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Effects of empagliflozin on progression of chronic kidney disease: a prespecified secondary analysis from the empa-kidney trial. Lancet Diabetes Endocrinol 2024; 12:39-50. [PMID: 38061371 PMCID: PMC7615591 DOI: 10.1016/s2213-8587(23)00321-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Sodium-glucose co-transporter-2 (SGLT2) inhibitors reduce progression of chronic kidney disease and the risk of cardiovascular morbidity and mortality in a wide range of patients. However, their effects on kidney disease progression in some patients with chronic kidney disease are unclear because few clinical kidney outcomes occurred among such patients in the completed trials. In particular, some guidelines stratify their level of recommendation about who should be treated with SGLT2 inhibitors based on diabetes status and albuminuria. We aimed to assess the effects of empagliflozin on progression of chronic kidney disease both overall and among specific types of participants in the EMPA-KIDNEY trial. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included individuals aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to less than 45 mL/min per 1·73 m2, or with an eGFR of 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher. We explored the effects of 10 mg oral empagliflozin once daily versus placebo on the annualised rate of change in estimated glomerular filtration rate (eGFR slope), a tertiary outcome. We studied the acute slope (from randomisation to 2 months) and chronic slope (from 2 months onwards) separately, using shared parameter models to estimate the latter. Analyses were done in all randomly assigned participants by intention to treat. EMPA-KIDNEY is registered at ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and then followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroups of eGFR included 2282 (34·5%) participants with an eGFR of less than 30 mL/min per 1·73 m2, 2928 (44·3%) with an eGFR of 30 to less than 45 mL/min per 1·73 m2, and 1399 (21·2%) with an eGFR 45 mL/min per 1·73 m2 or higher. Prespecified subgroups of uACR included 1328 (20·1%) with a uACR of less than 30 mg/g, 1864 (28·2%) with a uACR of 30 to 300 mg/g, and 3417 (51·7%) with a uACR of more than 300 mg/g. Overall, allocation to empagliflozin caused an acute 2·12 mL/min per 1·73 m2 (95% CI 1·83-2·41) reduction in eGFR, equivalent to a 6% (5-6) dip in the first 2 months. After this, it halved the chronic slope from -2·75 to -1·37 mL/min per 1·73 m2 per year (relative difference 50%, 95% CI 42-58). The absolute and relative benefits of empagliflozin on the magnitude of the chronic slope varied significantly depending on diabetes status and baseline levels of eGFR and uACR. In particular, the absolute difference in chronic slopes was lower in patients with lower baseline uACR, but because this group progressed more slowly than those with higher uACR, this translated to a larger relative difference in chronic slopes in this group (86% [36-136] reduction in the chronic slope among those with baseline uACR <30 mg/g compared with a 29% [19-38] reduction for those with baseline uACR ≥2000 mg/g; ptrend<0·0001). INTERPRETATION Empagliflozin slowed the rate of progression of chronic kidney disease among all types of participant in the EMPA-KIDNEY trial, including those with little albuminuria. Albuminuria alone should not be used to determine whether to treat with an SGLT2 inhibitor. FUNDING Boehringer Ingelheim and Eli Lilly.
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T, Tamori Y, Tamura R, Tamura Y, Tan CHH, Tan EZZ, Tanabe A, Tanabe K, Tanaka A, Tanaka A, Tanaka N, Tang S, Tang Z, Tanigaki K, Tarlac M, Tatsuzawa A, Tay JF, Tay LL, Taylor J, Taylor K, Taylor K, Te A, Tenbusch L, Teng KS, Terakawa A, Terry J, Tham ZD, Tholl S, Thomas G, Thong KM, Tietjen D, Timadjer A, Tindall H, Tipper S, Tobin K, Toda N, Tokuyama A, Tolibas M, Tomita A, Tomita T, Tomlinson J, Tonks L, Topf J, Topping S, Torp A, Torres A, Totaro F, Toth P, Toyonaga Y, Tripodi F, Trivedi K, Tropman E, Tschope D, Tse J, Tsuji K, Tsunekawa S, Tsunoda R, Tucky B, Tufail S, Tuffaha A, Turan E, Turner H, Turner J, Turner M, Tuttle KR, Tye YL, Tyler A, Tyler J, Uchi H, Uchida H, Uchida T, Uchida T, Udagawa T, Ueda S, Ueda Y, Ueki K, Ugni S, Ugwu E, Umeno R, Unekawa C, Uozumi K, Urquia K, Valleteau A, Valletta C, van Erp R, Vanhoy C, Varad V, Varma R, Varughese A, Vasquez P, Vasseur A, Veelken R, Velagapudi C, Verdel K, Vettoretti S, Vezzoli G, Vielhauer V, Viera R, Vilar E, Villaruel S, Vinall L, Vinathan J, Visnjic M, Voigt E, von-Eynatten M, Vourvou M, Wada J, Wada J, Wada T, Wada Y, Wakayama K, Wakita Y, Wallendszus K, Walters T, Wan Mohamad WH, Wang L, Wang W, Wang X, Wang X, Wang Y, Wanner C, Wanninayake S, Watada H, Watanabe K, Watanabe K, Watanabe M, Waterfall H, Watkins D, Watson S, Weaving L, Weber B, Webley Y, Webster A, Webster M, Weetman M, Wei W, Weihprecht H, Weiland L, Weinmann-Menke J, Weinreich T, Wendt R, Weng Y, Whalen M, Whalley G, Wheatley R, Wheeler A, Wheeler J, Whelton P, White K, Whitmore B, Whittaker S, Wiebel J, Wiley J, Wilkinson L, Willett M, Williams A, Williams E, Williams K, Williams T, Wilson A, Wilson P, Wincott L, Wines E, Winkelmann B, Winkler M, Winter-Goodwin B, Witczak J, Wittes J, Wittmann M, Wolf G, Wolf L, Wolfling R, Wong C, Wong E, Wong HS, Wong LW, Wong YH, Wonnacott A, Wood A, Wood L, Woodhouse H, Wooding N, Woodman A, Wren K, Wu J, Wu P, Xia S, Xiao H, Xiao X, Xie Y, Xu C, Xu Y, Xue H, Yahaya H, Yalamanchili H, Yamada A, Yamada N, Yamagata K, Yamaguchi M, Yamaji Y, Yamamoto A, Yamamoto S, Yamamoto S, Yamamoto T, Yamanaka A, Yamano T, Yamanouchi Y, Yamasaki N, Yamasaki Y, Yamasaki Y, Yamashita C, Yamauchi T, Yan Q, Yanagisawa E, Yang F, Yang L, Yano S, Yao S, Yao Y, Yarlagadda S, Yasuda Y, Yiu V, Yokoyama T, Yoshida S, Yoshidome E, Yoshikawa H, Young A, Young T, Yousif V, Yu H, Yu Y, Yuasa K, Yusof N, Zalunardo N, Zander B, Zani R, Zappulo F, Zayed M, Zemann B, Zettergren P, Zhang H, Zhang L, Zhang L, Zhang N, Zhang X, Zhao J, Zhao L, Zhao S, Zhao Z, Zhong H, Zhou N, Zhou S, Zhu D, Zhu L, Zhu S, Zietz M, Zippo M, Zirino F, Zulkipli FH. Impact of primary kidney disease on the effects of empagliflozin in patients with chronic kidney disease: secondary analyses of the EMPA-KIDNEY trial. Lancet Diabetes Endocrinol 2024; 12:51-60. [PMID: 38061372 DOI: 10.1016/s2213-8587(23)00322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND The EMPA-KIDNEY trial showed that empagliflozin reduced the risk of the primary composite outcome of kidney disease progression or cardiovascular death in patients with chronic kidney disease mainly through slowing progression. We aimed to assess how effects of empagliflozin might differ by primary kidney disease across its broad population. METHODS EMPA-KIDNEY, a randomised, controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA). Patients were eligible if their estimated glomerular filtration rate (eGFR) was 20 to less than 45 mL/min per 1·73 m2, or 45 to less than 90 mL/min per 1·73 m2 with a urinary albumin-to-creatinine ratio (uACR) of 200 mg/g or higher at screening. They were randomly assigned (1:1) to 10 mg oral empagliflozin once daily or matching placebo. Effects on kidney disease progression (defined as a sustained ≥40% eGFR decline from randomisation, end-stage kidney disease, a sustained eGFR below 10 mL/min per 1·73 m2, or death from kidney failure) were assessed using prespecified Cox models, and eGFR slope analyses used shared parameter models. Subgroup comparisons were performed by including relevant interaction terms in models. EMPA-KIDNEY is registered with ClinicalTrials.gov, NCT03594110. FINDINGS Between May 15, 2019, and April 16, 2021, 6609 participants were randomly assigned and followed up for a median of 2·0 years (IQR 1·5-2·4). Prespecified subgroupings by primary kidney disease included 2057 (31·1%) participants with diabetic kidney disease, 1669 (25·3%) with glomerular disease, 1445 (21·9%) with hypertensive or renovascular disease, and 1438 (21·8%) with other or unknown causes. Kidney disease progression occurred in 384 (11·6%) of 3304 patients in the empagliflozin group and 504 (15·2%) of 3305 patients in the placebo group (hazard ratio 0·71 [95% CI 0·62-0·81]), with no evidence that the relative effect size varied significantly by primary kidney disease (pheterogeneity=0·62). The between-group difference in chronic eGFR slopes (ie, from 2 months to final follow-up) was 1·37 mL/min per 1·73 m2 per year (95% CI 1·16-1·59), representing a 50% (42-58) reduction in the rate of chronic eGFR decline. This relative effect of empagliflozin on chronic eGFR slope was similar in analyses by different primary kidney diseases, including in explorations by type of glomerular disease and diabetes (p values for heterogeneity all >0·1). INTERPRETATION In a broad range of patients with chronic kidney disease at risk of progression, including a wide range of non-diabetic causes of chronic kidney disease, empagliflozin reduced risk of kidney disease progression. Relative effect sizes were broadly similar irrespective of the cause of primary kidney disease, suggesting that SGLT2 inhibitors should be part of a standard of care to minimise risk of kidney failure in chronic kidney disease. FUNDING Boehringer Ingelheim, Eli Lilly, and UK Medical Research Council.
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KATO R, Suzuki Y, Suzuki H, Aoki R, Koizumi A, Lee M, Homma N, Fukao Y, Nakayama M, Nihei Y, Muto M, Kano T, Makita Y, Miyazaki T, Arai S. WCN23-0498 The pathogenesis of glomerular inflammatory mechanism through Apoptosis Inhibitor of Macrophage. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.152] [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: 03/22/2023] Open
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LEE M, Suzuki H, Kato R, Fukao Y, Nakayama M, Kano T, Makita Y, Suzuki Y. WCN23-0093 TLR9/TLR7 ARE STRONG CANDIDATES FOR DISEASE-SPECIFIC THERAPEUTIC TARGETS IN IgA NEPHROPATHY. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.02.464] [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: 03/22/2023] Open
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Tsuda N, Inokuma S, Noguchi H, Yamaji M, Harada T, Misaki M, Masui Y, Kano T. AB0382 COMPARISON OF ADVERSE EVENTS (AEs) RELATED TO MAJOR ANTI-RHEUMATIC DRUGS, REPORTED TO THE OFFICIAL JAPANESE ADVERSE DRUG EVENT REPORT DATABASE (JADER). Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.118] [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: 11/04/2022]
Abstract
BackgroundCurrently, many disease-modifying anti-rheumatic drugs (DMARDs) are available for the treatment of rheumatoid arthritis (RA). Among them, methotrexate (MTX), biologic DMARDs (bDMARDs) and Janus kinase inhibitors (JAKi) are the major options. AEs related to these are major concerns. In Japan, the AEs data spontaneously reported to and summarized by Pharmaceuticals and Medical Devices Agency (PMDA) are freely accessible.ObjectivesThe major AEs relating to MTX, bDMARDs, and JAKi observed in the real world were compared.MethodsThe number of AEs listed by JADER from 2014 to 2020 was collected. The AEs were classified by System Organ Class (SOC) of Medical Dictionary for Regulatory Activities (MedDRA) and compared using the chi-square test. The bDMARDs included were etanercept (ETN), adalimumab (ADA), golimumab (GOL), tocilizumab (TCZ), and abatacept (ABT), and JAKi was tofacitinib (TOF) and baricitinib (BAR).ResultsThe total number of AEs was 27,604. The number was significantly increasing in total and MTX, GOL, TOF during these years, although the number of cases that have each DMARD is not known in this study. The proportion of SOCs among each DMARD was similar throughout the period.The most frequent was infections/infestations in all DMARDs except for MTX, in which neoplasms were the most. The primary cause of infection was bacterial, including pneumonia. Varicella-zoster virus infection in JAKi, and tuberculosis in ADA and GOL were conspicuous.Neoplasms were the second major in many DMARDs. Lymphoproliferative disorders were most common in MTX-related neoplasms, whereas solid tumors were more in other DMARDs like ABT or BAR.Other SOCs include all other categories such as the musculoskeletal, nervous system, cardiac, and vascular disorders. Among them, major adverse cardiovascular events (MACE, including cardiovascular death, myocardial infarction and stroke) and venous thromboembolism (VTE) were both reported in small numbers. However, more MACE was noted in BAR and GOL, and more VTE was in BAR and TOF compared to other DMARDs.ConclusionThe number of AEs cases related to DMARDs was increasing. Significant difference among AEs related to DMARDs was noted in the JADER database, especially regarding MTX and JAKi.References[1]S. Inokuma. Expert Open Drug Saf. 2021 Nov 11. Online ahead of print.Table 1.Total case numbers and proportion of adverse events related to each DMARD.DMARDs (year of launch)TotalMTX (1999)ETN (2005)ADA (2008)GOL (2011)TCZ (2008)ABT (2010)TOF (2013)BAR (2017)Number of AEs2760411636297419591302424517093065714Blood/lymphatic system disorders5.89.92.03.22.64.00.92.83.5Gastrointestinal disorders5.04.13.47.55.97.73.95.24.2General disorders/administration site reactions4.63.211.34.12.23.04.07.62.5Infections/infestations28.020.321.332.234.236.537.137.049.2 Pneumonia (bacterial)6.64.06.15.210.97.712.59.415.1 Other bacterial infection9.15.95.612.39.517.69.19.810.6 Herpes zoster2.11.10.41.41.21.01.28.211.2 Tuberculosis1.40.91.96.03.50.60.60.31.0Investigations5.04.95.52.32.65.72.28.32.8Neoplasms benign, malignant, unspecified21.134.811.013.512.77.415.610.815.4 Lymphoproliferative diseases14.329.82.84.14.02.24.52.12.2 Solid tumors5.63.87.37.87.54.09.97.310.5Respiratory, thoracic, mediastinal disorders7.16.88.38.49.56.57.46.26.7Other System Organ Class23.315.937.328.830.229.228.922.215.7 Major adverse cardiovascular events1.10.41.11.62.51.51.61.32.9 Venous thromboembolism0.40.10.40.50.60.30.21.11.4Background colors indicate: comparing to the total cases, higher with p<0.05, light pink; higher with p<0.00001, dark pink; higher with p<1E-10, red. Lower with p<0.05, light blue; lower with p<0.00001, blue; lower with p<1E-10, dark blue, using chi-square test. Yellow indicates System Organ Classes.Figure 1.Total number of adverse events reported from 2014 to 2020.Linear regression is shown only for DMARDs with increasing numbers of AEs.Disclosure of InterestsNone declared
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KIM J, Suzuki H, Kano T, Fukao Y, Nakayama M, Suzuki Y. POS-399 Anti-BAFF antibody is effective to inhibit the production of immunoglobulins, but not nephritogenic IgA in murine IgA nephropathy. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.421] [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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Kano T, Nagata Y, Sawada R, Ishimoto U, Nishimura T, Noguchi M, Ohkuma M, Kosuge M, Amano K, Eto K, Saruta M. Tolerability and feasibility of oxaliplatin-containing adjuvant chemotherapy for elderly patients with colorectal cancer. J Geriatr Oncol 2021. [DOI: 10.1016/s1879-4068(21)00343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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KING A, Oballa R, Gunawan M, Cox J, Wu J, Chong O, Surendradoss J, Lester J, Nieh C, Kano T, Suzuki Y. POS-378 SELECTIVE ETA ANTAGONIST ATRASENTAN, RAPIDLY REDUCES ALBUMINURIA AND DOWNREGULATES INTRA-RENAL PRO-INFLAMMATORY AND PRO-FIBROTIC TRANSCRIPTIONAL NETWORKS IN THE GDDY MOUSE MODEL OF SPONTANEOUS IGA NEPHROPATHY. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Brown R, Imawari M, Izumi N, Osaki Y, Bentley R, Baykal T, Ochiai T, Kano T. Abstract No. 617 Lusutrombopag reliably increases platelets regardless of baseline platelet counts in thrombocytopenic chronic liver disease patients undergoing planned invasive procedures: results of two phase 3 trials. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Brown R, Imawari M, Izumi N, Osaki Y, Ochiai T, Kano T, Bentley R, Peck-Radosavljevic M. Abstract No. 615 Lusutrombopag is a safe and efficacious treatment option for thrombocytopenia in patients with chronic liver disease undergoing planned invasive procedures: integrated analysis of two phase 3 trials. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Brown R, Izumi N, Kano T, Ochiai T, Kurosaki M, Violi F, Shrestha P. Abstract No. 616 Lusutrombopag is a safe treatment option for thrombocytopenia in patients with chronic liver disease undergoing a planned invasive procedure: pooled safety analysis from three studies. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Nagata Y, Kinoshita C, Ishimoto U, Kano T, Ishikawa M, Mikuni H, Nakatsuka K, Harada K, Nishimura T, Noguchi M, Sawada R, Amano K, Saruta M. Details of response with first-line gemcitabine and nab-paclitaxel therapy in patients with advanced pancreatic cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.067] [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: 11/12/2022] Open
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Murata K, Kokubun T, Onitsuka K, Oka Y, Kano T, Morishita Y, Ozone K, Kuwabara N, Nishimoto J, Isho T, Takayanagi K, Kanemura N. Controlling joint instability after anterior cruciate ligament transection inhibits transforming growth factor-beta-mediated osteophyte formation. Osteoarthritis Cartilage 2019; 27:1185-1196. [PMID: 31026650 DOI: 10.1016/j.joca.2019.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 02/14/2019] [Accepted: 03/04/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Abnormal joint instability contributes to cartilage damage and osteophyte formation. We investigated whether controlling joint instability inhibited chronic synovial membrane inflammation and delayed osteophyte formation and examined the role of transforming growth factor-beta (TGF-β) signaling in the associated mechanism. DESIGN Rats (n = 94) underwent anterior cruciate ligament (ACL) transection. Anterior tibial instability was either controlled (CAM group) or allowed to continue (SHAM group). At 2, 4, and 8 weeks after surgery, radiologic, histopathologic, immunohistochemical, immunofluorescent, and enzyme-linked immunosorbent assay examinations were performed to evaluate osteophyte formation and TGF-β signaling. RESULTS Joint instability increased cartilage degeneration score and osteophyte formation, and cell hyperplasia and proliferation and synovial thickening were observed in the synovial membrane. Major findings were increased TGF-β expression and Smad2/3 following TGF-β phosphorylation in synovial membarene, articular cartilage, and the posterior tibial growth plate (TGF-β expression using ELISA: 4 weeks; P = 0.009, 95% CI [260.1-1340.0]) (p-Smad2/3 expression density: 4 weeks; P = 0.024, 95% CI [1.67-18.27], 8 weeks; P = 0.034, 95% CI [1.25-25.34]). However, bone morphogenetic protein (BMP)-2 and Smad1/5/8 levels were not difference between the SHAM model and the CAM model. CONCLUSIONS This study showed that the difference between anterior tibial instability caused a change in the expression level of TGF in the posterior tibia and synovial membrane, and the reaction might be consequently involved in osteophyte formation.
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Affiliation(s)
- K Murata
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
| | - T Kokubun
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
| | - K Onitsuka
- Department of Rehabilitation, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan.
| | - Y Oka
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - T Kano
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - Y Morishita
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - K Ozone
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - N Kuwabara
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - J Nishimoto
- Department of Health and Social Services, Health and Social Services, Graduate School of Saitama Prefectural University, Saitama, Japan.
| | - T Isho
- Department of Rehabilitation, Fujioka General Hospital, Gunma, Japan.
| | - K Takayanagi
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
| | - N Kanemura
- Department of Physical Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan.
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Fukuhara A, Owaki D, Kano T, Kobayashi R, Ishiguro A. Spontaneous gait transition to high-speed galloping by reconciliation between body support and propulsion. Adv Robot 2018. [DOI: 10.1080/01691864.2018.1501277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Fukuhara
- Research Institute of Electric and Communication, Tohoku University, Sendai, Japan
| | - D. Owaki
- Department of Robotics, Graduate School of Engineering, Tohoku University, Sendai, Japan
| | - T. Kano
- Research Institute of Electric and Communication, Tohoku University, Sendai, Japan
| | - R. Kobayashi
- Graduate School of Science, Hiroshima University, Hiroshima, Japan
| | - A. Ishiguro
- Research Institute of Electric and Communication, Tohoku University, Sendai, Japan
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Kokubun T, Shono H, Morishita Y, Kanemura N, Murata K, Kano T, Ozone K, Oka Y, Hayashi H, Takayanagi K. Integrin and fibronectin guide bridging movement of remnants during anterior cruciate ligament spontaneous healing in rat model. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.963] [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: 10/28/2022]
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Naganuma R, Sato S, Kudo A, Sato C, Uwatoko H, Shirai S, Nishimura H, Takahashi I, Matsushima M, Kano T, Yabe I, Houzen H, Sasaki H. Long term observation of Lambert-Eaton myasthenic syndrome patients treated with 3,4-diaminopyridine. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Yamashita H, Kubota K, Takahashi Y, Kaneko H, Kano T, Mimori A. AB0970 Utility of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Early Diagnosis and Evaluation of Disease Activity of Relapsing Polychondritis. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1039] [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: 11/04/2022]
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Iino Y, Kano T, Adachi F, Suzuki M, Nishikawa R, Ishii N, Ohata C, Furumura M, Hamada T, Hashimoto T. A case of bullous pemphigoid associated with psoriasis vulgaris showing Hailey-Hailey disease-like histopathological changes in regenerated epidermis without genomic mutation in ATP2C1
or ATP2A2
gene. J Eur Acad Dermatol Venereol 2014; 29:1646-8. [DOI: 10.1111/jdv.12521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Y. Iino
- Department of Dermatology; Ibaraki Prefectural Central Hospital; Kasama Ibaraki Japan
| | - T. Kano
- Department of Dermatology; Ibaraki Prefectural Central Hospital; Kasama Ibaraki Japan
| | - F. Adachi
- Department of Dermatology; Ibaraki Prefectural Central Hospital; Kasama Ibaraki Japan
| | - M. Suzuki
- Department of Dermatology; Ibaraki Prefectural Central Hospital; Kasama Ibaraki Japan
| | - R. Nishikawa
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
| | - N. Ishii
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
| | - C. Ohata
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
| | - M. Furumura
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
| | - T. Hamada
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
| | - T. Hashimoto
- Department of Dermatology; Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology; Kurume Fukuoka Japan
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Yamashita H, Takahashi H, Kubota K, Ueda Y, Ozaki T, Yorifuji H, Bannai E, Minamimoto R, Morooka M, Miyata Y, Okasaki M, Takahashi Y, Kaneko H, Kano T, Mimori A. Utility of fluorodeoxyglucose positron emission tomography/computed tomography for early diagnosis and evaluation of disease activity of relapsing polychondritis: a case series and literature review. Rheumatology (Oxford) 2014; 53:1482-90. [DOI: 10.1093/rheumatology/keu147] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Yamashita H, Shimizu A, Tsuchiya H, Takahashi Y, Kaneko H, Kano T, Mimori A. Chronic active Epstein-Barr virus infection mimicking autoimmune hepatitis exacerbation in a patient with systemic lupus erythematosus. Lupus 2014; 23:833-6. [PMID: 24608961 DOI: 10.1177/0961203314527367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/17/2014] [Indexed: 11/16/2022]
Abstract
Chronic active Epstein-Barr virus infection (CAEBV) is characterized by chronic infectious mononucleosis-like symptoms. We report a very rare case with autoimmune hepatitis (AIH) complicated by CAEBV. A 50-year-old woman with systemic lupus erythematosus (SLE) complicated by AIH began to suffer from acute respiratory failure and her clinical symptoms improved rapidly in response to steroid treatment. However, during the gradual tapering of the steroid dose, a steady increase of the serum hepatobiliary enzyme levels subsequently was observed and the patient began to have continuous fever. Moreover, upper gastrointestinal endoscopy revealed multiple intractable gastric ulcers. When EBER-ISH was performed on liver biopsy and gastric mucosal biopsy specimens, EBER-positive lymphocytes were observed. When peripheral blood was examined, 2.1 × 10(6) copies/µg of EBV-DNA were observed in the CD4-positive T cells, confirming the diagnosis of CAEBV. A cooling therapy was started by steroid and cyclosporine. Thereafter, despite the start of CHOP therapy, she developed a malignant lymphoma (PTCL-NOS) and died of hepatic failure. When treatment-resistant AIH patients are encountered, not only AIH exacerbation but also CAEBV should be considered in the differential diagnosis.
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Affiliation(s)
- H Yamashita
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - A Shimizu
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - H Tsuchiya
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Y Takahashi
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - H Kaneko
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - T Kano
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - A Mimori
- Division of Rheumatic Diseases, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
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Harada M, Kuwahara R, Yoshida H, Hashimoto O, Sakamoto M, Koga Y, Kano T, Sata M. Dextromethorphan for neuropathic pain with Churg-Strauss syndrome. Mod Rheumatol 2014; 11:80-2. [PMID: 24387027 DOI: 10.3109/s101650170050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract A 48-year old man who had been treated with prednisolone, aminophylline, and pranlukast, a leukotriene-receptor antagonist, was diagnosed with Churg-Strauss syndrome based on the findings of asthma, eosinophilia, mononeuropathy, and extravascular eosinophils. Intractable neuropathic pain of the legs was successfully controlled with an N-methyl-d-aspartate receptor antagonist, dextromethorphan. We suggest that dextromethorphan receptor antagonists may be a useful treatment for the pain of neuropathy caused by vasculitis syndrome.
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Affiliation(s)
- M Harada
- Second Department of Medicine, Kurume University School of Medicine , 67 Asahi-machi, Kurume 830-0011 , Japan
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Yamashita H, Takahashi Y, Kaneko H, Kubota K, Kano T, Mimori A. SAT0390 Differential FDG-PET/CT findings for spondylarthropathies, PMR, and RA. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3336] [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: 11/03/2022]
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Tsumita M, Kokubo Y, Kano T. Effect of surface treatments on the bond strengths of facing composite resins to zirconia copings. Eur J Prosthodont Restor Dent 2012; 20:122-129. [PMID: 23101178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The present study evaluated and compared the bond strength between zirconia and facing composite resin using different surface conditioning methods before and after thermocycling. Four primers, three opaque resins, and two facing composite resins were used, and 10 surface treatment procedures were conducted. The bond strength was measured before and after 4,000 cycles of thermocycling. The mean values of each group were statistically analyzed using one-way analysis of variance (ANOVA). The bond strengths of facing composite resins to zirconia after various treatments varied depending on the primers, opaque resins, body resins, and thermocycling. The application of primers and opaque resins to the zirconia surface after sandblasting is expected to yield strong bond strength of the facing composite resin (Estenia CG&B) even after thermocycling.
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Ichimura S, Ohira T, Kobayashi M, Kano T, Akiyama T, Orii M, Fukunaga A, Kawase T. Assessment of Cognitive Function before and after Surgery for Posterior Cranial Fossa Lesions Using Computerized and Conventional Tests. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1314324] [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: 10/28/2022]
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Kano T, Kobayashi M, Ohira T, Kawase T. P29-24 Speech-induced modulation of interhemispheric inhibition. Clin Neurophysiol 2010. [DOI: 10.1016/s1388-2457(10)61140-6] [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]
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Kano T, Kinoshita S. Control of individual phase relationship between coupled oscillators using multilinear feedback. Phys Rev E Stat Nonlin Soft Matter Phys 2010; 81:026206. [PMID: 20365637 DOI: 10.1103/physreve.81.026206] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Indexed: 05/29/2023]
Abstract
Due to various technological and medical demands, several methods for controlling the dynamical behavior of coupled oscillators have been developed. In the present study, we develop a method to control the individual phase relationship between coupled oscillators, in which multilinear feedback is used to modify the interaction between the oscillators. By carrying out a simulation, we show that the phase relationship can be well controlled by using the proposed method and the control is particularly robust when the target coupling function is selected properly.
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Affiliation(s)
- T Kano
- Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan.
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Kokubo Y, Kano T, Tsumita M, Sakurai S, Itayama A, Fukushima S. Retention of zirconia copings on zirconia implant abutments cemented with provisional luting agents. J Oral Rehabil 2009; 37:48-53. [PMID: 19849775 DOI: 10.1111/j.1365-2842.2009.02013.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study is to measure and compare the retentive force of zirconia-based all-ceramic crowns cemented on zirconia abutments using five provisional luting agents. In addition, the effect of sandblasting and thermocycling on the retentive force was evaluated. Two hundred zirconia abutments and copings were fabricated (Procera system; Nobel Biocare) and divided into five groups. Hy bond temporary cement hard (Hard), Hy bond temporary cement soft (Soft), experimental temporary cement (New), Tempbond NE (Temp) and Freegenool temporary pack (Pack) were used according to the manufacturers' instructions. Each group was divided into two groups, one with and one without sandblasting. Furthermore, thermocycling up to 2000 cycles was conducted on half of each group. After 24 h and thermocycling, the retentive force was measured using a universal testing machine. The data were subjected to analysis of variance, and comparisons of the means were performed with a Games-Howell test at a level of 95%. As a result, Hard showed the highest retentive force, sandblasting was effective for improving the durability, and no effect of sandblasting was detected in the others. New showed stability of the retentive force even after thermocycling. The retentive force of Temp and Pack decreased significantly after thermocycling even with sandblasting. The retentive forces were different from the provisional cement and sandblasting, and Temp and Pack may not be appropriate for the retention of single-tooth zirconia abutments and coping restorations.
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Affiliation(s)
- Y Kokubo
- Department of Fixed Prosthodontics, Tsurumi University School of Dental Medicine, Yokohama, Japan.
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Abstract
A density oscillator is a well-known system, which exhibits relaxation oscillation. It alternately exhibits up and down flows through a pipe that connects two containers filled with fluids that have different densities. Although the up-flow, down-flow, and flow-reversal processes have been studied separately, the entire oscillatory dynamics has not been modeled quantitatively. In this study, we derive a model of a density oscillator by considering all the above mentioned processes. The model thus obtained describes the oscillatory behavior in a unified manner, and its viscosity and pipe-length dependence is well described. Moreover, for the demonstration of this model, we have extended it to describe the dynamical behaviors observed in coupled density oscillators. Thus, this model provides a general expression for density oscillators.
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Affiliation(s)
- T Kano
- Graduate School of Frontier Biosciences, Osaka University, Suita, Japan.
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Kano T, Kinoshita S. Method to control the coupling function using multilinear feedback. Phys Rev E Stat Nonlin Soft Matter Phys 2008; 78:056210. [PMID: 19113203 DOI: 10.1103/physreve.78.056210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Indexed: 05/27/2023]
Abstract
Methods to control the dynamics of coupled oscillators have been developed owing to various medical and technological demands. In this study, we develop a method to control coupled oscillators in which the coupling function expressed in a phase model is regulated by the multilinear feedback. The present method has wide applicability because we do not need to measure an individual output from each oscillator, but only measure the sum of the outputs from all the oscillators. Moreover, it allows us to easily control the coupling function up to higher harmonics. The validity of the present method is confirmed through a simulation.
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Affiliation(s)
- T Kano
- Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan.
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Hori Y, Yamano S, Iwanaga K, Kano T, Tanabe M, Uechi M, Kanai K, Nakao R, Hoshi F, Higuchi S. Evaluation of plasma C-terminal atrial natriuretic peptide in healthy cats and cats with heart disease. J Vet Intern Med 2008; 22:135-9. [PMID: 18289300 DOI: 10.1111/j.1939-1676.2007.0007.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The clinical implications of evaluating C-terminal atrial natriuretic peptide (ANP) concentration in cats are still controversial. HYPOTHESIS The objective of this study was to investigate the relationship between plasma C-terminal ANP concentration and left atrial pressure (LAP) in healthy cats with volume overload (study 1), and to compare plasma C-terminal ANP in normal cats and cats with cardiomyopathy (study 2). ANIMALS Five healthy adult cats were used in study 1, and clinically healthy cats (n=8) and cats with cardiomyopathy (n=14) were used in study 2. METHODS In study 1, cats were anesthetized and given acetated Ringer's solution (100 mL/kg/h for 60 minute) via the cephalic vein. Hemodynamic measurements and blood samples, collected from the jugular vein, were performed at 10-min intervals. In study 2, blood samples from normal cats and cats with cardiomyopathy were collected from the cephalic vein. The plasma C-terminal ANP concentration was determined by radioimmunoassay for human alpha-ANP. RESULTS In study 1, volume overload significantly increased the C-terminal ANP concentration and LAP from baseline. The C-terminal ANP concentration was strongly correlated with the mean LAP. In study 2, age, E wave velocity, and the ratios of the left atrium to aorta were significantly higher in the cats with cardiomyopathy compared with the normal cats. The C-terminal ANP concentration was significantly higher in the cats with cardiomyopathy compared with the normal cats. CONCLUSIONS AND CLINICAL IMPORTANCE Our results suggest that the measurement of plasma C-terminal ANP in cats may provide additional information for the diagnosis of heart disease.
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Affiliation(s)
- Y Hori
- Department of Small Animal Internal Medicine, School of Veterinary Medicine, Kitasato University, Aomori, Japan.
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Nagao M, Nakajima Y, Sudo M, Kano T, Ishizaki A, Harada T, Tanimura K, Okajima F, Tamura H, Ishii S, Sugihara H, Asai A, Oikawa S. SERUM INSULIN-LIKE GROWTH FACTOR-1 LEVELS ARE ASSOCIATED WITH CAROTID ATHEROSCLEROSIS IN TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70304-0] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Tanimura K, Nagao M, Nakajima Y, Sudo M, Kano T, Ishizaki A, Harada T, Okajima F, Tamura H, Ishii S, Sugihara H, Oikawa S. FASTING LEVEL AND DIURNAL CHANGE OF SERUM APOLIPOPROTEIN B48 CORRELATED TO CAROTID ARTERY PLAQUE IN TYPE 2 DIABETES. ATHEROSCLEROSIS SUPP 2008. [DOI: 10.1016/s1567-5688(08)70284-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kano T, Kinoshita S. Viscosity-dependent flow reversal in a density oscillator. Phys Rev E Stat Nonlin Soft Matter Phys 2007; 76:046208. [PMID: 17995083 DOI: 10.1103/physreve.76.046208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 07/26/2007] [Indexed: 05/25/2023]
Abstract
The density oscillator is a simple system that exhibits self-sustained oscillation. It alternately exhibits up and down flow through a pipe which connects two containers filled with fluids of different densities. However, the mechanism of the flow reversal has not yet been fully understood. From the detailed measurements, we have found that flow reversal begins with an intrusion of fluid, which is followed by rapid growth. This process is definitely sensitive to the viscosities of the fluids, and as a consequence, the critical heights leading to flow reversal are clearly viscosity dependent. These experimental results are explained by a simple model, derived by considering forces acting on a unit volume element located at the tip of the intrusion. Using this model, we can successfully explain the mechanism of flow reversal, which is the most essential process in a density oscillator.
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Affiliation(s)
- T Kano
- Graduate School of Frontier Biosciences, Osaka University, Suita 565-0871, Japan.
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Kano T, Harada T, Hirayama T, Katayama Y. Combination Therapy Using tPA and Edaravone Improves the Neurotoxic Effect of tPA. Interv Neuroradiol 2007; 13 Suppl 1:106-8. [PMID: 20566086 DOI: 10.1177/15910199070130s115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Accepted: 01/15/2007] [Indexed: 11/17/2022] Open
Abstract
SUMMARY In acute ischemic stroke patients, administration of tissue plasminogen activator (tPA) was proven to improve clinical outcome. On the other hand, neurotoxic effects of tPA have been reported in animal experimental studies. Using a rat thromboembolic stroke model, we examined whether or not the free radical scavenger, edaravone, could attenuate such neurotoxic effect of tPA administered for the purpose of fibrinolysis. Even when early recanalization was induced by administering tPA at 30 minutes after the onset of ischemia, significant amount of tPA was extravasated through the cerebral vessels. Edaravone significantly attenuated extravasation of tPA. Combination therapy using tPA and edaravone appears to be a promising strategy for diminishing the negative effects of tPA.
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Affiliation(s)
- T Kano
- Department of Neurological Surgery, Nihon University School of Medicine; Japan -
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Hoshino T, Sakatani K, Kano T, Murata Y, Katayama Y. Cerebral blood oxygenation changes induced by bypass blood flow in moyamoya disease and non-moyamoya cerebral ischaemic disease. Acta Neurochir (Wien) 2006; 148:551-7; discussion 557. [PMID: 16467961 DOI: 10.1007/s00701-006-0733-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2005] [Accepted: 12/06/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis has been used to prevent stroke in patients with moyamoya disease (MD) and non-moyamoya ischaemic disease (non-MD). However, little is yet known regarding the difference between these groups of patients in the extent to which the bypass contributes to maintaining adequate cerebral blood oxygenation (CBO), or the temporal changes after surgery. In the present study, we evaluated the CBO changes induced by bypass blood flow in patients with MD and non-MD during the peri-operative periods employing optical spectroscopy. METHODS We investigated 13 patients who underwent STA-MCA anastomosis, including 5 MD and 8 non-MD patients. We evaluated the effects of STA blood flow on the CBO in the MCA territory on the anastomosis side, employing visual light spectroscopy during surgery and near infrared spectroscopy (NIRS) at one week after surgery. FINDINGS In 4 MD patients and one non-MD patient, the STA blood flow increased the oxyhaemoglobin and cortical oxygen saturation (CoSO2), indicating that the bypass supplied blood flow to the ischaemic brain; the CBO changes were observed more frequently in MD than in non-MD patients (p<0.02). The pre-anastomosis CoSO2 (65.4+/-5.4%) in MD was significantly lower than that (72.8+/-7.6%) in non-MD (p<0.05). Postoperative NIRS demonstrated that the bypass began to supply blood flow to the brain in 5 non-MD patients whose bypass did not supply blood flow during surgery. CONCLUSIONS Although MD has vessels of small diameter as compared to non-MD, the bypass begins to supply blood flow to the ischaemic brain earlier in MD than in non-MD after anastomosis. The fact that the CoSO2 in MD was lower than that in non-MD suggested that the perfusion pressure in MD was lower than that in non-MD, and this might account for the difference in the bypass blood supply after anastomosis between MD and non-MD. Our data suggest that, even if the bypass does not supply blood to the brain during surgery in non-MD, the bypass blood flow gradually increases after surgery.
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Affiliation(s)
- T Hoshino
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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Fukaya C, Otaka T, Obuchi T, Kano T, Nagaoka T, Kobayashi K, Oshima H, Yamamoto T, Katayama Y. Pallidal high-frequency deep brain stimulation for camptocormia: an experience of three cases. Acta Neurochir Suppl 2006; 99:25-8. [PMID: 17370758 DOI: 10.1007/978-3-211-35205-2_4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
INTRODUCTION The term "camptocormia" describes a forward-flexed posture. It is a condition characterized by severe frontal flexion of the trunk. Recently, camptocormia has been regarded as a form of abdominal segmental dystonia. Deep brain stimulation (DBS) is a promising therapeutic approach to various types of movement disorders. The authors report the neurological effects of DBS to the bilateral globus pallidum (GPi) in three cases of disabling camptocormia. METHODS Of the 36 patients with dystonia, three had symptoms similar to that of camptocormia, and all of these patients underwent GPi-DBS. The site of DBS electrode placement was verified by magnetic resonance imaging (MRI). The Burke Fahn and Marsden dystonia rating scale (BFMDRS) was employed to evaluate the severity of dystonic symptoms preoperatively and postoperatively. RESULTS Significant functional improvement following GPi-DBS was noted in the majority of dystonia cases. At a follow-up observation after more than six months, the overall improvement rate was 71.2 +/- 27.0%, in all dystonia cases who underwent the GPi-DBS. In contrast, the improvement rate of the three camptocormia cases was 92.2 +/- 5.3%. It was confirmed that the improvement rate for camptocormia was much higher than for other types of dystonia. CONCLUSION According to our experience, a patient with a forward-bent dystonic posture indicative of camptocormia is a good candidate for GPi-DBS. The findings of this study add further support to GPi-DBS as an effective treatment for dystonia, and provide the information on predictors of a good outcome.
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Affiliation(s)
- C Fukaya
- Department of Neurological Surgery, Nihon University School of Medicine, Itabashi-ku, Japan.
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Kano T, Katayama Y, Kobayashi K, Kasai M, Oshima H, Fukaya C, Yamamoto T. Detection of boundaries of subthalamic nucleus by multiple-cell spike density analysis in deep brain stimulation for Parkinson's disease. Acta Neurochir Suppl 2006; 99:33-5. [PMID: 17370760 DOI: 10.1007/978-3-211-35205-2_6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
When microelectrode recording of single cell activity is employed for targeting the subthalamic nucleus (STN), multiple sampling of single cells is needed to determine whether the electrode has passed through the ventral boundaries of the STN. In contrast, stepwise recording of multiple cell activities by a semimicroelectrode reveals robust changes in such activities at the dorsal and ventral boundaries. We attempted to quantify changes in multiple cell activities by computing multiple-cell spike density (MSD). We analyzed MSD in 60 sides of 30 patients with Parkinson's disease. Neural noise level was defined as the lowest cut-off level at which neural noise is separated from larger amplitude spikes. MSD was analyzed at cut-off levels ranging from 1.2 to 2.0-fold the neural noise level in the white matter in each trajectory. Both the dorsal and ventral boundaries were clearly identified by an increase and a decrease (p < 0.0001) in MSD, respectively, in all the 60 sides. The cut-off level of 1.2-fold showed the clearest change in MSD between the STN and the pars reticulata of substantia nigra. MSD analysis by semimicroelectrode recording represents the most practical means of identifying the boundaries of STN.
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Affiliation(s)
- T Kano
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
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Katayama Y, Kano T, Kobayashi K, Oshima H, Fukaya C, Yamamoto T. Feed-forward control of post-stroke movement disorders by on-demand type stimulation of the thalamus and motor cortex. Acta Neurochir Suppl 2006; 99:21-3. [PMID: 17370757 DOI: 10.1007/978-3-211-35205-2_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Deep brain stimulation (DBS) of the thalamus (Vo/Vim) has become popular as a means of controlling involuntary movements, including post-stroke movement disorders. We have also found that post-stroke movement disorders and motor weakness can sometimes be controlled by motor cortex stimulation (MCS). In some forms of movement disorders, motor dysfunction becomes evident only when patients intend to move their body. We have developed an on-demand type stimulation system which triggers stimulation by detecting intrinsic signals of intention to move. Such a system represents feed-forward control (FFC) of involuntary movements. We report here our experience of DBS and MCS for controlling post-stroke movement disorders, and discuss the value of FFC. Excellent control of post-stroke movement disorders was achieved by conventional DBS and/or MCS in 20 of 28 patients with hemichoreoathetosis, hemiballism tremor, and motor weakness. FFC was tested in 6 patients who demonstrated excellent control of post-stroke postural tremor or motor weakness by conventional DBS or MCS. The on-demand stimulation provided satisfactory FFC in 4 of 4 patients with postural tremor and 2 of 2 patients with motor weakness, when the activity of muscles involved in posturing or intention to move was fed into the system. These findings justify further clinical studies on DBS and MCS in patients with post-stroke movement disorders. The on-demand type stimulation system may also be useful for overcoming various post-stroke movement disorders.
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Affiliation(s)
- Y Katayama
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
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Aotsuka S, Okawa-Takatsuji M, Nagatani K, Nagashio C, Kano T, Nakajima K, Ito K, Mimori A. A retrospective study of the fluctuation in serum levels of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis. Clin Exp Rheumatol 2005; 23:475-81. [PMID: 16095115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To investigate the fluctuation in serum levels of anti-cyclic citrullinated peptide antibody (anti-CCP) retrospectively in patients with rheumatoid arthritis (RA). METHODS Serum levels of anti-CCP were measured retrospectively in 131 patients with RA and 90 patients with non-RA rheumatic diseases using a commercially available kit. All sera were collected from patients during the 22-year period, 1982-2004. To analyze the fluctuation in anti-CCP levels, 17 RA patients were selected on the basis of showing a significantly higher anti-CCP level in a serum sample taken at the first visit (> 80 U/ml), and availability of preserved serum samples that had been taken from each patient at 10 time points. RESULTS The test gave a sensitivity of 88% (115/131) and a specificity of 81% (73/90). The longitudinal study of 17 RA patients showed that anti-CCP levels were elevated at the first visit in 12 (71%) patients and then decreased gradually, whereas those in the other five (29%) patients fluctuated substantially. In both cases, anti-CCP levels tended to fluctuate in parallel with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, reflecting the spontaneous aggravation of arthritis and the efficacy of anti-rheumatic drugs. The courses of three representative RA patients are illustrated in detail along with their therapeutic regimens, and these further confirm the correlation of anti-CCP levels with laboratory parameters (ESR and CRP) as well as the activity of arthritis. CONCLUSION Measurement of serum anti-CCP levels was found to be useful for not only the diagnosis but also the management of RA.
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Affiliation(s)
- S Aotsuka
- Department of Clinical Immunology, Clinical Research Institute, International Medical Center of Japan, Shinjuku-ku, Tokyo, Japan.
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Ikenaga M, Kato T, Mishima H, Fukunaga M, Murata K, Tominaga S, Kano T, Morita S, Sekimoto M, Sakamoto J, Monden M. A multicenter phase 2 study of irinotecan (CPT-11) and doxifluridine (5’-DFUR), an intermediate form of capecitabine, for metastatic colorectal cancer (MCRC). J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- M. Ikenaga
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - T. Kato
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - H. Mishima
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - M. Fukunaga
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - K. Murata
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - S. Tominaga
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - T. Kano
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - S. Morita
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - M. Sekimoto
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - J. Sakamoto
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
| | - M. Monden
- MCSGO Colorectal Cancer Treatment Group, Suita, Osaka, Japan; ECRIN, Kyoto, Japan
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Moriyama M, Watanabe S, Hiraki T, Kano T, Okawa T, Ishibashi M. Relationship between intraoperative transoesophageal echocardiography findings and perfusion lung scintigraphy results on first postoperative day. Br J Anaesth 2005; 94:607-12. [PMID: 15749733 DOI: 10.1093/bja/aei112] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/12/2022] Open
Abstract
BACKGROUND Although intraoperative transoesophageal echocardiography (TOE) has been used to detect the occurrence of echogenic macro- and/or microembolic phenomena during total hip arthroplasty (THA), no direct correlation between macroembolism and the formation of pulmonary embolism (PE) has been conclusively determined in early postoperative periods after THA. METHODS Sixty-two patients scheduled for primary THA were enrolled in this study. Intraoperative TOE images were continuously recorded on videotape and the echogenic events were evaluated throughout surgery. Perfusion lung scintigraphy was performed on the first postoperative day (POD1). RESULTS Perfusion lung scintigraphy revealed the existence of PE in nine (15%) of the 62 patients who underwent THA: five (25%) of 20 patients with cemented THA and four (10%) of 42 patients with non-cemented THA. The grading score of intraoperative TOE findings, including the amount of echogenic particles in right atrium, the longest time of echogenesis and the diameter of the largest echogenic particles, did not differ between the groups with and without PE. The sensitivity, specificity, and positive and negative predictive values for the detection of echogenic macroemboli for the prediction of the development of PE on POD1 were 0.78, 0.60, 0.25 and 0.94, respectively. CONCLUSION Intraoperative TOE monitoring did not predict the occurrence of PE on POD1.
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Affiliation(s)
- M Moriyama
- Department of Anaesthesiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
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Affiliation(s)
- M Sadanaga
- Surgical Center, Kumamoto University Hospital, Kumamoto, Japan
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Abstract
Brain slices maintained in vitro have been extensively used for studying neuronal synchronization. However, the validity of this approach may be questioned since pharmacological procedures are usually required to elicit spontaneous events similar to the EEG activity recorded in vivo. Here, we report that when superfused with control medium, rat brain slices comprising the entorhinal and perirhinal cortices along with a portion of the basolateral/lateral nuclei of the amygdala can synchronously generate periodic oscillatory activity at 5-11 Hz every 5-30 s. The periodic events: (i) correspond intracellularly to synaptic depolarizations in regularly firing neurons analyzed in the three areas; (ii) have no fixed site of onset; (iii) spread with time lags of 8-20 ms; and (iv) continue to occur asynchronously after their surgical isolation. NMDA receptor antagonism reduced the duration of the oscillatory events, while glutamatergic non-NMDA receptor antagonism abolished them. Activation of mu-opioid receptors, a procedure that hyperpolarizes interneurons thus decreasing GABA release, reversibly decreased the rate of occurrence of periodic oscillatory activity (POA). However, periodic events continued to occur during application of GABA(A) or GABA(B) receptor antagonists as well as in the presence of the cholinergic agent carbachol. We also found that POA was abolished by baclofen and irreversibly reduced by the gap junction decoupler carbenoxolone. These findings demonstrate that parahippocampal networks in a brain slice preparation can generate periodic, synchronous activity under quasi-physiological conditions. These network oscillations (i) reflect the activation of ionotropic glutamatergic and GABAergic receptors, (ii) are contributed by gap-junction interactions, and (iii) are controlled by GABA(B) receptors that are presumably located presynaptically.
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Affiliation(s)
- T Kano
- Montreal Neurological Institute and Department of Neurology and Neurosurgery, McGill University, 3801 University Street, Room 794, Montreal, Quebec, H3A 2B4 Canada
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Kano T, Harada T, Katayama Y. Infiltration of tissue plasminogen activator through cerebral vessels: evaluation using a rat thromboembolic stroke model. Acta Neurochir Suppl 2004; 86:167-8. [PMID: 14753427 DOI: 10.1007/978-3-7091-0651-8_35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
In recent years, evidence has been accumulating that tissue plasminogen activator (tPA) possesses neurotoxic effects. However, such deleterious effects have been attributed to endogenously generated tPA. In the present study, focusing on exogenously administered tPA for the purpose of fibrinolysis, we evaluated the extent and the degree of extravasated tPA in a rat model of thromboembolic stroke. Even after early recanalization of occluded cerebral vessels, significant infiltration of tPA occurred through the cerebral vessels. It is assumed that exogenous tPA also exerts neurotoxic effects in the ischemic brain tissue.
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Affiliation(s)
- T Kano
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.
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Yoshida M, Abe T, Kano T, Tamai M. Two types of optical coherence tomographic images of retinal pigment epithelial detachments with different prognosis. Br J Ophthalmol 2002; 86:737-9. [PMID: 12084740 PMCID: PMC1771214 DOI: 10.1136/bjo.86.7.737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To report the optical coherence tomographic (OCT) findings in retinal pigment epithelium (RPE) detachments. METHODS 24 eyes were analysed by OCT and by fluorescein (FAG) and/or indocyanine green angiography. RESULTS RPE detachments were classified by the OCT images into those with a partial or total highly reflective line in the area of the detachment (nine eyes), and those that showed the same reflex in the detached area as in other parts (15 eyes). The nine eyes had irregular hyperfluorescence by FAG, significantly larger detachments, and lower visual acuity than the 15 eyes. CONCLUSION The OCT showed that two types of RPE detachments are associated with eyes with different characteristics.
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Abe T, Yoshida M, Kano T, Tamai M. Visual function after removal of subretinal neovascular membranes in patients with age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2001; 239:927-36. [PMID: 11820698 DOI: 10.1007/s00417-001-0393-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 11/29/2022] Open
Abstract
BACKGROUND Retinal pigment epithelial (RPE) cells have been transplanted to replace the RPE cells lost after surgical excision of choroidal neovascular membranes (CNV) associated with age-related macular degeneration. The purpose of this study was to analyze the visual function of eyes with altered RPE after surgical excision of choroidal neovascular membranes (CNV) associated with age-related macular degeneration, and to determine the effect of proliferated or migrated RPE cells on visual function. METHODS Forty-seven patients with age-related macular degeneration underwent excision of CNVs following vitrectomy and tamponade with sulfur hexafluoride (SF6) or silicone oil. The appearance of pre- or subretinal fibrosis and pigmentation of the lesion was considered to indicate proliferation and migration of RPE cells. Microperimetry was also performed. RESULTS A significant correlation was found between the size of CNVs removed by surgery and the size estimated by indocyanine green angiography (P=0.0126). The mean number of RPE cells lost was estimated at 1.52 x 10(4). Pre- or subretinal fibrosis or pigmentation was observed in 37 patients (75.5%). The number of eyes with fibrosis was significantly higher in eyes with silicone oil tamponade than with SF6 tamponade (P=0.0016). A statistically significant correlation was not found between the presence of fibrosis or pigmentation and the postoperative visual acuity. Not all patients used the area of pigmentation for fixation, and microperimetry showed that some of the patients had scotomas in well-pigmented areas. CONCLUSIONS Fibrosis and pigmentation after excision of CNVs may not always indicate normal function in these areas. These observations are especially relevant for transplantation of pigment epithelial cells in the future.
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Affiliation(s)
- T Abe
- Department of Ophthalmology, School of Medicine, Sendai, Miyagi, Japan.
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Taniguchi M, Sakoda S, Zhu BL, Ishida K, Quan L, Kano T, Fujita MQ, Maeda H. [Radiographic examination of skeletalized remains of an abandoned infant: a case report with special reference to odontological findings]. Nihon Hoigaku Zasshi 2001; 55:339-42. [PMID: 11905043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
A homeless couple confessed that they had buried their baby, who died at the age of three months, in the graveyard two years earlier. The recovered infantile remains had been already completely skeletonized and dismembered. However, the maxilla and mandibula of the average matured infants, the age of the body was estimated to be 1 to 2.5 months old on the basis of the degree of calcification of deciduous teeth.
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Affiliation(s)
- M Taniguchi
- Department of Legal Medicine, Osaka City University Medical School, Osaka 545-8585, Japan
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Yanagawa A, Shimada J, Mori N, Sugihara T, Sakai A, Yamaji S, Yano K, Kitamura T, Kano T. Effects of gastrointestinal stimulant and suppressant pretreatment on the pharmacokinetics of AS-924, a novel ester-type cephem antibiotic. Int J Antimicrob Agents 2001; 18:483-7. [PMID: 11711265 DOI: 10.1016/s0924-8579(01)00442-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The effects of pretreatment with the gastrointestinal stimulant domperidone and the suppressant scopolamine butylbromide on the absorption of AS-924, a novel prodrug-type cephem antibiotic, were investigated in six healthy adult male volunteers by a cross-over method. The T(max) of ceftizoxime (CTIZ), the active moiety of AS-924, was slightly prolonged by scopolamine butylbromide (T(max)=1.8 vs. 1.5 h for the group without pretreatment). However, there were no significant differences in pharmacokinetic parameters including T(max), cumulative urinary excretion rates of CTIZ and cumulative urinary excretion rates of pivaloylcarnitine for 12 h after the dosing between the pretreated and control groups. Domperidone did not affect the absorption of AS-924.
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Affiliation(s)
- A Yanagawa
- Medical Research Center, St. Marianna University School of Medicine, 2-16-1, Sugao, Miyamae-ku, 216-0015, Kanagawa, Japan
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Takahashi H, Tono T, Tamagaki S, Yasue A, Okada K, Kano T, Iwazawa T, Matsui S, Nakano Y, Yano H, Kinuta M, Matsushita M, Okamura J, Monden T. [Usefulness of hepatic arterial infusion chemotherapy for liver metastasis in gastric cancer]. Gan To Kagaku Ryoho 2001; 28:1724-7. [PMID: 11708018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
UNLABELLED We have performed intra-hepatic arterial chemotherapy for 9 patients with liver metastasis arising from gastric cancer. We mainly used 5-FU and CDDP as antineoplastic drugs. RESULTS The median survival after gastrectomy was 600 days. Of 9 cases, 2 showed CR, 4 PR, 2 NC, 1 PD. The response rate was 67%. The 9 cases were classified into 2 groups. One group, the short-term survival group, concised of 5 patients that had no more than 2 years survival and the other, the long-term survival group, consisted 4 patients that had more than 2 years survival. We compared these 2 groups and found no difference in the primary lesions between the 2 groups. The patients in the long-term survival group had fewer and smaller metastatic lesions in the liver than the patients of the short-term survival group. The patients in the long-term survival group had no unresectable lesions except liver metastasis when gastrectomy was performed. However, 2 patients in the short term survival group had unresectable lymphatic involvement at the time gastrectomy was performed. Of 9 patients, 6 died from the extrahepatic lesion. CONCLUSION The intra-arterial chemotherapy was effective and useful for liver metastasis arising from gastric cancer. However, the majority of patients died from extrahepatic lesions. We should therefore consider the use of systemic chemotherapy with intra-arterial chemotherapy.
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Abstract
BACKGROUND Adult-onset foveomacular vitelliform dystrophy is characterized by a solitary, oval, slightly elevated, yellowish subretinal lesion of the fovea. We examined a patient with adult-onset foveomacular vitelliform dystrophy with stellate retinal folds by optical coherence tomography and scanning laser ophthalomoscopy. CASE A 58-year-old Japanese woman with a complaint of decreased vision in her right eye was diagnosed as having adult-onset foveomacular vitelliform dystrophy. OBSERVATIONS Ophthalmoscopic examination revealed a yellowish lesion of one-third disc diameter in size at the fovea in the right eye. Fluorescein angiography demonstrated an irregular block of choroidal fluorescence corresponding to the yellowish lesion, which was surrounded by stellate retinal folds. Optical coherence tomography images showed a steep elevation of the retinal pigment epithelium (RPE) as a focally protruded reflective band over an optically clear space. Scanning laser ophthalmoscopy provided morphologic enhancement in the specifically affected layers of the macula. Using an argon green laser, band-shaped bright reflexes were seen in the right fovea. The helium-neon laser revealed a bright patch corresponding to the yellowish lesion over the fovea, which was surrounded by stellate retinal folds. The diode laser revealed a bright patch corresponding to the yellowish lesion. CONCLUSION The stellate retinal folds of this patient were considered to be caused by the steep elevation of the RPE with an extracellular accumulation of the vitelliform deposits.
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Affiliation(s)
- K Yamaguchi
- Department of Ophthalmology, Tohoku University School of Medicine, Sendai, Miyagi-ken, Japan
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