from a Multicenter Prospective Study. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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28
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Izumikawa T, Takeshita S, Yamada T, Mizuguchi Y, Taniguchi N, Nakajima S, Hata T, Takahashi A. P1761Distal transradial approach for primary percutaneous coronary intervention for patients with acute myocardial infarction: a multicentre study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0514] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The distal transradial approach (dTRA) for coronary catheterisation is a newly introduced alternative to the conventional transradial approach. This technique is expected to decrease the incidence of haemorrhagic complications and improve patient comfort. However, limited data are available regarding the application of this technique in patients with acute myocardial infarction (AMI). This study investigated the feasibility and safety of the dTRA for primary percutaneous coronary intervention (PCI) in patients with AMI.
Methods
This study included patients with AMI who underwent primary PCI via the distal radial artery across 3 Japanese hospitals between January 2018 and January 2019. Patients' background, procedural characteristics, and clinical outcomes including the incidence of haemorrhagic complications were analysed.
Results
This study enrolled 95 consecutive patients with AMI, including 68 patients (71.6%) with ST-segment elevation myocardial infarction (STEMI), in whom distal radial artery puncture was attempted for primary PCI. The patients included 70 men (73.7%), and the mean age was 72.2±12.4 years. Among these patients, cannulation was successfully performed in 89 patients (93.7%). A 5-, 6-, or 7-French sheath (conventional or slender) was used in this study. Cannulation was performed using a forearm radial artery approach in patients in whom dTRA failed.
PCI was successfully performed in all patients. The meantime to achieve haemostasis was 6.3±5.3 hours, and no major bleeding complications occurred. Based on The Early Discharge After Transradial Stenting of Coronary Arteries trial haematoma scale, grade I, II, and III subcutaneous haemorrhages were observed in 16 (16.8%), 4 (4.2%), and 1 patient (1.1%), respectively. No patient developed a haematoma > grade IV.
In patients with STEMI, the mean door-to-balloon time was 39.4±31.9 min, and the mean puncture-to-balloon time was 19.7±14.2 min.
Conclusions
The distal radial approach is feasible and safefor primary PCI in selected patients with AMI.The application of the dTRA may serve as a less invasive strategy for the treatment of patients with AMI.
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Affiliation(s)
| | - S Takeshita
- Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - T Yamada
- Sakurakai Takahashi Hospital, Kobe, Japan
| | | | | | - S Nakajima
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - T Hata
- Sakurakai Takahashi Hospital, Kobe, Japan
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29
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Kimura Y, Seguchi O, Mochizuki H, Iwasaki K, Toda K, Kumai Y, Kuroda K, Nakajima S, Tateishi E, Watanabe T, Matsumoto Y, Fukushima S, Kiso K, Yanase M, Fujita T, Kobayashi J, Fukushima N. Role of Gallium-SPECT-CT in the Management of Patients With Ventricular Assist Device-Specific Percutaneous Driveline Infection. J Card Fail 2019; 25:795-802. [DOI: 10.1016/j.cardfail.2019.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/25/2019] [Accepted: 08/20/2019] [Indexed: 12/30/2022]
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30
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Ota T, Fukui T, Nakahara Y, Takeda T, Uchino J, Mouri T, Kudo K, Nakajima S, Suzumura T, Okabe T, Hayashi H, Miyatake N, Nakano Y, Terashima M, Hasegawa Y, Tsukuda H, Matsui K, Masuda N, Fukuoka M. P1.04-40 Serum Perforin Levels During the First Cycle of Anti-PD-1 Antibody Therapies in Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.943] [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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31
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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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32
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Kuroda K, Seguchi O, Matama H, Kimura Y, Iwasaki K, Toda K, Kikuchi N, Kumai Y, Nakajima S, Matsumoto Y, Watanabe T, Yanase M, Fukushima S, Tomoyuki F, Kobayashi J, Fukushima N. Left ventricular assist device implantation in an adult male with Danon disease. J Cardiol Cases 2019; 20:106-109. [PMID: 31497177 PMCID: PMC6718825 DOI: 10.1016/j.jccase.2019.06.002] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/05/2019] [Accepted: 06/10/2019] [Indexed: 11/26/2022] Open
Abstract
Danon disease is an extremely rare inherited disorder characterized by cardiac involvement, myopathy, and intellectual disability. As patients with Danon disease die at an early age, mainly as a result of cardiac involvement, implantation of a left ventricular assist device (LVAD) and/or heart transplantation are essential options. However, various comorbidities associated with Danon disease should be assessed when these patients are being considered as potential heart transplant candidates. We report the case of an adult male patient with dilated-phase hypertrophic cardiomyopathy secondary to Danon disease, who received an LVAD as a bridge to transplantation. <Learning objective: Some patients with Danon disease who underwent heart transplantation have been reported in Japan, but all were female. Male patients with Danon disease have more severe systemic comorbidities than females and heart failure progression is usually too rapid for them to be listed as heart transplant candidates. We present a rare case of an adult male with Danon disease who successfully underwent implantation of a left-ventricular assist device as a bridge to transplantation.>
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Affiliation(s)
- Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Hideo Matama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yuki Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Keiichiro Iwasaki
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Koichi Toda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Noriko Kikuchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yuto Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yorihiko Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Fujita Tomoyuki
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
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33
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Matsumoto Y, Fukushima S, Shimahara Y, Kawamoto N, Tadokoro N, Kuroda K, Nakajima S, Watanabe T, Seguchi O, Yanase M, Fukushima N, Shimizu H, Kobayashi J, Fujita T. Early postoperative heparinization reduce hemolysis in patients with HeartMate II devices. J Artif Organs 2019; 23:19-26. [PMID: 31482437 DOI: 10.1007/s10047-019-01129-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/26/2019] [Indexed: 12/28/2022]
Abstract
Hemolysis is closely related with pump thrombosis and thromboembolic events in patients with continuous flow left ventricular assist devices. We retrospectively investigated the impact of early postoperative heparinization on hemolysis in patients with HeartMate II devices. From April 2013 to August 2017, 83 patients (age 45 ± 12 years; 20 females; body surface area 1.6 ± 0.2 m2) underwent HeartMate II implantation. Postoperative heparinization was started when hemostasis was achieved and continued until full warfarinization. Hemolysis was defined in accordance with the Interagency Registry for Mechanically Assisted Circulatory Support definitions. The average support period was 22 ± 14 months. The 6-, 12-, and 24-month freedoms from hemolysis were 72%, 70%, and 67%, respectively. Pump thrombosis developed in five (6%) patients and four (5%) required pump exchanges. Heparin start time was significantly later in patients with hemolysis (43 ± 23 h after implantation) versus those without (29 ± 14 h after implantation; p = 0.01). Receiver operating characteristic analysis determined the cut-off point of heparin start time as 29 h. The patients were divided into the early group (heparin start time < 29 h; n = 29), and the late group (heparin start time > 29 h; n = 54). The respective 6-, 12-, and 24-month freedoms from hemolysis for the early group (86%, 86%, and 86%, respectively) were significantly higher than those for the late group (49%, 47%, and 44%, respectively; p = 0.002). Being in the late group was an independent risk factor for hemolysis (hazard ratio 4.09). Early postoperative heparinization (within 29 h after implantation) reduces hemolysis in patients with HeartMate II devices.
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Affiliation(s)
- Yorihiko Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.,Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Yusuke Shimahara
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Naonori Kawamoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Naoki Tadokoro
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Kensuke Kuroda
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Seiko Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takuya Watanabe
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Osamu Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masanobu Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Norihide Fukushima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hideyuki Shimizu
- Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan.
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Iwata M, Nakajima S, Tie D, Kabashima K. 408 Skin colonized Staphylococcus aureus exacerbates the inflammation of murine irritant contact dermatitis via modulating innate immune pathways. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.410] [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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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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Kimura Y, Seguchi O, K Kono A, Matsumoto M, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Matsumoto Y, Fukushima S, Yanase M, Fujita T, Ishibashi-Ueda H, Kobayashi J, Fukushima N. Massive Biventricular Myocardial Calcification in a Patient with Fulminant Myocarditis Requiring Ventricular Assist Device Support. Intern Med 2019; 58:1283-1286. [PMID: 30568151 PMCID: PMC6543210 DOI: 10.2169/internalmedicine.2039-18] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
The natural course of myocardial calcification is unclear. We herein report a case of massive biventricular myocardial calcification associated with fulminant myocarditis and present its natural course. The patient was a 15-year-old boy. Massive calcification was detected in both ventricles on computed tomography several months after left ventricular assist device placement. Although the calcification gradually regressed, the patient's cardiac function did not recover, and he underwent heart transplantation after a waiting period of 3 years. A histological examination revealed severe fibrosis in both ventricles of the original heart. Myocardial calcification might suggest severe myocardial inflammation and injury in cases of fulminant myocarditis.
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Affiliation(s)
- Yuki Kimura
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Atsushi K Kono
- Department of Radiology, National Cerebral and Cardiovascular Center, Japan
| | - Manabu Matsumoto
- Department of Pathology, National Cerebral and Cardiovascular Center, Japan
| | - Yuto Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yorihiko Matsumoto
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Satsuki Fukushima
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Tomoyuki Fujita
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Japan
| | | | - Junjiro Kobayashi
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center, Japan
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center, Japan
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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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38
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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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Kimura Y, Yanase M, Mochizuki H, Iwasaki K, Toda K, Matsuda S, Takenaka H, Kumai Y, Kuroda K, Nakajima S, Watanabe T, Ikura MM, Wada K, Matsumoto Y, Seguchi O, Fukushima S, Fujita T, Kobayashi J, Fukushima N. De novo malignancy in heart transplant recipients: A single center experience in Japan. J Cardiol 2019; 73:255-261. [DOI: 10.1016/j.jjcc.2018.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/12/2018] [Accepted: 11/23/2018] [Indexed: 12/31/2022]
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Seguchi O, Kuroda K, Fujita T, Kumai Y, Nakajima S, Watanabe T, Yanase M, Matsumoto Y, Fukushima S, Kimura K, Fukushima N. Heart Transplantation Ameliorates Ambulation Capacity in Patients With Muscular Dystrophy - An Analysis of 9 Cases. Circ J 2019; 83:684-686. [PMID: 30686808 DOI: 10.1253/circj.cj-18-1060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Heart transplantation (HTx) is reported to have a comparable effect on the prognosis of heart failure patients without muscular disease and for those with muscular dystrophy (MD). However, little is known about the changes in muscular diseases in patients with MD after HTx. Methods and Results: We assessed the ambulatory capacity of 9 patients with MD who underwent HTx. All patients demonstrated improvement in ambulation to varying degrees and 1 patient successfully climbed Mount Fuji 3.8 years after HTx. CONCLUSIONS HTx potentially improves not only the prognosis but also the ambulatory capacity of patients with MD.
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Affiliation(s)
- Osamu Seguchi
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Kensuke Kuroda
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Yuto Kumai
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Seiko Nakajima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Takuya Watanabe
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Masanobu Yanase
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
| | - Yorihiko Matsumoto
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Koichi Kimura
- Department of Advanced Medical Science, The Institute of Medical Science, The University of Tokyo
| | - Norihide Fukushima
- Department of Transplant Medicine, National Cerebral and Cardiovascular Center
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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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Yamazaki K, Araki A, Miyashita C, Itoh S, Ikeno T, Nakajima S, Kajiwara J, Hori T, Kishi R. ERP P3 of school age children and prenatal exposure to dioxin: the Hokkaido Study on Environment and Children's Health. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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43
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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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44
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Matsumoto M, Asaumi Y, Nakamura Y, Nakatani T, Nagai T, Kanaya T, Kawakami S, Honda S, Kataoka Y, Nakajima S, Seguchi O, Yanase M, Nishimura K, Miyamoto Y, Kusano K, Anzai T, Noguchi T, Fujita T, Kobayashi J, Ishibashi-Ueda H, Shimokawa H, Yasuda S. Clinical determinants of successful weaning from extracorporeal membrane oxygenation in patients with fulminant myocarditis. ESC Heart Fail 2018; 5:675-684. [PMID: 29757498 PMCID: PMC6073023 DOI: 10.1002/ehf2.12291] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 01/10/2018] [Accepted: 03/17/2018] [Indexed: 11/25/2022] Open
Abstract
Aims Patients with fulminant myocarditis (FM) often present with cardiogenic shock and require mechanical circulatory support, including extracorporeal membrane oxygenation (ECMO) and ventricular assist device (VAD) implantation. This study sought to clarify the determinants of successful weaning from ECMO in FM patients. Methods and results We studied 37 consecutive FM patients supported by ECMO as the initial form of mechanical circulatory support between January 1995 and December 2014 in our hospital. Twenty‐two (59%) patients were successfully weaned from ECMO, while 15 (41%) were not. There were significant differences in levels of peak creatine kinase and those of its MB isoform (CK‐MB), left ventricular posterior wall thickness (LVPWT), and prevalence of cardiac rhythm disturbances. Receiver operating characteristic curve analysis revealed that a peak CK‐MB level of 185 IU/L and LVPWT of 11 mm were the optimal cut‐off values for predicting successful weaning from ECMO (areas under the curve, 0.89 and 0.85, respectively). During the follow‐up [median 48 (interquartile range 8–147) months], 83% of FM patients who were weaned from ECMO survived, with preserved fractional shortening based on echocardiography. Of the 15 FM patients who were not weaned from ECMO, nine bridged to VAD, and only two were successfully weaned from VAD and survived. Conclusions These results indicate that myocardial injury, as evidenced by CK‐MB and LVPWT, and prolonged presence of cardiac rhythm disturbances are important clinical determinants of successful weaning from ECMO.
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Affiliation(s)
- Manabu Matsumoto
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Department of Innovative Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yuichi Nakamura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Takeshi Nakatani
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Toshiyuki Nagai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Shoji Kawakami
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yu Kataoka
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Seiko Nakajima
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Osamu Seguchi
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Masanobu Yanase
- Department of Transplantation, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kunihiro Nishimura
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Yoshihiro Miyamoto
- Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Toshihisa Anzai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Junjiro Kobayashi
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hatsue Ishibashi-Ueda
- Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Department of Innovative Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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Hurabielle C, Nakajima S, Han S, Harrison O, Tamoutounour S, Merrill E, Lionakis M, Kaplan M, Belkaid Y. 953 Adaptive responses to skin microbe control the pathogenesis of experimental psoriasis. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.965] [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]
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46
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Malik K, Czarnowicki T, Wen H, Noda S, Pavel A, Nakajima S, Honda T, Shin J, Lee H, Krueger J, Lee K, Kabashima K, Guttman-Yassky E. 555 Integrating serum and skin biomarkers to assess disease extent beyond clinical scores, advancing precision therapeutics. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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47
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Tohda Y, Iwanaga T, Uejima H, Nagasaka Y, Nakajima S. Effects of Cytokines on Oxygen Radical Production by Peripheral Blood Monocytes and Alveolar Macrophages in Patients with Lung Cancer. Tumori 2018; 82:382-5. [PMID: 8890975 DOI: 10.1177/030089169608200417] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The effects of cytokines (interleukin-2, tumor necrosis factor-alpha and interferon-gamma) on the ability of peripheral blood monocytes and alveolar macrophages to produce oxygen radicals were examined by the chemiluminescence assay in patients with lung cancer. Oxygen radical production by peripheral blood monocytes before stimulation with cytokines was lower in the lung cancer group than in healthy controls, suggesting reduced immune function in lung cancer patients. However, the activity in the lung cancer group was elevated to the control level when the monocytes were stimulated by any of the three aforementioned cytokines. Oxygen radical production by alveolar macrophages did not differ significantly between nonstimulated monocytes from lung cancer patients and those from healthy controls. In the lung cancer group, stimulation of the macrophages with any of the three cytokines elevated their ability to produce oxygen radicals to the same extent as in the control group. The results suggest that stimulation of macrophages by interleukin-2, tumor necrosis factor-alpha or interferon-gamma can exert an antitumor action in patients with lung cancer.
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Affiliation(s)
- Y Tohda
- Fourth Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan
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48
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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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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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50
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Niki K, Okamoto Y, Nakajima S, Uejima E. The analgesic effect of rescue administration of intravenous acetaminophen in cancer patients may be associated with sex and opioid dose, and the effect would appear to patients administered under 45 mg/day opioid (oral morphine equivalents). Pharmazie 2018; 73:161-164. [PMID: 29544564 DOI: 10.1691/ph.2018.7878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
There have been no investigations examining the analgesic effect of rescue administration of intravenous acetaminophen (IV APAP) for pain in cancer patients. Fifty cancer patients who received IV APAP for pain at Ashiya Municipal Hospital (Hyogo, Japan) between January 2014 and July 2016 were retrospectively evaluated. The degree of pain was evaluated using a 4-point verbal rating scale. Pain intensity differences ≥ 1 defined the IV APAP effective group, and the patient' characteristics were compared by a medical chart review. Variables were extracted from medical records for logistic regression analyses of factors associated with analgesic effect. The cut-off value of opioid dose (oral morphine equivalent) was determined using receiver operator characteristic (ROC) curve analysis. Thirty eight (76%) patients experienced an analgesic effect of rescue administration of IV APAP. Sex (odds ratio [OR] 5.4014; p = 0.0397) and opioid dose used for pain control (OR 0.9901; p = 0.0147) were found to be associated with the efficacy of rescue administration of IV APAP. The cut-off value of opioid dose (oral morphine equivalent), which may be difficult to match the analgesic effect of IV APAP, was calculated to be more than 45 mg/day. This study demonstrated the efficacy of a rescue administration of IV APAP for pain in cancer patients, and revealed that sex and opioid dose may be associated with the analgesic effect. Furthermore, this study also proposes a criterion for the analgesic effect.
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