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Horie K, Takahara M, Nakama T, Tanaka A, Tobita K, Hayakawa N, Mori S, Iwata Y, Suzuki K. Retrospective Multicenter Comparison Between Viabahn Covered Stent-Grafts and Supera Interwoven Nitinol Stents for Endovascular Treatment in Severely Calcified Femoropopliteal Artery Disease: The ARMADILLO Study (Adjusted Retrospective coMparison of scAffolDs In caLcified LesiOns). J Endovasc Ther 2024; 31:400-409. [PMID: 36146948 DOI: 10.1177/15266028221124727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE The previous single-arm registries showed the acceptable primary patency after endovascular therapy (EVT) using covered stent-graft (CSG) and Supera interwoven nitinol stent (Supera peripheral stent [SPS]) in calcified femoropopliteal lesions. The aim of this study was to compare the safety and efficacy between CSG and SPS in calcified femoropopliteal lesions in clinical practice. MATERIALS AND METHODS We retrospectively analyzed 341 cases who had Rutherford class 2 to 6 peripheral artery disease and underwent EVT with either CSG (n=137) or SPS (n=204) for femoropopliteal lesions with bilateral calcification in fluoroscopic image, based on the Peripheral Arterial Calcium Scoring System (PACSS) classification, between April 2017 and February 2021 at 7 cardiovascular centers in Japan. RESULTS After propensity score (PS) matching, the final study population consisted of 150 matched patients with no remarkable intergroup difference in baseline characteristics. The primary patency at 1 year was not statistically different between CSG and SPS groups (81.4% vs 71.2%, p=0.32). There was also no significant difference in freedom from target lesion revascularization (82.8% vs 77.6%, p=0.28) and overall survival rate (88.6% vs 87.2%, p=0.81). The stratification analysis demonstrated that advanced age, current smoking, diabetes mellitus, and PACSS grade 4 had a significant interaction on the association of CSG versus SPS implantation with restenosis (interaction p<0.05). CONCLUSIONS In patients with bilaterally calcified femoropopliteal lesions, 1-year primary patency was not significantly different between treatments using CSG and SPS after the PS matching. CLINICAL IMPACT Covered stent-graft (CSG) and Supera interwoven nitinol stent (SPS) are reliable endovascular devices in calcified femoropopliteal lesions. This retrospective multicenter study compared the clinical outcomes between the two devices. After propensity score matching, 150 matched patients with no remarkable intergroup difference in baseline characteristics. The primary patency at 1 year was not statistically different between the CSG and SPS group (81.4% vs. 71.2%, p=0.32). There was also no significant difference in freedom from target lesion revascularization (82.8% vs. 77.6%, p=0.28) and overall survival rate (88.6% vs 87.2%, p=0.81). The two devices showed the similar efficacy in calcified femoropopliteal lesions.
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Affiliation(s)
- Kazunori Horie
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyobay UrayasuIchikawa Medical Center, Urayasu, Japan
| | - Akiko Tanaka
- Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Japan
| | - Shinsuke Mori
- Department of Cardiology, Yokohama-City Tobu Hospital, Yokohama, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
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Suzuki K, Takahara M, Tobita K, Hayakawa N, Mori S, Iwata Y, Horie K, Nakama T. Contemporary Therapy of Femoropopliteal In-Stent Restenosis / Occlusion, 36-month Follow up Study. Vasc Endovascular Surg 2024:15385744241253170. [PMID: 38739243 DOI: 10.1177/15385744241253170] [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] [Indexed: 05/14/2024]
Abstract
BACKGROUND Drug-eluting devices improved outcomes of endovascular therapy (EVT) for femoropopliteal lesions, but mainly for de novo lesions. Endovascular therapy for in-stent restenosis/occlusion (ISR/O) is challenging, and large trials and long-term data are not well reported. MATERIALS AND METHODS This study is a physician initiated, multicenter, and retrospective design. From 7 Japanese institutes, 3635 femoropopliteal cases were enrolled in the study. Among these, 346 cases of first ISR/O were studied. We defined drug-coated-balloon, drug-eluting stent, and covered stent as New devices. Balloon angioplasty and bare nitinol stent were included in the control group. RESULTS The propensity score matching extracted 112 pairs. At 12 months, the primary patency rate was 80.3% in the new device group and 52.7% in the control group, and there was a significant intergroup difference (P = .004). However, at 36 months, the rate was 43.3% vs 39.2%, with no significant difference (P = .090). No baseline characteristics had any significant interaction effect (all P > .05). CONCLUSIONS The New devices were more effective than the control group for ISR/O at 1 year, but caught up at 3 years.
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Affiliation(s)
- Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Chiba, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Chiba, Japan
| | - Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo-bay Urayasu Ichikawa Medical Center, Chiba, Japan
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Iwata Y, Takahara M, Tobita K, Hayakawa N, Mori S, Horie K, Nakama T, Suzuki K, Fukuzawa S. Retrospective analysis on diameters of drug-coated balloons and predilatation balloons in infra-inguinal endovascular treatment (RABBIT study). Cardiovasc Interv Ther 2024:10.1007/s12928-024-01001-9. [PMID: 38632168 DOI: 10.1007/s12928-024-01001-9] [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: 10/21/2023] [Accepted: 03/22/2024] [Indexed: 04/19/2024]
Abstract
This multicenter retrospective study assessed the clinical outcomes of endovascular therapy (EVT) using a drug-coated balloon (DCB) that was larger than the predilatation balloons for femoropopliteal artery lesions. We analyzed 1140 cases with symptomatic peripheral artery disease that underwent EVT with DCB for femoropopliteal lesions between 2017 and 2021. The primary endpoint was procedural failure, defined as a composite of deteriorated dissection and bailout stenting. The secondary endpoints included deteriorated dissection, bailout stenting, restenosis, and target lesion revascularization. We performed propensity score matching to compare the clinical outcomes between EVT with a DCB which was larger than the predilatation balloon (larger DCB) and EVT with a DCB which was not (nonlarger DCB). We assigned 276 cases to the larger DCB group and 864 cases to the nonlarger DCB group. Procedural failure was observed in 75 cases, whereas restenosis occurred in 282 cases during a mean follow-up period of 12.7 ± 9.7 months. Propensity score matching extracted 273 pairs with no intergroup difference in baseline characteristics, except the predilatation balloon size. Procedural failure (9.2% versus 6.1%, P = 0.11), deteriorated dissection and bailout stenting proportion (both P > 0.05), and 1-year rates of freedom from restenosis (82.4% versus 84.1%, P = 0.59) and target lesion revascularization (89.7% versus 90.4%, P = 0.83) showed no significant difference between the larger and nonlarger DCB groups. Irrespective of whether the DCB size was larger than the predilatation balloon, no difference was observed in either procedural or clinical outcomes.
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Affiliation(s)
- Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, 1-21-1, Kanasugi, Funabashi, Chiba, 273-8588, Japan.
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Chiba, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama-City Tobu Hospital, Kanagawa, Japan
| | - Kazunori Horie
- Department of Cardiology, Sendai Kousei Hospital, Miyagi, Japan
| | - Tatsuya Nakama
- Department of Cardiovascular Medicine, Tokyo-Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Shigeru Fukuzawa
- Department of Cardiology, Funabashi Municipal Medical Center, 1-21-1, Kanasugi, Funabashi, Chiba, 273-8588, Japan
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Iwata Y. Developing a Novel Pediatric Eye Chart Assessing Visual Acuity by Minimum Separable Threshold. Children (Basel) 2024; 11:397. [PMID: 38671614 PMCID: PMC11048868 DOI: 10.3390/children11040397] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
The purpose of this study was to develop a new pediatric acuity chart that can assess the minimum separation threshold by incorporating the minimum separation threshold into the picture. To overcome the design limitations of the Landolt ring, two designs of highly versatile minimum separable thresholds that can be easily incorporated into a picture were created: a black, filled circle (the "Circle") and a segment (the "Square"), both with the same break as in the Landolt ring. The three designs-the Landolt ring, Circle, and Square-were used to evaluate and compare the differences in the visual acuity of 21 healthy adults. No significant differences were observed between the results of the visual acuity tested with the Landolt ring, Circle, and Square (Landolt ring vs. Circle: p = 0.92, Landolt ring vs. Square: p = 0.31, Circle vs. Square: p = 0.40). The Bland-Altman analysis revealed no fixed errors between the Landolt ring and Circle and between the Landolt ring and Square (95% CI: -0.09-0.08, -0.09-0.12). Proportional errors were also not observed (p = 0.68, p = 0.41). The Landolt ring, Circle, and Square designs obtained equal results in visual acuity, thus achieving the successful development of a novel pediatric visual acuity chart using these designs.
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Affiliation(s)
- Yo Iwata
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
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Horie K, Takahara M, Nakama T, Tobita K, Tanaka A, Shintani Y, Tsubakimoto Y, Yoshioka N, Hayakawa N, Sasaki S, Iwata Y, Ogata K, Takagi T, Doijiri T, Fujihara M. Multicenter Registry of Common Femoral Artery Disease Treated With Endovascular Revascularization Using Interwoven Nitinol Stents: An Observational Retrospective Study. J Endovasc Ther 2024:15266028241231472. [PMID: 38369732 DOI: 10.1177/15266028241231472] [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] [Indexed: 02/20/2024]
Abstract
PURPOSE Surgical thromboendarterectomy has been the gold standard treatment for common femoral artery (CFA) disease. However, endovascular therapy (EVT) is conducted in certain patients with CFA lesions because of multiple comorbidities. The interwoven nitinol stent (IWS) has been developed to prevent stent fracture. Thus, this study aimed to evaluate the feasibility of EVT using IWS for CFA lesions in clinical practice. MATERIALS AND METHODS This retrospective multicenter registry analyzed patients who had symptomatic lower-extremity artery disease due to CFA lesions and underwent EVT using IWS between 2019 and 2021. The primary endpoint was restenosis 2 years after EVT. RESULTS This study enrolled a total of 177 patients with 196 CFA lesions. The 2-year estimate of freedom from restenosis was 88.0%. The 2-year freedom rates from the target-lesion revascularization, major amputation, and all-cause death were 92.9%, 99.0%, and 75.2%, respectively. The clinical features significantly associated with restenosis risk were the reference vessel diameter (RVD, per 1.0 mm, hazard ratio [HR], 0.24 [0.08-0.70]; p=0.009), external iliac artery (EIA) involvement (HR=4.03 [1.56-10.4]; p=0.004), superficial femoral artery (SFA) involvement (HR=3.05 [1.00-9.25]; p=0.049), body mass index (BMI; per 1.0, HR=0.85 [0.73-0.99]; p=0.032), occlusion of deep femoral arteries (DFAs) at baseline (HR=7.89 [2.04-30.5]; p=0.003), and chronic limb-threatening ischemia (CLTI, HR=2.63 [1.02-6.78]; p=0.045). Their significant association was also confirmed by the random survival forest analysis. During a median follow-up of 12.0 months, guiding sheaths were inserted via CFAs implanted IWSs in 73 cases (37.2%), and no patients had cannulation-related complications, such as failed hemostasis, fracture of IWS, and stent occlusion. CONCLUSIONS Endovascular therapy using IWS in CFA lesions showed acceptable 2-year patency rates at 88.0% and might preserve the arterial access via the ipsilateral CFAs. Small RVD, involving EIA and SFA lesions, emaciation, occluded DFA, and CLTI are associated with poor 2-year patency rates following EVT, thus, IWS implantation in CFA lesions may be an option for patients unsuitable for surgical revascularization. CLINICAL IMPACT This retrospective multicenter registry enrolled 177 patients with 199 CFA lesions treated with EVT using interwoven nitinol stents, because surgical thromboendarterectomy was difficult due to their multiple comorbidities. The 2-year estimate of freedom from restenosis was acceptable at 88.0%. The 2-year freedom rate from major amputation was also high at 99.0%. Moreover, during a median follow-up of 12.0 months, guiding sheaths were inserted via CFAs implanted IWSs in 73 cases, and no patients had cannulation-related complications such as failed hemostasis, fracture of IWS, and stent occlusion.
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Affiliation(s)
- Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Akiko Tanaka
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Yoshiaki Shintani
- Department of Cardiology, Ageo Central General Hospital, Ageo, Japan
| | | | - Naoki Yoshioka
- Department of Cardiology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Japan
| | - Shinya Sasaki
- Department of Cardiology, Saka General Hospital, Shiogama, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Kenji Ogata
- Cardiovascular Center, Miyazaki Medical Association Hospital, Miyazaki, Japan
| | - Tomonari Takagi
- Cardiovascular Center, Takatsu General Hospital, Kawasaki, Japan
| | - Tatsuki Doijiri
- Department of Cardiology, Yamato Seiwa Hospital, Yamato, Japan
| | - Masahiko Fujihara
- Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan
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Nakama T, Takahara M, Iwata Y, Suzuki K, Tobita K, Hayakawa N, Horie K, Mori S, Obunai K, Ohki T. Low-Dose vs High-Dose Drug-Coated Balloon for Symptomatic Femoropopliteal Artery Disease: The PROSPECT MONSTER Study Outcomes. JACC Cardiovasc Interv 2023; 16:2655-2665. [PMID: 37804292 DOI: 10.1016/j.jcin.2023.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Randomized trials have shown comparable outcomes between second-generation low-dose drug-coated balloons (LD-DCBs) and first-generation high-dose drug-coated balloons (HD-DCBs); but the trial patients had low clinical complexity, and there were no comparisons in medically complex populations. OBJECTIVES The aim of this study was to compare outcomes between an LD-DCB (Ranger; 2.0 μg/mm2) and an HD-DCB (IN.PACT; 3.5 μg/mm2) in patients with symptomatic femoropopliteal artery disease. METHODS PROSPECT MONSTER (Prospective Comparison of Second-Generation Low-Dose Drug-Coated Balloon With High-Dose Drug-Coated Balloon) was a prospective, multicenter, nonrandomized trial that prospectively collected data from 581 patients who underwent endovascular therapy with the LD-DCB (n = 370) or the HD-DCB (n = 211) for symptomatic femoropopliteal artery disease (Rutherford classes 2-5). The primary outcome was the 1-year primary patency of the LD-DCB in comparison with that of the HD-DCB, as evaluated using propensity score matching. The incidence of impaired flow after drug-coated balloon application was also evaluated. RESULTS Propensity score matching extracted 163 pairs (358 and 163 patients in the LD-DCB and HD-DCB groups, respectively), with no significant intergroup difference in baseline characteristics. The 1-year primary patency rates in the matched population were similar between the LD-DCB and HD-DCB groups (87.0% [95% CI: 82.5%-91.7%] vs 81.3% [95% CI: 74.8%-88.5%]; HR: 0.93; 95% CI: 0.55-1.59; P = 0.79), as was the incidence of impaired flow (13.6% vs 9.8%; OR: 1.46; 95% CI: 0.78-2.73; P = 0.24). No baseline characteristics had any significant interaction effects on the association of the LD-DCB vs the HD-DCB and 1-year restenosis risk. CONCLUSIONS LD-DCBs demonstrate efficacy and safety comparable with HD-DCBs in patients with complex clinical backgrounds, suggesting that drug-coated balloon treatment using a lower dose may be possible.
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Affiliation(s)
- Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan; Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan.
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yo Iwata
- Department of Cardiology, Heart & Vascular Institute, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Japan
| | - Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Takao Ohki
- Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
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Usami K, Iwata Y, Aoyama R, Okino S, Fukuzawa S. A case of chronic limb threatening ischemia with kinking of the external iliac artery due to downward deviation of abdominal aortic stent graft. Cardiovasc Interv Ther 2023; 38:436-437. [PMID: 37369951 DOI: 10.1007/s12928-023-00943-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Affiliation(s)
- Kota Usami
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan.
| | - Yo Iwata
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Rie Aoyama
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Shinichi Okino
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
| | - Shigeru Fukuzawa
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, 273-8588, Japan
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Horie K, Takahara M, Nakama T, Tanaka A, Tobita K, Hayakawa N, Mori S, Iwata Y, Suzuki K. Impact of Postoperative Lumen Gain on the Reduction of Restenosis Risk after Endovascular Treatment using Drug-coated Balloon for Femoropopliteal Lesions Assessed by Intravascular Ultrasound. J Atheroscler Thromb 2023; 30:1142-1151. [PMID: 36436877 PMCID: PMC10499445 DOI: 10.5551/jat.63886] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 10/30/2022] [Indexed: 09/05/2023] Open
Abstract
AIM This study aimed to reveal whether a larger postprocedural minimum lumen area (MLA) would reduce restenosis risk after endovascular therapy (EVT) using drug-coated balloons (DCBs) in femoropopliteal (FP) lesions. METHODS This retrospective, nonrandomized, single-arm, and multicenter registry analyzed patients with FP lesions undergoing intravascular ultrasound (IVUS)-guided EVT with DCB between 2017 and 2021. The primary outcome was restenosis 1 year after EVT. The association between IVUS-based MLA and restenosis risk was investigated using a generalized propensity score (GPS) method to address imbalance of baseline covariates. The dose-response function of IVUS-measured MLA for restenosis risk was developed using the GPS-adjusted Cox proportional hazards regression model. RESULTS This study enrolled consecutive 489 patients with 595 lesions undergoing DCB treatment. The median MLA (interquartile range) was 13.20 (9.90-16.91) mm2. Kaplan-Meier estimates showed that freedom from restenosis was 84.4% at 1 year. The GPS-adjusted dose-response function showed that MLA was inversely associated with restenosis risk. The upper limit of 95% confidence interval (CI) of the slope was lower than 0 between 10.6 and 17.0 mm2 of MLAs. The 1-year cumulative incidence of restenosis was estimated to be 9.8% (95% CI, 5.8%-13.7%) for the 3rd quartile of MLA (16.91 mm2) versus 18.5% (12.3%-24.1%) for the 1st quartile (9.90 mm2), with a hazard ratio of 0.51 (95% CI, 0.39-0.67; p<0.001). CONCLUSIONS The present GPS analysis suggested that larger IVUS-measured MLA might be associated with lower risk of 1-year restenosis after DCB treatment for FP lesions.
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Affiliation(s)
- Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyobay UrayasuIchikawa Medical Center, Chiba, Japan
| | - Akiko Tanaka
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Chiba, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Chiba, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
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Horie K, Takahara M, Nakama T, Tanaka A, Tobita K, Hayakawa N, Mori S, Iwata Y, Suzuki K. Multicenter, retrospective registry of isolated atherosclerotic popliteal arteries treated with endovascular revascularization. Heart Vessels 2023:10.1007/s00380-023-02271-8. [PMID: 37217811 DOI: 10.1007/s00380-023-02271-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/10/2023] [Indexed: 05/24/2023]
Abstract
Isolated atherosclerotic popliteal lesions (IAPLs) have been considered challenging. This study aimed to investigate the efficacy of endovascular therapy (EVT) using the newer devices for IAPLs. This retrospective multicenter registry analyzed patients with lower extremity artery disease having IAPLs who underwent EVT using the newer devices between 2018 and 2021. The primary outcome was primary patency 1 year after EVT. A total of 392 consecutive patients undergoing EVT for IAPLs were enrolled. The Kaplan-Meier analysis showed that the primary patency and the freedom from target lesion revascularization were 80.9% and 87.8% 1 year after EVT, respectively. The multivariate Cox proportional hazards regression analysis showed that the clinical features that were independently associated with restenosis risk were drug-coated balloon (DCB) use for younger age (< 75 years old; adjusted hazard ratio, 3.08 [95% confidence interval 1.08-8.74]; P = 0.035), non-ambulatory status (2.74 [95% confidence interval 1.56-4.81]; P < 0.001), cilostazol use (0.51 [95% confidence interval 0.29-0.88]; P = 0.015), severe calcification (1.86 [95% confidence interval 1.18-2.94]; P = 0.007), and small external elastic membrane (EEM) area measured by intravascular ultrasound (IVUS) (< 30 mm2) (2.07 [95% confidence interval 1.19-3.60]; P = 0.010). From the univariate analysis, among patients treated with DCB, younger patients (n = 141) were associated with more comorbidities including smoking (P < 0.001), diabetes mellitus (P < 0.001), end-stage renal disease (P < 0.001), history of revascularization (P = 0.046) and small EEM area (P = 0.036), compared to older patients (n = 140). Moreover, smaller post-procedural minimum lumen area measured by IVUS after DCB dilatation was observed in younger patients (12 ± 4 vs. 14 ± 4 mm2, P = 0.033). This retrospective study demonstrated that the current EVT provided an acceptable 1-year primary patency rate in patients with IAPLs. The primary patency was lower following DCB in younger patients, likely due to the higher rates of comorbidities in this patient population.
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Affiliation(s)
- Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-Cho, Aoba-Ku, Sendai, Miyagi, 980-0873, Japan.
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyobay UrayasuIchikawa Medical Center, Chiba, Japan
| | - Akiko Tanaka
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-Cho, Aoba-Ku, Sendai, Miyagi, 980-0873, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Chiba, Japan
| | - Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Chiba, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
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Iwata Y, Takahara M, Nakama T, Fujimura N, Suzuki K, Yamaoka T, Fukuzawa S. Stent Implantation and Thromboendarterectomy for the Common Femoral Artery in Real-World Practice. J Endovasc Ther 2023:15266028231165697. [PMID: 37039260 DOI: 10.1177/15266028231165697] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
PURPOSE To compare the outcomes of thromboendarterectomy (TEA) and endovascular therapy (EVT) with stenting for patients with atherosclerotic common femoral artery (CFA) occlusive disease. MATERIALS AND METHODS From a retrospective registry of 1193 consecutive patients with CFA treatment performed between 2018 and 2020 at 66 institutions in Japan, we identified patients who underwent TEA (n=432) or stent implantation (n=157). The primary outcome measures were the 1-year primary patency of TEA versus stenting with propensity score matching. The secondary outcome measures were perioperative complications, length of hospital stay, any reintervention, limb salvage, and overall survival. Interaction analysis for primary patency was performed with propensity score stratification to determine the appropriate target population for CFA stenting. RESULTS Propensity score matching extracted 101 pairs (101 patients in the EVT group and 253 patients in the TEA group). The 1-year primary patency rate was significantly higher in the TEA cohort (92.8% vs 84.6%, p=0.006). The freedom from reintervention rate was also significantly higher in the TEA cohort (94.0% vs 89.9%, p=0.030). However, the 1-year limb salvage (98.7% vs 100.0%, p=0.32), 1-year overall survival (90.8% vs 85.0%, p=0.14), and frequency of perioperative complications were not significantly different between the cohorts (6.9% vs 14.2%, p=0.10). Based on interaction analysis, the superiority of TEA over EVT in terms of patency was less apparent in patients with advanced age and chronic heart failure. CONCLUSIONS Thromboendarterectomy was superior to stenting in terms of primary patency and freedom from revascularization at 1 year. There was no significant difference in the incidence of perioperative complications between both groups. Thromboendarterectomy may be recommended as the standard treatment strategy for patients with atherosclerotic CFA disease, whereas stenting may be considered for patients with advanced age and chronic heart failure. CLINICAL IMPACT Thromboendarterectomy compared to stenting was the preferred revascularization strategy for patients with CFA disease in terms of primary patency and freedom from target lesion revascularization during the 1st year. The difference was attenuated in subgroups with advanced age (85 years or older) or chronic heart failure, thus stenting may be considered in patients with these backgrounds.
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Affiliation(s)
- Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
| | - Naoki Fujimura
- Department of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Terutoshi Yamaoka
- Department of Vascular Surgery, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Shigeru Fukuzawa
- Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
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11
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Mori S, Takahara M, Nakama T, Tobita K, Hayakawa N, Iwata Y, Horie K, Suzuki K, Yamawaki M, Ito Y. Impact of calcification on clinical outcomes after drug-coated balloon angioplasty for superficial femoral artery disease: Assessment using the peripheral artery calcification scoring system. Catheter Cardiovasc Interv 2023; 101:892-899. [PMID: 36883957 DOI: 10.1002/ccd.30622] [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] [Received: 09/20/2022] [Revised: 02/10/2023] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
PURPOSE To investigate whether the severity of calcification assessed by the peripheral artery calcification scoring system (PACSS) was associated with clinical outcomes of drug-coated balloon (DCB) angioplasty for femoropopliteal lesions. MATERIALS AND METHODS We retrospectively analyzed 733 limbs with intermittent claudication of 626 patients, who underwent DCB angioplasty for de novo femoropopliteal lesions between January 2017 and February 2021 at seven cardiovascular centers in Japan. The patients were categorized using the PACSS classification (grades 0-4: no visible calcification of the target lesion, unilateral wall calcification < 5 cm, unilateral calcification ≥ 5 cm, bilateral wall calcification < 5 cm, and bilateral calcification ≥ 5 cm, respectively). The main outcome was primary patency at 1 year. The Cox proportional hazards analysis was used to explore whether the PACSS classification was an independent predictor of clinical outcomes. RESULTS The distribution of PACSS was grade 0 in 38%, grade 1 in 17%, grade 2 in 7%, grade 3 in 16%, and grade 4 in 23%. The 1-year primary patency rates in these grades, respectively, were 88.2%, 89.3%, 71.9%, 96.5%, and 82.6%, respectively (p < 0.001). Multivariate analysis disclosed that PACSS grade 4 (hazard ratio: 1.82, 95% confidence interval 1.15-2.87, p = 0.010) was associated with restenosis. CONCLUSION The PACSS grade 4 calcification was independently associated with poor clinical outcomes after DCB angioplasty for de novo femoropopliteal lesions.
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Affiliation(s)
- Shinsuke Mori
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kishiwada, Osaka, Japan
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Kishiwada, Japan
| | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital, Kishiwada, Japan
| | - Naoki Hayakawa
- Department of Cardiovascular Medicine, Asahi General Hospital, Asahi, Chiba, Japan
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Kishiwada, Osaka, Japan
| | - Kazunori Horie
- Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Miyagi, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Kishiwada, Osaka, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kishiwada, Osaka, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kishiwada, Osaka, Japan
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Aoyama R, Oka N, Iwata Y, Okino S, Fukuzawa S. GENDER DIFFERENCES OF PROGNOSTIC VALUE AND CLINICAL OUTCOMES FOR MECHANICAL CIRCULATORY SUPPORT IN ACUTE CORONARY SYNDROME WITH CARDIOGENIC SHOCK. J Am Coll Cardiol 2023. [DOI: 10.1016/s0735-1097(23)01762-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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13
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Yamauchi Y, Takahara M, Iwata Y, Suzuki K, Fujimura N, Yamaoka T, Miyamoto A, Nakama T. Lesion Characteristics Associated with Loss of Primary Patency After Endovascular Therapy for Common Femoral Artery Lesions. Cardiovasc Intervent Radiol 2023; 46:310-316. [PMID: 36627522 PMCID: PMC10014791 DOI: 10.1007/s00270-022-03343-4] [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] [Received: 09/15/2022] [Accepted: 11/25/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE To identify lesion characteristics associated with restenosis after endovascular therapy (EVT) for common femoral artery (CFA) lesions in patients with peripheral artery disease (PAD) in real-world practice. MATERIALS AND METHODS We included 751 Japanese patients with PAD who underwent CFA EVT. Data were from a large-scale retrospective multicenter registry study. The association of lesion characteristics with the risk of restenosis was investigated with the Cox proportional hazards regression model. RESULTS Lesions extended to the external iliac artery in 10.0% of patients, were isolated in the CFA in 59.9%, and involved the bifurcation in 30.1%. Chronic total occlusion was noted in 21.1%, and 99% stenosis, in 19.9%. Among the limbs with CFA lesions, 16.4% had a history of CFA EVT. Mean total lesion length was 32 ± 15 mm, and reference vessel diameter, 7.3 ± 1.4 mm. Plain old balloon angioplasty, drug-coated balloon angioplasty, and stent implantation were performed in 56.3, 23.2, and 20.5% of patients, respectively. The mean follow-up period was 10.4 ± 9.5 months. Rates of freedom from restenosis and reintervention at 1 year were 78.2 and 86.6%, respectively. Lesion characteristics independently associated with restenosis were history of CFA EVT, reference vessel diameter less than 6 mm, and lesion length greater than or equal to 50 mm; adjusted hazard ratios were 1.63 (P = 0.007), 1.93 (P = 0.006), and 1.71 (P = 0.018), respectively. CONCLUSION History of CFA EVT, smaller reference vessel diameter, and longer lesion length are independent risk factors for restenosis after CFA EVT. LEVEL OF EVIDENCE Level 3.
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Affiliation(s)
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yo Iwata
- Department of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center, Chiba, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Naoki Fujimura
- Department of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Terutoshi Yamaoka
- Department of Vascular Surgery, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Akira Miyamoto
- Cardiovascular Center, Takatsu General Hospital, Kanagawa, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Chiba, Japan
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14
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Horie K, Takahara M, Nakama T, Tanaka A, Tobita K, Hayakawa N, Mori S, Iwata Y, Suzuki K. Retrospective multicenter registry for endovascular treatment with newer devices in over 25-cm femoropopliteal artery disease: A retrospective observational study. Health Sci Rep 2022; 6:e1003. [PMID: 36544617 PMCID: PMC9764405 DOI: 10.1002/hsr2.1003] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/10/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims Endovascular therapy (EVT) is recommended in femoropopliteal (FP) lesions shorter than 25 cm by current guidelines; however, diffuse FP lesions remains challenging for EVT. The aim of this study was to investigate the efficacy of EVT with the latest devices for FP lesions longer than 25 cm. Methods This retrospective multicenter registry analyzed patients presented peripheral artery disease (PAD) having FP lesions longer than 25 cm who underwent EVT using the latest devices between 2017 and 2021. The primary outcome was restenosis 1 year after EVT. Results The present study enrolled a total of 504 PAD patients with 614 lesions undergoing EVT for diffuse FP lesions. The Kaplan-Meier analysis showed that the rates of freedom from restenosis and clinically-driven target lesion revascularization were 79.3% and 82.4% 1 year after EVT, respectively. The multivariate Cox proportional hazards regression analysis showed that clinical features associated independently with restenosis risk were cilostazol use (adjusted hazard ratio, 0.49 [0.32-0.74]; p = 0.001), reference vessel diameter (RVD) (0.72 [0.58-0.89] per 1-mm increase; p = 0.002), and P3 segment involvement (2.08 [1.33-3.26]; p = 0.001). The Kaplan-Meier analysis was conducted to compare the primary patency between cases with and without a small RVD, P3 involvement, and/or lack of cilostazol; any risk factors were related to a worse primary patency rate, compared with cases without risk factors. Conclusion In the current EVT era, the primary patency at 1 year was acceptable at 79.3% in patients with FP lesions longer than 25 cm. A small vessel and P3 segment involvement might be associated with a poor 1-year patency rate after EVT, whereas cilostazol administration might contribute to reducing restenosis.
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Affiliation(s)
- Kazunori Horie
- Department of Cardiovascular MedicineSendai Kousei HospitalMiyagiJapan
| | - Mitsuyoshi Takahara
- Department of Metabolic MedicineOsaka University Graduate School of MedicineOsakaJapan
| | - Tatsuya Nakama
- Department of CardiologyTokyobay UrayasuIchikawa Medical CenterChibaJapan
| | - Akiko Tanaka
- Department of Cardiovascular MedicineSendai Kousei HospitalMiyagiJapan
| | - Kazuki Tobita
- Department of CardiologyShonan Kamakura General HospitalKanagawaJapan
| | - Naoki Hayakawa
- Department of Cardiovascular MedicineAsahi General HospitalChibaJapan
| | - Shinsuke Mori
- Department of CardiologySaiseikai Yokohama City Eastern HospitalKanagawaJapan
| | - Yo Iwata
- Department of CardiologyFunabashi Municipal Medical CenterChibaJapan
| | - Kenji Suzuki
- Department of CardiologyTokyo Saiseikai Central HospitalTokyoJapan
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15
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Hayakawa N, Takahara M, Nakama T, Horie K, Takanashi K, Kanagami T, Ichihara S, Arakawa M, Tobita K, Mori S, Iwata Y, Suzuki K, Kanda J. Clinical outcome of drug-coated balloons in patients with femoropopliteal chronic total occlusive lesions: results from the multicenter EAGLE study. CVIR Endovasc 2022; 5:51. [PMID: 36201088 PMCID: PMC9537392 DOI: 10.1186/s42155-022-00329-8] [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: 07/05/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Background Several studies have reported the efficacy of drug-coated balloons (DCB) for simple femoropopliteal (FP) lesions. However, the effectiveness of DCB for FP chronic total occlusive lesions (CTO) is controversial. The present study investigated the clinical outcomes of DCB for FP-CTO. Materials and methods We retrospectively analyzed 359 limbs of 318 patients who underwent endovascular therapy with DCB for FP-CTO between July 2017 and February 2021 at seven cardiovascular centers. The primary endpoint was 12-month primary patency. The secondary endpoints were the 12-month rates of freedom from: (1) clinically-driven target lesion revascularization (CD-TLR), and (2) re-occlusion. The association of baseline characteristics with the 12-month restenosis risk was investigated using the Cox proportional hazards regression model. Results The 12-month rate of primary patency was 79.8% (95% confidence interval [95%CI], 75.1% to 84.8%), whereas the corresponding rates of freedom from CD-TLR and re-occlusion were 86.4% (95%CI: 82.6% to 90.4%) and 88.5% (95%CI: 84.7% to 92.4%), respectively. The bailout stent rate was 8.9%. Independent risk factors for restenosis were hemodialysis (adjusted hazard ratio, 2.18 [1.39 to 3.45]; P = 0.001), chronic limb-threatening ischemia (CLTI) (2.02 [1.33 to 3.07]; P = 0.001), and restenosis lesion (2.02 [1.32 to 3.08]; P = 0.001). Use of dual antiplatelet therapy (DAPT) was identified as a protective factor for restenosis (0.54 [0.35 to 0.82]; P = 0.003). Conclusions Despite the low rate of bailout stent, DCB treatment for FP-CTO was effective in real-world clinical practice. Hemodialysis, CLTI, and restenosis lesion were independent risk factors for 12-month restenosis, and the use of DAPT significantly attenuated the risk of 12-month restenosis.
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Affiliation(s)
- Naoki Hayakawa
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
| | - Mitsuyoshi Takahara
- grid.136593.b0000 0004 0373 3971Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan ,grid.411898.d0000 0001 0661 2073Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Kazunori Horie
- grid.415501.4Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Keisuke Takanashi
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
| | - Teruaki Kanagami
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
| | - Shinya Ichihara
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
| | - Masataka Arakawa
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
| | - Kazuki Tobita
- grid.415816.f0000 0004 0377 3017Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Shinsuke Mori
- grid.461876.a0000 0004 0621 5694Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan
| | - Yo Iwata
- grid.415167.00000 0004 1763 6806Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Kenji Suzuki
- grid.270560.60000 0000 9225 8957Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Junji Kanda
- grid.413946.dDepartment of Cardiovascular Medicine, Asahi General Hospital, I-1326 Asahi, Chiba, 289-2511 Japan
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Matsumura T, Hashimoto H, Sekimizu M, Saito A, Asakura M, Kimura K, Iwata Y. VP.59 A single-arm, open-label, multicenter study of tranilast for advanced heart failure in patients with muscular dystrophy. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.253] [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: 11/07/2022]
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17
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Nakama T, Takahara M, Iwata Y, Fujimura N, Yamaoka T, Suzuki K, Obunai K. 1-Year Outcomes of Thromboendarterectomy vs Endovascular Therapy for Common Femoral Artery Lesions: CAULIFLOWER Study Results. JACC Cardiovasc Interv 2022; 15:1453-1463. [PMID: 35863795 DOI: 10.1016/j.jcin.2022.03.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/28/2022] [Accepted: 03/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Thromboendarterectomy (TEA) is the gold-standard treatment for common femoral artery (CFA). However, because of its low invasiveness and short hospitalization duration, CFA endovascular therapy (EVT) is performed in real-world practice. However, the clinical benefits and appropriate target population for CFA EVT remain unclear. OBJECTIVES The aims of this study were to compare the clinical outcomes of TEA with those of EVT in patients with symptomatic CFA diseases and to identify the adequate target population for CFA EVT. METHODS A total of 1,193 consecutive patients who underwent EVT (n = 761) or TEA (n = 432) for CFA were identified and retrospectively reviewed from a registry of 66 institutions. The primary outcome was 1-year primary patency compared between EVT and TEA using propensity score matching. An interaction analysis was performed to explore the appropriate target population for CFA EVT. RESULTS After propensity score matching, the 1-year primary patency rate was significantly higher in the TEA group (82.3% vs 96.6%; P < 0.001), whereas perioperative complications were more frequently observed in the TEA group (P = 0.047). Nonambulatory status attenuated the HR of EVT vs TEA for restenosis risk (P = 0.021), whereas the presence of nodular calcification significantly increased the HR (P = 0.040). In the EVT subgroup analysis for restenosis risk, stent use showed the lowest HR compared with plain balloon angioplasty and drug-coated balloon angioplasty (P < 0.001). CONCLUSIONS TEA showed superior 1-year patency compared with EVT in a nationwide multicenter study. Nonambulatory status attenuated the superiority, whereas the presence of nodular calcification enhanced it.
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Affiliation(s)
- Tatsuya Nakama
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan.
| | - Mitsuyoshi Takahara
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yo Iwata
- Department of Cardiology, Heart & Vascular Institute, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Naoki Fujimura
- Department of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Terutoshi Yamaoka
- Department of Vascular Surgery, Matsuyama Red Cross Hospital, Ehime, Japan
| | - Kenji Suzuki
- Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Medical Center, Urayasu, Japan
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18
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Tanaka Y, Iwata Y, Saito K, Fukushima H, Watanabe S, Hasegawa Y, Akiyama M, Sugiura K. Cutaneous ischemia-reperfusion injury is exacerbated by IL-36 receptor antagonist deficiency. J Eur Acad Dermatol Venereol 2021; 36:295-304. [PMID: 34699104 DOI: 10.1111/jdv.17767] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/26/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Loss-of-function homozygous or compound heterozygous mutations in IL36RN, which encodes interleukin-36 receptor antagonist (IL-36Ra), has been implicated in the pathogenesis of skin disorders. However, the pathogenic role of IL-36Ra in cutaneous ischemia-reperfusion (I/R) injury remains unclear. OBJECTIVES We investigated the role of IL36Ra in cutaneous I/R injury. METHODS We examined I/R injury in Il36rn-/- mice. The area of wounds, numbers of infiltrated cells, apoptotic cells and neutrophil extracellular trap (NET) formation were assessed. The expression levels of various genes were analysed using real-time RT-PCR. The expression of high mobility group box 1 (HMGB1), an endogenous toll-like receptor (TLR) 4 ligand, was confirmed using immunohistology, and serum HMGB1 levels were measured by ELISA. Cytokine production by stimulated cultured J774A.1 and HaCaT cells was examined. RESULTS IL-36Ra deficiency resulted in significantly delayed wound healing and increased neutrophil and macrophage infiltration into the wound tissues. Il36rn-/- mice had increased mRNA expression levels of CXCL1, CXCL2, CCL4, TNF-α, TGF-β, IL-1β, IL-6 and IL-36γ relative to wild-type mice. Apoptosis was identified in keratinocytes by TUNEL assay. HMGB1 expression in the I/R site was decreased in both keratinocytes and adnexal cells, while serum HMGB1 levels were significantly elevated after reperfusion. The mRNA levels of various cytokines, including IL-1β, were elevated in J774A.1 cells through TLR4 signalling by HMGB1 stimulation. In addition, HaCaT cells stimulated with IL-1β showed significantly increased CXCL1, TNF-α, IL-6, IL-36β and IL-36γ mRNA expression. Furthermore, NET formation was increased by IL-36Ra deficiency. Finally, either the blockade of TLR4 signalling by TAK-242 or inhibition of NET formation by Cl-amidine normalized exacerbated I/R injury in Il36rn-/- mice. CONCLUSIONS This study indicated that IL-36Ra deficiency exacerbates cutaneous I/R injury due to excessive inflammatory cell recruitment, NET formation, and excessive cytokine and chemokine production via the TLR4 pathway by HMGB1 released from epidermal apoptotic cells.
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Affiliation(s)
- Y Tanaka
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Y Iwata
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - K Saito
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Fukushima
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Watanabe
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Y Hasegawa
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Sugiura
- Department of Dermatology, Fujita Health University School of Medicine, Toyoake, Japan
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Fukuzawa S, Fukuzawa S, Okino S, Ishiwaki H, Iwata Y, Kuroiwa N, Uchiyama T, Shibayama N. Cardiac amyloidosis in patients undergoing aortic valve replacement for aortic stenosis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0273] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Transthyretin cardiac amyloidosis (ATTR) has been increasingly recognized in patients with degenerative aortic stenosis (AS). In some reports, the uptake of Tc-99m labeled bone radiotracers in cardiac amyloidosis has been documented. Tc-99m pyrophosphate (PYP) scintigraphy in the absence of evidence of a monoclonal gammopathy was diagnostic for transthyretin cardiac amyloidosis, providing a cost-effective and non-invasive technique with a specificity and positive predictive value of nearly 100%. We sought to determine the prevalence of ATTR as detected by the bone scan tracer among the patients with severe AS requiring surgical valve replacement.
Methods
We retrospectively analyzed clinical and echocardiographical data for 44 patients with severe AS requiring surgical valve replacement between Jan. 2009 and Dec. 2016. All eligible patients were offered Tc-99m PYP scintigraphy. Retention of Tc-99m PYP in the heart was assessed using both a semiquantitative visual score (range, 0 [no uptake] to 3 [uptake greater than bone]). Positive uptake was defined score 2 and 3.
Results
Myocardial deposition of Tc-99m PYP (Score 2–3) was identified in 4 of 44 patients (9%), all >70 years and 75% male. Patients with myocardial deposition of the tracer were older (78±8 years vs. 70±12 years), and had more mean interventricular septum thickness (18±3 mm vs. 14±5 mm). Both groups had at least ejection fraction and abnormal global longitudinal strain with no significant difference between groups. Pre-operative serum median NT-pro BNP level was similar between two groups, but post-operative improvement of NT-pro BNP was larger in non-deposition of the tracer group. During the post operative follow-up, survival was significantly worse if patients had amyloid deposition compared with no deposition subjects (25% vs. 7.5%).
Conclusion
Incidental transthyretin cardiac amyroidosis had a prevelance of 9% among patients undergoing surgical aortic valve replacement and was associated with a poor outcome.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- S Fukuzawa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Fukuzawa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Okino
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - H Ishiwaki
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - Y Iwata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Kuroiwa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - T Uchiyama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Shibayama
- Funabashi Municipal Medical Center, Funabashi, Japan
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20
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Abstract
Purpose: To investigate the usefulness and efficacy of a novel eye-tracking device that can objectively measure nine gaze-directions. Methods: We measured each of the nine gaze-directions subjectively, using a conventional Hess screen test, and objectively, using the nine gaze-direction measuring device, and de-termined the correlation, addition error, and proportional error. We obtained two consecu-tive measurements of the nine gaze-directions using the newly developed device in healthy young people with exophoria and investigated the reproducibility of the measurements. We further measured the nine gaze-directions using a Hess screen test and the newly developed device in three subjects with cover test-based strabismus and compared the results. Results: We observed that the objective measurements obtained with the newly developed gaze-direction measuring device had significant correlation and addition error compared to the conventional subjective method, and we found no proportional error. These measure-ments had good reproducibility. Conclusion: The novel device can be used to observe delayed eye movement associated with limited eye movement in the affected eye, as well as the associated excessive movement of the healthy eye in patients with strabismus, similar to the Hess screen test. This is a useful device that can provide objective measurements of nine gaze-directions.
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21
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Maseki H, Kinoshita T, Matsui A, Iwata Y, Harada H, Sasahara M, Ichimura Y, Murata Y, Urakami S, Seki S, Oishi T, Isobe Y. The effect of Scalp-Cooling System on the prevention of alopecia after chemotherapy. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30666-3] [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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22
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Nishiuchi M, Sakaki H, Dover NP, Miyahara T, Shiokawa K, Manabe S, Miyatake T, Kondo K, Kondo K, Iwata Y, Watanabe Y, Kondo K. Ion species discrimination method by linear energy transfer measurement in Fujifilm BAS-SR imaging plate. Rev Sci Instrum 2020; 91:093305. [PMID: 33003787 DOI: 10.1063/5.0016515] [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: 06/05/2020] [Accepted: 09/04/2020] [Indexed: 06/11/2023]
Abstract
We have developed a novel discrimination methodology to identify ions in multispecies beams with similar charge-to-mass ratios, but different atomic numbers. After an initial separation by charge-to-mass ratios using co-linear electric and magnetic fields, individual ions can be discriminated by considering the linear energy transfer of ions irradiating a stimulable phosphor plate (Fujifilm imaging plate) by comparison with the Monte Carlo calculation. We apply the method to energetic multispecies laser-driven ion beams and use it to identify silver ions produced by the interaction between a high contrast, high intensity laser pulse; and a sub-micrometer silver foil target. We also show that this method can be used to calibrate the imaging plate for arbitrary ion species in the range of Z ≥ 6 with dE/dx > 0.1 MeV/μm without requiring individual calibration.
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Affiliation(s)
- M Nishiuchi
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - H Sakaki
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - N P Dover
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - T Miyahara
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - K Shiokawa
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - S Manabe
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga, Fukuoka 816-8580, Japan
| | - T Miyatake
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - Ko Kondo
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
| | - Ke Kondo
- Research Group for Radiation Materials Engineering, Nuclear Science and Engineering Center, Japan Atomic Energy Agency (JAEA), 2-4 Shirakata, Tokai-mura, Ibaraki 319-1195, Japan
| | - Y Iwata
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences (NIRS), National Institutes for Quantum and Radiological Science and Technology (QST), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - Y Watanabe
- Interdisciplinary Graduate School of Engineering Sciences, Kyushu University, Kasuga, Fukuoka 816-8580, Japan
| | - Ki Kondo
- Kansai Photon Science Institute (KPSI), National Institutes for Quantum and Radiological Science and Technology (QST), 8-1-7 Umemidai, Kizugawa, Kyoto 619-0215, Japan
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23
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Aihara H, Higashitani M, Takimura H, Tobita K, Jujo K, Hozawa K, Yamaguchi T, Iwata Y, Tokuyama H, Sakurai M, Murata N, Fujimoto Y, Kikuchi A, Koganei H, Sato A, Noguchi Y, Ieda M. Differences in Intravascular Ultrasound Measurement Values Between Treatment Modalities for Restenosis in Femoropopliteal Lesions. Circ J 2020; 84:1320-1329. [PMID: 32581151 DOI: 10.1253/circj.cj-20-0218] [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 The risk of restenosis after intervention is higher in femoropopliteal than in aortoiliac lesions. However, the appropriate endovascular therapy (EVT) for preventing restenosis after intervention for femoropopliteal lesions remains unknown. This study aimed to elucidate the relationship between lesion characteristics and patency after EVT using intravascular ultrasound (IVUS) measurement and to determine the predictors of restenosis on IVUS.Methods and Results:This prospective observational study was performed at 18 Japanese centers. We evaluated the lesion characteristics before and after EVT for femoropopliteal lesion using IVUS. Angiographic or duplex ultrasound follow-up was performed at 1 year after EVT. A total of 263 lesions underwent EVT between December 2016 and December 2017. In total, 20 lesions (8 cases of isolated common femoral artery lesion and 12 cases of restenosis lesion) were excluded, and 243 lesions were enrolled in this study. A total of 181 lesions were treated with stent placement, and 62 lesions were treated only with balloon angioplasty. In the case of stent use, a larger distal plaque burden was associated with restenosis, while a lower calcification angle was associated with higher patency in the case of balloon angioplasty alone. CONCLUSIONS The factors related to patency differed depending on the treating modality. The findings suggest that IVUS is a useful tool for predicting patency because it can provide a more accurate evaluation after EVT for femoropopliteal lesions.
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Affiliation(s)
- Hideaki Aihara
- Department of Cardiology, Tsukuba Medical Center Hospital
| | | | | | - Kazuki Tobita
- Department of Cardiology, Shonan Kamakura General Hospital
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Center Hospital
| | - Koji Hozawa
- Department of Cardiology, New Tokyo Hospital
| | | | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center
| | - Hideo Tokuyama
- Department Cardiology, Kawaguchi Cardiovascular and Respiratory Hospital
| | | | - Naotaka Murata
- Department of Cardiology, Tokyo Medical University Hospital
| | - Yo Fujimoto
- Department of Cardiology, Toranomon Hospital
| | - Arifumi Kikuchi
- Department Cardiology, Nippon Medical School Musashi Kosugi Hospital
| | - Hiroshi Koganei
- Department of Cardiology, Cardiovascular Center, Ogikubo Hospital
| | - Akira Sato
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Yuichi Noguchi
- Department of Cardiology, Tsukuba Medical Center Hospital
| | - Masaki Ieda
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
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24
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Mizushima K, Iwata Y, Muramatsu M, Lee SH, Shirai T. Experimental study on monitoring system of clinical beam purity in multiple-ion beam operation for heavy-ion radiotherapy. Rev Sci Instrum 2020; 91:023309. [PMID: 32113412 DOI: 10.1063/1.5127537] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Abstract
The National Institute of Radiological Sciences has investigated multiple-ion therapy using energetic beams of helium, carbon, oxygen, and neon ions, to improve treatment outcomes of refractory cancer. For this therapy, it is necessary to ensure the helium-ion beam purity to avoid irradiation by unwanted ions. Here, we develop a measurement method for monitoring beam purity. This method can measure the charge number of the ions in a high-purity beam using an ionization chamber and Faraday cup. In addition, it can be used to detect the contamination of the clinical helium-ion beam. We perform beam experiments to evaluate our beam-purity monitoring method and predict that our method is capable of detecting contamination below 1%.
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Affiliation(s)
- K Mizushima
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Y Iwata
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - M Muramatsu
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - S H Lee
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - T Shirai
- Department of Accelerator and Medical Physics, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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25
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Fukuzawa S, Okino S, Ishiwaki H, Iwata Y, Uchiyama T, Kuroiwa N, Oka N, Shibayama N, Inagaki M. Positive Myocardial Uptake of Bone Scintigraphic Agents Associated with Cardiac Amyloidosis: Frequency of Positive Uptake Data Based on Daily Clinical Practice. Ann Nucl Cardiol 2020; 6:27-32. [PMID: 37123498 PMCID: PMC10133927 DOI: 10.17996/anc.20-00121] [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] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/25/2020] [Accepted: 06/10/2020] [Indexed: 05/02/2023]
Abstract
Objective: The bone scan plays an important role for detecting number of conditions relating to bones, including: bone cancer or bone metastasis, bone inflammation. Extraosseous uptake, in particular, myocardial uptake, was observed in some patients examined with the bone scans. Positive uptake of 99mTc-labeled bone radiotracers is associated with cardiac amyloidosis. However, the frequency and cause of positive cardiac 99mTc-MDP uptake have not been fully studied. In this regard, the aim of this study was to assess the frequency and characteristics of patients with high myocardi-al uptake of bone scintigraphy in daily clinical practice setting. Methods: We retrospectively analyzed 4180 bone scintigraphies performed in daily clinical practice during 7-years period. The intensity of the myocardial uptake was graded based on a visual scale ranging from 0 to 3 points. Score 0 indicates the absence of uptake. Score 1 defined uptake less than that of bone (referred to as the adjacent rib). Uptake similar to that of bone was classified score 2. Score 3 was defined as uptake greater than that of reference bone. Positive myocardial uptake included a visual score 2 or 3. Result: Positive 99mTc-MDP myocardial uptake occurred in 12 patients among 4180 patients (0.3%). 7 of 12 positive scan patients were consistent with amyloidosis confirmed by biopsy. In these patients, the mean age was 75.6 ± 5.2 years old. Ten cases showed biventricular uptake and 2 showed LV uptake only. Conclusion: Positive cardiac uptake of bone scintigraphic agents was present in 0.3% of bone scintigraphies in a clinical practice setting. This may be a sign of cardiac amyloidosis involvement which may give the presence of extraosseous bone tracer uptake its own importance and a new role.
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Affiliation(s)
- Shigeru Fukuzawa
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Shinichi Okino
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Hikaru Ishiwaki
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Yo Iwata
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Takashi Uchiyama
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Nobuyuki Kuroiwa
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Norikiyo Oka
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Noeru Shibayama
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
| | - Masayuki Inagaki
- Division of Cardiology, Heart and Vascular Institute, Funabashi Municipal Medical Center
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26
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Kitasato M, Iwamitsu Y, Iwata Y, Ueta T, Fukaya E, Ishikawa H. Investigation of Stress and Distress Experienced by Guardians of Children with Strabismus and/or Amblyopia. J Binocul Vis Ocul Motil 2019; 70:21-28. [PMID: 31858895 DOI: 10.1080/2576117x.2019.1691872] [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] [Indexed: 10/25/2022]
Abstract
Purpose: To investigate the stress experienced by the guardians of children with strabismus and/or amblyopia.Patients and Method: This study included 98 guardians of children with strabismus and/or amblyopia. First, guardians were asked to complete an independent questionnaire and the K6 screening scale. We analyzed stress associated with caring for their child. Second, we examined the responses to the free description questions of the consultation contents and benefits acquired from treatments.Results: A relationship between the attitudes of children regarding treatment and the receptive psychology of their guardians was established. Since strabismus and amblyopia treatments require practice and wearing glasses or patches in everyday living, guardians of affected children desired explanation regarding better and more specific treatments to improve the daily lives of their children. On the other hand, they had a feeling of anxiety about the future of their children. In addition, the stress-free guardians mentioned the importance of support, indicating that receiving support contributed to reducing their stress levels.Conclusion: Creating an environment that allows affected children to actively engage in their own treatment, while providing guardians with relevant information on the course of treatment and their children's future, may help reduce stress in guardians of affected children.
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Affiliation(s)
- Miwa Kitasato
- Department of Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yumi Iwamitsu
- Department of Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Yo Iwata
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
| | - Tomoki Ueta
- Department of Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Etsuko Fukaya
- Department of Psychology, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan
| | - Hitoshi Ishikawa
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences, Kitasato University, Kanagawa, Japan
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27
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Fukuzawa S, Okino S, Ishiwaki H, Iwata Y, Uchiyama T, Kuroiwa N, Oka M, Furihata S, Shibayama N, Inagaki M. P2725Transthyretin cardiac amyloidosis in heart failure with preserved ejection fraction: Imaging by Tc-99m bone scan. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous clinical syndrome with multiple underlying causes. Transthyretin amyloidosis (ATTR) is an underdiagnosed cause of HFpEF. Extraosseous uptake, in particular, myocardial uptake, was observed in a number of ATTR patients examined with the bone scan tracers.
Objectives
We sought to determine the prevalence of ATTR as detected by the bone scan among the patients admitted due to HFpEF.
Methods
We screened all consecutive patients ≥60 years old admitted due to HFpEF (left ventricular ejection fraction ≥50%). All eligible patients were offered an echocardiogram and a bone scan (a 99mTc-DPD/MDP/HMDP scintigraphy). Echocardiographic and clinical variables were gathered in all the subjects. The intensity of the myocardial uptake was graded according to a visual scale ranging from 0 to 3 points, in which the absence of uptake was assigned a score of 0 points; uptake less than that of bone (referred to as the adjacent rib), 1 point; uptake similar to that of bone, 2 points; and uptake greater than that of bone, 3 points. The distribution of the uptake in myocardium was defined as focal uptake, diffuse uptake, uptake in a ventricular wall segment, diffuse ventricular uptake, or diffuse biventricular uptake.
Results
The study included 62 HFpEF patients (52% women, 73±9 years). The bone scintigraphic analysis revealed relatively intense myocardial uptake in 7 of 62 patients (11.2%). 7 patients had intense Tc-99m uptake (score of 2–3) in the cardiac region, showing deposition in both right and left ventricles in every case. Patients with amyloid deposition were older (78±6 vs. 70±12 years, p<0.05), had a lower systolic blood pressure (118±23 vs. 148±28 mmHg, p<0.05), and left ventricular ejection fraction (52±11 vs. 58±6%, p<0.05). Both groups had at least moderate left ventricular hypertrophy and abnormal global longitudinal strain with no significant difference between groups. In 6 all the cases, the final diagnosis of amyloidosis was based on the results of abdominal fat aspiration biopsy.
Conclusion
ATTR is an underdiagnosed disease that accounts for a significant number (11.2%) of HFpEF cases. These findings create an opportunity for further investigation in the targeted therapy of patients with HFpEF.
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Affiliation(s)
- S Fukuzawa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Okino
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - H Ishiwaki
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - Y Iwata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - T Uchiyama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Kuroiwa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - M Oka
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Furihata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Shibayama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - M Inagaki
- Funabashi Municipal Medical Center, Funabashi, Japan
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28
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Kawarada O, Hozawa K, Zen K, Huang HL, Kim SH, Choi D, Park K, Kato K, Kato T, Tsubakimoto Y, Ichihashi S, Fujimura N, Higashimori A, Sato T, Yan BPY, Pang SYC, Wongwanit C, Leong YP, Chua B, George RK, Chen IC, Lee JK, Hsu CH, Pua U, Iwata Y, Miki K, Okada K, Obara H. Peak systolic velocity ratio derived from quantitative vessel analysis for restenosis after femoropopliteal intervention: a multidisciplinary review from Endovascular Asia. Cardiovasc Interv Ther 2019; 35:52-61. [PMID: 31292931 PMCID: PMC6942011 DOI: 10.1007/s12928-019-00602-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/08/2019] [Accepted: 06/24/2019] [Indexed: 01/08/2023]
Abstract
With technological improvements in the endovascular armamentarium, there have been tremendous advances in catheter-based femoropopliteal artery intervention during the last decade. However, standardization of the methodology for assessing outcomes has been underappreciated, and unvalidated peak systolic velocity ratios (PSVRs) of 2.0, 2.4, and 2.5 on duplex ultrasonography have been arbitrarily but routinely used for assessing restenosis. Quantitative vessel analysis (QVA) is a widely accepted method to identify restenosis in a broad spectrum of cardiovascular interventions, and PSVR needs to be validated by QVA. This multidisciplinary review is intended to disseminate the importance of QVA and a validated PSVR based on QVA for binary restenosis in contemporary femoropopliteal intervention.
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Affiliation(s)
- Osami Kawarada
- Department of Cardiovascular Medicine, Ikuwakai Memorial Hospital, 3-20-29 Tatsumikita, Ikunoku, Osaka, Osaka, 544-0004, Japan.
| | - Koji Hozawa
- Department of Cardiology, New Tokyo Hospital, Matsudo, Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hsuan-Li Huang
- Division of Cardiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| | - Su Hong Kim
- Department of Cardiology, Busan Veterans Hospital, Busan, Korea
| | - Donghoon Choi
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kihyuk Park
- Department of Vascular Surgery, Daegu Catholic University Hospital, Daegu, Korea
| | - Kenichi Kato
- Department of Vascular Laboratory, Ikuwakai Memorial Hospital, Osaka, Japan
| | - Taku Kato
- Department of Cardiology, Rakuwakai Otowa Hospital, Kyoto, Japan
| | | | - Shigeo Ichihashi
- Department of Radiology, Nara Medical University, Kashihara, Japan
| | - Naoki Fujimura
- Division of Vascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | | | - Tomoyasu Sato
- Department of Radiology, Tsuchiya General Hospital, Hiroshima, Japan
| | - Bryan Ping-Yen Yan
- Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Sha Tin, Hong Kong, China
| | - Skyi Yin-Chun Pang
- Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China
| | - Chumpol Wongwanit
- Department of Vascular Surgery, Siriraj Hospital, Bangkok, Thailand
| | - Yew Pung Leong
- Department of Vascular Surgery, Cardiac Vascular Sentral Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Benjamin Chua
- Department of Vascular Surgery, Vascular and Interventional Centre Singapore, Mount Elizabeth Novena Specialist Centre, The Farrer Park Hospital, Singapore, Singapore
| | - Robbie K George
- Department of Vascular Surgery, Narayana Hrudayalaya and Mazumdar Shaw Medical Centre, Bengaluru, India
| | - I-Chih Chen
- Division of Cardiology, Department of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan
| | - Jen-Kuang Lee
- Department of Cardiology, National Taiwan University, Taipei, Taiwan
| | - Chung-Ho Hsu
- Department of Cardiology, China Medical University Hospital, Taichung, Taiwan
| | - Uei Pua
- Department of Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Yo Iwata
- Department of Cardiology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Kojiro Miki
- Department of Cardiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kozo Okada
- Department of Cardiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Hideaki Obara
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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29
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Fukuzawa S, Okino S, Ishiwaki H, Iwata Y, Uchiyama T, Kuroiwa N, Oka M, Furuhata S, Shibayama N, Inagaki M. 29Cardiac amyloidosis revealed by bone scintigraphy in heart failure with preserved ejection fraction. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez142.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Fukuzawa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Okino
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - H Ishiwaki
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - Y Iwata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - T Uchiyama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Kuroiwa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - M Oka
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Furuhata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Shibayama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - M Inagaki
- Funabashi Municipal Medical Center, Funabashi, Japan
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30
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Fukuzawa S, Okino S, Iwata Y, Kuroiwa N, Uchiyama T, Inagaki M. P4701The elusive role of myocardial perfusion imaging for the patients with insufficient fractional flow reserve after drug eluting stent implantation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- S Fukuzawa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - S Okino
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - Y Iwata
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - N Kuroiwa
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - T Uchiyama
- Funabashi Municipal Medical Center, Funabashi, Japan
| | - M Inagaki
- Funabashi Municipal Medical Center, Funabashi, Japan
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31
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Iwata Y, Handa T, Ishikawa H, Goseki T, Shoji N. Evaluation of the Effects of the Occlu-Pad for the Management of Anisometropic Amblyopia in Children. Curr Eye Res 2018; 43:785-787. [PMID: 29451999 DOI: 10.1080/02713683.2018.1439066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE In recent years, amblyopia treatment device that can be used with both eyes open have been reported. The Occlu-pad is a device that can present images of tablet terminals to one eye only under binocular open conditions. Till date, no study has reported the effectiveness of Occlu-pad training for anisometropic amblyopia in a series of cases. In the present study, we evaluated the effectiveness of the Occlu-pad for the management of anisometropic amblyopia without the use of occlusion therapy (eyepatch). MATERIALS AND METHODS We implemented Occlu-pad training for 22 children (mean age ± standard deviation: 4.7 ± 1.2 years) with anisometropic amblyopia. The visual acuity before treatment initiation was 0.25 ± 0.08. The difference in refraction between the healthy and amblyopic eyes was 3.10 ± 0.58 D. RESULTS The visual acuity at 3 months and 6 months after training initiation was 0.06 ± 0.09 and -0.04 ± 0.07, respectively; this indicates a significant improvement in vision. The compliance rates for Occlu-pad use during 0 - 3 months and 4 - 6 months after training initiation were 88.6% ± 18.9% and 73.2% ± 18.9%; these rates decreased significantly with time. CONCLUSIONS Our findings suggest that the Occlu-pad is an effective tool for the management of anisometropic amblyopia in children.
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Affiliation(s)
- Yo Iwata
- a Department of Ophthalmology , Doctor's Program of Medical Science, Kitasato University Graduate School , Sagamihara , Japan.,b Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences , Kitasato University , Sagamihara , Japan
| | - Tomoya Handa
- b Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences , Kitasato University , Sagamihara , Japan
| | - Hitoshi Ishikawa
- b Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Sciences , Kitasato University , Sagamihara , Japan.,c Department of Ophthalmology, School of Medicine , Kitasato University , Sagamihara , Japan
| | - Toshiaki Goseki
- c Department of Ophthalmology, School of Medicine , Kitasato University , Sagamihara , Japan
| | - Nobuyuki Shoji
- c Department of Ophthalmology, School of Medicine , Kitasato University , Sagamihara , Japan
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Iwata Y, Tanaka Y, Kubosaki S, Morita T, Yoshimi Y. A strategy for generating aryl radicals from arylborates through organic photoredox catalysis: photo-Meerwein type arylation of electron-deficient alkenes. Chem Commun (Camb) 2018; 54:1257-1260. [DOI: 10.1039/c7cc09140k] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Generation of a variety of aryl radicals from arylboronic acids through metal-free photoredox catalysis under mild conditions.
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Affiliation(s)
- Y. Iwata
- Department of Applied Chemistry and Biotechnology
- Graduate School of Engineering
- University of Fukui
- Fukui 910-8507
- Japan
| | - Y. Tanaka
- Department of Applied Chemistry and Biotechnology
- Graduate School of Engineering
- University of Fukui
- Fukui 910-8507
- Japan
| | - S. Kubosaki
- Department of Applied Chemistry and Biotechnology
- Graduate School of Engineering
- University of Fukui
- Fukui 910-8507
- Japan
| | - T. Morita
- Department of Applied Chemistry and Biotechnology
- Graduate School of Engineering
- University of Fukui
- Fukui 910-8507
- Japan
| | - Y. Yoshimi
- Department of Applied Chemistry and Biotechnology
- Graduate School of Engineering
- University of Fukui
- Fukui 910-8507
- Japan
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Fukuzawa S, Okino S, Kuroiwa N, Iwata Y, Uchiyama T, Yamanaka K, Inagaki M. 4779Myocardial uptake of bone scintigraphic agents associated with cardiac amyloidosis in daily practice. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.4779] [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: 11/14/2022] Open
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Takayama S, Koyanagi K, Miyazaki H, Takami S, Orikasa T, Ishii Y, Kurusu T, Iwata Y, Noda K, Obana T, Suzuki K, Ogitsu T, Amemiya N. Design and Test Results of Superconducting Magnet for Heavy-Ion Rotating Gantry. ACTA ACUST UNITED AC 2017. [DOI: 10.1088/1742-6596/871/1/012083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Heilbronn L, Zeitlin CJ, Iwata Y, Murakami T, Nakamura T, Yonai S, Ronningen RM, Iwase H. Neutron-Production Yields from 400 MeV/Nucleon Iron Stopping in Carbon, Aluminum, Copper, and Lead Targets. NUCL SCI ENG 2017. [DOI: 10.13182/nse10-112] [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: 11/12/2022]
Affiliation(s)
- L. Heilbronn
- University of Tennessee, 214 Pasqua Engineering Building Knoxville, Tennessee 37996
| | - C. J. Zeitlin
- Southwest Research Institute, 1050 Walnut Street, Boulder, Colorado 80302
| | - Y. Iwata
- National Institute of Radiological Sciences, Department of Accelerator Physics and Engineering 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - T. Murakami
- National Institute of Radiological Sciences, Department of Accelerator Physics and Engineering 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - T. Nakamura
- Tohoku University, Cyclotron and Radioisotope Center Aoba, Aramaki, Sendai 980-8578, Japan
| | - S. Yonai
- Tohoku University, Cyclotron and Radioisotope Center Aoba, Aramaki, Sendai 980-8578, Japan
| | - R. M. Ronningen
- Michigan State University, National Superconducting Cyclotron Laboratory East Lansing, Michigan 48824-1321
| | - H. Iwase
- KEK, Radiation Science Center, Oho 1, Tsukuba 305-0801, Japan
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Heilbronn L, Zeitlin CJ, Iwata Y, Murakami T, Iwase H, Nakamura T, Nunomiya T, Sato H, Yashima H, Ronningen RM, Ieki K. Secondary Neutron-Production Cross Sections from Heavy-Ion Interactions between 230 and 600 MeV/Nucleon. NUCL SCI ENG 2017. [DOI: 10.13182/nse07-a2719] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- L. Heilbronn
- Lawrence Berkeley National Laboratory, MS 74-197, Berkeley, California 94720
| | - C. J. Zeitlin
- Lawrence Berkeley National Laboratory, MS 74-197, Berkeley, California 94720
| | - Y. Iwata
- National Institute of Radiological Sciences, Department of Accelerator Physics and Engineering 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - T. Murakami
- National Institute of Radiological Sciences, Department of Accelerator Physics and Engineering 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - H. Iwase
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Sendai 980-8578, Japan
| | - T. Nakamura
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Sendai 980-8578, Japan
| | - T. Nunomiya
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Sendai 980-8578, Japan
| | - H. Sato
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Sendai 980-8578, Japan
| | - H. Yashima
- Tohoku University, Cyclotron and Radioisotope Center, Aoba, Aramaki, Sendai 980-8578, Japan
| | - R. M. Ronningen
- Michigan State University, National Superconducting Cyclotron Laboratory East Lansing, Michigan 48824-1321
| | - K. Ieki
- Rikkyo University, Department of Physics, 3-34-1 Nishi Ikebukuro Toshima, Tokyo 171-8501, Japan
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Iwata Y, Kobayashi T, Kuroda M, Mizoguchi Y, Arima M, Numata S, Watanabe S, Yagami A, Matsunaga K, Sugiura K. Case report of multiple pustules of the bilateral lower limbs caused by a granulocyte colony-stimulating factor-producing solid pseudopapillary tumour of the pancreas. Br J Dermatol 2016; 177:1122-1126. [PMID: 27925156 DOI: 10.1111/bjd.15219] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 11/29/2022]
Abstract
Here we report a rare case of neutrophilic dermatoses related to a granulocyte colony-stimulating factor (G-CSF)-producing solid pseudopapillary tumour (SPT). The patient was a 39-year-old woman presenting with scattered pustules and crusts of the palms, heels and thighs and plaques of the bilateral lower legs. The skin biopsy revealed dense neutrophil infiltration in the epidermis to the dermis. A pancreatic head tumour was detected using computed tomography. A pathological examination of the resected specimen suggested an SPT. As the skin eruption promptly disappeared after SPT resection, we hypothesized that SPT secretes growth factors including epidermal growth factor (EGF) and G-CSF. The SPT cells stained positive for both EGF and G-CSF tumour cells. The serum levels of interleukin (IL)-6 and IL-10 and tumour necrosis factor-α were within normal limits before and after the SPT resection. In contrast, the serum IL-8, EGF and G-CSF levels decreased after the SPT resection. This is a rare case of neutrophilic dermatoses related to a G-CSF-producing SPT. The present case suggests that physicians should be aware that a G-CSF-producing tumour is a differential diagnosis to consider in patients with unusual aseptic pustulosis.
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Affiliation(s)
- Y Iwata
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - T Kobayashi
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - M Kuroda
- Department of Diagnostic Pathology and, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - Y Mizoguchi
- Department of Integrative Medical Science for Allergic Disease, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - M Arima
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - S Numata
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - S Watanabe
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - A Yagami
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
| | - K Matsunaga
- Department of Diagnostic Pathology, Nishichita General Hospital, Tokai, Aichi, 477-8522, Japan
| | - K Sugiura
- Department of Dermatology, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan
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Nishikawa H, Enomoto H, Iwata Y, Kishino K, Shimono Y, Hasegawa K, Nakano C, Takata R, Nishimura T, Yoh K, Ishii A, Aizawa N, Sakai Y, Ikeda N, Takashima T, Iijima H, Nishiguchi S. Serum Wisteria floribunda agglutinin-positive Mac-2-binding protein for patients with chronic hepatitis B and C: a comparative study. J Viral Hepat 2016; 23:977-984. [PMID: 27476460 DOI: 10.1111/jvh.12575] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 07/07/2016] [Indexed: 12/12/2022]
Abstract
We compared Wisteria floribunda agglutinin-positive Mac-2-binding protein (WFA+ -M2BP) levels between patients with chronic hepatitis B (n=249) and chronic hepatitis C (n=386) based on the degree of liver fibrosis. We examined WFA+ -M2BP levels in patients with F4 (cirrhosis), F3 or more (advanced fibrosis) and F2 or more (significant fibrosis) in the two groups. We further examined the relationship between five fibrosis markers and the degree of fibrosis. The WFA+ -M2BP values ranged from 0.25 cut-off index (COI) to 12.9 COI in patients with hepatitis B and 0.34-20.0 COI in patients with hepatitis C (P<.0001). The median WFA+ -M2BP values in F4 in the two groups were 2.83 COI in patients with hepatitis B and 5.03 COI in patients with hepatitis C (P=.0046). The median WFA+ -M2BP values in F3 or more in the two groups were 1.79 COI in patients with hepatitis B and 3.79 COI in patients with hepatitis C (P<.0001). The median WFA+ -M2BP values in F2 or more in the two groups were 1.49 COI in the hepatitis B cohort and 3.19 COI in the hepatitis C group (P<.0001). Among five liver fibrosis markers, WFA+ -M2BP had the highest correlation coefficient (rs =.629) in terms of correlation with the degree of fibrosis in the patients with hepatitis C and had the second highest rs value (.415) in the hepatitis B group. Although WFA+ -M2BP could be a useful indicator of liver fibrosis, WFA+ -M2BP levels in the two groups significantly differed even in the same degree of fibrosis. Individual cut-off values in each aetiology for the degree of fibrosis should be determined.
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Affiliation(s)
- H Nishikawa
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - H Enomoto
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Y Iwata
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - K Kishino
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Y Shimono
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - K Hasegawa
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - C Nakano
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - R Takata
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - T Nishimura
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - K Yoh
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - A Ishii
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - N Aizawa
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - Y Sakai
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - N Ikeda
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - T Takashima
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - H Iijima
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - S Nishiguchi
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan
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Iwata Y, Shimizu N, Otsuka T, Utsuno Y, Menéndez J, Honma M, Abe T. Erratum: Large-Scale Shell-Model Analysis of the Neutrinoless ββ Decay of ^{48}Ca [Phys. Rev. Lett. 116, 112502 (2016)]. Phys Rev Lett 2016; 117:179902. [PMID: 27824452 DOI: 10.1103/physrevlett.117.179902] [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: 10/04/2016] [Indexed: 06/06/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.116.112502.
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Matsumura T, Matsui M, Iwata Y, Asakura M, Saito T, Fujimura H, Sakoda S. TRPV2 inhibition therapy can be effective for cardiomyopathy of muscular dystrophy. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
We conducted a retrospective review of 11 patients with bilateral Kienböck’s disease from our series of 251 patients with Kienböck’s disease. There were no significant differences in radiographic parameters, including ulnar variance and carpal bone angle, between those with unilateral and those with bilateral Kienböck’s disease. None of the patients with bilateral disease had been treated with corticosteroids or had a systemic disease that predisposed to osteonecrosis. Thus, this study failed to demonstrate any risk factor for bilateral, as opposed to unilateral Kienböck’s disease.
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Affiliation(s)
- N Yazaki
- Department of Hand Surgery, Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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Affiliation(s)
- Yo Iwata
- Master's Program of Medical Science; Kitasato University Graduate School; Sagamihara Japan
| | - Tomoya Handa
- Department of Rehabilitation, Orthoptics and Visual Science Course; School of Allied Health Science; Kitasato University; Sagamihara Japan
| | - Nobuyuki Shoji
- Department of Rehabilitation, Orthoptics and Visual Science Course; School of Allied Health Science; Kitasato University; Sagamihara Japan
- Department of Ophthalmology; School of Medicine; Kitasato University; Sagamihara Japan
| | - Hitoshi Ishikawa
- Department of Rehabilitation, Orthoptics and Visual Science Course; School of Allied Health Science; Kitasato University; Sagamihara Japan
- Department of Ophthalmology; School of Medicine; Kitasato University; Sagamihara Japan
| | - Kimiya Shimizu
- Department of Ophthalmology; School of Medicine; Kitasato University; Sagamihara Japan
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Takahashi K, Suzuki M, Iwata Y, Shigeta S, Yamanishi K, De Clercq E. Selective Activity of Various Nucleoside and Nucleotide Analogues against Human Herpesvirus 6 and 7. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029700800102] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We have developed a new sensitive enzyme immunoassay (EIA) and MTT (tetrazolium salt) assay for screening compounds against two variants of human herpesvirus 6 (HHV-6A, HHV-6B) and human herpesvirus 7 (HHV-7) and evaluated the anti-HHV-6 and HHV-7 activity of a series of anti-herpesvirus compounds and acyclic nucleoside phosphonate analogues. The results indicate that the pattern of activity of these compounds against these betaherpesviruses is similar to that for human cytomegalovirus (HCMV). The highest potency and selectivity against the two variants of HHV-6 and HHV-7 was demonstrated by S2242 (N7-isomer of 6-deoxy-ganciclovir). Also, ganciclovir (GCV), foscarnet, (phosphonoformic acid; PFA) and the acyclic nucleoside phosphonate analogues such as cidofovir (HPMPC) exhibited selective inhibitory activity against these viruses. Thymidine kinase (TK)-dependent drugs (acyclovir, ACV; brivudin, BVDU; and sorivudine, BVaraU) showed little, if any, activity. These results suggest a structural homology of the DNA polymerase and a lack of TK gene among these three betaherpesviruses (HHV-6, HHV-7 and HCMV). The finding that HHV-7 was highly sensitive to GCV also suggests that HHV-7 may have an HCMV-UL97-homologue gene for the phosphorylation of GCV. The present EIA method is more rapid and sensitive than the previously reported procedures and could be useful for the large-scale screening of compounds against HHV-6 and HHV-7.
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Affiliation(s)
- K Takahashi
- Department of Microbiology, Fukushima Medical College, 1 Hikarigaoka, Fukushima, 960-1 2, Japan
| | - M Suzuki
- Department of Microbiology, Fukushima Medical College, 1 Hikarigaoka, Fukushima, 960-1 2, Japan
| | - Y Iwata
- Department of Microbiology, Fukushima Medical College, 1 Hikarigaoka, Fukushima, 960-1 2, Japan
| | - S Shigeta
- Department of Microbiology, Fukushima Medical College, 1 Hikarigaoka, Fukushima, 960-1 2, Japan
| | - K Yamanishi
- Department of Microbiology, Osaka University School of Medicine, Osaka, Japan
| | - E De Clercq
- Rega Institute for Medical Research, Katholieke Universiteit Leuven, B-3000 Leuven, Belgium
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Abstract
This study reports a novel stress radiography technique to evaluate an avulsion fracture at the lateral malleolus in children. Radiographs in the stress anteroposterior view or the Haraguchi calcaneofibular ligament or anterior tarofibular ligament (ATFL) projection could not detect any fracture; only manual inversion stress radiography in the Haraguchi ATFL projection could identify the avulsion fracture.
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Affiliation(s)
- Y Iwata
- Iwata Orthopedics and Rheumatology Clinic, Japan
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Iwata Y, Shimizu N, Otsuka T, Utsuno Y, Menéndez J, Honma M, Abe T. Large-Scale Shell-Model Analysis of the Neutrinoless ββ Decay of ^{48}Ca. Phys Rev Lett 2016; 116:112502. [PMID: 27035297 DOI: 10.1103/physrevlett.116.112502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Indexed: 06/05/2023]
Abstract
We present the nuclear matrix element for the neutrinoless double-beta decay of ^{48}Ca based on large-scale shell-model calculations including two harmonic oscillator shells (sd and pf shells). The excitation spectra of ^{48}Ca and ^{48}Ti, and the two-neutrino double-beta decay of ^{48}Ca are reproduced in good agreement to the experimental data. We find that the neutrinoless double-beta decay nuclear matrix element is enhanced by about 30% compared to pf-shell calculations. This reduces the decay lifetime by almost a factor of 2. The matrix-element increase is mostly due to pairing correlations associated with cross-shell sd-pf excitations. We also investigate possible implications for heavier neutrinoless double-beta decay candidates.
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Affiliation(s)
- Y Iwata
- Center for Nuclear Study, The University of Tokyo, 113-0033 Tokyo, Japan
| | - N Shimizu
- Center for Nuclear Study, The University of Tokyo, 113-0033 Tokyo, Japan
| | - T Otsuka
- Center for Nuclear Study, The University of Tokyo, 113-0033 Tokyo, Japan
- Department of Physics, The University of Tokyo, 113-0033 Tokyo, Japan
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Instituut voor Kern- en Stralingsfysica, Katholieke Universiteit Leuven, B-3001 Leuven, Belgium
| | - Y Utsuno
- Center for Nuclear Study, The University of Tokyo, 113-0033 Tokyo, Japan
- Advanced Science Research Center, Japan Atomic Energy Agency, Tokai, 319-1195 Ibaraki, Japan
| | - J Menéndez
- Department of Physics, The University of Tokyo, 113-0033 Tokyo, Japan
| | - M Honma
- Center for Mathematical Sciences, University of Aizu, 965-8580 Fukushima, Japan
| | - T Abe
- Department of Physics, The University of Tokyo, 113-0033 Tokyo, Japan
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Muramatsu M, Hojo S, Iwata Y, Katagiri K, Sakamoto Y, Takahashi N, Sasaki N, Fukushima K, Takahashi K, Suzuki T, Sasano T, Uchida T, Yoshida Y, Hagino S, Nishiokada T, Kato Y, Kitagawa A. Development of a compact ECR ion source for various ion production. Rev Sci Instrum 2016; 87:02C110. [PMID: 26932120 DOI: 10.1063/1.4935221] [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: 06/05/2023]
Abstract
There is a desire that a carbon-ion radiotherapy facility will produce various ion species for fundamental research. Although the present Kei2-type ion sources are dedicated for the carbon-ion production, a future ion source is expected that could provide: (1) carbon-ion production for medical use, (2) various ions with a charge-to-mass ratio of 1/3 for the existing Linac injector, and (3) low cost for modification. A prototype compact electron cyclotron resonance (ECR) ion source, named Kei3, based on the Kei series has been developed to correspond to the Kei2 type and to produce these various ions at the National Institute of Radiological Sciences (NIRS). The Kei3 has an outer diameter of 280 mm and a length of 1120 mm. The magnetic field is formed by the same permanent magnet as Kei2. The movable extraction electrode has been installed in order to optimize the beam extraction with various current densities. The gas-injection side of the vacuum chamber has enough space for an oven system. We measured dependence of microwave frequency, extraction voltage, and puller position. Charge state distributions of helium, carbon, nitrogen, oxygen, and neon were also measured.
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Affiliation(s)
- M Muramatsu
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - S Hojo
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - Y Iwata
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - K Katagiri
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - Y Sakamoto
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
| | - N Takahashi
- Sumitomo Heavy Industries, Ltd., 19 Natsushima, Yokosuka, Kanagawa 237-8555, Japan
| | - N Sasaki
- Accelerator Engineering Corporation, 3-8-5 Konakadai, Inage, Chiba 263-0043, Japan
| | - K Fukushima
- Accelerator Engineering Corporation, 3-8-5 Konakadai, Inage, Chiba 263-0043, Japan
| | - K Takahashi
- Accelerator Engineering Corporation, 3-8-5 Konakadai, Inage, Chiba 263-0043, Japan
| | - T Suzuki
- Accelerator Engineering Corporation, 3-8-5 Konakadai, Inage, Chiba 263-0043, Japan
| | - T Sasano
- Accelerator Engineering Corporation, 3-8-5 Konakadai, Inage, Chiba 263-0043, Japan
| | - T Uchida
- Bio-Nano Electronics Research Centre, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama 350-8585, Japan
| | - Y Yoshida
- Bio-Nano Electronics Research Centre, Toyo University, 2100 Kujirai, Kawagoe-shi, Saitama 350-8585, Japan
| | - S Hagino
- Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita-shi, Osaka 565-0871, Japan
| | - T Nishiokada
- Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita-shi, Osaka 565-0871, Japan
| | - Y Kato
- Graduate School of Engineering, Osaka University, 2-1 Yamada-oka, Suita-shi, Osaka 565-0871, Japan
| | - A Kitagawa
- National Institute of Radiological Sciences (NIRS), 4-9-1 Anagawa, Inage, Chiba 263-8555, Japan
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Nishi T, Kitahara H, Iwata Y, Fujimoto Y, Nakayama T, Takahara M, Sugimoto K, Kobayashi Y. Efficacy of combined administration of intracoronary papaverine plus intravenous adenosine 5'-triphosphate in assessment of fractional flow reserve. J Cardiol 2016; 68:512-516. [PMID: 26811149 DOI: 10.1016/j.jjcc.2015.12.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 11/17/2015] [Accepted: 12/16/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND Inducing maximal coronary hyperemia is important to measure fractional flow reserve (FFR) accurately. Intravenous adenosine and adenosine 5'-triphosphate (ATP) have been used to achieve maximal hyperemia. However, they may not induce maximal hyperemia in all patients. The present study evaluated the combined effect of intracoronary papaverine and intravenous ATP on FFR measurements. METHODS FFR measurements with administration of intracoronary papaverine (12mg in the left coronary artery and 8mg in the right coronary artery), intravenous ATP (140μg/kg/min), and combined administration of intracoronary papaverine and intravenous ATP were performed in 51 patients with 57 intermediate lesions. RESULTS The mean FFR after intravenous ATP was higher compared to intracoronary papaverine and intravenous ATP plus intracoronary papaverine (0.76±0.13 vs. 0.75±0.13 vs. 0.75±0.13, p=0.01). FFR-positive lesions (FFR ≤0.80) were observed more frequently with intravenous ATP plus intracoronary papaverine compared to intravenous ATP (64.9% vs. 47.4%, p=0.02). Of 32 and 25 FFR-negative lesions with intravenous ATP and intracoronary papaverine, 11 (34%) and 7 (28%) had positive FFR after administration of intravenous ATP plus intracoronary papaverine. No ventricular tachycardia or ventricular fibrillation was observed after administration of intracoronary papaverine. CONCLUSIONS Maximal hyperemia may not be induced with intravenous ATP in all lesions. When sufficient hyperemia is doubtful during intravenous infusion of ATP, additional intracoronary administration of papaverine may be a possible option.
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Affiliation(s)
- Takeshi Nishi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yo Iwata
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshihide Fujimoto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Takashi Nakayama
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masayuki Takahara
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kazumasa Sugimoto
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
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Iwata Y, Handa T, Ishikawa H, Shoji N, Shimizu K. Efficacy of an Amblyopia Treatment Program with Both Eyes Open: A Functional Near-Infrared Spectroscopy Study. Am Orthopt J 2016; 66:87-91. [PMID: 27799581 DOI: 10.3368/aoj.66.1.87] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION AND PURPOSE To investigate the efficacy of an amblyopia treatment program with both eyes open. METHODS Ten subjects (mean age 20.5 ± 1.5 years) were enrolled. All subjects had un-remarkable ophthalmic examinations, but several subjects had minor refractive errors. Vision function was evaluated using the 3-D visual function trainer-ORTe. Brain measurements were made using functional near-infrared spectroscopy (fNIRS) to examine the oxygenated hemoglobin (HbO2) concentration change upon visual stimulus presentation. The three conditions were as follows: both eyes open and both eyes stimulated, both eyes open and only one eye stimulated, and one eye open and one eye stimulated. RESULTS Changes in HbO2 between the rest and stimulation phases were not statistically different between the unilateral and bilateral stimulation conditions with both eyes open. However, HbO2 change was significantly higher in subjects with both eyes open than in subjects with one eye closed (P < 0.001, all comparisons). CONCLUSION Greater activation of the visual cortex is achieved when subjects are treated with both eyes open as compared to subjects with one eye occluded. From a perspective of functional brain activation, amblyopia treatment administered without occluding the healthy eye may provide the greatest therapeutic benefit.
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Affiliation(s)
- Yo Iwata
- From the Doctor's Program of Medical Science, Kitasato University Graduate School, 1-15-1 Kitasato, Sagamihara 252-0373;
| | - Tomoya Handa
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373
| | - Hitoshi Ishikawa
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373
- Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
| | - Nobuyuki Shoji
- Department of Rehabilitation, Orthoptics and Visual Science Course, School of Allied Health Science, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373
- Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
| | - Kimiya Shimizu
- Department of Ophthalmology, School of Medicine, Kitasato University, 1-15-1 Kitasato, Sagamihara 252-0373, Japan
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Suga K, Kanzaki H, Fukushima S, Iwata Y, Inoue K, Urayama I. Effects of wearing insoles on biomechanical injury risks for patients who have undergone ACL reconstruction: emphasizing the sagittal plane. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1418] [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: 10/23/2022]
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Sekiya A, Kodera M, Yamaoka T, Iwata Y, Usuda T, Ohzono A, Yasukochi A, Koga H, Ishii N, Hashimoto T. A case of lichen planus pemphigoides with autoantibodies to the NC16a and C-terminal domains of BP180 and to desmoglein-1. Br J Dermatol 2014; 171:1230-5. [PMID: 24813536 DOI: 10.1111/bjd.13097] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2014] [Indexed: 11/29/2022]
Abstract
Lichen planus pemphigoides (LPP) is a rare autoimmune blistering disease that occurs in association with lichen planus (LP). This report describes a 59-year-old Japanese female patient with LPP. The patient first showed LP lesions on her hands, and subsequently developed bullae on her extremities and erosions of the oral mucosa. The patient's serum was positive for IgG autoantibodies against the BP180 NC16a domain, the BP180 C-terminal domain and desmoglein-1. However, a serum sampled one and a half years before the diagnosis of LPP was negative for autoantibodies against BP180 NC16a and BP180 C-terminal domains. These findings strongly suggest that the damage to the basal cells in the LP lesions exposed a sequestered antigen or formed neoantigens, leading to the production of pathogenic autoantibodies for LPP. Most of the previous cases of LPP have produced autoantibodies to the NC16a domain of BP180. This is the first case in which autoantibodies to the C-terminal domain of BP180 were detected. The oral mucosal symptoms in this case may have been caused by autoantibodies to the BP180 C-terminal domain.
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Affiliation(s)
- A Sekiya
- Department of Dermatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Syouwa-ku, Nagoya, Aichi, 4668550, Japan
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