1
|
Moritsubo M, Furuta T, Miyoshi J, Komaki S, Sakata K, Miyoshi H, Morioka M, Ohshima K, Sugita Y. Increased expression of leucine-rich α-2 glycoprotein 1 as a predictive biomarker of favorable progression-free survival in meningioma. Neuropathology 2024; 44:96-103. [PMID: 37749948 DOI: 10.1111/neup.12944] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
Most meningiomas, which are frequent central nervous system tumors, are classified as World Health Organization (WHO) grade 1 because of their slow-growing nature. However, the recurrence rate varies and is difficult to predict using conventional histopathological diagnoses. Leucine-rich α-2 glycoprotein 1 (LRG1) is involved in cell signal transduction, cell adhesion, and DNA repair and is a predictive biomarker in different malignant tumors; however, such a relationship has not been reported in meningiomas. We examined tissue microarrays of histological samples from 117 patients with grade 1 and 2 meningiomas and assessed their clinical and pathological features, including expression of LRG1 protein. LRG1-high meningiomas showed an increased number of vessels with CD3-positive cell infiltration (P = 0.0328) as well as higher CD105-positive vessels (P = 0.0084), as compared to LRG1-low cases. They also demonstrated better progression-free survival (hazard ratio [HR] 0.11, 95% confidence interval [CI] 0.016-0.841) compared to LRG1-low patients (P = 0.033). Moreover, multivariate analysis indicated that high LRG1 expression was an independent prognostic factor (HR, 0.13; 95% CI, 0.018-0.991; P = 0.049). LRG1 immunohistochemistry may be a convenient tool for estimating the prognosis of meningiomas in routine practice. Further studies are required to elucidate the key role of LRG1 in meningioma progression.
Collapse
Affiliation(s)
- Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Junko Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Satoru Komaki
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sugita
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
| |
Collapse
|
2
|
Otsu Y, Kikuchi J, Nakahara Y, Yoshitake H, Kajiwara S, Sakata K, Morioka M. A Ruptured Aneurysm of the Transdural Anastomotic Artery Occurring at the Temporal Base in Moyamoya Disease: Case Report and Literature Review. NMC Case Rep J 2024; 11:79-84. [PMID: 38590925 PMCID: PMC10999459 DOI: 10.2176/jns-nmc.2023-0263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/17/2024] [Indexed: 04/10/2024] Open
Abstract
A 24-year-old woman with hemorrhagic onset moyamoya disease received bilateral indirect bypass surgery 11 years ago. She presented with a life-threatening atraumatic acute right subdural hematoma with temporal lobe intracerebral hemorrhage due to a transdural anastomosis (TDA) aneurysm rupture. We reviewed six cases of rare TDA aneurysms, all of which occurred around the temporal base. TDA aneurysms may occur near the main trunk of the middle meningeal artery (MMA) where hemodynamic stress is high. Therefore, we must pay attention to skull base aneurysms that form near the MMA; otherwise, the prognosis would be poor if such an aneurysm ruptured.
Collapse
Affiliation(s)
- Yusuke Otsu
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Jin Kikuchi
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoichiro Nakahara
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hidenobu Yoshitake
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| |
Collapse
|
3
|
Amemiya K, Sakata K. Real-time observation of polarization dependence of soft x-ray absorption spectrum during chemical reaction under near-ambient pressure conditions. Rev Sci Instrum 2023; 94:123906. [PMID: 38147455 DOI: 10.1063/5.0170516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/03/2023] [Indexed: 12/28/2023]
Abstract
The real-time observation of the polarization dependence of soft x-ray absorption spectra during chemical reactions is realized by combining the fluorescence-yield wavelength-dispersive x-ray absorption spectroscopy technique with a 10 Hz switching between horizontal and vertical polarizations. The soft x-ray absorption spectra for both the horizontal and vertical polarizations are recorded every 100 ms with a time difference of 50 ms, which enables the real-time observation of changes in the anisotropic structure around the surface. The technique is applied to the oxidation reaction of a cobalt thin film under an air pressure of up to 25 Pa, and it is suggested that an anisotropic structure appears during the growth of the cobalt oxide species. By using the developed technique, it is expected that the changes in the anisotropic structures, such as molecular orientations, are observed during chemical reactions under near-ambient pressure conditions, which gives a deeper insight into the understanding of the reaction mechanism.
Collapse
Affiliation(s)
- K Amemiya
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
- Graduate Institute for Advanced Studies, SOKENDAI, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - K Sakata
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| |
Collapse
|
4
|
Sakata K, Komaki S, Takeshige N, Negoto T, Kikuchi J, Kajiwara S, Orito K, Nakamura H, Hirohata M, Morioka M. Visual Outcomes and Surgical Approach Selection Focusing on Active Optic Canal Decompression and Maximum Safe Resection for Suprasellar Meningiomas. Neurol Med Chir (Tokyo) 2023; 63:381-392. [PMID: 37423756 PMCID: PMC10556211 DOI: 10.2176/jns-nmc.2021-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 04/17/2023] [Indexed: 07/11/2023] Open
Abstract
The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension. Optic canal decompression and exploration were performed as key surgical procedures. Simpson grade 1 to 3 resection was achieved in 80% of cases. Among the 26 patients with pre-existing visual dysfunction, vision at discharge improved in 18 patients (69.2%), remained unchanged in six (23.1%), and deteriorated in two (7.7%). Further gradual visual recovery and/or maintenance of useful vision were also observed during follow-up. We propose an algorithm for selecting the appropriate surgical approach to a suprasellar meningioma based on preoperative radiologic tumor characteristics. The algorithm focuses on effective optic canal decompression and maximum safe resection, possibly contributing to favorable visual outcomes.
Collapse
Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University School of Medicine
| | | | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Jin Kikuchi
- Department of Neurosurgery, Kurume University School of Medicine
| | - Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
| |
Collapse
|
5
|
Otsu Y, Komaki S, Takeshige N, Sakata K, Morioka M. Visual-evoked potential predicts the efficacy of the optical canal decompression for traumatic optic nerve neuropathy showing blindness: A case report. Surg Neurol Int 2023; 14:245. [PMID: 37560571 PMCID: PMC10408612 DOI: 10.25259/sni_450_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/25/2023] [Indexed: 08/11/2023] Open
Abstract
Background The indication for surgical optic canal decompression (OCD) for traumatic optic neuropathy (TON) remains controversial because there is no reliable predictor of a good outcome. We report the case of a blind patient with TON whose remaining visual-evoked potential (VEP) suggested recovery potential of the injured optic nerve after OCD. Case Description A 48-year-old man had fallen from a height of 7 m, striking his head. He immediately complained of right-eye blindness. He had no light perception and the direct light reflex disappeared from the right pupil, although there was no fracture or traumatic lesion on computed tomography and magnetic resonance imaging. Because the amplitude of the VEP with the right eye stimulation remained unchanged, we performed the right OCD. During surgical OCD, the amplitude and latency of VEP began to improve. Finally, the visual field improved in almost all directions, and eyesight improved to 0.2. Conclusion The retained VEP activity in TON may suggest the recovery potential of the injured optic nerve, even in cases of blindness. It is possible that VEP is an indicator of aggressive treatment for TON such as OCD.
Collapse
Affiliation(s)
- Yusuke Otsu
- Department of Neurosurgery, Kurume University School of Medicine, Kurume City, Japan
| | | | | | | | | |
Collapse
|
6
|
Yamashita S, Takeshima H, Hata N, Uchida H, Shinojima N, Yokogami K, Nakano Y, Sakata K, Fudaba H, Enomoto T, Nakahara Y, Ujifuku K, Sugawara K, Iwaki T, Sangatsuda Y, Yoshimoto K, Hanaya R, Mukasa A, Suzuki K, Yamamoto J, Negoto T, Nakamura H, Momii Y, Fujiki M, Abe H, Masuoka J, Abe T, Matsuo T, Ishiuchi S. Clinicopathologic analysis of pineal parenchymal tumors of intermediate differentiation: a multi-institutional cohort study by the Kyushu Neuro-Oncology Study Group. J Neurooncol 2023; 162:425-433. [PMID: 37052748 DOI: 10.1007/s11060-023-04310-w] [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: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE Pineal parenchymal tumors of intermediate differentiation (PPTIDs), which were recognized in the 2007 World Health Organization (WHO) classification, are rare, accounting for less than 1% of all central nervous system tumors. This rarity and novelty complicate the diagnosis and treatments of PPTID. We therefore aimed to evaluate the clinicopathological significance of this tumor. METHODS At 11 institutions participating in the Kyushu Neuro-Oncology Study Group, data for patients diagnosed with PPTID were collected. Central pathology review and KBTBD4 mutation analysis were applied to attain the diagnostically accurate cohort. RESULTS PPTID was officially diagnosed in 28 patients: 11 (39%) with WHO grade 2 and 17 (61%) with WHO grade 3 tumors. Median age was 49 years, and the male:female ratio was 1:2.1. Surgery was attempted in all 28 patients, and gross total resection (GTR) was achieved in 46% (13/28). Adjuvant radiotherapy and chemotherapy were administered to, respectively, 82% (23/28) and 46% (13/28). The 5-year progression-free survival (PFS) and overall survival rates were 64.9% and 70.4% respectively. Female sex (p = 0.018) and GTR (p < 0.01) were found to be independent prognostic factors for PFS and female sex (p = 0.019) was that for OS. Initial and second recurrences were most often leptomeningeal (67% and 100% respectively). 80% (20/25) of patients harbored a KBTBD4 mutation. CONCLUSIONS Female sex and GTR were independent prognostic factors in our patients with PPTID. Leptomeningeal recurrence was observed to be particularly characteristic of this tumor. The rate of KBTBD4 mutation observed in our cohort was acceptable and this could prove the accuracy of our PPTID cohort.
Collapse
Affiliation(s)
- Shinji Yamashita
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Hideo Takeshima
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Nobuhiro Hata
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hiroyuki Uchida
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kiyotaka Yokogami
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yoshiteru Nakano
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirotaka Fudaba
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Toshiyuki Enomoto
- Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yukiko Nakahara
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Kenta Ujifuku
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichi Sugawara
- Department of Neurosurgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tooru Iwaki
- Department of Neuropathology, Neurological Institute, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan
| | - Yuhei Sangatsuda
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryousuke Hanaya
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kohei Suzuki
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Yasutomo Momii
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Minoru Fujiki
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hiroshi Abe
- Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Jun Masuoka
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Takayuki Matsuo
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shogo Ishiuchi
- Department of Neurosurgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| |
Collapse
|
7
|
Otsu Y, Kajiwara S, Hashimoto A, Sakata K, Negoto T, Hasegawa Y, Nakamura H, Hirohata M, Morioka M. Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia. Neurol Med Chir (Tokyo) 2023. [PMID: 37019653 DOI: 10.2176/jns-nmc.2022-0288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable.
Collapse
Affiliation(s)
- Yusuke Otsu
- Department of Neurosurgery, Kurume University School of Medicine
| | - Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Aya Hashimoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Yu Hasegawa
- Department of Neurosurgery, Kurume University School of Medicine
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
| |
Collapse
|
8
|
Ohkubo T, Kajiwara S, Hasegawa Y, Hashimoto A, Takeuchi Y, Orito K, Kawano T, Fujimori K, Sakata K, Hirohata M, Morioka M. Bold-S Signs on Computed Tomography Angiography Are Sensitive Markers for Diagnosing Subcortical Hemorrhage Due to Dural Arteriovenous Fistulae on Emergent Admission. Neurol Med Chir (Tokyo) 2023; 63:97-103. [PMID: 36599432 PMCID: PMC10072889 DOI: 10.2176/jns-nmc.2022-0256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
An optimal treatment strategy for subcortical hematomas caused by dural arteriovenous fistulae (dAVF) is important because of the high rebleeding rate. However, it is very difficult to diagnose that on admission. Therefore, an early sensitive predictive marker for subcortical hemorrhage caused by dAVF is necessary, especially during the first contact on admission. S-shaped dilated vessels around the hematoma (bold-S sign) on computed tomography angiography (CTA) performed during admission could be one such marker. Herein, we evaluated the characteristics of these vessels. Among 273 patients with intracerebral hemorrhage between April 2012 and March 2020, 67 patients with subcortical hematomas who underwent CTA on admission without arteriovenous malformations were included. The patients in the dAVF group (n = 7) showed fewer disturbances in consciousness, milder neurological deficits, and more frequent seizures than patients without dAVF (without dAVF group, n = 60). All patients in the dAVF group had dilated S-shaped vessels (2.59 ± 0.27 mm) around the hematomas, and only 20% of the patients in the without dAVF group had these vessels (1.69 ± 0.22 mm). The ratio of the ipsilateral S-shaped/contralateral largest vessels was 1.80 ± 0.29 in the dAVF group and 1.07 ± 0.16 in the group without dAVF. We called the dilated S-shaped vessels the "bold-S sign," with a cutoff ratio of 1.5. Bold-S sign findings are novel and help in diagnosing subcortical hematomas caused by dAVF on admission.
Collapse
Affiliation(s)
- Taku Ohkubo
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Sosho Kajiwara
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Yu Hasegawa
- Departments of Neurosurgery, Kurume University School of Medicine
- Departments of Pharmaceutical Science, School of Pharmacy at Fukuoka, International University of Health and Welfare
| | - Aya Hashimoto
- Departments of Neurosurgery, Kurume University School of Medicine
| | | | - Kimihiko Orito
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Takayuki Kawano
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Kana Fujimori
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Kiyohiko Sakata
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Masaru Hirohata
- Departments of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Departments of Neurosurgery, Kurume University School of Medicine
| |
Collapse
|
9
|
Hayashi K, Tanaka Y, Tsuda T, Nomura A, Fujino N, Furusho H, Sakai N, Iwata Y, Usui S, Sakata K, Kato T, Tada H, Kusayama T, Usuda K, Kawashiri MA, Passman RS, Wada T, Yamagishi M, Takamura M, Fujino N, Nohara A, Kawashiri MA, Hayashi K, Sakata K, Yoshimuta T, Konno T, Funada A, Tada H, Nakanishi C, Hodatsu A, Mori M, Tsuda T, Teramoto R, Nagata Y, Nomura A, Shimojima M, Yoshida S, Yoshida T, Hachiya S, Tamura Y, Kashihara Y, Kobayashi T, Shibayama J, Inaba S, Matsubara T, Yasuda T, Miwa K, Inoue M, Fujita T, Yakuta Y, Aburao T, Matsui T, Higashi K, Koga T, Hikishima K, Namura M, Horita Y, Ikeda M, Terai H, Gamou T, Tama N, Kimura R, Tsujimoto D, Nakahashi T, Ueda K, Ino H, Higashikata T, Kaneda T, Takata M, Yamamoto R, Yoshikawa T, Ohira M, Suematsu T, Tagawa S, Inoue T, Okada H, Kita Y, Fujita C, Ukawa N, Inoguchi Y, Ito Y, Araki T, Oe K, Minamoto M, Yokawa J, Tanaka Y, Mori K, Taguchi T, Kaku B, Katsuda S, Hirase H, Haraki T, Fujioka K, Terada K, Ichise T, Maekawa N, Higashi M, Okeie K, Kiyama M, Ota M, Todo Y, Aoyama T, Yamaguchi M, Noji Y, Mabuchi T, Yagi M, Niwa S, Takashima Y, Murai K, Nishikawa T, Mizuno S, Ohsato K, Misawa K, Kokado H, Michishita I, Iwaki T, Nozue T, Katoh H, Nakashima K, Ito S, Yamagishi M. Correction: Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry. Heart Vessels 2023; 38:412. [PMID: 36508013 DOI: 10.1007/s00380-022-02218-5] [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: 12/14/2022]
Affiliation(s)
- Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
| | - Yoshihiro Tanaka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Department of Cardiology, Ishikawa Prefectural Central Hospital, 2-1, Kuratsuki-higashi, Kanazawa, Japan
| | - Norihiko Sakai
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Yasunori Iwata
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Soichiro Usui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Takashi Kusayama
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Keisuke Usuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | - Rod S Passman
- Center for Arrhythmia Research, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Takashi Wada
- Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.,Osaka University of Human Sciences, Settsu, Osaka, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Sakata K, Hashimoto A, Kotaki Y, Yoshitake H, Shimokawa S, Komaki S, Nakamura H, Furuta T, Morioka M. Successful Treatment of Pure Aqueductal Pilomyxoid Astrocytoma and Arrested Hydrocephalus With Endoscopic Tumor Resection Followed by Chemotherapy: A Case Report and Technical Considerations. Neurosurgery Open 2023. [DOI: 10.1227/neuprac.0000000000000030] [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: 02/05/2023] Open
|
11
|
Negoto T, Komaki S, Hashimoto A, Yoshitake H, Moritsubo M, Furuta T, Sakata K, Nakamura H, Morioka M. CBMS-4 CHROMOSOMAL INSTABILITY IN GLIOMA USING SPECTRAL KARYOTYPING METHOD. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.003] [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: 12/05/2022] Open
Abstract
Abstract
Introduction
Chromosomal instability, the cell condition in which chromosome mis-segregation occur at a high frequency during cell division, has been considered to be involved in the molecular mechanisms that give rise to the complex genetic background of glioma. However, most of this phenomenon has been based on researches using cell line, and there have been few studies of chromosomal instability in clinical specimens of gliomas.
Methods
Primary cell culture was obtained from 11 glioma specimens (eight Glioblastoma (GBM), one Anaplastic PXA (aPXA), one Astrocytoma, and one Ependymoma), which was removed at our hospital, and chromosomes of up to five cells per case were analyzed by the SKY method. Chromosome instability was quantified by two parameters, one was AS (Aneuploidy score), which means the number of gain or loss of whole of the chromosome, and the other was SS: Structural abnormality score, which means the number of chromosome structural abnormality per cell. In addition, the phenotypes, which were characteristic of chromosomal instability were observed individually.
Results
Each quantitative value was as follows: GBM; AS:2.30±0.51 /SS:1.64±0.38, aPXA; AS :1.40±1.33 / SS:8.20±0.99, Astrocytoma and Ependymoma; AS:0.00 /SS:0.00, suggesting that chromosomal instability was associated with GBM and aPXA. Chromosome 7 amplification was most frequent in GBM (57%), and Mosaic loss of chromosome Y was also observed in 60% of males. Some characteristic karyotypes which suggest the phenomenon of Chromothripsis or Double minute were also observed. The karyotype concordance rate in the cases with p53 mutation was 60%, and that with p53 wild type was 100%, indicating that the p53 mutation increased the genotype heterogeneity in the same specimen.
Discussion
In clinical specimens of gliomas, aneuploidy and structural abnormalities were identified in GBM and aPXA, suggesting that chromosomal instability contributes to their cellular phenotype and malignancy.
Collapse
Affiliation(s)
- Tetsuya Negoto
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Aya Hashimoto
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Hidenori Yoshitake
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University of Medicine , Fukuoka , Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University of Medicine , Fukuoka , Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| |
Collapse
|
12
|
Kajiwara S, Nakamura H, Sakata K, Komaki S, Negoto T, Morioka M. Endoscopic aqueductal membrane fenestration was effective for intractable hydrocephalus after removal of a nongerminomatous germ cell tumor exhibiting growing teratoma syndrome: a case report. BMC Pediatr 2022; 22:683. [PMID: 36443673 PMCID: PMC9703769 DOI: 10.1186/s12887-022-03743-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Primary central nervous system (CNS) germ cell tumors (GCTs) are rare neoplasms predominantly observed in the pediatric and young adult populations. A mixed GCT including immature teratoma exhibiting growing teratoma syndrome is presented. The pathogenesis of growing teratoma syndrome remains unclear, and its treatment strategy has not been established. GCTs are often located within the ventricles, causing hydrocephalus, which sometimes improves after removal of the tumor due to restoration of cerebrospinal fluid (CSF) flow. On the other hand, even if the flow route of CSF from the third ventricle to arachnoid granulations on the brain surface quadrigeminal cistern is restored after removal of the tumor, hydrocephalus may not improve. CASE PRESENTATION A case whose intractable hydrocephalus improved after penetrating the aqueductal membrane via endoscopy is described. An 11-year-old boy was treated for pineal intracranial growing teratoma syndrome (IGTS). The tumor grew rapidly in a short period, and hydrocephalus progressed despite endoscopic third ventriculostomy (ETV). Although the obstruction was removed by radiation, chemotherapy, and total tumor resection, the hydrocephalus did not improve. Endoscopic membrane perforation was performed because a membrane-like structure was seen at the entrance of the cerebral aqueduct on magnetic resonance imaging. The hydrocephalus improved immediately after the operation, and the patient's consciousness disturbance also improved significantly. CONCLUSION The purpose of this report is to update the current knowledge and standards of management for patients with growing teratoma syndrome, as well as to drive future translational and clinical studies by recognizing the unmet needs concerning hydrocephalus.
Collapse
Affiliation(s)
- Sosho Kajiwara
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Hideo Nakamura
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Kiyohiko Sakata
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Satoru Komaki
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Tetsuya Negoto
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Motohiro Morioka
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| |
Collapse
|
13
|
Cui S, Hayashi K, Usuda K, Usui S, Sakata K, Kawashiri M, Kusayama T, Tsuda T, Fujino N, Kato T, Takamura M. Utility of in vivo zebrafish cardiac assay to predict the functional impact of KCNQ1 variants. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2969] [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
Genetic testing for inherited arrhythmias and discriminating pathogenic from benign variants are integral for the gene-based medicine. However, the high throughput in vivo functional analysis for the rare variants of the KCNQ1 potassium channel is scarce.
Purpose
We tested the utility of the in vivo zebrafish cardiac assay for determining the pathogenicity of the KCNQ1 variants identified in patients with long QT syndrome (LQTS) and atrial fibrillation (AF).
Methods
We generated a knock-out zebrafish with CRISPR-mediated insertions or deletions of the KCNQ1 homolog in zebrafish (kcnq1+/+). To test the utility of the cardiac assay, we used five KCNQ1 variants identified in patients with LQTS or familial AF. Human wild-type or mutant KCNQ1 cRNA (Q1) was co-injected with human KCNE1 cRNA (E1) into the F3 generation embryos with homozygous deletions. We dissected the hearts from the thorax at 72 hour-post-fertilization and measured transmembrane potential in zebrafish heart using the disrupted patch technique. Action potential duration was calculated as the time interval between the peak maximum upstroke velocity and 90% of repolarization (APD90). We compared the APD90s with patients' clinical phenotype and IKs density measured by patch-clamp technique in heterologous system.
Results
The mean APD90 of embryos with kcnq1del/del was 279±48 ms, which was restored by injecting Q1 WT and E1 (159±29 ms) to that with kcnq1+/+ (167±28 ms). We tested if the mean APD90 of embryos with kcnq1del/del was restored (shortened) by injecting the KCNQ1 variants. First we tested the dominant negative variant p.S277L and the trafficking deficient variant p.T587M. Patients with these variants showed significant prolonged QT intervals, and patch clamp study showed both variants caused the non-functional channels. Zebrafish cardiac assay showed the mean APD90 of embryos with kcnq1del/del+ Q1 S277L+E1 or Q1 T587M+E1 was significantly longer than that with kcnq1del/del+Q1 WT+E1 (Table). Next we tested in-frame variant c.1472_1473 ins GGACCT, which was identified from a patient with AF and normal QT interval. Patch clamp study showed the current density of the mutant KCNQ1 channel with KCNE1 was comparable to that of wild-type KCNQ1 channel with KCNE1. Zebrafish assay showed the mean APD90 of embryos with kcnq1del/del shortened by injecting Q1 insACCTGG +E1 (Table). Finally we tested a missense variant p.R451Q, which was identified from a patient with LQTS. Patch clamp study showed the currents in the cells transfected with R451Q+KCNE1 were similar to those with WT+KCNE1. Zebrafish assay showed the mean APD90 of embryos with kcnq1del/del+Q1 R451Q+E1 was longer than that with kcnq1del/del+Q1 WT+E1 (Table).
Conclusions
Functional analysis of in vivo zebrafish cardiac assay might be useful for determining the pathogenicity of rare variants in patients with LQTS.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): The Grant-in-Aid for Scientific Research (C)
Collapse
Affiliation(s)
- S Cui
- Kanazawa University , Kanazawa , Japan
| | - K Hayashi
- Kanazawa University , Kanazawa , Japan
| | - K Usuda
- Kanazawa University , Kanazawa , Japan
| | - S Usui
- Kanazawa University , Kanazawa , Japan
| | - K Sakata
- Kanazawa University , Kanazawa , Japan
| | | | | | - T Tsuda
- Kanazawa University , Kanazawa , Japan
| | - N Fujino
- Kanazawa University , Kanazawa , Japan
| | - T Kato
- Kanazawa University , Kanazawa , Japan
| | | |
Collapse
|
14
|
Orito K, Kajiwara S, Takeuchi Y, Sakata K, Abe T, Tanoue S, Uchiyama Y, Hirohata M, Morioka M. Relationship between Transient Cortical Blindness and Contrast Medium Leakage That Occurs after Endovascular Treatment of Posterior Circulation Aneurysms. J Neuroendovasc Ther 2022; 16:535-541. [PMID: 37501739 PMCID: PMC10370876 DOI: 10.5797/jnet.oa.2021-0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/27/2022] [Indexed: 07/29/2023]
Abstract
Objective The mechanism of transient cortical blindness after endovascular treatment-a rare phenomenon-has not been elucidated; however, it is assumed to be related to contrast medium leakage (CML). We investigated the relationship between postoperative CML and cortical blindness in patients who underwent endovascular treatment for vascular lesions of posterior circulation. Methods This retrospective cohort study included 28 patients who underwent endovascular treatment for posterior circulation aneurysms at our hospital between January 2014 and December 2018. Cerebral CT was performed immediately after endovascular treatment and 24 h later. CT images were retrospectively evaluated with special interest in the presence and distribution of leakage of the contrast medium (CM). Patients were classified into the following three groups based on CT findings: Group A, no CML (11 patients); Group B, unilateral CML (5 patients); and Group C, bilateral CML (9 patients). Results The posterior circulation aneurysms were located in the basilar artery in 13 (52.0%) cases, in the posterior cerebral artery in 1 (4.0%) case, and in the vertebral artery in 11 (44.0%) cases. There was no difference regarding the adjunctive technique used for endovascular treatment between the groups. Patients in Group C used a significantly larger amount of CM than those in the other two groups. A longer operation time was associated with a larger amount of CM used during treatment. VerifyNow assay revealed that the P2Y12 reaction unit was significantly lower in Groups B and C. Cortical blindness was transiently observed in 2 of 9 patients (22.2%) in Group C, both of which showed CML surrounding the bilateral parieto-occipital sulcus. Conclusion Both patients with cortical blindness showed bilateral CML, both of which showed CML surrounding the bilateral parieto-occipital sulcus. The CM-induced blood-brain barrier disruption may be the cause of cortical blindness.
Collapse
Affiliation(s)
- Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sosyo Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yasuharu Takeuchi
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yusuke Uchiyama
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| |
Collapse
|
15
|
Nonaka T, Sakata K, Abe T, Hattori G, Orito K, Miyagi N, Tokutomi T, Morioka M. The eagle jugular syndrome as the cause of delayed intracranial hemorrhage after microvascular decompression for hemifacial spasm: A case report. Surg Neurol Int 2021; 12:584. [PMID: 34992901 PMCID: PMC8720428 DOI: 10.25259/sni_808_2021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background:
Eagle syndrome is a rare disorder whereby an elongated styloid process (ESP) causes not only some otolaryngological symptoms, but also cerebrovascular events caused by compression of the carotid artery. In recent years a syndrome, denominated as Eagle jugular syndrome, involving internal jugular vein (IJV) compression caused by an ESP has been proposed as a variation of Eagle syndrome. Clinical impact of the Eagle jugular syndrome on neurosurgical procedures has not been reported yet.
Case Description:
We present a case of a 68-year-old woman who underwent microvascular decompression for hemifacial spasm of the left side and developed delayed intracranial hemorrhage on postoperative day 3. We also demonstrate that this patient developed ipsilateral IJV stenosis between an ESP and the muscle bundle of the rectus capitis lateralis with antero-flexion neck position, which would induce venous congestion in addition to surgical disruption of emissary vein.
Conclusion:
This case is the first report demonstrating the association of an ESP with postoperative delayed intracranial hemorrhage. Our report elucidates the importance of the awareness among neurosurgeons of considering the ESP as an important bony anomaly, especially when planning for posterior fossa surgery.
Collapse
Affiliation(s)
- Takahisa Nonaka
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Toshi Abe
- Department of Radiology, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Gohsuke Hattori
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Kimihiko Orito
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Naohisa Miyagi
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Takashi Tokutomi
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, School of Medicine, Kurume University, Kurume City, Fukuoka, Japan
| |
Collapse
|
16
|
Goten C, Usui S, Okada H, Inoue O, Takashima S, Sakata K, Kawashiri M, Takamura M. Progression of liver fibrosis in pulmonary arterial hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1957] [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
Pulmonary arterial hypertension (PAH) causes congestive liver due to right heart failure. There are few cases of PAH that lead to liver cirrhosis, and little attention is paid to liver function in PAH patients. However, it is certain that long-term congestion due to right heart failure in PAH causes a gradual exacerbation of liver dysfunction and affects metabolic function.
Purpose
The purpose of this study is to investigate liver fibrosis associated with the severity and prognosis of PAH.
Methods
This retrospective observational study was included 57 PAH patients and 22 control subjects. PAH patients were assigned to three risk variables according to the simplified risk stratification proposed at the 6thWSPH 2018 after measuring hemodynamic parameters using right heart catheterization, WHO functional class, 6- minutes walking distance (6MWD), and BNP plasma levels. The Fibrosis-4 (FIB4)-index, a liver fibrosis marker, was calculated using the formula: FIB-4 = Age (years) × AST (U/L) / [PLT (109/L) × ALT1/2 (U/L)], and assessed for association with severity of PAH. PAH patients were followed up for 12 years to assess the occurrence of major adverse event, such as death or lung transplantation.
Next, adult 8-week-old C57BL/6 mice were exposed to chronic hypoxia (10% O2) or normoxia for 6 weeks. Then, mice were anesthetized and performed right heart catheterization. Liver tissue was collected for histological assessment by Hematoxylin and eosin and Azan staining, and evaluated RNA expression involved in liver fibrosis by real-time PCR.
Results
The levels of FIB4-index in intermediate and high risk groups of PAH patients had significantly increased compared to those in control group. In PAH patients, FIB4-index was not obviously correlated with hemodynamic parameters, BNP, or 6MWD. Major adverse events occurred in 18 PAH patients (32%): death in 18 (100%) and lung transplant in none (0%). Kaplan-Meier curves for PAH patients with and without major adverse events were constructed based on a cut-off frequency of 2.001 for FIB4-index. During the 12-years follow-up period, major-event-free survival was significantly better in PAH patients with FIB4-index <2.001 than in patients with FIB4-index >2.001 (hazard ratio, 3.3; P=0.038).
In a PAH model mice, hemodynamic parameters showed that chronic hypoxia significantly increased the right ventricular systolic pressure. In histological analysis, there was no significantly difference in liver fibrosis in hypoxia or normoxia group. However, the RNA expression such as αSMA and TGFβ1 associated with liver fibrosis in PAH model mice was increased compared to control mice.
Conclusion
This study showed that the liver fibrosis gradually progressed subsurfacely with severity of PAH. Even the slight liver dysfunction may affect metabolism and cause exacerbation of PAH, so it might be necessary to pay attention to liver fibrosis as one of the risk factors of PAH.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- C Goten
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - H Okada
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - O Inoue
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - S Takashima
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| |
Collapse
|
17
|
Sugimoto H, Murai H, Hirai T, Hamaoka T, Mukai Y, Tokuhisa H, Usui S, Sakata K, Kawajiri M, Takamura M. Different contribution of sympathetic nerve activity to arterial velocity pulse index in hypertensive patients with and without diastolic dysfunction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2306] [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
Introduction
Left ventricular diastolic dysfunction (LVDD) is the main cause of heart failure with preserved ejection fraction (HFpEF). LVDD is related not only to arterial stiffness but also sympathetic nerve activity (SNA). Recent study demonstrated that increased muscle sympathetic nerve activity (MSNA) may be one of contributing factor for arterial stiffness. In clinical practice, Cardio-ankle vascular index (CAVI) provides a reproducible index of arterial stiffness, independent of blood pressure (BP). Recently, Arterial Velocity pulse Index (AVI), which is an index of arterial reflected waves, have been proposed as new index of arterial stiffness. We reported that AVI was associated with MSNA in hypertensive (HT) patients. However, it is still uncertain the effect of LVDD on the association between AVI and SNA in HT patients. Thus, we tested the hypothesis that AVI would be increased and related to MSNA in HT patients with LVDD.
Methods
Patients with essential HT subjects were included in this study. HT was diagnosed as systolic blood pressure (SBP) ≥140mmHg or diastolic blood pressure (DBP) ≥90mmHg. Patients with secondary HT was excluded. AVI was measured from left upper arm by NAS-1000 (Nihon Koden, Japan). CAVI was measured by VaSera VS-1500A (Fukuda Denshi, Japan). Transthoracic echocardiography was performed by trained sonographers. SNA was evaluated by direct recording of MSNA from peroneal nerves.
Results
25 HT patients were included (age 63±14 years, Male/Female 9/16). They were divided into two groups according to E/e' (no LVDD group, E/e' ≤9, N=12; LVDD group, E/e' >9, N=13). There were no significant differences between no LVDD and LVDD groups in age (63±9 vs 69±9 years p=0.205), body mass index (23±3 vs 24±4 p=0.355), BP (SBP 139±16 vs 144±20mmHg p=0.524, DBP 87±15 vs 78±14mmHg p=0.167). LV Ejection Fraction (EF) and Stroke Volume (SV) did not differ between two groups (EF 66±7 vs 69±6% p=0.471, SV 58±7 vs 62±14ml p=0.599). MSNA had tendency to increase in LVDD group compared to no LVDD group (MSNA 53±10 vs 44±12 bursts/100 heartbeats, p=0.052). Contrary to our hypothesis, AVI and CAVI did not differ between two groups (AVI 27±7 vs 29±7 p=0.398, CAVI 8.7±1.4 vs 8.6±1.4 p=0.894). However, a significant correlation was seen between AVI and MSNA in no LVDD group (r=0.57, p<0.05), but no correlation in LVDD group. There is no correlation between CAVI and MSNA in no LVDD and LVDD group. Significant relationship was observed between AVI and CAVI in LVDD group (r=0.61, p<0.05), but no relationship in no LVDD group.
Conclusion
AVI was significantly associated with MSNA in HT patients without LVDD, but not with LVDD. CAVI was related to AVI in HT patients with LVDD, but not without LVDD. MSNA was slightly increased in HT patients with LVDD compared to without LVDD. These results indicate that augmented SNA could contribute to the increase in arterial stiffness in HT patients without LVDD, however, this contribution might be attenuated in HT patients with LVDD.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hirai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | | | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | | | |
Collapse
|
18
|
Usuda K, Hayashi K, Ishikawa T, Aizawa Y, Kato T, Kusayama T, Tsuda T, Usui S, Sakata K, Kawashiri M, Mishima H, Yoshiura K, Makita N, Takamura M. Novel variant of the glycerol-3-phosphate dehydrogenase-1 Like (GPD1-L) gene in Japanese Brugada syndrome patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0640] [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 incidence of Brugada syndrome (BrS) varies among racial groups. Several studies reported Glycerol-3-Phosphate Dehydrogenase 1-Like (GPD1-L) gene is associated with BrS. However, most of these studies were reported from Western countries, so the evidence about GPD1-L mutation is limited especially among Asian BrS patients. This study aimed to search for rare variants in GPD1-L among Japanese BrS patients and to investigate the pathogenicity.
Method
We performed whole-exome sequencing for patients with Brugada type 1 ECG pattern from Japanese multicenter BrS cohort consisting of SCN5A-negative BrS probands (n=288) and controls (n=372). We conducted patch-clamp study in human embryonic kidney (HEK) 293 cells cotransfected with the wild-type sodium channel (SCN5A) and wild-type or mutant GPD1-L expression plasmid.
Results
We identified a rare variant in GPD1-L, p.D262N (c.784g>a) in 2 of 288 BrS probands, which was not identified in 372 controls. The minor allele frequency of the variant is 0.0014% in the Genome Aggregation Database. One proband was a 49-year-old man and the other was 34-year-old man who both developed a ventricular fibrillation. ECGs of both probands showed Brugada Type 1 pattern after administration of the pilsicainide. In functional study, coexpression of D262N GPD1-L with SCN5A in HEK293 cells significantly reduced inward sodium currents compared with wild-type GPD1-L. Additionally, inward sodium currents with D262N were similar to those with A280V GPD1-L, which was associated with BrS in previous reports (Figure). Also, several pathogenicity prediction programs, such as SIFT (score: 0.031) and PolyPhen2 (score: 0.937) predicted deleterious effects of GPD1-L D262N.
Conclusion
We identified a rare variant in GPD1-L at the rate of 0.7% in Japanese BrS patients without SCN5A mutations. GPD1-L, p.D262N reduces inward sodium currents and may be a novel susceptible variant for BrS in the Japanese population.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Current–voltage curve
Collapse
Affiliation(s)
- K Usuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Ishikawa
- National Cerebral and Cardiovascular Center Hospital, Omics Research Center, Osaka, Japan
| | - Y Aizawa
- International University of Health and Welfare, Department of Cardiovascular Medicine, Tochigi, Japan
| | - T Kato
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Kusayama
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - S Usui
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| | - H Mishima
- Nagasaki University, Department of Human Genetics, Nagasaki, Japan
| | - K Yoshiura
- Nagasaki University, Department of Human Genetics, Nagasaki, Japan
| | - N Makita
- National Cerebral and Cardiovascular Center Hospital, Omics Research Center, Osaka, Japan
| | - M Takamura
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine, Kanazawa, Japan
| |
Collapse
|
19
|
Sugimoto H, Murai H, Hirai T, Hamaoka T, Mukai Y, Tokuhisa H, Usui S, Sakata K, Kawajiri M, Takamura M. Age differences in the association between arterial velocity pulse index and muscle sympathetic nerve activity in hypertensive patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2307] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Increased arterial stiffness characterize by aging. It is reported that age-related increases in muscle sympathetic nerve activity (MSNA) may be one of contributing factor for arterial stiffness. Arterial reflected wave was composed of SNA and aging. Increased arterial reflected wave partly plays an important role in blood pressure. Recently, we reported that arterial velocity pulse index (AVI), a novel index of arterial reflected waves, was associated with MSNA in hypertensive patients. It is still uncertain the effect of age on the association between AVI and SNA in hypertensive patients.
Method
Patients with essential HT and matched non-hypertensive control subjects were included in this study. HT was diagnosed as systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. AVI was measured from left upper arm by NAS-1000. SNA was evaluated by direct recording of muscle sympathetic nerve activity (MSNA) from peroneal nerves.
Results
45 HT patients and 46 control subjects were included. Age, SBP and DBP were significantly increased in HT group compared to control (Age 63±14 vs 42±16 years, p<0.001; SBP 144±16 vs 115±9 mmHg, p<0.001; DBP 80±14 vs 67±9 mmHg, p<0.001). MSNA and AVI were significantly increased in HT group compared to control (MSNA 34±10 vs 25±8 bursts/min, p<0.05; AVI 28±9 vs 17±5, p<0.05). AVI was significantly correlated with MSNA, age, and SBP in HT group. HT group was divided into two groups according to their age (group 1, age ≤63 N=21, group 2, age ≥64 N=26). AVI in group 1 showed correlation with MSNA (r=0.59, p<0.05), but no correlation was seen in group 2. However excluded SBP>160 mmHg subjects in group 2, significant correlation was clarified between AVI and MSNA (r=0.62, p<0.05).
Conclusion
The relationship between AVI and MSNA in HT patients is preserved regardless of aging, however, high blood pressure over 160mmHg might obscure its correlation. These results indicate that AVI is useful to estimate sympathetic nerve activity in high aging HT patient treated <160 blood pressure.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hirai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | | | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | | | |
Collapse
|
20
|
Yamagami K, Nomura A, Kometani M, Shimojima M, Sakata K, Usui S, Furukawa K, Takamura M, Okajima M, Watanabe K, Yoneda T. Early detection of exacerbation of the severe acute respiratory syndrome coronavirus 2 infection using Fitbit (DEXTERITY pilot study). Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3089] [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
Some patients with coronavirus disease 2019 (COVID-19) experienced sudden death because of sudden symptom deterioration. Thus, an alarm system that could detect early signs of COVID-19 exacerbation beforehand, to prevent serious illness or death of patients while receiving outpatient treatment at home or in hotels is necessary. Here, we tested whether estimated oxygen variations (EOV), a relative physiological scale that represents users' blood oxygen saturation level during sleep measured by Fitbit, predicted COVID-19 symptom exacerbation. Study period was from August to November 2020. We enrolled 23 COVID-19 patients diagnosed by SARS-CoV-2 polymerase chain reaction-positive (mean age ± standard deviation, 50.9±20 years; 70% female), let each patient wore the Fitbit for 30 days; COVID-19 symptoms were exacerbated in 6 (26%). High EOV signal (a patient's oxygen level exhibits significant dip and recovery within the index period) had 80% sensitivity before symptom exacerbations, whereas resting heart rate signal only had 50% sensitivity. Coincidental obstructive sleep apnea syndrome confirmed by polysomnography was detected in a patient by consistently high EOV signals. This pilot study successfully detected early COVID-19 symptoms exacerbation by measuring EOV and may help to identify early signs of COVID-19 exacerbation.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The investigational device used in this study, Fitbit Charge 3, was provided by Fitbit Japan. Summary of high EOV signals and eventsThe clinical course of COVID-19
Collapse
Affiliation(s)
- K Yamagami
- Kanazawa University Hospital, Kanazawa, Japan
| | - A Nomura
- Kanazawa University Hospital, Kanazawa, Japan
| | - M Kometani
- Kanazawa University Graduate School of Medicine, Department of Health Promotion and Medicine of the Future, Kanazawa, Japan
| | - M Shimojima
- Kanazawa University Hospital, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Kanazawa, Japan
| | - K Furukawa
- Health Care Center, Japan Advanced Institute of Science and Technology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Kanazawa, Japan
| | - M Okajima
- Kanazawa University Hospital, Intensive Care Unit, Kanazawa, Japan
| | - K Watanabe
- JCHO Kanazawa Hospital, Kaznazawa, Japan
| | - T Yoneda
- Kanazawa University Graduate School of Medicine, Department of Health Promotion and Medicine of the Future, Kanazawa, Japan
| |
Collapse
|
21
|
Sakata K, Nagata Y, Takeshige N, Kikuchi J, Shikata M, Ashida K, Nomura M, Morioka M. Early postoperative prediction of both disease remission and long-term disease control in acromegaly using the oral glucose tolerance test. Hormones (Athens) 2021; 20:515-526. [PMID: 33738782 DOI: 10.1007/s42000-021-00281-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 03/07/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE Transsphenoidal surgery (TSS) is the cornerstone of acromegaly treatment. Two biochemical parameters, growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels, sometimes diverge postoperatively; however, it is important to maintain disease control without further treatment, regardless of whether these parameters converge. This study investigated whether remission and long-term disease control could be predicted using early postoperative GH and IGF-1 levels. METHODS We reviewed 36 consecutive surgically treated patients with acromegaly. IGF-1 levels and minimum GH levels during an oral glucose tolerance test (OGTT) were evaluated at 2 weeks, as well as at 3 months postoperatively. After comparison between the remission and nonremission groups, we analyzed whether early postoperative parameters could predict remission and long-term disease control. RESULTS Twenty-five patients (69.4%, Group A) achieved remission within 1 year postoperatively. Of the remaining patients (median follow-up period, 53 months), seven (19.5%, Group B) maintained normal IGF-1 levels without treatment, whereas four (11.1%, Group C) required additional treatment. GH levels <1.5 ng/mL measured on the morning after surgery and nadir GH levels <0.7 ng/mL during the OGTT conducted at 2 weeks postoperatively were predictive of remission, with the latter demonstrating 95.2% sensitivity and 100% specificity. All group C patients had nadir GH levels ≥0.7 ng/mL during the OGTT and IGF-1 levels ≥SD +3 at 2 weeks postoperatively. CONCLUSION Early postoperative nadir GH levels during the OGTT and IGF-1 levels at 2 weeks postoperatively demonstrated excellent predictive value for both endocrinological remission and the necessity for additional treatment.
Collapse
Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan.
| | - Yui Nagata
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuyuki Takeshige
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Jin Kikuchi
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Masato Shikata
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| |
Collapse
|
22
|
Kajiwara S, Hasegawa Y, Negoto T, Orito K, Kawano T, Yoshitomi M, Sakata K, Takeshige N, Yamakawa Y, Jono H, Saito H, Hirayu N, Takasu O, Hirohata M, Morioka M. Efficacy of a Novel Prophylactic Barbiturate Therapy for Severe Traumatic Brain Injuries: Step-down Infusion of a Barbiturate with Normothermia. Neurol Med Chir (Tokyo) 2021; 61:528-535. [PMID: 34078830 PMCID: PMC8443969 DOI: 10.2176/nmc.oa.2021-0097] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study aimed to examine the beneficial effects of a novel prophylactic barbiturate therapy, step-down infusion of barbiturates, using thiamylal with normothermia (NOR+sdB), on the poor outcome in the patients with severe traumatic brain injuries (sTBI), in comparison with mild hypothermia (MD-HYPO). From January 2000 to March 2019, 4133 patients with TBI were admitted to our hospital. The inclusion criteria were: a Glasgow coma scale (GCS) score of ≤8 on admission, age between 20 and 80 years, intracranial hematoma requiring surgical evacuation of the hematoma with craniotomy and/or external decompression, and patients who underwent management of body temperature and assessed their outcome at 6-12 months. Finally, 43 patients were included in the MD-HYPO (n = 29) and NOR+sdB (n = 14) groups. sdB was initiated intraoperatively or immediately after the surgical treatment. There were no significant differences in patient characteristics, including age, sex, past medical history, GCS on admission, type of intracranial hematoma, and length of hospitalization between the two groups. Although NOR+sdB could not improve the patient's poor outcome either at discharge from the intensive care unit (ICU) or at 6-12 months after admission, the treatment inhibited composite death at discharge from the ICU. The mean value of the maximum intracranial pressure (ICP) in the NOR+sdB group was <20 mmHg throughout the first 120 h. NOR+sdB prevented composite death in the ICU in patients with sTBI, and we may obtain novel insights into the beneficial role of prophylactic barbiturate therapy from suppression of the elevated ICP during the first 120 h.
Collapse
Affiliation(s)
- Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Yu Hasegawa
- Department of Neurosurgery, Kurume University School of Medicine.,Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine
| | - Takayuki Kawano
- Department of Neurosurgery, Kurume University School of Medicine
| | | | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | | | | | - Hirofumi Jono
- Department of Pharmacy, Kumamoto University Hospital
| | | | - Nobuhisa Hirayu
- Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
| | - Osamu Takasu
- Department of Emergency and Critical Care Medicine, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
| |
Collapse
|
23
|
Takeshige N, Uchikado H, Nakashima D, Negoto T, Nagase S, Yoshitomi M, Sakata K, Morioka M. Endoscopic third ventriculostomy for myelomeningocele-related hydrocephalus after shunt failure: Long-term outcome in a series of 8 patients. Clin Neurol Neurosurg 2020; 201:106406. [PMID: 33341457 DOI: 10.1016/j.clineuro.2020.106406] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Endoscopic third ventriculostomy (ETV) has now become an accepted mode of hydrocephalus treatment. However, the long-term effects of ETV for myelomeningocele-related hydrocephalus (MMC-rH) after shunt malfunction remains unclear. We aimed to assess the long-term outcome and the factors associated with the success of ETV for MMC-rH after shunt malfunction. METHODS We performed a retrospective analysis of data collected between 2001 and 2018 from 8 patients with MMC-rH after shunt malfunction, who underwent ETV at the Kurume University Hospital and were followed up for at least 5 years. We extracted data regarding age, sex, clinical symptoms, radiological imaging, intraoperative findings, and outcomes. RESULTS The overall success rate was 62.5% and their ETV success score is 67.5. The most frequent clinical symptom was intracranial hypertension symptoms (100 %), followed by Chiari type II symptoms (87.5 %). In preoperative MRI scans, we observed aqueduct stenosis in 6 cases, Chiari type II malformations in 7 cases, four patients had a narrow prepontine cistern, five patients had an absent septum pellucidum, and three presented with stenosis of the foramen of Monro. All cases in the failure group had the above 5 symptoms. Based on intraoperative findings, a thick third ventricle floor was found in 5 patients. Two patients had a thin hypothalamic adhesion in the third ventricle floor. They had no major complications. CONCLUSION ETV for MMC-rH after shunt malfunction is an effective treatment option. However, we recommend that a neurosurgeon with extensive experience in neuroendoscopy perform ETV because MMC patients more often had intraventricular malformations than those with other hydrocephalus diseases.
Collapse
Affiliation(s)
- Nobuyuki Takeshige
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan.
| | - Hisaaki Uchikado
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan; Uchikado Neuro-Spine Clinic, Fukuoka, Fukuoka Prefecture, Japan
| | - Daisuke Nakashima
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Tetsuya Negoto
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Satoshi Nagase
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Munetake Yoshitomi
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Kiyohiko Sakata
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Motohiro Morioka
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| |
Collapse
|
24
|
Shikata M, Ashida K, Goto Y, Nagayama A, Iwata S, Yano M, Hasuzawa N, Hara K, Mawatari K, Sakata K, Tsuruta M, Wada N, Nomura M. Pasireotide-induced hyperglycemia in a patient with Cushing's disease: Potential use of sodium-glucose cotransporter 2 inhibitor and glucagon-like peptide-1 receptor agonist for treatment. Clin Case Rep 2020; 8:2613-2618. [PMID: 33363790 PMCID: PMC7752440 DOI: 10.1002/ccr3.3230] [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: 03/21/2020] [Revised: 06/05/2020] [Accepted: 07/18/2020] [Indexed: 12/17/2022] Open
Abstract
Pasireotide improves hypercortisolemia and induces hyperglycemia via somatostatin receptor type-5 stimulation. GLP-1RA and SGLT2 inhibitor potentially help regulate hyperglycemia in patients with Cushing's disease, especially after pasireotide administration.
Collapse
Affiliation(s)
- Masato Shikata
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Kenji Ashida
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Yuka Goto
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Ayako Nagayama
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Shimpei Iwata
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Mamiko Yano
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Nao Hasuzawa
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Kento Hara
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Kazutoshi Mawatari
- Division of Cardiovascular MedicineDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Kiyohiko Sakata
- Department of NeurosurgeryKurume University School of MedicineFukuokaJapan
| | - Munehisa Tsuruta
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Nobuhiko Wada
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| | - Masatoshi Nomura
- Division of Endocrinology and MetabolismDepartment of Internal MedicineKurume University School of MedicineFukuokaJapan
| |
Collapse
|
25
|
Takeshige N, Uchikado H, Yoshitake H, Negoto T, Yoshitomi M, Sakata K, Morioka M. Long-term outcomes of endoscopic third ventriculostomy for Blake's pouch cyst in adults. Clin Neurol Neurosurg 2020; 200:106357. [PMID: 33168333 DOI: 10.1016/j.clineuro.2020.106357] [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: 08/08/2020] [Revised: 09/19/2020] [Accepted: 11/02/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The optimal treatment method for persistent Blake's pouch cyst (BPC) remains unclear owing to its low prevalence. We aimed to characterize a patient population with adult BPC and to identify the risk factors associated with endoscopic third ventriculostomy (ETV) for BPC. This study reports the largest number of BPC cases in adults and is the first report to reveal the long-term outcomes of ETV in such patients. METHODS We performed a retrospective analysis of data collected from seven adult patients with BPC between 2005 and 2019. They underwent ETV at the Kurume University Hospital and were followed up for five years or more. We extracted data regarding patient age, sex, clinical symptoms, radiological imaging, intraoperative findings and outcomes. RESULTS The ages of the patients ranged between 30 and 60 years (45 ± 12 years). The mean postoperative follow-up time was 92.1 ± 13.5 months. The overall success rate was 71.4%. The most frequent symptom was headache (86%), followed by mild cognitive impairment (71%). The average cerebrospinal fluid pressure was slightly elevated (18.4 ± 1.4 cmH2O). A decrease in ventricular size (Evans' index) detected early after ETV was associated with satisfactory clinical outcomes (p = 0.02). The incidence of prepontine scarring was observed in all cases of the ETV failure group. A significant risk factor for ETV was the to-and-fro movements of the third ventricle floor after ETV (p = 0.048). CONCLUSIONS ETV could be a safe and effective treatment option for adult patients with BPC. It is important that prepontine scarring and the to-and-fro movements of the third ventricle after ETV should be confirmed carefully when performing ETV on adult patients with BPC.
Collapse
Affiliation(s)
- Nobuyuki Takeshige
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan.
| | - Hisaaki Uchikado
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan; Uchikado Neuro-Spine Clinic, Fukuoka, Fukuoka Prefecture, Japan
| | - Hidenobu Yoshitake
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Tetsuya Negoto
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Munetake Yoshitomi
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Kiyohiko Sakata
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| | - Motohiro Morioka
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka Prefecture, Japan
| |
Collapse
|
26
|
Usuda K, Kato T, Tada H, Tsuda T, Takeuchi K, Niwa S, Usui S, Sakata K, Hayashi K, Furusho H, Kawashiri M, Takamura M, Nagashima K, Okumura Y. Recurrence of atrial fibrillation after catheter ablation is associated with major adverse cardiac and cerebrovascular events: insights from AF frontier ablation registry. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0603] [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
Recent observational studies have suggested that catheter ablation for atrial fibrillation (AF) is significantly associated with reduced risk for stroke, cardiovascular events and all-cause death. However, little is known whether late recurrence of AF after catheter ablation is associated with worse clinical outcomes.
Purpose
We aimed to clarify whether late recurrence of AF after catheter ablation is associated with major adverse cardiac and cerebrovascular events (MACCE).
Methods
We retrospectively investigated 2,737 participants (74.4% men, mean age 63.4±10.3 years, 62.7% paroxysmal AF) who received first catheter ablation for AF and completed follow-up more than 3 months after the procedure from AF Frontier Ablation Registry, a multicenter cohort study in Japan. We evaluated an association between late recurrence of AF after catheter ablation and first MACCE in cox-regression hazard models adjusted for known risk factors. MACCE were defined as stroke/transient ischemic attack (TIA), cardiovascular events or all-cause death. Late recurrence was defined as AF relapse more than 3 months after the procedure.
Results
During a mean follow-up period of 25.2 months, 2,070 patients (75.6%) were free from AF after catheter ablation and 122 patients (4.5%) had MACCE (ischemic stroke 18 [14.8%], hemorrhagic stroke 16 [13.1%], TIA 7 [5.7%], hospitalization for heart failure 19 [15.6%], acute coronary syndrome 19 [15.6%], hospitalization for other cardiovascular events 24 [20%] and all-cause death 19 [15.6%]). The MACCE occurred significantly more frequently in the recurrence group than in non-recurrence group (7.5% vs. 3.5%; hazard ratio [HR] 1.85; 95% confidence interval [CI] 1.28–2.65; P=0.001) (Figure). Multivariate analysis revealed that baseline age (HR 1.05; 95% CI 1.03–1.08; P<0.001), heart failure (HR 1.76; 95% CI 1.17–2.66; P=0.007), old myocardial infarction (HR 4.49; 95% CI 2.59–7.81; P<0.001), non-ischemic cardiomyopathy (HR 2.56; 95% CI 1.47–4.46; P=0.001), left atrial diameter (HR 1.22 per 5-mm increase; 95% CI, 1.06–1.41; P=0.006) and recurrence of AF (HR 1.69; 95% CI 1.17–2.44; P=0.005) were independently associated with the incidence of MACCE after catheter ablation.
Conclusion
In the Japanese multicenter cohort of AF ablation, late recurrence of AF was independently associated with increased MACCE, suggesting the significance of sinus rhythm maintenance by catheter ablation.
Kaplan-Meier curves for MACCE
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Usuda
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - T Kato
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Tada
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - T Tsuda
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - K Takeuchi
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - S Niwa
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - K Hayashi
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - H Furusho
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Department of Cardiology, Kanazawa, Japan
| | - K Nagashima
- Nihon University Hospital, Department of Cardiovascular Medicine, Tokyo, Japan
| | - Y Okumura
- Nihon University Hospital, Department of Cardiovascular Medicine, Tokyo, Japan
| |
Collapse
|
27
|
Goten C, Usui S, Inoue O, Okada H, Takashima S, Sakata K, Kawashiri M, Takamura M. Nerve growth factor receptor is involved in maintaining homeostasis of pulmonary arterial hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2235] [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
Introduction
Pulmonary arterial hypertension (PAH), characterized by vascular remodeling, is still disease with poor prognosis although many pulmonary vasodilators have been developed, and new mechanism of treatment for PAH is desired. Nerve growth factor receptor (Ngfr) is known to relate to inflammatory reaction and repair process in the damaged tissue. We have reported that Ngfr is associated to vascular remodeling in patients with acute coronary syndrome. However, it is unclear how Ngfr is involved in the pathogenesis of PAH.
Purpose
In this study, we investigated whether Ngfr relate to pathophysiology in PAH.
Methods
We estimated the frequency of Ngfr positive cells (% Ngfr+) in peripheral blood mononuclear cells obtained from PAH and non-PAH patients using flowcytometric analysis. In PAH patients, the hemodynamic parameters such as mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) were obtained by right heart catheterization, and evaluated for correlation with the % Ngfr+.
Next, adult 8-week-old C57BL/6 (WT) mice and Ngfr knock out (KO) mice were exposed to chronic hypoxia (10% O2) or normoxia for 6 weeks. Then, mice were anesthetized and performed echocardiography and right heart catheterization. Then, mice were exsanguinated and blood sample was collected to evaluate the % Ngfr+ by flow cytometry. Right ventricular weight was measured and lung tissue was also collected for histological assessment and molecular pathway profiling.
Results
PAH (n=24) patients and non-PAH patients (n=17) were enrolled. The % Ngfr+ was significantly higher in PAH patients than that in non-PAH patients (0.056% versus 0.019%, p<0.0001). In PAH patients, the % Ngfr+ was correlated with severity of hemodynamic parameters such as mPAP (R=0.64 p<0.001), PVR (R=0.62 p<0.005), and CI (R=−0.48 p<0.05).
In WT mice, chronic hypoxia significantly increased the right ventricular systolic pressure and induced vascular medial thickness and fibrosis around the pulmonary artery. Flow cytometry analysis revealed that the % Ngfr+ was significantly increased in the hypoxia compared to that in the normoxia. Under hypoxic conditions, the right ventricular systolic pressure was significantly increased in Ngfr KO mice compared to that in WT mice. In histological analysis, hypoxia-induced peripheral vascular fibrosis and medial thickness was more severe in Ngfr KO than that in WT mice.
Conclusion
Circulating Ngfr-positive cells are associated with severity of PAH in patients. In the hypoxia-induced PH model, gene deletion of Ngfr shows the progression of the pathogenesis of PAH. These results suggest that circulating Ngfr-positive cells have an important role in the pathogenesis of PAH and may be a novel target for PAH therapy.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- C Goten
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - S Usui
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - O Inoue
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - H Okada
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - S Takashima
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Cardiovascular Medicine, Kanazawa, Japan
| |
Collapse
|
28
|
Sakata K, Tanaka T, Yamashita S, Yamashiro K. The outcome of ablation for non-paroxysmal atrial fibrillation targeting spatiotemporal electrogram dispersion compared with ganglionated plexi ablation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0617] [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
Although catheter ablation targeting ganglionated plexi (GP) playing an important role in formation of triggers and substrates of atrial fibrillation (AF) has been reported as one of the effective ablation strategies in non-paroxysmal AF (non-PAF) patients, its effectiveness varies among the study groups. More recently, ablation targeting spatiotemporal electrogram dispersion (STED) areas, assumed to contain AF drivers in forms of rotational activation is proposed. However, the optimal ablation strategy for non-PAF is still controversial since the exact mechanisms of non-PAF are not well understood.
Purpose
To investigate the effectiveness of GP ablation for autonomic modification and STED ablation for modulation of AF drivers.
Methods
Consecutive 149 non-PAF patients who underwent STED ablation in our center were enrolled. We detected STED areas within the whole left and right atrium during AF using PentaRay®, and ablated them. If AF was terminated during STED ablation, we finished the procedure without burning the remaining STED areas. If not, electrical cardioversion was applied. The outcome was compared with that in consecutive 156 non-PAF patients undergoing GP ablation previously in our center.
Results
(1) The clinical characteristics were comparable between two groups (see Table). (2) A Kaplan-Meier curve showed that there was no significant difference between the freedom rates from non-PAF/non-paroxysmal atrial tachycardia (non-PAT) after single procedure in STED group and GP group (Figure, left). (3) However, the freedom rates from non-PAT in STED group was significantly lower than that GP group (Figure, right).
Conclusions
The recurrence type of atrial arrhythmia after ablation was remarkably different between ablation of STED and GP. STED ablation might eliminate fibrillatory conduction and control AF driver in patients with non-PAF.
Freedom from atrial arrhythmia
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Sakata
- Takatsuki General Hospital, Takatsuki, Japan
| | - T Tanaka
- Takatsuki General Hospital, Takatsuki, Japan
| | - S Yamashita
- Takatsuki General Hospital, Takatsuki, Japan
| | - K Yamashiro
- Takatsuki General Hospital, Takatsuki, Japan
| |
Collapse
|
29
|
Sugimoto H, Murai H, Hamaoka T, Mukai Y, Inoue O, Okabe Y, Tokuhisa H, Takashima S, Kato T, Usui S, Sakata K, Talamura M. Novel index of arterial reflected waves, Arterial Velocity pulse Index, relates to muscle sympathetic nerve activity independent of Arterial Pressure volume Index in patients with hypertension. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2720] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Arterial reflected wave is determined by not only atherosclerosis but also sympathetic nerve activity. Recently, Arterial Velocity pulse Index (AVI), which is an index of arterial reflected waves, and Arterial Pressure volume Index (API), which is an index of volume of a conductive blood vessel, have been proposed as new index of arterial stiffness. However, it is unclear whether API and AVI would be associated with muscle sympathetic nerve activity (MSNA) in hypertensive subjects.
Purpose
The purpose of this study was to evaluate the correlation between AVI, API and MSNA in hypertensive subjects.
Method
41 hypertensive patients and 40 non-hypertensive subjects were included in this study. We performed a cross-sectional, observational study. Hypertension (HT) was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg or medical treatment for HT. AVI and API was measured by NAS-1000 (Nihon Koden, Japan). MSNA, central sympathetic outflow to peripheral muscle, was recorded directly from peroneal nerve. MSNA was expressed by burst frequency (bursts/minute) and burst incidence (bursts/100heartbeats). Blood pressure, heart rate and MSNA were recorded simultaneously.
Results
Age, systolic and diastolic pressure were significantly higher in hypertensive patients compared to control (40±15 vs 61±13 years, p<0.001; 142±16 vs 113±9 mmHg, p<0.001; 81±14 vs 67±9 mmHg, p<0.001). MSNA and AVI were significantly augmented in hypertensive patients compared to control (34±11 vs. 23±6 bursts/min, p<0.05; 26±7 vs. 16±4, p<0.05). AVI was correlated with MSNA in each group (hypertension: r=0.59, P<0.001, non-hypertension: r=0.51, p<0.001). However, no correlation was shown between API and MSNA in each group (hypertension: r=0.22, p=0.15, non-hypertension: r=0.07, p=0.63). Multiple regression analysis also showed MSNA was significantly related with AVI but was not with API.
Conclusion
Our finding showed that AVI relates to MSNA independent of API in patients with hypertension. It suggested that Novel index of arterial reflected waves, AVI, is helpful to estimate augmented SNA in hypertensive subjects regardless of volume of a conductive blood vessel.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
| | - H Murai
- Kanazawa University, Kanazawa, Japan
| | - T Hamaoka
- Kanazawa University, Kanazawa, Japan
| | - Y Mukai
- Kanazawa University, Kanazawa, Japan
| | - O Inoue
- Kanazawa University, Kanazawa, Japan
| | - Y Okabe
- Kanazawa University, Kanazawa, Japan
| | | | | | - T Kato
- Kanazawa University, Kanazawa, Japan
| | - S Usui
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | |
Collapse
|
30
|
Hayashi K, Fujino N, Furusho H, Usui S, Sakata K, Kato T, Tsuda T, Niwa S, Takeuchi K, Kawashiri M, Takamura M. Rare SCN10A variants associated with cardiac conduction system diseases. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0341] [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 genetic bases of cardiac conduction-system disease (CCSD) range from ion channelopathies to mutations in many other genes. Genome-wide association studies have shown common variants in SCN10A influence cardiac conduction. However, it has not yet to be determined whether vulnerability to CCSD is associated with rare coding sequence variation in the SCN10A gene.
Purpose
We sought to determine the clinical impact of rare variants in SCN10A in patients with CCSD and classified the variants according to the 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines.
Methods
We performed screening for rare variants (minor allele frequency ≤0.001) in SCN10A in CCSD patients with an onset at a young age under 65 or those who had a family history of pacemaker implantation (PMI) (n=40; 18 female; mean age, 41±18 years). We transiently expressed engineered variants in ND 7/23 cells, and conducted whole-cell voltage clamp experiments to clarify the functional properties of the Nav1.8 current.
Results
We identified nine rare variants in SCN10A in 7 patients. Two patients were carriers of two rare variants in SCN10A and 5 were carriers of one rare variant in SCN10A. Four patients were affected with sinus node dysfunction, 1 were atrioventricular block, and 2 were both dysfunctions. We performed electrophysiological study for 8 of 9 rare variants. It demonstrated that 2 rare variants showed gain-of-function, and 3 rare variants showed loss-of-function. We finally determined 5 likely pathogenic variants in SCN10A in 5 patients (12.5%) according to the ACMG standards and guidelines. All 5 patients underwent a pacemaker implantation at an average age of 43±16.
Conclusions
These results demonstrate that SCN10A variants play a pivotal role in enhanced susceptibility of CCSD. We suggest the importance for screening SCN10A variants in clinical settings.
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- K Hayashi
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - N Fujino
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - H Furusho
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - S Usui
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - T Kato
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - S Niwa
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - K Takeuchi
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| |
Collapse
|
31
|
Takashima S, Usui S, Matsuura S, Goten C, Inoue O, Ohtani K, Kubota K, Sakata K, Kawashiri M, Takamura M. Bone marrow-derived NGFR+ cells regulate arterial remodeling and those poor mobilizations in peripheral blood in acute coronary syndrome predicts plaque progression at the non-targeted lesion. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1679] [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
In our previous 5-year cohort study, we demonstrated that low gene expression of nerve growth factor receptor (NGFR) in peripheral leucocytes in acute coronary syndrome (ACS) predicted repetitive coronary interventions at the de novo lesions. An NGFR-positive cell has been demonstrated to reside in bone marrow (BM) stromal fraction and to be increased in peripheral blood mononuclear cell (MNCs) fraction in patients with ischemic heart disease.
Purpose
To investigate whether the BM-NGFR+ cell is associated with arterial remodeling and the relationship between the levels of peripheral NGFR+ cells after ACS and coronary plaque progression in an experimental and prospective clinical study.
Methods and results
In an experimental study, 8-week-old C57B6/J wild type male mice were subjected to irradiation with 9.6 Gy and transplantation with BM (BMT) isolated from GFP-transgenic NGFR wild type (WT) or knock-out (KO) mice at day 1. Four weeks after BMT, the right carotid artery was ligated for 4 weeks. Induced neointimal area was increased (p<0.05), where cells under apoptosis were decreased (p<0.05) in NGFR-KO-BMT group compared to WT-BMT group (n=4). NGFR+ cells were not detected in wild type sham-operated artery, whereas in the ligated artery in WT-BMT group NGFR+ cells assembled in the developed neointima and exclusively presented double positive with GFP, but absent in NGFR-KO-BMT group (p<0.05, n=4). In a clinical study, thirty patients with ACS who underwent primary percutaneous coronary intervention (PCI) were enrolled. The peripheral blood sample was collected on days 0, 3 and 7, and 9 months follow-up and the number of NGFR+MNCs were measured by flowcytometric analysis. The plaque volume at non-targeted coronary lesion (non-TL:>5 mm proximal or distal to the implanted stents) were quantitatively analysed using gray-scale intravascular ultrasound (IVUS) and Q-IVUS™ software at the acute phase and 9 months follow-up. The number of NGFR+MNCs in peripheral blood was 1.5-fold increased at day 3 (0.064±0.056%) compared to day 0 (0.042±0.030%) (p<0.05). The change in normalized total plaque volume (TAVN) at non-TL at 9 months was negatively correlated with the number of NGFR+MNCs at day 0 (r=−0.51), day 3 (r=−0.51) and 9 months (r=−0.59) after ACS (p<0.05). Multiple regression analysis showed that NGFR+MNCs at day 0 (β=−0.48, p=0.01) and CRP (β=−0.53, P<0.01) are independent factors associating with TAVN change at non-TL at 9 months, regardless of LDL-cholesterol control level. ROC analysis revealed that NGFR+MNCs <0.049 at day 0 predicted the increase of TAVN with AUC 0.78; sensitivity 0.82 and specificity 0.67.
Conclusions
Bone marrow-derived peripheral NGFR+ cells negatively regulate arterial remodeling through appropriate apoptosis of neointimal cells and the peripheral level of NGFR+ cells in ACS predicts plaque progression at the non-targeted lesion.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): KAKENHI
Collapse
Affiliation(s)
- S Takashima
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - S Usui
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - S Matsuura
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - C Goten
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - O Inoue
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - K Ohtani
- Public Central Hospital of Matto Ishikawa, Hakusan, Japan
| | - K Kubota
- Public Central Hospital of Matto Ishikawa, Hakusan, Japan
| | - K Sakata
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| |
Collapse
|
32
|
Sakata K, Takeshige N, Nagata Y, Yoshitake H, Komaki S, Miyagi N, Morioka M. Endoscopic Endonasal Removal of Primary/Recurrent Meningiomas in the Medial Optic Canal: Surgical Technique and Long-Term Visual Outcome. Oper Neurosurg (Hagerstown) 2020; 17:470-480. [PMID: 30753703 DOI: 10.1093/ons/opz001] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 01/22/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Tuberculum sellae meningiomas frequently extend into the optic canals, which leads to a progressive longitudinal visual loss. Therefore, in addition to tumor removal, unroofing and exploration inside the optic canal are important procedures. OBJECTIVE To perform endoscopic endonasal tumor removal with optic canal decompression for small primary or recurrent meningiomas associated with a progressive visual loss at the inferior-medial optic canal, which corresponded to a blind corner in the ipsilateral pterional/subfrontal approach. METHODS We retrospectively reviewed 2 cases of primary meningiomas that arose in the inferior-medial optic canal and 4 recurrent cases from the remnant inside the medial optic canal that had previously undergone craniotomy for tuberculum sellae meningiomas, and were treated by the endoscopic endonasal approach. RESULTS All tumors were detectable and could be removed without manipulation of the affected optic nerve. The average maximum diameter of the tumor was 8.4 mm (range: 5-12 mm). Two patients who had a long history of progressive visual disturbance and papillary atrophy did not recover from severe visual disturbances postoperatively. However, others showed considerable improvement, maintaining postoperative visual function during follow-up. There were no postoperative complications. CONCLUSION Endoscopic endonasal approach has several advantages for meningiomas in the medial optic canal and associated with progressive visual disturbance. In surgery of tuberculum sellae meningiomas, optic canal decompression and exploration inside the optic canal are important procedures to avoid symptomatic recurrence, which may be facilitated by the endoscopic endonasal approach. Papillary atrophy and duration of visual deterioration are predictive factors for postoperative visual outcomes.
Collapse
Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuyuki Takeshige
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yui Nagata
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hidenobu Yoshitake
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naohisa Miyagi
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| |
Collapse
|
33
|
Sakata K, Fujimori K, Komaki S, Furuta T, Sugita Y, Ashida K, Nomura M, Morioka M. Pituitary Gangliocytoma Producing TSH and TRH: A Review of "Gangliocytomas of the Sellar Region". J Clin Endocrinol Metab 2020; 105:5876003. [PMID: 32706866 PMCID: PMC7451506 DOI: 10.1210/clinem/dgaa474] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/17/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Pituitary gangliocytomas (GCs) are rare neuronal tumors that present with endocrinological disorders, such as acromegaly, amenorrhea-galactorrhea syndrome, and Cushing's disease. Most pituitary GCs coexist with pituitary adenomas pathologically and are diagnosed as mixed gangliocytoma-adenomas. Herein, we report a case of 45-year-old man who presented with the syndrome of inappropriate secretion of thyroid-stimulating hormone (SITSH) and discuss the pathogenesis of pituitary GCs. METHODS Pituitary magnetic resonance imaging showed an 8-mm homogeneous and poorly enhanced mass inside the pituitary gland. Endoscopic transsphenoidal surgery was performed under a preoperative diagnosis of thyrotroph adenoma. However, the tumor was finally diagnosed as gangliocytoma without an adenomatous component. The tumor was further analyzed via immunohistochemistry and electron microscopy. Additionally, we searched MEDLINE and PubMed for previously published cases of isolated pituitary GCs and analyzed the reported clinicopathological findings. RESULTS The patient showed complete clinical and endocrinological recovery after an operation. The tumor was positive for thyrotropin (TSH), TSH-releasing hormone (TRH), Pit-1, GATA-2, and most neuronal markers. Electron microscopy demonstrated the presence of intracytoplasmic secretory granules and neuronal processes. Co-secreting hypothalamic and pituitary hormone inside the tumor indicated autocrine/paracrine endocrinological stimulation. CONCLUSION Herein, we report a case of SITSH caused by an isolated pituitary gangliocytoma, expressing both TSH and TRH, which, to our best knowledge, is the first reported case of such a condition. The multidirectional differentiation and multihormonal endocrine characteristics of these tumors indicate that they are a member of neuroendocrine neoplasms, further supporting that they are derived from neural crest cells.
Collapse
Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University, School of Medicine, Fukuoka, Japan
- Correspondence and Reprint Requests: Kiyohiko Sakata, MD, Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan. E-mail: .
| | - Kana Fujimori
- Department of Neurosurgery, Kurume University, School of Medicine, Fukuoka, Japan
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University, School of Medicine, Fukuoka, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University, School of Medicine, Fukuoka, Japan
| | - Yasuo Sugita
- Department of Neuropathology, Neurology Center, St. Mary’s Hospital, Fukuoka, Japan
| | - Kenji Ashida
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Masatoshi Nomura
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University, School of Medicine, Fukuoka, Japan
| |
Collapse
|
34
|
Amemiya K, Sakata K, Suzuki-Sakamaki M. Development of fluorescence-yield wavelength-dispersive x-ray absorption spectroscopy in the soft x-ray region for time-resolved experiments. Rev Sci Instrum 2020; 91:093104. [PMID: 33003794 DOI: 10.1063/5.0021981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/30/2020] [Indexed: 06/11/2023]
Abstract
A fluorescence-yield wavelength-dispersive x-ray absorption spectroscopy technique in the soft x-ray region, by which the x-ray absorption spectra are recorded without scanning the monochromator, has been developed. The wavelength-dispersed soft x rays, in which the wavelength (photon energy) continuously changes as a function of the position, illuminate the sample, and the emitted fluorescence soft x rays at each position are separately focused by an imaging optics onto each position at a soft x-ray detector. Ni L-edge x-ray absorption spectra for Ni and NiO thin films taken in the wavelength-dispersive mode are shown in order to demonstrate the validity of the technique. The development of the technique paves the way for a real-time observation of time-dependent processes, such as surface chemical reactions, with much higher gas pressure compared to the electron-yield mode, as well as under magnetic and electric fields.
Collapse
Affiliation(s)
- K Amemiya
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - K Sakata
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| | - M Suzuki-Sakamaki
- Institute of Materials Structure Science, High Energy Accelerator Research Organization, 1-1 Oho, Tsukuba, Ibaraki 305-0801, Japan
| |
Collapse
|
35
|
Kondo Y, Kaneko Y, Saito S, Ohta Y, Sakata K, Inoue Y, Takahashi C, Hiramoto K, Inamo J, Takeuchi T. SAT0113 DISCORDANCE OF CLINICAL REMISSION AND IMAGING REMISSION BY ULTRASONOGRAPHY IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH BIOLOGIC AGENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Residual synovitis can be detected by sensitive modalities such as ultrasonography in patients with rheumatoid arthritis in clinical remission. On the other hand, a previous study has shown that ultrasound-guided treatment provides modest benefit compared to a conventional strategy aiming clinical remission in early patients. It is still unclear how discordant clinical remission is from imaging remission by ultrasonography in patients treated with biologic agentsObjectives:To clarify the discordance between clinical remission and imaging remission in patients with rheumatoid arthritis treated with biologic agents.Methods:Patients with rheumatoid arthritis who were treated with biologic agents and in clinical remission defined as disease activity score for 28 joints (DAS28)<2.6 were enrolled. All patients were performed comprehensive ultrasound examination of 44 joints as well as physical examinations. Ultrasound images of gray scale (GS) and power doppler (PD) were evaluated with a semi-quantitative score of 0-3. Imaging remission with ultrasound was defined as no PD signal detected in any joints. Clinical information was collected from their medical charts.Results:A total of 41 patients were enrolled with 22 patients treated with tumor necrosis factor (TNF)-α inhibitors and 19 with interleukin (IL)-6 inhibitors. The mean age, female ratio, the mean disease duration, and the mean duration of clinical remission were 60 years old, 87%, 5.1 years and 11.5 years. The imaging remission by ultrasonography was observed only in 51.2 %. When patients were divided according to biologic agents, baseline characteristics including median age, disease duration and clinically remission duration were comparable between both groups, while the rates of seropositivity and the stage of radiological progression was higher in IL-6 group (seropositivity, p=0.04; radiological progression, p=0.02). The mean DAS28 was 1.93 in the TNFα group and 1.02 in the IL-6 group. The discordance of clinical remission and imaging remission was observed in 28.6% of the TNFα group and 71.4% of the IL-6 group (p=0.03). The residual synovitis scores of GS and PD in 44 joints were significantly lower in the TNFα than the IL-6 group (GS, 1.1±1.8 vs 4.7 ± 4.6, p<0.01; PD, 0.6 ± 1.3 vs 3.3 ± 3.5, p<0.01, respectively). A receiver operating characteristic curve demonstrated an optimal score of DAS28 that discriminated imaging remission as 1.89 in the TNFα group and 1.25 in the IL-6 group.Conclusion:Our results showed that there was substantial discordance between clinical remission and imaging remission, especially in the patients treated with IL-6 inhibitors. In patients treated with biologic agents, clinical remission should be assessed more stringently than the usual 2.6, and ulltrasound-guided management may be useful.References:[1]Smolen JS, et al. Ann Rheum Dis 2020;0:1–15.[2]Iwamoto T, et al. Arthritis Care Res (Hoboken). 2014;66(10):1576-81[3]Tanaka Y. Ann Rheum Dis 2010;69:1286 –91[4]Kaneko Y, et al. Ann Rheum Dis 2018;77:1268–1275[5]Brown AK, et al. Arthritis Rheum 2008;58: 2958 – 67.Acknowledgments:We would like to thank Harumi Kondo for their assistance.Disclosure of Interests:Yasushi Kondo: None declared, Yuko Kaneko Speakers bureau: Dr. Kaneko reports personal fees from AbbVie, personal fees from Astellas, personal fees from Ayumi, personal fees from Bristol-Myers Squibb, personal fees from Chugai, personal fees from Eisai, personal fees from Eli Lilly, personal fees from Hisamitsu, personal fees from Jansen, personal fees from Kissei, personal fees from Pfizer, personal fees from Sanofi, personal fees from Takeda, personal fees from Tanabe-Mitsubishi, personal fees from UCB, Shuntaro Saito: None declared, Yuichiro Ohta: None declared, Komei Sakata: None declared, Yumiko Inoue: None declared, Chihiro Takahashi: None declared, Kazuoto Hiramoto: None declared, Jun Inamo: None declared, Tsutomu Takeuchi Grant/research support from: Eisai Co., Ltd, Astellas Pharma Inc., AbbVie GK, Asahi Kasei Pharma Corporation, Nippon Kayaku Co., Ltd, Takeda Pharmaceutical Company Ltd, UCB Pharma, Shionogi & Co., Ltd., Mitsubishi-Tanabe Pharma Corp., Daiichi Sankyo Co., Ltd., Chugai Pharmaceutical Co. Ltd., Consultant of: Chugai Pharmaceutical Co Ltd, Astellas Pharma Inc., Eli Lilly Japan KK, Speakers bureau: AbbVie GK, Eisai Co., Ltd, Mitsubishi-Tanabe Pharma Corporation, Chugai Pharmaceutical Co Ltd, Bristol-Myers Squibb Company, AYUMI Pharmaceutical Corp., Eisai Co., Ltd, Daiichi Sankyo Co., Ltd., Gilead Sciences, Inc., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi K.K., Dainippon Sumitomo Co., Ltd.
Collapse
|
36
|
Sakata K, Mitsuda H, Ito J, Isaka A, Gouda A, Soejima K. P942 Outcome prediction by exercise stress echocardiography and cardiopulmonary exercise testing assessment in patients with heart failure. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.575] [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
Cardiopulmonary exercise testing (CPX) is essential to the assessment of functional impairment and prognosis in patients with heart failure (HF). Peak oxygen consumption (peak VO2) continues to be considered the gold standard for assessing prognosis in HF. The minute ventilation-carbon dioxide production (VE-VCO2) slope has recently demonstrated prognostic significance in patients with HF. Ergometer stress echocardiography (Erg-Echo) is useful to evaluate the exercise-induced pulmonary hypertension and the potential cardiac dysfunction that are difficult to evaluate in the resting state.
Objective
The aim of this study is to evaluate the relationship between CPX and Erg-echo indices, and the usefulness of Erg-echo to determine the severity of cardiac dysfunction and the prognosis in patients with HF.
Methods
We studied 58 patients with HF (age 65.2 ± 11.9 years) and performed CPX and Erg-Echo. The peak VO2 and the VE-VCO2 slope were measured by CPX. Cardiac output (CO) and estimated mean pulmonary artery pressure (mPAP) were measured by Erg-Echo at rest and peak exercise load, and the change ratio (ΔmPAP / ΔCO) were calculated. We evaluated the clinical outcome during a1 year period.
Results
The ΔmPAP / ΔCO was significantly correlated with the peak VO2 (R = -0.6767, P <0.0001) and the VE-VCO2 slope (R = 0.6809, P <0.0001). Cardiovascular events (1 patient of cardiovascular death, 8 patients of re-hospitalization due to HF, 4 patients of myocardial ischemia, 2 patients of Cardiac Resynchronization Therapy (CRT) devices implantation, 1 patient of ventricular tachycardia) developed in 16 of the 58 patients (27.5%: Group CE) during the 1 year. The peak VO2 was significantly lower (12.1 ± 2.5 vs. 16.1 ± 3.1ml/min/kg, P <0.0001) and the VE-VCO2 slope was significantly higher (41.1 ±. 12.3 vs. 31.8 ± 6.1ml/ml, P <0.0001) in Group CE compared to the other 42 patients (Group N). The ΔmPAP was significantly higher (19.1 ± 4.4 vs. 14.9 ± 6.4, P = 0.0408) and the ΔCO was significantly lower (2.4 ± 1.2 vs. 4.1 ± 2.0, P = 0.0078), and the ΔmPAP / ΔCO was significantly higher (9.7 ± 4.6 vs. 4.4 ± 2.4, P <0.0001) in Group CE compared to Group N.
Conclusions
The ΔmPAP/ ΔCO by Erg-Echo is useful to evaluate the severity of cardiac dysfunction and the prognosis of HF patients.
Collapse
Affiliation(s)
- K Sakata
- Kyorin University School of Medicine, Tokyo, Japan
| | - H Mitsuda
- Kyorin University School of Medicine, Tokyo, Japan
| | - J Ito
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Isaka
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Gouda
- Kyorin University School of Medicine, Tokyo, Japan
| | - K Soejima
- Kyorin University School of Medicine, Tokyo, Japan
| |
Collapse
|
37
|
Sakata K, Mitsuda H, Ito J, Isaka A, Furuya M, Minamishima T, Matsushita K, Soejima K. P1802 Prevalence and prognostic significance of pulmonary artery aneurysms in patients with pulmonary artery hypertension. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1155] [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
Pulmonary artery aneurysm (PAA) occurs in some patients with pulmonary arterial hypertension (PAH) and can be accompanied by various complications.
Objective
The aim of the this study is to evaluate the characteristics of cardiac dysfunction and the prognostic impact of PAA by analysing the outcome of patients with PAH complicated by PAA.
Methods
We performed echocardiography and right-heart catheterization in 130 PAH patients. We measured the maximum dimensions of the main pulmonary artery (MPA) trunk. We evaluated the right ventricular (RV) function and the five-year prognosis of patients with PAA.
Results
The maximum MPA trunk diameter of >40 mm by echocardiography was defined as PAA. PAA appeared in 32 of the 130 PAH patients (24.6%: Group PAA), other 98 patients were defined as Group non-PAA. Systolic pulmonary artery pressure (76 ±18 vs. 61 ± 21 mmHg, P = 0.0008) and mean right atrial pressure (10.0 ± 8.1 vs. 5.4 ± 3.8 mmHg, P < 0.0001) were significantly higher in Group PAA than in Group non-PAA. RV end-diastolic area index was significantly larger (37.3 ± 8.8 vs. 32.3 ± 7.8 mmHg, P = 0.0048), and RV fractional area change (32 ± 8 vs. 36 ± 9 %, P = 0.0176) and RV longitudinal strain amplitude (-16 ±5 vs. -20 ± 6, P = 0.0017) were significantly lower in Group PAA than those in Group non-PAA. During the five-year follow-up period, 20 patients (15%) died. The five-year mortality rate was significantly higher in Group PAA compared to Group non-PAA (30% vs. 10%, P = 0.007).
Conclusion
In PAH patients with PAA, RV dysfunction was more severe and the prognosis was poor. Assessment of PAA can be a useful index for the extraction of high-risk PAH patients.
Collapse
Affiliation(s)
- K Sakata
- Kyorin University School of Medicine, Tokyo, Japan
| | - H Mitsuda
- Kyorin University School of Medicine, Tokyo, Japan
| | - J Ito
- Kyorin University School of Medicine, Tokyo, Japan
| | - A Isaka
- Kyorin University School of Medicine, Tokyo, Japan
| | - M Furuya
- Kyorin University School of Medicine, Tokyo, Japan
| | | | - K Matsushita
- Kyorin University School of Medicine, Tokyo, Japan
| | - K Soejima
- Kyorin University School of Medicine, Tokyo, Japan
| |
Collapse
|
38
|
Yoshida S, Nomura A, Tada H, Sakata K, Nakanishi C, Fujino N, Hosomichi K, Tajima A, Takamura M. 3073Leveraging transcriptome sequencing for detecting novel disease-related pathways using human cardiac sarcoidosis myocardium biopsies. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0029] [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/Introduction
Cardiac sarcoidosis (CS) is one of the main causes of poor outcomes in patients with sarcoidosis, a systemic granulomatous disorder of complex etiology including a genetically susceptible host and specific exposure to disease-triggering antigens. Recently, transcriptome analysis using sarcoidosis peripheral monocytes was reported to be useful for exploring genetic susceptibility and novel disease-causing pathways. However, transcriptome sequencing has not been used to explore disease-related genes and pathways directly using human CS myocardial biopsies.
Purpose
This study aimed to identify transcriptome profiles and novel disease-related pathways of CS by comparing human CS myocardial biopsies with control samples using ribonucleic acid (RNA) sequencing (RNA-Seq).
Methods
We assessed 30 patients with suspected myocardial disorders who underwent transcatheter endomyocardial biopsies at our University Hospital, Japan. Of those, 7 were clinically diagnosed with CS, 9 with hypertrophic cardiomyopathy (HCM), and 14 with dilated cardiomyopathy (DCM). Messenger RNAs were extracted from cardiac muscle biopsies using the Ovation SoLo RNA-Seq System (NuGEN Technologies), according to the manufacturer's instructions. Sequencing was performed with coverage of approximately 20 million reads per sample using Illumina HiSeq 2000. Sequencing reads were mapped using the STAR 2-pass method with GRCh37 as the reference. The DESeq2 R package (version 3.8) was used for further analyses. Principal component analysis (PCA) on gene expression was conducted for detecting outliers such as non-muscular samples. Differential gene expression analysis was performed between the 7 patients with CS and 23 patients with cardiomyopathy (HCM and DCM, non-CS). Gene Ontology (GO) enrichment analysis was conducted to estimate possible disease-related pathways.
Results
We successfully sequenced 60 myocardial biopsy samples (original and biological duplicates) from 30 CS patients. Of these, 2 outlier samples shown by the PCA plot were removed, and 58 were used for further analyses. We found 243 genes that were differentially expressed between CS patients and non-CS patients. Top-rated genes were RP11–366M4.8, RELN, S100A6, WASF3and UCHL1. Pathway analysis using GO demonstrated enrichment oflymphocyte activation (P=4.8x10–16), organelle fission (P=6.1x10–14), the M phase of the mitotic cell cycle (P=2.2x10–13), nuclear division (P=2.4x10–13), mitosis (P=2.4x10–13) and T-cell activation pathways (P=1.2x10–12).
Conclusions
Our differential gene expression and pathway analysis results using human CS myocardial biopsies suggested that lymphocyte activation, specifically the T-cell activation pathway, is linked to CS pathogenesis. Further studies are needed to decipher the role of specific genes related to genetic susceptibility and/or pathways associated with CS occurrence.
Collapse
Affiliation(s)
- S Yoshida
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - A Nomura
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - H Tada
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - C Nakanishi
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - N Fujino
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| | - K Hosomichi
- Kanazawa University Graduate School of Advance Preventive Medical Sciences, Department of Bioinformatics and Genomics, Kanazawa, Japan
| | - A Tajima
- Kanazawa University Graduate School of Advance Preventive Medical Sciences, Department of Bioinformatics and Genomics, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Graduate School of Medicine, Department of Cardiology, Kanazawa, Japan
| |
Collapse
|
39
|
Yamauchi H, Kondo K, Tanaka S, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, Miura K, Chan Q, Masaki K, Elliott P, Stamler J, Ueshima H. P6234The relationship of alcohol consumption with risk factors of coronary heart disease and the intake of macro- and micro-nutrients in Japanese: the INTERLIPID study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0836] [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
Many studies have reported the J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk; therefore, light-drinkers is generally recognized to be associated with the lower risk of CHD. However, the mechanisms of lower risk for CHD in light-drinkers are still unclear. Alcohol drinking status is likely to be associated with not only CHD risk factors but also dietary intake. Nevertheless, few studies report these relationships in detail.
Purpose
The purpose of this study is to evaluate the relationships of alcohol drinking status with CHD classical risk factors and the intake of macro- and micro- nutrients in Japanese.
Methods
Study participants were 1,090 Japanese men and women aged 40–59 years from The INTERLIPID study excepted for 55 individuals who had missing data (n=26) and were past-drinkers (n=29). Alcohol consumption was assessed with two 7-day alcohol records, and average ethanol intake (per week) was calculated. Participants were classified into following 4 groups: non-drinkers (0g/week), light-drinkers (<100 g/week), moderate-drinkers (100–299 g/week), and heavy-drinkers (≥300 g/week). Serum LDL and HDL cholesterol, blood pressure (BP), the prevalence of hypertension and dyslipidemia, and smoking status were assessed as CHD risk factors. The intake of energy and macro- and micro-nutrients were evaluated from the four-timed in-depth 24-hr dietary recalls. Nutrient intake densities were calculated per total energy intake without alcohol. The analysis of variance and chi-squared test were used to evaluate the relations of alcohol status with CHD risk factors and nutrient intake.
Results
Serum HDL cholesterol levels increased and LDL cholesterol levels decreased with increasing alcohol consumption. Systolic and diastolic BP increased with increasing alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smoker, number of cigarettes, and the prevalence of hypertension; that is, light-drinkers was lowest among all groups. The prevalence of dyslipidemia was the highest in non-drinkers, and decreased with increasing alcohol consumption. In heavy-drinkers, total energy (kcal/day) was the highest, but energy intake without alcohol (kcal/day) was the lowest. For macronutrients, the intake of carbohydrate (%kcal) decreased, and the intakes of total and animal protein (%kcal) increased with increasing alcohol consumption. The intakes of total cholesterol (mg/1000kcal) and sodium (mg/1000kcal) increased, and total fiber (g/1000kcal) decreased with increasing alcohol consumption. These associations were similar in men and women.
Conclusions
Alcohol consumption was related with not only CHD classical risk factors but also the intake of macro- and micro-nutrients. Non-drinkers had a higher proportion of some CHD risk factors than light-drinkers. These results might influence on J-shaped relationship between alcohol consumption and CHD risk.
Acknowledgement/Funding
1: Ministry of Education, Science, Sports, and Culture of Japan, 2: National Institutes of Health, Bethesda, MD, USA
Collapse
Affiliation(s)
- H Yamauchi
- Shiga University of Medical Science, Center for Epidemiologic Research in Asia, Shiga, Japan
| | - K Kondo
- Shiga University of Medical Science, Department of Public Health, Shiga, Japan
| | - S Tanaka
- Shiga University of Medical Science, Department of Medical Statistics, Shiga, Japan
| | - N Okuda
- University of Human Arts and Sciences, Department of Health and Nutrition, Saitama, Japan
| | - H Nakagawa
- Kanazawa Medical University, Department of Epidemiology and Public Health, Kanazawa, Japan
| | - K Sakata
- Iwate Medical University, Department of Hygiene and Preventive Medicine, Iwate, Japan
| | - S Saitoh
- Sapporo Medical University, School of Health Sciences, School of Medicine, Sapporo, Japan
| | - A Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - K Yoshita
- Osaka City University, Department of Food Science and Nutrition, Osaka, Japan
| | - K Miura
- Shiga University of Medical Science, Department of Public Health, Shiga, Japan
| | - Q Chan
- Imperial College London, Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, London, United Kingdom
| | - K Masaki
- University of Hawaii and Kuakini Medical Center, Department of Geriatric Medicine, John A. Burns School of Medicine, Honolulu, United States of America
| | - P Elliott
- Imperial College London, Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, London, United Kingdom
| | - J Stamler
- Northwestern University, Department of Preventive Medicine, Feinberg School of Medicine, Chicago, United States of America
| | - H Ueshima
- Shiga University of Medical Science, Center for Epidemiologic Research in Asia, Shiga, Japan
| |
Collapse
|
40
|
Tada H, Nakagawa T, Okada H, Nakahashi T, Mori M, Sakata K, Kawashiri M, Takamura M. P1535Clinical impact of carotid plaque score rather than carotid intima-media thickness on atherosclerotic cardiovascular disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0297] [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
Carotid intima-media thickness (cIMT) assessed by ultrasound has been widely accepted as a surrogate marker of atherosclerotic cardiovascular disease. On the other hand, carotid plaque score (cPS) reflecting throughout the carotid artery plaque burden may be better marker.
Methods
We retrospectively examined 2,035 patients who underwent carotid ultrasonography between January 2006 and December 2015 at our University Hospital. Median follow-up period was 4 years. We used Cox models that adjusted for established risk factors of ASCVD, including age, gender, hypertension, diabetes, smoking, and serum lipids to assess the association of cIMT as well as cPS with major adverse cardiac events (MACE). MACE was defined as all-cause mortality or rehospitalization for a cardiovascular-related illness
Results
During follow-up, 243 participants experienced MACE. After adjustment for established risk factors, cPS was associated with MACE (hazard ratio [HR] = 3.38 for top quintile vs. bottom quintile of cPS; 95% confidence interval [CI] 1.82 to 6.27; P-trend = 1.4×10–8), while cIMT was not (HR = 0.88, P=0.57). Addition of the cPS to established risk factors significantly improved risk discrimination (C-index 0.726 vs. 0.746; P=0.017)
Conclusion
As a marker, cPS, rather than cIMT can identify 20% of individuals who are at more than three-fold increased risk for MACE. Targeting diagnostic or therapeutic interventions to this subset may prove clinically useful.
Collapse
Affiliation(s)
- H Tada
- Kanazawa University, Kanazawa, Japan
| | | | - H Okada
- Kanazawa University, Kanazawa, Japan
| | | | - M Mori
- Kanazawa University, Kanazawa, Japan
| | - K Sakata
- Kanazawa University, Kanazawa, Japan
| | | | | |
Collapse
|
41
|
Takeshige N, Aoki T, Sakata K, Kajiwara S, Negoto T, Nagase S, Tanoue S, Uchiyama Y, Hirohata M, Abe T, Morioka M. Sagittal diffusion-weighted imaging in preventing the false-negative diagnosis of acute brainstem infarction: Confirmation of the benefit by anatomical characterization of false-negative lesions. Surg Neurol Int 2019; 10:180. [PMID: 31637081 PMCID: PMC6778332 DOI: 10.25259/sni_182_2019] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 08/08/2019] [Indexed: 11/06/2022] Open
Abstract
Background: In some cases of acute brainstem infarction (BI), standard axial diffusion-weighted imaging (DWI) does not show a lesion, leading to false-negative (FN) diagnoses. It is important to recognize acute BI accurately and promptly to initiate therapy as soon as possible. Methods: Of the 171 patients with acute cerebral infarctions in our institution who were examined, 16 were diagnosed with true-positive BI (TP-BI) and six with FN-BI. We evaluated the effectiveness of sagittal DWI in accurately diagnosing acute BI and sought to find the cause of its effectiveness by the anatomical characterization of FN-BIs. Results: Considering the direction of the brainstem perforating arteries, we supposed that sagittal DWI might more effectively detect BIs than axial DWI. We found that sagittal DWI detected all FN-BIs more clearly than axial DWI. The mean time between the onset of symptoms and initial DWI was significantly longer in the TP group (17.6 ± 5.5 h) than in the FN group (5.0 ± 1.2 h; P < 0.0001). The lesion volumes were much smaller in FN-BIs (259 ± 82 mm3) than in TP-BIs (2779 ± 767 mm3; P = 0.0007). FN-BIs had a significant inverse correlation with the ventrodorsal length of infarcts (FN 3.5 ± 1.1 mm, TP 11.4 ± 3.6 mm; P < 0.0004) and no correlation with other size parameters such as rostrocaudal thickness and lateral width. Conclusion: Anatomical characterization clearly confirmed that the addition of sagittal DWI to the initial axial DWI in suspected cases of BI ensures its accurate diagnosis and improves the patient’s prognosis.
Collapse
Affiliation(s)
- Nobuyuki Takeshige
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takachika Aoki
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiyohiko Sakata
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Soushou Kajiwara
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tetsuya Negoto
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Satoshi Nagase
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Syuichi Tanoue
- Departments of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yusuke Uchiyama
- Departments of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Masaru Hirohata
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Toshi Abe
- Departments of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motohiro Morioka
- Departments of Neurosurgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| |
Collapse
|
42
|
Orito K, Hirohata M, Nakamura Y, Yamamoto M, Takeshige N, Aoki T, Hattori G, Sakata K, Takeuchi Y, Uzu H, Takasu O, Abe T, Uchiyama Y, Morioka M. Predictive Value of Leakage Signs for Pure Brain Contusional Hematoma Expansion. J Neurotrauma 2019; 35:760-766. [PMID: 28967295 DOI: 10.1089/neu.2017.5247] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Hematoma expansion is an important consideration in patients with traumatic brain injury (TBI). No precise methods are available, however, for predicting the expansion of TBI-related hematoma. We aimed to establish a more sensitive predictor for contusional hematoma expansion based on the presence of leakage signs on computed tomography angiography (CTA). Thirty-three patients with pure contusion were included in the analysis (age: 64.1 ± 20.6 years; 24 men and 7 women). We compared Hounsfield unit (HU) values within set regions of interest (diameter, 10 mm) between serial CTA phase and delayed-phase CT images (5 min after CTA phase). Positive leakage signs were defined as >10% increases in HU value. Hematoma expansion was determined using plain CT at 24 h in patients who did not undergo emergent surgery. Glasgow Coma Scale (GCS) scores measured at admission and 24 h after admission were also compared. Leakage signs predicted hematoma expansion with high specificity (100%) and sensitivity (92.8%). Patients with positive leakage signs had significant decreases in GCS scores 24 h after the scan (GCS change: positive group, -0.92 ± 0.59; negative group, 1.14 ± 0.82). Positive leakage signs were clearly associated with surgical hematoma removal. Five patients without hematoma who had positive leakage signs at admission exhibited significant expansion of hematomas 24 h later. Our results indicate that leakage signs had high sensitivity in the prediction of contusional hematoma expansion and were significantly associated with delayed neurological deterioration and the necessity of surgical removal.
Collapse
Affiliation(s)
- Kimihiko Orito
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Masaru Hirohata
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Yukihiko Nakamura
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Masafumi Yamamoto
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Nobuyuki Takeshige
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Takachika Aoki
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Gohsuke Hattori
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Kiyohiko Sakata
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Yasuharu Takeuchi
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| | - Hideaki Uzu
- 3 Department of Emergency and Acute Intensive Care Medicine, Kurume University School of Medicine , Fukuoka, Japan
| | - Osamu Takasu
- 3 Department of Emergency and Acute Intensive Care Medicine, Kurume University School of Medicine , Fukuoka, Japan
| | - Toshi Abe
- 2 Department of Radiology, Kurume University School of Medicine , Fukuoka, Japan
| | - Yusuke Uchiyama
- 2 Department of Radiology, Kurume University School of Medicine , Fukuoka, Japan
| | - Motohiro Morioka
- 1 Department of Neurosurgery, Kurume University School of Medicine , Fukuoka, Japan
| |
Collapse
|
43
|
Ono T, Sakata K, Tanaka N, Hashiguchi S, Migita H, Kiyokawa K, Morioka M, Kurita T, Sato K, Takeshige N, Umeno H. Salvage surgery for a locally persistent or recurrent tumour in maxillary cancer patients who have undergone radiotherapy and concomitant intra-arterial cisplatin: implications for surgical margin assessment. Int J Oral Maxillofac Surg 2019; 48:567-575. [DOI: 10.1016/j.ijom.2018.10.019] [Citation(s) in RCA: 1] [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] [Received: 05/02/2018] [Revised: 09/07/2018] [Accepted: 10/25/2018] [Indexed: 11/26/2022]
|
44
|
Moriwaki M, Wakabayashi H, Sakata K, Domen K. The Effect of Branched Chain Amino Acids-Enriched Nutritional Supplements on Activities of Daily Living and Muscle Mass in Inpatients with Gait Impairments: A Randomized Controlled Trial. J Nutr Health Aging 2019; 23:348-353. [PMID: 30932133 DOI: 10.1007/s12603-019-1172-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the effects of continuous intervention with branched chain amino acids-enriched nutritional supplements from the acute phase to convalescent rehabilitation wards in inpatients with gait impairments. DESIGN Open-label, randomized, parallel-group comparison study (UMIN Clinical Trials Registry ID: UMIN000018640). SETTING Acute care and convalescent rehabilitation wards. PARTICIPANTS We studied 80 patients undergoing stand/gait training. INTERVENTIONS Participants in the intervention group (RJ group) received nutritional supplements (jelly foods comprising 2500 mg BCAA and 20 IU vitamin D) twice a day until hospital discharge. MEASUREMENTS The primary outcome was the motor components of the Functional Independence Measure (FIM-m), and the secondary outcome was skeletal muscle mass index. RESULTS Analyses were conducted on 55 patients who were able to perform stand/gait training continuously from the acute until the recovery phases. FIM-m was significantly elevated in the RJ group and the control group , but no difference was noted between the two groups. Only the RJ group showed a significant increase in skeletal muscle mass index, and the amount of variation was significantly different between the two groups (the control group decreased an average of 2.2% and the RJ group increased an average of 4.3%; P = 0.014). A significant decrease in body weight was found only in the control group (P = 0.084). CONCLUSIONS Nutritional interventions using branched chain amino acids (BCAA)-enriched nutritional supplements demonstrated no significant difference in activities of daily living; however, an increase in skeletal muscle mass was noted. Skeletal muscle mass and body weight differed significantly between the two groups, and BCAA-enriched nutritional supplements intake in acute and convalescent rehabilitation wards may be effective for the prevention of malnutrition and sarcopenia.
Collapse
Affiliation(s)
- M Moriwaki
- Misa Moriwaki MD, Department of Rehabilitation Medicine, Midorigaoka Hospital, 3-13-1 Makami-cho, Takatsuki, Osaka, Japan 569-1121, Tel.: +81-72-681-5717, Fax: +81-72-681-5796, E-mail:
| | | | | | | |
Collapse
|
45
|
Sugita Y, Furuta T, Komaki S, Ohshima K, Sakata K, Morioka M. Malignant progression of an extraventricular neurocytoma arising from the VIIIth cranial nerve: A case report and literature review. Neuropathology 2018; 39:120-126. [DOI: 10.1111/neup.12533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/04/2018] [Accepted: 11/25/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Yasuo Sugita
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Takuya Furuta
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Satoru Komaki
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Koichi Ohshima
- Department of PathologyKurume University School of Medicine Kurume Japan
| | - Kiyohiko Sakata
- Department of NeurosurgeryKurume University School of Medicine Kurume Japan
| | - Motohiro Morioka
- Department of NeurosurgeryKurume University School of Medicine Kurume Japan
| |
Collapse
|
46
|
Sakata K, Suematsu K, Takeshige N, Nagata Y, Orito K, Miyagi N, Sakai N, Koseki T, Morioka M. Novel method of intraoperative ocular movement monitoring using a piezoelectric device: experimental study of ocular motor nerve activating piezoelectric potentials (OMNAPP) and clinical application for skull base surgeries. Neurosurg Rev 2018; 43:185-193. [PMID: 30209640 DOI: 10.1007/s10143-018-1028-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 11/25/2022]
Abstract
Intraoperative monitoring systems that utilize various evoked potentials for the detection and/or preservation of cranial nerves have become increasingly common due to recent technical and commercial developments, particularly during skull base surgeries. We established a novel system for the intraoperative monitoring of the extraocular motor nerves (eOMNs) using a piezoelectric device capable of detecting imperceptible vibrations induced by ocular movement, with sensors placed on the eyelids alone. We first evaluated the efficacy and reliability of this device for the intraoperative monitoring of eOMNs in two Beagle dogs. Based on the results, we then determined the appropriate stimulation parameters for use in human surgical cases involving removal of various skull base tumors. Animal experiments revealed that a 0.4 mA monopolar electrical stimulation was required to elicit significant responses and that these responses were not inferior to those obtained via the electrooculogram/electromyogram. Significant responses were also detected in preliminary clinical investigations in human patients, following both direct and indirect monopolar electrical stimulation of the oculomotor and abducens nerves, although obtaining responses from the trochlear nerve was difficult. Intraoperative monitoring using a piezoelectric device provides a simple and reliable method for detecting eOMNs, especially the oculomotor and abducens nerves. This monitoring system can be adapted to various surgeries for skull base tumor.
Collapse
Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
| | - Keiko Suematsu
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Takeshige
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Yui Nagata
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naohisa Miyagi
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoki Sakai
- Unique Medical Co., Ltd., 1-13-5, Izumihon-cho, Komae-shi, Tokyo, 201-0003, Japan
| | - Tsunekazu Koseki
- Unique Medical Co., Ltd., 1-13-5, Izumihon-cho, Komae-shi, Tokyo, 201-0003, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| |
Collapse
|
47
|
Nakahashi T, Sakata K, Tada H, Terai H, Horita Y, Ikeda M, Namura M, Takamura M, Hayashi K, Kawashiri M, Yamagishi M. P3672Assessment of ankle-brachial index to predict in-hospital bleeding complication and optimal duration of dual antiplatelet therapy in patients with acute coronary syndrome. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3672] [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: 11/12/2022] Open
Affiliation(s)
- T Nakahashi
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - K Sakata
- Kanazawa University Hospital, Division of Cardiovascular Medicine, Kanazawa, Japan
| | - H Tada
- Kanazawa University Hospital, Division of Cardiovascular Medicine, Kanazawa, Japan
| | - H Terai
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - Y Horita
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Ikeda
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Namura
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Takamura
- Kanazawa University Hospital, Disease Control and Homeostasis, Kanazawa, Japan
| | - K Hayashi
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Kawashiri
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| | - M Yamagishi
- Kanazawa Cardiovascular Hospital, Department of Cardiology, Kanazawa, Japan
| |
Collapse
|
48
|
Gnatiuc L, Herrington WG, Halsey J, Tuomilehto J, Fang X, Kim HC, De Bacquer D, Dobson AJ, Criqui MH, Jacobs DR, Leon DA, Peters SAE, Ueshima H, Sherliker P, Peto R, Collins R, Huxley RR, Emberson JR, Woodward M, Lewington S, Aoki N, Arima H, Arnesen E, Aromaa A, Assmann G, Bachman DL, Baigent C, Bartholomew H, Benetos A, Bengtsson C, Bennett D, Björkelund C, Blackburn H, Bonaa K, Boyle E, Broadhurst R, Carstensen J, Chambless L, Chen Z, Chew SK, Clarke R, Cox C, Curb JD, D'Agostino R, Date C, Davey Smith G, De Backer G, Dhaliwal SS, Duan XF, Ducimetiere P, Duffy S, Eliassen H, Elwood P, Empana J, Garcia-Palmieri MH, Gazes P, Giles GG, Gillis C, Goldbourt U, Gu DF, Guasch-Ferre M, Guize L, Haheim L, Hart C, Hashimoto S, Hashimoto T, Heng D, Hjermann I, Ho SC, Hobbs M, Hole D, Holme I, Horibe H, Hozawa A, Hu F, Hughes K, Iida M, Imai K, Imai Y, Iso H, Jackson R, Jamrozik K, Jee SH, Jensen G, Jiang CQ, Johansen NB, Jorgensen T, Jousilahti P, Kagaya M, Keil J, Keller J, Kim IS, Kita Y, Kitamura A, Kiyohara Y, Knekt P, Knuiman M, Kornitzer M, Kromhout D, Kronmal R, Lam TH, Law M, Lee J, Leren P, Levy D, Li YH, Lissner L, Luepker R, Luszcz M, MacMahon S, Maegawa H, Marmot M, Matsutani Y, Meade T, Morris J, Morris R, Murayama T, Naito Y, Nakachi K, Nakamura M, Nakayama T, Neaton J, Nietert PJ, Nishimoto Y, Norton R, Nozaki A, Ohkubo T, Okayama A, Pan WH, Puska P, Qizilbash N, Reunanen A, Rimm E, Rodgers A, Saitoh S, Sakata K, Sato S, Schnohr P, Schulte H, Selmer R, Sharp D, Shifu X, Shimamoto K, Shipley M, Silbershatz H, Sorlie P, Sritara P, Suh I, Sutherland SE, Sweetnam P, Tamakoshi A, Tanaka H, Thomsen T, Tominaga S, Tomita M, Törnberg S, Tunstall-Pedoe H, Tverdal A, Ueshima H, Vartiainen E, Wald N, Wannamethee SG, Welborn TA, Whincup P, Whitlock G, Willett W, Woo J, Wu ZL, Yao SX, Yarnell J, Yokoyama T, Yoshiike N, Zhang XH. Sex-specific relevance of diabetes to occlusive vascular and other mortality: a collaborative meta-analysis of individual data from 980 793 adults from 68 prospective studies. Lancet Diabetes Endocrinol 2018; 6:538-546. [PMID: 29752194 PMCID: PMC6008496 DOI: 10.1016/s2213-8587(18)30079-2] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Several studies have shown that diabetes confers a higher relative risk of vascular mortality among women than among men, but whether this increased relative risk in women exists across age groups and within defined levels of other risk factors is uncertain. We aimed to determine whether differences in established risk factors, such as blood pressure, BMI, smoking, and cholesterol, explain the higher relative risks of vascular mortality among women than among men. METHODS In our meta-analysis, we obtained individual participant-level data from studies included in the Prospective Studies Collaboration and the Asia Pacific Cohort Studies Collaboration that had obtained baseline information on age, sex, diabetes, total cholesterol, blood pressure, tobacco use, height, and weight. Data on causes of death were obtained from medical death certificates. We used Cox regression models to assess the relevance of diabetes (any type) to occlusive vascular mortality (ischaemic heart disease, ischaemic stroke, or other atherosclerotic deaths) by age, sex, and other major vascular risk factors, and to assess whether the associations of blood pressure, total cholesterol, and body-mass index (BMI) to occlusive vascular mortality are modified by diabetes. RESULTS Individual participant-level data were analysed from 980 793 adults. During 9·8 million person-years of follow-up, among participants aged between 35 and 89 years, 19 686 (25·6%) of 76 965 deaths were attributed to occlusive vascular disease. After controlling for major vascular risk factors, diabetes roughly doubled occlusive vascular mortality risk among men (death rate ratio [RR] 2·10, 95% CI 1·97-2·24) and tripled risk among women (3·00, 2·71-3·33; χ2 test for heterogeneity p<0·0001). For both sexes combined, the occlusive vascular death RRs were higher in younger individuals (aged 35-59 years: 2·60, 2·30-2·94) than in older individuals (aged 70-89 years: 2·01, 1·85-2·19; p=0·0001 for trend across age groups), and, across age groups, the death RRs were higher among women than among men. Therefore, women aged 35-59 years had the highest death RR across all age and sex groups (5·55, 4·15-7·44). However, since underlying confounder-adjusted occlusive vascular mortality rates at any age were higher in men than in women, the adjusted absolute excess occlusive vascular mortality associated with diabetes was similar for men and women. At ages 35-59 years, the excess absolute risk was 0·05% (95% CI 0·03-0·07) per year in women compared with 0·08% (0·05-0·10) per year in men; the corresponding excess at ages 70-89 years was 1·08% (0·84-1·32) per year in women and 0·91% (0·77-1·05) per year in men. Total cholesterol, blood pressure, and BMI each showed continuous log-linear associations with occlusive vascular mortality that were similar among individuals with and without diabetes across both sexes. INTERPRETATION Independent of other major vascular risk factors, diabetes substantially increased vascular risk in both men and women. Lifestyle changes to reduce smoking and obesity and use of cost-effective drugs that target major vascular risks (eg, statins and antihypertensive drugs) are important in both men and women with diabetes, but might not reduce the relative excess risk of occlusive vascular disease in women with diabetes, which remains unexplained. FUNDING UK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union BIOMED programme, and National Institute on Aging (US National Institutes of Health).
Collapse
|
49
|
Tsubota-Utsugi M, Yonekura Y, Tanno K, Nozue M, Shimoda H, Nishi N, Sakata K, Kobayashi S. Association between health risks and frailty in relation to the degree of housing damage among elderly survivors of the great East Japan earthquake. BMC Geriatr 2018; 18:133. [PMID: 29898680 PMCID: PMC6001143 DOI: 10.1186/s12877-018-0828-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 05/28/2018] [Indexed: 11/15/2022] Open
Abstract
Background Many survivors of the Great East Japan Earthquake that occurred in 2011 were at risk of deteriorating health, especially elderly people living in disaster-stricken areas. The objectives of this prospective study were: a) to clarify the different lifestyle and psychosocial factors associated with frailty by sex among the non-disabled elderly survivors, and b) to describe the differences in characteristics stratified by the degree of disaster-related housing damage. Methods We followed 2261 Japanese survivors aged ≥65 years (45.3% male; mean age, 71.7 years) without disability or frailty who completed a self-administered questionnaire at baseline. All participants completed a baseline questionnaire in 2011 and at least one identical follow-up questionnaire between 2012 and 2015 regarding lifestyle (smoking status, alcohol intake, physical activity, sedentary lifestyle, and dietary intake) and psychosocial factors (self-rated health, standard of living, psychological distress, and social networks). Frailty was defined as a score of ≥5 on the Kihon Checklist, which is used by the Japanese government to certify the need for long-term care insurance. Adjusted odds ratios and 95% confidence intervals with frailty as the dichotomous dependent variable and health factors as the independent variables were calculated using a multilevel model for repeated measures by sex, followed by stratification analyses by the degree of housing damage. Results Over the 4-year study period, 510 participants (22.6%) developed frailty. In the post-disaster setting, many of the psychosocial factors remained more prevalent 4 years later among survivors with extensive housing damage. The presence of risk factors regarding the development of frailty differed by the degree of housing damage. Among men, psychological distress, in parallel with a poor social network, was related to frailty among only the participants with extensive housing damage and those living in temporary housing, whereas among women, worsening psychological distress was associated only with no damage and no displaced survivors. Among women with extensive damage and displacement, health outcomes such as overweight and diabetes and poor social networks were strongly related to frailty. Conclusions Lifestyle and psychosocial factors associated with the risk of frailty differ by sex and the degree of housing damage. Electronic supplementary material The online version of this article (10.1186/s12877-018-0828-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- M Tsubota-Utsugi
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, 2-1-1 Nishitokuta, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan.
| | - Y Yonekura
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - K Tanno
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, 2-1-1 Nishitokuta, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - M Nozue
- Department of Health and Nutritional Sciences, Faculty of Health Promotional Sciences, Tokoha University, Shizuoka, Japan
| | - H Shimoda
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, 2-1-1 Nishitokuta, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - N Nishi
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - K Sakata
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine, 2-1-1 Nishitokuta, Yahaba-cho, Shiwa-gun, Iwate, 028-3694, Japan
| | - S Kobayashi
- Iwate Medical University School of Medicine, Iwate, Japan
| | | |
Collapse
|
50
|
Dong BE, Xue Y, Sakata K. The effect of enriched environment across ages: A study of anhedonia and BDNF gene induction. Genes Brain Behav 2018; 17:e12485. [PMID: 29717802 DOI: 10.1111/gbb.12485] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 12/19/2022]
Abstract
Enriched environment treatment (EET) is a potential intervention for depression by inducing brain-derived neurotrophic factor (BDNF). However, its age dependency remains unclear. We recently found that EET during early-life development (ED) was effective in increasing exploratory activity and anti-despair behavior, particularly in promoter IV-driven BDNF deficient mice (KIV), with the largest BDNF protein induction in the hippocampus and frontal cortex. Here, we further determined age dependency of EET effects on anhedonia and promoter-specific BDNF transcription, by using the sucrose preference test and qRT-PCR. Wild-type (WT) and KIV mice received 2 months of EET during ED, young-adulthood and old-adulthood (0-2, 2-4 and 12-14 months, respectively). All KIV groups showed reduced sucrose preference, which EET equally reversed regardless of age. EET increased hippocampal BDNF mRNA levels for all ages and genotypes, but increased frontal cortex BDNF mRNA levels only in ED KIV and old WT mice. Transcription by promoters I and IV was age-dependent in the hippocampus of WT mice: more effective induction of exon IV or I during ED or old-adulthood, respectively. Transcription by almost all 9 promoters was age-specific in the frontal cortex, mostly observed in ED KIV mice. After discontinuance of EET, the EET effects on anti-anhedonia and BDNF transcription in both regions persisted only in ED KIV mice. These results suggested that EET was equally effective in reversing anhedonia and inducing hippocampal BDNF transcription, but was more effective during ED in inducing frontal cortex BDNF transcription and for lasting anti-anhedonic and BDNF effects particularly in promoter IV-BDNF deficiency.
Collapse
Affiliation(s)
- B E Dong
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Y Xue
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - K Sakata
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, Tennessee
| |
Collapse
|