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Nagata I, Kawashima M, Miyazaki A, Miyoshi M, Sakuraya T, Sonomura T, Oyanagi E, Yano H, Arakawa T. Icing after skeletal muscle injury with necrosis in a small fraction of myofibers limits iNOS-expressing macrophage invasion and facilitates muscle regeneration. Am J Physiol Regul Integr Comp Physiol 2023; 324:R574-R588. [PMID: 36878487 DOI: 10.1152/ajpregu.00258.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Growing evidence from animal experiments suggests that icing after skeletal muscle injury is harmful to muscle regeneration. However, these previous experimental models yielded massive necrotic myofibers, whereas muscle injury with necrosis in a small myofiber fraction (<10%) frequently occurs in human sports activities. Although macrophages play a pro-reparative role during muscle regeneration, they exert a cytotoxic effect on muscle cells through an inducible nitric oxide synthase (iNOS)-mediated mechanism. In this study, we established an animal injury model with necrosis limited to a small myofiber fraction and investigated the effect of icing on muscle regeneration with a focus on macrophage-related events. Icing after muscle injury of this model resulted in an enlarged size of regenerating myofibers compared with those in untreated animals. During the regenerative process, icing attenuated the accumulation of iNOS-expressing macrophages, suppressed iNOS expression in the whole damaged muscle, and limited the expansion of the injured myofiber area. Additionally, icing increased the ratio of M2 macrophages within the injured site at an earlier time point than that in untreated animals. Following these phenomena in icing-treated muscle regeneration, an early accumulation of activated satellite cells within the damaged/regenerating area was occurred. The expression level of myogenic regulatory factors, such as MyoD and myogenin, was not affected by icing. Taken together, our results suggest that icing after muscle injury with necrosis limited to a small fraction of myofibers facilitates muscle regeneration by attenuating iNOS-expressing macrophage invasion, limiting muscle damage expansion, and accelerating the accumulation of myogenic cells which form regenerating myofibers.
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Affiliation(s)
- Itsuki Nagata
- Department of Rehabilitation Sciences, Kobe University, Kobe, Japan
| | - Masato Kawashima
- Department of Rehabilitation Sciences, Kobe University, Kobe, Japan.,Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Anna Miyazaki
- Department of Rehabilitation Sciences, Kobe University, Kobe, Japan
| | | | - Tohma Sakuraya
- Department of Rehabilitation Sciences, Kobe University, Kobe, Japan.,Department of Oral Anatomy, Asahi University, Gifu, Japan
| | | | - Eri Oyanagi
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Hiromi Yano
- Department of Health and Sports Science, Kawasaki University of Medical Welfare, Kurashiki, Japan.,Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
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Miyazaki A, Kawashima M, Nagata I, Miyoshi M, Miyakawa M, Sugiyama M, Sakuraya T, Sonomura T, Arakawa T. Icing after skeletal muscle injury decreases M1 macrophage accumulation and TNF-α expression during the early phase of muscle regeneration in rats. Histochem Cell Biol 2023; 159:77-89. [PMID: 36114866 DOI: 10.1007/s00418-022-02143-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2022] [Indexed: 02/07/2023]
Abstract
Following skeletal muscle injury, both myogenic and immune cells interact closely during the regenerative process. Although icing is still a common acute treatment for sports-related skeletal muscle injuries, icing after muscle injury has been shown to disrupt macrophage accumulation and impair muscle regeneration in animal models. However, it remains unknown whether icing shortly after injury affects macrophage-related phenomena during the early stages of muscle regeneration. Therefore, we focused on the distribution of M1/M2 macrophages and cytokines expressed predominantly by macrophages during the early stages of muscle regeneration after muscle crush injury. Icing resulted in a decrease, not retardation, in the accumulation of M1 macrophages, but not M2 macrophages, in injured muscles. Consistent with the decrease in M1 macrophage accumulation, icing led to a reduction, instead of delay, in the level of tumor necrosis factor-α (TNF-α) expression. Additionally, at subsequent timepoints, icing decreased the number of myogenic precursor cells in the regenerating area and the size of centrally nucleated regenerating myofibers. Together, our findings suggest that icing after acute muscle damage by crushing disturbs muscle regeneration through hindering tM1 macrophage-related phenomena.
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Affiliation(s)
- Anna Miyazaki
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Masato Kawashima
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.,Department of Health and Sports Science, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Itsuki Nagata
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Makoto Miyoshi
- Department of Biophysics, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Motoi Miyakawa
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.,Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Megumi Sugiyama
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.,General Tokyo Hospital, 3-15-2 Egota, Nakano-ku, Tokyo, 165-8906, Japan
| | - Tohma Sakuraya
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.,Department of Oral Anatomy, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Takahiro Sonomura
- Department of Oral Anatomy, Asahi University School of Dentistry, 1851 Hozumi, Mizuho, Gifu, 501-0296, Japan
| | - Takamitsu Arakawa
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
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Umemura T, Hatano T, Ogura T, Miyata T, Agawa Y, Nakajima H, Tomoyose R, Sakamoto H, Tsujimoto Y, Nakazawa Y, Wakabayashi T, Hashimoto T, Fujiki R, Shiraishi W, Nagata I. ADC Level is Related to DWI Reversal in Patients Undergoing Mechanical Thrombectomy: A Retrospective Cohort Study. AJNR Am J Neuroradiol 2022; 43:893-898. [PMID: 35550283 DOI: 10.3174/ajnr.a7510] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In patients with ischemic stroke, DWI lesions can occasionally be reversed by reperfusion therapy. This study aimed to ascertain the relationship between ADC levels and DWI reversal in patients with acute ischemic stroke who underwent recanalization treatment. MATERIALS AND METHODS We conducted a retrospective cohort study in patients with acute ischemic stroke who underwent endovascular mechanical thrombectomy with successful recanalization between April 2017 and March 2021. DWI reversal was assessed through follow-up MR imaging approximately 24 hours after treatment. RESULTS In total, 118 patients were included. DWI reversal was confirmed in 42 patients. The ADC level in patients with reversal was significantly higher than that in patients without reversal. Eighty-three percent of patients with DWI reversal areas had mean ADC levels of ≥520 × 10-6 mm2/s, and 71% of patients without DWI reversal areas had mean ADC levels of <520 × 10-6 mm2/s. The mean ADC threshold was 520 × 10-6 mm2/s with a sensitivity and specificity of 71% and 83%, respectively. In multivariate analysis, the mean ADC level (OR, 1.023; 95% CI, 1.013-1.033; P < .0001) was independently associated with DWI reversal. Patients with DWI reversal areas had earlier neurologic improvement (NIHSS at 7 days) than patients without reversal areas (P < .0001). CONCLUSIONS In acute ischemic stroke, the ADC value is independently associated with DWI reversal. Lesions with a mean ADC of ≥520 × 10-6 mm2/s are salvageable by mechanical thrombectomy, and DWI reversal areas regain neurologic function. The ADC value is easily assessed and is a useful tool to predict viable lesions.
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Affiliation(s)
- T Umemura
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - T Hatano
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - T Ogura
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - T Miyata
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - Y Agawa
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - H Nakajima
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - R Tomoyose
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - H Sakamoto
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - Y Tsujimoto
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - Y Nakazawa
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - T Wakabayashi
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - T Hashimoto
- Department of Neurology (T.H., R.F., W.B.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - R Fujiki
- Department of Neurology (T.H., R.F., W.B.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - W Shiraishi
- Department of Neurology (T.H., R.F., W.B.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
| | - I Nagata
- From the Department of Neurosurgery (T.U., T.H., T.O., T.M., Y.A., N.H., R.T., H.S., Y.T., Y.N., T.W., I.N.), Stroke Center, Kokura Memorial Hospital, Kitakyushu City, Japan
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Kawashima M, Kawanishi N, Tominaga T, Suzuki K, Miyazaki A, Nagata I, Miyoshi M, Miyakawa M, Sakuraya T, Sonomura T, Arakawa T. Icing after eccentric contraction-induced muscle damage perturbs the disappearance of necrotic muscle fibers and phenotypic dynamics of macrophages in mice. J Appl Physiol (1985) 2021; 130:1410-1420. [PMID: 33764172 DOI: 10.1152/japplphysiol.01069.2020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Icing is still one of the most common treatments to acute skeletal muscle damage in sports medicine. However, previous studies using rodents reported the detrimental effect of icing on muscle regeneration following injury. This study aimed to elucidate the critical factors governing the impairment of muscle regeneration by icing with a murine model of eccentric contraction-induced muscle damage by electrical stimulation. Because of icing after muscle injury, the infiltration of polynuclear and mononuclear cells into necrotic muscle fibers was retarded and attenuated, leading to the persistent presence of necrotic cellular debris. These phenomena coincided with the delayed emergence and sustained accumulation of Pax7+ myogenic cells within the regenerating area. In addition, due to icing, delayed and/or sustained infiltration of M1 macrophages was noted in accordance with the perturbed expression patterns of inflammation-related factors, including tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10). The key myogenic regulatory factors (i.e., MyoD and myogenin) involved in the activation/proliferation and differentiation of myogenic precursor cells were not altered by icing during the regenerative process. A detailed analysis of regenerating myofibers by size distribution at day 14 after muscle damage showed that the ratio of small regenerating fibers to total regenerating fibers was higher in icing-treated animals than in untreated animals. These findings suggest that icing following muscle damage blunts the efficiency of muscle regeneration by perturbing the removal of necrotic myofibers and phenotypic dynamics of macrophages rather than affecting myogenic factors.NEW & NOTEWORTHY Icing blunted the muscle regeneration by perturbing the infiltration of polynuclear and mononuclear cells into necrotic myofibers and the phenotypic dynamics of macrophages rather than affecting the myogenic regulatory factors. Because of icing, the disappearance of necrotic muscle debris was retarded, coinciding with the delayed emergence and sustained accumulation of Pax7+ cells within the regenerating area. The expression patterns of TNF-α and IL-10 were altered by icing consistent with the perturbation of the macrophage phenotype.
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Affiliation(s)
- Masato Kawashima
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Noriaki Kawanishi
- Faculty of Advanced Engineering, Chiba Institute of Technology, Narashino, Japan
| | - Takaki Tominaga
- Graduate School of Sport Sciences, Waseda University, Tokorozawa, Japan.,Research Fellow of Japan Society for the Promotion of Sciences, Tokyo, Japan
| | | | - Anna Miyazaki
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Itsuki Nagata
- Faculty of Health Sciences, Kobe University School of Medicine, Kobe, Japan
| | - Makoto Miyoshi
- Department of Biophysics, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Motoi Miyakawa
- Department of Health and Sport Sciences, Graduate school of Medicine, Osaka University, Osaka, Japan
| | - Tohma Sakuraya
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Takahiro Sonomura
- Department of Oral Anatomy, Asahi University School of Dentistry, Gifu, Japan
| | - Takamitsu Arakawa
- Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Arimura T, Kondo N, Matsuyama M, Kitano I, Mukoyoshi T, Nagata I, Ogino T. Proton Beam Therapy for Inoperable Stage III Pancreatic Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Koge J, Matsumoto S, Nakahara I, Ishii A, Hatano T, Sadamasa N, Kai Y, Ando M, Saka M, Chihara H, Takita W, Tokunaga K, Kamata T, Nishi H, Hashimoto T, Tsujimoto A, Kira J, Nagata I. Reduction in stroke alert response time for patients with in-hospital stroke using a standardized protocol. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Matsumoto S, Koyama H, Hatano T, Sadamasa N, Kai Y, Saka M, Ando M, Hashimoto T, Chihara H, Takita W, Tokunaga K, Kamata T, Tujimoto A, Nagata I, Kira J. The development of visual task management ICT system for acute stroke care. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1745] [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: 10/18/2022]
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Katayama S, Uchino S, Uji M, Ohnuma T, Namba Y, Kawarazaki H, Toki N, Takeda K, Yasuda H, Izawa J, Tokuhira N, Nagata I. Factors Predicting Successful Discontinuation of Continuous Renal Replacement Therapy. Anaesth Intensive Care 2016; 44:453-7. [DOI: 10.1177/0310057x1604400401] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
This multicentre, retrospective observational study was conducted from January 2010 to December 2010 to determine the optimal time for discontinuing continuous renal replacement therapy (CRRT) by evaluating factors predictive of successful discontinuation in patients with acute kidney injury. Analysis was performed for patients after CRRT was discontinued because of renal function recovery. Patients were divided into two groups according to the success or failure of CRRT discontinuation. In multivariate logistic regression analysis, urine output at discontinuation, creatinine level and CRRT duration were found to be significant variables (area under the receiver operating characteristic curve for urine output, 0.814). In conclusion, we found that higher urine output, lower creatinine and shorter CRRT duration were significant factors to predict successful discontinuation of CRRT.
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Affiliation(s)
- S. Katayama
- Intensive Care, Tokyo Women's Medical University, Department of Emergency Medicine, Asahi General Hospital, Chiba, Japan
| | - S. Uchino
- Intensive Care, Tokyo Women's Medical University, Department of Emergency Medicine, Asahi General Hospital, Chiba, Japan
| | - M. Uji
- Intensive Care Unit, Osaka University Hospital, Osaka, Japan
| | - T. Ohnuma
- Intensive Care Unit, Department of Anesthesiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Y. Namba
- Department of Emergency and Critical Care, Showa University Fujigaoka Hospital, Kanagawa, Japan
| | - H. Kawarazaki
- Department of Nephrology and Hypertension, St. Marianna University School of Medicine, Kanagawa, Japan
| | - N. Toki
- Department of Internal Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - K. Takeda
- Division of Intensive Care Medicine, Hyogo College of Medicine, Hyogo, Japan
| | - H. Yasuda
- Intensive Care Unit, Department of Emergency and Critical Care Medicine, Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - J. Izawa
- Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan
| | - N. Tokuhira
- Division of Intensive Care, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - I. Nagata
- Department of Emergency, Kanto Rosai Hospital, Kanagawa, Japan
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Lavine SD, Cockroft K, Hoh B, Bambakidis N, Khalessi AA, Woo H, Riina H, Siddiqui A, Hirsch JA, Chong W, Rice H, Wenderoth J, Mitchell P, Coulthard A, Signh TJ, Phatorous C, Khangure M, Klurfan P, terBrugge K, Iancu D, Gunnarsson T, Jansen O, Muto M, Szikora I, Pierot L, Brouwer P, Gralla J, Renowden S, Andersson T, Fiehler J, Turjman F, White P, Januel AC, Spelle L, Kulcsar Z, Chapot R, Spelle L, Biondi A, Dima S, Taschner C, Szajner M, Krajina A, Sakai N, Matsumaru Y, Yoshimura S, Ezura M, Fujinaka T, Iihara K, Ishii A, Higashi T, Hirohata M, Hyodo A, Ito Y, Kawanishi M, Kiyosue H, Kobayashi E, Kobayashi S, Kuwayama N, Matsumoto Y, Miyachi S, Murayama Y, Nagata I, Nakahara I, Nemoto S, Niimi Y, Oishi H, Satomi J, Satow T, Sugiu K, Tanaka M, Terada T, Yamagami H, Diaz O, Lylyk P, Jayaraman MV, Patsalides A, Gandhi CD, Lee SK, Abruzzo T, Albani B, Ansari SA, Arthur AS, Baxter BW, Bulsara KR, Chen M, Delgado Almandoz JE, Fraser JF, Heck DV, Hetts SW, Hussain MS, Klucznik RP, Leslie-Mawzi TM, Mack WJ, McTaggart RA, Meyers PM, Mocco J, Prestigiacomo CJ, Pride GL, Rasmussen PA, Starke RM, Sunenshine PJ, Tarr RW, Frei DF, Ribo M, Nogueira RG, Zaidat OO, Jovin T, Linfante I, Yavagal D, Liebeskind D, Novakovic R, Pongpech S, Rodesch G, Soderman M, terBrugge K, Taylor A, Krings T, Orbach D, Biondi A, Picard L, Suh DC, Tanaka M, Zhang HQ. Training Guidelines for Endovascular Ischemic Stroke Intervention: An International Multi-Society Consensus Document. AJNR Am J Neuroradiol 2016; 37:E31-4. [PMID: 26892982 DOI: 10.3174/ajnr.a4766] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Nagata I, Ike A, Nishikawa H, Zhang B, Sugihara M, Mori K, Iwata A, Kawamura A, Shirai K, Uehara Y, Ogawa M, Miura SI, Saku K. Associations between lipid profiles and MACE in hemodialysis patients with percutaneous coronary intervention: From the FU-Registry. J Cardiol 2015; 65:105-11. [DOI: 10.1016/j.jjcc.2014.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Revised: 03/07/2014] [Accepted: 03/13/2014] [Indexed: 10/25/2022]
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Ohta T, Nakahara I, Ishibashi R, Matsumoto S, Gomi M, Miyata H, Nishi H, Watanabe S, Nagata I. The maze-making and solving technique for coil embolization of large and giant aneurysms. AJNR Am J Neuroradiol 2014; 36:744-50. [PMID: 25542878 DOI: 10.3174/ajnr.a4198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/23/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Despite major progress in treating aneurysms by coil embolization, the complete occlusion of aneurysms of >10 mm in diameter (large/giant aneurysms) remains challenging. We present a novel endovascular treatment method for large and giant cerebral aneurysms called the "maze-making and solving" technique and compare the short-term follow-up results of this technique with those of conventional coil embolization. MATERIALS AND METHODS Eight patients (65 ± 11.5 years of age, 7 women) with large/giant unruptured nonthrombosed cerebral aneurysm (mean largest aneurysm dimension, 19 ± 4.4 mm) were treated by the maze-making and solving technique, a combination of the double-catheter technique and various assisted techniques. The coil-packing attenuation, postoperative courses, and recurrence rate of this maze group were compared with 30 previous cases (conventional group, 65.4 ± 13.0 years of age; 22 women; mean largest aneurysm dimension, 13.4 ± 3.8 mm). RESULTS Four maze group cases were Raymond class 1; and 4 were class 2 as indicated by immediate postsurgical angiography. No perioperative deaths or major strokes occurred. Mean packing attenuation of the maze group was significantly higher than that of the conventional group (37.4 ± 5.9% versus 26.2 ± 5.6%). Follow-up angiography performed at 11.3 ± 5.4 months revealed no recurrence in the maze group compared with 39.2% in the conventional group. CONCLUSIONS The maze-making and solving technique achieves high coil-packing attenuation for efficient embolization of large and giant cerebral aneurysms with a low risk of recurrence.
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Affiliation(s)
- T Ohta
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan.
| | - I Nakahara
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - R Ishibashi
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - S Matsumoto
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - M Gomi
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - H Miyata
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - H Nishi
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - S Watanabe
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
| | - I Nagata
- From the Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
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Shiga Y, Miura SI, Norimatsu K, Hitaka Y, Nagata I, Koyoshi R, Morii J, Kuwano T, Uehara Y, Inoue A, Shirotani T, Fujisawa K, Matsunaga E, Saku K. Efficacy and safety of combination therapy of high-dose losartan and hydrochlorothiazide in patients with hypertension. J Renin Angiotensin Aldosterone Syst 2014; 16:1078-84. [PMID: 25143336 DOI: 10.1177/1470320314529358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We analyzed the efficacy and safety of combination therapy of high-dose losartan (100 mg/day) and hydrochlorothiazide (HCTZ, 12.5 mg/day) compared with those of the combination of high-dose telmisartan (80 mg/day) and HCTZ (12.5 mg/day). METHODS Forty hypertensive patients who received a combination of high-dose telmisartan and HCTZ were enrolled. We applied a changeover strategy with switching from a combination of high-dose telmisartan and HCTZ to high-dose losartan and HCTZ. We divided the patients into two groups; those who achieved the target blood pressure (controlled group) and those who did not reach the target blood pressure (uncontrolled group) before the changeover and performed further analysis. RESULTS The uncontrolled group showed a significant decrease in systolic blood pressure (SBP) (143±12 mmHg to 126±11 mmHg at three months). In addition, serum uric acid significantly decreased in all subjects, and in each of the controlled and uncontrolled groups. There were no significant changes in other biochemical parameters, such as potassium and hemoglobin A1c, at three months after the changeover in all subjects. CONCLUSION Combination therapy with high-dose losartan and HCTZ was superior to the combination of telmisartan and HCTZ with respect to significant decreases in systolic blood pressure and serum uric acid in hypertensive patients.
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Affiliation(s)
- Yuhei Shiga
- Department of Cardiology, Fukuoka University School of Medicine, Japan Inoue Hospital, Fukuoka, Japan Shirotani Hospital, Fukuoka, Japan Fujisawa Clinic, Fukuoka, Japan
| | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Japan Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Japan
| | - Kenji Norimatsu
- Department of Cardiology, Fukuoka University School of Medicine, Japan
| | - Yuka Hitaka
- Department of Cardiology, Fukuoka University School of Medicine, Japan Inoue Hospital, Fukuoka, Japan
| | - Itsuki Nagata
- Department of Cardiology, Fukuoka University School of Medicine, Japan Matsunaga Hospital, Fukuoka, Japan
| | - Rie Koyoshi
- Department of Cardiology, Fukuoka University School of Medicine, Japan
| | - Joji Morii
- Department of Cardiology, Fukuoka University School of Medicine, Japan Matsunaga Hospital, Fukuoka, Japan
| | - Takashi Kuwano
- Department of Cardiology, Fukuoka University School of Medicine, Japan
| | - Yoshinari Uehara
- Department of Cardiology, Fukuoka University School of Medicine, Japan Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Japan
| | | | | | | | | | - Keijiro Saku
- Department of Cardiology, Fukuoka University School of Medicine, Japan Department of Molecular Cardiovascular Therapeutics, Fukuoka University School of Medicine, Japan
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Ike A, Shirai K, Nagata I, Sugihara M, Nishikawa H, Kawamura A, Mori K, Saku K. Significant differences in lipid profile associated with mace between hemodialysis (HD) and non-HD patients: FU-registry. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.768] [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: 11/25/2022]
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17
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Takeshita T, Hayashi K, Horie N, Morikawa M, Suyama K, Nagata I. Endovascular treatment of intractable bleeding from a traumatic pseudoaneurysm of the internal maxillary artery. Neuroradiol J 2013; 25:469-74. [PMID: 24029039 DOI: 10.1177/197140091202500409] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/07/2012] [Indexed: 11/16/2022] Open
Abstract
Traumatic pseudoaneurysms of the internal maxillary artery (IMA) are rare and difficult to treat. A 58-year-old man with a traumatic pseudoaneurysm of the IMA presented with intractable nasal and oral hemorrhage during dual antiplatelet therapy. Transcatheter artery embolization with N-butyl cyanoacrylate (NBCA) completely occluded the pseudoaneurysm. Transcatheter artery embolization with NBCA is a feasible and effective treatment because of its shorter treatment time and lower incidence of recurrence.
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Affiliation(s)
- T Takeshita
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Science; Nagasaki, Japan -
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18
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Nagata I, Shiga Y, Miura SI, Saku K. Patent ductus arteriosus detected on 64-multidetector row CT. Intern Med 2013; 52:405-6. [PMID: 23370756 DOI: 10.2169/internalmedicine.52.9184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Itsuki Nagata
- Department of Cardiology, Fukuoka University School of Medicine, Japan
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19
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Matsumoto J, Nagata I, Okagaki R. O440 THE COMPARATIVE FOLLOW-UP STUDY OF TENSION-FREE VAGINAL MESH AND CONVENTIONAL SURGERY FOR PELVIC ORGAN PROLAPSE. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60870-4] [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: 11/29/2022]
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20
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Shiga Y, Miura SI, Mitsutake R, Norimatsu K, Nagata I, Arimura T, Shimizu T, Morii J, Kuwano T, Uehara Y, Inoue A, Shirotani T, Fujisawa K, Matsunaga E, Saku K. Efficacy and safety of a single-pill fixed-dose combination of high-dose telmisartan/hydrochlorothiazide in patients with uncontrolled hypertension. J Renin Angiotensin Aldosterone Syst 2012; 13:394-400. [PMID: 22427308 DOI: 10.1177/1470320312439493] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Many patients still have high blood pressure (BP) after treatment with high-dose angiotensin II type 1 receptor blockers (ARBs) or Preminent® (medium-dose of losartan (50 mg/day)/hydrochlorothiazide (HCTZ) (12.5 mg/day)). Therefore, we analyzed whether Micombi®BP (high-dose telmisartan (80 mg/day)/HCTZ (12.5 mg/day)) could provide better results with regard to efficacy and safety for patients with uncontrolled hypertension. METHODS In total, 44 hypertensive patients (22 males, age 71±14 years) who showed uncontrolled BP despite the use of high-dose ARBs or Preminent® were enrolled in this study. We used a changeover design in which the patients were switched from high-dose ARBs or Preminent® to Micombi®BP. We analyzed BP, heart rate (HR), and biochemical parameters before and after treatment for 3 months. RESULTS Systolic BP and diastolic BP significantly decreased (125±15/69±11 mmHg) and 85% of the patients achieved their target BP at 3 months after changeover. Patients who switched from ARBs and those who switched from Preminent® showed similar BP-lowering effects. In addition, the reductions in BP after 3 months in patients with or without chronic kidney disease and in those with or without metabolic syndrome (MetS) were also similar. There were no significant changes in HR during the study period. Although blood levels of potassium, hemoglobin A1c and uric acid (UA) significantly increased after 3 months for all of the patients, none of the patients showed serious adverse effects. CONCLUSION High-dose telmisartan/HCTZ therapy was associated with a significant reduction in BP and helped patients achieve their target BP.
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Affiliation(s)
- Yuhei Shiga
- Department of Cardiology, Fukuoka University School of Medicine, Japan
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21
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Horie N, Morikawa M, Nozaki A, Hayashi K, Suyama K, Nagata I. "Brush Sign" on susceptibility-weighted MR imaging indicates the severity of moyamoya disease. AJNR Am J Neuroradiol 2011; 32:1697-702. [PMID: 21799039 DOI: 10.3174/ajnr.a2568] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE SWI is a high spatial resolution MR imaging technique showing magnetic inhomogeneity that could demonstrate increased oxygen extraction in focal cerebral ischemia. The aim of this study was to investigate the characteristics in the signal intensity of DMVs by using SWI and to determine whether this method could indicate the severity of the hemodynamics in MMD by evaluating the correlation between SWI stage and hemodynamics on SPECT. MATERIALS AND METHODS Consecutive MMD patients were prospectively analyzed before treatment. Routine MR imaging including SWI was performed, and the number of the conspicuous DMVs draining into the subependymal veins was classified: stage 1, mild (< 5); stage 2, moderate (5-10); and stage 3, severe (> 10). The SWI stage was evaluated in correlation with clinical presentations, and CBF and CVR were quantified by using a SPECT iodine 123 N-isopropyl-p-iodoamphetamine split-dose method. RESULTS Patients were 12 males and 21 females (range, 8-66 years), consisting of 4 asymptomatic patients, 13 patients with TIA, 9 patients with infarct, and 7 patients with hemorrhage. There was a significant difference in CVR among clinical presentations, though there was no difference in age, Suzuki stage, or CBF. Conversely, SWI stage was significantly higher in patients with TIA and infarct than asymptomatic patients (P < .01). Higher SWI stage significantly had lower CBF and CVR in the middle cerebral artery area (P < .05). CONCLUSIONS SWI stage strongly correlates with ischemic presentations in MMD and also correlates with hemodynamics on SPECT, especially CVR. Increased conspicuity of DMVs, known as "brush sign", could predict the severity of MMD.
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Affiliation(s)
- N Horie
- Department of Neurosurgery, Nagasaki University School of Medicine, Nagasaki, Japan.
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Matsumoto J, Okagaki R, Ito Y, Takahashi T, Nagata I. O594 Comparison of postoperative outcomes between tension-free vaginal mesh and traditional procedures of reconstructive surgery for pelvic organ prolapse. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)60967-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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23
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Ohzeki T, Motozumi H, Hanaki K, Ohtahara H, Ishitani N, Tanaka Y, Nakai M, Nagata I, Tamai E, Shiraki K. Salt-losing form of 21-hydroxylase deficiency accompanied by hypopituitarism in a boy. Exp Clin Endocrinol 2009; 101:119-20. [PMID: 8405140 DOI: 10.1055/s-0029-1211217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- T Ohzeki
- Department of Pediatrics, Faculty of Medicine, Tottori University, Yonago, Japan
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24
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Hiu T, Kitagawa N, Morikawa M, Hayashi K, Horie N, Morofuji Y, Suyama K, Nagata I. Efficacy of DynaCT digital angiography in the detection of the fistulous point of dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30:487-91. [PMID: 19213824 DOI: 10.3174/ajnr.a1395] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Identifying the precise hemodynamic features, including the fistulous point, is essential for treatments of dural arteriovenous fistulas (DAVFs). This study illustrates the efficacy of DynaCT digital angiograms obtained from a 3D C-arm CT to directly visualize the location of the fistulous points in DAVFs. MATERIALS AND METHODS This retrospective study observed 14 consecutive patients with DAVFs, which included 7 cavernous sinuses, 4 transverse-sigmoid sinuses, 2 convexity-superior sagittal sinuses, and 1 tentorial sinus. In the assessment of the practical applicability for the diagnosis of DAVFs, images obtained from 2D digital subtraction angiography (DSA) and DynaCT were comparatively evaluated. RESULTS In all patients, DynaCT digital angiography could clearly demonstrate the feeding arteries, the fistulous points, and the draining veins. Significant anatomic landmarks for the fistulous points with relationships to osseous structures were also provided. Compared with 2D DSA, DynaCT digital angiograms demonstrated 12 additional findings in 8 patients (57%), including the detection of the fistulous points (n = 7), the feeders (n = 1), the retrograde leptomeningeal drainage (n = 1), the draining veins (n = 1), and the venous anomaly (n = 2). CONCLUSIONS In comparison with 2D DSA, DynaCT may provide more detailed information to evaluate DAVFs. DynaCT digital angiograms have a high contrast and isotropic spatial resolution, allowing a reliable visualization of small vessels and fine osseous structures. Such detailed information, especially for the location of the fistulous points, could be very useful for either the endovascular or the surgical treatments of DAVFs.
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Affiliation(s)
- T Hiu
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
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25
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Fukuda S, Naritomi H, Hashimoto N, Takaichi S, Nishimura H, Nagata I, Kikuchi H. Difference in vulnerability of cerebral arterial bifurcation and straight portion for development of endothelial damage. J Stroke Cerebrovasc Dis 2007; 7:275-80. [PMID: 17895101 DOI: 10.1016/s1052-3057(98)80043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/1997] [Accepted: 03/05/1998] [Indexed: 11/24/2022] Open
Abstract
Cerebral atherosclerotic changes develop most commonly on the lateral side of the bifurcation, one of the sites where the wall shear stress is lowest in the cerebral arteries. Endothelial cells exposed to the lower shear stress appear to be more vulnerable to stimuli such as free radicals. We hypothesized that the difference in endothelial vulnerability on cerebral arteries may be involved in the local preference of atherogenesis. To clarify this hypothesis, the present study was carried out by using a laser-dye technique that causes cell damage by heat and free radicals. A helium-neon laser in the presence of circulating Evans blue was used to illuminate three sites of the rat middle cerebral artery; the straight portion, the apex of the bifurcation, and the lateral side of the bifurcation. The magnitude of endothelial damage was morphologically estimated with the electron microscope. After the laser irradiation, the straight portion and the lateral side of the bifurcation developed severe endothelial damage. However, the apex of the bifurcation developed no appreciable damage, showing significantly milder changes compared with other sites. The results suggest that endothelial cells are more vulnerable to stimuli by free radicals at the straight portion and the lateral side of the bifurcation than at the apex. We conclude that the imbalance between the strength of stress stimuli, such as free radicals, and the vulnerability of endothelium is likely to be one of the key requirements for the development of cerebral atherosclerotic changes.
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Affiliation(s)
- S Fukuda
- Department of Neurosurgery, Kyoto University Hospital, Kyoto Japan
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26
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Yoshioka T, Kitagawa N, Yokoyama H, Nagata I. Selective transvenous coil embolization of dural arteriovenous fistula. A report of three cases. Interv Neuroradiol 2007; 13 Suppl 1:123-30. [PMID: 20566089 DOI: 10.1177/15910199070130s118] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Accepted: 01/15/2007] [Indexed: 11/15/2022] Open
Abstract
SUMMARY We herein report three cases of dural arteriovenous fistula (DAVF) in which the venous outlet immediately adjacent to the fistula was selectively embolized. Case 1: A 69-year-old man presented with a subarachnoid hemorrhage (SAH). Angiography demonstrated a DAVF in the left superior petrous sinus. Case 2: A 59-yearold woman presented with dizziness. Angiography demonstrated a DAVF adjacent to great vein of Galen. The DAVF drained through the great vein of Galen with retrograde leptomeningeal venous drainage (RLVD). The basal vein of Rosenthal was enhanced from the great vein of Galen. Case 3: A 51-year-old man presented with an occipital seizure. Angiography demonstrated a DAVF adjacent to the left side of the superior sagittal sinus with RLVD. All three cases were successfully treated by the selective embolization of the venous outlet immediately adjacent to the fistula. Therefore, selective embolization preserved normal venous return.
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Affiliation(s)
- T Yoshioka
- Department of Neuroendovascular Surgery, Nagasaki Rosai Hospital; Japan - -
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27
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Abstract
PURPOSE To determine whether the signal changes on magnetic resonance imaging (MRI), including fluid attenuated inversion recovery (FLAIR), T2*-weighted gradient echo (GE) imaging, and diffusion-weighted imaging (DWI) in diffuse axonal injury (DAI) patients correlate with the clinical outcome. MATERIAL AND METHODS We diagnosed patients with DAI based on the following criteria: 1) a loss of consciousness from the time of injury that persisted beyond 6 h; 2) no apparent hemorrhagic contusion on computed tomography (CT); 3) the presence of white matter injury on MRI. Twenty-one DAI patients were analyzed (19 M, 2 F, mean age 34 years) with MRI (FLAIR, T2*-weighted GE imaging, and DWI). RESULTS 325 abnormalities were detected by MRI within a week after injury. The T2*-weighted GE imaging was significantly more sensitive than FLAIR and DWI in diagnosing DAI. DWI detected only 32% of all lesions, but could depict additional shearing injuries not visible on either T2*-weighted GE imaging or FLAIR. The mean number of lesions in brainstem detected by DWI in the favorable group (good recovery/moderately disabled) was significantly smaller than in the unfavorable group (severely disabled/vegetative survival/death). This trend was not observed on the T2*-weighted GE imaging and FLAIR findings. CONCLUSION DWI cannot detect all DAI-related lesions, but is a potentially useful imaging modality for both diagnosing and assessing patients with DAI.
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Affiliation(s)
- Y Ezaki
- Department of Neurosurgery, Nagasaki University Graduate School of Medicine, Nagasaki, Japan.
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Saito Y, Kawashima Y, Kondo A, Chikumaru Y, Matsui A, Nagata I, Ohno K. Dysphagia-gastroesophageal reflux complex: complications due to dysfunction of solitary tract nucleus-mediated vago-vagal reflex. Neuropediatrics 2006; 37:115-20. [PMID: 16967360 DOI: 10.1055/s-2006-924428] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report on the complication of gastroesophageal reflux (GER) in four patients with lower brainstem dysfunction. These patients suffered from perinatal asphyxia, cerebellar hemorrhage, or congenital dysphagia of unknown origin and showed facial nerve palsy, inspiratory stridor due to vocal cord paralysis, central sleep apnea, and dysphagia, in various combinations. Naso-intestinal tube feeding was introduced in all of the patients due to recurrent vomiting and aspiration pneumonia resulting from GER. T2-weighted magnetic resonance (MR) imaging revealed symmetrical high intensity lesions in the tegmentum of the lower pons and the medulla oblongata in two of the patients, and pontomedullary atrophy in another patient. In normal subjects, lower esophageal sphincter contraction is provoked by distension of the gastric wall, through a vago-vagal reflex. Since this reflex arc involves the solitary tract nucleus, where the swallowing center is located, the association of dysphagia and GER in the present patients is thought to result from the lesions in the tegmentum of medulla oblongata. We propose the term "dysphagia-GER complex" to describe the disturbed motility of the upper digestive tract due to lower brainstem involvement. In children with brainstem lesions, neurological assessment of GER is warranted, in addition to the examination of other signs of brainstem dysfunction, including dysphagia and respiratory disturbance.
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Affiliation(s)
- Y Saito
- Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan.
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Ezaki Y, Tsutsumi K, Morikawa M, Nagata I. Lesions identified on T2*-weighted gradient echo images in two patients with suspected diffuse axonal injury that resolved in less than ten days. Acta Neurochir (Wien) 2006; 148:547-50; discussion 550. [PMID: 16341631 DOI: 10.1007/s00701-005-0692-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2005] [Accepted: 10/19/2005] [Indexed: 10/25/2022]
Abstract
T2*-weighted gradient echo (GE) imaging is useful for detection of intracranial hemorrhage in the patients with diffusion axonal injury (DAI). However, the temporal changes in the DAI-related lesions on T2*-weighted GE images are not clear. We report two very rare cases with DAI in which lesions identified on T2*-weighted GE images resolved in less than ten days.
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Affiliation(s)
- Y Ezaki
- Department of Neurosurgery, Nagasaki University Graduate School of Medicine, Nagasaki, Japan.
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30
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Horie N, Morikawa M, Kitigawa N, Tsutsumi K, Kaminogo M, Nagata I. 2D Thick-section MR digital subtraction angiography for the assessment of dural arteriovenous fistulas. AJNR Am J Neuroradiol 2006; 27:264-9. [PMID: 16484389 PMCID: PMC8148811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
BACKGROUND AND PURPOSE Although dynamic contrast-enhanced MR angiography studies for arteriovenous malformations (AVFs) and brain tumors have shown promising results, no formal attempt has yet been made to similarly evaluate dural AVFs. To assess the practical applicability of 2D thick-section contrast enhanced MR digital subtraction angiography (MRDSA) for the diagnosis and management of dural AVFs, MRDSA and intra-arterial digital subtraction angiography (IADSA) were comparatively evaluated. METHODS We performed 80 consecutive MRDSA studies for 25 dural AVFs, including 11 cavenous sinuses, 9 sigmoid sinuses, 2 tentorial sinuses, one anterior condylar vein, one craniocervical junction, and one spine. MR images were continuously obtained following the initiation of a bolus injection of gadrinium chelates and subtraction images were constructed. We thereafter evaluated the imaging quality and hemodynamic information from all 46 MRDSA images performed in parallel with IADSA in either perioperative or follow-up studies. RESULTS Most MRDSA images detected early venous filling, sinus occlusion, leptomeningeal venous drainage, and varices. It was difficult, however, to identify the feeding arteries because of both the partial volume effect and a low spatial resolution. Most important, MRDSA accurately detected aggressive lesions with leptomeningeal venous drainage and varices. CONCLUSION Our MRDSA technique was found to have limited value for depicting all the anatomic details of dural AVFs, though it was able to identify important hemodynamic abnormalities related to the risk of hemorrhaging. MRDSA is therefore useful as a less invasive, dynamic angiographic tool, not only for perioperative studies but also for follow-up studies.
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Affiliation(s)
- N Horie
- Department of Neurosurgery and Radiology, Nagasaki University School of Medicine, Nagasaki-shi, Nagasaki, Japan
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31
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Ohtsuka T, Ishiwa D, Kamiya Y, Itoh H, Nagata I, Saito Y, Yamada Y, Sumitomo M, Andoh T. Effects of barbiturates on ATP-sensitive K channels in rat substantia nigra. Neuroscience 2005; 137:573-81. [PMID: 16289884 DOI: 10.1016/j.neuroscience.2005.08.078] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2005] [Revised: 08/07/2005] [Accepted: 08/31/2005] [Indexed: 10/25/2022]
Abstract
ATP-sensitive K channels are widely expressed in cytoplasmic membranes of neurons, and they couple cell metabolism to excitability. They are thought to be involved in neuroprotection against cell damage during hypoxia, ischemia and excitotoxicity by hyperpolarizing neurons and reducing excitability. Although barbiturates are often used in patients with brain ischemia, the effects of these agents on neuronal ATP-sensitive K channels have not been clarified. We studied the effects of thiopental and pentobarbital on surface ATP-sensitive K channels in principal neurons of rat substantia nigra pars compacta. Whole cell voltage- and current-clamp recordings were made using rat midbrain slices. ATP-sensitive K channels were activated by intracellular dialysis with an ATP-free pipette solution during perfusion with a glucose-free solution. When the pipette solution contained 4mM ATP and the perfusing solution contained 25 mM glucose, the membrane current at -60 mV remained stable. When intracellular ATP was depleted, hyperpolarization and an outward current developed slowly. Although thiopental did not affect the membrane current in the presence of ATP and glucose, it reversibly inhibited the hyperpolarization and outward current induced by intracellular ATP depletion at 100 and 300 microM. Thiopental reduced the ATP depletion-induced outward current by 4.7%, 36.7% and 87% at 30, 100 and 300 microM, respectively. The high dose of pentobarbital also exhibited similar effects on ATP-sensitive K channels. These results suggest that barbiturates at high concentrations but not at clinically relevant concentrations inhibit ATP-sensitive K channels activated by intracellular ATP depletion in rat substantia nigra.
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Affiliation(s)
- T Ohtsuka
- Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Yokohama 236-0004, Japan
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Abstract
We retrospectively analyzed the prevalence and surgical outcomes of unruptured cerebral aneurysms in the elderly for the past five years. Between 1998 and 2002, we collected data from 575 subjects with unruptured aneurysms who had no history of subarachnoid hemorrhage (SAH). One hundred and eighty-two of these patients (31.7%) were aged > or = 70 years and they had 233 aneurysms. The proportion of older patients among all subjects increased significantly from 21.4% in 1998 to 40.3% in 2002. Unruptured aneurysms found in the elderly had a predominance of female, higher frequency of multiple aneurysms, and lower frequency of anterior communicating artery aneurysms when compared with those in the younger patients. The majority of intradural aneurysms detected in the elderly were less than 10 mm in diameter (84.8%). One hundred and eleven out of 224 intradural aneurysms in the elderly were treated (49.6%); most aneurysms were directly clipped, while only 13 aneurysms including six basilar artery aneurysms were coiled endovascularly. Among the 83 elderly subjects who underwent direct surgery, perioperative complication appeared in seven subjects (morbidity 8.4%, mortality 1.2%). No SAH occurred postoperatively and conservatively during 1-5 years of follow-up. Since the rupture rate of small unruptured aneurysms without SAH history is reported to be low, surgical indication should be considered with care particularly in the elderly.
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Affiliation(s)
- K Suyama
- Department of Neurosurgery, National Hospital Organization, Nagasaki Medical Center, Nagasaki, Japan.
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Ohta H, Sakai H, Nakahara I, Sakai N, Nagata I, Ishibashi-Ueda H. Spontaneous superficial temporal artery aneurysm associated with multiple intracranial cerebral aneurysms--does it segmental mediolytic arteriopathy of the intra- and extra-cranial arteries? Acta Neurochir (Wien) 2003; 145:805-6. [PMID: 14505110 DOI: 10.1007/s00701-003-0079-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- H Ohta
- Department of Neurosurgery, National Cardiovascular Center, Osaka, Japan.
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Fukuda H, Iihara K, Sakai N, Murao K, Sakai H, Higashi T, Kogure S, Takahashi J, Hayashi K, Nagata I. Staged carotid stenting and carotid endarterectomy for bilateral internal carotid artery stenosis. Preliminary experience. Interv Neuroradiol 2003; 9:143-8. [PMID: 20591244 DOI: 10.1177/15910199030090s120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2003] [Accepted: 02/06/2003] [Indexed: 11/15/2022] Open
Abstract
SUMMARY The purpose of this study was to evaluate the efficacy and safety of staged carotid stenting (CS) and carotid endarterectomy (CEA) for bilateral internal carotid artery stenosis. With this strategy, initial carotid stenting was performed for the high grade carotid stenosis to reduce the risk of subsequent CEA. Eight patients were treated with staged CS and CEA; CS for asymptomatic side followed by CEA for symptomatic side. Sufficient revascularization was obtained in all procedures but one CS procedure. Two minor stroke caused by distal embolism occurred during the perioperative period of CS. Postprocedural persistent hypotension was observed in one CS procedure. The mean interval between CS and CEA was 19.8 days. In conclusion, although our strategy has some advantages such as avoidance of bilateral cranial nerve palsy and shorter admission period over staged CEA, relatively high complication rate was noted at the first CS without any stroke morbidity post CEA. Our preliminary result showed that further reduction of periprocedural complication rate at the initial stenting is mandatory for this approach justified.
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Affiliation(s)
- H Fukuda
- Department of Neurosurgery, National Cardiovascular Center, Osaka; Japan -
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35
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Shimozuru T, Kamezawa T, Kuratsu J, Sakai N, Nagata I, Kishida A, Akashi M, Matsusaki M. Hydroxyapatite and bFGF Coating of Detachable Coils for Endovascular Occlusion of Experimental Aneurysm. Interv Neuroradiol 2003; 9:29-33. [PMID: 20591225 DOI: 10.1177/15910199030090s102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2003] [Accepted: 02/06/2003] [Indexed: 11/17/2022] Open
Abstract
SUMMARY The purpose of this study was to evaluate the effect of hydroxyapatite (HAp) and fibroblast growth factor-basic (bFGF) coating on Guglielmi detachable coils (GDCs) in an experimental aneurysm model. A total of 18 aneurysms were experimentally made in the common carotid arteries of swine. Embolization was done on these aneurysms using standard GDCs and coated GDCs with HAp (GDC-HAp) and with bFGF (GDC-HAp-bFGF). The animals were then killed 14 days after embolization. The development of tissue scarring and coverage the aneurysm's orifice were evaluated macroscopically. No significant difference of volume ratio of the coils exited in each groups. Macroscopically, covering ratio of fibrous membrane at the neck of aneurysms were 88.3 +/- 14.7% in a group with GDC-HAp-bFGF, while it were 26.7 +/- 15.3% in a group with standard GDC and it was 41.7 +/- 31.7% in a group with GDC-HAp. These results indicated that coating by hydroxyapatite and bFGF might facilitate a wound healing in an experimental aneurysm model.
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Affiliation(s)
- T Shimozuru
- Department of Neurosurgery, Faculty of Medicine, Kagoshima University
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36
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37
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38
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Okamoto Y, Ueba Y, Nagata I, Banks E. Rare earth metal-containing polymers. 4. Energy transfer from uranyl to europium ions in ionomers. Macromolecules 2002. [DOI: 10.1021/ma50004a065] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Kogure S, Sakai N, Iihara K, Sakai H, Sakaida H, Higashi T, Takahashi JC, Ohta H, Nagamine T, Anei R, Soeda A, Taniguchi A, Nagata I. Restenosis after stent placement for ostial stenosis of vertebral artery. Interv Neuroradiol 2002; 7:167-9. [PMID: 20663396 DOI: 10.1177/15910199010070s125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 09/15/2001] [Indexed: 11/16/2022] Open
Abstract
SUMMARY The purpose of this study was to evaluate our initial procedural success rate and angiographical outcome of stent placement for vertebral artery (VA) stenosis at the intermediate followup period (11.3 +/- 7.3 months). Stent placement was successfully performed in 20 procedures (19 patients), resulting in a marked reduction of stenosis from 78.7 +/- 12.6 % before to 8.7% +/- 10.6 after stenting. Follow-up angiography, performed after an interval of 11.3 +/- 7.3 months, revealed restenosis greater than 50% in a total of 6 procedures (40%) out of 15. Although PTA with stent placement for stenosis affecting VA origin provided excellent initial success, restenosis occurred at a significant rate even during the intermediate follow-up period.
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Affiliation(s)
- S Kogure
- Department of Neurosurgery, National Cardio-Vascular Center; Osaka, Japan -
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40
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Kishimoto H, Taniguchi A, Fukushima M, Sakai M, Tokuyama K, Oguma T, Nin K, Nagata I, Hayashi R, Kawano M, Hayashi K, Tsukamoto Y, Okumura T, Nagasaka S, Mizutani H, Nakai Y. Effect of short-term low-intensity exercise on insulin sensitivity, insulin secretion, and glucose and lipid metabolism in non-obese Japanese type 2 diabetic patients. Horm Metab Res 2002; 34:27-31. [PMID: 11832998 DOI: 10.1055/s-2002-19963] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aim of the present study was to investigate the effects of short-term physical exercise that did not change body mass on insulin sensitivity, insulin secretion, and glucose and lipid metabolism in 39 non-obese Japanese type 2 diabetic patients. Insulin sensitivity and insulin secretion were estimated with homeostasis model assessment insulin resistance (HOMA-IR) and HOMA-B-cell function proposed by Matthews et al., respectively. All patients were hospitalized and were engaged in low-intensity exercise that consisted of walking and dumbbell exercise for successive 7 days. There were no changes in hospital diet and the dose of any medications used throughout the study. Fasting glucose, insulin, and lipids were measured before and after exercise. After exercise, serum triglyceride levels significantly decreased, but no significant changes were observed in total and HDL cholesterol concentrations. Fasting glucose, insulin, and HOMA-IR levels significantly decreased after exercise, but HOMA-B-cell function did not change during the study. There was no significant difference between BMI levels before and after exercise. From these results, it can be concluded that short-term (7 days) low-intensity physical exercise combined with hospital diet reduces serum triglycerides, insulin resistance, and fasting glucose levels without affecting BMI in non-obese Japanese type 2 diabetic patients.
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Affiliation(s)
- H Kishimoto
- Division of Diabetes, Kansai-Denryoku Hospital, 2-1-7 Fukushima, Fukushima-ku, Osaka-city, Osaka 553-0033, Japan
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41
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Shimozuru T, Kamezawa T, Kuratsu J, Sakai N, Nagata I, Kishida A, Akashi M, Matsusaki M. Hydroxyapatite coating of detachable coils for endovascular occlusion of experimental aneurysm. Interv Neuroradiol 2001; 7:105-10. [PMID: 20663386 DOI: 10.1177/15910199010070s115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2001] [Accepted: 09/15/2001] [Indexed: 11/16/2022] Open
Abstract
SUMMARY The purpose of this study was to evaluate the effect of hydroxyapatite (HAp) coating on Guglielmi detachable coils (GDCs) in an experimental aneurysm model. A total of 12 aneurysms were experimentally made in the common carotid arteries of swine using a microsurgical technique. Embolization was done on these aneurysms using standard GDCs and GDCs coated with HAp (GDC-HAp). The animals were then killed 14 days after embolization. The physical properties of coated coils and the development of tissue scarring and coverage the aneurysm's orifice were evaluated macroscopically and microscopically. Macroscopically, a scar formation and coverage at the neck of aneurysms were observed in a group with GDC-HAp, while such findings were not seen in a group with GDC. With light microscope, fibroblasts were seen in the neck of the aneurysms in a group using GDC-HAp, whereas only a fibrin- like net was seen in a group using GDC. In a group with GDC-HAp, inflammatory response was more intense in the dome of the aneurysm with faster re-endothelial coverage of the neck of the aneurysm than the ones in a group with GDC. These results indicated that GDC-HAp might create a clinically beneficial biological surface in an experimental aneurysm model.
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Affiliation(s)
- T Shimozuru
- Department of Neurosurgery, Faculty of Medicine; Kagoshima University; Sakuragaoka, Japan
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42
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Takami S, Minami M, Nagata I, Namura S, Satoh M. Chemokine receptor antagonist peptide, viral MIP-II, protects the brain against focal cerebral ischemia in mice. J Cereb Blood Flow Metab 2001; 21:1430-5. [PMID: 11740204 DOI: 10.1097/00004647-200112000-00007] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The authors previously reported that mRNA for macrophage inflammatory protein-1alpha (MIP-1 alpha), a member of the CC chemokines, was expressed in glial cells after focal cerebral ischemia in rats. However, the function of chemokines in the ischemic brain remains unclear. Recently, viral macrophage inflammatory protein-II (vMIP-II), a chemokine analogue encoded by human herpesvirus-8 DNA, has been demonstrated to have antagonistic activity at several chemokine receptors. In the present study, the effects of vMIP-II and MIP-1alpha on ischemic brain injury were examined in mice to elucidate the roles of chemokines endogenously produced in the ischemic brain. Intracerebroventricular injection of vMIP-II (0.01-1 microg) reduced infarct volume in a dose-dependent manner when examined 48 hours after 1-hour middle cerebral artery occlusion followed by reperfusion. However, 1 microg MIP-1alpha increased infarct volume in the cortical region. These results supported the possibility that chemokines endogenously produced in the brain are involved in ischemic injury, and that chemokine receptors are potential targets for therapeutic intervention of stroke.
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Affiliation(s)
- S Takami
- Department of Molecular Pharmacology, Faculty of Pharmaceutical Sciences, Kyoto University, Kyoto, Japan
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43
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Minami M, Kume N, Shimaoka T, Kataoka H, Hayashida K, Akiyama Y, Nagata I, Ando K, Nobuyoshi M, Hanyuu M, Komeda M, Yonehara S, Kita T. Expression of SR-PSOX, a novel cell-surface scavenger receptor for phosphatidylserine and oxidized LDL in human atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2001; 21:1796-800. [PMID: 11701468 DOI: 10.1161/hq1001.096652] [Citation(s) in RCA: 122] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Receptor-mediated endocytosis of oxidized low density lipoprotein (Ox-LDL) by macrophages and the subsequent foam cell transformation in the arterial intima are key events in early atherogenesis. Recently, we have identified a novel macrophage cell-surface receptor for Ox-LDL by expression cloning from a cDNA library of phorbol 12-myristate 13-acetate-stimulated THP-1 cells, designated as the scavenger receptor for phosphatidylserine and oxidized lipoprotein (SR-PSOX). Here, we examined SR-PSOX expression in human atherosclerotic lesions. Total cellular RNA and fresh frozen sections were prepared from human carotid endarterectomy specimens (from 21 patients) and directional coronary atherectomy specimens (from 11 patients). Fragments of human aortas of 2 patients without visible atherosclerotic lesions served as negative controls. Quantitative reverse transcription-polymerase chain reaction demonstrated that SR-PSOX mRNA expression was prominent in atherosclerotic lesions but undetectable in normal aortas. Immunohistochemistry showed that SR-PSOX was predominantly expressed by lipid-laden macrophages in the intima of atherosclerotic plaques in carotid endarterectomy and directional coronary atherectomy specimens, although its expression was not detectable in normal arterial wall. Double-labeled immunohistochemistry confirmed that SR-PSOX is expressed by intimal macrophages. Taken together, SR-PSOX may be involved in Ox-LDL uptake and subsequent foam cell transformation in macrophages in vivo and thus may play important roles in human atherosclerotic lesion formation.
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Affiliation(s)
- M Minami
- Department of Geriatric Medicine, Graduate School of Medicine, Kyoto University, and Institute for Virus Research, Kyoto University, Kyoto, Japan
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44
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Sakaida H, Sakai N, Nagata I, Sakai H, Iihara K, Higashi T, Kogure S, Takahashi J, Ohta H, Nagamine T, Anei R, Soeda A, Taniguchi A, Shindo A, Kikuchi H. [Stenting for the occlusive carotid and subclavian arteries in Takayasu arteritis]. No Shinkei Geka 2001; 29:1033-41. [PMID: 11758310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The authors report the initial results of stenting in four patients of Takayasu arteritis for 11 occlusive carotid and subclavian arteries between January 1999 and December 2000. The lesions included stenoses of two right subclavian, three right common carotid, two left common carotid, and two left subclavian arteries, and total occlusion of two subclavian arteries. A total of 14 stents were implanted in 10 arterial lesions, resulting in a 91% procedural success rate. One failure was due to inability to cross the total occlusion of the subclavian artery. Procedural complications and problems were pain during balloon angioplasty in three patients, vaso-vagal reflex in two, carotid artery perforation associated with transient horseness in one, and stent migration in one. There was no permanent morbidity. Follow-up over a mean duration of 12 months revealed one symptomatic recurrence of left subclavian stenosis, followed by a successful re-dilatation. The results of the current study indicated that primary stenting is an excellent therapeutic option for the occlusive carotid and subclavian arteries in Takayasu arteritis. A long-term follow-up is required to determine the response or behavior of stented segments of the affected arteries.
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Affiliation(s)
- H Sakaida
- Department of Neurosurgery, Mie University School of Medicine, 2-174 Edobashi, Tsu-City, Mie 514-8507, Japan
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45
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Sekine M, Nagata H, Tsuji S, Hirai Y, Fujimoto S, Hatae M, Kobayashi I, Fujii T, Nagata I, Ushijima K, Obata K, Suzuki M, Yoshinaga M, Umesaki N, Satoh S, Enomoto T, Motoyama S, Tanaka K. Mutational analysis of BRCA1 and BRCA2 and clinicopathologic analysis of ovarian cancer in 82 ovarian cancer families: two common founder mutations of BRCA1 in Japanese population. Clin Cancer Res 2001; 7:3144-50. [PMID: 11595708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We analyzed genetic alterations in BRCA1 and BRCA2 genes among 82 ovarian cancer families in Japan. The clinical characteristics of BRCA-associated ovarian cancer patients were compared with cases carrying no mutations as well as with population controls. Using a direct sequencing method, 45 of the 82 ovarian cancer families were found to carry BRCA1 or BRCA2 germ-line mutations (40 with BRCA1 and 5 with BRCA2). In 24 independent mutations of BRCA1, 5 recurrent mutations were found and 2 of them, the L63X and Q934X mutations, were detected in seven and eight independent families, respectively. In addition, 16 mutations of BRCA1 and 3 mutations of BRCA2 have never been described previously. In consideration of clinicopathological features, there was a significantly higher proportion of tumors with serous adenocarcinoma and of cases of advanced stages in the BRCA1 or BRCA2 cases than in those of the controls. On the other hand, there were no differences of mean age at diagnosis between patients with BRCA1 or BRCA2 mutation and those of the controls. Our results indicate that the features of BRCA-associated ovarian cancer in Japan appear to be similar to those in Western countries, and the L63X and Q934X mutations of BRCA1 appear to be common founder mutations unique to the Japanese population.
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Affiliation(s)
- M Sekine
- Department of Obstetrics and Gynecology, Niigata University School of Medicine, 1-757, Asahimachi-dori, Niigata City 951-8510, Japan
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Namura S, Iihara K, Takami S, Nagata I, Kikuchi H, Matsushita K, Moskowitz MA, Bonventre JV, Alessandrini A. Intravenous administration of MEK inhibitor U0126 affords brain protection against forebrain ischemia and focal cerebral ischemia. Proc Natl Acad Sci U S A 2001; 98:11569-74. [PMID: 11504919 PMCID: PMC58770 DOI: 10.1073/pnas.181213498] [Citation(s) in RCA: 315] [Impact Index Per Article: 13.7] [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: 11/18/2022] Open
Abstract
Brain subjected to acute ischemic attack caused by an arterial blockage needs immediate arterial recanalization. However, restoration of cerebral blood flow can cause tissue injury, which is termed reperfusion injury. It is important to inhibit reperfusion injury to achieve greater brain protection. Because oxidative stress has been shown to activate mitogen-activated protein kinases (MAPKs), and because oxidative stress contributes to reperfusion injury, MAPK may be a potential target to inhibit reperfusion injury after brain ischemia. Here, we demonstrate that reperfusion after forebrain ischemia dramatically increases phosphorylation level of extracellular signal-regulated kinase 2 (ERK2) in the gerbil hippocampus. In addition, i.v. administration of U0126 (100-200 mg/kg), a specific inhibitor of MEK (MAPK/ERK kinase), protects the hippocampus against forebrain ischemia. Moreover, treatment with U0126 at 3 h after ischemia significantly reduces infarct volume after transient (3 h) focal cerebral ischemia in mice. This protection is accompanied by reduced phosphorylation level of ERK2, substrates for MEK, in the damaged brain areas. Furthermore, U0126 protects mouse primary cultured cortical neurons against oxygen deprivation for 9 h as well as nitric oxide toxicity. These results provide further evidence for the role of MEK/ERK activation in brain injury resulting from ischemia/reperfusion, and indicate that MEK inhibition may increase the resistance of tissue to ischemic injury.
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Affiliation(s)
- S Namura
- Stroke and Brain Protection, Research Institute, and Department of Neurosurgery, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan.
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47
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Shindo A, Sakai N, Sakai H, Higashi T, Nagata I, Kikuchi H. [Problems involved in endovascular embolization of intracranial aneurysms with three-dimensional Guglielmi detachable coils]. No Shinkei Geka 2001; 29:815-20. [PMID: 11596464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We experienced nine cases of intracranial aneurysms which were treated with three-dimensional Guglielmi detachable coils (3D-GDC). 3D-GDC is useful in the construction of the initial frame for the embolization of aneurysms, but it also has certain disadvantages for achieving successful treatment. Nine patients with nine intracranial aneurysms were treated with 3D-GDC for initial framing from October, 1999 to September, 2000 at the National Cardio-Vascular Center, Japan. Angiographically complete and successful occlusion was performed in only three patients. Four patients developed parent artery stenosis due to small loops of the 3D-GDC protruding from the aneurysm. Two patients experienced incomplete occlusion because small loops of the 3D-GDC caused cells to form in the framing, and additional coils could not be inserted into some cells. 3D-GDC is useful as an initial framing coil, but we should be careful when placing additional coils into an aneurysm because we cannot predict the effect of the small loops of 3D-GDC on the embolization of aneurysms.
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Affiliation(s)
- A Shindo
- Department of Neurosurgery, National Cardio-Vascular Center, 5-7-1 Fujishirodai, Suita-city, Osaka 565-8565, Japan
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48
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Kishimoto H, Taniguchi A, Sakai M, Fukushima M, Nagasaka S, Fukunaga A, Nagata I, Nakaishi S, Tokuyama K, Nakai Y. Assessments of insulin sensitivity in non-obese Japanese Type 2 diabetic patients: comparison of quantitative insulin sensitivity check index with minimal model approach. Diabet Med 2001; 18:772-3. [PMID: 11606181 DOI: 10.1046/j.1464-5491.2001.00526-4.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Iwama T, Kotani Y, Yamakawa H, Nagata I, Hashimoto N, Sakai N. Cerebral ischemic complications following intracranial bleeding in patients with moyamoya disease--three case reports. Neurol Med Chir (Tokyo) 2001; 41:450-3. [PMID: 11593973 DOI: 10.2176/nmc.41.450] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Three patients with bleeding-type moyamoya disease suffered ischemic complications following their first episode of intracranial bleeding. The patients presented with intraventricular hemorrhage and suffered cerebral infarction on the 14th, 16th, and 11th days after the ictus, respectively. The clinical records revealed no obvious hypotension before progression to infarction and suggested that dehydration accelerated by the administration of hyperosmotic drugs was a contributing factor to the infarction. Two patients underwent superficial temporal artery-middle cerebral artery anastomoses in the chronic stages and have never experienced further ischemic complications. The other patient died despite receiving intensive care. Hemodynamic reserve may be severely impaired in patients with bleeding-type moyamoya disease. Adequate control of hydration is important to prevent cerebral infarction after intracranial bleeding in patients with moyamoya disease.
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Affiliation(s)
- T Iwama
- Department of Neurosurgery, Gifu University School of Medicine, Gifu
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50
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Sakaida H, Sakai N, Nagata I, Sakai H, Iihara K, Higashi T, Kogure S, Takahashi J, Ohta H, Nagamine T, Anei R, Soeda A, Taniguchi A, Shindo A, Kikuchi H. [Stenting for proximal subclavian and brachiocephalic artery occlusion--preliminary results]. No Shinkei Geka 2001; 29:717-25. [PMID: 11554089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The authors report the initial results, between January 1998 and February 2001, of stenting utilizing the brachial approach in seven patients for total occlusions at the following locations: two right subclavian, one brachiocephalic, and five left subclavian arteries. All lesions were associated with subclavian steal syndrome. Indications for the treatment included ischemic symptoms in the affected arm (seven patients), and vertebrobasilar insufficiency (five patients). A total of eight stents were implanted in six occluded arteries, resulting in a 75% procedural success rate. Procedural complications encountered were two subintimal dissections by a 0.035-inch guide wire during recanalization, and one stent dislodgement with migration. There was no stroke, presumably because of the previously reported preventive effect of delayed reversal of a stealing vertebral artery. Follow-up over a mean duration of 11 months revealed no sign or symptom of recurrence in cases with initial technical success. The results of the current study, with a literature survey, indicated that percutaneous transluminal angioplasty with primary stent deployment in an occluded prevertebral segment of the subclavian or the brachiocephalic artery should be considered as an available choice for treatment. Further points, such as some remaining technical and clinical problems, will require more experience and consideration.
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Affiliation(s)
- H Sakaida
- Department of Neurosurgery, Mie University School of Medicine, 2-174 Edobashi, Tsu-shi, Mie 514-8507, Japan
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