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Aiyoshi T, Kakihara T, Watanabe E, Tanaka N, Ogata Y, Masuoka H, Kurokawa R, Fujishiro J, Masumoto K, Suda W. A comprehensive microbial analysis of pediatric patients with acute appendicitis. J Microbiol Immunol Infect 2023; 56:695-704. [PMID: 37029071 DOI: 10.1016/j.jmii.2023.03.006] [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] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/06/2023] [Accepted: 03/12/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND Pathogenesis of pediatric acute appendicitis (AA) is yet to be elucidated. Therefore, we performed a comprehensive microbial analysis of saliva, feces, and appendiceal lumen of AA patients using 16S ribosomal RNA (rRNA) gene amplicon sequencing to elucidate the pathogenesis of pediatric AA. METHODS This study included 33 AA patients and 17 healthy controls (HCs) aged <15 y. Among the AA patients, 18 had simple appendicitis, and 15 had complicated appendicitis. Salivary and fecal samples were obtained from both groups. The contents of the appendiceal lumen were collected from the AA group. All samples were analyzed using 16S rRNA gene amplicon sequencing. RESULTS The relative abundance of Fusobacterium was significantly higher in the saliva of AA patients as compared to that in HCs (P = 0.011). Bacteroides, Escherichia, Fusobacterium, Coprobacillus, and Flavonifractor were significantly increased in the feces of AA patients, as compared to that in HCs (P = 0.020, 0.010, 0.029, 0.031, and 0.002, respectively). In the appendiceal lumen, Bacteroides, Parvimonas, Fusobacterium, and Alloprevotella were the top bacterial genera with an average relative abundance >5% (16.0%, 9.1%, 7.9%, and 6.0%, respectively). CONCLUSIONS The relative abundance of Fusobacterium was high in the appendiceal lumen of pediatric AA patients. Moreover, the relative abundance of Fusobacterium was significantly higher in the saliva and feces of pediatric AA patients than in those of healthy children. These results suggest that ectopic colonization of oral Fusobacterium in the appendix might play an important role in the pathogenesis of pediatric AA.
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Affiliation(s)
- Tsubasa Aiyoshi
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan; Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Tomo Kakihara
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan; Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Eiichiro Watanabe
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Nao Tanaka
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yusuke Ogata
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Hiroaki Masuoka
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Rina Kurokawa
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kouji Masumoto
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Wataru Suda
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan.
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Kitamura T, Murakami K, Watanabe E. Treatment of post-operative infected nonunion distal radius fracture using the Darrach procedure and radioscapholunate fusion with volar locking plate. Trauma Case Rep 2023; 45:100827. [PMID: 37096137 PMCID: PMC10122001 DOI: 10.1016/j.tcr.2023.100827] [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] [Accepted: 04/02/2023] [Indexed: 04/05/2023] Open
Abstract
There is no established standard treatment for post-operative infected nonunion distal radius fracture with severe damage to the joint surface. Herein, we report a case of post-operative infected nonunion distal radius fracture with severe articular damage, which was treated using a combination of the Darrach procedure and radioscapholunate fusion with a volar locking plate after implant removal and antibiotic treatment. A 61-year-old man underwent internal fixation with a volar locking plate for a distal radius fracture. Repeated post-operative infections caused distal radius nonunion, a bone defect in the lunate fossa of the radius, subluxation of the carpal bones on the palmar and ulnar sides, and significant limitation of rotation. Implant removal and wound debridement were performed to control infection. After oral antibiotic treatment, the Darrach procedure and radioscapholunate fusion with a volar locking plate combined with ulnar head bone grafting were performed. The patient was able to perform his activities of daily living without any problems after the two-stage surgery. This is the first report describing the treatment of post-operative infected nonunion distal radius fracture with severe damage to the radiocarpal and distal radioulnar joints.
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Affiliation(s)
- Takaki Kitamura
- Corresponding author at: Fuji Orthopaedic Hospital, 1-4-23 Nishikicho, Fuji, Shizuoka 417-0045, Japan.
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3
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Makrakis LR, Oliveira VC, Santos ES, Nascimento C, Watanabe E, Ribeiro AB, Silva-Lovato CH. Analysis of microbial communities of ocular prostheses and anophthalmic sockets using 16S rRNA gene sequencing. Biofouling 2023; 39:555-564. [PMID: 37470406 DOI: 10.1080/08927014.2023.2236562] [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] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/06/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
Ocular prostheses are liable to host microbial adhesion, which can favor conjunctival inflammation. Knowing the microbiota of the ocular prosthesis and anophthalmic socket is important for predicting infection-related pathogens. This study evaluated the microbiota of the prostheses and anophthalmic sockets of six individuals by 16S rRNA sequencing. The microbial abundance and diversity were analyzed using the Operational Taxonomic Units at the genus level. Forty-seven phyla, capturing 1,258 named genera, were recorded in the sample set. In both sites, the most frequent genera were Fusobacterium, Staphylococcus, Prevotella, and Streptococcus. The microbial abundance was higher for the anophthalmic socket than for the prosthesis. Alpha diversity showed no significant differences in bacterial richness or diversity between sites. Although the microbial abundance in the anophthalmic socket was higher, both sites had similar microbiota with high diversity and low dominance among the genera.
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Affiliation(s)
- L R Makrakis
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - V C Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Human Exposome and Infectious Diseases Network-HEID, School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - E S Santos
- Department of Clinical Toxicological and Bromatologic Analysis, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - C Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - E Watanabe
- Human Exposome and Infectious Diseases Network-HEID, School of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - A B Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - C H Silva-Lovato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Watanabe E, Hashizume N, Yoneda A, Kasahara M, Ozeki G, Saito T, Fujiogi M, Kano M, Yamamoto Y, Miyazaki O, Maekawa T, Nakano N, Yoshioka T, Fujino A, Kanamori Y. Infantile Kaposiform hemangioendothelioma in a female patient complicated with severe obstructed jaundice: a case report. Surg Case Rep 2022; 8:225. [PMID: 36580178 PMCID: PMC9800675 DOI: 10.1186/s40792-022-01581-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Kaposiform hemangioendothelioma (KHE) is a rare locally aggressive vascular neoplasm that occurs mainly in the pediatric population. KHE usually originates just underneath the skin and affects deeper tissues through infiltrative growth; however, visceral tissue involvement is quite rare. CASE PRESENTATION An 8-month-old girl with jaundice and acholic stool was referred to our hospital for further evaluation of a hepatoduodenal ligament tumor. A blood examination revealed high bilirubin and liver enzyme levels, but no signs of coagulopathy. The first attempt at a diagnostic surgical procedure did not provide sufficient diagnostic information. However, the histopathological diagnosis of the cystic duct excised in the second surgery indicated KHE. Therefore, in our case, KHE was considered a cause of obstructive jaundice. Sirolimus (rapamycin) was initiated, and the patient was discharged 7 months after admission. CONCLUSIONS In cases of atypical hypervascular lesions in the abdominal cavity, especially in the pediatric population, it is important to consider the possibility of KHE, and surgical intervention with proper strategies is required for diagnosis, followed sequentially by promising treatments.
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Affiliation(s)
- Eiichiro Watanabe
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Naoki Hashizume
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Akihiro Yoneda
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan ,grid.63906.3a0000 0004 0377 2305Division of Pediatric Surgical Oncology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Mureo Kasahara
- grid.63906.3a0000 0004 0377 2305Organ Transplantation Center, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Genta Ozeki
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takeshi Saito
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Michimasa Fujiogi
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Motohiro Kano
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Yuki Yamamoto
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Osamu Miyazaki
- grid.63906.3a0000 0004 0377 2305Department of Radiology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takanobu Maekawa
- grid.63906.3a0000 0004 0377 2305Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Noriyuki Nakano
- grid.63906.3a0000 0004 0377 2305Department of Pathology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takako Yoshioka
- grid.63906.3a0000 0004 0377 2305Department of Pathology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Akihiro Fujino
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Yutaka Kanamori
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
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Kano M, Furugane R, Hogetsu K, Yamada Y, Maniwa J, Kobayashi T, Hashizume N, Mori T, Watanabe E, Takahashi M, Fujino A, Kanamori Y, Terashima K, Matsumoto K, Yoneda A. Vaginal yolk sac tumor resected by a novel laparo/endoscope-assisted posterior sagittal approach: a case report. Surg Case Rep 2022; 8:162. [PMID: 36036317 PMCID: PMC9424445 DOI: 10.1186/s40792-022-01520-8] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Yolk sac tumor (YST) is a germ cell tumor that is generally associated with good prognosis in children. It has been recently reported that vaginal YSTs can be cured using chemotherapy alone. Thus, minimal invasiveness and function preservation are pre-requisites for surgical approaches. Herein, we report a case of vaginal YST that was resected in a function-preserving manner using a unique combination of surgical approaches. Case presentation In a 9-month-old Asian female infant, a vaginal tumor was detected while investigating for vaginal bleeding. The patient was referred to our hospital, and the tumor was diagnosed as a YST after incisional biopsy. Six courses of carboplatin-based chemotherapy were administered. Contrary to the findings in previous reports, the tumor was chemo-resistant and surgical resection was required for the residual tumor. During surgery, we utilized laparoscopic and endoscopic procedures to ensure tumor-free surgical margins at the cervix, rectum, and lateral wall of the vagina. Additionally, the posterior sagittal approach was used to easily resect the tumor, and the vagina was reconstructed leaving only inconspicuous scars in the intergluteal cleft. No complications occurred postoperatively. Pathological examination of the surgical specimen revealed tumor-free surgical margins. The patient received four cycles of intensified chemotherapy before and after the surgery. The patient has been disease-free for 6 months now. Conclusions Our combination of laparo/endoscopic and posterior sagittal approach ensured a tumor-free macroscopic surgical margin with easier, cosmetically pleasing vaginal reconstruction, while preserving the anorectal and urinary functions. We believe that this approach could be utilized not only for vaginal YST, but also for any vaginal tumor, especially those arising from the posterior or lateral wall.
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Lima NG, Monteiro RM, Torres CP, de Souza-Gabriel AE, Watanabe E, Borsatto MC. Influence of antimicrobial photodynamic therapy with different pre-irradiation times on children's dental biofilm: randomized clinical trial. Eur Arch Paediatr Dent 2022; 23:897-904. [PMID: 35666375 DOI: 10.1007/s40368-022-00716-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/03/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Photodynamic therapy (PDT) is effective in reducing pathogenic microorganisms in the oral cavity and in preventing dental diseases. This study evaluated the pre-irradiation time using PDT (diode laser associated with 0.01% methylene blue) to decrease the number of microorganisms in the visible plaque in permanent teeth. METHODS This randomized clinical trial included 108 homologous lower permanent first molars (36 and 46) with biofilm from 54 children aged six to 12 years. PDT was performed (0.01% methylene blue photosensitizer/therapeutic laser-InGaAIP), according to the following protocols: Group 1, biofilm collection of the distal area of the lingual surface of 36 µm before PDT; group 2, mesial area of the lingual surface of 36 µm 1 min after PDT; group 3, area of the lingual surface of 46 µm before PDT; and group 4, mesial area of the lingual surface of 46 µm 5 min after PDT. RESULTS After statistical analysis, significant differences were observed between the groups (p = 0.000). In groups 2 and 4, the number of bacteria tended to decrease, with a more evident bacterial reduction in group 4. CONCLUSIONS Pre-irradiation reduced the number of colony-forming units of mature bacterial biofilms in vivo. A time of 5 min resulted in a greater reduction in the number of colony-forming units. CLINICAL TRIAL REGISTRATION ReBEC Identifier: RBR-6bqfp3; Date of Register: March 2nd, 2020. Retrospectively Registered.
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Affiliation(s)
- N G Lima
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil
| | - R M Monteiro
- Department of Fundamental Nursing, The College of Nursing, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - C P Torres
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil
| | - A E de Souza-Gabriel
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - E Watanabe
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Prêto, SP, Brazil
| | - M C Borsatto
- Department of Pediatric Clinics, Departamento de Clínica Infantil, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto Dental School, University of São Paulo (USP), Av. do Café, s/n Subsetor Oeste 11, Ribeirão Prêto, SP, 14040-940, Brazil.
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Furugane R, Kobayashi T, Hashizume N, Mori T, Watanabe E, Kano M, Takahashi M, Murakoshi M, Sato M, Kamei K, Fujino A, Yoneda A, Kanamori Y. Recurrent outflow obstruction of a choked catheter for peritoneal dialysis caused by a fallopian tube fimbria in a five-month-old female. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2021.102131] [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: 10/19/2022] Open
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Watanabe E, Ota H, Takasugi N, Hiwatari M, Fujishiro J. A school-aged case of intratumor bleeding of an adrenal neuroblastoma rescued by transcatheter atrial embolization. Pediatr Int 2022; 64:e14987. [PMID: 35312221 DOI: 10.1111/ped.14987] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/14/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Eiichiro Watanabe
- Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hidehito Ota
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nao Takasugi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsuteru Hiwatari
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Sato T, Nakajima M, Takeishi Y, Nakajima K, Egawa K, Watanabe E, Hasegawa M. Effect of brown rice intake on obese people with exercise habits. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.441] [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: 10/19/2022]
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Iwami N, Kawamata M, Ozawa N, Yamamoto T, Watanabe E, Mizuuchi M, Moriwaka O, Kamiya H. P–763 Neonatal outcomes of the first 65 infants delivered after IVF treatment with progestin-primed ovarian stimulation using dienogest in patients with endometriosis. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.762] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the perinatal outcome of pregnancies resulting from a controlled ovarian hyperstimulation (COH) regimen of progestin-primed ovarian stimulation (PPOS) protocol using dienogest (DNG) in patients with endometriosis?
Summary answer
No difference in mean birth weight, however preterm and low birth weight babies are significantly more in the group treated with PPOS using DNG.
What is known already
Dienogest is an oral progestin effective for the treatment of endometriosis, such as reduction of endometrial lesion and control of pain intensity with safety profile and good tolerability. We reported for the first time in the world that DNG was better than dydrogesterone (DYG) for PPOS in terms of the mature oocytes rate and the fertilization rate in patients with endometriosis. Although there have been several reports of infants born with PPOS using DYG, it is essential to report on the perinatal outcome of embryos transferred after treatment with PPOS using DNG from now on. Study design, size, duration: We prospectively investigated the perinatal outcomes of 65 newborns which were the result of using a new COH regimen; PPOS with DNG. The results were compared with perinatal outcome data of babies born between 2018 and 2020 to 815 patients who underwent assisted reproductive technology (ART) treatment at our fertility center. As for the congenital malformation rate, the data was also compared with the 2017 Japanese data bank of babies born after ART treatment.
Participants/materials, setting, methods
We studied the perinatal data of all babies born after transfer of frozen embryos acquired by COH using PPOS protocol with DNG. The rate of maternal complications during pregnancy, pregnancy duration, birth weight, congenital malformations and method of delivery were investigated. We compared the perinatal outcomes of infants born after in vitro fertilization (IVF) and frozen embryo transfer at our center during the same period.
Main results and the role of chance
Perinatal data of 65 babies (study group) were compared with the perinatal data of 840 babies born after IVF at our center, and 47807 babies born after ART in Japan, 2017. We found 3 twin and 59 singleton pregnancies in the study group, compared to 23 twins, 1 triplet and 791 singleton pregnancies during the same period at our center. Considering singletons, there was no difference in mean birthweight (study group; 2893.2±652g vs. total at our center; 3001.2±425g, respectively, p = 0.102). Preterm births (<37 weeks) were significantly more frequent in the PPOS using DNG treatment group than in total at our center (19.2% vs. 9.7%, p = 0.016). The percentage of infants with a birth weight < 2.5 kg was also significantly higher in the PPOS treatment group compared to the total at our center (22.6% vs.11.9%, p = 0.015). The Caesarean section rate was 53.2% in the study group vs. 47.1% control group of our center respectively (p = 0.353). One babies in the study group had malformations in the ocular region. There was no significant difference in congenital malformations between the study group and ART data bank in Japan, 2017 (OR 0.67, 95% CI 0.093: 4.836).
Limitations, reasons for caution
The number of babies is still low, further prospective studies including larger populations are needed to confirm the efficacy of PPOS protocol with DNG.
Wider implications of the findings: This is the first report on the perinatal outcome of babies born by a new COH method using PPOS with DNG, which is a combination of endometriosis treatment and COH for IVF. The association of endometriosis with preterm birth and low birth weight needs to be further investigated.
Trial registration number
UMIN000031111
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Affiliation(s)
- N Iwami
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - M Kawamata
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - N Ozawa
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - T Yamamoto
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - E Watanabe
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - M Mizuuchi
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - O Moriwaka
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
| | - H Kamiya
- Kamiya Ladies Clinic, Center of reproduction, Sapporo, Japan
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Sunouchi T, Watanabe Y, Tomonaga K, Watanabe E, Ichijo C, Hoshino N, Suzuki K, Fujishiro J. Optimal treatment of pneumothorax in adolescents with Marfan syndrome. J Pediatr Surg 2021; 56:1103-1106. [PMID: 33896616 DOI: 10.1016/j.jpedsurg.2021.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Pneumothorax often develops in patients with Marfan syndrome (MFS). Here, we examined the effects of conservative and surgical pneumothorax treatments in children with MFS. METHODS In this study, 23 patients, less than 20 years old, diagnosed with both MFS and pneumothorax between 1999 and 2019 were included. All data were collected retrospectively from patients' medical records. RESULTS In total, 18 of 23 patients (78%) had relapsed pneumothorax either on the ipsilateral or contralateral side. Among these 18 patients, 6 (26%) patients had multiple relapses. Conservative and surgical treatments of pneumothorax were attempted in 33 and 29 lungs, respectively. The conservative treatment was attempted as a definitive therapy in 21 lungs. Twelve conservative treatments (57%) failed, which required surgical intervention. In 9 lungs (43%) with successful conservative treatment, 6 (67%) had ipsilateral relapses. In contrast to the above findings, only 4 (13%) ipsilateral relapses were observed in 29 surgical treatments. CONCLUSIONS Our study revealed a low response and high relapse rate when MFS adolescents who diagnosed pneumothorax were subjected to the conservative treatment modality. Thus, we recommend surgical intervention as the first line of therapy to treat pneumothorax in adolescents diagnosed with MFS. LEVEL OF EVIDENCE Ⅲ (Treatment Study).
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Affiliation(s)
- Tomohiro Sunouchi
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
| | - Yasuo Watanabe
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kotaro Tomonaga
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Eiichiro Watanabe
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Chizue Ichijo
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Noriko Hoshino
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Kan Suzuki
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
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12
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Arima H, Yamato Y, Sato K, Uchida Y, Tsuruta T, Hashiguchi K, Hamamoto H, Watanabe E, Yamanaka K, Hasegawa T, Yoshida G, Yasuda T, Banno T, Oe S, Ushirozako H, Yamada T, Ide K, Watanabe Y, Matsuyama Y. Characteristics affecting cervical sagittal alignment in patients with chronic low back pain. J Orthop Sci 2021; 26:577-583. [PMID: 32800526 DOI: 10.1016/j.jos.2020.07.004] [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] [Received: 04/08/2020] [Revised: 06/07/2020] [Accepted: 07/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sagittal spino-pelvic malalignment in patients with chronic low back pain (CLBP) have been reported in the past, which may also affect cervical spine lesions. The purpose of this study is to investigate the cervical alignment in patients with CLBP. METHOD Of the patients who visited an orthopedic specialist due to low back pain lasting more than three months, 121 cases (average 71.5-years-old, 46 male and 75 female) with whole standing spinal screening radiographs were reviewed (CLBP group). Cervical parameters included cervical lordosis (CL), C2-C7 sagittal vertical axis (C2-7 SVA), and the T1 slope minus CL (T1S-CL). Cervical spine deformity was defined as C2-7 SVA >4 cm, CL <0°, or T1S-CL ≧20°. We compared the cervical alignment of these patients with 121 age and gender matched volunteers (control group). RESULTS The prevalence of cervical spine deformity was significantly higher in the CLBP group than in the control group (20.7% vs. 10.7%, P = 0.034). The mean CL was smaller in the CLBP group than in the control group (16.1° vs. 21.4°, P = 0.002). The mean C2-7 SVA was 17.6 mm vs. 18.7 mm in the CLBP group and in the control group, respectively (P = 0.817). The mean T1S-CL was larger in the CLBP group than in the control group (9.1° vs. 3.5°, P < 0.001). Multivariate analysis showed that people with CLBP were more likely to have cervical deformities than people without CLBP (odds ratio 2.16, 95% confidence interval 1.006 to 4.637). CONCLUSIONS This study results suggest that people with CLBP present with worse cervical sagittal alignment and higher prevalence of cervical spine deformities than age and gender matched volunteers with no CLBP. This means CLBP impacts cervical spine lesions negatively. LEVEL OF EVIDENCE Ⅳ.
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Affiliation(s)
- Hideyuki Arima
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan.
| | - Yu Yamato
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Kimihito Sato
- Sato Orthopedic Clinic, 5-4-1-16 Nakakasai, Edogawa-ku, Tokyo, 134-0084, Japan
| | - Yoshihiro Uchida
- Seisen Clinic, 191-1 Kakita, Shimizu-cho, Sunto-gun, Shizuoka, 411-0904, Japan
| | - Toshiyuki Tsuruta
- Tsuruta Orthopedic Clinic, 1241-6 Ushizuchoukatsu, Ogi city, Saga, 840-0306, Japan
| | - Kanehisa Hashiguchi
- Hashiguchi Orthopedic Clinic, 1-41-3 Komatsubara, Kagoshima city, Kagoshima, 891-0114, Japan
| | - Hajime Hamamoto
- Hamamoto Orthopedic Clinic, 40-5 Johoku, Aoi-ku, Shizuoka city, Shizuoka, 420-0805, Japan
| | - Eiichiro Watanabe
- Fuji Orthopedic Hospital, 1-4-23 K|Nishiki-cho, Fuji city, Shizuoka, 417-0045, Japan
| | - Kaoru Yamanaka
- Yamanaka Orthopedic Clinic, 1-28-6 Shikiji, Suruga-ku, Shizuoka city, Shizuoka, 422-8036, Japan
| | - Tomohiko Hasegawa
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Go Yoshida
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Tatsuya Yasuda
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Tomohiro Banno
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Shin Oe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Hiroki Ushirozako
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Tomohiro Yamada
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Koichiro Ide
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Yuh Watanabe
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
| | - Yukihiro Matsuyama
- Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-Ku, Hamamatsu city, Shizuoka 431-3192, Japan
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13
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Ito Y, Sasaki T, Li Y, Tanoue T, Sugiura Y, Skelly AN, Suda W, Kawashima Y, Okahashi N, Watanabe E, Horikawa H, Shiohama A, Kurokawa R, Kawakami E, Iseki H, Kawasaki H, Iwakura Y, Shiota A, Yu L, Hisatsune J, Koseki H, Sugai M, Arita M, Ohara O, Matsui T, Suematsu M, Hattori M, Atarashi K, Amagai M, Honda K. Staphylococcus cohnii is a potentially biotherapeutic skin commensal alleviating skin inflammation. Cell Rep 2021; 35:109052. [PMID: 33910010 DOI: 10.1016/j.celrep.2021.109052] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 03/09/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022] Open
Abstract
Host-microbe interactions orchestrate skin homeostasis, the dysregulation of which has been implicated in chronic inflammatory conditions such as atopic dermatitis and psoriasis. Here, we show that Staphylococcus cohnii is a skin commensal capable of beneficially inhibiting skin inflammation. We find that Tmem79-/- mice spontaneously develop interleukin-17 (IL-17)-producing T-cell-driven skin inflammation. Comparative skin microbiome analysis reveals that the disease activity index is negatively associated with S. cohnii. Inoculation with S. cohnii strains isolated from either mouse or human skin microbiota significantly prevents and ameliorates dermatitis in Tmem79-/- mice without affecting pathobiont burden. S. cohnii colonization is accompanied by activation of host glucocorticoid-related pathways and induction of anti-inflammatory genes in the skin and is therefore effective at suppressing inflammation in diverse pathobiont-independent dermatitis models, including chemically induced, type 17, and type 2 immune-driven models. As such, S. cohnii strains have great potential as effective live biotherapeutics for skin inflammation.
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Affiliation(s)
- Yoshihiro Ito
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Takashi Sasaki
- Center for Supercentenarian Medical Research, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Youxian Li
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Takeshi Tanoue
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Yuki Sugiura
- Department of Biochemistry, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Ashwin N Skelly
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Wataru Suda
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Graduate School of Advanced Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Yusuke Kawashima
- Department of Applied Genomics, Kazusa DNA Research Institute, Chiba 292-0818, Japan
| | - Nobuyuki Okahashi
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Eiichiro Watanabe
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Hiroto Horikawa
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Aiko Shiohama
- Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Rina Kurokawa
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Graduate School of Advanced Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Eiryo Kawakami
- Medical Sciences Innovation Hub Program (MIH), RIKEN, Kanagawa 230-0045, Japan
| | - Hachiro Iseki
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Hiroshi Kawasaki
- Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Medical Sciences Innovation Hub Program (MIH), RIKEN, Kanagawa 230-0045, Japan
| | - Yoichiro Iwakura
- Research Institute for Biomedical Sciences, Tokyo University of Science, Chiba 278-0022, Japan
| | - Atsushi Shiota
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Liansheng Yu
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo 189-0002, Japan
| | - Junzo Hisatsune
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo 189-0002, Japan
| | - Haruhiko Koseki
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Medical Sciences Innovation Hub Program (MIH), RIKEN, Kanagawa 230-0045, Japan
| | - Motoyuki Sugai
- Antimicrobial Resistance Research Center, National Institute of Infectious Diseases, Tokyo 189-0002, Japan
| | - Makoto Arita
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Osamu Ohara
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Department of Applied Genomics, Kazusa DNA Research Institute, Chiba 292-0818, Japan
| | - Takeshi Matsui
- JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Makoto Suematsu
- Department of Biochemistry, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masahira Hattori
- Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan; Graduate School of Advanced Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Koji Atarashi
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Masayuki Amagai
- Department of Dermatology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan
| | - Kenya Honda
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan; JSR-Keio University Medical and Chemical Innovation Center, Keio University School of Medicine, Tokyo 160-8582, Japan; Center for Integrative Medical Science (IMS), RIKEN, Kanagawa 230-0045, Japan.
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14
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Suzuki K, Fujishiro J, Ichijo C, Watanabe E, Tomonaga K, Sunouchi T, Watanabe Y. Prophylactic innominate artery transection to prevent tracheoinnominate artery fistula: a retrospective review of single institution experiences. Pediatr Surg Int 2021; 37:267-273. [PMID: 33388953 DOI: 10.1007/s00383-020-04792-z] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE This study aimed to investigate the optimal indication and availability of prophylactic innominate artery transection (PIAT). METHODS We retrospectively analyzed the medical records of the patients with neurological or neuromuscular disorders (NMDs) who underwent PIAT. Meanwhile, we originally defined the tracheal flatting ratio (TFR) and mediastinum-thoracic anteroposterior ratio (MTR) from preoperative chest computed tomography imaging and compared these parameters between non-PIAT and PIAT group. RESULTS There were 13 patients who underwent PIAT. The median age was 22 years. PIAT was planned before in one, simultaneously in five, and after tracheostomy or laryngotracheal separation in seven patients. Image evaluations of the brain to assess circle of Willis were performed in all patients. Appropriate skin incisions with sternotomy to expose the innominate artery were made in four patients. All patients are still alive except one late death without any association with PIAT. No neurological complications occurred in any patients. As significant differences (p < 0.01) between two groups were observed for TFR and MTR, objective validity of the indication of PIAT was found. CONCLUSIONS PIAT is safe and tolerable in case of innominate artery compression of the trachea with NMDs. TFR and MTR are useful objective indexes to judge the indication of PIAT.
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Affiliation(s)
- Kan Suzuki
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Jun Fujishiro
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Chizue Ichijo
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Eiichiro Watanabe
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kotaro Tomonaga
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Tomohiro Sunouchi
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Yasuo Watanabe
- Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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15
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Watanabe E, Kawashima Y, Suda W, Kakihara T, Takazawa S, Nakajima D, Nakamura R, Nishi A, Suzuki K, Ohara O, Fujishiro J. Discovery of Candidate Stool Biomarker Proteins for Biliary Atresia Using Proteome Analysis by Data-Independent Acquisition Mass Spectrometry. Proteomes 2020; 8:proteomes8040036. [PMID: 33260872 PMCID: PMC7709124 DOI: 10.3390/proteomes8040036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/25/2020] [Indexed: 11/16/2022] Open
Abstract
Biliary atresia (BA) is a destructive inflammatory obliterative cholangiopathy of the neonate that affects various parts of the bile duct. If early diagnosis followed by Kasai portoenterostomy is not performed, progressive liver cirrhosis frequently leads to liver transplantation in the early stage of life. Therefore, prompt diagnosis is necessary for the rescue of BA patients. However, the prompt diagnosis of BA remains challenging because specific and reliable biomarkers for BA are currently unavailable. In this study, we discovered potential biomarkers for BA using deep proteome analysis by data-independent acquisition mass spectrometry (DIA–MS). Four patients with BA and three patients with neonatal cholestasis of other etiologies (non-BA) were recruited for stool proteome analysis. Among the 2110 host-derived proteins detected in their stools, 49 proteins were significantly higher in patients with BA and 54 proteins were significantly lower. These varying stool protein levels in infants with BA can provide potential biomarkers for BA. As demonstrated in this study, the deep proteome analysis of stools has great potential not only in detecting new stool biomarkers for BA but also in elucidating the pathophysiology of BA and other pediatric diseases, especially in the field of pediatric gastroenterology.
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Affiliation(s)
- Eiichiro Watanabe
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (E.W.); (T.K.); (K.S.)
| | - Yusuke Kawashima
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu 292-0818, Japan; (Y.K.); (D.N.); (R.N.); (O.O.)
| | - Wataru Suda
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Yokohama 230-0045, Japan;
| | - Tomo Kakihara
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (E.W.); (T.K.); (K.S.)
| | - Shinya Takazawa
- Department of Surgery, Gunma Children’s Medical Center, Shibukawa 277-8577, Japan; (S.T.); (A.N.)
| | - Daisuke Nakajima
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu 292-0818, Japan; (Y.K.); (D.N.); (R.N.); (O.O.)
| | - Ren Nakamura
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu 292-0818, Japan; (Y.K.); (D.N.); (R.N.); (O.O.)
| | - Akira Nishi
- Department of Surgery, Gunma Children’s Medical Center, Shibukawa 277-8577, Japan; (S.T.); (A.N.)
| | - Kan Suzuki
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (E.W.); (T.K.); (K.S.)
| | - Osamu Ohara
- Department of Applied Genomics, Kazusa DNA Research Institute, Kisarazu 292-0818, Japan; (Y.K.); (D.N.); (R.N.); (O.O.)
| | - Jun Fujishiro
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan; (E.W.); (T.K.); (K.S.)
- Correspondence: ; Tel.: +81-3-5800-8671; Fax: +81-3-5800-5104
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16
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Otsuki H, Arashi H, Nakazawa M, Inagaki Y, Ebihara S, Tanaka K, Nakao M, Watanabe E, Ogawa H, Yamaguchi J, Hagiwara N. Aggressive lipid lowering therapy with pitavastatin and ezetimibe improve cardiovascular outcomes in patients with ST segment elevation myocardial infarction: insights from the HIJ-PROPER Study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aims
The purpose of this study was to evaluate the effect of aggressive lipid-lowering therapy with pitavastatin and ezetimibe in patients with ST-segment elevation myocardial infarction (STEMI) as compared with those with other classification of an acute coronary syndrome (ACS) including non-STEMI (NSTEMI) and unstable angina pectoris (UA).
Methods
This is a post hoc sub-analysis of the HIJ-PROPER study. In the original study, ACS patients with dyslipidemia were randomized to either pitavastatin + ezetimibe therapy or pitavastatin monotherapy. In the present analysis, we divided HIJ-PROPER participants into the STEMI group (n=880) and NSTEMI + UA group (n=841). Cardiovascular events were analyzed between the two groups. The primary endpoint was a composite of major advanced cardiovascular events (MACE; all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina pectoris, and ischemia-driven revascularization)
Result
During median follow-up period of 3.4 years, the cumulative incidence of the primary endpoint in STEMI group was 31.9% in the pitavastatin+ezetimibe therapy, compared with 39.7% in the pitavastatin-monotherapy (HR, 0.77; 95% CI, 0.62–0.97; p=0.02). However, there was no effect of pitavastatin+ezetimibe therapy on the primary endpoint in the NSTEMI + UA group. Concerning the individual components of the primary endpoint in STEMI group, the percentage of occurrence of all-cause death was significantly lower in the pitavastatin+ezetimibe therapy compared to pitavastatin mono-therapy (14 patients (3.2%) vs. 31 patients (6.9%), respectively; HR, 0.45; 95% CI, 0.23–1.84, p=0.01). Multivariate analysis revealed that use of ezetimibe and prevalence of diabetes mellitus at baseline were independent predictors of primary endpoints in STEMI group (HR, 0.79; 95% CI, 0.63–0.99; p=0.04 for use of ezetimibe, HR 1.54; 95% CI, 1.22–1.94, p=0.0003 for diabetes mellitus).
Conclusion
Patients with pitavastatin+ezetimibe therapy as compared with pitavastatin-monotherapy had lower cardiovascular event in patients with ST-segment elevation myocardial infarction.
Kaplan-Meier curves for primary endpoint
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Otsuki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Arashi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nakazawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - Y Inagaki
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - S Ebihara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - K Tanaka
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nakao
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - E Watanabe
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - H Ogawa
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - J Yamaguchi
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, Department of Cardiology, Tokyo, Japan
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Ohtake H, Ishii J, Nishimura H, Kawai H, Muramatsu T, Harada M, Motoyama S, Watanabe E, Ozaki Y, Iwata M. Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1707] [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
The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.
Purpose
We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.
Method
We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset >3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.
Results
Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.
Conclusion
The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ohtake
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | | | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - M Harada
- Fujita Health University, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - M Iwata
- Fujita Health University, Toyoake, Japan
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18
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Harada M, Nomura Y, Nishimura A, Motoike Y, Koshikawa M, Watanabe E, Izawa H, Ozaki Y. Factors associated with silent cerebral events during catheter ablation for atrial fibrillation in the era of uninterrupted oral anticoagulation therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A silent cerebral event (SCE), detected by brain magnetic resonance imaging (MRI), is defined as an acute new brain lesion without clinically apparent neurological deficit, and is frequently observed after catheter ablation in atrial fibrillation (AF) patients. Although the small number of SCEs does not cause neurocognitive dysfunction, the greater volume and/or larger number of SCE lesions are reportedly related to neuropsychological decline; SCE incidence may be a surrogate marker for the potential thromboembolic risk. Thus, strategies to reduce SCEs would be beneficial. Uninterrupted oral anticoagulation strategy for peri-procedural period reportedly reduced the risk of SCEs, but the incidence hovers at 10% to 30%. We sought factors associated with SCEs during catheter ablation for AF in patients with peri-procedural uninterrupted oral anticoagulation (OAC) therapy.
Methods
AF patients undergoing catheter ablation were eligible (n=255). All patients took non-vitamin K antagonist oral anticoagulants (NOACs) or vitamin K antagonist (VKA) for peri-procedural OAC (>4 weeks) without interruption during the procedure. Brain MRI was performed within 2 days after the procedure to detect SCEs. Clinical characteristics and procedure-related parameters were compared between patients with and without SCEs.
Results
SCEs were detected in 59 patients (23%, SCE[+]) but not in 196 patients (77%, SCE[-]). Average age was higher in SCE[+] than SCE[-] (66±10 years vs. 62±12 years, p<0.05). Persistent AF prevalence, CHADS2/CHA2DS2-VASc scores, and serum NT-ProBNP levels increased in SCE[+] vs. SCE[-]. In transthoracic/transesophageal echocardiography, left-atrial dimension (LAD) was larger and AF rhythm/spontaneous echo contrast were more frequently observed in SCE[+] than SCE[-]. SCE[+] had lower initial activated clotting time (ACT) before unfractionated heparin (UFH) injection and longer time to reach optimal ACT (>300 sec) before trans-septal puncture than SCE [-]. In multivariate analysis, LAD, initial ACT before UFH injection, and time to reach optimal ACT were predictors for SCEs.
Conclusions
LAD and intra-procedural ACT kinetics affect SCEs during the procedure in patients with uninterrupted OAC for AF ablation. Shortening time to achieve optimal ACT during the procedure may reduce the risk of SCEs.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | | | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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19
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [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
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - W Fujiwara
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - M Ohta
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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20
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Kubo T, Takano H, Takayama M, Doi Y, Minami Y, Ebato M, Inomata T, Katoh T, Okamoto R, Chikamori T, Watanabe E, Furugen A, Maekwa Y, Shimizu W, Kitaoka H. Baseline clinical features in a large-scale registration survey of patient with hypertrophic cardiomyopathy throughout Japan: J-HCM registry study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2085] [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: 11/12/2022] Open
Abstract
Abstract
Background
Hypertrophic cardiomyopathy (HCM) is a most prevalent primary myocardial disorder with heterogeneous clinical features. However, there have been few studies on clinical features of HCM as a prospective cohort. In 2015, we established a large-scale registration survey of patients with HCM throughout Japan, named J-HCM registry study.
Purpose
The aim of this study was to clarify the clinical features of Japanese patients with HCM.
Methods
J-HCM registry study is a prospective, multicenter investigation, consisting of 24 hospitals. This time, we present the baseline clinical characteristics in this survey.
Results
Total 1484 patients were registered. The ages at registration and at diagnosis were 65±15 and 56±17 years, respectively, and 806 patients (54%) were men. Majority of the patients (95%) was NYHA class I or II. With regard to subtypes of HCM, there were 526 patients (36%) in the HCM with left ventricular (LV) outflow tract obstruction, 126 patients (8%) in the mid-ventricular obstruction, 57 patients (4%) in the end-stage phase characterized by LV ejection fraction <50%, and 197 patients (14%) in apical HCM. At registration, 80 patients (6%) had prior successful recovery from sustained ventricular tachycardia or ventricular fibrillation, 162 patients (11%) suffered from heart failure hospitalization, and 64 patients (4%) had history of embolic event. Regarding invasive treatment, 160 patients (10%) had prior septal reduction therapy and 162 patients (11%) had ICD implantation. According to the 2014 European Society of Cardiology Guidelines on sudden cardiac death (SCD) prevention, the study patients were divided into 3 categories by the HCM Risk-SCD calculator: patients distribution, 4% in the high risk group (≥6% calculated HCM Risk-SCD at 5 years), 7% in the intermediate risk group (4% to <6%), 69% in the low risk group (<4%), and 16% in the patients with extreme characteristics (Figure 1).
Conclusions
In this multicenter registration survey of patients with HCM, the baseline clinical characteristics were almost similar to several retrospective large-scale cohorts in Western countries except older age and less symptomatic state. This study will provide important knowledge regarding management of HCM.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Kubo
- Kochi Medical School, Kochi, Japan
| | - H Takano
- Nippon Medical School Teaching Hospital, Tokyo, Japan
| | - M Takayama
- Sakakibara Heart Institute, Fucyu Tokyo, Japan
| | - Y.L Doi
- Kochi Medical School, Kochi, Japan
| | - Y Minami
- Tokyo Women's Medical University, Tokyo, Japan
| | - M Ebato
- Showa University Fujigaoka Hospital, Yokohama, Japan
| | - T Inomata
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Katoh
- Kyoto University, Kyoto, Japan
| | - R Okamoto
- Mie University Graduate School of Medicine, Tsu, Japan
| | - T Chikamori
- Tokyo Medical University Hospital, Tokyo, Japan
| | - E Watanabe
- Fujita Health University School of Medicine, Toyoake, Japan
| | - A Furugen
- Sapporo Cardio Vascular Clinic, Sapporo, Japan
| | - Y Maekwa
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - W Shimizu
- Nippon Medical School Teaching Hospital, Tokyo, Japan
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21
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Yamamoto A, Nagao M, Ando K, Nakao R, Sakai A, Watanabe E, Momose M, Sato K, Sakai S, Hagiwara N. High-risk plaque burdens myocardial flow reserve in intermediate coronary artery disease: hybrid analysis of 13N-ammonia PET and coronary CT angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0288] [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
13N-ammonia PET (NH3-PET) can detect myocardial perfusion abnormalities in patients with coronary artery disease (CAD) and also obtain diagnostic quantitative values of absolute myocardial blood flow and myocardial flow reserve (MFR). Low MFR (MFR<2.0) is an independent prognostic factor for major adverse cardiac event in patients with ischemic and non-ischemic heart disease. A feature of low attenuation plaque (LAP) on coronary CT angiography (CCTA) has been known as high-risk plaque (HRP) for acute coronary syndrome even if there is no significant coronary stenosis. The presence of HRP potentially adversely affects MFR, but the hypothesis has not been elucidated.
Purpose
We aimed to investigate the affect of LAP to MFR in intermediate CAD.
Methods
One hundred five patients (age 67±9 years, 65% male) with CAD underwent NH3-PET and CCTA within 6 months between April 2015 and March 2019 were enrolled. Based on the results of CCTA, mild and moderate stenosis were defined as 1% to 49% and 50% to 69% stenosis. Ischemic territories for major three vessels were identified by stress/rest NH3-PET images. Finally, 194 coronary arteries with mild to moderate stenosis corresponding to non-ischemic territory were analyzed in this study. LAP was defined as plaques containing CT value less than 90HU. Partially calcified plaques were included in LAP. Entirely calcification plaque without LAP was defined as calcified plaque. MFR for major three vessels were calculated from dynamic scan at stress/rest NH3-PET.
Results
CCTA showed 80 coronary arteries with LAP (41%), 104 coronary arteries with calcified plaque (54%), 102 vessels with mild stenosis (53%), and 92 vessels with moderate stenosis (47%). MFRs for coronary arteries with LAP were significantly lower than those without LAP (2.1±0.6 vs 2.5±0.6, p<0.0001). The significant difference in MFR between with and without LAP was observed in both mild and moderate stenosis (mild: 2.0±0.6 vs 2.5±0.6, p=0.0015, moderate: 2.1±0.6 vs 2.5±0.6, p<0.0001). In contrast, coronary arteries with calcified plaque had significantly higher MFR than those without (2.5±0.6 vs 2.1±0.6, p<0.0001).
In 58 coronary arteries with MFR<2.0, 71% (41/58) had LAP and 24% (14/58) had calcified plaque. In 136 coronary arteries with MFR≥2.0, 29% (39/136) had LAP and 66% (90/136) had calcified plaque. LAP was significantly more frequent in the former and calcified plaque was significantly more frequent in the latter.
Conclusion
The presence of LAP burdens MFR in mild to moderate CAD. On the other hand, calcified plaque alone had no adverse effect on MFR. LAP is an important sign in CAD risk assessment even without significant coronary stenosis.
MFR and stress MPI
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Yamamoto
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - M Nagao
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - K Ando
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - R Nakao
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - A Sakai
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - E Watanabe
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - M Momose
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - K Sato
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - S Sakai
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
| | - N Hagiwara
- Tokyo Women's Medical University Hospital, Shinjyuku, Japan
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22
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Terui K, Hirahara N, Tachimori H, Kato N, Fujishiro J, Watanabe E, Tomita H, Okamoto T, Fujiogi M, Okamoto S, Yonekura T, Miyata H, Usui N. Development and validation of risk models for mortality and morbidity in 12 major pediatric surgical procedures: A study from the National Clinical Database-Pediatric of Japan. J Pediatr Surg 2020; 55:2064-2070. [PMID: 32507636 DOI: 10.1016/j.jpedsurg.2020.03.031] [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] [Received: 09/19/2019] [Revised: 02/22/2020] [Accepted: 03/27/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE To establish and validate risk models of mortality and morbidity associated with 12 major pediatric surgical procedures using the National Clinical Database-Pediatric (NCD-P) data. METHODS We used the NCD-P data for the development and validation datasets. By using multivariate logistic regression to analyze the development dataset, we created a prediction model for 30-day mortality and morbidity in 12 major pediatric surgical procedures, including tracheoplasty, pneumonectomy, fundoplication, total/subtotal excision of malignant tumor, and surgeries for Hirschsprung disease, anorectal malformation, biliary atresia, choledocal cyst, midgut volvulus, funnel chest, gastrointestinal perforation, and intestinal obstruction. We selected variables that were almost identical to those used in the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P). The primary outcomes were 30-day mortality and composite morbidity. We assessed the obtained models using the C-indices of the development and validation datasets. RESULTS Overall, 10 and 21 variables were identified for mortality and morbidity, respectively. C-indices of mortality were 0.940 and 0.924 in the development and validation datasets, respectively. C-indices of morbidity were 0.832 and 0.830 in the development and validation datasets, respectively. CONCLUSIONS Based on the NCD-P data, we developed satisfactory risk models for mortality and morbidity prediction in major pediatric surgeries. LEVEL OF EVIDENCE Level I (Prognosis Study).
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Affiliation(s)
- Keita Terui
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan.
| | - Norimichi Hirahara
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Hisateru Tachimori
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan; The Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naohiro Kato
- Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Eiichiro Watanabe
- Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Hirofumi Tomita
- Department of Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Tatsuya Okamoto
- Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Graduate School of Medicine, Kyoto University, Kyoto, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Michimasa Fujiogi
- Department of Pediatric Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Shinya Okamoto
- Department of Pediatric Surgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Takeo Yonekura
- Department of Pediatric Surgery, Kindai University School of Medicine Nara Hospital, Nara, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriaki Usui
- Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan; National Clinical Database Committee and (l)) Pediatric Surgical Database Committee, The Japanese Society of Pediatric Surgeons, Tokyo, Japan
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23
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Nakamoto S, Tanaka K, Watanabe E, Takeda N, Nakamura T, Kumamoto Y. Colorectal cancer with peritoneal carcinomatosis in a teenager. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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24
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Iwasaki T, Endo K, Watanabe E, Tsuya D, Morita Y, Nakaharai S, Noguchi Y, Wakayama Y, Watanabe K, Taniguchi T, Moriyama S. Bubble-Free Transfer Technique for High-Quality Graphene/Hexagonal Boron Nitride van der Waals Heterostructures. ACS Appl Mater Interfaces 2020; 12:8533-8538. [PMID: 32027115 DOI: 10.1021/acsami.9b19191] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Bubbles at the interface of two-dimensional layered materials in van der Waals heterostructures cause deterioration in the quality of materials, thereby limiting the size and design of devices. In this paper, we report a simple all-dry transfer technique, with which the bubble formation can be avoided. As a key factor in the technique, a contact angle between a picked-up flake on a viscoelastic polymer stamp and another flake on a substrate was introduced by protrusion at the stamp surface. Using this technique, we demonstrated the fabrication of high-quality devices on the basis of graphene/hexagonal boron nitride heterostructures with a large bubble-free region. Additionally, the technique can be used to remove unnecessary flakes on a substrate under an optical microscopic scale. Most importantly, it improves the yield and throughput for the fabrication process of high-quality van der Waals heterostructure-based devices.
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Affiliation(s)
- Takuya Iwasaki
- International Center for Young Scientists (ICYS) , National Institute for Materials Science (NIMS) , Tsukuba , Ibaraki 305-0044 , Japan
| | - Kosuke Endo
- International Center for Materials Nanoarchitectonics (WPI-MANA), NIMS , Tsukuba , Ibaraki 305-0044 , Japan
- School of Science & Technology , Meiji University , Kawasaki 214-8571 , Japan
| | | | - Daiju Tsuya
- Nanofabrication Platform, NIMS , Tsukuba , Ibaraki 305-0047 , Japan
| | - Yoshifumi Morita
- Faculty of Engineering , Gunma University , Kiryu , Gunma 376-8515 , Japan
| | - Shu Nakaharai
- International Center for Materials Nanoarchitectonics (WPI-MANA), NIMS , Tsukuba , Ibaraki 305-0044 , Japan
| | - Yutaka Noguchi
- School of Science & Technology , Meiji University , Kawasaki 214-8571 , Japan
| | - Yutaka Wakayama
- International Center for Materials Nanoarchitectonics (WPI-MANA), NIMS , Tsukuba , Ibaraki 305-0044 , Japan
| | - Kenji Watanabe
- Research Center for Functional Materials, NIMS , Tsukuba , Ibaraki 305-0044 , Japan
| | - Takashi Taniguchi
- Research Center for Functional Materials, NIMS , Tsukuba , Ibaraki 305-0044 , Japan
| | - Satoshi Moriyama
- International Center for Materials Nanoarchitectonics (WPI-MANA), NIMS , Tsukuba , Ibaraki 305-0044 , Japan
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25
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Proshutinsky A, Krishfield R, Toole JM, Timmermans M, Williams W, Zimmermann S, Yamamoto‐Kawai M, Armitage TWK, Dukhovskoy D, Golubeva E, Manucharyan GE, Platov G, Watanabe E, Kikuchi T, Nishino S, Itoh M, Kang S, Cho K, Tateyama K, Zhao J. Analysis of the Beaufort Gyre Freshwater Content in 2003-2018. J Geophys Res Oceans 2019; 124:9658-9689. [PMID: 32055432 PMCID: PMC7003849 DOI: 10.1029/2019jc015281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/25/2019] [Accepted: 12/02/2019] [Indexed: 05/31/2023]
Abstract
Hydrographic data collected from research cruises, bottom-anchored moorings, drifting Ice-Tethered Profilers, and satellite altimetry in the Beaufort Gyre region of the Arctic Ocean document an increase of more than 6,400 km3 of liquid freshwater content from 2003 to 2018: a 40% growth relative to the climatology of the 1970s. This fresh water accumulation is shown to result from persistent anticyclonic atmospheric wind forcing (1997-2018) accompanied by sea ice melt, a wind-forced redirection of Mackenzie River discharge from predominantly eastward to westward flow, and a contribution of low salinity waters of Pacific Ocean origin via Bering Strait. Despite significant uncertainties in the different observations, this study has demonstrated the synergistic value of having multiple diverse datasets to obtain a more comprehensive understanding of Beaufort Gyre freshwater content variability. For example, Beaufort Gyre Observational System (BGOS) surveys clearly show the interannual increase in freshwater content, but without satellite or Ice-Tethered Profiler measurements, it is not possible to resolve the seasonal cycle of freshwater content, which in fact is larger than the year-to-year variability, or the more subtle interannual variations.
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Affiliation(s)
| | | | - J. M. Toole
- Woods Hole Oceanographic InstitutionWoods HoleMAUSA
| | | | - W. Williams
- Fisheries and Oceans CanadaInstitute of Ocean SciencesSidneyBritish ColumbiaCanada
| | - S. Zimmermann
- Fisheries and Oceans CanadaInstitute of Ocean SciencesSidneyBritish ColumbiaCanada
| | - M. Yamamoto‐Kawai
- Graduate School of Marine Science and TechnologyTokyo University of Marine Science and TechnologyTokyoJapan
| | - T. W. K. Armitage
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - D. Dukhovskoy
- Center for Ocean‐Atmospheric Prediction StudiesFlorida State UniversityTallahasseeFLUSA
| | - E. Golubeva
- Institute of Computational Mathematics and Mathematical GeophysicsSiberian Branch of Russian Academy of ScienceNovosibirskRussia
- Laboratory of Mathematical Modeling of Atmosphere and Hydrosphere ProcessesNovosibirsk State UniversityNovosibirskRussia
| | - G. E. Manucharyan
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - G. Platov
- Institute of Computational Mathematics and Mathematical GeophysicsSiberian Branch of Russian Academy of ScienceNovosibirskRussia
- Laboratory of Mathematical Modeling of Atmosphere and Hydrosphere ProcessesNovosibirsk State UniversityNovosibirskRussia
| | - E. Watanabe
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - T. Kikuchi
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - S. Nishino
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - M. Itoh
- Japan Agency for Marine‐Earth Science and TechnologyYokosukaJapan
| | - S.‐H. Kang
- Korea Polar Research InstituteIncheonRepublic of Korea
| | - K.‐H. Cho
- Korea Polar Research InstituteIncheonRepublic of Korea
| | - K. Tateyama
- Kitami Institute of TechnologyKitami, HokkaidoJapan
| | - J. Zhao
- Physical Oceanography LaboratoryOcean University of China, QingdaoChina
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Kawashima Y, Watanabe E, Umeyama T, Nakajima D, Hattori M, Honda K, Ohara O. Optimization of Data-Independent Acquisition Mass Spectrometry for Deep and Highly Sensitive Proteomic Analysis. Int J Mol Sci 2019; 20:ijms20235932. [PMID: 31779068 PMCID: PMC6928715 DOI: 10.3390/ijms20235932] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [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] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/20/2019] [Accepted: 11/23/2019] [Indexed: 02/07/2023] Open
Abstract
Data-independent acquisition (DIA)-mass spectrometry (MS)-based proteomic analysis overtop the existing data-dependent acquisition (DDA)-MS-based proteomic analysis to enable deep proteome coverage and precise relative quantitative analysis in single-shot liquid chromatography (LC)-MS/MS. However, DIA-MS-based proteomic analysis has not yet been optimized in terms of system robustness and throughput, particularly for its practical applications. We established a single-shot LC-MS/MS system with an MS measurement time of 90 min for a highly sensitive and deep proteomic analysis by optimizing the conditions of DIA and nanoLC. We identified 7020 and 4068 proteins from 200 ng and 10 ng, respectively, of tryptic floating human embryonic kidney cells 293 (HEK293F) cell digest by performing the constructed LC-MS method with a protein sequence database search. The numbers of identified proteins from 200 ng and 10 ng of tryptic HEK293F increased to 8509 and 5706, respectively, by searching the chromatogram library created by gas-phase fractionated DIA. Moreover, DIA protein quantification was highly reproducible, with median coefficients of variation of 4.3% in eight replicate analyses. We could demonstrate the power of this system by applying the proteomic analysis to detect subtle changes in protein profiles between cerebrums in germ-free and specific pathogen-free mice, which successfully showed that >40 proteins were differentially produced between the cerebrums in the presence or absence of bacteria.
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Affiliation(s)
- Yusuke Kawashima
- Department of Applied Genomics, Kazusa DNA Research Institute, Chiba 292-0818, Japan; (Y.K.); (D.N.)
| | - Eiichiro Watanabe
- Laboratory for Gut Homeostasis, RIKEN Center for Integrative Medical Sciences, Kanagawa 230-0045, Japan; (E.W.); (K.H.)
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan
- Department of Pediatric Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Taichi Umeyama
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa 230-0045, Japan; (T.U.); (M.H.)
| | - Daisuke Nakajima
- Department of Applied Genomics, Kazusa DNA Research Institute, Chiba 292-0818, Japan; (Y.K.); (D.N.)
| | - Masahira Hattori
- Laboratory for Microbiome Sciences, RIKEN Center for Integrative Medical Sciences, Kanagawa 230-0045, Japan; (T.U.); (M.H.)
- Graduate School of Advanced Science and Engineering, Waseda University, Tokyo 169-8555, Japan
| | - Kenya Honda
- Laboratory for Gut Homeostasis, RIKEN Center for Integrative Medical Sciences, Kanagawa 230-0045, Japan; (E.W.); (K.H.)
- Department of Microbiology and Immunology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Osamu Ohara
- Department of Applied Genomics, Kazusa DNA Research Institute, Chiba 292-0818, Japan; (Y.K.); (D.N.)
- Laboratory for Integrative Genomics, RIKEN Center for Integrative Medical Sciences, Kanagawa 230-0045, Japan
- Correspondence: ; Tel.: +81-438-52-391; Fax: +81-438-52-3914
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Harada M, Motoike Y, Nomura Y, Nishimura A, Nagasaka R, Koshikawa M, Ichikawa T, Watanabe E, Ozaki Y. P1901Use of direct thrombin inhibitor on the day of atrial fibrillation ablation decreases incidence of silent cerebral ischemia detected by magnetic resonance imaging. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0648] [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: 11/12/2022] Open
Abstract
Abstract
Background
There is increasing evidence to use direct oral anticoagulants (DOACs) in atrial fibrillation (AF) ablation. Uninterrupted use of DOACs is recommended for peri-procedural anticoagulation; the ways of choosing and/or using DOACs depend on physicians' decisions and preferences. Uninterrupted dabigatran (DAB), a direct thrombin inhibitor, reportedly decreased the risk of major bleeding (MB) in AF ablation, compared to uninterrupted warfarin (NEJM 2017; 376:1627). Among DOACs, only regular-dose of DAB (150 mg b.i.d.), showed superiority to warfarin for preventing ischemic thromboembolism (TE) in patients with non-valvular AF, implicating the powerful anti-thrombotic agent. DAB may decrease the potential risk of procedure-related TE.
Purpose
To evaluate whether use of DAB on the day of AF ablation decreases the prevalence of silent cerebral ischemia (SCI) detected by magnetic resonance imaging (MRI).
Methods
414 AF patients on DOACs were enrolled and admitted on the day before AF ablation. Among 354 patients on factor Xa inhibitors (rivaroxaban, apixaban, and edoxaban), the original DOACs were switched to DAB (150 mg b.i.d.) on the day of the procedure in 172 patients (Group D); the treatment remained unchanged in 182 patients (Group non-D). In both groups, DOACs were continuously used throughout the procedure. After propensity-score matching, procedure-related parameters/events and the incidence of MRI-detected SCI were compared between Group D (n=134) and Group non-D (n=134). These parameters in patients originally taking DAB, used without interruption during the procedure (uninterrupted DAB, n=55), were also compared to Group D (n=55) after propensity-score matching.
Results
Baseline activated clotting time (ACT) before initial heparin injection was increased in Group D vs. Group-non-D (179±25* vs. 146±23 sec, *p<0.05 vs. Group non-D). The time to achieve optimal ACT (>300 sec) was shorter in Group D (34±29* vs. 43±32 min). The amounts of heparin needed to achieve optimal ACT and the total amount of heparin used during the procedure were unchanged between Group D and Group non-D. The incidence of SCI decreased in Group D (13.1%* vs. 21.9%), suggesting the potential anti-thrombotic efficacy of DAB. No MB or symptomatic TE events were observed in either group. Baseline ACT, the time to achieve ACT >300 sec, and the incidence of SCI in Group D were comparable to those in uninterrupted DAB (183±38 vs. 181±32 sec, 39±31 vs. 42±28 min, and 14.5% vs. 16.4%, respectively). No MB or symptomatic TE events were observed either in Group D or uninterrupted DAB.
Conclusions
Temporarily switching to DAB from the other DOACs and using it on the day of procedure enable us to achieve optimal ACT quickly and decrease the incidence of SCI, showing similar potential anti-thrombotic efficacy to uninterrupted DAB. Use of DAB on the day of AF ablation also benefits from the availability of its antidote in the case of MB during the procedure.
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Affiliation(s)
- M Harada
- Fujita Health University, Toyoake, Japan
| | - Y Motoike
- Fujita Health University, Toyoake, Japan
| | - Y Nomura
- Fujita Health University, Toyoake, Japan
| | | | - R Nagasaka
- Fujita Health University, Toyoake, Japan
| | | | - T Ichikawa
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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28
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Kinoshita T, Hashimoto K, Yoshioka K, Miwa Y, Yodogawa K, Watanabe E, Nakamura K, Nakagawa M, Nakamura K, Watanabe T, Yusu S, Tachibana M, Nakahara S, Mizumaki K, Ikeda T. P5639Risk stratification for mortality using electrocardiographic markers based on 24-hour holter recordings: the JANIES-SHD study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0582] [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
Recent guidelines have stated that reduced left ventricular ejection fraction (LVEF) is the gold standard marker for identifying patients at risk for cardiac mortality. Although reduced LVEF identifies patients at an increased risk of cardiac arrest, sudden cardiac deaths (SCDs) occur considerably more often in patients with relatively preserved LVEF. Current guidelines on SCD risk stratification do not adequately cover this general population pool. Several noninvasive electrocardiographic (ECG) risk stratifiers that reflect depolarization abnormality, repolarization abnormality, and autonomic imbalance have been evaluated so far. With current therapeutic advances using new medicines or devices, an LVEF is often preserved in patients with structural heart disease (SHD). However, the usefulness of noninvasive ECG markers for risk stratification in such a patient population has not yet been elucidated.
Purpose
This study aimed to assess clinical indices and ECG markers based on 24-hour Holter ECG recordings for predicting cardiac mortality in patients with SHD who have left ventricular dysfunction (LVD) but relatively preserved LVEF.
Methods
In total, 1,829 patients were enrolled into the Japanese Multicenter Observational Prospective Study (JANIES study). In this study, we analyzed data of 719 patients (569 men, age 64±13 years) with SHD including mainly ischemic heart disease (65.8%). As ECG markers based on 24-hour Holter recordings, nonsustained ventricular tachycardia (NSVT), ventricular late potentials, and heart rate turbulence (HRT) were assessed. The primary endpoint was all-cause mortality, and the secondary endpoint was fatal arrhythmic events.
Results
During a mean follow-up of 21±11 months, all-cause mortality was eventually observed in 39 patients (5.4%). Among those patients, 32 patients (82%) suffered from cardiac causes such as heart failure and arrhythmia. Multivariate Cox regression analysis showed that after adjustment for age and LVEF, documented NSVT (hazard ratio=2.82, 95% confidence interval [CI]: 1.38–5.76, P=0.005) and abnormal HRT (hazard ratio=2.31, 95% CI: 1.15–4.65, P=0.02) were significantly associated with the primary endpoint. These two ECG markers also had significant predictive values with the secondary endpoint. The combined assessment documented NSVT and abnormal HRT improved predictive accuracy.
Conclusion
This study demonstrated that combined assessment of documented NSVT and abnormal HRT based on 24-hour Holter ECG recordings are recommended for predicting future serious events in SHD patients who have relatively preserved LVEF.
Acknowledgement/Funding
Grants-in-Aid (21590909, 24591074, and 15K09103 to T.I.) for Scientific Research from the Ministry of Education, Culture, Sports, Science, and Technol
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Affiliation(s)
- T Kinoshita
- Toho University Faculty of Medicine, Tokyo, Japan
| | - K Hashimoto
- National Defense Medical College, Saitama, Japan
| | - K Yoshioka
- Tokai University School of Medicine, Kanagawa, Japan
| | - Y Miwa
- Kyorin University, Tokyo, Japan
| | - K Yodogawa
- Nippon Medical School Hospital, Tokyo, Japan
| | | | - K Nakamura
- Cardiovascular Hospital of Central Japan, Gunma, Japan
| | | | | | | | - S Yusu
- Inagi Municipal Hospital, Tokyo, Japan
| | | | - S Nakahara
- Dokkyo Medical University, Tochigi, Japan
| | | | - T Ikeda
- Toho University Faculty of Medicine, Tokyo, Japan
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Nakao R, Nagao M, Momose M, Kasuga N, Matsuo Y, Fukushima K, Watanabe E, Sakai A, Hagiwara N. P3354Papillary muscle ischemia and global myocardial flow reserve: assessment by high-resolution cine imaging of 13N ammonia PET. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0230] [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: 11/12/2022] Open
Abstract
Abstract
Purpose
Papillary muscle ischemia (PMI) is caused by micro-vessels' occlusion in the broad endocardium because papillary muscle perfusion is supply from micro-vessels of peripheral coronary arteries and is easy to fail by the increase in peripheral vascular resistance. However, the clinical significant is not understood because PMI could not be detected by existing perfusion imaging such as SPECT and MRI. We propose the detection method of PMI using 13N-ammonia PET (NH3-PET), and investigate the association with the global myocardial flow reserve (Global-MFR) reflecting coronary microvascular dysfunction.
Methods
Data of adenosine-stress NH3-PET for consecutive 260 patients with coronary artery disease (CAD) or suspected CAD was retrospectively analyzed. Using high-resolution cine imaging derived from NH3-PET, PMI was defined as the absence of the PM accumulation at stress conditions. Myocardial flow was generated from the time activity curve of left ventricle input and myocardial uptake using 3-compartment model and the first 2 minutes' dataset of list mode images. Global-MFR was calculated by stress to rest flow ratio. Summed stress score (SSS) was used as an estimate of the extent of myocardial ischemia. 150 out of 260 patients (58%) with SSS ≥4 or with the past history of coronary artery diseases were classified as ischemic group, and 110 patients (42%) with SSS<4 were classified as non-ischemic group.
Results
PMI was seen in 68 of 260 patients (26.6%). The frequency of PMI was higher in the ischemic group than the non-ischemic group (37.8% vs. 10.1%, p<0.0001). Global-MFR was significantly lower in patients with PMI than those without (1.87±0.55 vs. 2.39±0.80, p<0.0001). In both ischemic and non-ischemic group, global-MFR was significantly reduced in patients with PMI. (Ischemic group: 1.83±0.56 vs. 2.12±0.52, p=0.0043, Non-ischemic group: 2.06±0.45 vs. 2.63±0.91, p=0.040).
Typical case of PMI
Conclusion
High-resolution cine imaging derived from NH3-PET makes it possible to detect PMI in about a quarter of patients with CAD or suspected CAD. PMI associates with reduced Global-MFR regardless of the presence of myocardial ischemia, suggesting that PMI is an important sign of early ischemia confined to the papillary muscle or the broad microvascular injury.
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Affiliation(s)
- R Nakao
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - M Momose
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - N Kasuga
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - Y Matsuo
- Tokyo Womens Medical University, Department of Diagnostic Imaging and Nuclear Medicine, Tokyo, Japan
| | - K Fukushima
- Saitama International Medical Center, Department of Nuclear Medicine, Cardiology, Hidaka, Japan
| | - E Watanabe
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
| | - N Hagiwara
- Tokyo Womens Medical University, Department of Cardiology, Tokyo, Japan
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Watanabe E, Yamashita T, Inoue H, Atarashi H, Okumura K, Kodani E, Origasa H, Kiyono K. P5668A decision-support tool framework to predict adverse outcome in patients with atrial fibrillation: J-Rhythm registry substudy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0611] [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: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is associated with increased mortality and morbidity. Modelling the risk of thrombosis, major bleeding and total mortality are often limited by the inadequate number of independent predictors.
Purpose
We compared the predictive accuracy of the decision-support tool framework and conventional risk score in AF patients.
Methods
We used data of AF patients enrolled into the nationwide AF registry. A random forest model was implemented to predict each outcome, and its predictive power was tested by a 5-fold cross-validation.
Results
We analyzed 7,937 patients with AF (age 70±10 years, female 31%). The type of AF was paroxysmal (37%), persistent (14%), and permanent (49%). The number of antithrombotic treatments were follows: warfarin only (n=5461), antiplatelet only (n=581), both warfarin and antiplatelet (n=1471) and no antithrombotic agents (424). The mean CHA2DS2-VASc score was 2.8±1.6 and HAS-BLED score was 2.7±1.2, respectively. We selected 20 from 50 clinical parameters and compared by the area-under-curve with the CHA2DS2-VASc score for thromboses and the HAS-BLED score for major bleeding. During the 2-year follow-up, 126 patients (1.6%) had thromboses, 140 (1.8%) had major bleeding, and 195 (2.5%) died. A random forest model had a higher value of the area-under-curve for predicting thromboses compared with the CHA2DS2-VASc (0.66 vs. 0.61, P<0.05), and had a significantly higher area-under-curve for major bleeding compared with the HAS-BLED (0.67 vs. 0.61, P<0.05). The area-under-curve for the all-cause mortality was 0.77.
Conclusions
A random forest model has a higher accuracy than conventional risk scheme in predicting thromboses and major bleeding, in addition to total mortality.
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Affiliation(s)
- E Watanabe
- Fujita Health University School of Medicine, Toyoake, Japan
| | | | - H Inoue
- Saiseikai Toyama Hospital, Toyama, Japan
| | - H Atarashi
- Minami Hachioji Hospital, Hachioji, Japan
| | - K Okumura
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - E Kodani
- Nippon Medical School, Tokyo, Japan
| | | | - K Kiyono
- Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
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Ishii J, Takahashi H, Nishimura T, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Hayashi M, Motoyama S, Sarai M, Watanabe E, Izawa H, Ozaki Y. P4620Circulating concentration of presepsin improves early prediction of short-term mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocytic activation. Presepsin appears to be an accurate diagnostic marker of sepsis, but its clinical significance remains unclear in cardiovascular disease.
Purpose
This prospective study aimed to investigate the predictive value of plasma presepsin levels on admission to medical (non-surgical) cardiac intensive care units (MCICUs) for short-term mortality.
Methods
We examined 1560 patients hospitalized in MCICUs and measured the baseline plasma presepsin levels at admission.
Results
Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Before MCICUs admission, emergent coronary angiography or percutaneous coronary intervention was performed in 36%, mechanical ventilation was required for respiratory insufficiency in 2.1%, and intraaortic balloon pumps were needed for hemodynamic instability in 8.9%. During 6 months after admission, there were 113 (7.2%) deaths. Patients who died were older (median: 77 vs. 71 years, P<0.0001); had higher levels of presepsin (263 vs. 119 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 696 vs. 186 pg/mL, P<0.0001), high-sensitivity troponin T (hsTnT: 81 vs. 47 pg/mL, P=0.004), and high-sensitivity C-reactive protein (13.8 vs. 2.2 mg/L, P<0.0001); and had lower levels of estimated glomerular filtration rate (50 vs. 65 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (43% vs. 51%, P<0.0001) than those of the survivors. In the multivariate Cox regression analysis, higher levels of presepsin (P=0.0002), BNP (P=0.04), and hsTnT (P=0.009) were all independent predictors of 6-month deaths. Quartiles of presepsin levels were associated with higher mortality rates within 6 months after admission (Table). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsTnT further enhanced reclassification (P=0.004) and discrimination (P=0.003) beyond that of the baseline model.
Mortality rates according to presepsin Presepsin quartile 1st 2nd 3rd 4th P value ≤80 pg/mL 81–124 pg/mL 125–232 pg/mL >232 pg/mL 1-month mortality 0.8% 2.0% 3.3% 8.0% <0.0001 6-month mortality 0.8% 3.8% 8.2% 16.3% <0.0001
Conclusions
Presepsin levels at admission could improve the prediction of short-term mortality in patients hospitalized at MCICUs.
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Hayashi
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Sarai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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Lopes LKO, Costa DM, Tipple AFV, Watanabe E, Castillo RB, Hu H, Deva AK, Vickery K. Complex design of surgical instruments as barrier for cleaning effectiveness, favouring biofilm formation. J Hosp Infect 2018; 103:e53-e60. [PMID: 30423413 DOI: 10.1016/j.jhin.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 11/02/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Inadequately reprocessed reusable surgical instruments (RSIs) may harbour infectious agents which may then be transferred to a suitable site for replication. AIM To determine the cumulative effect of 20 cycles of contamination, cleaning (manual or manual followed by automated) and steam sterilization on high-complex-design RSIs used for orthopaedic surgery. METHODS New flexible medullary reamers and depth gauges were contaminated by soaking in tryptone soya broth, containing 5% sheep blood and 109 cfu/mL of Staphylococcus aureus (ATCC 25923), for 5 min. To mimic a worse-case scenario, RSIs were dried 7 h and subjected to either (a) rinsing in distilled water, (b) manual cleaning or (c) manual plus automated cleaning (reference standard), and steam sterilization. The contamination, cleaning, and sterilization cycle was repeated 20 times. Adenosine triphosphate (ATP) was measured after cleaning procedures; microbial load and residual protein were measured following the 10th and 20th reprocessing, in triplicate. Scanning electron microscopy (SEM) was used to confirm soil and biofilm presence on the RSIs after the 20th reprocessing. FINDINGS Manual and manual plus automated cleaning significantly reduced the amount of ATP and protein residues for all RSIs. Viable bacteria were not detected following sterilization. However, SEM detected soil after automated cleaning, and soil, including biofilms, after manual cleaning. CONCLUSION Soil and/or biofilms were evident on complex-design RSIs following 20 cycles of contamination and reprocessing, even using the reference standard method of cleaning. Although the depth gauges could be disassembled, biological residues and biofilm accumulated in its lumen. The current design of these RSIs prevents removal of all biological soil and this may have an adverse effect on patient outcome.
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Affiliation(s)
- L K O Lopes
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil; Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - D M Costa
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil; Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - A F V Tipple
- Faculty of Nursing, Federal University of Goiás, Goiânia, Brazil
| | - E Watanabe
- School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - R B Castillo
- Macquarie University Hospital, Macquarie University, Sydney, Australia
| | - H Hu
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - A K Deva
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - K Vickery
- Surgical Infection Research Group, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia.
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Abe T, Sakai A, Watanabe E, Nagao M, Sakai S, Hagiwara N. P3701Analysis of myocardial fibrosis using cardiac magnetic resonance T1 imaging and late gadolinium enhancement: Association with ventricular tachycardia in hypertrophic cardiomyopathy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3701] [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)
- T Abe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - A Sakai
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - E Watanabe
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
| | - M Nagao
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - S Sakai
- Tokyo Women's Medical University, Department of Diagnostic Imaging & Nuclear Medicine, Tokyo, Japan
| | - N Hagiwara
- Tokyo Women's Medical University, cardiology, Tokyo, Japan
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Komatsu K, Morita Y, Watanabe E, Tsuya D, Watanabe K, Taniguchi T, Moriyama S. Observation of the quantum valley Hall state in ballistic graphene superlattices. Sci Adv 2018; 4:eaaq0194. [PMID: 29795780 PMCID: PMC5959303 DOI: 10.1126/sciadv.aaq0194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/04/2018] [Indexed: 06/08/2023]
Abstract
In graphene superlattices, bulk topological currents can lead to long-range charge-neutral flow and nonlocal resistance near Dirac points. A ballistic version of these phenomena has never been explored. We report transport properties of ballistic graphene superlattices. This allows us to study and exploit giant nonlocal resistances with a large valley Hall angle without a magnetic field. In a low-temperature regime, a crossover occurs toward a new state of matter, referred to as a quantum valley Hall state (qVHS), which is an analog of the quantum Hall state without a magnetic field. Furthermore, a nonlocal resistance plateau, implying rigidity of the qVHS, emerges as a function of magnetic field, and this plateau collapses, which is considered a manifestation of valley/pseudospin magnetism.
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Affiliation(s)
- Katsuyosih Komatsu
- International Center for Materials Nanoarchitectonics, National Institute for Materials Science (NIMS), Tsukuba, Ibaraki 305-0044, Japan
| | - Yoshifumi Morita
- Faculty of Engineering, Gunma University, Kiryu, Gunma 376-8515, Japan
| | | | - Daiju Tsuya
- Nanofabrication Platform, NIMS, Tsukuba, Ibaraki 305-0047, Japan
| | - Kenji Watanabe
- Research Center for Functional Materials, NIMS, Tsukuba, Ibaraki 305-0044, Japan
| | - Takashi Taniguchi
- Research Center for Functional Materials, NIMS, Tsukuba, Ibaraki 305-0044, Japan
| | - Satoshi Moriyama
- International Center for Materials Nanoarchitectonics, National Institute for Materials Science (NIMS), Tsukuba, Ibaraki 305-0044, Japan
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Atarashi K, Suda W, Luo C, Kawaguchi T, Motoo I, Narushima S, Kiguchi Y, Yasuma K, Watanabe E, Tanoue T, Thaiss CA, Sato M, Toyooka K, Said HS, Yamagami H, Rice SA, Gevers D, Johnson RC, Segre JA, Chen K, Kolls JK, Elinav E, Morita H, Xavier RJ, Hattori M, Honda K. Ectopic colonization of oral bacteria in the intestine drives T H1 cell induction and inflammation. Science 2018; 358:359-365. [PMID: 29051379 DOI: 10.1126/science.aan4526] [Citation(s) in RCA: 513] [Impact Index Per Article: 85.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/07/2017] [Indexed: 12/20/2022]
Abstract
Intestinal colonization by bacteria of oral origin has been correlated with several negative health outcomes, including inflammatory bowel disease. However, a causal role of oral bacteria ectopically colonizing the intestine remains unclear. Using gnotobiotic techniques, we show that strains of Klebsiella spp. isolated from the salivary microbiota are strong inducers of T helper 1 (TH1) cells when they colonize in the gut. These Klebsiella strains are resistant to multiple antibiotics, tend to colonize when the intestinal microbiota is dysbiotic, and elicit a severe gut inflammation in the context of a genetically susceptible host. Our findings suggest that the oral cavity may serve as a reservoir for potential intestinal pathobionts that can exacerbate intestinal disease.
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Affiliation(s)
- Koji Atarashi
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Wataru Suda
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan.,Cooperative Major in Advanced Health Science, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Chengwei Luo
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Takaaki Kawaguchi
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Iori Motoo
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Seiko Narushima
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Yuya Kiguchi
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan
| | - Keiko Yasuma
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Eiichiro Watanabe
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Takeshi Tanoue
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.,RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Christoph A Thaiss
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Mayuko Sato
- RIKEN Center for Sustainable Resource Science, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Kiminori Toyooka
- RIKEN Center for Sustainable Resource Science, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
| | - Heba S Said
- Cooperative Major in Advanced Health Science, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan.,Department of Microbiology and Immunology, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Hirokazu Yamagami
- Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Scott A Rice
- The Singapore Centre for Environmental Life Sciences Engineering, The School of Biological Sciences, Nanyang Technological University, Singapore
| | - Dirk Gevers
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Ryan C Johnson
- Microbial Genomics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Julia A Segre
- Microbial Genomics Section, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kong Chen
- Richard King Mellon Foundation Institute for Pediatric Research, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
| | - Jay K Kolls
- Richard King Mellon Foundation Institute for Pediatric Research, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA 15224, USA
| | - Eran Elinav
- Department of Immunology, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Hidetoshi Morita
- Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan
| | - Ramnik J Xavier
- Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.,Center for Computational and Integrative Biology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Masahira Hattori
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8561, Japan. .,Cooperative Major in Advanced Health Science, Graduate School of Advanced Science and Engineering, Waseda University, Tokyo, Japan
| | - Kenya Honda
- Department of Microbiology and Immunology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. .,RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama, Kanagawa 230-0045, Japan
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Valenza G, Wendt H, Kiyono K, Hayano J, Watanabe E, Yamamoto Y, Abry P, Barbieri R. Multiscale properties of instantaneous parasympathetic activity in severe congestive heart failure: A survivor vs non-survivor study. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2017:3761-3764. [PMID: 29060716 DOI: 10.1109/embc.2017.8037675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Multifractal analysis of cardiovascular variability series is an effective tool for the characterization of pathological states associated with congestive heart failure (CHF). Consequently, variations of heartbeat scaling properties have been associated with the dynamical balancing of nonlinear sympathetic/vagal activity. Nevertheless, whether vagal dynamics has multifractal properties yet alone is currently unknown. In this study, we answer this question by conducting multifractal analysis through wavelet leader-based multiscale representations of instantaneous series of vagal activity as estimated from inhomogeneous point process models. Experimental tests were performed on data gathered from 57 CHF patients, aiming to investigate the automatic recognition accuracy in predicting survivor and non-survivor patients after a 4 years follow up. Results clearly indicate that, on both CHF groups, the instantaneous vagal activity displays power-law scaling for a large range of scales, from ≃ 0.5s to ≃ 100s. Using standard SVM algorithms, this information also allows for a prediction of mortality at a single-subject level with an accuracy of 72.72%.
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Takayasu L, Suda W, Watanabe E, Fukuda S, Takanashi K, Ohno H, Takayasu M, Takayasu H, Hattori M. A 3-dimensional mathematical model of microbial proliferation that generates the characteristic cumulative relative abundance distributions in gut microbiomes. PLoS One 2017; 12:e0180863. [PMID: 28792501 PMCID: PMC5549704 DOI: 10.1371/journal.pone.0180863] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 06/22/2017] [Indexed: 12/14/2022] Open
Abstract
The gut microbiome is highly variable among individuals, largely due to differences in host lifestyle and physiology. However, little is known about the underlying processes or rules that shape the complex microbial community. In this paper, we show that the cumulative relative abundance distribution (CRAD) of microbial species can be approximated by a power law function, and found that the power exponent of CRADs generated from 16S rRNA gene and metagenomic data for normal gut microbiomes of humans and mice was similar consistently with ∼0.9. A similarly robust power exponent was observed in CRADs of gut microbiomes during dietary interventions and several diseases. However, the power exponent was found to be ∼0.6 in CRADs from gut microbiomes characterized by lower species richness, such as those of human infants and the small intestine of mice. In addition, the CRAD of gut microbiomes of mice treated with antibiotics differed slightly from those of infants and the small intestines of mice. Based on these observations, in addition to data on the spatial distribution of microbes in the digestive tract, we developed a 3-dimensional mathematical model of microbial proliferation that reproduced the experimentally observed CRAD patterns. Our model indicated that the CRAD may be determined by the ratio of emerging to pre-existing species during non-uniform spatially competitive proliferation, independent of species composition.
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MESH Headings
- Animals
- Anti-Bacterial Agents/pharmacology
- Cell Proliferation/physiology
- Colon/drug effects
- Colon/metabolism
- Colon/microbiology
- Colon/pathology
- Computer Simulation
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/microbiology
- Diet, Vegetarian
- Feces/microbiology
- Gastrointestinal Microbiome/physiology
- Humans
- Infant
- Infant, Newborn
- Inflammatory Bowel Diseases/metabolism
- Inflammatory Bowel Diseases/microbiology
- Intestine, Small/drug effects
- Intestine, Small/metabolism
- Intestine, Small/microbiology
- Intestine, Small/pathology
- Mice
- Models, Biological
- Multiple Sclerosis/metabolism
- Multiple Sclerosis/microbiology
- RNA, Ribosomal, 16S/metabolism
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Affiliation(s)
- Lena Takayasu
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5, Kashiwanoha, Kashiwa, Chiba, 277-8561, Japan
| | - Wataru Suda
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5, Kashiwanoha, Kashiwa, Chiba, 277-8561, Japan
- School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Eiichiro Watanabe
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
| | - Shinji Fukuda
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
- Institute for Advanced Biosciences, Keio University, 246-2 Mizukami, Kakuganji, Tsuruoka, Yamagata, 997-0052, Japan
| | - Kageyasu Takanashi
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5, Kashiwanoha, Kashiwa, Chiba, 277-8561, Japan
| | - Hiroshi Ohno
- RIKEN Center for Integrative Medical Sciences, 1-7-22 Suehiro-cho, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
| | - Misako Takayasu
- Institute of Innovative Research, Tokyo Institute of Technology, G3-52, 4259, Nagatsutacho, Midori-ku, Yokohama-shi, Kanagawa 226-8502, Japan
| | - Hideki Takayasu
- Sony Computer Science Laboratories, Inc. 3-14-13, Higashigotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Masahira Hattori
- Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5, Kashiwanoha, Kashiwa, Chiba, 277-8561, Japan
- Graduate School of Advanced Science and Engineering, Waseda University, 3-4-1 Okubo Shinjuku-ku, Tokyo, 169-8555, Japan
- * E-mail:
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Amino M, Yoshioka K, Ichikawa T, Watanabe E, Nakamura M, Hashida T, Kanda S, Ikari Y. P5528The positive result of late potential after percutaneous coronary intervention for acute coronary syndromes may help the evaluation of the cardiovascular events. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5528] [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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Watanabe E, Smith DM, Delcarpio JB, Sun J, Smart FW, Van Meter CH, Claycomb WC. Cardiomyocyte Transplantation in a Porcine Myocardial Infarction Model. Cell Transplant 2017; 7:239-46. [PMID: 9647433 DOI: 10.1177/096368979800700302] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Transplantation of cardiomyocytes into the heart is a potential treatment for replacing damaged cardiac muscle. To investigate the feasibility and efficiency of this technique, either a cardiac-derived cell line (HL-1 cells), or normal fetal or neonatal pig cardiomyocytes were grafted into a porcine model of myocardial infarction. The myocardial infarction was created by the placement of an embolization coil in the distal portion of the left anterior descending artery in Yorkshire pigs (n = 9). Four to 5 wk after creation of an infarct, the three preparations of cardiomyocytes were grafted, at 1 × 106 cells/20 μL into normal and into the middle of the infarcted myocardium. The hearts were harvested and processed for histologic examinations 4 to 5 wk after the cell grafts. Histologic evaluation of the graft sites demonstrated that HL-1 cells and fetal pig cardiomyocytes formed stable grafts within the normal myocardium without any detrimental effect including arrhythmia. In addition, a marked increase in angiogenesis was observed both within the grafts and adjacent host myocardium. Electron microscopy studies demonstrated that fetal pig cardiomyocytes and the host myocardial cells were coupled with adherens-type junctions and gap junctions. Histologic examination of graft sites from infarct tissue failed to show the presence of grafted HL-1 cells, fetal, or neonatal pig cardiomyocytes. Cardiomyocyte transplantation may provide the potential means for cell-mediated gene therapy for introduction of therapeutic molecules into the heart.
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Affiliation(s)
- E Watanabe
- Department of Biochemistry and Molecular Biology, Louisiana State University Medical Center, New Orleans 70112, USA
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Maruyama K, Watanabe E, Saito K, Sato K, Yoshida H, Kume S, Noguchi A, Shiokawa Y, Nagane M. P04.17 Novel augmented reality-based neuronavigation using smart glasses and clinical application to brain tumor surgery. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.157] [Citation(s) in RCA: 3] [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] [Indexed: 11/13/2022] Open
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41
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Ichihara G, Suzuki Y, Watanabe E, Hayashida A, Osada Y, Furutani T, Izuoka K, Ichihara S. Effect of physicochemical characteristics of nano-sized titanium dioxide on adhesion of monocytes to endothelial cells. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.06.1948] [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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42
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Tsujimura M, Fujita T, Endo S, Nagai S, Watanabe E. AB1030 Effects of Conducting Directly Observed Treatment, Short-Course (DOTS) Strategy and Conferences on Latent Tuberculosis Infection in Rheumatoid Arthritis Patients Undergoing Immunosuppressive Therapy. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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43
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Valenza G, Wendt H, Kiyono K, Hayano J, Watanabe E, Yamamoto Y, Abry P, Barbieri R. Point-process high-resolution representations of heartbeat dynamics for multiscale analysis: A CHF survivor prediction study. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:1951-4. [PMID: 26736666 DOI: 10.1109/embc.2015.7318766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Multiscale analysis of human heartbeat dynamics has been proved effective in characterizeing cardiovascular control physiology in health and disease. However, estimation of multiscale properties can be affected by the interpolation procedure used to preprocess the unevenly sampled R-R intervals derived from the ECG. To this extent, in this study we propose the estimation of wavelet coefficients and wavelet leaders on the output of inhomogeneous point process models of heartbeat dynamics. The RR interval series is modeled using probability density functions (pdfs) characterizing and predicting the time until the next heartbeat event occurs, as a linear function of the past history. Multiscale analysis is then applied to the pdfs' instantaneous first order moment. The proposed approach is tested on experimental data gathered from 57 congestive heart failure (CHF) patients by evaluating the recognition accuracy in predicting survivor and non-survivor patients, and by comparing performances from the informative point-process based interpolation and non-informative spline-based interpolation. Results demonstrate that multiscale analysis of point-process high-resolution representations achieves the highest prediction accuracy of 65.45%, proving our method as a promising tool to assess risk prediction in CHF patients.
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Wendt H, Kiyono K, Abry P, Hayano J, Watanabe E, Yamamoto Y. Multiscale wavelet p-leader based heart rate variability analysis for survival probability assessment in CHF patients. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:2809-12. [PMID: 25570575 DOI: 10.1109/embc.2014.6944207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A priori discrimination of high mortality risk amongst congestive heart failure patients constitutes an important clinical stake in cardiology and involves challenging analyses of the temporal dynamics of heart rate variability (HRV). The present contribution investigates the potential of a new multifractal formalism, constructed on wavelet p-leader coefficients, to help discrimination between survivor and non survivor patients. The formalism, applied to a high quality database of 108 patients collected in a Japanese hospital, enables to assess the existence of multifractal properties amongst congestive heart failure patients and to reveal significant differences in the multiscale properties of HRV between survivor and non survivor patients, for scales ranging from approximately 60 to 250 beats.
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Tsuchiya R, Lee J, Watanabe E, Park J, Fukahori A, Mori K, Kawakubo K. Socio-demographic characteristics and daily physical activity among rural Japanese residents with back pain and knee pain. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1534] [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]
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46
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Ishiguro R, Watanabe E, Sakuma D, Shinozaki T, Tsuchiya S, Nago Y, Osato H, Tsuya D, Kashiwaya H, Kashiwaya S, Nomura S, Takayanagi H, Maeno Y. Development of nano and micro SQUIDs based on Al tunnel junctions. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/1742-6596/568/2/022019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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47
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Higashiyama R, Aikawa J, Iwase D, Minatani A, Watanabe H, Yoshihira T, Kenmoku T, Fukushima K, Watanabe E, Takaso M. Arthroscopic anterior talofibular ligament reconstruction using an autogenic gracilis tendon. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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48
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Watanabe E, Tanaka K, Takeda N, Watanabe M. Six cases of life-threatening peptic ulcer bleeding associated with virus infection. Journal of Pediatric Surgery Case Reports 2014. [DOI: 10.1016/j.epsc.2014.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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49
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Sato M, Toriumi T, Watanabe N, Watanabe E, Akita D, Mashimo T, Akiyama Y, Isokawa K, Shirakawa T, Honda MJ. Characterization of mesenchymal progenitor cells in crown and root pulp from human mesiodentes. Oral Dis 2014; 21:e86-97. [PMID: 24605962 DOI: 10.1111/odi.12234] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 01/08/2014] [Accepted: 02/02/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Mesiodentes are usually found in the central position of the upper or lower jaw as supernumerary teeth. Here, we obtained 10 mesiodentes and three permanent teeth (PT) and separated the dental pulp (DP) from these into crown and root portions. We then characterized and compared the isolated crown portion-derived cells (crown cells) with root portion-derived cells (root cells) using a range of in vitro assays. MATERIALS AND METHODS Crown cells and root cells were examined for cell surface marker expression, colony-forming unit-fibroblast (CFU-F), cell proliferation, cell cycle characteristics and markers, and osteogenic and adipogenic differentiation. RESULTS The proportion of CD105-positive cells (CD105(+) cells) in the crown cells vs the root cells varied among the mesiodentes, but not among the PT. When there were more CD105(+) cells in the root cells than in the crown cells, the root cells showed higher CFU-F, proliferation capacity, and osteogenic differentiation capacity. In contrast, when the crown cells contained more CD105(+) cells than the root cells, the crown cells showed the higher CFU-F, proliferation capacity, and osteogenic differentiation capacity. In addition, the sorted CD105(+) cells showed higher CFU-F and proliferation capacity than the sorted CD105(-) cells. CONCLUSION These results indicated that proportion of CD105(+) cells is an effective means of characterizing DP-derived cells in mesiodentes.
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Affiliation(s)
- M Sato
- Nihon University Graduate School of Dentistry, Tokyo, Japan
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50
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Guerreiro-Tanomaru JM, Nascimento CA, Faria-Júnior NB, Graeff MSZ, Watanabe E, Tanomaru-Filho M. Antibiofilm activity of irrigating solutions associated with cetrimide. Confocal laser scanning microscopy. Int Endod J 2014; 47:1058-63. [PMID: 24433253 DOI: 10.1111/iej.12248] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/10/2014] [Indexed: 02/02/2023]
Abstract
AIM To evaluate the antibiofilm activity of sodium hypochlorite (NaOCl) and chlorhexidine (CHX) solutions associated with cetrimide (CTR), and QMiX using confocal laser scanning microscopy. METHODOLOGY Enterococcus faecalis (ATCC- 29212) biofilms were induced on bovine dentine blocks for 14 days. The dentine blocks containing biofilm were immersed for 1 min in the following solutions: 2.5% NaOCl; 2.5% NaOCl + 0.2% CTR; 2% CHX; 2% CHX + 0.2% CTR; 0.2% CTR; QMiX. After contact with the solutions, the dentine blocks were stained with Live/Dead(®) BacLight for analysis of the remaining biofilm using confocal laser scanning microscope. Images were evaluated using the BioImage_L software to determine the total biovolume (μm(3) ), the green biovolume (live cells) (μm(3) ) and the percentage of substrate coverage (%). The data were subjected to nonparametric statistical test using Kruskal-Wallis and Dunn's tests at 5% significance level. RESULTS After exposure to irrigants, the total biovolume observed for CHX, CHX+CTR, CTR, QMiX was similar to distilled water (P > 0.05). NaOCl and NaOCl+CTR had the lowest total and green biovolume. The CTR and QMiX had intermediate green biovolume, with greater antibacterial activity than CHX and CHX+CTR (P < 0.05). The NaOCl and NaOCl+CTR solutions were associated with microorganism removal and substrate cleaning ability. CONCLUSIONS NaOCl and NaOCl+CTR solutions were effective on microorganism viability and were able to eliminate biofilm. The addition of cetrimide did not influence antibacterial activity.
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Affiliation(s)
- J M Guerreiro-Tanomaru
- Department of Restorative Dentistry, Araraquara Dental School, UNESP (Univ Estadual Paulista), Araraquara, SP, Brazil
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