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Fujita N, Ono Y, Kobayashi T, Kozono S, Horiuchi Y, Sano A, Kawamura Y, Miyoshi Y, Kimata M, Sekizawa A, Hashimoto K, Obuchi Y, Tanaka Y. Iodine-containing ointment-induced hypothyroidism in a patient with anorexia nervosa and sacral decubitus ulcer: a case report with literature review. Endocr J 2022; 69:1423-1429. [PMID: 36058848 DOI: 10.1507/endocrj.ej22-0248] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
We present a case of a 58-year-old woman with anorexia nervosa and a sacral decubitus ulcer who developed hypothyroidism because of an iodine-containing ointment. Considering the absence of autoimmune thyroid diseases, the development of hypothyroidism after the use of an iodine-containing ointment, and the recovery of thyroid function after the discontinuation of the ointment, we presumed that her hypothyroidism was induced by the iodine-containing ointment. Although the hypothyroidism improved after discontinuing the iodine-containing ointment, she developed aspiration pneumonia and required long-term hospitalization. Many patients with autoimmune thyroid diseases develop hypothyroidism after excessive iodine intake. However, anorexia nervosa may have exacerbated the iodine-induced hypothyroidism in our patient. To the best of our knowledge, no previous study has reported a case of hypothyroidism caused by iodine-containing ointment in a patient with anorexia nervosa. Hence, physicians must pay careful attention to a patient's background factors to ensure the early diagnosis of hypothyroidism due to iodine-containing ointments.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Takahiro Kobayashi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Sawako Kozono
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yugo Horiuchi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yuka Miyoshi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Akinori Sekizawa
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama 359-8513, Japan
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Ando Y, Ono Y, Sano A, Fujita N, Ono S, Tanaka Y. Clinical characteristics and outcomes of pheochromocytoma crisis: a literature review of 200 cases. J Endocrinol Invest 2022; 45:2313-2328. [PMID: 35857218 DOI: 10.1007/s40618-022-01868-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 03/09/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Pheochromocytoma crisis is a life-threatening endocrine emergency that requires prompt diagnosis and treatment. Because of its rarity, sudden onset, and lack of internationally uniform and validated diagnostic criteria, pheochromocytoma crisis remains to be fully clarified. Therefore, we aimed to describe the clinical characteristics and outcomes of pheochromocytoma crisis through a literature review. METHODS We performed a systematic literature search of PubMed/MEDLINE database, Igaku-Chuo-Zasshi (Japanese database), and Google Scholar to identify case reports of pheochromocytoma crisis published until February 5, 2021. Information was extracted and analyzed from the literature that reported adequate individual patient data of pheochromocytoma crisis in English or Japanese. Cases were also termed as pheochromocytoma multisystem crisis (PMC) if patients had signs of hyperthermia, multiple organ failure, encephalopathy, and labile blood pressure. RESULTS In the 200 cases of pheochromocytoma crisis identified from 187 articles, the mean patient age was 43.8 ± 15.5 years. The most common symptom was headache (39.5%). The heart was the most commonly damaged organ resulting from a complication of a pheochromocytoma crisis (99.0%), followed by the lungs (44.0%) and the kidney (21.5%). PMC accounted for 19.0% of all pheochromocytoma crisis cases. After excluding 12 cases with unknown survival statuses, the mortality rate was 13.8% (26/188 cases). Multivariable logistic regression analysis revealed that nausea and vomiting were significantly associated with a higher mortality rate. CONCLUSION Pheochromocytoma can present with different symptomatology, affecting different organ systems. Clinicians should be aware that patients with nausea or vomiting are at a higher risk of death because of pheochromocytoma crisis.
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Affiliation(s)
- Y Ando
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
- Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Y Ono
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - A Sano
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - N Fujita
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - S Ono
- Department of Eat-Loss Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Y Tanaka
- Department of General Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
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Ando Y, Sano A, Ono Y. Primary central nervous system lymphoma mimicking brain hemorrhage. Am J Med Sci 2022; 364:e19-e20. [PMID: 35595080 DOI: 10.1016/j.amjms.2022.05.015] [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] [Received: 02/18/2021] [Revised: 10/02/2021] [Accepted: 05/12/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Saitama, Japan; Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan.
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Ando Y, Ono Y, Sano A, Fujita N, Ono S. Subacute Thyroiditis after COVID-19: A Literature Review. Am J Trop Med Hyg 2022; 107:1074-1082. [PMID: 36067987 DOI: 10.4269/ajtmh.21-1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/17/2022] [Indexed: 11/07/2022] Open
Abstract
Subacute thyroiditis (SAT), potentially caused by severe acute respiratory syndrome coronavirus 2 infection, has been reported as a complication of COVID-19 since 2020. The clinical characteristics and outcomes of SAT after COVID-19 remain incompletely defined. Therefore, we aimed to collect and survey case reports of SAT after COVID-19. We performed a systematic search of PubMed/MEDLINE, Web of Science, and Google Scholar. The keywords and MeSH terms used for the searches were "subacute thyroiditis" and "COVID-19." A total of 38 patients from 26 case reports, case series, and letters on SAT associated with COVID-19 were included and analyzed. The most frequent SAT symptom was neck pain (27 cases), followed by fever (22 cases). Of the 25 cases with information on the duration between onset of COVID-19 symptoms and onset of SAT symptoms, the shortest was simultaneous occurrence, and the longest was 4 months. In most cases, patients developed SAT at several days or weeks after the onset of COVID-19. All patients with SAT recovered with no severe complications or sequelae. Clinicians should be aware of the possibility of SAT development in patients with neck pain and fever following COVID-19. Further research is necessary to determine the relationship between SAT and COVID-19.
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Affiliation(s)
- Yuya Ando
- Department of Internal Medicine, Division of Gastroenterology, Self-Defense Forces Central Hospital, Tokyo, Japan.,Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Horiuchi Y, Hashimoto K, Horikoshi H, Sano A, Kawamura Y, Fujita N, Kimata M, Ono Y, Obuchi Y, Makino A, Kaneko M, Kimura F, Itoh K, Tanaka Y. Fulminant elderly adult-onset Still disease effectively treated with tocilizumab and methotrexate: A case report. Medicine (Baltimore) 2022; 101:e29354. [PMID: 35839054 DOI: 10.1097/md.0000000000029354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Adult-onset Still disease (AOSD) is a rare inflammatory disease of unknown etiology. AOSD is common in young or middle-aged adults; however, in recent years, there have been increasing reports of elderly AOSD. Differentiating AOSD from diseases such as infections and malignancies is difficult. Moreover, rare fulminant AOSD cases with resistance to corticosteroids and immunosuppressive drugs have been reported. PATIENT CONCERNS An 80-year-old woman presented with flaccid fever, generalized arthralgia, and erythema of the anterior chest for 2 weeks. On day 5 of hospitalization, the patient developed pleural effusion with hypoxemia and her vital signs indicated rapid progression to shock. During the clinical course, the levels of inflammatory markers, including maximum level of ferritin and white blood cells (WBCs) were elevated (252,796 ng/mL and 86,500/μV, respectively) with disseminated intravascular coagulation syndrome (DIC) and macrophage activation syndrome (MAS). DIAGNOSIS The patient was diagnosed with elderly AOSD as per the Yamaguchi criteria for AOSD. The state of disease was extremely severe with rapid progression and was, thus, categorized as a fulminant form of elderly AOSD. INTERVENTIONS The patient was treated with prednisolone (PSL) pulse therapy (1000 mg/d) twice and plasma exchange in the intensive care unit for the primary disease and shock. Although she recovered from shock, she developed DIC and MAS. Methotrexate (MTX; 10 mg/d) improved the DIC and MAS. However, severe pleuritis recurred and the patient developed pericarditis; her primary disease was poorly controlled. Finally, tocilizumab (TCZ) was introduced using interleukin-18 (IL-18) as a surrogate marker. The IL-18 level was measured repeatedly following admission, with the peak level (170,000 pg/mL) recorded on the 75th day of hospitalization, immediately prior to introducing TCZ. OUTCOMES The combined use of MTX, TCZ, and PSL was effective in suppressing elderly AOSD, which was unsuccessfully controlled with MTX and PSL. Frequent monitoring of IL-18 levels proved useful for differentiating elderly AOSD from other diseases. LESSONS A fulminant form of elderly AOSD was treated with a combination of MTX, TCZ, and PSL. Repeated monitoring of IL-18 levels can be useful for decision-making in treating elderly AOSD.
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Affiliation(s)
- Yugo Horiuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Hideyuki Horikoshi
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yusuke Kawamura
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
- Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Arisa Makino
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Mayuko Kaneko
- Department of Traumatology and Critical Care Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Fumihiko Kimura
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Kenji Itoh
- Division of Hematology and Rheumatology, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
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Sano A, Ono Y, Fujita N, Tanaka Y. Spotty skin pigmentation in Carney complex. Cleve Clin J Med 2022; 89:307-308. [PMID: 35649565 DOI: 10.3949/ccjm.89a.21069] [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: 11/14/2022]
Affiliation(s)
- Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama, Japan
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Fujita N, Ono Y, Sano A, Tanaka Y. Mantle Cell Lymphoma with Multiple Lymphomatous Polyposis. Intern Med 2022; 61:591-592. [PMID: 34565780 PMCID: PMC8907783 DOI: 10.2169/internalmedicine.8287-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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Abstract
Posterior reversible encephalopathy syndrome (PRES) is a group of clinical syndromes typically characterized by bilateral reversible vasogenic edema of the subcortical white matter in the parieto-occipital region on neuroimaging that causes a wide variety of acute or subacute neurological symptoms, including headache, mental status alteration, seizures, and visual dysfunction. PRES is classically suspected in patients with severe hypertension, renal failure, autoimmune disorders, eclampsia, or immunosuppressant medications. Frequent neurological evaluations and neuroimaging examinations by computed tomography or magnetic resonance imaging are required for both the diagnosis and assessment of the condition. Early detection of the disease is key for a rapid recovery and good prognosis.
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Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Japan
- Department of Family Medicine, Graduated School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Sachiko Ono
- Department of Eat-loss Medicine, Graduate School of Medicine, The University of Tokyo, Japan
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Fujita N, Ono Y, Sano A, Kimata M, Oyama S, Hashimoto K, Sato I, Kudo M, Miyashiro Y, Fujikata A, Tanaka Y. Serum diiodotyrosine - a biomarker to differentiate destructive thyroiditis from Graves' disease. Eur J Endocrinol 2022; 186:245-253. [PMID: 34874894 DOI: 10.1530/eje-21-0901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Conventional diagnostic methods are limited in their ability to differentiate destructive thyroiditis from Graves' disease. We hypothesised that serum diiodotyrosine (DIT) and monoiodotyrosine (MIT) levels could be biomarkers for differentiating destructive thyroiditis from Graves' disease. DESIGN Patients with destructive thyroiditis (n = 13) and Graves' disease (n = 22) were enrolled in this cross-sectional study. METHODS We assayed the serum DIT and MIT levels using liquid chromatography-tandem mass spectrometry. A receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of the serum DIT and MIT levels as biomarkers for differentiating destructive thyroiditis from Graves' disease. RESULTS The serum DIT and MIT levels were significantly higher in patients with destructive thyroiditis than in those with Graves' disease. The ROC curve analysis showed that the serum DIT levels (≥359.9 pg/mL) differentiated destructive thyroiditis from Graves' disease, significantly, with 100.0% sensitivity and 95.5% specificity (P < 0.001). The diagnostic accuracy of the serum MIT levels (≥119.4 pg/mL) was not as high as that of the serum DIT levels (sensitivity, 84.6%; specificity, 77.3%; P = 0.001). CONCLUSIONS The serum DIT levels may serve as a novel diagnostic biomarker for differentiating destructive thyroiditis from Graves' disease.
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Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Motohiro Kimata
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Seigo Oyama
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Ikuya Sato
- ASKA Pharmaceutical Co., Ltd., Minato-ku, Tokyo, Japan
| | - Masahiko Kudo
- ASKA Pharmaceutical Co., Ltd., Minato-ku, Tokyo, Japan
| | | | - Akira Fujikata
- ASKA Pharma Medical Co., Ltd., Fujisawa, Kanagawa, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan
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Sano T, Miyata J, Sano A, Ono Y, Tanaka Y, Matsukuma S, Ueki S, Kawana A. Eosinophilic sialoadenitis in a patient with severe asthma: a case report. Asia Pac Allergy 2021; 11:e29. [PMID: 34386405 PMCID: PMC8331254 DOI: 10.5415/apallergy.2021.11.e29] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/08/2021] [Indexed: 12/29/2022] Open
Abstract
Activated eosinophils can infiltrate various tissues and cause inflammatory tissue damage. Asthma is a typical type of eosinophilic inflammatory disease that occurs in the respiratory system. Eosinophilic sialodochitis and sialoadenitis of the salivary gland are rare diseases clinically characterized by painful swelling. In this report, we present a 68-year-old woman with asthma who presented to our hospital with mandibular swelling. Her asthma had been well controlled with an inhaled combination of a corticosteroid and a long-acting β2 agonist, although she reported a past history of frequent asthma attacks and hospitalization. Laboratory investigation on admission revealed blood eosinophilia (2,673/μL), high levels of total immunoglobulin E (390 U/mL) and immunoglobulin G4 (183 mg/dL). Bone marrow examination showed no evidence of eosinophilic neoplasia. Histological examination of her minor salivary glands disclosed an infiltration of mixed lymphocytes and eosinophils. Chromatolytic eosinophils with Charcot-Leyden crystals were also observed within the edematous dermis and fibrous tissues surrounding the minor salivary gland. The patient was diagnosed with eosinophilic sialoadenitis. Treatment with oral corticosteroids (0.5 mg/kg/day) was initiated. Thereafter, the mandibular swelling improved. This report describes a rare case of eosinophilic sialoadenitis in a patient with severe eosinophilic asthma, for which histopathological and immunefluorescence microscopic analyses were performed.
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Affiliation(s)
- Tomoya Sano
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Jun Miyata
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Saitama, Japan
| | - Susumu Matsukuma
- Department of Pathology and Laboratory Medicine, National Defense Medical College, Saitama, Japan
| | - Shigeharu Ueki
- Department of General Medical Practice and Laboratory Diagnostic Medicine, Akita University Graduate School of Medicine, Akita, Japan
| | - Akihiko Kawana
- Division of Infectious Diseases and Respiratory Medicine, Department of Internal Medicine, National Defense Medical College, Saitama, Japan
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Ando Y, Hashimoto K, Sano A, Fujita N, Yanagawa R, Ono Y, Obuchi Y, Tatsushima D, Watanabe S, Tomifuji M, Tanaka Y. Frequent occurrence of postbreakfast syncope due to carotid sinus syndrome after surgery for hypopharyngeal cancer: A case report. Medicine (Baltimore) 2021; 100:e25959. [PMID: 34011078 PMCID: PMC8137094 DOI: 10.1097/md.0000000000025959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 04/28/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Syncope often occurs in patients with advanced head and neck cancers due to the stimulation of the autonomic nervous system by the tumor. Here, we describe a case of frequent syncopal episodes after laryngopharyngectomy for hypopharyngeal cancer. As all syncopal episodes were observed during the forenoon, we also evaluated the heart rate variability using ambulatory electrocardiography to determine why the syncopal episodes occurred during a specified period of the day. PATIENT CONCERNS A 73-year-old Japanese man who underwent laryngopharyngectomy for recurrent hypopharyngeal cancer started experiencing frequent episodes of loss of consciousness that occurred during the same time period (10:00-12:00). He had never experienced syncopal episodes before the operation. From 23 to 41 days postoperatively, he experienced 9 syncopal episodes that occurred regardless of his posture. DIAGNOSES Pharyngo-esophagoscopy revealed an anastomotic stricture between the free jejunum graft and the upper esophagus. Swallowing videofluoroscopy confirmed the dilatation of the jejunal autograft and a foreign body stuck on the oral side of the anastomosis. Contrast-enhanced computed tomography revealed that the carotid artery was slightly compressed by the edematous free jejunum. The patient was diagnosed with carotid sinus syndrome (CSS) as the free jejunum was dilated when consuming breakfast, which may have caused carotid sinus hypersensitivity and induced a medullary reflex. INTERVENTIONS Administration of disopyramide was effective in preventing syncope. Heart rate variability analysis using ambulatory electrocardiography showed that parasympathetic dominancy shifted to sympathetic dominancy during 10:00 to 12:00. The significant time regularity of the syncopal episodes may have been affected by modified diurnal variation in autonomic tone activity. OUTCOMES After the surgical release and re-anastomosis of the pharyngoesophageal stenosis via an open-neck approach, no recurrent episodes of syncope were reported. LESSONS We reported a case of frequent syncopal episodes limited to the forenoon due to CSS after surgery for hypopharyngeal carcinoma. The patient was treated with anticholinergics followed by the release and re-anastomosis of the pharyngoesophageal stenosis. When syncope occurs after surgery for head and neck lesions, CSS due to postoperative structural changes should be considered as a differential diagnosis of syncope.
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Affiliation(s)
- Yuya Ando
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
- Department of Family Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo
| | - Kenichi Hashimoto
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Rempei Yanagawa
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Yasuhiro Obuchi
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
| | - Daisuke Tatsushima
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Shun Watanabe
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Masayuki Tomifuji
- Department of Otolaryngology, National Defense Medical College, Tokorozawa, Saitama, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Tokorozawa, Saitama
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Sano A, Ono Y, Fujita N, Tanaka Y. Diabetes-associated Necrotizing Fasciitis of the Foot. Intern Med 2020; 59:2805-2806. [PMID: 32669501 PMCID: PMC7691028 DOI: 10.2169/internalmedicine.5001-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Azusa Sano
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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Fujita N, Ono Y, Sano A, Tanaka Y. IgG4-related Paravertebral Mass and Peri-aortitis. Intern Med 2020; 59:2447-2448. [PMID: 32611963 PMCID: PMC7644484 DOI: 10.2169/internalmedicine.4770-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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Fujita N, Ono Y, Sano A, Tanaka Y. Primary Cutaneous Diffuse Large B-cell Lymphoma, Leg Type. Intern Med 2020; 59:1785. [PMID: 32238727 PMCID: PMC7434555 DOI: 10.2169/internalmedicine.4497-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Naoya Fujita
- Department of General Medicine, National Defense Medical College, Japan
| | - Yosuke Ono
- Department of General Medicine, National Defense Medical College, Japan
| | - Azusa Sano
- Department of General Medicine, National Defense Medical College, Japan
| | - Yuji Tanaka
- Department of General Medicine, National Defense Medical College, Japan
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Kubota S, Yoshikawa K, Takeuchi R, Endo Y, Sano A, Koseki K, Mataki Y, Iwasaki N, Kohno Y, Mutsuzaki H. Robotic rehabilitation training with a newly developed upper limb single-joint hybrid assistive limb (HAL-SJ) for an adult with birth palsy. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.1160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Fischer D, McHill A, Sano A, Picard RW, Barger LK, Czeisler CA, Klerman EB, Phillips AJ. 0338 Composite Phase Deviation (CPD) As A Predictor Of Mood In College Students. Sleep 2018. [DOI: 10.1093/sleep/zsy061.337] [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: 11/13/2022] Open
Affiliation(s)
- D Fischer
- Brigham and Women’s Hospital/Harvard Medical School, Boston, MA
| | - A McHill
- Oregon Health and Science University, Portland, OR
| | - A Sano
- Massachusetts Institute of Technology, Cambridge, MA
| | - R W Picard
- Massachusetts Institute of Technology, Cambridge, MA
| | - L K Barger
- Brigham and Women’s Hospital/Harvard Medical School, Boston, MA
| | - C A Czeisler
- Brigham and Women’s Hospital/Harvard Medical School, Boston, MA
| | - E B Klerman
- Brigham and Women’s Hospital/Harvard Medical School, Boston, MA
| | - A J Phillips
- Brigham and Women’s Hospital/Harvard Medical School, Boston, MA
- Monash University, Melbourne, AUSTRALIA
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Hino H, Nishimura T, Sano A, Yoshida Y, Fukami T, Furuhata Y, Tanaka M, Karasaki T, Takahashi T, Kawashima M, Kuwano H, Nagayama K, Nitadori J, Anraku M, Sato M, Nakajima J. P-153PROGNOSTIC IMPACT ON LUNG CANCER SURGERY IN OCTOGENARIANS: A JAPANESE MULTICENTRE RETROSPECTIVE ANALYSIS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.153] [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: 11/14/2022] Open
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Phillips AJ, McHill AM, Chen D, Beckett S, Barger LK, O’Brien CS, Sano A, Taylor S, Lockley SW, Czeisler CA, Klerman EB. 0079 PREDICTING THE TIMING OF DIM LIGHT MELATONIN ONSET IN REAL-WORLD CONDITIONS USING A MATHEMATICAL MODEL. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.078] [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: 11/13/2022] Open
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McHill AW, Barger LK, Sano A, Phillips AJ, Czeisler CA, Klerman EB. 0061 INFLUENCE OF SLEEP AND CIRCADIAN PREFERENCE ON EXERCISE AND SUBJECTIVE MOOD IN COLLEGE UNDERGRADUATES. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.060] [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: 11/13/2022] Open
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20
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Chen W, Sano A, Lopez D, Taylor S, McHill AW, Phillips AJ, Barger LK, Czeisler CA, Picard RW. 1179 MULTIMODAL AMBULATORY SLEEP DETECTION USING RECURRENT NEURAL NETWORKS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.1178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Sano A, Phillips AJ, McHill AW, Taylor S, Barger LK, Czeisler CA, Picard RW. 0182 INFLUENCE OF WEEKLY SLEEP REGULARITY ON SELF-REPORTED WELLBEING. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.181] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Taylor S, Jaques N, Nosakhare E, Sano A, Klerman EB, Picard RW. 0795 IMPORTANCE OF SLEEP DATA IN PREDICTING
NEXT-DAY STRESS, HAPPINESS, AND HEALTH IN COLLEGE STUDENTS. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Taylor S, Sano A, Picard RW. 0113 STRUCTURE OF ELECTRODERMAL RESPONSES DURING SLEEP. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.112] [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: 11/14/2022] Open
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24
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Okahashi K, Oiso N, Ishii N, Miyake M, Uchida S, Matsuda H, Kitano M, Hida J, Kawai S, Sano A, Hashimoto T, Kawada A. Paraneoplastic pemphigus associated with Castleman disease: progression from mucous to mucocutaneous lesions with epitope-spreading phenomena. Br J Dermatol 2017; 176:1406-1409. [DOI: 10.1111/bjd.15389] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K. Okahashi
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - N. Oiso
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - N. Ishii
- Department of Dermatology; Kurume University School of Medicine; Kurume Japan
| | - M. Miyake
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - S. Uchida
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - H. Matsuda
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - M. Kitano
- Department of Otolaryngology - Head and Neck Surgery; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - J. Hida
- Department of Surgery; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - S. Kawai
- Department of Neurology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - A. Sano
- Department of Respiratory Medicine and Allergology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
| | - T. Hashimoto
- Kurume University Institute of Cutaneous Cell Biology; Kurume Japan
| | - A. Kawada
- Department of Dermatology; Kindai University Faculty of Medicine; Osaka-Sayama Japan
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Affiliation(s)
- Y. Tanaka
- Department of Engineering Physics, Electronics and Mechanics, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - Y. Goto
- Department of Engineering Physics, Electronics and Mechanics, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya, Japan
| | - A. Sano
- Department of Engineering Physics, Electronics and Mechanics, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya, Japan
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Ohashi M, Hirano T, Watanabe K, Katsumi K, Shoji H, Sano A, Tashi H, Takahashi I, Wakasugi M, Shibuya Y, Endo N. Preoperative prediction for regaining ambulatory ability in paretic non-ambulatory patients with metastatic spinal cord compression. Spinal Cord 2016; 55:447-453. [PMID: 27752060 DOI: 10.1038/sc.2016.145] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 07/28/2016] [Accepted: 09/02/2016] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective multicenter study. OBJECTIVES To analyze the predictive factors for postoperative ambulatory recovery in paretic non-ambulatory patients with metastatic spinal cord compression (MSCC). SETTING Japan. METHODS Eighty-two consecutive patients (74.4% men; mean age, 66.2 years) who could not walk before surgery due to cervical or thoracic MSCC and underwent posterior decompressive surgery between 2003 and 2014 were included. Patients were divided into two groups according to ambulatory status at 6 weeks after surgery: recovery (group R) and non-recovery (group NR). To evaluate the speed of progression of motor deficits, we assessed the period from onset of neurological symptoms to gait inability (T1). RESULTS Fifty patients (61.0%) regained the ability to walk (group R). The period of T1 demonstrated a positive correlation with probability of ambulatory recovery (P=0.00; Kendall's tau-b=0.38), and a receiver operating characteristic curve analysis showed that the cutoff value of T1 was 5 days (area under the curve=0.72; P=0.001). In multivariate analysis, <6 days of T1 was one of the independent risk factors for failing to regain ambulatory ability (odds ratio, 8.74; P=0.00). CONCLUSIONS The speed of progression of motor deficits can independently and powerfully predict the chance of postoperative ambulatory recovery as well as previously identified predictors. Since information about the speed of progression can be obtained easily by interviewing patients or family members, even if the patient is in an urgent state, our results will be helpful in clinical decision-making.
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Affiliation(s)
- M Ohashi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Hirano
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Watanabe
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Katsumi
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - H Shoji
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - A Sano
- Department of Orthopedic Surgery, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - H Tashi
- Department of Orthopedic Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - I Takahashi
- Department of Orthopedic Surgery, Niigata City General Hospital, Niigata, Japan
| | - M Wakasugi
- Department of Orthopedic Surgery, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - Y Shibuya
- Department of Orthopedic Surgery, Tsuruoka Municipal Hospital, Tsuruoka, Japan
| | - N Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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Abstract
We aimed to realize smooth 3D biped walking in a robot through control based on information obtained from various sensors. We employed a method to control walking by divid ing it into motions in the sagittal plane and in the lateral plane. We treated motion in the lateral plane as a regulator prob lem with two equilibrium states. We also used relatively low gain feedback coefficients obtained from the optimal regula tor theory. For motion in the sagittal plane, we put the body speed close to the smooth speed function given in advance by controlling the ankle torque. The effectiveness of the proposed control method was ex amined by computer simulation and proved by experiments with our BLR-G2 walking robot. The BLR-G2 is equipped with foot pressure and ankle torque sensors to provide infor mation about the condition of contact with the floor. The sole and ankle driving actuators undergo force/torgue feedback control based on the sensor information. These contributed toward realizing smooth walking with the sole firmly gripping the floor.
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Affiliation(s)
- J. Furusho
- Department of Mechanical Engineering Gifu University Yanagido, Gifu City, Japan
| | - A. Sano
- Department of Mechanical Engineering Gifu University Yanagido, Gifu City, Japan
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Suzuki S, Komemushi A, Sano A, Kariya S, Kanno S, Nakatani M, Yoshida R, Kono Y, Tanigawa N. Short term efficacy and safety of balloon-occluded retrograde transvenous obliteration of portosystemic shunt in patients with hepatic encephalopathy. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.332] [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: 11/24/2022] Open
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Lenhard-Vidal A, Assolini JP, Ono MA, Bredt CSO, Sano A, Itano EN. Paracoccidioides brasiliensis and P. lutzii Antigens Elicit Different Serum IgG Responses in Chronic Paracoccidioidomycosis. Mycopathologia 2013; 176:345-52. [DOI: 10.1007/s11046-013-9698-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/17/2013] [Indexed: 10/26/2022]
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Tada H, Kuroki Y, Funabashi T, Kamiya Y, Goto T, Suyama K, Sano A, Mitsushima D, Etgen AM, Takahashi T. Phasic synaptic incorporation of GluR2-lacking AMPA receptors at gonadotropin-releasing hormone neurons is involved in the generation of the luteinizing hormone surge in female rats. Neuroscience 2013; 248:664-9. [PMID: 23811398 DOI: 10.1016/j.neuroscience.2013.06.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [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: 10/10/2012] [Revised: 06/05/2013] [Accepted: 06/19/2013] [Indexed: 11/17/2022]
Abstract
Reproductive success depends on a robust and appropriately timed preovulatory luteinizing hormone (LH) surge, which is induced by the activation of gonadotropin-releasing hormone (GnRH) neurons in response to positive feedback from increasing estrogen levels. Here we document an increase in postsynaptic GluR2-lacking Ca2+ -permeable AMPA-type glutamate receptors (CP-AMPARs) at synapses on GnRH neurons on the day of proestrus in rats, coincident with the increase in estrogen levels. Functional blockade of CP-AMPARs depressed the synaptic responses only on the day of proestrus and concomitantly attenuated the LH surge. Thus, the phasic synaptic incorporation of postsynaptic CP-AMPARs on GnRH neurons is involved in the generation of the LH surge.
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Affiliation(s)
- H Tada
- Department of Physiology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
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Haraguchi K, Miyachi S, Matsubara N, Nagano Y, Yamada H, Marui N, Sano A, Fujimoto H, Izumi T, Yamanouchi T, Asai T, Wakabayashi T. A mechanical coil insertion system for endovascular coil embolization of intracranial aneurysms. Interv Neuroradiol 2013; 19:159-66. [PMID: 23693038 DOI: 10.1177/159101991301900203] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/09/2013] [Indexed: 11/16/2022] Open
Abstract
Like other fields of medicine, robotics and mechanization might be introduced into endovascular coil embolization of intracranial aneurysms for effective treatment. We have already reported that coil insertion force could be smaller and more stable when the coil delivery wire is driven mechanically at a constant speed. Another background is the difficulty in synchronizing operators' minds and hands when two operators control the microcatheter and the coil respectively. We have therefore developed a mechanical coil insertion system enabling a single operator to insert coils at a fixed speed while controlling the microcatheter. Using our new system, the operator manipulated the microcatheter with both hands and drove the coil using foot switches simultaneously. A delivery wire force sensor previously reported was used concurrently, allowing the operator to detect excessive stress on the wire. In vitro coil embolization was performed using three methods: simple mechanical advance of the coil; simple mechanical advance of the coil with microcatheter control; and driving (forward and backward) of the coil using foot switches in addition to microcatheter control. The system worked without any problems, and did not interfere with any procedures. In experimental coil embolization, delivery wire control using the foot switches as well as microcatheter manipulation helped to achieve successful insertion of coils. This system could offer the possibility of developing safer and more efficient coil embolization. Although we aim at total mechanization and automation of procedures in the future, microcatheter manipulation and synchronized delivery wire control are still indispensable using this system.
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Affiliation(s)
- K Haraguchi
- Department of Neurosurgery, Nagoya University, Nagoya, Japan
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Yamagata S, Tomita K, Sano H, Itoh Y, Fukai Y, Okimoto N, Watatani N, Inbe S, Miyajima H, Tsukamoto K, Santoh H, Ichihashi H, Sano A, Sato R, Tohda Y. Non-genomic inhibitory effect of glucocorticoids on activated peripheral blood basophils through suppression of lipid raft formation. Clin Exp Immunol 2012; 170:86-93. [PMID: 22943204 DOI: 10.1111/j.1365-2249.2012.04636.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
We investigated the non-genomic effects of glucocorticoids (GCs) on inhibition of plasma membrane lipid raft formation in activated human basophils. Human basophils obtained from house dust mite (HDM)-sensitive volunteers were pretreated with hydrocortisone (CORT) or dexamethasone (Dex) for 30 min and then primed with phorbol 12-myristate 13-acetate (PMA, 10 ng/ml) or HDM (10 µg/ml). The expression of CD63, a basophil activation marker, was assessed by flow cytometry. Membrane-bound GC receptors (mGCRs) were analysed by flow cytometry and confocal laser microscopy. Lipid rafts were assessed using a GM1 ganglioside probe and visualization by confocal laser microscopy. Pretreatment of basophils with CORT (10(-4) M and 10(-5) M) and Dex (10(-7) M) significantly inhibited CD63 expression 20 min after addition of PMA or HDM. The inhibitory effects of GCs were not altered by the nuclear GC receptor (GCR) antagonist RU486 (10(-5) M) or the protein synthesis inhibitor cycloheximide (10(-4) M) (P < 0·05). CORT coupled to bovine serum albumin (BSA-CORT) mimicked the rapid inhibitory effects of CORT, suggesting the involvement of mGCRs. mGCRs were detectable on the plasma membrane of resting basophils and formed nanoclusters following treatment with PMA or HDM. Pretreatment of cells with BSA-CORT inhibited the expression of mGCRs and nanoclustering of ganglioside GM1 in lipid rafts. The study provides evidence that non-genomic mechanisms are involved in the rapid inhibitory effect of GCs on the formation of lipid raft nanoclusters, through binding to mGCRs on the plasma membrane of activated basophils.
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Affiliation(s)
- S Yamagata
- Department of Respiratory Medicine and Allergology, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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Murakawa T, Konoeda C, Ito T, Inoue Y, Sano A, Nagayama K, Nakajima J. The ground glass opacity component can be eliminated from the T-factor assessment of lung adenocarcinoma. Eur J Cardiothorac Surg 2012; 43:925-32. [DOI: 10.1093/ejcts/ezs467] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Nakamura T, Akao T, Sano A, Fukai Y, Horikoshi H, Akiyoshi T, Oya S, Takeuchi K, Saito H, Nogawa H. 389. Portal Venous Thromboses in Post-hepatectomy Patients - Successful Thrombolyses in Consecutive Two Cases. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Reyes J, Seerup J, Sano A, Hawkins D, Gorospe G, Mbogo W, Choe T. A “Road Map” to Create a Standardized, Defect Free Hematopoietic Cell Transplant (HCT) Schedule Utilizing Lean Methodology – A3 Thinking. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Sano A, Takeuchi E, Fukami T, Murakawa T, Nakajima J. Erosion bleeding as a late complication of chest wall reconstruction with a Dacron mesh silicone prosthesis. Thorac Cardiovasc Surg 2011; 60:170-1. [PMID: 21442584 DOI: 10.1055/s-0030-1250771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A 71-year-old man who had undergone chest wall resection and reconstruction with a Dacron mesh silicone prosthesis for chondrosarcoma 23 years previously presented with a chest wall hematoma. Since the hematoma was found to increase in size over time, we performed an operation to achieve hemostasis. Operative findings showed that the prosthesis had separated into three sheets.
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Affiliation(s)
- A Sano
- Department of Cardiothoracic Surgery, The University of Tokyo, Tokyo, Japan.
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Abstract
ABSTRACTElectromigration activation energies (Ea) of Al and Cu interconnections are strongly dependent on the grain boundary morphology, and it is pointed out that Ea of bamboo-like Al interconnection is not less than Ea of small grain Cu interconnections. Small resistance oscillatory changes caused by electromigration, which are classified into three categories; oscillation, downward spikes, and upward spikes, are investigated in detail. It seems most likely that oscillations correspond to annihilation and formation of the one void. It is also pointed out that downward spikes are local, while upward spikes are non-local. Dislocation dynamics such as generation, rapid transport and subsequent annihilation are considered to be origins of spikes.
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Shingubara S, Sano A, Sakaue H, Takahagi T, Horiike Y, Radzimski ZJ, Posadowski WM. Cu Deposition Characteristics into Submicron Contact Holes Employing Self-Sputtering With a High Ionization Rate. ACTA ACUST UNITED AC 2011. [DOI: 10.1557/proc-427-185] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractCu deposition profiles in submicron contact holes are investigated employing the Cu self-sputtering which do not need any inert gas e.g. Ar during sputtering. Excellent bottom coverage in the high aspect ratio contact holes was obtained at a large target-substrate distance in the selfsputtering due to a long mean free path of Cu ions and atoms, although a coverage is poor in Ar sputtering at 6 mTorr. It is also shown that the self-sputtering has low resputtering effect and high self-diffusivity of Cu, while the resputtering predominates in the case of Ar sputtering when DC bias is applied on the substrate. As a consequence, the bottom coverages of the self-sputtered films are much improved than the Ar sputtered ones. The present work strongly suggests that the self-sputtering is promising to fill Cu in sub micron via and contact holes.
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Sano A, Kosugi N, Kitano K, Sakamoto M, Yoshida Y, Fukami T, Murakawa T, Nakajima J. [Thymoma with synchronous pulmonary metastasis; report of a case]. Kyobu Geka 2010; 63:1090-1093. [PMID: 21066855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We report a resected case of thymoma with a solitary pulmonary metastasis. A 63-year-old woman had pointed out a solitary nodule in right lung field on chest X-ray. Computed tomography (CT) scan showed an anterior mediastinal tumor and a solitary lung nodule in the right lower lobe. Extended thymectomy and partial resection of right lung was performed. Pathological diagnosis showed an invasive thymoma (type B3) and a pulmonary metastasis. Post operative radiotherapy was administered and she is doing well 19 months following the resection. Thymoma with a solitary synclonous pulmonary metastasis is rare and is classified into Masaoka stage IVb. Generally, thymoma cases with distant metastasis are not indication for operation. But, if radical resection is possible, operation is recommended for good prognosis.
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Affiliation(s)
- A Sano
- Department of Cardiothoracic Surgery, The University of Tokyo, Graduate School of Medicine Tokyo, Japan
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Kitaoka K, Sano A, Chikahisa S, Yoshizaki K, Séi H. Disturbance of rapid eye movement sleep in senescence-accelerated mouse prone/8 mice is improved by retinoic acid receptor agonist Am80 (tamibarotene). Neuroscience 2010; 167:573-82. [DOI: 10.1016/j.neuroscience.2010.01.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Revised: 01/27/2010] [Accepted: 01/28/2010] [Indexed: 10/19/2022]
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42
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Munchan C, Kurata O, Wada S, Hatai K, Sano A, Kamei K, Nakaoka N. Exophiala xenobiotica infection in cultured striped jack, Pseudocaranx dentex (Bloch & Schneider), in Japan. J Fish Dis 2009; 32:893-900. [PMID: 19735347 DOI: 10.1111/j.1365-2761.2009.01068.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This report describes Exophiala infection in cultured striped jack, Pseudocaranx dentex, in Japan in 2005. One hundred out of 35,000 fish died per day and mortalities continued for 1 month. Diseased fish showed swelling of the abdomen and kidney distension. Numerous septate hyphae, pale brown in colour, were seen in kidney in squash preparations. Histology revealed abundant fungal hyphae and conidia in gill, heart and kidney. Fungal hyphae were accompanied by cell necrosis and influx of inflammatory, mainly mononuclear cells. The fungus isolated from the diseased fish had septate hyphae, pale brown in colour and 1.8-3.0 microm in diameter. Conidiogenous cells were conspicuous annellides, short or cylindrical or fusiform in shape. Conidia were one-celled, ellipsoidal with smooth walls, accumulated in balls at the apices of annellides that tended to slide down, 1.5-2.0 microm in width and 3.0-5.0 microm in length. The fungus was classified into the genus Exophiala based on its morphology and as Exophiala xenobiotica based on the sequences of the ITS 1-5.8S-ITS 2 regions of rDNA. This is the first record of this fungus in a marine fish.
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Affiliation(s)
- C Munchan
- Laboratory of Fish Diseases, Nippon Veterinary and Life Science University Musashino, Tokyo, Japan
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Abstract
We compared the electroencephalographic changes during actual and imaginary movements with four limbs and classified optimally the responses during four-limb imagery. Evoked potentials in imagery exhibited lower and delayed peaks compared to actual-movement responses, but activations in the primary and the supplementary motor area were similar. Source-modeling analysis revealed that the motor and the parietal cortex were activated similarly, but several dipole sources were active in the frontal cortex for imagery. We compared thirteen classification methods and a combination of template matching and time-frequency methods showed the highest average of 70% classification rate for all limbs.
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Affiliation(s)
- A Sano
- School of Fundamental Science and Technology, Graduate School of Science and Technology, Keio University, Yokohama, Kanagawa, Japan. akane
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Tatibana BT, Sano A, Uno J, Kamei K, Igarashi T, Mikami Y, Miyaji M, Nishimura K, Itano EN. Detection of Paracoccidioides brasiliensis gp43 gene in sputa by loop-mediated isothermal amplification method. J Clin Lab Anal 2009; 23:139-43. [PMID: 19288448 DOI: 10.1002/jcla.20304] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The fungus Paracoccidioides brasiliensis is the pathogen of paracoccidioidomycosis (PCM), a systemic mycosis prevalent in Latin America. The loop-mediated isothermal amplification method (LAMP) was used in this study to detect the presence of P. brasiliensis in sputa samples from patients with chronic PCM, suspected PCM, and a negative control. The target P. brasiliensis gp43 gene was amplified in less than 4 hr in 11 of 18 sputa samples tested. The LAMP method had the advantage of speed and simplicity compared with the classic diagnostic methods such as the histopathological test or biological material culture and did not require sophisticated technical apparatus. It would be an important aid in cases where immediate treatment would mean patient survival, especially in immune-suppressed patients.
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Affiliation(s)
- B T Tatibana
- Microbiology Post Graduation Program, State University of Londrina, Londrina, PR, Brazil
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45
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Komatsu K, Sano A, Kagi H, Loveday J. The interaction between H-bond and polyhedral network in the polymorphs of aluminium hydroxide. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308085784] [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: 11/10/2022] Open
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46
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Ogawa S, Shibahara T, Sano A, Kadota K, Kubo M. Generalized hyperkeratosis caused by Scopulariopsis brevicaulis in a Japanese Black calf. J Comp Pathol 2008; 138:145-50. [PMID: 18295781 DOI: 10.1016/j.jcpa.2007.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2007] [Accepted: 10/31/2007] [Indexed: 11/30/2022]
Abstract
A 6-month-old Japanese Black female calf became gradually emaciated over a 40-day period and was humanely killed. At necropsy, hyperkeratotic nodules were seen to have spread over almost the entire body surface. Scopulariopsis brevicaulis was isolated from the skin and identified morphologically and by gene sequence analysis of the D1/D2 domain of large subunit ribosomal RNA. Numerous periodic acid-Schiff-positive, lemon-shaped conidia were detected histologically in the keratinized layer and the hair follicles. The distribution of the fungal elements in the skin corresponded to that of the hyperkeratotic lesions. This is the first report of a disease caused by S. brevicaulis in animals. Previously reported human infections have not included generalized hyperkeratosis.
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Affiliation(s)
- S Ogawa
- Chuo Livestock Hygiene Service Center, Akita Prefecture, 1-15-5 Hirune, Terauchi, Akita 011-0904
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47
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Inoue T, Yagami A, Sano A, Nakagawa M, Abe M, Mori A, Sasaki K, Matsunaga K. Contact dermatitis because of antimicrobial coating desk mat. Contact Dermatitis 2008; 58:123-4. [PMID: 18186760 DOI: 10.1111/j.1600-0536.2007.01202.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T Inoue
- Department of Dermatology, Fujita Health University School of Medicine, Aichi 470-1192, Japan.
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48
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Sugiura M, Nakajima J, Morota T, Yamamoto T, Sano A, Fukami T, Murakawa T, Ota S, Takamoto S. [Posterior mediastinal hemangioma successfully resected with cardiopulmonary bypass; report of a case]. Kyobu Geka 2007; 60:857-60. [PMID: 17703628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Mediastinal hemangioma is a rare tumor. We report a case of a 62-year-old woman with a posterior mediastinal hemangioma. She had a history of right breast cancer and a follow-up chest radiography revealed a mass located in the left posterior mediastinum. The size was about 80 mm in diameter. The tumor surrounded the descending thoracic aorta and involved intercostal arteries. Complete excision could be achieved by decompressing the descending aorta with the aid of partial cardiopulmonary bypass and the aortic cross-clamp. Histologically, the tumor was diagnosed as a benign hemangioma. It was reported that hemangioma would reccur after subtotal excision. To employ cardiopulmonary bypass was a very effective approach for the purpose of complete excision in our case.
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Affiliation(s)
- M Sugiura
- Department of Cardiothoracic Surgery, The University of Tokyo, Japan
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Togitani K, Kobayashi M, Sakai M, Uemura Y, Taguchi H, Morita T, Sugihara S, Sano A, Nishimura K. Ethmoidal sinusitis caused by Exserohilum rostratum in a patient with malignant lymphoma after non-myeloablative allogeneic peripheral blood stem cell transplantation. Transpl Infect Dis 2007; 9:137-41. [PMID: 17462000 DOI: 10.1111/j.1399-3062.2007.00212.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe a patient with aggressive lymphoma who contracted an ethmoidal sinus infection due to Exserohilum rostratum after non-myeloablative allogeneic peripheral blood stem cell transplantation. E. rostratum is an extremely rare causative pathogen of invasive fungal infection. Phylogenetic tree analysis of the D1/D2 domains within the LSU rDNA identified the molecular structure of isolates. We believe this is the first description of E. rostratum infection in a patient who underwent hematopoietic stem cell transplantation.
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Affiliation(s)
- K Togitani
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Kochi, Japan
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50
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Sano A, Kage H, Sugimoto K, Kitagawa H, Aki N, Goto A, Fukayama M, Nakajima J, Takamoto S, Nagase T, Yatomi Y, Ohishi N, Takai D. A second-generation profiling system for quantitative methylation analysis of multiple gene promoters: application to lung cancer. Oncogene 2007; 26:6518-25. [PMID: 17452971 DOI: 10.1038/sj.onc.1210483] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cancer-specific gene promoter methylation has been described in many types of cancers, and various semi-quantified results have shown their usefulness. Here, we show a more sensitive and specific second-generation system for profiling the DNA methylation status. This method is based on bisulfite reaction of DNA and real-time PCR using two TaqMan MGB probes labeled with different fluorescence, followed by clustering analysis. Primers were designed with CpG-less sequences, and TaqMan MGB probes were designed to contain three or four CpG sites and to be shorter than conventional TaqMan probes. We have added new criteria for primer and probe design for further specificity. We confirmed the reliability of this system and applied it to analysis of lung cancers. Using 10 promoters, 90 primary lung cancers were clustered into six groups consisting of cases having similar smoking status and pathological findings. EGFR mutation and p16 promoter DNA methylation were exclusive, as previously reported; however, DNA methylation in other genes was unrelated to EGFR mutation. This system was also useful to distinguish double primary lung cancers from a single cancer with intrapulmonary metastasis. As above, our system has widespread availability in clinical use and biological research.
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Affiliation(s)
- A Sano
- Department of General Thoracic Surgery, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
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